GENERAL
Encephalitis disease is seasonal and occurs only in the spring and summer - time activation of the tick life. The carrier lives in grass and tree crowns, has very low mobility and has no ability to pursue their prey. Mite clinging to a human or an animal which is in the immediate vicinity, and a parasite on it for a few days. They selected the least significant place for fixing - axillary and inguinal folds, knee bends, head, neck, so Mite detection in the early days of very difficult. It can be detected a few days after it increases in size in a few dozen times.
By itself, the ticks are not the source of the virus - he catches them from sick animals. The total number of infected ticks is approximately equal to 20%, so the bite of an arthropod is not always threatening infection.
Spread of the virus throughout the body occurs immediately, but the incubation period can range from 4 to 20 days, while in the cerebrospinal fluid it is found already 2-3 days after the bite.
CAUSES
The cause of tick-borne encephalitis -
virus, belonging to the group in the genus Flavivirus. The causative agent belongs to arboviruses - so called infections that are carried by blood-sucking arthropods. Carrier of the virus is the female ticks inhabiting almost the entire territory of Central and Northern Europe.Infection occurs when sucking insect to human skin or during the blood sucking them. There have been cases of transmission through the digestive tract, while taking food (especially raw milk and other dairy products), infected with encephalitis.
CLASSIFICATION
Tick-borne encephalitis, depending on the degree of symptoms and the severity of symptoms is divided into the following forms:
- Feverish, which tend to most easily and quickly over. The acute phase of tick-borne encephalitis takes only 3-5 days, and complications almost never appear.
- Polientsefalomieliticheskaya, where soon after the first symptoms develop paralysis and paresis cervical muscles and muscles of the shoulder girdle, causing typical for this form of the disease syndrome hanging head. Gradually paralysis covers first the lower, then the upper limbs and spreads to the rest of the body's muscles. The latter affects the respiratory muscles.
- Encephalitic, characterized by a combination of general cerebral and focal symptoms. Encephalitis manifested impairment of consciousness, convulsions, seizures.
- Meningeal, characterized by typical symptoms: fever, headaches, disturbance of consciousness.
- Poliradikulonevriticheskaya whose characteristics is the defeat of the peripheral nervous system.
- Poliomieliticheskaya at which marked fatigue and weakness, accompanied by twitching of the limbs, and numbness in them. Later symptoms complicated by paresis of muscles in the arms, legs and shoulder girdle.
Perhaps also erased during tick-borne encephalitis, in which there is mixed with a predominance of symptoms of meningeal symptoms.
SYMPTOMS
The first signs of infection of tick-borne encephalitis appear 3-4 days after infection (When ingested via the digestive tract) or 7-20 (by ingestion through the carrier bite). Depending on the severity and form multiple tick-borne encephalitis symptoms may occur in a patient.
Early symptoms of tick-borne encephalitis:
- febrile fever (38-40ºS);
- severe headache;
- pain and weakness in the limbs, their numbness;
- a feeling of weakness, fatigue, reduced performance;
- in some forms of encephalitis at the early stages can be observed pomrachneniya and loss of consciousness, convulsions;
- indigestion, nausea, vomiting (sometimes with blood);
- state of stupefaction;
- eye pain, fear of light.
Since the disease often over time complicated by severe psychomotor agitation, Violation of orientation in space and reflexes, paresis of mimic muscles, seizures epileptic nature, gastric bleeding, spastic disorders of breathing, hallucinations and delirium. In severe and the absence of timely medical care encephalitis quickly goes into a comatose stage.
DIAGNOSTICS
During the diagnosis, the doctor in the first place, based on the objective data history - finding the patient in epidemiological zone, spring and summer, the discovery of his skin integument tick.
The laboratory diagnosis is activated method for detection of antibodies to the causative agent of encephalitis - tick-borne encephalitis virus. Also Ill do a complete blood countThat the presence of his disease shows raising leucocyte and erythrocyte sedimentation rate. In the body of the patient observed a significant increase in protein level - it reaches 1 g / l. In order to determine its amount is assigned to the patient puncture cerebrospinal fluid.
Much attention is paid differential diagnosis - encephalitis be distinguished from diseases such as serous meningitis, polio, Typhus, brain tumor, etc. For this mite or its fragments extracted from the patient's body is sent to the PCR diagnostics.
TREATMENT
When detecting a person shows sign borne encephalitis emergency hospitalization in infectious disease clinic for intensive care. patient Serum introduced protivoentsefalitnaya, Protivokleschevoy γ-globulin, immunoglobulin, antiviral drugs.
The rest of the treatment is symptomatic, it includes fever, detoksiruyuschie drugs, vitamins, and drugs that normalize the body's water balance.
COMPLICATIONS
After the tick-borne encephalitis in a patient may remain paresis of varying severity, Preferably on the upper extremities. The possibility of their compensation depends on such factors as the patient's age, severity of illness and suffering from the resources of the body.
PREVENTION
To reduce the risk of infection with the tick-borne encephalitis is recommended to take precautions when walking in the forest areas in spring and summer. Of great importance in this matter is a form of clothes - legs, arms and neck should be covered, desirable headdress. After the walk be sure to conduct a thorough examination of the entire skin, Paying particular attention to the risk zones and hairy parts of the body. Upon detection of the mite is necessary to go to the nearest emergency center - there is a potential causative agent is removed and tested for carrier entsefalovirusa. Independently tick better not delete - under the skin may remain fragments.
Preventive measures also include:
- refusal to use in the warmer months of dairy products that have not undergone heat treatment;
- Timely vaccination (may be conducted in the autumn and winter period, and for 4 days after the detection itself mite - different types of vaccines are used for this purpose);
- use repellents ticks repellents.
FORECAST FOR RECOVERY
Forecast at a feverish and meningeal forms of encephalitis favorable, While others - much worse. Lethal outcome during infection of these types of disease is around 25-30% of cases. In the case of survival of the patient may suffer from muscle atrophy, seizures, dementia.
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