Viral Hemorrhagic Fever

Reportable by Laboratories and Providers

About this Reportable Disease

This is an immediately reportable condition. Please contact the Tennessee Department of Health at 615-741-7247 and ask to speak to the epidemiologist on call.

Infectious agent: : Ebola virus, Lassa virus, Marburg virus, and others

Description of illness: Viral hemorrhagic fevers (VHFs) refer to a group of illnesses that are caused by several distinct families of viruses (Ebola virus, Lassa virus, Marburg virus, and others). In general, the term “viral hemorrhagic fever” is used to describe a severe multisystem syndrome (multisystem in that multiple organ systems in the body are affected). Characteristically, the overall vascular system is damaged, and the body’s ability to regulate itself is impaired. These symptoms are often accompanied by hemorrhage (bleeding); however, the bleeding is itself rarely life-threatening. While some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses cause severe, life-threatening disease.

Laboratory Reporting for this Disease

Ebola Virus (Zaire)

TEST NAME	Ebola Virus (Zaire)
DISEASE/DISORDER	Viral Hemorrhagic Fever
ALTERNATE NAME(S)
METHODOLOGY	LRN-B PCR /7500
SPECIAL INSTRUCTIONS	Contact CEDEP prior to submission. Contact Bioterrorism laboratory before submission.
ORDERING INFORMATION	Lab Web Portal TDH DLS Requisition: PH-4263 Clinical Select Agent Rule-Out Submission Requisition

Ebola Virus (Sudan)

TEST NAME	Ebola Virus (Sudan)
DISEASE/DISORDER	Viral Hemorrhagic Fever
ALTERNATE NAME(S)
METHODOLOGY	LRN-B Ebola Warrior Panel/ FilmArray Biofire
SPECIAL INSTRUCTIONS	PRIOR CONSULTATION REQUIRED. Requested through consultation with epidemiology only.
ORDERING INFORMATION	Lab Web Portal TDH DLS Requisition: PH-4263 Clinical Select Agent Rule-Out Submission Requisition

Specimen Requirements- Ebola Virus (Zaire)

Patient Preparation	Contact Bioterrorism laboratory before submission.
Specimen Collection	Acceptable Specimen Sources/Type(s) for Submission: - Whole blood - Serum - Plasma
Specimen Labeling	Specimen should be labeled with at least two unique patient identifiers along with specimen source and match accompanying test order.
Specimen Processing	Contact Bioterrorism laboratory prior to shipment to determine appropriate specimen handling based on LRN protocols.
Specimen Storage and Preservation	Contact Bioterrorism laboratory prior to shipment to determine appropriate specimen handling based on LRN protocols.
Specimen Transport	Contact Bioterrorism laboratory prior to shipment to determine appropriate specimen handling based on LRN protocols. CATEGORY A infectious substance - All infectious substance shipments must conform to U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR 49 C.F.R. Parts 171-180).
Specimen Acceptability and Rejection	Contact Bioterrorism laboratory prior to shipment to determine appropriate specimen handling based on LRN protocols.
Testing Location	Nashville

Specimen Requirements- Ebola Virus (Sudan)

Patient Preparation	None
Specimen Collection	Acceptable Specimen Sources/Type(s) for Submission: - Whole blood: Collect 2 EDTA (purple top) plastic blood collection tubes. - Minimum volume per tube: 4mL for adult and 1mL per child
Specimen Labeling	Specimen should be labeled with at least two unique patient identifiers along with specimen source and match accompanying test order.
Specimen Processing	Contact Bioterrorism laboratory before submission
Specimen Storage and Preservation	Contact Bioterrorism laboratory before submission
Specimen Transport	CATEGORY A infectious substance - All infectious substance shipments must conform to U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR 49 C.F.R. Parts 171-180).
Specimen Acceptability and Rejection	Contact Bioterrorism laboratory before submission
Testing Location	Nashville

Laboratory Reporting

Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.

Manually report results to TDH by faxing or mailing a completed PH-1600 form to your local health department, or faxing to the state health office at (615) 741-3857
Automatically submit results to TDH via electronic laboratory reporting (ELR), which automates the process of sharing data with TDH using interoperability standards.
- See the ELR Onboarding Handbook for details on the onboarding process, checklist, frequently asked questions, business rules, message format, and vocabulary.
- To initiate the ELR onboarding process with TDH, register in the Trading Partner Registration (TPR) system TPR provides documentation for Promoting Interoperability (PI) attestation and milestone letters to document onboarding progress. Contact MU.Health@tn.gov for assistance.
Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.

Information about this Reportable Disease for Healthcare Providers

Clinical Summary

VHFs are severe illnesses caused by viruses like Ebola, Lassa, and Marburg.
They damage blood vessels and organs, leading to bleeding and shock.
Symptoms include fever, fatigue, bleeding, and organ failure.
Treatment is supportive; no cure for most, prevention relies on infection control.

Clinical Links & Info

Review the case definition | CDC

Viral Hemorrhagic Fever Case Report Form (2014) | TDH

Healthcare Provider Reporting

Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.

Providers must report cases of all diseases and conditions listed through one of these methods:

• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857

• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.

• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.

• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.

Information about this Reportable Disease for the Public

What It Is

Viral Hemorrhagic Fevers (VHFs) are severe illnesses caused by different viruses.They affect blood vessels and organs, leading to internal bleeding. Spread occurs through animals, insects, or infected body fluids.They can be life-threatening without prompt care.

Types

Caused by four main virus families: Arenavirus, Filovirus, Bunyavirus, Flavivirus. Includes diseases like Ebola, Marburg, Lassa fever, Crimean-Congo HF. Some are spread by rodents, others by mosquitoes or bats. Each virus type causes different regional outbreaks

Signs and Symptoms

High fever, weakness, muscle pain, and headache.
Bleeding from gums, nose, or under skin in severe cases.
Low blood pressure, vomiting, and organ failure may occur.
Shock and multi-organ damage in advanced stages.

Treatment

No specific cure for most VHFs.
Treatment is supportive: fluids, oxygen, and blood products.
Isolation and infection control are critical.
Some viruses (like Lassa) may respond to antivirals.

This Page Last Updated: March 25, 2026 at 8:53 PM