What exactly is the epidemic hemorrhagic fever that occurred in Xi'an? How to prevent and treat it?

As the year draws to a close, Xi'an has encountered a new wave of "epidemic" at a critical juncture of the COVID-19 epidemic - major hospitals in the city have successively received many patients with hemorrhagic fever, which has aroused widespread concern in society and once again touched everyone's nervous hearts.

What is hemorrhagic fever? Why is it making people so nervous? Are there any effective drugs to treat it?

Infectious diseases spread by rats

Hemorrhagic fever is called epidemic hemorrhagic fever, also known as hemorrhagic fever with renal syndrome (HFRS) internationally. It is caused by Hantavirus and is a Class B infectious disease with rodents as the main source of infection. The general population is susceptible to it, and the peak season is spring, autumn and winter. my country is one of the countries with the most serious damage from HFRS, and Shaanxi Province, especially Guanzhong area, is a high-incidence area of ​​the disease.

Hantavirus mainly infects humans through the respiratory tract. The excrement of rodents carrying the virus, such as urine, feces, and saliva, pollutes the environment and forms dust or aerosols that are inhaled by humans, causing infection. In addition, it can also be transmitted through eating food contaminated by rodents and being directly bitten by rodents. After a pregnant woman is infected, the virus can also infect the fetus through the placenta.

Initial symptoms are similar to those of a cold

The incubation period of epidemic hemorrhagic fever is generally 7 to 14 days. Typical cases can be divided into 5 stages, namely fever stage, hypotension shock stage, oliguria stage, polyuria stage and recovery stage. The fever stage has an acute onset, mainly high fever, with body temperature fluctuating between 38℃ and 40℃, and generally lasts for 4 to 6 days. It is often accompanied by headache, body muscle and joint pain, and some patients have digestive tract symptoms such as nausea, vomiting and abdominal pain. Because it is very similar to the symptoms of a cold, many patients mistakenly think it is a common cold and delay treatment.

Be vigilant against the “three pains” and “three reds”

Hemorrhagic fever is a serious systemic inflammatory disease that can cause damage to the vascular endothelium, increased vascular permeability, and the clinical manifestations of "three pains" and "three reds".

The “three pains” are headache, back pain, and orbital pain;

The "three reds" are congestion of the conjunctiva and face, congestion of the neck, and congestion of the skin of the upper chest, just like being drunk. In severe cases, symptoms such as hemoptysis, hematemesis, and blood in the stool may occur.

In addition, hemorrhagic fever can also cause systemic tissue edema and kidney damage (oliguria or anuria). A small number of patients may have overlapping stages of fever, hypotension shock, and oliguria. These patients are often in critical condition and have a high mortality rate.

Special groups need attention

The incidence rate in children is low, and the symptoms of systemic poisoning are mild, but there may be damage to the digestive system, heart, lungs, etc. If children in the epidemic area have fever symptoms, it is recommended to undergo Hantavirus IgM antibody testing and kidney B-ultrasound examination, which will help timely diagnosis.

The early clinical manifestations of the elderly are mostly moderate to low fever. Because they often have other underlying diseases, once infected, complications are likely to occur and the mortality rate is high.

Pregnant women often have severe symptoms after infection, and some patients may die from miscarriage, stillbirth, and vaginal bleeding. Hantavirus can also be transmitted vertically through the placenta, causing intrauterine infection of the fetus and leading to death.

"Three early and one close" is the key

There is currently no effective medicine for Hantavirus infection. Early detection, early rest, early treatment and treatment in the nearest hospital with conditions (three early and one near) can significantly reduce the severity of illness and death.

It is generally recommended to rest in bed, eat a light diet, and ensure the necessary calorie supply. Ribavirin antiviral treatment can be used in the early stage of the disease, and the course of treatment should not exceed 7 days. It should be noted that physical cooling is the main method during the fever period. Do not use aspirin or ibuprofen. Use acetaminophen with caution to reduce fever to avoid increasing the risk of bleeding.

Three key prevention points

Epidemic hemorrhagic fever is a preventable infectious disease. The key to prevention is to do three things well:

1. Take precautions to prevent and eliminate rats: Wear gloves and masks when clearing rat nests, rat excrement, and houses and weeds where rats have bred. When working or exploring outdoors, be careful to protect your skin to avoid injuries or mite bites.

2. Vaccination is an effective measure: HFRS bivalent vaccine has good immunogenicity, and a high antibody level can be obtained after two doses of basic immunization. As time goes by, the vaccine protection rate will decrease, and it is recommended that people in endemic areas receive another dose every 7 to 8 years.

3. Do a good job of disinfecting and storing food: do not eat raw or cold food, do not leave food residues, clean up garbage in time, and storage containers should be tight and seamless to prevent contamination by rats.

Author: Zhang Wei, Chief Pharmacist of Shanxi Yangmei Group General Hospital

Review expert: Ren Jianye, chief pharmacist of Shanxi Yangmei Group General Hospital

Liu Guiyang, Chief Pharmacist of the Pharmacy and Pharmacology Department of the Fourth Medical Center of the PLA General Hospital