Epidemic Hemorrhagic Fever, also known as Hemorhagic Fever with Renal Syndome, HFRS, is an acute infectious disease caused by the Hantavirus virus. The disease is mainly transmitted through rodents (e.g. rats) and has significant seasonal and regional characteristics. The clinical manifestations of epidemic haemorrhagic fever are complex and rapid, and failure to treat them in a timely manner can lead to serious complications and even death. Details of the symptoms of the epidemic haemorrhagic fever and the treatments are given here.
I. Symptoms of epidemic haemorrhagic fever
The clinical manifestations of epidemiological haemorrhagic fever are typical of stages, which can be divided into five stages: fever, hypotensive shock, urination, hyperuresis and recovery. The symptoms at each stage are characteristic.
(i) Heating period (days 1-7 of the course)
The fever period is the early stage of the epidemic haemorrhagic fever, and the patient usually manifests itself in acute cases, the main symptoms of which are:
1. High heat: body temperature rises rapidly to 39-40°C, accompanied by cold warfare and physical inactivity.
2. Symptoms of the whole body: headaches, muscular sourness, eye pains, nausea, vomiting, etc.
Face of the neck is covered with blood: the patient’s face, neck and upper chest are red, with “drink”.
4. Haemorrhage: Some patients may suffer from skin bruises, bruises, haemorrhage of their teeth or nose.
5. Other symptoms: convulsion, osteoporosis, larvae, etc.
(ii) Low blood pressure shock (3-7 days)
This is the most serious period, and the patient may have the following symptoms:
1. Low blood pressure or shock: due to increased vascular permeability and reduced blood capacity, patients may be exposed to reduced blood pressure, faster heart rate, freezing of limbs, etc.
2. Circulatory failure: A serious person may have heart failure or multi-organ dysfunction.
(iii) Utility reduction (5-14 days)
The reduction of urinary periods is the stage of renal damage of the epidemic haemorrhagic fever, mainly as follows:
1. Decrease in urine: less than 400 ml/day or even no urine.
2. Kidney function impairment: Increased levels of urea nitrogen (BUN) and acetic anhydride, possibly associated with metabolic acid poisoning and electrolytic disorders (e.g., potassium haematoma).
3. Full body edema: due to reduced urine and sodium sodium leaching, the patient may have faces, limbs or full oedema.
(iv) Pediatric period (10-21 days)
As the condition improves, the patient enters the urination period, as shown by:
1. Increase in urine: The daily urine can be as much as 3,000 – 6,000 ml or more.
Dehydration symptoms: Due to the high number of urine excretions, the patient may have dehydration manifestations such as thirst, lack of strength and low blood pressure.
(v) Recovery period (after day 21)
The recovery period is the stage of gradual improvement in the patient ‘ s symptoms, and the kidney function and the whole body ‘ s condition are back to normal, but full recovery may take weeks to months.
II. Treatment of epidemic haemorrhagic fever
The treatment of epidemic haemorrhagic fever is based on support for treatment of symptoms, combined with antiretroviral treatment and treatment of complications. Early diagnosis and timely treatment are key to reducing disease and death rates.
(i) General treatment
1. Segregation and care
Patients should be treated in isolation to avoid cross-infection. The ward should be kept clean and ventilated and care should be taken to prevent secondary infections.
2. Bed rest
Patients should rest in bed to avoid intense activity to reduce the risk of heart burden and bleeding.
(ii) Antiviral treatment
1. Libavirin
Libaverin is a special effect drug for the treatment of epidemic haemorrhagic fever, and early use can significantly reduce morbidity and the incidence of complications. Usually used during heat or hypotensive shock, dosages and treatments are adjusted to the patient ‘ s condition.
2. Other antiviral drugs
There are no other well-defined and effective antiretroviral drugs, but new antiviral treatment strategies are being studied.
(iii) Patient support treatment
1. Remediation and correction of electrolyte disorders
Reasonable resupply of liquids based on patient ‘ s blood capacity and electrolyte levels to correct dehydration, acidic poisoning and electrolyte disorders.
Control of haemorrhage
For patients with an apparent tendency to haemorrhagic, hemorrhage meds (e.g. vitamin K1) or infusion plate, coagulation factors, etc.
3. Protection of kidney function
Patients with less urea should limit liquid intake and avoid the use of renal toxicity. Blood dialysis or peritoneal dialysis may be performed if necessary.
4. Anti-shock treatment
For patients with low blood pressure or shock, the blood capacity should be replenished in a timely manner, with the use of pressure-up drugs (e.g. dopamine, adrenaline) if necessary.
(iv) Treatment of complications
1. Infection control
Re-infection is an important complication of epidemic haemorrhagic fever and appropriate antibiotics should be selected based on pathogen tests.
Multi-organ functional impairment syndrome (MODS)
For patients with MODS, comprehensive treatment should be provided, including respiratory support, cycling support and kidney function support.
(v) Recovery management
1. Nutritional support
Persons in the recovery period should be provided with better nutrition and a high protein and vitamin diet to facilitate physical recovery.
2. Regular follow-up visits
After discharge, patients should regularly review indicators such as kidney function, blood routine, etc. to monitor recovery.
III. Epidemic haemorrhagic fever prevention
Epidemic haemorrhagic fever prevention is centred on control of rat transmission, combined with vaccination and health education.
1. Control of rats
Strengthen environmental health management, remove rat habitats and avoid exposure to rats and their excreta.
Vaccination
People in high-prevalence areas should be vaccinated against epidemiological haemorrhagic fever, especially those at high risk (e.g. farmers, forest workers, etc.).
3. Health education
Raise public awareness of the prevalence of haemorrhagic fever, increase knowledge of rat and disease prevention and reduce the risk of infection.
Concluding remarks
Epidemic haemorrhagic fever is a serious infectious disease with a complex and rapidly changing pathology, but with early diagnosis, timely treatment and scientific management, most patients can fully recover. Improved disease prevention and health education and control of rat transmission are key to reducing the incidence of epidemic haemorrhagic fever. In the future, as medical research deepens, the treatment and prevention of epidemic haemorrhagic fever will become more efficient, providing patients with better prognosis and quality of life.
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