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Hemorrhagic fever with renal syndrome
includes diseases such as Korean hemorrhagic fever, epidemic
hemorrhagic fever, and nephropathis epidemica. It is a group of
clinically similar illnesses caused by hantaviruses from the family
Bunyaviridae.
Hantavirus is
usually acquired directly from rodents. In these rodents, the virus is
detected primarily in the lung and kidney, where it is able to persist
in the presence of serum antibodies. Large quantities of virus are
excreted throughout life.
Hemorrhagic fever with renal syndrome
(Korean hemorrhagic fever) occurs in rural communities where people
may become
infected through minor cuts and abrasions contaminated with rodent
urine or feces, but evidence also suggests that aerosol infection may
occur where virus contamination is heavy.
The illness was known to Russians in
Vladivostok (1890), and similar diseases are found across the entire
European land mass, from European and Asiatic Russia to Manchuria,
Korea, and Japan.
The disease became known to American
medicine when it struck United Nations troops serving in Korea in
1951, hence the misnomer “Korean”.
Clinically five
stages have been described : Febrile ; shock ; oliguric ;
polyuric, and convalescent.
Symptoms include
fever, periorbital edema, flushed face and palatal and axillary
petechiae. Conjunctivitis, headache and lumbar pain may be present.
Principal
laboratory findings are proteinuria, hemoconcentration, and
thrombocytopenia.
Recovery is usual, but
fatal cases do occur. In such cases, morphologic evidence of
shock is present.
There is a mononuclear cell
infiltrate in the sinusoids of liver and spleen, and throughout the
body damage to the capillaries is manifested by dilatation,
engorgement, diapedesis of erythrocytes, and rupture.
Viral antigen has been
found in endothelial cells.
Patients are
determined to have HFRS if they have serologic test results positive
for hantavirus infection or evidence of hantavirus antigen in tissue
by immunohistochemical staining and microscope examination
Visit related
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Marburg Virus Disease
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Kyasanur Forest Disease
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Omsk hemorrhagic fever
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