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Guidance

Viral haemorrhagic fever: ACDP algorithm and guidance on management of patients

Specialist guidance on the management (including infection control) of patients with viral haemorrhagic fever (VHF).

Updates to this page

From:
Department of Health and Social Care
Published:
10 July 2014
Last updated:
9 September 2026
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  1. Updated sections 4 and 5 of 'Risk assessment and immediate management of viral haemorrhagic fevers (contact high consequence infectious diseases) in acute hospitals' to clarify the actions that must be taken by clinicians and relevant bodies, and appendix 4 to include more detail on the role of the NHS England Contact HCID Network in transfer of patients. Out-of-date contact details have also been removed from both the guidance and accompanying 'Viral haemorrhagic fevers risk assessment algorithm' poster.

  2. Replaced 'HCID assessment PPE' with 'unified HCID PPE' throughout to reflect change in name of the PPE ensemble.

  3. Updated the list of further information under 'The patient's VHF risk category' to replace the link to 'High Consequence Infectious Diseases: Monthly Summaries' with a link to 'Outbreaks under monitoring'.

  4. Updated the viral haemorrhagic fevers risk assessment algorithm to replace the link to 'High Consequence Infectious Diseases: Monthly Summaries' with a link to 'Outbreaks under monitoring'.

  5. Updated the risk assessment guidance and algorithm to change the phone number for NHS England emergency preparedness, resilience and response (EPRR).

  6. Updated the viral haemorrhagic fevers risk assessment algorithm to correct a missing arrow directing from 'Has the patient returned from a VHF outbreak area?' with the answer 'No' to the box 'Manage as malaria; VHF unlikely'.

  7. Replaced the pdf attachment ‘Viral haemorrhagic fevers risk assessment algorithm (October 2024)’ with an updated version - the link text ‘High containment infectious disease: country specific risks’ (under ‘VHF endemic countries’) has been corrected to ‘High consequence infectious disease: country specific risks’.

  8. The risk assessment algorithm and guidance have been updated to reflect increasing data showing that a substantial proportion of patients with a viral haemorrhagic fever (VHF) do not have fever at presentation. The guidance has been renamed: ‘Risk assessment and immediate management of viral haemorrhagic fevers (contact high consequence infectious diseases) in acute hospitals’. Throughout the document, clinical and epidemiological terminology has been updated to better reflect current terminology. Sections on managing suspected and confirmed cases of VHF have been updated to match current high consequence infectious disease operational arrangements in the NHS, including NHS infection prevention and control measures and PPE recommendations for suspected cases.

  9. Updated both documents and amended page text to reflect changes.

  10. Updated version of the guidance (November 2014) and algorithm (version 5: 06.11.2014) published.

  11. Updated guidance and algorithm.

  12. New version of guidance and algorithm published.

  13. First published.

Documents

Risk assessment and immediate management of viral haemorrhagic fevers (contact high consequence infectious diseases) in acute hospitals

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Viral haemorrhagic fevers risk assessment algorithm (September 2026)

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Details

The Advisory Committee on Dangerous Pathogens (ACDP) has produced specialist guidance on the management of patients with viral haemorrhagic fevers (VHFs) or other infectious diseases of high consequence.

The accompanying risk assessment algorithm sets out a series of steps to establish whether a patient is at minimal risk of VHF or at risk of VHF, and subsequently direct treatment accordingly.

This guidance is for:

  • healthcare staff in emergency departments, infectious disease departments, infection control, microbiology or virology, and acute medical units
  • ambulance staff who may be required to transport a patient in whom VHF is suspected or confirmed
  • those working in laboratories dealing with specimens from patients in whom VHF is suspected or confirmed
  • public health professionals, including those in port health authorities, who may be required to carry out public health actions associated with a VHF case
  • mortuary and funeral personnel who may need to deal with a VHF case

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