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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