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Treatment of tularemia during pregnancy

Treatment of tularemia during pregnancy should be entrusted to a doctor specializing in the field of contagious and infectious diseases, who will decide on the expediency and prospects of the application of specific preparations.

The disease, being acute and infectious, has an extremely negative effect on pregnancy, therefore it is advisable to prevent it at the stage of family planning.

Important preventive measures are the liquidation of natural outbreaks or the reduction of their areas, hydromelioration activities, improvement of the systems for carrying out agrotechnical measures, ensuring the protection of sources for supplying the population with drinking water, of food storages and the taking of measures to prevent the settlement of rodents such as house mice and rats in the living quarters.

In epizootic outbreaks of tularemia, it is necessary to carry out systematic deratization and disinsection in the field, in warehouses and in populated areas.

The regulation of the number of industrial rodents is also recommended.

The population should be widely recommended to use repellents and other individual means to protect people from bites of arthropods such as ticks and mosquitoes in particular.

It is extremely important to ensure the inaccessibility of drinking water to rodents. The use of water from open reservoirs should be prohibited. When using hay bales inhabited by rodents, agricultural workers should wear protective glasses and masks.

Immunizations are carried out mainly for persons falling into the risk groups – hunters, agricultural workers.

In people who have had tularemia and in those who have been immunized, vaccination can cause a strong allergic reaction. Therefore, before vaccination, it is necessary to take an allergy test. Revaccination takes place after 5 years.

Epidemiological observations show that if 80-90% of the population is immunized after 10-14 days, the morbidity among people stops.

In cases of occurrence of tularemia among large groups of the population, as is expected in Bulgaria from mid-March, the World Health Organization does not currently recommend extreme vaccination.

If necessary, post-contact antibiotic therapy with doxycycline is allowed.

Which doctors should pregnant women consult if they suspect tularemia?

• General practitioner;
• Immunologist;
• Specialist in infectious and parasitic diseases;

Clinical-epidemiological criteria:

• Epidemiological – contact with rodents, insect bites / ticks, mosquitoes/, use of water from open reservoirs, work in the field, warehouses, grain storages;< /p>

• Clinical – presence of moderately painful enlarged mobile lymph nodes, not connected to each other and to the surrounding tissues;

• Prolonged course of an apparently acute respiratory or cold illness;

• A significant increase in the size of the lymphatic vessels around the trachea and bronchi, this is characteristic of the pulmonary form of tularemia.

Etiological misinterpretation of swollen lymph nodes can lead to errors in differentiating rabbit fever from bubonic plague.

Characteristic signs of the plague are severe pain of the enlarged lymph nodes, absence of clear contours, as a result of the developed inflammatory process, involvement of the subcutaneous fatty tissue and skin in the pathological process.

The condition of the patients is much worse compared to the relatively mild course of tularemia.

The presence of hemoptysis distinguishes plague pneumonia from pulmonary tularemia.

The skin ulcers of patients with rabbit fever are distinguished from those of plague by being less painful, with a frequent manifestation of lymphangitis, with the absence of dangerous complications and with a milder clinical course.

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