Multiple cases of hemorrhagic fever have been found in Xi'an. Can we still eat strawberries?

The day before yesterday, Xi'an News Network reminded citizens that since the beginning of winter, major hospitals in the city have successively received many patients with hemorrhagic fever. The early symptoms of the disease are similar to those of influenza. Once citizens have fever and other physical discomfort, they should seek medical treatment in time. After the release of this news, it attracted a lot of attention.

Figure丨Screenshot from Weibo

The "hemorrhagic fever" here refers to hemorrhagic fever with renal syndrome, also known as epidemic hemorrhagic fever. The Guanzhong area of ​​Shaanxi Province has always been a high-incidence area for this disease. The disease is mainly transmitted by rodents. Avoiding contact and vaccination are the most effective ways to prevent it. Since the disease progresses quickly, it is necessary to seek medical attention as soon as possible after symptoms appear.

The incidence is high in Guanzhong, and also occurs in other areas

China is one of the regions with the highest incidence of hemorrhagic fever with renal syndrome in the world. From 1950 to the end of 2020, a total of 1.68 million cases have been reported in my country. In the past 20 years, the overall incidence rate in my country has declined significantly, but the epidemic situation in some areas has fluctuated repeatedly.

Changes in the number of cases in mainland China from April 2008 to March 2015 | References [1]

Except for Qinghai and Xinjiang, hemorrhagic fever with renal syndrome is prevalent in most provinces, municipalities and autonomous regions in the country, with more than 80% of cases concentrated in a few high-incidence provinces and cities. From 2004 to 2015, Shaanxi Province and the three northeastern provinces were the hardest hit areas in the country. In 2017, Shaanxi Province reported 2,001 cases, accounting for 17% of the total number in the country that year, and Guanzhong region accounted for 94.56% of the total number in the province.

Clustering results of cases in mainland China from 2004 to 2013 | References [1]

Hemorrhagic fever with renal syndrome can occur throughout the year, with a small peak from May to July and a large peak from October to January of the following year. The phenomenon of multiple cases in Xi'an after the beginning of winter this year is in line with the change pattern of previous years.

Inhalation is most common, strawberries are less dangerous

The pathogen that causes hemorrhagic fever with renal syndrome is an RNA virus - Hantavirus, and the main animal that transmits the virus to humans is rodents.

The most common mode of transmission is that the urine, feces and saliva of virus-carrying rodents contaminate the soil, water, threshing floors and crops, forming dust or aerosols that are inhaled through the respiratory tract by people working in the fields, processing food or traveling, causing infection.

In addition, situations that may cause people to develop hemorrhagic fever with renal syndrome include: being bitten by rodents carrying the virus, eating food contaminated by them, contact of their blood or excrement through conjunctiva or skin wounds, and being bitten by gamasid mites or chiggers.

In areas with a high incidence of hemorrhagic fever with renal syndrome, rat prevention and extermination are necessary. It is recommended to avoid going to places where rats are active as much as possible. When entering these places, wear a mask and prevent parasite bites. Try not to touch objects such as haystacks that may be contaminated by rats.

In the investigation of exposure factors of 876 patients,

The most common is contact with rat feces, etc. | References [2]

In terms of diet, if the urine, feces and saliva of virus-carrying rodents come into contact with food, people who eat the contaminated food within a short period of time may be infected with the virus through the oral cavity or gastrointestinal mucosa. Studies have shown that at room temperature of 15-20°C, Hantavirus can survive in water, rice, steamed bread and other foods for 48 hours and is contagious. Another study also suggests that bloody urine containing the virus on a piece of cloth or paper can infect mice after being placed in an environment of 4-15°C for 48 hours.

However, Hantavirus is relatively easy to inactivate, and general disinfectants such as alcohol, ultraviolet irradiation, heating at 60℃ for 10 minutes or 100℃ for 1 minute are all effective. In addition, in recent years, hemorrhagic fever with renal syndrome has mostly been sporadic, with cases concentrated in high-incidence areas. These characteristics suggest that eating contaminated food is not the main route of transmission of the disease.

Therefore, in areas with a high incidence of hemorrhagic fever with renal syndrome, people need to be careful about food and water contaminated by rodents. For example, in a greenhouse with rodents, eating unwashed strawberries while picking them may cause a certain risk of infection. As for other areas, the chance of infection caused by food from high-incidence areas that have traveled a long way is very low, so regular washing (preferably fully heated) is sufficient.

Ye Feng, deputy director of the infectious disease department of the First Affiliated Hospital of Xi'an Jiaotong University, believes

Hemorrhagic fever has no direct relationship with eating strawberries | Weibo screenshot

Vaccination is required when entering high-incidence areas

In addition to the above protective measures, vaccination is the most effective way for individuals to prevent hemorrhagic fever with renal syndrome.

my country began to promote the use of a bivalent inactivated vaccine against hemorrhagic fever with renal syndrome in the 1990s. Currently, it is recommended that people aged 16 to 60 in high-incidence areas be vaccinated, including local residents and outsiders. After three doses of the vaccine, the antibody level is high for 5 years, and the vaccine protection rate drops below 90% after 7 to 8 years, so it is necessary to strengthen it once every 7 to 8 years.

For specific vaccination matters, please consult the local CDC. In some areas, you can make online appointments for vaccination on the health department’s official account.

Photo | Xinglong Street Health Center, High-tech Zone

Like the flu, but worse

One of the important reasons why Xi'an News Network released this news is to remind citizens to seek medical treatment as soon as possible.

Hantavirus can spread throughout the body through the blood. When the disease is severe, fever can progress to severe bleeding, renal failure, hypotension, shock and coma, with a mortality rate of about 2.89%. There is currently no specific drug for Hantavirus, and treatment is mainly symptomatic support.

Therefore, early detection and timely medical treatment are important ways to avoid serious consequences. After exposure to the virus, people usually develop symptoms 1 to 2 weeks later. The initial symptoms are similar to those of influenza, with a fever of 38 to 40 degrees Celsius, accompanied by headaches, back pain, orbital pain, and soreness of muscles and joints throughout the body. After 2 to 3 days of fever, most patients may experience conjunctival hemorrhage, and congestion and redness of the face, neck, and upper chest skin.

Because the disease progresses rapidly, it is recommended to go to the hospital promptly if similar symptoms are found.

Hemorrhagic fever with renal syndrome is a Class B infectious disease in my country, with a strict reporting and monitoring mechanism. Although the disease is widespread and harmful, vaccination and rodent control can effectively control the disease, and early diagnosis can significantly improve the treatment effect.

References

[1] Guan Peng, Wu Wei, Huang Desheng, Nie Xiaonan, Guo Haiqiang. Study on the spatiotemporal distribution characteristics of hemorrhagic fever with renal syndrome in China from 2004 to 2013. Chinese Journal of Vector Biology and Control. 2016;27(2):124-127.

[2] Bai Jingjing, Wang Xiaonan, Guan Xuhua, Liu Li, Guo Yanping, Xing Xuesen, Wu Yang. Retrospective analysis of epidemiological and clinical characteristics of 876 patients with hemorrhagic fever with renal syndrome. Chinese Journal of Disease Control. 2017;21(6):594-597.

[3] Shaanxi Provincial Health Commission, Tangdu Hospital of Air Force Medical University. Expert consensus on diagnosis and treatment of hemorrhagic fever with renal syndrome in Shaanxi Province. Shaanxi Medical Journal. 2019;48(3):275-288.

[4] Chinese Society of Preventive Medicine, Infectious Diseases Prevention and Control Branch, Chinese Medical Association, Infectious Diseases Branch. Expert consensus on the prevention and treatment of hemorrhagic fever with renal syndrome. Infectious Disease Information. 2021;34(3):193-212.

[5] Chinese Association of Preventive Medicine. Expert consensus on informed consent for vaccination (Part 2). Chinese Journal of Epidemiology. 2021;42(3): 382-413.

[6] Geng Yahui, Wang Chao, Xu Qin, Huang Fangfang, Guo Xiuhua. Temporal and spatial distribution and spatial clustering of hemorrhagic fever with renal syndrome in mainland my country. Journal of Capital Medical University. 2016;37(5):641-645.

[7] Zhang Yaping, Wang Wenying, Li Lili, Liu Zengzeng, Han Xueling. Epidemiological characteristics and prevention and control status of hemorrhagic fever with renal syndrome in my country. Chinese Journal of Insecticides and Equipment. 2020;26(4):387-393.

[8] Li Jinsong, Lu Jianchun, Che Fengxiang, Meng Lingying, Liu Minxia. Laboratory and field sampling studies on airborne infection of Hantavirus. Chinese Journal of Virology. 2001;16(2):124-127.

[9]https://www.xiancn.com/content/2021-12/18/content_6433141.htm

Author: Dai Tianyi

Editor: Luna

This article comes from Guokr and may not be reproduced without permission.

If necessary, please contact [email protected]