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Common findings include fever, sweating, bradycardia, conjunctival injection, flushing of the face and trunk, hyporeflexia, tremor, shock, leukopenia, and thrombocytopenia with petechial rash. Bleeding from the nose, bladder, and gastrointestinal tract occurs in severe cases. The case fatality rate ranges from 15%-30%. The viruses are carried by wild rodents. Field workers are at increased risk if exposed to dispersed rodent feces, e.g., by harvesting machines. Outbreaks in clinics through direct contact with blood and body fluids have occurred. Person-to-person airborne transmission of Machupo virus has been reported. There is an effective vaccine for Junin (Argentinean) hemorrhagic fever. Ribavirin "is likely to be useful" to treat these infections. [CCDM, p. 26-8] Other symptoms are dizziness, hyperesthesias, epigastric pain, back pain, lethargy, and in complicated cases hemorrhagic diathesis and/or delirium, coma, and convulsions. Weakness is prominent during the prolonged recovery. [ID, p. 2136-7] Other findings are myalgias, ataxia, nausea, constipation, lymphadenopathy, and pulmonary edema and infiltrates from vascular leaks. [PPID, p. 2095; JAMA. 2002;287:2391-2404] |
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