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Клещевой энцефалит

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kleshhevoj-encefalit.jpgКлещевой энцефалит является природно-очаговой инфекцией и вызывается вирусом клещевого энцефалита.

Основными переносчиками вируса являются некоторые виды иксодовых клещей. Иксодовые клещи- это основной резервуар вируса в природе. Дополнительным резервуаром вируса служат прокормители клещей: многочисленные мышевидные грызуны, более крупные дикие и домашние животные, птицы. В природе вирус поддерживается циркуляцией по замкнутой цепи: клещи, животные – прокормители - клещи.

Типичными ландшафтами природных очагов инфекции оказываются лиственные и смешанные хвойно-лиственные леса с выраженным подлеском и высоким травостоем, пойменные луга по берегам рек, берега озер и прудов, лесные просеки, придорожная растительность, лесные тропинки.

Заражение человека вирусом клещевого энцефалита происходит во время кровососания голодных зараженных вирусом клещей. Процесс присасывания клеща практически безболезненный, и часто остается незамеченным. Заразиться можно и при употреблении не кипяченого козьего молока.

Через кожу вирус попадает в организм и распространяется по кровеносным, лимфатическим сосудам, нервным путям и достигает мозга, который является местом длительного размножения и основным центром локализации патологического процесса.

Для клещевого энцефалита характерна весеннее – летняя сезонность заболеваемости, связанная с активностью клещей переносчиков. Инфекция клещевого энцефалита распространена по всей лесной и лесостепной умеренной климатической зоне Евроазиатского континента. Природные очаги этой инфекции выявлены более чем в 40 субъектах Российской Федерации.

Заболеваемость клещевым энцефалитом в России за последние 10 лет выросла в 9 раз. Основная заболеваемость приходится на Урал, Западную Сибирь, Восточную Сибирь. Однако, в последнее время случаи заболевания клещевым энцефалитом стали выявляться и среди населения ранее благополучных по этой инфекции Пензенской, Ярославской областей и др. В Саратовской области переносчиков клещевого энцефалита нет, местных случаев заболевания не зарегистрировано. Смертность от клещевого энцефалита, в среднем по стране составляет 1-2%, но может достигать 23-25% (на Дальнем Востоке).

Клинические проявления клещевого энцефалита, как правило, развиваются остро. Характерна высокая лихорадка, сильные головные боли, тошнота, рвота, судороги. Возможно развитие параличей и парезов. Тяжелые поражения головного мозга могут завершиться смертельным исходом. Лечение больных клещевым энцефалитом проводится в инфекционном стационаре.

Единственным надежным способом профилактики клещевого энцефалита является вакцинация. Прививки проводятся лицам, выезжающим в природные очаги клещевого энцефалита по профессиональной необходимости или в частном порядке. Курс прививок должен быть завершен за 2 недели до выезда в эндемичный район.

Для непривитых лиц в целях профилактики присасывания клещей и заражения клещевым энцефалитом необходимо:

- во время пребывания в лесу носить головной убор и закрытую одежду, плотно прилегающую к телу, хорошо заправленную в сапоги;

-постоянно проводить само - и взаимоосмотры для обнаружения клещей: каждые 10-15 минут поверхностные и каждые 2 часа со снятием одежды;

-в лесу не садиться, не лежать на траве, для стоянки выбирать сухие места, лишенные растительности;

-применять репелленты;

-на дачах и садовых участках не допускать травостоя, кустарник должен быть подстрижен, старые кусты своевременно удалены;

-в случае присасывания клеща, как можно быстрее удалить его, для чего обратиться за медицинской помощью. Если нет такой возможности, удалить клеща самостоятельно. Капнуть на него каплю растительного масла и через 1-2 минуты удалить пинцетом, ниткой, завязанной у хоботка, или пальцами, обернутыми марлей, раскачивая из стороны в сторону. Место извлечения клеща смазать йодом или спиртом. Снятого клеща сжечь. Нельзя сбрасывать клеща на землю, особенно опасно раздавливать руками, так как вирус может попасть через микротрещины на руках в организм человека;

-в эндемичном районе в течении трех дней после укуса клеща необходимо провести экстренную иммунопрофилактику, ввести пострадавшему противоклещевой иммуноглобулин, который заменит отсутствующие у человека антитела и обеспечит защиту от заболевания;

-при повышении температуры, головной боли, головокружении, тошноте, рвоте, появлении большого красного пятна в течении 21 дня после укуса клеща необходимо немедленно обратиться к врачу.

 

ГУЗ «Саратовский областной центр медицинской профилактики»

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