View source for Toloupum fever

'''Toloupum fever''' is a term referring to members of the genus or virological taxon ''Toloupumvirus''. It also refers commonly to Toloupum virus disease, or the {{wp|viral hemorrhagic fever}} in which a Toloupumvirus is the {{wp|disease causative agent}}.

==Toloupumvirus==
{{Taxobox
| name               = Toloupum fever
| image              = Toloupumfilovirus.png
| virus_group        = v
| ordo               = ''{{wp|Mononegavirales}}''
| familia            = ''{{wp|Filoviridae}}''
| genus              = ''Toloupumvirus''
| species            = ''Eastern toloupumvirus''<br>''Toloupum toloupumvirus''<br>''Western toloupumvirus''
}}
A '''toloupumvirus''' belongs to the family ''Filoviridae'' under the order ''Mononegavirales''. There are three known species of Toloupum viruses, all of which cause Toloupum virus disease. Over 50% of cases involving said disease are caused by ''Toloupum toloupumvirus'' but diseases caused by any Toloupum viruses have nearly the same {{wp|case fatality rate}}s.

Toloupum viruses are classified into the same family and order as {{wp|ebolaviruses}} and {{wp|marburgviruses}}. They meet {{wp|Filoviridae#Family_inclusion_criteria|criteria}} for classification into the family ''Filoviridae'', as they are capable of inducing VHFs and generate poorly-{{wp|neutralisation (immunology)|neutralized}} {{wp|virus|virions}} for instance. All Toloupum viruses are classified as {{wp|Biosafety level#Biosafety level 4|BSL-4}} agents and {{wp|Bioterrorism#Category A|Category A}} bioterrorism agents.

At least 70% of the [[Viral hemorrhagic fevers in Pavonistade|annual cases]] of viral hemorrhagic fevers in Pavonistade are caused by Toloupum viruses.

===Transmission===
Toloupum fever may spread through contact with bodily fluids, including drug sharing and sexual contact. It is also a {{wp|zoonosis|zoonotic}} disease. Certain insects, particularly {{wp|tick}}s and {{wp|mosquito}}es, have the potential to act as {{wp|vector (epidemiology)|vectors}} for the Toloupum fever viruses. Primates (e.g. chimpanzees) and bats may be reservoirs for the virus.

Toloupum fever is not an {{wp|airborne disease|airborne}} disease, though it is {{wp|waterborne diseases|waterborne}}. Its virions resist osmotic lysis more effectively than Ebola or other ''Filoviridae'' virions in water for at most several days. How Toloupum fever virions survive for an extended period in water is not known. Additionally, the disease can be {{wp|vertically transmitted infection|spread vertically}} and has a potential to cause {{wp|hospital-acquired infection|outbreaks in medical facilities}}.

===Species===
There exists three Toloupum viruses belonging to the same genus. Of the three species, ''Toloupum toloupumvirus'' is the most widespread and is the only member to have appeared in regions outside of Pavonistade.

The below report lists the number of cases in 2015 involving the three characteristic Toloupum viruses.
*'''Toloupum toloupumvirus (TOTOV)''' - 30 cases
*'''Eastern toloupumvirus (EASTV)''' - 18 cases
*'''Western toloupumvirus (WESTV)''' - 8 cases

==Toloupum virus disease==
[[File:Toux impromptue.jpg|200px|right|thumb|Coughing, when accompanied by occurrence of blood and noticeable pain, is a classical sign of sign of Toloupum fever]]
'''Toloupum virus disease (TVD)''', also referred to as '''Toloupum fever''', '''Tropical flu''' or simply the '''Fever''', is the disease caused by any of the three Toloupum viruses. Toloupum virus disease has a CFR ranging from 90% to 95% if untreated, and the CFR may be reduced to 35% or lower if proper care is provided.

===Symptoms and prognosis===
The symptoms of Toloupum virus disease are very similar to those of {{wp|Ebola virus disease|Ebola}} and {{wp|Marburg virus disease|Marburg}} virus diseases. Certain symptoms and the time at which they are noticed are also comparable to those of other {{wp|viral hemorrhagic fever|VHF}}s.

Early symptoms of Toloupum fever tend to be rashes, {{wp|vomiting}}, {{wp|nausea}}, {{wp|headache}}, {{wp|fever}} and {{wp|malaise}}. Redness in the eyes, rapid weight loss, {{wp|hemoptysis}} (coughing up blood), {{wp|diarrhea}}, {{wp|bleeding|internal and external hemorrhaging}}, and {{wp|abdominal pain}} would follow the early symptoms. {{wp|Encephalitis}}, {{wp|organ dysfunction|organ failure}}, severe hemorrhaging and certain {{wp|neurological disorder}}s are reported in the late stages of the disease. Hemorrhaging in the early and intermediate stages of Toloupum virus disease may result in {{wp|disseminated intravascular coagulation}}.

Cases that lead to survival will see different late-stage symptoms (convalescence stage) compared to cases that lead to fatalities. A case in the convalescence stage will involve symptoms such as {{wp|weakness#Asthenia_vs._myasthenia|asthenia}} and {{wp|delirium}}, while one in a fatal case will experience symptoms such as {{wp|coma}} and {{wp|shock}}.

The typical incubation period of Toloupum fever can range from 2 to 18 days, though the average incubation period is 4-9 days. The clinical phases of Toloupum fever can overlap or vary between patients. One who is elderly or is not in adulthood (<18 years of age) would typically exhibit symptoms earlier. Other medical conditions such as {{wp|immunodeficiency}} can affect the onset of Toloupum fever symptoms.

After an infection recedes, the Toloupum virus may remain in the host, specifically in certain parts such as the eyes. This provides the possibility that the host will again be afflicted with Toloupum virus disease. Long-term health problems may be noticed, such as vision loss, pain (particularly in {{wp|joint}}s and {{wp|muscle}}s) and abnormal {{wp|desquamation|skin peeling}}. Contrary to Pavonistadian popular belief, the prognosis of Toloupum fever is unaffected by climatic conditions, which affect only the {{wp|apparent infection rate}}.

More than 90% of untreated Toloupum fever cases lead to coma and death, which occurs 7 to 14 days after the first symptoms appear. Otherwise, recovery from the infection begins slightly later.

===Treatment===
{{wp|palliative care|Palliative}} or {{wp|intensive care|intensive}} care are important in improving the chances of survival, particularly if care begins at the earliest time possible. Other important steps include appropriate use of {{wp|anticoagulant}}s and {{wp|coagulation|procoagulant}}s. The former counters {{wp|disseminated intravascular coagulation|DIC}} while the latter limits later hemorrhaging. Rehydrating and balancing fluids by {{wp|electrolyte}} replacement is also important when treating people with Toloupum fever.

Additional care must also be taken when organ failure occurs or is likely to occur. Any other infections from bacteria or fungi may be treated respectively with {{wp|antibiotics}} and {{wp|antimycotics}}. Certain medical treatments or drugs that are effective for viral hemorrhaging fevers and diseases are not effective against Toloupum fever. For example, the antiviral drug {{wp|ribavirin}} have proven to be ineffective in alleviating Toloupum fever symptoms.

===Prevention===
The simplest way to prevent the spread of Toloupum fever is by avoiding direct contact with a person or item that may be exposed to the virus. Avoiding contact with bodily fluids, waste matter and wildlife (particularly certain primate and bat species) is also vital in preventing Toloupum fever infections.

{{wp|Isolation (health care)#High isolation|High isolation}} must apply for anyone that may have been exposed to Toloupum fever. One that is suspected of infection must be relocated to isolation facilities, as prompt {{wp|infection control}} of Toloupum fever is essential for preventing further infections. Additionally, {{wp|contact tracing}} is an important step in limiting or halting the spread of Toloupum fever. Anyone that may have contact with an infected person should be {{wp|quarantine}}d and monitored for further medical developments for up to 19 days, while anyone exhibiting Toloupum fever symptoms must be isolated.

In a health care and laboratory setting, various {{wp|Prevention of viral hemorrhagic fever#Protective clothing|protective clothing}} must be worn. Toloupum viruses are recognized as {{wp|Biosafety level#Biosafety level 4|BSL-4}} agents. Such samples must be handled in BSL-4 facilities and {{wp|biosafety|biosafety containment protocols}} are expected to be strictly followed.

[[Category:Pavonistade]][[Category:Diseases]]