Early this morning, a news story about the death of "hemorrhagic fever" was on the hot search. I guess you might see the words "infectious disease", "rat", "virus" and make your nerves that have just relaxed a little from the new coronavirus epidemic tense up again.
Don't panic! This disease is not newly discovered, not plague (related article: Ji Lianmei | Don't be afraid! Plague has a special medicine! It's also basically not human-to-human, and there are vaccines that can be prevented, not so terrible.
During the Korean War in the 1950s, epidemic haemorrhagic fever broke out in the United Nations military. Since the 1970s, China has been actively treating this disease, it was once the second most serious infectious disease in China after hepatitis B, and was included in the national statutory infectious disease prevention and control, and the number of cases and deaths is notified every month.
According to the epidemic situation of notifiable infectious diseases published on the official website of the National Bureau of Disease Control and Prevention, in December 2019, 1364 cases of epidemic haemorrhagic fever were reported nationwide, and 7 cases of death were reported.
Calculated in 12 months a year, the number of epidemic haemorrhagic fever cases notified in China every year is more than 16,000+ .
With the improvement of our living environment, the incidence of epidemic haemorrhagic fever in China has been declining since the late 1990s, because wild rats are no longer a regular visitor in our lives.
But now that more and more urban families are raising hamsters, a beloved critter, is there a possibility that they will also spread the virus? I guess you'll have that question.
Below, I will ask The pharmacist team's Guo Lin pharmacist to answer your questions, take you to understand what is "epidemic hemorrhagic fever" and "hemorrhagic fever vaccine", and whether soft hamsters can spread this disease.
—— Ji Lianmei Medicine Master
What is epidemic haemorrhagic fever?
Epidemic hemorrhagic fever, also known as renal syndrome hemorrhagic fever, caused by hantavirus and transmitted by mice, is a severe acute infectious disease with fever, bleeding, and kidney damage as the main symptoms.
If early detection, early rest, and early treatment can be achieved after infection, the rate of severe illness and mortality can be significantly reduced.
Which rats spread?
In China, the pathogenic hantavirus is mainly carried by the haddock rat (wild rat) Hantan type virus and the Seoul type virus carried by the brown rat, in addition to these two kinds of mice, although almost all common mouse species have been detected hantavirus, they almost do not transmit diseases, the main cause of disease is wild mice.
Epidemic haemorrhagic fever is a natural source infectious disease, which has existed for a long time in nature, and China is one of the main epidemic areas. In addition to Qinghai, other provinces in China have reported cases, and the incidence rate is higher in the three northeastern provinces, Shandong, Shaanxi, Hebei, Hubei and other provinces.
In our country, epidemic haemorrhagic fever mainly occurs in the spring when crops are planted, and another wave of outbreaks occurs in autumn.
At that time, farmers were thrown into the autumn harvest, and they may have been exposed to hantavirus by sleeping in loosely closed houses infested with wild rats.
How do people get infected?
First, there must be a hantavirus-infected rodent around before it causes a person to become infected with epidemic haemorrhagic fever.
People usually contract the virus in enclosed, poorly ventilated buildings or through aerosols from rat excrement during cleaning.
Hantavirus can be present in the urine, feces, and saliva of infected rodents and is found in the highest concentrations in the lungs.
When the urine and feces of mice containing hantavirus are stirred up and float into the air, people can be infected by inhaling the virus-containing aerosol by breathing.
Infection occurs by touching the urine, feces, or rat nest of rats containing the virus, and then touching the mucous membranes of one's own eyes, nose, mouth, etc.
Infection is caused by being bitten by a rat, or by being bitten by a parasite such as a murine surface mite.
Pregnant women can also be transmitted to the fetus through the placenta after infection.
Direct human-to-human transmission is rare, and only one case has been reported in southern Argentina.
How can I tell if I'm infected?
The incubation period after human infection with hantavirus is usually 7-14 days, and occasionally as short as 4 days or as long as 2 months.
Typical cases of epidemic haemorrhagic fever have the following symptoms at the onset of the disease:
Fever (initially mistaken for a cold and fever)
Three pains (headache, low back pain, orbital pain)
Three reds (redness of the face, neck, upper chest)
Nausea, vomiting, chest tightness, abdominal pain, diarrhea, generalized joint pain, etc.
The mucous membranes of the skin, the conjunctiva of the eyes are hyperemic, and the heavy ones seem to be drunk
Bleeding spots or ecchymos of varying sizes appear in the oral mucosa, chest, back, and armpits, or in the form of cord-shaped, scratch-like bleeding spots.
With the development of the disease, the symptoms of the patient gradually worsen after the fever is reduced, followed by symptoms such as hypotension, shock, oliguria, anuria and severe bleeding.
If you encounter the above symptoms, you must isolate as soon as possible and seek medical treatment as soon as possible.
Is there a vaccine that can be prevented?
The vaccine currently used to prevent epidemic haemorrhagic fever in China is [bivalent renal syndrome hemorrhagic fever inactivated vaccine].
The whole course is three doses, of which the basic vaccination is two, with an interval of 14 days, that is, one vaccine on the 1st day (the same day) and the 15th day, and one more intensive injection after the basic vaccination.
Three injections should be vaccinated on time, and if the three injections are not vaccinated on time or the three injections are not completed, the immune effect will be affected.
Who needs to be vaccinated?
In China, immunization against epidemic hemorrhagic fever has been included in the Expanded Programme on Immunization, with residents of high-incidence townships in high-incidence provinces as the target group, and free routine vaccinations for people aged 16-60 years.
It is best to be vaccinated before going to areas where the disease is endemic for field expeditions, tourism, farming and other activities to prevent infection.
Vaccines are best given before the epidemic season and before entering high-endemic areas, rather than waiting until after being bitten by a rat.
At the same time, because there is currently no very effective treatment for the treatment of epidemic haemorrhagic fever, vaccination can play a "prevention" greater than "treatment" effect.
By consulting the CDC website in high-prevalence areas, local vaccination options can be found. Take the Shaanxi Provincial Center for Disease Control and Prevention as an example:
Do I need to be vaccinated after being caught/bitten by a domestic hamster?
My answer is: No.
Now domestic hamsters are generally accompanied by us and children as domestic pets, this type of pet hamster has not been exposed to the outside world, and the possibility of carrying pathogenic hantavirus can be said to be minimal.
There is also a question that is often asked by parents about whether to get the rabies vaccine after being bitten by hamsters, and parents do not have to worry, hamsters and other artificially bred pets have almost no way to contact the rabies virus, and rodents are not effective carriers of rabies virus.
In fact, even cases of rabies virus infection after being bitten by small rodents such as rabbits, Dutch pigs, and squirrels have not been seen in recent years.
The specific vaccine varieties and vaccination schedules are subject to the vaccine status and specifications of the local immunization unit.
How should we prevent it?
1. Prevent epidemic hemorrhagic fever requires us to pay attention to personal hygiene and pay attention to the environmental hygiene of the family.
2, wild rats are the main source of this infectious disease, so if you find dead rats in your home, you must deal with them in time and disinfect them.
If wild rats and brown rats are found to be infested, they must take timely measures to kill rats and clean up all the food, tableware, etc. they have come into contact with. In the wild, contact with rodents should also be avoided to prevent scratches and bites.
3. For patients with suspected hemorrhagic fever symptoms, just in case, we must also isolate them in time and send them to medical treatment in time.
References: (Updated 24 March 2020)
1. Chinese Center for Disease Control and Prevention website: How individuals and families can prevent epidemic haemorrhagic fever
2. Research on purified vaccine for hemorrhagic fever of bivalent renal syndrome Chinese Journal of Biologics, Vol. 17, No. 4, July 2004
3. Immune effect of bivalent purified biochemical syndrome hemorrhagic fever gopher renal primary cell vaccine Chinese Journal of Biologics Vol. 16, No. 1, 2003
4. Analysis of the epidemic situation of key infectious diseases in the winter and spring of 2017-2018 Disease Surveillance, Volume 33, No. 3, March 31, 2018
5. Research progress on the epidemiological characteristics of hemorrhagic fever in renal syndrome and the prevention and treatment measures Laboratory Medicine and Clinical Laboratory Medicine and Clinical Studies, Vol. 15, No. 20, late October 2018
6. Exploring the prevention and control measures of epidemic haemorrhagic fever Chinese Medical Guidelines, October 16, 2018, No. 29
7. Clinical research on hemorrhagic fever vaccine for renal syndrome Chinese Journal of Experimental and Clinical Virology, Vol. 20, No. 4, December 2006
8. Discussion on the impact of hemorrhagic fever vaccination on the incidence of epidemic hemorrhagic fever Journal of Health Must Read September 2013
9. Epidemic Haemorrhagic Fever Vaccination Questions and Answers Chinese Journal of Epidemiology, June 2002, Vol. 23, No. 3