Immunoglobulin for tick bites: benefits and harms for children

General information about ticks

There are more than 40,000 species of mites, most of which feed on rotted plants, fungi and small insects. But there are also those who prefer blood.

These insects bite mainly in warm weather. They don't like dampness. It is difficult to notice a tick attack, since during the bite it injects an anesthetic. Insects prefer places that are hidden under clothing and where the skin is thinner. Most often, people find them on their elbows, scalp, arms and legs, and also in the groin.

How dangerous is a tick bite?

These insects are dangerous because they are carriers of many different diseases, the most terrible of which are encephalitis and Lyme disease. Of course, not all ticks carry diseases, but this can only be determined in each specific case in the laboratory.

The most dangerous species are European forest and taiga ticks. They are quite large, feed on blood, and people often become their victims.

The first individuals appear in April. They are most active from May to early July, then the population disappears, but not all. Occasionally, cases of tick attacks are recorded in early autumn.

Ticks can smell a victim from a distance of 10 meters. Typically, insects attack from blades of grass or bushes no higher than 50 centimeters. They prefer damp places, not very shady and with thick grass. Their “favorites” are forest edges, grassy paths, and ravines.

Ticks do not attack from above. If an insect is found on the head, it means that it crawled there from below in search of the most suitable place for suction.

Prevention of bites

The best protection against infection with tick-borne encephalitis is timely vaccination. Its validity period is 3 years. But there are no vaccinations against Lyme disease; only precautions can help.

To avoid contact with blood-sucking insects, you can use repellents. They are applied to clothing and exposed skin. Before application, be sure to read the instructions. It is enough to treat shoes, trousers and sleeves. For best protection, tuck your pants into your socks or boots.

When bitten by a tick

If it was not possible to avoid contact and the tick bites you, you should carefully remove it. Be sure to make sure that you have pulled out the entire insect and that its head is not left in the wound. The tick is placed in a glass jar and delivered alive to the laboratory for examination within the next 24 hours. Tests will tell whether he was a carrier of encephalitis or Lyme disease.

Even if the tick itself turns out to be a carrier of the disease, this does not mean that the victim has already become infected. However, you should definitely go to the hospital if the bite site becomes very swollen and red. If within a month after the bite there is a significant deterioration in health, you should also consult a doctor.

It is also important to remember that ticks carry more than just encephalitis or Lyme disease. They can also transmit many other diseases that are less dangerous, but still unpleasant and require treatment.

What to do if you are bitten by a tick and how to prevent viral encephalitis. Expanded instructions

Author:

gastroenterologist Anton Smirnov

7 minutes

1875

We recently published a major piece on the current tick season and the diseases they carry. In connection with updated information about the foci of tick-borne viral encephalitis (TBE) in Moscow, Mednovosti provides detailed instructions on what to do if you are bitten by a tick.

According to the April report of the Research Institute of Epidemiology of Rospotrebnadzor, which is cited by Izvestia, a cluster of TVE was discovered in the city of Moscow. Epidemiologists refer to data from last year’s studies that discovered ticks and mammals infected with TVE in the Krylatsky Forest Park. In 2021, one victim, bitten by an encephalitis tick, contacted the research institute; another person ended up in the hospital a year earlier. Experts point out that these were the first cases of detection of the virus in the city. They warn residents of the capital that the situation could repeat itself this year.

It was previously reported that last year 13,332 people (2,699 of them children) visited medical institutions in the capital alone due to tick bites. This year, in 70 constituent entities of the federation, about four thousand victims, including 1,591 children, contacted medical organizations, which is below average.

Here are recommendations on what to do if you find a tick on yourself, taken from the leaflet “Beware of Ticks,” compiled by the chief freelance specialist in infectious diseases of the Ministry of Health of the Russian Federation, Professor I.V. Shestakova.

Removing the tick

Contact the specialists

If tick suction does occur, an initial consultation can always be obtained by calling a landline number: 103, or from a mobile (cell) phone: 103* or 112.

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.

If for some reason you do not have the opportunity to seek help from a medical institution, then you will have to remove the tick yourself, and the sooner you remove the embedded parasite, the better.

Removing ticks 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.

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.

After removing the tick 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 (ammonia, gasoline, etc.) to the bite site;
• 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.

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 a 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.

We send the removed tick for examination

If research is not possible, the tick should be burned or doused with boiling water. The removed tick should be placed in a small hermetically sealed container with a small piece of slightly damp cotton wool or a napkin and sent to the laboratory. The jar with the tick is placed in the refrigerator if it is impossible to transport it to the laboratory immediately after removing the tick. Within two days, the tick must be taken to the laboratory to be tested for tick-borne infections. Usually the analysis can be done in a regional infectious diseases hospital or a special laboratory.

Laboratory addresses

For Moscow residents:

• in the department of especially dangerous infections of the microbiological laboratory of the Federal State Institution "Center for Hygiene and Epidemiology in Moscow" at the address: Moscow, Grafsky lane, 4/9 (entrance from the courtyard, 2nd floor), tel.. Reception is held from 9-00 until 15-30 daily, except Saturday, Sunday and holidays (lunch break from 13-00 to 13-30), the results of research can be found out from 15-00 to 18-00;
• branch of the Federal State Institution "Center for Hygiene and Epidemiology in Moscow" at the address Moscow, Krasnogvardeisky Boulevard, 17 building 1 microbiological laboratory, reception from 9.30 to 15.00 daily, except Saturday and Sunday, tel.;
• Federal Budgetary Institution of Health "Federal Center for Hygiene and Epidemiology of Rospotrebnadzor" in Moscow at the address Varshavskoye Highway 19a (Nagatinskaya metro station) Mon-Fri from 9.00-18.00 tel. +7(495)954-45-36.

Residents of the Moscow region can receive specialized assistance at their place of residence in the Central District Hospital or at the above addresses.

What should a person bitten by an infected tick understand?

It is impossible to judge by the appearance of a tick whether it is a carrier of infection or not. The tick becomes infected when feeding on an infected animal. The virus can be contained in females, males, nymphs, and larvae. 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.

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.

There is no need to self-medicate; if in doubt, consult a doctor! If a tick bite has occurred, if your health worsens, consult a doctor immediately!

We carry out specific prevention (only tick-borne viral encephalitis)

Emergency prevention of tick-borne borreliosis, human monocytic ehrlichiosis and human granulocytic anaplasmosis is usually not carried out.

Tick-borne viral 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 (when virus ticks are sucked on by people who have not been sick or previously vaccinated, as well as those who have an incomplete or defective vaccine course in the first 96 hours after sucking, intramuscularly, once). A doctor carries out preventive measures.

When an encephalitis tick bites, the virus enters the bloodstream with saliva. In the future, 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 tick-borne viral encephalitis can be stopped by other factors of antiviral protection. 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.

Where to go for emergency prevention against tick-borne encephalitis in Moscow

For adults:

• Infectious Clinical Hospital No. 2 of the Moscow Department of Health, Moscow, 8th st. Sokolinaya Gora, 15. Help service.
• City advisory office on vaccine-serum prevention of tick-borne viral encephalitis: tel., +7(495)365-01-47 (www.mosgorzdrav.ru/ikb2)

For children:

• Children's City Clinical Hospital No. 13 named after. N.F.Filatova, Moscow, st. Sadovaya Kudrinskaya, 15. Help desk: +7(499)254-91-29.

Vaccinations against tick-borne encephalitis

If you frequently visit tick habitats, it is advisable to get vaccinated against tick-borne viral encephalitis. The vaccine protects for at least 3 years. Persons working in endemic areas (foresters, geologists, etc.) and children living in endemic areas are subject to mandatory vaccination.

In Russia, vaccination is carried out with domestic vaccines (Tick-borne encephalitis vaccine, cultural purified concentrated inactivated dry, EnceVir) and foreign vaccines (FSME-Immun Inject/Junior, Encepur adult, Encepur children) or by primary and emergency schemes. All vaccines have the same immunogenicity. Vaccination can be carried out according to two schemes: the main and emergency. The main scheme (0, 1-3, 9-12 months) is carried out with subsequent revaccination every 3-5 years. To form immunity to the onset of an epidemic season, the first dose is administered in the fall, the second in winter. An emergency regimen (two injections with an interval of 14 days) is used for previously unvaccinated persons arriving in endemic foci in the spring and summer. Emergency vaccinated persons are immunized for only one season (immunity develops after 2- 3 weeks), after 9-12 months they are given the 3rd injection.

Emergency help

Within 3 days (or better yet, the first 24 hours) from the moment the tick is removed, you need to examine it in the laboratory, and also contact a medical facility to prevent the development of serious diseases. It is mandatory, even if the person bitten has previously been vaccinated.

What immunoglobulin is given for a tick bite? There are a lot of them. In medical institutions, doctors give preference to anti-encephalitis, since this disease is the most dangerous.

Immunoglobulin will not help if a person has become infected with tick-borne borelliosis or other diseases. The drug is quite expensive, this is its disadvantage. The cost of one ampoule is about 600 rubles. A pack of 10 ampoules is already quite expensive. It can also cause an allergic reaction.

The medicine is produced from the serum of donor blood from people who have suffered tick-borne encephalitis. The medicine is used both as a preventive measure and during the disease itself. Before using it, it is important to learn as much as possible about the drug.

Immunoglobulin as part of the treatment of encephalitis

Today, immunoglobulin in the form of an injection is classified as a preventive vaccination, but the direct indication for their use is considered to be emergency prevention and treatment of tick-borne encephalitis in people of various age categories. In this case, the drug is prescribed rather to relieve the severity of symptoms.

Treatment of tick-borne encephalitis with immunoglobulin injection:

1. The drug helps relieve the symptoms of a febrile state, for which the victim is prescribed 1 dose of immunoglobulin serum daily (the dose is calculated in the proportion of 0.1 ml per 1 kg of the patient’s weight).
2. The medicine helps eliminate the initial development of meningitis, since the proteins eliminate the symptoms of the disease that are dangerous to humans.
3. Treatment of extremely severe or acute encephalitis requires injections of immunoglobulin with a dose of 0.15 ml per 1 kg.
4. The drug is especially effective for the treatment of biphasic encephalitis throughout the entire therapy.

Anti-tick immunoglobulin

The drug contains an immunologically active protein fraction, which is isolated from donor plasma or serum. Donors are people who have had tick-borne encephalitis. Their bodies have antibodies to this virus. They are the basis of the medicine. The protein is taken only from healthy people who have additionally been tested for the absence of hepatitis C and HIV.

The protein stabilizer is glycine (aminoacetic acid). There are no antibiotics or preservatives in the medicine.

Immunoglobulin for tick bites is mainly used in the form of ampoules with a capacity of 1 milliliter each. It is a colorless liquid, which, however, may have a slight yellowish tint. If there is sediment at the bottom of the ampoule, just shake it and it will disappear.

Immunoglobulins belong to class G drugs. The active antibodies contained in the drug neutralize the tick-borne encephalitis virus in the body. The medicine also increases the resistance of the human body.

The highest concentration of antibodies in the body is achieved on the second day after administration of the drug. The half-life takes 4-5 weeks.

What is Immunoglobulin and features of its use

Immunoglobulin is a special protein that begins to be produced by the immune system as a response to the invasion of foreign microorganisms into the body. This substance is obtained from the serum or plasma fluid of healthy people, with a high content of antibodies to TBE. The active component of the drug is class G immunoglobulins, which neutralize the encephalitis virus.

Not every type of tick is a carrier of dangerous diseases. However, a person cannot determine this on his own and this is usually found out after removing the insect from the victim’s body and examining it. Therefore, for the purpose of prevention, immunoglobulin vaccination is done. Unfortunately, it can only protect against tick-borne encephalitis; it is powerless against Lyme disease.

Tick ​​immunoglobulin is used in the following cases:

• for the purpose of preventing tick-borne encephalitis in persons who have not yet been vaccinated.
• to prevent infection of already vaccinated persons in the presence of a large number of bites.
• in the treatment of infectious diseases transmitted by ticks, accompanied by high fever.
• for the prevention of encephalitis after a bite, when immunity has not yet developed - less than a month has passed since the vaccination.
• with a high probability of being bitten.
• when a person cannot tolerate vaccination against tick-borne encephalitis due to high sensitivity to it.
• as a preventive measure for diseases transmitted by ticks to people who have already been vaccinated, but who have not yet developed immunity.

In order to obtain this drug, immunoglobulins contained there are taken from human blood. To do this, it is necessary to screen potential donors for antibodies to these diseases. Before blood is taken to separate antibodies, it undergoes a thorough study, in particular for HIV and hepatitis B and C. In addition, great attention is paid to protein, its indicators should not be more than 16%. The antibodies themselves are present in a ratio of 1:80. Glycine (or aminoacetic acid) is also very important, ideally it should be present in an amount of 2.5%. There should be no antibiotics or preservatives present.

Immunoglobulin is administered once for a bite or for prophylaxis. If any disease occurs, injections are given depending on its form.

This remedy is equally suitable for prevention and therapy itself. The highest concentration of antibodies in the blood of a vaccinated person is observed 2–3 days after injection of the drug. The period of elimination from the body is 4–5 weeks.

Immunoglobulin is a colorless liquid for intramuscular injection that may precipitate. This is considered normal and should be shaken well before use. Intravenous administration is strictly prohibited. The medicine from an opened ampoule must be used immediately - it is not suitable even for short-term storage in an open form.

There are a number of contraindications for the use of immunoglobulin:

• Allergic reactions to this group of drugs are an absolute contraindication, as well as chronic nephritis and diseases of the blood and connective tissue.
• presence in the anamnesis of descriptions of allergies to other administered drugs. If this happened, then injections with immunoglobulin are permissible only in a hospital under the supervision of a resuscitator and the presence of an anti-shock kit.
• bronchial asthma.
• dermatitis of an allergic nature.
• urticaria with relapses.
• allergies to foods and medications.

Indications and contraindications

As a rule, immunoglobulin is prescribed as a prophylactic agent for tick bites. The main purpose is the treatment of encephalitis.

But is immunoglobulin so harmless? In case of a tick bite, the drug has contraindications. It should not be taken when a person has serious allergic reactions to a certain list of components of the medication. Atopic dermatitis, asthma or systemic diseases associated with immunopathological mechanisms are contraindications to the use of the drug.

When taking the medicine, adverse reactions occur quite rarely. Among them, the following are noted: fever, hyperemia, pain in the area where the dose of immunoglobulin was administered due to a tick bite, allergic reactions, and, extremely rarely, anaphylactic shock.

There is no data on the effect of the drug on a woman’s body during pregnancy and lactation, so doctors do not recommend taking it to avoid negative consequences.

Contraindications

This product has a number of contraindications for use. These include individual intolerance to individual components.

Use is prohibited if a person has:

• Hives.
• Asthma.
• Food allergies.
• Atopic dermatitis.

Injection is allowed in emergency situations, but in this case the patient must take a course of antihistamines. Regarding injections for pregnant women, they are possible only in case of a real risk of contracting encephalitis. If children are undergoing treatment and taking calcium gluconate, then the injection is prohibited.

Advantages and disadvantages

This medicine is ineffective after 4 days from the moment of the bite. It can also be used as a preventive measure, but the effect will last no more than a month.

Immunoglobulin helps very well with a tick bite; the maximum protective effect is achieved within a day. However, vaccination is still much better.

The medicine can only be administered in a hospital setting; the procedure must be carried out by a medical professional. There are several reasons for this: firstly, the drug should be stored in a dry and dark place at a temperature of 2 to 10 degrees, and secondly, it can cause various allergic reactions, including anaphylactic shock. In the latter case, the presence of a doctor will save the patient's life.

Methods of using the medicine

The drug is available in ampoules. It is not put into a vein. The administration of “Immunoglobulin” for a tick bite must be done intramuscularly. Before this, it is recommended to keep the drug for 2 hours at room temperature. The medicine is drawn into the syringe only with a needle with a wide bore, in order to avoid the appearance of foam.

An open ampoule cannot be stored. Also, if there is a possibility that the medicine has been spoiled (the integrity of the packaging has been damaged or the labeling is in doubt), it should not be used.

Is it necessary to give immunoglobulin for a tick bite? If there are no contraindications, then it is better to do it anyway. A disease such as tick-borne encephalitis is very difficult to tolerate. It should be remembered that the medicine will only help if it was administered within the first 3 days after the bite.

Immunoglobulin can also be used in advance if there is a high probability that a person will be bitten by a tick in the near future. The medicine takes effect within 24-48 hours, and overall protection will last for a month. Then, if necessary, you can repeat the immunoglobulin injection. If a tick bites, the injection is also repeated.

Instructions for the use of immunoglobulin after a tick bite

Since using immunoglobulin after an insect bite can in some cases cause complications, the drug should be used strictly according to the instructions, taking into account the precisely calculated dosage of the medicine.

Instructions for administering immunogolobulin serum:

• Before the capsule with the drug is opened, it must be left in a warm room for a couple of hours so that the serum warms up to room temperature;
• before opening the ampoule, hands should be washed well with soapy water, and the ampoule itself should be rubbed with an alcohol solution;
• before opening, the drug is shaken to dissolve the sediment;
• From the open ampoule, the serum is drawn into a syringe located vertically, trying to prevent foam from getting in.
• the selected area is wiped with cotton wool soaked in alcohol;
• during an injection, the needle should not enter the muscle deeper than 1–2 cm;
• the injection site is re-treated with alcohol.

Dose calculation for adults and children

Before administering the injection, doctors recommend using a dosage table to determine the required amount of the drug.

Table: immunoglobulin dosage

Special conditions for using the injection

People who have completed a course of immunoglobulin vaccination are not recommended to receive a second injection until the end of the interval of 2-3 months after the end of the preventive course.

For allergy sufferers, it is recommended to take antihistamines for a week after administering immunoglobulin.

In cases of anaphylactoid reactions, a course of antihistamine therapy is prescribed.

Note! For people with developing autoimmune diseases, the drug can be used only in the absence of current treatment.

Is the injection used for pregnant women?

The introduction of proteins is not recommended for pregnant and nursing mothers; exceptions are made only for women living in epidemic areas or with the development of immunity disorders in the fetus. In this case, only the doctor determines the dosage of immunoglobulin, based on the health status of the mother and child.

Doses of the drug

As a preventive measure, the drug is administered at the rate of 0.1 milliliter per 1 kilogram of live weight.

If symptoms of the disease have already appeared, immunoglobulin is also used as one of the medications. The dose calculation is the same. The course of taking the drug in this case is 3-5 days. In total, during this time the patient must receive at least 21 milliliters of medication.

If a focal form of tick-borne encephalitis is observed, the course of medication should be slightly extended until the patient’s condition stabilizes. In severe cases of the disease, it is allowed to increase the dose of the drug to 0.15 milliliters per 1 kilogram of weight.

Immunoglobulin for a tick bite can be taken together with other drugs. In this case, it is important not to mix them. This means that medications must be administered separately.

If a person wants to get vaccinated against tick-borne encephalitis, and has recently been injected with immunoglobulin, he will have to wait a month.

You can also give immunoglobulin for tick bites in children. The dosage in this case is also calculated based on the child’s weight. In special cases, only a doctor can write a prescription indicating the dose of medicine for the child.

What is immunoglobulin?

Immunoglobulins are a special type of proteins that are produced by lymphocytes in the human body and are responsible for immunity, which means that additional proteins are introduced to increase its level.

Useful properties of immunoglobulin:

• Such proteins react in a special way to foreign substances and microorganisms, which forces the immune system to neutralize their spread and eliminate the threat;
• The presence of a harmful bacteria or virus causes the immunoglobulin to produce special antibodies, which certainly speeds up recovery.

In humans, such immunoglobulins can be found on B lymphocytes, blood serum, tissue fluid, and also in secretions.

Since the human body is constantly attacked by various bacterial and viral diseases, the products produced by different classes trigger a function similar to the built-in hormonal defense of the body from various irritants.

Let's celebrate! In total, there are 5 classes of immunoglobulins in the human body: G, M, A, E, D, which differ in amino acid composition, structure and, of course, functions.

How does immunoglobulin work against a tick bite?

An injection of immunoglobulin for a tick bite is needed to neutralize the tick-borne encephalitis virus in a person bitten by an insect.

The effectiveness of beneficial proteins is significantly improved by timely therapy, since when immunoglobulin is used in the first 24 hours after a parasite attack, it practically eliminates the body’s allergic reactions to the introduction of amino acids.

It is worth considering that 24 hours after the bite, squirrels can cause a deterioration in health, thereby allowing the disease to develop faster.

Using immunoglobulin before a tick bite

Immunoglobulin is often used as a prophylactic against tick-borne encephalitis, since proteins prepare the body to develop immunity to this disease.

Note! In other words, upon contact with an infected insect, the injection will immediately begin the production of antibodies, which will immediately stop the development of the disease.

special instructions

Administering the entire dose of medication at once may cause a skin reaction. This can be avoided if the injections are given in several areas of the body.

After the injection, the doctor must observe the patient for at least another half hour in order to save the person’s life in the event of anaphylactic shock. So the doctor should also have anti-shock drugs in his arsenal.

Car enthusiasts should not be afraid to get an immunoglobulin injection. Its effect does not reduce concentration, so they can safely drive their car.