What Kind of Bites Can You Get From the Ocean?

California’s sunny weather, gorgeous beaches and cool waters make it a virtual playground for summer fun-seekers. But enjoying the coast isn’t without risks. From stingray encounters to jellyfish stings, knowing what to do in case of emergency could save your summer.

According to California State University Long Beach’s Shark Lab, most stingray injuries occur between June and August. The afternoons are prime stingray striking times, when the tide is lower, the water is warmer and more people are visiting the beach.

Often hiding on the ocean floor, stingrays are difficult to see and can deliver a painful sting when they feel threatened, usually by people walking through their territory. A stingray will whip its tail to defend itself and can cause a laceration on whatever it encounters — usually peoples’ feet, ankles or legs.

How to avoid stingrays
“When walking in the ocean, you should use the ‘stingray shuffle,’” says Dr. Julie Phillips, an emergency medicine doctor affiliated with Sharp Grossmont Hospital. “Drag your feet through the sand to warn the stingray you’re coming and give it time to swim away.”

If a person is stung at a location where lifeguards are stationed, tell them right away. Stingray wounds should be soaked in hot water for 30 to 40 minutes to neutralize the toxin.

One can try to remove the stinger, but if it’s too deeply embedded, a trip to the ER may be required for removal. Make sure to keep the wound clean and watch for signs of infection as it heals.

Do’s and Don’ts when jellyfish attack
The outlook is a little brighter when it comes to jellyfish. “In general, California doesn’t have venomous jellyfish, so very few jellyfish stings require a trip to the ER,” says Dr. Phillips.

Typically, jellyfish stings occur when people rub up against them in the ocean or touch them once they’ve washed up on the beach. While most jellyfish stings are painful, they are not life-threatening.

Stingers, called nematocysts, look like small capsules and attach to the skin, injecting a small amount of toxin. Pain and a red streaking line will occur at the site of the sting.

“It’s necessary to remove the stingers one at a time to stop further release of the toxin,” Dr. Phillips says. “Using tweezers or a flat surface, such as a credit card, to flick them off is best. Avoid using your bare hands, if possible.”

Dr. Phillips offers these additional tips:

1. DON’T use a vinegar rinse to treat the sting. “Recent studies indicate it may make some stings worse.”

2. DO remove the stingers in salt water and then apply hot water afterward. A mixture of baking soda and water can also be used to help remove the stingers.

3. DON’T urinate on the sting. “That’s a myth and doesn’t help.”

Meat tenderizer and alcohol are also not helpful, Dr. Phillips adds, and can cause more toxin release. If the pain isn’t relieved after soaking and removing the stingers, you can take an over-the-counter pain reliever, such as ibuprofen, for relief.

Talk with your doctor if you are concerned about a recent stingray wound or jellyfish sting. And seek care if blisters form; signs of infection are present; or severe itching, redness or rash last more than 48 hours.

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13 questions answered after I got stung by a stingray – The cerulean sea

It’s been an eventful past few days and a rather interesting New Year’s Eve. Last Thursday, I was at work trying to service some equipment at low tide and needed to walk through an intertidal area. The site was rather rocky, covered by thick mats of Sargassum seaweed during the blooming season. As I was making my way through the water, I felt a sudden stabbing pain pierce through the top of my left foot. Gingerly lifting my foot out of the water to take a look, I noticed a spine embedded in my booties, still attached to wispy trails of blue flesh. A little in awe that the barb pierced through the thick layer of neoprene and rubber, I looked around for the culprit but saw nothing in the murky waters.

To be honest, I felt a bit of relief when I saw that dash of blue because I knew I hadn’t stepped on something worse. The blue was a telltale sign that the poor spooked guy was a blue-spotted ribbontail ray (Taeniura lymma). This is not to be confused with the blue-spotted stingray (Neotrygon kuhlii), which has black and white bands on its tail and was unlikely the culprit. Stingrays can cause a lot of pain, but unless the sting is delivered straight into major organs or causes severe blood loss, it’s unlikely to cause death. While it was unlucky that I happened to step onto a stingray, I was immensely lucky it wasn’t something worse. There are a few highly venomous sea creatures in Singapore such as cone snails, stonefish and the rarely-sighted blue-ringed octopus (which purportedly has enough venom to kill 26 adults in minutes).

The likely culprit: A blue-spotted ribbontail ray (Taeniura lymma). I photographed this species a few years ago at Pulau Satumu in Singapore

I’ve put together a list of questions asked by friends and medical staff in the hopes that if anyone is accidentally stung by a stingray, they can easily understand what’s happening to them and how to handle it. While writing this, I also learnt quite a few new things about venomous sea creatures and stingrays. I sincerely hope that some of these answers spread awareness instead of blindly antagonizing stingrays and other venomous fish. While stingrays get a bad reputation from notable deaths caused (Sorry Steve Irwin), they are behaving the way any animal does when it feels threatened and is trying to protect itself. If anything, this encounter has become a reminder that when we venture into the sea, we are entering a different world -their world- and it’s vital that we respect it.

Q: Does it hurt when a stingray stings you?

Probably the first question anyone asked and the answer is…Duh!? For me, the pain was bearable at the start but progressively worsened over the next few hours. The peak was almost four hours in when I was waiting for my x-ray and blood test results at which point I begged the nurses for more painkillers. Some extreme accounts liken the pain to a gunshot wound but I think that’s a bit dramatic. My point is, even if you feel the pain is bearable at the start, don’t be a hero and seek immediate medical attention. You’ll thank me four hours later.

The stingray’s barb embedded in my foot

Q: How large was the barb and which part of your foot did it pierce through?

It went between the extensor tendon and the third metatarsal head of my left foot. The blue-spotted ribbontail ray is one of the smaller stingray species and the total length of the barb was 5 cm (around 2 inches). Around half of the barb was lodged in my foot.

The X-ray before my sting operation (haha)

Q: Why didn’t you just pull out the sting/barb in your foot?!

Stingray barbs have backwards-facing spines. Pulling it out would have caused further injury as the flesh is torn out or may even cause excessive bleeding. It’s best to leave it in and seek professional medical attention. In my case, it required surgery that took no more than two hours to remove it.

This was the barb that got removed from my foot! If you look carefully, the black material attached to it was the neoprene from my booties. (Lol some bits of my flesh are still stuck too)

The barb in my foot after my diving booties were cut and removed

Q: Are stingrays poisonous?

Stingrays are venomous, not poisonous. The easy way to remember the difference is — Poison: You bite it, it harms you. Venom: It bites you, it harms you. Venom is injected through the bloodstream whereas poison is ingested and harmful when it is absorbed by your digestive system. An example of a venomous sea creature in Singapore would be the yellow-lipped sea krait and an example of a poisonous sea creature would be the map pufferfish. Although highly venomous, sea snakes in Singapore are shy creatures that feed mainly on fish. Furthermore, these snakes are rare locally with some species listed as locally endangered. Meanwhile, pufferfish have toxins on their skin and in their internal organs, requiring expert preparation for consumption. Cases of pufferfish poisoning occur but are uncommon.

Q: What type of venom is found in the sting?

According to an article on Venomous Fish Stings in Tropical Northern Australia, “Stingray wounds have the greatest potential to cause necrosis and infection.” While the barb can be easily removed and leaves a small wound in my case, the main concern was the aftercare of the wound to prevent and monitor infections.

Stingray venom contains a whole host of different proteins known to be cardiotoxic, hemotoxic and neurotoxic (affects the heart, red blood cells and brain). One of these compounds includes bibrotoxin, which causes blood vessels to constrict leading to pain and inflammation. Another source shows stingray venom has fibrinolytic and anticoagulant properties that exacerbate blood loss. The thin layer of skin surrounding the spine of the stingray not only introduces venom but exposes the wound to other bacteria and microorganisms. In some cases, this can lead to further bacterial infections such as tetanus.

Q: How is the venom delivered from the barb?

Stingray venom isn’t produced by venom glands but by two long grooves under the skin that contain venom-secreting glandular cells. The skin acts as a sheath and peels back when the barb is thrust into the victim, thus releasing the venom.

Anatomy of a stingray’s barb. Photo credits here and here.

Q: Where is the sting on stingrays? How do they sting? Will the stingray die after using its sting?

One common misconception is that the entire length of the stingray’s tail is the sting. That’s not correct, the barb of the stingray is usually located near the base of the tail that connects with its main body. It rests on the top of the tail and is primarily made up of keratin, the same protein that makes up our hair and nails. When stingrays sting, they whip their tail around to lodge the barb into its assailant’s flesh and the barb breaks off. Thankfully, the stingray will not only survive this ordeal but is also capable of growing its barb back within a year or so, with some observations of stingrays regularly shedding their barb 2-3 times a year.

https://gifs.com/gif/stingray-lRXQE6

A snippet of a motoro stingray on the River Monsters series impaling a pork leg with its venomous barb

Q: Why do stingrays and other fishes sting?

Most marine and freshwater fish use their stings for defence with less than 2% of fish known to use venom for predatory purposes. Similar to the rest of the majority, stingrays do not use their sting for any other purpose apart from self-defence. The blue spots on the ray that stung me is actually a great example of aposematism or warning colouration that is used to deter predators. It is used as a last resort because having to regrow a barb is energetically costly.

Q: How did fish evolve their stings? Which parts of these fish are venomous?

There are more than 2900 species of venomous fish worldwide in both freshwater and marine habitats, most of which use venom for defence and the minority for predation or competition. What surprised me was that these venom systems are likely convergently evolved, meaning that different lineages of fish evolved venom independently as an adaptation. Fish seem to engineer and evolve a similar solution to the problem of being eaten by predators.

Different types of venomous species across families and the various types of morphological structures used by fish to deliver venom. Diagrams adapted from this paper.

Some other notable types of venomous fish include catfishes, which represent 58% of venomous fish species, because of its large diversity. Meanwhile, venomous fangblennies are unique in that they inject venom through their canine teeth instead of spines like most other fish. These fangblennies are tiny, no larger than your finger. When ingested by a predator, it bites its predator from the inside and stuns it into opening its jaw and gills, then swims away out of the predator’s mouth unscathed.

Striped Blenny (Meiacanthus grammistes) – A type of venomous fangblenny that looks really cute because it smiles while peering out of small holes in corals or bottles, but also has opioid toxins that cause a drop in blood pressure. (Photo credits here and here)

Q: How do I avoid being stung by all of these creatures?

The easiest solution is to keep out of the water, but hey, that’s not entirely viable is it? The next best option is to wear proper protective clothing such as booties when exploring rocky or intertidal areas. Avoid walking in places with low visibility. If you must, shuffle your feet slowly when walking in submerged sandy areas with poor visibility. Most animals will move away when they sense a large animal coming their way.

Q: What should I do if I get stung by a stingray? What kind of medical attention did I receive?

Firstly, stay calm and signal for help so you can make your way to shore or the boat as safely and quickly as possible. Assess the severity of the wound — Is it bleeding profusely? Is the sting intact? Some tips for first aid and treatment of stingray stings are listed in the Clinical Toxinology Resources, which I’ve copied below. This is a really good resource for bites and stings with the appropriate first aid for each type of animal.

1. The victim should immediately leave the water.
2. Loose broken stings in limb wounds, away from major blood vessels, can be gently removed. If force is required, leave the sting alone. Stings to the chest and abdomen, in general, should be left untouched, as removal may cause further damage and endanger the patient. In particular, stings to the chest wall, near the heart, can prove lethal and inexpert removal of the sting can precipitate rapid collapse and death.
3. The wound should not be rubbed, or stings crushed as this may worsen the local effects of the sting.
4. There may be significant tissue injury and bleeding. Staunch bleeding by application of local pressure. If necessary, apply a bandage to maintain local pressure over the wound. Only if there is severe bleeding, caused by damage to major blood vessels, apply a tourniquet above the wound, to a single-boned part of the limb (thigh for leg; upper arm for arm) to control the bleeding. Tourniquets are effective at controlling bleeding, but in doing so, deprive the limb of oxygen, so cannot be left on for more than 30-45 minutes, or they will cause permanent injury. They therefore require regular release for short periods.
5. The use of immersion in hot water is controversial. Some authorities suggest that immersing the stung limb in hot water may reduce pain. Others suggest it is useless. For stingray injuries, experience suggests hot water immersion is often very effective at providing pain relief and therefore should always be considered. However, it is potentially hazardous, if used incorrectly, as it may cause burn injuries. If used, immerse the opposite limb to that stung in water which is hot, but bearable with prolonged contact. It should not be so hot as to cause pain. Then immerse the stung limb as far as necessary to include the sting area. Keep both limbs in the water for 15-20 minutes, providing there is relief of pain. If there is no relief of pain in this time, abandon the immersion. If pain has subsided, it may return on removal from the water, in which case, reimmerse for a further 15-20 minutes. Repeat this process up to 4 times. If after 1-2 hours, the pain is still severe on removal from hot water, then other forms of pain relief may be required, but these will require medical intervention.
6. Transport the victim to medical care as soon as safely possible, except where the wound is very minor and pain has been easily and fully controlled and the victim has current anti-tetanus immunisation.
7. All stingray wounds to the chest, abdomen, or neck are potentially very serious, even if the wound looks minor and no sting barb is visible. All such cases require urgent hospital assessment.

Q: What role do stingrays play in the ecosystem?

Stingrays function as bioturbators, stirring up sediments as they hunt for crustaceans and molluscs. This process helps oxygen disseminate into the ocean’s sediments and helps with nutrient cycling. Populations of blue-spotted stingrays have actually been increasing, and one possible reason could be the collapse in shark populations, their main predator. According to the WWF Sustainable Seafood Guide, all shark and ray species are considered unsustainable. It’s unclear to me why these rays are considered unsustainable though, but my guess is that the methods of fishing can be rather destructive? In any case, I have no intention to take revenge with a plateful of sambal stingray.

Q: Can the venom from stingrays be useful?

Our understanding of venoms in the marine environment is still limited as most studies so far have focused on terrestrial snakes. What we do know about venoms in general, is that they are potent and highly targeted, consisting peptides that can alter cell function rapidly, properties that are useful to drug development. For instance, peptides in cone-snail venom are used to slow down prey by causing paralysis and pain-suppression. This led to the creation of Prialt, a painkiller that prevents neurons from communicating with each other that is reportedly 1,000 times as powerful as morphine. Dr. Mandë Holford’s laboratory focuses on “the power of venom to transform organisms and to transform lives when it is adapted to create novel therapeutics for treating human diseases and disorders”. The medicinal and other applications of marine life show that the conservation of biodiversity can benefit humanity in ways we don’t often expect. Each time we lose a species, we also lose an important player in ecosystems, the potential it has for biochemical compounds and so much more.

This post started off being an efficient way to answer all the questions I’ve had about my foot (and more importantly, to reassure my mother I would be alright). Little did I realise how fascinating the world of venom is and how little we know of it. I suppose the silver lining of being ordered bed rest for two weeks, is that I’ve gained time to ponder on how I landed myself in this situation, what I could’ve done to prevent it and finally, marvel at nature with its insane adaptations. I can’t wait to be back in the water.

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“Pulse. Anti-tick” – insurance against tick bite, apply for protection against ticks

“Pulse. Anti-tick» – tick bite insurance, apply for protection against ticks

• Up to 6 persons in one policy

  You can insure adults and children (under 18 years old)

• Valid throughout Russia

  1 year, starting from the 5th day after the payment of the insurance policy

• Protects against 12 tick infections

• Not only for tick bites

  Payments for bites of wild animals, stray dogs, poisonous snakes and insects

Suitable for

• Gardeners and summer residents

• Lovers of outdoor recreation

• Travelers in Russia

How to issue

• Step 1
• Step 2
• Step 3
• Step 4

Go to your personal account VTB-ONLINE

online. vtb.ru/login

Open the “Services” section in the menu and select “Insurance”

Go to your personal account VTB

In the “Insurance” section, select “Anticlesch”

Go to your VTB personal account

Click the “Checkout” button

Go to your VTB personal account

Previous step

Next step

90 005 Go to your personal account VTB-ONLINE

online.vtb.ru/login

Open the Services section in the menu and select Insurance0006

Click the “Checkout” button

Go to your personal account VTB

Sample documents

Policy, memo, program, rules

• Program “For myself”

  Download

• For Yourself (Extended)

  Download

• Family Program

  Download

Popular questions and answers

Questions left

Policy expiration date

The policy begins to operate on the 5th day after the payment of the insurance policy and is valid for 1 year.

Example:
Day of registration and payment: January 1, 2022
Validity: January 5, 2022 – January 4, 2023

Who can be insured

Only citizens of the Russian Federation. Up to 6 people in one policy: yourself, spouse, children (under 18 years old, common children of spouses, children of spouse or spouse)

Who can’t be insured

• Other family members (parents, siblings, etc.)
• Registered in narcological, oncological, neuropsychiatric and tuberculosis dispensaries
• HIV infected
• Having malignant neoplasms, including blood diseases

What area is covered by the insurance?

Insurance is valid on the territory of the Russian Federation

What is an insured event

These are unplanned unpleasant events against which you can insure yourself and your loved ones. Under the insurance policy, you will receive protection against tick bites, as well as bites from poisonous snakes, insects (except for ticks), wild animals (including stray dogs) if the bites required medical care on an outpatient or inpatient basis.

What is the sum insured

This is the amount within which medical assistance will be organized and / or payments will be made upon the occurrence of an insured event.

• we pay for medical care provided by the insurance program up to 1,500,000 ₽
• in the event of accidents and illnesses, we pay up to 1,500,000 ₽ (only in the programs – “For myself (extended)”, “For the family”)

After each payment for an insured event, the corresponding sum insured is reduced by the amount of the payment made.

How to seek help for a tick bite

It is important to get help in the first 72 hours. Call 8 800 707-00-94 as soon as possible.

The manager of the Asko-Med service company will advise you on what to do next, since each case is individual.

The phone works around the clock. The call is free on the territory of the Russian Federation.

How to seek help for other bites

In case of bites from wild animals, stray dogs, poisonous snakes or other insects, contact the nearest emergency room or call an ambulance at 103 or 112

At the end of the treatment, keep your medical records and contact us for payment

• Hotline: +7 (800) 302-15-54
  (on the territory of the Russian Federation the call is free)
• [email protected]

The expanded program provides for payments

• Diagnosis of “Tick-borne encephalitis” – payment of 100,000 ₽
• Traumatic, hemorrhagic, anaphylactic shock resulting from the bite of animals, including snakes, or insects – payment of 25,000 ₽
• Death due to tick-borne encephalitis – payment of 1,500,000 ₽
• Death as a result of being bitten by wild animals, including stray dogs, poisonous snakes or insects — payment 1,500,000 ₽

• Bites from wild animals, including stray dogs, venomous snakes, or insects (excluding ticks) that require medical attention.

  For the fact of a bite, 3,000 ₽ is paid

  For the fact of a bite that required inpatient treatment, a payment is made depending on the duration of inpatient treatment:

  • 6 – 10 days – payment 15,000
  • 11 – 20 days – payment of 25,000
  • from 20 days – payment of 50,000 ₽

  Payouts are not cumulative

How to terminate the contract

The contract can be terminated at any time by contacting LLC IC “Pulse”

• Email: [email protected]

We will refund the full cost of the insurance policy

If 14 days have not passed since the date of conclusion of the insurance contract (payment) and no insured events have been declared

We will not return the money

If the termination of the insurance contract occurred after 14 days from the date of its conclusion or within 14 days from the date of its conclusion, insurance events occurred, including those requiring medical assistance

How to receive an insurance policy on your email

How to receive an insurance policy to your email

Tick-borne encephalitis: infection, symptoms and prevention

Tick-borne encephalitis is an infectious disease of the nervous system, which is carried by ticks.

TBE virus variants and distribution

There are natural foci in which the tick-borne encephalitis virus (TBEV) lives. There are 5 main genotypes (variants) of the virus, which correspond to their territories:

1. The Far East variant occupies the Far East.
2. Western (Central European version) distributed in Europe and the European part of Russia to Siberia.
3. Greek-Turkish variant.
4. The East Siberian variant prevails beyond the Ural range.
5. The Ural-Siberian variant is present in most of the distribution of viral encephalitis.

There are Far Eastern tick-borne encephalitis (more dangerous and deadly) and Central European tick-borne encephalitis (it is easier and often ends in recovery).

Infection through tick bite

In nature, there are reservoirs and carriers of the pathogen. The reservoir is the organism in which the virus is present. The vector carries the virus from one organism to another. Sometimes the carrier is also a reservoir.
The main reservoir and carrier of TBEV are the ticks Ixodes persulcatus, Ixodes ricinus.
An additional reservoir are mammals and birds:

1. Rodents (chipmunk, field mouse, hare).
2. Predators (wolf, bear).
3. Large wild animals (moose, deer).
4. Insectivores (hedgehogs).
5. Birds (thrush, goldfinch, tap dance, chaffinch).
6. Farm animals (goats, sheep, cows).

During their life, ticks go through 3 stages of development: larva – nymph – imago (adult insect). Females need blood for the maturation of eggs, as well as the transformation of larvae and nymphs into an adult insect. All ixodid ticks are blood-sucking parasites of animals and humans. They feed on blood at all stages of their development.

A tick becomes infected with TBEV from an animal. In the body of the tick, the virus persists throughout all stages of development, but the closer to the adult stage, the lower the probability of transmission of the virus. Females transmit TBEV to their offspring up to the 4th generation. Ticks are found not only in forests, but also in settlements near forests, as well as in city parks and squares. In settlements, ticks get on the clothes of people, animals and objects from the forest. Usually, parks and squares are treated with anti-tick agents before the season, but there are cases when a tick sticks to a person in the city.

In anticipation of the prey, ticks climb onto plants to a height of 30 cm, sometimes more than 1 m. It takes from 3 to 8 days to fully saturate the ticks. Males stick for a few minutes, for a maximum of 1.5 hours, and often go unnoticed. Since the concentration of the virus in the saliva of the tick is very high, it is with a bite that infection occurs.

In all natural foci, on average 1 – 3% of ticks have TBE. The virus is more common in females. The seasonal peak of tick activity depends on the weather, usually lasting from April to August.

On the human body, ticks choose places with thin, delicate skin (armpits, scalp, chest, neck, groin), as well as places where clothes do not fit completely. A tick bite does not cause discomfort, pain, itching and may go unnoticed.
80% of human infections occur precisely when a tick is sucked. In 7-11% of cases, it is not possible to establish the source of infection, but there is always an episode of visiting a forest or similar area. Perhaps, in such cases, a short-term suction of the male occurs, or the tick is crushed and the virus is rubbed into the damaged skin.

Infection through consumption of milk and dairy products

It is possible to infect a person with tick-borne encephalitis by consuming raw milk of goats and cows, as well as dairy products. In milk and dairy products, TBE persists for up to 2 months at a temperature of +16°C. When pasteurizing milk, the virus dies after 20 minutes, when boiling – after 2 minutes. Acidic gastric juice does not always destroy TBEV.
Goat’s milk is more dangerous than cow’s. Goats are more sensitive to TBEV, its concentration in goat’s milk is higher than in cow’s.

How is tick-borne encephalitis

A person is very susceptible to TBE, the most vulnerable are people who visit a natural focus for the first time.
The virus multiplies at the site of its introduction (skin or gastrointestinal tract). Further, with blood and lymph, it enters other tissues. It mainly affects the nervous tissue.
The incubation period for infection through a tick bite lasts 5-25 days, on average 1-2 weeks. With food contamination, it is reduced to 3 days. Although there are cases when the incubation period was 1 day or even 40 days. Symptoms of tick-borne encephalitis are very diverse, their combination depends on the form of the disease.

Forms of tick-borne encephalitis

Inapparent (asymptomatic) form – most common. It is determined only by the presence of antibodies against TBEV.

Subclinical (low-symptomatic) form – resembles a mild infection. A slight rise in body temperature, malaise and loss of working capacity for a couple of days are possible. Patients do not go to the doctor.
Asymptomatic and oligosymptomatic forms of infection predominate among the indigenous inhabitants of natural foci.
Other forms of the disease begin acutely with a temperature above 38°C. Rarely there is a prodromal period, when 1-3 days before the temperature rises, a person feels weakness, fatigue, irritability, headaches, pain in the lower back, arms and legs.

Febrile form – develops in 40 – 50% of cases, lasts from several hours to 6 days. The temperature rises to 38 – 40°C and above. There are two or three waves of fever, when the temperature falls, and after a short time rises again.
A number of symptoms resemble the flu: headache, weakness, feeling hot or chills, loss of appetite, redness of the throat, pain in the muscles and joints, pain in the eyeballs. Nausea and vomiting are possible. Symptoms that are not typical for the flu: sleep disturbance, pain in the bones, spine, neck and shoulder girdle. Red eyes, face and upper body.
In most cases, a person recovers: within 3-10 days, the temperature returns to normal, appetite and sleep return.

Meningeal form – covers 50 – 60% of cases. To the symptoms of the febrile form, a staggering gait and trembling of the hands are added. Vomiting is frequent, provoked by transportation, medication and food. Possible asymmetry of the face, different sizes of pupils, spontaneous movements of the eyeballs (nystagmus).

Meningoencephalitic form is a severe variant of the disease with a lethality of 5 to 15% of cases. It is dangerous with convulsions, paresis and paralysis, impaired consciousness up to coma, impaired breathing and cardiac activity. Paresis is a decrease in muscle strength that makes it difficult to make voluntary movements.

Polio is the most severe. It used to be common, now it is observed in 1 – 2% of patients. Paresis and paralysis of the muscles of the arms of the neck develop when the head falls on the chest. Paresis and paralysis of the lower extremities are rare.
Improvement comes slowly. Only at a half of patients former functions are moderately restored. All those who have recovered suffer from residual effects: weakness of the muscles of the neck and upper limbs, a symptom of a “hanging” head, paresis of the muscles of the upper limbs, hypotrophy of the muscles of the neck, shoulder girdle, forearms, intercostal muscles.

Polyradiculoneuritis form – occurs in 1-3% of patients. The leading symptoms are nerve damage, which leads to pain and movement disorders.

Chronic (progredient) form – develops in 1-3% of patients several months or even years after the acute period of the disease. Physical or mental trauma, hypothermia, childbirth, abortion and other causes provoke a chronic form.
A variety of symptoms of damage to the nervous system, mental disorders are growing. Paresis and paralysis develop mainly in the muscles of the neck, shoulder girdle and arms. Possible epilepsy.

Immunity against TBEV (antibodies in the blood) lasts a lifetime. After tick-borne encephalitis, which proceeded with obvious symptoms, fully recovered people have consequences for months. The more severe the illness, the more difficult the recovery. The most serious cases lead to disability.

Prevention of tick-borne encephalitis

When visiting the forest, wear tight-fitting clothing treated with anti-mite agents. Tuck pants or trousers into boots. It is better to choose clothes of light colors, because ticks are clearly visible on it. In the forest every 2 hours it is important to examine each other.

After visiting the forest, as well as parks and squares, you need to take off your clothes, inspect yourself or each other. Most often, ticks stick in the axillary and inguinal regions, on the neck, behind the ears, on the chest, on the scalp. It is also important to inspect clothes, animals and objects brought from the forest. You can not crush the tick and even take it without gloves. It is dangerous to drink raw milk, it must be boiled or pasteurized. Avoid dairy products made from raw unprocessed milk.

There is a vaccine against tick-borne encephalitis. It can be done by anyone, if he has no contraindications. In vaccinated people, severe forms of tick-borne encephalitis are 4 times less common than in unvaccinated people.

What to do after a tick bite

A sucked tick cannot be lubricated with oil, since when it dies, it will throw additional portions of the virus into the wound. The best thing is to see a doctor as soon as possible, who will remove it properly. The faster the tick is removed, the less virus will enter the body.

If there is no medical facility nearby, you can try the thread loop method. A loop of thread covers the skin around the wound closer to the mite’s proboscis. It is necessary to rotate the loop with rotating movements, unscrewing the tick from the wound.