Symptoms and Case Definitions



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Chapter 3 : Symptoms and Case Definitions

Topics covered in this snack-sized chapter:



Symptoms and Case Definitions arrow_upward


  • Incubation period 2 to 21 days (3-12)
  • Sudden onset of fever, weakness, muscle pain, headache and sore throat, conjunctivitis, hiccups, dysphagia
  • Followed by vomiting, diarrhea, rash
  • Internal and external bleeding, often absent or minimal

  • Late features arrow_upward


  • Confusion and irritability
  • Seizures
  • Easy bleeding;
  • Rash e.g. ecchymosis, petechiae, purpura
  • Bleeding from the gums,
  • Conjunctival hemorrhage
  • Oozing from puncture sites
  • Epistaxis
  • Hematemesis
  • Hemoptysis
  • Melena
  • Unexplained vaginal bleeding in women
  • Hematuria
  • Fever may be absent in late stages
  • Shock (compounded by dehydration)

  • Case definition arrow_upward


  • Suspected (clinical) case:
  • Any person ill or deceased with fever and hemorrhage. Documented prior contact with an EHF case is not required.
  • Probable case (with or without bleeding )
  • Any person (living or dead) with contact with a clinical case of EHF and a history of acute fever
    • OR
  • Any person (living or dead) with a history of acute fever and three or more of the following-
  • Headache /vomiting/nausea/ loss of appetite/ diarrhea/ intense fatigue/ abdominal pain/ general muscular or articular pain/ difficulty in swallowing/ difficulty in breathing/ hiccoughs
    • OR
  • Any unexplained death.
  • The distinction between a suspected case and a probable case in practice relatively unimportant as far as outbreak control is concerned.


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