Forms of tick-borne encephalitis and the name of the vaccine against the disease

1 Types of acute infection

When the tick-borne encephalitis virus is infected, the following clinical forms of the disease may occur:

• febrile;
• is meningeal;
• is meningoencephalitic;
• poliomyelitis;
• polyradiculoneuritic;
• mixed options.

Form	Clinic	Diagnosis
Feverish	After the incubation period( it lasts from 8-20 days) there is a mild headache, fever, more often to febrile digits.	There will be no change in the study of cerebrospinal fluid. In the blood, IgM will be detected to the virus of tick-borne encephalitis( hereinafter IgM to CE).
Meningeal	Patients develop serous meningitis. The disease begins acutely with fever, general malaise, in parallel with this or in 1-2 days there is an intense headache, which is accompanied by nausea, vomiting may occur.	In the study of cerebrospinal fluid, the composition of the CSF is changed - the lymphocyte content is increased, there may be an increase in cerebrospinal pressure, but insignificantly. In the blood there will be IgM to CE, also it will be determined by carrying out the PCR method in the cerebrospinal fluid. instagram viewer
Meningoencephalitic	In this case, the involvement of the brain substance - meningoencephalitis - is added to the meningitis. Depending on the area of ​​the brain affected by the virus, the clinical picture will be dominated by certain symptoms( paresis or paralysis, lesions of the cranial nerves, hyperkinetic syndromes, etc.).	Lumbar puncture will reveal lymphocytic cytosis and increase in protein content due to brain cell death. The MRI will determine the focus or lesions of the brain substance. In the blood and CSF, IgM will be detected to the CE.
Poliomyelitis	With this form of the disease, the spinal cord, the favorite department of the tick-borne encephalitis virus, is damaged - the cervical spinal cord. There are flaccid paralysis and atrophy of the muscles of the neck and shoulder girdle, a characteristic symptom of the "drooping head."Still can develop bulbar syndrome - a violation of phonation, ingestion of food, speech( dysphonia, dysphagia, dysarthria).	Lumbar puncture: in liquor - lymphocytic cytosis, increase in protein. At the MRI of the cervical region - foci of the altered substance, according to ENMG - a violation at the level of alpha-motoneurons of the cervical region. In liquor and blood IgM to CE.
Polyradiculoneuritic	In this case, the peripheral nerves of the hands and feet are damaged, the disease proceeds according to the type of polyneuropathy, patients are disturbed by a violation of the sensitivity of the hands and feet, pain along the nerve trunks and motor disorders( paresis, paralysis).	Likvor - lymphocytic cytosis is insignificant, the protein content is slightly increased. In liquor and serum IgM is determined for CE.ENMG is demyelination.

Currently, the most common clinical forms of the disease - a febrile form and meningeal, which can not but rejoice, as these forms are benign and do not bear any consequences in most cases. But every year the habitat of ixodid ticks increases, they quickly master the northern territories and adapt to new environmental conditions. Chronic forms of tick-borne encephalitis, which lead to disability, began to appear. Precisely established data, why there is a chronic course of the disease, no, it is believed that the virus after treatment persists for a long time in the human body and slowly continues to affect the cells of the nervous system, so a chronic infection manifests itself many years after a tick bite or transferred acute tick-borne formencephalitis, a person can even forget about this incident. That is why it is important to prevent the emergence of a clinical picture of the disease in case of infection, this is what vaccine prevention is directed at. It is not difficult to get vaccinated against tick-borne encephalitis.

2 Chronic course of the disease

Form	Clinic
Hyperkinetic form( kozhevnikovskaya epilepsy, myoclonus-epilepsy, epileptiform seizures).	Kozhevnikovskaya epilepsy is a focal form of epilepsy, that is, convulsive twitchings occur in one area, for example, in one hand;part of the seizures proceed as follows, a part is subjected to generalization, namely, a tonic-clonic seizure occurs with loss of consciousness. Myoclonus-epilepsy - seizures in the form of myoclonium, can still be accompanied by secondary generalization.
Amiotrophic syndrome.	There is a flaccid paralysis of the muscles of the neck and shoulder girdle, a symptom of a "drooping head".In addition, it can occur as a syndrome of amyotrophic lateral sclerosis.
Other syndromes.	In the chronic form of the disease lesions are detected in various areas of the nervous system, so the clinical picture can be very diverse: oculomotor disorders, polyneuropathy, paresis, etc.

3 Prevention of the disease

In connection with the above, one can conclude that it is better not to allowpenetration of the virus into the nervous system. The vaccination protects by 95%, and in case of infection with the virus and the appearance of clinical symptoms in vaccinated citizens, the disease proceeds more favorably.

Prevention of tick-borne encephalitis is divided into two global directions: actions directed against the tick bite, and actions aimed at preventing the development of the disease.

Preventive measures against the vector itself are to spray its habitats with special insecticides, such a measure was used in the period of the USSR, it is still used in Finland.

It is necessary to observe elementary safety rules when visiting forest belts: the absence of open areas of the body, the use of repellents, examination of the body and clothing.

Effective spraying of household plots and suburban areas with insecticides.

Vaccination has been developed for disease prevention. It is carried out according to a certain scheme, depending on the vaccine. The Russian vaccine for tick-borne encephalitis is called EnceVir for adults, for children - EnceVir Neo. EnceVir is a formalin-inactivated tick-borne encephalitis virus. With the usual vaccination: 0.5 ml is injected twice with an interval of every 5-7 months, revaccination in a year from the second injection in a dose of 0.5 ml. Subsequent revaccinations of 0.5 ml every 3 years. In case of emergency prophylaxis, 0.5 ml 2 times is injected with an interval of 1-2 months.

German Encepur vaccine is given in / m or s / c. The traditional scheme: 1st vaccination is carried out by a dose of 0.5 ml, in 1-3 months the second inoculation, the third in 9-12 months. Revaccination is performed after 3 years.