Bolivian haemorrhagic fever - Machupo virus: information sheet for category 5 contacts

You have been given this information sheet because you have been in very close contact with someone who is infected with Machupo virus, or material contaminated with Machupo virus. Machupo virus causes a disease called Bolivian haemorrhagic fever. You should stay at home and away from other people for 21 days after your last exposure to Machupo virus and regularly check yourself for symptoms of Bolivian haemorrhagic fever. If you develop symptoms of Bolivian haemorrhagic fever within 21 days of your last exposure to Machupo virus, call your designated contact immediately.

About Machupo virus

Machupo virus was first identified in the North-Eastern lowlands of Bolivia. Outbreaks and cases of Machupo virus have been reported from Bolivia. There is no evidence of the virus originating from countries outside Bolivia.

How Machupo virus spreads

Machupo virus can spread by:

• direct contact with the organs, the blood, secretions or other body fluids of an infected person (for example their vomit, faeces, urine, saliva, or semen)
• contact with objects, such as needles or soiled clothing, that have been contaminated with infected bodily fluids
• contact with infected rodents

Machupo virus is not spread through routine, social contact (such as shaking hands or sitting next to someone) with people who do not have symptoms.

It can take up to 21 days from when someone is exposed to the virus for symptoms to appear.

Symptoms of Bolivian haemorrhagic fever

The illness can begin with symptoms including:

• feeling unwell
• chills
• fever (temperature above 37.5°C)
• headache
• loss of appetite
• generalised aches and pains in muscles

A few days later symptoms can include:

• pain behind the eyes
• nausea
• vomiting
• abdominal pain
• constipation or mild diarrhoea
• seizures
• confusion
• coma

Some patients with severe illness may develop internal and external bleeding.

Preventing and treating infection with Bolivian haemorrhagic fever

There are currently no licensed vaccines or specific antivirals to treat infection with Machupo virus.

To avoid Machupo virus spreading between people, those caring for individuals with possible or suspected Bolivian haemorrhagic fever should avoid contact with the patient’s bodily fluids  and should wear personal protective equipment (PPE).

Treatment for Bolivian haemorrhagic fever is with supportive care including maintaining good fluid and electrolyte balance, and managing diarrhoea, vomiting, fever and pain with medications and blood transfusions as required. Supportive therapy can also include maintaining the patient’s oxygen status and blood pressure and treating any other infections they may have at the same time. Supportive care can improve survival, particularly if started early.

Your risk of developing Bolivian haemorrhagic fever

You reported that:

• you are a household or overnight contact of a confirmed symptomatic case

Or

• you have had significant exposure to material from a Bolivian haemorrhagic fever case, for example a needlestick injury or direct contact of mucous membranes or broken skin with a Bolivian haemorrhagic fever case or their body fluids (for example blood, vomit, faeces, urine, saliva) while they were symptomatic. This includes sexual contact

Because of your level of exposure, you are at risk of developing Bolivian haemorrhagic fever. We would therefore like to closely monitor you for a period of 21 days from when you were last exposed to Machupo virus. You should also carry out the actions listed below to minimise the risk to you and others close to you.  

What you need to do

Because you are at risk of developing Bolivian haemorrhagic fever, you should take the following actions for the 21 days from when you were last exposed to Machupo virus:

• self-isolate in private accommodation (unless an alternative arrangement has been agreed with UKHSA). See the information below on how to self-isolate
• record your temperature and monitor yourself for other symptoms suggestive of Bolivian haemorrhagic fever  twice per day at the same times each day
• report these temperatures to your designated contact by 12 noon each day. They will want to know whether your temperature is below, equal to, or above 37.5°C, and will arrange further evaluation as necessary. They will explain the local arrangements for accessing healthcare
• if you become ill with any of the symptoms listed above in between reporting to your designated contact, you should phone your designated contact immediately. See below for further information on what you should do if you become ill

How to self-isolate

You should self-isolate for 21 days from when you were last exposed to Machupo virus. This means you should stay at home and not go to work, school or public areas. You should not travel, either within the UK or internationally.

You should self-isolate in a separate room from other members of your household, and avoid all contact with them, including sexual contact. You should sleep in a separate room to other people and use separate bathroom facilities for going to the toilet and for washing.

You should only leave your home if it is essential, for example in an emergency, or for urgent health and wellbeing issues. You should also not have visitors to your home. 

If you need help with groceries or other essentials, ask friends or family to drop your shopping off, or order online. Ask your friends, family or delivery drivers to leave your shopping at your front door to avoid contact with them.

Do not share items which you use, such as bedding, towels, wash cloths, toothbrushes, or razors. You should also use separate items for eating and drinking, such as cutlery, cups, or plates, to other people in your household. These measures are advised as a precaution to help protect others in case you are infected.

Postpone any non-essential medical or dental treatment. You should discuss any essential treatment required with your designated contact before attending a healthcare facility.

Use of medicines such as aspirin, paracetamol or ibuprofen

Certain medicines, such as paracetamol, ibuprofen and aspirin, can reduce your body temperature during a fever (antipyretic) for up to 8 hours. Thermometer measurements may therefore show a lower temperature than would be expected for up to 8 hours after taking an antipyretic.

You must call your designated contact for further advice if you need to take an antipyretic medicine.

Please take your temperature before you take paracetamol, ibuprofen or aspirin, and if your temperature is 37.5°C or higher, you must call your contact immediately.

A temperature of 37.5°C or higher is always significant, whether you are taking one of these medicines or not and must be reported urgently.

What to do if you become ill

If you are feeling unwell or develop any of the symptoms of Bolivian haemorrhagic fever (including a temperature of 37.5°C or higher) , please remain at home. Take your temperature if you have not done this already. Phone your designated contact immediately, who will arrange for you to be assessed by an appropriate clinician. If there is any delay in making contact, phone 111 reporting your recent contact with someone with Bolivian haemorrhagic fever. In an emergency, you should call 999 and tell them about your symptoms and your recent contact with Machupo virus.

Further information

More information about Machupo virus can be found at:

• Haemorrhagic fevers in Bolivia: origins, reservoirs, transmission and guidelines