Acute infectious diseases of viral nature, characterized by toxicosis, fever and hemorrhagic syndrome - the flow of blood from the vessels (bleeding, hemorrhage). Pathogens belong to the group of arboviruses, whose reservoir is predominantly mouse-like rodents and ixodid ticks. Infection occurs when ticks bite, 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. Occur in the form of individual cases or small outbreaks in rural areas, especially in areas that are not sufficiently developed by man.
Three types of illness are described: 1) hemorrhagic fever with renal syndrome (hemorrhagic nephrosonephritis); 2) Crimean hemorrhagic fever; 3) Omsk hemorrhagic fever.
Hemorrhagic fever with renal syndrome. Incubation period
- 13-15 days. The disease usually begins acutely: severe headache, insomnia, pain in the muscles and eyes, sometimes blurred vision. The temperature rises to 39 - 40 ± С and lasts for 7-9 days. The patient is first excited, then lethargic, apathetic, sometimes delirious. The face, neck, upper chest and back are brightly hyperemic, there is redness of the mucous membranes and dilation of the sclera vessels. By 3-4 days of illness, 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 are increasing every day, there are bleeding, most often nasal. The borders of the heart do not change, the tones are muffled, sometimes arrhythmia appears and, rarely, a pericardial rubbing noise (hemorrhage) suddenly occurs. Blood pressure remains normal or decreases. Shortness of breath, congestion in the lungs. The tongue is dry, thickened, thickly coated with a gray-brown patina. The abdomen is painful (retroperitoneal hemorrhages), the liver and spleen increase non-permanently. The renal syndrome is especially typical: sharp pains in the abdomen and lower back when tapping. Reducing the amount of urine, or its complete absence. Urine becomes turbid due to the presence of blood and high protein content. In the future, recovery gradually begins: the pain subsides, vomiting stops, diuresis increases - the amount of urine released. For a long time, there is a weakness and instability of the cardiovascular system.
Crimean hemorrhagic fever. Body temperature per day reaches 39 - 40 ± C and lasts an average of 7-9 days. The patient is excited, the skin of the face and neck are red. Sharp redness of the conjunctiva of the eyes. Pulse is slow, blood pressure is low. Breath is speeded up, in lungs quite often dry scattered rattles. The tongue is dry, covered with a thick gray-brown bloom, urination is free. In the absence of complications after a decrease in body temperature, a gradual recovery occurs.
Omsk hemorrhagic fever in the clinical picture is reminiscent of the Crimean, but it is more benign, with a short incubation period (2-4 days). The features are the wave-like character 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:The mode of bed rest, careful care of the patient, a milk-vegetable diet. Pathogenetic therapy is corticosteroid drugs. To reduce toxicosis injected solutions of sodium chloride or glucose (5%) to 1 l. In acute renal failure, peritoneal dialysis is performed.
Prevention:Food storage areas protect against rodents. Use deterring agents. Patients are subjected to isolation and hospitalization, epidemiological examination of the source of infection and population monitoring are carried out. In rooms where there are patients, carry out the current and final disinfection.