Prevention and treatment of diseases in the tropics, help with bites of snakes, leeches and insects, malaria, yellow fever.

Climatogeographic features and weather in the tropics, constantly high temperatures and humidity, the specifics of flora and fauna create extremely favorable conditions for the emergence and development of various tropical diseases. 

Prevention and treatment of diseases in the tropics, help with bites of snakes, leeches and insects, malaria, yellow fever.

Moreover, in the tropics, due to the lack of seasonal climate variations, diseases also lose their seasonal rhythm. A significant role in the emergence and spread of diseases in the tropics is played by social factors, especially the low sanitary conditions of settlements, especially rural ones, the lack of sanitary treatment, centralized water supply and sanitation, the lack of basic hygiene rules, the lack of measures to identify and isolate patients, bacilli carriers and etc.

the patient is injected with drugs that support cardiac activity and stimulate the respiratory center. The same group of diseases includes lesions caused by the juice of guao plants, which are widespread in the tropical forests of Central and South America, on the islands of the Caribbean. After 5 minutes the white juice of the plant turns brown, and after 15 minutes it turns black. When juice enters the skin (especially damaged) with dew, raindrops or when touching leaves and young shoots, numerous pale pink vesicles appear on it.

They grow rapidly, merge, forming spots with uneven edges. The skin swells, itching unbearably, headache, dizziness appear. The disease can last for 1-2 weeks, but always ends in a successful outcome. Such plants include mancinella (Hippomane mancinella) from the family of euphorbiaceae with small, apple-like fruits. After touching its trunk during rain, when water dissolving the juice flows down it, after a short time a severe headache appears, pain in the intestines, the tongue swells so much that it is difficult to speak. In Southeast Asia, the juice of the khan plant has a similar effect, somewhat resembling large nettles in appearance, causing deep painful burns.

Dangers in the tropics from poisonous snakes.

Poisonous snakes pose a formidable danger to humans in the rainforest. Annually, 25 30 thousand people become victims of poisonous snakes in Asia, 4 thousand in South America, 400-1000 in Africa, 300-500 in the USA, and 50 people in Europe. Of the 2,200 known venomous snakes, approximately 270 species. These are mainly representatives of the families Collbridae, Viperidae, Elapidae and Crotalidae. Poisonous snakes are usually small in size (100-150 cm), however, there are specimens reaching 3 meters or more, for example, bushmeister, king cobra, big naya.

The venom of snakes is complex in nature. Toxic substances, hemotoxins and neurotoxins that have the action of enzymatic poisons affect the circulatory and nervous systems. Hemotoxins give a strong local reaction in the bite area, which is expressed in sharp pain, swelling and the occurrence of hemorrhages. After a short period of time, dizziness, abdominal pain, vomiting, thirst appear. Blood pressure drops, temperature drops, breathing quickens. All these phenomena develop against a background of strong emotional arousal. Neurotoxins, acting on the nervous system, cause paralysis of the limbs, which then go to the muscles of the head and trunk. There are disorders of speech, swallowing, incontinence of feces, urine, etc. With severe forms of poisoning, death occurs after a short time from respiratory paralysis.

All these phenomena develop especially rapidly when poison enters directly into the great vessels. That is why bites in the neck and large vessels of the limbs are extremely dangerous. The degree of poisoning depends on the size of the snake, the amount of poison that has got into the human body, on the period of the year. For example, snakes are most poisonous in spring, during mating, after hibernation. The physical condition of a bitten person, its age, weight, etc. are of no small importance. Some types of snakes, for example black-necked cobra (Naja nigricollis), collared cobra (Haemachatus haemachatus), one of the subspecies of the Indian spectacle snake (Naja naja sputatrix), can affect your victim in the distance.

By drastically reducing the temporal muscles, the snake can create pressure in the poisonous gland up to 1.5 atmospheres, and the poison is sprayed with two thin streams that merge into one at a distance of half a meter. When poison enters the mucous membrane of the eye, the entire symptom complex of poisoning develops. What a victim of a poisonous snake attack feels is dramatically described in his book Through the Andes to the Amazon by the German naturalist Edward Peppig, bitten by one of the most poisonous South American snakes by the bushmeister (Crotalus mutus).

I was about to cut down the neighboring trunk that was bothering me, when I suddenly felt a sharp pain in my ankle, as if they were dripping molten wax on it. The pain was so strong that I involuntarily jumped in place … My leg was swollen and I couldn’t step on it … The bite of a bite-free and almost sensible spot was indicated by a blue square-sized tip, spot and two black dots, as a prick with a pin … The pains intensified, I lost consciousness every now and then, the impending insensitive state could be followed by death…

Everything around began to sink into darkness, I lost consciousness and did not feel any more pain. It was already well after midnight, when I came to my senses, the young organism triumphed over death. Severe fever, profuse perspiration and excruciating pain in my leg indicated that I was saved … For several days the pain from the resulting wound did not stop, and the consequences of the poisoning made themselves felt for a long time. Only two weeks later, with outside help, I was able to get out of the dark corner and stretch out on the skin of a jaguar at the door of the hut (1960).

For snake bites, various first aid methods were used, which should either prevent the poison from spreading through the blood vessels, apply a tourniquet above the bite site, remove a part of the venom by cutting the wound and aspirating the venom, or neutralize the poison with powder sprinkled with potassium permanganate). However, studies conducted in recent years cast doubt on the effectiveness of some of them. This primarily refers to the recommendation to apply a tourniquet on a limb after a snakebite, since it is still found in both popular and specialized literature..

Studies conducted in laboratories and observations in hospital conditions have shown that applying a tourniquet can cause immeasurable harm to the victim. This is primarily due to the fact that in the tissues below the site of constriction, lymph and blood circulation are abruptly or completely stopped, which leads to tissue destruction, accompanied by necrosis, and often to the occurrence of gangrene of a bitten limb. In addition, when applying a tourniquet due to the hyaluronidase activity of the poison and the release of serotonins, under the influence of which the permeability of capillaries and connective tissue increases sharply, conditions arise for the rapid spread of poison throughout the body.

The experiments carried out by Z. Barkagan (1963) on rabbits, which, after introducing snake venom into the muscles of the paws, were ligated for various times, showed that a limb extension of 1.0 1.5 hours significantly accelerates the death of animals. Many authors point out the inadmissibility of injury to a wound by cauterization by hot objects, potassium permanganate powder, etc., believing that this method not only does not have any benefit, but also leads to the destruction of already affected tissue. At the same time, a number of works indicate the need to remove at least part of the poison that got into it from the wound. This can be achieved with the help of cruciform deep incisions made through the wounds and subsequent suction of the poison by mouth or a medical jar..

Sucking poison and drinking alcohol from snake bites in the tropics.

This is one of the most effective treatments. It is safe enough for the carer if there are no wounds in the mouth. For safety reasons, in case of erosion of the oral mucosa, a thin rubber or plastic film is placed between the wound and the mouth. The degree of success will depend on how soon and how completely the poison is sucked off after the bite. Some authors suggested chipping the bite site with 1% 2% potassium permanganate solution, while others believed that one could confine oneself to abundant washing of the wound with water or a weak solution of any antiseptic at hand, followed by applying lotion from a concentrated solution of potassium permanganate.

The opinions in the literature regarding the ingestion of alcohol during snake bites are very contradictory. Even in the writings of Mark Portia, Cato, Censorius, Celsius, cases of treatment of snake-bitten large doses of alcohol are mentioned. This method is widely used among residents of India and other countries of Southeast Asia. However, convincing data on the adverse effects of alcohol on the condition of a person bitten by a poisonous snake have been obtained. It is established that after the introduction of alcohol into the body, the nervous system reacts much more sharply to the action of snake venom. In addition, alcohol, as shown by experimental studies by I. Valtseva (1969), firmly fixes snake venom in the nervous tissue.

Treatment after snakebites in the tropics.

Whatever treatment measures are carried out, one of the prerequisites is to create maximum rest for the victim and immobilize a bitten limb (as in a fracture). Absolute peace contributes to a more rapid elimination of the local edematous inflammatory reaction and a favorable outcome of poisoning. The most effective treatment is the immediate administration of specific serum subcutaneously or intramuscularly, and with the rapid development of symptoms intravenously. In this case, there is no need to introduce serum at the site of the bite, since it gives not so much local as the general antitoxic effect.

The exact dose of serum depends on the type of snake and its size, the strength of poisoning, the age of the victim. MN Sultanov (1969) recommends dosing the amount of serum depending on the severity of the case: 500 1000 AE in the lungs, 1500 AE in medium, 2000-2500 AE in severe cases. A set of measures when helping a bitten by a poisonous snake at the scene of the incident will consist of sucking the poison from the wound, ensuring complete rest, immobilizing the affected limb, giving plenty of water. After the victim is delivered to a medical institution, he must first enter a specific serum. With further treatment, painkillers (except morphine and its analogues), cardiac and respiratory analeptics (according to indications) are used.

Given the difficult mental state of people bitten by a poisonous snake, it is advisable to use tranquilizers (phenazepam, melliril, etc.). Poisonous snakes themselves rarely attack a person and when meeting with him strive to crawl away as soon as possible. However, with carelessness, you can step on a snake, hook it. by hand. Then the bite is inevitable. That is why, making your way through the thicket, you must be extremely careful. Losing the snake to the battlefield is much safer than engaging in a fight with it. And only as a last resort, when the snake has taken a fighting pose and the attack is imminent, should immediately strike her head.

Spider bites in the tropics.

Among the numerous (more than 20 thousand species) detachment of spiders, there are many representatives dangerous to humans. The bite of some of them, for example Licosa raptoria, Phormictopus, living in the Amazonian selva, gives a severe local reaction (gangrenous tissue disintegration), and sometimes it is fatal. Especially dangerous is the small spider Dendrifantes nocsius, whose bite is often fatal. As for tarantulas (Trochos singoriensis, Lycosa tarantula, etc.), their toxicity is significantly exaggerated, and bites, except for soreness and a small tumor, rarely lead to serious complications..

Dangers in the tropics from leeches.

Tropical ponds inhabit about 250 species of leeches (Hirudinea), and after bathing a person often discovers about a dozen sucking parasites. Making his way through the thicket of the rainforest, you can be attacked by land leeches from the genus Haemadipsa, which hide on the leaves of trees and shrubs, on the stems of plants along the paths laid by animals and people. In the jungle of Southeast Asia, there are mainly several types of leeches: Limhatis nilotica, Haemadipsa zeylanica, H.ceylonica (Demin, 1965, etc.). The sizes of leeches vary from a few millimeters to a dozen centimeters.

A leech bite is completely painless, which is why it is usually found only when examining the skin, when it was already pumped with blood. The sight of a leech swollen with blood terrifies an inexperienced person. He seeks to get rid of it as soon as possible, tear it from the skin, and at the same time the proboscis and jaw of the parasite remain in the skin. According to our observations, the wound continues to bleed for about 40 to 50 minutes, and soreness at the site of the bite persists for 2 3 days. The leech is easy to remove by touching it with a lit cigarette, sprinkling it with salt, tobacco or greased with iodine. The effectiveness of any of the above methods is approximately the same. Leech bite does not pose an immediate danger, but secondary infection easily occurs in the tropics.

Therefore, after removing the leech, the wound must be treated with alcohol or iodine solution. If small parasites enter the body with water and food, they can cause indomitable vomiting, prolonged bleeding. The penetration of leeches into the airways can lead to mechanical blockage and subsequent asphyxiation. You can remove them with a cotton swab moistened with alcohol, iodine or concentrated sodium chloride solution. It is recommended to lower the sleeves of the shirts, fasten the cuffs, tuck the trousers in the tropics in tropics. At halts in the tropics, you should examine the skin and remove sucked parasites. Currently, there are special compounds that lubricate the skin to repel leeches..

The dangers of worms in the tropics.

Of the many works of domestic and foreign authors, it is known that diseases caused by various types of worms are widespread in the tropics (group IV). Human infection usually occurs when larvae and helminth eggs enter the body with food and water. But most importantly, mature cercaria larvae of some parasites (schistosomes, intestinal acne, hookworms) can enter the body through intact skin when walking barefoot, bathing, etc. Helminthic invasion can be avoided by observing precautions: do not swim in stagnant and slow-flowing ponds, be sure to wear shoes, thoroughly boil and fry food, use only boiled water for drinking.

Tropic insect bites and malaria.

Group V includes diseases transmitted by flying blood-sucking insects (mosquitoes, mosquitoes, flies, midges), filariasis, yellow fever, trypanosomiasis, malaria, etc. The greatest practical interest among these vector-borne diseases in terms of the problem of survival is malaria. Malaria is one of the most common diseases on the globe. The area of ​​its distribution is whole countries, for example Burma. The number of patients registered by WHO is 100 million. The incidence is especially high in the tropics, where its most severe form is tropical malaria..

The disease is caused by protozoa of the genus plasmodia, the transmitters of which are various types of mosquitoes from the genus Anopheles. It is known that for the full cycle of mosquito development, the sum of β-heat is extremely important. In the tropics, where daily average temperatures reach 24-27 degrees, the mosquito develops almost twice as fast as, for example, at 16 degrees, and during the season the malaria mosquito can give 8 generations, multiplying in myriad numbers. Thus, the jungle with its hot, moisture-saturated air, slow circulation of air masses and an abundance of standing ponds is an ideal place for breeding mosquitoes and mosquitoes.

After a short incubation period, the disease begins with an attack of tremendous chills, fever, headaches, vomiting, etc. Tropical malaria is very characteristic of muscle pain, general symptoms of damage to the nervous system. Often there are malignant forms of malaria, which are very severe and give a high percentage of mortality. Protection against flying bloodsuckers is one of the most important issues of maintaining health in the jungle. However, liquid repellents often turn out to be ineffective in the hot daytime, as they are quickly washed off from the skin with heavy sweat.

In this case, it is possible to protect the skin from insect bites by lubricating it with a solution of silt or clay. Having dried up, it forms a dense, insurmountable crust for insect sting. Mosquitoes, biting midges, mosquitoes are twilight insects, and in the evening and at night their activity sharply increases. Therefore, with the sunset, you must use all available means of protection: put on a mosquito net, lubricate the skin with repellent, make a smoke-bonfire. For the prevention of malaria, a number of drugs are used: chloroquine (0.5 g), haloquine (0.3 g), chloridine (0.025 g), paludrin, etc. One of these drugs should be taken from the first day of your stay in the jungle once a week.

Yellow fever in the tropics.

It is caused by the filtering virus Viscerophicus, which is transmitted by mosquitoes Aedes aegpti, A. africanus, A. Simpsony, A.haemagogus and others. Yellow fever in endemic form is widespread in Africa, South and Central America, and Southeast Asia. After a short incubation period (3-6 days), the disease begins with tremendous chills, fever, nausea, vomiting, headaches, followed by an increase in jaundice, damage to the vascular system (hemorrhage, nose and intestinal bleeding). The disease proceeds very seriously and in 5 10% ends with the death of a person. Vaccines with live vaccines are a very reliable way to prevent yellow fever..

Trypanosomiasis or sleeping sickness in the tropics.

This is a natural focal disease, common only in Africa between 15 degrees north latitude and 28 degrees south. This disease, which is considered the scourge of the African continent, threatens, according to the World Health Organization, 35 million of its inhabitants. Its causative agent Tripanosoma gambiensis carries the infamous tsetse fly. In the blood of a person bitten by a fly, trypanosomes that penetrate there with the saliva of the insect quickly multiply. And after 2 3 weeks the patient falls down in a severe fever. Against the background of high temperature, the skin is covered with a rash, signs of damage to the nervous system, anemia, and exhaustion appear; the disease often ends in human death.

Mortality from sleeping sickness is so high that, for example, in some areas of Uganda, as N.N. Plotnikov points out (1961), the population over the past 6 years has decreased from 300 to 100 thousand people. In Guinea alone, 1,500–2,000 deaths were reported annually. About 36 million dollars a year are spent annually on fighting this terrible disease of 36 countries of the African continent, where it is rampant. However, to date, a vaccine against sleeping sickness has not yet been created.. 

Based on materials from the book Man in extreme environmental conditions.
V.G. Volovich.

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