Table 2

Clinical features of viral haemorrhagic fevers in children

General/systemicGastrointestinal
Fever (90%)Loss of appetite (73%)
Headache (59%)Abdominal pain (47%)
Myalgia (38%)Vomiting (62%)
Arthralgia (35%)Diarrhoea (60%)
Fatigue/weakness (79%)Jaundice (11%)
Difficulty swallowing (20%)
Sore throat (16%)Respiratory
Hiccups (7%) Rash (6%)Difficulty breathing/tachypnoea (20%)
Cough (31%)
Chest pain (29%)
Haemorrhagic
Unexplained bleeding (10%)Neurological
Epistaxis (1.3%)Confusion (10%)
Bleeding from gums (2.1%)Unresponsive/obtunded (5%)
Bleeding from eyesSeizures (later stages)
Haematemesis (1.4–1.9%)
Melaena/haemorrhagic diarrhoea (3.2%)Ocular
Vaginal bleeding (0.7%)Conjunctivitis (22%)
Haematuria (0.5%)Eye pain (6%)
Bleeding from injection site (0.5%)
Common haematological/biochemical parameters
Leucopenia
Thrombocytopenia
Transaminitis
Coagulopathy—prolonged PT, APTT and reduced fibrinogen
  • Percentage figures are symptom incidence specifically for children presenting during the current Ebola virus epidemic in West Africa.2

  • APTT, activated partial thromboplastin time; PT, prothrombin time.