Highly vigilant!

Recently, the new crown pneumonia epidemic in Xi'an has resumed, and the number of new local confirmed cases has continued to rise.
As of December 23, there were 63 new cases and 229 confirmed cases
.

Under the precarious situation, Xi'an has reported a number of cases of hemorrhagic fever.

Haemorrhagic fever is easily mistaken for a cold and can be life-threatening in severe cases

Hemorrhagic fever is easy to be mistaken for a cold, and it can be life-threatening in severe cases.
Hemorrhagic fever is easy to be mistaken for a cold and can be life-threatening in severe cases.

Hantavirus 3D image
.

Source: Scientific Animations

Hantavirus 3D image

Cause

Cause of Cause

01 Host animal and source of infection

01 Host animal and source of infection

Mainly small rodents, including wild mice and house mice
.

02 Ways of transmission

02 Ways of transmission

The main transmission is of animal origin.
The virus can be excreted through the blood, saliva, urine, and feces of the host animal.
The direct transmission of mice to humans is an important way for human infection
.

03 Population susceptibility

03 Population susceptibility

It is generally believed that the population is generally susceptible, with a low rate of hidden infections, a high incidence of young adults, and long-lasting immunity after illness
.

 

Clinical manifestations

Clinical manifestations Clinical manifestations

Clinical manifestations: The incubation period of hemorrhagic fever is generally 2 to 3 weeks
.

The typical clinical course is divided into five stages: fever period, hypotension shock period, oliguria period, polyuria period and recovery period

1.
Fever period

1.
Fever period

Mainly manifested as symptoms caused by infectious viremia and systemic capillary damage
.

Acute onset, with fever (38℃～40℃), three pains (headache, low back pain, orbital pain) and symptoms such as nausea, vomiting, chest tightness, abdominal pain, diarrhea, and general joint pain.
The skin and mucous membranes are three red (face, neck and Redness of the upper chest), conjunctival hyperemia, and severe cases of drunken appearance
.

Bleeding spots or ecchymosis of varying sizes appear on the oral mucosa, chest, back, and underarms, or hemorrhage spots in the form of strings or scratches

2.
Hypotensive shock period

2.
Hypotensive shock period

Most of the fever is 4-6 days, when the body temperature begins to drop or shortly after the fever, it is mainly the performance of plasma loss hypovolemic shock
.

The patient has hypotension, and severe cases have shock

3.
Oliguria

3.
Oliguria

The 24-hour urine output is less than 400ml, and there is often no obvious boundary between oliguria and hypotension
.

4.
Polyuria

4.
Polyuria

Kidney tissue damage is gradually repaired, but because the renal tubular resorption function has not been fully recovered, the urine output has increased significantly
.

It is more common on the 8th to 12th day and lasts for 7 to 14 days.

5.
Recovery period

5.
Recovery period

With the gradual recovery of renal function, when the urine volume drops below 3000ml, the recovery period is entered
.

Urine volume and symptoms gradually return to normal, and it will take several months to recover

Patients with common cold and fever will get better after the fever subsides, while patients with hemorrhagic fever may become more severe after the fever subsides
.

When the above-mentioned clinical symptoms appear, you must not take cold medicine at will.

 

my country used to be the main endemic area of ​​hemorrhagic fever

China used to be the main endemic area of hemorrhagic fever China used to be the main endemic area of ​​hemorrhagic fever

China was once one of the main endemic areas of epidemic hemorrhagic fever.
In the 1980s, the highest annual number of reported cases of hemorrhagic fever in the country exceeded 100,000.
Hemorrhagic fever was listed as one of the national key infectious diseases for prevention and treatment
.
The number of reported cases in China accounts for about 80% of the total number of cases in the world
.
The incidence is higher in Shaanxi, the three northeastern provinces, Shandong, Hebei, and Hunan .
In recent years, with the improvement of domestic medical standards and the improvement of human living conditions and natural environment, the risk of virus transmission among rats and human exposure has been greatly reduced, and the epidemic of hemorrhagic fever infectious disease has dropped significantly, but there are still cyclical fluctuations in a few areas
.
According to Sun Yaping, an expert from the Xi’an Center for Disease Control and Prevention, due to the combined effects of climate, topography, rivers, vegetation and other factors, Apodemus agrarianus is more common in Guanzhong, Shaanxi, and the rate of carrying Hantavirus is higher in the wild
.
The annual number of cases reported in Xi'an, Weinan, Xianyang, Baoji and Yangling Demonstration Zones in the Guanzhong region accounted for about 95% of the total number of cases in the province
.
The affected population is mainly rural residents, accounting for about 80% of the total cases
.

"Time Series Analysis of the Incidence of Hemorrhagic Fever with Renal Syndrome in China from 2005 to 2019" Source: Nature

"Time series analysis of incidence of hemorrhagic fever with renal syndrome in China 2005-2019" source: Nature "Time series analysis of incidence of hemorrhagic fever with renal syndrome in China 2005-2019" source: Nature

The incidence series of hemorrhagic fever with renal syndrome is broken down into three parts: (A) the actual observed sequence; (B) the trend; (C) seasonal changes; (D) irregular components
.

The incidence series of hemorrhagic fever with renal syndrome is broken down into three parts: (A) the actual observed sequence; (B) the trend; (C) seasonal changes; (D) irregular components
.
The incidence series of hemorrhagic fever with renal syndrome is broken down into three parts: (A) the actual observed sequence; (B) the trend; (C) seasonal changes; (D) irregular components
.

The analysis results show that the incidence of hemorrhagic fever with renal syndrome has a strong seasonality, with a bimodal pattern.
Spring and autumn and winter are the two peak incidences, and autumn and winter are much higher than spring
.
A strong peak is observed from November to January of the following year, and a weak peak is observed in May and June of each year
.
This observation is consistent with the results reported in most parts of China.
This significant difference in seasonal behavior is mainly affected by the climate and demographic factors of cities in the northern hemisphere
.
In China, the bimodal activity of the incidence of hemorrhagic fever with renal syndrome may be mainly affected by its etiology and climatic factors
.
Early studies have found that Hantavirus-related hemorrhagic fever with renal syndrome infections are reported throughout the year, but most occur in autumn and winter, while Seoul virus (SEOV)-related cases are usually observed in spring.
These two pathogens It is mainly composed of rodents such as Apodemus agrarius and Rattus norvegicus
.
It is worth noting that climatic driving factors, such as temperature, relative humidity, precipitation, etc.
, will affect the reproduction of the host and will lead to the spread of hemorrhagic fever
.

Does hemorrhagic fever spread from person to person?

Does hemorrhagic fever spread from person to person? Does hemorrhagic fever spread from person to person?

"Haemorrhagic fever is not a respiratory infectious disease such as SARS and influenza A.
It will not be transmitted from person to person.
It is mainly spread through contact with rodent secretions or excrement, so there will be no large-scale leapfrog infection
.
"Song Rui, chief physician of the Infectious Disease Diagnosis and Treatment Center of Beijing Ditan Hospital, explained
.

According to information released by Xi’an Disease Control and Prevention, the mortality rate of hemorrhagic fever is very high.
If you are bitten by a mouse, or eat food and water that the mouse has crawled, you may be infected with the blood, urine, feces, etc.
of the mouse that has the virus.
Hemorrhagic fever
.
The population is generally susceptible to infection, and the incidence is extremely high among rural residents who often farm in the wild, or workers engaged in food and agricultural products processing, and students majoring in agronomy
.

Due to the rapid onset and rapid progress of hemorrhagic fever, severely ill patients have a certain risk of mortality
.
If the patient cannot be diagnosed and treated in time, it may even be life-threatening
.
In terms of infectiousness, this disease is generally sporadic, rarely clusters, and the risk of direct contact with the population is very small
.
Severe hemorrhagic fever can lead to acute renal failure.
Such patients need dialysis to combat the disease.
Such severe patients will not infect other people through the respiratory tract.
Therefore, dialysis does not require separate isolation
.

How to prevent hemorrhagic fever infectious disease?

How to prevent hemorrhagic fever infectious disease? How to prevent hemorrhagic fever infectious disease?

Epidemic hemorrhagic fever is a preventable infectious disease.
As long as preventive measures are in place, viral infection can be avoided
.
Deratization and rodent prevention are the key to preventing epidemic hemorrhagic fever
.
If there are suspicious symptoms such as high fever, three reds, three pains, and a history of rodent contact within 1 month before the onset of illness, seek medical attention as soon as possible.
Early detection, early rest, and early treatment can significantly reduce the incidence of severe illness and death
.

1.
Control the source of infection : strengthen rodent control and rodent control in epidemic areas and new development areas
.

Control the source of infection

2.
Cut off the route of transmission : strengthen personal protection when working in the field, cleaning up weeds and stalks and field activities
.
Prevent inhalation of rodent excretion pollutants and rodent parasites
.

Cut off the route of transmission

3.
Protect susceptible people : Vaccination against hemorrhagic fever is one of the most effective measures to prevent hemorrhagic fever
.
It is recommended that residents in affected areas and foreign populations of appropriate age be vaccinated against hemorrhagic fever
.
The hemorrhagic fever vaccine was vaccinated with a total of 3 doses during the whole course, the first two doses were separated by 14 days, and the third dose was separated by one year
.
The first two injections are basic immunizations, which are very important.
Please make sure to complete at least the basic injections to gain a certain degree of immunity
.
If more than one year after completing the basic immunization, the third injection can be replanted at any time
.

Protect susceptible people

Vaccine immune effect

Vaccine immune effect

The positive conversion rate of neutralizing antibody after immunization: 46% for 2 injections, 96% for 3 injections, 3 injections are appropriate
.
According to the observation of epidemiological effects, the protection rate can reach about 90%
.

Vaccination reaction: no response or mild reaction after injection, low reaction rate, a small number of people have fever or rash
.
The body temperature is all <38℃, and local reactions are rare.
Very few people may experience temporary induration due to slow absorption after injection, but they can be absorbed quickly
.

Contraindications: ① Fever and acute and chronic infectious diseases
.
②Severe liver and kidney disease
.
③ Chronic cardiovascular disease
.
④Patients with a history of allergies
.

4.
Strengthen the surveillance of the epidemic situation : do a good job of monitoring the density of rodents, the rate of rodent carrying viruses, and susceptible populations
.

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