[Nervous system lesions in patients with ixodid tick-borne borreliosis]. / Porazheniia nervnoi sistemy u bol'nykh iksodovym kleshchevym borreliozom.

Previous studies indicated that in the Perm Region there are two pathogen species: B. garinii and B. afzelii which cause the disease mainly with neurological and dermatological manifestations. In 1990-1994, in the Perm Region 646 patients with Ixodes tick-borne borreliosis (ITBB), including 535 with erythema migrans, 54 without it, and 57 with late chronic disease were studied. Damages to the central and peripheral nervous systems were detected at all stages of an infectious process. The prevalent clinical manifestations are encephalitis, encephalomyeloradiculoneuropathies, mono- and polyneuropathies. These abnormalities are more frequently formed in patients with its erythema-free type both in the acute period of the disease and in the late period of infection. A varying spectrum of neurological syndromes and their significant incidence determine the resemblance of ITBB in Russia and West Europe. The clinical findings are in good agreement with the results of etiological structural studies of ITBB in the region.

[Antibacterial therapy as a means of preventing ixodid tick-borne borreliosis]. / Antibakterial'naia terapiia kak sposob profilaktiki iksodovykh kleshchevykh borreliozov.

A special epidemiological experiment to prevent borreliosis in persons bitten by infected ticks was performed in 1992-1994 in the Russia's Perm region where Borrelia garinii and B.afzelii circulate, and Ixodes persulcatus tick is the sole vector transmitting these pathogens to human beings. Adult ticks were removed from the bodies of persons who had referred to health facilities for first aid. Vital preparations were made from the material obtained from the gut of each tick and examined microscopically (up to 250 microscopic fields per preparation). The patients bitten by infected ticks were divided into experimental and control groups and kept under special medical and serological control for 4-5 months. The patients of the experimental group received doxycycline (100 mg twice daily) for 3-5 days after ticks had bitten. Borreliosis was diagnosed by a combination of clinical and serological data. The control group consisted of 97 patients who took no antibiotics after ticks biting and 12 of them contracted borreliosis. In 823 cases Borrelia were not revealed while microscopically analyzing the ticks removed from the patients' bodies; in this group six patients contracted borreliosis. The morbidity rate (per 100 patients) in the experimental group was 1.1, i.e. 11 times lower than that in control group. Among the patients bitten by infected ticks and untreated with antibiotics, this index was 17.6 times higher than in the group bitten by ticks in which Borrelia were not found. There is no absolute probability of detecting the pathogen during a direct microscopic analysis of the preparation made from the tick removed from the body of a bitten patient. However, this rapid identification of Borrelia, followed by short-term antibiotic treatment for microbiological evidence is an effective tool for preventing patients from contracting borrelioses.

[The interferon system in acute tick-borne encephalitis and effect on the dynamics of clinical laboratory indicators using different methods of interferon therapy]. / Sistema interferona pri ostrom kleshchevom éntsefalite i vliianie na dinamiku kliniko-laboratornykh pokazatelei razlichnykh metodov interferonoterapii.

Study of the interferon system parameters, natural killer activity, and immunologic characteristics in patients with acute tick-borne encephalitis confirmed that addition of interferon preparations to combined therapy is pathogenetically justified. Reaferon was conducive to shortening of the manifest period of the disease and to alleviation of its symptoms, but it depressed its own interferonogenesis. Viferon had not only a positive impact on the time course of clinical parameters, but promoted a more active recovery of interferon production and immunologic parameters.

[The clinical picture and course of the nonerythematous form of ixodid tick-borne borreliosis]. / Klinika i techenie bezéritemnoi formy iksodovykh kleshchevykh borreliozov.

The territory of the Perm region is highly endemic in Ixodes (B. garinii and B. afzelii)-borne borreliosis. The clinical manifestations of erythema-less Ixodes-borne borreliosis were studied in the 1991-1994 epidemiological seasons. A total of 54 patients were examined in the acute stage of infection and 4-6 months later. There were common symptoms of damage to the central nervous system in early infection and pronounced signs of damage to the central and peripheral nervous systems in the late period which was characterized by cardiovascular diseases as disturbances of automatism functions, conduction, diffuse and local muscle changes.