Tick ​​diseases in humans, methods for their detection and treatment

Hello! Those people who have been living in the countryside for a long time have gradually become more relaxed about ticks and their bites.

This does not cause such a panic as the first contact with these insects. But do not be too frivolous about the threat of a tick bite.

In some situations, the consequences can be very dangerous in the form of serious diseases. Want to learn about the most common tick diseases in humans? What are the symptoms that appear first? Then read all the details in the article below.

Tick-borne borreliosis (lime disease)

Tick-borne borreliosis (Lyme disease) is an infectious vector-borne natural focal disease caused by spirochetes and transmitted by ticks, which is prone to chronic and recurrent course and predominant damage to the skin, nervous system, musculoskeletal system and heart.

Cause. The causative agents of Lyme disease are spirochetes of the genus Borrelia. The causative agent is closely associated with pasture (ixodid) ticks and their natural hosts. The common vector for the pathogens of tick-borne tick-borne borreliosis and tick-borne encephalitis viruses causes the presence in ticks, and therefore in patients, of cases of mixed infection.

The geographical distribution of Lyme disease is extensive, it is found on all continents (except Antarctica).

Leningrad, Tver, Yaroslavl, Kostroma, Kaliningrad, Perm, Tyumen regions, as well as the Ural, West Siberian and Far Eastern regions on pasture (ixodid) tick-borne borreliosis are considered very endemic (a constant manifestation of this disease in a certain area).

Infection with Lyme disease pathogens of ticks - carriers in different natural foci can vary in a wide range (from 5-10 to 70-90%).

Lyme disease is not contagious to others.

The process of developing the disease. Infection occurs when bitten by an infected tick. Borrelia with tick saliva enter the skin and multiply for several days, after which they spread to other parts of the skin and internal organs (heart, brain, joints, etc.).

Borrelia for a long time (years) can persist in the human body, causing a chronic and relapsing course of the disease.

The chronic course of the disease can develop after a long period of time. The process of developing a disease with borreliosis is similar to the process of developing syphilis.

A characteristic sign of the onset of the disease in 70% of cases is the appearance of redness of the skin at the site of the bite with a tick. The red spot gradually increases on the periphery, reaching 1-10 cm in diameter, sometimes up to 60 cm or more.

The spot shape is round or oval, less often irregular. The outer edge of the inflamed skin is more intensely red, rises somewhat above the level of the skin.

Over time, the central part of the spot fades or acquires a bluish tint, a ring shape is created. In the place of the tick bite, in the center of the spot, a crust is determined, then a scar. The spot without treatment persists for 2-3 weeks, then disappears.

Recognition of the disease. The appearance of a red spot at the site of a tick bite gives reason to think primarily about Lyme disease. A blood test is performed to confirm the diagnosis.

Treatment should be carried out in an infectious diseases hospital, where, first of all, therapy is carried out aimed at the destruction of borrelia. Without such treatment, the disease progresses, becomes chronic, and in some cases leads to disability.

Clinical examination. Those who are ill are under medical supervision for 2 years and are examined after 3, 6, 12 months and after 2 years.

Protection in endemic foci can be achieved with the help of special anti-mite suits with rubber cuffs, zippers, etc.

For these purposes, you can adapt ordinary clothes, tucking a shirt and trousers, the latter into boots, tightly fitting cuffs, etc. Various repellents - repellents (DETA, Diftolar, etc.) can prevent mites from attacking open areas of the body for 3-4 hours.

The use of clothing impregnated with the Permet preparation fully protects against crawling and tick bites during the day spent in the outbreak.

When a tick bite occurs, the next day, it should come to the infectious diseases hospital with the tick removed to examine it for borrelia.

In order to prevent Lyme disease after being bitten by an infected tick, doxycycline is recommended to take 1 tablet (0.1 g) 2 times a day for 5 days (children under 12 are not prescribed).

What diseases do ticks carry?

Today, science knows more than 48 thousand species of ticks that live on all continents and feel quite comfortable in any climate zone. People and animals should be afraid of only three species: ixodic, argassic and gamazovye, which are attracted by the heat of a living organism.

They are carriers of tick-borne encephalitis virus, Q fever, tularemia, North Asian tick-borne rickettsiosis, human monocytic ehrlichiosis (MEC), human granulocytic anaplasmosis (GAC) and some other diseases.

Argas ticks usually live in nests, burrows, caves, and clay buildings. And gamasid ticks - the causative agents of vesicular rickettsiosis - live in all climatic zones in the upper layers of the soil, forest litter, in rodent nests, and bird houses.

The largest group of ticks - ixodidae - is most often activated twice a year: from April to May and from August to September. In southern Russia, the most common species is Hyalomma marginatum, which is active from April to August.

This may be labor activity related to animal husbandry and agricultural work, hunting, tourism or, let's say, outdoor recreation.

Infection of a human with CVE is possible by an alimentary route - by eating raw goat milk. Birds are capable of carrying ticks over long distances.

What diseases do ticks transmit?

Tick-borne viral encephalitis (CVE) is an acute infectious viral disease that most commonly affects the central nervous system.

Human Monocytic Ehrlichiosis (MEC) is an infection that affects the skin, liver, central nervous system and bone marrow. Most often, the disease is diagnosed in children and patients older than 40 years.Typical symptoms of the disease: fever, fever, chills, headache, weakness, loss of appetite. Some patients develop a rash, abdominal pain, vomiting, and diarrhea.

Tick-borne infectious borreliosis (Lyme disease) is an infectious disease that can cause disturbances in the functioning of the nervous system, musculoskeletal system and heart. It is also often characterized by skin lesions.

Crimean hemorrhagic fever (CHF) - also known as Crimean Congo hemorrhagic fever. This is an acute infectious disease, which is accompanied by fever, multiple bleeding. First described in Crimea.

Tularemia is an infection whose causative agent parasitizes in the body of a certain animal species and dies after 10 minutes at a temperature of 60 ° C. In the case when a person becomes ill, the disease affects the lymph nodes, the skin, sometimes the eyes and lungs. Infection is accompanied by severe intoxication.

Vesicular rickettsiosis is an acute infectious disease characterized by fever and rash.

Relapsing tick-borne fever is a disease that is accompanied by fever, nausea, vomiting, headache, fever, which is often replaced by chills and pain in the joints and muscles. It is found all over the world except Australia.

Tsutsugamushi fever is an acute febrile disease that causes a family of intracellular rickettsia parasites.

Tick-borne rickettsiosis is an infectious disease characterized by fever, headache, rash, a sharp increase in temperature, chills, pain in joints and muscles.

Q fever (Rocky Mountain Spotted Fever, tick-borne typhus, Marseille or Mediterranean fever) is an infectious disease that most often affects people caring for animals.

The disease is accompanied by fever, pain in the lower back, muscles and joints, loss of appetite, sweating, dry cough and sleep disturbances. In infected people, pneumonia and tracheobronchitis are also often found.

Tick-borne diseases

Russia is one of the world's largest areas of infectious diseases transmitted by ticks. Every year, hundreds of thousands of patients come to doctors of various specialties for a tick bite.

Ticks are known to carry a number of human diseases, the causative agents of which are viruses, bacteria and protozoa.

All diseases have some common features: natural focality, seasonality (usually spring-summer), transmission of the pathogen to the person by ixodid ticks during bloodsucking, acute onset of the disease, fever, symptoms of intoxication, signs of damage to the nervous system, various rashes on the skin.

With the act of bloodsucking, the tick injects painkillers, vasodilators and other substances into the human skin, and along with them the pathogens that are in the intestines and salivary glands of ticks. Tick ​​suction, as a rule, does not cause pain and passes unnoticed.

The most preferred tick locations are the neck, armpits, chest and inguinal folds. A tick that has drunk blood increases tenfold, taking the form of a dense gray or light ball.

About 25% of diseased persons do not indicate the absorption of ticks: it occurs either within a short period of time, or in an area of ​​the body that is difficult to detect.

Natural foci of CE are registered in all forest and taiga zones of Russia. The incidence of TB is especially high in the Urals, the Urals and Siberia. CE endemic to the Kaliningrad and Leningrad regions. In 2008, for the first time in many years, several ticks were infected with TBE virus in several regions of the Moscow Region.

Infection of humans with TBE can occur not only during the suction of ticks, but also by the alimentary route when consuming raw goat or cow's milk.

The incubation period is from 5 to 25 days, with alimentary infection it is shortened to 2-3 days. In CE, the number of manifest forms is related to the number of subclinical (asymptomatic) ones as 1: 100–200 or more.

Some researchers believe that there is a definite relationship between the clinical manifestations of TBE and the genome of the pathogen.

Since the beginning of the study of CE, based on clinical and laboratory studies, there are: febrile (obliterated), meningeal and focal, or paralytic, forms of the disease.

The main share in the CE structure is occupied by the febrile and meningeal forms. They account for 80 to 90 percent or more of diseases. These are generally quite benign, in most self-sustaining forms, which do not require special treatment.

Any form of TBE begins acutely, with chills, a rapid increase in body temperature to high numbers, severe headache, myalgia. Photophobia, pain in eyeballs are possible. Patients are usually lethargic, drowsy, less often excited. When examined, hyperemia of the skin of the face, neck, upper body and mucous membrane of the oropharynx, scleritis, conjunctivitis attract attention. General hyperesthesia is characteristic.

The febrile form is limited to the above symptoms; the duration of the febrile period ranges from several hours to 5-6 days, two-wave fever is possible. After persistent normalization of body temperature, the condition of patients improves, but asthenic syndrome can persist for another 2-3 weeks.

With the meningeal form, in addition to the symptom complex inherent in the febrile form, the meningeal syndrome is joined: vomiting at the height of the headache, severe general hyperesthesia, stiff neck muscles, pain when pressing on the eyeballs, symptoms of Kernig, Brudzinsky, etc.

Sometimes, focal neurological symptoms can also be transiently detected: asymmetry of the face, anisocoria, nystagmus, etc. With lumbar puncture, cerebrospinal fluid (CSF) flows under increased pressure, transparent, sometimes opalescent.

Pleocytosis is from several tens to several hundred cells, in the first days it can be neutrophilic, then lymphocytic; the protein content in CSF is moderately increased, glucose is normal; these data indicate the development of serous meningitis.

Fever lasts up to two weeks, changes in CSF persist for a relatively long time: from several weeks to several months. In the period of convalescence, asthenovegetative syndrome is present for a long time.

The focal (paralytic) form differs from the two described above by the severity of the course and high mortality.Against the background of fever, general infectious and meningeal syndromes, cerebral symptoms appear in the form of impaired consciousness, motor excitement, seizures (generalized tonic-clonic or focal).

Another feature of CE is the development of the Kozhevnikovskaya epilepsy syndrome in some patients - the most serious condition in the form of constant muscle contractions in one half of the body - myoclonus, periodically aggravated by generalized epileptic seizures.

The only characteristic feature of CE is the transition of the disease in some patients to a chronic, progressive process, which ends in death.

According to the materials of domestic epidemiologists, in different natural foci, depending on specific environmental conditions, up to 5–10% of adult individuals simultaneously infected with borrelia and TBE virus can be found in taiga tick populations.

Currently, there is no radical treatment for paralytic lesions in TBE, which brings these forms of the disease closer to polio.

The only real way to prevent the development of severe disabling and fatal consequences in TBE is prevention - the introduction of a tick-borne encephalitis vaccine.

In recent years, the production of anti-tick-borne immunoglobulin has been discontinued in Europe (previously it was used there only for prophylactic purposes), which is argued by the danger of an antibody-dependent increase in the infectious process and the lack of evidence-based methods indicating its positive effect.

Another tick-borne disease is tick-borne tick-borne borreliosis - IKB (synonyms: Lyme borreliosis, tick-borne erythema, tick-borne tick-borne borreliosis) - a widespread infectious natural focal bacterial disease with a vector-borne transmission, often taking a chronic, recurrent course and affecting a number of body systems.

IKB diseases are widespread in the eastern and western hemispheres. Cases of the disease are noted in the USA, Canada, practically throughout Europe (except for the Benelux countries and the Iberian Peninsula), Russia, Mongolia, Northern China, Japan and other countries.

According to the estimates of domestic epidemiologists, the number of cases in our country reaches 10–11 thousand people every year. Probably, this figure is underestimated, because in Germany, a country with a smaller population and a more favorable epidemiological situation than Russia, the annual number of cases is about 60 thousand people, in the United States - more than 13 thousand people.

The causative agent of ICD, B. burgdorferi, belongs to the family of spirochetes, is isolated from vector ticks, and in patients with ICD from the erythema zone that develops at the site of suction of the tick, from blood, CSF, synovial fluid with Lyme arthritis, etc.

The bulk of diseases are observed in the spring-summer period (April-June), but the incidence season can shift significantly depending on weather conditions - the sooner the warm period begins, the faster ticks wake up and become active, which means they often attack a person.

In the spring-summer period, the first peak in incidence occurs. The second - at the end of summer, the beginning of autumn (August-October).

Getting with tick saliva into the general blood stream, Borrelia spreads throughout the body, settling in various organs (brain, heart, joints, eyes, liver) and causing inflammatory changes in them. This acute organ damage as a result of dissemination of infection characterizes the second stage of ICD.

In accordance with the periods of infection and the signs of their clinical manifestation, three stages of the disease are distinguished: the first - local infection, the second - disseminated infection (acute organ damage) and the third - persistent infection (chronic organ damage).

To assign the disease to the third stage of ICD, the duration of inflammatory changes on the part of the affected organ should be at least 6 months. The sequence of organ damage described above is the exception rather than the rule, and it is rarely possible to see in a patient with ICD the chronological following of one stage after another described above.

The manifestations of one or two stages of the disease in one patient are more common. So, in a patient with symptoms of the second stage of ICD, there may be no manifestations of a local infection or the third stage of ICD can manifest without acute damage in the first two phases of the disease.

The stages of the disease are determined by the clinical signs of the predominant involvement of the affected organ, if the time of onset of the disease is known, or by the duration of the disease, if there is no exact indication of the initial period of the disease.

IKB can occur with a sequential alternation of all stages of the disease, with the “skipping” of one of the stages or the primary manifestation at any stage.

At the local stage, the incubation period of the disease ranges from 1 to 30 days, averaging 7-10 days. The onset of the disease in the vast majority is gradual. A spot or papule appears at the site of suction of the tick.

Erythema is one of the characteristic pathognomonic signs of ICD and is the "gold standard" for diagnosing the disease. Due to its inherent property of increasing in size, it is called "migratory tick-borne erythema."

Erythema may be the only sign of an acute period, but more often it is accompanied by other symptoms of the disease: regional lymphadenopathy, malaise, weakness, myalgia, arthralgia, respiratory manifestations, fever up to 37–38 ° C, rarely higher; chills, headache, nausea, and vomiting.

In some patients, the disease can end at this stage and erythema can disappear spontaneously. In another part of erythema persists for weeks and even months and against its background there are signs of damage to other organs.

The second stage of the disease (disseminated infection) is characterized by acute organ damage to the nervous system (neuroborreliosis); internal organs (heart, joints, liver) and organ of vision (ophthalmoborreliosis).

The second stage of ICD develops 2-10 weeks after the acute period. Neurological manifestations with ICD are quite diverse, but most researchers point to the three most common types of lesions of the nervous system: radiculoneuritis, neuritis of the cranial (facial) nerves and meningitis.

In half or more cases, a combination of these syndromes of lesion is observed, manifested in various symptom complexes. Cardiac disorders are observed from 4-5 weeks of the appearance of erythema.

They include changes of 1-3 degrees of atrioventricular conduction, disturbances of intraventricular conduction, atrial fibrillation and others. The duration of cardiac disorders is short and does not exceed several weeks. Serious abnormalities in the form of dilated cardiomyopathy and fatal pancreatitis are also observed.

In the case of tick-borne erythema in the acute period of the disease, the interval between erythema and the onset of neurological symptoms is usually 4-12 months.

The main forms of the third stage of ICD are considered to be: neuroborreliosis (progressive encephalomyelitis; cerebrovascular neuroborreliosis; mono- or polyneuritis), combined with chronic atrophic acrodermatitis (HAA); dermatoborreliosis (XAA, benign skin lymphadenosis); mono - and polyarthritis.

Decisive help in the diagnosis of ICD, especially those that occur without tick-borne erythema, can be provided by serological testing for antibodies to B. burgdorferi. The most commonly used reactions are: indirect method of fluorescent antibodies (nMFA), enzyme-linked immunosorbent assay (ELISA), immunoblot.

They are replaced by IgG antibodies, which appear at weeks 3-4 of the ICD and persist for months or years. Unfortunately, serological tests for IKB are not standardized. The presence of antibodies to borrelia confirms infection with B. burgdorferi, but is not an absolute criterion for the active or inactive phases of the disease.

A number of researchers point to molecular polymorphism of the causative agent genoids, manifested in the heterogeneity of the surface proteins of B. burgdorferi, which entails difficulties in the serodiagnosis of ICD.

Treatment of ICD is carried out with broad-spectrum antibiotics. They are administered orally in the erythema stage and parenterally iv in case of neuroborreliosis and XAA in the second and third stages of ICD.

The duration of treatment is from 10 days to a month. In the second and third stages, the main drug is ceftriaxone (2 g / day), it is possible to use cefotaxime, massive doses of penicillin. The duration of treatment is 2 weeks.

Tick-borne spotted fever

The group of tick-borne spotted fever (CPL) includes a number of natural focal diseases caused by rickettsia of vector-borne diseases, among which are long-known (Marseille or Mediterranean fever, Rocky Mountain spotted fever, tick-borne typhus of North Asia, vesicular rickettsiosis, etc.) first described (Japanese and Israeli spotted fevers, African tick-borne fever), including in our country - Astrakhan spotted fever and Far Eastern tick-borne rickettsiosis.

This list continues to replenish, new representatives of rickettsia open, previously unknown diseases are described.

In Russia, natural foci of KPL are widespread. Tick-borne typhus in North Asia (the causative agent of Rickettsia sibirica) is recorded in Western and Eastern Siberia, Altai, Krasnoyarsk, Khabarovsk and Primorsky Territories.At the beginning of the XXI century, the incidence increased, up to 3000 cases and more are detected annually; This is the most common rickettsiosis in Russia.

Marseilles fever (causative agent of R. conorii) occurs in the coastal regions of the Black and Azov Seas; Astrakhan (pathogen R. conorii subtype caspiensis) - in the lower Volga, Astrakhan region, Kalmykia and Western Kazakhstan.

All CPLs share some common clinical features, including:

• the presence of primary affect at the site of suction of the tick in the form of a papule or a painless small infiltrate with necrosis in the center, covered with a dark (black) crust / scab;
• regional lymphadenitis;
• acute onset of the disease after an incubation period, the average duration of which is 1-2 weeks;
• cyclic flow (initial period - until the rash appears;
• then periods of high and convalescence);
• chills, fever from 3 to 10 days;
• intoxication (usually moderate);
• headache, weakness, myalgia, arthralgia, insomnia;
• flushing of the skin of the face and neck, scleritis, conjunctivitis;
• enlarged liver;
• the appearance of exanthema 3-4 days after an increase in body temperature.

The rash is usually plentiful, spotty-papular, on the skin of the trunk and extremities, including often on the palms and soles, not itchy. After 5-7 days, the rash disappears, and pigmentation of the skin remains in its place.

CPL is usually benign. The exception is Rocky Mountain Spotted Fever, found in the Americas.

The diagnosis is confirmed by the detection of antibodies to antigens of the corresponding rickettsia in various laboratory methods: indirect immunofluorescence reaction (RNIF), ELISA, complement binding reaction (CSC), indirect hemagglutination reaction (RNGA).

CPL is treated with tetracycline drugs (doxycycline 0.2 g / day), fluoroquinolones (ciprofloxacin 0.5 g 2 times a day) or macrolides (erythromycin 0.5 g 4 times a day).

Specific prophylaxis using a vaccine is designed only for Rocky Mountain spotted fever, while non-specific prophylaxis is similar to that for all tick-borne diseases.

It has been established that the main reservoir of infection is the water rat, red vole, muskrat, as well as ticks Dermacentor pictus and D. marginatus. No human infections were observed. Natural foci of OHL were identified in the regions of Omsk, Novosibirsk, Tyumen, Kurgan, and Orenburg regions.

The gates of infection are the skin at the site of the tick bite or its minor injuries, infected by contact with the muskrat or water rat. At the gates of the infection, primary affect is not observed. The virus enters the blood, spreads hematogenously throughout the body and affects mainly the vessels, nervous system and adrenal glands.

The incubation period lasts from 2 to 4 days. The disease begins suddenly, an increase in body temperature reaches 39–40 ° C. General weakness, intense headache, muscle pain appear. Patients are inhibited, reluctant to answer questions. The temperature remains at a high level for 3-4 days, then lytically decreases by 7-10 days of illness.

From 1–2 days, most patients develop a hemorrhagic rash. The skin of the face, neck and upper parts of the chest is hyperemic, the face is puffy, the scleral vessels are injected.

Nasal, pulmonary, intestinal, uterine bleeding appears. There is a decrease in blood pressure, deafness of heart sounds, bradycardia, dicrotism of the pulse and certain extrasystoles. 30% of patients develop pneumonia (small-focal), there may be signs of kidney damage (proteinuria, microhematuria, cylindruria).

From the side of the central nervous system, signs of meningitis and meningoencephalitis are noted (in severe forms of the disease). In the blood - pronounced leukopenia (1200–2000 in 1 μl), ESR is not increased. To confirm the diagnosis, RSK, a neutralization reaction are used. Etiotropic treatment is not developed.

Crimean hemorrhagic fever (CHF) is an acute viral disease related to zoonoses with natural foci. It is characterized by two-wave fever, general intoxication, severe thrombohemorrhagic syndrome, severe course.

The reservoir of the virus is wild small mammals (forest mouse, small ground squirrel, brown hare, eared hedgehog), as well as domestic animals (sheep, goats, cows). The carrier and keeper are ticks from the genus Hyalomma. The incidence is characterized by seasonality with a maximum from May to August (in our country).

The disease occurs in the Crimea, Astrakhan, Rostov, Volgograd regions, Krasnodar and Stavropol territories, in Chechnya, Kalmykia, as well as in Central Asia, China, Bulgaria, Yugoslavia, and in sub-Saharan Africa (Congo, Kenya, Uganda, Nigeria and other).

CHF is a dangerous infectious disease. Infection occurs not only when bitten by an infected tick or when it is crushed, but also when it comes into contact with the skin or mucous membranes of the blood and bloody discharge of the patient.

A constant symptom is a fever, which lasts an average of 7-8 days. Before the onset of hemorrhagic syndrome, a decrease in body temperature to subfebrile is noted, after 1-2 days the body temperature rises again (the "two-humped" temperature curve).

During the height of the disease (2-4 days from the onset of the disease), hemorrhagic rash appears on the skin and mucous membranes, hemorrhages at the injection site, nasal, gastrointestinal, uterine bleeding, hemoptysis, etc.

Sick listless, dynamic, sometimes, on the contrary, excited. Meningeal syndrome is not uncommon. The severity of thrombohemorrhagic syndrome determines the severity and outcome of the disease. The convalescence period is calculated in several months.

A CHF patient is hospitalized in the box of an infectious diseases hospital. Ribavirin is recommended as an etiotropic drug.

Ehrlichiosis as an epidemic infectious disease was first recognized in the USA in 1986. Two etiologically and epidemiologically different forms of the disease are distinguished: monocytic human ehrlichiosis (MEP) caused by E. chaffeensis and human granulocytic ehrlichiosis (EHP), or anaplasmosis caused by E. phagocytop .

Pathogens are transmitted to humans through the bite of infected ticks, which they receive when they feed them on infected animals. Ehrlichia belong to the Rickettsiae family, have a characteristic rounded shape with a membrane bounding it from the outside.There are publications on the detection of patients in Germany, England, Scandinavia, France.

The duration of the incubation period with ehrlichiosis is an average of 8-14 days.

Clinically, MEP and HEC are almost indistinguishable and are characterized by a complex of symptoms: sudden onset, chills, fever, headache, myalgia, thrombocytopenia, leukopenia, increased activity of liver enzymes. A rash is observed in approximately 1/3 of patients with LES, but is rare in patients with HES.

Exanthema appears on days 1–8 of the disease, first on the extremities, then on the trunk, face and neck, not abundant, mostly spotty, sometimes petechial. The duration of the febrile period is from several days to 3 weeks. The course of the disease varies from mild benign to extremely severe.

In a number of cases, complications such as respiratory distress syndrome, renal failure, neurological disorders, disseminated intravascular coagulation are noted. Mortality with LEC is 5%, with HEC - 10%, although, obviously, the true mortality can be higher.

For diagnosis, the most commonly used RNIF. Cases of the disease are confirmed by a 4-fold increase in antibody titers in RNIF or a single titer of specific antibodies in RNIF ≥ 64, positive PCR. Microscopy of Wright blood smears in monocytes or granulocytes reveals intracellular inclusions of the corresponding Ehrlichia.

Ehrlichia are sensitive to tetracycline drugs, chloramphenicol, which allows you to quickly and effectively treat this disease. Cases of co-infection with Lyme borreliosis and ehrlichiosis have been reported.

Babesiosis, or pyroplasmosis, is an acute infectious disease accompanied by fever, intoxication, anemia, and a severe progressive course. Babesiosis is a vector-borne parasitic zoonotic infection.

When stained according to Gram, they look like thin rings with a diameter of 2-3 microns or pear-shaped formations with a diameter of 4-5 microns. To date, a little more than 100 cases of human babesiosis have been described in world literature, most of which have ended lethally.

Forms of the disease with a manifestation of infection were observed in individuals with severe disorders of the immune system (after splenectomy, with HIV infection, etc.). In people with a normal immune system, the disease is asymptomatic, despite the presence of parasitemia, reaching 1–2%.

The disease occurs in Europe (Scandinavia, France, Germany, Yugoslavia, Poland, Russia) and in the USA (East Coast). The host is vole mice and other mouse-like rodents, dogs, cats and cattle.

After suctioning the tick, the pathogen enters the bloodstream and into red blood cells. Babesia replication occurs in red blood cells, which are lysed not only under the influence of parasites, but also under the influence of anti-erythrocyte antibodies. When the number of affected red blood cells reaches 3-5%, clinical manifestations of the disease are observed.

During the destruction of red blood cells, the vital products of babesia and heterogeneous proteins enter the bloodstream, which causes a powerful pyrogenic reaction and other toxic manifestations of the disease.

The incubation period lasts from three days to three weeks (an average of 1-2 weeks). The disease begins acutely with chills and fever up to high numbers. Fever is accompanied by severe weakness, adynamia, headache, epigastric pain, nausea and vomiting.

From 3-4 days of illness against the background of increasing intoxication, pale skin, an increase in the liver, jaundice, oligoanuria are observed. Subsequently, in the clinical picture, the symptoms of acute renal failure come to the fore.

The lethal outcome is caused by uremia or by joining intercurrent diseases (pneumonia, sepsis, etc.). Clinical diagnosis is difficult due to the rarity of the disease. Long-term fever due to anemia, hepatomegaly, renal pathology, lack of effect from taking antibiotics force us to conduct laboratory tests for babesiosis.

It is important to take into account the epidemiological data (tick bites, stay in an endemic area), the identification of violations of the immune status. The diagnosis is confirmed by the detection of the pathogen in a smear and a thick drop of blood, as well as in the RNIF.

Differential diagnosis is carried out with tropical malaria, sepsis, blood diseases, HIV infection. The basis of treatment is early antiparasitic therapy. The use of quinine (650 mg / day) and clindamycin (2.4 g / day) for 2–3 weeks is effective. Without etiotropic treatment, the disease often (50–80% of cases) is fatal.

Tick-borne fevers Kemerovo, Lipovnik - “new” zoonotic natural focal arbovirus infectious diseases with a transmissible mechanism of transmission of pathogens. The causative agent is RNA-containing viruses from the Reoviridae (Orbivirus) family of the Kemerovo group.

The reservoir and sources of the pathogen are rodents, small mammals, birds. The main species supporting the existence of viruses in nature are Dermacentor spp mites.

The natural susceptibility of people is high. After the disease, immunity remains. Repeated diseases are rare. Kemerovo fever was detected in the forest and forest-steppe part of the Kemerovo region of Russia, Lipovnik fever - in several European countries.

The duration of the incubation period is 4–5 days. Clinically characterized by two-wave fever, intoxication, sometimes a rash, hemorrhage, signs of meningoencephalitis, myocarditis. Laboratory diagnostics and treatment are under development.

So, on the territory of Russia in the warm season, the risk of infection with one or several infections transmitted by ixodid ticks is real. Clinical diagnosis of them is difficult, laboratory in the early stages is not always informative.

The population should be encouraged to take protective measures when visiting forests, parks and other mite habitats (putting on clothes such as overalls, using repellents, self and mutual inspection). If a tick is found, it should be removed immediately and consult a general practitioner or infectious disease specialist.

It is advisable to conduct a study of the tick for the presence of possible pathogens in it. If a TBE virus is detected in a tick, the victim is given an anti-encephalitic immunoglobulin, Borrelia - antibiotics (doxycycline or amoxicillin) are prescribed for 7-10 days.

Tick ​​bite diseases: 7 tick-borne diseases

Ticks are ectoparasites that promote the circulation of pathogens of natural focal diseases.They can transmit different pathogens from one host to another while sucking blood.

The most relevant among transmissible natural focal diseases from ticks in humans are: Lyme disease (borreliosis), tick-borne encephalitis, ehrlichiosis.

These infections are very difficult, can lead to disability, have a chronic course and a long rehabilitation period (up to 1 year). Ticks also carry: tick-borne relapsing fever, tularemia, babesiosis, spotted fever.

Diseases transmitted by ticks are characterized by various pathological processes in the human body.

Lyme Disease or Borreliosis

It can be transmitted by three types of bacteria of the genus Borrelia. In the Northern Hemisphere, this is the most common tick-borne infection.

The clinical presentation is characterized by skin manifestations with the addition of neurological, articular and cardiac symptoms.

Tick-borne encephalitis

It is transmitted by arbovirus, which belongs to the genus Flavivirus. Ticks become infected from animals and transmit the virus to humans.

The disease is accompanied by biphasic fever, damage to the central nervous system (encephalitis, meningitis) and needs intensive treatment. May lead to persistent neurological and psychiatric complications.

Ehrlichiosis

Among tick-borne diseases, monocytic ehrlichiosis is a relatively young infection. The pathology was first detected in 1987 in the United States.

Pathogens (ehrlichia) enter the body with tick saliva and, multiplying, lead to inflammatory processes of a different nature in the internal organs.

Clinical manifestations have a wide spectrum: from an asymptomatic form of the course to death.

Tick-borne relapsing fever

This acute infectious disease is transmitted by ticks of the family. The pathology is caused by borrelia, manifests itself in febrile recurrent seizures. The disease is more likely to be benign; deaths are an exception.

Tularemia

Clinical manifestations depend on the form of the disease. A characteristic feature is an increase in lymph nodes to the size of a walnut. Pathology can provoke specific complications (secondary tularemia pneumonia, peritonitis, meningoencephalitis), as well as abscesses and gangrene.

Babesiosis

Another of the diseases transmitted from ticks to humans. It is caused by babesias, which after a bite penetrate into human red blood cells, where they multiply, destroying red cells.

With its course, anemia increases, and symptoms of acute renal and hepatic failure are observed. In people with normal immune status, babesiosis is asymptomatic.

Spotted fever

Called by microorganisms of bacterial origin from the rickettsia group. This disease occurs in a person from a tick bite, the pathogen can also get into the wound when the infected arthropod ruptures and combes this area.

It affects blood vessels, causes such serious complications as strokes, renal failure. In all cases, the forecast is quite serious.

Tick-borne diseases

Ixodid ticks, massively living in the Brest region, are carriers of infectious diseases: tick-borne encephalitis and Lyme disease (tick-borne borreliosis). Most often ticks appear in March - April and are active until October - November.

Lyme disease was first described in 1975 as a local outbreak of arthritis in Lyme (USA). And only in 1982 it became clear that the cause of the disease is spirochete, and the carrier is the ixodid tick. In the Republic of Belarus, the diagnosis of this disease began in 1993.

The natural hosts of Borrelia in nature are wild vertebrates, small mammals, birds. Ticks become infected by eating the blood of animals and birds.

In the stage of development of the tick, the larval stage, the stage of the nymph and the mature individual are distinguished. Ticks attack people at any stage of development, infection occurs when a tick bites, when removing it from animals, when crushed.

During the disease, 3 stages are distinguished. The first stage may be asymptomatic, or soreness, redness, and itching appear at the site of the bite.

General infection manifestations in the form of headache, weakness, nausea, fever are possible. The most characteristic manifestation of the first stage of Lyme disease is erythema migrans. Migratory erythema has the appearance of a ring of irregular shape with a clearly defined outer edge and uneven contours.

The width of the “ring” is about 0.5 cm. In some cases, the migrating erythema is not visible and becomes noticeable after the bath. The diameter of erythema can be up to 70 cm. There may also be skin rashes in the form of urticaria, small punctate, annular rashes. Sometimes erythema resembles erysipelas.

The first symptoms of the disease, even without treatment, disappear within a few days or weeks. If untreated, after 5 weeks, the disease goes into stage 2. At this stage, dissemination of borrelia into various organs and tissues occurs. This period of the disease is characterized by neurological, articular, cardiac manifestations.

It can be meningitis, neuritis of the cranial nerves (often facial). Patients complain of recurrent pain and paresthesia in the limbs and muscles, paresis of the facial, oculomotor and other cranial nerves, unexpressed headaches, nausea, and tension in the muscles of the neck can be observed.

A manifestation of heart damage is myocarditis with the development of atrio - ventricular block. Patients complain of weakness, shortness of breath, dizziness, low-grade fever.

Another of the pathognomonic manifestations of Lyme disease is benign skin lymphocytoma, which is a cyanotic - red tumor-like infiltrate more often on the earlobes, nipples of the mammary glands, and the scrotum.

The joints swell, movements are limited due to pain. The inflammatory process continues continuously. There is cartilage destruction and joint deformation, due to which disability develops.

Also, atrophic acrodermatitis is characteristic of the third stage of the disease, which is manifested by redness and swelling of the skin on the back of the hands, feet, legs in the form of spots. Then the skin turns pale, thinner, loses elasticity and resembles wrinkled paper. In this case, the joints of the fingers of the hands and feet are affected.

Damage to the nervous system (chronic neuroborreliosis) is manifested by chronic encephalitis or chronic encephalomyelitis. At this stage, the disease resembles multiple sclerosis.

Laboratory diagnosis of Lyme disease is based on the detection of specific antibodies in the patient's blood serum.

The basis for the treatment of Lyme disease is antibiotic therapy. The sooner therapy is started, the more successful it is. The main antibiotics used in the treatment: amoxicillin, doxycycline, cefotaxime, ceftriaxone.

In addition to etiotropic therapy, other types of treatment are also used, including physiotherapeutic procedures.

Prevention of Lyme disease consists in the use of rational clothing through which ticks could not penetrate. In cases where a sucking tick is detected, after its removal, a course of preventive antibiotic therapy should be taken: doxycycline, amoxicillin.

Ticks can also be carriers of a disease such as tick-borne encephalitis. Infection occurs with a tick bite, an alimentary route of infection is also possible with the use of raw (unboiled) milk from infected goats.

The incubation period of the disease is from 1 to 26 days. Most often, tick-borne encephalitis begins with chills, headache, mainly in the frontal part, there may be vomiting, decreased appetite, dizziness, and insomnia.

The fever lasts 3-5 days. On the 4th-5th day of the disease, the symptoms of the disease die out. After 5-15 days of the so-called “inter-febrile” period, the temperature rises again to 39–40, an intense headache appears with nausea, vomiting, meningeal symptoms: stiff neck, severe photophobia.

In about 1/3 of the patients, the first febrile wave is absent and the phenomena of meningoencephalitis develop on the 4th-6th day of the disease. In severe cases of the disease, delirium, hallucinations, psychomotor agitation are noted, epileptic seizures may develop.

Laboratory confirmation of the diagnosis is an increase in the titer of antibodies to tick-borne encephalitis virus. Diagnostic is an increase in antibody titer by 4 times.

Treatment of patients is carried out in a hospital: anti-tick-borne immunoglobulin is used, which is more effective for early use; interferon preparations or interferon inducers with antiviral effects.

Pathogenetic therapy consists of measures aimed at reducing intoxication: the introduction of fluids, potassium salts, vitamin preparations. Application for dehydration of lasix, diacarb, with encephalitis, dexamethasone has been shown.

Vaccination includes vaccination of endangered populations and the population living in natural highly active foci of tick-borne encephalitis. Perhaps the use of anti-mite immunoglobulin, as well as remantadine.