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1/4. Venezuelan haemorrhagic fever.

    An outbreak of severe haemorrhagic illness began in the municipality of Guanarito, Portuguesa State, venezuela, in September, 1989. Subsequent detailed study of 15 cases confirmed the presence of a new viral disease, designated Venezuelan haemorrhagic fever. Characteristic features are fever, toxicity, headache, arthralgia, diarrhoea, conjunctivitis, pharyngitis, leucopenia, thrombocytopenia, and haemorrhagic manifestations. Other features include facial oedema, cervical lymphadenopathy, nausea/vomiting, cough, chest or abdominal pain, and convulsions. The patients ranged in age from 6 to 54 years; all were residents of rural areas in central venezuela, and 9 died. infection with Guanarito virus, a newly recognised arenavirus, was shown by direct culture or by serological confirmation in all cases. Epidemiological studies suggest that the disease is endemic in some rural areas of central venezuela and that it is rodent-borne. Venezuelan haemorrhagic fever has many similarities to lassa fever and to the arenavirus haemorrhagic fevers that occur in argentina and bolivia. ( info)

2/4. New arenavirus isolated in brazil.

    A new arenavirus, called Sabia, was isolated in brazil from a fatal case of haemorrhagic fever initially thought to be yellow fever. Antigenic and molecular characterisation indicated that Sabia virus is a new member of the Tacaribe complex. A laboratory technician working with the agent was also infected and developed a prolonged, non-fatal influenza-like illness. Sabia virus is yet another arenavirus causing human disease in south america. ( info)

3/4. Sabia virus incident at Yale University.

    An incident involving a human exposure to a newly isolated arenavirus, Sabia virus, in the Yale Arbovirus research Unit occurred at Yale University on August 8, 1994. A senior-level visiting research scientist was exposed to Sabia virus while purifying the virus from a large volume of tissue culture fluid. The exposure resulted in development of a Sabia virus infection followed by recovery of the patient. The incident resulted in a comprehensive review by a Yale faculty committee and an external expert committee. As a result, a number of new practices and procedures were added to Yale's biosafety policy for investigating infectious agents in BL-3 facilities. ( info)

4/4. Treatment of Bolivian hemorrhagic fever with intravenous ribavirin.

    Bolivian hemorrhagic fever (BHF) is a potentially severe febrile illness caused by Machupo virus (family arenaviridae). Initial symptoms include headache, fever, arthralgia, and myalgia. In the later stages of this illness, patients may develop hemorrhagic manifestations including subconjunctival hemorrhage, epistaxis, hematemesis, melena, and hematuria, as well as neurological signs including tremor, seizures, and coma. During the BHF epidemics of the 1960s, convalescent-phase immune plasma from survivors of BHF was administered to selected patients infected with Machupo virus. However, there is currently a paucity of survivors of BHF who can donate immune plasma, and there is no active program for collection and storage of BHF immune plasma; therefore, we had the opportunity to offer intravenous ribavirin to two of three patients with this potentially life-threatening infection. One patient with laboratory-confirmed Machupo virus infection who received ribavirin recovered without sequelae, as did a second patient with suspected BHF whose epidemiological and clinical features were similar to those of the first patient. This report describes the first use of intravenous ribavirin therapy for BHF in humans, and the results suggest the need for more extensive clinical studies to assess the usefulness of ribavirin for treating BHF. ( info)

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