Viral Hemorrhagic Fevers

Viral hemorrhagic fevers (VHFs) are a group of severe life-threatening illnesses caused by viruses such as Ebola, Marburg, Lassa and Dengue. These viruses can damage blood vessels and may cause severe internal bleeding, organ failure and death. Some viruses that cause VHFs are regularly found in parts of Africa and can lead to outbreaks. The risk of exposure to VHF in Canada is very low. Ontario has never had a confirmed case of VHF.

Symptoms may start one to 21 days after exposure but can be up to 8 weeks.

Symptoms may begin gradually or may begin with severe symptoms depending on the type of virus causing the illness. Common symptoms include fever, headache, sore throat, cough, vomiting, diarrhea, muscle aches, bleeding not related to an injury and chest and abdominal pain.

This may lead to serious illness including:

  • Blood pooling under the skin
  • Severe bleeding from the nose
  • Vomiting blood
  • Coughing up blood
  • Bloody stools (blood in poop)
  • Blood shot eyes

VHF can lead to seizures, organ failure and death.

Viruses that cause VHFs usually spread through contact with blood, saliva, vomit, urine, or feces of an infected person. VHFs can also spread through contact with contaminated objects (such as medical equipment, clothing, or bedding), contact with infected animals (such as rodents or primates), and through bites from infected insects (such as ticks or mosquitoes).

  • Check travel health notices for specific recommendations.
  • Wash your hands frequently with soap and water. Use an alcohol-based hand sanitizer if soap and water are not available.
  • Avoid VHF affected areas and activities such as unprotected contact with people who are sick or their items (clothing, bedding, etc.) and participation in unsafe burial practices.
  • Avoid direct contact with body fluids and tissues of a sick person or someone who has died from a VHF.
  • Avoid unprotected sexual activity with a sick person.
  • Avoid handling or eating wild animals including bushmeat in VHF-affected areas.
  • Wear light-coloured, long-sleeved shirts and long pants when outdoors.
  • Apply insect repellent approved by Health Canada, following manufacturer’s instructions. Check the label to make sure it works against ticks and mosquitoes.
  • After spending time outdoors in wooded or bushy areas, carefully check your full body and head for attached ticks and shower to remove ticks before they become attached.
  • If you find a tick on your body, remove it as soon as possible.

Before you visit a doctor or a hospital, call Toronto Public Health immediately.

Toronto residents should call 416-338-7600, Monday to Friday, from 8:30 a.m. to 4:30 p.m., or call 311 after hours and ask to speak to the Communicable Disease Manager. Let health care workers know of your potential exposure to VHF before seeking health care.

Toronto Public Health will make arrangements for your medical assessment. Describe your symptoms over the phone, where you have been travelling and mention any possible exposure to VHF.

If you think you have a VHF, it is important that you isolate immediately:

  • Stay home, separate yourself from those around you and do not have physical contact with people, pets or animals.
  • Do not take public transportation, taxi or ride share.
  • Ensure that others do not come into contact with your body fluids (including blood, urine, feces, vomit, saliva, sweat, breast milk and semen) or anything that may have come in contact with your body fluids (e.g., linens, clothing, toilet, toiletries).
  • Wash your hands frequently, especially after vomiting or using the toilet.

    Your health care provider may suspect VHF based on your symptoms and travel history. VHF is diagnosed through laboratory testing.

    There is no specific treatment for VHF. Patients with VHF can be given oxygen, intravenous fluids and other drugs to help manage their symptoms.

    Call Toronto Public Health at 416-338-7600 (TTY at 416-392-0658) or speak to your health care provider. You can also call 811  to connect to a registered nurse day or night for free, secure and confidential health advice.
    Date modified: June 17, 2026