Hemorrhagic fevers, including dengue, yellow fever, and others:

Hemorrhagic fevers, including dengue, yellow fever, and others: 

Viral hemorrhagic fevers (VHFs) are a group of diseases that are caused by several distinct families of viruses. The term “viral hemorrhagic fever” refers to a condition that affects many organ systems of the body, damages the overall cardiovascular system, and reduces the body’s ability to function on its own. Symptoms of this type of condition can vary but often include bleeding, or hemorrhaging.

Some viral hemorrhagic fevers include:

  • Dengue
  • Ebola
  • Lassa
  • Marburg
  • Yellow fever

These diseases most commonly occur in tropical areas. In the United States, people who get them usually have recently traveled to one of those areas.


These illnesses are caused by viruses from 4 groups:

  • Arenaviruses
  • Filoviruses
  • Bunyaviruses
  • Flaviviruses

These viruses infect insects or rodents. You can become infected from exposure to the body, body fluids, or the droppings of an infected rodent or through an insect bite, usually from a mosquito or tick. Some of the viruses  also spread from person to person. Viruses can also be spread if you crush an infected tick.


Symptoms of VHFs vary depending on the disease. Early in the illness, they often include:

  • Body aches
  • Dizziness
  • Fatigue (extreme tiredness)
  • Fever
  • Headache
  • Rashes

In severe cases, VHFs can cause symptoms that include:

  • Bleeding from the eyes, ears or mouth
  • Difficulty breathing
  • Coma (a prolonged and deep unconscious state)
  • Internal bleeding
  • Organ failure
  • Shock (a condition where the organs do not receive enough blood or oxygen)
  • Death 


Diagnosing specific viral hemorrhagic fevers in the first few days of illness can be difficult because the early signs and symptoms,  high fever, muscle aches, headaches and extreme fatigue are common to many other diseases.

To help with diagnosis, tell your doctor about your medical and travel history and your exposure to rodents or mosquitoes. Include the countries you visited and the dates, as well as any contact you might have had with possible infection sources.

Lab tests, usually using a blood sample, are needed to confirm a diagnosis. Because viral hemorrhagic fevers are particularly infectious and contagious, these tests are usually performed in specially designated labs using strict precautions.

Note: Rate under the appropriate body system any residual disability of infection, which includes, but is not limited to, conditions of the central nervous system, liver, or kidney.

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