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]]>Viral Hemorrhagic Fevers (VHF) are a group of diseases caused by several families of viruses. The term VHF refers to an illness that can affect multiple organ systems and can be accompanied by fever, headache, vomiting, abdominal pain, diarrhea, and hemorrhage. VHFs addressed in this document include Crimean-Congo Hemorrhagic Fever (CCHF), Ebola Virus Disease (EVD), Lassa Fever, and Marburg Virus Disease (MVD).
All health care facilities are part of the frontline defense against the spread of disease, as patients will seek care in emergency departments, urgent care centers and clinics. Health care facility preparedness to care for patients with a VHF is essential to prevent transmission to staff, other patients, and our communities.
NETEC developed the Health Care Facility Viral Hemorrhagic Fever Preparedness Checklist to help health care facilities assess their readiness to identify, isolate, inform, and provide initial treatment for patients suspected or confirmed to have a VHF. This checklist is intended to guide facilities through a review of their immediate care capabilities and provide resources to assist in the resolution of preparedness gaps it reveals.
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While cases in the U.S. are rare, recent outbreaks of Marburg in Ghana, Crimean-Congo Hemorrhagic Fever in Iraq, Lassa Fever in Nigeria, and Ebola in the Democratic Republic of Congo mean that health care workers need to know how to identify and treat these viral illnesses. Where do they get their names? What are the symptoms of viral hemorrhagic fevers? What can health care workers do to prevent transmission in health care settings? Learn the answers to these questions and more on the podcast.
Questions or comments for NETEC? Contact us at info@netec.org.
Visit us on the web at netec.org/podcast.
]]>In this episode of Transmission Interrupted, NETEC hosts Jill Morgan and Trish Tennill go back to the basics of viral hemorrhagic fevers and personal protective equipment. They discuss four of the most serious and deadly viral hemorrhagic fevers: Ebola, Marburg, Lassa, and Crimean-Congo Hemorrhagic fevers.
While cases in the U.S. are rare, recent outbreaks of Marburg in Ghana, Crimean-Congo Hemorrhagic Fever in Iraq, Lassa Fever in Nigeria, and Ebola in the Democratic Republic of Congo mean that health care workers need to know how to identify and treat these viral illnesses. Where do they get their names? What are the symptoms of viral hemorrhagic fevers? What can health care workers do to prevent transmission in health care settings? Learn the answers to these questions and more on the podcast.
Questions or comments for NETEC? Contact us at info@netec.org.
Visit us on the web at netec.org/podcast.
Hosts
Jill Morgan, RN
Emory Healthcare, Atlanta, GA
Jill Morgan is a registered nurse and a subject matter expert in personal protective equipment (PPE) for NETEC. For 35 years, Jill has been an emergency department and critical care nurse, and now splits her time between education for NETEC and clinical research, most of it centering around infection prevention and personal protective equipment. She is a member of the Association for Professionals in Infection Control and Epidemiology (APIC), ASTM International, and the Association for the Advancement of Medical Instrumentation (AAMI).
Patricia Ann Tennill RN, BSN
Associate Director of Nursing
NYC Health + Hospitals / Bellevue , New York, NY
Patricia Tennill is an Associate Director of Nursing in Staff Development and the nursing lead for the NYC Health + Hospitals / Bellevue Special Pathogens Program. Patricia has been involved with the Special Pathogens Program since 2014 as a nurse leader responsible for coordinating and overseeing all nursing operations on the Special Pathogens Unit, including the development of protocols concerning the movement and care of patients with special pathogens and the subsequent hands-on training for all staff involved in the Special Pathogens Program.
Resources
Transmission Interrupted, Ep 16: Back to the Basics – PPE and Mpox: https://netec.org/transmission-interrupted/back-to-basics-ppe-and-monkeypox/
NETEC PPE Resources: https://repository.netecweb.org/exhibits/show/ppe101/ppe
NETEC Viral Hemorrhagic Fever resources: https://repository.netecweb.org/items/browse?tags=Viral+Hemorrhagic+Fever
NETEC Resource Library: https://repository.netecweb.org
Transmission Interrupted on the web: https://netec.org/podcast/
About NETEC
A Partnership for Preparedness
The National Emerging Special Pathogens Training and Education Center’s mission is to set the gold standard for special pathogen preparedness and response across health systems in the U.S. with the goals of driving best practices, closing knowledge gaps, and developing innovative resources.
Our vision is a sustainable infrastructure and culture of readiness for managing suspected and confirmed special pathogen incidents across the United States public health and health care delivery systems.
For more information, visit NETEC on the web at www.netec.org.
NETEC Consultation Services
Assess and Advance Your Readiness for Special Pathogens with Free, Expert Consulting.
NETEC offers free virtual and onsite readiness consulting to help healthcare facilities and EMS agencies prepare for special pathogen events. Our targeted support services are delivered by experts selected and assigned to each inquiry based on the unique needs of your organization. Have a question? Ask a NETEC expert.
For more information, visit netec.org/consulting-services.
Many small molecules have been identified as entry inhibitors of filoviruses. However, a lack of understanding of the mechanism of action for these molecules limits further their development as anti-filoviral agents. Here we provide evidence that toremifene and other small molecule entry inhibitors have at least three distinctive mechanisms of action and lay the groundwork for future development of anti-filoviral agents. The three mechanisms identified here include: (1) direct binding to the internal fusion loop region of Ebola virus glycoprotein (GP); (2) the HR2 domain is likely the main binding site for Marburg virus GP inhibitors and a secondary binding site for some EBOV GP inhibitors; (3) lysosome trapping of GP inhibitors increases drug exposure in the lysosome and further improves the viral inhibition. Importantly, small molecules targeting different domains on GP are synergistic in inhibiting EBOV entry suggesting these two mechanisms of action are distinct. Our findings provide important mechanistic insights into filovirus entry and rational drug design for future antiviral development.
Filoviruses are among the deadliest pathogens known to mankind with case-fatality rates ranging from 25–90%. New outbreaks in central Africa and the identification of novel filoviruses in other regions highlight the urgent need to develop novel therapeutics. Although many novel anti-filovirus compounds have been reported as entry inhibitors, to date, none have made to market. This high rate of failure is in part due to a lack of knowledge of the mechanisms of action. In this report, we provide a molecular basis for the multiple mechanisms of action by which small molecule inhibitors of Ebola virus and Marburg virus block virus entry, which provides new mechanistic insight to guide design for next-generation viral entry inhibitors.
Objectives: This article is a summary of countermeasures for Marburg virus disease focusing on pathogenesis, clinical features, and diagnostics, with an emphasis on therapies and vaccines that have demonstrated potential for use in an emergency situation, through their evaluation in nonhuman primates (NHPs) and/or in humans.
Methods: A standardized literature review was conducted on vaccines and treatments for each pathogen, with a focus on human and nonhuman primate data published in the last five years. More detail on the methods used are summarized in a companion methods paper.
Results: We identified six treatments and four vaccine platforms that have demonstrated potential benefit for treating or preventing infection in humans, through their efficacy in NHPs.
Conclusion: We provide succinct summaries of Marburg countermeasures to give the busy clinician a head start in reviewing the literature if faced with a patient with Marburg virus disease. We also provide links to other authoritative sources of information.
Keywords: Ebola virus; Marburg virus; antiviral countermeasure; antiviral therapy; filovirus; treatment; vaccine.
Copyright © 2020. Published by Elsevier Ltd.
While the list of reportable conditions varies by state, the Council of State and Territorial Epidemiologists (CSTE) has recommended that state health departments report cases of selected diseases to CDC’s National Notifiable Diseases Surveillance System (NNDSS). Every year, case definitions are updated using CSTE’s Position Statements. They provide uniform criteria of national notifiable infectious and non-infectious conditions for reporting purposes.
]]>A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.
While the list of reportable conditions varies by state, the Council of State and Territorial Epidemiologists (CSTE) has recommended that state health departments report cases of selected diseases to CDC’s National Notifiable Diseases Surveillance System (NNDSS). Every year, case definitions are updated using CSTE’s Position Statements. They provide uniform criteria of national notifiable infectious and non-infectious conditions for reporting purposes.
The following links provide surveillance case definitions (a set of uniform criteria used to define a disease for public health surveillance) for current and historical conditions. These links link out to the CDC website.
Acanthamoeba disease (excluding keratitis)
Acquired immunodeficiency syndrome
Anaplasma phagocytophilum infection
Arboviral diseases, neuroinvasive and non-neuroinvasive
Arboviral encephalitis or meningitis
Balamuthia mandrillaris disease
California serogroup encephalitis
California serogroup encephalitis/meningitis
California serogroup virus diseases
Candida auris, colonization/screening
Candida auris, screening/surveillance
Carbapenemase Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE)
Chlamydia trachomatis infection
Chlamydia trachomatis, genital infections
Coronavirus Disease 2019 (COVID-19)
CP-CRE, Escherichia coli (E. coli)
Crimean-Congo hemorrhagic fever virus
Eastern equine encephalitis virus disease
Eastern equine encephalitis/meningitis
Ehrlichia chaffeensis infection
Encephalitis, postinfectious (or parainfectious)
Enterohemorrhagic Escherichia coli
Haemophilus influenzae, invasive disease
Hantavirus infection, non-Hantavirus pulmonary syndrome
Hemolytic uremic syndrome, post-diarrheal
Hepatitis B, perinatal virus infection
Hepatitis C, Perinatal Infection
HIV infection (AIDS has been reclassified as HIV Stage III)
Human granulocytic ehrlichiosis
Influenza-associated hospitalizations
Influenza-associated pediatric mortality
Latent TB Infection (TB Infection)
Lead, elevated blood levels, adult (≥16 Years)
Naegleria fowleri causing primary amebic meningoencephalitis (PAM)
New World arenavirus – Guanarito virus
New World arenavirus – Junin virus
New World arenavirus – Machupo virus
New World arenavirus – Sabia virus
Novel influenza A virus infections
Other or unspecified human ehrlichiosis
Pesticide-related illness and injury, acute
Poliovirus infection, nonparalytic
Powassan encephalitis/meningitis
Respiratory Syncytial Virus-Associated Mortality (RSV-Associated Mortality)
Salmonella Typhi infection (Salmonella enterica serotype Typhi)
Severe acute respiratory syndrome-associated coronavirus disease
Shiga toxin-producing Escherichia coli
St. Louis encephalitis virus disease
St. Louis encephalitis/meningitis
Streptococcal toxic shock syndrome
Streptococcus disease, invasive, Group A
Streptococcus pneumoniae, drug-resistant invasive disease
Streptococcus pneumoniae, invasive disease
Streptococcus pneumoniae, invasive disease (child, <5 years)
Streptococcus pneumoniae, invasive disease non-drug resistant (child, <5 years)
Syphilis, early non-primary non-secondary
Syphilis, late, with clinical manifestations other than neurosyphilis
Syphilis, latent unknown duration
Syphilis, unknown duration or late
Toxic shock syndrome (other than streptococcal)
Undetermined human ehrlichiosis/anaplasmosis
Vancomycin-intermediate Staphylococcus aureus and Vancomycin-resistant Staphylococcus aureus
West Nile encephalitis/meningitis
Western equine encephalitis virus disease
Western equine encephalitis/meningitis
Zika virus disease and Zika virus infection
Zika virus disease, congenital
Zika virus disease, non-congenital
There are 4 families of viruses that cause viral hemorrhagic fever (VHF), including Filoviridae. Ebola virus is one virus within the family Filoviridae and the cause of the current outbreak of VHF in West Africa. VHF-endemic areas are found throughout the world, yet traditional diagnosis of VHF has been performed in large reference laboratories centered in Europe and the United States. The large amount of capital needed, as well as highly trained and skilled personnel, has limited the availability of diagnostics in endemic areas except in conjunction with governmental and nongovernmental entities. However, rapid diagnosis of VHF is essential to efforts that will limit outbreaks. In addition, increased global travel suggests VHF diagnoses may be made outside of the endemic areas. Thus, understanding how to diagnose VHF is imperative for laboratories worldwide. This article reviews traditional and current diagnostic modalities for VHF.
© The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.
From: Public Health England
Published: 5 September 2014
Marburg virus is one of two viruses of the Filovirus family which, along with Ebola virus, can cause a severe and fatal haemorrhagic fever (VHF).]]>From: Public Health England
Published: 5 September 2014
Marburg virus is one of two viruses of the Filovirus family which, along with Ebola virus, can cause a severe and fatal haemorrhagic fever (VHF).