Criteria
Centers for Disease Control and Prevention (CDC): viral hemorrhagic fever (VHF) 2025 case definition[136]
Clinical criteria
Acute onset of one or more of the following clinical findings (list of signs and symptoms is not exhaustive and may be nonspecific):
Subjective or measured fever >100.4°F (>38°C)
Headache
Muscle pain and/or joint pain
Weakness and fatigue
Cough/difficulty breathing
Pharyngitis
Loss of appetite
Chest pain
Skin rash
Red eyes
Vomiting
Diarrhea
Abdominal pain
Intractable hiccups
Encephalitis or other neurologic manifestations
Unexplained bleeding or bruising not related to injury or menstruation
Laboratory criteria
Confirmatory laboratory evidence:
Detection of VHF-specific nucleic acid in blood or other body fluids, blood products, or tissues using a diagnostic molecular test (e.g., NAAT, genome sequencing), OR
Detection of VHF-specific IgM by enzyme-linked immunosorbent assay (ELISA), OR
Detection of a fourfold rise in VHF-specific IgG titer from an acute sample to a convalescent sample, OR
VHF viral isolation in cell culture for blood, blood products (e.g., serum), or tissues.
Epidemiologic linkage
Within the incubation period of the VHF any of the following:
Contact with a person who had known or suspected VHF or any object contaminated by their body fluids without use of or confidence in proper adherence to, or experiences a breach in, recommended infection prevention and control (IPC) precautions, including personal protective equipment (PPE) use, OR
Handles specimens that contain or might contain replication competent VHF viruses without use of or confidence in proper adherence to, or experiences a breach in, recommended IPC precautions, including PPE use, OR
Handles bats, rodents, or primates that are or may be infected with a VHF without use of or confidence in proper adherence to, or experiences a breach in, recommended IPC precautions, including PPE use, OR
Exposure to body fluids (i.e., urine, saliva, sweat, vomit, breast milk, amniotic fluid, semen, aqueous humor, or cerebral spinal fluid) from a person who clinically recovered from a VHF without use of or confidence in proper adherence to, or experiences a breach in, recommended IPC precautions, including PPE use, OR
Residence in or travel to a VHF endemic area or area with active transmission AND an experience with any of the following scenarios for potentially unrecognized VHF exposures: contact with someone who was sick or died; visiting or work in a healthcare facility; breach in PPE and/or IPC precautions; visiting a traditional healer; attend or participate in funerals or burials; contact with animals; consumption of or handling raw meat; tick or mosquito bite; spent time in a mine or cave; any other scenario for previously unrecognized VHF exposure as determined in consultation with subject matter experts at CDC.
Suspect case:
Meets clinical criteria AND epidemiologic linkage evidence, OR
Meets vital records evidence.
Confirmed case:
Meets confirmatory laboratory evidence.
CDC: viral hemorrhagic fever (VHF) 2025 case definition Opens in new window
World Health Organization: case definition for Ebola or Marburg virus disease[97]
The World Health Organization (WHO) has also produced a case definition:
WHO: case definition recommendations for Ebola or Marburg virus diseases Opens in new window
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