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hantavirus hemorrhagic fever with renal syndrome : ウィキペディア英語版
hantavirus hemorrhagic fever with renal syndrome

Hantavirus hemorrhagic fever with renal syndrome (HFRS) is a group of clinically similar illnesses caused by species of hantaviruses from the family Bunyaviridae. It is also known as Korean hemorrhagic fever, epidemic hemorrhagic fever, and nephropathis epidemica. The species that cause HFRS include Hantaan River virus, Dobrava-Belgrade, Saaremaa, Seoul, Puumala and other hantaviruses. It is found in Europe, Asia, and Africa.〔Cosgriff TM, Lewis RM. Mechanisms of disease in hemorrhagic fever with renal syndrome. Kidney Int Suppl 1991; 35:S72.〕 Of these species, Hantaan River virus and Dobrava-Belgrade virus cause the most severe form of the syndrome and have the highest morbidity rates.
Both hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS) appear to be immunopathologic, and inflammatory mediators are important in causing the clinical manifestations.
== Signs and symptoms ==
Symptoms of HFRS usually develop within 1 to 2 weeks after exposure to infectious material, but in rare cases, they may take up to 8 weeks to develop. Initial symptoms begin suddenly and include intense headaches, back and abdominal pain, fever, chills, nausea, and blurred vision. Individuals may have flushing of the face, inflammation or redness of the eyes, or a rash. Later symptoms can include low blood pressure, acute shock, vascular leakage, and acute kidney failure, which can cause severe fluid overload.
The severity of the disease varies depending upon the virus causing the infection. Hantaan and Dobrava virus infections usually cause severe symptoms, while Seoul, Saaremaa, and Puumala virus infections are usually more moderate. Complete recovery can take weeks or months.〔Lee HW, van der Groen G. Hemorrhagic fever with renal syndrome. Prog Med Virol. 1989;36:62-102.〕
The course of the illness can be split into five phases:
;Febrile phase: Symptoms include redness of cheeks and nose, fever, chills, sweaty palms, diarrhea, malaise, headaches, nausea, abdominal and back pain, respiratory problems such as the ones common in the influenza virus, as well as gastro-intestinal problems. These symptoms normally occur for three to seven days and arise about two to three weeks after exposure.
;Hypotensive phase: This occurs when the blood platelet levels drop and symptoms can lead to tachycardia and hypoxemia. This phase can last for 2 days.
;Oliguric phase: This phase lasts for three to seven days and is characterised by the onset of renal failure and proteinuria.
;Diuretic phase: This is characterized by diuresis of three to six litres per day, which can last for a couple of days up to weeks.
;Convalescent phase: This is normally when recovery occurs and symptoms begin to improve.
This syndrome can also be fatal. In some cases, it has been known to cause permanent renal failure.

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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