What are viral haemorrhagic fevers?

Viral haemorrhagic fevers (VHF) are a group of rare but potentially life-threatening illnesses. They are caused by different viruses that can lead to bleeding and fever.

Examples of these illnesses include:

• dengue fever
• yellow fever
• Ebola virus disease
• Marburg virus disease
• Lassa fever
• Crimean-Congo haemorrhagic fever
• Lujo haemorrhagic fever

Each of these illnesses is present in specific areas in the world. Dengue fever is the only viral haemorrhagic fever known to happen in Australia.

What are the symptoms of viral haemorrhagic fevers?

The symptoms of VHF may vary based on the virus. The first symptoms to develop often include:

• fever
• headache, muscle aches and feeling unwell
• nausea, vomiting and diarrhoea
• sore throat or cough
• chest or abdominal pain
• rash

Symptoms may not be specific, which makes it hard to tell VHF apart from other illnesses. Sometimes, people may not notice any symptoms. Many people infected with Lassa fever have mild or no symptoms.

Some people get better after this stage. For others, the disease may lead to bleeding in different parts of the body. Severe blood loss may lead to complications including organ failure and death.

If you develop bleeding problems, you may:

• bleed from your nose or gums
• vomit up blood (haematemesis)
• cough up blood (haemoptysis)
• develop bruises
• have blood in your urine (haematuria) or bowel (stool) motions

How do viral haemorrhagic fevers spread?

Viral haemorrhagic fever viruses are spread between some animals and biting insects. Sometimes, these viruses are passed to humans and spread from person to person.

Different haemorrhagic viruses spread in different ways.

You can catch some of these viruses from infected animals or insects if you:

• travel to an area where the virus happens
• get bitten by an infected mosquito or tick
• have direct contact with rat faeces (poo) or urine

Some of these viruses can spread from an infected person to others through:

• contact with blood or body fluids from an infected person
• touching contaminated surfaces
• sexual contact (for Ebola virus and Lassa fever)
• breathing in infectious droplets in the air (Lassa fever)

When should I see my doctor?

See your doctor if you have a fever above 38°C and have returned from a high-risk area in the past 3 weeks. Go to hospital if you are bleeding or feel unwell and have been in contact with someone who has viral haemorrhagic fever.

If you start feeling unwell while travelling, see a doctor or visit the local emergency department in that country.

Call your doctor or the hospital before you visit and let them about your symptoms and what countries you have visited. This helps prevent the spread of VHF.

How are viral haemorrhagic fevers diagnosed?

If your doctor suspects your symptoms may be caused by VHF, they may arrange diagnostic testing. Testing must take place in a high-security laboratory.

The specific virus can be detected with a:

• nose or throat swab
• blood test
• urine sample

Diseases that cause viral haemorrhagic fevers are notifiable diseases. This means your doctor must report the diagnosis to the Department of Health. This allows the Department of Health to monitor and track people infected, find outbreaks and improve healthcare responses.

According to Australian law, anyone with the following illnesses must be in quarantine:

• Ebola virus disease
• Marburg virus disease
• Lassa fever
• Crimean-Congo haemorrhagic fever

How are viral haemorrhagic fevers treated?

Viral haemorrhagic fevers are mainly treated with supportive care. Currently there are no specific treatments available for VHF. You will be cared for in isolation in a hospital.

Treatment may include:

• fluids to keep you hydrated
• medicines to control your symptoms
• depending on the type of virus, you may receive intravenous (into your vein) anti-viral medicine

You will be monitored while in hospital for any complications or other infections that may develop.

What are the complications of viral haemorrhagic fevers?

VHF can lead to severe bleeding which may lead to other complications. Complications of viral haemorrhagic fevers may include:

• haemorrhage (bleeding)
• failure of multiple organs
• shock
• death

Can viral haemorrhagic fevers be prevented?

There are no vaccines available for most of these viruses. While a vaccine for Ebola virus is currently not available for the general public, there is a vaccine for yellow fever. This vaccine is recommended and sometimes required if you travel to a country where yellow fever is present.

To reduce your risk of catching one of these viruses while travelling to a high-risk area:

• Don’t eat raw or undercooked meat, especially from apes, monkeys or bats.
• Protect yourself from tick bites and mosquito bites.
• Avoid contact with rats and mice.
• Make sure to wash your hands and maintain personal hygiene.

If you have one of these viruses, you can help prevent spreading it to others:

• Stay in isolation until you are no longer contagious.
• Use a condom during sex after you recover, until your doctor tells you it’s safe to stop.
• Use appropriate protective wear, such as a mask, to protect those around you.

Resources and support

• If you are planning to travel overseas, visit Smartraveller to find out about risks at your destination and how to stay safe.
• World Health Organisation provides information about current world outbreaks when travelling.

Healthdirect offers travel information on topics, including:

• Travel health advice
• 10 tips for a healthy holiday
• Travel vaccinations

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Other languages

• NSW Multicultural Health Communication Service offers a translated fact sheet about yellow fever.
• NSW Multicultural Health Communication Service also offers a translated fact sheet about mosquito borne diseases.