About tick-borne encephalitis have heard, perhaps, everything. With the approach of summer, you can often find TV and radio programs about the disease, articles in newspapers and magazines. What is that tick-borne encephalitis (TBE), than it is dangerous and how to protect yourself from it?
Carriers of the disease - ticks. Unfortunately, they can be found in almost all the forests of Eurasia. And, although the carriers of the virus are not all the mites, but only 2 - 15% of them, the probability of contracting in the case of a bite is still quite large.
Ticks are very fond of mixed forests with dense undergrowth, bushes, tall grass. They prefer damp places. But direct sunlight and dry air is not to their liking. In very hot weather or during heavy rain these parasites inactive, and almost no attack.
In different areas different activity of ticks. The most dangerous are parasites that live in the Far East and Eastern Siberia. Compared to these regions in the European part of Russia the situation is calmer, but neglect the precautions when leaving the nature should not.
It should be borne in mind that for "ticks" it is not necessary to go far into the forest. This insect is quite possible to bring home with a bouquet of flowers, gathered herbs. And even with mushrooms, bought on the market.
Active carriers of tick-borne encephalitis in the spring - summer. Asian mites exhibit maximum activity in the first half of the summer, usually in May and June. But their European counterparts are active twice a year. They are somewhat reduce its activity in July to August and September to re-enter the hunt.
But disease caused by mites European flows into a lighter form. According to statistics, in the Far East, tick-borne encephalitis in 20 - 40% of cases leads to death. For the European part of Russia, the figure is 1 - 3%.
Ticks infect human blood-sucking process. And the female sucks blood for a long time, usually several days. At the same time it increases the weight about a hundred times. But males sucking a few hours, and suction can sometimes be overlooked, though infected with encephalitis can be as early as the first minute after sucking infected tick.
Forms and stages of tick-borne encephalitis
Most often, the disease manifests itself in the 10 - 12 day of illness, but the incubation period can be from 7 to 21 days.
Tick-borne encephalitis can be subdivided into several clinical forms. Any of them starts, usually hot, i.e. overnight. The first symptoms are very similar to those observed with the flu:
- rapid rise in temperature to 38 - 39 °
- pain throughout the body
- weakness, fatigue
- loss of appetite
- nausea, sometimes vomiting
Tick-borne encephalitis occurs, usually in several stages:
- Stage 1. At this stage, the virus replicates only in the blood, may not penetrate into the nervous system. No symptoms other than those listed above may not be observed. The fever lasts several days - up to about 10. The most lightweight, feverish form of the disease at this stage zavershaetsya.Posle first stage the temperature may decrease for a few days. Meanwhile, the virus overcomes the barriers between the nervous system and circulatory systems of the body, called the blood-brain barrier and into the brain. Stage 2 starts.
- Stage 2 encephalitis. The virus affects the lining of the brain. The patient experiences severe headache, photophobia appears, vomiting. There is a stiff neck, that they have such a power, that he can not bring your chin to chest. At this stage is completed meningeal, the most common form of the disease.
- Stage 3 is present in the forms, which are called focal. At this stage, the virus infects not only the membrane but also the brain cells themselves. Symptoms depend here on in which part of the brain lesions are located and what size they have reached.
For meningoencephalitic form encephalitis characterized by impaired consciousness, the appearance of seizures, psychiatric disorders, movement disorders (paresis and paralysis).
When poliomieliticheskoy form of the disease damages nerve cells in the cervical spinal cord. Observed sluggish (ie with a complete lack of movement) paralysis of muscles of the neck and hands, which often lead to disability.
It is the latter two forms are the most dangerous, with the probability of death. Even when they leave the patient recovery "in memory" headaches, paralysis and other neurological problems.
Differential diagnosis of tick-borne encephalitis
Diagnosis of the disease is extremely difficult. In one clinical symptoms to determine the tick-borne encephalitis is not possible - in fact, these symptoms are typical for almost any infectious disease.
Suspected encephalitis can be based on the fact that the patient is in the countryside, in the woods. On the idea of QE, of course, is to bring the fact that the patient has been bitten by a tick. But, as we remember, the male mite can infect humans and thus remain unnoticed.
In order to confirm the presence of tick-borne encephalitis, require special analyzes on:
- Immunoglobulin M (IgM). The presence of immunoglobulin in the blood indicates that the virus of TBE have recently entered the body.
- Immunoglobulin G (IgG). These antibodies appear in the blood later than M, and stored after recovery throughout life. Provide lifelong immunity to pathogens. It is done to develop IgG vaccination against tick-borne encephalitis.
The presence of both antibodies speaks of human infection with TBE. If blood is found only IgG - means a person or sick for a long time or had been vaccinated or had already suffered the disease.
- Polymerase chain reaction (PCR) of blood and CSF (cerebrospinal fluid) on the tick-borne encephalitis - allows you to detect the virus, the causative agent of the disease.
All patients were examined at the same time TBE tick-borne Lyme disease, since it is not possible human infection once both infections at once.
Treatment of tick-borne encephalitis
Treatment is usually limited primarily symptomatic therapy. The patient is required to be appointed strict bed rest.
Sometimes a virus neutralization using protivokleschevoy immunoglobulin (a drug that contains the IgG antibodies to the pathogen of the disease), but the feasibility of such treatment now put into question. European medicine has renounced the use of immunoglobulin G for the treatment of tick-borne encephalitis.
In the treatment of CE can be used vitamins. For example, ascorbic acid (vitamin C), which enhances immunity and improves liver to neutralize toxic substances. The day the patient is administered 300 to 1000 mg of ascorbic acid.
In addition to ascorbic acid, patients are encouraged to B vitamins
From one person to another tick-borne encephalitis is not passed, so the isolation of the patient, in this case is not required.
Prevention of tick-borne encephalitis
Vaccination against tick-borne encephalitis
If you live in an area where the probability of encountering encephalitic tick is quite high, or planning a trip to this area, you should be warned beforehand about the vaccination against tick-borne encephalitis. Vaccinate you at any time of the year. But always keep in mind that a possible meeting with the tick should be held not earlier than fourteen days after the second vaccination.
It must be remembered that the immunity is finally formed only 45 days after the second vaccination. If you vaccinated against tick-borne encephalitis cases on an emergency scheme, this period is reduced to 28 days.
Vaccines against tick-borne encephalitis
Today in Russia used both imported and Russian vaccine. They are about the same in composition. Their production technology is also very close. In all cases, in chicken embryos grown viruses - pathogens and then neutralize them.
All live vaccines is not the causative agent of the disease, so infected with encephalitis after vaccination impossible. The body is introduced only antigen of the virus particle. This antigen is the human immune system starts to produce antibodies - immunoglobulins. When the body gets the actual virus - the causative agent of TBE already present in the blood immunoglobulins quickly neutralize it.
All vaccines are active against the European encephalitis and against Asian types. Their effectiveness is quite large. According to various sources, after three vaccination completely protected from the virus are between 90 and 98% of vaccinees.
What is contra-vaccination encephalitis?
For imported vaccines are very few contraindications:
- allergies to egg protein;
- any acute infectious disease (vaccination may be carried out only two weeks after recovery);
- up to 1 year.
Russian vaccines for tick-borne encephalitis is much broader list of contraindications:
- the presence of food allergies (especially egg whites);
- allergies to drugs;
- systemic connective tissue diseases;
- complication or too strong reaction (swelling and redness of a diameter greater than 8 cm, the temperature is above 40 °)
- after the first administration of the vaccine;
- bronchial asthma;
- frequent epileptic seizures;
- blood diseases;
- exacerbation of chronic diseases of the kidneys and liver;
- cardio - vascular insufficiency II or III degree;
- transferred once a stroke or myocardial infarction;
- endocrine disorders (hyperthyroidism, diabetes, and others.);
- Pregnancy (vaccination available two weeks after delivery);
- Any acute infectious diseases (the vaccine is administered in a month after recovery);
- viral hepatitis and meningococcal vaccine (used six months after the recovery);
- up to 1 year (for the vaccine EntseVir - up to age 3 years).
Can I get vaccinated against tick-borne encephalitis pregnant or nursing women?
The fact is that at the moment no reliable knowledge about the impact of the vaccine on the fetus. It is also unknown whether the vaccine components are allocated to breast milk. Therefore, pregnant and lactating women are vaccinated only if absolutely necessary. Previously should weigh the "pros" and "cons" to assess the real risk of exposure to tick-borne encephalitis women.
Maximum closed clothes, regular check-ups
Going to the woods or the mountains, wear light colored clothing with long sleeves, preferably with a hood. If there is no hood, be sure to hide any hair under a headdress. Tuck pants into socks.
It is not suitable for hiking in the woods clothing of velvet, wool and other rough fabrics, as seen on her mite is rather difficult.
Every quarter of an hour inspect clothing and reset all caught insects on it. After returning from the forest, perform a thorough examination, with particular attention to the groin, armpits, ears, neck - ticks often attach themselves in these places.
The clothes on his return from the forest should be washed in hot water.
Repellents ticks ("Off! Extreme!", "Gull RET", "Deta-Wocke", "DEFI-Taiga", "Biban" and others), is now sold in almost all stores.
Is applied to exposed areas of skin and clothing. It is recommended to apply insect repellent circular bands around the waist, neck, ankles, knees, on their sleeves.
Repellents have a deterrent effect on carriers of tick-borne encephalitis. Finding such a substance, the parasite crawls away in the opposite direction. Action repellents inflicted on clothing, saved from a few hours to five days.
There are also more dangerous to tick products - acaricide ("Reftamid taiga", "Pretiks", "Picnic anti-mite", "Gardeks-anti-mite" and others.) And insecticide-repellent products ("Medilis-comfort", "Tick-kaput "," Edge-rap "), and others.) These funds are deposited on the clothes, up to two weeks retain their ability to kill parasites.
Because of the strong toxicity insecticide-repellent and acaricide strictly prohibited applied to the skin. Do not use them to protect children.
For children there are special repellents that contain less toxic ingredients, "Off-children", "Efkalat", "Biban-gel" and others.
If you find a tick
If you found the body stuck tick, remove it with tweezers manicure. If the hand did not have tweezers, wrap the thread head of the parasite as close as possible to the proboscis and gently pull.
Note: removing the tick, try not to make any sudden movements. Gently rocking and twisting, try gently to get it, not crushing (crushing the tick can be blown into the bloodstream pathogens bitten by tick-borne encephalitis). Wound after removing mite treat the alcohol solution of iodine, chlorhexidine or other disinfectant.
If it so happened that the head of the tick remains in the body (in this case you will see a black dot), treat this place with a disinfectant solution, take the needle and remove the head as is usually removed a splinter.
To remove a tick, you can go to the hospital. However, it should be borne in mind that the early removal of the tick reduces the probability of infection bitten.
If a person has been bitten by encephalitic tick, apply emergency prevention measures.
Emergency prevention measures
Introduction protivokleschevoy immunoglobulin. Get this drug from the blood donors who have been vaccinated against TBE.
Protivokleschevoy immunoglobulin is administered to unvaccinated people. Sometimes it is administered and graft - if there were a few ticks, or if there has been re-infection encephalitis virus after a month and a half after the first.
The feasibility of the introduction of immunoglobulin protivokleschevoy many physicians today is highly questionable. Studies have shown that intravenous immunoglobulin helps prevent disease maximum 60% of cases.
Furthermore, when applying the immunoglobulin sufficiently high risk of side effects.
Note: In no case should not be administered this drug on their own! The risk of such treatment can greatly outweigh the possible benefits.
Jodantipyrin - an antiviral drug has immunostimulating action. Approved for use in 1996. It is used as a tool for emergency prevention of tick-borne encephalitis in adults and adolescents from 14 years of age.
According to studies by the efficiency exceeds Jodantipyrin protivokleschevoy immunoglobulin. It can be freely purchased at the pharmacy and take an out of town. Thus, you will be able to take immediate Jodantipyrin if, despite all precautions, you still were attacked by a mite.
The drug is taken for the first two days after the detection of the parasite by 3 tablets three times a day, then two more days to 2 tablets thrice daily. Finally, in the next five days, take one tablet per day.
Note: Jodantipyrin is contraindicated in case of hypersensitivity to iodine.
Children anaferon can also help in this case. In the case of tick bite for children under 12 years are at anaferon tablet three times a day. A child over 12 years old - two tablets. Preventive reception anaferon stopped three weeks after detection of the mite on the body of the child.
It is important to bear in mind that urgent measures are not effective enough in comparison with the vaccination against tick-borne encephalitis and do not protect against other diseases that are carried by ticks.