Encephalitis carrier Taiga tick. Mite Spring-Summer Encephalitis (Taiga
- (ENCEPHALITIS Acarinarum Orientalis; Sin.: Encephalitis Far Eastern, Encephalitis Russian Spring Summer, Encephalitis Taiga, Encephalitis Endemic Spring) Acute viral natural focal infectious disease with transmissible (through anodic ... ... ... Great Medical Dictionary
Encephalitis Kleshchev - (Sin.: Encephalitis Taiga, Encephalitis Springnaya Summer) - Acute viral disease, characterized by damage to the gray matter of the head and spinal cord with the development of paresis and paralysis. The causative agent is Arbovirus. It is thermolabile, sensitive to ... ...
See encephalitis tick-free Summer Summer ... Great Medical Dictionary
Encephalitis Mite, Spring-Summer, Taiga - caused by neurotropic viruses from the group of arboviruses. The carriers and custodians of the infection are ixodic ticks. The incubation period after the bite with an infected tick - from 2 to 20 days, more often from 7 to 14 days, with an alimentary infection - from ... ... Encyclopedic Dictionary of Psychology and Pedagogy
Far Eastern Encephalitis - (Taiga, Springnaya Summer, Klechkin, Russian Encephalitis) - Naturally focal neuroinfection. The disease began to register from 1932 due to the development of the Taiga zone of the Far East. In 1935 A. G. Panov established her nosological independence and ... ... Encyclopedic Dictionary of Psychology and Pedagogy
The same thing that tick-free encephalitis. * * * Taiga encephalitis taiga encephalitis, the same as tick-free encephalitis (see tick-borne encephalitis) ... encyclopedic Dictionary
Ticking encephalitis: infection, signs and ways of protection - mite encephalitis (encephalitis of summer type spring, taiga encephalitis) is a viral infection that affects the central and peripheral nervous system. Heavy complications of acute infection can be completed with paralysis and fatal outcome. ... ... Encyclopedia Newsmakers
- (Taiga, Spring Summer Encephalitis), acute viral disease with severe natural foci. Characterized by the defeat of the brain with the development of paralysis. The source of the virus is various animals, melt carrier. Serotherapy is used. * * * ... encyclopedic Dictionary
- (Taiga Spring Summer Encephalitis), acute viral disease with severe natural foci. Characteristic brain defeat with the development of paralysis. The source of the virus is various animals, melt carrier. Serotherapy applies ... Big Encyclopedic Dictionary
The mite encephalitis is a viral natural-based disease with the defeat of the central nervous system. The causative agent of tick-borne encephalitis is a tick-borne encephalitis virus related to the group of arboviruses.
It has varying degrees of sustainability. When heated to 60 ° C dies for 10 minutes, with boiling - 2 minutes. Quickly destroyed with ultraviolet irradiation, exposure
disinfectants.
Distinguishable nosogeographic species: East, Western and two-wave. The carrier of the pathogen of fever is the ixodic ticks:
Ixodes Persulcatus prevails in the eastern regions;
Ixodes Ricinus lives in Western regions.
3-6 days after the blood circulation of the infected animal, the virus penetrates into all the organs of the tick, concentrating in the sexual apparatus and salivary glands. The virus lives in the glue for 2-4 years. In various locations, the infection of the tick reaches from 1 to 20%.
The tank of the tick-borne encephalitis virus is rodents, wild mammals and some birds.
The contamination of a person occurs when biteing by infected ticks. The longer the bloodsuit, the greater the likelihood of infection.
When crushing the ticks, infection can occur through damaged skin, mucous membranes of the eye.
There is also an alimentary path of infection: when eating raw goat or cow's milk.
The following types of diseases are distinguished:
Natural foci in wildlife conditions;
Foci, resulting from human economic activities;
Secondary foci - near settlements, when ticks live on pets.
In Russia, tick-earth encephalitis is registered in the Far East, the Urals, in Siberia, the European part of Russia.
Piczabasablasia falls on May, July, the end of the autumn.
This is due to an increase in the number and increasing tick activity.
The entrance gate at the bite of the tick is the skin, and with an alimentary path of transmission - the mucous membrane of the digestive tract.
The virus hematogenically and lymphogenously enters the internal organs, the central nervous system, causing an inflammatory response in the nerve cells. A gray substance of the head and spinal cord is involved in the pathological process, including motor neurons of the spine and brain (brain barrel).
The incubation period lasts from 3 to 21 days.
Currently, preventive vaccinations in epidemiological indications are carried out in areas endemic in tick-borne encephalitis.
Population living in an enzyotic terrain on tick-borne encephalitis;
The persons who arrived on this territory performing the following works: agricultural, hydro-elevative, construction, in the excavation and movement of soil, procurement, comradized, geological, deratization, disinsectional;
Faces working on logging, leather clearing;
Persons operating with the creation of tick-borne encephalitis causative cultures.
Vaccination is carried out from four years of age, revaccination - after 1 year, then every 3 years.
There are several varieties of vaccine against tick-borne encephalitis (Table.
Table 33. Vaccines against tick-borne encephalitis
|
Emergency prevention of tick-borne encephalitis is carried out by an immunoglobulin of a person against tick-borne encephalitis (Russia). It is produced in ampoules of 1.0 ml.
For the prevention of tick-borne encephalitis, the dose is 0.1 ml / kg of body weight, after the tick bite, 0.1 ml / kg is introduced no later than 4 days (Table 34).
The protective effect of the vaccine manifests itself after 24 hours and persists within 1 month.
Table 34. Schemes for using tick-borne encephalitis vaccine
| Name | Permissible | Period of Vlkdiniyin | Period revakshchtshіn |
||||||||||||||
| Vaccine For maple encephalitis for adults and children | From 3 years | Subcutaneously and deltoid we seek I spring - 0.3 ml. II accele - 0.3 md | After 1 year, IT to least 1 3 years | ||||||||||||||
| Enipei R. | From 3 years | In] | Moodscs4] 10. I spring - 0.3 mil. II OSєEIMIO - 0.3 ml | After 1 year, ISM must 1 3 × | ||||||||||||||
| FSM E- 11 mm mind | Older 16 l p | Intramuscularly 1 and II VACPNNAIN NI ^ 5 MD interval 1-3 months. ILL - except 1 3- 12 months | 3 years | ||||||||||||||
| FSM E- Immun | C (- ■ months] [Universal infection is universal, but most infected people proceed in the form of asymptomatic carriage. In the place of introducing meningococcal infection, the inflammatory process develops, meningococcus penetrates into the blood, meningococcum develops. When the meningococci penetration is hematogenically, when they fall into the subarachnoid space, there is inflammation of the brain shells, in the future the inflammatory process is localized on the surface of large hemispheres and the base of the brain and in the spinal cord. The duration of the incubation period is from 1 to 10 days. The clinically primary localized forms are distinguished: Meningococcality; Acute naphorgitis; Pneumonia. Hematogenous-generalized forms are also found: Meningococcum; Meningitis; Meningococcum and meningitis; Rare forms that are manifested by endocarditis, arthritis, iridocykpit. In severe cases, the inflammatory process captures the brainstant. In the process of reverse development, the connecting and wedding rebirth of inflammatory changes occurs. This leads to the development of the adhesive process, oblusting peri vascular paths. In addition to activities aimed at sources of infection, activities in the focus, an increase in non-specific sustainability of people is used by active immunization with the help of meningococcal vaccines, in particular polysaccharide vaccines A and C, as well as vaccines from the group of group B (Table 35). The following categories of persons are subject to vaccinations: Children over 2 years old; Teens and adults in the foci of infection caused by meningococcus A and C; Persons of increased risk of infection, which include: children of children's preschool institutions, students of the 1st school classes, teenagers from organized teams united by a hostel; Children from family hostels in disadvantaged sanitary epidemiological conditions with increasing incidence of 2 times. Vaccinations are made from 1 year old, revaccination is carried out in 3 years. Table 35. Applied Meningococcal Vaccines
Vaccines of types A and C create immunity in children over 2 years old, which is preserved for 3 years. Immunization of the entire population Vaccine A + C is carried out with a sharp rise in incidence. Such vaccination is carried out in the foci of infection. Usually vaccination is carried out in the first 5 days after contact. In accordance with the order of the Ministry of Health of the Russian Federation No. 375 children from the center of meningitis under the age of 7 years it is recommended to introduce immunoglobulin human: under the age of 2 years at a dose of 1.5 ml, over 2 years - 3 ml. PostAscital reaction When vaccine vaccine type A, local sickness and hyperemia of the skin are noted, the temperature is rare to subfebrile numbers. These symptoms disappear in 2 days. Vaccine A + C (Meningo A + C) gives little reactions. Mentsevak ACWY can cause a local response in the form of redness, soreness at the injection site. |
text_fields.
text_fields.
arrow_upward
A84.0 disease code (ICD-10)
Syn. : Tick-top encephalitis, taiga encephalitis, Russian Far Eastern Encephalitis, Spring-Summer Meningoencephalitis, tick-free encephalomyelitis, etc.
Encephalitis ACARINA (ENCEPHALITIS Acarina) is a viral natural-focal transmissible disease with predominantly damage to the central nervous system.
Three nosogeographic variants of the disease are known - East, Western and two-wave (two-wave milk fever), differing in a number of clinical and epidemiological parameters.
Historical information
text_fields.
text_fields.
arrow_upward
Heavy diseases accompanied by the defeat of the central nervous system and led to high mortality, began to be celebrated since 1932, in a number of areas of the Taiga zone of the Far East. In 1935 A.G. Panov set the clinical independence of the disease, carried it to Encephalitis. Complex expeditions of the Narc Complex of the USSR, led by L.A.Zilberom, E.N. Pavlovsky, A.A.Sorodintsev, I.Rogozin in 1937-1941, revealed 29 Encephalitis pathogens strains have established the role of ixodic ticks as virus carriers, studied epidemiological features of infection in general terms, its clinical manifestations, pathomorphology, developed methods for specific prevention and treatment of the disease. In 1951-1954. A.A.Sorodintsev, M.P. Shumakov et al. In the western regions of the USSR, a peculiar nosogeographic shape of the tick-borne encephalitis was described - a two-wave milk fever (the independence of the two-wave dairy fever, installed by A.A.Sorodintsev in 1951-1955, Time by many researchers are questioned).
Etiology
text_fields.
text_fields.
arrow_upward
The causative agent of tick-borne encephalitis Refers to a complex of tick-borne encephalitis viruses by Flavivirus family, a family of Togavirida, an ecological group Arboviruses. Viruses have the form of round particles with a size of 25-40 them, contain RNA, surrounded by a protein sheath. An introduction in the experiment with viral RNA animals causes them a disease similar to the resulting complete virus. There are oriental ("persultant") and western ("ricinous") antigenic variants of viruses that cause various nosogeographic forms of tick-borne encephalitis.
The virus is cultivated on chicken embryos and cell cultures of various origin.
From laboratory animals are most sensitive to white mice virus, cotton rats, hamsters, monkeys, from pets - sheep, goats, piglets and horses.
Sustainability . The tick-borne encephalitis virus has varying degrees of resistance to the factors of the external environment: when heated to 60 ° C he dies after 10 minutes, and when boiling - after 2 minutes. The virus is rapidly destroyed in ultraviolet irradiation, the effects of lysole and chlorine-containing drugs.
Antigenic properties tick-borne encephalitis viruses differ from the properties of other arboviruses, which is used for serological identification of tick-borne encephalitis.
Epidemiology
text_fields.
text_fields.
arrow_upward
Cleaning encephalitis is a transmissive natural and focal infection.
Main tanks and carriers The causative agents are Ixodes Persulcatus, prevailing in the eastern regions of Russia, and Ixodes Ricinus, which lives mainly in Western regions of Russia and a number of European countries, as well as some other types of ixodic and hammovas ticks. 5-6 days after bloodsuit on an infected animal, the virus penetrates into all the organs of the tick, concentrating in the sexual apparatus, intestines, salivary glands, is maintained throughout the lifelong lifeline (2-4 years), which determines the mechanism of infection of animals and humans and a crossarial and Transfold transmission of the virus in ticks. In various foci of the disease, the infection of the tick reaches 1-3%, and in some years - 15-20 %.
Additional tanks Tick-borne encephalitis viruses are about 130 types of rodents and other wild mammals - "feeders" of ticks: hedgehogs, moles, squirrels, chips, voles, whiteflies, etc., as well as some birds: Rybokchiki, rags, finches, frozard, etc.
Mechanism of infection . Virus carriers are ixodic ticks. The person is most often infected with tick-borne encephalitis by transmissive through the bite of a virusforphous tick; The probability of infection increases with increasing blood duration. Putting the ticks in the process of their removal and enhancing viruses on the mucous membranes of the eye or damaged areas can also cause infection in natural and laboratory conditions. There is an alimentary path of human infection with tick-borne encephalitis when eating raw goat or cow's milk.
The habitat of the main virus tanks determines the boundaries of foci of infection.
Three types of diseases of the disease are distinguished:
- I type - natural foci in wildlife conditions;
- II type - transitional foci with a modified composition of biocenosis components as a result of human economic activity;
- III type - anthropurgical (secondary) foci in areas near settlements, where pets, except rodents, and pets are also becoming domestic purposes. Depending on biotic and abiotic factors, 7 groups of focal regions are distinguished. The foci of tick-borne encephalitis is known in the Taiga zone of the Far East, in the forest areas of Siberia, the Urals, East Kazakhstan, the European part of Russia, in the Czech Republic, Slovakia, Bulgaria, Austria, Venfia, Poland, Sweden, Finland.
Seasonality . The incidence of tick-borne encephalitis has a seasonal nature, reaching a maximum in May - June. The second, less pronounced incidence is observed at the end of the summer - the beginning of autumn, which is due to the number and activity of ticks in nature.
Pathogenesis and pathoanatomy painting
text_fields.
text_fields.
arrow_upward
The entrance gate of infection during transussive infection is the skin, and with an alimentary - mucous membrane of the digestive tract.
After replication in the field of entrance gates, the hematogenically and lymphogenic virus is disseminated into lymphatic components, the internal organs reaches the CNS, where it has a direct effect on the nerve cells and induces a mesenchymal-inflammatory reaction that enhances the pathogenic effect of the virus. With an alimentary infection, the visceral phase with visiosia and the replication of the virus in the internal organs is first observed, and in the future, secondary virusemia arises with the damage to the central nervous system (two-wave meningoencephalitis). In some cases, the process takes a chronic progressive course with the profession of morphological damage.
The pathological process is involved in the gray substance of the head and spinal cord, in particular the motor neurons of the dorsal and brain barrel. There is a damage to the nervous tissue in the middle brain, the Talalamic and hypothalamic regions, in the cerebral cortex and cerebellum. In the roots of peripheral nerves, a picture of an interstitial neuritis is developing. The defeat of the soft shells of the brain is naturally.
At opening, the edema of the brain shells and the brain substance, expansion and full-blood vessels, hemorrhage, signs of violation of liquor and hemodynamics are often detected. Already in the early, preparalitic phase of the disease, the proliferation of microglia is noted, the phenomenon of neurophagia. The most pronounced necrobiotic processes are developing in the front horns of the cervical spinal cord, in the core nerve kernels and the reticular substance.
Typically, the full-blood of internal organs is noted, hemorrhage into serous shells, the mucous membrane of the stomach, respiratory tract, intestines.
Under the acute course of the process, slow reparation of damage is observed and persistent immunity is formed. Disorders of the immune status determine the steadily progressive course of the disease with persistent irreversible paresis and paralysis.
Clinical picture (symptoms)
text_fields.
text_fields.
arrow_upward
The incubation period lasts 3-21 days, an average of 10-14 days.
Phase flow tick-borne encephalitis
- Primary phaseflowing with the predominance of general oxic syndrome,
- Phase of neurological disorderscharacterized by various variants of the lesion of the central and peripheral nervous system,
- Phase Exodes (recovery with the gradual restoration or preservation of residual neurological disorders, the formation of progressive chronic variants or death of patients).
Forms tick-borne encephalitis
Depending on the depth and severity of neurological disorders, the following forms of illness are distinguished:
- feverish
- meningeal
- meningoencephalitic,
- meningoencephalopolyomelitic,
- polyradiculoneuritic.
Fevering and meningeal forms are basic with Western versions of tick-borne encephalitis, paralytic forms prevail with the eastern version of the disease.
Types of tick-borne encephalitis
According to the severity of the clinical picture of the disease, the following types of tick-borne encephalitis are distinguished:
1) abortion disease (or light shape of the disease), fever for 3-5 days, transient signs of serous meningitis and recovery for 3-5 weeks;
2) Middle Health Diseasesflowing with meningeal and generalized symptoms having a benign dynamics with recovery for 1.5-2 months;
3) Heavy Forms With high mortality, protracted and incomplete recovery, persistent residual signs in the form of parisov, paralysis, muscle atrophy.
Known lightning forms Diseases ending with letters in the first day of the disease even before the development of a characteristic clinical picture, as well as chronic and recurrent forms of tick-borne encephalomyelitis.
In 8-15% of cases of the disease, there is a brief area: headache, weakness, fatigue, sleep impairment, root pain, feeling of numbness in the skin of the face or body, mental disorders.
The disease is usually developing sharply, suddenly . There is a high fever with a temperature rise to 39-40.5 ° with a duration of 3-12 days, heat, oznoby, painful headache, brutal pains in limbs, lumbar region, nausea, re-vomiting, total hyperesthesia, photophobia, eye pain Apples.
Usually from the 3-4th day, and sometimes in the first hours of the disease there are signs of focal damage to the central nervous system: paresthesia, limb paresa, diplopia, epileptiform cramps. Consciousness in the first days of the disease is preserved, but the patients are injected, indifferent to the surrounding, survivors. Occasionally, stuporing, nonsense, copor and coma are possible.
In acute period the face of patients hyperticated, injected with scler and conjunctiva vessels, hyperemia of the neck and chest is noted. Characteristic bradycardia, muffling of cardiac tones, arterial hypotension. Electrocardiographic signs of conductivity disorders are detected, resistant, but reversible signs of myocardial dystrophy. Heavy myocardiodistrophy may cause development in patients with acute heart failure leading to death.
It is often noted hyperemia of the mucous membrane of the upper respiratory tract, breathing, shortness of breath. Early and late pneumonia are often revealed; The latter, leaking against the background of the impairment of the central regulation of respiration and blood circulation, are prognostically unfavorable.
The changes in the digestive system are characteristic in the form of a language of language, while there are often a tremor of the tongue, the bloating of the abdomen and the delay of the stool. In cases of alimentary infection, hepatolyenal syndrome is often noted.
In the acute period, neutrophilic leukocytosis is observed (up to 10.0-20.0 * 10 ^ 9 / l), an increase in ESO, hypoglycemia, transient proteinuria.
- Fever shape of tick-borne encephalitis It is characterized by a benign course and is limited by the development of general toxic syndrome.
- Meningheal form proceeds benign with the development of general-toxic syndrome and signs of serous meningitis.
It is characterized by the occurrence of a high fever, a strong headache in the dark-occipital region, amplifying when moving, re-vomiting at the height of the headache, photophobia, hyperactus and hyperesthesia of the skin, unevenness of tendon reflexes. From the first days of the disease, shell symptoms are revealed: muscle rigidity, the nape, symptoms of Kernig, Burutzinsky, etc., persistent within 2-3 weeks. In some patients, transient encephalitic symptoms can be observed.
In the study of the cerebrospinal fluid - an increase in its pressure to 200-400 mm water., Lymphocytic temperate plea-virocytosis, a slight increase in protein level, glucose and chlorides.
- MeningoEncephalitic form Diseases is characterized by the development of diffuse or focal brain damage.
- With diffuse ticklete meningoencephalitis, In addition to symptomic and meningeal symptoms, a violation of the consciousness of patients from light inhibition to a deep spin and coma is revealed.
With a favorable forecast, consciousness clarifies after 10-12 days, but drowsiness is preserved. Part of patients in the acute feverish period are observed nonsense, hallicosis, psychomotor excitation with a loss of orientation in time and atmosphere. In the first days of the disease, motor disorders are noted in the form of partial or generalized single or multiple epileptiform seizures, which usually worsens the forecast. Fibrillar twitching of the muscles of the face and limbs, tremor hands, depression of deep reflexes, reduced muscle tone, are observed.
- With focal meningoencephalite Clinical manifestations are determined by the ZNS damage zone.
The lesion of the white substance of one of the hemispheres of the brain entails the occurrence of spastic paresis of the right or left limbs and pass timers of the facial and sub-speaking nerves from the same side. When localizing the process in the left hemisphere, there is also a speech disorder.
The lesion of the white substance in the stem department of the brain leads to the development of a pan of the cranial nerves on the side of the focus of inflammation and the label of the limbs on the opposite side of the body (alternating syndrome). In the reconvising period, motor disorders are restored for 2-3 months.
Along with the symptoms of the loss of motor functions, hypercines are observed in the form of clonic seizures of the limbs or part of the body. In some cases, persistent myoclonic hyperkers in combination with epileptiform supplies are included in the leather shovel epilepsy syndrome. Possible attacks of Jackson epilepsy. The cork and trunk localization of the lesion leads to tico-shaped and ferret muscle twitching.
A characteristic feature of the tick-borne encephalitis is the combined rust of the cranial nerves, due to damage to the gray matter of the brain. Card nerves are involved in the pathological process with different frequencies.
There is a damage to the glasses and sympathetic innervation of the eye, leading to ptosis, squint and diplopia. Party of faces of the face nerve is often noted, the visual, auditory and vestibular nerves suffer less often.
The distribution of the process to the core nerve nuclei area, so characteristic of the tick-borne encephalitis, leads to the occurrence of early bulbar symptoms: a paresa of a soft sky, voices, voices, speech, lubricacy, imaging, violation of swallowing, increasing savory with filling the respiratory tract, Tachycardia, dnae. The frequency of bulbar disorders reaches 25%.
- MeningoEncephaalopolyomelitic form of illness It is characterized by along with general-toxic and meningeal syndromes of signs of diffuse encephalitis, focal encephalitis and damage to the gray substance of the spinal cord. The latter relate to typical clinical signs of the disease, arise already in the first days of the disease and after 3-4 days become the most pronounced.
The patients develop early sluggish muscles of the neck, torso, the limbs, symmetrically affecting the muscles of the neck, the shoulder belt, the upper extremities, sometimes intercostal muscles and the diaphragm. Motor disorders of the lower extremities are rarely detected and is slightly expressed, but the ascending type paralysts, starting with the lower extremities and then propagating the torso and the upper limbs. During the end of the outcome of the disease, along with the paresis, there is a sharply pronounced atrophy of the muscles, especially deltoid, trapezoidal, double-headed, three-chapter and chest. At the same time, the head is not held in a vertical position, passively hangs, the movements of the upper limbs are almost completely lost. Muscular atrophy is observed in cases of reconvaluedness with the disappearance of paresis.
- Polyradiculoneuritic form The tick-borne encephalitis, observed in 2-4% of patients, is manifested along with general-toxic and meningeal symptoms of signs of damage to the roots and peripheral nerves. Characterized by paresthesia in the form of "crawling of flies", tingling in the skin of various sites, pains along the nerve trunks, positive symptoms of "tension" (Lassega, etc.), a sensitivity disorder in the distal limbs by the type "gloves" and "socks".
- Double-wave meningoencephalitis (two-wave milk fever), recorded in the European foci of tick-borne encephalitis, is characterized by the development of a two-phase temperature reaction, every 2-15 days with an interval of 1-2 weeks, the predominance of general-toxic syndrome during the first temperature wave and the development of meningeal and general-friendly symptoms when reducing the temperature Body with rapid positive dynamics and recovery without residual phenomena.
Diagnostics
text_fields.
text_fields.
arrow_upward
The clinical diagnosis of tick-borne encephalitis is based on a complex of epidemiological and clinical and laboratory data that detect characteristic disease syndromes.
Specific diagnosis of the disease is carried out using virological and serological methods. The virus method involves the release of the virus from the blood and cerebrospinal fluid of the patient (in the first 5-7 days of the disease) or the brain of the dead people - by intracerebral infection of newborns with white mice with the material under study, as well as using the cell culture and subsequent virus identification using the method of fluorescent antibodies (MFA).
Along with virological, serological methods of verification of the diagnosis using RSK, RDPA, RPGA, IFA, pH in pair serums of patients taken with intervals of 2-3 weeks were widely used.
At the same time, detoxification, dehydration therapy is carried out, with a severe course of the disease - anti-deposit, prescribe corticosteroids are prescribed, combat respiratory failure. With convulsive syndrome, a 25% solution of magnesium sulfate, relaignium, sodium oxybutirate, barbiturates and other sedatives are used. In the period of subsidiaries of acute manifestations of the disease, vitamins of group B, prozerne, dibazole, antihistamines are prescribed. Patient extract is made in 2-3 weeks: after normalization of temperature, in the absence of neurological disorders. Reconvoles are subject to dispensarization.
Prevention
text_fields.
text_fields.
arrow_upward
In the foci of the tick-borne encephalitis, a set of measures to protect the population from the attack of ticks (anti-leaky overalls, repellents - dimethyl and dibutyl adhesives) are carried out with intercessors with removal and destruction of the detected ticks. After removal of the ticks, a specific donor immunoglobulin is used (adults of 3 ml intramuscularly). It is not recommended to use non-confused milk.
Specific prophylaxis is carried out according to epidemic testimony in 1-1.5 months before the tick activity season. Fabric inactivated or living attenuated vaccines are administered 1 ml under the skin three-time at intervals of 3 months to 1 year, followed by an annual revaccination of 1 ml of vaccine.
With the arrival of spring, the population is visited by forest zones in order to collect birch juice, first colors, leisure activities, while forgetting about precautions. A visit to the suburbs and the forestry is always associated with the risk of bite with a tick, which causes an outbreak of tick-borne encephalitis.
"Cleaning encephalitis is a severe disease at which brain inflammation occurs. Its causative agent is the smallest organism from a group of viruses, which can only be seen with an electron microscope, which gives an increase in tens and hundreds of thousands of times. The magnitude of the tick-borne encephalitis virus is 30 millcons. " This smallest organism lives in the body of the forest tick to 4 years. The tick is the main keeper of the causative agent of the disease in nature and the main source of human infection. Therefore, the disease was called "tick-free encephalitis".
q Viral infection is transmitted mainly by melt Q seasonality - Spring-summer q affects the nervous system q in the absence of proper prevention and treatment, leads to disability (80%) Q mortality ranges from 2% to 20%
The most actively ticks in spring and summer (in some areas - in autumn). At this time, being in nature (it does not matter - in the forest, in the country dacha, fishing) you need to be extremely careful: - try to walk along paths, away from high grass and shrub; - the head should be put on a golk or cap, and the best thing to walk in a hooded jacket, pants need to be filmed into boots or press rubber bands to the ankle;
- self and intercessors when leaving the forest, returning home - it is necessary to undress and thoroughly examine the skin - whether the tick is not preserved; - The possibility of infection is the use of raw milk of goats or cows (when boiling, the virus dies after 2 minutes).
Immunoglobulin for several weeks (up to month) protects against infection. If in a few days the tick will bite you, it is not necessary to do the injection. Immunoglobulin is worth introducing both a grafted person if a lot has been ticks.
It is simultaneously receiving cycloferone 4 tablets on the first day, 2 tablets for 2, 4, 6 days of preventive treatment.
Self and mutual assistance (if you are not in the city) - this is the removal of a tick: the bite is pre-lubricated with fat (vaseline, sunflower oil), after 15 minutes carefully pull the loop made from the thread, shaking out of the side to the side.
The destruction of the tick should be avoided, as a virus infection can occur! The place of bite is treated with iodine or alcohol.
People whose work is connected with staying in the forest (geodesists, forestry, summer houses) must be vaccinated against tick-borne encephalitis. Without vaccination - will not allow work.
The grafts are less likely, in case of illness, they have light shapes in case of illness. The full course of vaccination consists of 3 vaccinations, so it is best to make 2 vaccinations in the fall, and the last - 3 vaccinations to make in spring 2 weeks before entering the forest. You can be given in the abbreviated scheme - two vaccinations, but the effectiveness of such vaccination is lower. In order to persist in the tick-borne encephalitis, it is necessary to repeat the next spring. Revaccination every 3 years.
The spread of ticks, encephalitis virus carriers, has recently undergoes a rise, including the human economic activity (it is better to say with mismanagement - the organization of spontaneous dumps and garbage coup) and an increase in the amount of mice, tick carriers. Visiting suburbs and logoson is always associated with the risk of bite with a tick and a tick-borne encephalitis. There are some simple folk methods to scare ticks.
There is an experience of highly efficient use of impregnation of clothing with exhaust gases of diesel engines for cars and tractors within 30 seconds. After such processing, the ticks are not found on the clothes of 4 -5 hours. Natural natural enemy ticks - Forest ants. Acid generated by them is a natural repellent and can be used to protect against ticks. The formic alcohol, which is 20 -30 after breeding with water 20 -30 times, can be treated with clothes and skin of the lower extremities before visiting forest arrays, country and recreational areas. The smell of ant alcohol scares ticks.
In the forest area, you can resort to a different method of processing clothing and leather, limbs by this means. A few seconds can be put in the anthill from red ants for a few seconds and then handle the pants, so pliers live, mainly on shrubs and in the herbal zone not higher than 70 cm. Over the ground. Reception should be repeated several times, and the sleeves can be treated and the clothing collar for greater reliability of protective events.
Of course, all of the above does not exclude the possibility of using repellents sold in pharmacies. But if they are not, do not neglect our simple, but very effective means.
What is encephalitis? Ticky encephalitis - viral natural - focal disease with predominant lesion of the central nervous system mosquito
The diagram of the life cycles of 3 2 16000 eggs 2. Purpose the blood of the female, laying eggs 3. Larva.
Methods of infection of a tick bite in the saliva of the ticks are present by thinning blood and painkillers crushing and rubbing the sucking tick eating into food of infected raw goat and cow's milk
Conditions of infection Visiting the forest 1. The tick is sitting on the edges or trees. 2. Can not fly or jump. 3. May be cling to the sacrifice. 4. May fall on it. Clamping animals (dogs, cats) with ticks (on clothes, with flowers, branches)
How does the disease develop? 1. Incubation period - 1, 5 -2 weeks 2. Defeat of the cortex of the brain (soft shell and gray substance) for several days 3. Inflammation of the entire brain (white substance) Symptoms: - Headaches - vomiting -poter of consciousness (up to coma) - T Body 39 -40 S.
Complications of tick-borne encephalitis Flower outcome (death) in 30 -60% of hesitated from 2% - up to 20% Sluggy paralysis limbs Full paralysis of the left limb. Violation of the muscles of the neck
First assistance in the bite of a tick what to do? 1. Lubricate the sucking tick with a fat (vaseline, cream, fieaken by oil) 2. Wait 12 -20 minutes 3. Nutty loop or tweezers cautiously pull the tick, shaking out of the side to side 4. To try not to destroy tick 5. Shot tick burn or pour Boiling water 6. Place a bite to treat alcohol, iodine, hydrogen peroxide, etc. 7. Wash hands not to do! It is impossible to crush the tick, since you can get infected with the virus contained in its internal organs
Prevention of tick-borne encephalitis Wearing in the forest of special clothes self-and-impact in the forest at the exit of the forest and at the privals boiling of raw goat and cow milk The use of liquid and aerosol preparations to combat insects
Kaya Ca Fi Ection Aktiki SP Il Rof Podiv about the BO IVI EVO PR Clap Alita Nisf UIA) NC KCI (for children under 10 years old
Where is the widespread malaria? Malaria is common in Asia, Africa and Central and South America. Approximately 100 countries; Approximately 40% of the world's population have the risk of malaria. If you are going to some of these countries, then definitely follow the precautions.
Kills people ... This infection threatens almost a third of the world's population. Annually in the world from malaria is dying over 2 million people. Only in African countries due to malaria or its consequences, every twentieth child dies, and 1,500 feminine die every day. For example, in India, the incidence of malaria over the past 20 years has grown up 70 times, reaching a record figure - 50 million cases per year.
Historical reference[ | ]
The first clinical description was given by the Soviet researcher A. G. Panov in 1935.
In 1937-1938 The complex expeditions of L. A. Zilbera, E. N. Pavlovsky, A. Smorodintsev and other scientists were studied in detail epidemiology, clinical picture and prevention of this disease. During the expedition, it was established that in the Far East, the outbreak of encephalitis occurs in early spring, when bloodsowing insects do not fly, Loch. The participants of the expedition were planted with hungry ticks on mice, which manifested later a sign of encephalitis - paralysis.
For the disease, a strict spring-summer seasonality of the disease corresponding to the activity of ticks is characteristic.
Ways transfer: Transmissive (suction of a tick), rarely - alimentary (eating crude milk of goats and cows).
Pathogenesis [ | ]
A person is infected with bite infected ticks. The primary reproduction of the virus occurs in macrophages, on these cells there is adsorption of the virus, receptor endocytosis, "stripping" RNA. Then the RNA replication and proteins of the cap begins in the cell, a mature virion is formed. By kinding through the modified membranes of the endoplasmic reticulum, the virions are collected in vesicles, which are transported to the outer cell membrane and leave the cell. There comes a period of virushemia, the secondary reproduction occurs in regional lymph nodes, in the cells of the liver, spleen and endothelium of vessels, then the virus enters the motor neurons of the front horns of the neck separation of the spinal cord, cerebellum cells and a soft cerebral shell.
Infection is also possible in the injection of biological fluids of the infected tick into the wound or mucous membranes (during calculations, crush with hands, etc.), as well as with the use of milk susceptible animals, in particular the infectious goats after their bite with infected tick.
Patomorphology [ | ]
In microscopy, hyperemia and edema of the brain and shells, infiltrates from mono- and polynuclear cells, mesodermal and gliosic reaction are found.
Inflammatory-degenerative changes are localized in the front horns of the neck of the spinal cord. Destructive vasculites, necrotic cameras and point hemorrhages are characteristic. For the chronic stage of tick-borne encephalitis typical fibrous changes in the brain shells with the formation of adhesions and arachnoid cyst, the pronounced proliferation of Glia. The most severe, irreversible lesions occur in the cells of the front horns of the neck segments of the spinal cord.
Prevention [ | ]
Vaccination is used as specific prophylaxis, which is the most reliable preventive measure. Persons living in endemic areas or entering them have the right to free vaccination. The population of endemic tick-borne encephalitis regions is approximately half of the total population of Russia. In Russia, vaccination is carried out by foreign (FSME, Enceptur) or domestic vaccines on the main and emergency schemes. The main scheme (0, 1-3, 9-12 months) is carried out with subsequent revaccination every 3-5 years. To form an immunity to the beginning of the epidseason, the first dose is administered in autumn, the second winter. Emergency scheme (two injections with an interval of 14 days) is used for non-vaccinated persons who come to endemic foci in spring and summer. Extremely promaccicated individuals are immunized only for one season (immunity develops after 2-3 weeks), after 9-12 months they put the 3rd injection.
In additionally, in addition, intramuscularly immunoglobulin from 1.5 to 3 ml is administered in addition when attaching ticks in unvaccinated people. Depending on age. 10 days later, the drug is reused in an amount of 6 ml. Emergency prevention efficiency with specific immunoglobulin needs confirmation in accordance with the modern requirements of evidence-based medicine.
Non-specific prevention measures are reduced to preventing plump, as well as their early removal.
- Avoid visiting the habitats of ticks (forest biotopes with high grass, shrub) in April-July. Encephalite mites attack, clinging for passing by warm-blooded animals and people like a burdock. The place to wait for the sacrifice, they elect blurred by the sweat trails of warm-blooded rods and sprigs in shady herbaceous places. Taking into account this, the campaigns should be held away from the trail of animals, and livestock. On the tracks and wide paths of the middle of the trail, avoiding contact with the vegetation hanging on the path.
- Apply repellents containing DETA or permethrin.
- It is necessary to wear clothes with a hood, long sleeves and pants without holes and holes, sheds necessarily fill in long socks, and a shirt in pants. Hair should be hiding under the headdress. To make it easier to notice the ticks, it is preferable to wear light clothes.
- While staying in the forest, it is recommended to regularly inspect clothes and control the open areas of the skin (neck, wrist hands). Under the observance of the rules of clothing, specified by the point above, ticks, not filmed from the clothes, inevitably fall on the neck, where they are easy to detect.
- Upon returning from the forest, inspection of clothes and bodies. Since some parts of the body are not available to self-impact, you should resort to assistance for inspection of the back and the scalp.
- Since the larval forms of ticks are very cradles, they can not be noticed on clothes. In order to avoid their sinking, clothing is recommended to be used in hot water.
- When the sucking tick is detected, it should be removed immediately. The earlier the tick is removed, the less likely to infection. You can remove the tick with a manicure tweezers or thread by throwing a loop from the stretch of the thread so that all limbs are outside, tighten. The tick is removed by the swinging and twisting movements. Avoid crushing the tick! Rank can be treated with any disinfectant solution (chlorhexidine, iodine solution, alcohol, etc.).
Increased people an additional administration of immunoglobulin is not required.
Clinical picture[ | ]
For the Far Eastern subtype of tick-borne encephalitis, a more stormy flow with a higher death is characteristic. The disease begins with a sharp increase in body temperature up to 38-39 ° C, severe headaches begin, sleep disorders, nausea. After 3-5 days, the damage to the nervous system is developing.
In the first phase laboratory detects leukopenia and thrombocytopenia. Perhaps a moderate increase in liver enzymes (ALT, AST) in a biochemical blood test. In the second phase, severe leukocytosis in the blood and the spinal fluid is usually observed. The tick-borne encephalitis virus can be detected in the blood, starting from the first phase of the disease. In practice, the diagnosis is confirmed by the detection of specific IGM antibodies in the blood or spinal fluid, which are detected in the second phase.
Diagnostics [ | ]
Serological method. The material is paired serums of the patient. Determination of the diagnostic increase in the titer of antibodies in the RTGA reactions (hemagglutination braking reaction) and ELISA (immuno-immimensional analysis).
Molecular biological method. Material is a tick. The ticks are examined for the presence of a tick-borne encephalitis virus antigen, less commonly with PCR (polymerase-chain reaction) reveals viral RNA (ticks). For research for the presence of antigen, live material is used, PCR diagnostics is possible according to tick fragments.
Virological method. Isolation of the virus from the blood and the spinal fluid by introducing material to the brain with newborns of white mice.
Differential diagnosis[ | ]
Ticky encephalitis must be differentiated with the following diseases:
- tumors CNS.
- purulent brain processes
- deep vascular brain pathology
- meningoencephalitis of various etiology
- coms of various origins
- encephalitis of other genes
Lyme disease [ | ]
Given the fact that in the regions endemic on CE, systemic tick borreliosis is often found (Lyme disease), the Differentiation of the CE accounted for with this disease. It should also be borne in account that there is a combined infection of both tick-borne encephalitis and tick-borough disease in the case of a tick of the causative agents of both infections, or with a bite of several ticks.
Symptoms characteristic of both tick-borne encephalitis and tick-borne borreliosis:
- in history - the presence of a tick bite
General infective symptoms:
- temperature reaction
- malaise
- headache
- signs of the defeat of the nervous system (to the paresis limbs and muscle atrophy).
The appearance of these symptoms for encephalitis is characteristic of the very beginning of the disease, whereas for Lime Burreliosis - after 3-6 weeks.
However, for Lyme disease (borreliosis) is characterized by the following. An erythema appears at the site of the plump, which can be a single, multiple, recurrent and often migrating, propagating from the site of the primary appearance to the periphery in the form of a pink-red rings with a more pale center.
The presence of three main syndromes of the damage to the nervous system:
- radiculonevironment, expressed in the soreness of cervical, shoulder and lumbar areas with a frequent occurrence of root pain and neuralgia (often in the localization site of Erythema)
- paris of facial nerve with one or on both sides
- serous Meningitis Syndrome.
With laboratory diagnostics: serological reactions to CE with borreliosis are negative, while on borreliosis is positive.
Polio [ | ]
Differential diagnosis of Ke must also be carried out with polio. Cleaning encephalitis and poliomyelitis combines the presence of both general-oxidation and neurological symptoms. Conscribe them.
There are two main forms of polio:
- Neparalithic
- Paralytic
Non-paralitic form ("Small disease") is:
- short-term (3-5 days) fever
- rubble
- small cough
- sometimes dyspeptic phenomena
- perhaps the presence of easily occurring serous meningitis.
When tick-borne encephalitis, there is no runny nose, cough and dyspeptic phenomena.
Paralytic poliomyelitis includes 4 stages:
- preparalithic
- paralytic
- restorative
- stage of residual phenomena.
In contrast to the tick-borne encephalitis, the long period for the paralytic form of polio is characterized by:
- rougom
- cache
- phenihytium phenomena
- constipation or diarrhea
- increased body temperature in the range of 37.2-37.5 degrees. FROM.
Whereas when tick-borne encephalitis amid alert and general weakness:
- periodically arise twitching muscles of fibrillar or fascicular nature,
- suddenly develops weakness in any limb and there is a sense of numbness, weaknesses in it. The pain syndrome is not characteristic.
- Headache with the slightest head twitching.
For polio, it is very characteristic of the appearance of sudden paralysis, which is more often developing for several hours (the front horns of the Nizhnegorudnaya and the lumbar spinal cord) are affected), mostly the proximal muscle departments are involved, most often the lower limbs are also noted disorders of the pelvic organs. For tick-borne encephalitis, the localization of lesions in the front horns of the cerzya-lumbar spinal cord is typical.
The growth of motor disorders during polio occurs as much as possible during the first two days from the beginning of the development of paralysis, while at CE, these phenomena continue to 7-12 days.
It should be noted that for CE pathognotic signs:
- epidemiological anamnesis
- laboratory diagnostics.
Differential diagnostics can eliminate poliomyelitis.
Flu [ | ]
Ticky encephalitis in the initial phase is similar to influenza.
Ticky encephalitis and flu are combined:
- weakness
- high fever
- chills
- muscle pain and bones
- nausea
- vomot
- photophobia.
However, for influenza, unlike tick-borne encephalitis, is characteristic:
- localization of headaches in the frontal and temporal areas and in the field of abnormal arcs
- pain when moving eyeballs
- dryness and throat
- dry and painful cough, dryness
- constitution in the nose with phenomena of difficult nasal breathing
- hyperemia of the nasophack mucosa, soft and solid
- perhaps the presence of trachea with pains along the go of the breast
- laboratory: leukopenia with eosinopenia and neutropenia, relative lymphocytosis and often monocytosis.
It must be borne in mind that for influenza, the presence of the precession of the preceding disease of the flu is characteristic.
Whereas to confirm the diagnosis of tick-borne encephalitis, it is necessary to take into account the presence:
- epidemiological data (presence of contact with ticks)
- positive serological reactions.
Meningitis [ | ]
Differential diagnosis is carried out with epidemic cerebral and tuberculosis meningitis.
Epidemic cerebral meningitis, in contrast to the meningeal shape of the tick-borne encephalitis, is characterized by:
- acute start
- rapid development of meningeal syndrome
- seasonality
- lack of instructions for bite tick
- purulent liquor.
Tuberculosis meningitis is a disease that flows:
- in the lycvore, you can find tuberculosis mycobacteria.
Conducting laboratory serological studies in patients also help differentiate tick-borne encephalitis from various serous meningitis.
Treatment [ | ]
In Western Europe, immunoglobulin injection containing high concentrations of antibodies against the tick-borne encephalitis virus did not have a positive effect when used for post-contact prophylaxis. This approach is no longer recommended. A recent review of Russian experience with immunoglobulin indicates that there was some protective effect of early post-contact introduction using Russian immunoglobulin drugs.
For many years, postcontact prevention (PCP) was carried out by the use of specific immunoglobulins against TBEV. However, in controlled clinical trials, it has never been proven that this method is effective; There are no sufficient clinical data confirming the use of this method. In addition, it was suggested that the use of immunoglobulins could worsen the clinical picture. However, the evidence of this hypothesis is weak. Immunoglobulin preparations for the PCP vs. TBE were withdrawn from the European market in the late 1990s. On the contrary, such products are still used in Russia. The recent Russian review came to the conclusion that the timely single administration of one dose (0.05 ml / kg of body weight) of the TBE immunoglobulin with a titer 1:80 provides protection on average in 79% of cases (Penyevskaya and Rudakov, 2010). Increasing the dose to 0.1 ml / kg or repeated administration of immunoglogulin did not provide additional protection. Contribusive experience relative to the impact of post-exposure immunoglobulin prophylaxis requires further analysis.
In Russia, the emergency prevention of tick-borne encephalitis is carried out using immunoglobulin preparations, in particular, homologous gamma globulin obtained from the blood plasma of donors. Immunoglobulins have a pronounced therapeutic effect: decrease in the body temperature of the patient, weakening the headaches and meningeal phenomena. To achieve maximum efficiency, the preparation is required as early as possible.
Russia has the standards of medical care to patients with tick-borne encephalitis, individuals for children and adults.
Forecast [ | ]
Persistent neurological and psychiatric complications are developing in 10-20% of infected persons. Infection mortality is 1-2% for the European subtype and 20-25% for Far Eastern; As a rule, death occurs within 5-7 days after the occurrence of neurological symptoms.
In addition to death, tick-borne encephalitis is highly risk of developing remote effects in the form of functional psycho-neurological disorders, of varying degrees of severity of paresis, focal disorders syndromes, including organic personality disorders, epileptic and epileptographic attacks, hypercines, amyotrophic disorders, contractures. Complete recovery occurs only in 25-51% of the sick people.
Statistics in the number of bites and diseased tick-borne encephalitis[ | ]
| Indicator | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 |
|---|---|---|---|---|---|---|---|---|
| Number of regions of Russia, where bites are noted | 69 | 69 | 73 | 82 | 87 | 82 | 138 | 100 |
| The number of referred to the bite of a tick, people. | 455 000 | 570 000 | 510 267 | 410 000 | 440 000 | 536 756 | 467 965 | 508 123 |
| Ticky encephalitis is fixed, people. | 3094 | 3527 | 2503 | 1981 | 1978 | 2308 | 2035 | 1910 |
| The percentage of infected CE from the total number of bust | 0,68 % | 0,61 % | 0,49 % | 0,48 % | 0,44 % | 0,42 % | 0,43 % | 0,37 % |
| Percentage of tick-borne encephalitis among busting | 9 % | 9,6 % | 5,3 % | 6,2 % | 8,4 % | 7,1 % |
Russian Federation, tick-borne infections[ | ]
see also [ | ]
Notes [ | ]
- Disease Ontology Release 2019-08-22 - 2019-08-22 - 2019.
- Monarch Disease Ontology Release 2018-06-29Sonu - 2018-06-29 - 2018.
- Is there natural immunity to tick-borne encephalitis virus? (Neopr.) . Science in Siberia.. Date of handling February 1, 2017.
- Shalaev V. F., Rykov N. A. Forest ticks. - Zoology (textbook for 6-7 classes). - Enlightenment, 1964. - P. 96. - 252 p.
- On the results of the seasons of tick activity in 2017 (rus.). Rospotrebnadzor in the Arkhangelsk region (October 6, 2017). Caption date December 25, 2018.
- N. V. Mednitsyn. Vaccisology. - 2nd ed. - M., 2004. - P. 242.
- §26. Pliers. General features of spider-shaped // Biology: Animals: Tutorial for 7-8 High School Classes / B. E. Bykhovsky, E. V. Kozlova, A. S. Montchadsky and others; Edited by M. A. Kozlov. - 23rd ed. - M.: Enlightenment, 1993. - P. 71-73. - ISBN 5090043884.
- Herzig R., Patt C. M., Proks T. An Uncommon Severe Clinical Course of European Tick-Borne Eropeanitis. (English) // Biomedical Papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia. - 2002. - Deceptber (Vol. 146, no. 2). - P. 63-67. - PMID 12572899.
- Investigation of cases of infection with tick-earth encephalitis through goat milk (rus.). 04.Rospotrebnadzor.ru.. Office of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in the Republic of Altai (June 10, 2016). Caption date July 22, 2019.
- L. B. Borisov Medical Microbiology, Virology, Immunology 3 Ed., M., 2002
- On approval of sanitary-epidemiological rules SP 3.1.3.2352-08 (Neopr.) . www.niid.ru. Date of appeal April 4, 2018.
- List of administrative territories of the constituent entities of the Russian Federation, endemic to tick-borne viral encephalitis in 2012 (Neopr.) . Office of Rospotrebnadzor in the city of Moscow (February 20, 2013). Test date on June 2, 2019.
- Yaschuk N. D., Vengerners Y. Ya. Infectious diseases. - M.: Medicine, 2003. - 10,000 copies. - ISBN 5-225-04659-2.
- Riccardi N., Antonello R. M., Luzzati R., Zajkowska J., Di Bella S., Giacobbe D. R. Tick-Borne Encephalitis in Europe: A Brief Update On Epidemiology, Diagnosis, Prevention, and Treatment. (eng.) // European Journal of Internal Medicine. - 2019. - APRIL (Vol. 62). - P. 1-6. - DOI: 10.1016 / J.EJIM.2019.01.004. - PMID 30678880.
- Subbotin A. A., Semenov V. A.