Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to page options Skip directly to site content

Viral Hemorrhagic Fever (VHF)
2010 Case Definition

CSTE Position Statement(s)

  • 09-ID-18


  • Crimean-Congo hemorrhagic fever virus
  • Ebola virus
  • Lassa virus
  • Marburg virus
  • New World arenavirus – Guanarito virus
  • New World arenavirus – Junin virus
  • New World arenavirus – Machupo virus
  • New World arenavirus – Sabia virus


New world Arenaviruses include: Guanarito, Machupo, Junin, and Sabia.

Clinical Description

A person with acute onset with ALL the following clinical findings:

  • A fever >40°C, AND
  • One or more of the following clinical findings:
    • Severe headache
    • Muscle pain
    • Erythematous maculopapular rash on the trunk with fine desquamation 3–4 days after rash onset
    • Vomiting
    • Diarrhea
    • Pharyngitis (arenavirus only)
    • Abdominal pain
    • Bleeding not related to injury
    • Retrosternal chest pain (arenavirus only)
    • Proteinuria (arenavirus only)

Laboratory Criteria for Diagnosis

One or more of the following laboratory findings:

  • Detection of viral hemorrhagic fever (VHF) viral antigens in blood by enzyme-linked immunosorbent assay (ELISA) antigen detection
  • VHF viral isolation in cell culture for blood or tissues
  • Detection of VHF viral genes using reverse transcriptase with polymerase chain reaction amplification (RT-PCR) from blood or tissues
  • Detection of VHF viral antigens in tissues by immunohistochemistry


  • One or more of the following exposures within the 3 weeks before onset of symptoms:
    • Contact with blood or other body fluids of a patient with VHF
    • Residence in—or travel to—a VHF endemic area
    • Work in a laboratory that handles VHF specimens
    • Work in a laboratory that handles primates from endemic areas
  • Exposure within the past 3 weeks to semen from a confirmed acute or convalescent case of VHF within the 10 weeks of onset of symptoms

Case Classification


Case meets the clinical and epidemiologic linkage criteria.


Case meets the clinical and laboratory criteria.