About Chapare Hemorrhagic Fever

Key points

  • Chapare hemorrhagic fever (CHHF) is a rare viral disease that is likely spread by rodents.
  • CHHF is deadly and around 60% of people with the disease die.
  • There is no treatment for CHHF.
  • There have only been two small, documented outbreaks of CHHF. Both occurred in Bolivia.
Rodent eating crumbs

What it is

Chapare hemorrhagic fever (CHHF) is a type of illness caused by infection with Chapare virus. Arenaviruses usually spread to people through contact with saliva, urine, and droppings of infected rodents.

There have been two documented outbreaks of CHHF. The first occurred in 2003 in Chapare Province, Bolivia. It resulted in one death. The second outbreak occurred in 2019 in Caranavi Province, Bolivia. It sickened five people and three of them died.

Healthcare providers:‎

Review guidance on emergency services, screening, testing, infection control and PPE for viral hemorrhagic fevers, like CHHF, here: Site Index | Viral Hemorrhagic Fevers (VHFs) | CDC

Signs and symptoms

The symptoms of CHHF resemble those of other South American hemorrhagic fevers, such as Argentine hemorrhagic fever or Bolivian hemorrhagic fever.

Due to the low number of known illnesses from the Chapare virus, there is limited information about the disease.

Documented signs and symptoms of CHHF include:

  • Fever
  • Headache
  • Joint and muscle pain
  • Pain behind the eyes
  • Stomach pain, vomiting, and diarrhea
  • Bleeding gums
  • Rash
  • Irritability

Evidence suggests that people who are infected during pregnancy may have complications, including miscarriage or death of the mother or newborn.

How it spreads

People can become infected with the Chapare virus by:

  • Being bitten or scratched by an infected rodent
  • Eating foods contaminated with the saliva, urine, or droppings from infected rodents
  • Close contact with body fluids of an infected person infected
  • Breathing in the virus when it is stirred up into the air

It is unknown if Chapare virus can be spread from mother to child during birth. However, other viruses in the Arenavirus family, the virus family in which Chapare virus belongs, are known to infect the fetus when it is in the uterus.

Prevention

If you are in a place where CHHF occurs, avoid areas that are infested with rodents and other small mammals, or where you see signs of rodent infestation, such as droppings.

Avoid contact with the body fluids of people who are sick with CHHF until they have tested negative.

Healthcare providers should use standard, contact and droplet precautions, with eye protection while managing suspected or confirmed CHHF cases. They should use airborne precautions when performing procedures that could cause the virus to spray into the air.

Testing and Diagnosis

Healthcare providers can diagnose CHHF with blood tests that detect the virus, like polymerase chain reaction (PCR). There are currently no antibody tests that can tell if someone had the virus in the past.

Clinicians should notify their state or local health department if a patient has recently been in an area with Chapare virus and has compatible symptoms.

Treatment and recovery

There is currently no treatment for CHHF. Supportive therapy can help people recover from and survive Chapare. This includes:

  • Providing fluids and electrolytes (body salts)
  • Using medication to support blood pressure, reduce vomiting and diarrhea, and manage fever and pain
  • Treating other infection, if they occur

Even months after symptoms stop, people who recover from CHHF may continue to shed virus in their blood, saliva, urine, or semen. Healthcare providers should monitor these fluids for Chapare virus. Recovering patients could possibly infect others, particularly sexual partners or other household members.

  • Delgado S, Erickson BR, Agudo R, Blair P, Vallejo E, Albarino CG, Vargas J, Comer JA, Rollin PE, Ksiazek TG, Olson JG, Nichol ST. Chapare Virus, a Newly Discovered Arenavirus Isolated from a Fatal Hemorrhagic Fever Case in Bolivia. PLOS Pathogens. 2008; 4(4):e1000047.
  • Enria DA, Mills JN, Bausch D, Shieh W-J, Peters CJ. Arenavirus infections. In: Guerrant RL, Walker DH, Weller PF, eds. Tropical Infectious Diseases. Principles, Pathogens and Practice. 3rd ed. Philadelphia,PA: Elsevier; 2011; pp. 449-461.
  • Loayza Mafayle, R., Morales-Betoulle, M. E., Romero, C., Cossaboom, C. M., Whitmer, S., Alvarez Aguilera, C. E., ... & Montgomery, J. M. (2022). Chapare hemorrhagic fever and virus detection in Rodents in Bolivia in 2019. New England Journal of Medicine, 386(24), 2283-2294.
  • Rollin PE, Nichol ST, Zaki S, Ksiazek TG. Arenaviruses and Filoviruses. In: Versalovic J, Carroll KC, Funke G, Jorgensen JH, Landry ML, Warnock DW., eds. Manual of Clinical Microbiology. 10th ed. Washington, DC: ASM Press; 2011; 2 pp. 1514-1529.