Dear colleagues - acarologists on dust mites! (2010)

At present time the presence of pandemic acariases, caused by dust mites, is indisputable fact. It is stated in my publications and on given site. In 2008, visiting Congress of Acarologists of Europe, I hoped for cooperation. I thank Professor M. Bertrand: he was ready to help me in all conditions. But I have arrived on the congress not prepared in respect of dialogue language. There was no translators. I want to my achievements in the field of clinical acarology became property EURAAC and acarologists because an achievements of one person remain on a paper and in a memory of few, but achievements of army acarologists will be realized. Acarologists have already proved the presence of mites in a dust of living quarters and manufacturing firms on all continents (except Arctic and Antarctic). The problem consists in repeating the same researches, but in dynamics of treatment of sick people. Only the acarologists are able to find out virtually the mites. This fact is especially actual because of the beginning of the XXI-st century without the proof of cause of illness the clinical diagnostics can be seem unpersuasive for a number of medical employees and many patients. But it is necessary to notice, that clinical diagnostics should be always predominating.

As any not diagnosed and not identified, and presented for a long time among the population infection - acariasis gives the most different clinical masks with which the doctors of all clinical specialities are dealing practically. Indirect acknowledgement of the given fact is uncontrollability of morbidity of initially-chronic illnesses: despite all diligences of an experts the "non infectious" diseases grows every year and it is predicted their growth. At the same time the clinical acarology is in the rudimentary. In medical institutions the acarological inspection of patients is not realize. The acarofauna of biotope even of allergic men (as the indicator of elimination of a life from mite allergens) in dynamics is not studying. Parasitological services at sanitary-and-epidemiologic establishments carry out the acarological control superficially. Hence, now the help of acarologists on dust mites is extremely necessary for medical employees and sick people.

Considering the above statement I offer colleagues - acarologists on house dust mites to realize the following work:

1. Every acarologist on house dust mites should offer to medical institutions (private and/ or state) in their region the services on acarological control of external covers and biotope of patients with allergic, skin, rheumatic and oncological diseases.

2. The expert with which you plan to work should have experience of clinical work on speciality not less than five years. Please, recommend to these experts spend the treatment against a background carefully elimination of patient's biotope. (Questions of elimination of a family life from dust and mites allergens are developed by allergists and described in the medical press.). In the present time the acariasis is present practically in any person (adult or baby) or in the form of an accompanying pathology, or in the form of leading disease - a clinical mask of acariasis. Therefore the elimination of a family life, bed, underwear and other accessories of the patient from mites of a household dust should make positive impact on recovery of the patient from any disease. (Please, read the articles «Obligatory conditions for full recovery», «The prevention of an allergy and allergodermatoses», «Everybody should know about it», etc. on our site.) Only against a background of elimination a family life from dust mites we have achieved full recovery of patients from many allergic and skin illnesses. Acarological inspection of patients with rheumatic and oncological illnesses, and also carrying out of treatment it against a background elimination a family life from dust mites was not spent with nobody and nowhere and you will be the first in this area of researches. I am sure that during the given work you will offer many new techniques of an inspection patients and environment on presence of mites.

3. The question of payment of acarologists work is important. For acarologists, which work over dust mites at government program, the offered work will be only expansion of researches. The work of other acarologists, probably, will be remunerated by clinics to which they will be addressed. In private hospitals the acarological control of external covers and biotope of patients can be included in the list of rendered paying services. Each patient of XXI-st century wishes to know the reason of his illness, therefore he exactly will not refuse from offered inspections. Probably some should work gratuitously within one year: the given work is planned exactly for such term.

The payment of the labour of attending physician from a former source of payment will remain. From desire of patient the attending physician can offer him the full recovery (the list of the completely cured illnesses is here: http://www.allergy.kz/en/beginning/what/ ). The patient will make additional payment for full recovery, and part from this payment will compensate attending physician.

My advisory help to such doctors and patients will be free of charge.

4. Dear colleagues! For a job management is necessary to select coordination council led by the most active, well-knowing both English and Russian languages acarologist on dust mites. Personally I offer a nominee of acarologist from Poland Krzysztof Solarz. Please understand me correctly: because of age and weak English I can’t supervise and co-ordinate work by myself, but I undertake to render free aid within questions of my competence. For this purpose I undertake to be one of the members of coordination council.

5. For simplification of acarologist's work is necessary to develop and introduce modern ways of diagnostics of acariases - the diseases caused by mites. Therefore it will be possible for some acarologists from region with hi-tech manufactures to contact the qualified technical officers for the purpose of joint working out of modern diagnostic devices of acarological control over external covers of people and entourage of them. Problems on creation of similar devices are reflected in article on <http://www.medlinks.ru/article.php? sid=43304>.

WARNING!

1. During work we (attending physicians, acarologists, me) should adhere to a strictly principle: «Do not harm!».

We must use only resolved by public health corresponding country and WHO methods of diagnostics and treatment plus noninvasive methods of diagnostics (see on <http://euraac.boku.ac.at/EuraacNews4.pdf>, pp. 9-11).

2. The attending physician should adhere strictly to the legislation in the field of country public health services in which he carry out the works. The treatment of patients should be spent by strictly installations in medicine. In supervision and treatment of patient is supplemented only acarologic control over external covers, household and industrial conditions. (Elimination of family life from dust and mite allergens does not contradict the legislation of any country.)

3. I will recommend only legal methods of treatment in clinical medicine. Therefore the terms of treatment and full recovery will be considerable. (The newest methods of treatment will be developed and will take root into medical practice only at a following stage of work and will be realize according to the standard rules of clinical medicine.)

4. My help to colleagues will be gratuitous! Only for the patients, wishing to consult personally at me, my services will be paid.

Dear colleagues! You know well, that there are no trivia in research work.

Therefore in advance I ask not to criticize me for excessive detailed elaboration of interrogation of the patient or family life. Sometimes even a small details are important for diagnostics and subsequent treatment. I will give only one example. In the summer of last year an old woman has addressed to me with complaints to presence on the body of 3-year-old granddaughter rash and itch. The rash was found out by mum overnight during bathing of the child. Earlier an allergy at the child was not observed. There was the bright red with slightly oedema papula rash. The quantity of rash considerably descend to front surface of body, arms and legs. The face and head were pure. I have told: strange localisation of rashes, such impression, that the girl was to slip on something dirty. The grandmother with surprise has answered: Yes, yesterday she to slip on the fabric which covered the cage of parrot. Naturally, antiparasitic (antiacariatic) treatment has helped the girl at once.

Desirable : It is better to spend an acarologic researches in a house of patient without warning of forthcoming inspection.

Spend the research of the collected material as soon as it is possible because of excessive mobility of mites. It is extremely important to supervise the correctness of performance on elimination of biotope. Thus a quality of monitoring can be different: from an unostentatious question till participation during cleaning. It is possible to learn to judge gradually about it on a condition of an integument of the patient in dynamics.

Please, write down the time of acarological inspections (that will allow to group in the subsequent a material on time signs) depending on the carried out hygienic action. If the patient and members of his family already had cleaning it is necessary to mark each time before the given research of acarofauna was carried out.

The fence of material should be spent from all walls, curtains, devices of heating, floors near a bed and other places, from external and internal walls of a bed, blankets, surfaces of pillows, from all surfaces of mattresses, etc. Please, especially pay attention for a fence of material from walls adjoins a ladder platform. Besides, it is necessary to investigate the material from shelves for clothes and products, carpets, upholstered furniture, etc.

The doctor-clinician carefully collects not only the anamnesis of illness and life, but also carefully asks about conditions of life, hygienic, labour, food, weekend and other habits of patient, etc. Such interrogation will help to define roughly the reasons of development of illness, and also to define the places of more accumulations of mites in household conditions, whence acarologists necessarily should spend a fence of material. It is desirable to be present by acarologist at interrogation of the patient as the results of acarological researches in the subsequent in many respects will help to explain features of clinical current of disease at the interrogated patient. For example, in one of these days I had on reception the patient of 6 years with his grandmother. The kid from one-year-old age had often aggravating bilateral purulent otitis. On objective results of researches the child had very old feather pillow. When I have told about it the grandmother confirmed it. «But how you recognize about it? We slept together with grandson on the trestle bed and very old feather pillow. Recently I have bought to the grandson synthetical pillow, and to myself had left the former. The grandson sleeps nearly and breathes in my pillow». Grandmother has discoid lupus erythematosus on the face. Here is a trick of a mites! Other example happened 15-years ago. Mum referred to us with 10 years old son with complaints on not to healing purulent wound on the left auricle. Before this they addressed everywhere but unsuccessfully. There was a triangular defect covered with pus oedema edges on the left auricle. The skin condition on the left side of head and neck allowed thinking that the boy likes to sleep on left side and on old feather pillow. Mum has confirmed our assumptions. The reason has been eliminated. Literally in two days the wound was cleared from pus. During 4 days the wound has completely healed up.

I offer not the full list of additional questions which should be asked to each patient.

Questions to the patient about habitation:

In what house lives: separately standing or municipal apartment. A residing floor. How many floors there are. How many people in how many rooms? Has the patient separate room? Where he sleeps: on the bed, sofa or floor? The quality of bedding: blankets, pillows, mattress, etc. How often the bed-clothes vary? As cleaning in bedroom and how is often made. How bed is situated with respect to wall, heating devices, windows, curtains, etc. What is on floor of bedroom and other rooms? Are there animals in the house? Likes to bathe in a bath or under a shower. How often bathes, uses soap and a bast whisp or without them? What kind of soap or washing-up liquids he uses. How often visits a bath-house or sauna. Is there dampness in apartment, in the house, bathroom? How many times a day wash a face, with or without soap?

Is apartment solar or shadow? The condition of apartments of neighbours of the patient from above, from below, side by side. The condition of resting place in front of an apartment. Does neighbours have any animals? How long time the old things is stored in the house, where is stored, etc.

Questions about cleaning in the house (in apartment):

Who and how makes cleaning. How is frequently? How often the subjects in the house are vacuumed? What kind of vacuum cleaner is using (with water, usual, frying a dust or other)? An abundance of carpets, heavy curtains, etc. What fabric upholsters the furniture? What kinds of special means are applied to washing the subjects in a house? What temperature of water is applied in a vacuum cleaner, washing of floors? How often cleans the dust collector of vacuum cleaner? How many niches, cases for linen and things are in the apartment, etc.?

How often is cleaning a bedroom, a drawing room and other rooms?

How often are moving the subjects in a house with cleaning it from all sides? How often is cleaning in a closet, niches, wardrobes, bookcases, kitchen cabinets, larders? Are carpets, oriental carpets and other life subjects are fried on the sun with the subsequent cleaning? How often these subjects are maintained in a cold in the winter with subsequent cleaning?

How often the refrigerator washes? How often is directed the full order in kitchen and bookcases? How do the winter things (in summer) and summer things (in winter) are stored? When does a repair in apartment made?

Questions about hygiene of a bed:

Who and how remakes a bed? How often does the bed-clothes vary? How often a bed and its accessories are wiped? How often a sofa if it using instead of a bed is cleaning? How often the floor under a bed washes?

If under a bed there are a part of a carpet, an oriental carpet - how often it’s vacuumed, shaken up and dried under the sun? Is a bed directly touched with a wall, a battery, curtains, a computer table, etc.? From what materials a mattress, blankets, pillows are?

On what mode of a washing machine the bed-clothes are washed? How the underwear is washed? Is underwear and bed-clothes ironed, when it was made: before application or in advance? From what material floors made?

Data about state of health of other members of a family:

Gathering of the corresponding anamnesis by the attending physician of the observed patient.

It is possible to photograph by digital camera most "healthy" and most "sick" (having any changes, beginning from dryness till rough changes) sites of an integument and send it to me by e-mail. Interpretation of a condition of a skin in respect of presence or absence of acariasis signs will be sent by me. If the attending physician has desire and possibility he can learn the clinic of acariasis from me. But during of the given work the attending physician will learn the clinic of acariasis himself.

The acarological research of summer zones of rest and stored subjects of summer using. Research of warehouse and stored things (without the preliminary inform of the personnel about forthcoming inspection). Research the correctly and incorrectly transported and after that during different terms stored underclothes, bedding, household things, a foodstuff on the presence of mites.

Similar research on the summer being on different conditions of storage winter clothes, bed and household accessories.

Similar research through different terms after departure of owners is desirable for spending in houses which are left by owners for some time.

The standard and known data from the literature, influencing on quantity of mites in the house:

Of what building materials the house was constructed, the age of the house, a quality of construction place, a house arrangement in relation to road, green plantings, subsidiary premises for cattle, fodder, etc. How the house repair inside and outside is made, etc.

Dear acarologists! In the medical literature there is an opinion that it is impossible to completely clear a house from dust mites. Such opinion is connected by now practically there are no people with the pure, not infected by mite’s skin. Acariasis, caused by dust mites, is an initially-chronic infection. Therefore acariasis has more percentage of latent and atypical forms of illness than any other sharp infectious disease. From a position of a doctor well-knowing clinic of acariasis, they are the infected people, but from a position of a modern medicine they are "practically healthy" people. That is why obvious infection by allergic, rheumatic, skin, oncological and some other illnesses are hidden from view. At the same time these people are hotbed of invasion. From any person infected with mites, besides of superficial skin epithelium, are also fall mites during recrawling from one skin pores to others. Falling on surrounding conditions (including bed) these mites adapt to new conditions, procreate and because of that allow asserting, that the life of the modern person cannot be cleared from dust mites. (Plus there are known cases of bringing the mites from the outside with clothes, footwear, products, the wind, etc.) The presence of not diagnosed acariasis was the main reason of those laboratory indicators of presence of an allergy in an organism (Ig E, etc.) remained the invariable at the allergic people taken out in conditions of the extreme north.

All set forth above and many other questions quite often will help to co-ordinate roughly a condition of skin and visible mucous membranes of the concrete patient and together with him living people with a condition of acarofauna of houses, apartments, bedrooms, beds, wardrobe, etc.

I can accept direct participation in work of each of you through the Internet. I can assure, that my help to the attending physician will be effective in cases of treatment of the illnesses, listed on http://www.allergy.kz/en/beginning/what/. We have only single supervisions in the field of rheumatic and oncological illnesses. Treatment of these patients should be spent at the rules of modern medicine! We only will add the acarological control of skin and subjects of their environment. I am sure, that continuous correct elimination of the nearest environment, underclothes and bedding from dust mites will essentially improve a condition of patients receiving treatment. Please, contact: e-mail: zhax-rd@mail.ru, skype rakhima86 in the working days from 8 to 9 PM (time of Astana).

During the given work patients can completely get rid from an allergic or skin problems. The attending physician will study clinic of acariasis and will learn to cure completely the patient from an allergy, skin pathology and some other clinical masks of acariasis. Acarologists will make an invaluable help to contemporaries. Pharmaceutical firms will increase release of the medicines necessary to patients, etc.

I invite as many acarologists on house dust mites as possible (from different regions of the planet) to participate in the given work. Having united results, you receive a useful practical exit, will lift the prestige of clinical acarology on due level, will publish many combined articles, will find the answer to a question why in one houses are so many mites, and in the others – there are a little bit of them («why some houses have a thriving mite population, whereas quite similar dwellings in the same neighbourhood are almost devoid of mites and mite allergens»), etc.

Dear colleagues! Good lucks and successes to you in the proof of presence of acariases pandemic - the illnesses caused by mites of house dust! You have already proved that mites are present at a dust of premises practically on all continents.

PS: I hope that my translation in English will be clear for you. Just in case I send the variant of the given letter in Russian

Yours faithfully

Zhaxylykova Rakhima, PhD, allergist-dermatologist-acarologist with the 48-years experience of clinical work.