ABSTRACT
Viral hemorrhagic fevers (VHFs) are caused by wide and various groups of viral pathogens. They belong to four viral families: Filoviridae, Arenaviridae, Flaviviridae, and Bunyaviridae. Although they all belong to RNA viruses, many biological differences can be found between each representative. As already described elsewhere in this book, VHFs belong to one of the most dangerous human diseases not only for individuals but, due to the possibility of their spreading widely, also for populations. Some VHFs exhibit very high mortality, up to 85%–90%. Rapid diagnosis is of high importance, especially for the initiation of adequate treatment of the infected persons, as well as the establishment of necessary epidemiological countermeasures. However, the development or routine usage of laboratory techniques for the diagnosis of VHF pathogens is complicated mostly because work with the causative agents of VHFs is limited to facilities with the highest biosafety level (BSL), BSL-4. In this chapter, we summarize the available ways for the detection and identi-cation of known VHF causative agents. The chapter is divided into four sections. The rst section is focused on non-laboratory diagnosis, i.e., clinical and especially epidemiological data, which are
12.1 Introduction .......................................................................................................................... 183 12.2 Clinical and Epidemiological Diagnosis .............................................................................. 184 12.3 Sampling ............................................................................................................................... 185 12.4 Laboratory Diagnosis ........................................................................................................... 186
12.4.1 Indirect Methods ....................................................................................................... 186 12.4.2 Direct Methods ......................................................................................................... 187
12.4.2.1 Electron Microscopy .................................................................................. 187 12.4.2.2 Cell Cultures and Animal Models ............................................................. 188 12.4.2.3 Antigen Detection ...................................................................................... 189 12.4.2.4 Amplication Methods .............................................................................. 190 12.4.2.5 Biosensors .................................................................................................. 191
12.4.3 Filovirus Detection ................................................................................................... 191 12.4.4 Arenavirus Detection ................................................................................................ 193 12.4.5 Flavivirus Detection ................................................................................................. 196 12.4.6 Bunyavirus Detection ............................................................................................... 198
12.5 Pitfalls of Working with Viral Hemorrhagic Fever Causative Pathogens ............................200 12.5.1 Pathogen Biohazard Classication ...........................................................................200 12.5.2 Laboratory Biosafety Classication .........................................................................200 12.5.3 Research and Diagnostic Problems of VHFs ...........................................................203
