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The tick season has already begun. One of the consequences of a tick bite can be tick-borne encephalitis. – Tick-borne encephalitis sometimes only causes flu-like symptoms. However, it must be remembered that this is the most common cause of viral neuroinfections in Poland – warns Prof. Joanna Zajkowska from Białystok.
Tick-borne encephalitis – how does it manifest?
– How is tick-borne encephalitis (TBE)? When illustrating the course of the infection, it would be best if we imagined a triangle placed with its base down – such a pyramid – explains Prof. Joanna Zajkowska from the Department of Infectious Diseases and Neuroinfections, University Teaching Hospital in Białystok. – Most often, nothing happens after the TBE virus enters the body: the body eliminates it from the very beginning; this is the bottom of the pyramid – he explains.
Another infection scenario, i.e. one floor above, is the so-called the flu-like form, and the first stage of the disease is viremia, fever and muscle pain. We often call it summer flu because it happens in summer. And at this stage, the disease may stop. All this happens up to 28 days after the tick bite.
When the body fails to cope with this viral infection, the flu-like period is followed by a day or two breaks (sometimes without this break) and central nervous system symptoms develop. This is another pirama floor.
Meningitis and its complications
– Then most often patients have meningitis, which is manifested by high fever, severe headache, nausea, vomiting. Patients then go to the hospital. If the patient is less fortunate, the meninges and the brain become inflamed with involvement of the centers in the brain, i.e. with disturbed consciousness. There may also be inflammation of the meninges, brain and spinal cord, and nerve roots, in various configurations, the specialist emphasizes.
He adds that when the disease ends in the period of flu-like symptoms, there are no further complications. The virus then does not reach the central nervous system, is eliminated in the periphery and does not cause permanent damage.
However, when the central nervous system is involved, complications arise that can leave permanent effects. The mildest complications after meningitis include headaches. There may also be a postencephalytic syndrome, i.e. fatigue, headaches, malaise. This is a complication that can last for quite some time.
– The most common complication of nerve root involvement is paralysis of the shoulder plexus. It can be unilateral or bilateral paralysis. It will show that the sick person cannot raise his hands up – that is, the mobility of the hands is kept, but they cannot be raised. Added to this is the so-called a symptom of a flabby neck. Paralysis can also affect the lower limbs, cranial nerves, and the respiratory center. With the latter paralysis, if the patient manages to survive, he will need constant breathing support – lists Professor Zajkowska.
Serious complications of TBE are irreversible. In the case of those influencing motor skills, it is only possible to improve the patient as part of rehabilitation.
– Motor damage caused by complications can be reduced to some extent by rehabilitation. With a few rehabilitation cycles, limb mobility is improved, but the full fitness is not regained. Damage such as muscle wasting cannot be “repaired” at all. Muscle mass does not rebuild, which makes the limbs weaker. It cannot be rehabilitated – points out the specialist.
Tick-borne encephalitis – who is most at risk?
Who is most at risk from TBE? It is not only a disease of foresters or people living close to the forest. The infection can even occur in the city, while walking the dog, jogging or in the garden. It can occur in adults and children.
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– The severe course of tick-borne encephalitis is especially dangerous for children, because their brain is in the process of developing and maturing. Even minor damage to it can have huge consequences for children in the future. TBE is also particularly dangerous for the elderly and those with impaired immunity (treated for psoriasis, rheumatoid arthritis or other autoimmune diseases). They do not have the body’s defenses to stop virus replication. The course of the disease can then be dramatic. Although it must be remembered that in young, healthy people, the disease can also involve the central nervous system and paralysis, and it is really difficult for us – doctors to tell why this happens – concludes Prof. Joanna Zajkowska.
The disease can even lead to death, but this is rare. – Approx. 2 percent die because of KZM. sick. Usually, these are people with impaired immunity or with other diseases, or taking medications that reduce immunity, as in patients after transplantation – he adds.
There is no medicine for TBE. When an infection occurs, only our immune system can fight the disease. The threat of it is not fully known in Poland. – Czechs, Lithuania, Latvia and Estonia have a lot of registered cases of TBE. We have fewer registered cases, about 200-300 per year, but research shows that this amount in Poland is underestimated – says the specialist.
The greatest number of infections is registered in Podlasie, Lublin and Małopolska regions. – As we expanded the research, it turned out that we also have a lot of cases of this disease in Silesia and in the vicinity of Wrocław. However, the greatest number is in Podlasie, Masuria, where we have the Białowieża Primeval Forest, the Knyszyńska Primeval Forest. However, it must be remembered that the disease is recorded all over Poland – the further west of the country, the less – he explains.
Tick-borne encephalitis – how to prevent it?
Vaccination is the only effective method of preventing TBE. However, it is not true that only those who work or live in the forest should be vaccinated. There are two main groups of precepts. – Inhabitants of the eastern provinces of Poland should be vaccinated, especially those who live outside large cities – emphasizes the specialist.
Our activity may also be an indication for vaccination. People who go out with their dogs for walks, run in the park, forest, in nature, mushroom pickers, garden owners – generally those who spend time in nature, should be vaccinated.
Additional protection that should be ensured by people who are particularly exposed to contact with ticks, but also for everyone who goes to places such as forests or parks, are special agents for ticks – such as liquid for ticks Tick Stop tick. They allow you to reduce the risk of being bitten by ticks.
Is it worth vaccinating children? – The youngest children are usually under greater care and control of adults and there are fewer cases of TBE among them. Most children are infected between the ages of 5-6. If we often go to the park with our child, spend time in nature, it is worth vaccinating the child against TBE. There is no risk associated with vaccination, and we are not able to predict the effects of the disease, especially the neurological ones, believes prof. Zajkowska.
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Author: Zbigniew Wojtasiński (PAP).