Barmah Forest virus disease
The symptoms of Barmah Forest virus infection are very similar and clinically indistinguishable from those caused by infection with the other alphavirus endemic to Australia, Ross River virus, though symptoms are often less severe and of shorter duration.
Infection is most likely in the summer and autumn. The incubation period for this infection is about 7 days. Patients then present with fever, a maculopapular rash (other rashes have also been described), lethargy, and arthralgias. Some patients may have true arthritis. Other associated symptoms may include lymphadenopathy and headaches. Symptoms typically last 2-10 days, but a minority of patients may report arthralgias for weeks to months.
A92.8 – Other specified mosquito-borne viral fevers
400060000 – Barmah Forest disease
Differential Diagnosis & Pitfalls
- Ross River virus – Serology can be checked but may not be routinely available.
- Dengue fever – Polyarthralgia is less common with Dengue fever. Serology can be checked.
- Chikungunya virus infection – An alphavirus that also causes fever, rash, and arthralgias. Diagnosis is by serology.
- Rubella – Symptoms include fever and rash. Diagnosis is less likely in those with a history of immunization. Diagnosis is made by serology.
- Epstein-Barr virus infection – Pharyngitis seen in this infection is not a prominent symptom of Barmah Forest virus. Diagnosis is made by heterophile antibody testing or polymerase chain reaction (PCR).
- Parvovirus B19 / erythema infectiosum – The classic malar rash of parvovirus B19 infection is not typical of Barmah Forest virus infection. Diagnosis is by serology or PCR.