希望楼主能够找到一期科普夏季常见传染病的文章

远洋, 2023-07-10 19:44, 医学养生

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前期症状和感冒很像

后期会导致多器官衰竭

严重可致命

又到恙虫病的高发季节

近期，浙江丽水已有近10人中招

医生提醒

去野外活动

请注意做好防护

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近日，浙江丽水莲都区碧湖镇的张大爷（化名）因持续高烧不退，来到市中心医院就诊。此前他曾吃过退烧药，也在当地诊所挂了一个多星期的盐水，但是效果不佳。

“患者入院时体温达到40多℃，连日高烧让他疲惫不堪，身体状况比较差。”该院感染科医生蒋翔伟告诉记者，经过仔细检查，发现张大爷右臂处有焦痂，且全身还发起了红色皮疹，结合血化验，确诊系恙虫病。

经询问，得知张大爷经常下地劳动，时常被各类蚊虫叮咬，但因平时身体好，被咬了也没放在心上。这次，他怎么也想不到，被小小的虫子叮了，会有这么严重的后果。经过合理治疗，目前张大爷已康复出院。

什么是恙虫病

恙虫病又名丛林斑疹伤寒，是由恙虫病东方体引起的急性传染病，是一种自然疫源性疾病，野生啮齿类动物为其主要传染源，恙螨幼虫为传播媒介，该病主要由恙螨幼虫叮咬人体而致，属人兽共患病，临床上以发热、皮疹及肝脾淋巴结肿大及火山口样焦痂为主要表现。

容易误诊漏诊

曾有人因此丧命

“每年的5至8月都是恙虫病高发季，我们近1个月内便收治了近10例。”蒋翔伟表示，患恙虫病后，病情轻重不一，临床表现多样，潜伏期4—20天。

“往往患者起病较急，主要临床特点为发热、特异性焦痂或溃疡、淋巴结肿大和皮疹。”蒋翔伟解释，恙虫叮咬人时会分泌一种酶使人麻痹，让人不会产生痛感及瘙痒感，从而难以察觉。被叮咬后，伤口会形成圆形黑色焦痂，周围有红晕。当痂皮脱落时，就形成无痛性溃疡。大多数患者为一个焦痂，极少数身上可见多处焦痂，分布在躯干、四肢，或者腹股沟、腘窝、腋窝、会阴等褶皱隐蔽的部位，容易错诊、误诊。

“很多恙虫病患者一直以为自己得的是普通感冒发烧，拖着不去医院，或者医生经验不足，无法做出正确诊断，从而延误治疗。”蒋翔伟告诉记者，恙虫病不是自限性疾病，也就是说，不会自愈，如果拖延太久，会导致多器官衰竭，严重可致命。

恙虫病危害健康

应该如何防护呢？

一起来看

蒋翔伟建议，要尽量避免长时间的户外活动，如需外出注意系好衣服领子、袖口及裤腿，不穿凉鞋，避免身体直接暴露在地面或在草丛上坐卧，最好在身上涂上防虫剂。户外活动或劳作后，回家要及时沐浴、换洗衣服，重点擦洗腋窝、腘窝、会阴部等处皮肤。如果出现发烧，检查身上是否有存在溃疡性焦痂，不错漏身上每一处皮肤。

出现这些症状，小心恙虫感染

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恙虫感染会出现怎么样的情况呢？患者一般会出现：

发热 ：体温多在38.5～41℃， 最高可达42℃，呈弛张热或稽留热，多有畏寒，偶有寒战。

焦痂或溃疡 ：是恙虫病特有的体征，发生率多为50%以上。焦痂或溃疡可全身分布，但多见于腋窝、腹股沟、外生殖器、肛门等隐蔽、潮湿且气味较浓的部位。

皮疹 ：皮疹的发生率有较大差异，可能与病原体的型别不同、病情轻重、就诊早晚等因素有关。多出现在发病后3～6天，充血性斑丘疹多见，持续3～7日后逐渐消退。皮疹呈暗红色，压之退色。形态大小不一，一般3～5mm，散在性分布，以胸、背和腹部较多，向四肢发展，面部很少，手掌脚底无皮疹。

淋巴结肿大 ：全身浅表淋巴结肿大是恙虫病常见的体征之一，焦痂或溃疡临近的浅表淋巴结肿大较为明显。

其他表现 ：全身不适、头昏头痛、肌肉酸痛、恶心呕吐、腹痛腹胀、纳差乏力等，可有咳嗽咳痰，肝脾肿大、结膜充血。

并发症 ：有支气管肺炎、脑炎或脑膜炎、中耳炎、腮腺炎、血栓性静脉炎、肝肾功能损害、心肌炎、心功能不全、DIC、感染性休克等。

3种途径教你预防

野外游玩时做好防护

消灭传染源

以灭鼠为主要措施。

切断传播途径

改善环境卫生，除杂草，消灭恙虫孳生地。野外作业时，可对该地区喷洒杀虫剂消减恙虫。

做好个人防护

在野外作业时应避免在草地上坐、卧、晾衣被。野外活动时，最好穿长袖衣服，还要扎紧袖口、裤管口，避免皮肤裸露于草丛，或在裸露皮肤上擦驱避剂等，防止恙虫的叮咬。

综合：丽水日报社-丽水网、人民日报

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Ocean Ocean, 2023-07-10 19: 44, Medicine

Focus on the button

Early symptoms are similar to colds.

It can lead to multiple organ failure.

Severe and fatal

It's the season of tsutsugamushi disease.

Recently, there are nearly 10 people recruited in Lishui, Zhejiang.

The doctor reminded

go to the field

Please take precautions.

Pictures

Recently, Zhejiang Lishui Liandu District Bihu town uncle Zhang (pseudonym) because of continued high fever, came to the downtown hospital for treatment. He had previously taken antipyretics and had been in the local clinic for more than a week with saline, but the results were not good.

"The patient's body temperature reached more than 40 °C when he was admitted to the hospital. He was tired and in poor condition with a high fever for days." The hospital infection department doctor Jiang Xiangwei told reporters, after careful examination, found that there is eschar in the right arm of uncle Zhang, and the whole body also initiated a red rash, combined with blood tests, confirmed tsutsugamushi disease.

Upon enquiry, I learned that Uncle Zhang often worked in the field, and was often bitten by various kinds of mosquitoes. But because he was in good health, he did not care about being bitten. This time, he could not imagine how small bug sting, will have such serious consequences. After reasonable treatment, uncle Zhang has recovered and discharged from hospital.

What is Tsutsugamushi Disease?

Tsutsugamushi disease, also known as jungle typhus, is an acute infectious disease caused by oriental tsutsutsugamushi disease, is a natural epidemic disease, wild rodents are the main infectious source, chigger larvae are the transmission vectors, The disease is mainly caused by chigger larvae biting human body, and is a zoonotic disease. The clinical manifestations are fever, rash, hepatosplenic lymphaden enlargement and crater-like scab.

easy to misdiagnose and miss diagnosis

People have been killed.

"May to August every year is the peak season of tsutsugamushi disease, we have treated nearly 10 cases in the past month." Jiang Xiangwei said that after suffering from tsutsutsugamushi disease, the condition varies in severity and variety of clinical manifestations, the incubation period is 4 lazy 20 days.

"The onset of the disease is often acute, and the main clinical features are fever, specific eschar or ulcer, lymphadenopathy, and rash." When a tsutsugamushi bites, it secretes an enzyme that paralyzes the person, making it difficult to detect pain and itching. After being bitten, the wound forms a round black eschar with a flush around it. When the scab peels off, it forms a painless ulcer. Most patients are an eschar, a few people see many eschar, distributed in trunk, limbs, or groin, popliteal fossa, axillary, perineum and other folds hidden sites, easy to misdiagnose, misdiagnosis.

"Many tsutsutsugamushi sufferers have been delaying treatment by thinking they have a common cold or fever, dragging their feet to the hospital, or their doctors are inexperienced and unable to make a correct diagnosis." Jiang Xiangwei told reporters, tsutsutsugamushi disease is not self-limiting disease, that is, will not heal, if delayed for too long, will lead to multiple organ failure, serious but fatal.

Tsutsugamushi disease endangers health

How should it be protected?

Together to see

Jiang Xiangwei suggested that you should avoid outdoor activities for a long time. If you need to go out, pay attention to tie the collar, cuffs, and trouser legs. Do not wear sandals. Avoid exposure to the ground or sitting on the grass. You should apply insect repellent to your body. Outdoor activities or work, home to timely bath, change clothes, focus on scrub armpits, popliteal fossa, perineum and other places of skin. If there is a fever, check the body for the presence of ulcerative eschar, a good leak of every skin.

Beware of Tsutsugamushi infection.

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What happens when tsutsugamushi is infected? Patients typically experience:

Fever: Body temperature is more than 38.5 ~ 41 °C, the maximum can reach 42 °C, is relaxed heat or retained heat, many have chills, occasionally chills.

Eschar or ulcer: Tsutsugamushi disease is a unique physical sign, the incidence of more than 50%. Eschar or ulcer can be distributed throughout the body, but more see in the armpit, groin, external genitalia, anus and other concealed, moist and smelly sites.

Rash: The incidence of rash has a large difference, and the pathogens may be different types, severity of illness, treatment sooner or later and other factors. It appears in 3 ~ 6 days after the onset of disease, congestive maculopapular eruption is more common, and gradually subsides after 3 ~ 7 days. The rash is dark red and fades under pressure. The shape is different in size, generally 3 ~ 5mm, distributed scattered, more in the chest, back and abdomen, developing to the limbs, few in the face, no rash on the palms and soles.

Adenopathy: The general superficial lymphadenopathy is one of the common signs of tsutsugamushi disease. The superficial lymphadenopathy near eschar or ulcer is more obvious.

Other manifestations: general discomfort, dizziness, headache, muscle soreness, nausea and vomiting, abdominal pain, abdominal distension, lack of strength, cough and expectoration, hepatosplenomegaly, conjunctival congestion.

Complications: Bronchopneumonia, encephalitis or meningitis, otitis media, mumps, thrombophlebitis, liver and kidney damage, myocarditis, cardiac dysfunction, DIC, septic shock, etc.

3 Ways to Teach You Prevention

Protect yourself when playing in the wild

Eliminate the source of infection

The main measure is to kill rodents.

cut off the transmission route

Improve environmental sanitation, weeds and eliminate tsugamushi breeding grounds. Field operations can be used to spray pesticides on the area to reduce tsugamushi.

Take personal protection.

In the field should avoid sitting, lying on the grass, drying clothes quilt. Outdoor activities, it is best to wear long-sleeved clothes, but also tie tight cuffs, trouser mouth, avoid skin exposed in the grass, or in the exposed skin on the wipe repellent, to prevent the bite of tsugamushi.

Comprehensive: Lishui Daily-Lishui Network, People's Daily

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