– Are grouped under this term a dozen disease etiologies and different transmission mode with common clinical signs.
– Dengue haemorrhagic fever is a viral haemorrhagic fever which is the subject of a specific chapter.
Clinical signs:
– Joint Syndrome:
• fever higher than 38.5 ° C
• short remission J3-J4
• hemorrhagic signs (purpura, epistaxis, melena, hematemesis)
– Clinical signs are often non-specific, their severity varies by etiology.
– Send a sample of whole blood for serological diagnostic reference laboratory (eg Institut Pasteur). Attach a clinical description.
– Protection during removal (gloves, glasses, etc.).
– Use a triple transport packaging: wrap a tube paper towel with the blood sample and place it in a primary container, rigid and sealed (package 1). The absorbent paper should be sufficient to absorb all the blood collected if a tube should break. then place the container in a rigid primary and secondary sealed container suitable for transporting infectious substances (package 2). then place the secondary container in a rigid cardboard packaging bearing the biohazard label (package 3).
– The filter paper may be used. It is easier to carry but the small volume of blood is used to test a limited number of causes.
To behave:
Suspected haemorrhagic fever (isolated cases of fever with haemorrhagic signs in endemic areas):
– Isolation: isolated room (or failing screens / partitions); restrict visits (ensure their protection: overalls, gloves, mask).
– Standard hygiene precautions:
The basic rules of hospital hygiene must in all cases be respected. Most cases of intra-hospital infections have occurred due to the non
Following these simple rules.
• gloves for blood samples
• coats during consultations and care
• household gloves for handling soiled laundry
• hand washing
• Safety procedures injections
– Completing these non-specific measures by wearing masks and gloves when examining the patient, and goggles if splashing.
Confirmed cases of Ebola, Marburg, Lassa, Crimean-Congo or epidemic of unknown etiology:
– Specific measures:
• strict confinement in a reserved area, with input / output sas,
• disinfection of excreta (2% available chlorine) and safe disposal,
• disinfection of soiled linen by chlorination (0.1% chlorine)
• protective clothing for staff: double gloves, mask, cap, goggles, double gown, apron, rubber boots,
• input / output circuit: clean laundry for the staff at the entrance; disinfection area exit: overalls, boots and rubber gloves are soaked in chlorine solution (0.1% chlorine) 2 hours before washing. Container for disposable material.Handwashing with soap.
– The accompanying (1 maximum), assisted and supervised by staff, following the same steps.
– In case of death, do not wash the body. If cultural imperative: protective clothing, chlorinated water wash (2% available chlorine), small number of people.
Burial as soon as possible, in a body bag if possible.
– Port of protective gear when handling soiled equipment. No contaminated material may leave the isolation area which includes an incinerator pit at sharp / sharp objects and organic waste pit.
Confirmed cases of yellow fever or fever, Rift Valley:
– Universal hygiene measures.
– Place the patient under mosquito net to prevent transmission.
In all cases: declare the country’s health authorities.
Treatment:
– Etiological treatment: only for Lassa and Crimean-Congo (ribavirin).
– Symptomatic treatment :
• Fever: paracetamol. Acetylsalicylic acid (aspirin) is cons-indicated.
• pains: lightweight (paracetamol), moderate (tramadol), severe (sublingual morphine): see pain.
• Dehydration: follow plans for the prevention or treatment of dehydration, WHO.
• hemorrhagic shock.
• convulsions.
• Vomiting: promethazine PO
Children 2 to 10 years: 10 to 25 mg to be repeated every 6 hours if necessary
Children over 10 years and adults: 25 mg to be repeated every 6 hours if necessary
– For Ebola and Marburg injections of information must be strictly limited.
The establishment and maintenance of venous catheters pose a risk of contamination to personnel. Any intravenously must be completely secured to the patient, often confused, can not pull it out.
Prevention:
– Vaccination
• Yellow fever: mass vaccination for epidemic
Children from the age of 6 months and adults: a single dose of 0.5 ml IM or deep SC preferably in the deltoid muscle.In pregnant women, do not give in case of epidemic. Routine Immunization (EPI)
• Fever, Rift Valley (only in epidemics)
– Fight against vectors when they are known.
– Hospital hygiene essential in all cases.