| Brazilian hemorrhagic fever | |
| Field: | Infectious disease |
Brazilian hemorrhagic fever (BzHF) is an infectious disease caused by Brazilian mammarenavirus, an arenavirus.[1] Brazilian mammarenavirus is one of the arenaviruses from South America to cause hemorrhagic fever.[2] It shares a common progenitor with Argentinian mammarenavirus, Machupo mammarenavirus, Tacaribe mammarenavirus, and Guanarito mammarenavirus.[2] It is an enveloped RNA virus and is highly infectious and lethal.[3] Very little is known about this disease, but it is thought to be transmitted by the excreta of rodents.[1] [3] This virus has also been implicated as a means for bioterrorism, as it can be spread through aerosols.[4]
As of 2019, there had only been four documented infections of Brazilian mammarenavirus: two occurred naturally, and the other two cases occurred in the clinical setting.[5] The first naturally occurring case was in 1990, when a female agricultural engineer who was staying in the neighborhood of Jardim Sabiá in the municipality of Cotia, a suburb of São Paulo, Brazil contracted the disease (The virus is also known as "Sabiá Virus").[6] She presented with hemorrhagic fever and died.[1] Her autopsy showed liver necrosis.[1] A virologist who was studying the woman's disease contracted the virus but survived.[1] Ribavirin was not given in these first two cases.[1] Four years later, in 1994, a researcher was exposed to the virus in a level 3 biohazard facility at Yale University when a centrifuge bottle cracked, leaked, and released aerosolized virus particles.[1] [7] He was successfully treated with ribavirin.[1] [8]
A fifth case, also naturally acquired in upstate São Paulo, was reported in January 2020.[9] The patient died 12 days after the onset of symptoms.[10]
Ribavirin is thought to be effective in treating the illness, similar to other arenaviruses.[1] [8] Compared to the patients who did not receive ribavirin, the patient who was treated with it had a shorter and less severe clinical course.[1] Symptomatic control such as fluids to address dehydration and bleeding may also be required.[8]
Brazilian mammarenavirus is a biosafety Level 4 pathogen.[3]