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},
"code": "B08.1",
"name": "Контагиозный моллюск",
"icd_name": "Контагиозный моллюск",
"gender": 0,
"age_min": 1,
"age_max": 100,
"cause": [
"2",
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"periodicity": 1,
"slug": "b08.1_kontagioznyy_mollyusk",
"lead": "вирусное заболевание кожи, которое проявляется полушаровидными узелками розового цвета с вдавлением в центре",
"description": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Контагиозный моллюск — это заразная инфекция кожи, вызванная поксвирусом, которая приводит к появлению на коже куполообразных, гладких или восковидных бугорков розового или белого цвета.</span></p>",
"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Контагиозный моллюск возникает из-за вируса Molitorhominis, который по структуре схож с возбудителем оспы. Он имеет неоднородную структуру, имеет 4 штамма. Вирус распространяется следующими способами:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Контактно-бытовым. Заражение происходит через контакт кожи с предметом, на котором имеется возбудитель: поверхностью, личными вещами, предметами гигиены. Также подхватить моллюска можно через близкий контакт.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Половым. Вирус передается через внутренние жидкости. При таком способе заражения новообразования в основном появляются в области половых органов, внизу живота и в промежностях.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Гематогенный. Заразиться контагиозным моллюском можно при контакте с кровью больного человека.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Существует также ряд факторов риска, при которых вероятность заразиться контагиозным моллюском возрастает. Среди них:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Посещение общественных мест, таких как бассейн, баня, спортивный зал, косметологические кабинеты;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Антисанитарные условия;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Сниженный иммунитет;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Постоянный неконтролируемый прием лекарств;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Стрессы, переутомление;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Склонность к аллергии;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Беспорядочные половые связи;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Наличие заболеваний воспалительной ткани.</span></li>\r\n</ul>\r\n<p> </p>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Заражение контагиозным моллюском происходит после взаимодействия с инфицированными людьми или заражёнными предметами. Вирус проникает в кожу через небольшие ссадины и микротрещины и размножается исключительно в клетках плоского эпителия. Поражённые клетки увеличиваются в размерах, а при достижении критической точки их стенки лопаются и скапливаются в центре папулы.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Без лечения высыпания на коже сохраняются 6-9 месяцев, но могут оставаться и до двух лет. Это связано с уклонением вируса контагиозного моллюска от иммунного ответа. Механизм не до конца изучен, но, вероятно, включает выработку вирусом специфических белков, которые мешают сформироваться правильному иммунному ответу и уничтожению контагиозного моллюска. Однако через 6-24 месяца иммунный ответ формуется — образуются защитные антитела, и наступает выздоровление</span></p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Диагностикой контагиозного моллюска занимается врач-дерматолог. Для начала ему необходимо собрать анамнез и провести визуальный осмотр. Далее диагностика включает:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Биопсию. Необходима при атипичных проявлениях;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">ПЦР-исследование. Определяет возбудителя в организме;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Соскоб кожи. Подтверждает диагноз;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Общий и биохимический анализы крови. Отражают состояние организма.</span></li>\r\n</ul>\r\n<p> </p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Лечение контагиозного моллюска направлено на борьбу с кожными новообразованиями и недопущение рецидивов. Если элементы небольшие, для их удаления используются средства местного применения – иммуномодулирующие и противовирусные препараты, такие как Циклоферон, Инфагель, Имиквад, Ацикловир. Чтобы укрепить иммунитет, пациентам рекомендуют Виферон, Изопринозин.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Контагиозный моллюск лечится амбулаторно. Если новообразование слишком большое либо не поддается медикаментозной терапии, показано удаление. Существуют следующие способы:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Вылущивание – моллюска удаляют тонким пинцетом;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Электрокоагуляция – прижигание новообразования электрическим током;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Лазеротерапия – разрушение образования при помощи лазера;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Криотерапия – воздействие жидким азотом.</span></li>\r\n</ul>\r\n<p> </p>",
"prevention": "<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">соблюдать правила личной гигиены — использовать индивидуальные полотенца, одноразовые бритвы, после посещения бассейна и тренировок принимать душ с мылом;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">ВИЧ-инфицированным пациентам с высыпаниями на лице следует бриться как можно реже или отпустить бороду, так как бритьё способствует распространению вируса;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">проходить профилактические осмотры в детских садах и школах для раннего выявления случаев заболевания;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">использовать презервативы и избегать контакта с областями, поражёнными контагиозным моллюском;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">изолировать до полного выздоровления больных детей в детских садах</span></li>\r\n</ul>\r\n<p> </p>",
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"etiology": "<p>Причиной развития тропической лихорадки является арбовирус рода Flavivirus, который проникает в кровь человека через укус зараженной самки комара. Вирус денге обладает резистентностью к низким температурам и высушиванию. Не выдерживает нагревания до 60°С, воздействия ультрафиолетовых лучей, обработку формалином или эфиром. </p>\r\n<p>Вирус денге имеет четыре серотипа: DEN-I, DEN-II, DEN-III, DEN-IV. Зависимость формы и тяжести протекания болезни от заражения определенным типом вируса не установлены. </p>\r\n<p>Источником инфекции является больной человек, обезьяны и летучие мыши. Передачу инфекции от больного человека осуществляют комары рода Aedes (A. albopictus и A. Aegypti, A. Polinesiensis, A. Cutellaris). Комары становятся заразными на 8-12 день после кровососания и сохраняют пожизненную способность к передаче вируса. В большей степени к лихорадке денге восприимчивы дети до 2-х лет, пожилые и ослабленные люди, а также приезжие лица, в т. ч. туристы. </p>",
"pathogenesis": "<p>После укуса москита в течение 3-5 дней происходит размножение вируса в регионарных лимфоузлах и эндотелии сосудов. По истечении периода первичной репликации вирусные частицы проникают в кровь, обусловливая развитие вирусемии, которая клинически проявляется лихорадочно-интоксикационным синдромом. Вторая волна лихорадки связана с проникновением вирусов в органы и ткани. Купирование клинической симптоматики наступает по мере накопления в крови вируснейтрализующих ант</p>\r\n<p>Инкубационный период составляет в среднем 3—15 дней (чаще 5—7 дней). </p>\r\n<p>Классическая лихорадка денге (заболевает человек при первичном инфицировании): </p>\r\n<p>повышение температуры до 39—40 °С (к концу 3-х суток температура резко снижается, а через 1—3 дня вновь повышается, далее опять снижается через 2—3 дня) </p>\r\n<p>учащение пульса в начале заболевания, а через 2—3 дня он сильно урежается </p>\r\n<p>озноб </p>\r\n<p>боли в костях (чаще в позвоночнике) </p>\r\n<p>боли в суставах (особенно в коленных суставах) </p>\r\n<p>боли в мышцах </p>\r\n<p>анорексия (отказ от еды из-за отсутствия аппетита) </p>\r\n<p>адинамия (резкий упадок сил) </p>\r\n<p>тошнота </p>\r\n<p>головокружение </p>\r\n<p>бессонница </p>\r\n<p>покраснение и отёчность лица </p>\r\n<p>покраснение глаз </p>\r\n<p>покраснение горла </p>\r\n<p>различная зудящая сыпь (сначала сыпь появляется на туловище, затем распространяется на конечности и сохраняется 3—7 дней): </p>\r\n<p>петехиальная — точечные кровоизлияния </p>\r\n<p>скарлатиноподобная — покраснение кожи, на фоне которого определяются пятнышки величиной с просяное зерно. </p>\r\n<p>уртикарная — возвышающиеся над поверхностью кожи отёчные волдыри ярко-розового цвета размером от 0,5 до нескольких сантиметров, сильно зудящие. </p>\r\n<p> </p>\r\n<p>ител. </p>",
"diagnostics": "<p>Критерии, разработанные ВОЗ, позволяют заподозрить лихорадку денге в случае развития: лихорадочного синдрома, сохраняющегося 2-7 дней; тромбогеморрагического синдрома; увеличения печени и шокового синдрома. Также учитывается наличие эпидемиологических предпосылок (посещение эндемичных регионов, укусов москитов, вспышек инфекции) и типичных клинических симптомов (двухволновой лихорадки, артралгии, миалгии, экзантемы). </p>\r\n<p>Лабораторные методы исследования: </p>\r\n<ul>\r\n<li>общий анализ крови - снижение тромбоцитов, увеличение гематокрита. </li>\r\n<li>выявление антител (реакция связывания комплемента, реакция торможения гемагглютинации, реакция нейтрализации) </li>\r\n<li>выявление РНК вируса лихорадки Денге методом ПЦР (позволяет дифференцировать вирус различных типов). </li>\r\n<li> </li>\r\n</ul>",
"treatment": "<p>Больных госпитализируют в стационар. </p>\r\n<p>При классической форме заболевания назначают: </p>\r\n<ul>\r\n<li>болеутоляющие препараты; </li>\r\n<li>витамины; </li>\r\n<li>антигистаминные препараты. </li>\r\n</ul>\r\n<p>Показаны строгий постельный режим и обильное питьё: не менее 200 гр. каждые 2 часа, или более 2 литров в день. ВОЗ рекомендует свежевыжатые соки, молоко. Употребление только воды может привести к сдвигу электролитического баланса. Предпочтительны витамины С, К, B. </p>",
"prevention": "<p> Для предупреждения инфицирования в регионах, эндемичных по развитию лихорадки денге, необходимо использовать репелленты и фумигаторы, отпугивающие комаров, противомоскитные сетки. Особую актуальность имеет уничтожение комаров-переносчиков вируса денге, применение инсектицидов, борьба с заболоченностью и засорением территории, хранение запасов воды в закрытых емкостях.</p>",
"clinical_picture": "<p>Инкубационный период составляет в среднем 3—15 дней (чаще 5—7 дней). </p>\r\n<p>Классическая лихорадка денге (заболевает человек при первичном инфицировании): </p>\r\n<ul>\r\n<li>повышение температуры до 39—40 °С (к концу 3-х суток температура резко снижается, а через 1—3 дня вновь повышается, далее опять снижается через 2—3 дня) </li>\r\n<li>учащение пульса в начале заболевания, а через 2—3 дня он сильно урежается </li>\r\n<li>озноб </li>\r\n<li>боли в костях (чаще в позвоночнике) </li>\r\n<li>боли в суставах (особенно в коленных суставах) </li>\r\n<li>боли в мышцах </li>\r\n<li>анорексия (отказ от еды из-за отсутствия аппетита) </li>\r\n<li>адинамия (резкий упадок сил) </li>\r\n<li>тошнота </li>\r\n<li>головокружение </li>\r\n<li>бессонница </li>\r\n<li>покраснение и отёчность лица </li>\r\n<li>гиперемия (покраснение) глаз </li>\r\n<li>гиперемия (покраснение) зева</li>\r\n<li>различная зудящая сыпь (сначала сыпь появляется на туловище, затем распространяется на конечности и сохраняется 3—7 дней): </li>\r\n</ul>\r\n<ol>\r\n<li>петехиальная — точечные кровоизлияния </li>\r\n<li>скарлатиноподобная — покраснение кожи, на фоне которого определяются пятнышки величиной с просяное зерно. </li>\r\n<li>уртикарная — возвышающиеся над поверхностью кожи отёчные волдыри ярко-розового цвета размером от 0,5 до нескольких сантиметров, сильно зудящие. </li>\r\n</ol>",
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"lead": "Повышение температуры тела человека более 38° С может быть опасно для здоровья и требует медицинской помощи",
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},
"code": "A91",
"name": "Лихорадка денге",
"icd_name": "Геморрагическая лихорадка, вызванная вирусом денге",
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"age_min": 5,
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6
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"slug": "a91_lihoradka_denge",
"lead": "Острое вирусное природно-очаговое инфекционное заболевание, характеризующееся лихорадкой, интоксикацией и геморрагическим синдромом",
"description": " Лихорадка денге представляет собой острое вирусное заболевание с интоксикационными признаками, сопровождающееся мышечно-суставными болями, высокой температурой, а также мелкой сыпью в виде кровоизлияний точечного характера различной степени выраженности. ",
"etiology": "<p>Причиной развития тропической лихорадки является арбовирус рода Flavivirus, который проникает в кровь человека через укус зараженной самки комара. Вирус денге обладает резистентностью к низким температурам и высушиванию. Не выдерживает нагревания до 60°С, воздействия ультрафиолетовых лучей, обработку формалином или эфиром. </p>\r\n<p>Вирус денге имеет четыре серотипа: DEN-I, DEN-II, DEN-III, DEN-IV. Зависимость формы и тяжести протекания болезни от заражения определенным типом вируса не установлены. </p>\r\n<p>Источником инфекции является больной человек, обезьяны и летучие мыши. Передачу инфекции от больного человека осуществляют комары рода Aedes (A. albopictus и A. Aegypti, A. Polinesiensis, A. Cutellaris). Комары становятся заразными на 8-12 день после кровососания и сохраняют пожизненную способность к передаче вируса. В большей степени к лихорадке денге восприимчивы дети до 2-х лет, пожилые и ослабленные люди, а также приезжие лица, в т. ч. туристы. </p>",
"pathogenesis": "<p>После укуса москита в течение 3-5 дней происходит размножение вируса в регионарных лимфоузлах и эндотелии сосудов. По истечении периода первичной репликации вирусные частицы проникают в кровь, обусловливая развитие вирусемии, которая клинически проявляется лихорадочно-интоксикационным синдромом. Вторая волна лихорадки связана с проникновением вирусов в органы и ткани. Купирование клинической симптоматики наступает по мере накопления в крови вируснейтрализующих и комплемент-связывающих антител. При геморрагической форме лихорадки денге происходит поражение преимущественно мелких сосудов, нарушение агрегатного состояния крови с развитием множественных кровоизлияний в оболочках сердца, плевре, слизистой ЖКТ, головном мозге. </p>",
"diagnostics": "<p>Критерии, разработанные ВОЗ, позволяют заподозрить лихорадку денге в случае развития: лихорадочного синдрома, сохраняющегося 2-7 дней; тромбогеморрагического синдрома; увеличения печени и шокового синдрома. Также учитывается наличие эпидемиологических предпосылок (посещение эндемичных регионов, укусов москитов, вспышек инфекции) и типичных клинических симптомов (двухволновой лихорадки, артралгии, миалгии, экзантемы). Дополнительным критерием может служить положительная «проба жгута» (внутрикожное кровоизлияние после наложения жгута или манжеты в области локтевого сгиба). </p>\r\n<p>Лабораторные методы исследования: </p>\r\n<ul>\r\n<li>общий анализ крови - снижение тромбоцитов, увеличение гематокрита. </li>\r\n<li>выявление антител (реакция связывания комплемента, реакция торможения гемагглютинации, реакция нейтрализации) </li>\r\n<li>выявление РНК вируса лихорадки Денге методом ПЦР (позволяет дифференцировать вирус различных типов)</li>\r\n</ul>",
"treatment": "<p>При геморрагической форме заболевания назначают: </p>\r\n<ul>\r\n<li>инфузионную терапию; </li>\r\n<li>введение плазмы и плазмозаменителей (в тяжёлых случаях); </li>\r\n<li>глюкокортикоиды (в тяжёлых случаях); </li>\r\n<li>кислородотерапию; </li>\r\n<li>препараты, повышающие свертываемость крови (коагулянты). </li>\r\n</ul>",
"prevention": "<p>Для предупреждения инфицирования в регионах, эндемичных по развитию лихорадки денге, необходимо использовать репелленты и фумигаторы, отпугивающие комаров, противомоскитные сетки. Особую актуальность имеет уничтожение комаров-переносчиков вируса денге, применение инсектицидов, борьба с заболоченностью и засорением территории, хранение запасов воды в закрытых емкостях. </p>",
"clinical_picture": "<p> Геморрагическая форма возникает при многократном инфицировании разными штаммами вируса и проявляется следующими симптомами: </p>\r\n<ul>\r\n<li>повышение температуры тела до 39—40 °С </li>\r\n<li>кашель </li>\r\n<li>анорексия </li>\r\n<li>тошнота </li>\r\n<li>рвота </li>\r\n<li>боли в животе </li>\r\n<li>увеличение лимфатических узлов </li>\r\n<li>увеличение печени </li>\r\n<li>выраженная слабость </li>\r\n<li>петехиальная сыпь (кровоизлияния на коже) </li>\r\n<li>десневое, желудочно-кишечное кровотечения </li>\r\n<li>рвота кровью </li>\r\n<li>снижение артериального давления, учащение пульса </li>\r\n<li>бледность, синюшность кожи </li>\r\n</ul>",
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