Two-wave viral meningoencephalitis
Two—wave viral meningoencephalitis is one of the forms of tick-borne encephalitis, the cause of which will be the defeat of the body by an infected tick. The main feature of this disease is that it has two forms of clinical manifestations, which are separated by a short remission. At risk are people from 20 to 40 years old, whose work is associated with a long stay in the forest. It can be hunters, geologists, tourists.
The content of the article:
Etiology of two-wave viral meningoencephalitis
Symptoms of two-wave viral meningoencephalitis
Diagnosis of two-wave viral meningoencephalitis
Treatment of two-wave viral meningoencephalitis
Prognosis of two-wave viral meningoencephalitis
Prevention of two-wave viral meningoencephalitis
Two-wave viral meningoencephalitis
The effectiveness of treatment and prognosis for the patient depend largely on the timely diagnosis of the disease. Otherwise, there may be serious health complications such as cerebral edema, cystic fibrosis, cerebral coma, epileptic syndrome. Therefore, people who have recently been in places of increased tick activity and noticed early signs of the disease should visit a therapist or an infectious disease specialist. It is also advisable to follow preventive measures to prevent encephalitis. The most effective preventive measure is timely vaccination.
Etiology of two-wave viral meningoencephalitis
The disease occurs due to infection of the body with a virus that has a tropicity to the glial tissues of the brain. At the same time, doctors note that the neurons of the brain almost always remain intact, which distinguishes the disease from other types of encephalitis. The immunological properties of this virus are almost identical to those of the virus that causes tick-borne encephalitis. After the virus enters the body, it first multiplies in the parenchymal organs, after which it gradually penetrates into the brain and begins to accumulate there.
Infection of the human body with a virus can occur in two ways:
The first pathway, which is called transmissible, involves the bite of an ixodic tick, which is a kind of reservoir of the pathogen and its carrier. At the same time, the disease has a rather long incubation period — 12-20 days.
The second, alimentary, way involves infection with the virus due to the consumption of milk obtained from an infected animal. In this case, the virus can infect several people at once, and its incubation period lasts no more than 4-7 days.
Symptoms of two-wave viral meningoencephalitis
A distinctive feature of this disease is the presence of two acute periods, each of which is accompanied by a significant increase in body temperature.
The first period of two-wave viral meningoencephalitis
The following clinical picture is characteristic of the first period of the disease:
high temperature, which reaches 39 degrees;
vertigo;
malaise;
chills;
headaches;
vomiting;
nausea;
myalgia (muscle pain);
arthralgia (joint pain).
The disease may also be accompanied by a mild manifestation of meningeal symptoms.
The first acute period of two-wave viral meningoencephalitis lasts no more than a week. Upon its completion, the patient’s body temperature returns to normal. Usually the remission period lasts about 5-7 days. At this time, the patient disappears all the symptoms that previously bothered him. However, after a week of remission, a new sharp rise in temperature occurs, and the general well-being of the patient deteriorates sharply.
The second period of two-wave viral meningoencephalitis
The second period of exacerbation of the disease is characterized by a severe clinical picture. The deterioration of the patient’s well-being is due to organic brain damage. For the second acute period of the disease, symptoms such as a decrease in deep and superficial sensitivity, cerebellar syndrome, vestibular ataxia, mental disorders, paresis of the extremities, epileptic seizures are characteristic. Unlike tick-borne encephalitis, bulbar syndrome with two-wave viral meningoencephalitis is extremely rare.
Diagnosis of two-wave viral meningoencephalitis
It is difficult to diagnose the disease at an early stage. This is due to the fact that it manifests itself mainly with general infectious symptoms, which are characteristic of most infectious diseases. Namely, the symptoms of two-wave viral meningoencephalitis are similar to the signs of acute respiratory viral infections, measles, scarlet fever, brucellosis. It is possible to make a diagnosis only due to the presence of epidemiological information such as the patient’s consumption of goat’s milk or a tick bite. It is much easier to diagnose the disease after the onset of the second acute period of the disease, which is characterized by more specific symptoms.
If two-wave viral meningoencephalitis is suspected, the patient should be examined by a therapist, an infectious disease specialist and a neurologist. As for diagnostic studies, lumbar puncture is the most effective of them. It is carried out for further virological, physico-chemical, microscopic examination of cerebrospinal fluid. The diagnosis can be confirmed by detecting a moderate increase in the cellular elements of the cerebrospinal fluid due to lymphocytes.
Differential diagnosis of two-wave viral meningoencephalitis
The results of the study of cerebrospinal puncture make it possible to differentiate this disease from purulent meningitis. Differential diagnosis will also be required to distinguish two-wave viral meningoencephalitis from meningitis and encephalitis with a completely different etiology, cyst suppuration, brain abscess, intracerebral hematoma. This will require additional diagnostic tests: MRI or CT of the brain.
Treatment of two-wave viral meningoencephalitis
Patients with two-wave viral meningoencephalitis, who have pronounced symptoms of the disease and a feverish state, need to observe bed rest. The doctor will also insist on following a strict diet, which provides for the predominance of vitamin-rich foods in the diet. Due to fever, the patient may become severely intoxicated. That is why, after admission to the hospital, doctors prescribe detoxification therapy.
Treatment of two-wave viral meningoencephalitis also involves the appointment of etiotropic antiviral drugs. Therapeutic tactics are selected as in tick-borne encephalitis. Namely, interferon, specific donor gamma globulin and ribonucleases are prescribed to the patient.
With a more acute course of the disease, when the patient has symptoms of increased intracranial pressure and hydrocephalus, they resort to dehydration methods. To eliminate various neurological abnormalities, vitamins, vascular preparations (trental, instenone, cavinton) and nootropics (aminalon, ginkgo biloba, glycine, piracetam) are prescribed. To eliminate the first wave of symptoms of the disease, mainly detoxification measures are prescribed, and the second — dehydration.
Prognosis of two-wave viral meningoencephalitis
The prognosis for the patient’s health depends on how quickly the diagnosis was made. Of course, it is desirable to identify pathology during the manifestation of the first set of symptoms. In most cases, two-wave viral meningoencephalitis proceeds favorably and, with adequate treatment, ends with the recovery of the patient. To date, there are no cases of death or the transition of the disease to a chronic form of medicine is not known. However, it is worth noting that after the patient recovers, asthenic syndrome may bother him for some time.
Prevention of two-wave viral meningoencephalitis
Doctors recommend taking preventive measures to prevent two-wave viral meningoencephalitis. These measures are in many ways similar to preventive measures to prevent spring-summer tick-borne encephalitis. In total, there are two groups of such measures that are especially relevant for areas with a high risk of encephalitis infection: specific and non-specific.
Non-specific prevention
Non-specific measures include: eating exclusively boiled milk, regular destruction of ticks, the use of closed clothing during a stay in the forest. Once in an endemic focus during the increased activity of ticks, it is necessary to check for their presence of skin and clothing. If you find a tick, you need to remove it very carefully or remove it from the skin, then treat the bite site with iodine. Then the tick must be burned. If you are not sure that you can get rid of the tick yourself, you should consult a doctor.
Specific prevention
Specific prevention involves vaccination against tick-borne encephalitis. However, it is worth remembering that immunity begins to form only two weeks after vaccination. During this period, it is better to take care of yourself and not visit places with high tick activity. It should be remembered that the interval between vaccinations is one month. That is why when planning a trip where there is a high risk of infection with encephalitis, it is worth thinking about vaccination in advance. It is best to get vaccinated a month and a half before the trip. The next vaccination is carried out in a year and allows you to form a stable immunity. After it, the re-administration of the vaccine will need to be done in three years.
