Crimean Congo hemorrhagic fever

Crimean-Congo haemorrhagic fever.  Viruses.  Photo from www.sciencephoto.com

What is it?

Hemorrhagic fever Congo-Crimea (Crimean-Congo fever, Central Asian fever) — Viral natural focal disease human pathogen that is transmitted by ticks. It is characterized by acute onset, two-wave rise in body temperature, severe intoxication and hemorrhagic syndrome (bleeding disorders).

Disease was first discovered by Russian doctors in 1944 in the Crimea, and later a similar disease has been described in the Congo, Nigeria, Senegal, Kenya.

The causative agent of fever is RNA comprising a virus of the genus neyrovirusov. Its reservoir in nature are wild small mammals, which are parasitic ticks (Hare, eared hedgehog, wood mouse), are carriers of many species of pasture ticks. Seasonality of infection in the south of Russia — from May to August.

A sick person can be a source of infection for others, described as cases of hospital infection by contact with the blood of patients.

What's going on?

The virus enters the body through the skin (with a tick bite), accumulates in the cells of the reticuloendothelial system, circulates in the blood. Incubatory period from 1 to 14 days (most 2-7). Disease begins badly, with a sharp increase in body temperature to39-40° C, accompanied by chills.

Noted the pronounced headache, weakness, drowsiness, muscle aches and joint pains, pains in the abdomen, sometimes accompanied by vomiting. On examination of patients in the initial period of a marked redness of the face, neck and upper chest ("symptom hood").

The virus affects vascular endothelium, as well as adrenal cortex, and hypothalamus, which eventually leads to increased vascular permeability, disruption of blood coagulation. Co.2-6days of the disease develops haemorrhagic syndrome. At the same time with a small decrease in temperature on the sides of the chest, in the shoulder girdle, on the upper and lower extremities appears abundant hemorrhagic rash.

There have been extensive hemorrhage at the injection sites, nosebleeds, bleeding gums. The severity of the disease increases during this period, there may be episodes of loss of consciousness. Stomach and intestinal bleeding worsen prognosis.

The average temperature remains elevated for 12 days, the recovery has been slow, enhanced slaost and fatigue (asthenia) is maintained for 1-2months. It can cause fatal complications such as pulmonary edema, sepsis, acute renal failure, pneumonia.

Diagnosis and treatment

Recognition of the disease based on characteristic clinical findings (acute onset, severe course, expressed haemorrhagic syndrome, seasonality, tick bites in history). Virological and serological methods of diagnosis are rarely used in practice.

Treatment is carried out under conditions of infectious disease ward. Assigned to anti-inflammatory treatment, normal urine output. Not used drugs that increase renal damage.

Prophylaxis

Reduced to care for nature inperiod tick activity in areas endemic for the disease (Krasnodar and Stavropol, Rostov, Astrakhan, Volgograd Region, the Republic of Dagestan). The bite of the tick is an urgent need to contact the hospital.

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