Crimean hemorrhagic fever: symptoms

Crimean hemorrhagic fever has an incubation period of 2-14 days (an average of 3-5).

There are three clinical forms of the disease:

• Crimean hemorrhagic fever with hemorrhagic syndrome;
• Crimean hemorrhagic fever without hemorrhagic syndrome;
• inapparantnaya form.

Crimean hemorrhagic fever without hemorrhagic syndrome can occur in mild and moderate forms; with hemorrhagic syndrome - in mild, moderate and severe forms. The course of the disease is cyclical and includes the following periods:

• the initial period (prehemorrhagic);
• the period of heat (hemorrhagic manifestations);
• period of convalescence and long-term consequences (residual).

The initial period lasts 3-4 days; there are such symptoms of the Crimean hemorrhagic fever as: a sudden rise in temperature, severe headache, aches and pains throughout the body (especially in the lower back), severe weakness, lack of appetite, nausea, and vomiting, not associated with eating; with severe flow - dizziness and a violation of consciousness. They also detect hypotension and bradycardia.

During the height of the 2nd-4th day of the course of the disease, a short-term decrease in body temperature is detected (within 24-36 h), and then it rises again and on the 6th-7th day begins to lytically decrease (the "two-humped" temperature curve) ; develops a hemorrhagic syndrome in the form of a petechial rash on the lateral surfaces of the chest and abdomen, hemorrhages at the injection sites, hematomas, bleeding gums, bleeding from the eyes and ears, as well as nasal, pulmonary, gastrointestinal and uterine bleeding. The patient's condition deteriorates sharply: symptoms of intoxication are expressed, muffled heart tones, arterial hypotension, bradycardia is replaced by tachycardia, the liver is enlarged. They identify lethargy, adynamy, sometimes deafness and confusion, less often excitement, hallucinations, delirium. Often expressed meningeal symptoms (rigidity of the occipital muscles, Kernig symptom), reveal transient anisocoria, pyramidal signs, violation of convergence. Patients have a characteristic appearance: yawn, face, neck and upper chest are hyperemic; scleras are injected; On the soft palate and mucous membrane of the oral cavity, the enanthema is expressed; rarely jaundice occurs. The severity and outcome of the disease is due to the severity of the hemorrhagic syndrome. Yellowness in combination with other manifestations of liver damage - poor prognostic symptoms of Crimean hemorrhagic fever. The dominance of hepatitis in a clinical picture can lead to death.

The period of convalescence is long (from 1-2 months to 1-2 years and more); begins with the normalization of body temperature, the cessation of manifestations of hemorrhagic syndrome. For this period, the following symptoms of Crimean hemorrhagic fever are typical: asthenovegetative disorders: weakness, fatigue, dizziness, headaches and pains in the heart, vascular scleral injection, congestion of the mucous membrane of the oropharynx, hypotension and pulse lability (persist for 2-3 weeks).

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

Complications of Crimean hemorrhagic fever

Crimean hemorrhagic fever can be complicated by infectious-toxic shock and hemorrhagic shock; DIC-syndrome; focal pneumonia; edema of the lungs; acute cardiovascular, renal and hepatic insufficiency; posthemorrhagic anemia.

Nonspecific complications of the Crimean hemorrhagic fever: pneumonia, otitis, parotitis, phlegmon, abscesses of soft tissues at the injection sites, myocarditis, tonsillitis, peritonitis, thrombophlebitis, sepsis.

[7], [8], [9], [10], [11], [12]

Mortality and causes of death

Crimean haemorrhagic fever has a high mortality; with the transmission pathway of the pathogen is 25%; with a contact from a sick person - up to 50% or more.