title: [The location of the infecting tick bite and the severity of the course of tick-borne encephalitis].
abstract: Analysis of 846 epidemiological charts of unvaccinated tick-borne encephalitis patients in the period of 1956-1985 established that in 21% cases the disease resulted from multiple bites of the ticks, in 67.3% it occurred from single bites. In 11.7% of the patients, the bite was denied. Single infecting bites were mostly those of the head and neck (39.2% cases), especially frequent among children (84.9%). The upper part of the body and hands were bitten less frequently (16.7 and 12.5%, respectively). Other sites of the bite were reported in 6-10%. The most complicated pattern of tick-borne encephalitis is observed in case of multiple bites: two-fold increase in mortality rates compared to single bites (23.2 vs. 10.7%) and higher percent of focal forms (72.7 vs. 56.5%). In case of the single bites a certain correlation is observed between the site of the bite and the outcome of the disease: fatal outcomes are most frequent in case of the bites in the axilla, arms (14-16%), head and neck (11.2%), and less frequent in case of the bites in the lower limbs (5.9%) and groin (0). The nature of the infecting bite determines, to a great extent, the pathogenesis and outcome of the disease. The prevention of multiple bites would help considerably to reduce mortality rates.
authors.forename: N M
authors.initials: NM
authors.lastname: Okulova
authors.forename: S P
authors.initials: SP
authors.lastname: Chunikhin
authors.forename: V E
authors.initials: VE
authors.lastname: Vavilova
authors.forename: A D
authors.initials: AD
authors.lastname: Maĭorova
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000818:Animals; D001733:Bites and Stings / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D002648:Child; D004675:Encephalitis, Tick-Borne / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000635:transmission*; D006801:Humans; D008875:Middle Aged; D012800:Siberia / Q000453:epidemiology; D013987:Ticks
vernacular_title: Lokalizatsiia zarazhaiushchego ukusa kleshcha i tiazhest' techeniia kleshchevogo éntsefalita.