encephalitis TICK

A B B D E F G And K L M N O U R C T Y P X C H W E I

TICK encephalitis (syn .: encephalitis taiga, encephalitis, spring and summer) - an acute viral disease characterized by lesions of the brain and gray matter of the spinal cord with the development of paresis and paralysis. Pathogen - arbovirus. It is thermolabile, it is sensitive to the action of disinfectants. The source of infection - the wild, sometimes pets and birds. Close to settlements can be a source of disease cows and goats. Reservoirs and vectors of disease are ticks. Established alimentary route of infection through raw milk. A sick person to others is not dangerous. Season spring-summer. The disease is common throughout Eurasia in the forest and steppe zones.

The clinical picture. The incubation period lasts for 3 - 21 (average of 7 - 14) days. Getting a sharp, sudden temperature rises to 39-40 ° C, there is a sharp headache , nausea , vomiting , flushing of the face, neck, upper chest, oropharynx, and conjunctival vascular injection sclera, myalgia. There are several variants of the disease.

The feverish form has a benign course, the fever lasts 3-8 days, marked headache , nausea ; neurological symptoms poorly developed, is fast disappearing. Meningeal form is characterized by fever within 7 to 10 days, nausea, vomiting, severe headache, severe meningeal symptoms. Changes in cerebral fluid (lymphocytic pleocytosis) are observed for 3-4 weeks. Meningoencephalitic form differs hyperthermia, confusion, drowsiness, marked meningeal syndrome, delirium, agitation with a loss of orientation, hallucinations, sometimes severe convulsive disorders by type of status epilepticus. In cerebral fluid - moderate lymphocytic pleocytosis, increased protein content. Already at 2 - 4th day of illness appear subcortical hyperkinesis, stem disorders (paralysis tabloid), paresis and paralysis of the muscles of the neck and shoulder girdle.

Poliomieliticheskoy form characterized by cerebral events (headache, nausea , lethargy), accompanied by flaccid paralysis of muscles of the neck and upper limbs with atrophy of the muscles at the end of 2-3 th week. Poliomieliticheskaya and to a lesser extent meningoencephalitic form are the most typical for tick-borne encephalitis. Poliradikulonevriticheskaya form differs from poliomieliticheskoy benign course, the absence of residual effects in the form of flaccid paralysis and muscle atrophy.

Two wavelength tick encephalitis - clinical form in which after the fever (3 - 5 days), a period apyrexia (3 - 8 days), and then develop their own encephalomyelitis, but benign course. This form is associated with alimentary infection (two-wave milk fever).

Residual effects - flaccid paralysis, muscle atrophy, dyskinesia, decreased intelligence, sometimes epilepsy . Recovery lasts for years. Full recovery can not occur. Possible chronic process (slow infection).

Diagnosis is based on epidemiologic (tick bite, seasonality) and the characteristic clinical symptoms. To confirm the diagnosis using serological tests (RSK, PHA and braking response) of hemagglutination.

Treatment is carried out in a hospital. Strict bed rest in acute stage of the disease. During the first three days of treatment, administered intramuscularly daily for 6 - 9 ml protivoentsefalitnogo donor gamma globulin. Assign also dehydration agents (mannitol, furosemide, or Lasix), oxygen therapy; in convulsions administered intramuscularly 1 ml of a 2.5% solution of chlorpromazine and 2 ml of a 1% solution of diphenhydramine, when tabloid disorders - cardiovascular and breathing stimulants. When seizures appoint phenobarbital or benzonal to 0.1 g 3 times a day.

Prevention. In endemic areas, carried out collective and individual prevention and vaccination of people epidemiological indications. Encephalitis vaccine injected subcutaneously three times at 3 and 5 ml every 10 days in a month, and booster (5 mL).