Blood infections is a group of infections whose pathogens penetrate the human bloodstream and develop in it through the bite of blood-sucking carriers (fleas, ticks, mosquitoes, mosquitoes, etc.).

Typhus- an acute infectious disease characterized by a cyclic course with fever, symptoms of acute intoxication of the body and a specific rash.

Only people get typhus.

Ways of transmission of the disease. The source of infection is a sick person, and the carrier is a louse (usually a body louse). Infection of a person does not occur as a result of a louse bite, but due to rubbing of louse feces along with pathogens into superficial skin wounds from a bite when scratching. Incubation period lasts on average 12-14 days.

Main symptoms. The disease usually begins acutely: malaise, a feeling of weakness, headaches, thirst appear, appetite is lost, and the temperature rises to 39-40°C. Later, a characteristic appearance appears on the skin. pinpoint rash. The toxins of the pathogen have a depressing effect on the central nervous system. During the period of rash, headaches intensify, delusions, hallucinations, and disturbances of consciousness appear. With typhus, serious complications are possible: mental disorders, thrombosis, intestinal bleeding, myocardial infarction, abscesses, nephritis, otitis, pneumonia.

Principles of treatment and patient care. Patients are treated in a hospital using antibiotics, dietary nutrition, bed rest.

Prevention. A decisive role in the fight against typhus is played by the prevention of pediculosis, which is achieved by sanitizing people.

Ways of transmission of the disease. The disease is characterized by spring-summer seasonality, which is determined by the biology of ticks. Ticks transmit infection when they suck blood, as well as when they are crushed and removed from the body. An additional reservoir of infection can be various rodents (hares, field mice, etc.), birds (thrush, goldfinch, finch, etc.). A special role in the spread is played by goats, and less often by cows, which are infected through ticks. The virus penetrates milk, and if it is consumed raw, infection can occur. Consequently, tick-borne encephalitis has two transmission routes - the main one through ticks and the additional one through milk.

Main symptoms. The incubation period lasts on average 7-14 days. The disease, as a rule, begins acutely with signs of general intoxication. Characterized by an increase in body temperature to 39-40°C, chills, severe headache and weakness, nausea, vomiting, sleep disturbance. There is redness of the skin of the face, neck, upper body, mucous membranes of the pharynx, loss of consciousness, convulsions, impaired peripheral sensitivity and reflexes, etc. residual effects relate flaccid paralysis, muscle atrophy, decreased intelligence, sometimes epilepsy.

For prevention tick-borne encephalitis for people working in areas possible infection, do preventive vaccinations. Those working in the tick attack zone must wear special protective clothing and carry out tick checks every 2 hours. preventive examinations body and clothing for the presence of ticks.

Review questions

1. Describe typhus.
2. What is tick-borne encephalitis?

Infectious diseases are the most common types of diseases. According to statistics, every person suffers from an infectious disease at least once a year. The reason for such prevalence of these diseases lies in their diversity, high contagiousness and resistance to external factors.

Classification of infectious diseases

A common classification of infectious diseases is based on the method of transmission: airborne, fecal-oral, household, vector-borne, contact, transplacental. Some of the infections may also be related to different groups, because they can be transmitted in different ways. Based on location, infectious diseases are divided into 4 groups:

1. Infectious intestinal diseases in which the pathogen lives and multiplies in the intestines. Diseases in this group include: salmonellosis, typhoid fever, dysentery, cholera, botulism.
2. Respiratory infections that affect the mucous membrane of the nasopharynx, trachea, bronchi and lungs. This is the most common group of infectious diseases, causing epidemic situations every year. IN this group include: ARVI, various types of influenza, diphtheria, chicken pox, tonsillitis.
3. Skin infections transmitted by touch. These include: rabies, tetanus, anthrax, erysipelas.
4. Blood infections transmitted by insects and through medical procedures. The pathogen lives in the lymph and blood. Blood infections include: typhus, plague, hepatitis B, encephalitis.

Features of infectious diseases

Infectious diseases have common features. In various infectious diseases these features manifest themselves in varying degrees. For example, contagiousness chickenpox can reach 90%, and immunity is formed for life, while the infectiousness of ARVI is about 20% and forms short-term immunity. The following features are common to all infectious diseases:

1. Contagiousness, which can cause epidemic and pandemic situations.
2. The cyclical nature of the disease: incubation period, the appearance of precursors of the disease, acute period, decline of illness, recovery.
3. Common symptoms include fever, general malaise, chills, and headache.
4. Formation immune defense regarding the disease.

Causes of infectious diseases

The main cause of infectious diseases are pathogens: viruses, bacteria, prions and fungi, but not in all cases the entry of a harmful agent leads to the development of the disease. The following factors will be important:

• what is the infectiousness of pathogens of infectious diseases;
• how many agents entered the body;
• what is the toxicogenicity of the microbe;
• what does it feel like general state body and condition immune system person.

Periods of infectious disease

From the time the pathogen enters the body until full recovery it takes some time. During this period, a person goes through the following periods of infectious disease:

1. Incubation period– the interval between the entry of a harmful agent into the body and the beginning of its active action. This period ranges from several hours to several years, but more often it is 2-3 days.
2. Pre-normal period characterized by the appearance of symptoms and a vague clinical picture.
3. Period of disease development, in which the symptoms of the disease intensify.
4. High period, in which the symptoms are most pronounced.
5. Extinction period– symptoms decrease, condition improves.
6. Exodus. Often this is recovery - the complete disappearance of signs of the disease. The outcome may be different: transition to chronic form, death, relapse.

Spread of infectious diseases

Infectious diseases are transmitted in the following ways:

1. Airborne– when sneezing, coughing, when particles of saliva with a microbe are inhaled by a healthy person. In this way, a massive spread of infectious disease among people occurs.
2. Fecal-oral– germs are transmitted through contaminated foods and dirty hands.
3. Subject– transmission of infection occurs through household items, dishes, towels, clothing, and bed linen.
4. Transmissible– the source of infection is an insect.
5. Contact– transmission of infection occurs through sexual contact and contaminated blood.
6. Transplacental– an infected mother transmits the infection to her child in utero.

Diagnosis of infectious diseases

Since the types of infectious diseases are diverse and numerous, to make a correct diagnosis, doctors have to use a complex of clinical and laboratory-instrumental research methods. At the initial stage of diagnosis important role Anamnesis is collected: history of previous diseases and this one, living and working conditions. After examination, medical history and initial diagnosis, the doctor prescribes laboratory test. Depending on the suspected diagnosis, this may include various blood tests, cell tests, and skin tests.

Infectious diseases - list

• lower respiratory tract infections;
• intestinal diseases;
• ARVI;
• tuberculosis;
• Hepatitis B;
• candidiasis;
• toxoplasmosis;
• salmonellosis.

Human bacterial diseases - list

Bacterial diseases are transmitted through infected animals, sick people, contaminated foods, objects and water. They are divided into three types:

1. Intestinal infections. Particularly common in summer. Caused by bacteria of the genus Salmonella, Shigella, coli. TO intestinal diseases include: typhoid fever, paratyphoid fever, food poisoning, dysentery, escherichiosis, campylobacteriosis.
2. Respiratory tract infections. They are localized in the respiratory system and can be complications viral infections: FLU and ARVI. Bacterial infections of the respiratory tract include the following: tonsillitis, tonsillitis, sinusitis, tracheitis, epiglottitis, pneumonia.
3. Infections of the external integument caused by streptococci and staphylococci. The disease can occur due to harmful bacteria coming into contact with the skin from the outside or due to an imbalance in the skin bacteria. Infections in this group include: impetigo, carbuncles, boils, and erysipelas.

Viral diseases - list

Human viral diseases are highly contagious and widespread. The source of the disease is a virus transmitted from a sick person or animal. Infectious disease agents spread rapidly and can affect people over a vast area, leading to epidemic and pandemic situations. They manifest themselves fully in the autumn-spring period, which is associated with weather conditions and weakened human bodies. The top ten common infections include:

• ARVI;
• rabies;
• chickenpox;
• viral hepatitis;
• herpes simplex;
• Infectious mononucleosis;
• rubella;

Fungal diseases

Fungal infectious diseases skin infections are transmitted through direct contact and through contaminated objects and clothing. Most fungal infections similar symptoms, therefore, to clarify the diagnosis it is necessary laboratory diagnostics skin scraping. Common fungal infections include:

• candidiasis;
• keratomycosis: lichen and trichosporia;
• dermatomycosis: mycosis, favus;
• : furunculosis, ulcers;
• exanthema: papilloma and herpes.

Protozoal diseases

Prion diseases

Among prion diseases, some diseases are infectious. Prions, proteins with an altered structure, enter the body along with contaminated food, through dirty hands, unsterile medical instruments, and contaminated water in reservoirs. Prion infectious diseases in humans are severe infections that are practically untreatable. These include: Creutzfeldt-Jakob disease, kuru, fatal familial insomnia, Gerstmann-Straussler-Scheinker syndrome. Prion diseases affect the nervous system and brain, leading to dementia.

The most dangerous infections

The most dangerous infectious diseases are diseases in which the chance of recovery is only a fraction of a percent. In the top five dangerous infections includes:

1. Creutzfeldt-Jakob disease, or spongiform encephalopathy. This rare prion disease is transmitted from animals to humans, leading to disorders brain activity and death.
2. HIV. The immunodeficiency virus is not fatal until it has progressed to the next stage - .
3. Rabies. Cure from the disease is possible with vaccination before symptoms appear. The appearance of symptoms indicates imminent death.
4. Hemorrhagic fever. This includes a group of tropical infections, some of which are difficult to diagnose and cannot be treated.
5. Plague. This disease, which once devastated entire countries, is now rare and can be treated with antibiotics. Only some forms of plague are fatal.

Prevention of infectious diseases

Prevention of infectious diseases consists of the following components:

1. Increasing the body's defenses. The stronger a person’s immunity, the less often he will get sick and the faster he will recover. To do this it is necessary to conduct healthy image life, eat right, exercise, get proper rest, try to be optimistic. Good effect to increase immunity has hardening.
2. Vaccination. During epidemics positive result provides targeted vaccination against a specific rampant disease. Vaccinations against certain infections (measles, mumps, rubella, diphtheria, tetanus) are included in the mandatory vaccination schedule.
3. Contact protection. It is important to avoid infected people, use protective by individual means During epidemics, wash your hands frequently.

Intestinal infections.

The causative agents of this group of infections enter the human body through gastrointestinal tract(enteral) with food or water. In the gastrointestinal tract, pathogens multiply and cause specific changes leading to the appearance of characteristic clinical symptoms. Pathogens are excreted from the human body primarily through feces. In cases where the pathogen circulates in the blood (with typhoid fever), it is possible to isolate the pathogen through other excretory organs, i.e., with urine and saliva. Pathogenic microorganisms can enter food products drinking water, and when they are consumed, infection occurs.

Transmission mechanism fecal-oral.

Transmission routes food (alimentary), water, contact and household. Transmission factors; food, water, dishes, care items, dirty hands.

To the group intestinal infections include:

Typhoid fever;

Paratyphoid A, Paratyphoid B;

Dysentery;

Salmonellosis;

Food poisoning;

Cholera;

Botulism;

Viral hepatitis A&E.

2. Respiratory tract infections (droplet infections).

The causative agents of this group of infections are localized on the mucous membrane of the upper respiratory tract, in epithelial cells which they reproduce, which leads to the development inflammatory reaction. The pathogen spreads aerogenously when coughing, sneezing, emotional conversation with tiny droplets of mucus and saliva, the pathogen is released in external environment and with a stream of air when inhaling it enters the mucous membranes of the upper respiratory tract healthy person. Transmission mechanism aerogenic.

Transmission routes airborne, airborne dust.

Transmission factors: air, dust.

TO The group of respiratory tract infections includes:

Flu;

Parainfluenza;

Adenovirus infection;

Infectious moponushoe;

Diphtheria;

Menipgococcal infection;

Smallpox.

An infection such as diphtheria has a contact and household transmission route through toys, towels, but this is not the leading route of transmission.

In these infections, the pathogen is localized in the blood and affects vascular endothelial cells. Transmission of the pathogen occurs only if the blood or its components of a sick person enters the internal environment of a healthy person. Transmission mechanism transmissible (blood).

Transmission routes parenteral, through the bites of blood-sucking insects (mosquitoes, ticks, fleas, mosquitoes), transplacental, sexual. Transmission factors: blood-sucking arthropods, blood and blood products, syringes and surgical instruments. TO The group of blood infections includes:

Typhus;

Relapsing fever;

Tick-borne encephalitis;

Hemorrhagic fever with renal syndrome;

Malaria;

Plague;

Tularemia;

Leishmaniasis;

Viral hepatitis B, C, D;

HIV infection.

4. Infections of the external integument. In these infections, the pathogen penetrates through damaged skin or mucous membranes. Infection can occur through an animal bite, contact with a sick animal, or when the pathogen gets into wounds or mucous membranes. Transmission mechanism contact.

Transmission path wounded

Transmission factors: soil, secretion of glands.

The group of infections of the external integument includes:

Erysipelas;

Rabies;

Tetanus;

Anthrax;

Foot and mouth disease.

A special group is allocated especially dangerous and conventional (quarantine) infections.

A single generally accepted formulation of the term "particularly dangerous infections" still no. Usually these include infectious diseases, which are characterized by epidemic spread, wide coverage of large masses of the population, severe course of the disease, high mortality or disability of those who have recovered from the disease. These include anthrax, tularemia, typhus, relapsing fever.

TO conventional or quarantine infections include those diseases the spread of which can be prevented through quarantines. The term quarantine is not accidental; it comes from the Italian word carante - forty, which implies a 40-day (longest incubation period) isolation of a person in order to prevent the introduction of infection. Later in the 20th century, an agreement (convention) was signed, according to which international health regulations were adopted in order to ensure anti-epidemic protection of the state from the importation of infections and mandatory notification of the World Health Organization (WHO) about the occurrence of disease cases was introduced. These rules apply to such infections as: plague, cholera, smallpox, yellow fever, so they belong to the group of conventional or quarantine infections.

LECTURE No. 10

Topic 2.3: " CEO of BLOOD-BORDER (BORDER-BORDER) INFECTIONS (MALARIA. TYPHUS and BRILL'S DISEASE. HFRS )»

This group includes IBs, the pathogens of which penetrate the bloodstream through the bite of blood-sucking arthropods (fleas, mosquitoes, ticks). That is, the disease is transmitted to humans through pathogen carriers. The transmission mechanism is transmission. The source of infection is a sick person.

The pathogen is poorly resistant to exposure environment, dies when boiled, under the influence of disinfection. funds. Resistant to low temperatures.

When diagnosing diseases Special attention refers to the epidemiological history.

Features when caring for patients of this group of infections will be:

1 mandatory hospitalization

2 strict bed rest (until the period of convalescence)

3 careful care skin and mucous membranes

4 monitoring daily diuresis

5 compliance with sanitary and hygienic rules

The fight against blood infections involves the destruction of breeding sites of infection carriers, carrying out disinfestation measures, identifying and isolating the source of infection and its treatment.

Malaria

Protozoal disease is characterized by febrile attacks, anemia, enlarged liver and spleen, and a relapsing course.

Etiology.

Plasmodium vivax – the causative agent of 3-day malaria

Plasmodium malaria – the causative agent of 4-day malaria

Plasmodium falciparum - the causative agent of tropical malaria

Plasmodium ovale is the causative agent of ovale malaria.

Types of pathogens vary according to morphological characteristics, virulence, sensitivity to chemotherapy.

Life cycle The pathogen includes 2 hosts:

mosquito is a carrier, it occurs in the body sexual development – sporogony

human – asexual development – schizogony(intermediate host)

During tissue schizogony, up to 10-50 thousand merozoites are formed from 1 sporozoite, which leave hepatocytes and invade erythrocytes. The stage begins erythrocyte schizogony, which lasts 48 hours for Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and for Plasmodium malaria – 72 hours.

Epidemiology.

The carrier is female mosquitoes of the genus Anopheles

Routes of transmission: - parenteral

Transplacental

In countries with temperate climates it occurs only in summer with a stable temperature of +16.

Immunity is short-lived and unstable.

Pathogenesis.

A malarial attack occurs in response to the release of pyrogenic substances into the plasma.

In tropical malaria, erythrocyte schizogony occurs in small vessels internal organs and brain, therefore microcirculation is disrupted, malarial coma and acute renal failure develop.

With 3-day malaria and oval malaria, late relapses (after 8-10 months) are caused by the entry into the blood of merozoites formed from slowly developing tissue schizonts.

Clinic.

Malaria is characterized by a cyclical course:

incubation period

stage of primary manifestations

latent period

late manifestations

reconvolution

Malarial attack: phases are distinguished:

chills (from 20 minutes to 2-3 hours)

fever (from several hours to a day) - temperature 40-42, agitation, headache, body aches, maybe nausea, vomiting.

sweat - temperature drops, severe weakness, dream.

After the attack, a period of apyrexia begins.

After 2-3 attacks, the spleen enlarges, and then the liver. As a result of the breakdown of red blood cells, hemolytic anemia, the content of bilirubin in the blood serum increases. The skin and visible mucous membranes are pale yellow in color.

The number of attacks with untreated primary malaria can be 10-14, the most severe in the 2nd week of illness. Then the attacks become less regular, more rare and stop; within 2 months attacks may appear, but there are few of them, their course is mild. These are early relapses

With tropical and 4-day malaria, a period of convalescence then begins, and with 3-day and oval malaria, after several relapses, a latent period begins. After 6-11 months. Untreated patients develop late relapses.

Total duration malaria: vivax, ovale – up to 1.5-3 years; malaria – several decades.

Tropical malaria is the most severe (98% deaths)

Tropical malaria: abnormal fever, severe anemia, late enlargement of the spleen and liver, diversity clinical manifestations. There is usually no chills at the beginning of the attack; the temperature lasts up to 36 hours; profuse sweating does not occur as the temperature drops. The periods of apyrexia are short – several hours. During an attack, symptoms of intoxication are pronounced: diarrhea, confusion.

3 days: The first few days the fever is daily, and then intermittent. Attacks develop in the first half of the day.

Ovale malaria: favorable course. After several attacks, recovery occurs even without treatment.

4 days: attacks are regular, not severe, anemia is moderate.

Complications.

malarial coma

infectious - toxic shock

acute renal failure (tropical malaria)

hemoglobinuric fever

Secondary hypochromic anemia (3-day malaria)

Rupture of the spleen in primary patients.

Diagnostics.

characteristic attacks

laboratory examination of a smear and a thick drop of blood

Treatment.

for cupping acute attacks– delagil – orally on the 1st day – 1.0 g per dose and after 6-8 hours another 0.5 g; on the 2nd and 3rd days - 0.5 g per day, after meals with plenty of water. Course dose for adults – 2.5 g.

for the prevention of late relapses - primaquine 15 mg orally for 14 days.

for tropical malaria - quinine; with early treatment started orally - 7 days; for late treatment - IV with 5% glucose slowly over 2-4 hours.

if necessary, detoxification and dehydration therapy.

The success of treatment depends on the timing of treatment.

Prevention.

Taking chemotherapy drugs (delagil, fansidar, mefloquine) once a week. Starting 2 weeks before and ending 4 days after returning from a dangerous area

Protection against mosquito attacks

Typhus

– characterized by vascular damage, the development of meningoencephalitis, roseola-petechial rash, and severe course.

Etiology.

The causative agent of Provacek's rickettsia. Hemolysins and endotoxins are released.

Epidemiology.

Carrier – lice (body lice, head lice)

Rickettsia is isolated in feces 4-5 days after blood sucking and throughout life (13-31 days). A person becomes infected by rubbing infected insect excrement into skin damaged by scratching, by squashing infected lice on the skin, or, less commonly, by getting infected material into the conjunctiva of the eyes or Airways(in laboratory conditions).

Seasonality - increase in the winter-spring period (clothing, crowding).

Clinic.

Incubation period from 6 to 25 days (average 11-14)

Begins acutely and progresses to 3 periods :

initial – before the rash appears (4-5 days)

height – from the appearance of the rash until the temperature normalizes (4-10 days)

reconvolution (2-3 weeks)

Elementary– temperature rises to 39-40 quickly, symptoms of intoxication. Headache intensifies every day and is strongest at night. Irritability, anxiety.

Appearance: face, neck, top part bodies are red. The eyes are shiny, the conjunctival vessels are injected. Dry bright lips, hot dry skin.

On the 2nd day, enanthema in the form of pinpoint hemorrhages on the mucous membrane of the soft palate, at the base of the uvula. On the 3rd day of illness transitional fold In the conjunctiva, pinpoint hemorrhages and purple-violet spots (Chiari-Avtsyn spots) appear.

height– insomnia, maybe dizziness, nausea, vomiting. Skin hyperesthesia and photophobia occur. Anxiety, euphoria, fatigue, tearfulness. In severe cases: patients do not orient themselves in space, frightening hallucinations, incoherent speech, and aggressiveness appear.

On the 4-5th day of illness, a skin rash appears; it consists of roseola and petechiae, appearing simultaneously on the lateral surfaces of the body, the skin of the chest, back, and then on the flexor surface of the limbs. The rash is profuse, lasts 4-9 days, roseola disappears without a trace, and pigmentation remains after petechiae. The tongue is dry, covered with a gray-brown coating.

Mental disorders, nightmares, meningeal syndrome, general tremors indicate damage nervous system.

Convalescence– persists: severe weakness, rapid exhaustion, emotional instability.

Complications.

acute cardiovascular failure

thrombosis and thromboembolism

bedsores

gangrene distal sections limbs

pneumonia, otitis, etc.

Diagnostics.

Serological methods:

RSK – antibodies to rickettsiae in a titer of 1:160 from the 6-7th day of illness.

RNGA - antibodies to rickettsia in a titer of 1:1000 from 5-7 days of illness.

Allergy skin test

Treatment.

hospitalization

Etiotropic treatment: tetracycline, chloramphenicol.

Pathogenetic treatment: detoxification – drinking plenty (2-3 liters per day); cardiac (camphor, cordiamine); tranquilizers (Elenium, Seduxen), bromides, barbiturates (Luminal), antipyretics

In severe cases: steroid hormones and heparin

monitoring urination

Prevention.

monitoring of contact persons (daily thermometry) 71 days.

sanitary treatment of contacts, their clothes and belongings are subject to chamber disinfection

according to epidemiological indications - active immunization with dry typhus vaccine, once 0.5 ml s.c.

Brill's disease.

Brill's disease is observed mainly in older people who have had typhus in the past.

The disease has no seasonality; in the presence of pediculosis, such a patient becomes a potential source of an epidemiological outbreak of typhus.

Brill's disease is characterized by the same symptoms as typhus, but the course is milder. There are no nightmares or symptoms of meningeal irritation. The rash is not abundant, there are few petechiae.

Monitoring of contact persons in the outbreak of infection is carried out for 25 days.

HFRS

Hemorrhagic fever with renal syndrome.

acute viral natural focal infection, characterized by severe intoxication, kidney damage and the development of hemorrhagic syndrome.

Etiology.

The causative agent is an RNA virus.

Epidemiology.

Zoonosis.

The main reservoir and source of infection are mouse-like rodents

Human infection can occur in various ways:

Airborne dust

Nutritional

Contact

The transmissible route of transmission for HFRS is practically excluded.

A sick person, regardless of the stage of the disease, does not pose an epidemic danger.

Seasonality: summer-autumn period is typical. Not registered from January to May.

Susceptibility: high, men from 20 to 50 years old are more often affected, which is explained by their professional activity(lumberjacks, tractor drivers).

Residents of rural areas are mainly infected, but city residents can also become infected during seasonal work in garden plots, trips to the forest to pick berries, mushrooms, etc.

Immunity : persistent.

Pathogenesis.

Regardless of the route of infection, the virus invades macrophages, where its primary accumulation occurs. After leaving the cells, viremia develops and the virus spreads throughout the body. The virus causes an increase in vascular permeability. The most pronounced changes occur in the vessels of the kidneys, in which serous-hemorrhagic edema, tubular necrosis develop, and a decrease in glomerular filtration leading to acute renal failure.

In addition, damage to the capillaries leads to multiple hemorrhages. Hemorrhages into the renal cortex can lead to its rupture.

The presence of the virus in the blood causes toxic damage nervous system.

Clinic.

The incubation period ranges from 7 to 45 days (usually 2-3 weeks).

During the course of the disease there are periods :

Elementary

Oliguric

Polyuric

Convalescence

Initial period (2 - 5 days): the disease begins acutely: with a rise in body temperature to 39-41, signs of intoxication appear. Particularly disturbing is the pain in the muscles of the whole body. In the first 3-4 days of the disease, visual disturbances are observed, acuity decreases, and fog appears before the eyes. Characterized by lower back pain, especially worse at night.

Appearance of patients: the face is red, the nasolabial triangle is pale, the conjunctiva and sclera are injected, the eyelids are swollen. Skin of the neck, chest and shoulder girdle red.

By the end initial period the temperature drops to subfibrile levels, but this does not bring relief. The condition of the patients is deteriorating. Hemorrhagic phenomena increase: a hemorrhagic rash appears, and in more severe cases, bleeding.

Oliguric period (from 2-3 to 7-12 days): intense pain in the lower back, the daily amount of urine decreases to 300-900 ml (with the development of anuria - up to 50 ml). The relative density of urine is monotonic low from 1001-1006, the content of protein in the urine increases, and leached erythrocytes, hyaline and fibrin casts in the urinary sediment. Pasternatsky's symptom is positive on both sides.

Various bleeding occurs. Characteristic manifestation of HFRS is hemorrhage in the sclera in the outer corner of the eye (red cherry symptom). Patients sleep poorly, are inhibited, and confusion is possible.

The polyuric period begins when the patients' condition begins to improve: lower back pain disappears, the amount of urine excreted sharply increases to 5-10 liters per day, especially at night (nocturia). Weakness, thirst, dry mouth, fast fatiguability still preserved long time.

The period of convalescence begins in the 4th week of illness. The excretory function of the kidneys recovers very slowly.

Complications.

2. infectious-toxic shock

3. pulmonary edema

4 rupture of the kidney capsule

5 secondary bacterial infections

Diagnostics.

Linked immunosorbent assay

Treatment.

A complete dairy-plant diet, drinking plenty of fluids

Detoxification therapy (hemodesis).

In severe cases - prednisolone.

If acute renal failure develops, the patient is transferred to a kidney center for extracorporeal hemodialysis (“artificial kidney”).

Discharge from the hospital is carried out after complete clinical recovery, 3-4 weeks from the onset of the disease and normal laboratory parameters. Patients are monitored for a year with quarterly urine tests.

Prevention.

When visiting the forest, you should choose places for rest that are not inhabited by rodents, and store food inaccessible to rodents.

In blood infections, pathogens circulate in a vicious circle circulatory system and therefore do not have a free exit from the patient’s body.

Plague - a particularly dangerous infectious disease caused by the plague bacillus (bacterium from the genus J. pestis) is a vector-borne zoonotic disease. The stick dies when exposed to conventional disinfectants.

The incubation period of plague is 2-3 days, rarely up to 6 days. Forms of the disease: bubonic (inguinal lymph nodes are affected), pulmonary, intestinal. When a person is infected in natural foci, bubonic or septicemic plague develops, which can be complicated by secondary pneumonic plague. With airborne transmission of the pathogen from patients with secondary pneumonic plague, primary pneumonic plague develops.

The possibility of spreading the plague pathogen is associated with the following features:

A) short incubation period of the disease;

B) rapid development, often sudden development of a severe clinical picture of the disease and high mortality;

C) the difficulty of differential diagnosis in the first days of the disease;

D) the possibility of creating persistent foci of infection as a result of the presence of infected fleas and rodents in them.

For outbreaks of plague, the most dangerous form of plague is the pneumonic form of plague, but multiple simultaneous occurrences of the bubonic form of plague are possible. These epidemics begin with a previous epizootic (spread of plague) among rodents.

The entrance gates for plague are the skin, mucous membranes of the eyes, respiratory tract, and gastrointestinal tract. The disease begins acutely: chills, severe headache, heat, with the bubonic form - pain in the groin or under the armpit, with the pulmonary form - severe shortness of breath, chest pain, bloody sputum. Sleep is disturbed, aches in the muscles and joints, tachycardia and increasing shortness of breath appear. At the height of the disease, signs of toxic damage to the central nervous system and of cardio-vascular system. The pulmonary form is the most dangerous for the patient and others, often ending in death. The intestinal form occurs when eating meat from sick animals.

Patients and persons in contact with it are subject to immediate isolation. A quarantine is established in the outbreak. Disinfection, disinsection, and deratization are widely carried out. Great importance Among the activities carried out are vaccinations. Contact people are given antibiotic therapy.

On the territory of Russia there are the following natural foci of plague: 1) Northwestern Caspian region (the main source is the ground squirrel); 2) Volga-Ural (gerbil); 3) Trans-Ural (gerbil); 4) Transcaucasian (gerbil); 5) Gorno-Altai (gophers and marmots); 5) Transbaikal (tarbagany); 6) Tuvan.

Typhus. The causative agent is rickettsia. The source of infection is a sick person, the transmitter is a body louse. The incubation period is 7-20 days. Symptoms - chills, headache, loss of consciousness, delirium, from the 5th day - a rash on the sides of the body.

The patient must be hospitalized. The outbreak is disinfected and disinfested, people who have been in contact with the sick are sanitized, and they are monitored. Vaccinations are being carried out.

Malaria. The causative agent is Plasmodium malaria, the carrier is the mosquito. It is not directly transmitted from patient to patient, but only through a mosquito. The incubation period is 1-3 weeks, sometimes 7-12 months.

Symptoms are sudden attacks of chills, fever, sweating, pain in the joints, muscles, and in the spleen area. The attacks last 6-10 hours and occur again with a certain frequency, depending on the form - three-day, four-day, tropical. The patient must be hospitalized. To prevent the disease - identifying and treating patients, as well as mosquito control. All those who were ill in the past year are given anti-relapse treatment in the spring, and then chemoprophylaxis throughout the entire period of mosquito activity.

Tick-borne encephalitis. The causative agent is a filter virus. The reservoir and carriers are ticks, as well as chipmunks, mice, moles, hedgehogs, and some birds. The virus is transmitted through tick bites. The incubation period is 10-14 days. The disease is seasonal - in spring, summer - due to the activity of ticks during this period.

Symptoms - severe headache, high temperature - 39-40 0, nausea, vomiting, convulsions, unconsciousness. There may be paralysis of the limbs. Mortality rate – 25%. After recovery, strong immunity remains. Prevention – vaccinations, protection against ticks, use of anti-tick products. When working in the forest, inspections and mutual inspections are required every 1.5-2 hours.

AIDS– an infectious viral disease transmitted through blood (transfusion of infected blood, injections, in dental offices, most often through sexual intercourse). There are patients who die quite quickly, and infected people who are carriers of the virus. The disease causes the body to lose its immunity and protective properties, and therefore indolent infections develop - sore throat, pneumonia, sudden weight loss, and in some patients sarcoma develops. There are no specific means of treatment and prevention yet. Risk groups are being checked for treatment of HIV infection, preventing the possibility of infection, checking donors, disposable syringes, etc.