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This is one disease that up till recently was still treated using Chinese Herbs in Nanjing. What happens is that the virus causes high fever, hemorrhage, shock, and most importantly, acute renal failure.

EHF happens mostly in the winter, next most frequently in the summer.

How the disease progresses is as follows:

1. Fever Period:
   1. here, we have poison in the blood, that destroys capillaries and kidneys
   2. there is also the “三痛”, which includes 头痛、腰痛 and 眼眶痛
      1. the headache is due to dilation of blood vessels in the brain
      2. the aching in the lumber region is due to blood and fluids collecting in the area around the kidneys - inflammatory response
      3. aching around the eye sockets is due to edema around the eye region.
2. Low Blood Pressure Period:
   1. As blood pressure falls, you face starts looking white, your limbs cold, and pulse weakening to almost nothing. Of course the volume of urine starts falling (see next period). Once the brain begins lacking in blood, you’ll start feeling vexed and may even start talking nonsense 
   2. This can lead to LBP-induced shock, ARDS et al.
3. Reduced Urinary Volume Period:
   1. less than 50ml in 24 hours.
   2. With reduced urinary volume comes 尿毒症（uremia）、酸中毒（acidosis）、电解质紊乱
      1. 酸中毒 （acidosis） increases breathing rate and kussmaul deep breathing
      2. With the edema and containment of sodium and water, we not only see ascites and increased blood volume, veins may start filling up and we have 洪大 pulse, pulse pressure (PP) increases and heart contractions are not complete.
      3. electrolyte imbalance may manifest as low blood sodium, high blood potassium i.e. palpitations
   3. Some people actually manifest high blood volume, leading to pulmonary edema.
4. Increased Urinary Volume Period:
   1. At some point, because of the increased intra vessel wall osmotic pressure, the body begins regulating itself again, and the urine starts oozing out again.
   2. Important to monitor serum BUN (blood urea nitrogen aka 血尿素氮) levels. BUN may indicate protein waste, i.e. proteins break down and produce nitrogen, which is converted to urea in the liver, from whence it should be eliminated by the kidneys. If the kidney doesn’t get rid of it (i.e. some kind of kidney malfunction), it will manifest as elevated levels in the blood.
   3. Usually at the start of this period, despite alot of urine being pumped out, BUN and Cr levels remain elevated. It’s only closer to the end of this period when we see an abating of this situation of azotemia (氮质血症).