What is Girudinosis?
Girudinosis (lat. Hinido, from lat. Hirudinis leech + -osis) is a human disease resulting from the attack of leeches.
Causes of Girudinosis
Girudinosis is caused by leeches. Leeches are common in many climatic zones, but the most widely – in tropical and subtropical. They live mainly in reservoirs, live in the jungle and on plants, are very mobile, feed on blood, mainly vertebrates. Leech attacks on humans occur when drinking water from stagnant bodies of water, aryks, swamps, reed lakes, while bathing, walking barefoot through wetlands.
Pathogenesis during Girudinosis
Infection with hirudinosis occurs when bathing and drinking water from natural reservoirs with standing or low-flowing water, which include wells, aryks, creeks, lakes (mainly reed), peat bogs, aged women, swampy bodies of water.
It is also quite possible to become infected while walking on wet grass, flood meadows and fields, among coastal vegetation. First of all it concerns walking barefoot. It is especially difficult to notice leeches in thick grass and when drinking from buckets and other dishes painted in a dark color.
The leeches, attacking a person, can stick to the skin and penetrate into various cavities of the body, communicating with the environment (for example, in the respiratory tract, gastrointestinal tract).
There are external and internal hirudinosis. External hirudinosis is the damage by the worms of the skin of the body. Leeches are fixed on the skin most often in the region of the calves, shoulders, underarms, neck, perineum, and between the buttocks. Internal hirudinosis is an infection by blood-sucking leeches of internal body cavities that are open to the penetration of parasites.
Highlighting hirudin, which is a strong anticoagulant, as well as histamine-like substance that expands the capillaries, leeches cause bleeding at the suction site. Possible development of anemia, headaches and other symptoms, depending on the localization of the parasite. The leech sucking to the vocal folds or to the wall of the trachea is most dangerous, since this can lead to asphyxiation.
Another pathogenesis factor is mechanical damage associated with leech movement and traumatizing of tender tissues. The last factor usually manifests itself in internal hirudinosis, when a worm stays in body cavities, ducts and internal organs can cause blockages of moves, irritation, cramping, etc.
These pathological processes aggravate the course of hirudinosis. Hirudinosis is most severe in persons who are predisposed or suffer from impaired blood clotting. The main symptoms of hirudinosis are bleeding (the leading symptom), headaches, general weakness and progressive anemia.
Symptoms of Girudinosis
Hirudinosis is manifested by bleeding, anemia, headaches and other symptoms depending on the location of the parasite. It is most dangerous for the leech to stick to the glottis or to the tracheal wall, since this can lead to asphyxiation.
Diagnosis of Girudinosis
The diagnosis of external hirudinosis is quite simple; it can be done even by the victim himself.
It is enough to examine the patient’s body and find a parasite or wound on it that remains at the site of the bite. Diagnosis of internal hirudinosis is difficult even with a leading symptom, i.e., bleeding. The doctor has to exclude other possible causes of the deterioration of the patient.
Nasal bleeding indicates the presence of leeches in the cavity of the nasopharynx or nose. Sometimes with the defeat of the nasopharynx opens bleeding from the mouth. Throat hemorrhage and hemoptysis are the leading signs of tracheal disease. However, the same symptoms accompany polyposis and some other diseases.
Treatment of Girudinosis
In fact, all treatment of this disease in most cases comes down to eliminating the leech that caused it. After the leech is removed from the skin (from the body cavities), the condition of the affected person improves. Sometimes, however, it is necessary to deal with the elimination of complications caused by a prolonged stay of the worm on the body or inside the body. The most common problems of this kind are the need to stop profuse bleeding.
Methods of release from skin parasites originated in the deep past. Already primitive hunters and fishermen who lived in the dense jungle, faced with jaw worms and were forced to find ways to remove them from the skin. The most trivial, at first glance, but at the same time technically incredibly difficult is the elimination of the leech by means of a knife or sharply sharpened wand.
Ancient people used for this purpose a reed with a kuvoobrazno cut off the tip. This “beak” prehistoric man placed leeches under the mouth sucker, forcing her to open his jaws and detach from the skin. Such a worm often falls off on its own and falls to the ground, or else it has to be torn off with its own hands, but this is now much easier to do. While the leech jaws pierce the flesh, it can not be unhooked.
Of course, if you apply force, you can tear off the body of the leech, but its jaws will remain stuck in the skin layer. Subsequently, such a wound with remnants of the worm’s mouth apparatus in it will become a source of extensive suppuration. In addition, this wound bleeds for 2-3 days. This serves as an additional risk factor for the occurrence of purulent infection in the affected tissues.
That is why the removal of leeches is performed using improvised means, but not with bare hands. However, the reed and partly replacing her knife can hardly be called the best of these tools. A twig or a knife can scratch the skin, make an infection in the wound, cut off the leech, leaving its jaw in place. Therefore, the use of other methods of combating harmful leeches will bring more benefits.
Smokers can recommend using lighted cigarettes. It is necessary to press the cigarette burning side to the body of the leech, as the worm is crocheted and falls off the skin. In order not to keep a lit cigarette at all times, it is reasonable to simply stock up on tobacco. If you put some tobacco powder on the leech, it will cause irritation of its skin, and it will lag behind the skin.
There are other effective ways to get rid of the parasite. All of them, one way or another, are associated with the property of the worm to react violently to chemical irritation of the skin. Instead of tobacco leech with equal success can be sprinkled with salt, lightly anointed with iodine or alcohol. Being applied to the skin of the leech, a few drops of medical alcohol or any strong drink, which was at hand, cause this animal to quickly unclench its jaws. When the leech is removed in the field, the place around the wound is treated with 5-10% iodine solution, medical alcohol or any other antiseptic. Then this area is bandaged with a tight (pressure) bandage. The patient must see a doctor.
Often with continued bleeding, it is necessary to put brackets on the wound. Removal of leeches from the internal cavities is carried out only by a specialist. To do this, he uses tampons with iodine or alcohol, which are introduced into the infected cavity to the depth of leech localization. Apply also rinsing of the oral cavity and nasopharynx with a strong solution of salt in the case of finding a worm in these cavities.
The solution causes leech skin irritation, forcing it to detach from the mucous membrane. Such a procedure can only be performed correctly by a doctor who will preliminarily dry the oral cavity from salivary secretions and provide the victim with a position in which the lagging leech cannot get into the trachea or esophagus.
It is forbidden to use the solution to douche the urethra and vagina, because salt adversely affects the mucous membranes of these organs. The entry of a parasitic worm into the urethra, esophagus, stomach, trachea and glottis is considered a difficult case. Often these situations require surgery. Stopping internal bleeding requires enhanced chemotherapy using, among other preparations, hirudin antagonists and other components of the salivary secretion of leeches.
Sometimes there is a need for surgical treatment, for example, when removing leeches from the nasal passages, pharynx, trachea.
The prognosis of hirudinosis with early diagnosis is almost always favorable, if there is an opportunity to provide medical assistance in a timely manner. Complications of hirudinosis occur relatively rarely, mostly severe cases are represented by hirudinosis on the background of hemophilia, hemolysis, anemia (anemia), other disorders of the blood coagulation system and hematopoiesis pathologies, that is, a practically healthy person will not suffer from leech infection.
Prolonged leech in the body of the victim is fraught with perceptible blood loss, accompanied by all sorts of negative consequences, including the general weakening of the body. The microclimate of the environment in which the victim is located, determines the degree of risk of infection of the wound caused by leech.
Prevention of Girudinosis
Prevention of infection by harmful leeches in the natural environment is reduced mainly to strict adherence to hygienic rules. In order to prevent internal hirudinosis, a person is obliged to avoid bathing in natural reservoirs populated with leeches, primarily in ponds, lakes, oxbows, creeks and other standing waters.
While relaxing in a country where hirudinosis is widespread, you should only visit swimming pools or specially equipped beaches. When visiting beaches on the shores of lakes, diving and swimming at the very bottom is excluded, since leeches gain access to the oral and other open body cavities. It does not hurt to stock up with a bathing cap that protects the swimmer’s ears, because worms are often fixed behind the ears.
It is undesirable to swim in natural waters in a bikini or, especially, without a bathing suit at all, as this increases the risk of infection. After staying in the water of a natural water body, it is necessary to conduct a thorough examination of the body surface and the oral cavity.
Since often blood-sucking worms are infected through drinking water, caution should be exercised when drinking from wells and other reservoirs associated with natural water bodies. It is advisable to exclude the use of water from natural sources of any type. If, nevertheless, the need for drinking is great, then it seems reasonable to scoop water with dishes.
Before use, water must be carefully considered, checking for leeches or plant debris under which they can hide (fallen leaves, etc.). In general, the above precautionary rules are also suitable as preventive measures against external hirudinosis. Staying near natural reservoirs or in the tourist area, one should not forget about land leeches, which are also causative agents of this disease. Consequently, the prevention of external hirudinosis is reduced to a special skin treatment and compliance with the rules of wearing clothes. Wherever leeches can occur, a person must protect his legs as the most vulnerable part of the body to infect.
It is necessary to choose clothes that securely cover the skin and at the same time do not interfere with skin breathing in conditions of moisture and heat. When you have to walk for a long time on wet grass or through wet thickets, you need to wear light-weight pants, possibly tucking the ends of your trousers into socks and (or) boots as you go. It is not recommended to wear jeans, because their fabric in tropical climates causes itchy skin.
In the morning, after the fog retreats, it is useful to wear high rubber boots on your feet when crossing the forest vegetation in hot countries, as this is the most effective protection against worms. You cannot leave the collar of your shirt or blouse unbuttoned, because the leeches can attach to the neck and go down it on the body. Socks, stockings and the lower part of the leg should be treated with indalone or dimethyl phthalate solution – means that frighten leeches.
Before walking in nature, shoes must be covered with a thin layer of liquid soap. It is necessary to take a bath or shower using fragrant soap before going out. Women can use tart perfume with a strong and persistent odor. As it is known, leeches do not tolerate such odors. Accordingly, men should use cologne. In this case, it is desirable to apply the perfume at the same time and on the legs, primarily on their unprotected parts.
Since leeches do not like salt, a salting dressing is a very effective deterrent, the wearing of which is recommended for active tourism fans who like to stay in nature for a long time, where there is a danger of infestation by parasites. This tool was invented by the indigenous population of the island of Sri Lanka (Ceylon), which suffers from several kinds of leeches.
Ceylon workers for preventive purposes bandage their legs with a bandage or make a gauze bandage. The layers of the dressing are poured with table salt. Of course, such a bandage is best done on top of socks. In no case should the skin be in contact with the gauze interspersed with salt, as this will cause severe irritation. Properly executed protective dressing is applied as follows.
Several layers of gauze are wound tightly over the sock or bare jellies and the lower part of the lower leg. These layers are not sprinkled with salt, but form a barrier for it, protecting the skin of the legs. Subsequent revolutions of the bandage are filled with salt, after which the bandage is tight, but not tight. Over her worn shoes with thick soles, do not let moisture.
In case of wetting, the dressing is removed as soon as possible in order to avoid dissolving the salt and the effect of the salt solution on the skin of the foot. Leaving such a bandage for the night, even if the tourist decided to sleep in a tent, is undesirable. To protect himself from harmful leeches that can climb into the tent on the wet grass, a man can take the gauze untied from his feet and spread it out before entering the tent and along its walls.