Leech bite

Leeches are well-known annelids, which can easily be found in almost any fresh water body, especially in places with stagnant water. Both children and adults also know that such worms bite quite unpleasantly, while sucking out 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 will be able to talk about the benefits of leech bites. However, such a benefit is really present if we mean medicinal worms that are specially grown for medical use.

If the worm lives in the wild, then its bite can be dangerous in its own way: it is best to avoid it. [1]

In general, leeches are parasites that harm animals, fish, and can also harm humans - for example, by infecting with some kind of blood-borne disease. In addition, after a bite, quite severe bleeding often develops, weakening the living organism. In nature, blood-sucking worms usually infect artiodactyl animals that come to water bodies to drink water. At the same time, the significant thickness of the skin that needs to be bitten through does not frighten leeches at all. And they bite through human skin even easier.

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

Another possible cause of hirudinosis may be leech parasitism. However, no parasitic leeches are found on the territory of our country: such harmful worms can infect a person, for example, after a trip abroad. [2]

Epidemiology

Leeches belong to the subclass "annelids". Their basic habitat is fresh water bodies, mainly with stagnant water.

The world fauna includes more than half a thousand varieties of leeches: among them, more than 60 species can be found in Russia, and 25 species in Ukraine. It is not known exactly how many wild leeches live on the territory of our country, since we are talking about tens of tons, and this calculation has never been carried out.

The most dangerous types of leeches are found in southern countries - for example, in 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, however, preference is given to large mammals, including humans. [4]

The digestive system of the worm is open with a mouth opening located in the anterior end segment. If you look inside the mouth, you can see small light formations that represent the jaw leech apparatus. Three jaws are present here: two of them are lateral, and one is dorsal. The teeth are small and sharp, they bite through even fairly thick skin without any problems.

After the pharynx, the esophagus follows, and then 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 clot, is not affected by bacteria and does not deteriorate.

The intestines of leeches are emptied several times a day.

The salivary apparatus deserves special attention, the conclusions of which are located around the pharynx. The salivary secret contains a large number of bioactive components that penetrate into the tissues bitten by the worm. Saliva is secreted during the entire sucking act.

Leeches have highly developed gustatory, tactile and olfactory abilities, which greatly helps in finding a source of food. First of all, the worm reacts to the smell: that is why the leech will never bite a person who emits a bright smell of detergent, perfume or deodorant. If there is no irritating aroma, then the attack occurs almost immediately. The most favorite leech aroma 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. The noise from the approach of the victim is picked up by the worms very quickly, after which they go straight to the sound source.

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

Therefore, if a person enters stagnant water without appropriate protection, does not have irritating odors (especially if there are scratches, inflammations and cuts with the aroma of blood on the skin), then he may well become a potential victim of a leech attack. [5]

Risk factors

Once in the vicinity of a mammal - and in particular, with a person, leeches do not bite everyone. Like a radar, their olfactory system "tunes" not only to search, but also to sort out sources of blood food. They are able to feel the aroma that is optimal for themselves for several tens of meters. At the same time, the smell that repels them is the aroma of detergents and cleaning products, toilet water, perfume, cologne, deodorant, and tobacco smoke. [6]

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

• travelers, tourists;
• residents of wet and swampy areas;
• lovers of swimming in natural reservoirs, on spontaneous beaches;
• fishermen, hunters.

Pathogenesis

On the end parts of the body of the leech there are peculiar suckers. The front one is formed from four to five segments, and the back one is formed from seven segments, which makes it more powerful. After sucking, the worm bites through the skin: the bite can penetrate to a depth of one and a half to two millimeters, while the salivary secret enters the tissues, which, among other things, includes the enzyme substance hirudin, which inhibits blood clotting processes. One leech in one bite usually sucks up to five milliliters of blood. After the "attack" on the skin there is a small damage, from which blood and lymphatic fluid can ooze for several hours. In general, after the “bloodsucker” falls off, an additional 5-30 ml of blood flows out of the wound. [7]

The composition of salivary leech secretion usually includes such enzyme substances:

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

Other components of the secret have a less pronounced effect, or their effect has not been fully studied at the moment. [8]

Symptoms Leech bite

Directly the moment of a 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. Such sensations may be repeated periodically during the entire period until the worm falls off. The average duration of the sucking act is 20-40 minutes, and after falling off the blood continues to be released for some more time. Post-leech bleeding can be stopped by applying a tight bandage to the wound. [9]

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

At the bite site, a specific triangular scar is formed, gradually it turns pale and disappears.

The release of blood after the worm falls off usually continues for several more hours, and depends on the individual coagulation parameters. People with excessive sensitivity may notice the appearance of swelling, redness, itching.

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

It is not difficult to notice the first signs of a leech attack, because it is difficult not to pay attention to a sharp burning sensation. Usually a person grabs the affected place and finds an "intruder" there. We will talk about what needs to be done at this moment, and what absolutely cannot be done, we will talk below.

In some cases - for example, if a person is wearing shoes, the bite of a river leech really remains ignored. This is often found among fishermen when the "bloodsucker" crawls into rubber boots and sticks to the skin on the leg. In such a situation, trouble is detected already at the time of changing shoes. The main thing is not to panic and not tear the parasite from the body. During tearing, his jaws may remain in the wound, after which the initially harmless bite of a wild leech will lead to irritation and infection of the tissues - the likelihood of complications will increase. [10]

Complications and consequences

Fortunately, most often single bites bring only short-term discomfort. In the worst case scenario, you can "earn" allergic reactions to a leech bite: they are manifested by intense itching, redness, swelling of the affected skin area. All of these symptoms are common manifestations of allergies. Although these symptoms are expressed in different ways: for example, some people just itch a little bit of a leech bite, while others have a much stronger reaction, up to anaphylactic shock. [11]

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

Slight itching from a leech bite usually lasts 3-4 days, after which it gradually disappears. If the itching sensations do not go away, but, on the contrary, increase, then a visit to the doctor should follow without fail, and as soon as possible. [12]

The wounds themselves after a leech bite can be delayed a little longer than usual. However, during the entire healing period, they should not bleed, redden, swell, inflame, and even more so, ichor and pus should not stand out from them. These signs often indicate the addition of an infection - that is, that inflammation develops from a leech bite. This often happens if a person bathes in a dirty pond, or is in infected stagnant water. Treatment of inflammation should be carried out in a hospital, and in advanced cases, you even have to resort to the help of a surgeon.

In order to prevent the development of complications, even a slight redness after a leech bite should be treated with any disinfectant: alcohol, potassium permanganate solution, furacilin, fucorcin, chlorhexidine, etc.

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

Bruises after a leech bite indicate that blood has leaked into the tissues: it is necessary to monitor this area, and if the bruise increases in size, immediately consult a doctor.

How long does a leech bite last? Blood can ooze from the damaged area within 2-5 hours, but the wound itself heals much longer - from several days to several weeks. A trace of a 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 victim for testing:

• general blood analysis;
• coagulogram (checking the quality of blood clotting);
• determination of blood sugar levels.

With an unclear clinical picture, it is standardly proposed to carry out auxiliary diagnostics:

• ultrasound procedure;
• hormonal tests;
• attraction and consultation of specialized specialists.

It is important for the doctor to know the patient's blood pressure indicators, to determine if he has anemia. [15]

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

Treatment Leech bite

Medical procedures for a wild leech bite usually come down to stopping bleeding and preventing an allergic reaction and infection.

Stopping bleeding is carried out by applying a tight bandage - often this is quite enough. Hemostatic drugs are used only in severe cases.

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

In order to prevent secondary infection, the wound is treated with drugs (optional) such as a solution of brilliant green, iodine, fucorcin, a weak solution of potassium permanganate, a solution of furacilin, hydrogen peroxide. You can also use alcohol solutions: tincture of propolis, calendula, mullein, etc. Is suitable. The question of the need to take antibiotics is decided by the doctor on an individual basis. [16]

First aid for a leech bite

The first thing to do when a leech is found on the body is to remove it. It is not necessary to try to tear off the worm, since the elements of its body can remain in the tissues and lead to the development of an inflammatory process.

It is impossible to cut the parasite with a knife and other cutting objects.

You can not sprinkle the wound surface with earth, cover it with a swamp, it is even undesirable to pour water from a reservoir, as this can cause secondary infection.

And yet, what to do after a leech bite?

• You need to force the worm to let you go voluntarily by sprinkling it with salt, crushed tobacco, or pouring it with alcohol, vodka, any alcohol solution (you can even use cologne), table vinegar.
• To prevent the penetration of infection into the tissues, the wound must be treated using hydrogen peroxide, iodine, brilliant green, fucorcin, or an alcohol solution.
• Apply a tight bandage to stop bleeding. If the bleeding is profuse, it is important to seek immediate medical attention.

If the parasite has got inside the body - into the esophagus, respiratory tract, genital tract - then you need to contact a specialist as soon as possible, since you definitely won’t be able to get the worm on your own. After drinking blood, it will increase in size and be able to block vital channels, so you need to remove it, the sooner the better. [17]

Medicines that can be useful for a leech bite

Suprastin	Antiallergic drug based on chloropyramine. Tablets are taken with food, 3-4 per day (no more than 4 pieces per day). With the appearance of a strong sedative effect, dizziness, with a drop in blood pressure, Suprastin is stopped.
Zyrtec	Antihistamine drug based on cetirizine. Take orally 20 drops once a day. Zyrtec has a minor side effect on the central nervous system, so treatment is usually not accompanied by drowsiness, fatigue, dizziness and headaches.
Fenistil	A systemic antiallergic drug based on dimethindene maleate, well eliminates itching and swelling after bites. The daily amount of the drug is 3-6 mg (for three doses). Usually take 30 drops three times a day. The beginning of treatment is often accompanied by drowsiness, which gradually disappears.
Water pepper tincture	Herbal hemostatic agent, the action of which is due to the presence of bioflavonoids in the preparation. Tincture reduces capillary permeability, normalizes the structure of the walls of blood vessels, 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	The drug menadione sodium bisulfite refers 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 to stop bleeding at the site of a leech bite?

It often happens that after bites, swelling, red spots remain on the skin, and blood is released from the wounds. A small release of blood can be called a natural process, because during the bite, an enzyme function is activated that prevents blood clotting. You don’t want to lose your own blood at all, so you need to take measures to stop the bleeding. You need to prepare any of these tools:

• brilliant green solution, fukortsin, iodine or alcohol solution;
• medical glue;
• infusion of oak bark, or diluted vinegar;
• ointment Rescuer, burdock oil, petroleum jelly or glycerin.

The wound is treated with one of the indicated means, after which a tight bandage is applied to the bitten place. Additionally, an ice pack can be placed on top. If the bleeding does not stop within more than 10-12 hours, despite the measures taken, then you should seek medical help. [18]

How to smear leech bites?

How to smear bites to speed up healing and get rid of the unpleasant symptoms of itching and swelling? There are a number of effective remedies that are sold in any of the pharmacies:

• ointment Rescuer - is a universal balm with absorbable, antimicrobial, regenerating action, accelerates healing, including inflamed bites;
• Boro Plus ointment is an antiseptic that quickly heals wounds in children and adults;
• Fenistil-gel - an antiallergic agent in the form of a 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 an active healing, moisturizing and regenerating effect;
• Epidel - 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 long term use.

Alternative Treatment

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

• With severe bleeding of the wound, a decoction of the bark or rhizome of barberry is prepared: pour 30 g of raw material with boiling water (200 ml), leave for 15-17 minutes, filter and take 1 tbsp. L. Every hour, until the bleeding stops completely.
• Apply lotions with a decoction of oak bark: pour 10 g of bark with one glass of boiling water, boil for 20 minutes and filter.
• Eat strawberries on an empty stomach (you need to eat at least 4-8 tablespoons of berries at a time).
• Apply chewed or crushed pure yarrow grass to the bitten place.
• During the day, they drink tea based on nettle leaves or yarrow.

Herbal treatment

• To accelerate healing, a washed leaf of nettle or burnet is applied to the wound.
• Prepare an infusion of yarrow: pour 250 ml of boiling water 1 tbsp. L. Crushed plant, infused for half an hour, filtered and used for washings and lotions.
• Parsley is added to all dishes, eat it until the condition is completely normal.
• Prepare a powder based on willow bark. Take 1 g before bedtime with water.
• Prepare an infusion of strawberry leaves: 1 tbsp. L. Leaves pour 200 ml of boiling water, leave to cool, filter. Used for washing and wiping wounds.
• Apply fresh cherry leaves to the bites.

Due to the presence of a large amount of tannins, calendula is successfully used to stop bleeding. The infusion of the plant is prepared as follows: 2 tbsp. L. Flowers pour a glass of boiling water, cover with a lid and insist until cool. Take 2 tbsp. L. Funds three times a day before meals. In addition, the infusion can be used to wash areas damaged by bites.

You can also prepare a tincture from calendula: 1 tbsp. L. Flowers pour 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 bites of insects and parasites most often pass without consequences and specific therapy, but in some cases you have to seek qualified help. It is especially dangerous when a leech bite falls on the neck and face - primarily because of the high risk of soft tissue edema and the development of allergies. If help is really needed, then proven homeopathic remedies will help buy time. But it should be remembered that these drugs are not able to replace emergency medical care.

• Apis mellifica is a remedy based on bee venom, especially effective for edema.
• Arnica montana is an effective drug, a drop of which is dripped into the wound, after which the unpleasant symptoms should disappear.
• Cantharis is a remedy for relieving an inflammatory reaction in the bite area.
• Carbolicum acidum - is used in case of joining some common symptoms, such as general weakness, itching all over the body, rash, respiratory failure.
• Lachesis - helps with a painful bite, with staining the affected area in a dark purple color.
• Ledum palustre - is considered one of the main homeopathic remedies for the treatment of any bites at all. Can be used as a first aid drug.
• Tarentula cubensis is a remedy for the treatment of 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 swim in reservoirs suitable for the habitat of leeches - first of all, it is stagnant water in ponds, lakes, backwaters.
• When visiting countries where worms dangerous to humans live, it is advisable to avoid swimming in natural reservoirs, preferring pools or special fenced beaches to them.
• If you still need to dive into a natural stagnant body of water, then you need to wear a special protective suit.
• Bathing in any natural reservoir should be completed by a careful examination of the skin.
• Since some species of leeches choose to live on the coast, and not the water itself, you need to approach the reservoirs carefully, in compliance with protective measures: you should especially protect your legs, arms, neck. If you have a long walk in nature in areas with a warm and humid climate, in areas with dense tropical vegetation, then you need to wear rubber boots or tight trousers tucked into shoes and socks.
• The lower segment of the trousers can be treated with dimethyl phthalate or indalone: this will scare away the worms. A similar effect is noted if the shoes are well lubricated with fragrant liquid soap, and the body is treated with eau de toilette or deodorant with a pronounced and persistent odor.
• If you have to spend the night in nature, and there is a possibility of leeches entering the tent, then you need to put several strips of cloth with salt in front of its entrance to scare it away.

Forecast

Such a complication of leech bites, like hirudinosis, occurs mainly in topical countries. In the territory of the post-Soviet space, this disease is not common.

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

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

In addition to the above problems, the bite wound is sometimes subject to secondary infection, which is especially dangerous for the development of purulent processes.

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