The disease is tick-borne encephalitis. Tick-borne encephalitis in humans - symptoms, treatment, prevention

Tick-borne encephalitis (spring-summer type encephalitis, taiga encephalitis) is a viral infection that affects the central and peripheral nervous system. Severe complications acute infection may result in paralysis and death.

The main carriers of the encephalitis virus in nature are ixodid ticks, whose habitat is located throughout the forest and forest-steppe temperate climatic zone of the Eurasian continent. Despite the significant number of species of ixodid ticks, only two species are of real epidemiological significance: Ixodes Persulcatus ( taiga tick) in the Asian and in a number of areas of the European part, Ixodes Ricinus ( European wood tick) - in the European part.

Tick-borne encephalitis is characterized by a strict spring-summer seasonality of the onset of the disease, associated with the seasonal activity of vectors. In the range of I. Persulcatus, the disease occurs in spring and the first half of summer (May-June), when the biological activity of this tick species is highest. For ticks of the species I. Ricinus, there is an increase in biological activity twice per season, and in the range of this tick there are 2 peaks of seasonal incidence of tick-borne encephalitis: in spring (May-June) and at the end of summer (August-September).

Infection human infection with tick-borne encephalitis virus occurs during the blood-sucking of virus-forming ticks. The female tick's blood-sucking continues for many days, and when fully saturated, it increases in weight 80-120 times. Blood sucking by males usually lasts several hours and may go unnoticed. Transmission of the tick-borne encephalitis virus can occur in the first minutes of tick attachment to a person. It is also possible to become infected through the digestive and gastrointestinal tracts by ingesting raw milk from goats and cows infected with tick-borne encephalitis.

Signs of tick-borne encephalitis. The incubation period of tick-borne encephalitis lasts on average 7-14 days with fluctuations from one day to 30 days. Transient weakness in the limbs, neck muscles, numbness of the skin of the face and neck are noted. The disease often begins acutely, with chills and an increase in body temperature to 38-40°C. Fever lasts from 2 to 10 days. General malaise, severe headache, nausea and vomiting, weakness, fatigue, and sleep disturbances appear. In the acute period, hyperemia (overflow of blood vessels of the circulatory system of any organ or area of ​​the body) of the skin of the face, neck and chest, mucous membrane of the oropharynx, injection of the sclera and conjunctiva is noted.

I am worried about pain throughout the body and limbs. Muscle pain is characteristic, especially significant in muscle groups, in which paresis (partial loss of muscle strength) and paralysis usually occur in the future. From the moment the disease begins, clouding of consciousness and stupor may occur, the intensification of which can reach the level of coma. Often, mites appear at the site of suction different sizes erythema (redness of the skin caused by dilation of capillaries).

If symptoms of tick-borne encephalitis are detected, the patient should be urgently admitted to an infectious diseases hospital for intensive treatment.

Treatment patients with tick-borne encephalitis is carried out according to general principles, regardless of previous preventive vaccinations or the use of specific gamma globulin for prophylactic purposes ( medicinal product, containing antibacterial and antiviral antibodies).

In the acute period of the disease, even in mild forms, patients should be prescribed bed rest until the symptoms of intoxication disappear. Almost complete restriction of movement, gentle transportation, and minimizing pain stimulation improve the prognosis of the disease. No less important role treatment includes rational nutrition of patients. The diet is prescribed taking into account functional disorders stomach, intestines, liver.

Taking into account vitamin balance disturbances observed in a number of patients with tick-borne encephalitis, it is necessary to prescribe vitamins B and C. Ascorbic acid, which stimulates the function of the adrenal glands, as well as improves the antitoxic and pigment functions of the liver, should be administered in an amount of 300 to 1000 mg per day.

Prevention of tick-borne encephalitis

The most effective protection against tick-borne encephalitis is vaccination. Clinically healthy people are allowed to get vaccinated after examination by a therapist. Vaccination can only be done in institutions licensed for this type of activity.

Modern vaccines contain inactivated (killed) tick-borne encephalitis virus. After the vaccine is administered, the immune system recognizes viral antigens and learns to fight the virus. Trained cells of the immune system begin to produce antibodies (immunoglobulins), which block the development of the virus that has entered the body. To maintain the protective concentration of immunoglobulin for a long time, it is necessary to administer several doses of the vaccine.

The effectiveness of vaccination can be assessed by concentration protective antibodies in the blood (IgG to tick-borne encephalitis virus).

Vaccines against tick-borne encephalitis registered in Russia:
- Tick-borne encephalitis vaccine, culture-based, purified, concentrated, inactivated, dry - for children over 4 years of age and adults.
- EnceVir - for children over 3 years of age and adults.
- FSME-IMMUN Inject - from 16 years old.
- FSME-IMMUN Junior - for children from 1 year to 16 years. (Children should be vaccinated during the first year of life if they are at risk of contracting tick-borne encephalitis.)
- Encepur adult - from 12 years old.
- Encepur for children - for children from 1 year to 11 years.

The above vaccines differ in virus strains, antigen dose, degree of purification, and additional components. The principle of action of these vaccines is the same. Imported vaccines are capable of developing immunity to Russian strains of tick-borne encephalitis virus.

Vaccination is carried out after the end of the tick season. In most regions of Russia, vaccination can begin in November. However, in case urgent need(for example, if you have a trip to natural hearth tick-borne encephalitis) vaccination can be done in the summer. In this case, the protective level of antibodies appears after 21-28 days (depending on the vaccine and vaccination schedule).

Immunity appears two weeks after the second dose, regardless of the type of vaccine and the chosen regimen. The third dose is administered to consolidate the result. Emergency regimens are not intended for protection after a tick bite, but for the fastest possible development of immunity if the timing of standard vaccination has been missed.

To the locals adverse reactions include: redness, thickening, soreness, swelling at the injection site, urticaria (an allergic rash resembling that of a nettle burn), enlargement of the lymph nodes close to the injection site. Usual local reactions are observed in 5% of vaccinated people. The duration of these reactions can reach 5 days.

Common post-vaccination reactions include widespread significant areas body rash, increased body temperature, anxiety, sleep and appetite disturbances, headache, dizziness, short-term loss of consciousness, cyanosis, cold extremities. Frequency of temperature reactions to Russian vaccines does not exceed 7%.

If a tick is attached, it should be removed immediately. It should be borne in mind that the likelihood of contracting tick-borne encephalitis depends on the amount of virus that penetrates during the “bite” of the tick, that is, on the time during which the tick was in the attached state. If you do not have the opportunity to seek help from a medical facility, then you will have to remove the tick yourself.

When removing a tick yourself, you must follow the following recommendations:

A strong thread is tied into a knot as close as possible to the tick’s proboscis, and the tick is removed by pulling it up. Sudden movements are not allowed.

If, when removing the tick, its head, which looks like a black dot, comes off, the suction site is wiped with cotton wool or a bandage moistened with alcohol, and then the head is removed with a sterile needle (previously calcined in a fire). Just like an ordinary splinter is removed.

Removing a tick must be done with caution, without squeezing it, since this may squeeze the contents of the tick along with pathogens into the wound. It is important not to tear the tick when removing it - the remaining part in the skin can cause inflammation and suppuration. It is worth considering that when the head of the tick is torn off, the infection process can continue, since in salivary glands and ducts there is a significant concentration of TBE virus.

There is no basis for some recommendations that for better removal it is recommended to apply ointment dressings to the attached tick or use oil solutions.

After removing the tick, the skin at the site of its attachment is treated with tincture of iodine or alcohol. A bandage is usually not required.

After removing the tick, save it for testing for infestation - usually such a test can be done in infectious diseases hospital. After removing the tick, place it in a small glass bottle with a tight lid and place a cotton swab lightly moistened with water. Cap the bottle and store it in the refrigerator. For microscopic diagnosis, the tick must be delivered to the laboratory alive.

The material was prepared based on information from open sources

– dangerous viral disease, which can lead to defeat nervous system, paralysis and death. It is transmitted through the bites of ixodid ticks - parasites from the family of arthropods that live in almost all climatic zones. To prevent complications and unpleasant consequences, you need to detect the bite in time and take appropriate measures.

How to understand what symptoms of illness people have if they are bitten by a tick, how many days do the first signs of infection appear after the bite, and what to do if they are detected?

Ixodid ticks are members of a family of arthropods that includes 650 species, distributed throughout the world except the North Pole. These are one of the hardiest creatures, capable of fasting for long periods of time and withstanding temperature changes. In appearance, they are a little reminiscent of spiders - the size ranges from 0.5 to 2 cm, the body is round, red, brown or brown, and there are 4 pairs of legs on it. They stick to

skin

victims and can remain on them for several days (sometimes 2-3 weeks), feeding on their blood. After this, they disappear on their own and hide for several weeks.

With an individual reaction to tick saliva, a mild allergic reaction of a local nature is possible - slight redness, inflammation and itching. If the tick falls off on its own, it is almost impossible to determine the fact of the bite, since no traces remain on the person’s skin. Photo The photo below shows what the area looks like after a tick bite, with

characteristic features

on the human body.

How quickly does the disease manifest in a person?

The incubation period of the disease in humans lasts from several days to two weeks; less often, the first signs of infection appear a month after the bite. The clinical picture depends on the age and health of the person, as well as the type of virus that caused the infection. The classic picture includes two stages, each of which has specific symptoms. Initial signs in children and adults absent in the first stages.

An attached tick can easily be confused with a mole or wart, and after it falls off, a small red spot remains, on which a drop of blood may appear. On the second day, redness usually increases, mild itching and rash may occur, but in an adult healthy person

After a bite, the signs are mild. If the wound becomes infected, slight suppuration may occur.

Elderly people, children and allergy sufferers suffer the most from tick bites. In such cases, severe allergic reactions, including Quincke's edema, are possible.

The first symptoms usually develop after a few days. They resemble ARVI or a severe cold, but occur without respiratory symptoms (cough, runny nose, sore throat). Sometimes the first phase of tick-borne encephalitis is confused with severe poisoning, especially in cases where it is accompanied by severe vomiting. The main differences are that patients do not have diarrhea, which is characteristic of such conditions. Sorbents like activated carbon also do not have an effect, since the pathogen is not in the digestive tract, but in the blood.

If you do not consult a doctor after the first symptoms appear, the disease will progress to the second stage, which is characterized by more severe symptoms and often leads to serious complications.

First phase

1. In the first phase, there are no specific signs - patients have fever, headaches, muscle and joint pain, and deterioration in general health.
2. Temperature increase. Typically, the temperature during infection rises to high numbers - 38-39 degrees. In rare cases, a clinical course of encephalitis is possible, accompanied by a slight fever - 37-37.5 degrees; Pain. Painful sensations in people infected with the virus they are quite pronounced - they are localized in large muscle groups and joints. They resemble the sensations after intense physical activity
3. or during inflammatory processes. In addition, there are sharp headaches without a specific localization, spreading to the entire head; Deterioration in health. Signs associated with intoxication of the body and deterioration in general health include weakness, fatigue, loss of appetite, and sometimes nausea and vomiting. In some cases, patients have decreased arterial pressure

The first phase of encephalitis lasts from 2 to 10 days (on average 3-4 days), after which remission occurs and symptoms recede. Between the first and second phases it can take from several hours to several days. Sometimes the clinical course is limited to one phase, the first or second, and in some cases the clinical course is characterized by the presence of symptoms of both stages simultaneously.

Second phase

The absence of symptoms does not mean recovery - the further course of the disease depends on the body’s response to the virus.

In 30% of cases, recovery occurs, but in 20-30% of patients, the second stage of encephalitis occurs, characterized by damage to the central nervous system.

• Its symptoms include:
• stiffness of the neck muscles;
• intolerance to bright light and loud sounds;
• movement disorders up to paresis and paralysis;
• disturbances of consciousness, hallucinations, incoherent speech;

coma. The severity of symptoms and duration of phases depends on various factors , including the variant of the course of the disease. "Western" encephalitis, which is common in Europe, is different favorable course

and quite rarely leads to serious consequences. The “Eastern” subtype (characteristic of the Far East) proceeds rapidly and has a high mortality rate. It begins abruptly, with severe fever, headaches and severe intoxication, and damage to the nervous system develops within 3-5 days. Patients experience severe damage to the brain stem, respiratory and circulatory disorders, which often results in death . Sometimes encephalitis progresses to

chronic form

, and then periods of remission alternate with exacerbations.

In case of recovery (either independently or as a result of treatment), the person receives lifelong immunity. With a repeated bite, it is impossible to become infected with encephalitis, but do not forget that ticks carry about a dozen other dangerous ones, and the risk of infection by them remains.

1. Forms of the disease in humans
2. Symptoms and clinical course of tick-borne encephalitis depend on the form of the disease. To date, 7 varieties of the disease have been described, which are combined into two groups - focal and non-focal.
3. Meningoencephalitic. The clinical course is characterized by meningeal signs and symptoms of brain damage.
4. Polyencephalitic. Accompanied by damage to the cranial nerves, most often pathological process affects the bulbar group - hypoglossal, glossopharyngeal, vagus nerves.
5. Poliomyelitis. A form of the disease that is diagnosed in 30% of patients, and got its name because of its similarity with polio. Causes disturbances in the functioning of motor neurons in the horns of the spinal cord.
6. Polioencephalomyelitis. It is characterized by manifestations characteristic of the two previous forms - simultaneous damage to the cranial nerves and neurons of the spinal cord.
7. Polyradiculoneuritic. Manifested by a dysfunction peripheral nerves and roots.

Nonfocal (febrile and meningeal) forms of the disease occur most easily. The manifestations of the first do not differ from the common cold, and if the fact of a tick bite has not been recorded, the person does not even suspect that he has had tick-borne encephalitis. The meningeal form can be quite difficult, but it is also almost always cured completely, without serious consequences for health.

In other cases (with focal forms), symptoms and prognosis depend on clinical course illness - in mild cases, complete recovery is possible, in severe cases, the patient may become disabled or die.

What does a patient look like?

There are no external manifestations of tick-borne encephalitis - in the first phase it is impossible to distinguish it from other diseases without clinical studies.

In people who have been bitten, the face turns red, sometimes there are pinpoint hemorrhages on the whites of the eyes and mucous membranes, and tearing. In severe cases, intoxication and weakness are so severe that the person is unable to lift his head from the pillow. In the vast majority of cases, there is no rash throughout the body - a similar sign is observed only in allergy sufferers, young children and people with weakened immune systems.

Below are photos of people after being bitten by an encephalitis tick.

• Changes in appearance and behavior when a person is bitten by an infected tick appear in the second stage, when the virus attacks the nervous system. Tick-borne encephalitis can be recognized by the following manifestations: motor agitation, hallucinations,;
• crazy ideas dysfunction facial muscles
• (the face looks distorted, one eye does not close, speech is impaired, the voice becomes nasal);
• change and constant lacrimation due to irritation of the mucous membrane, strabismus, impaired movement eyeballs;
• minor muscle twitching, usually occurring after physical exertion, sometimes even minor;
• a specific pose with a bent back and head hanging on the chest (the reason is weakness of the neck muscles, chest, hands);
• weakness of the lower extremities, muscle atrophy (observed very rarely).

Even in the presence of characteristic symptoms, put accurate diagnosis possible only after comprehensive survey sick. Signs of tick-borne encephalitis resemble manifestations of other diseases associated with damage to the nervous system, tumor processes and other pathologies.

REFERENCE! A patient with tick-borne encephalitis does not pose a danger to others at any stage, since in human body the virus has reached its final stage of development and is unable to be transmitted further.

What are the consequences after illness?

Tick-borne encephalitis can cause serious complications, including death. With the Western subtype of the disease, the mortality rate is 2-3%, with the Far Eastern variety - about 20%.

With irreversible damage to the nervous system, the patient may remain partially or completely disabled. People who have had to deal with complications of tick-borne encephalitis experience paralysis, muscle weakness, epileptic seizures, persistent speech disorders.

It is impossible to restore impaired body functions, so the person and his loved ones will have to adapt to their condition and completely change their lifestyle.

Diagnostics

To make a diagnosis if tick-borne encephalitis is suspected, modern methods blood tests and cerebrospinal fluid sick. Using serological testing to determine specific antibodies to the virus, it is possible to determine not only the fact of infection, but also the clinical features of its course. Sometimes the PCR method and virological research are used, but they are considered less accurate and informative.

If the entire tick can be removed, it is placed in a clean container and delivered to the laboratory, where testing is carried out for the presence of the virus antigen. This option for detecting infection is considered optimal, since treatment can begin immediately, before the first symptoms appear.

IMPORTANT! The most dangerous forms of tick-borne encephalitis are those characterized by damage to the cranial nerves and brain matter. In case of disruption of the respiratory center and vascular system there is a serious threat to human life.

Treatment

There is no specific treatment for tick-borne encephalitis. For several days after the bite, the patient can be given drugs containing immunoglobulins, which have a pronounced therapeutic effect and prevent complications.

If symptoms of damage to the nervous system occur, a person must be urgently taken to a hospital, where supportive and symptomatic therapy is provided.

For treatment, corticosteroids, anticonvulsants, drugs that normalize the functions of the nervous and of cardio-vascular system, vitamins. In severe cases, tracheal intubation and artificial ventilation are necessary. During the rehabilitation period, patients are prescribed massage, physical therapy, and sanatorium-resort treatment.

Protecting yourself from tick-borne encephalitis is much easier than dealing with the symptoms and complications of the disease. To do this, you need to take precautions while walking in nature, and after returning home, carefully examine your entire body. If, after spending time in a forest or park, a person has a fever and their health worsens, they should immediately consult a doctor.

Encephalitis is a group of diseases that are characterized by inflammation of the brain. In the territory Russian Federation Tick-borne encephalitis is widespread - viral infection, carried by ticks. This viral infection affects brain cells and nerve endings and, in the absence of the necessary prevention or treatment, can be fatal. We discussed how to prevent infection in the previous article “Prevention: how to protect yourself from a tick bite.” How to suspect tick-borne encephalitis and what to do if you think it really is? You will learn about this from the material below.

Symptoms of tick-borne encephalitis

Tick-borne encephalitis (alternative names: spring-summer or taiga encephalitis) is an acute viral pathology, which is part of the group of natural focal diseases. It is transmitted by ixodid ticks, but a person can become infected from wild or domestic animals and birds, as well as after consuming raw cow (goat) milk.

The incubation period for viral encephalitis ranges from 10 to 30 days. The development of the disease begins immediately after the pathogen enters the blood. Moreover, only a small amount is sufficient, which is carried with saliva, even if the tick has attached itself to the skin for a short time.

The development of encephalitis is accompanied severe pain in the muscles, headache, increased body temperature up to 40 degrees Celsius, sleep disorders, nausea and vomiting. The mentioned symptoms can last from a week to two, after which (if left untreated) more serious consequences occur.

The clinical picture depends on the forms of pathologies. There are the following types:

1. Feverish. The least dangerous type of pathology. It manifests itself in the form of a mild fever, after which the patient is cured without harm to health.
2. Meningeal. A fairly common form, it manifests itself in the form of headaches and stiffness of the muscles in the back of the neck. The pathology is accompanied by Kernig's symptom (the patient's leg, lying on his back, passively bends at an angle of 90° in the hip and knee joints (the first phase of the study), after which the examiner makes an attempt to straighten this leg at the knee joint (the second phase). If the patient has meningeal syndrome, it is impossible to straighten his leg at the knee joint due to a reflex increase in the tone of the leg flexor muscles; with meningitis, this symptom is equally positive on both sides) This form lasts from 6 to 14 days, after which remission occurs.
3. Meningoencephalitic. It is dangerous because in 20% of cases it leads to the death of the patient. In addition to the symptoms listed above, it is accompanied by hallucinations and delusions, psychomotor agitation, and muscle twitching.
4. Poliomyelitis. The symptoms are clear from the name and are similar to clinical manifestations polio. The patient suffers from fever and the muscles of his neck and arms are paralyzed.
5. Polyradiculoneuric. A very rare form of infection. Are affected ganglia, which manifests itself in numbness and tingling of the extremities.

To accurately diagnose the disease, it is necessary to take a blood test. The disease is identified by the presence of antibodies produced by the human immune system.

Treatment of tick-borne encephalitis

The disease is treated exclusively in a hospital setting. The patient must be placed in the infectious diseases department. Immunoglobulin, antibacterial drugs, stimulants and B vitamins are used for treatment.

After suppression of the virus in recovery period neuroprotectors are administered to the patient and a course is prescribed physical therapy and/or massage. Upon completion of the course of therapy, it is possible residual effects caused by encephalitis - atrophy shoulder girdle, full-blown seizures of epilepsy with muscle twitching.

Preventive actions

The best way to avoid infection and long-term treatment from tick-borne encephalitis - this preventive actions. Usually, vaccinations are used to protect the body, which are given in advance.

However, there is currently another effective remedy– yodantipyrine. This drug underwent clinical trials at the Siberian State Medical Institute, where it showed an effectiveness of more than 99%: out of 460 people taking yodantipirin, only 3 developed the virus.

Prevention before a tick bite using iodantipyrine is carried out according to the following scheme:

• 2 tablets 1 time per day throughout the spring-summer period, when there is a danger of tick bites and virus infection;

• 2 tablets 3 times a day 2 days before visiting an area where ticks may live.

If the tick has already attached itself to the skin, it must be removed with tweezers or thread, and then take a course of iodantipyrine according to the following scheme:

• 3 tablets 3 times a day for 2 days;
• 2 tablets 3 times a day for the next 2 days;
• 1 tablet 3 times a day for the next 5 days

After completing the course, you should re-donate blood for analysis.

Tick-borne encephalitis is an acute viral disease of the nervous system. The causative agent of the disease is a specific virus, which often enters the human body through a tick bite. Infection is possible by consuming raw milk from sick animals. The disease manifests itself with general infectious symptoms and damage to the nervous system. Sometimes it is so severe that it can lead to fatal outcome. People living in areas with a high prevalence of the disease are subject to preventive vaccination. Vaccination reliably protects against the disease. From this article you will learn how tick-borne encephalitis occurs, how it manifests itself and how to prevent the disease.

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 warm time years when ticks are most active. Taiga, because the natural focus of the disease is predominantly located in the taiga. Siberian - due to the distribution zone, and Russian - due to detection mainly in Russia and description of a large number of virus strains by Russian scientists.

Causes of tick-borne encephalitis

The disease is caused by a virus belonging to the arbovirus group. The prefix "arbo" means transmission by arthropods. The reservoir of the tick-borne encephalitis virus is ixodid ticks, which live in the forests and forest-steppes of Eurasia. The virus among ticks is transmitted from generation to generation. And, although only 0.5-5% of all ticks are infected with the virus, this is enough for periodic epidemics to occur. In the spring-summer period, there is an increased activity of ticks associated with their development cycle. At this time, they actively attack people and animals.

The virus reaches a person through the bite of an ixodid tick. Moreover, tick suction even for a short period of time is dangerous for the development of encephalitis, since the tick saliva containing the pathogen immediately enters the wound. Of course, there is a direct relationship between the amount of pathogen that has entered the human blood and the severity of the disease that has developed. The duration of the incubation period (the time from the pathogen entering the body until the first symptoms appear) also directly depends on the amount of virus.

The second method of infection is consumption of raw milk or food products made from thermally untreated milk (for example, cheese). More often, the disease is caused by the consumption of milk from goats, less often - from cows.

Another rare method of infection is the following: a tick is crushed by a person before being sucked on, but from contaminated hands the virus gets onto the oral mucosa if the rules of personal hygiene are not followed.

After entering the body, the virus multiplies at the site of penetration: in the skin, in the mucous membrane gastrointestinal tract. The virus then enters the blood and spreads throughout the body. The favorite place of localization of the virus is the nervous system.

Several types of virus have been identified that have a certain territorial affinity. In the European part of Russia there is a virus that causes less severe forms diseases. The closer to the Far East, the worse the prognosis for recovery, and the more common deaths are.

The incubation period lasts from 2 to 35 days. When infected due to consumption of infected milk, it lasts 4-7 days. You should know that a patient with tick-borne encephalitis is not dangerous to others, as it is not contagious.

Tick-borne encephalitis begins acutely. First, general infectious signs appear: body temperature rises to 38-40°C, chills, general malaise, diffuse headache, aching and nagging pain in muscles, weakness, sleep disturbance. Along with this, there may be abdominal pain, sore throat, nausea and vomiting, redness of the mucous membrane of the eyes and throat. In the future, the disease may progress in different ways. In this regard, several clinical forms of tick-borne encephalitis are distinguished.

Clinical forms of tick-borne encephalitis

Currently, 7 forms are described:

• febrile;
• meningeal;
• meningoencephalitic;
• polyencephalitic;
• polio;
• polioencephalomyelitis;
• polyradiculoneuritic.

Fever form characterized by the absence of signs of damage to the nervous system. The disease proceeds like a common cold. That is, the increase in temperature lasts 5-7 days, accompanied by general intoxication and general infectious symptoms. Then spontaneous recovery occurs. No changes in the cerebrospinal fluid (as in other forms of tick-borne encephalitis) are detected. If a tick bite has not been recorded, then usually there is not even a suspicion of tick-borne encephalitis.

Meningeal form, perhaps, is one of the most common. In this case, patients complain of severe headache, intolerance to bright light and loud sounds, nausea and vomiting, and pain in the eyes. As the temperature rises, meningeal signs appear: tension in the neck muscles, Kernig's and Brudzinski's symptoms. Possible disturbance of consciousness such as stupor, lethargy. Sometimes there may be motor agitation, hallucinations and delusions. The fever lasts up to two weeks. When carried out in the cerebrospinal fluid, an increase in the content of lymphocytes and a slight increase in protein are detected. Changes in the cerebrospinal fluid persist longer than clinical symptoms, that is, your health may improve, but the tests will still be poor. This form usually ends with complete recovery after 2-3 weeks. Often leaves behind a long-term asthenic syndrome, characterized by increased fatigue and fatigue, sleep disturbances, emotional disorders, poor tolerance to physical activity.

Meningoencephalitic form characterized by the appearance not only meningeal signs, as in the previous form, but also symptoms of damage to the brain substance. The latter are manifested by muscle weakness in the limbs (paresis), involuntary movements in them (from minor twitching to pronounced contractions in amplitude). There may be a violation of the contraction of facial muscles associated with damage to the nucleus of the facial nerve in the brain. In this case, the eye on one side of the face does not close, food flows out of the mouth, and the face looks distorted. Among other cranial nerves, the glossopharyngeal, vagus, accessory, and sublingual nerves are most often affected. This is manifested by speech impairment, nasal voice, choking when eating (food ends up in Airways), impaired tongue movements, weakness of the trapezius muscles. Possible disturbances in breathing and heart rate due to the lesion vagus nerve or centers of respiration and cardiac activity in the brain. Often with this form, epileptic seizures and disturbances of consciousness of varying degrees of severity occur, up to coma. An increase in the content of lymphocytes and protein is detected in the cerebrospinal fluid. This is a severe form of tick-borne encephalitis, in which cerebral edema may develop with dislocation of the brainstem and disruption of vital functions, as a result of which the patient may die. This form of tick-borne encephalitis often leaves behind paresis, persistent speech and swallowing disorders, which cause disability.

Polyencephalitic form characterized by the appearance of symptoms of damage to the cranial nerves on the 3-5th day of increased body temperature. The bulbar group is most often affected: glossopharyngeal, vagus, hypoglossal nerves. This is manifested by impaired swallowing, speech, and immobility of the tongue. The trigeminal nerves are also somewhat less likely to suffer, which causes symptoms such as sharp pains in the facial area and its deformation. At the same time, it is impossible to wrinkle your forehead, close your eyes, your mouth twists to one side, and food pours out of your mouth. Tearing is possible due to constant irritation of the mucous membrane of the eye (because it does not close completely even during sleep). Lesion develops even less frequently oculomotor nerve, which is manifested by strabismus, impaired movement of the eyeballs. This form of tick-borne encephalitis may also be accompanied by disruption of the respiratory and vasomotor centers, which can lead to life-threatening states.

Poliomyelitis form has this name due to its similarity with. It is observed in approximately 30% of patients. Initially, general weakness and lethargy, increased fatigue appear, against which minor muscle twitching (fasciculations and fibrillations) occurs. These twitchings indicate damage to the motor neurons of the anterior horns of the spinal cord. And then in upper limbs paralysis develops, sometimes asymmetrical. It may be combined with sensory loss in the affected limbs. Within a few days, muscle weakness affects the muscles of the neck, chest and arms. Appear following symptoms: “head hanging on the chest”, “bent and stooped posture”. All this is accompanied by pronounced pain syndrome, especially in the area of ​​the back of the neck and shoulder girdle. Less common is the development of muscle weakness in the legs. Usually, the severity of paralysis increases for about a week, and after 2-3 weeks, an atrophic process develops in the affected muscles (the muscles become exhausted and “lose weight”). Muscle recovery is almost impossible; muscle weakness remains with the patient for the rest of his life, making movement and self-care difficult.

Polioencephalomyelitis form characterized by symptoms characteristic of the previous two, that is, simultaneous damage to the cranial nerves and neurons of the spinal cord.

Polyradiculoneuritic form manifested by symptoms of damage to peripheral nerves and roots. The patient experiences severe pain along the nerve trunks, impaired sensitivity, paresthesia (crawling sensation, tingling, burning, etc.). Along with these symptoms, ascending paralysis may occur, when muscle weakness occurs in the legs and gradually spreads upward.

Described separate form tick-borne encephalitis, characterized by a peculiar two-wave course of fever. With this form, in the first wave of temperature rise, only general infectious symptoms appear, reminiscent of a cold. After 3-7 days, the temperature returns to normal and the condition improves. Then comes the “bright” period, which lasts 1-2 weeks. There are no symptoms. And then a second wave of fever occurs, along with which damage to the nervous system occurs according to one of the options described above.

There are also cases chronic course infections. For some reason, the virus is not completely eliminated from the body. And after a few months or even years, it “makes itself felt.” More often this manifests itself epileptic seizures and progressive muscle atrophy, which leads to disability.

The disease leaves behind a strong immunity.

Diagnostics

To make a correct diagnosis, the fact of a tick bite in areas where the disease is endemic is important. Since specific clinical signs there is no disease, then they play an important role in diagnosis serological methods, with the help of which antibodies against the tick-borne encephalitis virus are detected in the blood and cerebrospinal fluid. However, these tests become positive starting from the 2nd week of illness.

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). If a virus is detected in tick tissue, a preventive treatment- administration of specific anti-tick immunoglobulin or administration of Yodantipirin according to the regimen.

Treatment and prevention

Treatment is carried out using various means:

• specific anti-tick immunoglobulin or serum from those who have recovered from tick-borne encephalitis;
• apply antiviral drugs: Viferon, Roferon, Cycloferon, Amiksin;
• symptomatic treatment consists of the use of antipyretic, anti-inflammatory, detoxification, dehydration drugs, as well as drugs that improve microcirculation and blood flow in the brain.

Prevention of tick-borne encephalitis can be nonspecific and specific. Non-specific measures include the use of products that repel and destroy insects and ticks (repellents and acaricides), wearing clothing that is as closed as possible, a thorough examination of the body after visiting a forested area, and eating heat-treated milk.

Specific prevention can be emergency or planned:

• emergency is to use anti-tick immunoglobulin after a tick bite. It is carried out only in the first three days after the bite, later it is no longer effective;
• It is possible to take Yodantipirin for 9 days after the bite according to the following regimen: 0.3 g 3 times a day for the first 2 days, 0.2 g 3 times a day for the next 2 days and 0.1 g 3 times a day for the last 5 days ;
• planned prevention consists of vaccination. The course consists of 3 injections: the first two with an interval of a month, the last - a year after the second. This administration provides immunity for 3 years. To maintain protection, revaccination is required once every 3 years.

Tick-borne encephalitis is a viral infection that initially occurs under the guise of a normal colds.
It may go unnoticed by the patient, or may cause severe damage to the nervous system. The results of tick-borne encephalitis may also vary from full recovery to permanent disability. It is impossible to get tick-borne encephalitis again, since the infection leaves a lasting lifelong immunity. In areas endemic for this disease, it is possible to carry out specific prophylaxis and vaccination, which reliably protects against tick-borne encephalitis.

TV review, story on “Tick-borne encephalitis”:

Useful video about tick-borne encephalitis

Tick-borne encephalitis with symptoms of damage to cerebral structures is an acute viral pathology that occurs in people after a tick bite. The peak incidence, as a rule, occurs in the warm season - May-August, when the population actively visits the forest. Without corresponding antiviral treatment death may occur or the person becomes deeply disabled. However, if introduced specific vaccine The body develops special protection against encephalitis. Therefore, doctors urge people to be vaccinated against encephalitis ticks.

Since viral particles require a certain time to activate in the human bloodstream after a tick bite, at this moment no special signs of tick-borne encephalitis are observed. Sometimes there may be a slight malaise in the form of chills, weakness, and dizziness.

Subsequently, the onset of encephalitis is acute. Typical symptoms after a tick bite are:

• intensive discomfort in the joints, sacrum area;
• cephalalgia – pain in the head, especially in the area of ​​the eyeballs;
• nausea and even uncontrollable vomiting often do not bring relief;
• hyperthermia - with an increase in body temperature to 39 degrees;
• disturbances of consciousness - lethargy, or stupor, drowsiness.

After the tick-borne virus has moved into the medulla with its inflammation, the signs of encephalitis will be clear and making a correct diagnosis does not cause difficulties for specialists:

• increased sensitivity to sunlight;
• violations of superficial as well as deep sensitivity;
• failures in muscular system– activity is lost first in the facial muscles, and then in the limbs;
• convulsive involuntary contractions, epileptic seizures are possible;
• Increasing weakness - the inability to lift your head from the pillow, take care of yourself, or eat food on your own.

If the brain stem is involved in the pathological process, symptoms of cardiovascular/respiratory failure will appear simultaneously with persistent hyperthermic syndrome. This form of tick-borne encephalitis often ends in coma and death of a person.

Incubation period

The tick itself does not pose a danger to humans - the integumentary tissue’s own defenses are able to cope with such external aggression. With a weakened immune system and a large dose of the tick-borne virus that enters the bloodstream after a tick bite, encephalitis can form literally in a matter of hours.

Experts do not indicate the exact timing of the incubation period. Traditionally, it is customary to focus on the fact that in most cases signs of damage nerve structures occur 8–21 days after infection. Less commonly observed is a fulminant form - encephalitis occurs in 1-3 days, or a protracted form - tick-borne infection makes itself felt by the end of the month after the virus enters the body.

On average, the time it takes for signs of a tick bite to appear in a person is 1.5–3 weeks, since it all depends on the type of encephalitis. For example, the most common, meningeal, variant is characterized by rapid development clinical picture inflammation of the membranes of the brain. Whereas with polyradiculoneurotic encephalitis incubation period can be 2.5–3 weeks.

Causes

The basis of human tick-borne encephalitis infection in 2/3 of cases is, of course, the bite of the carrier tick. Damage to cerebral structures viral infection occurs after injection of particles dangerous to the nervous system into the bloodstream.

A characteristic of the tick-borne virus is its low resistance to exposure high temperatures and UV rays. Therefore, it practically cannot exist outside the host’s body. Meanwhile, in cold weather, viral particles external environment last a long time.

Tick-borne encephalitis develops not only when a person is bitten by an insect, but also from receiving milk from an infected cow - a nutritional route of infection. Less commonly, the virus penetrates through scratched skin that contains tick feces or particles of its damaged body.

Arobavirus enters human brain tissue exclusively from the outside in the following ways:

• tick bite;
• nutritionally – through products from infected animals;
• fecal-oral through dirty hands that contain tick waste products;
• through microtraumas on integumentary tissues– the virus is introduced by scratching the skin on which the tick was present.

Encephalitis can be avoided by carefully following generally available safety rules.

Diagnostics

Detection of the disease after a tick bite is facilitated by the correct collection of anamnesis - the doctor asks the person whether he has recently visited the forest, whether he has traveled to those regions where the epidemic situation for tick-borne encephalitis is unfavorable. Then the specialist examines the integumentary tissue - identifying wounds or inflammatory areas of the skin that may indicate a pre-existing bite. This is especially true if encephalitis is suspected in children. After all, children are not always able to answer questions that interest a specialist.

Will confirm preliminary diagnosis tests for tick-borne encephalitis:

• examination of a directly infected tick;
• PCR diagnostics – detection of virus particles in the cerebrospinal fluid, as well as in the blood;
• The serological concentration of antibody titer to the virus is its decrease/increase in two sera that were taken with a break of two weeks.

From additional instrumental studies To determine encephalitis in a person, a doctor may recommend electroencephalography and computed tomography brain. After collating all the information from diagnostic procedures the specialist gives his opinion and selects the optimal therapy.

Treatment tactics

For effective fight with signs of tick-borne encephalitis, treatment should be started on the day of the bite and in full. Anti-encephalitis immunoglobulin therapy has proven itself to be excellent. Administration of an inactivated vaccine with ribonucleic acid is beneficial if the procedure is carried out immediately 1.5–3 hours of suspected encephalitis after a tick bite.

For complex treatment tick-borne encephalitis, a person must be admitted to a hospital, where he is immediately injected with immunoglobulin - strictly under the supervision of a doctor. It is with its help that the infected person’s own immune system is able to quickly cope with the insidious neurotropic virus.

In the future, after a tick bite, treatment follows the principles of symptomatic therapy:

• antipyretics – antipyretics;
• detoxifying solutions – accelerating the removal of toxins from tissues;
• vitamins - to boost immunity, improve the functioning of the nervous system;
• medications that correct the water-salt balance in the body;
• antiemetics;
• analgesics.

The manifestations of tick-borne encephalitis in children are more severe. Therefore, doctors observe them longer and are in no hurry to discharge them from the hospital for outpatient observation by neurologists. In the future, dispensary monitoring of children should be at least three years old.

Prevention

As such, specific prevention tick-borne encephalitis is a three-time vaccination. After all, the body then produces anti-tick antibodies. The National Calendar for Universal Immunization of the Population does not provide for a similar procedure. However, each person at will may consult a doctor to be vaccinated against tick-borne infection.

Nonspecific prevention of the disease:

• stop eating unpasteurized products, especially dairy;
• when traveling to the forest, wear clothes that will completely cover all parts of the body;
• promptly contact a medical facility if a case of a tick bite has been identified;
• be sure to use repellents;
• Carefully follow the rules of personal safety during the season when ticks are active - take a hygienic shower and inspect your clothes and clothes after each trip to the countryside or to the country.

Great attention is paid to maintaining the health of the population medical workers. However, every person should know and be able to apply the rules for preventing tick bites.

Consequences and complications

Since human infection does not occur in all cases of human collision with forest insects, the percentage of complications of tick-borne encephalitis among those bitten is low. The prognosis largely depends on the type of pathology and the initial state of health of the patient.

The main consequences of an encephalitis tick bite in humans are:

• persistent headaches;
• tendency to epilepsy;
• various sensitivity disorders;
• decreased memory and intellectual capabilities.

In severe cases of the disease, the encephalitis tick in humans provokes complications such as paralysis of the muscles of the arms and lower extremities, sudden weakening brain activity, chronic focal disorders. People become deeply disabled, and it is not possible to return them to society.

The prognosis is more favorable for the febrile form of encephalitis - recovery reaches 2/3 of cases. Whereas with meningoencephalitis, complications occur more often and are more severe.