Encephalitis is called inflammatory process, which originated in the gray or white matter of the brain. It can be caused by a virus, a bacterial process, or even allergic reaction to the administered serum or vaccine. Symptoms of encephalitis infection may appear unexpectedly when there has been no vaccination, insect bite, or other apparent reason. These may be so-called sclerosing panencephalitis or Economo's encephalitis, the causes of which have not yet been established.
How does encephalitis manifest? Symptoms of the infectious process:
1. Such encephalitis usually begins with prodromal phenomena: cough, sore throat, runny nose. There may be a rash and other manifestations characteristic of chickenpox, measles or rubella, or the disease will be preceded by a purulent process.
2. encephalitis: severe headache, which is usually localized in the frontal region or covers the entire head. It intensifies when turning the head or sudden movements. It is often accompanied by nausea and vomiting, and the latter can be sudden, without nausea, profuse, and does not get better after it.
3. Appetite decreases, and it is often impossible to give the patient something to drink. Adult patients, being conscious and realizing that they need to drink, are afraid to do so because of nausea or vomiting.
4. Weakness and drowsiness increase.
5. Dizziness.
6. Photophobia.
These signs are very similar to the manifestations of meningitis, and isolated meningitis can only be distinguished from encephalitis or meningoencephalitis using MRI data.
The following symptoms indicate encephalitis:
Convulsions, often with respiratory arrest, occurring repeatedly;
A person may become inadequate, aggressive, then drowsiness increases, leading to coma;
Sometimes drowsiness increases so quickly that after 6-8 hours the patient cannot be woken up;
There may be breathing disorders: frequent (more than 20 per minute) or, conversely, rare (8-10 per minute), you can sometimes notice that the intervals between breaths are unequal;
Strabismus;
Unsteadiness of gait;
Numbness in the limbs, pins and needles sensation;
Difficulty urinating when there is an urge, but you cannot go to the toilet;
Paralysis or paresis (incomplete paralysis);
Swallowing problems;
Asymmetry of the face and pupils also indicate encephalitis;
There may be other manifestations of encephalitis, such as decreased hearing or vision.
For yourself, you need to remember the following: if such symptoms appear against the background normal temperature, it increases only later, this may mean that the person is having a stroke. These diseases are often distinguished only by data lumbar puncture and MRI pictures.
– infection, which is based on damage to the brain and spinal cord a flavivirus transmitted to humans through the bites of ixodid ticks. Depending on the form of the disease, its manifestations are fever, headache, convulsions, vomiting, impaired coordination of movements, pain along the nerves, flaccid paresis and paralysis. The diagnosis is confirmed using blood PCR and cerebrospinal fluid. Treatment for early stages disease is to prescribe immunoglobulin against tick-borne encephalitis, antiviral drugs. On later Only prevention of life-threatening conditions and symptomatic treatment are possible.
General information
Treatment includes specific (directed at the pathogen), pathogenetic (blocking the mechanisms of disease development) and symptomatic therapy. The patient is prescribed strict bed rest. Scheme specific treatment depends on the time that has passed since the first symptoms appeared. At the very beginning of the disease (first week), the administration of anti-mite immunoglobulin to patients showed high effectiveness. It is administered over 3 days. Also when early diagnosis good results are obtained with the use of antiviral drugs: ribonuclease, ribavirin, interferon, potato shoot extract.
All of these drugs are ineffective late stages diseases when the virus has already affected the central nervous system. In this case, treatment is aimed not at combating the causative agent of the disease, but at pathological mechanisms, life threatening patient. To do this, use oxygen supply through a mask, mechanical ventilation in case of breathing problems, diuretics to reduce intracranial pressure, drugs that increase the brain's resistance to oxygen starvation, neuroleptics.
Forecast and prevention of tick-borne encephalitis
The prognosis for tick-borne encephalitis depends on the degree of damage to the nervous system. In the febrile form, as a rule, all patients recover completely. At meningeal form The prognosis is also favorable, however, in some cases, persistent complications from the central nervous system may be observed in the form of chronic headaches and the development of migraines. Focal form tick-borne encephalitis has the worst prognosis. The mortality rate can reach 30 people per 100 cases. Complications of this form are the occurrence of persistent paralysis, convulsive syndrome, and decreased mental abilities.
Prevention of tick-borne encephalitis is divided into 2 areas: organizational measures and vaccination. Organizational events consist of training residents of endemic regions (places where the disease is spread) to observe the rules for visiting forest areas and outdoor recreation areas during the period of tick activity: wearing clothing that covers most bodies (with long sleeves and trousers, Panama hats or caps on the head); thorough examination of clothing and body to identify live ticks; immediate appeal for medical care in case of detection of a sucking insect; a warning about the inadmissibility of removing an attached tick from the skin on your own; applying repellent to clothing before a walk; mandatory boiling of milk, purchasing dairy products only from official producers.
Vaccination includes: passive immunization– administration of immunoglobulin to patients who have not previously been vaccinated against tick-borne encephalitis (in case of a tick bite) and active immunization – vaccination of residents of the area where the disease is spread 1 month before the season of tick activity.
Tick-borne encephalitis is an acute viral disease nervous system. Its main sources are two types of ixodid ticks - taiga and European forest ticks. The peak incidence of encephalitis occurs in spring (May-June) and late summer and early autumn (August-September).
Tick-borne encephalitis is sometimes called differently - spring-summer, taiga, Siberian, Russian. Synonyms arose due to the characteristics of the disease. Spring-summer, because the peak incidence occurs in the warm season, when ticks are most active. The first peak of the disease is recorded in May-June, the second - at the end of summer.
If you are bitten by an encephalitis tick, the virus enters the bloodstream within the first minutes of contact. According to statistics, six ticks out of a hundred are carriers of the virus (at the same time, from 2 to 6% of people bitten can get sick from an infected individual).
The causative agent of tick-borne encephalitis is an RNA virus belonging to the Vlaviviridae family. There are 3 types of virus:
- Far Eastern - the most virulent (can cause severe forms illness);
- Siberian - less contagious;
- Western - the causative agent of two-wave encephalitis - causes mild forms of the disease.
The ixodid tick bite is main reason occurrence . Due to damage to the body by a natural focal viral infection, which is dangerous for the membranes of the brain and spinal cord, meningitis and meningoencephalitis occur.
There are known cases of human infection with tick-borne encephalitis after consuming milk from tick-infected domestic animals. Therefore, you can only drink pasteurized or boiled milk.
Features of the tick-borne encephalitis virus are weak resistance to the action of high temperatures, disinfectants and ultraviolet radiation. So, when boiled, it dies after 2 minutes and cannot be stored in environment in hot sunny weather. However, when low temperatures it is able to maintain viability for a long time.
Incubation period
During a tick bite, some viruses begin to multiply in subcutaneous tissue and tissue macrophages, another part of them enters the blood and penetrates the vascular endothelium, The lymph nodes, parenchymal organs, in the tissue of the central nervous system, where they intensively multiply and accumulate. Treatment of tick-borne encephalitis is carried out using many groups of drugs that affect the virus itself and all parts of the pathological process.
Sometimes diagnosed lightning forms tick-borne encephalitis (the first symptoms appear within a day) and protracted - the incubation period can include up to 30 days.
You should know that a patient with tick-borne encephalitis is not dangerous to others, as it is not contagious.
On average, the incubation period is 1-3 weeks, since the forms of development of the disease are different:
- Lightning fast. With her initial symptoms appear already on the first day.
- Lingering. In this case, the duration of the incubation period can be about a month, sometimes even a little longer.
Symptoms of tick-borne encephalitis
Tick-borne encephalitis is viral infection, which initially occurs under the guise of normal colds. It may go unnoticed by the patient, or may cause severe damage to the nervous system.
After a tick bite, the virus multiplies in tissues and penetrates the lymph nodes and blood. When the virus multiplies and enters the bloodstream, flu-like symptoms form.
Often the disease begins with the following symptoms:
- an increase in body temperature to 39-40 C and with chills characteristic of this condition,
- severe pain in the lower back and limbs,
- pain in the eyeballs,
- general weakness
- nausea and vomiting,
- consciousness is preserved, but there is lethargy, drowsiness, and symptoms of stupor.
When the virus enters the membranes of the brain, and then into the substance of the brain, symptoms of disturbances in its activity appear (neurological):
- sensation of goose bumps, touches on the skin;
- skin sensitivity disorders;
- disturbances in muscle movements (first facial movements, then the ability to voluntarily make movements of the arms and legs is lost);
- convulsive seizures are possible.
Violations may later occur:
- cardiovascular system (myocarditis, cardiovascular failure, arrhythmia),
- digestive system - stool retention, enlarged liver and spleen.
All of the above symptoms are observed against the background toxic damage body - increase in body temperature to 39-40 degrees C.
The most common and noticeable signs encephalitis tick:
- transient weakness of the limbs;
- weakness of the muscle tissue of the cervical region;
- feeling of numbness of the facial and cervical skin.
The outcome of tick-borne encephalitis occurs in the form of three main options:
- recovery with gradual long-term recovery;
- transition of the disease to chronic form;
- death of a person infected with tick-borne encephalitis.
After a tick bite infected with the encephalitis virus, it is necessary to carry out emergency prevention for 3 days.
Forms of tick-borne encephalitis
Currently, the following forms of the disease are distinguished:
Febrile form of tick-borne encephalitis
Tick-borne encephalitis in this form occurs with a predominance of a febrile state, which can last from 2 to 10 days. As the most characteristic manifestations headache, weakness and nausea are noted. In this case, neurological symptoms are mild.
Meningeal
Meningeal, which proceeds relatively favorably. It begins, like any other manifestation, with the phenomena of intoxication of the body:
- weakness,
- increase in body temperature,
- sweating
Then symptoms of brain damage appear (occipital headaches, vomiting, fear of light and impaired reflexes). Within two to three weeks they appear typical symptoms.
Meningoencephalitic
Meningoencephalitis is characterized by a two-wave temperature reaction. Each wave lasts from 2 to 7 days. At intervals of 1-2 weeks. The first wave occurs with general toxic symptoms, and the second with meningeal and cerebral signs. The course of this form is favorable, observed fast recovery and no complications.
Poliomyelitis form
It is observed in 30% of patients. It begins with general lethargy of the whole body, observed within 1-2 days. Accompanied by the following symptoms:
- weakness in the limbs, which can subsequently lead to numbness;
- characterized by pain in the neck;
- all violations described in the previous forms are possible;
- the ability to hold the head in an upright position disappears;
- loss of movement in the hands.
Motor pathologies progress over 1-1.5 weeks. From the beginning of the second to the end of the third week, the muscles begin to atrophy.
Polyradiculoneuritic form
It is observed rarely, in no more than 4% of cases. In addition to the symptoms of meningitis, with the development of this variant of tick-borne encephalitis, severe paresthesia (tingling) in the extremities and severe sensitivity in the area of the fingers appear. Sensitivity is impaired central departments bodies.
As you can see, the signs of this disease can be completely different. Some forms of encephalitis are quite difficult to diagnose. That is why it is extremely important to consult a doctor in time, preferably before the appearance of disorders of the nervous system.
Signs of tick-borne encephalitis in children
The main symptoms and signs of tick-borne encephalitis in children include:
- the first sign of tick-borne encephalitis is headache, expressed by a rise in body temperature;
- sleep disorders;
- eyeball disorders;
- disorders of the vestibular apparatus.
The best measure to prevent tick-borne encephalitis in children and adults has been and remains vaccination. Vaccination against tick-borne encephalitis is recommended for everyone who lives or stays in epidemic foci.
Complications and possible consequences
The consequences of an encephalitis tick bite cannot be called pleasant. You can endlessly list why the encephalitis tick is dangerous and what its attack is fraught with.
Complications:
- Memory impairment.
- Headache.
- Complete or partial disturbances of movement and/or sensitivity in the limbs and facial area.
- Decreased muscle strength and volume (usually the upper shoulder girdle).
Diagnostics
The only answer to the question: what to do if suddenly bitten by an encephalitis tick is to deliver the patient to the nearest infectious diseases hospital as soon as possible.
When making a diagnosis of tick-borne encephalitis, it is necessary to take into account a combination of three factors:
- clinical manifestations (symptoms),
- epidemiological data (time of year, whether the vaccine was given, whether there was a tick bite)
- laboratory tests (analysis of the tick itself - optional, blood test, cerebrospinal fluid analysis, etc.).
I would especially like to note the fact that the virus can be detected in the tick itself. That is, if you are bitten by a tick, then it must be taken to medical institution(if possible).
To accurately confirm the diagnosis, it is necessary to determine specific antibodies:
- immunoglobulin class M for encephalitis (IgM) – the presence indicates an acute infection,
- IgG - the presence indicates contact with an infection in the past, or the formation of immunity.
If both types of antibodies are present, this is a current infection.
All patients with tick-borne encephalitis must be examined for It is possible to become infected with both infections at the same time.
Treatment
An effective method of treatment for tick-borne encephalitis in early stage detection is considered anti-encephalitis immunoglobulin therapy. Also most useful for successful recovery inactivated vaccine and ribonucleic acid (RNA). Timely vaccination and protection against ticks – effective methods preventing the complex course of the disease.
When prescribing treatment, they are guided by the principle of symptom relief. Therefore, medications are mainly prescribed to maintain the body. It includes:
- antipyretics,
- detoxifying drugs,
- vitamins,
- normalizing medications water balance body.
The patient is prescribed strict bed rest. The specific treatment regimen depends on the time that has passed since the first symptoms appeared.
Patients are discharged on days 14-21 of normal temperature. Dispensary observation turns out to be an infectious disease specialist and neurologist for 1 year after a febrile form with examination once every 6 months. After other forms of the disease - 3 years with quarterly examination.
Forecast
The meningeal and febrile form of the disease proceeds favorably in most cases. Meningoencephalitic, poliomyelitis and polyradiculoneuritic are significantly worse. Fatalities are 25-30%.
The consequences of tick-borne encephalitis can be decreased memory, headaches, and paralysis.
Prevention of tick-borne encephalitis
Prevention of tick-borne encephalitis is carried out in two directions:
- vaccination is the most reliable protection against tick-borne encephalitis are their own antibodies, which are produced in response to vaccination. Traditionally, they are held in advance in the autumn-winter period.
- preventive measures (nonspecific prevention).
TO preventive measures also include:
- refusal to consume dairy products that have not undergone heat treatment during the warm season;
- timely vaccination (can be carried out both in the autumn-winter period and within 4 days after a tick is detected on oneself - for this purpose, different types vaccines);
- wearing clothing that covers the body (it is better to go out into nature in clothes with long sleeves and pants, the head should be covered with a cap);
- contact a doctor in a timely manner if any insects are detected (it is highly not recommended to remove ticks on your own);
- use of tick repellents;
- after returning home, you need to take off all your clothes and immediately take a shower, then you need to carefully examine your clothes “from the forest” and your body for ticks.
If you find a tick embedded in your skin on your body, immediately seek help from medical workers– they will remove the insect and carry out anti-encephalitis vaccination.
Relaxing in the lap of nature is not only a pleasant time spent outdoors in the fresh air, but also an opportunity to encounter some insects that are dangerous to your health. For example, with the encephalitis tick, the bite of which can cause paralysis and even lead to death.
Distinguish a virus carrier from an uninfected tick by external signs does not seem possible. Both females and males, larvae and nymphs can be spreaders of this dangerous disease. The most common method of infecting the insect itself is by feeding on the blood of an infected animal.
Typically, representatives of two types of ticks become carriers of the disease: canine(Ixodes ricinus) or taiga(Ixodes persulcatus). In addition to encephalitis, insects can transmit other dangerous diseases, such as Lyme disease and borreliosis.
Tick in literally this word preys on its potential victim. He sits in ambush for a long time, for example, in the grass or on a bush, and waits for the approach of a person (or animal). Contrary to popular belief, these insects cannot fly or jump.
Once on clothing, a small insect begins a long journey to some warm and soft part of the body. Ticks usually choose the armpits, groin area, stomach, neck. Often the location of the insect becomes hairy part heads. A tick can spend several hours searching for the most “appetizing” area.
Even an infected tick does not always infect its victim with encephalitis. The degree of probability of getting sick is determined by the length of time the insect remains on the body and the amount of virus entering the blood.
Forms and main symptoms of encephalitis
- high temperature (39-40 degrees);
- weakness and aches throughout the body;
- headache;
- nausea and vomiting.
These symptoms indicate the activity of the virus and last from 5 to 10 days. If problems with well-being stop there, then the person has suffered from a febrile disease and has received stable immunity to encephalitis. The disease rarely progresses from febrile to chronic form.
In the meningeal form, the main signs of encephalitis are as follows:
- increased body temperature;
- severe and painful headaches;
- photophobia;
- muscle rigidity, which does not allow the patient to press his head to his chest.
If after a fever there is a break (7-10 days) and the state of health worsens again, then the virus has already penetrated the blood-brain barrier, began to infect the nervous system and multiply in internal organs. Symptoms and consequences of encephalitis infection for the body differ depending on the location of the lesion. So, with the polio form, paralysis of the neck and arms begins, in case of untimely treatment medical care leading to disability.
The meningoencephalitic form is characterized by mental disorders, serious disturbances of consciousness, hallucinations, epileptic attacks. The polyradiculoneurotic form of the disease is indicated by severe pain in the groin area, lethargy or paralysis of the limbs, loss of sensitivity associated with damage to the peripheral nerves by the virus.
If with the febrile and meningeal form of encephalitis the medical prognosis is usually favorable, then the meningoencephalitic, poliomyelitis and polyradiculoneuritic form can be fatal in 25-30% of cases. Changes in the functioning of the central nervous system in people who have undergone treatment for encephalitis may persist for 1-2 years.
First aid to the victim
Don't have tweezers or thread at hand? You can use the method described in the video “The simplest and effective method tick removal." The tick is easily removed by rotating movements, always counterclockwise.
IMPORTANT! It is necessary to preserve the integrity of the insect when removing it. If it remains in the body the slightest part mite, this will cause suppuration and inflammation. The severed head continues to infect tissues, since salivary glands the virus is in significant concentration.
Diagnosis of encephalitis
The diagnosis of “tick-borne encephalitis” is made only after comprehensive survey patient. It is necessary to differentiate the disease from disorders with similar symptoms - tumors of the central nervous system, Lyme disease, typhus, encephalitis of other origins and even influenza.
At the first stage, the doctor collects the necessary endemic data and compiles clinical picture. To do this, the specialist asks the patient about visiting places possible infection, receives information about the patient’s health status and the presence of certain symptoms of tick-borne encephalitis.
Further diagnostics include:
- spinal puncture followed by analysis of cerebrospinal fluid to investigate the presence of central nervous system disorders, purulent inflammation and bleeding;
- serological study;
- virological method.
Encephalitis is treated exclusively in a hospital under the constant supervision of an infectious disease specialist. Treatment consists of the following measures:
- Mandatory bed rest for the entire time spent in a medical institution.
- Symptomatic therapy aimed at relieving symptoms of intoxication and reducing all specific signs diseases.
- Antiviral therapy, which consists of intramuscular injection special gamma globulin and taking medications from the interferon group.
- At pathological changes connection of the patient to the device is required artificial ventilation lungs.
- For children, detoxification measures are also required to cleanse the body of infection and reduce tissue swelling.
Methods intensive care treatment is not limited. After discharge from the hospital, the patient is prescribed drug treatment, massage, gymnastics. Within a year, a person must visit a neurologist and avoid severe physical activity, going to the bathhouse, drinking alcohol. Failure to comply with doctor's instructions can lead to the development of arthritis and neuritis.
Prevention
Residents of areas belonging to areas of increased spread of encephalitis ticks, as well as people whose activities involve staying in the forest or field, should take preventive measures to reduce the consequences of insect bites to a minimum.
Vaccination is used as a preventive measure, which significantly reduces the risk of contracting encephalitis. The vaccine is safe. Therefore, doctors recommend doing it annually for children from 1 year of age and adults (living in unfavorable regions). Vaccination is mandatory for foresters, geologists, drillers and representatives of other professions whose occupations are often located in places where dangerous ticks are spread.
An encephalitis tick bite can become unpleasant consequence family picnic in nature or mushroom picking. You can protect yourself from insect bites using ultrasonic repellers, special sprays and ointments. When going into nature, you should cover your body with clothing as much as possible to prevent ticks from getting on your skin.
Conclusion
Encephalitis is one of the most dangerous diseases which are carried by ticks. Knowing how to properly remove a tick, what the symptoms may be after an insect bite, and what preventive measures exist, you can protect yourself and your loved ones.
Tick-borne encephalitis is an infectious disease transmitted by ticks. It is severe and can be life threatening. However, against such dangerous disease Like tick-borne encephalitis, there is a vaccine.
How to avoid tick bites? Following the rules can help with this:
- avoid grassy areas (for example, if you have a picnic, sit only on a blanket and away from trees and bushes);
- when walking in the forest, trouser legs should be tucked into boots (short shorts are not recommended at all, as are open shoes);
- when walking, you must wear a hat;
- before going for a walk, you should use insect repellents based on natural ingredients (preparations containing DEET may be dangerous to the child’s health);
- after each walk, it is necessary to carefully examine the entire body in search of a possible unwanted guest (take a good look at the scalp - there the encephalitis tick can easily slip out of sight).
How to properly remove a pest?
To successfully remove a tick, you need to gently grab it with tweezers as close to the skin as possible, then carefully pull it out. You should not press the tick in any way, as this may introduce infectious material into the skin. The tick should not be lubricated with oil, alcohol, solvent or any other substance.
After removing the tick, the area on the skin should be thoroughly disinfected. It is necessary to observe whether signs of an encephalitis tick bite have appeared - erythema. In a situation where the symptoms of the bite persist and intensify, this may indicate infection with a virus. Don't hesitate to seek medical help the same day.
To facilitate the process of removing ticks, special tongs and loops are available in pharmacies that can remove the entire insect.
When to vaccinate?
Prevention of encephalitis consists of several methods, these include the following:
- avoiding exposure to ticks on the skin by wearing appropriate clothing that covers as much of the body as possible;
- use of tick repellents (repellents);
- proper removal of them from the surface of the body;
- pasteurization of milk before consumption;
- vaccination.
Only vaccination against tick-borne encephalitis provides significant protection against the disease. However, this vaccine does not protect against Lyme disease, which is also transmitted by ticks.
Registered the following types vaccines against tick-borne encephalitis:
- Encepur® K (for children);
- Encepur® Adults (for adults);
- FSME-IMMUN 0.25 ml Junior (for children);
- FSME-IMMUN 0.5 ml (for adults).
They are inactivated, that is, they contain a killed tick-borne encephalitis virus, which eliminates the risk of infection and makes it possible to use it for people with reduced resistance.
Vaccination against tick-borne encephalitis is carried out according to the following scheme: first dose, second dose after 1-3 months, after 5-12 months - third dose. The vaccination is done 3 years after the last vaccination, the next one is carried out every 3-5 years. Vaccination has a very high level effectiveness after 3 doses.
By getting vaccinated in winter or early spring, you provide yourself with protection from the very beginning of tick activity.
In European countries, accelerated is used. It is recommended for persons before traveling to endemic areas where cases of encephalitis have been reported in the past 24 months. Depending on the manufacturer’s indications, one of the schemes is used: 0.14 days, for 5-12 months or 0.7 days, 21 days, 12 months.
Contraindications to the procedure
A contraindication to vaccination against tick-borne encephalitis is increased sensitivity to the components of the drug, that is, to chicken protein and formalin, neomycin, gentamicin, acute reaction to a previous dose of vaccine, as well as ongoing acute infectious disease, exacerbation of chronic diseases.
Despite high degree The safety of this vaccine has not been determined; its effect on pregnant women has not been determined; therefore, vaccination during pregnancy is not recommended, except in justified circumstances.
After vaccination, local vaccination reactions may occur: swelling, soreness, redness, muscle and head pain.
All people who have no contraindications to it can get vaccinated. Children can only be vaccinated after 12 months of age.
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