Features of clinical and laboratory diagnostics of hantavirus infection at a prehospital stage

Abstract

The features of clinical and laboratory diagnostics of hantavirus infection at the prehospital stage in the regions of the Northwestern Federal District is considered. The analysis of the terms of patients treatment from the moment of the appearance of the first symptoms of the disease was carried out. It was found that more than half of the patients sought a medical help during the height of the disease. The structure of hospitalizations of the patients with a hemorrhagic fever with renal syndrome who were admitted to inpatient treatment was studied; most patients were hospitalized by the ambulance team. The data of our own research are presented, indicating the predominance of the nonspecific symptoms in the onset of the disease. The overwhelming majority of the patients in the initial period of the disease had fever, severe headache, myalgia. Hemorrhagic syndrome was detected in a minimal number of the patients. The dynamics of the clinical picture of a hemorrhagic fever with the renal syndrome in patients admitted to hospitals in St. Petersburg was analyzed. Diversity and a rapid change of the symptoms and syndromes in dynamics were noted. In the structure of diagnoses of the direction, diseases of the respiratory system prevailed. A smaller proportion of a preliminary diagnoses were diseases of the gastrointestinal tract, pathology of the kidneys and urinary tract, diseases of the central nervous system, and only one patient was diagnosed with the hemorrhagic fever with renal syndrome. The laboratory parameters of the early period of the disease in patients were assessed. The most frequent and characteristic changes in the blood and urine parameters were revealed. Signs of hemoconcentration and thrombocytopenia were noted in almost half of the patients in the initial period of the disease. In a small part of outpatients, impaired renal nitrogen excretory function was found; the intensity of azotemia in the initial period of the diseases was low. Urine changes in the initial period were characterized by the moderate proteinuria, leukocyturia, erythrocyturia, cylindruria. The need for a thorough comparison of a clinical, laboratory, epidemiological data for a timely and correct diagnosis is noted.