1. Submitted by:
Susan Henry
Keith Noble

2. Program Goals
 Educate first responders on the following:
 Background information on Viral Hemorrhagic Fever
(VHF)
 Recognition of signs and symptoms of VHF
 Treatment of patients with S/S of VHF
 Transport of patients with VHF
 Proper personal protection equipment (PPE) guidelines
 Notification guidelines

3. Program Initiatives
 Focus on the recognition, treatment, and transport of
suspects VHF patients
 Deliver training via an online format
 Simple online test
 Printable easy to read chart

4. Viral Hemorrhagic Fever (VHF)
 A family of viruses causing severe multisystem
syndrome
 Damages the vascular system
 Prevents self regulation ability
 Can cause mild conditions or life threatening
conditions

5.  Zoonotic
 A disease of animals that may be transmitted to man
under natural conditions
 Category A agent
 Easily transmitted from human to human
 High mortality rate
 Require special action from public health agenices

6. Four Types of VHF
 Arenaviruses:
 Lassa & Latin American Fever
 Carried by rats and mice
 Transmitted by feces and urine
 Bunyaviruses:
 Crimean-Congo & Rift Valley
 Transmitted though a arthropod vector
 Filoviruses:
 Ebola & Marburg
 Host of virus is unknown, possible bats
 Hemorrhagic Flaviviruses:
 Yellow & Dengue
 Arthropod vector

7. Recognition is the key

8. Signs and Symptoms
 Minor Signs and
Symptoms
 Travel history
 Fever
 Fatigue, weakness
 Dizziness
 Muscle aches
 Headache
 Sore throat
 Severe Signs and
Symptoms
 Travel history
 Petechia (bleeding under the
skin)
 Bleeding from internal
organs
 Signs of shock
 Bleeding from external
orifices
 Nervous system malfunction
 Coma, AMS, SZ

9. Petechia

10. Possible Travel History

11. Modes of Transmission
 Animal to Human
 Contact with
 Urine
 Feces
 Saliva
 Other body fluids
 Bites
 Human to Human
 Contact with body fluid
 Contact with
contaminated surfaces
 Up to 3 weeks
 No agreement as far as
airborne transmission
 Shown in monkeys, but
not humans

12. Protective Measures
 Double Gloves
 Gowns
 Masks
 Shoe Covers
 Eye wear
 N95
 Also place on patient

13. N95 Mask

14. Decontamination
 After exposure
 Limit exposure with
proper PPE
 Wash with soap and
water
 Irrigate exposed mucous
membranes
 Non exposure
 Disposable equipment
discarded
 Non-disposable
autoclaved
 Interior of ambulance
needs to be disinfected
 Disinfection EMS
clothing and footwear

15. Protocol
 Proper PPE
 Immediately notify supervisor if you suspect VHF
– isolate location if possible
 Coordinate transport & reception at hospital prior
to leaving scene
 Hospital needs to be secure
 Able to handle isolates patients
 Supervisor to contact local and state public health
departments

16. Treatment
 Treatment is normally
supportive in care
 Fever control
 Electrolyte control
 Fluid replacement
 Blood pressure control
 Fluid replacement
 Pain management

17. Post Incident Actions
 No current post exposure prophylaxis
 A fever of over 101F will trigger isolation and treatment
 Will be isolated at home or hospital
 Supportive treatment as needed
 Information will be provided on how to protect family

18. Common
Types of VHF
Signs and
Symptoms
PPE
Required
Treatment Transport
Consideration
s
Notes
Ebola
Hemorrhagic
Fever
Rapid onset of fever,
headache, joint pain,
weakness, diarrhea,
vomiting, and
abdominal pain, rash,
red eyes, internal and
external bleeding may
be present
Spread by direct
contact and blood
Standard PPE
Outer gown
Rubber boots
HEPA Filter Mask
Eye Protection
Class C Haz-Mat suit
No standard treatment
Supportive in nature
Fluids and O2
Isolation
Proper PPE
Often Fatal
Filoviridae Virus
Obtained from
infected non-human
primates
Lassa Fever Nonspecific S/S.
May include fever,
chest pain, back pain,
N/V/D, hearing loss,
tremors
Spread by direct
contact and
contaminated food
Standard PPE
Gowns, protective
eyewear
Ribavirin (antiviral
drug)
Supportive Care
Isolation
Proper PPE
Arenaviridae Virus
No S/S in 80% infected
Most common in West
Africa,
Spread from rodents to
humans
Marburg
Hemorrhagic
Fever
Rapid onset of fever.
After 5 days of
exposure possible
N/V/D, maculpapular
rash, weight loss,
massive hemorrhage
Spread from direct
contact and blood
Standard PPE
Outer gown
Rubber boots
HEPA Filter Mask
Eye Protection
Class C Haz-Mat suit
No standard treatment
Supportive in nature
Fluids and O2
Isolation
Proper PPE
Filoviridae Virus
Rare
Spread via Marburg
Bat
Common in mine
workers
Dengue Fever High fever, headache,
severe pain behind
eyes, joint pain,
muscle and bone pain,
rash, and mild
bleeding
Spread by mosquitoes
Limit mosquito
opportunities
No standard treatment
Rest
Fluids
Isolation
Proper PPE
Protect from
mosquitoes
Spread by infected
mosquitoes
Yellow Fever S/S after 3 to 6 days:
Fever, chills, headache,
back pain, bleeding
from GI tract
Only spread from
infected mosquitoes
Standard PPE
No standard treatment
Supportive in nature
Fluids and O2
Isolation
Proper PPE
Vaccination available
Protect from
mosquitoes
Spread by infected
mosquitoes
Information obtained from the Centers for Disease Control