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ViralHemorrhagicFever广州网站建设•Severemultisystemsyndrome•Damagetooverallvascularsystem•Symptomsoftenaccompaniedbyhemorrhage−Rarelylifethreateninginitself−Includesconjunctivitis,petechia,echymosisCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004Overview•Organism•History•Epidemiology•Transmission•DiseaseinHumans•DiseaseinAnimals•PreventionandControlTheOrganismsCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ViralHemorrhagicFever•Virusesoffourdistinctfamilies−Arenaviruses−Filoviruses−Bunyaviruses−Flaviviruses•RNAviruses−Envelopedinlipidcoating•Survivaldependentonananimalorinsecthost,forthenaturalreservoirCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ClassificationArenaviridaeBunyaviridaeFiloviridaeFlaviviridaeJuninCrimean-CongoH.F.EbolaKyasanurForestDiseaseMachupoHantavirusMarburgOmskH.F.SabiaRiftValleyfeverYellowFeverGuanaritoDengueLassaArenaviridaeJuninvirusMachupovirusGuanaritovirusLassavirusSabiavirusCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ArenaviridaeHistory•Firstisolatedin1933•1958:Juninvirus-Argentina−Firsttocausehemorrhagicfever−Argentinehemorrhagicfever•1963:Machupovirus–Bolivia−Bolivianhemorrhagicfever•1969:Lassavirus–Nigeria−LassafeverCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ArenaviridaeTransmission•Virustransmissionandamplificationoccursinrodents•Shedvirusthroughurine,feces,andotherexcreta•Humaninfection−Contactwithexcreta−Contaminatedmaterials−Aerosoltransmission•Person-to-persontransmissionCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ArenaviridaeEpidemiology•Africa−Lassa•SouthAmerica−Junin,Machupo,Guanarito,andSabia•Contactwithrodentexcreta•Casefatality:5–35%•ExplosivenosicomialoutbreakswithLassaandMachupoCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ArenaviridaeinHumans•Incubationperiod−10–14days•Feverandmalaise−2–4days•Hemorrhagicstage−Hemorrhage,leukopenia,thrombocytopenia−NeurologicsignsBunyaviridaeRiftValleyFevervirusCrimean-CongoHemorrhagicFevervirusHantavirusCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004BunyaviridaeHistory•1930:RiftValleyFever–Egypt−Epizooticinsheep•1940s:CCHF-Crimeanpeninsula−Hemorrhagicfeverinagriculturalworkers•1951:Hantavirus–Korea−HemorrhagicfeverinUNtroops•5generawithover350virusesCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004BunyaviridaeTransmission•Arthropodvector−Exception–Hantaviruses•RVF–Aedesmosquito•CCHF–Ixodidtick•Hantavirus–Rodents•Lesscommon−Aerosol−ExposuretoinfectedanimaltissueCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004BunyaviridaeEpidemiology•RVF-AfricaandArabianPeninsula−1%casefatalityrate•CCHF-Africa,EasternEurope,Asia−30%casefatalityrate•Hantavirus-NorthandSouthAmerica,EasternEurope,andEasternAsia−1-50%casefatalityrateCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004BunyaviridaeHumans•RVF−Incubationperiod–2-5days−0.5%-HemorrhagicFever•CCHF−Incubationperiod–3-7days−HemorrhagicFever-3–6daysfollowingclinicalsigns•Hantavirus−Incubationperiod–7–21days−HPSandHFRSCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004BunyaviridaeAnimals•RVF−Abortion–100%−Mortalityrate§90%inyoung§5-60%inolderanimals•CCHF−Unapparentinfectioninlivestock•Hantaviruses−UnapparentinfectioninrodentsFiloviridaeMarburgvirusEbolavirusCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FiloviridaeHistory•1967:Marburgvirus−Europeanlaboratoryworkers•1976:Ebolavirus−EbolaZaire−EbolaSudan•1989and1992:EbolaReston−USAandItaly−ImportedmacaquesfromPhilippines•1994:EbolaCôted'IvoireCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FiloviridaeTransmission•ReservoirisUNKNOWN−BatsimplicatedwithMarburg•Intimatecontact•Nosicomialtransmission−Reuseofneedlesandsyringes−Exposuretoinfectioustissues,excretions,andhospitalwastes•Aerosoltransmission−PrimatesCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FiloviridaeEpidemiology•Marburg–Africa−Casefatality–23-33%•Ebola-Sudan,ZaireandCôted'Ivoire–Africa−Casefatality–53-88%•Ebola–Reston–Philippines•PatternofdiseaseisUNKOWNCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FiloviridaeHumans•Mostseverehemorrhagicfever•Incubationperiod:4–10days•Abruptonset−Fever,chills,malaise,andmyalgia•HemorrhageandDIC•Deatharoundday7–11•PainfulrecoveryCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FiloviridaeAnimals•Hemorrhagicfever−Sameclinicalcourseashumans•EbolaReston−Highprimatemortality-~82%FlaviviridaeDenguevirusYellowFevervirusOmskHemorrhagicFevervirusKyassnurForestDiseasevirusCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FlaviviridaeHistory•1648:YellowFeverdescribed•17th–20thcentury−YellowFeverandDengueoutbreaks•1927:YellowFevervirusisolated•1943:Denguevirusisolated•1947−OmskHemorrhagicFevervirusisolated•1957:KyasanurForestvirusisolatedCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FlaviviridaeTransmission•Arthropodvector•Ye