Submitted by:

Susan Henry

Keith Noble

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

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

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

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

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

Recognition is the key

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

Petechia

Possible Travel History

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

Protective Measures

Double Gloves

Gowns

Masks

Shoe Covers

Eye wear

N95

Also place on patient

N95 Mask

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

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

Treatment Treatment is normally

supportive in care

Fever control

Electrolyte control Fluid replacement

Blood pressure control Fluid replacement

Pain management

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

CommonTypes of VHF

Signs andSymptoms

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 PPEOuter gown

Rubber bootsHEPA Filter Mask

Eye ProtectionClass C Haz-Mat suit

No standard treatmentSupportive in nature

Fluids and O2

IsolationProper PPE

Often FatalFiloviridae VirusObtained 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 foodStandard PPE

Gowns, protective eyewear

Ribavirin (antiviral drug)

Supportive Care

IsolationProper PPE

Arenaviridae VirusNo S/S in 80% infectedMost common in West

Africa, Spread from rodents to

humans

MarburgHemorrhagic

Fever

Rapid onset of fever.After 5 days of

exposure possible N/V/D, maculpapular

rash, weight loss, massive hemorrhage

Spread from directcontact and blood

Standard PPEOuter gown

Rubber bootsHEPA Filter Mask

Eye ProtectionClass C Haz-Mat suit

No standard treatmentSupportive in nature

Fluids and O2

IsolationProper PPE

Filoviridae VirusRare

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 mosquitoesLimit mosquito opportunities

No standard treatmentRest

Fluids

IsolationProper PPE

Protect frommosquitoes

Spread by infectedmosquitoes

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 treatmentSupportive in nature

Fluids and O2

IsolationProper PPE

Vaccination availableProtect frommosquitoes

Spread by infected mosquitoes

Information obtained from the Centers for Disease Control