Dr. Jessica Pelletier, Dr. Sidwell Kyeyune, and Dr. Kakande Reagan discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of Marburg virus disease.

Take-Home Points:

• Marburg virus disease infection can occur via zoonotic exposure to Egyptian fruit bats or via human-to-human transmission.
• Initial symptoms are non-specific but can progress to hemorrhage, multiorgan failure, and death.
• Diagnosis involves RT-PCR.
• Treatment is mostly supportive, including blood products (for bleeding), IV fluid resuscitation, and symptom control (with avoidance of NSAIDs).
• Remdesivir and monoclonal antibodies may be given under compassionate use.
• PPE involves standard, contact, and droplet precautions, with environmental decontamination via chlorine.
• Morbidity and mortality are high, so infection prevention is essential.

You can view the full show notes and references here: https://docs.google.com/document/d/12A8bV3BxUbWBRocbi66Gy31b0vAyt2ZUIQU04btgEPI/edit?usp=sharing

Image attribution: generated with Adobe Firefly.

Episode sound attributions:

• More jazz guitar: more Jazz guitar.wav by Sub-d: https://freesound.org/s/49658/ -- License: Creative Commons 0
• Ragtime Logo Standard Version: https://pixabay.com/sound-effects/ragtime-logo-standard-version-116100/
• Counting to 20: Creative Commons 0: http://creativecommons.org/publicdomain/zero/1.0/
• Monkey noise (imitation) 3 by wilika2 -- https://freesound.org/s/588625/ -- License: Creative Commons 0
• bat.wav by tomschuetz -- https://freesound.org/s/635147/ -- License: Attribution NonCommercial 4.0
• Bats Settling into Trees by Yoyodaman234 -- https://freesound.org/s/667578/ -- License: Creative Commons 0
• disappointed aww by kanyonwyvern -- https://freesound.org/s/727358/ -- License: Creative Commons 0
• Ambulance_Traffic_Mic on top of car.WAV by deleted_user_6718832 -- https://freesound.org/s/365254/ -- License: Creative Commons 0

Dr. Jessica Pelletier, Dr. Lawrence Mendy, Dr. Elicana Nduhuura, and Malan Alfred Opoka discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of Crimean-Congo Hemorrhagic Fever (CCHF).

Take-Home Points:

• CCHF is a severe tick-borne viral illness caused by CCHFV, occurring in Africa, the Middle East, Asia, and parts of Europe.
• Transmission is primarily via Hyalomma tick bites, but also through contact with infected animal tissues or the blood/body fluids of infected patients.
• High-risk groups include farmers, livestock handlers, abattoir workers, veterinarians, hunters, military personnel, healthcare workers, and travelers to endemic areas.
• CCHF progresses through four phases: incubation, prehemorrhagic, hemorrhagic, and convalescent. Early symptoms are nonspecific (fever, headache, myalgia, back pain, nausea, vomiting, abdominal pain, weakness). Hemorrhagic signs (e.g., petechiae, epistaxis, hematemesis) indicate severe disease.
• Labs often show thrombocytopenia, leukopenia, elevated liver enzymes, and DIC.
• Diagnosis is by RT-PCR in the acute phase; serology (IgM/IgG) is useful later.
• Management is supportive: isolation, fluids, blood products, and avoidance of NSAIDs. Ribavirin is commonly used, though mortality benefit is uncertain.
• Mortality ranges from 10–40%, depending on severity and complications (e.g., shock, DIC, multiorgan failure).
• Prevention includes tick avoidance, protective equipment, animal handling precautions, and infection control in healthcare settings.

You can view the full show notes and references here: https://docs.google.com/document/d/1jDZcgifY0BKCgB3fzPxzePjcu_eOfJYSFEqhAAhg-IA/edit?usp=sharing

Image attribution: generated with Adobe Firefly using this image as a reference:

By Adam Cuerden - Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=3148918

Episode sound attributions:

• More jazz guitar: more Jazz guitar.wav by Sub-d: https://freesound.org/s/49658/ -- License: Creative Commons 0
• Ragtime Logo Standard Version: https://pixabay.com/sound-effects/ragtime-logo-standard-version-116100/
• Counting to 20: Creative Commons 0: http://creativecommons.org/publicdomain/zero/1.0/
• Sheep on Shearing Day 4 by Ali_6868 -- https://freesound.org/s/679001/ -- License: Creative Commons 0
• harpsicord_dream-leave3.flac by zerolagtime -- https://freesound.org/s/29628/ -- License: Attribution 4.0
• Ambulance_Traffic_Mic on top of car.WAV by deleted_user_6718832 -- https://freesound.org/s/365254/ -- License: Creative Commons 0

Credit goes to Nakamatte Swaburah for assisting Dr. Pelletier with the writing of the podcast transcript.

Dr. Jessica Pelletier and Dr. Sabel Bass co-interview Dr. Valentine Aroh, discussing the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of Lassa fever.

Take-Home Points:

• Lassa fever is a viral hemorrhagic fever endemic to West Africa.
• Rats are the primary animal reservoir and are becoming more of an issue as dry seasons lengthen in the face of climate change.
• Mortality rates vary widely due to underreporting; many cases are asymptomatic, but among the symptomatic, mortality is quite high.
• Pregnant women are at extremely high risk for severe disease and death.
• Lassa can resemble other endemic viral illnesses and hemorrhagic fevers, but facial swelling is a distinctive feature.
• RT-PCR is the gold standard for diagnosis.
• Treatment is largely symptomatic, but Ribavirin can be tried in the first 6 days of symptoms.
• Contact and droplet precautions are essential to prevent the spread of disease.

You can view the full show notes and references here: https://docs.google.com/document/d/1pn2Ml_rDbHfgBqHRC9KIWL6z5qlUsR8QeeghcAavy6o/edit?usp=sharing

Image attribution: generated with Adobe Firefly

Episode sound attributions:

• More jazz guitar: more Jazz guitar.wav by Sub-d: https://freesound.org/s/49658/ -- License: Creative Commons 0
• Ragtime Logo Standard Version: https://pixabay.com/sound-effects/ragtime-logo-standard-version-116100/
• Counting to 20: Creative Commons 0: http://creativecommons.org/publicdomain/zero/1.0/
• airplane_stereo_flyby_05.wav by Izmotion -- https://freesound.org/s/623159/ -- License: Creative Commons 0
• cough9.aiff by Fratz -- https://freesound.org/s/19124/ -- License: Attribution 4.0
• vomit sound effect.wav by KirbyTheSoundingMan -- https://freesound.org/s/672378/ -- License: Creative Commons 0
• Toilets at Mount McIntyre Recreation Centre- Main Floor by SoundsLikeYukon -- https://freesound.org/s/852220/ -- License: Creative Commons 0
• Cat Smokey Meow 1 by redjamie7 -- https://freesound.org/s/729031/ -- License: Attribution 4.0