Viral hemorrhagic fever (VHF) can cause a range of symptoms, ranging from mild fever to life-threatening bleeding and disseminated intravascular coagulation (DIC). This chapter discusses neurological symptoms and VHF neuropathogenesis resulting from four families of single-stranded RNA viruses: Arenaviridae, Bunyaviridae, Filoviridae, and Flaviviridae, focusing on the specific host organisms, vectors and diseases caused by each virus. The neuropathogenesis of VHF varies within the same viral family and in different viral families. The single-stranded RNA viruses have complex mechanisms allowing them to evade the host's immune system, suppress interferon systems, and multiply rapidly within the host cells. This chapter provides an overview of VHF neuropathogenesis and neurological manifestations for each virus family, with a comprehensive review of the intricate relationship between VHFs and the nervous system, blood-brain barrier disruption, and cytokine disruption. More specifically, neurologic sequelae, including encephalitis, are presented with a focus on Flaviviridae, and a detailed analysis of the Bunyaviridae, Arenaviridae, and Filoviridae viral families, which includes Rift Valley fever, Crimean-Congo Hemorrhagic fever, Lassa fever, Ebola, and Marburg viruses.
