Symptoms and treatment of helminthiasis in adults and children. A

• Contact path- through dirty hands(larvae enter through the mouth) or through the skin (larvae are introduced by walking barefoot on contaminated soil)
• Nutritional route - when consuming insufficiently processed meat, fish, as well as when washing vegetables and fruits with contaminated water
• Household route - through contact with dishes, personal hygiene items belonging to an infected person

Classification of helminthiasis

Helminths are divided into three classes:

• Roundworms (nematodes) – cause strongyloidiasis, ascariasis, hookworm disease, enterobiasis, necatoriasis, trichuriasis
• Tapeworms (cestodes) – taeniasis, hymenolepiasis, teniarynchosis, diphyllobothriasis
• Flukes (trematodes) – opisthorchiasis, fascioliasis

According to stages, helminthiases are divided into:

Helminths can also be divided in relation to their hosts:

Depending on their habitat, helminths are divided into:

• Luminal - live in the intestines
• Tissue - live in various tissues (muscles, adipose tissue and others)

Symptoms of helminthiasis

The acute phase is characterized by:

• Increased body temperature. The duration of this symptom ranges from several days to 2 months. It does not exceed 38ºС, is accompanied by general weakness, sweating
• Pain in muscles and joints
• Signs of bronchitis and difficulty breathing
• Loeffler's syndrome. It manifests itself as a suffocating cough, severe shortness of breath, chest pain and x-ray eosinophilic volatile infiltrates are determined (determined by a radiologist)
• Quincke's edema. Manifests allergic edema tongue, oropharynx, nasopharynx and trachea, leading to difficulty breathing
• Discomfort in the abdomen
• Frequent stools
• Heart pain (myocarditis)
• Enlarged spleen and liver
• Increase lymph nodes
• Increase in eosinophils in the blood up to 80% (normally 0-5%)

The chronic stage is characterized by the following symptoms:

• Asthenovegetative syndrome. Manifested by increased fatigue, headaches, drowsiness, depressed mood
• Discomfort and pain in the abdominal area
• Tendency to diarrhea
• Pain in the heart
• Blood pressure surges
• Decreased immunity
• Night grinding of teeth (bruxism)
• Increased salivation

Diagnosis of helminthiases

To diagnose helminthiases, laboratory and instrumental methods research:

• General blood test
• Analysis of feces for helminth eggs
• Enzyme-linked immunosorbent assay (ELISA)
• Study of duodenal contents
• Biopsy of muscle tissue and affected organs
• X-ray of the chest and abdomen
• Endoscopic examination of the gastrointestinal tract
• Computed tomography

Treatment of helminthiases

Medicinal methods of treatment are mainly used as treatment. The basis is anthelmintic drugs. They affect both larvae and adults. These include drugs such as mebendazole, vormil, vermox, levomisol and many others. These remedies are best combined with detoxification medications. These are solutions of sodium chloride, glucose, sodium bicarbonate with the addition of vitamins. They are administered intravenously.

In case of a severe allergic reaction, suprastin or prednisolone is administered. You can take it either in the form of tablets or receive a course of treatment with injections. Necessity additional drugs will be determined by an infectious disease specialist or therapist during an individual examination.

If complications develop, it is possible to use surgical treatment to eliminate intestinal obstruction or blockage of blood vessels.

Traditional treatment of helminthiasis

• Every day, for 1-2 months, you need to take crushed raw pumpkin seeds, 2 tablespoons per day and combine them with any laxative.
• Horseradish and garlic should be grated in equal proportions. Pour 500 ml of vodka into this mixture (2 tablespoons). Leave for 1-2 weeks in a dark place with the lid closed. After straining, take 1 tablespoon 30-60 minutes before meals 3 times a day.
• Mix wormwood, elecampane root, chamomile flowers and tansy in equal proportions. For three days you need to drink this dry mixture, 5 tablespoons every 2 hours, with required quantity liquids.

Complications of helminthiases

The following pathological conditions may occur as complications of helminthiases:

• Intestinal obstruction
• Blockage of blood vessels
• Appendicitis
• Peritonitis
• Liver abscess
• Pancreatitis
• Asphyxia (choking)

Prevention of helminthiasis

To prevent the development of helminthiasis it is necessary:

• Maintain personal hygiene rules
• Avoid washing vegetables and fruits in open, untested bodies of water
• Process meat and fish before eating it
• Don't go bare feet on the ground
• Get tested periodically for helminths

Helminthic infestations (helminthiasis)

Opisthorchiasis.

Symptoms of opisthorchiasis.

The disease often occurs as a chronic invasion with sensitization of the body and allergic symptoms. The course of the disease is quite variable, from asymptomatic forms to severe forms, sometimes with fatal. More than half of the patients complain of pain in the epigastric region and right hypochondrium, and dyspeptic symptoms are often detected. The liver is enlarged, painful, and hardened. Increased gallbladder. Marked low-grade fever, weakness, irritability, insomnia. Eosinophilia is detected from the 2nd week (earlier than with other helminthiasis), moderate anemia is observed. With opisthorchiasis usually develop chronic hepatitis and pancreatitis.

Treatment of opisthorchiasis.

Before starting specific treatment, table No. 5, antispasmodics and choleretic drugs. Chloxil is prescribed orally 3 times a day after meals. Per course no more than 20 g for adults. The treatment cycle takes two (0.1-0.15 g per 1 kg of body weight per day) or five days (0.06 g per 1 kg of body weight per day). Chloxyl powder is shaken in milk. Laxatives are not prescribed. Biltricide is prescribed orally after meals at 20-25 mg/kg. Maximum dose 40 mg/kg. Treatment with biltricide is carried out over one day in 1, 2 or 3 doses. The tablets are swallowed whole with a small amount of liquid. For a one-time dose, it is recommended to take the tablets in the evening, 2-3 times a day with an interval of 4-6 hours. A laxative is not prescribed.

Clonorchiasis.

Symptoms and treatment of clonorchiasis.

Clinical manifestations, laboratory diagnosis and treatment of clonorchiasis are the same as for opisthorchiasis.

Nanophyetosis. Nanophyetosis helminthiasis with predominant damage to the intestines. In Russia, it is found in the Primorsky Territory (basins of the Amur and Ussuri rivers) on Sakhalin; high infestation is noted in Udege villages. The disease has also been reported in North America.

Symptoms of nanophyetosis.

Clinical manifestations of the disease may be practically absent with weak invasion or be insignificant. Most often, patients experience abdominal pain, unstable chair(alternating constipation and diarrhea), nausea, possible vomiting and other signs of enteritis. Laboratory diagnostics is based on the detection of eggs in the stool of patients (not earlier than 5-7 days after infection).

Treatment of nanophyetosis.

For treatment, male fern extract (up to 3.5 g for an adult) or quinacrine (one dose 0.6-0.8 g) is used.

Symptoms of fascioliasis.

Clinical manifestations depend on the intensity of the invasion. For acute phase The disease is most often characterized by manifestations of allergosis with fever, skin rashes like urticaria, asthmatic attacks. Patients complain of pain in the abdomen, right hypochondrium, and nausea. Hepatomegaly, less commonly splenomegaly, leukocytosis, and eosinophilia are noted. The duration of the acute period is usually 3-4 months. The chronic stage clinically resembles opisthorchiasis with symptoms of cholangitis, hepatocholecystitis, hepatitis and cirrhosis of the liver, and the development of obstructive jaundice is possible.

Laboratory diagnosis is established based on examination of stool and duodenal contents, in which the appearance of fasciola eggs is possible no earlier than 3 months after infection. Therefore, in the early stages, the diagnosis is based on epidemiological, clinical data and the results of an immunological examination (complement fixation reaction).

Treatment of fascioliasis.

The specific drug is Chloxyl, prescribed at the rate of 60 mg/kg per day for a 5-day course of treatment and 150 mg/kg for a 2-day course. The daily dose is distributed into 3 doses, 2 hours after breakfast, lunch and dinner. After 2-3 days, duodenal intubation is performed. You can repeat the course of treatment after 2-3 months.

Diphyllobothriasis.

Diphyllobothriasis helminthiasis with the predominant localization of the pathogen in the intestines. Refers to the number of invasions with natural focality, distributed mainly in countries with temperate climates. In Russia, diphyllobothriasis is registered everywhere on Kola Peninsula, in Karelia, in the regions of the Gulf of Finland, in the basins of the Northern Dvina, Pechora, Ob, Yenisei, Lena, Kama, Volga, on Far East and on Baikal. Intensive outbreaks are located in the northern regions of the Krasnoyarsk Territory. In addition, in connection with the construction of irrigation structures, new foci of diphyllobothriasis arose in the Kama, Kuibyshev, Volgograd, Gorky, and Rybinsk reservoirs.

The causative agent of the disease is various types tapeworms, of which the broad tapeworm is the most important for humans. Their development occurs in bodies of water, where immature eggs fall with the feces of the definitive hosts. The definitive hosts of tapeworms are humans, dogs, cats, pigs, and wild carnivorous mammals. The main intermediate host of tapeworms are crustaceans, and the additional host is freshwater fish(pike, burbot, perch, ruffe, lake and migratory salmon, lake trout, omul, whitefish, grayling, etc.).

Symptoms of diphyllobothriasis.

Treatment of diphyllobothriasis.

Treatment is carried out with fenasal or male fern extract. Fenasal is prescribed in the following doses: children under 3 years old 0.5 g, up to 6 years old 1 g, up to 9 years old 1.5 g; over 12 years old and adults 2 g. In some cases, the dose of phenasal is increased to 3 g (in persistent cases). There are 2 main treatment regimens with phenasal:

in the morning, 10-15 minutes before taking phenasal, the patient drinks 1/2 glass of water with 1-2 g of sodium bicarbonate (soda). 1 hour after this, you need to drink a glass of sweet tea. Laxatives are not given;

3 hours after light dinner drink soda in a dose of 1-2 g in 1 glass of water, after another 10 minutes take a stirred suspension of phenasal in water. A saline laxative is recommended the next morning. The day before and on the day of treatment with phenasal, the patient takes easily digestible food.

Treatment with male fern extract involves the following preparation of the patient: pureed, liquid, low-fat food is prescribed for 2-3 days, a cleansing enema is given on the 1st day of preparation, a saline laxative is given at night for 2-3 days, a cleansing enema is given again in the morning on the day of treatment enema.

The drug is prescribed in the following doses per course: up to 1 year 0.5 g, at 2 years 1.0 g, at 3 years 1.5 g, at 4 years 2.0 g, at 5-6 years 2.5 g, at 7-9 years old 3.0 g, at 10-12 years old 3.5-4.0 g, at 13-16 years old 4.0 g, from 17 years old and older 4, 0-7.0 g. The course dose is taken in 2-3 doses with an interval of 5-10 minutes in a mixture with honey, jam, preserves or fractionally (in capsules) for 30 minutes. The drug is washed down with water or a 5% solution baking soda. 1.5 hours after taking the fern extract, a saline laxative is prescribed, and even after that easy hour breakfast sweet tea with a bun.

Teniarinhoz.

Infection of livestock occurs when they eat grass and feed contaminated with tapeworm segments and eggs. Tapeworm larvae (Finns) are found in the intermuscular connective tissue animal, where they retain invasive ability for up to 1 year. A person becomes infected by eating contaminated undercooked or undercooked meat, or by tasting raw minced meat in the process of preparing cutlets and dumplings. IN small intestine person bull tapeworm can live for decades.

Symptoms of teniarinhoz.

Clinical manifestations of invasion in early phase are missing. IN chronic phase There are 3 main syndromes: asthenoneurotic, pain and dyspeptic. Irritability, sleep disturbances are often observed, convulsions are possible, appetite disturbances (both decreased and increased), rumbling and cramping pain in the abdomen, often in the right iliac region, stool instability. Possible weight loss.

Diagnosis is based on the patient indicating the active discharge of helminth segments. Provocation of discharge is carried out by prescribing pumpkin seeds (up to 30 g) or garlic (2-3 cloves) the day before, and a saline laxative is given in the evening. In the morning after bowel movement, the fecal matter is washed and the detached segments are examined. The method of scraping from the perianal folds is also used. It is almost impossible to distinguish between the eggs of armed and unarmed tapeworms.

Treatment of teniarinchiasis.

Fenasal is used to treat teniarinchiasis. The drug is prescribed in the morning (on an empty stomach) or in the evening (3 hours after eating). The entire dose of phenasal is given in the form of an aqueous suspension. Doses of the drug: children under 3 years 0.5 g, from 3 to 6 years 1 g, from 6 to 9 years 1.5 g, over 9 years 2 g, adults 2-3 g. After taking phenasal the patient should not eat for 3 hours. Male fern extract and pumpkin seeds can also be used.

Symptoms of taeniasis.

Clinical manifestations of the disease are determined by the intensity and duration of the invasion, age, and general condition of the patient and vary from mild to relatively severe. With uncomplicated taeniasis, patients complain of decreased or increased appetite, dizziness, nausea, vomiting, unstable and unformed stools, and less often of abdominal pain without a specific localization. From the outside nervous system weakness, irritability, sleep disturbances are noted, and children often experience weight loss.

Due to the fact that taeniasis can be complicated by cysticercosis in any form, it is classified as a dangerous invasion. Laboratory diagnosis is based on the detection and study of the nature of the segments and eggs in the stool and in the scraping material of the perianal folds.

Treatment of taeniasis.

Treatment is carried out in the hospital with male fern extract or pumpkin seeds, biltricide (orally after meals, 20-25 mg/kg 1-3 times a day), vermox (200 mg 2 times a day for 3 consecutive days before complete cure; children 100 mg 2 times a day for 3 consecutive days).

Cysticercosis.

Symptoms of cysticercosis.

Diagnosis of cysticercosis can be complex and includes a careful collection of epidemiological history, analysis clinical manifestations, ophthalmoscopy, immunological methods diagnostics (indirect hemagglutination reaction, fluorescent antibody reaction).

Treatment of cysticercosis.

Treatment is symptomatic and, if necessary, surgical. Echinococcosis. Echinococcosis is widespread almost everywhere. In Russia, this helminthiasis is more often recorded in the Novosibirsk, Tomsk and Omsk regions, Yakutia (Sakha Republic) and Buryatia. Humans are the intermediate host of Echinococcus and serve as the final host. domestic dog, which has the greatest epidemiological significance, as well as the wolf, jackal, fox, hyena, coyote and some other predatory animals.

Human infection occurs through close contact with infested dogs, as well as through eating greens and vegetables contaminated with Echinococcus eggs, in water, and when removing and butchering the skins of infected predators.

Symptoms of echinococcosis.

The clinical picture of invasion in humans depends on the number, size and location of echinococcal blisters. Liver echinococcosis is the most common (60-80%). IN initial stages clinical manifestations are scanty: severity and moderate intermittent pain in the right hypochondrium, possible urticaria as a manifestation of allergization, eosinophilia. Further, slowly progressive enlargement of the liver, ascites, edema, and jaundice are determined. In cases of pulmonary echinococcosis, persistent dry cough, hemoptysis, pain in the chest. Physical findings on examination of the lungs are nonspecific. Echinococcosis of other organs is rare; the symptoms in these cases are similar to those of the neoplasm.

Treatment of echinococcosis.

Treatment of echinococcosis is only surgical. Alveococcosis. Alveococcosis (alveolar, or multilocular, echinococcosis). In Russia, alveococcosis occurs in Yakutia, Bashkiria, Tatarstan, Magadan, Kamchatka, Irkutsk, Novosibirsk, Omsk and Tomsk regions; V lately also registered in Central European regions Russian Federation. The definitive hosts of the invasion are domestic dogs, foxes, arctic foxes, wolves, and rarely domestic cats.

Humans are the intermediate host (along with rodents, mainly voles). A person becomes infected in various ways: when removing and cutting the skins of fur-bearing animals, during contact with dogs and cats, when consuming water, berries, and garden crops contaminated with secretions of sick animals.

Symptoms of alveococcosis.

Treatment of alveococcosis.

Treatment is surgical. Trichinosis. Trichinosis occurs everywhere, in Russia it is more often registered in the Magadan region, Khabarovsk, Krasnoyarsk and Krasnodar territories. A person becomes infected by eating pork infected with Trichinella larvae, and less often the meat of brown bears, wild boar and other animals. Trichinella larvae are carried into the bloodstream various organs and tissue, primarily into muscles. The incubation period is 5-45 days.

Symptoms of trichinosis.

The disease is acute, body temperature rises, nausea and diarrhea appear, and pronounced swelling of the eyelids and puffiness of the face are characteristic. Swelling and hyperemia of the conjunctiva are noted. Later, muscle pain appears, often intense. The muscles of the neck, lower back, and calf are most often affected. A variety of rashes appear on the skin. Complications of invasion are varied: thrombosis, pneumonia, nephritis, myocarditis, meningoencephalitis.

Diagnosis of trichinosis is complex, including an epidemiological history, analysis of clinical manifestations, immunological tests (RNGA indirect agglutination reaction, RSK complement fixation reaction, allergy skin test), examination of the animal’s muscles and a piece of the patient’s muscles (trapezius, deltoid or gastrocnemius) followed by microscopy.

Treatment of trichinosis.

Treatment of hymenolepiasis.

Treatment of hymenolepiasis is carried out with biltricide. The drug is prescribed orally after meals at a dose of 20-25 mg/kg 1-3 times a day. The tablets are swallowed whole with a small amount of liquid. For a one-time prescription, it is better to take the tablets in the evening; for a 2-3-time prescription, the interval between doses should be 4-6 hours. A laxative is not prescribed when taking biltricide.

Ascariasis.

Ascariasis is the most common of all human helminthiases. The only source of invasion is humans. Infection occurs when helminth eggs are ingested in water or food. Next, the roundworm larvae migrate with the bloodstream through the portal system of the liver and the inferior vena cava, right heart, are carried into the lungs, where they remain from several days to one and a half weeks. From the lungs, the larvae move to the trachea and pharynx and, with ingested saliva and food, re-enter the intestines, where they transform into mature helminths. Ascaris eggs are resistant to external environment and can be stored in soil at a depth of 20 cm in middle lane In Russia up to 7 years, in the southern regions - more than 10 years.

Symptoms of ascariasis.

Treatment of ascariasis.

Vermox is used for treatment (adults and children over 1 year of age are prescribed 100 mg 2 times a day: morning and evening for 3 consecutive days), decaris (150 mg once; children 1-6 years old 25-50 mg; 7-14 years old 50-125 mg; usually 2.5 mg/kg), mebendazole (1 tablet in the morning and evening for 3 days in a row), piperazine, naphthamon.

Strongyloidiasis.

Strongyloidiasis helminthiasis with a chronic course, periodic exacerbations and a multiplicity of clinical manifestations: gastroduodenitis, skin rashes, bronchitis with an asthmatic component. The disease is widespread in tropical and subtropical countries. However, due to the fact that eel larvae can develop in the soil in wide range temperatures range from 10 to 40°C, cases of strongyloidiasis occur in temperate climates, up to Moscow and even St. Petersburg. The causative agent of the disease is intestinal eel, the main source of invasion is a sick person, as well as a dog. A person becomes infected with strongyloidiasis by drinking water and food products contaminated with larvae, and upon contact with soil in which the larvae have developed to the invasive stage. Migration of larvae when penetrating the skin blood vessels into the lungs, exit into the respiratory tract, then through the larynx into digestive system explains the sensitization of the body and the uniqueness of the clinic of strongyloidiasis. During the course of the disease, acute and chronic phases are distinguished.

Symptoms of strongyloidiasis.

In the acute phase (it can be detected only in 7-25% of hospitalized patients), fever, skin rashes, often of a polymorphic or exudative nature, bronchitis, and less often pneumonia are observed. Bronchitis can occur with an asthmatic component. In other cases it develops clinical picture acute ulcer duodenum or stomach. In the chronic stage, the disease occurs in one of three main ways:

according to the type of chronic recurrent gastroduodenitis; with symptoms of gastroduodenitis and chronic cholecystitis; mainly with allergic manifestations - skin rashes, asthmatic bronchitis, arthralgia. The diagnosis of strongyloidiasis is confirmed by microscopic examination of duodenal contents or stool examination.

Treatment of strongyloidiasis.

Symptoms of enterobiasis.

The enterobiasis clinic is characterized by irritation, itching and a burning sensation in the area anus, perineum and external genitalia, mainly at night. Disorders are common emotional sphere, and in women and girls, when pinworms crawl into the genital tract, symptoms of gynecological diseases appear. Diagnosis of enterobiasis is usually not difficult. Pinworm eggs are found in scrapings of the perianal folds.

Treatment of enterobiasis.

Treatment is carried out with piperazine, vermox (for adults and children over 1 year 100 mg once and again once after 2 and 4 weeks), mebendazole (taken orally, pre-chewed or mixed with food, 1 tablet 100 mg once).

Schistosomiasis.

Schistosomiasis helminthiases of tropical and subtropical countries, occurring in the form chronic disease with a predominant defeat genitourinary system, intestines, liver, spleen, sometimes nervous system. Schistosomiasis is widespread in African countries, South America, Southeast Asia.

Symptoms of schistosomiasis.

It can occur at lightning speed, with general severe symptoms in the absence of local manifestations or in the form acute colitis, enterocolitis. In intestinal schistosomiasis, the predominant gastrointestinal manifestations or hepatolienal forms with the development of liver cirrhosis. Lung damage, encephalitis, and meningoencephalitis (the result of egg laying) are also possible. Intercalate schistosomiasis is the most benign form and is relatively rare.

Treatment of schistosomiasis.

Specific treatment carried out with biltricide 20-25 mg/kg 1-3 times a day. The tablets are swallowed whole without chewing.

Hundreds of species infect the human body, causing a disease called helminthiasis. The spread is due to climatic conditions country and socio-economic level. Progressive countries with low disease rates, unlike tropical ones. The infection rate in children is much higher.

Where does the infection come from?

The following reasons are identified:

In adults there are protective barriers– oral enzymes, stomach acid and intestinal immunity. When the immune system is weakened, worms penetrate bypassing barriers.

How does the disease manifest itself?

Ascariasis

• Rash on the body;
• Nausea, abdominal pain;
• Decreased appetite;
• Changes in blood composition;
• Peritonitis or appendicitis;
• Liver damage;
• Intestinal obstruction.

Diphyllobothriasis

Diphyllobothriasis develops gradually when infected with the helminth Diphyllobothrium.

Main symptoms:

• Nausea, weakness, vomiting, bowel dysfunction.
• Dizziness, abdominal pain.
• Decreased hemoglobin, lack of vitamin B, iron and protein.
• Intestinal obstruction.

Trichocephalosis

The causative agent is whipworm. Symptoms progress over many years. The disease is characteristic chronic and has dire consequences. The patient develops hemorrhagic colitis, accompanied by hemorrhages.

Enterobiasis

Main symptoms:

• Itching and dermatitis of the anal canal.
• Stomach ache.
• Vaginal complications in girls and women.

Helminth infections have similar symptoms: refusal to eat, nausea, frequent diarrhea, constipation, weakness. Then muscle and joint pain occurs. Some are asymptomatic, but with serious consequences - decay of cysts, pleurisy, damage to the nervous system, and death.

Stages of the disease

Helminthiasis has two stages: acute (up to 2 months) and chronic (up to several years). During acute course worm development is observed. At this moment there are allergic manifestations. Symptoms in acute period similar for all types of infection.

Chronic is characterized by a variety of manifestations of organ damage. It all depends on the place of attachment of the worms, the peculiarities of their existence and the extent of the damage.

When infected with a single worm, in chronic process There may be no symptoms. The exception is large worms. When developing en masse, worms disrupt digestion and cause other symptoms.

Common worms

Different biological characteristics appearance in humans and reproduction of helminths are divided into:

Roundworms live in the rectum, large and small intestines of people. Flat or ribbon-like ones stick to various organs.

What worms are often found in humans?

There are helminths that more often infect people.

The whipworm is a worm that has a thin body similar to a hair. The length reaches up to 5.5 mm. Living in the intestine, it sucks blood from the intestinal mucosa. Lives up to 4 years.

Pork tapeworm is especially dangerous. Unprocessed meat can cause infection. The larvae live in the small intestine for up to 30 years. Once settled in an organ, the worm harms the muscles, heart and brain.

Helminths may not appear for a long time. Subsequently they become the cause of complicated human diseases.

How to cleanse the body of worms?

Treatment should be carried out with those drugs to which sensitivity has been identified. To treat ascariasis, enterobiasis and taeniasis, drugs based on levamisole and mebendazole are used. The most common tablets for worms: dekaris, helmifag, medamin. This treatment is carried out for the whole family and repeated after 2 weeks.

Also general hygiene– an important component of treatment to avoid reinfection. In addition to washing your hands after going to the toilet, you should properly store food and handle raw meat and eggs.

Traditional medicine

Treatment helminthic diseases perhaps folk remedies. You can safely call pumpkin seeds and grapefruit effective. Onions and garlic are also used as medicines for helminthic infestations. These drugs have a pathogenic effect on some helminths, but are ineffective without special medicinal herbs. The collection of tansy, horsetail, calamus root, chamomile, wormwood and calendula is brewed with boiling water. For worms, the infusion should be taken in the morning in half with water.

Recipes traditional medicine There are many types of helminths in the intestines. Traditional methods proven over generations and without side effects.

How to avoid infection?

To avoid invasions in preschool educational institutions, the following preventive measures are taken:

• Neutralization of sewage systems and soil on playgrounds.
• Purification of drinking water.
• Epidemiology recommends compliance with sanitary rules: wet cleaning of furniture, floors, and equipment twice a day. Storing food in the dining room at temperature conditions.
• Infected children are not allowed into the preschool. Helminthic diseases are treated at home.

Rules for the prevention of helminthiasis, which should be like a reminder for parents:

The main thing in prevention is to promptly find characteristic signs of helminthiasis and examine infected people. For this purpose, examinations of adults and children are periodically carried out on a large scale. Only this measure can reduce the spread of helminthiasis.

Depending on the method of transmission, all human helminthiases are divided into:

Signs

The characteristic signs of helminthiasis appear first of all on the peripheral blood. If you carry out clinical analysis, then a significant increase in the amount can be detected (especially in acute stage illness). It is worth noting that it is often combined with pronounced.

Other signs of the presence of helminths include:

• itching in the anus;
• Possible unstable stool – alternation and diarrhea;
• grinding teeth in a dream;
• nausea in the morning. Most often it occurs in a person while brushing his teeth;
• weight loss, while the diet has not changed;
• hyperthermia, accompanied by joint and muscle pain;
• drooling in the morning;
• a person constantly feels hungry;
• appearance of rash elements on skin(sometimes on eyelids);
• the skin on your fingers may peel.

Symptoms

• diarrhea;
• hyperthermia;
• the upper respiratory tract becomes inflamed;
• elements of a rash appear on the skin;
• the face swells. This symptom is especially pronounced in children;
• In young children, sore throat sometimes occurs.

Pathological process may be complicated:

• bronchospasm;
• the appearance of infiltrates in the lungs;

• . An allergic reaction comes to the fore. Allergy symptoms reach their maximum. In the most severe clinical situations, it is even possible to develop;
• filariasis and strongyloidiasis. Skin rashes intensify, and swelling of the face is observed.

Experts consider the most severe helminthiasis to be:

• echinococcosis;
• paragonimiasis;
• cysticercosis.

These helminthiases affect almost all vital important organs and systems, so even with timely treatment the prognosis is often unfavorable.

Diagnostics

Due to the fact that there are quite large number helminth infections, diagnosis includes many research methods. The most informative and frequently used are the following:

• stool analysis. In it, doctors have the opportunity to detect helminth eggs, as well as undigested food debris, which indicates a disruption in the functioning of the gastrointestinal tract;
• blood for microfilariae;
• to detect roundworms and pinworms in the human body, they resort to macroscopic examination;
• microscopic examination;
• bile examination;
• coproovoscopy. Diagnosis of helminthiases using this method allows you to determine the intensity of helminthic infestation;
• examination of the contents of the duodenum;
• if doctors suspect that a person has progressive trichinosis, they prescribe a biopsy of muscle tissue;
• X-ray;
• fibrogastroduodenoscopy;
• blood test for the presence of specific antibodies to certain helminthiases.

Treatment

The basis for the treatment of helminthiases is the use of specific anthelmintic drugs. Most often, doctors prescribe:

• pyrantel;
• Wormil;
• carbendacim;
• mabendazole;
• albendazole;
• medamin;
• levamisole;
• Praziquantel

They must be taken only as prescribed by the attending physician and in the dosage that he prescribes. In the acute phase of the disease, a single dose of medication is enough to get rid of helminths. But most often treatment is carried out according to a certain scheme.

During treatment, it is important to adhere to the following principles:

• strict adherence to personal hygiene rules;
• diet therapy;
• all products consumed must be processed;
• the place where the patient is being treated must be regularly disinfected.

Treatment of helminthiasis in children is carried out only in a hospital setting, so that the doctor can constantly monitor the patient’s condition and, if necessary, adjust therapy. It is worth noting that in children the disease is more severe, so the course of treatment can be lengthy.

Prevention

Prevention of helminthiasis in children and adults should be carried out throughout life. Since helminths live in the ground and can also be transmitted by contact, you should maintain maximum hygiene - wash your hands, use personal hygiene items, etc. It is also important to thoroughly process vegetables and fruits before consumption.

For preventive purposes, it is important to promptly identify people infected with helminths. For this purpose, surveys of certain categories of adults (especially food workers, medical field and so on).

Helminthiasis is characterized by a relatively slow development of the disease, chronic course, often with long-term compensation. According to WHO experts, helminth infections have now, to some extent, become “ forgotten diseases“- all over the world there is an underestimation of their medical and social significance. Even in endemic countries, they receive insufficient attention from both health authorities and the population.

In the pathogenesis and clinical picture of helminth infections, two main phases are distinguished: acute - the first 2-3 weeks after invasion, and when severe course- up to 2 months or more, and chronic - lasting from several months to many years.

Factor of influence of the pathogen on immune system The “host” continues to play a significant role in the chronic phase of invasion. One of the important reasons for organ and systemic lesions, especially with tissue helminthiasis, is the formation immune complexes, which activate mediator systems (complement, cytokines, etc.). Along with stimulating the immune response, helminths have an immunosuppressive effect, which promotes their survival in the host body. The state of immunodeficiency during helminthiases negatively affects a person’s resistance to bacterial, viral and other infections, contributes to their protracted course and the formation of carriage, and reduces the effectiveness preventive vaccinations. This is well shown in the frequency of typhoid carriage, the incidence of tuberculosis and other chronic infectious diseases among the population of hyperendemic foci of opisthorchiasis.

In clinically manifest forms of helminthiases, the first signs appear in different terms after infection: with ascariasis, manifestations of the acute phase are observed already on the 2-3rd day, with most other helminthiases - after 2-3 weeks, with filariasis incubation period lasts 6-18 months. In the early acute phase of helminthiases, manifestations are characteristic: allergic reactions: fever, recurrent itchy skin rashes, swelling - from local to generalized, swollen lymph nodes, myalgia, arthralgia, in the peripheral blood - leukocytosis with hypereosinophilia. Against this background, pulmonary syndrome (from minor catarrhal phenomena to asthmatic conditions, pneumonia and pleurisy) and abdominal syndrome (abdominal pain and dyspeptic disorders) often develop. The liver and spleen increase in size, possible to varying degrees severity of symptoms and syndromes of damage to the central nervous system (CNS). With some helminthiases, specific symptoms are also observed: with trichinosis, in typical cases, from the first days of the disease, a symptom complex is observed, including fever, muscle pain, swelling of the eyelids and face; with liver trematodes (opisthorchiasis, fascioliasis) - icteric syndrome, enlarged liver and spleen. Even among helminthiasis caused by closely related species of pathogens, significant differences in the severity of the course and the nature of the manifestations of the acute period: for example, with Japanese schistosomiasis, it develops much more often and is more severe than with genitourinary and intestinal schistosomiasis.

Strongyloidiasis is characterized by a large polymorphism of clinical manifestations, in which, along with a variety of allergic and dyspeptic symptoms, patients often exhibit signs of dysfunction of the biliary tract. With liver trematodes (opisthorchiasis, clonorchiasis, fascioliasis), chronic cholecystocholangitis, hepatitis, pancreatitis develop, and possible lesions various departments gastrointestinal tract, neurological disorders are also observed. A characteristic feature Urogenital schistosomiasis is “terminal hematuria” (the appearance of a drop of blood at the end of urination) and dysuric disorders. In patients with filariasis, it is expressed to varying degrees allergic syndrome Lymphatic filariasis (wuchereriosis and brugiosis) is characterized by lymphadenopathy, lymphangitis and lymphostasis; with onchocerciasis, along with these symptoms, serious eye damage is noted.

Intestinal cestodiasis (diphyllobothriasis, teniarhynchosis, taeniasis, hymenolepiasis) in many cases are asymptomatic, manifesting only by the passage of mature helminth segments during defecation or independently (only with teniarhynchosis). Patients with diphyllobothriasis develop anemia caused by vitamin B12 deficiency. Among helminthiases, a special place is occupied by larval cestodiases: echinococcosis, alveococcosis, cysticercosis. They can also long time proceed asymptomatically even in the presence of fairly large cysts. At the same time, rupture or suppuration of even a small echinococcal bladder leads to severe consequences: development anaphylactic shock, purulent peritonitis, pleurisy, etc. As a result of compression of the portal and inferior vena cava by a growing bladder or alveococcus, portal hypertension with everyone characteristic manifestations and consequences.

Cysticercosis of the central nervous system occurs in the form of cerebral and spinal lesions with corresponding varied symptoms; Localization of the helminth in the ventricles of the brain is accompanied by signs intracranial hypertension. Toxocariasis, registered in our country mainly in children, is clinically expressed as abdominal, pulmonary syndromes, neurological disorders, eye damage, severe eosinophilia in the peripheral blood.

Biological material for research on the presence of helminths, their fragments, larvae and eggs are feces, urine, duodenal contents, bile, sputum, rectal and perianal mucus, blood, and muscle tissue. Taking into account the predominant localization of most of the most common helminths in gastrointestinal tract, most often the object of research is feces. Macroscopic methods are used to detect isolated helminths or their fragments: heads, strobila fragments or individual segments. Purpose microscopic studies is the detection of eggs and larvae. Currently, thick smears according to Kato-Miura, sedimentation methods, and flotation methods are recommended for use.

In the diagnosis of the acute phase of helminth infections and diseases caused by tissue helminths or larval stages (echinococcosis, cysticercosis, trichinosis, toxocariasis), serological methods: indirect agglutination reactions, complement fixation, lysis agglutination, immunofluorescence, enzyme immunoassay etc.

For some helminthiasis (cysticercosis, echinococcosis, etc.) it is important diagnostic value They also have instrumental methods (radiography, ultrasound examination, computed tomography, magnetic resonance imaging, endoscopy with endobiopsy).

Treatment of helminthiases

In the acute period, the basis of treatment is desensitization and detoxification. Glucocorticosteroids are used according to indications only for severe cases of certain helminthiases (trichinosis, schistosomiasis, liver trematodes) or for the purpose of prevention allergic complications chemotherapy (onchocerciasis, loiasis). It should be taken into account that with some helminthiases, their improper use can lead to generalization of invasion (strongyloidiasis) or a protracted course of the acute phase (opisthorchiasis, trichinosis, etc.).

Specific treatment is the basis for combating most human helminthiases. The main anthelmintic drugs and their use for various helminthiasis are given in the table.

Currently, there are highly effective anthelmintic drugs for the treatment of nematodes: albendazole, mebendazole, carbendacim, pyrantel. An indispensable condition for successful deworming of patients with enterobiasis is simultaneous treatment all family members (team) and strict adherence to a hygienic regime to prevent reinfestation; In addition, re-treatment is usually carried out at intervals of 10 days. Ivermectin has been successfully used to treat strongyloidiasis and some filariasis. Praziquantel is widely used for trematodes and cestodes. Patients with opisthorchiasis, clonorchiasis, paragonimiasis are prescribed daily dose 75 mg/kg (in 3 doses) - 1 day, for schistosomiasis, depending on the form - in doses from 40 mg/kg once to 60 mg/kg in 2 doses; for fascioliasis, the effectiveness of the drug is low; triclabendazole is recommended for these purposes. For intestinal cestodiasis (diphyllobothriasis and taeniasis), deworming is achieved with a single dose of praziquantel at a dose of 20 mg per 1 kg of the patient's body weight, for hymenolepiasis the same dose is prescribed 2 times with an interval of 10 days, for cerebral cysticercosis abroad the same drug is used in a daily dose of 50 mg/kg in 3 divided doses for 14 days or more. Specific treatment of other larval cestodiases - echinococcosis and alveococcosis - is still not effective enough. Treatment of patients is not limited to prescription anthelmintics: complex is carried out therapeutic activities in accordance with the characteristics of the pathological effect of a particular pathogen and the course of helminthiasis.

Prevention of helminthiases includes a set of measures to identify patients, treat them, ensure living conditions, everyday life and production that exclude the spread of these diseases, protection and health improvement environment from pathogens. The volume and nature of the measures taken to reduce the incidence of the most common geohelminthiasis among the population of the Russian Federation are determined by the level of infection, climatic conditions, the characteristics of the life and economic activities of the population and the results of sanitary and helminthological monitoring, since geohelminthiasis is primarily a sanitary problem. The basis for the prevention of trichinosis, teniarynchosis, taeniosis is to ensure the safety of meat products for human health, and the prevention of opisthorchiasis, clonorchiasis, metagonimiasis, nanophyetosis, paragonimiasis, diphyllobothriasis, anisakiasis, heterophyosis, sparganosis and other helminthiases transmitted through fish, crustaceans, mollusks and reptiles, is to ensure guaranteed safety of fish and other related products. Prevention and control of echinococcosis and alveococcosis is carried out using measures aimed at preventing infection of humans, farm animals, and dogs; health education, regular medical examination risk contingents (reindeer herders, fur breeders, hunters). In the prevention of helminthiases transmitted by contact (enterobiasis, hymenolepiasis), the main importance is measures aimed at breaking the mechanism of transmission of their pathogens, and it should be taken into account that these helminthiases mainly affect children in organized groups.

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A. K. Tokmalaev, doctor medical sciences, professor