title: Patients infected with high-hazard viruses: scientific basis for infection control.
abstract: Most of the viral hemorrhagic fevers (VHFs) are caused by viruses that are handled in high containment laboratories in Europe and the United States because of their high pathogenicity and their aerosol infectivity. Special precautions should be taken when caring for patients infected with these viruses, but most hospitals can safely provide high-quality care. The major danger is parenteral inoculation of a staff member. Fomites and droplets must be considered as well. The role of small particle aerosols in inter-human transmission continues to be controversial. We believe that the aerosol infectivity observed for these viruses in the laboratory and the rare clinical situations that suggest aerosol spread dictate caution, but the many instances in which no transmission occurs provide a framework in which a measured approach is possible. The major challenge is in early recognition by an educated medical staff and rapid specific etiological diagnosis.
authors.affiliation: Special Pathogens Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Peters
authors.forename: P B
authors.initials: PB
authors.lastname: Jahrling
authors.forename: A S
authors.initials: AS
authors.lastname: Khan
mesh_terms: D000336:Aerosols; D000818:Animals; D000830:Animals, Laboratory; D001116:Arenaviridae / Q000145:classification / Q000472:pathogenicity; D002043:Bunyaviridae / Q000145:classification / Q000472:pathogenicity; D005060:Europe; D005190:Family; D016563:Filoviridae / Q000145:classification / Q000472:pathogenicity; D018067:Flaviviridae / Q000145:classification / Q000472:pathogenicity; D006482:Hemorrhagic Fevers, Viral / Q000517:prevention & control* / Q000635:transmission* / Q000662:veterinary; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D007753:Laboratories / Q000592:standards; D051379:Mice; D008954:Models, Biological; D014187:Transportation of Patients / Q000592:standards; D014481:United States; D014766:Viremia
chemical_list: D000336:Aerosols