How do infections manifest in cancer patients. What are the common symptoms of infections in individuals undergoing cancer treatment. How can cancer patients reduce their risk of infections. What are the typical infection sites in cancer patients. How should cancer patients respond to potential infection symptoms.

Understanding Infection Symptoms in Cancer Patients

Infections can pose significant risks to cancer patients, particularly those undergoing treatment. Recognizing the symptoms of an infection is crucial for prompt intervention and management. While fever is often considered a primary indicator, it’s important to note that not all infections present with elevated temperature.

Do all infections in cancer patients cause fever. No, some infections may not present with a fever, and other symptoms could be the first sign of an infection. This is why it’s essential for cancer patients to be vigilant about any changes in their health status.

Key Infection Symptoms to Watch For

• Temperature changes (37.5°C or higher, or below 36°C)
• General malaise and fatigue
• Flu-like symptoms (chills, headaches, muscle aches)
• Respiratory issues (coughing, shortness of breath)
• Gastrointestinal problems (diarrhea, vomiting)
• Urinary tract symptoms
• Skin changes or wound site issues
• Neurological symptoms (confusion, disorientation)

When should cancer patients seek medical advice for potential infections. It’s crucial to contact the 24-hour advice line immediately if any infection symptoms develop, especially following recent cancer treatment. Early intervention is key to preventing potentially life-threatening complications.

Common Infection Sites in Cancer Patients

Understanding where infections commonly occur can help patients and caregivers remain vigilant. Cancer and its treatments can compromise the body’s natural defenses, making certain areas more susceptible to infection.

Primary Infection Sites

1. Mouth and throat
2. Skin
3. Lungs
4. Kidneys and bladder
5. Intravenous line sites (cannula and PICC line sites)
6. Surgical wounds and drain sites
7. Ulcerating tumors
8. Bloodstream

Are there other less common infection sites in cancer patients. Yes, infections can also occur in the liver, abdomen, esophagus, vagina, anus, brain, and spinal cord, although these are less frequent.

The Role of Temperature in Infection Detection

Fever is often considered a primary indicator of infection, but its absence doesn’t necessarily rule out an infection. Some medications can mask fever symptoms, complicating infection detection.

Medications That Can Mask Fever

• Painkillers (e.g., paracetamol, ibuprofen)
• Steroids

How do certain medications affect fever detection in cancer patients. Some painkillers and steroids have antipyretic properties, meaning they can bring down or mask a fever. This can potentially hide signs of infection, making it crucial for patients to report any feelings of being unwell, even without an elevated temperature.

Infection Prevention Strategies for Cancer Patients

While it’s impossible to eliminate all infection risks, cancer patients can take proactive steps to reduce their vulnerability to infections. Implementing good hygiene practices and being mindful of potential exposure risks are key components of infection prevention.

Essential Infection Prevention Measures

• Daily bathing or showering
• Frequent and thorough hand washing
• Proper oral hygiene
• Food safety precautions
• Avoiding potential sources of infection

Should cancer patients completely isolate themselves to prevent infections. No, complete isolation is generally not necessary or recommended. Patients can maintain normal social interactions unless specifically advised otherwise by their healthcare team. However, it’s important to avoid contact with individuals who have known infections or are feeling unwell.

Managing Infections in Cancer Patients

When an infection is suspected or confirmed in a cancer patient, prompt and appropriate treatment is essential. The specific treatment approach depends on the type and severity of the infection, as well as the patient’s overall health status.

Key Aspects of Infection Management

1. Rapid assessment and diagnosis
2. Timely initiation of appropriate antimicrobial therapy
3. Close monitoring of patient response
4. Adjustment of treatment as necessary
5. Supportive care measures

What is the primary goal of infection management in cancer patients. The primary goal is to quickly control the infection while minimizing potential complications and supporting the patient’s overall treatment plan. This often involves a multidisciplinary approach, combining expertise from oncology, infectious disease specialists, and other relevant medical professionals.

Neutropenic Sepsis: A Critical Concern for Cancer Patients

Neutropenic sepsis is a potentially life-threatening condition that can occur in cancer patients, particularly those undergoing chemotherapy. It results from a combination of neutropenia (low white blood cell count) and infection, leading to a severe systemic response.

Understanding Neutropenic Sepsis

• Definition: Sepsis occurring in a patient with neutropenia
• Risk factors: Recent chemotherapy, certain cancer types, prior episodes of neutropenic sepsis
• Symptoms: Fever, chills, rapid heartbeat, low blood pressure, confusion
• Management: Immediate antibiotic therapy, supportive care, close monitoring

Why is neutropenic sepsis considered a medical emergency for cancer patients. Neutropenic sepsis can rapidly progress to severe sepsis or septic shock, potentially leading to organ failure and death. The compromised immune system of cancer patients, particularly those with neutropenia, makes them especially vulnerable to severe infections. Prompt recognition and treatment are crucial for improving outcomes.

The Impact of Cancer Treatment on Infection Risk

Cancer treatments, while essential for fighting the disease, can significantly impact a patient’s immune system and overall health, increasing their susceptibility to infections. Understanding these effects can help patients and healthcare providers better manage infection risks.

Cancer Treatments and Infection Vulnerability

1. Chemotherapy: Can lower white blood cell counts, particularly neutrophils
2. Radiation therapy: May affect bone marrow function and local tissue integrity
3. Surgery: Creates potential entry points for pathogens
4. Immunotherapy: Can alter immune system function
5. Stem cell transplantation: Temporarily suppresses the immune system

How long does the increased infection risk persist after cancer treatment. The duration of increased infection risk varies depending on the type and intensity of treatment. For some patients, the risk may be elevated for weeks to months after completing therapy. Regular follow-ups and ongoing vigilance are essential during this recovery period.

Emerging Research and Advances in Infection Management for Cancer Patients

The field of oncology is continuously evolving, with ongoing research aimed at improving infection prevention and management strategies for cancer patients. These advancements hold promise for reducing infection-related complications and enhancing overall patient outcomes.

Key Areas of Research and Innovation

• Novel antimicrobial agents and delivery methods
• Immunotherapy approaches to boost infection resistance
• Predictive biomarkers for infection risk
• Advanced diagnostic tools for rapid pathogen identification
• Personalized infection prevention protocols

How might future developments impact infection management in cancer care. Emerging technologies and treatment strategies could lead to more targeted and effective infection prevention and management approaches. This may include personalized risk assessments, tailored prophylactic measures, and more precise antimicrobial therapies, ultimately reducing the burden of infections in cancer patients.

As research progresses, it’s crucial for patients and healthcare providers to stay informed about the latest developments in infection management. Regular updates to clinical guidelines and treatment protocols help ensure that cancer patients receive the most current and effective care strategies for preventing and managing infections.

In conclusion, managing infection risks is a critical aspect of comprehensive cancer care. By understanding the symptoms, prevention strategies, and treatment approaches for infections, patients and healthcare providers can work together to minimize complications and support successful cancer treatment outcomes. Ongoing vigilance, prompt communication, and adherence to recommended guidelines are key components of effective infection management in the oncology setting.

Symptoms of infections | Coping physically fever

Infections can sometimes be life threatening. A fever may be the first or only sign of an infection. But some infections may not present with a fever and it could be another symptom.

Contact your 24 hour advice line immediately if you’ve had cancer treatment recently and think you might have an infection.

Even if it turns out that you don’t have an infection, it’s better to find out as soon as possible than wait for things to get more serious.

Signs and symptoms of an infection

You could have one or more of the following symptoms:

• a change in your temperature – 37.5°C or higher or below 36°C
• feeling generally unwell – not able to get out of bed
• flu-like symptoms – feeling cold and shivery, headaches, and aching muscles
• coughing up green phlegm
• a sore throat or sore mouth
• a throbbing, painful tooth
• pain having a wee, going more often or cloudy or foul-smelling wee
• diarrhoea – 4 or more loose, watery bowel movements in 24 hours
• skin changes – redness, feeling hot, swelling or pain
• a fast heartbeat
• quick breathing or feeling short of breath
• feeling dizzy or faint
• feeling confused or disorientated
• being sick (vomiting)
• a headache
• pain, redness, discharge, swelling or heat at the site of a wound or intravenous line such as a central line or PICC line
• pain anywhere in your body that was not there before your treatment

An increase in your temperature to 37. 5C or higher might be the first sign that you have an infection. Call your 24 hour advice line immediately, you might need injections of antibiotics to control the infection.

Medicines that mask or bring down a temperature

Some types of painkillers such as paracetamol and ibuprofen are anti pyretics. This means they bring down temperatures. Taking these may disguise that you have an infection. Taking steroids can also hide the signs of infection.

Call your 24 hour advice line if you feel unwell even if you don’t have a temperature.

Where infections commonly start

A fever in itself is not usually dangerous, but the infection that causes it can be. It’s very important to tell your medical team if you develop a fever or any symptoms of a fever. They can treat the infection that is causing it.

An infection can occur anywhere in your body. The most common places are:

• the mouth and throat
• the skin
• the lungs
• the kidneys and bladder, especially if you have a catheter to drain urine from your bladder
• where a drip or central line goes in (cannula sites and PICC line sites)
• wounds and where wound drains go in
• ulcerating tumours
• the bloodstream

Other less common places are the:

• liver and abdomen
• gullet (oesophagus)
• vagina and anus
• brain and spinal cord

What you can do

There are some ways to reduce your risk of getting an infection when you have treatment for cancer. These include:

• taking a bath or shower daily
• washing your hands – particularly before eating, after using the toilet, if you sneeze or cough
• brushing your teeth and using mouthwash
• making sure cooked food is properly heated through to kill off bacteria
• not sharing things like drinking cups and cutlery
• washing all fruit and salads well in clean water
• avoiding contact with anyone who has (or may have been) exposed to chicken pox
• wearing disposable gloves to pick up pet poo – preferably ask someone else to do it
• wearing gloves when gardening

Don’t be afraid to live your life as normal. You do not need to stop seeing family and friends unless they have an infection or feel unwell. You do not need to avoid crowded places unless specifically advised to do so by your healthcare team.  

Treating an infection

Treatment depends on the type of infection you have. We have a section on treating fever and infection. 

• Neutropenic sepsis: prevention and management in people with cancer
  National Institute for Health and Care Excellence, (NICE) 2012.

• Acute Oncology Initial Management Guidelines. (Version 2.0)
  UK Oncology Nursing Society (UKONS), March 2018.

• Infections in Cancer Patients with Solid Tumors: A Review

  K Rolston

  Infection disease therapy, 2017. Volume 6, Issue 1, Pages 69–83.

• Management of Febrile Neutropaenia: ESMO Clinical Practice Guidelines.
  J Klastersky and others
  Annals of Oncology, 2016. Volume 27, Issue 5, Pages 111- 118

• Neutropaenic sepsis: prevention, identification, and treatment.
  C Warnock
  Nursing Standard, 2016. Volume 30, Issue 35, Pages 51 – 60.

• Febrile neutropenia
  BMJ best practice, 2022 

• The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. If you need additional references for this information please contact [email protected] with details of the particular risk or cause you are interested in. 

Last reviewed: 

12 Feb 2023

Next review due: 

12 Feb 2026

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Fever Causes, Symptoms and Treatments

Medically Reviewed by Jennifer Robinson, MD on August 24, 2022

When you have an illness or infection, your body temperature may rise above its normal range. This is a fever. It could help your body fight back against its cause. But it might make you feel hot and achy, too. If you have a fever, you may not need to see a doctor. But if your child has one, you may need to call or visit.

Most of us learned that a normal body temperature is 98.6 F. But new research shows that was the norm for people in the 1800s. Today, studies show that people may be slightly cooler, so the norm is anywhere between 97 and 99 F.

Did you know that your temperature changes through the day? You’re at your coolest overnight and warmest in the evening. You may get warmer if you exercise.

If your temperature is higher than normal but it’s lower than 100.4 F, your doctor may say that you have a low-grade fever. A mild illness, like a cold or an ear infection, may cause one. Some people may have a low-grade fever after they get a vaccine. If yours doesn’t get back to normal in a few days, ask your doctor if you should pay a visit.

If you have a fever, you may feel hot and sweaty. You also might shiver because you feel chilled. Weakness, aches, or fatigue could happen. You may have symptoms of the illness that caused the fever, like a cough or sore throat. Food may not sound good. A rotten mood also is possible. Fevers may be a bit more severe for your child. A small percentage of kids have something called a febrile seizure when their body temperature goes up.

Up to 4% of children ages 6 months to 5 years may have a seizure with a fever. Their eyes may roll back. They may seem to faint, and their bodies could become stiff. Shaking and twitching are possible too, but they should stop within a minute. Doctors consider febrile seizures harmless. But to be safe, you should let your doctor know if your child has one.

Your body may raise its temperature to help you fight off an infection. When your body is hotter, it makes it harder for viruses or bacteria to survive. The fever also tells your immune system to make more white blood cells to join in the fight. So a fever may help protect you, even if it makes you feel worse for a little while.

Thermometers can measure your temperature by mouth, ear, armpit, forehead, or rectum. For older kids and adults, the most accurate method is by mouth with an oral digital thermometer. Rectal is best for babies or small children. To take a temperature that way, put petroleum jelly on the thermometer tip, insert it about half an inch into their rectum, and hold the thermometer still until you get the result.

If your baby has a fever of 100.4 F or higher, tell your doctor right away so they can find out if the fever is a sign of something more serious. No matter how high the fever is, reach out if a seizure comes with it. If the seizure lasts for more than 5 minutes, call 911. A low temperature could also mean that your baby is sick, so if theirs drops below 97.7 F, give your pediatrician a call.

Talk with your doctor right away if your child’s fever is above 104 F or lasts several days. Also call if the temperature doesn’t drop after you give medicine to lower it, or if the fever is above 102 F after a vaccine. And tell the doctor if your child seems too sleepy, if they don’t drink or pee enough, or if they have a febrile seizure for the first time. If the seizure lasts more than 5 minutes, even if it isn’t the first, call 911.

If your temperature is 103 F or higher, the fever lasts at least 2 days, or if the number doesn’t drop after you take medicine to lower it, reach out to your doctor’s office. You may also want to call if you haven’t drunk enough fluid or peed enough, or you’ve vomited many times and can’t keep down fluids. Go to the emergency room if you have a fever with a bad headache, a stiff neck, a new rash or confusion, or if it’s 105 F or more.

If you or your child feels well enough to eat, sleep, and do things at home (like read or watch TV), you may not need to try to lower a fever, because the fever itself may fight the illness. Studies show that some people in hospitals get better whether their fevers are treated or not. If your child gets febrile seizures, medicine may make them feel better, but it won’t make seizures less likely. Still wonder what to do? Ask your doctor.

Over-the-counter medicines like acetaminophen and ibuprofen may ease a fever in adults and children older than 6 months. If your baby is 3-6 months old and has a low-grade fever, fluids and rest should do the trick, but call the doctor if your baby becomes irritable. Adults can use aspirin, but never give it to children. Lighter clothes may help. A light blanket and drinking cool liquids could also. A lukewarm shower, bath, or sponge bath may also help people cool down.

IMAGES PROVIDED BY:

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SOURCES:

Mayo Clinic: “Fever,” “Common cold,” “Fever: Diagnosis and treatment.”  

Cleveland Clinic: “Your kid has a fever: Which thermometer is best?” “Body temperature: What is (and isn’t) normal?” ““What’s happening in my body when I have a fever?” “Kids’ fevers: When to worry, when to relax,” “Febrile seizures,” “Fever: When to call the doctor.”

Elife: “Decreasing human body temperature in the United States since the Industrial Revolution. ”

Critical Care Medicine: “Guidelines for evaluation of new fever in critically ill adult patients: 2008 update from the American College of Critical Care Medicine and the Infectious Diseases Society of America.”

American Academy of Pediatrics: “Signs and symptoms of fever,” “Fever and your baby,” “How to take a child’s temperature,” “Treating a fever without medicine.”

Stanford Children’s Health: “Fever in a newborn.”

Journal of Thoracic Disease: “Fever: Suppress or let it ride?”

Michigan Medicine, University of Michigan: “Fever or chills, age 12 or older.”

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Mouse fever (Hemorrhagic fever) in children and adults: symptoms, signs, treatment

Hemorrhagic fever with renal syndrome (the second name is mouse fever) is a disease of the infectious group, often associated with the beginning of the summer season and agricultural work. Every year, about 7,000 cases of infection are recorded in the country, which makes itself felt with characteristic symptoms – a hemorrhagic rash, vascular damage, malfunctioning of the kidneys and a general deterioration in a person’s condition. In the absence of timely assistance, the disease can cause serious complications and death. Only timely seeking medical help will help preserve the health of the patient and return him to normal life.

Causes of mouse fever

For a long time, the beginning of the summer season was marked by a sharp increase in patients who went to the doctor with the same symptoms – impaired excretory function, skin rashes, changes in blood composition, weakness and malaise. Detailed studies have identified the culprits who are carriers of a dangerous infection.

These are rodents, in the body of which there is a sufficient amount of pathogenic microflora. Together with secretions, it enters the soil and on the skin of a person during summer work, digging the soil, outdoor recreation and sports. Through dirty hands, pathogens enter the body, penetrate the respiratory system and blood vessels, causing the appearance of characteristic symptoms. Most of the sick are lovers of summer holidays and employees of agricultural enterprises involved in planting plants and harvesting in the fields and gardens.

A significant part of the rodents that are carriers of hemorrhagic fever infection move through fields, broad-leaved forests, garden plots, abandoned agricultural land, auxiliary buildings, etc. With the onset of cold weather, they tend to penetrate into houses, where they continue to actively breed. Their waste products remain on the surfaces of the floor and walls, tables and shelves, which significantly increases the risk of infection during cleaning and tidying up.

Routes of infection include:

• airborne – inhalation of dust containing small particles of excrement;
• alimentary – consumption of water contaminated by rodents;
• contact – in contact with human skin of the remains of waste products and contaminated soil.

Cases of transmission of the disease from an infected person to healthy people have not been registered.

Mouse Fever Symptoms

The disease manifests itself in several stages:

In the initial stage, which takes about 3 days, the first signs of mouse fever resemble the flu or an acute viral infection. There is an increase in temperature, aches and pain in the muscles, chills and weakness, thirst, a decrease in pressure and a slowing of the pulse. Many patients complain of inflammation of the mucous membrane of the eyes, conjunctivitis, and a rash.

At the next stage, the patient has nausea and vomiting, swelling of the face and body, bloating of the abdominal cavity, back pain in the lumbar region. The duration of this period is about 10-11 days. In the absence of medical attention, with symptoms of mouse fever, there is a risk of internal bleeding with subsequent death.

Thanks to timely medical care, the patient’s recovery takes about one to one and a half months. Complete disposal of the body from the pathogen and symptoms of mouse fever in men and women is observed after 4-6 months.

Consequences of mouse fever

The presence in the body of complex diseases of internal organs, the general depressed state of the immune system and the rapid development of the disease against the background of the lack of timely medical care can cause the development of the following pathologies:

• pancreatitis;
• myocarditis;
• sepsis;
• edematous phenomena in the lungs;
• meningitis, cerebral hemorrhage;
• renal failure.

The combination of the listed consequences of mouse fever contributes to the rapid deterioration of the patient’s condition and can lead to irreversible consequences in the body.

Diagnostic methods

Some signs of an infectious disease can be detected at the stage of visual examination and history taking. Confirm the doctor’s assumptions allow the analysis of PCR (polymerase chain reaction) enzyme immunoassay, showing the presence of antibodies to the pathogen in the blood. Radiography, ultrasound diagnostics and urinalysis allow to clarify the state of internal organs.

How to treat?

Putting off going to the doctor, hoping for the results of folk methods, is a serious risk. The result of such a decision can be a significant deterioration in the patient’s condition up to the failure of internal organs, extensive internal bleeding and death. Moreover, the medical institution will offer comprehensive treatment aimed at eliminating the symptoms and causes of the pathology:

• intravenous injections of ribavirin;
• the introduction of saline and glucose solution to restore the basic functions and nutrition of the body;
• a course of multivitamin preparations;
• blood transfusion, excluding the consequences of its infection with a pathogen.

A therapeutic diet with the complete exclusion of spicy and spicy foods, alcohol, vinegar and seasonings can speed up recovery.

Ways to prevent infection with mouse fever

You can avoid infection by following these guidelines:

• regular cleaning of the premises of a country house and an agricultural enterprise using automatic equipment and disinfectants;
• protection of the skin of the hands and respiratory tract when cleaning or working with open ground;
• destruction of products spoiled by rodents;
• sealing joints and seams through which uninvited vectors of infection can enter the room;
• storage of foodstuffs in hermetically sealed containers;
• thorough heat treatment of food before eating.

Other recommendations for infection prevention can be obtained from the attending physician who supervises the treatment of murine fever.

Diagnosis and treatment of mouse fever in Moscow

The qualified staff of the clinic of JSC “Medicina” in the Central Administrative District of Moscow invites patients with the first signs of the disease for an initial consultation, diagnosis and treatment of mouse fever. All the necessary examinations and procedures can be done at the medical center, equipped with advanced equipment from leading world manufacturers. Each patient is guaranteed an attentive attitude, careful development of an individual treatment course, control of specialists and confidentiality of personal information. You can make an appointment on the clinic’s website or by calling the indicated numbers in Moscow.

Questions and answers

What is mouse fever?

Mouse fever is the second name for hemorrhagic fever with renal syndrome. This is a human infectious disease that occurs after contact with the waste products of rodents that are carriers of the virus. Direct contact, drinking contaminated water or inhaling the smallest particles of excrement during field or country work often cause infection to enter the body and cause dangerous symptoms of infection.

How do you get mouse fever?

Most of the reported cases are the consequences of being in nature or country work in violation of personal hygiene requirements. The pathogen enters the body through dirty hands, respiratory tract, minor injuries on the skin. Quickly spreading throughout the body, it manifests itself with a rash, a violation of the excretory function of the kidneys, changes in the composition of the blood and other signs. More often, mouse fever is infected by holidaymakers, farm workers, soil explorers and residents of old houses who are forced to deal with uninvited guests and clean up traces of their life.

Is mouse fever transmitted?

The main carrier of the disease are rodents, who prefer to settle in abandoned houses, warehouses, and old buildings. Most of the infected are summer residents or employees of agricultural enterprises working with soil or harvesting. Cases of mutual infection of people have not been identified.

Hemorrhagic fevers

Hemorrhagic fevers are a group of acute infectious diseases caused by representatives of four types of viruses: arenaviruses, bunyaviruses, flaviviruses and filoviruses. Common to these diseases is severe intoxication and a characteristic thrombohemorrhagic syndrome.

Viruses that cause hemorrhagic fevers are widespread in many parts of the world. Some are also found in developed countries, but Africa, Asia and South America are endemic for most types of pathogens.

The course of hemorrhagic fever, depending on the pathogen, can vary from moderate to extremely severe. Mortality from individual variants of infection ranges from 10 to 90%. Certain variants of hemorrhagic fever lead to severe damage to internal organs and often to death.

The prognosis of the disease depends on the type of virus, the age and general condition of the patient, in particular on the activity of his immune system.

Synonyms English

Viral hemorrhagic fevers, hemorrhagicfevers, VHF, VHFs.

Symptoms

Symptoms of hemorrhagic fevers vary depending on the type of virus that caused the disease. Common manifestations for all infections are severe fever itself and increased bleeding. Symptoms in the initial stage of the disease are most often nonspecific, however, in the process of further development of the pathological process, signs of damage to certain organs and body systems may appear.

Main symptoms of hemorrhagic fevers:

• fever;
• weakness, dizziness;
• muscle pain;
• skin hyperemia;
• petechial rash on skin and mucous membranes;
• disturbance of consciousness;
• redness of the eyes;
• blood in stool, vomiting blood;
• drop in blood pressure.

General information about the disease

Hemorrhagic fevers can be caused by four families of RNA viruses: arenaviruses (Arenaviridae), bunyaviruses (Bunyaviridae), filoviruses (Filoviridae) and flaviviruses (Flaviviridae). Arenaviruses cause Lassa fever, Argentinean, Brazilian, Venezuelan and Bolivian fevers, bunyaviruses cause Crimean-Congo fever, Rift Valley fever, hemorrhagic fever with renal syndrome, filoviruses cause Ebola fever, flaviviruses cause yellow fever, Dengue fever, etc.

“Reservoirs” of viruses are some animals and insects, most often small rodents, bats, mosquitoes, ticks. As a rule, certain types of hemorrhagic fevers are found mainly in the habitat of those animals that are the source of a particular pathogen. For example, the source of the Rift Valley fever virus, which is common in Africa, is mosquitoes. Crimean-Congo hemorrhagic fever occurs in Europe, Asia, Africa, it is spread by ticks. The source of some diseases, such as Ebola, remains unknown, suggesting that it may be bats. Some types of viruses are transmitted through the blood or semen of an infected animal or person, through unsterile needles. Certain causative agents of hemorrhagic fevers can be infected by inhalation of microparticles of faeces and urine of animal carriers.

All representatives of the viruses that cause hemorrhagic fevers are united by a common pathogenesis. They tend to affect the vascular endothelium, which explains the development of the hemorrhagic syndrome in most hemorrhagic fevers. After the virus enters the bloodstream through insect bites, scratches, abrasions, injections, the respiratory mucosa, a local reaction to infection is first formed, followed by viremia and a generalized lesion of the microcirculation system (the virus also infects the cells of the vascular wall). When the pathogen enters the bloodstream, it adheres to the cell membrane, penetrates into it, actively multiplies and spreads to other tissues of the body. This is accompanied by the release of biologically active substances that violate the permeability of blood vessels, the rheological properties of blood. A manifestation of this process is a rash, hyperemia of the skin, redness of the vessels of the sclera, internal bleeding may occur, accompanied by a sharp drop in blood pressure, shock. A number of viruses cause damage to the bone marrow, in particular megakaryocytes. Weakening of the body’s immune system, a weak or delayed response of protective mechanisms can lead to the rapid development of the pathological process, accompanied by massive bleeding, multiple organ damage.

Who is at risk?

• Workers with infected people or animals, such as medical workers, biologists, pest control workers, livestock farm workers.
• Living in endemic areas.
• Intravenous drug users.
• Those who neglect barrier methods of contraception.

Diagnosis

Diagnosis is based on anamnesis, physical examination, results of laboratory and instrumental studies. When questioning the patient, attention is drawn to possible contact with the pathogen – travel to regions endemic for the disease, contact with animal carriers or infected people. The incubation period of most hemorrhagic fevers is 10-21 days, so the disease can develop after returning from a trip to a dangerous area. If hemorrhagic fever is suspected, it is necessary to conduct a series of studies in the hospital as soon as possible to differentiate the disease from other diseases and establish the type of pathogen:

• Complete blood count (without leukocyte formula and ESR). In the general analysis of blood in hemorrhagic fevers, leukopenia and thrombocytopenia can be detected. In some cases, such as Lassa fever, these changes are absent. Hemoglobin levels may drop.
• Erythrocyte sedimentation rate (ESR). May be upgraded.
• Prothrombin index (PI) , activated partial thromboplastin time (APTT) are increased.
• Fibrinogen. Fibrinogen and platelet monitoring is used to detect possible disseminated intravascular coagulation.
• The test is used when a urinary tract infection is suspected.
• Culture of biological fluids: blood, urine, throat and nose swabs. Used to identify possible infectious agents.
• Detection of the causative agent of infection in the blood by polymerase chain reaction (PCR).
• Detection of antibodies to the infectious agent in the blood.

All diagnostic manipulations should be performed with extreme caution due to the high pathogenicity of pathogens.