Завозные случаи лихорадки денге у жителей Республики Татарстан

Abstract

The article presents an analysis of clinical-epidemiological and laboratory-instrumental data of 15 patients with dengue fever (DF), residents of the Republic of Tatarstan, who visited regions endemic for DF as tourists. To verify the diagnosis, PCR diagnostics of blood serum for dengue virus RNA and determination of dengue virus serotypes were carried out. The classical form of the disease of moderate severity was diagnosed in 14 (93.3%) patients. The clinical picture was characterized by an acute onset, fever, chills, myalgia, arthralgia. The total duration of the febrile period varied from 3 to 7 (4.1 (2.09)) days. In 7 (46.7%) patients, maculopapular exanthema of various localization was observed, in 43% it was hemorrhagic in nature and was accompanied by itching (28.6%). In 5 (33.3%) cases, dyspeptic syndrome developed. 4 (26.7%) patients were diagnosed with respiratory syndrome. Hematological changes were characterized by thrombocytopenia in 93.3% (105.6 (35.9) 109/l) and leukopenia in 86.7% (3.2 (1.9) 109/l) of patients. 7 (46.7%) patients had a moderate cytolytic syndrome with a predominance of ALT (61 (43.3) U/l) and AST (59.6 (36.9) U/l) activity in the early period of the disease. In 7 (46.7%) patients, an increase in the pulmonary pattern of both lungs with perivascular and peribronchial changes was diagnosed radiographically. Sonographic examination of the abdominal organs revealed an increase in the size of the liver and spleen in 3 (20%) patients. Thus, imported cases of DF in the Republic of Tatarstan were characterized by the development of the classical moderate form caused by serotypes 1-3. Due to the increased DF incidence in the Russian Federation and, in particular, in the Republic of Tatarstan, it is necessary to improve medical alertness in diagnosing the disease characterized by fever combined with arthralgia, myalgia and exanthema in people who returned from endemic countries. Due to the lack of vaccination in the Russian Federation, it is necessary to inform patients who recovered from DF about the risk of developing a hemorrhagic form of the disease in case of re-infection.