Résumé de : ANONYME - 1988 - Centers for Disease Control. Management of Patients with Suspected Viral Hemorrhagic Fever. MMWR 1988, 37 (suppl. S-3): pp. 1-16.

TEXTE PARTIEL :
IDENTIFICATION, SURVEILLANCE, AND MANAGEMENT OF PATIENT CONTACTS
A contact is defined as a person who has been exposed to an infected person or to an infected person's secretions, excretions, or tissues within 3 weeks of the patient's onset of illness. Contacts may be subdivided into three levels of risk.

• 1. Casual contacts are persons who had remote contact with the ill patient. These include persons on the same airplane, in the same hotel, etc. Since the agents of VHF are not spread by such contact, no special surveillance is indicated.
• 2. Close contacts are persons who had more than casual contact with the patient. They include persons living with the patient, nursing or serving the patient when he or she was ill, shaking hands with or hugging the patient, handling the patient's Iaboratory specimens, etc. These contact persons should be identified by state and local health departments, in collaboration with CDC, as soon as VHF is considered a likely diagnosis for the index case. Once the diagnosis is confirmed, close contacts should be placed under surveillance. This requires these individuals to record their temperatures twice daily and report any temperature of 101° F (38.3° C) or above or any symptom of illness to the public health officer responsible for surveillance. SurveilIance should be continued for 3 weeks after the person's last contact with the index patient.
• 3. High-risk contacts are persons who have had mucous membrane contact with the patient, such as kissing or sexual intercourse, or have had a needle stick or other penetrating injury involving contact with the patient's secretions, excretions, blood, issues, or other body fluids. These individuals should be placed under surveillance as on as VHF is considered a likely diagnosis in the index case.

Any contact who develops a temperature of 101° F (38.3° C) or higher or any other syptoms of illness should be immediately isolated and treated as a VHF patient. Ribavirin should be prescribed as postexposure prophylaxis for high-risk contacts of patients with Lassa fever. Dosage schedules are given in the box on page 11. Although experience is more limited, postexposure prophylaxis with ribavirin is also recommended for high-risk contacth of patients; with CCHF.
Convalescent patients and their contacts should be warned that some of the causative agents of VHF may continue to be excreted for many weeks in semen, as demonstrated with Marburg and Ebola viruses, and in urine, as occur sometimes with Lassa virus. It is recommended that the persons listed in the introduction be contacted about arranging shipment to CDC introduction be contacted about arranging shipment to CDC of seminal fluid and urine specimens from patients in the convalescent period for virus isolation.
Convalescent patients must be meticulous about personal hygiene. While data are limited concernig infectivity in the convalescent period, abstinence from sexual intercourse is advised until genital fluids have been shown to be free of the virus. If the patient does engage in sexual intercourse before tests are done, the use of condoms is advised.