Chapare Hemorrhagic Fever and Virus Detection in Rodents in Bolivia in 2019

Background: In June 2019, the Bolivian Ministry of Health reported a cluster of cases of hemorrhagic fever that started in the municipality of Caranavi and expanded to La Paz. The cause of these cases was unknown.

Methods: We obtained samples for next-generation sequencing and virus isolation. Human and rodent specimens were tested by means of virus-specific real-time quantitative reverse-transcriptase-polymerase-chain-reaction assays, next-generation sequencing, and virus isolation.

Results: Nine cases of hemorrhagic fever were identified; four of the patients with this illness died. The etiologic agent was identified as , or Chapare virus (CHAPV), which causes Chapare hemorrhagic fever (CHHF). Probable nosocomial transmission among health care workers was identified. Some patients with CHHF had neurologic manifestations, and those who survived had a prolonged recovery period. CHAPV RNA was detected in a variety of human body fluids (including blood; urine; nasopharyngeal, oropharyngeal, and bronchoalveolar-lavage fluid; conjunctiva; and semen) and in specimens obtained from captured small-eared pygmy rice rats (). In survivors of CHHF, viral RNA was detected up to 170 days after symptom onset; CHAPV was isolated from a semen sample obtained 86 days after symptom onset.

Conclusions: was identified as the etiologic agent of CHHF. Both spillover from a zoonotic reservoir and possible person-to-person transmission were identified. This virus was detected in a rodent species, . (Funded by the Bolivian Ministry of Health and others.).

Citing Articles

Chapare virus hemorrhagic fever in Bolivia, 2020-2025.

Escalera-Antezana J, Montesinos-Jove R, Gonzales-Flores C, Arauco-Gutierrez C, Aviles-Sarmiento J, Montenegro-Narvaez C New Microbes New Infect. 2025; 64:101569.

PMID: 40070948 PMC: 11894320. DOI: 10.1016/j.nmni.2025.101569.

Viral diversity in wild rodents in the regions of Canaã de Carajás and Curionopólis, State of Pará, Brazil.

Monteiro A, da Silva F, Cruz A, da Silva S, Queiroz A, Casseb L Front Microbiol. 2025; 15():1502462.

PMID: 39839123 PMC: 11747277. DOI: 10.3389/fmicb.2024.1502462.

Delayed low-dose oral administration of 4'-fluorouridine inhibits pathogenic arenaviruses in animal models of lethal disease.

Welch S, Spengler J, Westover J, Bailey K, Davies K, Aida-Ficken V Sci Transl Med. 2024; 16(774):eado7034.

PMID: 39565871 PMC: 11875022. DOI: 10.1126/scitranslmed.ado7034.

Understanding Viral Haemorrhagic Fevers: Virus Diversity, Vector Ecology, and Public Health Strategies.

Hewson R Pathogens. 2024; 13(10).

PMID: 39452780 PMC: 11510013. DOI: 10.3390/pathogens13100909.

Analysis of early warning indicators of death in patients with severe fever with thrombocytopenia syndrome.

Yang M, Yin M, Hou B, Zhou L, Wang J, Zhao Z BMC Infect Dis. 2024; 24(1):765.

PMID: 39090556 PMC: 11293107. DOI: 10.1186/s12879-024-09599-0.

References

Peters C, KUEHNE R, Mercado R, Le Bow R, SPERTZEL R, WEBB P . Hemorrhagic fever in Cochabamba, Bolivia, 1971. Am J Epidemiol. 1974; 99(6):425-33. DOI: 10.1093/oxfordjournals.aje.a121631. View

Veliziotis I, Roman A, Martiny D, Schuldt G, Claus M, Dauby N . Clinical Management of Argentine Hemorrhagic Fever using Ribavirin and Favipiravir, Belgium, 2020. Emerg Infect Dis. 2020; 26(7):1562-1566. PMC: 7323566. DOI: 10.3201/eid2607.200275. View

Ezeomah C, Adoga A, Ihekweazu C, Paessler S, Cisneros I, Tomori O . Sequelae of Lassa Fever: Postviral Cerebellar Ataxia. Open Forum Infect Dis. 2019; 6(12):ofz512. PMC: 6923636. DOI: 10.1093/ofid/ofz512. View

. Bolivian hemorrhagic fever--El Beni Department, Bolivia, 1994. MMWR Morb Mortal Wkly Rep. 1994; 43(50):943-6. View

Carroll D, Mills J, Montgomery J, Bausch D, Blair P, Burans J . Hantavirus pulmonary syndrome in Central Bolivia: relationships between reservoir hosts, habitats, and viral genotypes. Am J Trop Med Hyg. 2005; 72(1):42-6. View

Carrillo-Bustamante P, Nguyen T, Oestereich L, Gunther S, Guedj J, Graw F . Determining Ribavirin's mechanism of action against Lassa virus infection. Sci Rep. 2017; 7(1):11693. PMC: 5601963. DOI: 10.1038/s41598-017-10198-0. View

Maes P, Alkhovsky S, Bao Y, Beer M, Birkhead M, Briese T . Taxonomy of the family Arenaviridae and the order Bunyavirales: update 2018. Arch Virol. 2018; 163(8):2295-2310. DOI: 10.1007/s00705-018-3843-5. View

Mbala-Kingebeni P, Pratt C, Mutafali-Ruffin M, Pauthner M, Bile F, Nkuba-Ndaye A . Ebola Virus Transmission Initiated by Relapse of Systemic Ebola Virus Disease. N Engl J Med. 2021; 384(13):1240-1247. PMC: 7888312. DOI: 10.1056/NEJMoa2024670. View

Overholt L, Wohl D, Fischer 2nd W, Westreich D, Tozay S, Reeves E . Stigma and Ebola survivorship in Liberia: Results from a longitudinal cohort study. PLoS One. 2018; 13(11):e0206595. PMC: 6261413. DOI: 10.1371/journal.pone.0206595. View

10.

Raabe V, Kann G, Ribner B, Morales A, Varkey J, Mehta A . Favipiravir and Ribavirin Treatment of Epidemiologically Linked Cases of Lassa Fever. Clin Infect Dis. 2017; 65(5):855-859. PMC: 5682919. DOI: 10.1093/cid/cix406. View

11.

Powers A, Mercer D, Watts D, Guzman H, Fulhorst C, Popov V . Isolation and genetic characterization of a hantavirus (Bunyaviridae: Hantavirus) from a rodent, Oligoryzomys microtis (Muridae), collected in northeastern Peru. Am J Trop Med Hyg. 1999; 61(1):92-8. DOI: 10.4269/ajtmh.1999.61.92. View

12.

Delgado S, Erickson B, Agudo R, Blair P, Vallejo E, Albarino C . Chapare virus, a newly discovered arenavirus isolated from a fatal hemorrhagic fever case in Bolivia. PLoS Pathog. 2008; 4(4):e1000047. PMC: 2277458. DOI: 10.1371/journal.ppat.1000047. View

13.

Li A, Grant D, Gbakie M, Kanneh L, Mustafa I, Bond N . Ophthalmic manifestations and vision impairment in Lassa fever survivors. PLoS One. 2020; 15(12):e0243766. PMC: 7728206. DOI: 10.1371/journal.pone.0243766. View

14.

Bharadwaj M, Botten J, Hjelle B . Rio Mamore virus: genetic characterization of a newly recognized hantavirus of the pygmy rice rat, Oligoryzomys microtis, from Bolivia. Am J Trop Med Hyg. 1997; 57(3):368-74. DOI: 10.4269/ajtmh.1997.57.368. View

15.

Christie A, Davies-Wayne G, Cordier-Lassalle T, Cordier-Lasalle T, Blackley D, Laney A . Possible sexual transmission of Ebola virus - Liberia, 2015. MMWR Morb Mortal Wkly Rep. 2015; 64(17):479-81. PMC: 4584553. View

16.

Kilgore P, Ksiazek T, Rollin P, Mills J, Villagra M, Montenegro M . Treatment of Bolivian hemorrhagic fever with intravenous ribavirin. Clin Infect Dis. 1997; 24(4):718-22. DOI: 10.1093/clind/24.4.718. View

17.

Diallo B, Sissoko D, Loman N, Bah H, Bah H, Worrell M . Resurgence of Ebola Virus Disease in Guinea Linked to a Survivor With Virus Persistence in Seminal Fluid for More Than 500 Days. Clin Infect Dis. 2016; 63(10):1353-1356. PMC: 5091350. DOI: 10.1093/cid/ciw601. View

18.

Patterson M, Grant A, Paessler S . Epidemiology and pathogenesis of Bolivian hemorrhagic fever. Curr Opin Virol. 2014; 5:82-90. PMC: 4028408. DOI: 10.1016/j.coviro.2014.02.007. View

19.

Richter M, Hanson J, Cajimat M, Milazzo M, Fulhorst C . Geographical range of Rio Mamoré virus (family Bunyaviridae, genus Hantavirus) in association with the small-eared pygmy rice rat (Oligoryzomys microtis). Vector Borne Zoonotic Dis. 2010; 10(6):613-20. PMC: 2979329. DOI: 10.1089/vbz.2009.0115. View

20.

Ficenec S, Percak J, Arguello S, Bays A, Goba A, Gbakie M . Lassa Fever Induced Hearing Loss: The Neglected Disability of Hemorrhagic Fever. Int J Infect Dis. 2020; 100:82-87. PMC: 7807889. DOI: 10.1016/j.ijid.2020.08.021. View