Crimean hemorrhagic fever in children

Crimean hemorrhagic fever is a natural focal viral disease transmitted by ixodid ticks. The disease is accompanied by fever, severe intoxication and hemorrhagic syndrome.

ICD-10 code

A98.0 Crimean hemorrhagic fever.

Epidemiology

The reservoir and carrier of the infection is a large group of ixodid ticks, in which transovarial transmission of the virus has been established. The source of infection can also be mammals (goats, cows, hares, etc.) with erased forms of the disease or carriers of the virus. A person becomes infected through the bite of ixodid ticks. It is possible for a person to become infected through contact with vomit or blood of sick people, as well as with the blood of sick animals. The spring-summer seasonality of the disease is determined by the activity of ticks-carriers.

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ]

Causes of Crimean hemorrhagic fever in children

The causative agent is an RNA-containing virus from the Bunyaviridae family, genus Nairovirus, with a diameter of 92-96 nm. The virus can be isolated from the blood of patients during the febrile period, as well as from the suspension of crushed ticks - carriers of the disease.

[ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 ]

Pathogenesis of Crimean hemorrhagic fever in children

The pathogenesis is the same as with Omsk hemorrhagic fever and HFRS. The virus mainly affects the endothelium of small vessels of the kidneys, liver and central nervous system, which leads to increased permeability of the vascular wall, disruption of the blood coagulation system by the type of DIC syndrome and the appearance of hemorrhagic diathesis. Macroscopically, multiple hemorrhages are found in the internal organs, as well as in the skin and mucous membranes. They fit into the picture of acute infectious vasculitis with extensive dystrophic changes and foci of necrosis.

Symptoms of Crimean hemorrhagic fever in children

The incubation period lasts from 2 to 14 days, most often 3-6 days. The disease begins acutely or even suddenly with an increase in body temperature to 39-40 ° C, chills, severe headache, general weakness, fatigue, body aches, muscle pain. Abdominal and lower back pain, nausea, and vomiting are often noted. The patient's face, neck, and mucous membranes of the pharynx are hyperemic, the vessels of the sclera and conjunctiva are injected. This is the so-called initial period of the disease. Its duration is about 3-5 days. Then the body temperature decreases, which coincides with the appearance of hemorrhagic diathesis in the form of petechial rashes on the skin, mucous membranes of the oral cavity, nosebleeds, hematomas at the injection sites. In especially severe cases, uterine and gastrointestinal bleeding may occur.

Diagnostics of Crimean hemorrhagic fever in children

Diagnosis is based on hemorrhagic manifestations against the background of general toxicosis, changes in the blood and urinary sediment. Epidemiological history is also important. For laboratory confirmation, methods for detecting the virus and detecting an increase in the titer of specific antibodies in the dynamics of the disease in the RSK, RNGA, etc. are used.

Crimean hemorrhagic fever is differentiated from influenza, typhus, leptospirosis, capillary toxicosis, acute leukemia, Omsk and other hemorrhagic fevers.

[ 15 ], [ 16 ], [ 17 ]

Treatment of Crimean hemorrhagic fever in children

The same as with hemorrhagic fever with renal syndrome and Omsk hemorrhagic fever.

Prevention

The same as for Omsk hemorrhagic fever and HFRS. Active immunization has not been developed.