Hemorrhagic fever viruses examined as potential bioweapons

May 07, 2002

Ebola, Marburg, Lassa, and other viruses that cause deadly hemorrhagic fever illnesses could be used as biological weapons, according to a report from the Working Group on Civilian Biodefense, a panel of 26 experts convened by the Center for Civilian Biodefense Strategies at the Johns Hopkins Bloomberg School of Public Health. The group's consensus statement, which appears in the May 8, 2002 issue of the Journal of the American Medical Association (JAMA), is based on an analysis of published research and offers public health and medical guidelines for managing a potential attack.

Like smallpox and anthrax, the Centers for Disease Control and Prevention (CDC) considers hemorrhagic fever viruses "category A" biological weapons agents, because they have the potential to cause widespread illness and death, and would require special public health preparedness measures to contain an outbreak. The Working Group's report focuses on eight viruses: Ebola, Marburg, Lassa fever, New World Arenavirus, Rift Valley Fever, yellow fever, Ornsk hemorrhagic fever, and Kyasanur Forest Disease. Ebola and Marburg, which belong to the Filoviridae family of viruses, can be spread from person to person and are among the most deadly hemorrhagic fever illnesses. Ebola kills 50 to 90 percent of those infected, while Marburg is fatal 23 to 70 percent of the time.

"An outbreak of Ebola and Marburg would have a significant impact on our society, because they carry significant morbidity and mortality, and other than supportive medical care, there are no specific treatments," explains lead author Luciana Borio, MD, fellow at the Johns Hopkins Center for Civilian Biodefense Strategies and the Critical Care Medicine Department of the National Institutes of Health. "It is not possible to predict whether any of the hemorrhagic fever viruses are likely to be used as a bioweapon. However, we know that it is not impossible to weaponize these viruses and we, in medicine and public health, are obliged to prepare."

If an attack were to occur in the United States, the report notes that diagnosing hemorrhagic fever viruses may be difficult, since most clinicians are unfamiliar with these diseases. Most hemorrhagic fever illnesses begin with a fever and rash, which is similar to other more common illnesses. In addition, there are no widely available diagnostic tests. Currently, the CDC in Atlanta, Georgia and USAMRIID in Frederick, Maryland house the only facilities in the U.S. equipped to diagnose hemorrhagic fever viruses.

According to the Working Group, few effective therapies or vaccines are available to deal with hemorrhagic fever viruses. The antiviral drug ribavirin is recommended only for the treatment of the Arenaviridae and the Bunyaviridae families of viruses. For the Filoviridae (Ebola, Marburg) and the Flaviviridae, the researchers recommend providing supportive care to treat the symptoms of infected patients. There is a vaccine to prevent yellow fever, but it is not widely available and it would not be useful to provide protection after exposure.

The Working Group says strict infection controls must be used to prevent the spread of hemorrhagic fever viruses during an outbreak, many of which can be spread from person-to-person contact, and less commonly, via the airborne route. The report recommends clinicians wear special protective gear and that patients be isolated.

"The Working Group's consensus recommends improvements to our diagnostic capacity and the development of a rapid test for diagnosing hemorrhagic fever viruses. Research efforts should also focus on new antiviral medications, vaccines, and a more fundamental scientific study of the viruses that cause hemorrhagic fever illness," adds Dr. Borio.
-end-
"Hemorrhagic Fever Viruses as Biological Weapons, Medical and Public Health Management" was written by Luciana Borio, MD; Thomas V. Inglesby, MD; C.J. Peters, MD; Alan L. Schmaljohn, PhD; James M. Hughes, MD; Peter B. Jahrling, PhD; Thomas Ksiazek, DVM, PhD; Karl M. Johnson, MD; Andrea Meyerhoff, MD; Tara O'Toole, MD, MPH; Michael S. Ascher, MD; John Bartlett, MD; Joel G. Breman, MD, DTPH; Edward M. Eitzen, Jr., MD, MPH; Margaret Hamburg, MD; Jerry Hauer, MPH; D.A. Henderson, MD, MPH; Richard T. Johnson, MD, Gigi Kwik, PhD; Marci Layton, MD; Scott Lillibridge, MD; Gary J. Nabel, MD, PhD; Michael T. Osterholm, PhD, MPH; Trish M. Perl, MD, MSc; Philip Russell, MD; and Kevin Tonat, DrPH, MPH and appears in the May 8 edition of JAMA.

The participant's institution or agency provided funding for the study.

News releases from the Johns Hopkins Bloomberg School of Public Health may be found at www.jhsph.edu. Information on the Johns Hopkins Center for Civilian Biodefense Studies may be found at www.hopkins-biodefense.org.

Johns Hopkins University Bloomberg School of Public Health

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.