Machupo Virus and Bolivian Hemorrhagic Fever: Epidemiology, Pathogenesis, and Control Strategies

Abstract

Machupo virus, a member of the Mammarenavirus genus within the Arenaviridae family, is the etiological agent of Bolivian Hemorrhagic Fever (BHF). This enveloped virus possesses a bi-segmented, single-stranded ambisense RNA genome. The small (S) segment encodes the glycoprotein precursor (GPC) and nucleoprotein (NP), while the large (L) segment encodes the RNA-dependent RNA polymerase (L) and the matrix protein (Z). The GPC is cleaved into GP1, which binds the human transferrin receptor 1 (hTfR1) for cell entry, and GP2, which mediates membrane fusion. Transmission to humans occurs primarily via contact with or inhalation of aerosols from the excreta of the natural rodent reservoir, Calomys callosus. The disease is endemic to the Bolivian plains, with outbreaks often linked to increased rodent populations. Following an incubation period of 7-14 days, BHF presents with non-specific symptoms including fever, headache, myalgia, and anorexia. The illness can progress to severe hemorrhagic manifestations such as epistaxis, hematemesis, and neurological signs like tremors and convulsions, with a mortality rate of 5-30%. Diagnosis is achieved through RT-PCR, antigen-capture ELISA, or serology, though testing requires high-containment biosafety level-4 facilities. Treatment relies on the antiviral ribavirin, which is most effective when administered early. Prevention focuses on public health measures, including rodent control, safe food storage, and the use of personal protective equipment to prevent nosocomial transmission. Currently, no vaccine is available for human use.