Bolivian hemorrhagic fever A96.1

• First described in 1959 in the Benin region, then spread throughout Bolivia with epidemic outbreaks.
• Since 1973, thanks to effective rodent control, the spread has been contained.
• Mortality: 5-30%.

• Reservoirs are wild mice and mouse-like animals that become chronically ill without symptoms and harbour and excrete the pathogen in the body for the rest of their lives.
• Contamination of the human environment by saliva, urine and blood of infected animals.
• Infection possible from person to person.

• Incubation period of 7-20 days. Gradual onset of flu-like symptoms.
• Integument: conjunctival hyperemia, periorbital oedema, erythema of skin and mucous membranes on face, neck, chest, palate, pharynx, tendency to gum and petechial hemorrhages.
• Extracutaneous manifestations: disturbances of muscle tone and deep reflexes, subtle tremor of the hands and tongue, relative bradycardia and hypertension.

• Virus isolation in blood, urine and from separated lymphomononuclear cells in cell cultures (antigen detection by immunofluorescence microscopy)
• antibody detection (ELISA).

• Ribavirin (Virazoles): initially once/day 30 mg/kg bw for 6 days, then once/day 16 mg/kg bw for 4 days, then once/day 8 mg/kg bw i.v. for 2 days.

  Notice! In Germany, Virazole is only approved for inhalation application, but internationally also for i.v. application. There is an exceptional indication for i.v. application!

• Immunoplasma (possible complication: benign, late central nervous symptoms as a result of an immunological process).

• Rodent control. Observance of general hygiene in health care.
• Pre-exposure to ribavirin.
• Inactivated vaccine against Junin virus shows good efficacy due to cross-reactivity.

Remember! Suspected illness, sickness and death must be reported by the doctor to the public health department in accordance with § 6. According to § 7, direct and indirect virus detection must be reported.