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What is rare Bolivian 'Chapare' virus from Arenavirus family?

Amid the COVID-19 pandemic, the world has become more aware of the potential deadly viruses that can be transmitted from one person to another. The newest addition to this is the Chapare virus, as per the CDC.

In 2003, a rare Ebola-like illness is believed to have originated in Chapare Province, Bolivia, which resulted in a single death. In 2019, a second outbreak occurred in Caranavi Province, Bolivia with five confirmed cases. Out of these five cases, three deaths were reported. 

What is the Chapare virus?

Chapare hemorrhagic fever (CHHF) is a viral hemorrhagic fever which is caused by Chapare virus of the Arenavirus family. Arenaviruses mainly spread to individuals through direct contact or indirectly through the urine or faeces (droppings) of an infected rodent. 

How the Chapare virus is transmitted?

As per the CDC, the exact types of rodents which cause this virus are unknown yet. However, similar Arenaviruses are either transmitted through direct or indirect contact with the saliva, urine, and faeces (droppings) of infected rodents.

Here, direct content includes bites and scratches by infected rodents and indirect include breathing in the virus when it is stirred into the air or ingestion of food contaminated with the urine, saliva, or droppings of infected rodents.

Once a person is infected by any mode (direct/indirect), he can spread it to other people through body fluids, or during procedures such as intubation in healthcare settings where the virus gets aerosolised. This could be the possible way the healthcare workers in Bolivia in the year 2019 caught the infection. 

It is not known whether the virus can be transmitted from mother to infant. Other viruses in this family have been documented to cause infection in utero, causing complications, including miscarriage or death of the mother or neonate.

What are the signs and symptoms of Chapare hemorrhagic fever (CHHF)?

Due to the fewer documented cases of CHHF, there's limited information about the signs and symptoms and the incubation period of the virus. As per the CDC, the incubation period is between 4-21 days for Arenaviruses. The documented signs and symptoms so far are as follows:

  1. Fever
  2. Headache
  3. Joint and muscle pain
  4. Pain behind the eyes
  5. Stomach pain
  6. Vomiting
  7. Diarrhoea
  8. Bleeding gums
  9. Rash
  10. Irritability

How is the Chapare virus diagnosed?

In 2003, Chapare virus was successfully isolated from blood and serum of the first confirmed case in Bolivia. This virus can be detectable in serum, blood, semen, urine, respiratory secretions of the survivors. These should be monitored prior to the patient's release. 

According to the CDC, the genomic analysis of Chapare virus facilitated the development of specific molecular detection assays such as rRT-PCR.

Is there any treatment available?

No, as of now there's no treatment for CHHF. However, below listed supportive therapies are important for recovery from the virus:

  1. Maintenance of hydration
  2. Management of shock (eg, fluid resuscitation, administration of vasopressin stocks)
  3. Sedation
  4. Pain relief
  5. Transfusions (when necessary)

As there have only been two documented outbreaks of this virus (in 2003 and 2019), little is known about its mortality and risk factors for mortality. As per the CDC, the survivors of this virus may continue to shed virus in blood, saliva, urine, or semen for months after they no longer have symptoms. Thus, the fluids of the patients must be monitored as they have the potential to infect others.

How to prevent CHHF?

In order to protect yourself from CHHF, keep a check on the rodents in and around your house. Seal up all the holes and gaps in your house to prevent or minimize rodent infestation. Also, avoid contact with people who are infected with the Chapare virus until they test negative, as they have the potential to infect you. 

Hand and respiratory hygiene can help prevent not only Chapare hemorrhagic fever (CHHF) but other infectious diseases too. 

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