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Hemorrhagic fever

Acute infectious diseases of a viral nature, characterized by toxicosis, fever and hemorrhagic syndrome - the outflow of blood from blood vessels (bleeding, hemorrhage). Pathogens belong to the group of arboviruses, the reservoir of which are mainly mouse-like rodents and ixodid ticks. Infection occurs 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 individual cases or small outbreaks in rural areas, especially in areas not well developed by humans.
Three types of the disease 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 visual impairment. The temperature rises to 39 - 40 ± C and lasts for 7-9 days. The patient is initially excited, then lethargic, lethargic, sometimes raving. The face, neck, upper chest and back are brightly hyperemic, reddening of the mucous membranes and the expansion of the vessels of the sclera are noted. By 3-4 days of illness, the condition worsens, intoxication increases, repeated vomiting is observed. A hemorrhagic rash appears in the form of single or multiple small hemorrhages on the skin of the shoulder girdle and in the armpits. These phenomena are amplified every day, bleeding, most often nosebleeds, is noted. The borders of the heart do not change, the tones are muffled, sometimes arrhythmia appears and, less often, pericardial friction noise (hemorrhage) suddenly occurs. Blood pressure remains normal or decreases. Dyspnea, congestion in the lungs. Tongue dry, thickened, densely lined with gray-brown coating. The abdomen is painful (retroperitoneal hemorrhage), the liver and spleen increase intermittently. Renal syndrome is especially typical: severe abdominal and lower back pains when striking. A decrease in the amount of urine or its complete absence. Urine becomes cloudy due to the presence of blood and a high protein content. In the future, recovery gradually begins: the pain subsides, vomiting stops, diuresis increases - the amount of urine excreted. For a long time, weakness, instability of the cardiovascular system is noted.
Crimean hemorrhagic fever. Body temperature in 1 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. The pulse is slow, blood pressure is lowered. Breathing is frequent, in the lungs often dry scattered rales. The tongue is dry, covered with a thick gray-brown coating, urination is free. In the absence of complications, a decrease in body temperature leads to a gradual recovery.
Omsk hemorrhagic fever, according to the clinical picture, resembles the Crimean one, but is distinguished by its higher quality, short incubation period (2-4 days). Features are the wavy 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.
Bed mode, careful patient care, a dairy and vegetable diet. Pathogenetic therapy is corticosteroid drugs. To reduce toxicosis, sodium chloride or glucose solutions (5%) are administered intravenously to 1 liter. In acute renal failure, peritoneal dialysis is performed.
Food storage areas protect against rodents. Use repellents. Patients undergo isolation and hospitalization, an epidemiological examination of the foci of infection and monitoring of the population are carried out. In the rooms where the patients are located, they carry out current and final disinfection.