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1、ViralHemorrhagicFever广州网站建设 http:/2021/9/11Center for Food Security and Public Health Iowa State University-2004WhatisViralWhatisViralHemorrhagicFever?HemorrhagicFever?SeveremultisystemsyndromeDamagetooverallvascularsystemSymptomsoftenaccompaniedbyhemorrhageRarelylifethreateninginitselfIncludesconju
2、nctivitis,petechia,echymosis2021/9/11Center for Food Security and Public Health Iowa State University-2004OverviewOverviewOrganismHistoryEpidemiologyTransmissionDiseaseinHumansDiseaseinAnimalsPreventionandControlTheOrganisms2021/9/11Center for Food Security and Public Health Iowa State University-20
3、04ViralHemorrhagicFeverViralHemorrhagicFeverVirusesoffourdistinctfamiliesArenavirusesFilovirusesBunyavirusesFlavivirusesRNAvirusesEnvelopedinlipidcoatingSurvivaldependentonananimalorinsecthost,forthenaturalreservoir2021/9/11Center for Food Security and Public Health Iowa State University-2004Classif
4、icationClassificationArenaviridaeBunyaviridaeFiloviridaeFlaviviridaeJuninCrimean-CongoH.F.EbolaKyasanurForestDiseaseMachupoHantavirusMarburgOmskH.F.SabiaRiftValleyfeverYellowFeverGuanaritoDengueLassaArenaviridaeJunin virusMachupo virusGuanarito virusLassa virusSabia virus2021/9/11Center for Food Sec
5、urity and Public Health Iowa State University-2004ArenaviridaeHistoryArenaviridaeHistoryFirstisolatedin19331958:Juninvirus-ArgentinaFirsttocausehemorrhagicfeverArgentinehemorrhagicfever1963:MachupovirusBoliviaBolivianhemorrhagicfever1969:LassavirusNigeriaLassafever2021/9/11Center for Food Security a
6、nd Public Health Iowa State University-2004ArenaviridaeTransmissionArenaviridaeTransmissionVirustransmissionandamplificationoccursinrodentsShedvirusthroughurine,feces,andotherexcretaHumaninfectionContactwithexcretaContaminatedmaterialsAerosoltransmissionPerson-to-persontransmission2021/9/11Center fo
7、r Food Security and Public Health Iowa State University-2004ArenaviridaeEpidemiologyArenaviridaeEpidemiologyAfricaLassaSouthAmericaJunin,Machupo,Guanarito,andSabiaContactwithrodentexcretaCasefatality:535%ExplosivenosicomialoutbreakswithLassaandMachupo2021/9/11Center for Food Security and Public Heal
8、th Iowa State University-2004ArenaviridaeinHumansArenaviridaeinHumansIncubationperiod1014daysFeverandmalaise24daysHemorrhagicstageHemorrhage,leukopenia,thrombocytopeniaNeurologicsignsBunyaviridaeRift Valley Fever virusCrimean-Congo Hemorrhagic Fever virusHantavirus2021/9/11Center for Food Security a
9、nd Public Health Iowa State University-2004BunyaviridaeHistoryBunyaviridaeHistory1930:RiftValleyFeverEgyptEpizooticinsheep1940s:CCHF-CrimeanpeninsulaHemorrhagicfeverinagriculturalworkers1951:HantavirusKoreaHemorrhagicfeverinUNtroops5generawithover350viruses2021/9/11Center for Food Security and Publi
10、c Health Iowa State University-2004BunyaviridaeTransmissionBunyaviridaeTransmissionArthropodvectorExceptionHantavirusesRVFAedesmosquitoCCHFIxodidtickHantavirusRodentsLesscommonAerosolExposuretoinfectedanimaltissue2021/9/11Center for Food Security and Public Health Iowa State University-2004Bunyaviri
11、daeEpidemiologyBunyaviridaeEpidemiologyRVF-AfricaandArabianPeninsula1%casefatalityrateCCHF-Africa,EasternEurope,Asia30%casefatalityrateHantavirus-NorthandSouthAmerica,EasternEurope,andEasternAsia1-50%casefatalityrate2021/9/11Center for Food Security and Public Health Iowa State University-2004Bunyav
12、iridaeHumansBunyaviridaeHumansRVFIncubationperiod2-5days0.5%-HemorrhagicFeverCCHFIncubationperiod3-7daysHemorrhagicFever-36daysfollowingclinicalsignsHantavirusIncubationperiod721daysHPSandHFRS2021/9/11Center for Food Security and Public Health Iowa State University-2004BunyaviridaeAnimalsBunyavirida
13、eAnimalsRVFAbortion100%Mortalityrate90%inyoung5-60%inolderanimalsCCHFUnapparentinfectioninlivestockHantavirusesUnapparentinfectioninrodentsFiloviridaeMarburg virusEbola virus2021/9/11Center for Food Security and Public Health Iowa State University-2004FiloviridaeHistoryFiloviridaeHistory1967:Marburg
14、virusEuropeanlaboratoryworkers1976:EbolavirusEbolaZaireEbolaSudan1989and1992:EbolaRestonUSAandItalyImportedmacaquesfromPhilippines1994:EbolaCtedIvoire2021/9/11Center for Food Security and Public Health Iowa State University-2004FiloviridaeTransmissionFiloviridaeTransmissionReservoirisUNKNOWNBatsimpl
15、icatedwithMarburgIntimatecontactNosicomialtransmissionReuseofneedlesandsyringesExposuretoinfectioustissues,excretions,andhospitalwastesAerosoltransmissionPrimates2021/9/11Center for Food Security and Public Health Iowa State University-2004FiloviridaeEpidemiologyFiloviridaeEpidemiologyMarburgAfricaC
16、asefatality23-33%Ebola-Sudan,ZaireandCtedIvoireAfricaCasefatality53-88%EbolaRestonPhilippinesPatternofdiseaseisUNKOWN2021/9/11Center for Food Security and Public Health Iowa State University-2004FiloviridaeHumansFiloviridaeHumansMostseverehemorrhagicfeverIncubationperiod:410daysAbruptonsetFever,chil
17、ls,malaise,andmyalgiaHemorrhageandDICDeatharoundday711Painfulrecovery2021/9/11Center for Food Security and Public Health Iowa State University-2004FiloviridaeAnimalsFiloviridaeAnimalsHemorrhagicfeverSameclinicalcourseashumansEbolaRestonHighprimatemortality-82%FlaviviridaeDengue virusYellow Fever vir
18、usOmsk Hemorrhagic Fever virusKyassnur Forest Disease virus2021/9/11Center for Food Security and Public Health Iowa State University-2004FlaviviridaeHistoryFlaviviridaeHistory1648:YellowFeverdescribed17th20thcenturyYellowFeverandDengueoutbreaks1927:YellowFevervirusisolated1943:Denguevirusisolated194
19、7OmskHemorrhagicFever virusisolated1957:KyasanurForestvirus isolated2021/9/11Center for Food Security and Public Health Iowa State University-2004FlaviviridaeTransmissionFlaviviridaeTransmissionArthropodvectorYellowFeverandDenguevirusesAedes aegyptiSylvaticcycleUrbancycleKasanurForestVirusIxodidtick
20、OmskHemorrhagicFevervirusMuskraturine,feces,orblood2021/9/11Center for Food Security and Public Health Iowa State University-2004FlaviviridaeEpidemiologyFlaviviridaeEpidemiologyYellowFeverVirusAfricaandAmericasCasefatalityratevariesDengueVirusAsia,Africa,Australia,andAmericasCasefatalityrate1-10%Kya
21、sanurForestvirusIndiaCasefatalityrate35%OmskHemorrhagicFevervirusEuropeCasefatlityrate0.53%2021/9/11Center for Food Security and Public Health Iowa State University-2004FlaviviridaeHumansFlaviviridaeHumansYellowFeverIncubationperiod36daysShortremissionDengueHemorrhagicFeverIncubationperiod25daysInfe
22、ctionwithdifferentserotypeKyasanurForestDiseaseOmskHemorrhagicFeverLastingsequela2021/9/11Center for Food Security and Public Health Iowa State University-2004FlaviviridaeAnimalsFlaviviridaeAnimalsYellowFevervirusNon-humanprimatesvaryingclinicalsignsDenguevirusNon-humanprimatesNosymptomsKyasanurFore
23、stDiseaseVirusLivestockNosymptomsOmskHemorrhagicFeverVirusRodentsNosymptomsDiseaseinHumans2021/9/11Center for Food Security and Public Health Iowa State University-2004ClinicalSymptomsClinicalSymptomsDifferslightlydependingonvirusInitialsymptomsMarkedfeverFatigueDizzinessMuscleachesExhaustion2021/9/
24、11Center for Food Security and Public Health Iowa State University-2004ClinicalSymptomsClinicalSymptomsMoresevereBleedingunderskinPetechiae,echymoses,conjunctivitisBleedingininternalorgansBleedingfromorificesBloodlossrarelycauseofdeath2021/9/11Center for Food Security and Public Health Iowa State Un
25、iversity-2004DiagnosisDiagnosisSpecimensmustbesenttoCDCU.S.ArmyMedicalResearchInstituteofInfectiousDisease(USAMRIID)SerologyPCRIHCViralisolationElectronmicroscopy2021/9/11Center for Food Security and Public Health Iowa State University-2004TreatmentTreatmentSupportivetreatmentRibavirinNotapprovedbyF
26、DAEffectiveinsomeindividualsArenaviridaeandBunyaviridaeonlyConvalescent-phaseplasmaArgentineHF,BolivianHFandEbolaStrictisolationofaffectedpatientsisrequiredReporttohealthauthoritiesPreventionandControl2021/9/11Center for Food Security and Public Health Iowa State University-2004PreventionandControlP
27、reventionandControlAvoidcontactwithhostspeciesRodentsControlrodentpopulationsDiscouragerodentsfromenteringorlivinginhumanpopulationsSafecleanupofrodentnestsanddroppingsInsectsUseinsectrepellentsProperclothingandbednetsWindowscreensandotherbarrierstoinsects2021/9/11Center for Food Security and Public
28、 Health Iowa State University-2004PreventionandControlPreventionandControlVaccineavailableforYellowfeverExperimentalvaccinesunderstudyArgentineHF,RiftValleyFever,HantavirusandDengueHFIfhumancaseoccursDecreaseperson-to-persontransmissionIsolationofinfectedindividuals2021/9/11Center for Food Security
29、and Public Health Iowa State University-2004PreventionandControlPreventionandControlProtectiveclothingDisposablegowns,gloves,masksandshoecovers,protectiveeyewearwhensplashingmightoccur,orifpatientisdisorientedoruncooperativeWHOandCDCdevelopedmanual“InfectionControlforViralHemorrhagicFeversIntheAfric
30、anHealthCareSetting”2021/9/11Center for Food Security and Public Health Iowa State University-2004ProtectiveequipmentwornbyanurseduringEbolaoutbreakinZaire,19952021/9/11Center for Food Security and Public Health Iowa State University-2004PreventionandControlPreventionandControlAnyonesuspectedofhavin
31、gaVHFmustuseachemicaltoiletDisinfectanddisposeofinstrumentsUsea0.5%solutionofsodiumhypochlorite(1:10dilutionofbleach)2021/9/11Center for Food Security and Public Health Iowa State University-2004VHFAgentsasVHFAgentsasBiologicalWeaponsBiologicalWeaponsOutbreakofundifferentiatedfebrileillness2-21daysf
32、ollowingattackCouldincludeRash,hemorrhagicdiathesisandshockDiagnosiscouldbedelayedUnfamiliarityLackofdiagnostictestsRibavirintreatmentmaybebeneficial2021/9/11Center for Food Security and Public Health Iowa State University-2004VHFAgentsasVHFAgentsasBiologicalWeaponsBiologicalWeaponsMostarenotstablei
33、ndryformMosthaveuncertainstabilityandeffectivenessinaerosolformArenaviruseshavetestedeffectivenessinaerosolformMarburgandEbolahavehighcasefatalityratesRiftValleyisthemoststableVHFinliquidorfrozenstateVHFsdoposeathreatasaerosolizedagents2021/9/11Center for Food Security and Public Health Iowa State U
34、niversity-2004AcknowledgmentsAcknowledgmentsDevelopment of this presentation was funded by a grant from the Centers for Disease Control and Prevention to the Center for Food Security and Public Health at Iowa State University.2021/9/11Center for Food Security and Public Health Iowa State University-2004AcknowledgmentsAcknowledgmentsAuthor:Co-authors:JamieSnow,DVM,MPHRadfordDavis,DVM,MPHStacyHolzbauer,DVM