Viral Hemorrhagic Fevers Toolbox

-About Viral Hemorrhagic Fevers

About Viral Hemorrhagic Fevers (NEW 8/13, Website, Regulation/Guidance)

CDC

Main page including an abridge description of the major VHF viruses. Includes a table with virus family, virus name, how long it takes for symptoms to start, where it is found, and if it is transmitted by animal or insect

keywords: VHF, VHFV

-Ebola

Ebola Virus Disease (EVD) is a deadly disease in people and nonhuman primates. The viruses that cause EVD are located mainly in sub-Saharan Africa and belong to a group of viruses within the genus Ebolavirus. Of these, only four (Ebola, Sudan, Taï Forest, and Bundibugyo viruses) are known to cause disease in people. Reston virus is known to cause disease in nonhuman primates and pigs, but not in people. It is unknown if Bombali virus, which was recently identified in bats, causes disease in either animals or people.

America Biological Safety Association (ABSA) Position Paper on Ebola (PDF 27KB), 12 December 2014

Preparing for another Ebola Outbreak: The impact of viral inactivation methods on commonly measured biochemistry analytes in plasma and urine (NEW 2/9, Website)

Clinical Biochemistry

17 January 2024

Zhou J, et al.
Infectious specimens containing viruses like Ebola require sample manipulation to ensure the safety of laboratory staff, which may negatively impact biochemistry test results. We evaluated the impact of viral inactivation methods on 25 biochemistry analytes in plasma, and seven biochemistry analytes in urine.

keywords: analytes, ebola, plasma, urine, VHF, viral inactivation

Ebola Virus Disease (Website)

WHO/Pan American Health Organization (PAHO)

Ebola virus disease (EVD), implications of introduction in the Americas (PDF), 13 August 2014

[SPANISH VERSION] Enfermedad por el virus del Ébola, implicaciones de la introducción en las Américas(PDF)

keywords: ebola, VHF

Ebola virus disease: Symptoms and treatment (Website, Regulation/Guidance)

Public Health Agency of Canada (PHAC)

keywords: ebola, VHF

Ebola virus disease (Website)

WHO

keywords: ebola, VHF

Ebola (Ebola Virus Disease) (Website, Regulation/Guidance)

CDC

keywords: ebola, VHF

Ebola virus persistence and disease recrudescence in the brains of antibody-treated nonhuman primate survivors (Website)

Science Translational Medicine

9 February 2022

Liu J, et. al

keywords: ebola, VHF

Non-Government Resources

Ebola (Website)

University of Nebraska Medical Center

keywords: ebola, VHF

Ebola Infection Prevention and Control Resources (Website, List of Resources)

Association for Professionals in Infection Control and Epidemiology (APIC)

keywords: ebola, Resource List, VHF

Ebola Preparedness Protocols (Website)

Emory Healthcare

keywords: ebola, preparedness, VHF

Ebola Action Center (Website)

The African Society for Laboratory Medicine (ASLM)

keywords: ebola, VHF

-News

Ebola Outbreak Caused by Sudan virus in Uganda (NEW 3/20, Website, Regulation/Guidance)

CDC / Health Alert Network (HAN)

6 February 2025

Includes recommendations for clinical and public health labs, clinicians and the public.

keywords: ebola, sudan strain, Uganda, VHF

WHO accelerates efforts to support response to Sudan virus disease outbreak in Uganda (NEW 2/10, Website)

World Health Organization (WHO)

30 January 2025

Following the confirmation of an outbreak of Sudan virus disease – which belongs to the same family as Ebola virus disease – in Uganda today, World Health Organization (WHO) is mobilizing efforts to support the national health authorities to swiftly contain and end the outbreak.

keywords: ebola, SDV, sudan strain, Uganda, VHF

Uganda declares Ebola Virus Disease outbreak (Website, Regulation/Guidance)

WHO

20 September 2022

WHO declares outbreak in Uganda with a rare Ebola Sudan virus.

keywords: ebola, outbreak, sudan strain, VHF

Sabin Vaccine Institute Receives Additional $34.5 Million from BARDA for Further Development of Ebola Sudan and Marburg Vaccines (Website)

The Sabin Vaccine Institute

21 October 2021

keywords: ebola, vaccines

Ebola vaccine regimen safe and effective for children and adults (Website)

Nature Africa

16 October 2021

keywords: ebola, vaccines

VirusMED Atlas Centralizes Atomic Structures of Virus Strains (Website)

Global Biodefense

14 October 2021

keywords: ebola

Fears that Ebola 'lurks under the radar' of immune system as new cases linked to past outbreak (Website)

The Telegraph

14 October 2021

Findings are ‘really weird’ and show deadly disease can persist in survivors longer than thought

keywords: ebola, outbreak, VHF

Marburg Virus Disease Detected in West Africa for First Time (Website)

The Scientist

10 August 2021

The finding of the Ebola-like disease, which killed a man in Guinea, has prompted public health measures.

keywords: africa, Marburg, VHF

Ivory Coast detects first Ebola case in 25 years (Website)

Reuters

15 August 2021

keywords: africa, ebola, VHF

World’s second-deadliest Ebola outbreak ends in Democratic Republic of the Congo (Website)

Nature

26 June 2020

Highlights official end of outbreak in the DRC, as another outreak emerges. Vaccines and new drugs were successfully used in this oubreak.

keywords: ebola, outbreak, transmission, VHF

Ebola: Pushed to the limit and beyond (Website)

Medicins Sans Frontieres (MSF)

23 March 2015

keywords: ebola, outbreak, response

A Brilliantly Designed Hazmat Suit for Ebola Workers (Website)

Wired

8 January 2015

A skunkworks team at Johns Hopkins University has developed a prototype protective suit to better shield healthcare workers on the frontlines.

keywords: ebola, outbreak, response

Healthcare Settings

Preventing Worker Fatigue Among Ebola Healthcare Workers and Responders (PDF)

NIOSH/OSHA

keywords: ebola, healthcare, VHF, worker fatigue

For Clinicians (Website)

CDC

information for healthcare workers and settings

keywords: ebola, healthcare, VHF

INTERIM GUIDANCE: Interim Infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Haemorrhagic Fever in Health-Care Settings, with Focus on Ebola (PDF)

WHO

1 December 2014

keywords: ebola, healthcare, VHF

VIRAL HAEMORRHAGIC FEVER Guidelines for the management of patients with suspected viral haemorrhagic fever (PDF)

WHO

26 February 1988

keywords: ebola, healthcare, VHF

Laboratories/Research

Guidance on Performing Routine Diagnostic Testing for Patients with Suspected VHFs or Other High-Consequence Disease (Website, Regulation/Guidance)

CDC

This guidance applies to viral hemorrhagic fevers caused by infections with:

Filoviruses (ebolaviruses and marburgviruses),
Arenaviruses [Lassa, Lujo, and South American hemorrhagic fever viruses (Guanarito virus, Sabia virus,
Junin virus, Chapare virus, Machupo virus)],
Rift Valley fever virus, and
Crimean Congo hemorrhagic fever virus.

keywords: ebola, laboratory testing, routine diagnostic testing, VHF

VHF Specimen Collection (Website)

CDC

This webpage provides guidance for staff at hospitals and clinical laboratories on collecting, transporting, and submitting specimens to laboratories to test for viral hemorrhagic fevers (VHFs) or other high-consequence diseases.

keywords: laboratory testing, shipping, specimen handling, VHF

Laboratory Testing for Patients with a Suspected VHF or High-Consequence Disease (Website)

CDC

Routine laboratory testing to monitor the patient’s clinical status and diagnostic testing for other potential causes of the patient’s illness should be pursued while testing for a VHF or other high-consequence disease is underway.

keywords: laboratory testing, shipping, specimen handling, VHF

Other Hemorrhagic Fevers

African Swine Fever

World Organisation for Animal Health (OIE): African swine Fever – African swine fever (ASF) is a highly contagious haemorrhagic viral disease of domestic and wild pigs, which is responsible for serious economic and production losses. This website contains general information about transmission, clinical signs, diagnostics, and prevention.

Lassa Fever Virus

International Journal of Infectious Diseases: A challenging response to a Lassa Fever outbreak in a non-endemic area of Sierra Leone in 2019, with export of cases to the Netherlands, Njuguna C, et.al., Feb. 12, 2022 – Report of a hospital associated outbreak that resulted in three confirmed cases (health workers) and 2 probable cases (patients). The case fatality rate was 60% while the secondary attack rate was 14%. Two cases involved exportations to the Netherlands.

Měnglà

Nature: New Ebola-like virus found in a Chinese bat’s liver, Jan 7, 2019 – The Měnglà virus can infect human cells but the risk of its transmission from bats to humans is unknown.

Notes from the Field: Response to a Case of Travel-Associated Lassa Fever — Iowa, October–November 2024 (NEW 4/20, Website, Case Study)

CDC / MMWR

3 April 2025

Von Stein DL, Barger A, Hennenfent A, et al.
A fatal Lassa fever case in a patient returning from Liberia, the first U.S. case diagnosed in eight years and the ninth U.S. travel-associated case since 1969, was identified in Iowa in late 2024. Investigation identified 180 contacts. Lassa fever virus testing was performed for five symptomatic contacts; all laboratory results were negative.

State and Hospital Officials Follow Federal Guidance After Lassa Fever Death (NEW 11/11, Website)

Iowa HHS

28 October 2024

The Iowa Department of HHS has confirmed the death of a middle-aged eastern Iowa resident from Lassa fever. The individual had recently returned from travel to West Africa.

keywords: Lassa, VHF

Marburg virus disease (NEW 10/17, Website, Regulation/Guidance)

World Health Organization (WHO)

This is a reference wensite including WHO’s approach to responding to this outbreak

keywords: Marburg, outbreak, VHF

Marburg Virus Disease Outbreak in Rwanda (NEW 10/17, Website, Regulation/Guidance)

AfricaCDC

1 October 2024

This is a reference website for resources including a “Weekly Special Press Briefing on the Mpox Outbreak and other Health Emergencies in Africa”

keywords: Marburg, outbreak, VHF

Pathogenicity and virulence of Marburg virus (Website)

Virulence

1 April 2022

Abir, M, et.al.

keywords: Marburg, VHF

Marburg Virus Disease Detected in West Africa for First Time (Website)

The Scientist

10 August 2021

The finding of the Ebola-like disease, which killed a man in Guinea, has prompted public health measures.

keywords: africa, Marburg, VHF

Marburg virus disease: A summary for clinicians (Website)

International Journal of Infectious Disesase

1 October 2020

Kortepeter, M, et.al.

keywords: Marburg, VHF

Packaging, Transportation, and Shipping

VHF Clinical Specimen Packaging and Shipping (NEW 8/13, Website, Regulation/Guidance)

CDC

This guidance applies to Filoviruses, Arenaviruses, Rift Valley fever virus, Crimean Congo HFV. This guidance also applies to other high-consequence diseases that require a specialized laboratory, are highly pathogenic, and have no vaccine or treatment currently available, like Nipah virus disease.

keywords: packaging, shipping, specimen handling, VHF

Infectious Substance Special Permits (Website, Regulation/Guidance)

US DOT

keywords: ebola, permits, transportation

Peer Reviewed Articles

Isolation of Diverse Simian Arteriviruses Causing Hemorrhagic Disease (NEW 4/3, Website, Article)

CDC / Emerging Infectious Diseases

1 April 2024

Shaw TM, Dettle ST, Mejia A, Hayes JM, Simmons HA, Basu P, et al.
Genetically diverse simian arteriviruses (simarteriviruses) naturally infect geographically and phylogenetically diverse monkeys, and cross-species transmission and emergence are of considerable concern.

keywords: macaques, SHFV, Simian hemorhagic fever virus, VHF

Establishment and application of a surrogate model for human Ebola virus disease in BSL-2 laboratory (NEW 4/3, Website, Article)

Virologica Sinica

29 March 2024

Yang W, et al.

Highlights

Recombinant vesicular stomatitis virus expressing Ebola virus glycoprotein is lethal in immunocompetent Syrian hamsters.
The pathogenicity of VSV-EBOV/GP is species-specific, age-related, gender-associated, and challenge route-dependent.
Syrian hamsters develop uveitis, multi-organ failure, and severe systemic diseases resembling symptoms of human EBOV patients.
The model is available for anti-EBOV antibody and vaccine evaluation under BSL-2 conditions.

keywords: drug screening, ebola, EBOV, pathogenicity, recombinant vesicular stromatitis virus, surrogate models, syrian hamsters, vaccine evaluation, VHF

MMWR Ebola Reports (Website)

CDC/MMWR

keywords: ebola

Use of Ebola Vaccine: Expansion of Recommendations of the Advisory Committee on Immunization Practices To Include Two Additional Populations — United States, 2021 (Website)

CDC/MMWR

25 February 2022

Malenfant JH, Joyce A, Choi MJ, et al.
The ACIP has expanded the recommendation for Ebola vaccine to health care personnel at special pathogens treatment centers and laboratorians and support staff members at Laboratory Response Network facilities.

keywords: ebola, vaccines