How to determine if the treatment of borreliosis is successful. What is tick-borne borreliosis: a description of the disease. How to take a blood test for tick-borne borreliosis

Lyme borreliosis is widely found in the habitat of ixodid ticks, namely in the northern hemisphere. In our country, about 8 thousand new cases of the disease are registered annually, all age categories are ill, but more than 10% of the cases are children. Ixodid ticks can be carriers of several infections at the same time, so when bitten by one tick, a person is at risk of contracting several infections.

What it is?

Lyme disease (tick-borne borreliosis) is an infectious natural focal transmissible disease that is caused by spirochetes and transmitted by ticks and has a tendency to recurrent and chronic course and predominantly affects the skin, nervous system, heart and musculoskeletal system.

Causes of Lyme Disease

The causative agent of the disease are several types of Borrelia - B. garinii, B. burgdorferi and B. afzelii. These are gram-negative spirochetes that grow on media containing amino acids, animal sera, and vitamins.

1. The natural hosts of Borrelia are rodents, deer, and birds. When bloodsucking, Borrelia find themselves in the intestines of the tick (their reproduction occurs there), and then they are excreted with feces. The circulation of the pathogen in natural foci occurs according to the scheme: ticks - wild birds and animals - ticks.
2. Infection with human Lyme disease occurs in natural foci of borreliosis through a tick bite. But there is a possibility of infection in case of contact with the skin of the feces of the tick during its subsequent combing. If the tick is not properly removed, if it ruptures, Borrelia can get into the wound. An alimentary route of transmission of the pathogen is also possible - with the use of raw cow or goat milk.

Infection with Lyme disease (borreliosis) occurs when visiting the forest, forest park areas inside cities, when removing ticks from pets.

The peak incidence of borreliosis falls on the period from May to June.

What happens in the human body

The causative agent of tick-borne borreliosis enters the body with the saliva of the tick. From the site of the Borrelia bite, blood and lymph flow into the internal organs, lymph nodes, and joints. The pathogen spreads along the nerve pathways with the involvement of the meninges in the pathological process.

The death of bacteria is accompanied by the release of endotoxin, which triggers immunopathological reactions. Irritation of the immune system activates the general and local humoral and cellular response. Directly the production of IgM antibodies, and a little later IgG occurs in response to the appearance of the flagellar flagellar antigen of bacteria.

As the disease progresses, the set of antibodies to Borrelia antigens expands, which leads to prolonged production of IgM and IgG. The proportion of circulating immune complexes increases. These complexes are formed in the affected tissues and activate inflammatory factors. The disease is characterized by the formation of lymphoplasmic infiltrates in the lymph nodes, skin, subcutaneous tissue, spleen, brain, peripheral ganglia.

Classification

In the clinical course of Lyme disease, an early period (stages I-II) and a late period (stage III) are distinguished:

• I - stage of local infection (erythemal and non-erythemic forms)
• II - stage of dissemination (course options - febrile, neuritic, meningeal, cardiac, mixed)
• III - stage of persistence (chronic Lyme arthritis, chronic atrophic acrodermatitis, etc.).

According to the severity of pathological reactions, Lyme disease can occur in mild, moderate, severe and extremely severe forms.

Symptoms

The incubation period of Lyme disease from infection to symptom onset is usually 1 to 2 weeks, but it can be much shorter (a few days) or longer (months to years).

Typically, symptoms appear from May to September, as this is when tick nymphs develop and are the cause of most infestations. Asymptomatic infection occurs but is statistically less than 7% of Lyme disease infections in the United States. The asymptomatic course of the disease is more typical for European countries.

The first symptoms of Lyme disease are nonspecific: fever, headache, chills, muscle aches, weakness. A characteristic symptom is the stiffness of the neck muscles. An annular redness (migratory annular erythema) develops at the site of the tick bite. In the first 1-7 days, a macula or papule appears, then within a few days or weeks, the erythema expands in all directions. The edge of redness is intensely red, slightly rises above the skin in the form of a ring, in the center the redness is somewhat paler. Erythema is round in shape, 10–20 cm in diameter (up to 60 cm), localized more often on the legs, less often on the lower back, abdomen, neck, axillary, inguinal areas. In the acute period, symptoms of damage to the soft meninges (nausea, headache, frequent vomiting, photophobia, hyperesthesia, meningeal symptoms) may appear. Pain in muscles and joints is often noted.

After 1-3 months, stage II may begin, which is characterized by neurological, cardiac symptoms. Systemic tick-borne borreliosis is characterized by a combination of meningitis with neuritis of the cranial nerves, radiculoneuritis. The most common cardiac symptom is atrioventricular blockade, the development of myocarditis, pericarditis is possible. There is shortness of breath, palpitations, constricting pains in the chest. Stage III is rarely formed (after 0.5–2 years) and is characterized by damage to the joints (chronic Lyme arthritis), skin (atrophic acrodermatitis), and chronic neurological syndrome.

What does Lyme disease look like: photo

The photo below shows how the disease manifests itself in humans.

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Chronic symptoms

If the disease is treated ineffectively or not treated at all, then a chronic form of the disease may develop. This stage is characterized by alternating remissions and relapses, but in some cases the disease has a continuously relapsing character. The most common syndrome is arthritis, which recurred over several years and acquired a chronic course through the destruction of bones and cartilage.

There are changes such as osteoporosis, thinning and loss of cartilage, less often - degenerative changes.

Among the skin lesions, there is a benign lymphocytoma, which has the appearance of a dense, edematous, raspberry-colored nodule (infiltrate) and causes pain on palpation. A typical syndrome is atrophic acrodermatitis, which causes skin atrophy.

Diagnosis of Lyme disease

A thorough history taking is critical to the diagnosis of Lyme disease. It is important not to miss the facts indicating the possibility of infection with tick-borne borreliosis (country walks, tourist trips, etc.). Also, experts pay attention to the presence of primary signs of the disease: skin erythema and general intoxication.

Depending on the stage at which the disease develops, various serological and immunological laboratory tests are used (PCR, RIF, ELISA, microscopic studies, etc.). In order to identify structural disorders of various organs and tissues, additional research methods are used, prescribing fluoroscopy, puncture followed by a laboratory study of the material, an electrocardiogram, a biopsy of epidermal tissues, etc.

A differential diagnosis should be made with such diseases as: encephalitis, rheumatoid arthritis, dermatitis of various origins, neuritis, rheumatism, Reiter's disease and others with similar symptoms. In patients suffering from syphilis and various autoimmune diseases (infectious mononucleosis or rheumatism), serological reactions are false positive, which requires additional confirmation of the diagnosis.

See photo

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Complications

Among the likely negative consequences of borreliosis, irreversible changes in the nervous system, heart, and inflammatory diseases of the joints should be highlighted, which, if not properly treated, lead to disability, and in severe cases, cause death.

Lyme Disease Treatment

If characteristic symptoms of Lyme disease are detected, complex treatment is carried out in the hospital of the infectious diseases hospital.

At stage I, antibiotic therapy is indicated for 2-3 weeks:

• Doxycycline 100 mg 2 r / day
• Amoxicillin 500 mg 3 r / day (children 25-100 mg / kg / day) orally
• Antibiotic reserve - ceftriaxone 2.0 g / m 1 r / day

Against the background of antibiotic therapy, the development of the Jarisch-Herxheimer reaction (fever, intoxication against the background of mass death of borrelias) is possible. In this case, antibiotics are canceled for a short time, and then the reception is resumed at a lower dose.

In stage II Lyme disease, antibiotic therapy is prescribed for 3-4 weeks:

• In the absence of changes in the cerebrospinal fluid, doxycycline 100 mg 2 r / day or amoxicillin 500 mg 3 r / day orally are indicated
• If there are changes in the cerebrospinal fluid - ceftriaxone 2 g 1 r / day, cefotaxime 2 g every 8 hours or benzylpenicillin (sodium salt) 20-24 million units / day IV

Stage III uses:

• Doxycycline 100 mg 2 times a day or amoxicillin 500 mg 3 times a day by mouth for 4 weeks
• If there is no effect, ceftriaxone 2 g 1 r / day, cefotaxime 2 g every 8 hours or benzylpenicillin (sodium salt) 20-24 million units / day IV for 2-3 weeks.

Early initiation of treatment, as a rule, leads to a complete recovery of the person. Chronic stages can lead to disability and death (irreversible changes in the nervous and cardiovascular systems). After the end of treatment, regardless of its effectiveness, a person is registered with an infectious disease specialist and narrow specialists.

Prevention

When visiting a forest area (park area), general prevention is reduced to the use of repellents, wearing clothes that cover the body as much as possible. In case of a tick bite, you should immediately contact the clinic, where it will be correctly removed, the bite site examined and further health monitoring provided.

If a person is often in his own summer cottage, it will not be superfluous to carry out acaricidal measures. After walking with the dog, you should carefully examine the pet for the presence of a tick on the body.

In autumn and spring, a large number of insects are activated, which can carry viruses dangerous to humans. Tick-borne borreliosis is a consequence of the bite of a tick that transmits the pathogen. At the first symptoms of the disease, it is necessary to go to the hospital, because in the first stages it is easier to cure the pathology and prevent the transition to a chronic migratory form.

What is tick-borne borreliosis

This dangerous disease has several names, in medicine it is called Lyme disease or Lyme borreliosis. This is an infectious disease that is transmitted by the bite of an ixodid tick. The disease manifests itself in the form of damage to the skin, joints, nervous system, heart and other organs. If in the early stages it was possible to notice signs of borreliosis, then complete recovery can be achieved with the help of antibacterial agents.

If the diagnosis was carried out in the later stages, an inadequate treatment regimen was prescribed, then Lyme borreliosis can turn into a chronic and intractable form. The name of the disease comes from the pathogen - Borrelia, which is transmitted by ticks. Lyme disease is called pathology, because in 1975 cases of the manifestation of the disease were recorded in the small town of Lyme in the United States.

The causative agent of borreliosis

The borreliosis tick becomes the carrier of pathogenic microorganisms; three types of borrelias cause the development of the disease:

• Borrelia garinii;
• Borrelia burgdorferi;
• Borrelia afzelii.

• Far East;
• Western Siberia;
• Ural;
• central regions of Russia;
• some regions of Europe.

In these zones, infection with the Ixodes tick virus is up to 60%, according to scientists. The peak of infection with tick-borne Lyme borreliosis occurs at the end of spring and the beginning of summer. This is dictated by the increased activity of ticks during this period. A person does not have protection against pathological microorganisms of this type, has a high susceptibility to Borrelia, therefore, when bitten, there is a high risk of infection.

Human immunity begins to produce antibodies against pathological microorganisms, but even at high titers, the body does not have the ability to completely destroy the virus. With the development of tick-borne borreliosis, immune complexes are formed that can provoke an autoimmune process (specific antibodies begin to attack useful body tissues). This can provoke chronic borreliosis. When the pathogen dies, toxic substances are released into the body, which aggravate the patient's well-being.

Symptoms

If you have time to notice the symptoms of borreliosis in time, you can significantly increase the chances of a complete recovery of the patient, reduce the time of therapy and avoid dangerous consequences from the pathology. Symptoms of the disease vary depending on the stage, there are three of them:

At this stage, symptoms appear at the general and local level. The first include the following manifestations:

• chills;
• nausea;
• an increase in body temperature up to 38 degrees;
• general malaise;
• vomit;
• rarely there is a runny nose, coughing and sore throat.

Local manifestations include swelling at the site of a tick bite, redness, itching and soreness. An annular erythema appears, which is a specific sign of borreliosis, present in 70% of patients. At the site of the bite of the skin, a dense red formation (papule) appears, gradually it grows on the sides and takes the form of a ring. In the very center, the skin color is paler, the rim of the circle has a rich red color, the formation is slightly raised above the surface of healthy nearby skin.

Erythema takes a round or oval shape, diameter - 10-60 mm. Sometimes the appearance of small rings inside a large ring is noted, more often this happens if the size of the swelling is large. Often, erythema does not cause discomfort to the patient, but in some cases there have been complaints that it bakes and itches. Often this reaction of the body to a bite becomes the only symptom of a tick-borne infection in the first stage of borreliosis, no common signs are observed.

Secondary erythema is rarely observed (appear where there was no bite). The swelling lasts from several days to several months, the average value is 30 days. Then it passes on its own, and pigmentation and peeling remain at the site of the bite. Other manifestations include the following reactions:

• development of conjunctivitis;
• hives;
• skin rash;
• soreness of the lymph nodes;
• stiff neck muscles;
• migrating musculoskeletal pain.

II stage

This period can last from several days to several months. This stage is characterized by damage to the joints, heart, skin and nervous system. By this stage, all previous symptoms of the first stage disappear. In some situations, tick-borne infection begins immediately from the second stage, erythema ring does not appear and there is no general infectious syndrome. When the nervous system is disturbed, the following processes occur:

• damage to the cranial nerves;
• serous meningitis;
• damage to the roots of the spinal nerves;

Inflammation of the meninges or serous meningitis causes the following symptoms:

• photophobia;
• severe headache;
• moderate tension of the occipital muscles;
• hypersensitivity to irritating factors;
• significant fatigue;
• possible insomnia, impaired attention, memory.

In case of violation of the functionality of the nerves, the facial one often suffers. Signs of this syndrome include involuntary complete closure of the eyes, a distorted facial expression, food falls out of the mouth. Often the lesion occurs on both sides of the face, as a rule, one first suffers, then the second. When infected with a tick-borne infection, the prognosis for recovery is good. Sometimes the auditory, optic, oculomotor nerves are also involved in the process, which manifests itself in the form of hearing and vision impairment, and strabismus develops.

When the spinal nerves are infected, a person experiences severe shooting pains. At the level of the body, they are girdle in nature, and in the limbs they have a direction from top to bottom. In the absence of treatment, muscle damage (paresis) joins these symptoms after 1-2 weeks, tendon reflexes, and sensory disorders fall out. In some cases, infection of the nervous system is accompanied by the following symptoms:

• shakiness, instability;
• speech disorders;
• involuntary movements;
• swallowing disorders;
• trembling of the limbs;
• epileptic seizures.

At this stage, joint damage is characterized by recurrent monoarthritis or oligoarthritis. The hip, knee, elbow, and ankle joints are often affected. There are restrictions of mobility, severe pain. With damage to the heart, doctors distinguish several clinical forms:

• conduction disorders of the heart, for example, atrioventricular blockade;
• pericarditis and myocarditis - are manifested by shortness of breath, palpitations, heart failure.

In the second stage, skin disorders have a variety of manifestations. The most common symptoms of this nature:

• secondary small ring erythema;
• rash like urticaria;
• lymphocytoma (a specific sign of borreliosis).

III stage

It comes after a few months, sometimes years pass after a tick infection enters the human body. There are several typical manifestations for this stage for diagnosing:

• chronic arthritis develops;
• lesions of the nervous system: polyneuropathy, tick-borne encephalitis, encephalomyelitis;
• atrophic acrodermatitis.

Often, borreliosis affects only one of the systems of the body, therefore, lesions of either the skin, or the compositions, or the nervous system are noted. Over time, the possibility of a combined lesion is noted. Chronic arthritis affects both small and large joints. The pathology is characterized by relapses, therefore, gradual deformation occurs, cartilage tissue becomes thinner, osteoporosis develops in bone structures. Nearby muscles are involved (chronic myositis). Atrophically, acrodermatitis manifests itself as follows:

• bluish red spots on the elbows, soles, back of the hands;
• swelling, thickening of the skin in the affected areas;
• when the process recurs, atrophy of the skin occurs, they become similar to tissue paper.

The nervous system in the third stage reacts in a peculiar way to the spread of infection. Symptoms include the following manifestations in different areas:

• coordinating - imbalance;
• sensitive - various kinds of pain, increased or decreased sensitivity, paresthesia;
• motor - paresis;
• mental - impaired thinking, memory, weakening of the intellect;
• emotional - depression, lethargy.

Borreliosis in children

As a rule, pathology is diagnosed in children older than 7 years. A preschool child is rarely affected by a tick-borne infection, even after an insect (carrier) bite. Clinical manifestations and the nature of the course coincide with adults, but children often develop symptoms of meningitis, as a sign of damage to the nervous system. Older people are more likely to develop peripheral nephropathy. Due to damage to the central nervous system, the child may have asthenovegetative reactions after recovery:

• sleep disorders;
• increased excitability;
• mood instability.

Diagnostics

Diagnosis is based on clinical findings and should include a history of tick bite and erythema annulare. The final decision is made on the basis of laboratory research methods. In cases where swelling does not appear, and the first stage proceeds without obvious symptoms, tests remain the only reliable method.

It is difficult to identify microorganisms (borrelia) in humans. You can find them in the affected fluids and tissues of the body. Material for research can be taken from the edge of erythema, with lymphocytoma and atrophic acrodermatitis, they take a piece of skin using a biopsy, cerebrospinal fluid or blood. The effectiveness of such laboratory tests is no more than 50%. Doctors use indirect diagnostic methods:

1. The polymerase chain reaction method in which Borrelia DNA is found in the cerebrospinal fluid, blood and synovial fluid.
2. Serological diagnosis. All includes the reaction of indirect immunofluorescence (abbreviated as RNIF), immunoblotting (detects the presence of antibodies in the cerebrospinal fluid, blood serum), enzyme immunoassay (ELISA).

A serological test gives a less reliable result than a search for DNA fragments. In the first case, sometimes a false positive result is obtained in people who have syphilis, mononucleosis or rheumatic pathologies. Negative variants were also noted for tick-borne infection, in 50% of cases in the initial stages this analysis is not able to confirm borreliosis. Such diagnostic methods require analysis in dynamics.

Treatment of borreliosis

The methods of treating the disease depend on the stage of the pathology, so the scheme should be selected exclusively by the doctor based on the diagnosis. It is necessary to treat borreliosis at the first stage, in which case the efficiency will be the highest. At later stages, there is a risk of developing consequences for a person. Patients with borreliosis are treated in two ways:

• pathogenetic, symptomatic treatment is aimed at the therapy of the affected systems and organs;
• etiotropic treatment is aimed at the extermination of the pathogen.

Antibiotic therapy

Depending on the stage, the doctor will prescribe appropriate antibacterial agents with the dosage necessary for these purposes. It is strictly forbidden to take it on your own, without the consent of a specialist. If the prescribed drugs do not provide the expected effect, then they are replaced with another:

1. At the first stage, antibacterial agents are used orally (tablet form). The doctor, at his discretion, prescribes one of the following medications: Doxycycline 2 r / day, 100 mg, Tetracycline 3 r / day, 500 mg, Cefuroxime 2 r / day, 500 mg, Amoxicillin 3 r / day, 500 mg.
2. In the second stage, parenteral administration is recommended to increase the concentration of the drug in the blood, synovial fluid and cerebrospinal fluid. The doctor prescribes the following drugs: Ceftriaxone 1-2 g / day, Penicillin 20-24 million units / day. Apply antibiotic treatment for 2-3 weeks. According to statistics, such treatment of borreliosis is successful in 85090% of cases.
3. In the third stage, antibacterial agents are taken for at least 28 days. As a rule, the penicillin series is used. Due to the peculiarities of the dosage (224 injections are required), a prolonged form is used - Extencillin once a week, 2.4 million units for 3 weeks.

Diet

Nutrition adjustment in the treatment of borreliosis is not associated with the goal of influencing the pathogenic microorganism, but with facilitating treatment. The child is recommended to add diluted freshly squeezed vegetable juice and sauerkraut to the diet. Everyone in the treatment of pathology is recommended to consume only easily digestible protein:

• young veal;
• rabbit;
• turkey.

Effects

If an infection is detected at the initial stage of borreliosis, then with adequate treatment, in most cases, a complete recovery occurs. In subsequent stages, the cure rate is 85% or less. The transition to the chronic form occurs with late diagnosis, defects in immunity, incomplete or inadequate course of treatment. Such a course of tick-borne infection, even with an additional course of antibiotics, full symptomatic, pathogenetic treatment, does not guarantee the patient a complete recovery. This can cause the following conditions:

• violation of sensitivity;
• persistent paresis;
• severity of unsteadiness during walking;
• when the facial nerve is damaged, facial deformity occurs;
• epileptic seizures;
• hearing and vision disorders;
• heart failure;
• dysfunction of the joints, their deformation;
• arrhythmia.

Prevention

The main measures for the prevention of pathology is the prevention of tick bites. Other preventive measures, including vaccination, do not exist at this stage. Preventive measures include the following:

1. If you are in a dangerous area where cases of tick bites have been recorded, before going to the forest, groves or places with thick grass, you must dress so that there are no exposed skin. It is recommended to wear high boots on your feet, tuck long trousers into socks, a shirt with long sleeves, tuck into trousers.
2. Before walking, clothes should be treated with insect repellents.
3. Treat exposed areas of skin with repellents.
4. If you walk on the street with a dog, then after returning home, carefully inspect it, they often crawl to a person from animals.

Prevention of borreliosis after a tick bite

If the precautions did not help and the insect managed to stick, it must be removed without delay. For these purposes, always take with you special tweezers for pulling out ticks or a regular one. The algorithm of actions is as follows:

Video

The causative agents of tick-borne borreliosis are gram-negative bacteria - spirochetes. These microorganisms look like springs. They have cilia, thanks to which they actively move. In most cases, ixodid ticks become carriers of infection.

Lyme disease (in other words, tick-borne borreliosis) received its name in 1975 at the place of registration of the first case of infection - the city of Lyme in the USA. Cases of tick-borne borreliosis have been registered in Russia, the USA, and European countries. In the Russian Federation, 6-8 thousand cases of infection are detected annually.

In nature, they live in mixed forests.

Mostly in temperate climates. The main food for these arthropods is livestock, rodents, deer, in the blood of which the borreliosis infection lives. Ticks become carriers of tick-borne borreliosis when they attack an infected animal. Borrelia are capable of being transmitted to subsequent generations of ticks.

When an infected tick bites, borreliosis can also occur. These are two different diseases. Encephalitis is caused by a virus, and Lyme disease is very similar to syphilis. The incubation period after a bite of an encephalitic tick is two days. Borreliosis makes itself felt after five days, however, the course can be latent and symptoms appear only after a month.

From the beginning of spring to October, insect activity increases. The greatest number of bites was recorded in the summer months. Anyone can be affected, but the disease is more severe in children and the elderly. You can get a tick bite when visiting forest areas, parks.

Who is at risk

Some groups are more likely to suffer from a tick bite:

• summer residents;
• agricultural workers;
• inhabitants of wooded areas;
• pet owners.

It is noteworthy that a tick can infect not only at the moment of a bite, but also during its improper removal from the skin.

There is a chance of infection when drinking unboiled goat's milk. In adults, the disease is not transmitted from person to person. An exception is a pregnant woman who has symptoms of borreliosis after. An infection carried by spirochete bacteria causes serious developmental disorders, heart pathologies, deformities, and death in the unborn child.

Forms of the disease

Depending on the course of borreliosis, acute and chronic forms are divided. The onset of the disease in a person occurs after a tick has bitten him. The first stage is characterized by an acute course. Over time, the symptoms intensify, the disease becomes chronic, and serious consequences occur.

Since Borrelia can stay in the human body for a long time (up to 10 years), Lyme disease has a chronic form. Spirochetes penetrate everywhere because of their small size. More than ten groups of microorganisms are known, so antibiotics do not always effectively fight tick-borne borreliosis.

Clinical manifestations of borreliosis

Symptoms of tick-borne borreliosis depend on the stage of the disease. There are three stages of the course of the disease:

Stage 1

Its duration is up to forty days. The bite site is clearly visible as a bright red dot. Afzelius-Lipshütz erythema forms around it.

This is a migratory dermatological symptom of borreliosis infection. It is characterized by the formation of a rounded spot, which increases over time, can be more than 20 cm in diameter.

The central part of the erythema regresses, has reddish blotches. The border looks like a red strip with a width of 2 to 20 mm. Erythema migrans is localized on the trunk, upper and lower extremities, sometimes on the face.

Afzelius-Lipshütz erythema appears in 40–70% of cases with Lyme disease. There is borreliosis without this marker sign. In some cases, there may be no symptoms at all. Then the course of the disease becomes chronic, and it is possible to determine the infection with spirochetes only by passing laboratory tests.

Symptoms of borreliosis after a bite are acute. These include:

• elevated temperature;
• chills;
• fever
• runny nose;
• general weakness;
• headache;
• body aches;
• nausea and vomiting
• conjunctivitis.

It is necessary to begin treatment of tick-borne borreliosis immediately after infection, otherwise the disease will progress and move into the second stage.

Stage 2

Starts 5 weeks after a tick bite. During this stage, pathogenic bacteria travel through the circulatory and lymphatic systems throughout the body. They affect certain organs, causing serious consequences. Most often, in the second stage, spirochetes lead to the following diseases:

• disturbances in the work of the central nervous system;
• serous meningitis;
• neuritis of the cranial nerves;
• disorders in the work of the cardiovascular system (angina pectoris, pericarditis, impaired conduction of the heart ventricles);
• radiculoneuritis.

Symptoms of the second stage of tick-borne borreliosis can be:

• dizziness;
• migrating pains;
• heartbeat;
• insomnia;

• shortness of breath;
• photophobia;
• irritability;
• paralysis of the facial nerve;
• hearing impairment.

In addition, the second stage of the disease is characterized by the appearance of an erythematous rash in the form of plaques on the ears, face, nipples of the mammary glands, and genitals. They have a crimson hue, are painful on palpation.

Stage 3

It develops one year after the tick bite and lasts from several months to ten years. Most often, an accumulation of spirochete bacteria in one organ is detected. As a consequence of the chronic form of Lyme disease, there are:

disorders of the musculoskeletal system;

• chronic encephalitis;
• monoarthritis;
• encephalomyelitis;
• polyarthritis.

There are such symptoms as specific lesions on the epidermal layer: patchy atrophy, chronic acrodermatitis, scleroderma-like changes in the skin.

At the chronic stage of tick-borne borreliosis, arthritis actively develops, which can have several variants of the course:

• recurrent (in which exacerbation and remission are periodically observed);
• migratory (characterized by wandering pains in the joints);
• chronic (with this form, arthritis affects all joints, more inflammatory processes occur over time).

Later, such external signs of chronic borreliosis as dementia, memory loss, convulsions appear. The disease at this stage is practically not amenable to treatment, internal organs are actively affected.

Since the body's immune response to this infection occurs late, it is necessary to seek medical help immediately after a tick bite has been detected.

Consequences of a tick bite

Ixodid tick-borne borreliosis causes complications in humans that pose a serious threat to life and health:

• disorders of the neuropsychic system (psychosis, neurosis, nerve paralysis, dementia);
• pathology of the heart muscle (arrhythmia, angina pectoris, impaired patency);
• violation of the senses (loss of hearing, vision);
• benign neoplasms in the places of tick bites.

All these diseases can significantly reduce the quality of human life, lead to disability. In severe cases, the disease is fatal.

Methods of treatment

When the victim contacts an infectious disease specialist, diagnostic measures are taken and therapy is prescribed. Before writing a list of drugs, giving recommendations, the doctor collects an anamnesis, directs the patient to a general and biochemical blood test. An important role in the diagnosis of tick-borne borreliosis is played by serological studies of the patient.

In addition, appointed:

• biopsy of the bitten skin area;
• ECG (electrocardiography);
• EEG (electroencephalography);
• x-ray;
• immunofluorometry.

To clarify the borreliosis infection, a scraping is taken from the tick itself, the surface of the wound and blood.

After analyzing the symptoms of tick-borne borreliosis, symptomatic treatment begins. In addition to eliminating clinical manifestations, antibacterial therapy and immunostimulation are carried out. Comprehensive treatment includes the use of medications of various subgroups and physiotherapy.

Antibiotics for tick bites

As with any infectious disease, a whole range of antibiotics is prescribed for tick-borne borreliosis.

If the disease is associated with skin rashes, tetracycline antibiotics (Amoxicycline, Tetracycline) are prescribed.

Penicillin and Cephalosporin, Ceftriaxone are used in cases where the heart and joints, the nervous system were under attack, as well as in the chronic form of the disease.

If the patient is intolerant to antibiotics, macrolides (eg, Erythromycin) are given.

The earlier antibiotic therapy is started, the more effective the fight against borreliosis infection and the fewer symptoms. The dosage of drugs and the course are prescribed by the attending physician, it is impossible to independently regulate the intake of drugs.

Probiotics

They are widely used in the treatment of infectious diseases, including when bitten by a borreliosis tick. With antibiotic therapy, not only harmful bacteria are destroyed, but also positive microflora. To enhance the body's defenses, maintain normal flora, drugs containing bacteria are prescribed. They fully correspond to the microflora of the human intestine (for example, drugs: Bifiform, Linex, Normobact).

Fight inflammation

NSAIDs and antihistamines (for example: Nurofen, Diazolin, Suprastin) are often used for insect bites.

They help relieve accompanying symptoms: fever, pain, allergic reactions and fever.

Body detoxification

Due to the fact that the patient's body is poisoned by the waste products of bacteria (endotoxins), detoxification is necessary. For this, an abundant drinking regimen and drugs Atoxil, Albumin are prescribed. Additionally, vitamin C is added to the water, as it stimulates the immune system. You need to drink at least three liters a day.

Immunomodulators

To strengthen the oppressed immune system, stimulating pharmaceuticals are prescribed - Immunal, Immudon. With symptoms of disorders in the nervous system, immunosuppressants are used. For general strengthening of the body, vitamin treatment is additionally used.

Physiotherapy

When the course of tick-borne borreliosis becomes chronic and affects the joints, arthritis, neuritis and other pathologies occur. In order to relieve their symptoms, physiotherapy procedures are required.

They help restore blood circulation, reduce inflammation in the joints. Among the physiotherapy in the treatment of tick-borne borreliosis are the following:

• physiotherapy;
• ultraviolet;
• electrophoresis;
• magnetotherapy;
• massage;

Regarding the prognosis, we can say that everything depends on whether the patient asked for help in time and received adequate treatment. If therapy is started at an early stage, then there is every chance to get rid of tick-borne borreliosis without a trace. The exceptions are some patients with body features.

In cases where treatment is untimely and the disease has passed into the chronic stage, serious diseases of the brain and nervous system develop. In the absence of treatment, the prognosis is poor.

If the disease has reached the second and third stages, then the treatment of tick-borne borreliosis will be long and difficult, but do not despair. Modern methods of struggle help to cope with many clinical manifestations of borreliosis.

Preventive measures

Prevention of borreliosis consists in the implementation of activities when visiting forest areas and parks:

• Wear tight-fitting, long-sleeved clothing and pants.
• Tuck pants into socks and boots.
• A headdress must be present.
• Apply repellents (sprays that repel insects).
• Avoid places where tall grass, bushes (it is advisable to bypass them).
• If it is impossible to bypass the site, you should crush the grass in front of you with a stick in order to throw ticks located there to the ground;
• When leaving the forest zone, you need to carefully examine your body (especially the neck, chest, armpits) for tick bites.

If an ixodid or encephalitic tick fails, it must be removed as soon as possible with a loop of thread. To do this, the loop is thrown over the body of the tick, and carefully rotating clockwise, pull it out of the wound. Then the wound needs to urgently consult a doctor without waiting for the symptoms of tick-borne borreliosis to appear. Doctors will take all necessary measures: they will treat the bite site, prescribe examinations, and, if necessary, treatment.

Some people treat such a phenomenon as a tick bite rather nonchalantly. But if you delve a little into the topic of the risk of infection from such bites, then we can conclude that there is something to worry about. The consequence of walking along forest paths can be a disease called borreliosis. In children and adults, it can cause equally dangerous symptoms, which, if not properly treated, can even lead to disability.

What is meant by tick-borne borreliosis?

Tick-borne borreliosis, also called Lyme disease or Lyme borreliosis, is an infectious disease. It is transmitted through a bite. The development of this disease leads to the defeat of various systems and organs. It can be the heart, nervous system, skin or joints. This natural-focal chronic infection took its name from the causative agent of the disease - the Borrelia microorganism. Such a diagnosis was first established in 1975 among residents of the town of Lyme in the United States.

If signs of borreliosis are detected in time and treatment with antibiotics is started, then the chances of a trouble-free recovery will be quite high. If the diagnosis determines Lyme disease at a late stage and after that illiterate therapy is carried out, borreliosis can turn into an intractable chronic form. Therefore, do not take a tick bite lightly.

Causes

The tick (borreliosis infects this particular insect) is a carrier of three types of microorganisms that can be the causative agents of an infectious disease. Those who wish to protect themselves from such a diagnosis as Lyme disease should be attentive to the bites of ixodid ticks, which become infected while sucking the blood of infected animals. Such mites are most often found in temperate zones, especially in areas occupied by mixed forests. As endemic zones where there is a danger of getting a dangerous bite, one can define the central and western regions of Russia: Western Siberia, the Urals, the Far East. The causative agent of borreliosis is also found in some parts of Europe and the United States.

In late spring and early summer, ticks are most active. For this reason, the maximum number of people become infected with borreliosis during this period. It is also worth knowing that the infection can enter the bloodstream not only with a bite, but also during the rupture of the tick, which occurs due to its improper removal.

There are also chances of catching the disease through alimentary transmission. We are talking about the use of dairy products without prior heat treatment. Especially dangerous in this regard is raw goat's milk. In this case, the disease borreliosis is not transmitted from one infected person to another. But if a tick bites a pregnant woman, then intrauterine transmission of the infection can lead to miscarriages, various congenital anomalies, and even the death of the baby. Therefore, for those who are expecting a baby, it is better to keep their distance from potential infection zones in the spring and summer.

The mechanism of the development of the disease

As mentioned above, the actual infection itself occurs only after the tick has been bitten. Borreliosis, or to be more precise, the causative microorganism, enters the nearest lymph nodes and begins to multiply there. A few days later, Borrelia enter the bloodstream and are carried with it throughout the body.

The defeat of the nervous system at this stage can be determined by the following signs: destructive processes occur in the cranial nerves and roots of the spinal nerves (defined as radiculopathy).

It is also possible to develop serous meningitis, which is nothing more than inflammation of the meninges. It is manifested by increased sensitivity to stimuli, moderate headache, photophobia, severe fatigue and muscle tension in the back of the head. Another symptom of meningitis can be insomnia.

As for the cranial nerves, the facial one is most often affected. The fact of the defeat will be evidenced by paralysis of the facial muscles: food falls out of the mouth, the eyes do not fully open, and the face looks noticeably skewed. Often a bilateral lesion is recorded, in which the work of one side of the face is initially disrupted and a few days or weeks later - the second. In addition to the facial, destructive processes can affect the auditory and optic nerves. This can be expressed in the form of strabismus, impaired hearing, vision and impaired movement of the eyeballs.

Considering tick-borne borreliosis, the consequences of which can be more than palpable, it is worth noting that the roots of the spinal nerves, in the event of a lesion, make themselves felt with a palpable shooting pain, which is directed from top to bottom in the limbs, and in the torso region takes on a girdle character.

Third stage

This period of disease development can occur even several years after the bite. At this stage, borreliosis has the following consequences: atrophic acrodermatitis, damage to the nervous system (encephalopathy, polyneuropathy and encephalomyelitis), chronic arthritis.

In most cases, one specific system is affected: the joints, the nervous system, or the skin. But if the disease is not fought, then in the process of development it can lead to a combined damage to the systems.

When chronic arthritis develops against the background of an infection such as ixodid tick-borne borreliosis, a devastating effect can be exerted on both large and small joints. In this case, the cartilage tissue will most likely begin to thin, deforming processes will appear in the joints, and osteoporosis will develop in the bone structure. Nearby muscle fibers will also be involved in the process of stable destruction (chronic myositis).

Damage to the nervous system in the third stage can manifest itself in different ways. It is possible to develop paresthesia, increase or decrease in sensitivity, the occurrence of various pains and even paresis. It makes sense to expect violations of mental (memory, intellect) and coordinating functions (balance). Hearing may also be affected. Do not exclude disorders of the pelvic organs and the appearance of epileptic seizures. It is worth noting the fact that most patients experience lethargy, severe fatigue and emotional disorders.

Chronic form of Lyme disease

If you ignore the treatment process and allow the infection to freely affect the body, then tick-borne borreliosis will go into a chronic stage. With this form of the disease, a stable undulating deterioration will be observed. If we highlight the most common clinical syndromes that develop in the chronic form of borreliosis, then you should pay attention to the following diseases:

Atrophic acrodermatitis;

Various forms of arthritis;

The defeat of the nervous system with the involvement in the process of any of its structures (in this case, there can be many foci of destruction);

Lymphocytomas.

Treatment

If tick-borne borreliosis was suspected, the patient must be immediately hospitalized in an infectious diseases hospital. Especially if a child is hurt. Borreliosis in children can lead to serious complications. And only with the participation of professional physicians is it possible to conduct complex therapy, the purpose of which is the destruction of the causative agents of Lyme disease. It is worth remembering that without full and timely treatment, borreliosis can lead to disability.

At the same time, the treatment of borreliosis with antibiotics can be defined as the most effective method of influencing harmful microorganisms. The good news is that if the infection is suppressed with antibacterial drugs at the first stage, there is every chance to avoid the development of cardiac neurological and arthrological complications.

For this reason, treatment of borreliosis with antibiotics should begin as early as possible.

If we talk about the early stage of the development of the infection, then it is worth noting that during this period, the drug "Amoxicillin" is used to neutralize the disease. This therapy lasts about 20-30 days. Actively used in the initial stage and "Tetracycline". If you do not act on erythema, then it can go away within a month, but when borreliosis is treated with antibiotics, the ring redness can go away much earlier.

Repeatedly proved its effectiveness and such a drug as "Doxycycline". It is most relevant for those patients who have developed skin diseases (benign skin lymphoma, erythema annulare migrans).

Those who have had damage to the nervous system in the second stage are prescribed penicillin. At the first stage, it is effective in the occurrence of fixed arthralgia and myalgia. Ceftriaxone can be identified as the most relevant antibiotic from the cephalosporin group. Its use is recommended for both early and late neurological disorders. This drug is also relevant for those patients who, on the background of Lyme disease, have developed a high degree of artrioventricular blockade or arthritis, including chronic arthritis.

In general, the treatment of borreliosis with antibiotics has proven itself exclusively from the best side.

Preventive measures

Lyme disease is too serious a diagnosis to be ignored. Therefore, if possible, the best option would be to avoid infection and prevent the unpleasant process of a serious infection affecting the body.

Prevention of borreliosis involves staying in areas where ticks can live, wearing closed shoes and clothes that completely cover the body (long trousers, trousers with drawstrings, sleeves with cuffs). It will not be superfluous to use repellents that can repel ticks.

If it so happened that the tick got on the skin and managed to be absorbed, then you should immediately visit the infectious diseases department of the nearest hospital. There they will take blood for borreliosis and establish whether infection has taken place. Conducting tests, and without delay, is a necessary measure that cannot be ignored. Otherwise, you will have to face very serious symptoms. Therefore, you should immediately use the recommended medicines. Prevention of borreliosis will be more effective if, after a bite, take 2 tablets of the drug "Doxycycline" per day for 5 days.

It is obvious that Lyme disease, with all its destructive potential, can be defeated without any special complications if the infected person quickly seeks medical help and follows their recommendations.

So, we examined tick-borne and treatment of this infection and possible preventive measures. Take care of your health!

This disease (syn. Lyme disease) is a natural focal chronic infectious disease. Tick-borne borreliosis is called by one of the species treponem – Borrelia Burgdorfer. How the disease manifests itself, how to determine it and treat the disease, find out below in the article.

Symptoms of different stages of tick-borne borreliosis

There are 3 stages of the disease. The signs of each of them have their own specifics.

Symptoms of stage I tick-borne borreliosis

Stage I lasts up to 40 days and is characterized by the development of a primary affect in the form of Afzelius-Lipshütz chronic migratory erythema at the site of introduction of the pathogen. The main symptom of the disease of this stage is a single (sometimes several) rounded red spot at the site of the bite, which over several weeks, gradually growing centrifugally, reaches 15–20 cm or more in diameter.

As erythema grows with tick-borne borreliosis, its central part undergoes regression, in its zone a trace (in the form of a reddish dot) from a tick bite can be clearly seen. The edge of erythema is represented by a narrow erythematous strip (width from a few millimeters to 1–2 cm). More often, the focus in borreliosis is localized on the trunk, limbs, but it can also be on the face.

The marginal border of erythema, with its growth, can break, turning into a garland-like strip, which sometimes passes through the chest, neck, face of the patient. Subjective symptoms are usually absent. Erythema is a marker sign of the disease, but in 30–60% of cases it may be absent. In addition to adult ticks, much smaller young individuals can attack a person, which stick painlessly, and the fact of a bite may not be noted.

Symptoms of tick-borne borreliosis at stage II

For stage II of the disease, caused by lympho- and hematogenous dissemination of the pathogen and developing from the 3rd to the 21st week of the disease (more often at the 4th-5th week), the following symptoms of tick-borne borreliosis are characteristic:

damage to the nervous system with the development of serous meningitis,

cranial neuritis,

radiculoneuritis,

cardiovascular system with the development of myocarditis,

pericarditis,

conduction disorders (especially atrioventricular blockade).

Often with tick-borne borreliosis, a flu-like syndrome occurs (headache, fever, weakness, myalgia). Skin lesions in this stage of the disease borreliosis can be in the form of secondary ring-shaped elements with a diameter of 1-5 cm, an erythematous rash on the palms of the type of capillaries, urticaria, as well as benign Spiegler's lymphocytoma of the skin in the form of a single infiltrate - a nodule or disseminated plaques more often on the earlobes, nipples and areolas of the mammary glands, swollen, bright crimson, slightly painful on palpation.

Signs of tick-borne borreliosis at stage III

In the III stage of tick-borne borreliosis, late, developing more often a year after infection and lasting from several months to 10 years or more, the pathogen persists more often in any organ, lesions of the musculoskeletal system are observed - monoarthritis (of the knee joints) or polyarthritis , chronic encephalitis, encephalomyelitis. Develop on the skin

• acrodermatitis atrophic chronic,
• patchy atrophy,
• scleroderma-like changes.

Histologically, borreliosis reveals microangiopathy, lymphocytic infiltration of the skin with an admixture of plasma cells.

There are also cases of congenital tick-borne borreliosis with malformations of the heart.

Diagnosis is based on clinical and serological findings. The causative agent of borreliosis can be isolated from the affected skin, cerebrospinal fluid, blood, synovial fluid, for which the material is inoculated with culture isolation. The most informative RIF in the diagnosis of the disease is the detection of antibodies to the pathogen in the blood, cerebrospinal fluid, which gives a positive result in 60% of cases in stage I of the disease and in 100% in stages II and III. Differential diagnosis is carried out with various types of erythema, scleroderma.

Symptoms and diagnosis of neuroborreliosis

The disease is a manifestation of Lyme disease. The causative agent of this form of the disease is Borrelia belonging to the genus Spirochetes. Infection occurs transmissibly through the bites of ixodid ticks.

Clinical manifestations of neurogenic borreliosis occur against the background of general clinical symptoms of neuroborreliosis, characteristic of borreliosis infection.

The characteristic symptoms of neuroborreliosis are annular erythema at the site of the bite, damage to the joints and nervous system. The appearance of headache, photophobia, hyperacusis, hyperesthesia of the skin, vomiting, obvious signs of meningeal syndrome, focal symptoms indicate the development of meningitis or meningoencephalitis. Most often, 3-4 pairs are exposed to pathogenic effects of borrelias, less often - 9-12 pairs.

Another typical symptom complex in neuroborreliosis is Bannwart's lymphocytic meningopolyradiculoneuritis. A characteristic manifestation is a pain syndrome associated with the site of tick suction and arising from the involvement of the spinal nerve roots in any part of the spine, more often in the cervicothoracic. A sign of irritation and loss of functions of sensory and motor roots is characteristic. Liquorological changes in Bannwart's syndrome are characterized by moderate lymphocytic pleocytosis and moderate protein content.

The etiological diagnosis of neurogenic borreliosis is based on serological tests with paired sera. The most promising methods are molecular genetic diagnostics.

Features of the treatment of tick-borne borreliosis

The general principles of therapy are as follows: Penicillin - 2,000,000 IU or more per day for 2-3 weeks (depending on the stage), Tetracycline - 1,000,000-2,000,000 IU per day, Amoxicillin - 1,000,000- 2,000,000 IU per day (children 20–40 mg/kg per day).

For the treatment of tick-borne borreliosis, Erythromycin is also used at 1,000,000 IU per day (children 30 mg / kg per day). With lesions of the nervous system and arthritis, Penicillin G and Ceftriaxone are used.

Etiotropic therapy of tick-borne borreliosis

Treatment includes a complex of therapeutic measures, in which the leading role is given to etiotropic therapy for the treatment of borreliosis. Drugs are prescribed orally or parenterally, depending on the clinical picture and the period of the disease. Of the oral preparations, preference is given to tetracycline antibiotics .

The drugs are prescribed in the first period of the disease in the presence of erythema at the site of tick suction, fever and symptoms of general intoxication, provided there are no signs of damage to the nervous system, heart, joints. Assign for the treatment of tick-borne borreliosis Tetracycline 0.5 g 4 times a day or Doxycycline (Vibramycin) 0.1 g 2 times a day, the course of treatment is 10 days.

Children under 8 years of age are prescribed Amoxicillin (Amoxil, Flemoxin) orally 30-40 mg / kg per day in 3 divided doses or parenterally 50-100 mg / kg per day in 4 injections. It is impossible to reduce a single dose of the drug and reduce the frequency of taking drugs, since in order to obtain a therapeutic effect, it is necessary to constantly maintain a sufficient bacteriostatic concentration of the antibiotic in the patient's body.

Neurological treatment for borreliosis

If patients are diagnosed with lesions of the nervous system, heart, joints (in patients with acute and subacute course), it is not advisable to prescribe tetracycline drugs, since in some patients after the course of treatment there were relapses, late complications, the disease acquired a chronic course. When neurological, cardiac and articular lesions are detected, Penicillin or Ceftriaxone is usually used. In contrast to the recommended schemes of penicillin therapy, we specified a single dose of the drug, the frequency of its administration and the duration of the course of treatment. Benzylpenicillin (penicillin G) is prescribed for 500 thousand. ED intramuscularly 8 times a day (with an interval strictly after 3 hours). The duration of the course is 14 days.

For patients with clinical symptoms for the treatment of tick-borne borreliosis in the form of meningitis (meningoencephalitis), a single dose of Penicillin is increased to 2–3 million units, depending on body weight, and reduced to 500 thousand. ED after CSF normalization. Repeated administration of Penicillin maintains a constant bactericidal concentration in the blood and affected tissues. A similar scheme of penicillin therapy has been tested and successfully used in the treatment of syphilis, the pathogenesis of which is in many respects similar to the pathogenesis of Lyme disease. Thus, there is a similar mechanism of early damage to the central nervous system in these infections, common features of immunological processes and the similarity of the causative agents of both infections.

Currently, the most effective drug for the treatment of tick-borne borreliosis is Ceftriaxone (Longacef, Rocefin) at a daily dose of 1–2 g. The duration of the course is 14-21 days.

Treatment of chronic tick-borne borreliosis

In the chronic course of the disease, the course of treatment with penicillin according to the same scheme continues for 28 days. It seems promising to use long-acting penicillin antibiotics - extencillin (retarpen) in single doses of 2.4 million units once a week for 3 weeks.

In the chronic course of the disease with isolated skin lesions, positive results can be obtained from the treatment of tetracycline antibiotics.

In cases of mixed infection (Lyme disease and tick-borne encephalitis), anti-tick gamma globulin is used along with antibiotics.

Preventive therapy for tick-borne borreliosis

Preventive (prophylactic after a bite) treatment of borreliosis victims of the bite of a tick infected with Borrelia (the contents of the intestine and hemolymph of the tick are examined by dark-field microscopy) are carried out with Tetracycline 0.5 g 4 times a day for 5 days or Bicillin-3 - 1 million 200 thousand - 2 million 400 thousand. ED intramuscularly once. Also for these purposes, the Department of Infectious Diseases of the Military Medical Academy with good results uses Retarpen (Extencillin) at a dose of 2.4 million units intramuscularly once, Doxycycline 0.1 g 2 times a day for 10 days, Amoxiclav 0.375 g 4 times a day for 5 days. Treatment of borreliosis is carried out no later than the 5th day from the moment of the bite. The risk of developing the disease is reduced to 80%.

Pathogenetic treatment of the disease

Along with antibiotic therapy, pathogenetic treatment of tick-borne borreliosis is used. It depends on the severity of the disease. So:

with high fever, severe intoxication, detoxification solutions are prescribed parenterally,

for meningitis - dehydration agents,

with neuritis of the cranial and peripheral nerves, arthralgia and arthritis - physiotherapy treatment.

Patients with signs of heart damage are prescribed | Panangin or Asparkam 0.5 g 3 times a day, Riboxin 0.2 g 4 times a day.

In cases of detection of immunodeficiency for the treatment of tick-borne borreliosis, Timalin is prescribed at 10–30 mg per day for 10–15 days.

In patients with symptoms of autoimmune manifestations, for example, often recurrent arthritis, Delagil is prescribed 0.25 g 1 time per day in combination with non-steroidal anti-inflammatory drugs (Indomethacin, Metindol, Brufen, etc.). The course of treatment for borreliosis is 1-2 months.

Prognosis for the treatment of tick-borne borreliosis

The prognosis is favorable. With late-started or inadequate etiotropic therapy, the disease progresses, often turning into a recurrent and chronic course. Decreased working capacity and, in some cases, disability are due to persistent residual symptoms of tick-borne borreliosis. Those who have been ill are subject to dynamic medical supervision during the year (examination by an infectious disease specialist, therapist, neuropathologist, setting up an indirect immunofluorescence reaction every 3 months), after which a conclusion is made about the absence or chronicity of the infection.

How is tick-borne borreliosis transmitted?

The carriers of the causative agent of tick-borne borreliosis are ixodid ticks, which are widespread in wooded areas of the temperate climate zone. The area of ​​the disease is close to the area of ​​tick-borne encephalitis. Ticks retain the pathogen for life and can pass it on to their offspring. Sources of infection in borreliosis are mouse-like rodents (mice-voles, small hamsters) - hosts of preimago - the early phase of tick development, large ungulates (moose, deer, farm animals) - hosts of adults.

The main route of transmission of tick-borne borreliosis to humans is transmissible - specific inoculation with the saliva of an infected tick. The seasonality of borreliosis is expressed with an increase in the number of cases in the spring-summer and summer-autumn periods. The incubation period for tick-borne borreliosis ranges from 3 days to 3 months (3 weeks on average).