Tick ​​bite after it has fallen off. Does the tick always stay at the bite site?

Behind medical care In Russia, more than half a million victims of tick bites are treated annually, of which 100 thousand are children.

Every year, up to 10 thousand cases of tick-borne encephalitis are registered in Russia.

The maximum peak of infection with tick-borne encephalitis occurs in spring and summer.
People who have recovered from tick-borne encephalitis develop lifelong immunity to this disease.

Often tick-borne encephalitis leaves behind unpleasant consequences. In cases of severe forms of the disease, people die or become disabled.

How does a bite and infection occur?

In most cases, a tick bite becomes invisible and is not immediately detected, since at the moment of the bite the tick releases special painkillers. The tick most often bites into places where the skin is softer and more delicate: the neck, skin behind the ears, armpits, skin under the shoulder blade, buttock area, groin, etc.

The tick bites through the skin and inserts a special harpoon-like outgrowth of the pharynx (hypostome) into the wound. A kind of harpoon is covered with teeth that hold the tick, so it is not so easy to pull it out.

In the case of tick-borne encephalitis, the virus enters the human blood through the saliva of the tick. Immediately from the moment of the bite, the virus enters the victim’s body. Therefore, even quick removal of a tick does not exclude infection with tick-borne encephalitis.

In the case of borreliosis, bacteria accumulate in gastrointestinal tract tick and begin to be released into the victim’s body at the moment when the tick begins to feed. This usually happens 4-5 hours after the bite. Therefore, timely tick removal can prevent infection.

It is worth noting that not all ixodid ticks are contagious. However, a tick infected with the tick-borne encephalitis virus retains it throughout its life.

The most common diseases transmitted through a tick bite

Disease	The causative agent of the disease	Tick ​​vector	What does it look like?
Tick-borne encephalitis	Virus from the Flavaviridae family	Ixodid ticks: I. ricinus, I. persicatus
Ixodid tick-borne borreliosis (Lyme disease)	Spirochete -Borrelia burgdoferi	Ixodid ticks: , I. persicatus (Europe, Asia) I. scapularis, I. pacificus ( North America)
Crimean hemorrhagic fever	Virus of the Nairovirus genus, Bunyavirus family	Ticks sort ofHyaloma N. marginatum H. punctata, D. marginatus, R. rossicus

Tick-borne encephalitis– infectious viral disease, transmitted through tick bites, characterized by fever and damage to the central nervous system, often leading to disability and death.

Where is tick-borne encephalitis most common?

Tick-borne encephalitis is most widespread in taiga-forest regions from Sakhalin to Karelia, countries of Eastern and Central Europe, northern China, Mongolia, Korea, the Baltic states, and Scandinavia.

Symptoms of tick-borne encephalitis

On average, symptoms of the disease appear 7-14 days (5-25 days) after infection. The onset of the disease is acute; more often the patient can indicate not only the day, but also the hour of onset of the disease.

General symptoms:

• Chills
• Feeling hot
• Pain in the eyeballs
• Photophobia
• Muscle pain
• Pain in bones, joints
• Headache
• Vomit
• Possible seizures, more common in children
• Lethargy
• Drowsiness
• Excitability (rare)
• The patient has red eyes, face, neck, and upper body.

Forms of meningitis

The disease can occur in several forms, which have some characteristics: febrile form, meningeal form, focal form.

• Feverish form develops in half of the cases of the disease (40-50%). Characterized by fever lasting 5-6 days (38-40 C and above). After the temperature drops, the condition improves, but general weakness may persist for another 2-3 weeks. In most cases, the disease ends in complete recovery.
• Meningeal form the most common form (50-60%). It is characterized by severe symptoms of general intoxication and symptoms of inflammation of the meninges. Symptoms of general intoxication: high temperature over 38 C, chills, feeling hot, sweating, headache of varying intensity. Symptoms of inflammation of the meninges: nausea, frequent vomiting, headache, decreased elasticity of neck muscles. Possible: facial asymmetry, different pupils, impaired movement of the eyeballs, etc. Recovery is slower than with the febrile form. Over the course of 3-4 weeks, symptoms such as weakness and irritability are characteristic. tearfulness, etc. The development of a chronic form of the disease is possible.
• Focal form– has the most severe course. Characterized by high temperature, severe intoxication, the appearance of impaired consciousness, delirium, hallucinations, disorientation in time and space, convulsions, impaired respiratory and cardiac activity. Most often it becomes chronic.
• Chronic form the disease develops several months or even years after the acute period of the disease. The chronic form occurs in 1-3% of patients. The disease is characterized by constant muscle twitching in the face, neck, shoulder girdle, frequent attacks of convulsions with loss of consciousness. The functions of the limbs, mainly the upper ones, decrease, their tone and tendon reflexes decrease. The psyche is disrupted to the point of dementia.

Forecast

In most cases, the disease ends in complete recovery. With focal forms, a large percentage of the person will remain disabled. The period of incapacity for work ranges from 2-3 weeks to 2-3 months, depending on the form of the disease.

Ixodid tick-borne borreliosis (Lyme disease)

This is an infectious disease transmitted through the bites of ixodid ticks, characterized by damage to the nervous system, skin, joints, heart, the disease is prone to chronicity.

How does infection occur?

Symptoms of the disease will depend on the stage of the disease. In total, 3 stages can be distinguished: 1) early stage, 2) stage of spread of infection 3) stage of chronic infection

1. Early stage

The first manifestations of the disease occur on average every 10-14 days after a bite.
Nonspecific symptoms:

• Headache
• Fatigue
• Temperature increase
• Chills
• Pain and aches in muscles and joints
• General weakness
• Symptoms of inflammation of the upper respiratory tract (sore throat, cough, etc.) are possible.

Specific symptoms:

• The appearance at the site of the bite of a special redness, usually ring-shaped, (erythema migrans), which expands to the sides over the course of several days.

In some patients, characteristic redness may be absent.

• Joint pain

Also possible: pinpoint rash, ring-shaped rash, conjunctivitis. Enlarged lymph nodes near the site of the bite.

1. Stage of infection spread(appears 2-3 weeks or 2-3 months after infection)

• Defeat nervous system: Inflammation of the nerve roots of the cranial nerves, the roots emerging from the spinal cord, which is manifested by lumbar pain, pain in the face along the nerves, etc.
• Defeat hearts: rhythm disturbance, development of myocarditis, pericarditis.
• Defeat skin: transient red rashes on the skin.
• Less commonly affected are: eyes (conjunctivitis, iritis, etc.), respiratory organs (bronchitis, tracheitis, etc.), genitourinary system (orchitis, etc.).

1. Chronic infection stage(manifestations occur 6 months or more after infection)

• Damage to the nervous system: disruption of thinking processes, memory loss, etc.
• Joint damage: joint inflammation (arthritis), chronic polyarthritis.
• Skin lesions: appearance of nodular, tumor-like elements, etc.

If the tick is removed no later than 5 hours after the bite, the development of borelliosis can be avoided. This is explained by the fact that the causative agent of the disease, Borrelia, is located in the intestines of the tick and begins to be released only when the tick actively begins to feed, and this occurs on average 5 hours after penetration into human skin.

Forecast

The prognosis for life is favorable. If started late and improperly treated, the disease becomes chronic and can lead to disability. The period of incapacity for work is from 7 to 30 days, depending on the course and form of the disease.

Crimean hemorrhagic fever

severe viral infectious disease, transmitted through tick bites, characterized by fever, intoxication and bleeding. The disease belongs to a number of dangerous infectious diseases.

Symptoms of the disease

On average, symptoms of the disease appear 3-5 days after the bite (from 2 to 14 days). Symptoms appear according to the period of the disease. In total, there are 3 periods of the course of the disease: initial, peak and recovery period.

1. Initial period (duration 3-4 days)

• Sudden rise in temperature
• Strong headache
• Pain and aches throughout the body, especially in the lumbar region
• Sharp general weakness
• Nausea, vomiting
• Lack of appetite
• Dizziness
• In severe cases, impaired consciousness

1. The peak period of the disease

• Temperature decreases for 24-36 hours, then increases again, and after 6-7 days decreases again
• The appearance of pinpoint subcutaneous hemorrhages (petechial rash) on the lateral surfaces of the abdomen, chest
• Bleeding gums
• Bloody discharge from the eyes, ears
• Nasal, gastrointestinal, uterine bleeding
• Sharp deterioration general condition
• Liver enlargement
• Lower blood pressure
• Increased heart rate
• Lethargy, confusion
• Face, neck, eyes red
• Jaundice

1. Recovery period (duration from 1-2 months to 1-2 years)

• Weakness
• Increased fatigue
• Headache
• Dizziness
• Heartache
• Redness of the eyes, mucous membranes of the mouth and throat
• Decreased blood pressure and heart rate variability (lasts for 2 weeks)

Forecast

Late hospitalization and incorrect diagnosis and treatment often lead to death. The mortality rate is 25%. The period of incapacity for work is from 7 to 30 days, depending on the form of the disease.

Diagnosis of diseases

The earliest diagnosis of the disease can be carried out only 10 days after infection. During this time, the human body accumulates required amount virus for its determination in the blood. A highly sensitive PCR method is used for diagnosis. Determination of antibodies (IgM) to the encephalitis virus is possible 2 weeks after the bite. Antibodies to Borrelia are detected only 4 weeks after the bite. Antibodies in the blood are determined using modern methods such as enzyme immunoassay, immunofluorescence assay, etc.

First aid for a tick bite

Do I need to call an ambulance?
Not really	Why?
By calling 03, they will tell you exactly, specific recommendations in accordance with your case. The departure of the ambulance team will depend on the severity of the victim. However, in any case, the victim should be consulted at the nearest trauma center or other medical facility. If the above options are not available, proceed to remove the tick yourself.	The sooner you remove the tick, the less likely it is to develop serious diseases such as encephalitis, borreliosis, etc. Proper removal mites reduces the likelihood of developing the disease and complications.

What should you not do if you are bitten by a tick?

• Remove ticks with bare hands. Through wounds on the skin, the virus secreted by the tick can easily enter the body and cause disease. You should use gloves, tweezers, a plastic bag or other available means that can protect the skin and mucous membranes.
• Do not touch your eyes and mucous membranes of your mouth and nose if you have been in contact with a tick.
• Do not drip oil, glue or other substances that cover the tick's respiratory opening, which is located in the back of its body. The lack of oxygen makes the tick aggressive, and it begins to throw out everything it has inside, including viruses and harmful microorganisms, into the victim’s body with greater force.
• Do not crush or sharply pull out a tick that has been sucked in. Pressure on the tick's digestive tract causes its saliva to be injected into the skin, thereby increasing the risk of infection. Trying to pull out a tick, you can tear it apart, then the parts remaining in the skin can become inflamed and fester. In addition, the glands and ducts remaining in the skin contain a significant concentration of the virus and can continue to infect a person.

How to remove a tick: what to do, how and why?

What to do?	How?	For what?
1.Take precautions	Do not touch the tick with bare hands. Wear gloves and use plastic bag or other available means.	The saliva secreted by a tick often contains viruses and bacteria; if it gets on damaged skin, infection can occur.
2. Remove the tick	Methods: 1.Using a special device ( Tick ​​Twister, The Tickkey, Ticked-Off , Trix Tick Lasso , Anti-mite, etc.) 2. Using thread 3. Using tweezers	The correct methods for removing a tick are based on the fact that the tick should be twisted out of the skin, and not pulled out. Because the part where the tick bites into the skin is covered with spines. The spines are directed in the opposite direction from the tick's movement. Thus, when trying to pull out a tick, there is a high probability that part of its body will remain in the skin. Rotational movements The spines are folded along the axis of rotation and the risk of tearing off the tick's head is significantly reduced.
Method using specially designed devices
Tick ​​Twister
Trix Tick Lasso
The Tickkey
Ticked-Off
Anti-mite
Method using thread Take a thin thread (sometimes you can use long strong hair) and make a loop. Place a loop over the tick and shade it at the very base. Then, holding the ends of the thread, pulling it a little, slowly and carefully begin to rotate clockwise or counterclockwise. After making a few rotations, the tick is freely removed.
Method using tweezers Use tweezers to carefully grasp the head of the tick, so as not to put pressure on its abdomen. Then you begin to turn the tick, as if you were twisting it, but do not pull or yank too much.
3. Remove the remains of the tick from the wound (if it was not possible to remove it entirely)	Disinfect the needle (with an alcohol solution or hydrogen peroxide), or better yet, sterilize it by holding it over a flame. Then carefully remove the remains.	The development of an inflammatory process and suppuration is possible. Additionally, remaining glands and ducts inside the skin may contain viruses and continue to infect the body.
4. Treat the bite site	You can use any antiseptic: alcohol, iodine, brilliant green, hydrogen peroxide, etc.	Prevents inflammation and suppuration of the wound. Hydrogen peroxide can also help in removing mite residues, if any.
5. Vaccine administration	Tick-borne encephalitis: Administration of immunoglobulin for the first time 3 days after the bite. Inject intramuscularly 0.1 ml per 1 kg of weight. Administration of an antiviral drug (yodantipyrine for adults, anaferon for children). Yodantipyrine – 2 tablets. within 2 days.	Immunoglobulin against tick-borne encephalitis: high cost, frequent allergic reactions, low effectiveness, not produced in European countries. Yodantipyrine - the drug is well tolerated, has low toxicity, and is effective against the tick-borne encephalitis virus. It is prescribed for both prevention and treatment.
6. Send the tick for analysis	Place the removed tick in an airtight container.	This will help determine the tactics of further treatment. Will save you from unwanted complications.

Preventing tick bites

Before visiting potentially dangerous places, be well prepared and be careful.

• Reduce the number of unprotected exposed areas of the body to a minimum. Clothing should have long sleeves that fit snugly at the wrist. Wear a hat. Tuck your trousers into high boots.
• To repel ticks, you can use special repellents (DEFI-Taiga, Gall-RET, Biban, etc.). For children Od “Ftalar” and “Efkalat” “Off-children”, etc. However, their effectiveness is very controversial.
• When moving through the forest, stay in the middle of the paths, avoiding tall grass and bushes.
• After leaving the potentially dangerous area, be sure to examine yourself and your loved ones. Once on the body, the tick does not immediately dig into the skin. It may take several hours for the bite to occur. Therefore, in many cases the bite can be avoided.
• You should not bring recently picked grass, branches, or outer clothing that could potentially contain ticks into the room.
• To prevent tick-borne encephalitis, it is necessary to be vaccinated. Vaccination of 3 vaccinations, followed by repetition after 4, 6 and 12 months. Or the introduction of immunoglobulin several hours before entering danger zone. When you are in places associated with possible tick bites, it is recommended to take 1 tablet. (200 mg) iodantipyrine.
• When going to an area where ticks are found, be as “armed” as possible, take all the necessary things that you will need in case of a tick bite. Necessary equipment: a device for removing a tick, a disinfectant (iodine, alcohol, etc.), an antiviral drug (Yodantipyrin), a container for transporting the tick for analysis. There are special kits on sale: “Anti-mite module”, “mini-anti-mite module”, etc., which include everything that is necessary for “anti-mite activity”.

The size of the tick's abdomen, not exceeding 2–4 mm, looks negligibly small in relation to any part of the human body

It is impossible to feel the moment of penetration of the arachnid, since it anesthetizes the bite site with saliva, with the help of which it is fixed in the wound.

Local complications after a tick bite

A bite is detected by a person immediately if visible complications arise. Otherwise, it may remain undetected for a long time. Local reactions can be controlled with medications.

Common reaction to inflammation: symptoms, treatment

As the wound heals, the discomfort disappears on its own. Normally, after 2–4 days, the pain dulls and the swelling subsides. All that remains is a red or purple infiltrate directly around the wound, which fades gradually until it disappears completely. The itching becomes unobtrusive. This is a sign of a decrease in the inflammatory response and restoration of affected tissues. The bite site itself becomes covered with a fibrin crust, which disappears by the end of the second week.

Allergy

Local allergy develops within 2–3 hours after the bite. A dark purple or bluish colored seal with a diameter of over a centimeter appears around the tick. The lesion is painful. Some victims report a feeling of “bloating,” pulsation, and severe itching.

With a local allergic reaction, a compacted area of ​​bright red or purple color forms around the bite site

With an extensive skin reaction, a rash appears on the body - allergic urticaria. It is eliminated with the help of antihistamines (Suprastin, Diazolin, Loratadine).

Allergic urticaria due to an allergy to a tick bite can cover both the entire body and part of it

If you are allergic to a tick bite, you need to select medications together with your doctor. But if it is not possible to get an appointment immediately, you should take any antihistamine that is in the medicine cabinet.

Possible complications and their manifestations

If a tick has infected a person with Lyme disease, the wound will not heal well. A ring erythema forms around it, which looks like diverging circles. The first symptoms of the pathology appear 7–14 days after contact with the tick.

If a tick has infected a person with the virus of tick-borne encephalitis, anaplasmosis, ehrlichiosis or tick-borne typhus, the local reaction will not have any visible features. Only inflammation of the lymph nodes close to the site can be alarming (for example, if the bite is located behind the ear, the cervical ones are affected, if on the shoulder, the axillary ones, and on inner surface thighs - inguinal). In this way, the immune system tries to contain the spread of dangerous viruses throughout the body.

Normally, lymph nodes are never palpable.

Treatment of the bite site

The bite site is treated with something after removing the tick from the skin. If this happens in nature or at home, use any product containing alcohol, hydrogen peroxide, brilliant green or iodine. It is also permissible to wash the wound with an antibiotic that is on hand. First, the tablet must be crushed and mixed with boiled water. If you have an ointment containing an antibiotic (for example, tetracycline, erythromycin), treat the bite site itself and the skin around it. As a last resort, use vodka, perfume, eau de toilette.

You need to wipe the source starting from the wound and then around it. This reduces the risk of additional infection from bacteria on the skin.

During treatment, everything that comes into contact with the wound must be disinfected. It is advisable to remove the tick and carry out initial treatment not independently, but in a medical facility.

Under no circumstances should you use ointments containing warming ingredients: pepper extracts, snake and bee venoms, mustard, tar. Such remedies will increase inflammation, making pain and itching unbearable. You should not use regular cosmetic creams on your face and body skin, as they do not provide any benefit.

Means that can be used to treat a tick bite - photo gallery

How long does it take for a tick bite wound to heal?

On average, the wound afterThe bite heals in 1–2 weeks. If this does not happen, think about possible reasons and complications:

The tick was removed in such a way that the head remained in the thickness of the skin. Long-term inflammation is inevitable. The need for surgical cleaning cannot be ruled out.

Complication of secondary infection. This is typical for children and adults who scratch a healing wound and introduce bacteria into it (staphylococci, E. coli, pathogenic fungi, etc.). In case of itching, you need to carefully treat the bite site with antiseptics (alcohol tinctures, iodine, etc.) and ointments that eliminate itching.

Weak immunity. If wounds heal poorly, bites are no exception. This is typical for people with severe chronic diseases (diabetes mellitus, bronchial asthma, decreased activity of the adrenal glands and thyroid gland, dermatological pathologies, a tendency to allergies). Additional medical consultation is needed to prescribe immunostimulating or antibiotic therapy.

10 important facts about tick bites - video

Encephalitis tick in nature

Growth and development require constant blood supply. If the male, having quickly satiated, leaves the body of the “master” himself, then the female, preparing for childbirth, can suck blood for up to a week and a half. Its size gradually increases. But even a short-term bite is enough for the PNA-containing pathogen found in the bloodsucker’s saliva to cause a serious illness.

Tick ​​bite (encephalitis): why is it dangerous?

The “biting” organ of the tick is called the hypostome. It looks like a proboscis with teeth, which, like a gimlet, is screwed into the body, holding it there long time. That is why the tick should not be pulled out, but rather twisted. The bite of an encephalitis tick is dangerous because it can be transmitted to humans along with saliva, which has an anesthetic effect, dangerous virus. It is saliva that makes piercing the skin with the proboscis painless. Infection can also occur when an animal is crushed. Then the virus penetrates through cuts, cracks, and wounds on the skin. Encephalitis transmitted by ticks is considered one of the most dangerous diseases.

Precautionary Reminder

Tick-borne encephalitis: symptoms of the disease

There are a number of other diseases that a tick can give a person:

• encephalitis;
• borreliosis;
• spotted fevers;
• hemorrhagic fever , etc.

Important! Encephalitis is characterized by specific focality (area of ​​distribution of ticks) and seasonality (months of the greatest aggressiveness of bloodsuckers and the time of breeding).

By itself, an infected tick found on the body cannot necessarily infect a person. If the body is removed, it is better to take a blood test to confirm (refute) the disease (borreliosis, encephalitis) one and a half weeks after removing the tick from the wound. If symptoms of encephalitis immediately appear after a tick bite in a person, then you should immediately go to medical institution. Points that should cause concern and a reason to visit an infectious disease specialist:

• redness at the site of the tick’s “invasion” into the body and the appearance of a bubble on it;
• sudden chills with a sharp rise in body temperature to 39 – 40°C,
• rash on the body;
• headache, weakness;
• aching bones;
• photophobia;
• eating disorder accompanied by nausea or vomiting,
• change internal organs: the spleen and liver increase in size;
• the skin and sclera acquire a yellowish tint.

This condition lasts for about a week in the patient. During this time, at the site of the bite, the virus actively multiplies in the cells that form blood vessels. It penetrates the blood and lymph nodes. In some patients, the central nervous system is affected. Meningeal manifestations are observed on the 4-5th day of illness: paralysis of the muscles of the chest, neck, upper body. There may be loss of consciousness and epileptic seizures. Signs of meningitis that appear in the first week of illness disappear completely or partially.

Then follows a decline in the disease, an imaginary improvement in health. Over time, the symptoms repeat. There may be several such attacks (more than 10). Since the signs of encephalitis after a tick bite are very similar to a severe cold, only a blood test will give a 100% diagnosis.

Map “Endemic territories for tick-borne encephalitis”

The more advanced the disease, the more difficult the treatment. It must be carried out in a hospital under the supervision of doctors. The time interval from the time the infection enters the human body to the first signs of illness in the case of encephalitis infection can range from 2 days to three weeks.

Reference. There is an asymptomatic development of infection. It is characterized by the fact that a person feels completely healthy due to the body producing antibodies to the virus. Only tests can indicate infection. The body itself develops a strong immunity to encephalitis (tick-borne).

Don't neglect prevention

It is easier to prevent a disease than to treat an illness. This needs to be done before going into the forest. It is known that May, June, early July, and then September and up to November are considered the most likely period to “catch” bloodsuckers. Therefore, tick-borne encephalitis is also called “spring-summer”. Equipment should conceal as much as possible open areas bodies. Considering that ticks like to live where the skin is most delicate (armpits, neck, groin, head, etc.), overalls are preferred for clothing. For shoes - high boots. On your head - a scarf or thick hat. It is also better to hide your hands in gloves. It is better to arrange a resting place in a sunny meadow, away from thickets of tall grass, bushes, trees and from water. It is necessary to conduct regular examinations of the body and clothing.

Tick ​​removal products will help you carry out the procedure correctly

Although the risk of infection will be much reduced, vaccination against encephalitis ticks is also necessary for prevention purposes. Moreover, it is done three times: in October, March and a year later. Subsequent vaccinations are carried out every three years. Vaccinations are also given to children, but only after consultation with a pediatrician.

Do not neglect preventive measures and vaccination. The oxide encephalitis mite is extremely dangerous - the consequences of the bite can last a lifetime. The price of health cannot be compared with the cost of the same not too cheap vaccine. Sometimes a microscopic mite can cause big trouble. And in some cases, its bite takes a person’s life.

For example, the photo below shows what a taiga tick bite looks like on human skin:

And here is a midge bite:

As you can see, by appearance bite marks in in this case not much different.

However, taking into account individual details in the appearance of tick bites on the human body makes it possible to distinguish them with a certain accuracy from the bites of other arthropods. Knowledge of the biology of ixodid ticks, including the specifics of their attacks on animals and people, also helps to distinguish between bites.

What does a tick bite look like in most cases?

The wound caused by a puncture of the skin is covered with a crust within an hour after the tick detaches, while some swelling and redness remain.

On a note

In ordinary cases, the next day the bite site no longer itches, after 2-3 days the swelling and redness subside, and after a few more days the crust at the site of the wound peels off.

After about 10-12 days, no trace remains at the site of the tick bite.

This happens normally when infection does not occur in the bite wound and the inflammatory process does not develop, and the wound itself is not disturbed, scratched or the protective crust on it is not damaged. However, often due to various undesirable factors the situation can become complicated, which is accompanied by the appearance of additional unpleasant symptoms.

Besides:

If the lump is lubricated with pain-relieving ointment in time and not disturbed, it gradually decreases in size and completely subsides after 4-5 days.

A more dangerous situation is when, when a tick is pulled out, its body is torn off from the head (gnathosoma), as a result of which the mouthparts remain in the wound. Removing them from here is not always easy, since they are difficult to grab even with tweezers or tweezers from a manicure set - the gnathosoma of the tick is deeply embedded in the skin, and rupture of its body usually occurs deeper level the very surface of the skin.

If the detached head of the tick is not removed like a splinter, on the second or third day the tissue at the site of the bite will begin to tear, an abscess will form here, from which the remains of the tick will subsequently come out along with the oozing pus.

A painful abscess with swelling often forms. From the moment the tick comes off until the abscess ruptures and pus flows out of it, on average, 3-4 days pass; the abscess site will heal for several more days.

The picture below shows the sequence of correct twisting of the tick:

And here are photographs with examples of tick removal using various tick removers:

On a note

In all cases, ixodid ticks bite only to suck blood. They never attack a person in self-defense.

Besides:

On a note

The exception to the latter rule is the bite of the Australian paralysis tick Ixodes holocyclus. Its individuals, at all stages of their development, secrete a toxin in their saliva, leading to paralysis of the limbs in animals and people, as well as symptoms similar to those of polio (even death is possible). The first signs of paralysis after bites of these ticks appear within 6-7 hours. The species Ixodes holocyclus lives only in Australia, and in Eurasia such situations are excluded.

Photo of Ixodes holocyclus paralysis tick:

Another important sign: ticks never bite through clothing, even very thin ones.(through tights, for example). Mosquitoes, midges, horseflies, spiders can bite through thin fabrics, wasps and bees can sting, but ticks never stick to the skin through clothing.

At the same time, under loose clothing - under wide pants, shirts, T-shirts, behind the head under a hat - a tick may well bite.

Differences between a tick bite and the bites of various insects

We have already mentioned the first important difference earlier: at the site of the tick bite there remains a red spot and a clearly visible wound, which gradually becomes covered with a crust. This is different from mosquito bites, in the place of which only an itchy swelling remains, but without visible place insertion of the proboscis.

Compared to the bites of most stinging insects, spiders and centipedes, tick bites are completely painless. Even mosquitoes that inject anesthetic substances into the wound do not do it so “skillfully”, and their injection immediately attracts attention with mild pain.

Tick ​​bites differ from bed bug bites (and to some extent fleas) in that they are not collected in “paths” of 2-3 wounds. Each bug bites several times in one attack, moving 1-2 centimeters between bites, and as a result, characteristic “chains” of reddened bumps remain on the human body. The tick bites only once, after which it falls away from the body, and therefore leaves only one trace of a skin puncture on the skin.

On a note

It is quite easy to distinguish a tick bite from the bite of a scolopendra, tarantula or small poisonous snake: these animals leave two points at once at the skin puncture sites. Scolopendras bite with two clearly visible jaws, spiders with two chelicerae, and snakes with two teeth. Consequently, there will be two clearly visible points at the sites of their bites. The tick pierces the skin with a saw-toothed hypostome in only one place.

By the shape of the wound itself, a tick bite can be distinguished from a leech bite. After sucking on a leech, due to its characteristic structure oral apparatus the wound looks like a small even cross. In a tick, it simply looks like a dot. After the leech falls off, the wound continues to bleed for a very long time, which does not happen after tick bites.

But it is impossible to judge whether a person is infected with the tick-borne encephalitis virus by the appearance of the bite - it does not appear outwardly.

The opposite situations happen very rarely - they can arise, for example, during a multi-day hunting or fishing trip, on hiking trips, that is, during a long stay in the wild without the opportunity to undress, wash and examine the body. Here the tick can suck blood from a person under clothing for several days, after which it detaches.

1. Get caught on the victim’s clothing or fur;
2. Get to a place convenient for blood sucking;
3. Pierce the skin and attach to the wound;
4. Suck blood;
5. Detach and leave the host's body.

It is important to understand that there are almost never situations in which a tick bites, but does not have time to attach itself and crawls away.

Then, from 2-3 minutes to an hour, the tick moves around the host’s body and looks for well-supplied areas with thin skin. Then the bite occurs:

The photo below shows the proboscis (hypostome) of a tick:

And this is what a hypostome looks like under a scanning electron microscope:

Representatives different types ticks and individuals on different stages They tend to choose different places on the body of the host for attachment. On the human body, these are most often the armpit areas, and then, in descending order of frequency of attachment, the following areas follow:

• Breast;
• Stomach;
• Hands (including between fingers);
• Buttocks and perianal area;
• Legs;
• Neck and head (especially the area behind the ears).

The photo below shows a tick attached to a child’s ear:

It is noteworthy that in children, ticks are more often than in adults attached to the head (including in the hair, often behind the ear) and sometimes even on the face - on the cheeks, on the chin.

This is interesting

The photos below show female ticks engorged with blood:

Therefore, by the way, during one feeding each tick sucks out more blood and other liquids than it weighs at the time of detachment. Within a few days of feeding on the host, most of the food consumed has time to be digested and spent on development and growth, and undigested components are excreted in excrement. As a result, female ticks, weighing 7-10 mg before feeding, absorb about 5500-8500 mg of food during attachment, but weigh only 900-1400 mg after falling off.

This is interesting

Almost no environmental factors can force an unsatiated tick to detach from its host. The fact is that the very fact of getting onto the host’s body and attaching to it is a vital necessity for each individual individual. Thus, one female lays several thousand eggs, and not all of them are fertilized and only a portion hatch into larvae.

Of several thousand larvae, only a few will be able to find the first host, and all the rest will die either from hunger or from predators. Likewise, of the several thousand larvae that have molted into the first instar nymph, only a few will be able to feed on the next host. As a result, for every adult tick that attaches itself to a person or animal, there are millions of its dead counterparts who did not manage to do so. Therefore, it is biologically conditioned that if a tick has attached itself, it will detach itself only after saturation, and it is impossible to force it to do this earlier. He would rather die than miss the chance to be satiated to the end.

It is for this reason that methods of removing attached ticks using hot matches, oil or repellents are ineffective. Even if burned or suffocated by a drop of oil, the tick will not let go of its victim.

It is interesting that if in nymphs of all ages, larvae and adult males, nutrition promotes general development body, then in adult females, when feeding, the reproductive system first fully matures, and after fertilization, degradation of the digestive system begins with the parallel development of a large number of eggs. In fact, after complete saturation and development, the adult female is a living egg sac, practically incapable of further life. She can still move a short distance to find shelter on the ground, but here, after laying eggs, all that remains of her is actually the mouthparts and the shell of the idiosome.

Adult males also do not live long after feeding, but their lives are a little more eventful. They actively search for females, fertilize them, and can feed them several times. However, engorged adult males no longer survive the change of seasons and do not live to see the next year.

Possible consequences of an Ixodid tick attack

Tick ​​bites can lead to consequences that vary both in their external manifestations and in the danger to the health and life of the victim.

If we talk about bites in humans, these consequences include:

• A normal temporary reaction to a bite is redness and slight itching after the tick detaches;
• Inflammation and suppuration of the wound, in which there was an accidental infection or the head of the tick remained after its removal;
• An allergic reaction, usually limited to swelling, spreading redness over the skin and a rash around the bite site. Anaphylaxis in response to bites and ticks has not been documented;
• Infection with dangerous tick-borne infections. In Russia and neighboring countries, such infections include the tick-borne encephalitis virus and Lyme disease (borreliosis); in other countries, ticks can carry the pathogens of spotted fever and Q fever.

Of the two most common in Eurasia tick-borne infections Encephalitis is considered much more dangerous than borreliosis, since there is no specific effective treatment against TBE. Borreliosis, with timely diagnosis, can be treated quickly and effectively with available antibiotics.

Moreover, even in the most dangerous areas for tick-borne encephalitis, the frequency of infection with this disease does not exceed 0.24% of the total number of bites. That is, out of 10,000 tick bites, only 24 of those bitten develop tick-borne encephalitis.

Is it possible to understand from the appearance of the bite that an infection has occurred?

It is impossible to determine by the appearance of the tick, just as it is impossible to determine from the bite itself whether transmission of the pathogen has occurred. Directly after a bite and immediately after it, tick-borne infections do not manifest themselves in any way, therefore, they do not affect the appearance of the wound in any way.

On a note

As noted above, after a few days annular migratory erythema may appear, which is a sign of infection with borreliosis.

The first symptoms of encephalitis and borreliosis develop on average after 2-3 weeks, but sometimes it can be different. Thus, borreliosis sometimes manifests itself within 4-5 days after the bite, and in other cases the development of infection is delayed for several weeks. Therefore, a person who has been bitten needs to remember about the bite itself, so that when the first signs of illness appear, immediately consult a doctor.

A few more photos

A tick has attached itself to a child's ear:

And this photo shows signs of an allergy to a tick bite:

Removing a tick with a thread:

What to do next

In most cases, treating a bite with antiseptics is sufficient for first aid to the bitten person. If the bite occurred in a region epidemiologically dangerous for tick-borne encephalitis, it is highly advisable to save the tick for analysis, as this will help to find out whether there is a risk of infection after the incident.

To do this you need:

On a note

As for pets, the incubation period for piroplasmosis is on average 1-2 weeks, and if at this time the pet shows signs of illness, it should be immediately taken to the veterinarian.

There is no need to take any medications on your own or start any treatment after a tick bite. None of the tick-borne infections can be treated at home. Only doctors prescribe and carry out such treatment.

Interesting video: what a tick bite can lead to

Visual testing of anti-tick products

Summer is already over, and the mushroom picking season is in full swing. This is the most dangerous time for mushroom pickers, since ticks are waiting for them in the forest. But if you are afraid of ticks, do not go into the forest.

The knowledge that a tick bite can be dangerous forces some mushroom pickers to use certain protective measures. Doctors advise protecting yourself by wearing long sleeves, tucking your pants into your socks, be sure to wear a hat, and use repellents that should be applied to clothing and exposed areas of the body.

But there are people who experience panic fear of “being bitten by a tick” and fear of getting sick. Fear of ticks, or fear of tick bites, is scientifically called acarophobia (Latin acarus - tick, Greek phobos - fear). This is one of the varieties of insectophobia - obsessive fear, fear of insects.

For many people, a tick bite leads to significant stress and panic. As practice shows, this fear is often based on false or incomplete information. It is fueled by articles with loud headlines: “Ticks are attacking again...”, etc. Lack of information also leads to panic. Moreover, among residents of large cities, acarophobia occurs much more often than among residents of rural areas. Strange, but the fear of “being bitten” does not lead to these people using preventive measures- for example, application available funds protection. Such people are most often afraid to travel to the countryside, walk in the park, or walk on the lawn or grass. In some cases, they may need psychological help to solve this problem.

Below are photos of different mites. There is no need to be afraid of them; What is needed here is not fear, but reasonable fears and correct preventive measures.

What are Ixodid ticks?

Ixodes scapularis

During the development process, the ixodid tick goes through the following stages: egg → larva → nymph → adult tick.

The larva hatches from the egg. She has 6 legs. After she drinks blood, molting occurs and the larva turns into a nymph. The nymph already has 8 legs. The nymph sucks blood, molts and turns into an adult tick.

Typically, larvae and nymphs feed on small animals, but sometimes they can attack people. Adult ticks feed on blood and attack both large animals and people. The female tick lays eggs only after drinking blood. She is capable of drinking a volume of blood that is more than 100 times her weight. Therefore, the female stays on the victim’s body longer than the male. The tick can remain on the body for several days. After the tick has drunk blood, it removes the proboscis from the body and falls off. Having laid eggs, the female tick dies.

Behind life cycle The tick feeds several times on different hosts. At the same time, he can become infected with pathogens of various diseases and transmit them during the next feeding. Most ticks feed on a new host each subsequent time. Some species of ticks go through the first phases of their life cycle or the entire life cycle without changing their host on one animal.

Ticks do not jump or fly. In order for a tick to get on the body, you need to walk in close proximity to it. Ticks wait for their victims sitting on the ground or grass, with their front paws outstretched, on which there are special sensory organs that respond to heat and smell. When a potential victim passes by, the tick grabs it with its front paws.

Once on the body, the tick does not bite immediately. It may take several hours for a tick to attach itself. If the tick is noticed in time, the bite can be avoided.

Having chosen the site of the bite, the tick bites through the skin with chelicerae and inserts a hypostome (a special outgrowth of the pharynx similar to a harpoon) into the wound. The hypostome is covered with chitinous denticles that hold the tick. Therefore, the tick is difficult to remove.

Few people are able to feel the moment of a tick bite, since the tick numbs the bite site well. With saliva, the tick injects various substances that prevent blood clotting and increase blood flow.

What are the dangers of a tick bite?

Tick ​​activity begins at the end of April and ends with the onset of frost. The peak of activity occurs in May-June, but tick bites are possible from April to October. When the soil warms up to 5-7 degrees, the first victims of bites begin to seek help.

Ixodid ticks transmit diseases to humans and animals: tick-borne encephalitis, borreliosis, ehrlichiosis and many others.

Undoubtedly, The best way prevention of these infections - protection against tick bites.

It should be remembered that ticks live not only in forests, but also in parks and on garden plots. There can also be ticks in cities: on lawns, in the grass along roadsides. Ticks sit on the ground, on grass or not tall bushes. Ticks can be brought home by animals; on branches, on country or forest flower bouquets, brooms or grass; on the clothes you wore while walking in the forest. At home, a tick can bite any family member, even several days later.

Bitten by a tick: what to do?

What should I do if bitten by a tick?
You returned from the forest and found a tick embedded in your body. What to do? There is no need to panic - taking the right measures in time will help prevent possible negative consequences.

1. Remove the tick.

If tick suction does occur, an initial consultation can always be obtained by calling 03 (in Minsk - 103).

A person who has suffered from a tick bite must seek medical help from the territorial clinic at his place of residence, the regional SES or the regional emergency room to remove the tick and deliver it for examination, as well as to organize medical observation, in order to make a timely diagnosis of tick-borne infection and resolve the question of prescribing preventive treatment.

How to remove a tick yourself?

There are several ways to remove ticks. They differ only in the tool used to remove the tick.

It is most convenient to remove a tick with curved tweezers or a surgical clamp; in principle, any other tweezers will do. In this case, the tick must be grabbed as close to the proboscis as possible, then it is carefully pulled up, while rotating around its axis in a convenient direction. Usually, after 1-3 turns, the entire tick is removed along with the proboscis. If you try to pull the tick out, there is a high probability of it breaking.

There are special hooks for removing ticks on sale. This hook looks like a curved two-pronged fork. The plier is inserted between the teeth and also unscrewed.

To remove ticks, there are special devices that have advantages over clamps or tweezers, since the body of the tick is not compressed, which prevents the contents of the tick from being squeezed into the wound, and reduces the risk of contracting tick-borne infections. Typically, such devices can be purchased at pharmacies.

If you have neither tweezers nor special devices for removing ticks at hand, then the tick can be removed using a thread.

A strong thread is tied into a knot as close as possible to the tick's proboscis, then the tick is removed, slowly shaking it to the sides and pulling it up. Sudden movements are not allowed.

If you don’t have tweezers or thread at hand, you should grab the tick with your fingers (it’s better to wrap your fingers in a clean bandage) as close to the skin as possible. Pull the tick slightly and rotate it around its axis. There is no need to crush the tick with your hands. After removing a tick, be sure to wash your hands. The wound must be treated at home with an antiseptic.

Removing a tick must be done with care, without squeezing its body, since this may squeeze the contents of the tick along with pathogens into the wound. It is important not to tear the tick when removing it - the remaining part in the skin can cause inflammation and suppuration. It is worth considering that when the head of the tick is torn off, the infection process can continue, since a significant concentration of the tick-borne encephalitis virus is present in the salivary glands and ducts.

If, when removing the tick, its head, which looks like a black dot, comes off, wipe the suction site with cotton wool or a bandage moistened with alcohol, and then remove the head with a sterile needle (previously calcined in a fire) in the same way as you remove an ordinary splinter.

There is no basis for some far-fetched advice that for better removal one should apply ointment dressings to the attached tick or use oil solutions. The oil can clog the tick's breathing holes, and the tick will die while remaining in the skin. Dripping oil, kerosene onto the tick, or burning the tick is pointless and dangerous. The tick's respiratory organs will become clogged, and the tick will regurgitate the contents, increasing the risk of infection.

After removing the tick, the skin at the site of its attachment is treated with tincture of iodine or alcohol, or another available skin antiseptic. A bandage is usually not required. Subsequently, the wound is treated with iodine until healing. There is no need to pour in a lot of iodine, as it can burn the skin. If everything is normal, the wound will heal within a week.

Hands and tools should be thoroughly washed after removing the tick.

When removing a tick you do not need to:

Apply caustic liquids to the bite site ( ammonia, gasoline, etc.).
- burn a tick with a cigarette.
- jerk the tick sharply - it will break off
- picking at the wound with a dirty needle
- apply various compresses to the bite site
- crush the tick with your fingers

2. If possible, check the health of the tick.

What are the dangers of a tick bite?

Ticks can be the source of a fairly wide range of diseases.

The removed tick can be destroyed, but it is better to leave it for laboratory testing for the presence of tick-borne infections. Within two days, the tick must be taken to the laboratory to be tested for infection with borreliosis, encephalitis and, if possible, other infections. Usually the analysis can be done in an infectious diseases hospital or a special laboratory.

Unfortunately, you cannot judge whether a tick is encephalitic or not by its appearance. The tick becomes infected when feeding on an infected animal. The virus can be contained in females, males, nymphs, and larvae. Percent encephalitis ticks small and different different regions, so most people who are bitten do not develop encephalitis.

Some centers agree to take only whole ticks for analysis. The answer is given in a few hours, or in a maximum of two days.

The tick should be placed in a small glass jar along with a piece of cotton wool or a napkin lightly moistened with water. Be sure to close the jar with a tight lid and store in the refrigerator.

For microscopic diagnosis, the tick must be delivered to the laboratory alive. Even individual tick fragments are suitable for PCR diagnostics. However, the latter method is not widespread even in large cities.

Even if the tick bite was short-lived, the risk of contracting tick-borne infections cannot be ruled out.

However, it should be understood that the presence of an infection in a tick does not mean that a person will get sick. A tick analysis is needed for peace of mind in case of a negative result and vigilance in case of a positive result.

If the test result is positive, there is no need to panic: firstly, even when infected, the disease does not always develop, and secondly, in most cases it ends in recovery.
If the test results are borderline or questionable, it is better to re-test in 1-2 weeks.

It is advisable that a person who has suffered from a tick bite be observed by an infectious disease specialist for a month, who, if necessary, will prescribe the necessary preventive or treatment measures. If more than 2 months have passed since the tick bite, there is no need to worry.

3. Calm ourselves down, dispel late doubts.

The surest way to determine the presence of the disease is to take a blood test. There is no point in donating blood immediately after a tick bite, since tests will not show anything. At least 10 days must pass, then the blood can be tested for tick-borne encephalitis and borreliosis using the PCR method. To test for antibodies (IgM) to the tick-borne encephalitis virus, blood should be donated two weeks after a tick bite, to test for antibodies (IgM) to Borrelia (tick-borne borreliosis) - three weeks after the bite. If the test result is positive, you should contact an infectious disease specialist.

After the tick is removed it is necessary:
- take pills according to the regimen prescribed by your doctor (if prescribed). If no infectious agents were found during tick examination, prevention continues according to the prescribed regimen.
- monitor your health and temperature
- observe the site of the bite.

If redness appears at the site of the bite, fever, headache, dizziness, vomiting, pain in the muscles of the torso and limbs, you should consult an infectious disease doctor. Redness can be both a symptom of borreliosis and an allergic reaction to a bite - slight redness around the wound in the first days after a tick bite is usually a reaction to the bite and goes away without consequences. If dirt gets into the wound, then redness may be a consequence of the development of a purulent infection.

In most patients, symptoms appear in the second week after the bite, but they may appear earlier or later (tick-borne encephalitis up to 21 days, borreliosis up to a month). If 21 days have passed since the bite, tick-borne encephalitis will no longer develop. For tick-borne borreliosis, the incubation period can be up to a month. The appearance of any of these symptoms does not mean that a disease associated with a tick bite has developed, but it is imperative to consult an infectious disease specialist.

Tick-borne encephalitis is a very dangerous tick-borne infection. Emergency prevention of tick-borne encephalitis should be carried out as early as possible, preferably on the first day. It is carried out using antiviral drugs or immunoglobulin. A doctor should prescribe such prevention.

When an encephalitis tick bites, the virus enters the bloodstream with saliva. IN further events may develop differently. If the bitten person has been vaccinated and the level of antibodies is sufficient, the virus immediately binds and the disease does not develop. The development of viral encephalitis can be stopped by other antiviral defense factors, such as the interferon system. Therefore, even if the tick was encephalitic, the person bitten may not get sick. The presence of a virus in a tick does not mean that the disease will develop. The number of people bitten by encephalitis ticks significantly exceeds the number of people sick with tick-borne encephalitis. But even one bite can lead to serious illness.

The best protection against encephalitis ticks is proper clothing, repellents and vaccination.

Tick-borne borreliosis is a dangerous and most common disease transmitted by ticks. Emergency prevention of tick-borne borreliosis is usually not carried out.

To treat borreliosis, a course of powerful antibiotics is usually prescribed. For example, I was prescribed doxycycline (one of the names is Unidox Solutab) according to the regimen of 200 mg (2 capsules or tablets) at the first dose, then one tablet (100 mg) in the morning and one tablet in the evening (100 mg) for 5 days. Remember that this is a very serious dosage and only a doctor can prescribe it. There is no need to self-medicate; if in doubt, consult a doctor!

You should not focus too much on the bite and listen to your body. There are people who, having noticed a tick bite, immediately find all the symptoms. It's like the joke:
Announcement at the clinic: “Patients waiting in line for an appointment are asked not to share the symptoms of their illnesses, as this greatly complicates the diagnosis.”

At the same time, we must remember that the bite took place, and if your health worsens, immediately consult a doctor. The doctor will examine the patient, collect anamnesis and, based on it, issue a conclusion on what should be done next. The doctor’s prescriptions depend on many factors, for example: intolerance to antibiotics, pregnancy, the area of ​​activity of the victim and his age; the area in which the tick was found, the time the tick spent on the human body, etc.

Prevention.

The best way to prevent tick-borne infections is to protect yourself from tick bites.

Tick ​​protection:
- Repellents.
- Vaccination.
- Fighting ticks in garden plots.

When visiting places where there may be ticks, it is better to wear closed shoes (boots, boots, sneakers)

Before going into the forest, try to protect your body, especially your neck, arms, and legs, from tick attacks. Wear clothing that protects your skin as much as possible from contact with ticks. Button up your sleeves and tuck your pants into your socks or shoes. It is best to wear long trousers, with drawstrings on the legs, or you can tuck the trouser legs into socks so that the tick cannot crawl under the trousers. The jacket should have drawstrings on the sleeves. There are special suits made of thick fabric and equipped with drawstrings that reliably protect against ticks (especially when correct use repellents).

In pharmacies, hardware and large stores, and gas stations, you can usually buy various repellents that repel insects (mosquitoes, midges, horse flies) and ticks. They are applied to the skin and washed off after visiting the forest. The protection time, method of application and contraindications are indicated on the packaging.

To protect against ticks, clothing is treated with preparations containing acaricides (substances that kill ticks). Such drugs protect against ticks for a week or more. After contact with clothing treated with an anti-tick preparation, the tick dies within a few minutes. Typically, such drugs should not be applied to the skin.

Use tick repellents according to the instructions for use.

In the forest, inspect yourself and your children every two hours, especially the areas of the thinnest skin where the tick prefers to attach itself. The tick takes a long time to find a place to bite, so inspect your clothes and body regularly. On clothes light colors It's easier to see the tick. Conduct self- and mutual examinations of the skin. The size of a tick that is not engorged with blood is 1-3 mm, and that of a tick that is engorged is up to 1 cm.

Do not walk on paths under low bushes, through bushes, or through tall grass.

When you return from the forest or park, take off your clothes and examine them carefully - ticks may be in folds and seams. Carefully inspect the entire body - the tick can attach itself anywhere. A shower will wash away any unattached ticks.

Check pets after walks and do not let them lie down on the bed. Dogs, cats and any other animals can bring ticks home.

Remember: you should not crush detected ticks with your hands, as you may become infected.

If you frequently visit tick habitats, it is advisable to get vaccinated against tick-borne encephalitis. The vaccine protects for at least 3 years.

To reduce the number of ticks in your garden plot, carry out timely cleaning of the plot area and the surrounding area - remove dead wood and dead wood, cut down unnecessary bushes, mow the grass. Sowing plant antagonists such as thyme and sage is very useful.

Laboratories where you can test ticks for infections in Minsk:

Minsk City Center for Hygiene and Epidemiology

address: st. P. Brovki, 13, laboratory building of the State Institution MGTSGE, room 101 "Reception of tests."

Center for Clinical Microbiology and Immunology

address: Minsk, st. Filimonova, 23

In other cities, contact the district clinic, SES, emergency room, or call 03 (or 103).

When preparing the material, open Internet sources, materials and photographs from the sites ixodes, ru and encephalitis, ru were used

Attention! This article is for informational purposes only and cannot serve as material for independent diagnosis and treatment. Please seek advice from a specialist in your area.