Viral hemorrhagic fevers: Current status of endemic disease and strategies for control

Hemorrhagic fever viruses are ubiquitous in nature and largely live as commensal organisms in rodent and arthropod hosts. Their clinical presentations overlap with other viral illnesses and serious bacterial infections, complicating diagnosis. Their potential for weaponized aerosol spread, person-to-person transmission in select species, a high case-fatality rate, and the relative lack of effective prophylaxis and treatment make these viruses attractive agents for bioterrorism. A vigorous public health program should include plans for large-scale triage and selective quarantine; regional coordination of emergency responses and use of inpatient resources; and education in effective infection control practices for both health care providers and the public at large.