Going through the throes with a tick bite: an enchanting personal experience. Where to take a tick for analysis and what to do after its bite Laboratories for testing encephalitis ticks

"All day I carried the tick on me, hoping that it would be examined"

Ticks carry terrible diseases from which you can die or remain disabled.

From early spring to late autumn, doctors warn us about this and tell the media, explaining what to do when bitten. Carefully unscrew the tick so as not to damage the head, take it for analysis and consult an infectious disease specialist.

Simple instructions, but very difficult to follow in practice.

After conducting field research, "MK" found that, while convincing citizens of the danger of tick bites, health care itself treats them quite indifferently.

Two or three weeks ago, “whites went to the Moscow region,” and my friends, residents of Kolomna, went for mushrooms.

They were dressed as one should dress in the forest. But they still came back with ticks. The next day, the wife removed one tick from her husband, and the husband took one from his wife. The next morning, a third one was found, which was also pulled out.

“The tick was small, but fat and moved its paws in displeasure,” said the victims. - We decided to hand it over for analysis, as medical sites call for.

Methodically and consistently, we called all possible authorities - emergency room, SES, Rospotrebnadzor. They did not want to see a tick in any of them.

The proposal to subject the tick to analysis introduced interlocutors into a stupor. They seemed to be barely able to contain the question: are you even sane? What the hell is a tick?"

The tick was planted in a box and put in the refrigerator. He is still there - and unclaimed by Russian health care and epidemiological surveillance.

His owners visited an infectious disease doctor and received instructions: to come in two weeks to take a blood test, and before that, to observe the bite site.

“We have the largest city in the Moscow region, and only one (!) infectious disease doctor per city and district. And this is despite the fact that we have borreliosis here in tangible quantities: 1 case per 10 bitten. And the bitten - the sea. The doctor said: "You have no idea how much."

Borreliosis is the most common tick-borne disease in the Moscow region. It is also called Lyme disease. It is treated with antibiotics, but needs to be treated immediately. If you start, the infection will take root and after a few years it will come out, for example, arthritis with excruciating pain or some other serious muck.

At first, borreliosis looks like a common cold. Unwellness of unknown nature. Fatigue, lethargy, headache, backache, chills. Such a state does not begin immediately after the bite, but after some time, when the patient himself has already forgotten about the tick, and his doctor is even more unaware of it. Happiness if he guesses to send the patient to take a blood test for borreliosis. But that rarely comes to mind.

Borreliosis is not the only disease that can be obtained from a tick. There are seven such diseases. Including granulocytic anaplasmosis, tularemia and - the worst - encephalitis. They die from it or remain crippled.

If, after a bite of an encephalitic tick, seroprophylaxis is given to the victim - to introduce human immunoglobulin - you can save him. But it must be done within four days. Then it won't help.

The ambush is that a blood test shows encephalitis after at least two weeks - just like borreliosis. But if you analyze not the blood of the victim, but the tick itself that bit him, it turns out faster. The results will be known in three days.

Impressed by the history of the inhabitants of Kolomna, I called several emergency stations near Moscow, asking one question: “Where can I take a tick for analysis?”

As a result, it became clear that it was possible to take the removed tick to Moscow - to the FBUZ "Center for Hygiene and Epidemiology in the City of Moscow" in Grafsky Lane, or to Mytishchi - to the same center, but in the Moscow Region.

You have to bring it in a jar. It doesn't have to be alive. The main thing is not to dry out, so put a damp cotton wool in a jar.

The analysis is done for four infections - encephalitis, borreliosis, anaplasmosis, ehrlichiosis.

In the Moscow center, you have to pay 1640 rubles for it, in the Moscow region it is cheaper - 1055 rubles.

How does such a commercial approach to ticks fit in with the free medical care we should be getting in public health facilities? With this question, I turned to the Ministry of Health of the Moscow Region.

They explained to me that free medical care in the form of a tick analysis is provided only if you come to the emergency room with a tick on your body and the doctor removes it from you.

Then the tick will be sent for analysis free of charge for you and, which is also important, without your participation. That is, you will not drag yourself to Moscow or Mytishchi with a jar and wet cotton wool, but a courier, since each clinic in the Moscow Region, in accordance with the order of the Minister of Health, must have an agreement with a laboratory - either in Mytishchi or in Grafsky Lane.

If a tick is removed by a citizen on his own, it is not subject to free analysis - the rules approved in our country were explained in the press service of the Ministry of Health of the region. Because you never know whose tick it is.

Maybe you took it not from yourself, but from someone else. From a friend, for example. Or from a dog. Or he didn’t bite anyone at all, walked peacefully, and you caught him - and in a jar. And what, now the state should spend money on it? Wasting folk remedies on orphan ticks?

While I was thinking about what funny idiots citizens see as health officials - after all, they are looking for ticks somewhere, catching them with their bare hands, and then dragging them for analysis without any benefit to themselves, just to ruin the state, - a beast ran to the catcher.

I myself was bitten by a tick.

On Saturday, September 2, we went for mushrooms, on Sunday morning I saw a convex black dot on my leg. The skin around was swollen and reddened. It wasn't exactly painful, but uncomfortable.

The tick wanted to be pulled out immediately. But I decided to play by the rules. I went from the dacha to Moscow, to the emergency room at the place of residence - in Strogino.

The queue was three hours long. Several people with fractures. Someone - for dressing. Someone wanted to remove the beatings. Someone, on the contrary, wanted to fight, although he was already beaten and covered in blood.

The tick and I squatted in the corner and felt like strangers at this celebration of life.

Where were you bitten? the doctor asked first.

I pointed to my leg.

In what area? repeated the doctor, already somewhat irritated.

Realizing that he was interested, I admitted that in Voskresensky.

There is no endemia in Voskresensky, - the doctor said and looked at me with significance.

I immediately realized that he would not send my tick for analysis. If there had been an endemia in the Voskresensky district, he might have sent it. And so - no.

All day I carried the tick on me, hoping that it would be examined. But in vain. OK. Since hopes are not destined to come true, it's time to get rid of it.

Will you take him for analysis? the doctor asked. He didn't insist. It was entirely my choice: to find out if my tick is infected with dangerous infections, or not to find out.

I decided to take it.

The doctor held out a paper strip with the address of the same Center for Hygiene and Epidemiology in Grafsky Lane. “The analysis is paid,” he muttered. “Last year it cost five thousand.”

The center is closed on weekends. On Monday I arrived at a quarter to four. Ticks, as it turned out, are only accepted until half past three.

Two more people were late with me - they were bringing their ticks from some distant parts of the Moscow region. The three of us began to moan. We were pitied.

The accountant returned to her workplace, accepted the money - 1643 rubles. for each tick. Having paid for the analysis, we suffered to hand over ticks to the window on the landing. There was still a small queue of those who were not late.

“There are a lot of ticks,” said the weary lab assistant. - Flow.

The laboratory is located inside the complex of buildings of the Center for Hygiene and Epidemiology. The path to it is indicated by sheets pasted on the walls: “Ticks”, “Ticks”, “Ticks reception - brown door”, “No entry - ticks are there!”

From the abundance of leaflets, it is clear that people with ticks in jars are absolutely sick of everyone here.

The lab said they would call me on Wednesday if the tick was infected. But from Saturday to Wednesday - five days. If it turns out that he is a carrier of encephalitis, it is still too late for emergency prevention.

According to the website of the capital's Rospotrebnadzor, over the past week, 1,106 ticks have been studied at the Center for Hygiene and Epidemiology of Moscow. Of these, 184 were positive for tick-borne borreliosis, 30 for granulocytic anaplasmosis.

In total, since the beginning of the season of tick activity, 11,112 people have contacted medical organizations in Moscow about bites.

434 cases of tick-borne borreliosis were registered.

This data is only for Moscow.

And here are the figures for the Moscow region.

As of September 1, 13,418 cases of tick bites were registered. 5372 ticks were studied. Borreliosis pathogens were detected in 11.1% of cases, anaplasmosis in 2.1%, ehrlichiosis in 0.3%. The causative agent of tick-borne encephalitis was not found.

The Moscow emergency room website paints a less optimistic picture of encephalitis. “Currently, the disease of tick-borne encephalitis is registered throughout Russia, and from those adjacent to the Moscow region - in the Tver and Yaroslavl regions. The territory of Moscow and the Moscow region (except for the Taldom and Dmitrovsky districts) is safe for encephalitis.”

Taldom and Dmitrovsky districts border on the Tver region. From there, infected ticks crawl to us.

Since the beginning of the season, the Center for Hygiene and Epidemiology of the Tver Region has examined 2,077 ticks taken from people. 343 ticks were found - carriers of the infection. Of these, 13 "carried" encephalitis, 290 - borreliosis, 21 - ehrlichiosis, 19 - anaplasmosis. Also, 23 ticks infected with several infections at once were identified.

Two people fell ill with tick-borne encephalitis in the Tver region this summer. 1406 people received emergency seroprophylaxis.

In regions recognized as endemic, it is allowed to be bitten at the expense of the MHIF.

When encephalitis ticks crawl from the Tver region to the Moscow region - and this will definitely happen sooner or later - it will also be recognized as endemic, and then our doctors will also be allowed to carry out seroprophylaxis and take ticks for analysis for free. But for this it is necessary that at least fifteen or twenty people in our region fall ill with encephalitis as a result of a tick bite.

The task of every sane resident of Moscow and the Moscow region is not to fall into their number.

Official medicine warns of terrible diseases carried by ticks, and at the same time saves money on their emergency detection and prevention.

Citizens are disoriented because of this.

So should we be afraid of ticks and rush with them to doctors and laboratories?

Or is it not necessary, because we do not have an endemic area, but simply remove the tick on our own and forget it?

Or is overdoing better than underdoing?

Or how?

I did my best to get the correct answer. I even experimented on myself. But she never recognized him.

That's how cleverly our health care system is able to powder people's brains.

This year, more than 100,000 Russians have been affected by ticks. With the onset of warm weather, there is a particular increase in the number of victims. The Ministry of Health reports alarming figures: compared to last year, the number of people bitten has increased almost five times! In the Trans-Baikal Territory alone, 800 residents asked for help in May. Last year, during the same period, only 62 people were bitten by ticks. Growth by 13 times!

In this regard, I think the information will be useful

How to remove a tick

The bite of a tick is practically painless, so ticks are often found when they have already sucked. The longer the tick sucks, the more likely it is to transmit tick-borne encephalitis or borreliosis through infected saliva, so the sucking tick should be removed as soon as possible.

It is necessary to remove the tick entirely so that the head does not remain in the wound, because. when leaving the head in the wound, the risk of transmission of infectious diseases remains. Often, the jaws of the tick remain in the wound, while the infected saliva is no longer secreted, but the jaws themselves can cause inflammation, like a foreign body, so it is advisable to remove them too.

How not to remove a tick

1. Do not douse the tick with oil, nail polish, alcohol or gasoline so that it suffocates (the tick, of course, suffocates, but before death it can literally be vomited into the wound with infected saliva);

2. you can not burn a tick with a cigarette or a match for the same reason;

3. you can not try to paralyze the tick with local anesthetics, such as lidocaine (the reason is the same);

4. do not squeeze the body of the tick;

5. you can not pull out the tick with twisting movements, because. this will most likely lead to head separation;

6. you can not take the removed tick with bare hands;

How to properly remove a tick

It is best to remove the tick with tweezers or tweezers. Having firmly grasped the tick as close to the wound as possible (between the head of the tick and the patient's skin - see Fig.), slowly and carefully begin to pull it strictly perpendicular to the skin. Jerks and sudden movements are unacceptable.

After removing the tick, the wound on the skin must be disinfected with alcohol or iodine.

The removed tick should be placed in a clean jar with a lid and submitted for analysis (for the presence of tick-borne encephalitis virus and Borrelia).

The wound must be monitored for 4 weeks. When rapidly spreading redness appears around it, you should see a doctor to rule out borreliosis.

If the head of the tick still comes off, it must be carefully removed with the same tweezers and tweezers, most often this succeeds.

Sometimes jaws remain in the wound - it can be almost impossible to remove them. In principle, the jaws can be left in the skin - sooner or later they will fall off on their own. Sometimes the jaws can cause local inflammation, like any foreign body, in which case you need to see a doctor.

Once the tick has been removed, prophylactic antibiotics are not needed, although some experts believe that antibiotics should be given to pregnant women as a preventive measure.

Where to take a tick for analysis in Moscow

1. When the tick is removed, it is necessary to collect information about the place, time and date of the bite and how long the tick could hang (sometimes this period can be set; the smaller it is, the less likely the disease is).

2. The removed tick is recommended to be examined for infection with Borrelia and TBE virus in the laboratory. To do this, it is placed in a hermetically sealed container with a small piece of slightly damp cotton wool (so that it does not dry out on the way) and sent to the laboratory. If research is not possible, the tick should be burned or poured with boiling water.

Dear patients!

A tick bite is a danger of various viral and bacterial pathogens of tick-borne infections entering the body.

Already now you can contact the nearest office of the Center for Molecular Diagnostics (CMD) and conduct a comprehensive study of a tick that has stuck or removed from clothes for the presence of pathogens of four main infections: tick-borne viral encephalitis, ixodid tick-borne borreliosis (Lyme disease), granulocytic anaplasmosis and monocytic human ehrlichiosis.

Rules for preparing for the study:

• A sucking tick should be removed as soon as possible. To do this, it is recommended to carefully tie a thread between the tick and the skin and with smooth movements “unscrew” the tick from the skin. Or use special devices (“plier-screwdriver” or “plier handle-lasso”). It is not recommended to smear the tick with oil - contrary to the well-known myth, it will not suffocate for a long time, but it will have time to transmit a lot of pathogens. It is also not recommended to get the tick with tweezers, since by squeezing the body of the tick, we contribute to an even greater influx of its saliva and thereby increase the number of microorganisms introduced into the wound; when using tweezers, a tick can be accidentally crushed, then its contents will also fall into the wound, and this increases the risk of infection.
• It is desirable to keep the tick for research in the most intact condition. If the tick is alive - place it in a hermetically sealed container with several blades of grass or a piece of cotton wool slightly moistened with water, if dead - also place it in a container (sealed bag), then put it in a thermos with ice. Send the sample to the laboratory as soon as possible for analysis.

Interpretation of the results of the study of the tick:

If you receive a “Not detected” result, you should monitor your health within 30 days and, in case of any clinical manifestations (fever, headache, weakness, malaise, etc.), seek advice from an infectious disease specialist.

If the result is "DETECTED":

• If TBEV RNA (tick-borne encephalitis virus) is detected in a tick, emergency seroprophylaxis is carried out in specialized medical facilities (no later than 96 hours from the moment the tick is sucked). The patient is injected with human immunoglobulin against tick-borne encephalitis. For dynamic monitoring of the possible development of the disease, it is recommended to examine paired blood sera for the presence of specific antibodies of the IgM and IgG classes no earlier than 2 weeks after the tick has been bitten with an interval of 7-10 days. In the CMD laboratory, antibodies are tested by ELISA: anti-TBE IgM (042702) and anti-TBE IgG (042701) in the blood.
• If the genetic material of bacterial pathogens is found in the test tick: B.burgdorferi sl (causative agents of ixodid tick-borne borreliosis), A.phagocytophillum (causative agent of human granulocytic anaplasmosis), E.chaffeensis / E.muris (causative agents of human monocytic ehrlichiosis) no later than the fifth day after suction ticks are treated with antibiotic prophylaxis, which is prescribed by an infectious disease specialist. For dynamic monitoring of the possible development of the disease, it is recommended to examine paired blood sera for the presence of specific antibodies of the IgM and IgG classes no earlier than 2-4 weeks after the tick has been bitten with an interval of 20-30 days. In the CMD laboratory, antibodies are tested by ELISA: anti-Borrelia IgM (044101) and anti-Borrelia IgG (044102) in the blood; immunochip method: Serological diagnosis of borreliosis (blood) (300049), Serological diagnosis of borreliosis (blood and CSF) (300051) .

Human infection with tick-borne borreliosis occurs through the bite of an infected tick. Ticks transmit the bulk of pathogens in the first minutes of the bite, along with the first portion of anesthetic saliva. Infection with tick-borne borreliosis is also possible when a tick is crushed in the process of removing it from animals or the human body, followed by the introduction of the virus to the mucous membranes of the eyes, nose and lips or to damaged areas of the skin.

If the tick has stuck to the skin of a person, then it should be removed especially carefully so as not to cut off the proboscis, which is deeply and strongly strengthened for the entire period of suction.

When removing a tick, the following guidelines should be followed:

• grab the tick with tweezers or fingers wrapped in clean gauze as close as possible to its mouth apparatus and holding it strictly perpendicular to the bite surface, turn the body of the tick around the axis, remove it from the skin;
• disinfect the bite site with any means suitable for these purposes (70% alcohol, 5% iodine, cologne, etc.);
• after removing the tick, wash your hands thoroughly with soap and water;
• the removed tick should be burned or poured with boiling water;
• in case of separation of the head or proboscis of the tick (accidentally or during its removal), a black dot remains on the skin, which must be treated with 5% iodine and left until natural elimination.

Ticks extracted from the skin can be delivered to the laboratory, where they are tested for Borrelia infection, subject to the following rules:

1. Only live ticks are suitable for research.

2. Do not lubricate ticks with oils, creams, etc.

3. The removed tick should be placed in a clean container (test tube, vial, jar, etc.), in which, in order to create high humidity, absorbent paper slightly moistened with water (filter, paper napkin, etc.) must first be placed.

4. Storage and delivery of ticks in compliance with the above conditions is possible only within 2 days.

Ixodid tick-borne borreliosis (ITB) is a transmissible natural focal infection with an acute or chronic course. The causative agent is the spirochete Borrelia burgdorferi, currently 12 genotypes of the pathogen have been described.

Many species of small mammals, ungulates, and birds are reservoirs of the pathogen and "feeders" of ticks. Human susceptibility to Borrelia is very high. Cases of diseases are registered among all age groups; the adult working-age population is more often ill. Clinically, tick-borne borreliosis is characterized by a polymorphism of manifestations: damage to the skin, nervous and cardiovascular systems, musculoskeletal system, general infectious intoxication, often acquires a chronic and recurrent course. Infection in endemic areas is possible from March-April to September-October, the most dangerous time being May and June.

The causative agent of the disease is transmitted to a person in the first minutes of the bite of a tick infected with Borrelia along with anesthetic saliva.

Infection of the population is possible:

• when visiting territories endemic for tick-borne borreliosis in forests, forest parks, in individual garden plots;
• when ticks are introduced by animals (dogs, cats) or people - on clothes, with flowers, branches, etc. (infection of people who do not visit the forest);
• when removing, crushing a tick or scratching the bite site, infection with tick-borne borreliosis can also occur as a result of rubbing into the skin with saliva or tick tissues of the infectious agent;
• when eating raw milk of goats (most often), cows and buffaloes, in which, during the period of a mass attack of ticks, Borrelia can be found in milk. Therefore, in disadvantaged areas for tick-borne borreliosis, it is necessary to use this product only after boiling.

The incubation (hidden) period ranges from 1 to 30 days (usually 7-14 days), the accuracy of which depends on the accuracy of establishing the fact of tick suction. The disease usually begins acutely or subacutely with the appearance of soreness, itching, swelling and redness at the site of the tick bite. Patients complain of moderate headache, general weakness, malaise. The body temperature rises, more often up to 38 degrees C. At the same time, characteristic skin erythema appears (in 70-90% of cases). Gradually, it increases in size from the center to the periphery, reaching a diameter of 3 to 68 cm. Sometimes, several red rings are surrounded by one common one.

The disease of tick-borne encephalitis can be prevented with the help of non-specific prophylaxis. The main objective of non-specific prophylaxis is to prevent a tick bite.

Non-specific prophylaxis includes the use of:

• special protective suits (a suit for protection against midges and ticks, consisting of a “knitted protective technical set” TU 17 - RSFSR-53-10-435-82 (top and underwear mesh shirts and a head cape) or a “male summer suit for workers - forest harvesters, protective against insects TU 17 - RSFSR-06-76-94-81 (trousers, jacket));
• adapted clothing that should not allow ticks to crawl through the collar and cuffs. Pants must be tucked into boots, stockings, socks with a tight elastic band. The upper part of the clothing (shirt, jacket) should be tucked into trousers, and the cuffs of the sleeves should fit snugly against the arm. Shirt collars and trousers should not have fasteners or have a zipper, under which a tick cannot crawl. On the head, a helmet-hood, tightly sewn to the shirt, is preferable, in extreme cases, the hair should be tucked under a scarf. Clothing should be plain, as ticks are more visible on it. Keep in mind that ticks always crawl up clothes, obeying negative geotaxis!;
• special chemicals applied to clothing to protect against tick attacks and reduce the risk of infection. Only funds registered in the territory of the Russian Federation in the prescribed manner should be used. The effectiveness and safety of these drugs depends on following the recommendations on how to use them, indicated on the label or in the "Guidelines" for each product. In this case, a prerequisite is the observance of precautionary measures, personal hygiene, and in case of poisoning - first aid. Preparations containing insecticides are applied only to clothing, their use on the skin is prohibited!

List of drugs approved in the Russian Federation for protection against ticks

Each person, being in the natural focus of tick-borne borreliosis during the season of insect activity, should often (every 10-15 minutes) conduct superficial examinations of their clothes, and every 2 hours it is necessary to conduct thorough examinations of the body with the removal and turning of clothes. In a dangerous area, one should not sit or lie down on the grass, or it is necessary to carry out self- and mutual examinations of clothing especially often and carefully. Dry pine forests with sandy soil or areas devoid of herbaceous vegetation are preferable for choosing a parking place, overnight stays. Before spending the night, you should carefully inspect clothes, body and hair. After returning from the forest, conduct a complete examination of the body and clothes. Do not bring into the room freshly picked flowers, branches, outerwear and other items that may be ticks.

Do not forget that usually ticks do not stick immediately! The faster the tick is removed from the body, the lower the dose of the pathogen it will transmit! A tick that has stuck to the body must be removed immediately after detection, trying not to tear off the proboscis immersed in the skin, and contact a medical facility. To remove a stuck tick, you need to grab it with tweezers or fingers wrapped in clean gauze as close as possible to the mouth apparatus and, holding it strictly perpendicular to the bite surface, turn the body of the tick around the axis, remove it from the skin. The removed tick should be burned or poured with boiling water. It is recommended to treat the wound at the site of the bite with iodine and wash your hands thoroughly.