Venezuelan hemorrhagic fever
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Venezuelan hemorrhagic fever (VHF) is a
zoonotic A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite or prion) that has jumped from a non-human (usually a vertebrate) to a human. ...
human illness first identified in 1989. The disease is most prevalent in several rural areas of central Venezuela and is caused by ''Guanarito mammarenavirus'' (GTOV) which belongs to the Arenaviridae family. The short-tailed cane mouse (''
Zygodontomys brevicauda ''Zygodontomys brevicauda'', also known as the short-tailed zygodont, short-tailed cane mouse, or common cane mouse, is a species of rodent in the genus ''Zygodontomys'' of tribe Oryzomyini. Distribution It occurs from Costa Rica via Panama, C ...
'') is the main host for GTOV which is spread mostly by inhalation of aerosolized droplets of saliva, respiratory secretions, urine, or blood from infected rodents. Person-to-person spread is possible, but uncommon.


Presentation

VHF has many similarities to
Lassa fever Lassa fever, also known as Lassa hemorrhagic fever (LHF), is a type of viral hemorrhagic fever caused by the Lassa virus. Many of those infected by the virus do not develop symptoms. When symptoms occur they typically include fever, weakness, ...
and to the arenavirus hemorrhagic fevers that occur in Argentina and Bolivia. It causes fever and malaise followed by hemorrhagic manifestations and convulsions. Some presentations of the virus are also characterized by vascular damage, bleeding diathesis, fever, and multiple organ involvement. Clinical diagnosis of VHF has proven to be difficult based on the
nonspecific symptom Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showi ...
s. The disease is fatal in 30% of cases and is endemic to Portuguesa state and Barinas state in
Venezuela Venezuela (; ), officially the Bolivarian Republic of Venezuela ( es, link=no, República Bolivariana de Venezuela), is a country on the northern coast of South America, consisting of a continental landmass and many islands and islets in th ...
. Treatment and prevention for the VHF virus are limited and there are currently no licensed vaccines available that can act to prevent the disease. However, once infected,
ribavirin Ribavirin, also known as tribavirin, is an antiviral medication used to treat RSV infection, hepatitis C and some viral hemorrhagic fevers. For hepatitis C, it is used in combination with other medications such as simeprevir, sofosbuvir, pe ...
, an anti-viral drug given intravenously, is one way to treat VHF.


Virus

Arenaviruses are enveloped, single-stranded, bisegmented RNA viruses with
antisense In molecular biology and genetics, the sense of a nucleic acid molecule, particularly of a strand of DNA or RNA, refers to the nature of the roles of the strand and its complement in specifying a sequence of amino acids. Depending on the context ...
genomes. Based on their antigenic properties, arenaviruses have been classified into two major groups: the Old World arenaviruses, and the New World arenaviruses. Old World arenaviruses include lymphocytic choriomeningitis virus and
Lassa virus ''Lassa mammarenavirus'' (LASV) is an arenavirus that causes Lassa hemorrhagic fever, a type of viral hemorrhagic fever (VHF), in humans and other primates. ''Lassa mammarenavirus'' is an emerging virus and a select agent, requiring Biosafet ...
. New world arena viruses are further broken down into three clades, A, B, and C. The Guanarito arena virus belongs to clade B and is the cause of VHF. On the biosafety level scale of one to four, with four causing the most risk, the viruses causing hemorrhagic fevers have been assigned a four by the CDC.


Host

The short-tailed cane mouse, the main host of GTOV, is native to western Venezuela and resides in large numbers in tall grass, cultivated agricultural fields, human homes, and outbuildings. It is speculated that demographic and ecological changes in the rural areas increased the frequency of contact between humans and infected rodents such that VHF emerged.


History

From September 1989 through December 2006, the State of Portuguesa recorded 618 cases of VHF. Nearly all of the cases were individuals who worked or lived in Guanarito during the time they became infected. The case fatality rate was 23.1%. Because the virus is contracted by aerosol dissemination, concern arose shortly after the first cases emerged in 1989 due to fear of
biological warfare Biological warfare, also known as germ warfare, is the use of biological toxins or infectious agents such as bacteria, viruses, insects, and fungi with the intent to kill, harm or incapacitate humans, animals or plants as an act of war. ...
. Potential biological terrorism agents were identified and categorized in 1999 by the
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georg ...
(CDC) as part of the Congressional initiative to further response capabilities to biological weapons.Hruby, D.E., Bolken, T.C., & Dai, D. (2011)
U.S. Patent No. 7,872,037
Corvallis, OR: Siga Technologies, Inc.
Arenaviruses causing
hemorrhagic fevers Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vagi ...
, along with a genus of virus called filoviruses, were categorized in Category A; these are pathogens with the highest potential impact on public health safety. A notable event in the timeline of this virus' scientific knowledge was the unexplained disappearance of a vial of the virus at the University of Texas Medical Branch Galveston National Laboratory, announced 2013 March 24.


References


External links

{{Taxonbar, from1=Q24719641, from2=Q16682764, from3=Q3067401 Animal viral diseases Hemorrhagic fevers Rodent-carried diseases