Ērces piesūkšanās ilguma nozīme
Vai zināji, ka apgalvojums: ērci noņemot 24 stundu vai 48 stundu laikā pēc piesūkšanās efektīvi novērsīs Laimas slimību (LS), vai, lai inficētos ar boreliozi ērces piesūkšanās laikam jābūt vismaz 36 stundas, nav pamatots pētījumos, un cilvēkiem infekcijas pārnešanas minimālais ērces piesūkšanās laiks nekad nav noteikts!?
Daudzviet minētais apgalvojums, ka, lai notiktu inficēšanās ir jāpaiet vismaz 36 stundām pēc ērces piesūkšanās, iespējams balstīts senos pētījumos ar grauzējiem. Pirmais avots šādai informācijai ir Falco et.al. (neatkarīga pētnieka Michael J Cook pētījuma atsaucēs minēta 1996.gada publikācija), kurā teikts „… pielipušo Ixodes scapularis ērču noņemšana 48 stundu laikā efektīvi novērsīs Laimas slimību”. Šāds apgalvojums balstīts pētījumā ar 14 grauzējiem.
Jaunākie ekspermentālie dati norāda uz LS spirohetu pārnešanu laika posmā no 16 stundām (iespējams ātrāk). Pastāv pierādījumi, ka nudien Laimas slimības risks palielinās ar ilgāku ērces piesūkšanās laiku, un padoms ērci noņemt ātri ir pamatots, tomēr nav skiadru datu par minimālo piesūkšanās laiku, kurā notiek inficēšanās, tāpēc Laimas slimību nevar izslēgt, neatkarīgi no ērces piesūkšanās ilguma.
Jāņem vērā arī fakts, ka pamanīt ērci var būt sarežģīti. Ērču lielums visos dzīves cikla posmos padara tās grūti atklājamas pat redzamās vietās un gandrīz neiespējami vietās, kur redzamība ir ierobežota, piemēram, galvas matainajā daļā. Nesāpīgais kodums un anestizējošā viela, ko izdala ērce, lielākoties piesūkšanās faktu padara nemanāmu. Līdz ar to klīniskā gadījuma aprakstīšanā būs diez gan neiespējami noteikt precīzu piesūkšanās laiku. Un būtiski: tas nav vienīgais iemesls infekcijai! Ērču un norēliju sugas ir faktori, kas jāņem vērā. Ir pierādījumi par ātrāku pārnešanu Eiropas celmiem. Ērces pārnes daudzas citas slimības, tai skaitā ērces izraisītu encefalītu, cilvēka granulozās ehrlichiozi, babeziozi, bartononelozes un citas. Pārnešanas laiki šīm slimībām nav zināmi, lai gan ir pierādījumi, ka dažas no tām tiek pārnestas ļoti ātri.
Borēliju nodošanas ātrumu nosaka vairāku faktoru kopums:
1. Spirohetu atrašanās vieta ērcē. Dažkārt spirohetas atrodas vairākkārt barojušos ērču siekalu dziedzeros, nevis viduszarnā. Tad infekcijas nodošana ir daudzkārt ātrāka.
2. Daļēji barojušās ērces borēlijas nodod daudz ātrāk. Tās ir ērces, kas kādu brīdi ir ēdušas, tad nokritušas, bet pēc tam atradušas jaunu saimniekorganismu, no kura baroties. Svarīgi saprast, ka daļēju barošanos veic lielākā daļa ērču. Tā ir norma, nevis izņēmums.
3. Ērces, kuras ir koinficētas ar citām transmisīvām baktērijām, borēlijas nodod daudz ātrāk nekā ērces bez koinfekcijām.
4. Nodošanas laiku būtiski ietekmē attiecīgā borēliju suga. Jo agresīvāks borēlijas tips, jo ātrāks nodošanas laiks. Latvijā pārsvarā izplatītais B. afzelii nodošanas ātrums ir lielāks nekā B. burgdoferi!
5. Liela nozīme ir tam, cik stipra vai vāja ir attiecīgās personas imūnsistēma. Jo spēcīgāka imūnsistēma, jo lēnāks nodošanas laiks. Jo vājāka – jo ātrāks.
Avoti:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4278789/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5857464/
35 komentāri - Ērces piesūkšanās ilguma nozīme
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If you are interested in an urgent loan for any financial reason, do not hesitate to contact us at ([email protected]) for more information about this loan transaction.
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