Does the encevir vaccine protect against lyme disease. Review of preventive vaccines and methods of protection against borreliosis and tick-borne encephalitis. Use of chemicals

The name tick-borne infections unites a group of infectious diseases that occur after the bite of ticks containing pathogens. The causative agent is not the tick itself, but the viruses and bacteria that live and reproduce in it. These diseases are classified as endemic, that is, they are not widespread everywhere, but in certain regions.

Are all insects dangerous to humans? Only a portion of ticks are infected with infectious agents, so the disease may not develop after a bite. However, it is impossible to determine whether a tick is infected by the appearance of the insect.

In particular, tick-borne infections include borreliosis and tick-borne encephalitis. These diseases often occur together, in the form of a mixed infection. If we consider infections separately, then borreliosis occurs several times more often than tick-borne encephalitis.

Insects like relatively cool weather and dark places. Therefore, they are more common in the north of the country.

Ixodid tick-borne borreliosis is one of the frequent illnesses developing after a tick bite. Borrelia, which causes this disease, is not a virus, but a special bacterium that lives in ticks. According to their own morphological properties it occupies an intermediate position between viruses and bacteria.

Its presence in the insect is determined in a special laboratory that deals with tick-borne infections. An important condition for identifying a microorganism is that the insect must be alive. Otherwise, the bacterium dies along with the tick, and it becomes impossible to determine its presence.

Unlike tick-borne encephalitis, Lyme disease, as borreliosis is also called, occurs with other symptoms. During the course of borreliosis, acute and chronic forms are distinguished.

First, nonspecific symptoms are observed in the form of fever up to 38°C, general malaise, and moderate headache.

Acute form characterized by two options:

1The disease is accompanied by characteristic redness of the skin at the site of insect suction - the erythema form.
2This redness may not be present - in this case, an erythematous form is observed.

As the process becomes chronic, symptoms of damage to the skin, bones and joints, and nervous system develop.

Specific erythema, which occurs in some cases at the site of tick suction, looks like this:

1The area of hyperemia has a round shape and clear boundaries.
2The size of hyperemia can vary - from a few millimeters to several centimeters.
3The erythema quickly becomes bright, and in its center there is an area of clearing.
4Gradually the size of the hyperemia decreases, and it itself turns pale.

Residual effects, accompanying borreliosis, mainly affect the musculoskeletal system and nervous system. The appearance of these symptoms is observed after acute period when the process becomes chronic.

Damage to the musculoskeletal system occurs in the form of pain in the muscles and joints, which intensifies when the weather changes. They can bother a person for several years, sometimes for life.

Pathology of the nervous system develops 5-7 years after the disease becomes chronic. Phenomena of encephalopathy and radicular lesions are observed. In some cases, paresis and paralysis of the limbs may develop.

Sometimes there is chronic skin damage in the form of areas of thickening and peeling. Redness resembling primary erythema may occasionally occur.

Vaccination against tick-borne infections is necessary for several reasons:

1To avoid getting sick with encephalitis and borreliosis.
2If the disease does develop, vaccination gives the disease a milder form.
3To avoid serious complications.
4To prevent the process from going into chronic form.

However, many people underestimate the importance of vaccination and refuse preventive vaccinations.

Who is at risk of contracting tick-borne infections?

1Persons living in endemic regions.
2People who often visit the forest: hunters, fishermen, tourists.
3People whose profession involves visiting the forest: geologists, foresters, builders of roads, oil and gas pipelines, power lines.
4The urban population may be attacked by ticks in forested areas and dachas.

When visiting a forest area, you need to wear special protective clothing. It should cover the body as much as possible and have cuffs on the sleeves and legs. Trousers must be tucked into boots, and hair must be completely tucked into a headdress.

It is important to know that ticks are most active during the short period from late April to early June. At this time, it is better to refrain from visiting the forest belt. If this is still necessary, you need to use special repellents that repel insects.

After returning from the forest, you need to carefully examine yourself for the presence of a tick. These insects contain an anesthetic substance in their saliva, so a person does not even notice that he has been bitten. A tick can stay on a person’s body for several days and secrete borrelia into the blood all this time.

At the moment, no specific protective vaccine against ixodid borreliosis has been created. There is only specific prevention of tick-borne encephalitis. A person can protect themselves from borreliosis only by nonspecific measures. They include:

1Measures to protect against insect attacks - protective clothing and repellents.
2Treat the bite site with antiseptics.
3Test of the tick in a special laboratory.
4Enzyme immunosorbent blood test to detect specific antibodies.
5Take Doxycycline for several days.

Who should be vaccinated:

1Any person can get vaccinated against tick-borne encephalitis and borreliosis.
2Vaccination is mandatory for children and people at risk.

The vaccine is called Encevir and Encepur. Vaccination begins for a child at one year of age. It consists of two stages, between which at least a month must pass. After a year, the first revaccination is carried out. Subsequent revaccinations are carried out at three-year intervals.

Since tick-borne encephalitis and borreliosis often occur together, the same preventive measures as for encephalitis can be used to protect against borreliosis.

If you find an attached tick, you must carefully remove the insect so as not to damage it. The bite site is treated with an antiseptic. Ticks are examined in the laboratory to detect infectious agents.

Sometimes manifestations of the disease do not appear immediately, but several weeks after infection. To find out whether there is an infection, you need to donate blood to identify specific antibodies - class M immunoglobulins. Their presence indicates an acute tick-borne infection in the body. If antibodies are detected, this is an indication for a course of antiborreliosis treatment in an infectious diseases hospital.

After an insect bite, intramuscular injection anti-encephalitis human immunoglobulin. To prevent the development of borreliosis, Doxycycline is prescribed for several days.

Although there is no specific prevention of borreliosis, vaccination against endemic infectious diseases is still necessary.

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Prevention of borreliosis: is there a vaccination?

Borreliosis, or Lyme disease, is transmitted by ixodid ticks and is a serious infectious disease. The disease affects the nervous system, skin, heart, and musculoskeletal system. Great importance has the prevention of borreliosis, since any disease, especially one with serious consequences, is better to prevent than to treat.

Unlike encephalitis, for which vaccination is the main preventative measure in high-risk areas, there is no vaccine against Lyme disease. The carrier of these two diseases is the same - ixodid ticks, so sometimes a mixed infection is observed.

Cases of borreliosis occur on all continents (with the exception of Antarctica). In Russia, many regions are considered endemic, that is, cases of the disease are constantly recorded in these areas. The existence of a vaccine against borreliosis could significantly reduce the incidence rate in dangerous regions. But there is no vaccine, so the only preventive measure is nonspecific, that is, protection from ticks getting on the skin, and their quick and correct removal.

How to protect yourself from ticks

All measures to prevent tick-borne borreliosis or Lyme disease can be divided into three groups:

1.Use of protective clothing.

You can use regular clothes, while following a number of rules:

Be sure to wear a hat with your hair covered.
Shoes should be high, closed, and have trouser legs tucked into them.
Sleeves and trouser legs should be long.
The shirt and jacket must be tucked into the trousers.
Clothing must be without buttons, with a zipper, or without a zipper at all. Cuffs should be tight-fitting or have elastic bands.
The color of clothing should be light. On light-colored fabrics, mites are more noticeable. Slippery materials are preferred so that ticks cannot attach to them.
Special protective clothing, for example, Biostop, Stop-Mite, Wolverine suits, which provide mechanical and chemical protection. The cut of the suit does not allow ticks to get under it, and the cuffs and special folds are equipped with special traps containing chemicals. Once caught in such a trap, the ticks die.

2.Use of chemicals

For example, the drug “Medilis Cyper” is an insecticide that is used to combat not only ticks, but also mosquitoes, ticks, cockroaches, and other insects. Active ingredient The drug is cypermethrin, which, when entering the body of a tick, acts on its nervous system, destroys it, leading to death.

The use of chemicals when hiking in the forest, during long stays in areas with high level the danger of infection is one of the most effective methods prevention of Lyme disease (borreliosis).

All drugs are divided into three groups:

Repellents – repel ticks.
Acaricides – kill ticks.
Repellent-acaricidal - act in two directions.

3.Quick and correct removal of the tick

The likelihood of contracting borreliosis directly depends on how long the infected tick sucked blood. You need to remove the tick using tweezers or a loop of thread. Do not crush the tick or lubricate it with oil. These actions increase the likelihood of infection.

There is no vaccination against borreliosis, so nonspecific prevention is of utmost importance - preventing ticks from coming into contact with the skin.

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Features of vaccination against borreliosis

How to remove an embedded tick?
A little about Lyme disease
Treatment of the disease and its consequences

Before the active season of ticks, many people get vaccinated, which are only effective against encephalitis. There are no vaccinations against borreliosis. To avoid contracting this unpleasant disease, it is better to take measures in advance to prevent insect bites.

Prevention of tick-borne borreliosis

There is no vaccine available for this disease at this time. Therefore, a person must take protective measures himself before visiting places where ticks may live.

The greatest tick activity occurs in May and June. But in the period from April to October, when the soil temperature is within 5°, bites of these insects are also possible. Most ticks crawl on the ground or live in grass. They do not bite their potential victims right away. First they cling to clothing, then spend several hours looking for a place to bite.

Ticks live not only in forests, but also on garden plots, on city lawns, in parks and other places with grass. Pets can bring them back to the apartment after a walk. Therefore, you need to carefully examine dogs and cats after returning home.

You need to prepare for visiting insect habitats as follows:

shoes should be as closed as possible;
trousers are tucked into shoes;
the jacket should have tight-fitting sleeves;
it is necessary to use various repellents that repel ticks;
It is better to get vaccinated against encephalitis first, even if there is no way to protect yourself from borreliosis.

Stores offer anti-encephalitis suits. This good clothes for visiting the forest, it protects against insects. You can treat the top of the suit with anti-mite agents.

The tick does not immediately dig into the body, but searches for a place for quite a long time. Therefore, it is necessary to constantly examine yourself and your companions. If the clothes are light, then all the insects are better visible on it.

Upon returning home, you need to carefully examine yourself again. By taking a shower, you can get rid of unattached ticks - the water will wash them away. You can’t crush them with your hands - you can get infected.

If the area is endemic for borreliosis, then prevention is carried out with antibiotics. But this does not guarantee that a person will not get sick. A person bitten by a tick should monitor his well-being, even if he was previously given medicine. If symptoms of tick-borne borreliosis are not observed, then it is better to play it safe and get tested after 6 weeks. If the result is negative, the test is repeated after another month, and then after six months, since antibodies can appear with a delay.

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If a tick has embedded itself, it is important to get rid of it correctly as quickly as possible. Do not smear it with oil under any circumstances - the risk of contracting borreliosis increases.

To remove, you can use tweezers to grab the insect’s body close to the proboscis. Rotating around the axis, slowly sip. After a couple of turns, the tick is easily removed.

After removing the harmful creature, the wound must be lubricated with iodine or any antiseptic. Wash your hands thoroughly with soap and disinfect the tool.

If the proboscis remains, then there is nothing to worry about. A slight suppuration forms at this place, gradually everything will come out with the pus.

There are a few rules to remember for getting rid of ticks:

Do not apply caustic solutions (ammonium, gasoline, etc.) to the bitten area;
do not burn the tick with improvised means (for example, a cigarette);
when removing, do not pull sharply to prevent rupture;
do not pick at the wound with anything;
Do not crush the tick under any circumstances.

The extracted insect must be taken to the laboratory for analysis. This will help to understand whether the person bitten has a disease. The sanitary and epidemiological station examines the tick for 3 days.

You can check the tick yourself by having a special rapid test on hand.

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Tick-borne borreliosis also has this name. The disease was first diagnosed in 1975 in the USA, in the city of Lyma. At the same time, several people were found to have rheumatoid arthritis. After 2 years, the causative agent was identified - it turned out to be an ixodid tick infected with the Borrelia microbe.

The study of the disease began, which led to the possibility of treating the disease. But it has not yet been possible to prevent infection: an effective vaccine against the disease has not been found.

Incubation period lasts about two weeks, sometimes up to a month. Where the tick has bitten, the skin turns red - this is the first sign of the disease. Gradually the red spot increases. Its size is up to 10 cm. There are cases of much larger spots - up to 60 cm. The shape of the spot is round, the outer layer is more red and convex. Gradually, the central part of the spot turns pale and may even acquire a bluish tint. A crust appears at the site of the bite, turning into a scar. If no treatment is performed, the spot disappears after 2-3 weeks.

The following symptoms appear on average after a month: damage to the heart, nervous system, joints.

Lyme disease is divided into 3 stages of development:

The first stage lasts about a month. The bite site turns red. Necrosis is possible. Gradually, secondary spots appear, rashes on the face in the form of rings, and conjunctivitis.
In the second stage, the pathogen penetrates other organs. The nervous system is affected. At the same time, the liver, kidneys, eyes, as well as skin covering.
After 3 months, the third stage begins. The disease becomes chronic. The patient experiences severe fatigue, sleep disturbances, and depression. Many organs begin to work poorly.

The disease is not transmitted to a healthy person from an infected person. But during pregnancy, a woman can infect her fetus with borreliosis.

In general, the level of tick-borne borreliosis is very high. Immunity against the disease is developed for a short period of time, therefore reinfection perhaps after 5 years from the moment of cure.

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Lyme disease affects the joints, so the patient needs rest. Prescribed for treatment antibacterial therapy. The patient takes medications for at least two weeks, usually tetracyclines. Treatment is most effective on initial stages. If a pregnant woman has been infected, it is necessary to inform the doctor caring for her pregnancy as soon as possible.

If the doctor has not yet received test results, but suspects the presence of a disease, then treatment is already prescribed. Patients with severe forms are hospitalized. Affected joints may undergo surgical intervention.

Complications occur in the absence of treatment. It can be:

heart diseases - arrhythmia, increased fatigue;
diseases of the nervous system - childhood dementia, mental disorders, multiple sclerosis, paralysis of the nervous periphery;
diseases of the musculoskeletal system - arthritis, muscle atrophy, joint inflammation.

All this leads to a change in the usual way of life. Complications in children are especially dangerous - the child’s body is destroyed.

Tick-borne encephalitis and borreliosis: symptoms, diagnosis, treatment, prevention

Over the past 30 years, the number of tick-borne infections has increased significantly. Different kinds Ticks inhabit the world, and many of them are carriers of pathogens. It is important to know their symptoms, diagnostic methods and treatment methods for tick-borne encephalitis and borreliosis (Lyme disease) - the two most common diseases in Europe that can be caused by the bite of these insects. After all, timely treatment plays a key role in preventing severe consequences. The elderly and children are most susceptible to them.

The most common tick-borne infections, tick-borne encephalitis (TBE) and Lyme disease, have several of these signs in the first stage. They both come with flu-like symptoms. However, TBE is a viral infection, while Lyme disease is caused by bacteria. Both diseases can cause serious long-term complications, so exposure to areas where these insects may be present should not be taken lightly.

Tick-borne encephalitis

The incubation period for TBE is generally 7 to 14 days and is asymptomatic. In the first stage, TBE infection causes flu-like symptoms such as high fever, malaise, decreased appetite, muscle pain, headaches, nausea and/or vomiting. They begin to appear one to two weeks after being bitten by an infected tick. About 25% of all patients infected with tick-borne encephalitis experience more than severe symptoms during the second stage, which begins four weeks later. Heat And constant drowsiness may be a sign of inflammation of the brain or spinal cord. Severe headaches, nausea, vomiting, disorientation, convulsions, paralysis, partial or complete loss of consciousness, and coma are also observed. The disease can lead to fatal outcome or leave indelible neurological complications.

Borreliosis

Lyme disease can cause wide range symptoms, which sometimes makes it difficult to diagnose. It usually strikes connective tissue, muscles and nervous system. The disease develops 1-3 weeks after the bite. Erythema migrans may also appear - redness with a diameter of one to several centimeters, slightly convex, warm, painful to the touch. This rash most often appears at or near the site of the bite, but does not always occur.

If the disease goes unnoticed, the bacteria can affect the nervous system at a later stage. This causes various neurological symptoms such as local paralysis, speech impediments, and mood swings.

Erythema migrans - Lyme disease rash

After a year, Lyme disease becomes chronic and has many symptoms, such as: fever, chills, headaches, arthritis, muscle twitching, dizziness, difficulty speaking, loss of spatial orientation.

Diagnostics

To diagnose encephalitis, the doctor needs information about all symptoms, as well as recent illnesses and risk factors (being near sick people). viral infections people, in areas where mosquitoes or ticks live, for example).

Magnetic resonance imaging (MRI), spinal tap and electroencephalogram (EEG) are also used. Taking a blood test to check for viruses, bacteria and immune cells is also very informative.

In some cases, a biopsy of brain tissue is performed, which is necessary to confirm the diagnosis if symptoms worsen and treatment does not help. positive results. This procedure is important in determining the type of encephalitis and in prescribing appropriate treatment.

Diagnosing Lyme disease is much more difficult because it has a number of nonspecific symptoms that can accompany other diseases. If there is no rash characteristic of borreliosis, then to make a diagnosis the doctor asks questions about medical history patient, including staying in tick habitats where there is a high probability of infection.

Laboratory tests to detect antibodies to bacteria can be used to confirm the diagnosis. These tests are the most reliable several weeks after infection, but, unfortunately, they cannot 100% confirm or deny the presence of borreliosis.

Early diagnosis and initiation of treatment provide a greater chance of full recovery.

Treatment

Treatment of tick-borne encephalitis involves intravenous administration antiviral drugs, such as:

Acyclovir (Zovirax);
Ganciclovir (Cytovene);
Foscarnet (Foscavir).

Side effects of antiviral drugs may include nausea, vomiting, diarrhea, and muscle pain.

For people suffering from encephalitis, additional supportive procedures are also needed. They provide:

continuous monitoring of cardiac function and respiration;
intravenous drips to ensure proper hydration and normal levels of essential minerals in the body;
anti-inflammatory drugs, such as corticosteroids, to reduce intracranial pressure and swelling;
anticonvulsants to stop or prevent attacks.

After an illness, restorative procedures may be necessary. These procedures may include:

physical therapy;
occupational therapy;
speech therapy;
psychotherapy.

Antibiotics are used to treat Lyme disease. At the first stage, their oral use is recommended. Treatment involves the use of doxycycline for adults and children over 8 years of age or amoxicillin (cefuroxime) for adults and children younger age, pregnant and lactating women. The duration of the course is 7-14 days.

If the disease affects the central nervous system, doctors recommend treatment intravenous antibiotics lasting from 14 to 28 days.

Along with antibiotics, additional and alternative methods treatment:

proper nutrition;
consumption of probiotics;
phytotherapy.

Prevention

The best prevention against tick-borne encephalitis and borreliosis is compliance following measures to protect against tick bites:

while staying in the forest or places with tall grass wear long-sleeved shirts and long pants
use repellents;
wear clothes light color, where ticks are easier to spot, and check your skin carefully after being outdoors.
If you find a tick, remove it with tweezers, making sure that all its parts (body and head) are removed.

Find out what to do if you are bitten by a tick.

Vaccination against tick-borne encephalitis and borreliosis

Vaccination against tick-borne encephalitis is possible. It is highly recommended for people who are regularly exposed to infections in contaminated areas. A variety of vaccines are available in health care settings. Full immunization can be achieved after three doses over three weeks. For long-term immunization, three initial doses are administered over 9-12 months. But they still need to be updated every three to five years. Immunization of children is also carried out.

How much does tick-borne encephalitis vaccination cost?

Lyme disease, or Lyme borreliosis, is a tick-borne disease caused by a spirochete Borreliaburgdorferi. Although it is widespread throughout the world, the disease occurs in humans and dogs only in certain areas of the United States. Over 90% of human cases occurred in 10 states in the northeast of the country. Therefore, vaccination of dogs against Lyme disease should be carried out only in endemic areas. In addition, Lyme disease affects horses, cows and cats, but since there are no vaccines for them yet, in this article we will limit ourselves to discussing vaccination of dogs.

With the increasing number of dog vaccines and thus the number of concerns about their adverse effects, the question arises as to whether every dog should be vaccinated against Lyme disease. Although in endemic areas almost 80% of dogs become infected, it is estimated that only 5% of them are seropositive and exhibit the most common clinical symptom of this disease- lameness. Additionally, dogs respond well to antibiotic treatment and, unlike humans, rarely develop the antibiotic-resistant form of Lyme arthritis.

There are compelling arguments for vaccinating dogs against Lyme disease. After a tick bite and an animal becoming infected with borreliosis, the disease persists in the body for many years, perhaps even a lifetime. Vaccination carried out after infection is not able to eliminate the causative agent of the disease. As mentioned above, only 5% of seropositive dogs become lame. However, even in the absence of clinical lameness with histological examination In experimentally infected dogs, moderate polyarthritis was found, which can lead to lethargy and reluctance to move. In addition, several cases of fatal nephritis caused by B. burgdorferi. This was especially true for Labrador retrievers, for which antibiotic treatment is ineffective.
Although it is commonly believed that antibiotics cure dogs of this disease, this may not be true. The most commonly used antibiotics are doxycycline and amoxicillin. In a recent study on dogs experimentally infected B. burgdorferi, Treatment with these antibiotics for 4 weeks reduced joint damage, but infection B. burgdorferi and didn't disappear. Therefore, even after treatment with antibiotics, the disease can recur.

It is for these reasons that it is recommended to vaccinate dogs that may become infected with ticks in endemic areas. However, the question remains about which vaccine should be used.
There are currently two types of Lyme disease vaccines. One of them, used for several years, consists of dead B. burgdorferi and patented adjuvants. Immediately after vaccination, dogs experience several side effects Therefore, it is very undesirable for the vaccine to be multicomponent, which do not directly affect the infection and may cause adverse reactions in the future. Hamsters inoculated with this vaccine and then infected with infected mites developed arthritis weeks or months later. This fact necessitates the development of this vaccine based on a human model, that is, based on a whole cell.

Another type of vaccine consists of recombinant protein A (OspA) taken from the outer surface of the virus B. burgdorferi, which stimulates the body's production of specific borreliacidal antibodies. This vaccine became available for dogs in 1996 and was later tested and found suitable for humans.

The protective properties of this vaccine appear to be due to the fact that it kills spirochetes in ticks. In addition, it stimulates the production of borreliacidal antibodies in dogs. When a tick attaches itself to a dog's skin and becomes engorged with blood, it takes Borrelia 24-48 hours to move from the tick's midgut to its salivary gland and only then move into a new organism. If the tick becomes engorged with blood containing borreliacidal antibodies, this movement is blocked and invasion of a new organism becomes impossible.

But why don’t borreliacidal antibodies rid the dog’s body of an existing infection? This appears to be due to a change in expression OspAV. burgdorferi when moving from the body of a tick, which has a low temperature, to the body of a mammal, whose temperature is much higher. After entering the mammalian body, expression OspA is replaced by OspC expression, as can be observed in Western blots with serum from mammals, including dogs. Inclusion OspC In a vaccine against Lyme disease may seem very desirable, since it can strengthen the body's resistance to infection. However, antibodies OspC are not as borreliacidal as antibodies OspA, and experiments on mice showed that they are also unable to rid the body of an infection that had previously entered it. Moreover, in the bodies of dogs and other mammals, after infection with ticks, a rapid and strong reaction occurs in the form of the production of antibodies to OspC. Obviously, these antibodies are not able to rid the body of such resistant Borrelia.

Against vaccines containing OspA And OspC, is also evidenced by the fact that there are different variants of antigens both among different serotypes B. burgdorferisensustricto, and between different types of Borrelia. In Europe, where it dominates B. burgdorferisensulato (B. garinii and B. afzelii),OspA And OspC are heterogeneous proteins. For North America this is less of a problem since there seems to be only B. burgdorferisensustricto, over 90% of which contain one serotype for OspA. As it appears, OspC shows greater diversity.

Another experimental approach to the vaccination problem seems more promising. Antibodies produced in mice against B. burgddorferi-binding protein, protect them from infection. These antibodies limit the migration of spirochetes. However, these research data are still in their early stages.

Several attempts have been made to take advantage of the immune response of cells to protect against infection. However, the results were less convincing than in the case of antibody production. It is very likely that the cellular response limits the spread of infection. It is well known that macrophages destroy spirochetes, so the T cell response is very important. However, it has been established that the infection remains in the bodies of cats and dogs. Thus, only partial cleansing of the body from spirochetes occurs.

Equally important are questions about the duration of immunity after vaccination and methods of vaccination. According to existing recommendations, revaccination is necessary every year. However, the research conducted so far is clearly insufficient. We tested and found that six months after OspA vaccination, dogs are completely protected from infection. It is wise to suggest vaccination in early spring before ticks begin to appear.

One of the disadvantages of vaccination is that the results of serological studies are very difficult to interpret. Unvaccinated dogs test positive ELISA or antibody titer on a fluorescence test indicates the presence of infection. In vaccinated dogs, these tests are not sufficient because it is impossible to determine whether the dog giving positive test on B. burgdorferi, Was she just vaccinated, or is she infected with a tick? To find out, a Western blot test is needed. Although after infection with a tick, the dog’s body produces a wide range of antibodies to various Borrelia-proteins, vaccinated dogs only have a reaction to OspA if they were vaccinated OspA-containing vaccine, or a limited number of Woggey-specific antibodies, including OspA, if vaccinated with a dead vaccine.

The question remains about vaccinating seropositive dogs: is it harmful, beneficial, or has no effect at all? So far, we only know that an animal already infected with Lyme disease cannot be cured by any vaccination. We don't even know most of the effects it will have on the animal's health. We can only recommend mandatory serological testing of dogs before vaccination. If the reaction is positive, the dogs should be treated with antibiotics before vaccination.

A frequently asked question is whether a dog with Lyme disease can be seronegative. Since the production of antibodies in humans and dogs begins after 3-4 weeks, then early symptoms diseases (erythema wandering) in humans are often observed with a seronegative reaction. The first symptom of Lyme disease in dogs is usually arthritis, which occurs after antibodies have begun to be produced. Under experimental conditions, we have not observed seronegativity in dogs with Lyme arthritis. Another reason for a seronegative reaction in people with Lyme disease may be previous treatment with antibiotics, which can suppress the production of antibodies, but is not able to rid the body of the spirochetes. In addition, other infections can mimic Lyme disease, such as granulocytic ehrlichiosis. It is caused by a bacterium Ehrlichiaequi, carried by the same ticks that cause Lyme disease.

Do you know that when sucking blood, the areas of the body between the sclerites (compacted areas of the chitinous cover of the tick) are stretched and the ticks (females, nymphs, larvae) increase in size up to 300 times?

Do you know that The emergence of ticks from their shelters from the litter after winter can be extended over several months. It is known that the peak release of mites after winter occurs when the buds of birch trees open. Daily activity ticks are associated with illumination (usually they do not attack at night). If it is very hot during the day, then activity is greater in the morning and evening, if the temperature is below 10 - 12 degrees. C - ticks are not active. Ticks do not like humidity (until the dew has dried, they do not attack).

Do you know that, If a tick attacks, it “thinks” for 2 hours before launching its proboscis and selects a suction site. If you remove a tick before it begins to feed, infection does not occur, so at least every 2 hours It is necessary to carry out a self-inspection or mutual inspection.

There are 6 genera of ticks found in Russia. The female attacks the host, attaches itself and feeds on blood for 10 days, then falls off, lays eggs in the soil and dies.

The threat posed by ticks living in Russia remains the highest in the world, not only in terms of the prevalence of diseases, but also the severity of the consequences. The strain of the tick-borne encephalitis virus that circulates in European countries does not pose a threat to life, while in Russia deaths have been registered after the bite of an infected tick, and more than 25% of victims of tick attacks were left disabled.

Every year according to medical institutions behind medical care 7-8 thousand residents of Moscow and the Moscow region who have suffered from tick bites are contacting us. The tick bite itself is not dangerous, but if the tick is infected with the tick-borne encephalitis virus, or borreliosis, then there is a threat to the health of the victim.

Where is the disease registered?

Currently, the disease with tick-borne encephalitis is registered almost throughout the entire territory of Russia (about 50 territories of the constituent entities are registered Russian Federation), where its main carriers are ticks. The most disadvantaged regions in terms of morbidity are: the Ural, West Siberian, East Siberian and Far Eastern regions, and those adjacent to the Moscow region - Tver and Yaroslavl.

When traveling to an area where tick-borne encephalitis is endemic, is it necessary to receive preventive vaccinations against this disease? Specific immunoglobulin against tick-borne encephalitis (seroprophylaxis) is indicated for administration to persons with tick suction that occurred in an area endemic for tick-borne encephalitis, no later than 4 days from the moment of suction. The territory of Moscow and the Moscow region is free from tick-borne encephalitis.

Where can you find out whether there is a risk of infection in the area of interest anddo I need to get vaccinated?

List of disadvantaged territories as of the current year, approved Federal service on supervision in the field of protection of consumer rights and human well-being, is available in medical institutions and on the Internet on the website of the Office of Rospotrebnadzor for the city of Moscow http://www.77rospotrebnadzor.ru/ press center.

Examination of ticks for infection with the tick-borne encephalitis virus can be carried out in the special department dangerous infections microbiological laboratory Federal State Institution "Center for Hygiene and Epidemiology in Moscow (Grafsky per. 4/9 tel. 687-40-47).

What are the main signs of the disease?

The disease is characterized by spring-summer seasonality associated with the period most active ticks. The incubation (latent) period usually lasts 10-14 days, with fluctuations from 1 to 60 days.

The disease begins acutely, accompanied by chills, severe headache, a sharp rise in temperature to -38-39 degrees, nausea, and vomiting. Worried about muscle pain, which is most often localized in the neck and shoulders, chest and lumbar region back, limbs. Appearance The patient's face is characteristically hyperemic (red), hyperemia often spreads to the torso.

Who is susceptible to infection?

All people are susceptible to infection with tick-borne encephalitis, regardless of age and gender. Most at risk Persons whose activities involve staying in the forest are susceptible: workers of timber industry enterprises, geological exploration parties, builders of roads and railways, oil and gas pipelines, power lines, topographers, hunters, tourists. City dwellers become infected in suburban forests, forest parks, and garden plots.

The population protection system is the basis of sanitary education work.

Special personal protective equipment:

treatment of clothing with chemicals;
special (anti-encephalitis) clothing.

Environmental transformation measure:

clearing the territory (in children's health camps it is better to have flower beds rather than bushes along the paths);
extermination of tick vectors – carrying out deratization;
elimination of living conditions and attraction of rodents (clearing areas, garbage collection, etc.)

How can you protect yourself from tick-borne encephalitis?

Tick-borne encephalitis can be prevented using nonspecific and specific prophylaxis.

Non-specific individual (personal) protection of people includes:

Compliance with the rules of behavior in an area dangerous in relation to ticks (carry out self-examinations and mutual inspections every 10-15 minutes to detect ticks; it is not recommended to sit and lie down on the grass; parking and overnight stays in the forest should be in areas devoid of grass vegetation or in dry pine forests on sandy soils; after returning from the forest or before spending the night, it is necessary to take off clothes and carefully inspect the body and clothing; it is not recommended to bring freshly picked plants, outerwear and other objects on which there may be ticks into the room; inspect dogs and other animals for detection and removal; them attached and sucked ticks);
Wearing special clothing. If special clothing is not available, you should dress in such a way as to facilitate quick inspection for detecting ticks; wear plain light-colored clothes; tuck trousers into boots, knee socks or socks with a thick elastic band, top part clothes - trousers; Sleeve cuffs should fit snugly to the arm; Shirt collars and trousers must have fasteners or have a tight fastener that ticks cannot crawl under; put a hood on your head, sewn to a shirt, jacket, or tuck your hair under a scarf or hat.

How to remove a tick?

To remove the tick and initially treat the bite site, you should go to a trauma center or remove it yourself. The tick should be removed very carefully so as not to tear off the proboscis, which is deeply and strongly strengthened for the entire period of suction.

When removing a tick, the following recommendations must be followed:

grab the tick with tweezers or fingers wrapped in clean gauze as close to its oral apparatus as possible and holding it strictly perpendicular to the surface of the bite, rotate the tick’s body around its axis, remove it from the skin;
disinfect the bite site with any product suitable for these purposes (70% alcohol, 5% iodine, alcohol-containing products).
After removing the tick, you must wash your hands thoroughly with soap.
if a black dot remains (severation of the head or proboscis), treat with 5% iodine and leave until natural elimination.

It is recommended to examine the removed tick for infection with Borrelia and the TBE virus in the laboratory. Ticks removed from a person are placed in a hermetically sealed container with a small piece of slightly damp cotton wool and sent to the laboratory. If it is impossible to examine the tick, it should be burned or doused with boiling water.

Measures for specific prevention of tick-borne encephalitis:

Preventive vaccinations against tick-borne encephalitis are carried out for persons of certain professions working in endemic foci or traveling to them (business travelers, students of construction teams, tourists, people traveling on vacation, to garden plots). All persons traveling for work or leisure to disadvantaged areas must be vaccinated.

Emergency seroprophylaxis is carried out for unvaccinated persons who apply due to tick infestation in an area where tick-borne viral encephalitis is endemic.

Where can I get vaccinated against tick-borne encephalitis?

In Moscow, in all administrative districts, from March to September, vaccination points operate annually at clinics, medical units, and health centers. educational institutions: (in the Western Administrative District - in children's clinic No. 119; in clinics for adults: No. 209, No. 162 and Moscow State University clinic No. 202), as well as the Central vaccination point based at clinic No. 13 (Trubnaya St., 19, building 1, telephone: 621-94-65).

When should you get vaccinated against tick-borne encephalitis?

Only a doctor can give advice on vaccination.

You can vaccinate with the Encevir vaccine (Russia) for children from 3 years of age and adults with the Encepur vaccine (Germany) for children from 1 year of age and adults.

Vaccination against tick-borne encephalitis must begin 1.5 months in advance (Russia) or 1 month in advance. (Germany) before leaving for a disadvantaged area.

Vaccination with the domestic vaccine consists of 2 injections, the minimum interval between which is 1 month. After the last injection, at least 14 days must pass before leaving for the outbreak. During this time, immunity is developed. After a year, it is necessary to do a revaccination, which consists of only 1 injection, then the revaccination is repeated every 3 years.

Vaccination with the Encepur vaccine three times over 21 days.

If before departure a person does not have time to get vaccinated in emergency cases, human immunoglobulin against tick-borne encephalitis can be administered before leaving for an unfavorable area (pre-exposure prophylaxis), the effect of the drug appears after 24 - 48 hours and lasts about 4 weeks.

What should you do and where should you go if you are not vaccinated and a tick bite occurred while visiting an area unfavorable for tick-borne encephalitis?

Unvaccinated persons are given seroprophylaxis - administration of human immunoglobulin against tick-borne encephalitis no later than the 4th day after tick ingestion (around the clock):

adults at the Research Institute of Emergency and Emergency Medical Care named after. Sklifosovsky (Moscow, Sukharevskaya sq., 3);;
children in the Children's room clinical hospital No. 13 named after. Filatova (Moscow, Sadovaya-Kudrinskaya, 15).

Where to conduct laboratory testing of ticks?

Research of ticks for infection with pathogens of natural focal infections is carried out at the Federal Budgetary Institution of Health "Federal Center for Hygiene and Epidemiology", Federal State Budgetary Institution "Center for Hygiene and Epidemiology in Moscow", at the Federal State Budgetary Institution Central Research Institute of Epidemiology of Rospotrebnadzor.

When contacting the laboratory, it is necessary to provide information about the date and territory in which the tick vapor occurred (region, area, locality).

Where can I get a laboratory blood test?

Upon receiving a positive result laboratory research It is necessary to urgently seek medical help from medical institutions.

TICK-BORNE BORRELIOSES (synonyms: Lyme disease, Lyme borreliosis, ixodic tick-borne borreliosis) are transmissible natural focal infections with acute or chronic course, which may cause skin damage. Nervous, cardiovascular systems, liver and musculoskeletal system.

The causative agent of Lyme disease, the spirochete Borrelia burgdorferi, is transmitted by ixodid ticks.

A person becomes infected through a transmissible route - when a tick is sucked on, the pathogen is transmitted through saliva.

Many species of small mammals, ungulates, and birds are reservoirs of the pathogen and “feeders” of ticks. In Russia, the main feeders are small rodents - bank and red-gray voles, root vole and wood mouse.

There is no official list of areas endemic for tick-borne borreliosis. The distribution area of this disease is wider than the area of tick-borne encephalitis. Cases of tick-borne borreliosis are also recorded in areas free from tick-borne encephalitis.

Incubation period ranges from 3 to 45 days (on average 12-14 days), according to some authors up to 60 days. The ability of the pathogen to persist for a long time in the body determines the formation of chronic forms of the disease, which occurs in the form of systemic damage organs.

Clinical manifestations. In most patients, a characteristic skin lesion in the form of migratory ring erythema develops at the site of the entrance gate. However, not always pathological process may be limited to skin lesions only. Changes in the regional lymphatic system, pain in muscles and joints, increased temperature, and signs of intoxication are observed. In cases caused by a large dose and pathogenicity of the pathogen, it spreads through the bloodstream and lymphatic vessels in the central nervous system, myocardium, muscles, joints, liver, spleen. In such cases, the second stage of the disease develops, in which various symptoms of neuroborreliosis (meningitis, polyneuritis, myelitis), arthritis, myositis, pericarditis, hepatitis, etc. may appear.

In 20-45% of Borls, a form of the disease without local skin changes is observed. Diagnosis in such cases is based on clinical signs practically impossible. Only serological diagnostic methods can make it possible to make a correct diagnosis.

Often the disease occurs in mild, erased forms.

Measures for specific prevention of tick-borne borreliosis have not been developed. In this regard, the main measures to prevent the disease are methods of nonspecific prevention (see Tick-borne encephalitis).

When a tick suctions in the forested areas of Morskoy and the Moscow region, it is necessary to remove the tick and carry out initial treatment of the suction site in the city's trauma centers; it is advisable to save the tick for further testing for Borrelia infection (see Tick-borne encephalitis).

When clinical manifestations You should contact an infectious disease specialist at a medical institution. If a patient is suspected of having tick-borne borreliosis, he should undergo serological blood tests.

Tests of ticks for Borrelia infection can be carried out in a laboratory that performs this type of research (see Tick-borne encephalitis).

If you receive positive results from a laboratory test of a tick for infection with Borrelia, you must contact an infectious disease specialist or your doctor for examination and possible prescription of antibiotics.

$350 million to develop an experimental VLA15 vaccine to prevent Lyme disease. A vaccine targeting six serotypes of the pathogen would cover almost all cases of this disease. infectious disease. Potentially suitable for people two years of age and older, the effectiveness of the vaccine is estimated to be up to 96%. The availability of a commercial product should be expected no earlier than five years from now. Global sales of VLA15 are projected to be between 700-800 million euros per year.

Lyme disease (Lyme borreliosis, tick-borne borreliosis) is a generalized infectious, predominantly transmissible disease caused by at least three species of bacteria of the genus Borrelia a type of spirochete. The three main pathogens are Borrelia burgdorferi s. s. (serotype 6, ST6), B. afzelii(ST2), B.bavariensis(ST4), B. burgdorferi(ST1), B. garinii(ST3, ST5 and ST6). There are other types including B. bissettii And B. valaisiana who are suspected. The infection, being the most common in the Northern Hemisphere among those transmitted by tick bites (mainly Ixodid ticks), annually affects an estimated 300 thousand people in the United States and 200 thousand in Europe. Lyme disease, characterized by a large polymorphism of clinical manifestations, remains untreated and becomes chronic, difficult to treat and often leading to disability and death. Primary therapy is with antibiotics.

The idea is is that the C-terminal portion of surface antigen A (OspA) expressed by spirochetes Borrelia when they are inside ticks, will be sufficient to induce protective immunity, realized by antibodies against OspA produced by the body after vaccination. To achieve this, VLA15 includes the C-terminal portions of six OspA serotypes stabilized by disulfide bonds; in this case, two monomers are linked to each other so that three heterodimers are formed (ST1-ST2, ST4-ST3, ST5-ST6). The connection of a lipid motif to the N-termini of the latter and the addition of adjuvant aluminum hydroxide helps to increase the immunogenicity of the vaccine.

In ongoing phase I clinical trials of VLA15-101 conducted in 179 healthy people under 40 years of age, not previously infected B. burgdorferi, participants were divided into six groups. Subjects received one of three different doses (12, 48 or 90 μg) of VLA15, implemented in one of two formulations - with or without adjuvant. Vaccination was carried out three times with an interval of one month.

Interim results obtained after three months allow us to confidently speak about the effectiveness of the vaccine: the seroconversion index ranged from 71.4% to 96.4%, depending on the OspA serotype. Final data on the safety and immunogenicity of VLA15, including one year of follow-up, are expected in early 2019.

Phase II clinical trials are being prepared for launch, in which VLA15 will be studied in people who have already recovered from the disease and living in endemic regions. Valniva hopes to improve the protective properties of VLA15 by adjusting the dose. VLA15 will later be tested in adolescents and children.

VLA15 is the only prophylactic vaccine against Lyme disease in active development. Yes, GlaxoSmithKline received regulatory approval for LYMErix in 1998, but the vaccine, which was 76 and 100 percent effective in adults and children, respectively, had to be withdrawn from the market in 2002 due to public pressure. , concerned about the possible connection of vaccination with the development of autoimmune arthritis, although no evidence of this has been found. The vaccine candidate ImuLyme, made by Pasteur Mérieux Connaught, now part of Sanofi, did not make it to commercialization, remaining in a successfully completed phase III clinical trial due to insufficient extensive market. An experimental vaccine developed by Baxter International is on pause.

The irony is that there is an abundance of vaccines on the market to prevent Lyme disease in dogs: Recombitek Lyme, LymeVax, Duramune Lyme, Nobivac Lyme, Vanguard crLyme.

Over the past 30 years, the number of tick-borne infections has increased significantly. Various species of ticks inhabit the world, and many of them are carriers of pathogens. It is important to know their symptoms, diagnostic methods and treatment methods for tick-borne encephalitis and borreliosis (Lyme disease) - the two most common diseases in Europe that can be caused by the bite of these insects. After all, timely treatment plays a key role in preventing severe consequences. The elderly and children are most susceptible to them.

Symptoms

Tick-borne encephalitis

The incubation period for TBE is generally 7 to 14 days and is asymptomatic. In the first stage, TBE infection causes flu-like symptoms such as high fever, malaise, decreased appetite, muscle pain, headaches, nausea and/or vomiting. They begin to appear one to two weeks after being bitten by an infected tick. About 25% of all patients infected with tick-borne encephalitis experience more severe symptoms during the second stage, which begins four weeks later. High fever and constant drowsiness may be a sign of inflammation of the brain or spinal cord. Severe headaches, nausea, vomiting, disorientation, convulsions, paralysis, partial or complete loss of consciousness, and coma are also observed. The disease can be fatal or leave permanent neurological complications.

Borreliosis

Lyme disease can cause a wide range of symptoms, making it sometimes difficult to diagnose. It typically affects connective tissue, muscles and the nervous system. The disease develops 1-3 weeks after the bite. Erythema migrans may also appear - redness with a diameter of one to several centimeters, slightly convex, warm, painful to the touch. This rash often appears in or near it, but is not necessary.

If the disease goes unnoticed, the bacteria can affect the nervous system at a later stage. This causes various neurological symptoms such as local paralysis, speech impediments, and mood swings.

Erythema migrans - Lyme disease rash

After a year, Lyme disease becomes chronic and has many symptoms, such as: fever, chills, headaches, arthritis, muscle twitching, dizziness, difficulty speaking, loss of spatial orientation.

Diagnostics

To diagnose encephalitis, the doctor needs information about all the symptoms, as well as recent illnesses and risk factors (being near people suffering from viral infections, in areas where mosquitoes or ticks live, for example).

Magnetic resonance imaging (MRI), spinal tap and electroencephalogram (EEG) are also used. Taking a blood test to check for viruses, bacteria and immune cells is also very informative.

In some cases, a biopsy of brain tissue is performed, which is necessary to confirm the diagnosis if symptoms worsen and treatment does not bring positive results. This procedure is important in determining the type of encephalitis and in prescribing appropriate treatment.

Diagnosing Lyme disease is much more difficult because it has a number of nonspecific symptoms that can accompany other diseases. If there is no rash characteristic of borreliosis, then to make a diagnosis, the doctor asks questions about the patient’s medical history, including stay in tick habitats where there is a high probability of infection.

Early diagnosis and initiation of treatment provide a better chance of full recovery.

Treatment

Treatment of tick-borne encephalitis involves intravenous administration of antiviral drugs, such as:

Acyclovir (Zovirax);
Ganciclovir (Cytovene);
Foscarnet (Foscavir).

Side effects of antiviral drugs may include nausea, vomiting, diarrhea, and muscle pain.

For people suffering from encephalitis, additional supportive procedures are also needed. They provide:

continuous monitoring of cardiac function and respiration;
intravenous drips to ensure proper hydration and normal levels of essential minerals in the body;
anti-inflammatory drugs, such as corticosteroids, to reduce intracranial pressure and swelling;
anticonvulsant medications to stop or prevent seizures.

After an illness, restorative procedures may be necessary. These procedures may include:

physical therapy;
occupational therapy;
speech therapy;
psychotherapy.

Antibiotics are used to treat Lyme disease. At the first stage, their oral use is recommended. Treatment involves the use of doxycycline for adults and children over 8 years of age, or amoxicillin (cefuroxime) for adults, young children, and pregnant and breastfeeding women. The duration of the course is 7-14 days.

If the disease affects the central nervous system, doctors recommend treatment with intravenous antibiotics for 14 to 28 days.

Additional and alternative treatments may be used in conjunction with antibiotics:

proper nutrition;
consumption of probiotics;
phytotherapy.

Prevention

The best prevention against tick-borne encephalitis and borreliosis is to comply with the following measures to protect against tick bites:

When in the woods or areas with tall grass, wear long-sleeved shirts and long pants
use repellents;
Wear light-colored clothing, which makes ticks easier to spot, and check your skin carefully after being outdoors.
If you find a tick, remove it with tweezers, making sure that all its parts (body and head) are removed.