prompt: What are the common causes of Acute haemorrhagic fever syndrome?

completion: Acute haemorrhagic fever syndromes can be caused by Ebola and Marburg viral diseases, Lassa fever, Rift Valley fever, Crimean-Congo haemorrhagic fever, dengue haemorrhagic fever, and yellow fever. Other viral, bacterial or rickettsial diseases with potential to produce epidemics can also cause this syndrome.


prompt: What is the main goal of surveillance for Acute haemorrhagic fever syndrome?

completion: The main goal is early detection of cases and outbreaks, rapid investigation, and early laboratory verification of the aetiology of all suspected cases. It also includes investigation of all suspected cases with contact tracing.


prompt: What are the symptoms of a suspected case of Acute haemorrhagic fever syndrome?

completion: A suspected case is characterized by the onset of fever and no response to treatment for usual causes of fever in the area, and at least one of the following signs: bloody diarrhea, bleeding from gums, bleeding into skin (purpura), bleeding into eyes and urine.


prompt: How is a confirmed case of Acute haemorrhagic fever syndrome defined?

completion: A confirmed case is a suspected case with laboratory confirmation or epidemiologic link to confirmed cases or outbreak.


prompt: What actions should be taken if a single case of Acute haemorrhagic fever syndrome is suspected?

completion: Immediate reporting of case-based information to the appropriate levels is required. Suspected cases should be isolated, strict barrier nursing techniques implemented, and standard precautions enhanced throughout the health care setting. The patient should be treated and managed with supportive care, and a specimen should be collected safely to confirm the case. Case-contact follow-up and active case search for additional cases should be conducted.


prompt: What actions should be taken if a single case of Acute haemorrhagic fever syndrome is confirmed?

completion: Strict VHF infection control practices should be maintained throughout the outbreak. The community should be mobilized for early detection and care, and community education about disease transmission and infection control in the home care setting and during funerals should be conducted. Case-contact follow-up and active searches for additional cases that may not come to the health care setting should be conducted. Additional help from other levels may be requested as needed, and an isolation ward should be established to handle additional cases.


prompt: How should data about a person with Acute haemorrhagic fever syndrome be analyzed and interpreted?

completion: Immediate case-based reporting of cases and deaths should be implemented. Age and sex distribution should be analyzed, risk factors assessed, and disease control interventions planned accordingly.


prompt: How should data about time in the context of Acute haemorrhagic fever syndrome be analyzed and interpreted?

completion: Cases and deaths should be graphed daily or weekly, and an epidemic curve should be constructed during the outbreak.


prompt: How should data about place in the context of Acute haemorrhagic fever syndrome be analyzed and interpreted?

completion: The locations of cases' households and work sites should be mapped.


prompt: What is the laboratory confirmation diagnostic test for Acute haemorrhagic fever syndrome?

completion: The presence of IgM antibodies against Ebola, Marburg, CCHF, Lassa or West Nile Fever or the presence of Ebola in post-mortem skin necropsy can confirm the diagnosis.


prompt: What are the laboratory confirmation specimen types for ELISA, PCR, and Immunohistochemistry in the context of Acute haemorrhagic fever syndrome?

completion: For ELISA, whole blood, serum or plasma is needed. For PCR, whole blood or blood clot, serum/plasma or tissue is required. For Immunohistochemistry, skin or tissue specimens from fatal cases are needed.


prompt: When should specimens for laboratory confirmation in the context of Acute haemorrhagic fever syndrome be collected?

completion: A specimen should be collected from the first suspected case. If there is more than one suspected case, collection should continue until specimens have been collected from 5 to10 suspected cases.


prompt: How should specimens for laboratory confirmation in the context of Acute haemorrhagic fever syndrome be prepared, stored, and transported?

completion: Specimens should be handled and transported with extreme caution. Protective clothing should be worn and barrier precautions used. For ELISA or PCR, serum or clot should be refrigerated and tissue specimens frozen. For Immunohistochemistry, a skin snip specimen should be fixed in formalin and can be stored up to 6 weeks at room temperature.


prompt: What are the results of laboratory confirmation for Acute haemorrhagic fever syndrome?

completion: Diagnostic services for VHF are not routinely available. Advance arrangements are usually required for VHF diagnostic services. The appropriate National authority or WHO should be contacted.


prompt: What are the references for Acute haemorrhagic fever syndrome?

completion: Interim Infection Control Recommendations for Care of Patients with Suspected or Confirmed Filovirus (Ebola, Marburg) Hemorrhagic Fever. BDP/EPR/WHO, Geneva March 2008.; Infection control for VHF in the African health care setting, WHO, 1998. WHO/EMC; WHO Recommended Surveillance Standards WHO/CDS/CSR/ISR/99.2; WHO recommended Guidelines for Epidemic Preparedness and Response: Ebola Haemorrhagic Fever (EHF). WO/EMC/DIS/97.7.; Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting WHO/EMC/ESR/98.2; Viral Infections of Humans; Epidemiology and Control. 1989. Evans, A.S. (ed). Plenum Medical Book Company, New York