Bolivian hemorrhagic feverA96.1
Synonym(s)
BHF; black typhoid; MHF; South American hemorrhagic fever
DefinitionThis section has been translated automatically.
Severe systemic infectious disease caused by the Machupo virus, which is one of the triggers of viral haemorrhagic fever.
PathogenThis section has been translated automatically.
Machupo virus, family Arenaviridae, Tacaribe subgroup, one of the triggers of haemorrhagic fever.
Occurrence/EpidemiologyThis section has been translated automatically.
- 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%.
EtiopathogenesisThis section has been translated automatically.
- 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.
Clinical featuresThis section has been translated automatically.
- 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.
LaboratoryThis section has been translated automatically.
Leukocytopenia, thrombocytopenia, elevated hematocrit, protein and cylindruria.
DiagnosisThis section has been translated automatically.
- Virus isolation in blood, urine and from separated lymphomononuclear cells in cell cultures (antigen detection by immunofluorescence microscopy)
- antibody detection (ELISA).
Differential diagnosisThis section has been translated automatically.
other haemorrhagic fevers; influenza (at the beginning of the disease); malaria.
TherapyThis section has been translated automatically.
- 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).
ProphylaxisThis section has been translated automatically.
- 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.
Note(s)This section has been translated automatically.
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.