Arenaviral haemorrhagic fever

Arenaviral haemorrhagic fever refers to severe human disease caused by infection with arenaviruses, a group of bi- or trisegmented ambisense RNA viruses in the family Arenaviridae that naturally infect rodents and occasionally humans ^[1]. At least eight arenaviruses, including Lassa, Junin, Machupo, Guanarito, Sabia, Whitewater Arroyo, and Lujo viruses, are known to produce haemorrhagic fever syndromes ^[1]. The term reflects viral groups whose name derives from sand-like ribosomal inclusions visible in virions ^[1].

The illnesses are characterised by an insidious onset of influenza-like symptoms, followed in severe cases by generalised bleeding diathesis, encephalopathy, and death ^[2]. Argentine haemorrhagic fever presents with haemorrhagic and neurological manifestations and a case fatality of fifteen to thirty percent ^[1]. Studies in Lassa fever indicate platelet and possibly endothelial-cell dysfunction contribute to the bleeding tendency, with plasma inhibitory factors affecting cellular function ^[2].

Three arenaviruses—Lassa, Junin, and Machupo—cause severe haemorrhagic disease in humans as Lassa fever, Argentine haemorrhagic fever, and Bolivian haemorrhagic fever, producing considerable economic hardship in endemic areas and global public-health concern ^[2]. A Lujo virus outbreak linked five patients in Zambia and South Africa, with four deaths after hospital transfer to Johannesburg ^[1]. Increased travel to and from endemic regions has led to importation of Lassa fever into non-endemic metropolitan areas worldwide ^[1].

Arenaviruses naturally infect rodents and occasionally transmit to humans, with disease spread facilitated by travel between endemic and non-endemic regions ^[1]. The Lujo virus outbreak originated near Lusaka and extended to Johannesburg after the first patient was transported to a hospital there ^[1]. Human infection arises from exposure to infected rodent reservoirs associated with these viral haemorrhagic fevers ^[1].

Prevention is constrained by the absence of a licensed vaccine and limited therapeutic options, leaving arenavirus infections among the most neglected viral groups ^[1]. No specific prophylactic measures beyond avoidance of rodent exposure in endemic settings are described in the available evidence ^[1]. Ribavirin is the only licensed drug for treatment of human arenavirus infection but is not framed here as a preventive intervention ^[1].

1. 1 Wikipedia contributors. Arenavirus - Wikipedia [Internet]. Wikipedia. cited 3 Sept 2026. Available from: https://en.wikipedia.org/wiki/Arenavirus
2. 2 Cummins D et al. Arenaviral haemorrhagic fevers. Blood Rev. 1991 Sep. PMID: 1777745. doi: 10.1016/0268-960x(91)90029-c. PubMed: https://pubmed.ncbi.nlm.nih.gov/1777745/