Due to the growing popularity of travel to remote parts of the world, the importation of diseases from abroad is an increasing problem. This induces more need for physicians to develop knowledge on epidemiological characteristics and clinical features of diseases in developing and tropical countries. Most illnesses are treatable and not a threat for the home country. However, a recent case of Marburg viral haemorrhagic fever (VHF) entering the Netherlands demonstrates that rare illnesses, which are initially difficult to recognize and have the potential of inducing an outbreak, can also be imported. The aim of this review is to raise the awareness of clinical symptoms of the four types of VHF containing a high risk of inducing an outbreak; Marburg, Ebola, Lassa, and Crimean Congo VHF. Improved alertness for the symptoms of these diseases probably leads to earlier diagnosis and timely initiation of proper strict isolation measures. © 2010, Nederlandse Vereniging voor Intensive Care. All Rights Reserved.