Brazilian hemorrhagic fever is caused by the Sabiá virus, which is the most recently discovered of the five arenaviruses from South America [1]. The reservoir and mode of transmission of Sabiá virus are not fully understood although wild rodents are known as the source of the other arenaviruses [2]. There have been only three reported cases of this disease. The first documented case occurred in 1990 in São Paulo, Brazil, when the virus was isolated from an agricultural engineer [3]. The other two cases resulted from laboratory accidents.

Although there are only a few cases of Brazilian hemorrhagic fever, it is clear that it shares similar presentations to other South American hemorrhagic fever illnesses, in which the onset is insidious and evolves gradually [4] following a two week incubation period [5].

The first patient, who had an unremarkable history, presented with a 12-day duration of fever, myalgia, weakness, headache, nausea, and emesis [3]. The diseases progressed over the next several days as she developed conjunctival petechia, hematemesis, and vaginal bleeding as well as seizures, tremors, difficulty walking which was followed by coma, shock, and death.

The second patient was a laboratory technician in Brazil who probably acquired the virus through aerosol [6]. He manifested with a fever, malaise, nausea, emesis, headache, myalgia, sore throat, and gingival bleeding [3]. The patient recovered after therapy.

The final case occurred at Yale University in 1994 through aerosol after accidental exposure [7]. This patient reported a fever, headache, myalgia and a nuchal stiffness [2]. Like the second patient, this individual recovered following appropriate treatment [2].

Complications

South American hemorrhagic fevers typically have multi-organ involvement [8]. Patients are likely to develop hepatitis [3], pleural effusion, and neurologic sequelae such as seizures and encephalopathy [9]. Hemorrhage is followed by dehydration, hypotension, shock, coma and possibly death [8] [9].

Physical exam

Patients are likely to have orthostatic hypotension and other abnormal vital signs. Overall, they appear ill and exhibit an altered mental status and signs of dehydration [3]. Generally, individuals with South American hemorrhagic fever will have flushing, lymphadenopathy, conjunctival injection, petechia, and palatal enanthem of a vesicular appearance. Facial and neck swelling are also common [9].

• Fever

  This patient reported a fever, headache, myalgia and a nuchal stiffness. Like the second patient, this individual recovered following appropriate treatment. Complications South American hemorrhagic fevers typically have multi-organ involvement. [symptoma.com]

  Infections and conditions requiring containment care during transport Arenavirus infection Argentine hemorrhagic fever (Junin virus) Bolivian hemorrhagic fever (Machupo virus) Brazilian hemorrhagic fever (Sabia virus) Lassa fever Venezuelan hemorrhagic [medical-dictionary.thefreedictionary.com]

  Urdu Translation English Translation for brazilian hemorrhagic fever brazilian hemorrhagic fever برازیل کے باشندے ادار خون بخار Multiple Word Search Search Result for brazilian hemorrhagic fever brazilian hemorrhagic fever All in One Brazilian hemorrhagic [ijunoon.com]

  MalaCards based summary : Brazilian Hemorrhagic Fever, is also known as sabia hemorrhagic fever. Affiliated tissues include skin and eye. [malacards.org]

  Entry H01544 Disease Name Brazilian hemorrhagic fever Supergrp South American hemorrhagic fever [DS: H00385 ] Arenaviral hemorrhagic fever [DS: H02173 ] Description Brazilian hemorrhagic fever is an infectious disease caused by Sabia virus (SABV), a New [genome.jp]

• Weakness

  Transmission: Carried by rodents Contracted through contact with or inhalation of rodent excretion Human-to-human transmission through contact with bodily fluids Symptoms: Fever Eye redness Fatigue Dizziness Muscle aches Weakness Severe Symptoms Bleeding [sites.google.com]

  The first patient, who had an unremarkable history, presented with a 12-day duration of fever, myalgia, weakness, headache, nausea, and emesis. [symptoma.com]

  In the end, all that remained was some minor weakness — and three other subtypes of virus to catch. Vanessa Barbara is a columnist for the Brazilian newspaper O Estado de São Paulo and the editor of the literary website A Hortaliça. [nytimes.com]

  Fever, headache, myalgia, nausea, vomiting, weakness, and pronounced sore throat were symptoms exhibited in all cases of Sabia infection. Additional symptoms include conjunctivitis, diarrhea, epigastric pain, and bleeding gums. [stanford.edu]

• Laboratory Technician

  The second patient was a laboratory technician in Brazil who probably acquired the virus through aerosol. He manifested with a fever, malaise, nausea, emesis, headache, myalgia, sore throat, and gingival bleeding. [symptoma.com]

  However, symptoms ceased in the index case due to death, while the laboratory technician convalesced following this time period. [stanford.edu]

  The virus was subsequently characterized as a new member of the Tacaribe complex of the family Arenaviridae. 2 A laboratory technician in Brazil who was involved in the characterization of the agent was also infected and had a severe nonfatal illness. [doi.org]

• High Fever

  Signs and symptoms of CCHF Initial signs include headache, high fever, back pain, joint pain, stomach pain, and vomiting. Red eyes, a flushed face, a red throat, and red spots on the roof of the mouth are also common. [express.co.uk]

  Symptoms of dengue fever include high fever, severe headache, backache, joint pains and eye pain, nausea, vomiting and a rash, according to the CDC. There is no vaccine to prevent dengue fever or dengue hemorrhagic fever, the CDC said. [cnn.com]

  While most victims recover at this point, approximately 15% to 20% advance to a second stage where symptoms intensify into high fever, hemorrhagic tissue damage, and liver failure. [invisiverse.wonderhowto.com]

• Acutely Ill Patient

  Since a number of nosocomial outbreaks have been described among hospital personnel attending acutely ill patients with arenavirus infections, a high level of precaution was instituted at our hospital, as recommended by the CDC. 3 Although extensive experience [doi.org]

• Pleural Effusion

  Patients are likely to develop hepatitis, pleural effusion, and neurologic sequelae such as seizures and encephalopathy. Hemorrhage is followed by dehydration, hypotension, shock, coma and possibly death. [symptoma.com]

  We did not consider ascites, pleural effusion, as these were very rarely recorded in the SINAN at the time. [journals.plos.org]

  […] or abdominal effusion or hypoalbuminemia). [jid.oxfordjournals.org]

• Severe Clinical Course

  Compared to the patients who did not receive ribavirin, the patient who was treated with it had a shorter and less severe clinical course. [en.wikipedia.org]

• Nausea

  The first patient, who had an unremarkable history, presented with a 12-day duration of fever, myalgia, weakness, headache, nausea, and emesis. [symptoma.com]

  Fever, headache, myalgia, nausea, vomiting, weakness, and pronounced sore throat were symptoms exhibited in all cases of Sabia infection. Additional symptoms include conjunctivitis, diarrhea, epigastric pain, and bleeding gums. [stanford.edu]

  Symptoms of dengue fever include high fever, severe headache, backache, joint pains and eye pain, nausea, vomiting and a rash, according to the CDC. There is no vaccine to prevent dengue fever or dengue hemorrhagic fever, the CDC said. [cnn.com]

  Within 3 to 6 days of being bitten by an infected mosquito, symptoms such as fever, headache, muscle aches, nausea, and vomiting can present and last for as long as 3 to 4 days. [contagionlive.com]

• Vomiting

  Fever, headache, myalgia, nausea, vomiting, weakness, and pronounced sore throat were symptoms exhibited in all cases of Sabia infection. Additional symptoms include conjunctivitis, diarrhea, epigastric pain, and bleeding gums. [stanford.edu]

  Signs and symptoms of CCHF Initial signs include headache, high fever, back pain, joint pain, stomach pain, and vomiting. Red eyes, a flushed face, a red throat, and red spots on the roof of the mouth are also common. [express.co.uk]

  Symptoms of dengue fever include high fever, severe headache, backache, joint pains and eye pain, nausea, vomiting and a rash, according to the CDC. There is no vaccine to prevent dengue fever or dengue hemorrhagic fever, the CDC said. [cnn.com]

  Within 3 to 6 days of being bitten by an infected mosquito, symptoms such as fever, headache, muscle aches, nausea, and vomiting can present and last for as long as 3 to 4 days. [contagionlive.com]

• Hematemesis

  The diseases progressed over the next several days as she developed conjunctival petechia, hematemesis, and vaginal bleeding as well as seizures, tremors, difficulty walking which was followed by coma, shock, and death. [symptoma.com]

  Ecchymoses often are accompanied by hemorrhage in other locations: epistaxis, puncture sites, hematemesis, melena, and hematuria. Image provided by Robert Swaneopoel, PhD, DTVM, MRCVS, National Institute of Virology, Sandringham, South Africa. [emedicine.medscape.com]

• Abdominal Pain

  Data on age, sex, previous dengue episodes, and key warning signs of illness (e.g., hypotension, intense abdominal pain, and significant bleeding) were recorded. [jid.oxfordjournals.org]

• Bleeding Gums

  Additional symptoms include conjunctivitis, diarrhea, epigastric pain, and bleeding gums. In both cases that occurred in 1990, symptoms lasted approximately 15 days. [stanford.edu]

• Hypotension

  Hemorrhage is followed by dehydration, hypotension, shock, coma and possibly death. Physical exam Patients are likely to have orthostatic hypotension and other abnormal vital signs. [symptoma.com]

  These highly infectious viruses lead to a potentially lethal disease syndrome characterized by fever, malaise, vomiting, mucosal and gastrointestinal (GI) bleeding, edema, and hypotension. [emedicine.medscape.com]

  Data on age, sex, previous dengue episodes, and key warning signs of illness (e.g., hypotension, intense abdominal pain, and significant bleeding) were recorded. [jid.oxfordjournals.org]

  These cytokines are known to have a fundamental role in one of the main phenomena responsible for the clinical manifestations of DHF, the third space fluid shift [23], which is a consequence of endothelial dysfunction and results in hemoconcentration, hypotension [journals.plos.org]

• Orthostatic Hypotension

  Hemorrhage is followed by dehydration, hypotension, shock, coma and possibly death. Physical exam Patients are likely to have orthostatic hypotension and other abnormal vital signs. [symptoma.com]

• Flushing

  Generally, individuals with South American hemorrhagic fever will have flushing, lymphadenopathy, conjunctival injection, petechia, and palatal enanthem of a vesicular appearance. Facial and neck swelling are also common. [symptoma.com]

  Red eyes, a flushed face, a red throat, and red spots on the roof of the mouth are also common. Symptoms may also include jaundice, and in severe cases, changes in mood and sensory perception. [express.co.uk]

• Petechiae

  The diseases progressed over the next several days as she developed conjunctival petechia, hematemesis, and vaginal bleeding as well as seizures, tremors, difficulty walking which was followed by coma, shock, and death. [symptoma.com]

  The image below depicts palatal petechiae and hemorrhage in a patient with Ebola virus disease (EVD). Filovirus disease - Ebola fever. Patient with Ebola hemorrhagic fever during 1976 outbreak in Zaire demonstrating palatal petechiae and hemorrhage. [emedicine.medscape.com]

• Conjunctival Injection

  Generally, individuals with South American hemorrhagic fever will have flushing, lymphadenopathy, conjunctival injection, petechia, and palatal enanthem of a vesicular appearance. Facial and neck swelling are also common. [symptoma.com]

  The only remarkable features were mild conjunctival injection and shotty cervical nodes in the anterior chain. [doi.org]

• Conjunctival Petechiae

  The diseases progressed over the next several days as she developed conjunctival petechia, hematemesis, and vaginal bleeding as well as seizures, tremors, difficulty walking which was followed by coma, shock, and death. [symptoma.com]

• Myalgia

  The first patient, who had an unremarkable history, presented with a 12-day duration of fever, myalgia, weakness, headache, nausea, and emesis. [symptoma.com]

  Fever, headache, myalgia, nausea, vomiting, weakness, and pronounced sore throat were symptoms exhibited in all cases of Sabia infection. Additional symptoms include conjunctivitis, diarrhea, epigastric pain, and bleeding gums. [stanford.edu]

  Case Presentation and Clinical Course On August 16, 1994, the virologist noted myalgias, a mild headache, a stiff neck, and fever while driving home to New Haven, Connecticut, after a weekend visit to Boston. [doi.org]

  […] which is very similar to the WHO [14] : (i) fever and positive serology for anti dengue virus IgM and/or viral isolation and characterization by cell culture or RT-PCR (ii) at least two signs or symptoms of dengue fever (headache or retroorbital pain, myalgia [journals.plos.org]

• Epistaxis

  Ecchymoses often are accompanied by hemorrhage in other locations: epistaxis, puncture sites, hematemesis, melena, and hematuria. Image provided by Robert Swaneopoel, PhD, DTVM, MRCVS, National Institute of Virology, Sandringham, South Africa. [emedicine.medscape.com]

• Neck Swelling

  Facial and neck swelling are also common. Patients presenting with the above symptoms should be evaluated with a full personal and travel history, physical exam, and the appropriate studies. [symptoma.com]

• Vaginal Bleeding

  The diseases progressed over the next several days as she developed conjunctival petechia, hematemesis, and vaginal bleeding as well as seizures, tremors, difficulty walking which was followed by coma, shock, and death. [symptoma.com]

• Headache

  The first patient, who had an unremarkable history, presented with a 12-day duration of fever, myalgia, weakness, headache, nausea, and emesis. [symptoma.com]

  I was exhausted and had an annoying headache. But no sore throat, no cough and no viscous substances running through my nose. So I reached Dr. [nytimes.com]

  Fever, headache, myalgia, nausea, vomiting, weakness, and pronounced sore throat were symptoms exhibited in all cases of Sabia infection. Additional symptoms include conjunctivitis, diarrhea, epigastric pain, and bleeding gums. [stanford.edu]

  Signs and symptoms of CCHF Initial signs include headache, high fever, back pain, joint pain, stomach pain, and vomiting. Red eyes, a flushed face, a red throat, and red spots on the roof of the mouth are also common. [express.co.uk]

  Symptoms of dengue fever include high fever, severe headache, backache, joint pains and eye pain, nausea, vomiting and a rash, according to the CDC. There is no vaccine to prevent dengue fever or dengue hemorrhagic fever, the CDC said. [cnn.com]

• Seizure

  Patients are likely to develop hepatitis, pleural effusion, and neurologic sequelae such as seizures and encephalopathy. Hemorrhage is followed by dehydration, hypotension, shock, coma and possibly death. [symptoma.com]

  Human-to-human transmission through contact with bodily fluids Symptoms: Fever Eye redness Fatigue Dizziness Muscle aches Weakness Severe Symptoms Bleeding under the skin, internal organs, or from body orifices Shock Nervous system malfunction Coma Delirium Seizures [sites.google.com]

  Severely ill patients show shock, nervous system malfunction, coma, delirium, and seizures. [1] The Sabiá virus can be acquired through inhalation, ingestion, the eyes, and contact with urine, saliva, blood, or feces of rodents. [1] The Sabiá virus is [wikidoc.org]

• Tremor

  The diseases progressed over the next several days as she developed conjunctival petechia, hematemesis, and vaginal bleeding as well as seizures, tremors, difficulty walking which was followed by coma, shock, and death. [symptoma.com]

• Neurologic Manifestation

  It is characterized by a gradual and progressive illness consisting of constitutional symptoms, hemorrhage, neurologic manifestations, etc. Complications include shock, coma, and death. [symptoma.com]

• Encephalopathy

  Patients are likely to develop hepatitis, pleural effusion, and neurologic sequelae such as seizures and encephalopathy. Hemorrhage is followed by dehydration, hypotension, shock, coma and possibly death. [symptoma.com]

Patients presenting with the above symptoms should be evaluated with a full personal and travel history, physical exam, and the appropriate studies. Urgent assessment and prompt initiation of therapy can prevent complications and death.

Laboratory tests

A complete blood count (CBC) and complete metabolic panel (CMP) including liver function tests (LFTs) are essential studies. Likely findings include leukopenia, thrombocytopenia, and possibly LFT abnormalities [3] [10].

Diagnostic studies

Viral detection techniques include reverse transcription-polymerase chain reaction (RT-PCR), virus isolation from blood or tissue samples, and antigen-capture enzyme-linked immunoabsorbent assay (ELISA) [11]. The latter may be the earliest diagnostic method.

Additionally, serological tests can be performed as well. For example, antibodies to arenaviruses may be measured through IgG-ELISA and IgM-ELISA. Other techniques include indirect immunofluorescence assay (IFA) or virus neutralization assay [11]. Of note, antibodies in patients with South American hemorrhagic fevers appear during the third week of the disease.

• Leukopenia

  Likely findings include leukopenia, thrombocytopenia, and possibly LFT abnormalities. [symptoma.com]

  His severe leukopenia and thrombocytopenia rapidly improved, and no further virus was detected in his blood by culture after treatment was initiated. [doi.org]

• Pleural Effusion

  Patients are likely to develop hepatitis, pleural effusion, and neurologic sequelae such as seizures and encephalopathy. Hemorrhage is followed by dehydration, hypotension, shock, coma and possibly death. [symptoma.com]

  We did not consider ascites, pleural effusion, as these were very rarely recorded in the SINAN at the time. [journals.plos.org]

  […] or abdominal effusion or hypoalbuminemia). [jid.oxfordjournals.org]

Seek medical attention immediately Supportive Treatment Quarantine Incubation Period: 7 - 16 days' Useful Links: [sites.google.com]

[…] of Malaria, and Diagnosis and Treatment of Sexually Transmitted Diseases. [books.google.de]

Treatment: Like other arenaviruses, Sabia virus proved to be responsive to treatment with ribavirin. In confirmed cases of Sabia infection, ribavirin is unquestionably the most appropriate treatment. [stanford.edu]

Current treatments are expensive and only partially effective. [hhmi.org]

We describe the epidemiology of dengue in Brazil, characterizing the changing patterns of it and DHF during the last 20 years. [ncbi.nlm.nih.gov]

A new epidemiological update released by PAHO on July 10, 2017, details the yellow fever situation in Brazil, Colombia, Ecuador, Peru, and the Plurinational State of Bolivia from epidemiological week 1 to 26 of 2017. [contagionlive.com]

Pages 43-53 Epidemiological Surveillance of Viral Hemorrhagic Fevers With Emphasis on Clinical Virology Montoya-Ruiz, Carolina (et al.) Pages 55-78 Diagnostics for Lassa Fever: Detecting Host Antibody Responses Salvato, Maria S. (et al.) Pages 79-88 [springer.com]

These data indicate a shift from mild illness toward a more severe clinical manifestation that could be interpreted as an epidemiologic transition pattern. [jid.oxfordjournals.org]

Epidemiology and History: Only one known case of naturally contracted Sabia virus infection has been documented, yet the virus remains important due to at least two laboratory infections that have occurred. [stanford.edu]

Finally, cross immunologic pathophysiologic studies based on the associations between diabetes, allergy and high socioeconomic status and DHF, are urgently needed to investigate the intricate mechanism controlling severe forms of dengue. [journals.plos.org]

Clear, step-by-step instructions make it easy for you to perform safety procedures and use the supplies and equipment needed to prevent the spread of infectious disease. [books.google.de]

There is no vaccine to prevent dengue fever or dengue hemorrhagic fever, the CDC said. E-mail to a friend All About Brazil • Rio de Janeiro • Centers for Disease Control and Prevention [cnn.com]

[…] transmission through contact with bodily fluids Symptoms: Fever Eye redness Fatigue Dizziness Muscle aches Weakness Severe Symptoms Bleeding under the skin, internal organs, or from body orifices Shock Nervous system malfunction Coma Delirium Seizures Prevention [sites.google.com]

Recommended vaccines The following vaccinations are recommended for your protection and to prevent the spread of infectious diseases. [iamat.org]

Preventable Through Better Sanitation Disease prevention efforts include controlling rodent populations (discouraging rodents from entering or living in homes or workplaces, encouraging safe cleanup of rodent nests and droppings) and arthropod vectors [novaccine.com]

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