Types of diseases of India, what are they and their treatment

Dirofilariosis: symptoms, subcutaneous and internal dirofilariosis in humans, treatment and prevention

Dirofilariosis is one of the helminth infections, previously considered exclusively zoo-specific and until recently, it was believed that only animals are susceptible to this disease. Dogs in the first place. But in recent years, more and more cases of human infection have been recorded.

Dirofilariasis: symptoms, subcutaneous and internal dirofilariasis in humans, treatment and prevention

Dirofilariosis is one of the helminth infections, previously considered exclusively zoo-specific and until recently, it was believed that only animals are susceptible to this disease. Dogs in the first place. But in recent years, more and more cases of human infection have been recorded.

Dirofilariasis refers to larval helminth infections. That is, this disease is parasitized not by adult nematode species, but its larvae that have not reached puberty. The carriers of the infection are mosquitoes, so this helminth is most commonly found in warm climates: from Australia, South America and Africa to southern Russia and Central Asia. In recent years, the largest number of cases of dirofilariosis has been registered in Iran and Greece. In recent years, however, the disease has been registered more and more often in temperate climates as well.

Thus, 35-40 cases of dyrofilariasis have been detected in the Russian Federation every year for several years. Moreover, the geography of infection is very wide: from warm Rostov, to moderate climatic zones of Tula and Ryazan, to frosty Siberia. In fact, the incidence rate can be much higher. Since this type of helminthiasis has long been considered inherent only in animals, it has not been studied by medics, and today it is little known and not immediately possible to make a correct diagnosis.

Most patients infected with dirophylyaria, when seeking medical attention, are initially diagnosed with either furunculosis or a cyst or tumor. The first description of human dirophylyariasis dates back to the middle of the 19th century, made by Portuguese doctor Lusitano Amato after he removed a helminth from a child’s eyeball. In Russia, the first recorded case of dirophylyariasis is considered to have been described by zemstvo doctor Vladychensky in 1915.

Causes of dirofilariosis

Literally, from Latin, dirofilaria “diro, filium” translates as “evil thread”. As mentioned earlier, the larval stage of the worm – microfilaria – can live in the human body. Most often people are infected with nematodes Dirofilaria repens and Dirofilaria immitis, which live in the body of pets – dogs and cats. Dirofilaria can rarely be transmitted to humans from wild animals – these nematodes parasitize all members of the canine and feline families, primates, bears, tigers and otters. That is why hunters account for a large proportion of cases of dirophylyariasis.

How does dirofilariosis infection occur?

The mechanism of infection in humans is transgemic, that is, infection occurs through blood. The disease is often transmitted through the bites of mosquitoes. Less often, through the bites of fleas, horseflies and other types of blood-sucking insects. And the source of infection, unfortunate as it may be, are our pets. Dogs and cats in the first place. According to the data of veterinary service up to 30% of dogs living in cities suffer from the mentioned invasion. In rural areas the figure is even higher. Adult Dirofilariae parasitize in the animal’s body in the heart, lungs, bronchi, and large blood vessels. Females excrete into the blood thousands of larvae-microfilariae that are microscopic in size – up to 0.3 mm in length. This is why they are spread throughout the body with the blood and lymph flow.

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Microfilariae are so microscopic that they not only enter all human or animal organs and tissues with blood and lymph, but even cross the placental barrier and infect the fetus intrauterus. Microfilariae travel with animal blood to an intermediate host, the mosquito. The insect, in turn, bites the infected animal, the larvae enter its abdominal cavity, but some of them remain in the mosquito’s proboscis. When the insect bites its next victim, some of the parasites from the trunk enter the bloodstream of the next host. This is how diphilariosis is transmitted from animal to animal and to humans.

Humans have total susceptibility to dirophyriosis – that is, if a person is bitten by an infected mosquito, he will be infected with 100% probability. But certain categories of people are at the greatest risk of contracting dirophylyariasis, including:

  • Dog and cat breeders;
  • People who live near open bodies of water;
  • Those who often visit nature – hunters, tourists, gardeners, fishermen.

Stages of development of dirofilariae

When a mosquito (less often another blood-sucking insect) swallows a nematode larva with blood, it remains in his intestines for about a day. Then the microfilariae migrate in the opposite direction, to the mosquito’s proboscis, where they mature to the invasive stage. During this period, the mosquito, bites the victim and infects it with dirofilariosis.

In the new host for about three months, the larvae remain in the mosquito bite site: in the skin or in the subcutaneous tissue. It is here that the microfilariae molt and, already more viable, enter the bloodstream and are spread throughout the body. Microfilariae can parasitize for about three years.

Dirophilaria develops to sexual maturity only in animals. The human body is a dead end for it, since most larvae still die in the blood of humans. This means that humans cannot be the source of infection.

Effects of dirophilariae on humans

Usually, only one parasite is found in a patient with dirofilariosis, and the development of this individual takes 8-9 months. Often the helminth does not leave the place of infestation – lives under the skin, where it was left by the mosquito after the bite.

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The main danger of dirofilariosis is primary reactions at the site of infiltration of microfilariae. A severe allergic reaction may occur. In addition, the skin becomes inflamed, seals (bumps) of rather large diameter are formed. Inside these seals is a serous fluid and/or pus, inside this content and lives for some time dirofilaria. Often the parasite dies, then the lump can gradually resolve itself. But more often still requires surgical intervention.

Types of dirofilariasis

An invasive disease is caused by a parasitic worm. The larvae of the threadworm nematode that causes the disease come in several varieties and therefore infestation with them leads to different forms of the disease.

Dirofilaria repens and Dirofilaria immitis are the main species affecting dogs and less frequently cats. It is these types of helminth are the most common among the sick people, because in the vast majority of cases, dirofilariasis in humans appears when bitten by a mosquito-transporter, who had previously had contact with these animals.

  • Dirofilaria repens causes a subcutaneous variant of dirofilariosis.
  • Dirofilaria immitis is visceral.

In Russia and neighboring countries, mainly subcutaneous diphilariosis occurs. Visceral dirofilariosis is widespread in the hot countries of Asia, Japan, India, USA, Africa, Canada, Vietnam, Australia, in the south of Europe.

Symptoms and sites of distribution of dirofilariosis

The latent form of dirofilariosis in humans lasts from 1 to 12 months. The main symptom is the appearance under the skin or mucosa, painful thickening, with redness and itching at the site of infiltration. At the same time, the helminth under the skin may move (at a rate of up to 15 mm per day), which may be noticeable to the person, both by feeling and visually. Often, having noticed a lump on the body, patients go to the surgeon, who decides that it is a lipoma, tumor, fibroma, atheroma, etc., and then during the operation detects the helminth.

Dirophilariae have favorite places on the human body – the organs of vision, legs and arms, neck, face, chest, scrotum. Symptoms such as weakness, passivity, nausea, nervousness, insomnia, fever, pain in the head and in the area affected by the parasite may appear. In 50% of cases, the visual organs are usually affected. A person complains of a sensation of something crawling in the eye, redness of the eyelids and eyes, blepharospasm. When the helminth moves, pain, lacrimation, and itching occur. Sometimes the helminth itself is visible through the conjunctiva.

When the diorophilaria is in the eye, a granuloma forms around it, causing exophthalmus and diplopia. Eye damage results in impaired vision. A person is able to see the migrating parasite. Observations have shown that its movement is intensified by exposure to heat.

Diphilariosis is usually chronic, with relapses characterized by periods of outbreaks and quiescence of the disease. If not treated in time, tissue inflammation and abscess may occur.

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Symptoms of internal dirofilariosis

In this variety, the lungs are affected by the parasite. The larva lives in the left ventricle of the heart and pulmonary arteries, forming a fibrous capsule. The disease is usually asymptomatic, less often causing chest pain, cough, and cough with blood.

The disease is often detected accidentally, such as in chest X-rays (1-2 cm nodules are visible) or during lung surgery.

Diagnosis of dirofilariasis in humans

Diagnosis of the disease presents a certain difficulty, since its symptoms are similar to many other diseases, so doctors often make a false diagnosis and timely treatment is delayed. The main complaints of patients are the appearance of migrating subcutaneous nodules, the feeling of movement of the parasite.

The diagnosis of dirofilariosis can be confirmed by taking the following tests:

  • blood test;
  • after removal of the parasite by a surgeon, its macroscopic examination is carried out;
  • testing for a serological reaction to detect the parasite’s antigen;
  • hardware diagnosis (ultrasound of nodes, X-rays, echocardiography and electrocardiography).

In addition, before making a diagnosis, a specialist analyzes the patient’s living conditions, the time of year, and his activities. Risk factors include the presence of domestic and stray dogs and cats, mosquitoes, trips to the woods, fishing, cottages or gardens.

The risk of dirofilariosis especially increases during periods of high mosquito activity. In this regard, preventive measures carried out by sanitary services on the elimination of insects in the territory of water bodies are important. It is known that the disease is seasonal, so the main number of cases is recorded in spring and summer. Peaks of disease occur in June-July and October-November.

Diagnosis of dirofilariosis in animals

To prevent the disease, pets should be regularly given anthelmintic preparations. Signs of parasite disease are various rashes, thickening, wounds, tumors on the skin.

Most of all, when affected, the cardiovascular system of the animal suffers. His behavior becomes passive, his appetite is lost, temperature and cough are noted. The dog may limp and suffer from seizures.

Treatment of dirofilariosis

The form of the disease dictates the methods of treatment. Usually, one immature specimen is parasitized in humans. The main method of getting rid of the parasite is surgical. To exclude the movement of the parasite, ditrazine is used. Rarely, therapy with medications using ivermectin or diethylcarbamazine is used. Additionally, sedatives and antihistamines, nonsteroidal anti-inflammatory drugs, and glucocorticosteroids are used in treatment.

For ocular dirofilariosis, the main treatment will be removal of the helminth by surgery and subsequent prescription of disinfectants and anti-inflammatory drugs for the eyes, sometimes dexamethasone drops are also prescribed to reduce inflammation. Antihistamines are mandatorily prescribed.

Prevention of dirofilariasis

In Russia 4-30% (depending on their geography) of domestic and street dogs are hosts-transporters of microfilariae. The highest percentage of infected animals in Greece and Iran is 25-60%.

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Prophylaxis of the disease includes exterminating mosquitoes and limiting human and animal contact, timely detection and treatment of dirophilariae in animals, struggle against stray animals, and anthelmintic prophylaxis in domestic pets.

As the foci of dirofilariosis are located in water reservoirs near residential areas, the efficiency of measures applied by sanitary authorities against blood-sucking insects is obvious. In addition, it is necessary to control mosquitoes in the basements of residential buildings, because here these parasites can live comfortably all year round. From the basements of residential buildings, mosquitoes and other insects get into apartments through the ventilation system.

In the woods and near water reservoirs you should use repellents and protect body parts with clothing. Pets may wear special collars in addition to repellents. If possible, try to avoid walking in the evening and at night.

The man himself is responsible for his health, as well as the health of their children, relatives and friends, so going on vacation in warm countries, be vigilant! It is easier to prevent the disease, observing preventive measures, than to treat its consequences!

Illnesses in India

Total unsanitation in all the localities, warm weather and rainy seasons strongly contribute to the development of many unpleasant diseases in India.

Today India has become one of the popular tourist countries. This is understandable, because in the world so few interesting and truly mysterious places. Many tourists come here confident that they will not get sick. But it is better to get acquainted in advance with the difficulties of which no one is immune, vacationing in India.

Important! Before a fascinating trip to a mysterious country, it is worthwhile to be vaccinated against hepatitis “A” and typhoid.

Unfortunately, there are no vaccines against malaria and other similar diseases. But absolutely all doctors recommend taking anti-malarial drugs for preventive purposes. You should start taking the pills a few weeks before departure, and continue for a month after your return. But there is another opinion, according to which taking such drugs for a long time is not allowed. However, to really protect yourself, it is worth protecting yourself and your loved ones from mosquito bites. You should use protective sprays, as well as install mosquito nets on the windows. Be sure to wear closed clothes before your evening walk, so that any insects cannot get to your skin.

India is a huge, densely populated country and has absolutely no common sewage system. In some areas it is represented by ordinary sewage ditches, which are also used as garbage cans. It is not uncommon for such a ditch to become clogged, and all the contents flow down the roadway. All owners of nearby stores try to quickly eliminate the consequences of the emergency by pushing the clog further. This attitude is very reminiscent of medieval Europe.

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At the end of the rainy season, cities are filled with freshness, but the evaporating moisture gathers crowds of insects carrying malaria and a variety of fevers. Not to say that absolutely all mosquitoes carry diseases, but still the risk of becoming infected is very high.

The rainy season in India usually falls in the summer. This is when there is the maximum amount of rainfall. All the cities drown in dirty, dusty water, sweeping away everything in their path. This is where the chance of contracting infectious diseases of the stomach is.

Coming to India in any season, it is worth remembering a few rules: always washed hands, hot food in restaurants and water in plastic bottles.

The incubation period after entry of the infection into the body lasts exactly a week. Fever rises sharply, accompanied by migraines, vomiting and bone aches. It is worth remembering that in such cases it is strictly forbidden to take aspirin. Only a blood test, which is done literally in all hospitals, will help in the diagnosis. The most dangerous infection is considered a fever “dengue”. During its fever, it can keep a high temperature for more than two weeks. There are no special remedies for dengue, and only antibiotics are used.

Some types of fevers leave limb pain after healing, lasting up to several months. As with other diseases, the person who is cured is immune. But because there are so many types of fevers, you should not relax.

The Indians have a belief that mosquitoes are very afraid of certain flowers, and that milk with an added tablet of paracetamol will help avoid infection. But none of these is scientifically proven. This is probably why even many locals get sick often. Interestingly, they try not to go to the doctors, and stay at home and treated with standard drugs, as well as remedies of folk medicine.

Before traveling to India, worry about buying health insurance. Despite the fact that Indian medicine is considered one of the cheapest, it can severely damage the wallet. In addition, the insurance will provide the best treatment to any tourist.

If the fever was not avoided, do not worry. You are not in danger of death, but have to endure the discomfort. Each day spent in the hospital will seem the same as the previous day. The only thing you will remember is the numerous drops, injections, and a high body temperature, which for several weeks will not drop below 38 degrees. There will be no gradual improvement in well-being. The illness ends as quickly as it began.

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