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Preparation and study of composite insecticido-repellent aerosols.

Insecticido-repellent mixtures sprayed on clothes, nets etc. are useful as a means of protection against attack by bloodsucking arthropods. These sprays provide repellence of insects sensitive to the repellent and kill those that are only weakly repellent sensitive. Combined formulae for aerosols including repellent DETA and the synthetic pyrethroid neopynamin ("Neorepellent-2") or sumithrin ("Sumirepellent") were proposed. The composite sprays were studied in an olfactometer fleas (X. cheopis) and under practical conditions by treating clothes with 7-15 g of mixture per 1 m2. The composite sprays gave 100% repellence for fleas and mosquitoes, 80-50% repellence for simuliids, 65-70% repellence for ceratopogonids and tabanids, 90-95% for ticks, and they killed 100% of insects having contacted treated surface. As regards Ixodes ticks, "Sumirepellent" was more effective than "Neorepellent-2" and caused irreversible paralysis. Toxicological tests showed the composite sprays to be safe in broad-scale practical use provided that measures of precaution were kept.

Aerosols↗

[Neuroborreliosis].

The principles of certain clinical symptoms first described at the beginning of the century are rediscovered again: Erythema chronicum migrans after tick-bite followed by numerous neurological manifestations. Meningopolyneuritis Garin-Bujadoux-Bannwarth is recognized to be a central nervous system-manifestation of Borrelian infection transmitted by tick-bites. In a period of 2 years we evaluated 15 patients with diagnosis neuroborreliosis. There is a good improvement after treatment with penicillin or ceftriaxone but there are also some cases with recidives and permanent lesions. We can also present a case report of a progressive borrelian encephalomyelitis.

Adult↗

Tick-borne meningopolyneuritis (Garin-Bujadoux, Bannwarth).

We studied 100 patients with tick-borne meningopolyneuritis (Garin-Bujadoux, Bannwarth), the neurologic component of European erythema chronicum migrans disease. They had intensive radicular pain, asymmetric polyneuritis combined often with uni- or bilateral facial palsy, lymphocytic meningitis without or with only slight meningismus, and a course lasting three to five months. Neurologic abnormalities were preceded by the bite of a tick or an insect in 37 percent of patients or by an erythema in 41 percent. In addition, many patients had extraneural involvement, such as fever or fatigue. The outcome was favorable in all cases, and occurred faster with antibiotic treatment, but a few patients had slight residual peripheral nervous system deficits.

Adolescent↗

Tick-borne Borrelia infection in patients with Bell's palsy.

An enzyme-linked immunosorbent assay was applied to serum samples of 94 patients diagnosed as having Bell's palsy: they were studied throughout two consecutive years in an attempt to establish serologic evidence of a tick-borne spirochetal infection. A strain of Borrelia spirochetes, isolated from Swedish Ixodes ricinus ticks, was used as an antigen, and separate estimations of spirochetal IgG and IgM antibodies were made; serum samples with titers above the 95th-percentile level of 120 healthy individuals were considered positive. Thirteen percent of the patients' serum samples were IgG-positive, 3% were positive for IgM, and 3% were positive for both IgG and IgM. A twofold or greater increase of IgG titers was found in 6%. All the patients who were seropositive experienced the onset of palsy during the period from July to December.

Adult↗

The effect of the pattern of attachment weights of female Ixodes rubicundus on Karoo paralysis in a naturally infested flock of sheep.

The weights of feeding female Ixodes rubicundus attaching to sheep was studied in a natural focus of Karoo paralysis. The studies showed fewer females in the middle weight ranges and more in the heavier and lighter categories than would be expected if the distribution was normal. Weights were also strongly skewed towards the lighter females between 0 and 400 mg. No differences in the pattern of attachment weights occurred over the four experimental groups used, suggesting that previous contact of sheep with I. rubicundus had no effect on the ability of the tick to engorge.

Animals↗

[Postvaccinal neuritis following prophylactic vaccination against early-summer meningo-encephalitis].

After a single dose of a commonly used commercial vaccine against early-summer meningo-encephalitis a 22-year-old woman developed neuritis of the nerves to the gravity muscles in the legs and feet. The course of the disease and absent antibodies in serum suggested a cellular immune response. In this case, as generally in postvaccinal neuritis, prognosis proved to be favorable. The estimated incidence of postvaccinal neuritis in general is 1:100,000. The indications for active immunization against early-summer meningo-encephalitis should continue to be narrowly defined.

Action Potentials↗

[Late neurological sequelae of tick-borne encephalitis in the population of the Olsztyn province].

The authors studied the incidence of late and permanent neurological sequelae of tick-borne encephalitis in the population of the Province of Olsztyn. The investigations were carried out in a group of 103 patients who were affected in the years 1970--1974. The diagnosis was confirmed in all cases with epidemiological, clinical and laboratory investigations and serological evidence of tick-borne encephalitis. It was shown in these studies that tick-borne encephalitis caused development of permanent lesions in the central and peripheral nervous system in 25.3% of cases. It was observed, moreover, that a considerable part of neurological signs found in the acute stage of the disease disappear during hospital treatment but later on after discharge from the hospital the symptoms of nervous system damage reappear and new signs develop which had not been observed in the acute stage. In the light of these studies the authors conclude that a considerable proportion of convalescents have limited physical and intellectual efficiency making impossible their return to their previous work and causing not infrequently permanent loss of working ability which must be kept in mind by physicians from different specialities.

Acute Disease↗

[Tick-borne meningopolyneuritis (Garin-Bujadoux, Bannwarth)].

The meningopolyneuritis first described in 1922 by Garin and Bujadoux develops after a tick bite. At the site of the bite in some of the cases, erythema chronicum migrans develops first. Severe pains follow in this area which may spread to other parts of the body. Then peripheral paralysis appears with asymmetrical distribution. The motor cerebral nerves, especially the facial nerve, are also frequently affected. Mild sensitivity disorders occur with no systematic arrangement. There is a lymphocyte pleocytosis of 100-2600/3 mm3 and an increase in protein of varying intensity, meningeal symptoms usually being absent. The disease persists for 3-5 months. Apart from rare residual, the prognosis is favorable.

Adolescent↗

[Prognosis of peripheral facial paralysis in Lyme borreliosis (Garin-Bujadoux, Bannwarth meningopolyradiculitis)].

Meningopolyradiculitis (Garin-Bujadoux syndrome, Bannwarth syndrome) is the second stage of Lyme disease, a tick-borne Borrelia infection. Almost 60% of these patients develop an acute peripheral facial paresis. The disease can be differentiated from Bell's palsy only by finding the specific Borrelia antibodies in serum and CSF. Other cranial nerve lesions can be found besides facial paresis. The follow-up of seven Borrelia-infected patients is described: one showed bilateral, the others unilateral, facial paresis. High dosage of penicillin or tetracycline for 10-14 days is the appropriate therapy. The prognosis of facial paresis in tick-borne Borrelia infection is considered to be good. All our patients showed complete recovery of motor nerve function.

Adolescent↗

[Tick-borne meningoradiculitis--a form of spirochetosis].

Three pediatric cases of tick-borne meningoradiculitis are presented. This disease is characterized by a distinct sequence of symptoms: erythema chronicum migrans, localized pain, and eventually radicular asymmetric neurologic involvement (in particular facial palsy) associated with findings of aseptic meningitis. On the basis of specific serologic data in these three patients, it is suggested that the etiology of tick-borne meningoradiculitis is also spirochetal , as recently shown for the tick-associated Lyme disease. Analogue positive spirochetal antibody titers were found in additional patients with erythema chronicum migrans and in a child with B afverstedt cutaneous lymphadenosis (see addendum). 20% of tick specimens collected in the area of Lucerne (Ixodes ricinus) were infected by these spirochetes.

Adolescent↗

[A review of Lyme disease].

Lyme disease is an infectious disease caused by the spirochete Borrelia burgdorferi, transmitted by certain ixodid ticks. The illness usually occurs in stages with many different clinical manifestations. The disease starts with a typical cutaneous lesion called erythema cronicum migrans, that usually develops at the site of the tick bite. After weeks or months, some patients develop neurological abnormalities, particularly meningitis, cranial nerve paralysis, peripheral radiculoneuritis, or cardiac involvement, such as atrioventricular blockade, myopericarditis and cardiomegaly, or migratory musculoskeletal pain. Months or years later, many patients develop arthritis, which usually occurs in intermittent attacks for several years. Lyme disease was only recently recognized in the United States. However this borreliosis has now been recognized in every continent except South America. In this paper we review the clinical and laboratorial features of Lyme borreliosis and discuss the possibility of its presence in Brazil or other parts of South America, where it has recently been recognized that ixodid ticks are common.

Borrelia burgdorferi Group↗

[Lymphocytic meningoradiculitis (Bannwarth's syndrome). Neurologic involvement of Lyme disease].

We describe a patient with Lyme's disease who showed neurologic symptoms of meningoradiculitis (Bannwarth's syndrome) and had no previous history of exposure to tick bite or chronic erythema migrans. He had longterm fever and bilateral facial paralysis. Antibody titres for Borrelia Burgdorferi in serum and cerebrospinal fluid (CSF) were increased. The CSF changes showed an intrathecal production of immunoglobulins (presence of plasmatic cells and immunoblasts; IgG-CSF: IgG-serum ratio much higher than albumin-CSF: Albumin serum ratio, according to Reiber's diagram; presence of oligoclonal bands). Therapeutic response to high doses of penicillin was resolutive. The second day of treatment the patient developed uveitis, that was treated with corticoids.

Adult↗

Tick-borne spirochetes as a cause of facial palsy.

Twenty consecutive patients visiting an otolaryngological department in Sweden with a facial palsy were investigated for serological signs of tick-borne spirochete infection. Four patients showed serological evidence of and had a medical history compatible with a tick-borne spirochetosis. Spinal fluid analyses were performed in 3 of these patients and showed elevated specific antispirochetal antibody titres and an increase in mononuclear cells. The importance of a correct diagnosis and of antibiotic therapy in patients with spirochete-induced facial palsy is emphasized.

Adolescent↗