Hemorrhagic fever with renal syndrome risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Risk Factors

VHF should be suspected in febrile persons who, within 3 weeks before onset of fever, have either

• Travelled in the specific local area of a country where VHF has recently occurred
• Had direct unprotected contact with blood, other body fluids, secretions, or excretions of a person or animal with VHF or
• Had a possible exposure when working in a laboratory that handles hemorrhagic fever viruses.

The likelihood of acquiring VHF is considered low in persons who do not meet any of these criteria. Even following travel to areas where VHF has occurred, persons with fever are more likely to have infectious diseases other than VHF (e.g., common respiratory viruses, endemic infections such as malaria or typhoid fever). Clinicians should promptly evaluate and treat patients for these more common infections while awaiting confirmation of a VHF diagnosis.

In Africa, transmission of VHF in healthcare settings has been associated with reuse of contaminated needles and syringes and with provision of patient care without appropriate barrier precautions to prevent exposure to virus-containing blood and other body fluids (including vomitus, urine, and stool). The transmission risks associated with various body fluids have not been well defined because most caregivers who have acquired infection had contacts with multiple fluids.