Hemorrhagic fevers – acute infectious diseases of a viral nature, characterized by toxicosis, fever and hemorrhagic syndrome – the outflow of blood from the vessels (bleeding, hemorrhage). The causative agents belong to the group of arboviruses, the reservoir of which is mainly mouse-like rodents and ixodid ticks. Infection begins when a tick bites, when people come into contact with rodents or objects contaminated with their secretions, through the air (hemorrhagic fever with renal syndrome). Hemorrhagic fevers are natural focal diseases. They occur in the form of isolated cases or small outbreaks in rural areas, especially in areas not sufficiently developed by man.
Three types of the disease have been described:
Hemorrhagic feverwith renal syndrome (hemorrhagic nephrosonephritis). The incubation period is 13-15 days. The disease traditionally begins acutely: severe headache, insomnia, pain in the muscles and eyes, sometimes blurred vision. The temperature rises to 39-40C and lasts for 7-9 days. The patient is initially agitated, then sluggish, apathetic, sometimes delusional. The face, neck, upper chest and back are brightly hyperemic, there is reddening of the mucous membranes and vasodilatation of the sclera. By the 3-4th day of the disease, the condition worsens, intoxication increases, repeated vomiting is observed. On the skin of the shoulder girdle and in the armpits, a hemorrhagic rash appears in the form of single or multiple small hemorrhages. These phenomena increase every day, bleeding is noted, most often nasal. The boundaries of the heart do not change, the tones are muffled, sometimes there is an arrhythmia and, less often, a sudden pericardial friction rub (hemorrhage). Blood pressure remains normal or decreases. Shortness of breath, congestion in the lungs. The tongue is dry, thickened, densely coated with a gray-brown coating. The abdomen is painful (retroperitoneal hemorrhages), the liver and spleen increase inconstantly. Renal syndrome is especially typical: sharp pains in the abdomen and lower back when tapping. Decrease in the amount of urine or its complete absence. Urine becomes cloudy due to the presence of blood and high protein content. In the future, recovery gradually begins: pain subsides, vomiting stops, diuresis increases – the volume of urine excreted. For a long time there is weakness, instability of the cardiovascular system. Blood pressure remains normal or decreases. Shortness of breath, congestion in the lungs. The tongue is dry, thickened, densely coated with a gray-brown coating. The abdomen is painful (retroperitoneal hemorrhages), the liver and spleen increase inconstantly. Renal syndrome is especially typical: sharp pains in the abdomen and lower back when tapping. Decrease in the amount of urine or its complete absence. Urine becomes cloudy due to the presence of blood and high protein content. In the future, recovery gradually begins: pain subsides, vomiting stops, diuresis increases – the volume of urine excreted. For a long time there is weakness, instability of the cardiovascular system. Blood pressure remains normal or decreases. Shortness of breath, congestion in the lungs. The tongue is dry, thickened, densely coated with a gray-brown coating. The abdomen is painful (retroperitoneal hemorrhages), the liver and spleen increase inconstantly. Renal syndrome is especially typical: sharp pains in the abdomen and lower back when tapping. Decrease in the amount of urine or its complete absence. Urine becomes cloudy due to the presence of blood and high protein content. In the future, recovery gradually begins: pain subsides, vomiting stops, diuresis increases – the volume of urine excreted. For a long time there is weakness, instability of the cardiovascular system. The abdomen is painful (retroperitoneal hemorrhages), the liver and spleen increase inconstantly. Renal syndrome is especially typical: sharp pains in the abdomen and lower back when tapping. Decrease in the amount of urine or its complete absence. Urine becomes cloudy due to the presence of blood and high protein content. In the future, recovery gradually begins: pain subsides, vomiting stops, diuresis increases – the volume of urine excreted. For a long time there is weakness, instability of the cardiovascular system. The abdomen is painful (retroperitoneal hemorrhages), the liver and spleen increase inconstantly. Renal syndrome is especially typical: sharp pains in the abdomen and lower back when tapping. Decrease in the amount of urine or its complete absence. Urine becomes cloudy due to the presence of blood and high protein content. In the future, recovery gradually begins: pain subsides, vomiting stops, diuresis increases – the volume of urine excreted. For a long time there is weakness, instability of the cardiovascular system. In the future, recovery gradually begins: pain subsides, vomiting stops, diuresis increases – the volume of urine excreted. For a long time there is weakness, instability of the cardiovascular system. In the future, recovery gradually begins: pain subsides, vomiting stops, diuresis increases – the volume of urine excreted. For a long time there is weakness, instability of the cardiovascular system.
Crimean hemorrhagic fever . Body temperature in 1 day reaches 39-40C and lasts about 7-9 days. The patient is agitated, the skin of the face and neck is red. Sharp reddening of the conjunctiva of the eyes. The pulse is slowed down, blood pressure is lowered. Respiration is speeded up, in the lungs there are not often dry scattered rales. The tongue is dry, covered with a thick gray-brown coating, urination is free. In the absence of complications after a decrease in body temperature, a gradual recovery begins.
Omsk hemorrhagic fever in the clinical picture resembles the Crimean one, but is more benign, with a short incubation period (2-4 days). Features are the undulating nature of the temperature curve and frequent damage to the respiratory system.
Recognition of hemorrhagic fevers is based on a characteristic clinical symptom complex, blood and urine tests, taking into account epidemiological data.
Treatment . Bed rest, careful patient care, a dairy-vegetarian diet.
Pathogenetic means of therapy are corticosteroid products. To reduce toxicosis, intravenous solutions of sodium chloride or glucose (5%) are administered up to 1 liter. In acute renal failure, peritoneal dialysis is performed.
Prevention . Food storage areas are protected from rodents. Repellents are used. Patients are isolated and hospitalized, an epidemiological survey of the focus of infection and monitoring of the population are carried out. In the premises where the patients are located, current and final disinfection is carried out.