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Vaccination against Lyme disease. Tick-borne encephalitis and borreliosis and preventive measures

Is there a vaccination against borreliosis - specific protection against this tick-borne infection? Is it possible to get a guarantee that a person will not get sick with either borreliosis or tick-borne encephalitis, which often occurs with the first infection? Which preventive measures What should a person do to avoid getting infected?

The concept of tick-borne infections

The name tick-borne infections unites the group infectious diseases, which occur after a tick bite 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, to determine whether a tick is infected is by appearance insect is impossible.

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.

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The essence of borreliosis

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 its 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.

The acute form is characterized by two options:

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

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

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

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

What are the consequences of the pathology?

Residual effects accompanying borreliosis mainly affect the musculoskeletal system and nervous system. The appearance of these symptoms is observed after the 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.

Why is vaccination needed?

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

To avoid getting sick with encephalitis and borreliosis.
If the disease does develop, vaccination gives the disease a milder form.
To avoid serious complications.
So that the process does not become chronic.

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

Who is at risk of contracting tick-borne infections?

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.

Preventive measures

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:

Measures to protect against insect attacks – protective clothing and repellents.
Treating the bite site with antiseptics.
Examination of a tick in a special laboratory.
Enzyme immunoassay blood test to detect specific antibodies.
Taking Doxycycline for several days.

Who should be vaccinated:

Anyone can get vaccinated against tick-borne encephalitis and borreliosis.
Vaccination 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.

Security measures

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, anti-encephalitis human immunoglobulin is administered intramuscularly. To prevent the development of borreliosis, Doxycycline is prescribed for several days.

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Although specific prevention Borreliosis does not exist; vaccination against endemic infectious diseases is still necessary.

The causative agent of infection is spirochetes complex Borrelia burgdorferi sensu lato transmitted to a patient after a tick bite.

The infectious agent was first identified in the 80s in the USA, due to a massive outbreak of arthritis in children after visiting Lyme Park. The distribution area of borreliosis currently covers almost the entire temperate zone of the Northern Hemisphere. The main natural reservoir of the causative agent of borreliosis are small rodents inhabiting anthropogenic landscapes (primarily forest parks and pastures).

The infectious agent is transferred mites of the kind Ixodes . In Western Siberia, the vector is the pasture or taiga tick Ixodes persulcatus- the one that is the carrier of another dangerous infection– viral tick-borne encephalitis. In the European part of the country, the main vector is the forest tick Ixodes ricinus.

Borreliosis is one of the most common tick-borne infections in the world

Acute development of infection - fever, fever, headaches and muscle pain- observed quite rarely. Much more often, the acute stage is practically absent, and the disease immediately becomes chronic. Under pressure from the immune system, borrelia go into tissues and organs where the activity of the immune system is reduced - nerve tissue, joints, tendons, heart.

One of the main primary symptoms borreliosis is migratory erythema– redness of the skin around the bite site that expands over time.

Another defense mechanism for Borrelia is a change in the main antigens, which significantly weakens the effectiveness of the humoral immune response. Strains Borrelia burgdorferi, found in different parts range, differ markedly from each other both in antigenic composition and in the symptoms that can be observed during the development of the disease. So, for example, B.garinii, dominant in the Novosibirsk region, often does not produce clearly defined erythema, which makes the symptomatic diagnosis of borreliosis in Novosibirsk especially difficult.

Currently, the disease is divided into three stages

First stage, local, includes local manifestations and usually lasts up to one month - intense erythema is observed at the site of the initial lesion, a vesicle and necrosis appear. In place of the former erythema, increased pigmentation and peeling of the skin often persists, secondary erythema, rash on the face, urticaria, transient pinpoint and small ring-shaped rashes, and conjunctivitis occur.
After the initial manifestations, the disease progresses to second stage associated with the dissemination of the pathogen into various organs and tissues. In non-erythema forms, the disease often begins with manifestations characteristic of this stage of the disease and is more severe than in patients with erythema. During this period, serous meningitis, meningoencephalitis and syndromes of damage to the peripheral nervous system may be observed: sensory, predominantly algic syndrome in the form of myalgia, neuralgia, plexalgia, radiculoalgia; amyotrophic syndrome, isolated neuritis of the facial nerve, mononeuritis. The most common heart lesions are atrioventricular block (I or II degree, sometimes complete), intraventricular conduction disturbances, and rhythm disturbances.
After 3-6 months, borreliosis becomes third stage, associated with the persistence of infection in any organ or tissue (unlike stage II, it is manifested by predominant damage to any one organ or system). Recurrent oligoarthritis of large joints is typical. Late lesions of the nervous system include encephalomyelitis, spastic paraparesis, ataxia, memory disorders, axonal radiculopathy, and dementia. Polyneuropathy with radicular pain or distal parasthesias is often observed. Patients note headache, increased fatigue, hearing impairment. Children experience slower growth and sexual development.

THE INFECTION IS NOT TRANSMITTED FROM A SICK TO A HEALTHY PERSON, however, TRANPLACENTAL TRANSMISSION of Borrelia during pregnancy FROM THE MOTHER TO THE FETUS IS POSSIBLE, which may explain the rather high percentage of patients of preschool and primary school age.

Human susceptibility to borrelia is very high, and possibly absolute. Primary infections are characterized by spring-summer seasonality, determined by the period of tick activity. Infection occurs during a visit to the forest, in a number of cities - in forest parks within the city limits; summer residents, outdoor barbecue lovers, mushroom pickers, and tourists are at high risk of infection.

In terms of incidence, this infection occupies one of the first places in our country among all natural focal zoonoses. According to indirect estimates, more than 10 thousand people fall ill with borreliosis in Russia every year. As with other spirochetoses, immunity in Lyme disease is non-sterile. Those who have recovered from the disease may be re-infected after 5-7 years.

Manifestations

Over 30 years of careful study of the disease, a fairly good correlation was established between the strain of the pathogen and the pattern of development of chronic infection:

B.burgdorferi sensu strictо(mainly a North American isolate, but also found in Europe) mainly manifests itself in the form of arthritis;
B.afzelii(the main European isolate, in Western Siberia it accounts for about 20%) - most often causes skin manifestations, primarily chronic atrophic dermatitis;
B.garinii(the main Siberian variant of Borrelia) - most often manifests itself in the form of neuroborreliosis (pain along the nerve fibers, perverted sensitivity, paralysis, damage to the central nervous system).

Almost always, chronic borreliosis is accompanied by various autoimmune manifestations. Establishing a diagnosis based on the described symptoms is complicated not only by their diversity and abundance, but also by its strong dependence on the individual characteristics of the patient, as well as cases of combined forms of infections.

Even one tick can infect two strains of Borrelia at once; with multiple bites this happens quite often. Due to the complexity and variability of the clinical picture B.burgdorferi received the epithet among clinical microbiologists "The Great Hoaxer".

Diagnostics

Unfortunately, in Novosibirsk clinics, diagnosing ticks for the presence of Borrelia is the exception rather than the rule. This is primarily due to the lack of certified diagnostic kits for Borrelia antigens. Using PCR tests to determine borreliosis in a patient immediately after a bite is difficult, as it involves taking pieces of skin. Immediately after a bite, there are practically no borrelia in the blood, however, analysis of the presence of borrelia in the blood using PCR reveals the pathogen in 25-30% of cases.

However, currently the only reliable way to diagnose tick-borne borreliosis is enzyme immunoassay based on the detection of specific immunoglobulins to major antigens Borrelia burgdorferi.

Class “M” immunoglobulins can appear in the patient’s blood within a week (usually 14 days) after infection, IgG - on average after 20-30 days. As the infection progresses, the spectrum of the main antibodies changes, but their overall titer remains high, which makes it possible to establish the presence of the disease with high reliability months and even years after the bite.

Treatment

Like most spirochetes Borrelia burgdorferi sensitive to antibiotics, so treatment with early stages, as a rule, is extremely effective and consists of a short course of antibiotic therapy. At the same time, “old” forms are quite difficult to treat, especially when organic changes begin to develop as a result of borreliosis.

It should be remembered that the earlier treatment is started, the simpler it is, the lower the required doses of antibiotics, the shorter the recommended course of therapy, the less the risk of developing the main symptoms of tick-borne borreliosis and its complications. Knowing about the presence of borreliosis infection is in the interests of the patient, therefore, after a tick bite, it is simply necessary to consult with a specialist and, at the appropriate time, analyze the presence of antibodies and DNA of the infectious agent in the blood.

Important to know!

Specialist consultation on tick-borne infections in Medical Center "Status" will help you respond competently to an encounter with a tick, minimize the risk of borreliosis, or start treatment on time.
All blood tests for diagnosis tick-borne borreliosis (antibodies to Borrelia classes M and G, PCR diagnosis of Borrelia DNA) in MC "Status" You can take it on the direction of your doctor or according to the plan prescribed by a specialist from the Status MC.

And remember:

Viral encephalitis and tick-borne borreliosis are two completely various infections, which require separate diagnostics and completely different treatment methods.
The so-called " tick vaccination”, which many wisely give themselves before the tick season, is a vaccination ONLY AGAINST VIRAL ENCEPHALITIS AND DOES NOT PROTECT FROM BORRELIOSIS IN ANY WAY. There are simply no vaccinations against tick-borne borreliosis.
Immunoglobulin injections, which are given after a tick bite, protect ONLY AGAINST VIRAL ENCEPHALITIS and are absolutely useless in the case of BORRELIOSIS.
The drugs that are prescribed for the treatment of viral encephalitis (viferon, iodantipirin, etc.) are almost USELESS AGAINST TICK-BORNE BORRELIOSIS.
The same tick can infect you with ENCEPHALITIS AND BORRELIOSIS AT THE SAME TIME (or even encephalitis and two different strains of borreliosis). Therefore, if an encephalitis virus is found in a tick, this does not mean that borreliosis is absent there.
According to long-term studies, the infection of ticks with encephalitis in the NSO rarely exceeds 5%, and the infection of ticks with BORRELIOSIS IS ABOUT 30% (in some areas it reaches 60%!).

To know how to prevent the development of the disease, it is necessary to study the mechanism of its development and the route of infection. The carriers of the infection are animals, mostly rodents -,. feeds on the blood of a sick animal, does not become infected itself, but becomes a spreader.

It is provoked by borreliosis or a certain type of bacteria – borrelia. They are concentrated in the saliva of the arachnid and are in an inactive state. When a person is bitten, the bacteria enters the skin through saliva. Initially they develop there, forming swelling, inflammation, and redness. After some time, they enter the systemic bloodstream and spread throughout the body.

Note!
The incubation period of tick-borne borreliosis lasts on average 14 days. Initially appears big spot on the skin, up to 60 cm in diameter. And after a couple of days, bright symptoms of Lyme disease appear. During this period, the death of Borrelia begins, in the process they release toxic substances that cause a number of negative consequences.

The danger of tick-borne borreliosis

The first symptoms of Lyme disease are a consequence of toxicosis. Body temperature instantly rises, muscle aches bother you, nausea, vomiting, weakness, and headache appear. The clinical picture resembles the flu, but there are specific symptoms - photophobia, lacrimation, sour eyes, limited neck movements, tense facial muscles. The condition returns to normal even without special treatment within a week, further development borreliosis after a tick bite occurs in one of two scenarios:

the human body produces antibodies, immunity stops the disease;
bacteria continue to multiply and affect the brain, central nervous system, muscles, internal organs– liver, spleen, heart, kidneys.

In the absence of qualified therapy, borreliosis develops into a severe form that is difficult to treat. Complications – loss of vision, deafness, osteoporosis, arthrosis, disability, paralysis, dementia, death.

Note!
The main method of treatment is. Drugs are selected individually in each case; with timely treatment, they stop the development of the disease and eliminate symptoms. The immunity developed is unstable, a person can get sick again the next year. There is no vaccine against borreliosis, so nonspecific methods of prevention must be followed.

Preventing Lyme Disease

Cloth

There is, but it is used mainly by specialists who work in dangerous places - timber harvesters, archaeologists, border guards, agricultural workers. And also fishermen and hunters. Modern suits have traps - pockets, places impregnated with insecticides. Since the cost of protective clothing is no less than 1,800 rubles, ordinary nature lovers are in no hurry to use it.

Note!
If you do not have a special suit, you must wear trousers, a long-sleeved jacket, socks, and a hat. Sleeves should be cuffed, trousers tucked into socks. In this case, the tick will not be able to reach the skin and will fall to the ground after a while.

Inspection

Repellents

Note!
Public prevention of tick-borne borreliosis consists of informing the population about the danger of the disease, the epidemic state of parks, forests, public gardens, and the destruction of rodents - mice, rats. Since there is no vaccine against Lyme disease, non-specific preventive measures are the main method of protection.
What to do after a bite
the vaccine is only against the latter disease. Tick-borne encephalitis – viral infection, when detected, it is administered to activate the immune system, antiviral drugs. To prevent the disease, 3 vaccines are given with an interval of 1 month, 1 year. The effect lasts for 3 years.

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 nearly 80% of dogs in endemic areas become infected, only 5% of them are found to be 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, histological examination of experimentally infected dogs revealed moderate polyarthritis, 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 raises the need to develop 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, it takes Borrelia 24-48 hours to move from the tick's midgut to its salivary gland before moving on to its new host. 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. Enable 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 various types 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 appears to be only B. burgdorferisensustricto, over 90% of which contain one serotype for OspA. Apparently, 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 it is very difficult to interpret the results of serological studies. 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 wide range 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.

Tick-borne borreliosis (Lyme disease, tick-borne erythema) is a disease that develops as a result of the bite of an ixodid tick infected with Borrelia. The causative agent of borreliosis affects the skin, joints and nervous system. There is no vaccine against Lyme disease, and lasting immunity is not developed even after illness.

Path of infection with borreliosis

Lyme disease got its name from the city of Lyme in Connecticut (USA). There, the pathogen was isolated for the first time - the bacterium Borrelia burgdorferi, which gave the disease a second name. The reservoir of infection is infected birds and mammals. Borrelia is transmitted by ticks of the genus Ixodes - they also transmit tick-borne encephalitis and can transmit both diseases in one bite at the same time. Borreliosis is less dangerous than tick-borne encephalitis - the victim has a much greater chance of a successful recovery, but we must take into account that ticks infected with borreliosis are much more common than ticks carrying the encephalitis virus.

It is known that Borrelia can be transmitted during pregnancy from mother to fetus. However, no symptoms of Lyme disease have been reported in infants infected before birth.

Prevention of borreliosis

The best way to protect yourself from ticks is to wear special clothing with cuffs on your wrists and ankles and check each other regularly (every 2-3 hours). The detected tick must be carefully tied with a thread, pulled out without tearing off the head, and try to send it for analysis. Maximum tick activity occurs in late spring and late summer-early autumn.

If the analysis showed that the tick was infected with Borrelia, then the disease can be stopped even before the first symptoms appear. To do this, the patient is prescribed certain antibiotics for 5 days after the bite. It is not recommended to take medications on your own - only after a positive response from the laboratory.

Symptoms of borreliosis

The incubation period for Lyme disease ranges from 3 to 32 days. One of the first signs is a ring-shaped redness at the site of the bite (migratory ring-shaped erythema). It gradually increases in size, the patient may experience pain and itching in this area, general weakness, and headache. The temperature rises. In the absence of treatment, from the 4-5th week of the disease, vomiting, increased light and sound sensitivity develop, symptoms of damage to the nervous system appear: para- and tetraparesis (impaired ability to move the arms and legs normally), paresis of the facial nerves (the patient loses the ability to control muscles faces: speech becomes slurred, has problems chewing, cannot close his eyes, etc.). The pathogen also affects the heart muscle and joints. A person experiences pain in the eyes - iritis or iridocyclitis may develop.

In later stages of the disease, pain and swelling in the joints are accompanied by memory and speech disorders, visual and hearing impairment, pain in the hands and feet. The skin may develop acrodermatitis atrophicus in the form of blue-red spots on the extremities. The spots merge and become inflamed. The skin at the site of the spots atrophies and becomes like tissue paper.
To diagnose borreliosis, a search for borrelia is carried out PCR method in the blood, skin, cerebrospinal fluid and joint fluid. In its external manifestations, Lyme disease is similar to allergic dermatitis, tick-borne encephalitis (and it is very important to accurately establish the absence of tick-borne encephalitis virus in the blood), with cardiomyopathy and a number of systemic diseases ( rheumatoid arthritis, Reiter's disease), etc.

Reusable borreliosis

Another special feature of borreliosis is that even a fully recovered disease does not provide long-term, stable immunity. Borrelia hides in the lymph nodes of an infected person and, while there, does not allow immune system fully respond to the introduction of foreign organisms. As a result, in areas where borreliosis is endemic, local residents may become ill with Lyme disease more than once.