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Ticks- the oldest inhabitants of our planet. In nature, there are more than 50 thousand varieties of these arachnids. Ixodid ticks pose the greatest danger to human and animal life.

When bitten, ixodid ticks can infect the victim with severe diseases that can lead to disability or death. No one is safe from contact with ticks. Reducing the likelihood of being bitten and providing first aid correctly is what everyone should know and be able to do.

Tick ​​bite - ICD 10 code

ICD 10 is an abbreviation that stands for International Classification of Diseases. This is a document with norms and rules that is taken as a basis throughout the world. Every 10 years this classification is updated and supplemented.

The main goal of the ICD is to structure data about diseases into certain codes and meanings, all this is done for quick analysis and collection of information for the purpose of further study.

According to this classification, the tick bite received the code V88.8. If the patient was infected with encephalitis, code A84.0 is assigned, if Lyme disease - A69.20.

How dangerous is a tick bite?

What does a tick bite mark look like?

It is quite easy to spot a tick on the body. The attached insect looks like a convex mole with small hairs on both sides. An individual tick reaches a length of 4 mm in a hungry state, and up to 10 mm after suction. A few hours after the bite, a red spot forms in its place.

Symptoms of a tick bite

The tick bites painlessly. This happens because when the skin is punctured, biological anesthetics enter it, which completely relieves pain.

After biting, the tick places its proboscis under the skin in order to find a blood vessel. The proboscis is positioned in such a way that it is extremely difficult for a person to remove it from the body.

Ticks are most often located on the neck, shoulders, groin and armpits, under the knees, and behind the ears.

The time period after which the first symptoms appear is different for everyone. Most often, children and the elderly, as well as those who have a number of chronic diseases, are the first to feel the effects of a bite. On average, the first symptoms appear within a couple of hours.

• Weakness.
• Chills.
• Aches in the joints.
• Photophobia.
• Body temperature rises to 38 degrees.
• Blood pressure decreases.
• Tachycardia appears.

After another couple of hours, you may notice an enlargement of the lymph nodes, redness of the bite site and itching, which becomes increasingly stronger.

Dangerous signs after a tick bite

To more danger signs include:

• The appearance of nausea.
• Frequent vomiting.
• Loss of consciousness.
• Disturbance of nervous activity.
• Hallucinations.
• It becomes difficult to breathe.

Symptoms of tick-borne encephalitis

After a tick bite, you need to clearly understand that an infection may have occurred. There's no need to panic. The sooner treatment is started, the greater the chances of a full recovery.

How can you tell if a tick could be infected with encephalitis?

• Chills appear;
• Body temperature rises;
• Aches in the joints appear;
• Breathing becomes difficult;
• The skin turns red.

The symptoms of encephalitis are very similar to ARVI. In such a situation, the main thing is to identify the disease in time so as not to waste precious time. Encephalitis is a severe disease that affects the nervous system. If treatment is not started, the patient may remain disabled or die.

Signs of Borreliosis

This disease is not as dangerous as encephalitis, but it can still significantly harm your health.

People infected with a tick bite exhibit the following symptoms:

• There may be a slight swelling at the site of the tick bite.
• At times there is nausea.
• A dry cough appears.
• Fever appears.

The insidiousness of this disease lies in the fact that Symptoms may appear after 6 months. Borreliosis can easily be confused with the common flu or cold. If left untreated, this disease can over time affect a person's heart, joints, and nervous system.

Manifestations of hemorrhagic fever

A common disease in Russia is Crimean fever. This viral disease, carried by ticks.

Ticks become carriers of this disease after biting cattle infected with it. You can also get a fever when you crush a tick. In this case, viruses can enter the bloodstream through small cuts or wounds.

This disease is seasonal. Outbreaks of Crimean fever most often occur in the summer months. The geography of distribution is vast and covers almost the entire territory of the country.

The first signs of Crimean fever:

• Headaches and muscle pain.
• Bleeding of various etiologies (nasal, gastric, uterine).
• This fever is characterized by a “two-humped” rise in temperature.
• Dizziness.
• Loss or impairment of consciousness.

After 48 hours from the onset of the disease, the patient develops a rash all over the body, the face begins to turn pale, and the lips turn blue. There may also be low blood pressure and diarrhea. The fever usually goes away within 12 days.

Important! Treatment of the disease should be carried out only in a hospital. The patient will need strict bed rest, diet, treatment with hormonal and immunostimulating drugs, as well as a blood transfusion.

Acute allergic reaction

When a tick bites, a phenomenon called an acute allergic reaction may occur. This occurs due to the penetration of a new allergen into the human body. Its acute manifestations can be life-threatening.

Symptoms:

• Severe itching and redness of the skin.
• Swelling of body parts.
• Fear.
• Feeling hot.
• Tachycardia.
• Loss of consciousness.
• Dyspnea.
• Paleness of the skin.

First aid for acute allergic reaction:

• Provide the patient with access to clean air;
• Take antihistamines;
• Lubricate the itching area with a weak vinegar or soda solution;

Depending on the severity of the disease, call a doctor or ambulance.

Help with a tick bite

As soon as a tick is found on the body, it must be removed immediately.

Important! Not worth using traditional methods, as indicated in many sources of information, and drip oil or alcohol onto the tick. Yes, the tick will suffocate, but before that there is a high probability of releasing a large amount of saliva into the human blood, and with it, infected microorganisms. Particularly extreme advisers say that you can set a tick on fire and it will come out on its own - this method also carries danger.

The tick must be pulled out carefully so that its entire body and proboscis are completely removed.

How to properly remove a tick:

1. You can use special forceps to remove the tick. They are sold at any pharmacy. You need to grip the tick closer to the head with the tips of the forceps and pull it out with small rocking movements. The body must be pulled out strictly perpendicularly.
2. If you don’t have tongs at hand, an ordinary thread will help you spot them., from which you need to make a loop and throw it over the head of the tick. The principle of operation is the same as with forceps.
3. If you have a medical syringe on hand– it can also help remove the tick. To do this, you need to cut off the tip of the syringe and attach the resulting round hole to the tick, so that it is completely inside it. Next, we pull the piston, and by creating a vacuum, the tick comes out.
4. After the tick has been removed, the wound should be washed with soap and water and treated with an antiseptic. The tick must be placed in glass jar with a well-closing lid and transport to the nearest laboratory to identify infection.

Consequences of a tick bite

After a tick bite, the patient needs to monitor his condition and measure his temperature for ten days. If one of the symptoms of the disease appears, you should immediately consult a doctor.

If, after undergoing an examination, infection with tick-borne encephalitis or borreliosis is confirmed, treatment should be started immediately, only in this case the risks of complications will be minimal.

If after 10 days no deviations from the norm were detected, and the tick examination data did not reveal infection, then everything went well.

How to avoid tick bites?

When going into a forest area for a walk, you should dress correctly:

• It is better to choose clothes in light, solid colors, preferably with a sporty cut.
• The jacket must have a collar and fasten with a zipper.
• The cuffs on the arms and legs should fit snugly against the skin.
• Your feet should be wearing tights or long socks.
• Pants need to be tucked into shoes, preferably high boots.
• It is better to hide long hair under a headscarf.

In addition, the following tips will help you avoid tick bites:

• Every 15 minutes you need to check for ticks on your clothes. Every 3 hours you need to conduct a thorough inspection with complete turning of clothes.
• In forest areas it is better to avoid the paths of wild animals, fallen leaves or tall grass. It is better to sit on bedding treated with repellent.
• If you plan to spend the night, it is better to set up a tent in a clearing. Before entering the tent, you need to take a good look at all your clothes and hair.
• Ticks can end up indoors, arriving, for example, on clothing or a bouquet. In this case, it is not recommended to bring flowers and leaves collected from the forest into the house; clothing must be carefully inspected and hung in a well-ventilated place for 10 hours.
• Various repellents have proven themselves to be effective in protecting against bites. They are used to treat skin and clothing. But remember that repellents can cause irritation and itching. They must be used strictly according to the instructions.
• Folk remedies can also help repel bloodsuckers. So, for example, the smell of star balm will be extremely unpleasant for a tick, and this insect will clearly not be delighted with a mixture of essential oils of clove, eucalyptus and rosemary.

Conclusion

Ticks for Lately very active. Some associate the increase in the number of arachnids with advertising by insurance companies, others with the environmental situation, but all theories agree on one thing - there are more and more ticks every year.

This situation discourages many people from walking in nature, thereby depriving them of fully enjoying the warm season.

Ticks are carriers of serious diseases, which can greatly weaken the health of a person or animal.

But still you shouldn’t be afraid of them. You just need to know which means of protection against ticks are most effective, and if a bite does occur, be able to provide first aid and distinguish the symptoms of dangerous diseases.

Therefore, the entire feeding strategy is to use the host as a source of nutrition as efficiently as possible. To do this, the tick very carefully selects hunting sites, prey, and, even more so, the place of attachment to it (after all, choosing an unsuccessful place for a bite means high probability be discovered and killed).

On a note

Ticks have 2 types of searching and lying in wait for prey:

• passive lying in wait;
• active pursuit.

On a note

The process of searching for a victim consists of two phases. The first phase is the spatial orientation of the tick. At this moment, the arthropod qualitatively evaluates all factors environment(humidity, temperature, chemical composition air) and climbs to the most convenient place for itself, often on grassy vegetation, after which it settles in its upper tier.

The second phase begins when the tick senses the approach of the victim. At the same time, it turns its body towards the possible owner, extends the first pair of legs upward and makes oscillatory movements. At the ends of its legs there are sharp claws, with which the tick clings to the clothing or fur (feathers) of the victim.

On a note

Ticks do not have a specialized organ that would help them determine the position of the body relative to the ground, so the animal is oriented solely by the degree of tension of certain muscle groups of the limbs. When hunting, when the front legs are extended upward, the other three pairs hold the body in the desired position, performing both attachment and sensory functions. Therefore, purely anatomically, a tick cannot bend over a victim or fall onto it from a tree.

How do ticks sense their prey? First of all, in terms of the component composition of the air. The most powerful irritant is an increase in the content carbon dioxide. Other components released by the body of animals also have an effect, including hydrogen sulfide and ammonia.

The main distant chemoreceptor is Haller's organs, located on the forelimbs of ticks. They look like pits, at the bottom of which there is a cluster of sensitive cells. These cells perceive the slightest change in the concentration of the above substances and prompt the tick to act. The tick can sense a potential victim at a distance of more than 10 meters. This explains the massive accumulations of ticks in places where a large number of animals and people.

In addition, being a cold-blooded animal, the tick clearly senses the infrared radiation of warm-blooded organisms, but for hunting it is still a secondary irritant.

How a tick clings and stays on the host’s body until it bites

The tick clings so tightly to the body that it is almost impossible to shake it off. The only way to get rid of a tick before it attaches itself is to deliberately remove it from the surface of the body.

Until the tick bites, all these devices allow it to remain on the host’s body long time, increasing the likelihood of successful feeding.

Given the size of the prey relative to the size of the tick, the arthropod often has to travel considerable distances, so selecting the location of the bite may take several hours. Since the tick drinks blood for a very long time (usually for several days), the process of choosing an attachment site is extremely important and takes a significant amount of time.

On a note

The actual structure of the skin is also important - how rough it is and how well vascularized it is.

On a note

The sites of tick bites in humans have been well studied. Shoes and clothing limit the number of places for attachment, but ticks find a way out of this situation.

The largest percentage of ticks attached to a person occurs in the axillary region, then in descending order: on the chest, abdomen, groin, buttocks, and legs. In children, frequent attachment to the head is also observed. It is worth noting that ticks navigate perfectly under clothing, making their way to the body even through small cracks.

The oral apparatus of a tick is a complex formation and consists of several components, each of which has its own morphology and functions. You can examine some interesting nuances in detail under a microscope (see photo below):

The oral apparatus includes a base, a proboscis or hypostome, one pair of chelicerae embedded in cases, and a pair of palps. The base of the proboscis has the form of a capsule with a dense chitinous cover - here the ducts of the salivary glands pass and the pharynx begins. The palps have a segmented structure, consist of 4 segments and perform a tactile function.

The hypostome is an unpaired chitinous plate immovably attached to the base. It has the appearance of an elongated “sting”, on which a large number of hooks bent back are located in regular longitudinal rows, as shown in the photographs below:

Towards the top, the hooks become smaller, forming a crown of small and at the same time very sharp thorns. When a tick bites, the sharp hypostome is involved in cutting through the skin along with the chelicerae.

On a note

At the base of the hypostome a pair of chelicerae are attached, which look like sharp blades enclosed in cases. Chelicerae are very mobile and can cut through the skin and integument. different angles and to different depths. When at rest, they are enclosed in cases that protect them from mechanical damage.

Collectively, this is called the gnathosoma and represents the anterior section of the tick’s body, which, during a bite, plunges into the integument of the victim’s body.

How does a tick bite?

Despite the high mechanical strength of the upper layer of skin, it does not create serious obstacles to the path of the tick's oral organs to the inner layers where the blood vessels are located. Moreover, there is no direct relationship between the thickness of the skin of the preferred host and the length of the chelicerae.

The process of cutting through the skin lasts the first 15-20 minutes from the moment the bite begins.

At the same time, the process of introducing the proboscis into the incision formed by the chelicerae begins. The entire proboscis is completely immersed in the wound, almost to the base of the head, and the palps are bent almost parallel to the skin.

On a note

An important fact is that the tick is able to regulate the depth of penetration of the proboscis into the integument. This depends on the size of the victim and the thickness of its skin. It is also worth considering that the deeper the tick burrows into the skin, the stronger the host’s immune defense reaction will be. Severe inflammatory processes may begin, negatively affecting the tick and reducing the chances of successful feeding.

After the tick has successfully burrowed into the skin, it begins to feed. At this moment, along with the proboscis, the wound also contains chelicerae with sheaths that expand the tissues near the hypostome.

Accordingly, first the food enters the cavity of the case, and then into the pre-oral cavity of the tick. On the surface of the skin, this case ends in a frozen roller, to which the base of the proboscis is glued.

This is interesting

It is worth noting that the tick feeds not only on blood, but also on lysed skin tissue where the proboscis is inserted.

This is also dangerous because pathogens such as Lyme disease and tick-borne encephalitis can enter the host’s body along with the tick’s saliva. Moreover, the longer the encephalitic or borreliosis tick feeds, the large quantity it secretes saliva and the greater the likelihood of a person becoming infected with the corresponding disease.

The duration of tick feeding varies and depends on the stage of its ontogenesis and gender. Nymphs drink blood for 2-3 days, and sexually mature females can stay on the host’s body for up to a week. Males usually do not feed, and if a male does attach itself, it stays on the host for only a few hours.

On a note

It is quite easy to distinguish a female tick from a male. The male has a wide chitinous matte scute on the upper side of the body, which completely covers the back, while in females the scute only reaches the middle of the back.

Tick ​​nymphs become saturated relatively quickly. They need food for molting and further development, however, they are also carriers of pathogens various diseases, like adults.

After the tick is completely saturated, it disappears on its own. The muscles of the oral apparatus relax, the chelicerae are pressed tightly against the proboscis, and the tick easily removes it from the integument of the victim’s body.

We should not forget about preventive measures. After walks, you need to carefully examine yourself, children and animals, and before going out into nature, use repellents, wear closed clothes and shoes. With the right approach, it is almost always possible to remove a tick from clothing (or body) in time - long before it has time to attach itself.

Video recording of a tick bite at high magnification - all the details of the process are visible

Is it possible to remove a tick from the skin using a syringe (vacuum): experiment

What to do if you have a fever after a tick bite

What to do if redness appears on the skin after a tick bite?

What to do if you are bitten by a tick, how to remove it correctly, what to do to prevent tick bites - video

Tick ​​bite: how to remove (methods), symptoms of tick-borne encephalitis and borreliosis after a tick bite, prevention - video

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Ticks that are found in the territories of Russia, Ukraine, Belarus, Moldova, as well as countries of Eastern and Western Europe, can stick to the skin of a person of any age and gender in order to obtain blood. Ticks need fresh human blood to start the reproduction cycle, so these insects literally cannot do without people. In this sense, ticks are similar to mosquitoes, which also require human blood to reproduce.

However tick bites, unlike most mosquitoes, is not harmless, since these insects are carriers of several dangerous infectious diseases. Therefore, after a bite, it is necessary to take a number of actions aimed at preventing the development of severe infectious diseases that the tick could infect a person with.

In Russia, Belarus, Moldova, Ukraine, Western and Eastern Europe and the USA, ticks are carriers and, accordingly, when bite can infect a person with the following infections:

• Tick-borne encephalitis;
• Borreliosis (Lyme disease);
• Congo-Crimean hemorrhagic fever;
• Omsk hemorrhagic fever;
• Hemorrhagic fever with renal syndrome.

Most often, ticks are carriers of tick-borne encephalitis and borreliosis, since these infections are common in almost all countries of Europe, the Asian part of Russia and the USA. That is why the main attention is paid to the prevention of these infections after tick bites.

Other infections (hemorrhagic fevers) are common only in the territory individual regions, so you can become infected with them if a person is bitten by a tick living in the area. And since ticks do not leave their habitat, moreover, they practically do not budge throughout their entire life, often spending it on the same bush, then you can become infected with hemorrhagic fevers only if you are bitten by a tick located in the region with the prevalence of these infections. Accordingly, the person himself must also be in a region where hemorrhagic fevers transmitted by local ticks are common.

So, Crimean-Congo hemorrhagic fever distributed only in Crimea, on the Taman Peninsula, in Rostov region, Southern Kazakhstan, Uzbekistan, Kyrgyzstan, Turkmenistan, Tajikistan and Bulgaria. Omsk hemorrhagic fever distributed in the territories of Omsk, Novosibirsk, Kurgan, Tyumen and Orenburg regions. Also, sometimes ticks that carry Omsk hemorrhagic fever are found in Northern Kazakhstan, Altai and Krasnoyarsk territories. Reservoir of hemorrhagic fever with renal syndrome is found in all countries of Europe and Asia, but the infection is recorded only in the form of episodic outbreaks and isolated cases of infection.

So, since ticks can infect humans with dangerous infections, let’s consider the algorithms of actions that need to be taken in various situations after being bitten by this insect.

What should I do if bitten by a tick?

Algorithm of actions if bitten by a tick

Regardless of who was bitten by a tick (child, woman, man, elderly person), when this fact is discovered, it is necessary to perform the following manipulations:
1. Remove the tick with any in an accessible way(see sections below);
2. Treat the site of tick suction with an antiseptic (iodine, alcohol, brilliant green, Chlorhexidine, hydrogen peroxide, etc.);
3. Place the tick in a closed container and, if possible, submit it for analysis to determine whether it is a carrier of infections;
4. Get tested for borreliosis and tick-borne encephalitis to determine whether the infection occurred after a tick bite;
5. Take prophylactic medications, the action of which is aimed at quickly suppressing the infectious disease transmitted to humans by ticks;
6. Monitor your own condition for a month after a tick bite.

When bitten by a tick, be sure to remove the insect as quickly as possible and treat the area where it is attached to the skin. You don’t have to do the remaining points of the algorithm, with the exception of monitoring your own condition for a month. If any signs of illness appear within 30 days of a tick bite, you should consult a doctor, as this may be a symptom of tick-borne infections that need to be treated.

It is advisable to place the tick after removal from the skin in a closed container only if it can be transported to a specialized laboratory for examination within a maximum of 24 hours. Such laboratories are usually located in infectious diseases hospitals. However, since in many cities and countries of Europe ticks are, in principle, not examined to see whether they are carriers of infections, but rather the condition of people is monitored after a bite, then in most cases it makes no sense to pack the insect in a container.

In general, identifying whether a tick is a carrier of infections is not necessary, but is necessary solely for early accurate determination of the subsequent tactics of behavior of the bitten person. So, if the tick is “clean”, that is, it is not a carrier of infections, then a person can forget about the bite forever, since it does not carry any consequences. If a tick is a carrier of infections, this does not mean that it has necessarily infected a person and that he needs to wait for the disease to develop. Indeed, in 80% of cases, a bite from an infected tick does not lead to human infection. Therefore, if a person is bitten by an infected tick, it is necessary to monitor his condition for a month and, if possible, take blood tests to determine whether an infection has occurred. That is, tick analysis allows the person himself to adhere to the correct tactics and be prepared for possible illness, and not rely on "maybe".

A more rational tactic (compared to submitting a tick to a laboratory) after a bite is to take blood tests to find out whether the insect has infected a person with any infection. However, there is no need to donate blood right away, since the tests will not be informative. No earlier than 10 days after the bite, you can donate blood to detect tick-borne encephalitis and borreliosis using the PCR method. If the analysis is carried out by ELISA or Western blotting (immunoblotting), then to detect tick-borne encephalitis, blood should be donated only two weeks after the bite, and borreliosis - after 4 - 5 weeks.

PCR detects the presence of a pathogen in the blood, so this analysis is very accurate. And during ELISA and Western blotting, IgM antibodies are detected against the tick-borne encephalitis virus and the causative agent of borreliosis. The ELISA method is inaccurate because the percentage of false positive results is high. Western blotting is reliable and accurate, but is performed mainly only in private laboratories located in large cities, as a result of which it is not available to every person who has been bitten by a tick.

If the results of any test (PCR, ELISA, Western blotting) are positive, this means that the tick has infected a person with an infection. In this case, it is necessary to immediately undergo a course of treatment that will allow early stage cure the disease.

You may not need to be tested, but immediately after the bite, carry out preventive treatment against tick-borne encephalitis and borreliosis by taking medications. In most cases, such treatment prevents the development of infection, and the person does not get sick, even if the tick has infected him.

Despite the temptation to carry out preventive treatment immediately after a bite in order to protect yourself from the development of infection, if infection occurs, you should not do this. Doctors and scientists consider the following tactics of behavior after a tick bite to be the most optimal and justified:
1. Remove the tick from the skin.
2. On the 11th day after the bite, donate blood to detect tick-borne encephalitis and borreliosis using the PCR method.

If the PCR result is positive for any one or both infections, then medication should be started to prevent the full development of the disease and cure it during the incubation period. To prevent borreliosis, antibiotics are taken: Doxycycline + Ceftriaxone, and encephalitis - Yodantipirin or Anaferon. If the result is positive for both infections, then antibiotics and Yodantipyrine are taken simultaneously for preventive treatment.

If the PCR result is negative, then 2 weeks after the tick bite you should donate blood to detect tick-borne encephalitis using ELISA or Western blotting. Then, after 4 weeks, donate blood again to detect borreliosis using ELISA or Western blotting. Accordingly, if a positive test result is obtained, antibiotics or Yodantipirin should be taken, depending on what kind of infection was detected (encephalitis or borreliosis).

Taking antibiotics and Yodantipirin immediately after a tick bite without testing is justified only in cases where the incident occurred far from civilization (for example, a hiking trip, bike ride, etc.) and it is impossible to get to medical laboratories. In this case, to prevent infection with encephalitis and borreliosis, it is necessary to take both antibiotics and Yodantipyrin, since it is unknown which infection the tick is transmitting.

General rules for tick removal

If a person of any age and gender is bitten by a tick, then first of all it is necessary to remove the insect as soon as possible, since the longer it stays on the skin, the higher the likelihood of contracting infectious diseases. You need to remove a tick from any place on the body, observing a certain technique, since the insect is very tightly attached to the skin using a proboscis with peculiar appendages. These processes make the tick's proboscis look like a harpoon, so simply pulling the insect out of the skin will not work (see Figure 1).

Picture 1– The proboscis of the tick is in the skin.

For the purpose of removal, do not drip oil, glue, milk onto the tick, cover it with a jar, or perform any other actions aimed at clogging the insect's spiracles located on the back of its body. The fact is that when the spiracles close, the tick cannot breathe normally, and this makes it aggressive, as a result of which it splashes its saliva into the blood very intensely and in large quantities. Namely, saliva contains infectious agents that are carried by ticks. Thus, blockage of tick spiracles increases the risk of human infection with encephalitis or borreliosis.

You can remove a tick with your hands, tweezers, thick thread or special devices of domestic or imported origin (Tick Twister, The Tick Key, Ticked-Off, Anti-Tick), which are sold in pharmacies or Medtekhnika stores. These devices have different shapes and methods of use, so it is recommended to select the optimal type from Medtekhnika and use it as needed. Such devices for removing ticks must be purchased in advance and carried with you during various trips into nature. If there are no devices, then you need to remove the tick using ordinary improvised means, such as tweezers, thread or your fingers.

Regardless of how the tick is removed, you should not touch the insect with your bare hands. This is due to the fact that when removing the tick, you can damage the tick and then its contents intestinal tract gets on the skin, from which it can penetrate the systemic bloodstream if there are any small wounds on it, invisible to the naked eye. That is, by removing a tick with bare hands, a person increases the risk of contracting various infections. That is why you need to put rubber gloves on your hands before removing an insect. If you don’t have gloves, you can simply wrap your hands with a regular bandage or clean cloth. Only after protecting your hands in this way can you begin to remove the tick from the skin.

After removing the tick, it is necessary to disinfect the wound by treating it with any available antiseptic, for example, iodine, Chlorhexidine, hydrogen peroxide, calendula tincture or alcohol. It is optimal to treat the wound left by a tick with alcohol or iodine. After treatment, the skin is left without a bandage. If a person wants to submit a tick for analysis to determine whether it is a carrier of any infection, then the insect must be placed in a jar along with a piece of cotton wool moistened with water, closed the container and stored in the refrigerator. If a person does not want to submit the tick for analysis, then the removed insect can simply be burned in the flame of a match, lighter or fire, or crushed with shoes.

Let's look at how to properly remove a tick in various ways.

Removing a tick using the Tick Twister

This device is the best for removing ticks for two main reasons. Firstly, Tick Twister allows you to completely remove the tick in 98% of cases without tearing it and thus leaving the insect head in the skin. This is a very important advantage, since the head remaining in the skin will have to be removed with a needle, like a splinter, which is quite painful and unpleasant. In addition, the head of the tick remaining in the skin is a source of pathogenic microbes that the insect carries. And, accordingly, the head of the tick located in the skin continues to be a source of infection for humans.

Secondly, using Tick Twister avoids pressure on digestive tract mites, as a result of which there is no risk of releasing large amounts of insect saliva containing infectious agents. When using tweezers, thread or fingers, strong pressure is often applied to the tick's digestive tract, as a result of which it sprays large amounts of saliva into the skin, which contains the causative agents of tick-borne infections. Accordingly, such a discharge of saliva increases the risk of contracting an infection, if this has not already happened.

In addition, Tick Twister is very easy to use and does not cause pain during the tick removal process.

Using the Tick Twister is very simple: you need to grab the tick between the teeth of the device, then rotate it around its axis counterclockwise 3 to 5 times and easily pull it towards you (see Figure 2). After several turns counterclockwise, the tick is easily pulled out of the skin. After removing the tick, the site of its suction is treated with iodine or alcohol.

Figure 2– Rules for using the Tick Twister tick removal device.

Rules for removing ticks using The Tick Key

This device allows, in most cases, to successfully remove a tick without tearing it into pieces, and also without putting pressure on its digestive tract, preventing the release of saliva into the blood. However, The Tick Key is somewhat worse in its characteristics than the Tick Twister, since it is inconvenient to use on some hard-to-reach areas of the body, such as the inguinal and axillary folds, the area under the breasts in women, etc.

Using The Tick Key to remove a tick follows three steps (see Figure 3):
1. Place the device on the skin so that the tick is inside the large hole;
2. Move The Tick Key without lifting it from the surface of the skin so that the tick falls into the small hole;
3. Turn The Tick Key counterclockwise 3 – 5 times, then pull the tick towards you.

After removing the tick, the site of its suction is treated with iodine or alcohol.

Figure 3– Rules for using The Tick Key to remove ticks.

Removing a Tick Using the Ticked-Off Tool

The Ticked-Off device is as convenient and practical as the Tick Twister, however, unfortunately, in most cases you can only buy it in the CIS countries through online stores.

Ticked-Off to remove a tick should be used as follows: place the spoon vertically to the skin, then push the protruding part of the tick into the hollow. Having fixed the tick in this way, you should rotate the device 3 – 5 times around its axis counterclockwise, after which you can easily pull it towards you (see Figure 4). After removing the tick, the site of its suction is treated with iodine or alcohol.

Figure 4– Rules for using Ticked-Off to remove ticks.

Rules for removing ticks using the Anti-Tick device

Anti-mite is a special wire tweezers (see Figure 5), which allows you to securely grab the tick and, at the same time, not put pressure on its digestive tract, which ensures quick, effective and safe removal of the insect from the skin.

Figure 5– Anti-mite device.

To remove a tick with the Anti-Tick device, you need to grab the insect as close to the surface of the skin as possible. To do this, you need to press the big and index finger In the middle of the tweezers, spread its tips to the sides and place them so that the tick's head is between them. Then you should stop pressing on the middle of the tweezers, allowing their tips to close around the tick. After this, you need to rotate the device 3 - 5 times counterclockwise around its axis and easily pull it towards you.

After removing the tick, it is necessary to treat the site of its suction with iodine or alcohol.

Rules for removing ticks with tweezers

To remove a tick with tweezers, you need to grab it by closing the tips of the tool as close to the surface of the skin as possible. Then, holding the tick in the grip, you need to rotate it around its axis counterclockwise 3 to 5 times. After this, you need to lightly pull the insect towards you, which should easily come out of the wound. If the tick cannot be pulled out, then you should turn it counterclockwise several more times and pull it again. After removing the tick, the site of its attachment must be treated with iodine or alcohol.

Rules for removing ticks with thread

First, you should apply a little pressure with your fingers on the skin in the area of ​​the attached tick, as if you were trying to squeeze out a pimple. After this, take a strong thread 15–30 cm long and make a loop in the middle with a diameter of 2–3 cm. Then place the loop on the skin so that the tick gets into it. Tighten the loop tightly, connect both ends of the thread into one and start twisting it counterclockwise with your fingers. When the thread is tightly twisted, you should pull it towards you, and the tick will be easily removed from the wound (Figure 6). Treat the wound remaining at the tick site with iodine or alcohol.

Figure 6– Removing a tick using a thread.

Rules for removing ticks with your fingers

Wear gloves on your hands, or cover your fingers with several layers of bandage or a clean cloth. Then, using protected fingers, grab the tick and rotate it around its axis counterclockwise 3 to 5 times. After this, pull the tick towards you, and it will easily be removed from the wound. Treat the tick site with iodine or alcohol.

Rules for removing tick remains from a wound

If it was not possible to completely remove the tick, and any parts of its body remain in the skin (most often the head with the proboscis), then they need to be pulled out. If the remains of the tick are not removed, an abscess may form on the skin or there will be long-term inflammation that does not go away until parts of the insect’s body come out on their own.

Removing tick remains from a wound is done in the same way as removing a splinter, that is, using a needle. The needle is pre-sterilized by treating it with hydrogen peroxide, alcohol or holding it in a flame for 1 - 2 minutes. Then, using a sterilized needle, remove the remains of the tick from the wound and treat it with iodine or alcohol.

What and how to treat the site of a tick bite?

After the tick has been removed from the skin, it is necessary to treat the area with any antiseptic. Alcohol and iodine are best suited for this purpose, but you can also use hydrogen peroxide, Chlorhexidine, brilliant green, etc. Any available antiseptic is poured onto a piece of clean cotton wool and generously lubricated with it on the wound left after removing the tick. After this treatment, the skin is left open and no bandage is applied.

Redness, swelling and itching may persist at the site of the tick bite for 3 weeks. In this case, it is recommended to lubricate the inflamed area daily with iodine and calendula tincture, and take any antihistamine orally (for example, Erius, Telfast, Suprastin, Fenistil, Cetrin, etc.).

How to transport a tick to the laboratory for analysis?

To transport a mite to the laboratory, it is necessary to place the live insect in a container that can be tightly closed, for example, a jar with a lid, etc. Be sure to put a small piece of cotton wool moistened with water in the container with the tick. Until the moment of transportation, the container with the tick must be kept in the refrigerator. Remember that only a living tick is suitable for analysis, so if the insect died during removal from the skin, then there is no point in transporting it to the laboratory.

How and what tests should I take after a tick bite to detect tick-borne encephalitis and borreliosis at the stage of the incubation period?

Currently, to determine whether a tick has infected a person with encephalitis or borreliosis, the following blood tests are performed:

• Venous blood to determine the presence of tick-borne encephalitis virus and Borrelia using the PCR method (the test is taken no earlier than 11 days from the moment of the bite, since before that it is not informative).
• Venous blood for determination of antibodies to the tick-borne encephalitis virus type IgM using ELISA (test taken at least 2 weeks after the bite).
• Venous blood for determination of antibodies to the borreliosis virus type IgM using ELISA (test taken at least 4 weeks after the bite).
• Venous blood to determine various variants of antibodies (VisE, p83, p39, p31, p30, p25, p21, p19, p17) to the IgM tick-borne encephalitis virus using Western blotting (tested at least 2 weeks after the bite).
• Venous blood for determination of various variants of antibodies (VisE, p83, p39, p31, p30, p25, p21, p19, p17) to the borreliosis virus type IgM using Western blotting (tested at least 4 weeks after the bite).

The most informative are blood tests performed by PCR and Western blotting. Therefore, it is best to perform these tests for the early detection of possible tick-borne infections. The ELISA method should only be used if PCR or Western blotting is not available.

To identify latent tick-borne infections, it is recommended to be tested twice after a tick bite. The first time within the time period specified for each method (after 11 days for PCR, after 2 or 4 weeks for ELISA and Western blotting), and the second time – a month after the first test. Both times you should donate blood for analysis using the same method. For example, if the first test was taken for PCR, then the second one should be performed using the same PCR method. Moreover, the analysis is given a second time only if the results of the first were negative.

If the first and second tests for both infections are negative, then the tick has not infected a person. In this case, you can simply forget about this unpleasant episode of your life. If the second test turns out to be positive, then you should undergo a course of preventive treatment, which will suppress the disease during the incubation period.

If the first analysis showed negative result for one of the infections and positive for the second, then the tactics change somewhat. To prevent a detected infection, the test for which was positive, take the necessary medications (Yodantipyrine for encephalitis and Doxycycline + Ceftriaxone for borreliosis). For a second infection, the test for which was negative, a repeat test is taken a month after the first. Accordingly, with a negative analysis, you can completely relax and forget about the tick bite. And when positive analysis– undergo a course of preventive treatment with the necessary medications.

How and what medications to take after a tick bite to prevent the development of tick-borne encephalitis and borreliosis?

To prevent the development of borreliosis After a tick bite, a person of any age and gender must take two antibiotics:

• Doxycycline – 100 mg 1 time per day for 5 days;

Taking these two antibiotics helps prevent the development of borreliosis (even if the tick has infected a person) in 80–95% of cases.

To prevent the development of encephalitis For people of any age and gender after a tick bite, there are two main methods:

• Serum administration is carried out in a clinic or hospital, and only in the first 72 hours after the bite. Introducing serum at a later date is useless.
• Taking Yodantipirin by people over 14 years of age and Anaferon for children by adolescents under 14 years of age.

Injecting serum is an ineffective and dangerous method, since people often develop severe allergic reactions, including anaphylactic shock. Therefore, this method of preventing tick-borne encephalitis is currently not used in Europe and the USA, and even in countries former USSR it is also being gradually abandoned.

Today it is quite effective and safe method Prevention of tick-borne encephalitis after a tick bite is to take Yodantipirin or children's Anaferon, depending on the age of the victim. Yodantipyrine after a tick bite, adults and adolescents over 14 years of age should take it according to the following regimen: in the first two days, 3 tablets 3 times a day, in the next two days, 2 tablets 3 times a day, and then for 5 days, 1 tablet 3 times a day.

Children's Anaferon given to all children and adolescents under 14 years of age after a tick bite to prevent tick-borne encephalitis. Children under 12 years old are given 1 tablet 3 times a day, and adolescents 12 - 14 years old - 2 tablets 3 times a day. Anaferon for children in the indicated dosages should be given to children within 21 days after a tick bite.

What to do at home if you are bitten by a tick?

At home, after a tick bite, you must first remove the insect from the skin and treat the remaining wound with an antiseptic (iodine or alcohol). After this, if it is possible to get tested within the appropriate time frame - after 11 days for PCR, after 2 and 4 weeks for ELISA and Western blotting. However, if for some reason it is impossible to get tested, then immediately after a tick bite it is recommended to take a course of antibiotics (Doxycycline + Ceftriaxone) and Yodantipirin (for adults) or children's Anaferon (for children) in order to prevent tick-borne encephalitis and borreliosis. Antibiotics and Yodantipirin or children's Anaferon can be taken simultaneously, each according to its own scheme. Moreover, taking medications should be started as soon as possible after a tick bite.

What to do if a child is bitten by a tick?

If a tick bites a child, then the algorithm of actions is exactly the same as for an adult. That is, first of all, you need to remove the tick from the skin and treat the suction site with iodine or alcohol. Then, at the appropriate time, take tests for the presence of infections in his body. Accordingly, if the test result is positive, conduct a course of preventive treatment for the child with the necessary medicines(Doxycycline + Ceftriaxone for borreliosis and Anaferon for children for tick-borne encephalitis). If the test result is negative, then take it again after a month. Accordingly, if the second test turns out to be negative, then you can forget about the tick bite, and if it is positive, then carry out a course of treatment.

In cases where it is impossible to get tested, it is recommended to start giving the child both antibiotics (Doxycycline + Ceftriaxone) and Anaferon for children as soon as possible after a tick bite in order to prevent the development of encephalitis and borreliosis. Antibiotics are given in age-specific dosages, with Doxycycline for 5 days, and Ceftriaxone for 3 days. Anaferon for children is given for 21 days, 1 tablet 3 times a day for children under 12 years of age, and 2 tablets 3 times a day for adolescents 12 - 14 years old.

What to do if a pregnant woman is bitten by a tick?

If a tick has bitten a pregnant woman, it should be removed from the skin and the wound should be treated with iodine or alcohol. Then, within the required time frame, it is recommended to be tested for the presence of tick-borne encephalitis and borreliosis. Further, if borreliosis is detected, then during pregnancy 16–20 weeks you should take Amoxiclav for 21 days, taking 625 mg 3 times a day.

To prevent tick-borne encephalitis, pregnant women should not take any medications, but can only wait and monitor their own condition. If signs of encephalitis (fever, headache, etc.) or poor health appear within a month after a tick bite, you should immediately consult a doctor, be hospitalized in a hospital and receive necessary treatment. There is no need to take any further action after a tick bite on a pregnant woman.

What to do if you are bitten by an encephalitis tick?

If you are bitten by an encephalitis tick, then it is optimal to prevent the development of an infection that has already entered the body, take a course of Yodantipirin (adults and adolescents over 14 years old) or children's Anaferon (children under 14 years old).

Yodantipyrine should be taken by all people over 14 years of age according to the following regimen:

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

Yodantipyrine is contraindicated in children and adolescents under 14 years of age. To prevent tick-borne encephalitis, they use children's Anaferon.

Children's Anaferon is given to all adolescents and children under 14 years of age for 21 days. Moreover, children under 12 years old are given 1 tablet 3 times a day, and adolescents 12 - 14 years old - 2 tablets 3 times a day.

What to do if you are bitten by a borreliosis tick?

If you are bitten by a Borreliosis tick, then to prevent the development of the disease, it is recommended to take a short course of antibiotics according to the following scheme:

• Doxycycline – 100 mg 1 time per day for 5 days;
• Ceftriaxone - 1000 mg 1 time per day for three days.

The tick bit, but did not stick

If a tick bites, but does not have time to attach itself, then you should simply treat the wound with an antiseptic (iodine, alcohol, etc.). There is no need to take any further action, since during the bite the tick does not have time to infect a person with infections. After all, to transmit borreliosis or encephalitis, the tick must remain in the skin for at least 6 hours.

Bitten by a tick - where to go?

If you are bitten by a tick, you should contact an infectious disease doctor at the clinic at your place of residence. In addition, you can contact the Centers for Epidemiology and Prevention (former sanitation stations) located in regional cities and district centers. In the cities of Siberia, where ticks are widespread and often bite people, there are specialized centers for the diagnosis and treatment of tick-borne infections. If a person lives in Siberia, then you should find out where such a center is located in the nearest city and contact there.

First aid for a tick bite

First aid for a tick bite consists of removing it from the skin and treating the remaining wound with an antiseptic (iodine, alcohol, etc.). To relieve itching and inflammation at the bite site, you can take any antihistamine (Fenistil, Suprastin, Telfast, Cetrin, etc.).

What to do if you have a fever after a tick bite

If you have a fever after a tick bite, you should consult a doctor and get tested for borreliosis and encephalitis. If the tests are negative, then there is no need to worry, since after a tick bite a person can have a temperature of up to 37.8 o C for a month.

What to do if redness appears on the skin after a tick bite?

Redness on the skin after a tick bite may be a symptom of the early stages of borreliosis or an allergic reaction. It is not always possible to quickly distinguish what caused the redness in each specific case - an allergic reaction or borreliosis. Therefore, when redness appears, it is recommended to take antihistamines (Suprastin, Fenistil, Claritin, Parlazin, etc.). If, under the influence of antihistamines, the redness significantly decreases in size within a few days, this means that an allergic reaction has occurred, which will completely disappear within a month. If, under the influence of antihistamines, the redness practically does not decrease, this means that the person is likely to develop borreliosis. In such a situation, it is necessary to take tests for borreliosis, and if the results are positive, begin treatment immediately.

In nature, a person can expect not only beauty and peace, but also many insects, the bites of which can lead to disastrous consequences. Doctors say that knowledge about the basic safety rules and symptoms of many diseases will help to avoid the problem or prevent complications in time. Find out what a tick bite looks like in a photo, what consequences such a “close encounter” can have, and what parts of the body should be inspected after a hike in nature.

What does a tick bite look like?

Tick ​​activity occurs in late spring and early autumn, when the soil has already warmed up well. These insects have a well-developed sense of smell, so they can sense their warm-blooded prey from 10-30 meters away. The habitat of ticks is tall grass or low shrubs. They dig into places with delicate skin: the lower back, armpits, ears, groin area, belly In the area of ​​the attached insect, redness, rash, and inflammation are characteristic.

Incubation period

The weaker the blood-brain barrier, the faster the first symptoms will appear after a bite. As a rule, this takes from a week to 24 days. In rare cases, the first signs may begin two months after infection. For these reasons, immunologists strongly recommend closely monitoring your health for at least 2-2.5 months. You should pay attention to sharply more frequent headaches, unstable body temperature, and chills.

Why are blood-sucking ticks dangerous?

Ticks can carry diseases such as viral encephalitis, a disease that affects the human nervous system. However, not every insect is a carrier of the virus: of the total number of ticks, this disease is found in only 10-15% of individuals. In addition, depending on the habitat of the insect, they can spread infections such as tick-borne borreliosis, rocky mountain spotted fever, typhus, Crimean-Congo hemorrhagic fever, etc.

Viral infections

The territory of Russia is characterized by the presence of a pathogen whose saliva contains viruses. A tick bite can trigger the development of:

Rickettsial infections

The bite of a tick that carries rickettsia differs in severity - from sluggish forms to dangerous diseases that threaten human life. Immunologists focus on:

• Marseilles fever is an acute zoonotic rickettsiosis characterized by a benign course.
• Astrakhan spotted fever is a rickettsiosis with a sluggish course. Clinically, the disease is manifested by an enlargement of the spleen, liver, and structural changes in the lungs.
• Tick-borne typhus is a disease that affects the body's lymphatic system and causes skin rashes. Infections are carried by insects living in the regions of Siberia, Krasnoyarsk region, Turkmenistan, Kazakhstan, Khabarovsk Territory.
• Q fever is an infectious natural focal disease. Main symptoms: lower back pain, migraine, feeling tired, dry cough, loss of appetite, insomnia.
• Smallpox rickettsiosis is a benign infection. Characterized by the appearance of moderate fever and papular eczema.

Protozoal infection

Among invasive human diseases, special attention is paid to babesiosis. In Russia, the area of ​​possible infection is the forest-steppe part of Siberia, the north-west and south of the European part of the country. In humans, the infection develops against the background of decreased immunity. Particularly susceptible to insect attacks are:

• aged people;
• patients who have undergone surgery;
• AIDS patients.

• General malaise, weakness, loss of appetite - appear if ticks that spread viruses attach themselves to a person.
• If, after removing the insect, redness of the skin, itching, and small rashes appear, we are talking about microbial and rickettsial infections.
• Increased body temperature. In Lyme disease, hyperthermia begins 10 to 18 days after the bite. With ehrlichiosis, fever is typical on days 8-14, and with anaplasmosis - after 2 weeks.

Signs of an encephalitis tick bite in humans

After detecting and removing ticks, they must be submitted to a laboratory, where specialists will determine whether the insect was a carrier of TVE. Symptoms of viral encephalitis appear suddenly: a person’s body temperature rises sharply, headache and chills. Sometimes patients complain of muscle pain and paralysis of the limbs. A characteristic sign of infection is appearance a victim who develops red spots at the bite sites.

Symptoms of Lyme disease

Symptoms of borreliosis look much clearer. This type of infection is characterized by the appearance of macular erythema. At the same time, redness can change in size over time, sometimes reaching 60 centimeters in diameter. The shape of the spot resembles an irregular oval, in the center of which there is a small white or blue blotch. Gradually, the skin at the site of the bite becomes rougher, a crust appears, and then a scar. With proper treatment, the scar disappears on its own within a few weeks.

Consequences

If you do not notice the presence of an insect in time, the consequences for the body can be unpredictable. For example, for tick-borne encephalitis there are three options for the course of the infection, each of which has its own characteristics. A favorable outcome is characterized by:

• the appearance of chronic weakness, which will continue for one to two months of treatment with the subsequent restoration of all body functions;
• moderate severity - with a recovery period of up to 6 months;
• severe form - with the resumption of all functions within 2-3 years.

An unfavorable outcome can bring complications in the form of:

• Decline motor activity, general weakness without progression of symptoms.
• Decrease in all body functions with periodic progression of symptoms and relapses. Patients with alcohol dependence, pregnant women and the elderly are at risk of infection. Poor nutrition, stress, and overwork contribute to the progression of symptoms.

The prolonged presence of symptoms of infection is the reason for a special commission to determine the disability group:

• Group 1 disability is given in the presence of severe impairments motor functions, epilepsy, acquired dementia, loss of self-care abilities, inability to move without assistance.
• The second group is issued in the presence of severe paresis in combination with epileptic seizures, mental changes, and loss of work activity.
• Disability category 3 is assigned if the patient has a neurological syndrome with impaired motor activity of the limbs, loss of some work skills, and rare epileptic seizures.

First aid

The sooner a tick is removed, the less likely it is that infectious agents will enter an open wound. If you are not sure that you can get to the nearest medical center in 1-2 hours, first aid for a tick bite is to pull the insect out yourself. The affected area must be treated with alcohol or iodine. You can get a sucking tick out in several ways:

Contacting a medical facility

The safest thing to do is to have the tick removed at the nearest hospital that has a trauma department. As a rule, every region of the country has 24-hour first aid stations. Then, depending on the situation, you will be referred to an infectious disease specialist, internist or surgeon. If you are in a region with a high percentage of tick-borne encephalitis infection, you will be given anti-tick immunoglobulin within three days after the bite.

How to avoid angioedema

If symptoms of an allergic reaction or suffocation appear, you should immediately call an ambulance. Your algorithm of actions before the arrival of doctors should be as follows:

• Open the windows, rip the neckline of your T-shirt or unbutton the top buttons of your shirt, and loosen your pants belt or waistband.
• Apply a cool compress to the swollen area.
• Be sure to give the patient an antihistamine - Diazolin, Loratadine, Suprastin, Zodak, Erius.

Treatment

Anti-tick therapy is carried out using drugs from different medical categories:

• For tick-borne encephalitis, immunoglobulin is prescribed in the first days. If meningitis is observed, prescribe ascorbic acid and B vitamins. To eliminate respiratory failure, ventilation is performed.
• For borreliosis, tetracycline drugs, bacteriostatics and intravenous injections of bactericidal antibiotics are prescribed. The lack of fluid is relieved by the introduction of blood substitutes.

Method of specific immunotherapy

During treatment of borreliosis, it is important to carry out emergency prevention of infection in the first 72 hours through intravenous administration of immunomodulators. If a tick bite provokes the development of viral encephalitis, the following medications are prescribed:

• Prednisolone - used once a day. The medicine is contraindicated in case of individual intolerance to the components and the presence of skin fungus.
• Reopoliglucin – intravenous injection. Helps eliminate multiple symptoms of encephalitic fever. Often leads to the development of allergies.

Antibiotic therapy for bacterial diseases

An effective remedy that will help cope with infection and eliminate the symptoms of the acute stage is the drug Bicillin - 5. It is used only in a hospital setting in the form of 5-10 daily intramuscular injections. To relieve swelling, Lymphomyosot is additionally prescribed. Bicillin injections are supplemented with antibiotics of the tselofasporin and tetracycline series. These are the drugs:

• Ceftriaxone;
• Timalin;
• Sumamed;
• Claforan;
• Doxycycline;
• Realdiron.

• Clindamycin and Quinine;
• Azithromycin plus Atovaquone;
• Cotrimoxazole, Pentamidine, Diisocyanate.

Prevention

To avoid possible complications and prevent the development of dangerous diseases, you should adhere to simple rules prevention:

• When going outdoors, choose the most closed clothing possible, put a cap on your head, and choose slippery fabrics.

Diseases from ticks in humans

Hi all! Those people who have been living in the countryside for quite some time have gradually become more and more relaxed about ticks and their bites.

This no longer causes such panic as upon first contact with these insects. But don't take the threat of a tick bite too lightly.

In some situations, the consequences can be very dangerous in the form of serious illnesses. Do you want to know about the most common diseases caused by ticks in humans? What symptoms appear first? Then read all the details in the article below.

Tick-borne borreliosis (Lyme disease)

Tick-borne borreliosis (Lyme disease) is an infectious transmissible natural focal disease caused by spirochetes and transmitted by ticks, which tends to be chronic and recurrent and primarily affects the skin, nervous system, musculoskeletal system and heart.

The study of the disease first began in 1975 in the town of Lyme (USA).

Cause. Lyme disease is caused by spirochetes of the genus Borrelia. The pathogen is closely related to pasture (ixodid) ticks and their natural hosts. The commonality of vectors for pathogens of ixodid tick-borne borreliosis and tick-borne encephalitis viruses determines the presence of cases of mixed infection in ticks, and therefore in patients.

The geographic distribution of Lyme disease is vast, occurring on all continents (except Antarctica).

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

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

A person with Lyme disease is not contagious to others.

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

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

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

Signs. The incubation period is from 2 to 30 days, on average - 2 weeks.

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 tick bite. The red spot gradually increases along the periphery, reaching 1-10 cm in diameter, sometimes up to 60 cm or more.

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

Over time, the central part of the spot turns pale or acquires a bluish tint, creating a ring shape. At the site of the tick bite, in the center of the spot, a crust is visible, then a scar. Without treatment, the spot persists for 2-3 weeks, then disappears.

After 1-1.5 months, signs of damage to the nervous system, heart or joints develop.

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. To confirm the diagnosis, a blood test is performed.

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

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

Attention!

Disease prevention. The leading role in the prevention of Lyme disease is the fight against ticks, where both indirect (protective) measures and their direct extermination in nature are used.

Protection in endemic areas can be achieved using special anti-tick suits with rubber cuffs, zippers, etc.

For these purposes, you can adapt ordinary clothes by tucking in your shirt and trousers, the latter in your boots, cuffs tightly adjusted, etc. From tick attacks on open areas The body can be protected for 3-4 hours by various deterrents - repellents (DEET, Diftolar, etc.).

The use of clothing impregnated with the drug “Permet” completely protects against crawling and tick bites during a 24-hour stay in the outbreak.

If you are bitten by a tick, you should go to the infectious diseases hospital the next day with the tick removed to have it examined for the presence of Borrelia.

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

source: http://www.infectology.ru/forall/noso/lyme.aspx

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 wary of only three species: Ixodidae, Argassidae and Gamasidae, which are attracted by the warmth of a living organism.

Ixodid ticks are the most numerous. They include 241 species. Representatives of ixodid ticks are found in Russia: Ixodes, Haemaphysalis, Dermacentor, Hyalomma, Rhipicephalus.

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

Argasid mites usually live in nests, burrows, caves, and adobe buildings. And gamasid mites - 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, the ixodid tick, is most often active twice a year: from April to May and from August to September. In the south of Russia, the most common species is Hyalomma marginatum, which is active from April to August.

In the vast majority of cases, the condition conducive to infection is the presence of people in areas enzootic for Crimean hemorrhagic fever (CHF) or tick-borne viral encephalitis (TBE).

It could be work activity, associated with livestock and agricultural work, hunting, tourism or, for example, outdoor recreation.

Human infection with TVE is possible through nutritional means - through consumption of food. raw milk goats Birds are capable of carrying ticks over long distances.

What diseases are transmitted by ticks?

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

Human monocytic ehrlichiosis (HEM) is an infection that affects the skin, liver, central nervous system and bone marrow. Most often, the disease is diagnosed in children and patients over 40 years of age. Characteristic symptoms diseases: fever, fever, chills, headache, weakness, loss of appetite. Some patients experience a rash, abdominal pain, vomiting and diarrhea.

Human granulocytic anaplasmosis (HGA) is an acute infectious disease caused by the bacterium Anaplasma. Characterized by high temperature and general symptoms of poisoning.

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

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

Relapsing tick-borne typhus 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. Found throughout the world except Australia.

North Asian tick-borne rickettsiosis is an infectious disease characterized by fever, headache, rash, sudden fever, chills, joint and muscle pain.

Attention!

Astrakhan spotted fever is an acute infectious disease characterized by fever and rash.

Q fever (Rocky Mountain spotted fever, tick-borne typhus, Marseilles 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. Pneumonia and tracheobronchitis are also often found in infected people.

source: http://rospotrebnadzor.ru/activities/recommendations/details.php?ELEMENT_ID=3651

Diseases transmitted by ticks

Russia is one of the world's largest areas of infectious diseases transmitted by ticks. Every year, several hundred thousand patients consult doctors of various specialties regarding tick bites.

It is known that ticks serve as carriers of 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 and summer), transmission of the pathogen to humans ixodid ticks during blood sucking, acute onset of the disease, fever, symptoms of intoxication, signs of damage to the nervous system, various skin rashes.

During the act of blood sucking, the tick injects painkillers, vasodilators and other substances into the human skin, and with them pathogens that are in the intestines and salivary glands ticks. Tick ​​suction usually does not cause pain and goes unnoticed.

The most favorite locations for ticks are the neck, armpits, chest and groin folds. A tick that has drunk blood enlarges tenfold, taking the form of a dense gray or light ball.

About 25% of sick people do not indicate tick bite: it occurs either over a short period of time, or in an area of ​​the body that is difficult to detect.

Tick-borne encephalitis (TBE) is the most common and severe epidemic encephalitis in Russia and many European countries. Among diseases caused by arboviruses, TBE occupies one of the leading positions.

Natural foci of TBE have been registered in all forest and taiga zones of Russia. The incidence of TBE is especially high in the Urals, the Urals and Siberia. Endemic for TBE Kaliningrad and Leningrad region. In 2008, for the first time in many years, in several districts of the Moscow region, individual ticks were infected with the TBE virus.

Human infection with TBE can occur not only during tick bites, but also through the nutritional route when consuming raw goat or cow 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 correlates with the number of subclinical (asymptomatic) forms by 1:100–200 or more.

Analysis of the genomic structures of all the main currently known strains of the TBE virus made it possible to identify three main genotypes of the virus, one of which corresponds to the Far East, the second to the West, and the third includes strains classified as the Ural-Siberian variant.

Some researchers believe that there is a certain connection between the clinical manifestations of TBE and the gene species of the pathogen.

Since the beginning of the study of FE, based on clinical and laboratory studies, the following have been distinguished: febrile (erased), meningeal and focal, or paralytic, forms of the disease.

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

In extremely rare cases - hundredths and thousandths of a percent - their transition to a chronic, progressive form is observed. CE is encephalomyelitis, i.e. combined damage not only to the brain, but also to the spinal cord.

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

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

In the meningeal form, in addition to the symptom complex inherent in the febrile form, meningeal syndrome is added: vomiting at the height of the headache, severe general hyperesthesia, stiffness of the muscles of the back of the head, pain when pressing on the eyeballs, symptoms of Kernig, Brudzinsky, etc.

Sometimes focal neurological symptoms can be identified transiently: facial asymmetry, anisocoria, nystagmus, etc. During lumbar puncture, cerebrospinal fluid (CSF) flows out under high blood pressure, transparent, sometimes opalescent.

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

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

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

Features unique to EC are the presence of severe damage to the nervous system in the form of upper poliomyelitis: paresis and paralysis of the upper shoulder girdle (neck and proximal parts of the upper extremities - “floppy head” syndrome), a combination of central and peripheral paresis: muscle atrophy and high reflexes.

Another feature of CE is the development in some patients of Kozhevnikov epilepsy syndrome - a severe condition in the form of constant muscle contractions in one half of the body - myoclonus, periodically aggravated by generalized epileptic convulsions.

A unique feature of CE is the transition of the disease in some patients into a chronic, progressive process, ending in death.

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

Up to 60% of meningoencephalitis in Western Siberia associated with tick bites are caused by co-infection of tick-borne encephalitis virus and B. burgdorferi.

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

The only real method of preventing the development of severe disabling and fatal consequences with TBE remains prevention - the introduction of a vaccine against tick-borne encephalitis.

IN last years In Europe, the production of anti-tick immunoglobulin has been discontinued (previously it was used there only for preventive 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.

Attention!

In Russia, immunoglobulin has been and is used for preventive and therapeutic purposes. For treatment, immunoglobulin against TBE is administered intramuscularly; doses and administration schedules depend on the clinical form.

Another disease transmitted by ticks is ixodic tick-borne borreliosis - ITB (synonyms: Lyme borreliosis, tick-borne erythema, systemic tick-borne borreliosis) - a widespread infectious natural focal, bacterial disease with transmissible transmission, often taking a chronic, relapsing course and affecting a number of body systems.

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

According to calculations by domestic epidemiologists, every year in our country the number of cases reaches 10–11 thousand people. This figure is probably 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 USA - more than 13 thousand people.

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

The bulk of diseases are observed in the spring-summer period (April-June), but the season of incidence can shift significantly depending on weather conditions - the earlier the warm period comes, the faster ticks awaken and become more active, and therefore more often they attack humans.

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

Entering the general bloodstream with the tick's saliva, borrelia spread throughout the body, settling in various organs (brain, heart, joints, eyes, liver) and causing inflammatory changes in them. This acute organ damage resulting from dissemination of infection characterizes the second stage of ICD.

Months or years after the end of the dissemination phase of the infection, new symptoms may develop, which mark the third stage of ICD - the stage of chronic organ damage or a period of persistent infection.

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 classify the disease as the third stage of ICD, the duration of inflammatory changes in the affected organ must be at least 6 months. The sequence of organ damage described above is the exception rather than the rule, and it is rare to see the above-described chronological progression of one stage after another in a patient with ICD.

More often there are manifestations of one or two stages of the disease in one patient. Thus, a patient with symptoms of the second stage of ICD may not have manifestations of local infection, or the third stage of ICD may manifest itself without acute damage in the first two phases of the disease.

Like other spirochetoses, ICD is a systemic disease that develops in stages corresponding to the chronology of the affected organs. The main organs involved in the disease are: skin, nervous system, heart and joints.

The stages of the disease are determined by clinical signs of 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 precise indication of the initial period of the disease.

ICD can occur with a sequential alternation of all stages of the disease, with the “skipping” of one of the stages or with a 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 tick suction.

This initial redness expands and increases in size over several days, forming into an erythema with an average diameter of 10–15 cm (ranges from 3–5 to 70 cm). Erythema can occur in any part of the body, but is more common on the trunk, thighs, or axillary areas.

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 “tick-borne erythema migrans.”

Erythema may be the only sign of the 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 may end at this stage and the erythema may disappear spontaneously. In another part, the erythema persists for weeks and even months, and against its background signs of damage to other organs appear.

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 the organ of vision (ophthalmic borreliosis).

The second stage of ICD develops 2–10 weeks after the acute period. Neurological manifestations of ICD are quite varied, 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 lesion syndromes is observed, manifested in various symptom complexes. Cardiac disorders are observed from 4–5 weeks of the appearance of erythema.

They include grade 1–3 changes in atrioventricular conduction, intraventricular conduction disorders, atrial fibrillation and others. The duration of cardiac disorders is short and does not exceed several weeks. Serious abnormalities such as dilated cardiomyopathy and fatal pancarditis are also observed.

Attention!

In contrast to the often spontaneously resolving first two stages of ICD, its third stage (chronic organ pathology) is characterized by a chronic, inflammatory, destructive process that affects the skin, joints and nervous system.

In the case of tick-borne erythema in the acute period of the disease, the interval between the 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 (CAA); dermatoborreliosis (CAA, benign lymphadenosis of the skin); mono- and polyarthritis.

Serological testing for the presence of antibodies to B. burgdorferi can provide decisive assistance in the diagnosis of ITB, especially those variants that occur without tick-borne erythema. The most commonly used reactions are: indirect fluorescent antibody method (IFA), enzyme-linked immunosorbent assay (ELISA), and immunoblot.

Early IgM antibodies to B. burgdorferi begin to appear no earlier than 2–3 weeks of the disease, so they are practically not found at the erythema stage and it is not advisable to conduct a serological examination during this period. IgM antibodies usually disappear quickly, but can persist for a long time.

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

A number of researchers point to the molecular polymorphism of the pathogen genotypes, manifested in the heterogeneity of the surface proteins of B. burgdorferi, which entails difficulties in the serodiagnosis of ITB.

ICD is treated with broad-spectrum antibiotics. They are prescribed orally in the erythema stage and parenterally intravenously for neuroborreliosis and CAA in the second and third stages of ICD.

In the first stage, etiotropic treatment is carried out with doxycycline in a daily dose of 0.2 g; The drugs of choice are amoxicillin (0.5 g 3 times a day), azithromycin (0.5 g/day).

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 and massive doses of penicillin. Duration of treatment - 2 weeks.

Tick-borne spotted fevers

The group of tick-borne spotted fever (TSF) includes a number of naturally focal, vector-borne diseases caused by rickettsia, including both long-known ones (Marseilles or Mediterranean fever, Rocky Mountain spotted fever, tick-borne typhus of North Asia, vesicular rickettsiosis, etc.) and recently first described (Japanese and Israeli spotted fevers, African tick-bite fever), including in our country - Astrakhan spotted fever and Far Eastern tick-borne rickettsiosis.

This list continues to grow, new representatives of Rickettsia are being discovered, and previously unknown diseases are being described.

In Russia, natural foci of LP are widespread. Tick-borne typhus of North Asia (pathogen Rickettsia sibirica) is recorded in Western and Eastern Siberia, Altai, Krasnoyarsk, Khabarovsk and Primorsky territories. At the beginning of the 21st century, the incidence increased, up to 3,000 or more cases are detected annually; This is the most common rickettsiosis in Russia.

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

All LP have some common clinical signs, including:

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

The rash is usually profuse, maculopapular, on the skin of the trunk and extremities, including often on the palms and soles, and is not pruritic. After 5–7 days, the rash disappears, and skin pigmentation remains in its place.

LLP is usually benign. The exception is Rocky Mountain spotted fever, which is found in North and South America.

The diagnosis of LP is based on epidemiological history (stay in a natural focus during the tick activity season) and a characteristic clinical symptom complex: primary affect at the site of tick suction, polymorphic exanthema, fever.

The diagnosis is confirmed by the detection of antibodies to the antigens of the corresponding rickettsia in various laboratory methods: indirect immunofluorescence reaction (IDIF), ELISA, complement fixation reaction (FFR), indirect hemagglutination reaction (IRHA).

Treatment of LP is carried out 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 prevention, using a vaccine, has been developed only for Rocky Mountain spotted fever, and nonspecific prevention is similar to that for all tick-borne diseases.

Omsk hemorrhagic fever (OHF) is an acute viral disease with natural focality, characterized by fever, hemorrhagic syndrome and damage to the nervous system. The causative agent belongs to the group of arboviruses, family Flaviviridae.

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

The portal of infection is the skin at the site of a tick bite or its small lesions infected through contact with a muskrat or water rat. At the site of the infection gate, no primary affect is observed. The virus penetrates the blood, spreads hematogenously throughout the body and primarily affects blood vessels, the nervous system and the adrenal glands.

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

Attention!

Fever rarely lasts less than 7 or more than 10 days. Almost half of the patients experience repeated waves of fever (relapses), often at 2–3 weeks from the onset of the disease and lasting from 4 to 14 days. The total duration of the disease is from 15 to 40 days.

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

Nasal, pulmonary, intestinal, uterine bleeding. There is a decrease blood pressure, deafness of heart sounds, bradycardia, dicrotia of pulse and individual extrasystoles. In 30% of patients, pneumonia develops (small-focal), and there may be signs of kidney damage (proteinuria, microhematuria, cylindruria).

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

Crimean hemorrhagic fever (CHF) is an acute viral disease that is classified as a zoonotic disease with natural focality. It is characterized by two-wave fever, general intoxication, severe thrombohemorrhagic syndrome, and a severe course.

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

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

CCHF is classified as a dangerous infectious disease. Infection occurs not only when bitten by an infected tick or when it is crushed, but also when blood and mucous membranes come in contact with the skin. bloody discharge sick.

The incubation period lasts from 1 to 14 days (usually 2–7 days). The disease begins suddenly, body temperature quickly rises to 39–40 °C, and at the same time headache, myalgia and other symptoms of intoxication appear.

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

During the height of the disease (2–4 days from the onset of the disease), hemorrhagic rashes appear on the skin and mucous membranes, hemorrhages at injection sites, nasal, gastrointestinal, uterine bleeding, hemoptysis, etc.

Patients are lethargic, adynamic, and sometimes, on the contrary, agitated. Meningeal syndrome is not uncommon. The severity of thrombohemorrhagic syndrome determines the severity and outcome of the disease. The convalescence period is estimated at several months.

When making a diagnosis, epidemiological data (stay in endemic regions, season, etc.) and characteristic clinical symptoms are taken into account: acute onset, early-onset and varying degrees of thrombohemorrhagic syndrome, two-wave temperature curve, leukopenia, anemization, etc. For specific diagnosis, RNIF is used , ELISA, PCR.

The patient with CHF is hospitalized in the isolation ward of the infectious diseases hospital. Ribavirin is recommended as an etiotropic drug.

Ehrlichiosis as an epidemic infectious disease was first recognized in the USA in 1986. There are two etiologically and epidemiologically various shapes diseases: human monocytic ehrlichiosis (HEM), caused by E. chaffeensis, and human granulocytic ehrlichiosis (HGE), or anaplasmosis, caused by E. phagocytophila.

Pathogens are transmitted to humans through the bite of infected ticks, which acquire them by feeding on infected animals. Ehrlichia belong to the family Rickettsiae and have a characteristic round shape with a membrane bounding it on the outside. There are publications about the detection of patients in Germany, England, Scandinavia, and France.

Ehrlichiosis is quite widespread in the USA and Japan. These are new diseases for Russia; the first cases of monocytic ehrlichiosis were diagnosed in the Perm region. in 1999, anaplasmosis - a few years later in the Far East.

The duration of the incubation period for ehrlichiosis is on average 8–14 days.

Clinically, MECH and HSE are almost indistinguishable and are characterized by a complex of symptoms: sudden onset, chills, fever, headache, myalgia, thrombocytopenia, leukopenia, increased activity of liver enzymes. The rash occurs in approximately 1/3 of patients with LECH, but is rare in patients with HES.

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

In some cases, complications such as respiratory distress syndrome, renal failure, neurological disorders, and disseminated intravascular coagulation are noted. The mortality rate for LECH is 5%, and for HSE it is 10%, although, obviously, the true mortality rate may be higher.

RNIF is most often used for diagnosis. Cases of the disease are confirmed by a 4-fold increase in antibody titers in the RNIF or a single titer of specific antibodies in the RNIF ≥ 64, positive PCR. When microscopy of blood smears stained by Wright, intracellular inclusions of the corresponding ehrlichia can be detected in monocytes or granulocytes.

Ehrlichia is sensitive to tetracycline drugs, chloramphenicol, which makes it possible to quickly and effectively treat this disease. Cases of co-infection with Lyme borreliosis and ehrlichiosis have been reported.

Attention!

The disease was first diagnosed in humans in Yugoslavia in 1957. The causative agent belongs to the protozoa, class Sporozoans, family Babesiidae. Babesia are located inside the affected red blood cells in the center or along the periphery.

When stained by Gram, they appear as thin rings with a diameter of 2–3 μm or pear-shaped formations with a diameter of 4–5 μm. To date, a little more than 100 cases of human babesiosis have been described in the world literature, most of which were fatal.

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

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

The incubation period lasts from three days to three weeks (on average 1–2 weeks). The disease begins acutely with chills and an increase in body temperature to high numbers. Fever is accompanied by severe weakness, adynamia, headache, epigastric pain, nausea and vomiting.

Constant or irregular temperature curve. High fever usually lasts 8–10 days with a critical drop to normal level in the terminal stage of the disease.

From the 3rd–4th day of illness, against the background of increasing intoxication, pale skin, enlarged liver, jaundice, and oligoanuria are observed. Subsequently, the symptoms of acute renal failure come to the fore in the clinical picture.

The lethal outcome is caused by uremia or associated intercurrent diseases (pneumonia, sepsis, etc.). Clinical diagnosis is difficult due to the rarity of the disease. Prolonged fever against the background of anemia, hepatomegaly, renal pathology, and lack of effect from taking antibiotics force laboratory tests to be performed for babesiosis.

It is important to take into account epidemiological data (tick bites, stay in endemic areas), and identify disorders 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.

Tick-borne fevers of Kemerovo and Lipovnik are “new” zoonotic natural focal arboviral infectious diseases with a vector-borne mechanism of pathogen transmission. The causative agent is RNA viruses from the Reoviridae (Orbivirus) family of the Kemerovo group.

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

People's natural sensitivity is high. After an illness, immunity remains. Recurrent diseases are rare. Kemerovo fever has been identified in the forest and forest-steppe parts of the Kemerovo region of Russia, Lipovnik fever - in a number of European countries.

Mostly men aged 20–50 years are affected. Persons professionally associated with forests (foresters, loggers, rangers, etc.) are at greatest risk. Diseases are detected mainly in the warm season, during the period when ticks are active.

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

So, on the territory of Russia in the warm season there is a real danger of contracting one or several infections transmitted by ixodid ticks at the same time. Their clinical diagnosis is difficult, laboratory early dates not always informative.

The population should be impressed upon the need for protective measures when visiting forests, parks and other tick habitats (wearing clothing such as overalls, using repellents, self- and mutual examination). If a tick is found, you should immediately remove it and consult a general practitioner or infectious disease specialist.

It is advisable to examine the tick for the presence of possible pathogens. If a TBE virus is detected in a tick, the victim is injected with anti-encephalitis immunoglobulin, Borrelia, and antibiotics (doxycycline or amoxicillin) are prescribed for 7–10 days.