Introduction
Deer fly fever or Tulaeremia is an infectious kind of fever that is seen in almost all parts of Asia Europe and America but it is mostly seen in south and central parts of the United States. It is seen almost everywhere in US but not in Hawaii. The disease spreads primarily from rodents or pet animals to humans, but not directly from person to person.
Signs and symptoms of Deer Fly Fever (Tularaemia)
The clinical manifestation differs according to the site affected
- Ulcero-glandular type:
Skin ulcer that is caused by an insect bite or infected animal bite
Painful and swollen lymph glands
General fatigue
Chills and fever
Headache
- Oculoglandular type affects the eyes. Signs and symptoms include:
Swollen, painful and running eyes
Reddish discolouration of the eyes
Sensitivity to the light
Ulcerations inside the eyelids
Tenderness of lymph glands in and around neck, ears and face
- Oropharyngeal type: this affects the upper respiratory and digestive systems mostly. This develops from drinking the contaminated water or contaminated food. There will be difficulties like throat ache, vomiting, diarrhoea, swollen lymph nodes in the neck, tonsilitis, mouth ulcers, and fever.
- There is another type of tularaemia known as pneumonic and it is associated with pneumonia.
- Difficulty in breathing
- Chest pain
- Dry cough that worsens at night
- Recurrent low-grade fever
- A very rare type of tularaemia known as typhoidal tularaemia. This is the most serious form of this disease with splenomegaly or hepatomegaly, vomiting, diarrhoea, severe lethargy and a high fever.
Causes of Deer Fly Fever (Tularaemia)
Tulaeremia does not develop within the human body as its own but only gets affected from an infected animal or insect. The condition is caused by the infection with a bacteria called Francisella tularensis. Many animals like rabbits, deer, sheep or birds can be affected by this bacterium and eventually can reach humans by direct contact.
Pathophysiology of Deer Fly Fever (Tularaemia)
Tulaeremia is a zoonotic disease caused by a bacterium, Francisella tularensis that affects human from animals, insects etc. No direct infection between humans reported yet. Francisella tularensis ia very dangerously infectious bacterium, and only a few bacteria can cause the infection. They penetrate into the body through breaks in the skin or mucous membranes. They are also capable of entering the body by inhalation or ingestion accidentally. It is an intracellular type of bacteria, meaning that it can live in a host cell, as a parasite. At first, they attack macrophages, a type of WBC that play an important role in immune response, hence hampering the body’s immune system. The bacteria travels and spreads into many organs in the body leading to organ failures like liver, lungs, spleen or the whole lymphatic system.
Diagnosis of Deer fly fever (Tularaemia)
Physical examination
Detailed case history taking to confirm the probability of an insect bite or any contact with the bacteria
Blood tests and culture for confirmation
Antibody tests like serum agglutination or ELISA
Treatments for Deer fly fever (Tulaeremia)
Broad spectrum antibiotics like streptomycin
Symptomatic management like anti-pyretic or anti-pruritic medicines as per needed
Prognosis of Deer fly fever (Tularaemia)
Most cases of tularaemia recover without any serious complications with two or three weeks of antibiotics. Some people also get cured without antibiotics, but some cases especially typhoid al or tularaemia with sepsis get fatal.
Complications of Deer fly fever (Tularaemia)
Untreated tularaemia can affect all the vital organs in the body and cause inflammation in them. Such complications include meningitis, myocarditis, pericarditis, inflammation of bones or joints, and hepatitis.
Deer fly fever (Tulaeremia) and Ayurveda
Krimi
Nidana-Ayurvedic causes
Causative factors for krimi are the same as that of Kushtha.
Sparsa
Aahaara together – By touch and sharing food, bed etc.
Sayya
Amrijothbhava – Due to lack of proper personal hygiene
Poorvarupa- Ayurvedic premonitory signs and symptoms
Not mentioned separately
Samprapti-Ayurvedic pathogenesis
Due to contact with krimi (microbes or parasites) and due to lack of proper hygiene, the microbes enter the body through skin, wounds or cuts, mouth, nose or eyes. They enter the bloodstream and release toxins. The vitiated rasa-raktadhatus cause the symptoms, mostly on skin. Such body reactions are understood as allergic manifestations and mostly are seen as skin rashes.
Lakshana – Ayurvedic signs and symptoms
Kotha – papules
Pitaka – pustules
Kandu – itching
Ganda-cysts or small lumps or even enlarged lymph nodes
Jwara – Fever
Sadhyasadhyata-Ayurvedic prognosis
Kricchrasadhyam
Chikitsa-Ayurvedic treatment
The Ayurvedic treatment of Krimi depends upon the type.
Here, the infestation is external and it is baahyakrimi. The main procedure is to physically remove the krimi from skin and other bodyparts. Also following good hygiene and preventive measures are advised.
Samana
Apakarshana – extraction with hand or tool
Uthkharshana-powder massage
Lepana-external application ofherbal pastes
Parisheka-Pouring medicated herbal decoctions on the area
Sodhana
Vamana
Virechana
Aasthapanavasti
And after the krimi has expelled from the body, anuvasanavasti should be done to compensate the dryness and deterioration caused by aasthapanavasti.
Commonly used Ayurvedic medicines
Amruthotharam Kashayam
Vidangakrishnadi kashayam
Aragwadharishtam
Avipattichoornam
Krimisodhinivatika
Home remedies
Using essential oils like cinnamon, clove and oregano.
Supplements including Vit B1, C, magnesium etc with natural foods like garlic and turmeric.
Intake of cat’s claw and chlorella
Diet and behaviour suitable
- To be avoided
Red meat, fried non-veg items, and sea foods
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods and spicy food- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening agni (digestive fire)
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, buttermilk boiled with turmeric, ginger and curry leaves
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Maintain proper personal hygiene.
Avoid sedentary lifestyle. Be active.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid forcing or holding of natural urges like urine, faeces, vomiting, hiccups etc.
Avoid Stress and emotional imbalance as much as possible.
Yoga and Pranayama
Halasanam
Ardha mathsyentra asanam
Vakrasanam
Dhanurasanam
Nadisuddhi pranayam
Research papers
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