Haemorrhagic Fever Syndrome
Description General measures Referral ICD-10 code: A98.0-5/A98.8/A99 *Notifiable medical condition. DESCRIPTION Characterised by high fever, together with disseminated intravascular coagulation (DIC) and bleeding tendency. Other symptoms and organ involvement vary according to the causative virus. Some important causes other than viral haemorrhagic fevers (VHF) are: severe bacterial infections, p
ICD-10 code: A98.0-5/A98.8/A99
*Notifiable medical condition.
DESCRIPTION
Characterised by high fever, together with disseminated intravascular coagulation (DIC) and bleeding tendency. Other symptoms and organ involvement vary according to the causative virus.
Some important causes other than viral haemorrhagic fevers (VHF) are:
- severe bacterial infections, particularly N. meningitidis,
- severe tick bite fever,
- severe falciparum malaria,
- fulminant hepatitis,
- leptospirosis, and
- other causes of DIC or bleeding tendency.
Endemic causes of VHF in South Africa are Crimean-Congo fever and Rift Valley fever, both of which may be transmitted between humans by means of blood and body fluids.
GENERAL MEASURES
- A detailed travel and clinical history is crucial.
- If VHF is suspected, isolate patient in a single room and take proper precautions to limit further exposure.
- Precautions should include:
- long sleeved disposable gown,
- vinyl or rubber apron if the patient is bleeding,
- two pairs of latex gloves, one below the gown and one over the gown,
- disposable face mask, preferably with a visor,
- goggles if a mask is used without a visor, and
- waterproof boots or 2 pairs of overshoes, one over the other.
- Exclude alternate diseases by means of appropriate laboratory testing.
- Testing for VHF may be required, both to confirm or, to exclude the possibility of VHF - this must be arranged with the NICD (see above), before sending the specimens, as specific precautions apply.
- Support patients with packed red cells and fresh frozen plasma, as required - See: Anaemia in critical care.
- Record and follow up all patient contacts.
Severe bacterial infections can mimic the features of haemorrhagic fever syndrome. Broad-spectrum antibiotics, e.g. ceftriaxone, IV, 2 g daily, are indicated in every case until the diagnosis is confirmed.
REFERRAL
- Discuss and manage all suspected VHF cases in consultation with the Regional Virologist or Infectious Diseases Consultant at the referral centre.
- Cases may also be discussed with the Special Pathogens Unit of the National Institute for Communicable Diseases (NICD):
Tel: 011 386 6000, Outbreak hotline: 082 883 9920. - Transfer of patients should only occur once all relevant arrangements have been made to limit further exposure to a potentially contagious and life-threatening virus.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2020-2024_Version 1.2_20 January 2025
Chapter 9 Systemic and Healthcare-Associated Infections_9.5 Haemorrhagic Fever Syndrome