Tick-borne encephalitis disease symptoms. Diagnosis of tick-borne encephalitis: symptoms and treatment of the disease. Drug treatment of encephalitis

Each tick bite causes justified and understandable anxiety in a person - whether this will be followed by infection with a deadly infection, namely encephalitis. Therefore, the signs of an encephalitis tick bite are of interest to most people who are bitten.

It is important to separate the symptoms of encephalitis from another, more common, but no less threatening infection - Lyme disease, or borreliosis, which at first resembles encephalitis in its manifestations.

In any case, as soon as the first symptoms of illness appear in the affected person, you need to contact an infectious disease specialist as soon as possible - only there they will determine whether it is definitely encephalitis and provide assistance. necessary help, giving an injection of immunoglobulin to prevent further development of the infection in the body.

It is especially important not to miss the very initial symptoms of an encephalitis tick bite, so that a person has the opportunity to neutralize the virus that enters the blood during the bite using immunoglobulin serum.

Immunoglobulin against tick-borne encephalitis

The first symptoms after an encephalitis tick bite

The very first symptoms that a person can feel after a tick bite that turns out to be a carrier of encephalitis repeat the general picture of a sharp onset of malaise in many diseases. However, there is also specific signs, which should alert a person if he has recently become a victim of a tick attack.

The main thing that everyone who has been subjected to a tick attack should know is the attack initial signs after an encephalitis tick bite in a person, they begin no earlier than a week or two later. This is how long the incubation period for the encephalitis virus lasts.

That is, the symptoms that the bite victim will feel immediately after removing the tick or on the next or third day will most likely not be related to encephalitis.

On initial stages The encephalitis virus can manifest itself with any of these signs.

The temperature rises, very often to the maximum, one feels fever or chills, or a combination of both.
A person is overtaken by a feeling of severe weakness and loss of strength.
Numbness and/or twitching may occur in the neck, collarbones, shoulder blades, or limbs.
Possible pain and hardening in the muscles covering cervicothoracic region, calves, arms, and also in these joints.
Often there is unbearable pain and a feeling of dizziness, because the brain and spinal cord primarily suffer from viral aggression.
There may be flickering in the eyes, loss of sharpness and clarity of the picture, and bright light is irritating.
Harsh sounds also cause suffering.
On the digestive side, a similar failure occurs - appetite is lost, nausea sets in, and the urge to vomit occurs.

Important! It is the reaction to the virus at least a week after the bite from the muscles, joints and sensory organs - vision and hearing - that can speak in favor of infection with encephalitis. You cannot ignore these symptoms, otherwise the consequences will be negative!

Further symptoms of encephalitis

If the period in the first 4 days was missed for a person bitten by a tick, and a preventive measure in the form of an immunoglobulin injection was not applied, then the disease will continue to develop.

The virus, which initially invaded the cells, transforms into them and, breaking through the cell membranes, enters the general bloodstream, aggressively infecting the entire body. The body reacts violently in response, and the person is overtaken life threatening symptoms that can only be relieved in a hospital, and sometimes in intensive care.

The clinical picture develops according to a scenario that depends on the subtype of encephalitis - Far Eastern or European, so for each subtype the dynamics and manifestation of symptoms will vary.

The Far Eastern subtype is more transient, active and dangerous, the European subtype is more smoothed out, with a favorable outcome.

Symptoms of the Far Eastern subtype after an encephalitis tick bite

Taiga tick (representatives)

This is explained by the migration of ticks that stick to the victim over impressive distances. Therefore, the risk of discovering this particular representative of the Ixodid family is not excluded for most Russians.

There is also information about the involvement of the Far Eastern subtype of encephalitis virus, which is close to the taiga species of the Pavlovsky tick Ixodes pavlovskyi, which also belongs to the Ixodes family, in transmitting to humans.

This encephalitic subtype of the virus is characterized by violent manifestations, demonstrating such symptoms.

The disease begins to appear after a week or two from the moment of infection
The temperature rises sharply, there is intense pain and dizziness, and pockets of redness of the skin are possible.
The neck, back of the head, back, and limbs may become numb, tingle, or ache.
It is difficult and painful for a person to move and turn his head.
A feeling of nausea and vomiting are added.
There are ripples in the eyes and a pain response to bright lighting.
On the 3rd - 5th day, meningitis sets in - the person’s consciousness becomes confused, he may fall into feverish delirium, convulsions and paralysis are possible.
Against this background, appetite completely disappears and sleep is disturbed, strength decreases.

Important! Due to the rapidity of the increase in symptoms, the main thing is not to attribute the primary ailment to another illness, do not stay at home, but seek emergency help, otherwise you may suffer and remain disabled for life!

Symptoms of the European subtype after an encephalitis tick bite

In recent years, the tick has been hunting for food not only in forest areas, but also in urban areas - parks, squares, cemeteries, as well as in vacant lots overgrown with grass.

Therefore, the risk of meeting him and becoming a victim of his bite in an urban environment cannot be ruled out - on a regular walk near thickets of bushes or tall grass.

The European subtype of encephalitis virus differs mainly from the Far Eastern subtype - the presence of two phases of the disease.

The first phase begins a week or more later, if you count from the moment of the bite, and lasts up to 5 days.

Its manifestations resemble the flu - acute course with a feverish state, accompanied by headaches, joint and muscle pain, general weakness, redness of the face.
The person loses his appetite, feels nauseous and sometimes vomits.
The neck may be sore or numb - it is difficult to turn, and the muscles become stiff.
After a maximum of 5 days, the first phase subsides and noticeable relief occurs.

About a quarter of the sick enter the second, more severe phase after 7-8 days.

The picture of meningitis is observed - severe, persistent headaches, which are accompanied by nausea and vomiting.
Are being added painful spasms muscles of the neck and back of the head, turning the head brings torment.
There may be problems with the digestive system - severe pain in the abdomen.
At the same time, the reaction to stimuli increases - light and sounds cause a physical sensation of pain.
The organs of movement - joints and muscles - suffer, convulsions and paralysis occur.

Important! It is precisely those who survived the second phase who risk being left with lifelong disorders of the nervous system!

Why do people have different symptoms after an encephalitis bite?

The manifestations of infection may vary for each tick bite victim. This happens for various reasons.

For your information! Symptoms also vary for each individual infected person due to which organ of the body is affected by the virus. It is customary for doctors to distinguish the febrile form from the meningeal and focal forms. Symptomatic therapy depends on this definition.

What threatens a person with an encephalitis tick bite?

Tick-borne encephalitis - terrible viral infection, terrible for its fatal consequences.

A special threat for half of the country's population is living in areas unfavorable for encephalitis, especially the Far Eastern type.

A quarter of victims of encephalitis tick bites that transmit the Far Eastern subtype die. Victims of the European subtype face a less terrible figure - about 2%.

A fifth of them remain incapacitated disabled people with neurotic and mental disorders for life.

The only preventive measure so far is vaccination, which guarantees the immunity acquired during a course of vaccinations.

Therefore, it is necessary even with minimal existing risk be exposed to a tick bite, get vaccinated, according to the main or emergency scheme, in order to protect yourself from the deadly disease.

Important! If you suddenly feel unwell, reminiscent of the flu or another disease, but have recently been bitten by a tick, you need to seek help and not treat yourself with folk recipes or advice from a pharmacist! You may have encephalitis, and the hours are counting!

Tick-borne encephalitis is a severe infectious naturally-mediated disease that is caused by a virus from the Flavivirus genus and is usually manifested by fever, damage to the central nervous system (central nervous system) and the development of flaccid paralysis and paresis.

An innocent walk in nature can turn into a completely healthy person profound disability, and even lead to death.

The disease was first described by the head of the neurological department of the naval hospital in Vladivostok A. G. Panov in 1934, and already in 1937 the virus was isolated from cerebrospinal fluid, blood, brains of deceased and ixodid ticks by a group of scientists headed by Academician L.A. Zilber.

Soviet neurologist, Doctor of Medical Sciences, Professor. Discoverer of tick-borne encephalitis in 1935.

Soviet immunologist and virologist, founder of the Soviet school of medical virology. Researcher and discoverer of the disease tick-borne encephalitis.

Every year, 10 - 12 thousand people become infected, and the real figure is considered much higher than indicated. Basically, all cases are associated with a tick bite in forest or park areas.

IN Lately It is believed that the most dangerous areas for infection are the territories Russian Federation, Slovenia and the Baltics. Infected ticks are present in many other countries and therefore residents of these regions are also at risk of infection (Austria, Poland, Switzerland, Slovakia, Albania, Sweden, Ukraine, Turkey, Korea and others).

Consequences of tick-borne encephalitis

The consequences of this disease in certain cases include disability from the central nervous system (central nervous system), paralysis, cognitive impairment, and more. The mortality rate for Russian spring-summer tick-borne encephalitis is 25%, for European tick-borne encephalitis - 5%.

The causative agent of tick-borne encephalitis

The causative agent of tick-borne encephalitis is an RNA-containing flavivirus, which belongs to the arboviruses. The virus has a spherical shape, contains a nucleocapsid (a complex of nucleic acid and a protein shell), protected by an outer lipid shell, into which spikes are immersed (provoking the adhesion of red blood cells).

There are 3 known subtypes of the pathogen:

European (western, Najdorf),
Far Eastern (spring-summer encephalitis, Sofin)
and Siberian (Vasilchenko and Zausaev).

These three subtypes differ from each other in biological properties. The Far Eastern strain of the Sofiin virus is one of the first isolates of the tick-borne encephalitis virus. Due to its wide distribution in virus collections, it has become a reference strain.

They carry the virus and its natural reservoirs are infected ixodid ticks (Ixodes persulcatus and Ixodes ricinus), less commonly - gamasid ticks, and even less often - fleas and horseflies.

Ticks often remain firmly attached to the skin for several days.

Additional sources of infection are about 130 species of wild mammals. Most often these are squirrels, moles, hedgehogs, wild boars and even some species of birds.

An interesting fact is that the greatest likelihood of infection the largest number The virus can be obtained from the taiga tick (Ixodes persulcatus), because the most favorable conditions for the active reproduction of the virus have been created in its body.

Infection most often occurs through a tick bite, less commonly, it is also possible when swallowing thermally untreated milk that has been contaminated with tick feces (in this case, familial outbreaks of the disease may occur).

There is no direct transmission of the virus from person to person

People are highly susceptible to the virus. Due to activation life cycle ticks, the disease has a spring-summer seasonality.

Tick-borne encephalitis infection clinic

The virus, penetrating into the blood after a bite, multiplies in protective blood cells - macrophages. Then the stage of viremia begins, when new viruses enter the blood. After this, they follow to the regional lymph nodes, cells of the liver, spleen, blood vessels and multiply there again. Next, the viruses enter the motor neurons of the anterior horns of the cervical part of the spinal cord (as a result of which paresis and paralysis occur), into the cells of the cerebellum and pia mater.

Period from infection to manifestation clinical symptoms averages from 7 to 14 days. The severity of the disease depends on the type of bitten tick, the type of pathogen and the duration of blood sucking (the longer, the higher the likelihood of receiving a large dose of the pathogen). It is also known that the severity of the disease increases with the age of the patient.

IN acute period A ring-shaped erythema may be observed at the site of tick suction. But the main clinical syndromes are general infectious, meningeal and focal.

During the prodromal period General infectious syndrome manifests itself in the form of the following symptoms:

temperature increase,
general weakness, lethargy,
headache,
nausea,
Sometimes muscle pain occurs in the neck and shoulder girdle,
feeling of numbness.

With a benign course this period is from 3 to 5 days. In some cases, against the background of severe intoxication, meningeal syndrome occurs, and meningeal signs may not be pronounced, and changes can be observed only in the cerebrospinal fluid.

In severe cases When encephalitis or meningoencephalitis develops, patients experience delusions, hallucinations, agitation, and the person is poorly oriented in time and space. The patient is inhibited and may feel fear and apathy.

Patient's appearance characterized by the following features: redness of the face, neck, conjunctiva, injection of scleral vessels, the tongue is covered with a whitish coating, the pharyngeal mucosa is often hyperemic. Abdominal bloating may occur. People often complain of photophobia, lacrimation, and blurred vision.

For diffuse brain symptoms disturbances of consciousness may occur, epileptic seizures, respiratory and cardiac dysfunction, signs of cerebral edema, pathological reflexes appear, as well as paresis of facial muscles and tongue.

With focal brain symptoms Hemiparesis, paresis after convulsions, epileptic seizures, and less often subcortical and cerebellar symptoms develop quickly. Characteristic lesions of the nuclei cranial nerves. Occasionally, gastric bleeding with bloody vomiting is possible (as a consequence of a violation of the autonomic nervous system).

In some patients, after the prodromal period, a pronounced pain syndrome occurs in the neck and shoulder girdle with periodic muscle twitching, which indicates damage to the motor neurons of the anterior horns of the spinal cord. Weakness and numbness may suddenly occur in any limb, which will subsequently be accompanied by movement disorders.

Over the course of several days, and sometimes even weeks, against the background of elevated temperature and general cerebral symptoms, the intensity of flaccid paralysis of the cervicobrachial and cervicothoracic localization increases (hunched over, stooping, “proud” posture, hanging head on the chest).

Movement disorders can be mixed. For example, flaccid paresis appears on the upper limbs, and spastic paresis appears on the lower limbs. An increase in motor impairment is observed for up to 12 days. By the end of 2-3 weeks, atrophy of the damaged muscles is observed. Also, paralysis can begin in the reverse order - with lower limbs on the muscles of the trunk and upper limbs.

All these manifestations can occur when infected with any type of tick-borne encephalitis virus, but with the Far Eastern variant, severe and pronounced damage to the central nervous system develops. The disease begins acutely, is very difficult to tolerate, and often ends in death and disability of the patient.

Clinical features of tick-borne encephalitis

Clinical features of Central European tick-borne encephalitis- two-wave fever.

1st stage corresponds to viremia (circulation of the virus in the patient’s blood). It is accompanied by nonspecific symptoms (fever, weakness, loss of appetite, muscle pain, nausea). In most cases, the person recovers. But in about 30% of cases, remission is observed (5-8 days), and then follows
2nd stage, which is characterized by damage to the central nervous system (meningitis, encephalitis).

It should be remembered that with nutritional infection (through milk), an enlargement of the liver and spleen is often observed.

Depending on which symptom complex prevails in a patient with tick-borne encephalitis, the following clinical forms are distinguished:

febrile,
two-wave milk fever,
meningeal,
meningoencephalitis,
polio-like,
polyradiculoneurotic.

After infection and passing through the acute stage, infectious process can be chronic in several forms (hyperkinetic, which is characterized by Kozhevnikov’s epilepsy; amyotrophic, when activity pathological process localized in the cervical-shoulder girdle).

The virus can remain in active form in the central nervous system and when favorable conditions appear after several months or years.

With tick-borne encephalitis, the development of complications is quite often observed. Most often they occur when infected with the Russian spring-summer subtype of the virus.

The most common complications include:

cerebral edema with the development of cerebral coma,
hemorrhages in the brain matter,
gastric hemorrhages,
Jacksonian or Kozhevnikov epilepsy,
respiratory and cardiac disorders as a result of damage to the medulla oblongata,
infectious-toxic myocarditis,
paralysis
and, as a consequence, disability of the patient.

Nonspecific complications include the addition of bacterial flora against the background of decreased immunity and the development of severe pneumonia with respiratory failure.

Laboratory diagnostics are used to confirm the diagnosis.

Clinical blood test: decreased leukocytes and increased lymphocytes and monocytes.
Clinical urine analysis: the appearance of protein and casts in the urine (with moderate severity diseases and especially in severe cases).
Cerebrospinal fluid - slight increase in lymphocytes and increased protein levels.
Virological methods: isolation of the virus from the blood, cerebrospinal fluid (on the 5-7th day of illness), in cell cultures with further identification using the method of fluorescent antibodies.
Serological methods: enzyme immunoassay, complement fixation reaction, passive hemagglutination reaction, neutralization reaction in paired sera taken at intervals of 2-3 weeks.
Polymerase chain reaction: determination of virus RNA in the blood.

Treatment of patients with tick-borne encephalitis is carried out in the infectious diseases department or in intensive care. Recommended bed rest and protein diet with increased content potassium

Antiviral treatment consists of administering homologous immunoglobulin against the tick-borne encephalitis virus. The faster it is administered, the faster the clinical effect will occur. Its mechanism of action is due to the fact that the antibodies that are part of the drug neutralize the effect of the virus (1 ml binds from 600 to 60,000 lethal doses virus), and also protect the cell from further penetration of the virus by binding to membrane receptors.

Also, for specific treatment, ribonuclease is used, which penetrates the membranes of the brain and inhibits the reproduction of the virus in the cells of the nervous system. In some cases, the administration of interferons in small doses is recommended.

Pathogenetic treatment is associated with detoxification (introduction saline solutions). If there is a risk of cerebral edema, glucocorticosteroids are administered. If breathing problems are noted, the patient is transferred to artificial ventilation. To combat hypoxia, hyperbaric oxygenation and sodium hydroxybutyrate are administered. For psychomotor agitation it is used lytic mixtures, sedatives(seduxen, relanium). To treat paralysis, muscle relaxants are administered, as well as drugs that improve blood supply and trophism of brain tissue. To eliminate seizures, patients take anticonvulsant and antiepileptic drugs.

The criterion for discharging a patient who has suffered tick-borne encephalitis is complete normalization of the clinical condition and the possibility of outpatient treatment.

How not to get infected? Prevention of tick-borne encephalitis

Prevention of tick-borne encephalitis is divided into general and specific. General prevention consists of individual protection against ticks. To do this, use special clothing, masks, repellents (tick repellents). It is especially important to examine people after walking in forests, park areas, and as much as possible quick removal tick from the human body, since the time of blood sucking affects the amount of the pathogen in the blood and the severity of the disease. Also, in endemic regions, the consumption of unboiled milk should be avoided.

The most effective and reliable method is specific prevention. For this purpose, vaccination is used, which is indicated for tick-borne encephalitis in risk groups.

But according to the recommendations World Organization Health Authority (WHO), in areas where the disease is highly endemic (that is, when average morbidity from vaccination is ± 5 cases per 100,000 people per year), implying that there is a high individual risk of infection, vaccination should be carried out for all ages and groups, including children.

Where the incidence and prevalence of a disease is moderate or low (that is, the annual average over a five-year period is less than 5 cases per 100,000 population) or is limited to specific geographic locations, certain outdoor activities, immunization should be targeted at individuals, most cases in cohorts that are at high risk of infection.

For people traveling from endemic areas in endemic areas, vaccination should also be carried out if visits to endemic areas will involve extensive outdoor activities.

There are several types of vaccines for specific prevention.

Western European vaccines

In Western Europe, two vaccines are available for both adult and pediatric formulations ( - Germany; - Austria). Despite the fact that these vaccines are based on the European (Western) subtype of the virus, the immune system produces antibodies against all subtypes of tick-borne encephalitis virus. These vaccines contain a suspension of purified virus that is inactivated with formaldehyde. All of these vaccines provide safe and reliable protection.

According to WHO guidelines, outside countries or areas at risk, tick-borne encephalitis vaccines may not be licensed and must be obtained upon special request.

Russian vaccines

Inactivated tick-borne encephalitis vaccines (cultural purified dry concentrated, “Entsevir”), produced in the Russian Federation, are based on the Far Eastern subtype of the virus and are multiplied in primary chicken embryo cells.

Side effects of vaccines

As for side effects, Western European vaccines are rarely characterized by adverse reactions, sometimes there is short-term redness and pain at the injection site in no more than 45% of cases and fever with a temperature above 38°C in less than 5-6%. However, none of these reactions are life-threatening or serious.

It is reported that Russian vaccines are moderately reactogenic and do not cause serious adverse reactions. Vaccines that were relatively common in causing fever and allergic reactions, particularly in children, were withdrawn from production.

What should I do if bitten by a tick?

Passive prophylaxis for persons who have been bitten by ticks infected with encephalitis consists of immediate administration of human immunoglobulin against tick-borne encephalitis. The most effective administration of this drug is in the first 96 hours of the disease, with the necessary repetitions according to a three-fold scheme.

Procedure for dealing with a tick bite

Vaccination is the most effective medical intervention ever invented by man.

Tick-borne encephalitis is the most severe infection, which is transmitted to humans from encephalitis ticks. The virus makes its way into the brain and spinal cord of an adult or child, causing severe intoxication and affecting the central nervous system. Severe encephalitic forms without timely treatment can lead to paralysis, mental disorders and even death. How to recognize symptoms dangerous pathology, what to do if you suspect a tick-borne infection and what is the importance of vaccination in the prevention and treatment of a deadly disease?

General description of the disease

Tick-borne encephalitis is classified as a natural focal disease that occurs in certain areas. The carriers of the pathogen are wild animals, in this case – Tick-borne Encephalitis. The main foci of tick-borne pathology are Siberia and Far East, Ural, Kaliningrad region, Mongolia, China, some areas of the Scandinavian Peninsula and Eastern Europe. Every year, about 5–6 thousand cases of encephalitis tick infection are registered in our country.

The severity and form depend on the immunity of the bitten person, the amount of virus in the body, the number of bites, and also on geographic location. Experts divide the encephalitis tick virus into 3 subspecies: Far Eastern, Siberian and Western. The most severe forms of the disease occur after a tick attack in the Far East, with a 20–40% fatality rate. If an encephalitis tick attack occurred in the European part of Russia, the chances of avoiding complications are much higher - the mortality rate here is only 1-3%.

Forms of the disease

Symptoms after an encephalitis tick attack are very diverse, but in each patient the period of the disease traditionally proceeds with several pronounced signs. In accordance with this, there are 5 main forms of tick-borne encephalitis.

Feverish, or erased (the most successful prognosis for treatment).
Meningeal (most often diagnosed).
Meningoencephalitic (occurs in 15% of the country as a whole, in the Far East 2 times more often).
Poliomyelitis (diagnosed in a third of victims of encephalitis ticks).
Polyradiculoneuritic.

A special form of tick-borne infection has a two-wave course. The first period of the disease is characterized by febrile symptoms and lasts 3–7 days. The virus then penetrates the meninges and neurological signs appear. The second period lasts about two weeks and is much more severe than the febrile phase.

Causes and routes of transmission of the virus

The causative agent of fatal encephalitis is an arbovirus from the genus Flaviviruses. It is very small in size (2 times smaller than the flu virus!), so it easily and quickly passes through human immune protection. Arbovirus is unstable to UV radiation, disinfection and heat: when boiled, it dies within a few minutes. But at low temperatures it maintains vital activity for a very long time.

The virus usually lives in the body of ixodid encephalitis ticks and attacks not only humans, but also livestock: cows, goats, etc. Therefore, there are 2 main ways to get encephalitis: through an insect bite and nutritionally (fecal-oral method). In this regard, we can name 4 main causes of encephalitis tick infection:

Immediately after being bitten by an infected insect;
If tick feces get on the skin and penetrate into the blood through scratching;
If, when trying to remove an embedded encephalitis tick, it bursts and the virus gets inside;
After consuming unpasteurized milk contaminated by an animal tick.

Symptoms

While the latent period of infection lasts, the virus multiplies at the site of the bite or in the intestinal walls, then penetrates the blood and spreads throughout the body. Regardless of the form of the disease, the initial symptoms of tick-borne encephalitis in adults appear the same:

A rapid increase in temperature to 39–40º and chills;
Headache and lumbar pain;
Muscle aches;
Lethargy along with lethargy;
Pain in the eyes and photophobia;
Nausea, vomiting and convulsions (in isolated cases);
Redness of the skin on the face and down to the collarbones;
Rapid breathing and rare pulse;
Coating on the tongue.

If the virus manages to penetrate the meninges, individual signs of damage to the nervous system appear: the skin goes numb, muscles weaken, goosebumps run through the body, and sometimes convulsions.

Children experience similar symptoms after an attack by a tick infected with encephalitis. The main difference is that the disease develops more rapidly and is more severe. Children especially often experience seizures due to high fever.

Feverish form

A febrile form of infection develops if the virus circulates in the blood and does not penetrate the lining of the brain.

At first, the disease looks like a classic one: fever begins (high temperature alternating with chills), constant weakness, the bitten person suffers from headaches, nausea, and sometimes vomiting. There may be mild neurological symptoms: mild muscle pain, lower back aches. Sometimes - goosebumps in separate attacks.

After recovery, individual symptoms may appear within a month: weakness, poor appetite, sweating, rapid heartbeat.

Meningeal form

This is the most common form of the disease after an encephalitis tick bite. Arbovirus in this form affects the membranes of the brain and spinal cord. The disease begins with classic signs: high fever, then an unbearable headache, which instantly intensifies at the slightest movement, dizziness, nausea and vomiting, pain in the eyes from bright light, lethargy, weakness and lethargy.

After infection with the encephalitis tick, rigidity occurs (the muscles of the back of the head are so tense that the head constantly tips back), tension in the muscles of the lower leg and the inability to straighten the leg at the knee, increased sensitivity of the skin (even clothes cause pain).

This period lasts 7–14 days; after recovery, lethargy, photophobia, and depressive mood may persist for about 2 months.

Meningoencephalitic form

With this form of infection, the bites of encephalitis ticks and the penetration of the virus cause damage directly to brain cells. Symptoms of the pathology depend on which part of the brain is affected by the arbovirus and the size of the lesion.

If the meningoencephalitic form of encephalitis develops, neurological symptoms will come first: disturbances in movements and facial expressions, loss of orientation in time and space, clouding of consciousness, sleep problems, delusions and hallucinations, muscle twitching, shaking arms and legs, damage to the facial muscles (strabismus, double vision, problems with swallowing, slurred speech, etc.).

Experts divide meningoencephalitis into 2 forms: diffuse and focal. Diffuse infection causes disturbances of consciousness, epileptic seizures, breathing problems, central paresis of facial expressions and language, that is, decreased strength in the muscles. Focal tick-borne encephalitis is manifested by muscle weakness after convulsions, monoparesis, and seizures.

Poliomyelitis form

Poliomyelitis tick-borne encephalitis is a lesion of cells exclusively in the spinal cord. During the prodromal period of this pathology, the patient feels weak for a couple of days and gets tired very quickly. Then difficulties with movement begin: first the facial muscles suffer, then the arms and legs, after which certain areas of the skin begin to go numb and lose sensitivity.

A person infected with an encephalitis tick cannot hold his head in its normal position, make normal movements with his hands, and suffers from severe pain in the back of the neck, shoulder girdle and arms. Muscles can significantly decrease in volume. All the signs of other encephalitic forms may also appear.

Polyradiculoneuritic form

With this type of tick-borne infection, peripheral nerves and roots suffer. The main manifestations are painful sensations all over the body, tingling and goosebumps, Lasegue symptoms (pain along the sciatic nerve when raising a straight leg) and Wasserman (pain in the front of the thigh when raising a leg).

The danger of the polyradiculoneuritis form is the development of ascending Landry's palsy. In this case, flaccid paralysis begins from the legs, rises up the body, covers the arms, then the facial muscles, pharynx, tongue and can lead to breathing problems. Paralysis may also begin in the shoulder muscles and move upward, involving the neck muscles.

Dual waveform

Some experts classify this tick-borne encephalitis as febrile, but most scientists classify it as a separate type.

After the bite and incubation period the temperature rises sharply, the patient becomes dizzy, nausea and vomiting begins, pain in the arms and legs, disturbances in sleep and appetite. Then a febrile period lasts for 3-7 days, which is replaced by calm for one to two weeks.

The second wave of encephalitis begins just as abruptly; signs of meningeal and focal meningoencephalitic forms are added to the listed symptoms. The prognosis for recovery from this type of encephalitis is favorable, as with a common febrile infection.

Diagnostics

When diagnosing “tick-borne encephalitis”, it is necessary to take into account a combination of three factors: clinical manifestations (symptoms), epidemiological data (time of year, whether the vaccine was given, whether there was a tick bite) and laboratory research(analysis of the tick itself - optional, analysis of cerebrospinal fluid, etc.).

The first thing to do if you are attacked by a tick is to examine the sore spot. The bite of an infected insect is just a red, inflamed wound, and the encephalitis tick itself looks like a regular one. Therefore, in any case, you need emergency prevention tick-borne encephalitis - administer immunoglobulin against the virus, and then do an analysis. The main diagnostic methods that need to be done after a tick bite are:

Analysis of patient complaints and medical history;
General examination (analysis of all symptoms in order to identify typical manifestations of tick-borne encephalitis);
Virological analysis of blood and cerebrospinal fluid;
Analysis of arbovirus and determination of its particles in physiological fluids;
Enzyme immunoassay (antibody level in the blood);
General and biochemical blood tests to determine the severity and characteristics of central nervous system damage.

Treatment

Today, treatment of tick-borne encephalitis is carried out exclusively in a hospital; the main medicine against the disease is immunoglobulin (a special solution made from serum or plasma of donor blood with antibodies to the virus). Immunoglobulin has virtually no side effects, but when used against tick-borne encephalitis it can cause serious allergies, so it is used strictly as directed and under the supervision of a physician.

What to do if a person is attacked by a tick? The first step is to remove it and urgently go to the hospital.

Regardless of whether the attacked tick was encephalitic, the victim is injected with a specific immunoglobulin against tick-borne infection for 3 days. Immunoglobulin is injected strictly intramuscularly: for febrile forms, daily for 3–5 days, for meningeal forms – every 10–12 hours for 5 days, dose – 0.1 ml/kg. In more severe forms, for the treatment of tick-borne encephalitis, immunoglobulin against the disease is prescribed in increased doses.

The doctor prescribes further treatment for tick-borne encephalitis depending on the encephalitic form and severity of symptoms:

Detoxification and restorative therapy;
Resuscitation measures ( artificial ventilation lungs, oxygen mask, etc.);
Reducing cerebral edema;
Symptomatic treatment.

In addition, after recovery, the patient remains under the supervision of a neurologist for up to 3 years.

Prevention

Prevention of tick-borne encephalitis is carried out in two directions: vaccination (specific prevention against tick-borne encephalitis) and preventive measures (non-specific).

Emergency prophylaxis against tick encephalitis virus is immunoglobulin, which is administered within 3 days after the bite. Immunoglobulin is also administered to unvaccinated persons in dangerous (endemic) areas. The protective effect lasts about 4 weeks; if the danger remains, immunoglobulin can be re-administered.

If immunoglobulin is more often used for emergency vaccination, then a routine vaccination against infection is a special vaccine of a killed virus. At standard scheme vaccination, the first vaccination is carried out in November, the second should be done after 1–3 months, the third – after 9–12 months. With an emergency regimen, the second vaccination can be done after 14 days, the third after 9-12 months.

What should you do to avoid an insect attack? Nonspecific prevention includes the following measures:

When hiking in the forests, wear thick clothing and use repellents;
Upon return, do a thorough examination of exposed areas of the body;
Boil raw milk from domestic goats and cows;
If you find an attached tick, remove it immediately or go to the nearest hospital.

For complete protection against encephalitis ticks in dangerous areas, it is necessary to combine vaccination against a dangerous infection and ordinary preventive measures.

Tick-borne encephalitis is an acute viral disease of the nervous system. Its main sources are two types of ixodid ticks - taiga and European forest ticks. The peak incidence of encephalitis occurs in spring (May-June) and late summer and early autumn (August-September).

Tick-borne encephalitis is sometimes called differently - spring-summer, taiga, Siberian, Russian. Synonyms arose due to the characteristics of the disease. Spring-summer, because the peak incidence occurs in the warm season, when ticks are most active. The first peak of the disease is recorded in May-June, the second - at the end of summer.

If you are bitten by an encephalitis tick, the virus enters the bloodstream within the first minutes of contact. According to statistics, six ticks out of a hundred are carriers of the virus (at the same time, from 2 to 6% of people bitten can get sick from an infected individual).

The causative agent of tick-borne encephalitis is an RNA virus belonging to the Vlaviviridae family. There are 3 types of virus:

Far Eastern - the most virulent (can cause severe forms of the disease);
Siberian - less contagious;
Western - the causative agent of two-wave encephalitis - causes mild forms of the disease.

The ixodid tick bite is main reason occurrence . Due to damage to the body by a natural focal viral infection, which is dangerous for the membranes of the brain and spinal cord, meningitis and meningoencephalitis occur.

There are known cases of human infection with tick-borne encephalitis after consuming milk from tick-infected domestic animals. Therefore, you can only drink pasteurized or boiled milk.

Features of the tick-borne encephalitis virus are weak resistance to the action of high temperatures, disinfectants and ultraviolet radiation. So, when boiled, it dies after 2 minutes and cannot be stored in environment in hot sunny weather. However, at low temperatures it is able to maintain viability for a long time.

Incubation period

During a tick bite, some viruses begin to multiply in subcutaneous tissue and tissue macrophages, another part of them enters the blood and penetrates the vascular endothelium, lymph nodes, parenchymal organs, and the tissues of the central nervous system, where they intensively multiply and accumulate. Treatment of tick-borne encephalitis is carried out using many groups of drugs that affect the virus itself and all parts of the pathological process.

Sometimes fulminant forms of tick-borne encephalitis are diagnosed (the first symptoms appear within a day) and protracted forms - the incubation period can include up to 30 days.

You should know that a patient with tick-borne encephalitis is not dangerous to others, as it is not contagious.

On average, the incubation period is 1-3 weeks, since the forms of development of the disease are different:

Lightning fast. With it, the initial symptoms appear already on the first day.
Lingering. In this case, the duration of the incubation period can be about a month, sometimes even a little longer.

Symptoms of tick-borne encephalitis

Tick-borne encephalitis is a viral infection that initially occurs under the guise of a normal colds. It may go unnoticed by the patient, or may cause severe damage to the nervous system.

After a tick bite, the virus multiplies in tissues and penetrates the lymph nodes and blood. When the virus multiplies and enters the bloodstream, flu-like symptoms form.

Often the disease begins with the following symptoms:

an increase in body temperature to 39-40 C and with chills characteristic of this condition,
severe pain in the lower back and limbs,
pain in the eyeballs,
general weakness
nausea and vomiting,
consciousness is preserved, but there is lethargy, drowsiness, and symptoms of stupor.

When the virus enters the membranes of the brain, and then into the substance of the brain, symptoms of disturbances in its activity appear (neurological):

sensation of goose bumps, touches on the skin;
skin sensitivity disorders;
disturbances in muscle movements (first facial movements, then the ability to voluntarily make movements of the arms and legs is lost);
convulsive seizures are possible.

Violations may occur later:

of cardio-vascular system(myocarditis, cardiovascular failure, arrhythmia),
digestive system - stool retention, enlarged liver and spleen.

All of these symptoms are observed against the background of toxic damage to the body - an increase in body temperature to 39-40 degrees C.

The most common and noticeable signs of an encephalitis tick:

transient weakness of the limbs;
weakness of the muscle tissue of the cervical region;
feeling of numbness of the facial and cervical skin.

The outcome of tick-borne encephalitis comes in three main options:

recovery with gradual long-term recovery;
transition of the disease to a chronic form;
death of a person infected with tick-borne encephalitis.

After a tick bite infected with the encephalitis virus, it is necessary to carry out emergency prevention for 3 days.

Forms of tick-borne encephalitis

Currently, the following forms of the disease are distinguished:

Febrile form of tick-borne encephalitis

Tick-borne encephalitis in this form occurs with a predominance feverish state, which can last from 2 to 10 days. The most typical manifestations include headache, weakness and nausea. In this case, neurological symptoms are mild.

Meningeal

Meningeal, which proceeds relatively favorably. It begins, like any other manifestation, with the phenomena of intoxication of the body:

weakness,
increase in body temperature,
sweating

Then symptoms of brain damage appear (occipital headaches, vomiting, fear of light and impaired reflexes). Within two to three weeks, typical symptoms appear.

Meningoencephalitic

Meningoencephalitis is characterized by a two-wave temperature reaction. Each wave lasts from 2 to 7 days. At intervals of 1-2 weeks. The first wave occurs with general toxic symptoms, and the second with meningeal and cerebral signs. The course of this form is favorable, rapid recovery and absence of complications are observed.

Poliomyelitis form

It is observed in 30% of patients. It begins with general lethargy of the whole body, observed within 1-2 days. Accompanied by the following symptoms:

weakness in the limbs, which can subsequently lead to numbness;
characterized by pain in the neck;
all violations described in the previous forms are possible;
Loss of ability to hold head in vertical position;
loss of movement in the hands.

Motor pathologies progress over 1-1.5 weeks. From the beginning of the second to the end of the third week, the muscles begin to atrophy.

Polyradiculoneuritic form

It is observed rarely, in no more than 4% of cases. In addition to the symptoms of meningitis, with the development of this variant of tick-borne encephalitis, severe paresthesia (tingling) in the extremities and severe sensitivity in the area of the fingers appear. Sensitivity in the central parts of the body is impaired.

As you can see, the signs of this disease can be completely different. Some forms of encephalitis are quite difficult to diagnose. That is why it is extremely important to consult a doctor in time, preferably before the appearance of disorders of the nervous system.

Signs of tick-borne encephalitis in children

The main symptoms and signs of tick-borne encephalitis in children include:

the first sign of tick-borne encephalitis is headache, expressed by a rise in body temperature;
sleep disorders;
eyeball disorders;
disorders of the vestibular apparatus.

The best measure to prevent tick-borne encephalitis in children and adults has been and remains vaccination. Vaccination against tick-borne encephalitis is recommended for everyone who lives in or stays in epidemic foci.

Complications and possible consequences

The consequences of an encephalitis tick bite cannot be called pleasant. You can endlessly list why the encephalitis tick is dangerous and what its attack is fraught with.

Complications:

Memory impairment.
Headache.
Complete or partial disturbances of movement and/or sensitivity in the limbs and facial area.
Decreased muscle strength and volume (usually the upper shoulder girdle).

Diagnostics

The only answer to the question: what to do if suddenly bitten by an encephalitis tick is to deliver the patient to the nearest infectious diseases hospital as soon as possible.

When making a diagnosis of tick-borne encephalitis, it is necessary to take into account a combination of three factors:

clinical manifestations (symptoms),
epidemiological data (time of year, whether the vaccine was given, whether there was a tick bite)
laboratory tests (analysis of the tick itself - optional, blood test, cerebrospinal fluid analysis, etc.).

I would especially like to note the fact that the virus can be detected in the tick itself. That is, if you are bitten by a tick, you must take it to a medical facility (if possible).

To accurately confirm the diagnosis, it is necessary to determine specific antibodies:

immunoglobulin class M for encephalitis (IgM) – the presence indicates an acute infection,
IgG - the presence indicates contact with an infection in the past, or the formation of immunity.

If both types of antibodies are present, this is a current infection.

All patients with tick-borne encephalitis must be examined for It is possible to become infected with both infections at the same time.

Treatment

Anti-encephalitis immunoglobulin therapy is considered an effective treatment method for tick-borne encephalitis at an early stage of detection. Also most useful for successful recovery inactivated vaccine and ribonucleic acid (RNA). Timely vaccination and protection against ticks are effective methods of preventing the complex course of the disease.

When prescribing treatment, they are guided by the principle of symptom relief. Therefore, medications are mainly prescribed to maintain the body. It includes:

antipyretics,
detoxifying drugs,
vitamins,
normalizing medications water balance body.

The patient is prescribed strict bed rest. The specific treatment regimen depends on the time that has passed since the first symptoms appeared.

Patients are discharged within 14-21 days normal temperature. Dispensary observation is provided by an infectious disease specialist and a neurologist for 1 year after febrile form with inspection once every 6 months. After other forms of the disease - 3 years with quarterly examination.

Forecast

The meningeal and febrile form of the disease proceeds favorably in most cases. Meningoencephalitic, poliomyelitis and polyradiculoneuritic are significantly worse. Fatalities are 25-30%.

The consequences of tick-borne encephalitis can be decreased memory, headaches, and paralysis.

Prevention of tick-borne encephalitis

Prevention of tick-borne encephalitis is carried out in two directions:

vaccination - the most reliable protection against tick-borne encephalitis is one’s own antibodies, which are produced in response to vaccination. Traditionally, they are held in advance in the autumn-winter period.
preventive measures (nonspecific prevention).

Preventive measures also include:

refusal to consume dairy products that have not undergone heat treatment during the warm season;
timely vaccination (can be carried out both in the autumn-winter period and within 4 days after a tick is detected on oneself - different types of vaccines are used for this);
wearing clothing that covers the body (it is better to go out into nature in clothes with long sleeves and pants, the head should be covered with a cap);
promptly consult a doctor if any insects are detected (removing ticks on your own is not recommended at all);
use of tick repellents;
after returning home, you need to take off all your clothes and immediately take a shower, then you need to carefully examine your clothes “from the forest” and your body for ticks.

If you find a tick embedded in your skin on your body, immediately seek help from medical professionals - they will remove the insect and carry out anti-encephalitic vaccination.

Definition of disease. Causes of the disease

Tick-borne encephalitis is an acute and chronic natural focal infectious disease caused by the tick-borne encephalitis virus, which leads to an acute febrile state, damage to various parts of the nervous system in the form of flaccid paresis and paralysis. As a rule, it is transmissible, i.e. transmitted by blood-sucking insects.

Etiology

The tick-borne encephalitis virus was first isolated in 1937 by L. Zilber.

Group - arboviruses

Family - togaviruses

Genus - Flavivirus (group B)

The species is a tick-borne encephalitis virus, which is divided into six genotypes (the most significant are Far Eastern, Ural-Siberian and Western).

Tick-borne encephalitis is an RNA virus that is localized in nervous tissue. It has a spherical shape with a diameter of 40-50 nm. Contains a nucleocapsid surrounded by an outer lipoprotein shell with glycoprotein spines built into it (capable of gluing red blood cells).

At low temperatures is well preserved, resistant to drying (at low temperatures), in milk (including in the refrigerator) it remains for up to two weeks, in butter and sour cream for up to two months, at room temperature it inactivates within 10 days, when boiled it dies within two minutes, at a temperature of 60°C it loses its properties after 20 minutes. Household disinfectants and ultraviolet radiation also lead to its rapid death. Antibiotics have no effect.

Epidemiology

Natural focal disease. The distribution area covers Siberia, the Far East, the Urals, the European part of Russia, as well as Europe.

The main reservoirs of infection are ixodid ticks Ixodes persulcatus (taiga ticks) and Ixodes ricinus (dog ticks), sometimes other representatives of ixodid ticks.

The secondary reservoir of the virus in nature is warm-blooded mammals (hares, squirrels, chipmunks, mice, foxes, wolves, goats and others) and birds (thrush, bullfinch, tererev and others).

Female ticks are capable of transmitting acquired viral pathogens to their offspring, which ensures a constant level of infectivity of these arthropods and circulation of the pathogen.

One tick can contain up to 10 10 viral particles, and entry of just 1:1,000,000 into the human body may well lead to the development of the disease. The more well-fed the tick, the greater the concentration of the virus in it.

The main circle of circulation of the virus: ticks - feeders (animals and birds) - ticks. When a person is infected, the cycle is interrupted, since after the virus enters the human body, it stops spreading (biological dead end).

The disease is characterized by autumn-summer-spring seasonality in the middle zone, caused by peaks of tick activity depending on natural and climatic conditions. Sometimes cases of activation of ticks and diseases are recorded in winter during thaws.

The habitats of ticks are deciduous and mixed deciduous-coniferous forests with pronounced shrub and grass cover, as well as paths of animals that feed ticks.

Infection occurs when ticks attack people in suburban areas, fields, forests, summer cottages during rest, or collecting forest products. Often cases of infection are recorded in the cities themselves: in park areas, lawn areas. Mechanical transfer of ticks on clothes, things, products and their crawling onto people who have never visited nature is possible.

Transmission mechanisms:

If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of tick-borne encephalitis

The clinical picture of the disease may vary depending on the serotype of the virus: as a rule, the Far Eastern and Siberian variants are more severe; the course of the disease in the European part of the Russian Federation and Europe is marked by a milder and more favorable course.

The incubation period is from 1 to 35 days (on average 2-3 weeks), there is no clear relationship between the severity of the disease and the incubation period.

Schematically, the course of the disease in the acute period can be divided into six stages:

infection;
incubation period;
prodromal period (appearance of precursors of the disease);
feverish period;
early convalescence (recovery);
recovery period.

Most often the disease occurs in a latent or mild form, manifested by a slight increase in body temperature, mild headache without clear localization, general malaise and sleep disturbances (up to 90% of all cases).

Sometimes, in cases of a more pronounced course, the disease begins with prodromal phenomena in the form of chills, weakness, heaviness in the head, and diffuse headaches of low intensity for 1-2 days. Then the disease manifests itself sharp increase body temperature up to 38-39°C, severe chills, sweating, severe bursting headaches, often accompanied by nausea, vomiting and loss of coordination. The patient is inhibited, apathetic, and reacts sluggishly to external stimuli. His face, neck and chest are hyperemic. Pain may appear in various parts of the body, muscles and joints, and sometimes fascicular twitching occurs. Subsequently, weakness, increased sweating, fluctuations (lability) in blood pressure, paresthesia (numbness) of certain parts of the body without impaired motor functions increase. Symptoms of damage to the meninges appear, such as stiff neck, Kernig's and Brudzinski's signs.

In case of nutritional infection (through food), abdominal pain, diarrhea, and the appearance of dense white plaque on the tongue, as well as a two-wave febrile reaction:

short first wave of fever for 2-3 days;
the second rise in temperature after a week-long “break” (usually more severe and longer).

With a favorable course, these signs gradually regress, sometimes leaving behind residual (residual) phenomena of varying severity and duration.

In some cases, symptoms increase and manifest themselves in the form of severe toxicosis, the appearance of focal symptoms, paresis, disturbances of consciousness, breathing and activity of the cardiovascular system. The prognosis in such cases is serious.

In case of chronic disease wide polymorphism possible clinical manifestations, however, the following symptoms are more often observed:

Pathogenesis of tick-borne encephalitis

The entrance gates are skin damaged by ticks, mucous membranes of the intestines, stomach, and rarely the conjunctiva of the eye (when the tick is smeared and hands are not washed).

Viremia - the entry of the virus into the blood and its spread in the body - goes through two stages.

Through the hematogenous route, the virus enters the brain, where it actively multiplies, and along the way, moving more slowly through the lymphatic tract, sensitizes (increases sensitivity) segmental areas of tissue - often more significant neurological changes are detected in these places.

After the phase of reproduction in the nervous tissue, the virus again enters the blood and causes re-sensitization of previously sensitized tissues. This leads to a specific allergic reaction, alteration (functional damage) nerve cells and microcirculation disorders. Foci of micronecrosis are formed in various parts of the nervous system, supported by generalized inflammatory process in nervous tissue (with predominant involvement central departments), which determines the severity of the symptoms of the disease.

Due to the cytopathic effect of the tick-borne encephalitis virus ( degenerative change) there is a depression in the production and a decrease in the content of circulating T-lymphocytes, as well as a delayed reaction of proliferation of B-lymphocytes (sometimes only by three months), i.e., an immunodeficiency state develops, supporting the development of pathological changes in the brain. The developing immune response deactivates viral particles first in the intercellular space, then, when the complement system attaches, it destroys the infected cells.

In some cases, the virus triggers mechanisms to evade the immune response (features of individual strains of the virus, antigenic drift, individual characteristics of a person’s immunological reactivity, etc.), which makes it possible for it to remain in the body for a long time and form chronic forms.

After an infection with recovery, persistent (possibly lifelong) immunity remains.

Classification and stages of development of tick-borne encephalitis

According to clinical form:

Acute tick-borne encephalitis:
Inaparent (hidden) form - identification of specific markers of infection in the blood in the absence or minimal severity of clinical manifestations.
Feverish form - a sudden increase in body temperature to 38-39°C, nausea, sometimes vomiting, increased tone occipital muscles without changes in the composition of the cerebrospinal fluid (meningism), general weakness, sweating lasting about a week. As a rule, it ends favorably, after which asthenovegetative syndrome of medium duration is possible.
Meningeal form (the most common manifest form) - the occurrence of all manifestations of the febrile form with the addition pathological symptoms irritation of the meninges, severe toxicosis. Sometimes, with the addition of transient diffuse neurological symptoms, changes in tendon reflexes, anisoreflexia (unevenness of reflexes), facial asymmetry, etc. occur. Changes in the cerebrospinal fluid are characterized by an increase in intracranial pressure to 300 mm H2O. Art., lymphocytic pleocytosis is detected up to 300-900 cells in 1 μl, the protein level increases to 0.6 g/l, the sugar content does not change. In general, the duration of the disease is about 20 days, more often it proceeds favorably, residual effects in the form of intracranial hypertension, headaches, low-grade fever for up to 2-3 months.
The meningoencephalitic (focal and diffuse) form is a severe, life-threatening form of the disease. With diffuse damage, toxic and cerebral symptoms, the development of seizures, disturbances of consciousness of varying severity, sometimes to the point of coma, come to the fore. With focal damage, against the background of general cerebral and toxic symptoms, movement disorders- central paresis (usually completely reversible).
Polioencephalitic form - disturbances in swallowing, drinking, speech, various visual disturbances, sometimes twitching of the tongue, when trying to drink water pours out through the nose, paresis is possible soft palate. Characteristic manifestations are central respiratory disorders, vascular collapse and cardiac paralysis, which leads to death. With a favorable course, a long-term (sometimes more than a year) asthenic syndrome is characteristic.
The polioencephalomyelic form is an extremely severe course, characterized by damage to the cranial nerves, paralysis of the heart and breathing with a mortality rate of up to 30%. In other cases, there is a high probability of paralysis and the disease becoming chronic.
Poliomyelitis form - flaccid paralysis of the muscles of the neck, shoulder girdle and upper limbs, periodic disturbances in the sensitivity of these areas, atony. The so-called "droop head" syndrome, when the patient cannot keep his head upright. Sometimes, due to damage to the diaphragm, breathing suffers, which is quite dangerous. The course of this form is long, restoration of the function of the affected parts does not always occur in full.
A two-wave course indicating the form of the second wave - the first wave of fever for a week with a complex of cerebral and intoxication disorders, then a period of imaginary well-being lasting 1-2 weeks, and the onset of a second wave of increased body temperature, accompanied by the development of meningeal and focal symptoms, usually without severe consequences.
Chronic tick-borne encephalitis:
Hyperkinetic form - Kozhevnikov epilepsy, myoclonus epilepsy, hyperkinetic syndrome.
Amyotrophic form - poliomyelitis and encephalopoliomyelitis syndrome, as well as disseminated encephalomyelitis and amyotrophic lateral sclerosis.
Rarely occurring syndromes.

As the disease progresses, it happens:

acute - 1-2 months;
acute protracted (progressive) - up to 6 months;
chronic - more than 6 months,

Chronic tick-borne encephalitis is caused by prolonged presence of the tick-borne encephalitis virus in the body. More often it develops in childhood and at a young age. There are four forms:

initial - continuation of the acute process;
early - during the first year;
late - after a year from the acute form;
spontaneous - without an acute period.

Severity of tick-borne encephalitis:

Complications of tick-borne encephalitis

Tick-borne encephalitis itself is serious illness which sometimes leads to human death. However, as it progresses, additional complications are possible that significantly worsen the prognosis:

Diagnosis of tick-borne encephalitis

Laboratory diagnostics:

Differential diagnosis:

Treatment of tick-borne encephalitis

When the disease develops, there is no specific highly effective etiotropic treatment.

In the acute period, strict bed rest, detoxification therapy, balanced diet, the use of vitamins, means of improving cerebral circulation, hormone therapy. If necessary, the patient can be transferred to a ward intensive care, prescribe the use of antispasmodic and relaxing drugs.

Sometimes in practice, immunotherapy agents, specific immunoglobulins, gamma globulins are used - their use to some extent can reduce the severity of the manifestations of tick-borne encephalitis and the severity of long-term consequences, but these drugs cannot radically affect the outcome of the disease.

In the chronic phase of the disease, it is possible to use vitamin and immunostimulating therapy, the use of antihypoxants and adaptogens.

For those who have recovered from the disease, regardless of the severity of the disease, dispensary observation is established for a period of up to three years with periodic examination by a neurologist and examinations (as indicated).

Forecast. Prevention

In inparant, mild forms of the disease, the prognosis is usually favorable. With the development of more serious forms of the disease, it is possible that quite long, sometimes lifelong, residual effects, accompanied by astheno-neurotic manifestations, headaches of varying intensity, decreased mental and physical performance. In severe forms, the prognosis is unfavorable.

Vaccination is the most effective preventive measure to prevent the development of the disease. It is carried out using any registered vaccine against tick-borne encephalitis. As a rule, it is performed first in the fall, then in the spring, then the next spring a year later, after which subsequent revaccination is indicated every three years (it is possible to determine the level of protective antibodies and adjust the schedule). This scheme provides virtually guaranteed protection against the development of the disease during infection. There are emergency vaccination regimens, but their effectiveness is lower than the main ones.

When bitten infected tick For unvaccinated people in Russia, they resort to the administration of immunoglobulin, but its effectiveness and safety are in doubt.

Measures nonspecific prevention similar to the prevention of tick-borne borreliosis:

When visiting a forested area, you should wear protective thick clothing and also use repellents that repel ticks;
periodically inspect skin and clothes (every two hours);
carry out centralized treatment of forests and parklands with tick control agents.

If you find an attached tick, you must immediately contact the trauma department to remove the tick and send it for examination. It is also necessary to consult an infectious disease specialist for observation, examination and recommendations for preventive therapy.