Argentine hemorrhagic fever
Introduction
Introduction to Argentine Bleeding Argentine hemorrhagic fever is caused by the Junin and Machupo viruses, a rodent-based natural epidemic disease. Clinical features include fever, severe myalgia, hemorrhage, shock, neurological abnormalities, and leukopenia and thrombocytopenia. basic knowledge The proportion of illness: 0.003% Susceptible people: no specific people Mode of infection: digestive tract spread complication:
Cause
Argentemia hemorrhagic fever
(1) Causes of the disease
Both Suining and Maqiubo virus belong to the genus of the genus Asparagus, which is named after the sand-like shape on the ultra-thin. The Suining virus is an RNA virus with a diameter of 60-280 nm, an average of 110-130 nm, which is spherical, spheroidal or diverse. There are 2 to 10 long rods on the outer membrane of about 6 nm, and the globules contain 2 to 10 sand particles with a diameter of 20 to 25 nm. The virus is pathogenic to newborn mice and hamsters, so it is available. To isolate the virus, the Maqiubo virus is similar in morphology and biological characteristics to the Suining virus.
(two) pathogenesis
At present, it is believed that the direct damage of the virus is the main factor. When the virus enters the human body, it will produce viremia through replication and proliferation, causing damage to the whole body capillary endothelial cells, increasing vascular permeability and fragility, causing bleeding, edema, shock and so on. Clinical symptoms.
Prevention
Argentine hemorrhagic fever prevention
At present, there is no such disease in China. It is necessary to pay attention to the quarantine of the border and prevent the importation. In the epidemic area, rodent control and rodent control are the main measures. Personal hygiene should be paid attention to avoid infection. The application of vaccine is the main preventive measure for hemorrhagic fever in Argentina. Bolivia bleeding There is no vaccine for heat.
Complication
Argentine hemorrhagic fever complications Complication
The main complications are fever, venom, hemorrhage, extravasation, renal damage, fever, hypotension, etc. The virus first combines with the receptor p3 integrin expressed on the surface of platelets, endothelial cells and monocytes. And then enter the cells and liver, spleen, lung, kidney and other tissues, and then replicate and then release into the bloodstream, causing viremia, due to viral infection and immune response induced by infection, and the release of various cytokines, resulting in Cell degeneration, necrosis or apoptosis, and impaired organ function. Because Hantavirus is a pan-tropic infection in humans, it can cause multiple organ damage.
Symptom
Argentine hemorrhagic fever symptoms common symptoms diarrhea congestion convulsions nausea sepsis abdominal pain
The incubation period is 6 to 14 days, the onset is slow, the first disease week, gradually appear discomfort, the body temperature gradually rises, the third disease day can reach 39 ° C, severe headache, low back pain, muscle and joint pain, anorexia, nausea, vomiting, upper abdominal pain, Some patients have eyelid pain, constipation or diarrhea, physical examination, neck and upper chest flushing, upper chest, upper arm and armpit skin visible defects, ecchymosis, moderate lymph nodes, conjunctival hyperemia, periorbital edema, oropharynx Mucosal congestion, small defects, soft palate with different sizes of blisters, gingival congestion or bleeding, 1/5 cases on the 4th to 6th day of the disease showed special neurological symptoms, manifested as disorientation, hand and tongue intentional tremor, medium Degree of ataxia, skin hypersensitivity, tendon reflex and hypotonia, female patients often have mild to moderate uterine bleeding, and can be the first symptom of Argentine hemorrhagic fever, a small number of patients with acute onset, like acute abdomen Caused by surgery, the first weekend with the rapid decline of fever, hypotension, oliguria and varying degrees of dehydration, continued to recover after 48h, severe cases can occur coma shock, a small number of deaths 48 to 72h.
Blood: white blood cells and thrombocytopenia, gradually recover after heat retreat, may have proteinuria and castosis and normal blood sedimentation.
Week 2: 70% to 80% of patients with the above symptoms and signs are relieved, but fatigue, hair loss and memory loss need to recover from 1 to 3 months, leaving no sequelae, 20% to 30% of patients in 8 to 12 days Severe bleeding or nervous system damage such as stomach, intestine, nose, gums, uterus, etc. (consciousness disorder, ataxia, excitement and tremors, even paralysis, convulsions, coma) can also occur at the same time, leading to death. , urethritis, sepsis, and even gas gangrene, but the increase in white blood cells is not obvious, easy to be delayed diagnosis.
Examine
Argentine hemorrhagic fever check
1. Blood: Leukocytes and thrombocytopenia, gradually recover after heat retreat, may have proteinuria and castosis and normal blood sedimentation.
2. Virus isolation:
1 The patient's blood (acute fever) lymphoid tissue (death case) was inoculated into mice, guinea pigs, and green monkey kidney cells, and golden hamster kidney cells were monolayer cultured to isolate the virus.
2 Peripheral blood mononuclear lymphocytes suspected of having Argentine hemorrhagic fever, inoculated in Vero cell monolayer culture, is the most sensitive method for isolating the Suining virus.
3. Immunohistochemistry methods such as immunofluorescence or PAP: results in 1 to 3 days, which is conducive to early diagnosis.
4. Serological tests: indirect fluorescence test and plaque reduction test, detection of specific antibodies, for early diagnosis, complement fixation test, can not be used for early diagnosis, but can be used to screen for Argentine hemorrhagic fever immune plasma donors.
Diagnosis
Diagnosis and diagnosis of hemorrhagic fever in Argentina
Diagnostic criteria
1. Clinical diagnosis in the epidemic area (Argentina or Bolivia) or into the epidemic area, or contact with the rodent, fever, severe headache, low back pain, muscle and joint pain, eyelid pain, upper abdominal pain, skin imperfections, freckle And uterine bleeding, facial flushing, conjunctival hyperemia, periorbital edema, pharyngeal mucosa congestion, sputum, ecchymoses and small blisters appear white blood cells and thrombocytopenia, proteinuria, cast, and erythrocyte sedimentation can make a diagnosis of this disease .
2. Laboratory diagnosis
(1) Virus isolation: 1 Take the patient's blood (acute fever) lymphoid tissue (death case) inoculated in mice, guinea pigs, and green monkey kidney cells, golden hamster kidney cells monolayer culture, virus isolation, 2 suspected Argentina Peripheral blood mononuclear lymphocytes in patients with hemorrhagic fever, inoculated in vero cell monolayer culture, are the most sensitive method for isolating the Suining virus.
(2) Immunohistochemistry methods such as immunofluorescence or PAP: results can be produced within 1 to 3 days, which is helpful for early diagnosis.
(3) Serological tests: indirect fluorescence test and plaque reduction test, detection of specific antibodies, for early diagnosis, complement fixation test, can not be used for early diagnosis, but can be used to screen for Argentine hemorrhagic fever immune plasma donors.
Differential diagnosis
The disease needs to be differentiated from hyperglycemia and dengue shock syndrome, leptospirosis, meningitis, sepsis, and the like.
