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TABLE 4.13
Viruses That Cause Hemorrhagic Fevers in Humans
Geographic
Vector
%Case
Treatment
a
mortalityb
Virus
Disease
range
transmission
(prevention)
Arenaviridae
Junin
Argentine HF
Argentine pampas
Infected field rodents,
Antibody effective, ribavirin
Calomys musculinus
probably effective; preventive
vaccine exists
Machupo
Bolivian HF
Beni province,
Infected field rodents,
15­30
Ribavirin probably effective
Bolivia
Calomys callosus
No data for humans, ribavirin
probably effective
Guanarito
Venezuelan HF
Venezuela
Infected field rodents,
Zygodontomys brevicauda
Intravenous ribavirin effective
in one case
Sabiá
HF
Rural areas near
Unidentified infected rodents
Salo, Brazil
Lassa
Lassa fever
West Africa
Infected Mastomys rodents
15
Ribavirin effective
Bunyaviridae
Rift Valley
Rift Valley fever
Sub-Saharan Africa
Aedes mosquito
50
Rapid course; ribavirin or
fever
antibody might be effective
Crimean-
Crimean-Congo
Africa, Middle East,
Tick-borne
15­30
Ribavirin used and probably
Congo HF
HF
Balkans, Russia,
effective
W. China
Variablec
Ribavirin useful; supportive
Hantaan, Seoul, HFRS
Worldwide
Each virus maintained in
Puumala,
(See Fig. 4.25)
a single species
therapy is mainstay
and others
of infected rodents
Sin Nombre
HPS, also
Americas
As for viruses causing
40­50
Rapid course makes specific
and others
rare HF
(See Fig. 4.26)
HFRS
therapy difficult
Filoviridae
Marburg
Filovirus HF
Africa
Unknown
Marburg 25
No effective therapy, barrier
Ebola
EbolaZ 30­90
nursing prevents spread in
epidemics
Flaviviridae
Yellow fever
Yellow fever
Africa,
Aedes mosquito
20
Very effective vaccine
South America
Dengue
DHF, DSS
Tropics and
Aedes mosquito
<1
Supportive therapy useful; vector
subtropics worldwide
control
Kyasanur forest KFD
Mysore State, India
Tick-borne
0.5­ 9
???
disease
Omsk
OHF
Western Siberia
Poorly understood
?
Needs further study
hemorrhagic
cycle involves ticks,
fever
voles, muskrats??
a
Abbreviations: HF, hemorrhagic fever; HFRS, hemorrhagic fever with renal syndrome; HPS, hantavirus pulmonary syndrome; DHF, dengue hemorrhagic
fever; DSS, dengue shock syndrome; KFD, Kyasanur Forest disease; OHF, Omsk hemorrhagic fever.
b
In humans.
c
Hantaan is 5­15% fatal, while Puumala is <1% fatal.
Source: This table includes data from Nathanson et al. (1996) Table 32.1 on p. 780.
promise for arenavirus disease. Human-to-human transmis-
EVOLUTION OF MINUS-STRAND RNA VIRUSES
sion is uncommon. Where limited transmission has occurred,
it has been by exposure to contaminated blood, or possibly
As has been described, all (-)RNA viruses share a
exposure to other bodily fluids, and resulted in limited epi-
number of features. These include virion structure (envel-
demics for such viruses as Ebola and Machupo virus.
oped viruses with helical nucleocapsids); mechanisms for
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