2023 Author: Josephine Shorter | [email protected]. Last modified: 2023-05-24 11:52
Tularemia in humans
What is tularemia?
Tularemia is an infectious disease caused by the bacterium francisella tularensis. It enters the human body when bitten by sick animals or after eating contaminated meat. There are also known routes of transmission through untreated water and when processing the skins of slaughtered livestock.
Bacteria enter the human body through the skin, mucous membranes, respiratory tract and gastrointestinal tract, causing intoxication and, as a result, inflammation of the lymph nodes.
The disease proceeds in a rather severe form and mainly affects the lymphatic system, forms ulcers on the skin, in some cases, changes concern the eyes, throat and lungs of the patient. The complications of tularemia include diseases of the internal organs.
Both children and adults are susceptible to tularemia, but in most cases the disease is recorded in the latter. According to statistics, the incidence rate in men is twice as high as in women.
The main risk factor for infection is professional activity: fishing, hunting and agriculture, which are based on direct contact with potentially dangerous natural sources.
Tularemia has long been recognized as a disease in rural areas, but in the modern world there is a tendency for a steady increase in the incidence among urban residents. The infection is active all year round, but about 80% of cases are recorded in summer and autumn.
Symptoms of tularemia in humans
From the moment of infection until the first symptoms of the disease appear, it takes about five days, in some cases this period lasts up to two weeks.
Toryalemia has a standard set of the following symptoms:
- body temperature 39 and above degrees, which can last up to 14 days;
- severe headache and dizziness up to fainting;
- general malaise, accompanied by weakness and rapid fatigability;
- muscle pain;
- decreased appetite and nausea.
Various forms of the disease have additional symptoms:
For ulcerative bubonic tularemia (after being bitten by an infected tick):
- an ulcer-like formation appears at the site of the bite;
- located closer to the site of the bite, the lymph node becomes inflamed and painful.
In the case of the bubonic form of the disease that develops after the bite of a sick animal:
- lymph nodes become especially painful at the site of the bite;
- after a while, the inflamed lymph node forms pus and opens up.
Abdominal tularemia occurs after eating meat from an infected animal.
The symptoms of this form are similar to those of food poisoning:
- decreased or complete lack of appetite;
- pain in the hypochondrium.
In the pulmonary form of tularemia, infection occurs by airborne droplets and proceeds according to the bronchial type:
- bronchi are affected, and a dry cough appears;
- there is pain behind the sternum;
- severe degree is characterized by symptoms of severe pneumonia: shortness of breath, cough with purulent sputum, chest pain.
Any form of tularemia requires immediate treatment, without which the probability of death occurs in 6 cases out of 10.
Treatment of tularemia in humans
The complex treatment of tularemia in humans involves therapy aimed at detoxifying the body and further relieving inflammation. The result obtained is consolidated by the appointment of antihistamines, vitamin complexes and agents that normalize and support the work of the cardiovascular system. Local treatment of bubonic and ulcerative formations on the skin consists in the use of dressings with ointment, compresses, as well as the use of laser irradiation and diathermy. If the buboes contain a purulent mass, they are opened and drained.
The high efficiency of treatment of tularemia with streptomycin has been proven. The drug is administered intramuscularly every 12 hours. The course is 7 to 14 days. If there is a likelihood of developing tularemia meningitis, gentamicin is prescribed. The doctor may prescribe tetracycline or other drugs, focusing on the severity of the disease and the individual characteristics of the patient.
Treatment continues until the normal temperature stabilizes (usually, body temperature control is required for 5 days).
A protracted and complicated form of tularemia requires a combination treatment, which includes antibiotic therapy with vaccination. The injection is administered intramuscularly, the dose is 1-15 million microbial bodies per procedure. The course of vaccination is 6-10 sessions every 3-5 days.
During treatment or after discharge, the doctor prescribes the use of vitamin complexes. In some cases, a blood transfusion may be required.
Discharge from the hospital is possible only after complete clinical recovery.
Prevention of tularemia
Treatment of tularemia is a lengthy and unpleasant procedure, so it is necessary to take some measures so as not to get infected with it.
Prevention of infection is as follows:
- Use of protective suits when going fishing, hunting. They will protect you from tick bites, rodents and small insects. Clothing should be worn in such a way as to limit access to the body as much as possible: long sleeves, a jacket under the throat, pants tucked into boots.
- Purchase of repellents - products that protect against tick bites and horseflies.
- On hikes, you need to take drinking water and in no case use unknown sources, because they can be contaminated.
- A thorough examination of the body after each visit to the forest for the detection of ticks. If you have one, you should immediately seek medical help and not try to remove the tick yourself.
- The risk of contracting tularemia is higher in areas where wildlife populations are common and hunting is a major activity. In such places, vaccination against this disease is necessary.
The tularemia vaccine triggers the production of special antibodies, thereby the human immune system, in the event of a bacterium-causative agent entering the body, is able to destroy the harmful cell and stop the further development of the disease.
The vaccine preparation is a dried live bacteria francisella tularensis. It is used in two ways: applied to the skin area or injected under the skin. After some time after the vaccination, swelling and redness form at the injection site. This is a normal reaction, indicating the formation of immunity to tularemia. If a similar reaction is not observed, but there is a need for re-vaccination after 30 days.
Normally, a month after the introduction of the vaccine, a person becomes the owner of good immunity against tularemia bacteria. The effect lasts for 5 years, after which the vaccination is carried out again.
Tularemia is a disease spread from animals to humans. Cases when a person becomes infected from a person have not been established.
After complete cure of tularemia, re-infection is impossible, because immunity to such a disease is formed for life.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".