Pathogenesis of the viral hemorrhagic fevers

Research output: Contribution to journalArticle

136 Citations (Scopus)

Abstract

Four families of enveloped RNA viruses, filoviruses, flaviviruses, arenaviruses, and bunyaviruses, cause hemorrhagic fevers. These viruses are maintained in specific natural cycles involving nonhuman primates, bats, rodents, domestic ruminants, humans, mosquitoes, and ticks. Vascular instability varies from mild to fatal shock, and hemorrhage ranges from none to life threatening. The pathogenic mechanisms are extremely diverse and include deficiency of hepatic synthesis of coagulation factors owing to hepatocellular necrosis, cytokine storm, increased permeability by vascular endothelial growth factor, complement activation, and disseminated intravascular coagulation in one or more hemorrhagic fevers. The severity of disease caused by these agents varies tremendously; there are extremely high fatality rates in Ebola and Marburg hemorrhagic fevers, and asymptomatic infection predominates in yellow fever and dengue viral infections. Although ineffective immunity and high viral loads are characteristic of several viral hemorrhagic fevers, severe plasma leakage occurs at the time of viral clearance and defervescence in dengue hemorrhagic fever. ©

Original languageEnglish (US)
Pages (from-to)411-440
Number of pages30
JournalAnnual Review of Pathology: Mechanisms of Disease
Volume8
DOIs
StatePublished - Jan 2013

Fingerprint

Viral Hemorrhagic Fevers
fever
Marburg Virus Disease
Ebola Hemorrhagic Fever
Fever
pathogenesis
Orthobunyavirus
Arenavirus
Severe Dengue
Yellow Fever
Flavivirus
Asymptomatic Infections
Blood Coagulation Factors
Dengue
Disseminated Intravascular Coagulation
Complement Activation
RNA Viruses
Ruminants
Ticks
Virus Diseases

Keywords

  • Arenaviruses
  • Dengue
  • Filoviruses
  • Hemorrhage
  • Vascular permeability
  • Yellow fever

ASJC Scopus subject areas

  • Plant Science
  • Medicine(all)

Cite this

Pathogenesis of the viral hemorrhagic fevers. / Paessler, Slobodan; Walker, David.

In: Annual Review of Pathology: Mechanisms of Disease, Vol. 8, 01.2013, p. 411-440.

Research output: Contribution to journalArticle

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