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To the Editor: In their Consensus Statement on hemorrhagic fever viruses that may be used as biological weapons, Dr Borio and colleagues¹ state, "There are no reported cases of person-to-person or nosocomial spread of flaviviruses." At least 2 cases of nosocomial transmission of dengue (a flavivirus) have been reported in the medical literature: one through a needlestick injury² and the other through bone marrow transplantation.³ These events, although rare, suggest that nosocomial spread may also be possible for a more feared flavivirus—yellow fever.

José G. Rigau-Pérez, MD,MPH
Dengue Branch, Division of Vector-Borne Infectious Diseases
National Center for Infectious Diseases
Centers for Disease Control and Prevention
San Juan, Puerto Rico

1. Borio L, Inglesby T, Peters CJ, et al. Hemorrhagic fever viruses as biological weapons: medical and public health management. JAMA. 2002;287:2391-2405. FREE FULL TEXT 2. de Wazières B, Gil H, Vuitton DA, Dupond JL. Nosocomial transmission of dengue from a needlestick injury. Lancet. 1998;351:498. PUBMED 3. Rigau-Pérez JG, Vorndam AV, Clark GG. The dengue and dengue hemorrhagic fever epidemic in Puerto Rico, 1994-1995. Am J Trop Med Hyg. 2001;64:67-74. ABSTRACT

To the Editor: In their Consensus Statement, Dr Borio and colleagues¹ briefly mention Kyasanur Forest disease virus (KFDV), which occurs in a remote part of the world. In 1957, 2 of my colleagues and I were accidentally infected with KFDV while . . . [Full Text of this Article]

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Hemorrhagic Fever Viruses as Biological Weapons: Medical and Public Health Management
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ABSTRACT | FULL TEXT