Most pediatricians advise introducing fish to feed the baby from 10-11 months. Ordinary citizens perceive this advice as a call to buy ready-made fish puree in a jar. This is an expensive product, but completely safe from a parasitological point of view. Villagers prefer to cook fish for the child on their own. This approach often ends in failure, because the elementary rules for disinfection are not respected. As a result, the baby can become infected with one of the most dangerous helminths - the Siberian fluke, the causative agent of opisthorchiasis. In children, the symptoms and treatment of this disease have certain characteristics. We will try to figure them out in today's article.
Prevalence of the disease
Opisthorchiasis is a type of helminthiasis that affects the biliary system: the pancreas, liver and gall bladder of a person. The heart and central nervous system are particularly affected by infection. It is dangerous in that it is characterized by a latent course and blurred symptoms. Quite often, the presence of parasites in the body is detected several years after infection. During this time, the body undergoes tremendous damage.
The causative agent of the disease is Siberian fluke. A small lanceolate worm belongs to the order of hepatic flukes. For the first time, the parasite was found and described in detail by Professor K.N. Vinogradov, therefore, opisthorchiasis is also called Vinogradov's disease.
According to medical statistics, every year at least 21 million children experience manifestations of this type of helminthiasis. It has no age limits. Both small children and adolescents equally suffer from the activity of the Siberian fluke. It is worth noting that in 80% of cases opisthorchiasis is diagnosed in residents of Western and Eastern Siberia, Dnieper. Such high rates are due to the characteristics of nutrition. In these regions, the diet mainly consists of fish.
Infection pathways
There is a danger of infection with opisthorchiasis in children living near freshwater bodies. The feces of sick people fall into rivers and lakes, which inevitably occurs with the modern type of water and sewer economy. Shellfish and small fish swallow eggs of liver flukes along with algae. They, in turn, are food for commercial species of cyprinids - an intermediate link of parasites. Siberian hepatic reaches puberty and reproductive ability in the human body.
There invasive helminth eggs get in various ways. They remain on the boards for cleaning fish, on the hands and clothes of people who are engaged in cooking. The eggs that enter the digestive tract provoke the development of the disease. Reproduction of parasitic worms in the child's body begins 2-4 weeks after infection with opisthorchiasis. In children, the symptoms and treatment of pathology are practically no different from those in adults. There are acute period and its chronic course. It is important to detect infection as early as possible in order to immediately begin therapy and prevent the development of complications.
Clinical development of the disease
After infection, the incubation period can last from 2 to 4 weeks. At this time, the disease manifests itself in different ways, depending on the state of immunity of the child, his age and degree of invasion. The culture of many northern peoples involves eating raw fish. Therefore, newborn children, along with mother's milk, acquire a kind of immunization with parasite antigens. Their incubation period is almost asymptomatic. Perhaps a slight increase in temperature and slight malaise. In other babies, infection can provoke an allergic reaction or exacerbation of viral ailments.
Symptoms of opisthorchiasis in children in acute form also appear in different ways:
- Easy flow. The disease is accompanied by increased fatigue, physical weakness and a slight rise in temperature to 37 degrees.
- Moderate course. In children, the temperature rises to 39-40 degrees and does not decrease for several weeks. Diarrhea, nausea, and muscle weakness are possible.
- Severe course. The development of this type of ailment is due to a stably high temperature. If the parasites settled in the bile ducts, jaundice occurs. When they enter the digestive tract, children complain of abdominal pain, a feeling of constant nausea. In some cases, inflammation of the lymph nodes is observed.
The chronic form of the disease is usually diagnosed in Siberians. Having been infected since childhood, many find opisthorchiasis after decades. Unaware of the presence of parasites in the orgasm, people seek medical help with cirrhosis, hepatitis or central nervous system lesions. They are constantly haunted by various allergic reactions in the form of skin rashes. Pain in the joints and muscles does not disappear even at night, arthrosis or arthritis may develop. In chronic opisthorchiasis, anemia is possible.
Other signs of helminthic infestation
It should be noted that, depending on age, the symptoms of opisthorchiasis in children can manifest themselves in different ways:
- At the age of 1 to 3 years, the main manifestations of the disease are pain in the hypochondrium, digestive disorders, high temperature and periodic breathing difficulties.
- In the period from 3 to 8 years, allergic reactions become more intense, they are often accompanied by icteric hepatitis and other liver pathologies.
- By their sixteenth birthday, previously infected children can develop immunity to parasites. However, by this time, the full-fledged work of the body will be disrupted by various complications of opisthorchiasis. In some cases, they result in cancer of the liver or pancreas.
Many pediatricians and the most famous of them, Dr. Komarovsky, are advised to look for parasites in the feces of the child. In case of detection, you must immediately seek help from a doctor and start therapy.
Diagnostic Methods
Identification of the disease at the initial stage is almost impossible, since parasites in the feces can be detected only after the end of the incubation period. If the child eats raw fish, he has obvious manifestations of helminthic invasion, you should immediately consult a doctor.
Diagnosis of opisthorchiasis in children begins with a study of the anamnesis, diet and clinical picture. After this, a detailed examination is prescribed, which includes:
- Fecal analysis. Today it is the most informative diagnostic method. Feces are given three times. If 100 g of eggs is detected in 1 g of the test substance, infection is considered easy. If 30 thousand eggs or more are found, they speak of a severe form of pathology.
- Blood analysis. Several studies are recommended: general analysis, sugar screening, enzyme / liver failure.
- Ultrasound of the abdomen. Allows you to assess the condition of the bile ducts, to detect adult parasites.
To determine the severity of the disease and identify anatomical changes in the organs, cholecystography and gastroscopy are performed.
Principles of Therapy
A doctor should tell how to treat opisthorchiasis in children. Therapy completely depends on the variant of the course of the disease. For example, in the acute form, anti-inflammatory and antihistamines are first prescribed. Only after they proceed to specific therapy. The chronic form requires an immediate fight against parasites, which ends with rehabilitation treatment.
The process of stopping symptoms consists of several stages. Below we consider each of them in more detail.
Preparatory stage
Before starting the full treatment of opisthorchiasis in children, it is necessary to cleanse the body of toxins accumulated in it. For this purpose, antihistamines (Suprastin, Tavegil) are prescribed to small patients. In the case of extensive invasion, it is recommended that they be administered parenterally, and for mild forms of the disease, orally. Contraindications to taking antihistamines are serious pathologies of the respiratory system. With a complicated course of the disease, the help of glucocorticosteroids may be required.
The main goal of the preparatory phase is the normalization of the heart and other organs. It lasts at least 5 days. However, on the second day, the patient usually has an improvement: a decrease in temperature, restoration of myocardial function. The main sign of stabilization is no arrhythmia.
Anthelmintic therapy
In case of positive dynamics, they proceed to the next stage of therapy. It implies the destruction of parasites by special means. The following drugs are especially effective: Biltricid and Azinox, Nemozol and Zentel. The active substance in the first two medicines is praziquantel. This is a toxic component that negatively affects the work of internal organs, immunity. Therefore, many parents, after consulting a doctor, decide to treat the opisthorchiasis in the child with Nemozolom. Its use is practically not accompanied by side effects.
Recovery phase
After a course of specific therapy, you can begin to restore the body. For this purpose, the child selects a diet and vitamin complexes. For better purification of the bile ducts, the help of choleretic agents ("Holiver") and antispasmodics may be required. Their dosage is calculated individually taking into account the age and weight of the patient.
To normalize the digestive tract, enzyme preparations are usually prescribed (Mezim, Festal). These medicines are allowed to take children from 3 years.
After the end of the course of therapy, re-diagnosis is recommended. Fecal analysis should be done after 1.3 and 6 months from the date of treatment. If the examination shows a positive result, therapy is resumed.
Diet features
A mandatory step in the treatment of opisthorchiasis in children is dieting. Only in this case can we hope for a speedy recovery. The best option is the diet table number 5, the essence of which is fractional and frequent nutrition. The number of meals per day should be at least 5-6.
With such a diet, fatty and fried foods, smoked meats, mushrooms and pastries are strictly prohibited. All food is best baked or cooked in a double boiler. It is worth noting that the daily calorie intake should not exceed the mark of 2600 kcal.
What can you eat with opisthorchiasis in a child? Reviews of doctors say that any lean meats and fish are allowed. The basis of the diet should be raw vegetables and fruits. The diet includes the use of wheat and rye bread, pasta. A variety of cereals on the water are allowed: oatmeal, buckwheat, rice.
Help traditional medicine
Treatment of opisthorchiasis with folk remedies is allowed only after consulting a doctor. Sometimes the combination of alternative medicine with anthelmintic drugs leads to a deterioration in the condition of the child, due to high intoxication of the body. Therefore, doctors recommend prescriptions for folk doctors before or after a course of antiparasitic treatment. Among them, the following have the greatest therapeutic effect:
- Pumpkin seeds. Since ancient times, this tool has been used to stop the symptoms of opisthorchiasis in children. And the treatment, and a delicious treat - such properties are combined by this recipe.
- Birch tar. A few drops of the product are added to milk and taken before bedtime.
- Aspen Bark. To prepare the broth, it is necessary to pour 30 g of bark with two glasses of boiling water, let it brew. Take the medicine in small sips before meals.
Opinions of parents and doctors about treatment
According to medical reviews, treatment of opisthorchiasis in children in most situations ends positively. Cases of mild and moderate course of the disease have a favorable prognosis. Timely seeking medical help and quality therapy can get rid of parasites quickly enough. In severe cases of the course of the disease, small patients require hospitalization.
Prevention of opisthorchiasis in children
We have already talked about the symptoms and treatment of the disease a little higher. Now you need to consider the main options for its warning.
A key point in preventing the development of helminthiasis is attention to the quality of food consumed. Special care should be taken with fish caught and sold within the endemic focus. We are talking about Eastern and Western Siberia, the Dnieper.
In addition, it is better to completely exclude fish from the diet of children. At the same time, kids are not only forbidden to eat it, but even touch it. Otherwise, it is recommended to heat the fish for at least 30 minutes, and after direct contact, wash your hands with soap.