Hemorrhagic Fever Viruses: Epidemiology, Pathogenesis and Emerging Control Strategies

Hemorrhagic fever diseases (HFDs) are severe viral illnesses caused by pathogens from 4 main families, mainly Filoviridae, Arenaviridae, Flaviviridae, and Bunyaviridae. These diseases are characterized by high fever, vascular leakage, and multi-organ dysfunction, with case fatality rates reaching 90 % in untreated cases. Transmission occurs through zoonotic spillover from animal reservoirs (i.e., bats, rodents, and arthropods) and human-to-human contact. Recent advances include the rVSV-ZEBOV Ebola vaccine and monoclonal antibody therapies, yet most HFDs lack specific treatments. Key challenges persist in diagnostics, outbreak containment, and climate-driven geographic expansion of vectors. The aim of this review is to improve current knowledge on HFD pathogenesis, epidemiology, and control strategies, highlighting critical gaps in global preparedness. Strengthening surveillance systems, developing pan-HFD countermeasures, and implementing One Health approaches are essential for mitigating these lethal viral pathogens.