Mouse Fever on the Rise in Russia

Hemorrhagic fever with renal syndrome [HFRS] is referred to colloquially as "mouse fever" because rodents are the principal vector. The human population usually becomes infected by inhaling dust in buildings where rodents are present.

In comparison with last year [2012], the incidence of mouse fever has decreased. During 10 months of 2013, 209 cases of "mouse" fever were recorded in the region, 6.5 per 100 000 inhabitants.. In the last 10 years, the highest incidences were recorded in 2003 (500 cases or 15.16 per 100 000 population), in 2008 (607 cases or 19.4 per 100 000 population), and 2012 (813 cases or 25.3 per 100 000 population). The source of infection and the reservoir host of HFRS are wild rodents.The largest number of cases -- 38 in total -- were recorded in Vladivostok.

Symptoms of HFRS usually develop within 1 to 2 weeks after exposure to infectious material, but in rare cases, they may take up to 8 weeks to develop. Initial symptoms begin suddenly and include intense headaches, back and abdominal pain, fever, chills, nausea, and blurred vision. Individuals may have flushing of the face, inflammation or redness of the eyes, or a rash. Later symptoms can include low blood pressure, acute shock, vascular leakage, and acute kidney failure, which can cause severe fluid overload. The severity of the disease varies depending upon the virus causing the infection. Hantaan and Dobrava virus infections usually cause severe symptoms, while Seoul, Saaremaa, and Puumala virus infections are usually more moderate. Complete recovery can take weeks or months.

Supportive therapy is the mainstay of care for patients with hantavirus infections. Care includes careful management of the patient’s fluid (hydration) and electrolyte (e.g., sodium, potassium, chloride) levels, maintenance of correct oxygen and blood pressure levels, and appropriate treatment of any secondary infections. Dialysis may be required to correct severe fluid overload. Intravenous ribavirin, an antiviral drug, has been shown to decrease illness and death associated with HFRS if used very early in the disease.

Depending upon which virus is causing the HFRS, death occurs in less than 1% to as many as 15% of patients. Fatality ranges from 5-15% for HFRS caused by Hantaan virus, and it is less than 1% for disease caused by Puumala virus.

In the absence of adequate treatment, the outcome of infection may be severe and a serious threat to life. Severe forms of the disease are a serious threat to human life, according to the Samara Region Rospotrebnadzor organization.

source; ProMEDmail & CDC

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Crimean-Congo Hemorrhagic Fever Death in Pakistan

A patient who had symptoms of Crimean-Congo hemorrhagic fever (CCHF) died on Tuesday [22 Oct 2013] in Lahore Pakistan

CCHF is a tick borne viral disease. Its symptoms include fever, bloody urine, vomiting, and nose bleeding. 30 per cent of the cases result in death on the 2nd week of the illness.

According to [local] sources, a 31 year old person, a suspected case of CCHF, was under treatment at a private clinic in the Ferozepur Road area of Lahore. He was brought to the hospital 5 days ago but died of the illness. The doctors said that blood samples of the patient have been sent to the National Institute of Health. A family member said the man's health destabilized after he visited a local cattle market to purchase a sacrificial animal.

This was the 1st death caused by CCHF in Punjab; however, the provincial Health Department has not, so far, confirmed diagnosis of the cause of death officially.

Although this may be the 1st death from the disease in Punjab province, CCHF is no longer rare in Pakistan, and it becomes particularly evident during the periods when animals are sacrificed during religious rituals.

CCHF virus is transmitted to people either directly by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days. The incubation period following contact with infected blood or tissues is usually 5 to 6 days, with a documented maximum of 13 days.

It is not correct to state that the disease is transmitted mainly to humans from pets. CCHF is a tickborne disease, and humans acquire infection directly by tick bite or by contact with the blood of infected livestock. Confirmation of the diagnosis by laboratory diagnostics is awaited.

Source www.promedmail.org

Ebola Outbreak in Congo

A suspected Ebola fever outbreak in the Orientale Province of the Democratic Republic of Congo has claimed [the lives of] at least 6 people in the last 3 weeks. 7 suspected cases of the deadly hemorrhagic fever have been reported in Isiro and Monga health zones in Orientale Province. One of the deaths was reported in Mongo health zone while 5 others occurred in Isiro Zone.

According to Dr Marrie-Josee Karani, the head of the office of the World Health Organization (WHO) in Kisangani, samples from the suspects were sent to the Institute of Biomedical Research (INRB) in Kinshasa and are yet to confirm the outbreak of the deadly virus. He however says the symptoms presented by the victims are similar to those of Ebola fever and asked the population to be extra careful. He also asked the locals to desist from eating wild [animal] meat and to isolate patients who show signs of Ebola fever.

If confirmed, this will be the 2nd time that the virus has hit the area in less than a year. In November 2012 the deadly virus claimed 30 people in the territory of Isiro, Orientale Province.

The disease was later declared to have been contained at the end of November 2012 by Congolese public health Minister Felix Kabange Numbi.

Ebola hemorrhagic fever is a severe, often-fatal disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees) that has appeared sporadically since its initial recognition in 1976.

The disease is caused by infection with Ebola virus, named after a river in the Democratic Republic of the Congo (formerly Zaire) in Africa, where it was first recognized.

The exact origin, locations, and natural habitat (known as the "natural reservoir") of Ebola virus remain unknown. However, on the basis of available evidence and the nature of similar viruses, researchers believe that the virus is zoonotic (animal-borne)’, with 4 of the 5 subtypes occurring in an animal host native to Africa. A similar host, most likely in the Philippines, is probably associated with the Ebola-Reston subtype, which was isolated from infected monkeys that were imported to the United States and Italy from the Philippines. The virus is not known to be native to other continents, such as North America.

People can be exposed to Ebola virus from direct contact with the blood and/or secretions of an infected person. Thus, the virus is often spread through families and friends because they come in close contact with such secretions when caring for infected persons. People can also be exposed to Ebola virus through contact with objects, such as needles, that have been contaminated with infected secretions.

. In African health-care facilities, patients are often cared for without the use of a mask, gown, or gloves. Exposure to the virus has occurred when health care workers treated individuals with Ebola HF without wearing these types of protective clothing. In addition, when needles or syringes are used, they may not be of the disposable type, or may not have been sterilized, but only rinsed before reinsertion into multi-use vials of medicine. If needles or syringes become contaminated with virus and are then reused, numerous people can become infected.

The incubation period for Ebola HF ranges from 2 to 21 days. The onset of illness is abrupt and is characterized by fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain. A rash, red eyes, hiccups and internal and external bleeding may be seen in some patients.

Researchers do not understand why some people are able to recover from Ebola HF and others are not. However, it is known that patients who die usually have not developed a significant immune response to the virus at the time of death.