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Tick-borne encephalitis: infection, symptoms and treatment, the use of immunoglobulin

There are many types and forms of encephalitis. All of them have a different nature of development, but are characterized by a community of severe pathological changes in the structure of the brain, its neurons, nerve cells and fibers.

One of its main types is tick-borne encephalitis. It refers to the type of neurovirus infections, which are carried by Ixodes mites.

Content

Tick-borne encephalitis infection

Vector encephalitis tick Dermacentor silvarum photo 1

Vector encephalitis tick Dermacentor silvarum photo 1

700 species of Ixodes, in the evolutionary process, have learned to survive, feeding on the blood of birds, domestic and wild animals. But only two of them are virulent (infectious) to humans. These are the taiga tick parasite - persulcatus, Asian and European habitat, and forest dweller - European ricinus.

Females of encephalitic ticks lay eggs in late spring, early summer, which explains their special activity at this time. After all, for such a crucial moment they must be filled with blood.

After some time, larvae emerge from the eggs, prey of which are birds, small rodents and animals. After spending 2 to 4 days with their breadwinners, they disappear.

In the forest litter, grown larvae molt, turning into nymphs. After wintering, these are full-fledged males or females. Their breadwinners are larger animals that feed on tick-borne parasitization.

Human infection with tick-borne encephalitis can occur from dairy products that have not been heat treated and milk obtained from infected goats and cows, or directly from a tick bite (the vast majority of cases).

When a tick sucks, its saliva relieves the wound, has a destructive effect on the vascular walls and suppresses the immune response of the human body.

The development of the virus begins in the loose hypodermis and serous space of tissue structures, penetration into the blood and vascular endothelium, the parenchyma of many organs, lymph nodes and central nervous system tissue. Here they are intensive reproduction and accumulation.

So begins the primary human viremia. Already in this period of infection is noted:

  1. hyperemia of many organs;
  2. individual hemorrhages in areas of serous and mucous membranes;
  3. violation of the cellular power of the heart muscle;
  4. enlarged liver and spleen.

All these changes occur during the incubation period of the virus - from three days to three weeks. In the overwhelming majority of cases (up to 95%), primary infection is not manifested by symptoms of tick-borne encephalitis.

The infectious process is suppressed and viral immunity is produced.

In the period of secondary viremia (up to a week latency), the virus is present in the blood plasma, urine, nasal mucosa, cerebrospinal fluid (brain fluid). In this phase, the body begins to fight the virus. Many are dying, causing fever and intoxication syndrome.

Not many victims can develop tick-borne encephalitis. Others become latent, persistent, or slow-moving chronic infections.

Symptoms and clinical signs of tick-borne encephalitis

Symptoms of tick-borne encephalitis photo 3

tick on human skin, photo 3

The clinical picture of the disease depends on the stage of development of the infectious process.

  1. The initial stage is characterized by the manifestation of intoxication syndrome.
  2. In the second phase of development, neurological symptoms dominate, manifesting themselves in different variations of disorders in the central nervous system.
  3. In the third, initial phase, the infection progresses, it is possible the patient’s death or cleansing of the body and its gradual restoration with the possible preservation of minor neurological pathologies.

According to the severity of neurological symptoms, tick-borne encephalitis is divided into types: with a predominance of meningeal syndrome, dominant febrile and meningoencephalopolyomyelitis symptoms, pathology with pronounced meningoencephalitic, or polyradiculoneuritic symptoms.

The process of the evolution of the disease depends on the severity of the clinical manifestation and is due to several variations.

1) The mild form of the disease is most favorable. Low temperature lasts up to five days. Short symptoms of etiroviral meningitis (serous) are noted. It is possible to stop the disease completely after a month and a half.

2) The disease is characterized by the severity of meningeal and cerebral symptoms. Timely adequate treatment restores the body in two months.

3) With a severe course of the disease - a long path to recovery. Full recovery is questionable. Residual effects are manifested by paresis, paralysis, and muscular atrophy. Perhaps fulminant course with mortality in the first days of the disease.

Sometimes, before the height of the disease (in the prodromal period), precursors of the disease may appear in the form of:

  • general weakness and headaches;
  • loss of strength and apathy;
  • partial muscular paresis of the face and body;
  • development of mental disorders.

The onset of the disease is almost always acute and sudden. There are symptoms of tick-borne encephalitis in humans - the initial high prodromal (up to 40˚) temperature index, prolonged (up to two weeks) hyperthermia, fever and chills, unbearable headaches, pain in the legs and lower back.

The intoxication syndrome develops with repeated vomiting and nausea. There is excessive sensitivity to light and pain in the eyes.

At the very beginning of the disease, symptoms of focal disorders in the central nervous system develop.

  1. Loss of skin sensitivity in the legs.
  2. Partial muscle paralysis.
  3. Bifurcation of objects in the eyes (diplopia).
  4. Involuntary muscle contraction.

At the beginning of the infection process (in the first hours), the person is slowed down, drowsy and apathetic. Possible delusions, loss of consciousness, coma.

It is diagnosed:

  1. extensive facial flushing;
  2. heart rhythm disorder;
  3. dull heart tone;
  4. hardened airways;
  5. signs of tachypnea (shortness of breath), shortness of breath.

When the airway is coated, hypoventilation develops, causing early or late development of pneumonia. Pathological processes in the gastrointestinal tract are expressed by a coating on the tongue, distension of the abdomen in the form of bloating, constipation.

Blood counts indicate:

  • the presence of infectious processes, manifesting neutrophilic leukocytosis and an increase in ESR;
  • on dehydration - the presence of hypoglycemic syndrome;
  • renal dysfunction - on the basis of an increase in the amount of protein excreted in the urine.

Diagnostic Examination Standards

Diagnosis of tick-borne encephalitis is based on the characteristic signs of the disease, on the identification of possible natural foci of infection, on specific laboratory tests - methods of virology and serology.

Virological methods of research are applied no later than a week of infection. These techniques allow us to isolate the pathogen from liquor and plasma, to identify it and evaluate its biological features.

In the serological studies use the most modern and accurate diagnostic techniques - enzyme immunoassay, to identify specific antibodies to the pathogen, the CRC method , which allows to detect the virus or its specific fragments in the human body at an early stage of infection for eight hours.

Tick-borne encephalitis treatment

Tick-borne encephalitis treatment Treatment of tick-borne encephalitis is due to various methods - correction of the diet of a special regime of rest, medication and physiotherapy treatment.

Drug treatment is based on:

  • taking biostimulating and anticholinesterase drugs;
  • antibiotic prescription;
  • dehydration and vitamin therapy (group B);
  • the introduction of immunoglobulin.

In the febrile course of the disease, therapy aimed at reducing the intoxication syndrome is prescribed. Prescribed glucocorticoid drugs, increase the amount of fluid intake.

With signs of disorder of consciousness, correction of the diet with the predominant amount of protein and potassium salts in food is recommended. Parenteral administration of drugs that limit leukocyte migration to the foci of inflammation ("Prednisolone" and its analogues).

Psychomotor excitement is stopped by lytic mixtures of the three components that have antipyretic, anti-allergic and antispasmodic effects (“Analgin” + “Dimedrol” + “Papaverine”).

During oxygen starvation (hypoxia), every hour with an interval of up to half an hour is performed, oxygen therapy - by means of a nasal catheter, moistened oxygen is introduced into the body, or oxygenation is applied in a pressure chamber (hyperbaric).

In emergency conditions, antihypoxic drugs and neuroleptics are prescribed, which directly affect the vascular system of the brain and optimize the blood supply to the organ.

In the recovery period, the treatment plan includes exercise therapy, massage procedures and neuroprotective drugs that reduce the residual effects of tick-borne encephalitis — muscle twitching or muscle atrophy in the area of ​​the shoulder girdle.

Features of the use of immunoglobulin

use of immunoglobulin

As for the use of immunoglobulin against tick-borne encephalitis, its introduction is considered as an emergency prophylaxis drug immediately after the parasite bite. It provides protection against the development of the disease, or contributes to its easy portability.

The drug interrupts the cycle of viral development in the initial path of infection, prevents its reproduction. Immunoglobulin antigenic structures recognize the virus, bind antigen molecules and neutralize them (0.1 g of serum can neutralize about 60,000 lethal viral doses).

The efficacy of the drug is proved when administered during the first days after the tick bite. Further, its effectiveness drops dramatically, as with long-term exposure to the virus, the cells of the body are already affected, and the cell walls are an insuperable barrier for our molecular preservers.

If more than 4 days have passed after contact with the tick, it is dangerous to inject the drug during the entire incubation period of the virus, this will only complicate the disease and not prevent its development.

Prevention methods

Prevention of tick-borne encephalitis . The most effective preventive measure is tick-borne encephalitis vaccination . To acquire a strong immunity from the disease, a stock of a certain amount of antibodies is needed, which can be achieved by three vaccinations.

The second vaccination provides more or less reliable protection. But, reliable immunity is formed after the third vaccination, which must be done after two weeks. In this case, protection against infection will last for three years.

An important role in the prevention of tick-borne encephalitis is played by the right choice of clothes during gathering for forest walks. Clothing should cover the whole body and be treated with anti-tick remedy. The head is covered with a scarf or hat. In high shoes must be tucked in the trousers holoshi.

After returning, it is necessary to undress and inspect the body, to check if there are ticks.

What if there is a tick on the body?

If a tick is found in the body, it must be removed as soon as possible.

1) Grab the manicure tweezers by the head and twist-pull it out with a twisting motion.

2) Make a loop-knot of thread, gently put on the tick as low as possible and tighten the knot. Then pull out the tick in the pump.

Do not pull sharply upwards - you can tear off the head or nose and they will remain in the body. A person who will have a mite removed will not feel anything, so don’t worry about his sensations - it’s not a tooth tugging.

Do not press on the body of the parasite or do not crush - by this you can provoke mixing of "him" and your blood and possible infection!

The sooner you notice the tick and remove it, the more likely it is to avoid infection. Place it on a wet fleece in any container and take it to the clinic to check for infection. Be sure to visit the infectious diseases specialist.

Tick-borne encephalitis in ICD 10

In the international classification of diseases of the 10th revision, the disease is:

Class I - Some infectious and parasitic diseases (A00 — B99)

A80-A89 - Viral infections of the central nervous system

A84 - Tick-borne viral encephalitis

  • A84.0 - Far Eastern tick-borne encephalitis (Russian spring-summer encephalitis)
  • A84.1 - Central European Tick-borne Encephalitis
  • A84.8 - Other tick-borne viral encephalitis
  • A84.9 - Tick-borne viral encephalitis, unspecified
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