Bolivian hemorrhagic fever

Bolivian hemorrhagic fever (BHF), also known as black typhus or Machupo virus, is a hemorrhagic fever and zoonotic infectious disease occurring in Bolivia. First identified in 1959, black typhus is caused by infection with machupo virus, a negative single-stranded RNA virus of the Arenaviridae family. The infection has a slow onset with fever, malaise, headache and muscular pains. Petechiae (blood spots) on the upper body and bleeding from the nose and gums are observed when the disease progresses to the hemorrhagic phase, usually within seven days of onset. The mortality rate is estimated at 5 to 30 percent. Due to its pathogenicity, Machupo virus requires Biosafety Level Four conditions, the highest level.

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The vector is the vesper mouse (Calomys callosus), a rodent indigenous to northern Bolivia. Infected animals are asymptomatic and shed virus in excretions, by which humans are infected. Evidence of person-to-person transmission of Machupo virus exists but is believed to be rare (Kilgore, et. al, 1995).

Measures to reduce contact between the vesper mouse and humans have effectively limited the number of outbreaks, with no cases identified between 1973 and 1994. A vaccine being developed for the genetically related Junín virus which causes Argentine hemorrhagic fever has shown evidence of cross-reactivity with Machupo virus and may be an effective prophylactic measure for people at high risk of infection.

There are no cures or immunisations for this disease, although those who have contracted it are immune. Treatment options are limited, mostly to supportive care, but are sometimes successful if started early.

References

• Kilgore, Paul E., et al. "Prospects for control of Bolivian Hemorrhagic Fever." >Emerging Infectious Diseases: 1 (3).