What measures should be taken to prevent helminthiasis. How to treat worms in a child? The infection process and its causes

biological feature development of helminths is the cyclical nature of their development, i.e. each helminth goes through the stages of larva, sexually mature form and egg. Features of the life cycles of helminths form the basis of their epidemiological classification (Table 12). There are three main types of worms:

Geohelminths- these are worms in which the maturation of eggs to an invasive (infectious) state occurs in the soil, i.e. outside the host body.

Biohelminths- worms, the development cycle of which occurs with the change of hosts, i.e. in their life cycle There are main and intermediate hosts. In the body of the intermediate host (human or animal), the stages of eggs and larvae pass, in the final host (human or animal), the helminth reaches puberty. The larvae of some biohelminths sequentially develop in the body of the hosts of two various kinds, of which the first is called intermediate, and the second - additional.

contact helminths- these are worms whose eggs mature quickly (within a few hours) and infection by them occurs most often by contact healthy person with the sick. Possible autoinvasion(autoinfection).

A person becomes infected with helminths in two ways: through the external environment, infested with helminth eggs, or by consuming the intermediate hosts of helminths - large meat cattle, pigs, fish that contain helminth larvae.

The distribution of helminths is influenced by natural geographical conditions (climate, soil nature, the presence of the necessary hosts and carriers, etc.) and social factors (lifestyle, customs, communal comfort, sanitary improvement, sanitary culture, etc.).

Table 12

Epidemiological characteristics of helminthiases

Geohelminthiases

A person becomes infected with ascariasis by ingestion of invasive eggs (containing a mature larva) that are on dirty hands, unwashed or poorly washed vegetables, fruits, berries grown on soil contaminated or fertilized with feces. Food products can be contaminated with ascaris eggs when washing dishes, vegetables, fruits with contaminated water.

The disease is characterized by a decrease in appetite, nausea, abdominal pain, unstable stool, and decreased performance. Ascaris can cause intestinal obstruction, biliary tract. There may be a pulmonary form of ascariasis.

Prevention of the disease includes the improvement of populated areas, sanitary protection of soil and water from contamination with fecal water, deworming of the population, personal hygiene (wash hands before eating, after going to the toilet, working in the garden, etc.), medical examination workers of food facilities for helminths. For food purposes, only drinking water. Vegetables and fruits must be thoroughly washed in running water before eating raw. The contents of latrine pits can only be used for fertilization after they have been composted for 5-12 months or kept in a closed pit latrine for 2 years.

It is important to instill hygiene skills in children as early as possible (wash hands, do not put fingers in your mouth, do not bite your nails, etc.). Systematically, examinations for roundworms of preschoolers should be carried out, junior schoolchildren and persons of certain professions (workers of subsidiary farms, greenhouses and greenhouses).

When a disease is detected, deworming is carried out. The effectiveness of treatment is determined by a 3-fold negative result when examined after 2-3 weeks.

Contact helminthiases

Examine all persons surrounding the patient. At food trade and public catering enterprises, such an examination is mandatory. Persons infected with pinworms are suspended from work until they are completely cured and sent to ambulatory treatment. After treatment, observation is carried out for 1.5 months. The result is evaluated by a 3-fold negative analysis after 2-3 days. Disinfection is required - wet cleaning, boiling, ironing the linen with a hot iron.

The pygmy tapeworm is attached to the intestinal mucosa and necrosis is formed at the site of attachment with the formation of ulcers. Waste products of the helminth cause allergies. Symptoms of the disease - abdominal pain, malaise, headaches, allergic conditions, asthmatic bronchitis, rhinitis, subfebrile temperature, anemia. Asymptomatic carriage is often noted. The study is double, in 2-3 days. Treatment is outpatient. At food trade and public catering enterprises, persons infected with pygmy tapeworm are suspended from work until they are completely cured. Control analysis of feces after treatment is carried out 8-10 times, observation - at least 6 months.

Biohelminthiases

The sanitary assessment of Finnos meat is reduced to counting the number of Finns on an area of ​​40 cm 2. If more than three Finns are found, the meat is sent for disposal, less than three Finns are used for the manufacture of minced sausages, canned food and meat loaves after disinfection by boiling according to the conditionally suitable meat processing mode.

Finns are not resistant to high and low temperatures. Finnose meat is reliably neutralized at a temperature inside the piece of 80 °C. Finns die relatively quickly when meat is frozen (at a temperature of - 9 ° C during the day). When salting pieces weighing 1.5-2.0 kg in a 10% solution table salt meat is rendered harmless within 20 days. Finnose corned beef must contain at least 7% salt.

In the prevention of taeniasis, a large role is given to the prevention of infection of livestock and people; active identification of patients and their treatment; conducting scheduled examinations of employees of risk enterprises - livestock, meat processing plants, as well as food trade and public catering enterprises; veterinary and sanitary control of cattle meat. Only branded meat that has passed a veterinary examination and proper cooking is subject to consumption. Meat is considered harmless from tapeworm larvae if, after boiling, it has a gray (beef) or white (pork) color on the cut, and the juice flowing from it does not contain blood impurities.

teniasis- a disease similar to teniarynchosis. Pathogen - pork tapeworm. Outwardly, it is similar to a bull tapeworm, but its length is not more than 3 m, the segments are up to 1000. On the head, in addition to four suckers, there is a corolla of 22-23 hooks, therefore the pork tapeworm is also called "armed tapeworm". The final host and source of invasion is a person from whose body helminth segments with eggs are excreted through the intestines. Intermediate host - domestic pigs and wild boars. Pigs become infected by eating feed contaminated with human feces containing oncospheres, from which Finns develop in the muscles of pigs, resembling Finns in structure. bull tapeworm. In pigs, Finns are most often localized in the chewing, lumbar, intercostal muscles, sometimes in the muscles of the tongue and heart. Pork meat is more contaminated with Finns compared to cattle meat.

Prevention of teniosis is similar to the prevention of bovine tapeworm and consists in the prevention of infection of livestock and people, as well as the active identification of persons with helminthiases. In this regard, it is important to carry out such activities as: settlements, farms (construction of toilets on farms, cattle yards, field camps, paddocks); providing water for livestock clean water; suspension of infected workers from work with livestock; veterinary and sanitary control of pig meat and its branding.

Finns pork meat also, like the Finns of the bull tapeworm, they are not resistant to heat treatment and cold. They are reliably neutralized at a temperature inside the piece of 80 °C. Neutralization by boiling is carried out according to the mode of processing conditionally suitable meat. Finns pork tapeworm more resistant to cold than bovine. When salting, Finnose meat is cut into pieces weighing 1.5-2 kg and poured with 10% salt solution, neutralized for 20 days.

Trichinosis- this is serious disease caused in humans by the larval form roundworm - trichinella. In the sexually mature form, the pathogen lives in the intestines of pigs, dogs, cats, rats, mice, and many wild animals (boars, bears). Pigs become infected by eating the corpses of rats and mice.

A person becomes infected with trichinosis by eating undercooked or fried pork, lard, wild boar meat, bear meat containing Trichinella larvae. Trichinella is not affected by cooling, salting and smoking. Especially dangerous is salted fat with streaks of meat.

Prevention of trichinosis is carried out by observing sanitary regulations regarding meat products and checking meat, especially pork, for infection with Trichinella in meat processing plants and markets. Meat that has not passed the veterinary and sanitary examination is not allowed to trade. Trichinella is not allowed in meat and meat products. Trichinella is not visible to the naked eye. If at laboratory research meat, at least one live or dead Trichinella was found in 24 muscle sections; such meat and offal are subject to technical disposal. The meat of pigs and wild animals must be boiled for at least 2.5 hours in pieces no more than 2.5 cm thick or well-fried. The outer fat is melted at 100 ° C for 20 minutes, internal fat used without restrictions. Important role dedicated to public health education. Rodents and uncontrolled slaughter of pigs should be controlled without testing for infection with Trichinella.

A person becomes infected with diphyllobothriasis by eating fish or caviar infested with tapeworm larvae. AT small intestine In humans, the larva attaches to the wall and turns into a sexually mature individual in 15-18 days. With diphyllobothriasis, a person develops nausea, vomiting, sometimes abdominal pain, as well as anemia (anemia) up to malignant form as a result of a violation of vitamin metabolism (especially vitamin B 12, which is absorbed by the tapeworm). Infection can occur when eating raw, undercooked, undercooked, dried or unsalted fish, pike caviar and burbot, infested with tapeworm larvae.

Infested fish is safely neutralized by all cooking methods, as well as by hot and cold smoking. For the prevention of diphyllobothriasis, it is necessary to eat only well-cooked, fried, smoked, salted fish. When salting, the fish is rendered harmless in 2-7 days. In pike caviar, tapeworm larvae die at 10% salting after 30 minutes, at 5% - after 6 hours, and at 3% - after two days. Freezing fish at a temperature of -18 ° C causes the death of larvae on the 2-4th day, and at a temperature of - 6 ° C after 6-7 days.

If infection with tapeworm larvae is detected, the fish is recognized as conditionally fit and is allowed for use only after special treatment, and the accompanying document indicates: "Conditionally fit, subject to special treatment."

Great importance in the prevention of diphyllobothriasis is the identification of patients and their treatment, wastewater treatment before their discharge into water bodies, health education of the population in areas where diphyllobothriasis is registered.

Helminth eggs get into the water with the feces of a person, dog or cat, are swallowed by molluscs, which, in turn, are absorbed by fish. In fish, the larvae of the cat fluke (metacircaria) penetrate into muscle tissue and subcutaneous fat cell, where they are covered with a dense shell. The number of cat fluke larvae can reach more than 1500.

Infection of humans, cats, dogs occurs only when eating raw (frozen, lightly salted) or undercooked (fried) fish.

When infested fish are eaten, the larvae through bile ducts and pancreatic ducts penetrate into the organs, where they turn into adult helminths and can live for many years. Opisthorchiasis usually proceeds according to the type chronic disease with occasional exacerbations. Patients with opisthorchiasis experience pain in the liver, epigastric region, sometimes in muscles and joints, fever, dizziness, loss of appetite, weight loss, nausea, heartburn. Complications in opisthorchiasis are serious - liver abscess, peritonitis, primary liver cancer.

Cat fluke larvae die at high temperatures. To prevent opisthorchiasis, the fish is boiled well for 20-25 minutes at a temperature inside the piece of 75-80 ° C. Fish cutlets weighing 90-100 g are fried for 20 minutes, and meatballs and fish, cut into pieces weighing 30-50 g, are cooked for at least 10 minutes from the moment of boiling. Freezing at -18 °C leads to the death of larvae on the 4-5th day. When salted, the fish is rendered harmless in 10-25 days. Prevention of opisthorchiasis is similar to the prevention of diphyllobothriasis.

A person becomes infected by drinking contaminated water, food products, raw vegetables and berries, as well as in contact with an animal. AT small intestine larvae are released from the eggs. With the bloodstream, they enter the liver, spleen, lungs, brain and other organs. In these organs, the larva slowly grows and after 3-10 years turns into a bubble with liquid (cyst), reaching a diameter of 5-15 cm. The symptoms of the disease are very diverse and their features are associated with the affected organ. Often there are allergic reactions, pain in the liver, chest pain, cough with sputum and streaks of blood, jaundice. Blisters can suppurate and break into the pleural and abdominal cavity. These complications are very dangerous and the prognosis of the disease is always serious.

Echinococcosis often affects pigs, cows and other domestic animals. At health assessment meat and offal proceed from the size of their defeat with echinococcus. With a continuous lesion of organs, the meat is sent for technical utilization, with partial damage (only the liver and lungs), the meat is considered conditionally suitable and, after the removal of the affected organs, can be eaten.

Prevention of echinococcosis is proper care for pets, regular veterinary supervision of them, in compliance with the rules of personal hygiene.

Similar information.

Introduction

Diseases caused by helminths and protozoa

Diagnosis of diseases caused by protozoa and helminths

Principles of microbiological diagnosis of helminthiases

Prevention and treatment of helminths

Helminth pathogenesis

Conclusion

Literature

Introduction

Signs of helminthic diseases depend on the type and number of worms, as well as on the individual reaction of the body to worms. The first symptoms of infection with worms: appetite worsens, vomiting, nausea or salivation appear, paroxysmal pain in the abdomen. Constipation alternates with diarrhea, fatigue and weakness develop, sleep is disturbed. When infected with pinworms, patients are concerned about itching in the anus and perineum. It intensifies at night and at rest. Sometimes it is so strong that the patient wakes up.

Diseases caused by helminths and protozoa

Infection of a person with helminths can occur when using infested drinking water /ascariasis, trichuriasis, enterobiasis, teniasis/ and when larvae of helminths in the water penetrate through the outer covers /dracunculiasis, schistosomiasis/. In addition, water is a medium in which eggs or larvae of some biohelminths live for a certain time, infecting people with which occurs when eating infested aquatic organisms /opisthorchiasis, diphyllobothriasis/. Helminth eggs enter water bodies from sewage. Gradually, the eggs settle to the bottom and sink into the silt, from where, under the influence of various hydrodynamic processes, they can again fall into the water.

Diagnosis of diseases caused by protozoa and helminths

In the blood serum of lamblia-infested people, antibodies to lamblia antigens belonging to various classes of immunoglobulins are detected. It has been shown that the penetration of Giardia antigens into the peripheral blood increases with the resorption of the intestinal mucosa.

For laboratory diagnosis of toxoplasmosis, a complex determination of specific IgM and IgG is used. The presence of IgM antibodies to toxoplasmosis is an indicator of acute toxoplasmosis. Negative test results do not rule out the possibility early stage diseases with low concentrations specific IgM.

Opisthorchiasis - helminthoses caused by various trematodes, characterized by a chronic course with a predominant lesion of the liver, gallbladder and pancreas. Opisthorchiasis causes significant changes in the hepatobiliary system, which in turn leads to the emergence of various forms of pancreatitis, liver and pancreatic cancer.

The mechanism of the pathological effect of opisthorchis on the human body consists mainly of three points:

Principles of microbiological diagnosis of helminthiases

The final diagnosis of helminthiases can only be established on the basis of positive laboratory data. The main method of laboratory diagnosis of these invasions is the detection of eggs or larvae of helminths. The material for the study is feces, the contents of the duodenum, blood, sputum, tissue biopsy specimens and other materials. The collection of material for research is carried out in clean glass or plastic dishes, on which a label is stuck indicating the necessary information.

Feces for analysis should be delivered to the laboratory no later than one day after their release, and if strongyloidiasis is suspected, immediately. If it is impossible to deliver feces within the specified time, they should be mixed with 2-5 times the amount of preservative liquids and stored chilled until examination.

Object exploration environment for helminth infestation.

Analysis of water, soil, vegetables, and various items is carried out to determine their role in the transmission of helminth eggs and human infection, the degree of environmental pollution and the selection of necessary preventive measures.

In the environment, helminth eggs gradually die, and only viable invasive eggs and larvae pose a danger to humans. Therefore, it is necessary in each case of finding eggs to determine the degree and percentage of their viability. This will make it possible to correctly assess the role of one or another transmission factor, find out the conditions and terms for the preservation of eggs in the environment, and justify certain measures for the neutralization (deinvasion) of environmental factors.

Determining the viability of helminth larvae found in meat or fish is necessary in cases where it is necessary to decide on the degree of their danger to human infection or the effectiveness of neutralizing a contaminated product.

Prevention and treatment of helminths

Preventive anthelmintic courses are best done in the spring, 1-2 months after the snow melts (April-May), and in the fall, when frosts begin (October-November). The prophylactic course is exactly the same as the curative one ( complex therapy of two anthelmintics).

You can reduce the likelihood of infection with helminths by observing basic hygiene:

refusal to use thermally unprocessed meat (pork), fish, salted fish, caviar, cooked in an artisanal way;

refusal to use raw water, especially from open reservoirs.

the need to wash hands before eating and after using the toilet;

washing with running water and boiling water treatment of greens and vegetables served raw;

Timely detection and prompt implementation of anthelmintic therapy will reduce the number of cases of severe helminthic invasions and their complications. If helminths are detected in someone in the family (or they are suspected by indirect signs), it is not necessary to treat all family members. Treat only those who have indirect signs possible helminthiasis, since most worms are not transmitted from person to person.

Drug prophylaxis is required for the whole family 2 times a year (for example, in spring and autumn). Most often, Albendazole is used for this purpose, which is prescribed according to the scheme: children over 2 years old and adults 400 mg (1 tablet or 10 ml of suspension) of the drug 1 time per day after meals for 3 days.

The likelihood of infection with worms is very high. Their ability to disrupt various bodily functions and the difficulty of diagnosis is also widely known. Therefore, it is recommended, regardless of the test results, to conduct prophylactic and therapeutic antihelminthic courses, taking into account indirect signs of infection. WHO recommends preventive anthelmintic courses for preschool children twice a year - in spring and autumn.

Treatment of the acute phase of helminthiases is based on desensitizing and detoxification therapy:

hemodez infusions, isotonic solution glucose, saline;

vitamin C;

vitamin B6;

bicarbonate of soda;

calcium chloride or gluconate;

with hyperthermia - analgin, diphenhydramine;

at high blood pressure- Cordiamin.

AT severe cases(with the development of hepatitis, allergic myocarditis) the appointment is indicated hormonal drugs especially prednisolone. In parallel with it, the patient should receive potassium supplements. In the case of heart failure, Korglikon and Cocarboxylase are used, with edema - Furosemide or Torasemide.

Helminth pathogenesis

It should be noted that infectious diseases, reducing the resistance of animals, violate their host specificity and contribute to a more severe course of helminthiases. For example, in some poultry farms in Ukraine, unfavorable for paratyphoid, pasteurellosis, ducks were easily infected and seriously ill with drepanidoteniosis and amidostomiasis (helminthiases not specific to them), and were also difficult to cure.

All helminthiases are characterized by a multi-stage development, and each stage is characterized by its own clinical pathological processes.

Stages of development of invasions:

Acute stage (the causative agent is a larva):

penetration phase;

migration phase.

Subacute stage (causative agents - young helminths).

Chronic stage (causative agents - adult helminths):

early phase (maximum reproductive activity);

late phase (decrease in reproductive activity).

Outcome (elimination of helminths or development of irreversible changes in the host). The most severe is the initial acute stage, caused by larvae that cause sensitization of the body and damage to those organs through which they migrate.

Conclusion

Literature

Skryabin K. I., Petrov A. M., Fundamentals of veterinary nematodology, M., 1964

Multi-volume guide to microbiology, clinic and epidemiology of infectious diseases 1968

Leikina E. S., The most important human helminthiases, M., 1967

Mozgovoy A. A., Helminthiases of domestic and wild pigs and the diseases they cause 1967

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Among the helminths there are round, flat, tapeworms, and often found in addition to the above are:

• echinococcus;
• pork and bovine tapeworms, or tapeworms;
• necators;
• whipworm;
• hookworms;
• multiceps;
• cysticercus;
• wide ribbon;
• alveococcus;
• dwarf tapeworm.

Enterobiasis, ascariasis, trichuriasis, teniidosis, ankylostomiasis are transmitted from person to person. The source of opisthorchiasis, schistosomiasis, dracunculiasis, fascioliasis can also be animals.

Trichinella, alveococcus and echinococcus are transmitted only from animals.

Signs and symptoms of helminthiasis

Clinical manifestations helminthiases are diverse, depending on the specific pathogen and its localization in the body. They may come from different systems and are often regarded as signs of other diseases. internal organs. Symptoms of helminthiasis in adults and children are different in acute and chronic stage pathology.

The acute form of helminthiasis lasts from 2 to 8 weeks after the penetration of the invasion into the body, after which it becomes chronic, which can last from 3-6 months to several years.

The acute stage is characterized by an increase in immunity activity in response to the ingress of foreign objects, and the symptoms for most helminthiases at this time are similar:

• high fever and sweating;
• puffiness;
• the appearance of a rash;
• enlarged lymph nodes;
• soreness of the joints and muscles;
• bloating;
• diarrhea or constipation;
• the spleen and liver are enlarged;
• a blood test shows an increase in the level of eosinophils (a type of white blood cell).

The course of the disease is often accompanied by apathy, depressive mood. It happens that the signs are absent or weakly expressed, and noticeable manifestations occur only if the worm is large enough (wide tapeworm, pork or bovine tapeworm).

Specific symptoms of helminthiases:

• development iron deficiency anemia- with ankylostomiasis;
• prolapse of the rectum, hemorrhagic colitis - with trichuriasis;
• edema due to stagnation of lymph, allergies, inflammation lymphatic vessels- with filariasis;
• pancreatitis, hepatitis, cholangitis, neurological disorders- with fasciolosis, opisthorchiasis;
• bleeding after urination - with urogenital schistosomiasis;
• pancreatitis, intestinal obstruction, jaundice - with ascariasis.

An asymptomatic course is characteristic of cysticercosis, echinococcosis and alveococcosis, even in the case of significant damage to internal organs. Only with cysticercosis can symptoms of a neurological nature appear (apathy, convulsions, abrupt change sentiment, etc.).

It leads to internal bleeding and the entry of a significant number of helminths into the bloodstream and, as a result, to peritonitis, anaphylactic shock, pleurisy and other complications.

Features of the symptoms of helminthiasis in children

AT childhood The risk of helminth infection is higher because:

• the child is in contact with many peers during games, learning;
• the immunity of children is not fully formed;
• personal hygiene skills are not developed.

Symptoms of helminthiasis in children are intoxication of the body, allergic manifestations and susceptibility to infections. Enterobiasis in childhood is most common, while the child may complain of itching in the anus.

Otherwise, the symptoms of helminthiases in children are similar to those in adults.

Diagnosis of infection with helminths

At the same time, serological, general clinical and immunological methods are also used, including ultrasound of organs, urine and blood tests, X-rays, CT scan, ELISA and others.

Most often, the source for analyzes is feces, which are studied by various methods:

1. Kato - used in most cases to detect helminth eggs;
2. deposition of Richie - to identify schistosomes;
3. Harada-Mori - to find necator and hookworm;
4. Berman - detects strongyloid larvae.

Treatment of helminthiasis in children and adults

Common types of helminthiases and drugs used for treatment are shown in the table.

Except antihelminthic drugs for the treatment of helminthiasis, sorbents for cleansing the intestines (Polysorb, Activated carbon, Polypefan) and antihistamines for stopping an allergic reaction (Claritin, Zirtek, Suprastin).

After a course of treatment with drugs against helminths, probiotics should be added to sorbents and antihistamines to normalize the intestinal microflora.

Additionally in the treatment of helminthiasis can be prescribed:

• means for normalization blood pressure if hypertension develops against the background of the disease;
• glucocorticosteroids are indicated for severe forms helminthiases, when vasculitis, arachnoiditis, myocarditis and other complications occur;
• with severe intoxication, Hemodez is administered intravenously, a glucose solution, orally - ascorbic acid, calcium chloride, vitamin B6.

The diet should be easily digestible food- vegetables, fermented milk products, fruits, lean soups and porridge. Before the course of treatment of helminthiasis, a thorough cleaning of the house is carried out soapy water and completely change bed sheets. Underwear should be ironed daily with a hot iron.

Measures for the prevention of helminthiasis

Prevention of helminthiasis in children and adults is to eliminate the conditions that contribute to infection. It's thorough heat treatment products of animal origin, the use of only purified or boiled water, washing vegetables, herbs and fruits, personal hygiene.

Twice a year, prophylactic courses of taking antihelminthic drugs will not interfere, especially if there are animals at home or there are other risk factors for infection with helminths.

Helminthiases- these are diseases that occur during the development of lower multicellular organisms in the body, they are called helminths.

They are found everywhere, for example, in water, in food, on earth. Therefore, it is very important to know what prevention of helminthiases exists in order to protect against their defeat.

The causes of infection are considered to be eating food that has not been properly cleaned. These are not washed vegetables, berries, fruits, and the development of the disease can also be triggered by plain water.

A liquid that has not been boiled or a helminth infection can be caused by wild-growing plants and herbs.

Infection with helminths can occur if you swim in a pond or come into close contact with the soil affected by the infection. You can often hear from medical workers a warning to wash your hands upon returning from the street. AT in public places a person comes into contact with various objects, and on them there are various bacteria that lead to infection.

Prevention against helminthiases in humans includes the observance of certain rules.

All meat and fish products must pass heat treatment. Wash your hands with soap as often as possible, and also try to completely eliminate contact with people who have diseases such as enterobiasis and hymenolepiasis. Drink plain water only after it has been boiled.

Infection with helminthiases is possible at home, most often this occurs due to the accumulation of dust on household items. In order to prevent the disease, it is necessary to carry out wet cleaning of the house as often as possible.

When cooking, monitor the cleanliness of kitchen tools, and dishes should be washed thoroughly and preferably poured over with boiling water. In summer, do not swim in ponds that are polluted.

As a rule, before the swimming season, experts take samples for pollution and then inform people about the presence of reservoirs that are suitable for swimming. Also, the prevention of the disease involves the rejection of travel to tropical countries where the environment is unfavorable.

Prevention with the use of drugs

Treatment and prevention of helminths without a diagnosis is still possible. If the house is inhabited by animals, such as dogs, cats or rodents. A person who is at risk systematically carries out prophylaxis using.

Going on vacation to African countries, it is advisable to drink medicine to prevent infection with worms.

In the treatment of the disease, drugs can be used - vermox, pyrantel, nemozol, sanoxal, vormin. They are considered effective means when infected with helminthiasis.

Hygiene prevention

To protect the ingestion of adult worms, personal hygiene must be observed. Most types of helminthiasis get inside through dirty limbs of the hands. Everyone knows from childhood that they must be kept clean. But adults sometimes neglect simple rules, and helminths develop in the body. To protect yourself from them, you need to make it a rule to wash your hands before eating.

After returning from a walk, wash your hands under warm water using antibacterial agent. When buying vegetables or fruits, a person tries them, but doctors do not recommend doing this. This conclusion is based on the fact that unwashed food contains a significant amount of helminth eggs.

When visiting the toilet, it is also necessary to wash your hands for prevention. This is due to the fact that helminthiases can remain on the toilet. The toilet should be cleaned regularly with disinfectants.

In order to prevent infection, it is worth refraining from the habit of biting your nails, taking dirty objects into your mouth, and cutting your nails short.

Treatment is carried out medicines. When one of the family members is infected, it is required as a preventive measure to change bedding frequently, wash it only when high temperatures, iron after drying. It is worth performing daily hygiene procedures.

Food processing

To prevent the risk of infection, it is necessary to follow some tips for eating fish. Prior to the start of butchering the carcass, its visual inspection is carried out. It should be cut according to the rules, and when cooking and frying, monitor readiness. If it is simply boiled, then the process should be lengthy. When it is fried, it is necessary to constantly turn the fish over.

It is also important to note that different cutting boards are used in the preparation of meat and fish products, this rule also applies to the preparation of vegetables. It is not recommended to purchase caviar that is lightly salted, as the product can be hazardous to health.

Eating meat from infected animals poses a serious threat to life. For example, if you eat infected pork, you can get taeniasis. Infected lamb or beef provokes the occurrence of a disease such as teniarinhoz. Care must be taken to prevent disease meat product before buying, as well as during preparation.

As a warning possible infection it is necessary to refuse steaks with blood, do not eat raw meat, such as minced meat. When cooking meat, the processing temperature should reach about 200 degrees, and the product must be boiled for an hour.

When cooking meat, many people prefer to boil it in a large piece. But this is not correct, you need to cook small pieces, up to a maximum of 8 centimeters. This contributes to a better brewing of the product. Pathogenic microorganisms die when the food is deep frozen.

• Nemathelminthes - roundworms, class Nematoda;
• Plathelminthes are flatworms that include the class Cestoidea - tapeworms, and Trematoda, a class of flukes.

• biohelminths;
• geohelminths;
• contact worms.

Representatives of biohelminths are pig, bovine tapeworm, echinococcus and other types of worms of the class cestodes, trematodes and certain types nematodes. These helminths develop with a successive change of one, two or three hosts; intermediate hosts can be fish, molluscs, crustaceans, insects. Sometimes intermediate host a person is also a carrier of larval forms of single-chamber or multi-chamber echinococcus or cysticerci - larvae of pork tapeworm.

A person becomes infected with biohelminthiasis by eating meat that has not undergone a full heat treatment - beef infected with the Finns of the bovine tapeworm, pork affected by the Finns of the pork tapeworm, lightly salted and raw fish with larvae of opisthorchis or wide tapeworm. The larvae of some helminths can swim in water or attach to algae - in this case, infection occurs while drinking raw water infected with larvae, processing vegetables, fruits and utensils with this water, eating infected aquatic plants.

To common helminthiases transmitted by contact, also include hymenolepiasis (causative agent - pygmy tapeworm). Infection with these diseases occurs through personal contact of a healthy person with an infected person, using common utensils, toilet items, linen, and also by inhaling dust in the room in which the infected are located. In the case of enterobiasis, self-infection occurs very often.

• most cestodes (pork, bovine, pygmy tapeworm) and nematodes (hookworms, roundworms, strongyloids) - in the colon;
• pinworms and whipworms - in the large intestine;
• trematodes (opisthorchis, clonorchis, fasciola) - in the liver and bile ducts;
• echinococcal cysts are primarily located in the liver, and after their rupture, daughter blisters can be found in the mesentery, peritoneum, spleen and other organs;
• larvae (cysticerci) of the tapeworm from the intestinal lumen enter the bloodstream and spread throughout the body, settling in fatty tissue, muscle vessels, eye chambers, and the brain.

Pathogenesis

In the pathogenesis of helminthiases, it is customary to distinguish 2 main phases: acute and chronic.

The acute phase lasts for 2–3, and in some, especially severe cases, up to 8 weeks from the moment the helminth enters the body - invasion. The clinical manifestations of this phase do not depend on the type of pathogen and are due to the general allergic reaction on foreign genetic material of larvae migrating through the body.

It is worth saying a few words about the phenomenon of immunological tolerance, which often occurs in helminthiases. Clinically, this syndrome is manifested by the absence of signs of the acute phase of the disease, mild or even subclinical course of the chronic phase.

Clinical picture of helminthiases

In the acute phase of the disease, patients complain of:

• itchy recurrent skin rashes;
• local or generalized edema;
• fever
• enlargement of regional lymph nodes;
• pain in muscles and joints;
• cough, asthma attacks, chest pain;
• abdominal pain, nausea, vomiting, stool disorders.

Serious lesions characteristic of the acute phase of the disease are:

• pneumonia;
• allergic myocarditis;
• meningoencephalitis;
• hepatitis;
• hemostasis disorders.

During examination, infected people may find an increase in the liver and spleen - hepatosplenomegaly, in the blood - increased amount eosinophils - eosinophilia, imbalance different types protein - dysproteinemia.

Intestinal helminthiases are manifested by dyspeptic, pain and asthenoneurotic syndromes, which are more pronounced in children. Ascariasis in case of massive invasion is often complicated intestinal obstruction, pancreatitis and obstructive jaundice. by the most a clear symptom with enterobiasis is the evening and night perianal itching.

Liver trematodes(fasciolosis, clonorchiasis) most often cause chronic pancreatitis hepatitis, cholecystocholangitis and different kind neurological disorders.

Ankylostomiasis appear first of all (weakness, fatigue, pallor), since hookworms feed on blood and, damaging blood vessels, provoke chronic bleeding of them.

Filariasis are uncharacteristic for our area - registered cases of this disease are imported. Filariasis is characterized by an allergic syndrome varying degrees severity, damage to regional lymph nodes.

Schistosomiasis are also imported helminthiasis. Chronic form urogenital schistosomiasis is characterized by the phenomenon of terminal hematuria (the appearance of a drop of blood at the very end of urination), as well as frequent urges on urination, pain during it. With intestinal schistosomiasis, patients present (pain along the intestine, bloating, stool disorders, stool mixed with blood).

• an increase in the number of eosinophils in general analysis blood;
• increase in content direct bilirubin, ALT and AST, alkaline phosphatase, thymol test, amylase activity in biochemical analysis- characteristic of trematodes.

Diagnosis of the acute phase of helminthiases, as well as diseases caused by larval stages (echinococcosis, alveococcosis) and tissue helminths, is also based on serological methods: RIF, RNGA, ELISA and others.

The following biological materials are examined for the presence of helminths, their fragments, larvae and eggs:

• feces;
• blood;
• urine;
• the contents of the duodenum;
• bile;
• sputum;
• muscle tissue;
• rectal and perianal mucus.

The test material is examined macroscopically (for the determination of whole helminths or their fragments) and microscopically (for the presence of eggs and larval forms).

The most common material for research is feces. Since helminths are not excreted in the feces at any stage of their development, in order to increase the likelihood of detecting them in patients, it is recommended to donate feces three times after 3-4 days.

Enterobiasis is diagnosed by detecting pinworms in material taken from the perianal folds using a spatula, swab, or impression using adhesive tape.

To diagnose filariasis, it is necessary to examine blood and skin sections.

To clarify the location of helminths, use:

• endoscopy with endobiopsy;
• computed tomography.

Treatment

Treatment of the acute phase of helminthiases is based on desensitizing and detoxification therapy:

• infusions of hemodez, isotonic glucose solution, saline;
• vitamin C;
• vitamin B6;
• bicarbonate of soda;
• calcium chloride or gluconate;
• with hyperthermia - analgin, diphenhydramine;
• antihistamines (Suprastin, Pipolfen);
• with increased pressure - Cordiamin.

The above drugs are administered mainly by infusion, less often by injection.

In severe cases (with the development of hepatitis, allergic), the appointment of hormonal drugs, in particular Prednisolone, is indicated. In parallel with it, the patient should receive potassium supplements.

In the case of heart failure, Korglikon and Cocarboxylase are used, with edema - Furosemide or Torasemide.

The basis of the fight against any helminthiasis is specific treatment. The following highly active and at the same time low-toxic drugs are most often used:

• Levamisole (more often - with ascariasis);
• Albendazole (trichinellosis, strongyloidiasis, ankylostomiasis, trichuriasis, ascariasis and enterobiasis);
• Mebendazole (trichinellosis, ascariasis, enterobiasis, trichuriasis and ankylostomiasis);
• Pirantel (enterobiosis, ascariasis);
• Medamin (strongyloidiasis, ascariasis, enterobiasis, trichuriasis and ankylostomiasis);
• Praziquantel (opisthorchiasis, clonorchiasis, paragonimiasis, schistosomiasis, diphyllobothriasis, taeniasis);
• Diethylcarbamazine (filariasis).

The frequency of taking the drug and its dosage are different for different helminthiases and also depend on the age or body weight of the patient.

Parallel to therapeutic measures, mentioned above, is carried out symptomatic treatment, the purpose of which is to eliminate the symptoms caused by the pathological effect of the helminth on the body of the infected.

Prevention of helminthiases

basis primary prevention any type of helminthiases (i.e., preventing infection) is the formation of both a child and an adult, healthy lifestyle life, including the social well-being of the family, the level of culture of all its members, material security, etc. An important point in the fight against helminthiasis is the use of only high-quality, parasite-free water in everyday life.