Upsurge in tick-borne disease predicted for summer 2000

RIGA - Tick-borne encephalitis is close to a major outbreak in Latvia.
The disease season started earlier this year with 22 cases registered
by the middle of May.

Baiba Rozentale, the head of the state Infection Center, predicts more
than 1,000 cases this year compared to last year's 350.

The encephalitis danger in Latvia is higher than in other European
countries. The warm winter and early spring helped ticks to survive and
multiply this year. Rozentale said encephalitis is present in all of
Latvia now, although the alarm came from only 11 Latvian regions. The
reason, she said, is that chemical fertilizers are not used anymore in
the countryside with the waning of agriculture.

First disease cases are usually registered on Jani, the summer solstice
holidays.

"They start biting in the beginning of June, but the signs of disease
appear only after two weeks - the incubation period," said Rozentale.

The major signs of the encephalitis are headaches and high temperatures
difficult to reduce, which last for a week and more.

"There are usually two waves of high temperature. The first lasts for
seven - 10 days, then after a two to three day spell, when a person
thinks everything is over, there is another wave. If a victim has only
one wave, he becomes immune against encephalitis. But if not, he needs
to be hospitalized and get special treatment," she said.

Mundris Deicenbergs, 32, got sick with encephalitis last fall. He said
he went to pick mushrooms with his brother, and did not notice that the
tick bit him.

"When we left the forest, my brother shook the ticks from his head, but
I did not find any. So in the end, I got sick, and he did not."

The complications depend on how soon the treatment is applied, said
Rozentale. The usual complications are meningitis and brain dropsy.
Sometimes it may lead to death. There were 17 such cases within the
last three years in Latvia.

Deicenbergs said he had usual symptoms - high temperature, headaches
and vertigo with the usual pills not helping. In 10 days he felt a
relief for three days and than another burst of temperature. The
physician at the local health center sent him to the state Infection
Center, where he spent two weeks, with the illness progressing without
complications.

"I went gathering mushrooms all my life, and nothing like this happened
before," he said. Now he is immune and doesn't have to consider
vaccination costing more than 20 lats. One of the reasons for high
disease rates in Latvia is the lack of money and accessibility of
vaccines. The immunity requires three vaccines, each costing 7-15 lats
($12-$25) - a considerable sum for an average Latvian. Though the
disease is quite dangerous, the vaccination is a commercial pro-duct
and not provided and mandated by the state.

Velga Kuse, the physician at the state Infection Center said that
people from the most distant Latvian cities come to Riga for
vaccinations against encephalitis.

"In the regions the accessibility of the vaccine is probably worse. It
depends highly on the local physicians' initiative," she said.

The trends in morbidity rates, that fluctuate in Latvia from over 1,300
in 1994 and 1995 to 350 in 1999, depend on the tick's activity
influenced by weather conditions and people's defense against them
through vaccination, said Kuse.

The informal way to avoid disease from ticks is after every forest or
country visit to scrutinize oneself and use some chemical sprays
against ticks, said Kuse. Still, she stressed that the best way is to
get vaccinated against encephalitis.