Viral hemorrhagic fever (VHF) is an infection caused by a virus that leads to fever and bleeding. The following conditions are grouped under the term “viral hemorrhagic fever (VHF)” according to ICD-10:
- Dengue hemorrhagic fever (A91) – describes an infectious disease that occurs in the (sub)tropics and is caused by dengue virus (DENV) [see “Dengue fever” below].
- Chikungunya hemorrhagic fever (A92.0) – infectious disease caused by Chikungunya virus (CHIKV; of the family Togaviridae) occurring in South/Southeast Asia, Arabian Peninsula, Indian Ocean, Africa, North America (Florida), Caribbean (Dominican Republic, Guadeloupe, Martinique), South America (Brazil, Bolivia, Venezuela), and increasingly in southern Europe (including Spain, southern France)
- West Nile fever (A92.3) – infectious disease caused by West Nile virus; West Nile fever virus (WNV) is transmitted by mosquitoes (Culex, Aedes and Ochlerotatus) from one host to the next; occurrence of the disease in parts of southern Europe, Africa and Asia; today increasingly also in Central Europe [see below “West Nile fever”].
- Rift valley fever (RVF) (A92.4) – infectious disease caused by the Rift valley virus (RVF, English Rift valley fever; from the family Bunyaviridae), which occurs in Africa, Arabian Peninsula and Madagascar; endemic areas are Sierra Leone, Guinea, as well as Liberia and, on the other hand, east of this region Nigeria
- Yellow fever (A95.-) – describes an infectious disease caused by yellow fever virus (GFV) [see below “Yellow fever”].
- Lassa fever (A96.2) – infectious disease caused by Lassa virus (LV; from the family of arenaviruses), which occurs in West Africa; endemic areas are Sierra Leone, Guinea, as well as Liberia and, on the other hand, east of this region, Nigeria
- Argentine hemorrhagic fever (A96.0) – infectious disease caused by Junin virus that occurs in Argentina
- Bolivian hemorrhagic fever (A96.1) – infectious disease caused by Machupa virus that occurs in Bolivia
- Venezuelan hemorrhagic fever – infectious disease caused by Guanarito virus that occurs in Venezuela.
- Other hemorrhagic fever caused by arenaviruses (A96.8).
- Crimean-Congo hemorrhagic fever (CCHF) (A98.0) infectious disease caused by Crimean-Congo virus (of the Bunyaviridae family), found in Africa, Balkan countries, Middle East, and Central Asia. Most affected are Turkey, Iran, Uzbekistan and the southernmost areas of Russia; 2016 for the first time in Spain.
- Omsk hemorrhagic fever (A98.1) – infectious disease caused by an arbo virus B that occurs in central Siberia
- Kyasanur forest disease (A98.2) – infectious disease caused by Kyasanur forest disease virus occurring in India in rainless months
- Marburg hemorrhagic fever (A98.3) – infectious disease caused by Marburg virus (MARV; of the family Filoviridae) that occurs in central and western Africa
- Ebola hemorrhagic fever (A98.4) – infectious disease caused by Ebola virus (EBOV; of the family Filoviridae) [see “Ebola” below].
- Hemorrhagic fever with renal syndrome (A98.5) – v. a. Hanta virus infection [see “Hanta virus disease” below]
- Unspecified viral hemorrhagic disease (A99).
Endemic areas
- West Africa: Ebola virus, Lassa virus
- Central Africa: Ebola virus, Marburg virus.
- Sub-Saharan Africa (tropics): yellow fever virus.
- Tropical America: yellow fever virus
Human-to-human transmission:
- Argentine hemorrhagic fever: ?
- Bolivian hemorrhagic fever: yes
- Ebola hemorrhagic fever: Yes
- Yellow fever: No
- Dengue hemorrhagic fever: No
- Chikungunya hemorrhagic fever: No
- Omsk hemorrhagic fever: No
- Crimean-Congo hemorrhagic fever (CCHF): Yes.
- Lassa fever: Yes
- Marburg hemorrhagic fever: Yes
- Rift Valley fever: No
- Venezuelan hemorrhagic fever: ?
- West Nile fever: no (though possible via infected blood donations as well as organ transplantation and breast milk).
Incidence (frequency of new cases): In Germany, these diseases are very rare. Mostly it is a matter of imported infections. The most common imported infectious disease in Germany is dengue fever and the second most common is Chikungunya fever. Reported cases of Lassa fever, Rift Valley fever, and Crimean-Congo virus infections are rare. Course and prognosis: The majority of hemorrhagic fevers are dangerous and can take a life-threatening course. The prognosis is unfavorable as soon as cerebral (affecting the brain) symptoms occur, as well as a particularly severe bleeding tendency. In Germany, viral hemorrhagic fever is notifiable under the Infection Protection Act (IfSG). The notification has to be made in case of suspected illness, illness and death or in case of pathogen detection in connection with an acute infection. In the following, only the diseases marked in bold are described in detail. Square brackets indicate when the disease exists as a separate chapter.
