Omsk hemorrhagic fever in children

Omsk hemorrhagic fever (OGL) is an acute infectious disease of a viral nature with a transmissible transmission, accompanied by fever, hemorrhagic diathesis, transient kidney damage, central nervous system and lung.

ICD-10 code

A98.1 Omsk haemorrhagic fever.

Epidemiology of Omsk haemorrhagic fever in children

The main reservoirs of the infection are muskrat and a water rat (water vole), as well as some species of small mammals and birds. The virus is kept for a long time in ticks and transmitted to the offspring transovarially. A person becomes infected through the bites of ixodid ticks Dermacentor pictus. It is also possible to infect humans with water, food, aspiration and contact routes. The greatest number of diseases is recorded in the spring-summer months. From the person to the person the infection is not transferred.

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What causes Omsk haemorrhagic fever in children?

The causative agent is a virus from the genus Flavivirus, the family Togaviridae. Contains RNA, virion diameter 30-40 nm, pathogenic for many wild and laboratory animals (muskrat, white mice, rabbits, guinea pigs, etc.). Omsk haemorrhagic fever virus is found in the blood of patients in the acute period of the disease and in the body of Dermacentorpictu mites - the main vectors of the disease.

Pathogenesis of Omsk haemorrhagic fever in children

The main pathogenetic link is the destruction of the vascular wall by the virus, which causes hemorrhagic syndrome and focal hemorrhages in the internal organs. Of great importance is the defeat of the virus of the central and autonomic nervous system, as well as of the adrenal and hematopoietic organs. After the transferred disease, persistent immunity remains.

Symptoms of Omsk haemorrhagic fever in children

Omsk hemorrhagic fever in children has an incubation period that is about 2-5 days, rarely extending to 10 days, after which typical symptoms of Omsk haemorrhagic fever appear. The disease begins sharply with a rise in body temperature to 39-40 ° C, headache, chills, aches all over the body, nausea, dizziness, pain in the calf muscles. The face of the patient is hyperemic, slightly puffy, the vessels of the sclera are injected, the lips are dry, bright, sometimes covered with bloody crusts. Constantly detect hyperemia of the soft and hard palate with spotted enanthema and hemorrhagic point hemorrhages. Often noted bleeding gums. With 1-2 days of the disease, a roseous and petechial rash appears on the anterior and lateral surfaces of the chest, on the extensor surfaces of the arms and legs. In severe cases, there may be extensive hemorrhages in the abdomen, sacrum and lower legs. In the following days, extensive necrosis may appear on these sites. Nasal, pulmonary, uterine and gastrointestinal hemorrhages are also possible. Hemorrhagic symptoms usually appear in the first 2-3 days of the disease, but may occur in later periods - on the 7-10th day.

Kidneys are constantly affected. First, there is albuminuria, then short haematuria and cylinduria join. In the sediment of urine, vacuolated granular cells of the renal epithelium are detected. Diuresis is significantly reduced. From the first day of the disease, leukopenia is detected in the blood, moderate neutrophilia with a leftward shift, thrombocytopenia; ESR is normal or decreased.

Diagnosis of Omsk haemorrhagic fever in children

Omsk hemorrhagic fever is diagnosed on the basis of fever, expressed hemorrhagic diathesis in combination with catarrhal phenomena, flushing of the face and injection of vessels of sclera, persistent hypotension and bradycardia. Diagnosis of Omsk hemorrhagic fever is facilitated by the characteristic changes in urinary sediment and blood. It should also take into account the stay in the natural focus of infection. Specific methods use virus isolation and detection of a rise in the titer of specific antibodies in DSC, RTGA, diffuse precipitation in an agar gel or PH in the course of the disease.

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Differential diagnostics

Omsk hemorrhagic fever differentiates with leptospirosis, tick-borne virus encephalitis, influenza, capillarotoxicosis, mosquito fever, HFRS and other hemorrhagic fevers.

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Treatment of Omsk haemorrhagic fever in children

Treatment of Omsk haemorrhagic fever is exclusively pathogenetic, aimed at combating intoxication (intravenous injection of 5-10% glucose solution, 1.5% reamberin solution, rheopolyglucin, etc.) and hemorrhagic manifestations (vitamin K, vikasol, blood transfusions, etc.). In severe cases, glucocorticoids, cardiac agents are indicated, with bacterial complications, antibiotics are prescribed.

How is Omsk haemorrhagic fever prevented in children?

It is aimed at the improvement of natural foci and prevention of infection of children in summer camps, kindergartens located in the natural hearth zone. For active immunization, a killed vaccine is proposed from the brain of white mice infected with the Omsk hemorrhagic fever virus. Vaccination is performed according to strict epidemiological indications.