Leech bite

Leeches are well-known ringworms that can be easily found in almost any freshwater body of water, especially in places with stagnant water. Both children and adults also know that these worms are quite unpleasant to bite, sucking a relatively large amount of blood. What is a leech bite, how dangerous is it, and what to do in such a case?

Is a leech bite dangerous?

Any therapist can tell you about the benefits of leech bites. However, such benefits are indeed present if they are therapeutic worms that are specially bred for medical use.

If the worm is in the wild, however, its bite can be dangerous in its own way: it is best avoided. [1]

In general, leeches are parasites that harm animals, fish, and can harm humans, for example, infecting any disease transmitted through the blood. In addition, after the bite often develop quite strong bleeding, exhausting the living organism. In nature, bloodsucking worms usually affect parnopod animals approaching water bodies to drink water. In this case, a significant thickness of the skin, which is required to bite, leeches are not at all frightened. And human skin they bite even easier.

What is the danger to humans? Wild ringed representatives are capable of causing the development of a disease called hirudinosis. This disorder appears due to the negative effect of bioactive salivary components against the background of loss of a certain amount of blood of the victim. Immediately you can reassure: such a disease is rare and does not develop from a single bite of a leech. Most often suffer from people who try to independently and illiterately engage in hirudotherapy, using not special, but ordinary worms.

Another possible cause of hirudinosis may be leech parasitization. However, on the territory of our country parasitizing leeches are not found: such harmful worms can affect a person, for example, after a trip abroad. [2]

Epidemiology

Leeches belong to the subclass "ringworms". Their basic habitat is freshwater bodies, mainly with standing water.

The world fauna counts more than half a thousand species of leeches: among them more than 60 species can be found in Russia, and 25 species - in Ukraine. Exactly how many wild leeches live on the territory of our country is unknown, as we are talking about tens of tons, and this calculation has never been carried out.

The most dangerous leech species are found in southern countries, such as Ceylon, Malaysia, Sumatra, Borneo, New Guinea, Sri Lanka. [3]

Causes Leech bite

Leeches are classified by scientists as hematophagous, which means that they do not eat anything but blood. In principle, the blood of any vertebrate animal is suitable, but preference is given to large mammals, including humans. [4]

The digestive system of the worm is opened by a mouth opening located in the anterior terminal segment. If you look inside the mouth, you can notice small light-colored formations that represent the jaw leech apparatus. Three jaws are present: two of them are lateral and one is dorsal. Teeth are small and sharp, they bite even rather thick skin without problems.

The pharynx is followed by the esophagus, and then by the multi-chambered gastric intestine, in which the consumed blood accumulates. Thanks to this accumulation, the worm is able to exist without food for several months. Interestingly, the blood in the leech stomach does not curdle, is not affected by bacteria and does not spoil.

The leeches' intestines empty several times a day.

Special attention should be paid to the salivary apparatus, the outputs of which are located around the circle of the pharynx. Salivary secretion contains a large number of bioactive components that penetrate the tissues bitten by the worm. Saliva is secreted during the entire sucking act.

Leeches have highly developed gustatory, tactile and olfactory abilities, which is very helpful in finding a food source. The first thing the worm reacts to is odor: that is why a leech will never bite a person who smells a strong odor of detergent, perfume or deodorant. If there is no irritating odor, the attack occurs almost immediately. The most favorite leech scent is the smell of blood, to which there is literally an instant reaction.

Additional factors contributing to the attack are water fluctuations provoked by large animals or humans. Noise from approaching prey is picked up by the worms very quickly, after which they head directly towards the sound source.

After suckling to the skin, the bite does not follow immediately: first the leech needs to find the warmest area with more intensive circulation of capillary blood. Therefore, inflammatory elements on the skin are often the place of choice.

Stalom, if a person goes into standing water without proper protection, no irritating odors (especially if there are scratches, inflammations and cuts on the skin with the scent of blood), he may well be a potential victim of a leech attack. [5]

Risk factors

Once in the vicinity of a mammal - and humans in particular - leeches do not bite everyone. Like radar, their olfactory system is "tuned" not only to search, but also to sort the sources of blood food. They are able to sense the optimal scent for themselves several dozens of meters away. The scent of detergents and cleaning agents, toilet water, perfume, cologne, deodorant, tobacco smoke is a deterrent for them. [6]

In general, the following populations are at risk of being bitten:

• travelers, tourists;
• inhabitants of wet and swampy areas;
• lovers of bathing in natural water bodies, on unauthorized beaches;
• fishermen, hunters.

Pathogenesis

At the end parts of the body of the leech there are peculiar suction cups. The front of them is formed of four or five segments, and the rear - of seven segments, which makes it more powerful. After sucking the worm bites the skin: the bite can penetrate to a depth of one and a half to two millimeters, while in the tissues gets salivary secretion, which, among other things, includes the enzyme substance hirudin, inhibiting the processes of blood coagulation. One leech during one bite usually sucks up to five milliliters of blood. After the "attack" on the skin remains a small lesion, from which can for several hours oozing blood and lymphatic fluid. In general, an additional 5-30 ml of blood flows out of the wound after the "bloodsucker" falls off. [7]

Salivary leech secretion usually includes such enzyme substances:

• hyaluronidase - a substance that improves tissue permeability;
• hirudin - a component that slows blood clotting and blocks thrombin;
• histamine-like component - ensures the development of local inflammation to improve blood flow to tissues in the bite area;
• substances, proteolytic enzyme inhibitors - reduce the body's overall inflammatory response;
• destabilase complex - has antithrombotic action by blocking platelet aggregation.

Other components of the secretion have less pronounced effects, or their effects are not fully understood at the moment. [8]

Symptoms Leech bite

The immediate moment of the leech bite is accompanied by a burning sensation, the intensity of which varies in similarity from a nettle burn to an ant or mosquito bite. These sensations may recur periodically throughout the period until the worm falls off. The average duration of his sucking act is 20-40 minutes, and after falling off, blood continues to be secreted for some time. Post-partum bleeding can be stopped by applying a tight bandage to the wound. [9]

What does a leech bite look like? Usually it is a wound about one and a half millimeters deep, from which blood oozes. The victim may feel fever, general discomfort for several hours. On the skin in the damaged area may form a hematoma, indicating the entry of blood into the tissues: at first the spot is bluish, then the color changes to yellow and disappears completely for a couple of weeks.

A specific triangular-shaped scar is formed at the site of the bite, gradually it pales and disappears.

Blood discharge after the worm falls off usually continues for several hours and depends on individual clotting parameters. People with excessive sensitivity may notice swelling, redness, itching.

Itching is usually limited to the bite site, but can also be general. In both the first and the second case, it completely disappears within 3-4 days. The main condition for successful wound healing is to avoid scratching and damage to the wound and to prevent infection.

The first signs of a leech attack are not difficult to notice, because a sharp burning sensation is difficult to ignore. Usually a person grasps the affected place and finds there "uninvited guest". About what it is necessary to do at this moment, and what to do categorically not, we will talk below.

In some cases - for example, if a person is wearing shoes, the bite of the river leech actually remains ignored. This is often the case with fishermen, when the "bloodsucker" crawls into rubber boots and sucks on the skin on the foot. In this situation, the nuisance is detected already at the moment of changing shoes. The main thing is not to panic and do not tear off the parasite from the body. During tearing off in the wound can remain its jaws, after which the initially harmless bite of a wild leech will lead to irritation and infection of tissues - increasing the likelihood of complications. [10]

Complications and consequences

Fortunately, most often single bites bring only brief unpleasant sensations. In the worst case, you can "earn" allergic reactions to the bite of a leech: they are manifested by intense itching, redness, swelling of the affected area of the skin. All these symptoms are the usual manifestation of allergy. Although these symptoms are expressed in different ways: for example, some people just a little itchy leech bite, and others have a much stronger reaction, up to anaphylactic shock. [11]

In order to understand how serious the consequences can be, you should listen carefully to your body. Minor itching or just discomfort, without the addition of other painful signs, most likely, will not be accompanied by complications. If significantly swollen, swollen place of leech bite, there is an increase in temperature, there is a general weakness and malaise, it is recommended to visit a doctor for consultation. Perhaps it is a hypersensitivity reaction, or an allergy.

Minor itching from a leech bite usually lasts for 3-4 days, after which it gradually comes to naught. If the itching sensations do not go away, but on the contrary, increasing, then a visit to the doctor should follow necessarily, and as soon as possible. [12]

The wounds themselves after a leech bite may take a little longer than usual to heal. However, during the entire healing period, they should not bleed, redden, swell, inflame, and even more so, they should not ooze blood and pus. These signs often indicate that the infection is attached - that is, that the inflammation develops from the bite of the leech. This often happens if a person bathes in a dirty body of water, or is in contaminated standing water. Treatment of inflammation should be carried out in hospital, and in neglected cases it is necessary to resort even to the assistance of a surgeon.

To prevent the development of complications, even a small redness after a leech bite should be treated with any disinfectant: alcohol, manganese solution, furacilin, fucorcin, chlorhexidine, etc.

Another type of complication is bleeding after a leech bite, which can be as small and short-lived as it can be significant and prolonged. Small bleeding is considered one of the variants of the norm. But abundant and prolonged blood loss, which is usually characteristic of people with poor blood coagulation, can lead to various adverse effects. Therefore, if blood continues to ooze from the wound after a certain time after the bite, it is better to see a doctor and take measures to stop bleeding. [13]

Bruising after a leech bite indicates that blood has seeped into the tissues: it is necessary to monitor the area, and if the bruise increases in size, urgently consult a doctor.

How long does a leech bite take to heal? Blood can ooze from the damaged place within 2-5 hours, but the wound itself heals much longer - from several days to several weeks. The trace from leech "attack" can remain on the skin for six months, which depends on the individual characteristics of the human body. [14]

Diagnostics Leech bite

To begin with, the doctor will send the affected person for tests:

• general blood work;
• Coagulogram (checking the quality of blood clotting);
• blood sugar levels.

If the clinical picture is unclear, ancillary diagnostics are routinely suggested:

• ultrasound;
• hormone tests;
• Involvement and consultation of specialized specialists.

It is important for the doctor to know the patient's blood pressure readings, to determine if the patient is anemic. [15]

Differential diagnosis is most often carried out with mechanical injuries, vascular diseases, insect bites, rodent bites, crustaceans.

Treatment Leech bite

Treatments for a wild leech bite are usually limited to stopping bleeding and preventing allergic reactions and infection.

The bleeding is stopped by applying a tight bandage, which is often sufficient. Stopping the bleeding by applying a tight bandage is often sufficient.

To prevent the development of the allergic process, the patient is prescribed antihistamines Suprastin, Tavegil, Zyrtec, Fenistil.

In order to prevent secondary infection, the wound is treated with such preparations (at your choice) as a solution of brilliant green, iodine, fucorcin, a weak solution of potassium permanganate, furacilin solution, hydrogen peroxide. You can also use alcohol solutions: propolis tincture, calendula, cowpea, etc. Will do. The question of the need for antibiotics is decided by a doctor on an individual basis. [16]

First aid in case of leech bite

The first thing to do when you find a leech on the body is to remove it. Trying to tear off the worm is not necessary, because its body elements can remain in the tissues and lead to the development of inflammation.

Do not cut the parasite with a knife or other cutting objects.

Do not cover the wound surface with earth, smear with marsh, it is undesirable even to irrigate with water from a body of water, as this can cause secondary infection.

Still, what to do after a leech bite?

• It is necessary to make the worm let you go voluntarily, sprinkling it with salt, crushed tobacco, or pouring alcohol, vodka, any alcohol solution (you can even cologne), table vinegar.
• To prevent the penetration of infection into the tissues, the wound should be treated with hydrogen peroxide, iodine, green, fucorcin, or alcohol solution.
• A tight bandage should be applied to stop the bleeding. If the bleeding is profuse, it is important to seek medical attention immediately.

If the parasite got inside the body - in the esophagus, respiratory tract, genital tract - then it is necessary to contact a specialist as soon as possible, because it is definitely not possible to get the worm on your own. Having drunk blood, it will increase in size and can block vital channels, so you need to remove it, the sooner the better. [17]

Medications that may be helpful for a leech bite

Suprastin	An anti-allergic drug based on chloropyramine. Tablets are taken with food, 3-4 per day (not more than 4 pieces per day). In case of strong sedation, dizziness, drop in blood pressure, Suprastin should be discontinued.
Zyrtec	Antihistamine drug based on cetirizine. It is taken orally 20 drops once a day. Zyrtec has a minor side effect on the CNS, so treatment is usually not accompanied by drowsiness, increased fatigue, dizziness and headaches.
Phenistil	Systemic anti-allergic drug based on dimethindene maleate, well eliminates itching and swelling after bites. The daily amount of the drug is 3-6 mg (in three doses). Standardly take 30 drops three times a day. The beginning of treatment is often accompanied by drowsiness, which gradually passes.
Water pepper tincture	Plant blood-stopper, the effect of which is due to the presence of bioflavonoids in the drug. Tincture reduces capillary permeability, normalizes the structure of the vessel walls, eliminates inflammation, accelerates blood clotting. Usually take 30-40 drops of the drug up to 4 times a day, between meals. Possible adverse reactions: headache, nausea.
Vikasol	Sodium bisulfite menadione drug belongs to hemostatic agents. Vikasol is administered intramuscularly, in a single dose of 10 mg, with a maximum daily dose of 30 mg. Possible side effects: jaundice, tachycardia, hypersensitivity reactions.

How do I stop the bleeding at the site of a leech bite?

It often happens that after bites on the skin swelling, red spots, and blood is released from the wounds. A small discharge of blood can be called a natural process, because during the bite, the enzyme function is activated, which prevents blood clotting. To lose your own blood is not at all desirable, so it is necessary to take measures to stop bleeding. It is necessary to prepare any of these remedies:

• Brilliant green solution, fucorcin, iodine or alcohol solution;
• medical glue;
• oak bark infusion, or diluted vinegar;
• Rescue ointment, turpentine oil, petroleum jelly or glycerin.

The wound is treated with one of the above remedies, after which a tight bandage is applied to the bitten area. Additionally, an ice pack can be applied on top. If bleeding does not stop for more than 10-12 hours, despite the measures taken, it is necessary to seek medical help. [18]

What do I use on leech bites?

How to ointment bite sites to accelerate healing and get rid of unpleasant symptoms of itching and swelling? There are a number of effective remedies that are sold in any of the pharmacies:

• Spasatel ointment - is a universal balm with resolving, antimicrobial, regenerating action, accelerates healing, including inflamed bite sites;
• Boro Plus ointment is an antiseptic that quickly heals wounds in children and adults;
• Phenistil-gel - anti-allergic agent in the form of gel (also exists in drops and capsules), helps to avoid side effects after leech bites (in particular, eliminates itching);
• Bepanten is a universal remedy with active healing, moisturizing and regenerating action;
• Epidel is an anti-inflammatory cream that stops the local development of inflammation, reduces the manifestations of itching and burning of the skin;
• Hydrocortisone ointment is a hormonal agent for external use that exhibits immunosuppressive, anti-allergic, anti-inflammatory and anti-exudative effects; not suitable for prolonged use.

Folk treatment

There are many folk medicine recipes that can be successfully used for leech bites from different places. Therefore, you should focus on such types of plants that are present in your area. If the remedy helps, but weakly, it is better to change it and replace it with another.

• With severe bleeding wounds prepared decoction of bark or rhizome of barberry: pour boiling water (200 ml) 30 g of raw materials, insist 15-17 minutes, filtered and taken inside 1 tbsp. Every hour, until the complete stop bleeding.
• Apply lotions with decoction of oak bark: one glass of boiling water poured 10 g of bark, boiled for 20 minutes and filtered.
• Eat strawberries on an empty stomach (it is necessary to eat once at least 4-8 tablespoons of berries).
• Apply chewed or crushed pure yarrow herb to the bitten place.
• During the day drink tea based on nettle leaves or yarrow.

Herbal treatment

• To accelerate healing apply to the wound washed nettle leaf or bloodwort.
• Prepare an infusion of yarrow: pour 250 ml of boiling water 1 tbsp. Of crushed plant, insist for half an hour, filtered and used for rinses and lotions.
• Add parsley to all dishes, eat it until the condition is completely normalized.
• Prepare powder on the basis of willow bark. Take 1 g before bedtime, drinking water.
• Prepare an infusion of strawberry leaves: 1 tbsp. Leaves poured 200 ml of boiling water, insist until cool, filtered. Use for washing and wiping wounds.
• Apply fresh cherry leaves to the bite sites.

Due to the presence of a large number of tannins, calendula is successfully used to stop bleeding. Infusion of the plant is prepared as follows: 2 tbsp. Of flowers pour a glass of boiling water, cover with a lid and insist until cooling. Take 2 tbsp. Of the remedy three times a day before meals. In addition, the infusion can be used to rinse bitten places damaged by bites.

From calendula can be prepared and tincture: 1 tbsp. Of flowers poured 100 ml of vodka, kept in a warm place for ten days, filtered, squeezed. Take 30 drops of tincture three times a day before meals. To prepare a solution for washing dilute 1 part of the tincture in 10 parts of cool water.

Homeopathy

Various insect and parasite bites most often pass without consequences and specific therapy, but in some cases it is necessary to seek qualified help. Especially dangerous when the bite of a leech falls on the neck and face - primarily because of the high risk of swelling of soft tissues and the development of allergies. If help is really necessary, then to buy time will help proven homeopathic remedies. But it should be remembered that these remedies are not able to replace emergency medical care.

• Apis mellifica is a remedy based on bee venom, especially effective in the appearance of edema.
• Arnica montana is an effective preparation, a drop of which is dripped into the wound, after which the unpleasant symptoms should disappear.
• Cantharis is a remedy to relieve the inflammatory response in the bite area.
• Carbolicum acidum - used if some general symptoms such as general weakness, itching all over the body, rash, respiratory disturbances join.
• Lahesis - helps with a painful bite, with the affected area turning a dark scarlet color.
• Ledum palustre is considered one of the main homeopathic remedies for the treatment of any bites at all. It can be used as a primary first aid remedy.
• Tarentula cubensis is a treatment for painful infected bites.

Prevention

Preventing leech bites is not as difficult as it seems at first glance. The main thing is to follow a few simple safety rules:

• You should not bathe in bodies of water suitable for leech habitat - above all, this is standing water in ponds, lakes, floods.
• When visiting countries that are home to worms dangerous to humans, it is advisable to avoid swimming in natural bodies of water, preferring swimming pools or special fenced beaches.
• If it is still necessary to dive into a natural standing body of water, a special protective suit should be worn.
• Bathing in any natural body of water should be completed with a careful skin inspection.
• Since some species of leeches choose to live on the shores, but not the water itself, it is necessary to approach water bodies carefully, with observance of protective measures: especially it is necessary to protect legs, arms, neck. If there is a long walk in nature in areas with warm and humid climate, in areas with dense tropical vegetation, you should wear rubber boots, or tight pants, tucked into shoes and socks.
• The lower segment of the pants can be treated with dimethyl phthalate or indalone to repel worms. A similar effect is observed if shoes are well lubricated with fragrant liquid soap and the body is treated with toilet water or deodorant with a strong and persistent odor.
• If you are going to spend the night in nature, and there is a possibility of leeches penetrating into the tent, you should put in front of its entrance several strips of cloth with salt, to deter them.

Forecast

Such complication of leech bites, as hirudinosis, occurs mainly in topical countries. On the territory of the post-Soviet space this disease is not widespread.

Prolonged stay of leeches on the body, as well as their presence in large numbers can lead to significant blood loss, to the development of anemia, to severe headaches and general weakness.

Some dangerous leeches can carry diseases such as typhoid fever and paratyphoid, and the causative agents of these diseases are able to exist inside the body of the parasite for 1-3 months.

In addition to the above problems, the wound from biting is sometimes subjected to secondary infection, which is especially dangerous development of purulent processes.

It is worth noting that the voiced complications are registered mainly in countries with hot and humid climates. On the territory of our country leech bite usually has a favorable prognosis.