Crimean-Congo Haemorrhagic Fever
Introduction
Introduction to the Crimean-Congo haemorrhagic fever Crimean-Congohemorrhagicfever is a natural-borne virus disease that is distributed in Europe, Asia and Africa. The disease is characterized by skin, mucous membrane and visceral hemorrhage. The clinical manifestations are similar to those of other types of hemorrhagic fever. However, the kidney damage is mild, and the patients are often severely admitted to hospital. The mortality rate is as high as 50%. This disease was named after the discovery in Crimea and Congo. It was first discovered in Xinjiang Bachu, so China is also known as Xinjiang hemorrhagic fever. basic knowledge The proportion of illness: 0.0002% Susceptible people: no specific population Mode of transmission: insect vector transmission Complications: shock
Cause
Crimea-Congo haemorrhagic fever
(1) Causes of the disease
The Crimean-Congo hemorrhagic fever virus belongs to the genus Nairovirus of the Bunyaviridae family, and the virus particles are round and elliptical. The diameter is about 85-120 nm, and the outer envelope is coated. Under the optical microscope, the cytoplasmic inclusions with erythrocyte size, which are basophilic in Giemsa staining, can be seen in the infected tissue of the rat brain, but in the ultrathin section under electron microscope. The ribosome-like dense particles accumulated by the inclusion bodies are identified, which may be antigen or viral subunit structures.
The mature virus particles are budded from the walls of the Golgi vesicles around the nucleus. The molecular weight is (3.26±0.46)-108, the sucrose float density is 1.16~1.18g/cm3, the temperature of the virus changes and the acid and ether They are all very sensitive. They can be completely inactivated at 56 °C for 30 min. The infection titer can be significantly decreased in 4 °C for 24 h in an ordinary refrigerator. However, in 50% neutral glycerol brine in the ice box, it can be stored for more than half a year. Vacuum drying can preserve viruses for years.
(two) pathogenesis
Vascular endothelial damage is more serious, telangiectasia, increased permeability, rash, dehydration, coagulopathy and even extreme anemia, lesions in vital organs, degeneration or necrosis of lung, liver, kidney and other cells, pulmonary edema, large area of liver Necrosis, cerebral parenchymal edema, cerebral hemorrhage, etc.
Prevention
Crimea-Congo haemorrhagic fever prevention
At present, there is no vaccine. The most practical prevention is to prevent annihilation and strengthen the publicity and education of herders and farm workers, so that they can have the knowledge of preventing cockroaches and bites. It is said that the outbreak caused by the hospital infection is as high as 70. %, the chance of blood-borne infection with the virus is more than that of the aerosol route. There have been cases in which medical personnel have been infected and killed in the rescue of patients. It is necessary to strictly isolate patients and refuse family visits to avoid patients. Contact with viral contaminants to prevent patients from transmitting the virus to health care workers and to eliminate any chance of causing infections in the hospital.
Complication
Crimea-Congo haemorrhagic fever complications Complications
There is no complication of this disease.
Symptom
Crimea-Congo haemorrhagic fever symptoms Common symptoms Acute pain, joint pain, congestion, confusion, slumber, nosebleed, black stool, blood, urine, chills
1. The incubation period is 2 to 12 days.
2. Symptoms and signs
Sudden onset, cold and trepidation, body temperature rose to 39 ~ 41 ° C, severe headache, especially in the forehead and ankle pain, unbearable pain in the face, facial pain, muscle pain in the whole body, severe joint pain, even difficult to walk, early course Facial and neck skin flushing, eye conjunctiva, oral mucosa and soft palate are marked with hyperemia, drunkenness, surface mucosa and skin can see bleeding spots or blood stasis at an early stage, nausea, vomiting lasts for several days, after onset 2 Nasal bleeding occurred in ~3 days, sometimes continued, there was hematemesis in the middle of the disease, a large number of hematemesis in severe cases, hematuria and bloody stools occurred at the same time, black stools were seen, and most of the liver was large, and the splenomegaly was rare.
Severe disease is short, only 2 to 3 days can die, died of severe bleeding, shock and neurological complications. Some patients may have meningoencephalitis accompanied by stiff neck, unconsciousness and even lethargy.
Examine
Crimea-Congo haemorrhagic fever check
It has certain value for diagnosis. For example, if the patient's blood is used to inoculate the pathogen, the complement-binding test, the indirect hemagglutination test or the indirect fluorescent antibody test is positive, the diagnosis can be confirmed, and the white blood cells of the disease are obviously reduced, sometimes Reduced to 1 × 109 / L, thrombocytopenia, urine routine examination mostly proteinuria and hematuria.
Mild liver dysfunction may occur early in the onset, and serum bilirubin is elevated in some patients.
Diagnosis
Crimea-Congo haemorrhagic fever diagnosis
The patient's recent location, bite history and suspicious contact history contribute to clinical diagnosis, based on bleeding spots on the surface mucosa and skin, bruises and acute exacerbations of major bleeding, in the epidemic area and the epidemic season. Diagnosis is not difficult, nose bleeding and bleeding are common early symptoms, which is conducive to early diagnosis.
According to epidemiology, such as regional, seasonal, patient location, bite history and suspicious contact history, according to clinical manifestations, such as acute exacerbation, hemorrhage and other features of hemorrhagic fever and insect-borne infections such as mosquitoes and ticks Identification.
