Clinical acarology must take the deserved place in medicine

Author: R. D. Zhaxylykova (2008)

Source: Congress of Acarologists, 2008. Thesises.

Dear chairman! Dear participants of conference! First of all allow to express gratitude to organizing committee and its chairman to Mister Michel Bertrand for the given opportunity of participation at the given conference and to wish creative successes in the further labour activity all participants of conference!

The theme of my appearance assume the name: Clinical acarology must take the deserved place in medicine. Clinical medical acarology - is an underdeveloped branch of biological science. The role of mites is researched mainly regarding their big representatives as carriers of the number of infectious human diseases. Sarcoptes scabiei is researched as a pathogen of classical scabies of humans (Novikov & Loginov, 2001). The students of 60th of XX century did not have any information about other representatives of mites at their Universities.

Being a researcher- gastroenterologist, in 1973-1974, we faced with a fact, paradoxical one in our view, fact is that dermatologists considered patients who had Demodex exuded on pathologically changed areas of the face skin as not dangerous for the others. This statement seemed to us as not true: if a great amount of mites exudes out of skin, how cannot they be not dangerous for the others? That’s why we started to research carefully the skin of the other patients, medical staff and also visitors’ skin. There were 21 persons. As a result minimal changes on the skin at the beginning of acarias were noticed, and then progressing ones with time was appearing.

Then we began to apply our clinical observations to all patients and to always around us without exception. Gradually we learned to distinguish a visually skin amazed by Demodex and healthy one. The itching of skin was considered as pathognomic symptom of chronic hepatitis in the stage of exacerbation. We have 268 patients with chronic hepatitis in the stage of exacerbation under supervision to observe this symptom in dynamic. They all had skin visually affected by Demodex. Patients were divided into six groups according age and gender.

Distribution of patients on groups is resulted in table. Men were 132, women - 136. The middle age of men - 48 years, of women - 43 years. Patients in all groups received a diet № 5. Moreover, all patients received a conventional in medicine minimal complex of medical treatment (hepatoprotectors, desintoxication therapy, necessarily antihistamines and etc.). Besides, patients of II and V groups received whole camel milk, III and VI groups - whole mare's milk in dose of 200 ml 5 times a day before, during and after meal (depending on gastric juices acidity). In IV-VI groups patients were receiving antiparasitic medical complex outwardly.

Described research took place in the period from 1974 to 1979. In all groups supervision in dynamic was kept of subjective patients and objective skin condition, clinical, biochemical and blood immunodetection. Necessarily radioisotopic, ultrasonic, X-ray examination in dynamic and liver puncture biopsy was carried out. As a result of medical treatment the normalization of the general condition of patients was seen in all groups, the results of laboratory and instrumental examinations improved, the itch of skin lessened or disappeared completely.

But at the same time the following distinct difference was noted in these figures. Patients of the first three groups had the itch of skin lessened little. In case of disappearing the itch of skin came back in a short period of time (14-45 days). Persons from IV-VI groups, receiving antiparasitic complex outwardly, had their itch of skin gone for more than half a year, the clinical condition of skin improved strikingly (Zhaxylykova, 1979). Gradually we learned to see natural spread of demodecosis among medical staff, visitors and friends.

So it was no difficult to see gradual renewal of the skin affection by Demodex during the next one or two years after discharge from the hospital. Automatically we started supervision of all people with healthy skin around us, and making notes. There were 317 people of this kind. Skin of most of them (74%) became affected by Demodex during 1977-1980. We observed the skin changes of 13 of people during more than 30 years. By 1979 we had firm conviction about the presence of contagious disease which is not identifiable by clinical medicine, but avalanche-like spreading among people - the demodectic acarias.

We worked in the first-class clinic of academician T.Sh. Sharmanov, equipped with the most contemporary medical apparatus. It was the end of XX century, when medicine was developed enough, and medical technique reached its peak. In such situation our conclusion was considered by ourselves as improbable. To make sure finally of our investigation reliability we decided to make independent experiment. In 1980, 10th of August a clinical experiment was run successfully – autoinfection by demodecosis.

This fact rejected all our doubts. From January of 1981 we started to divulge our result officially. The result was that we got a possibility to research widely in many of medical establishments in Almaty (adult and children outpatient hospitals and polyclinics, including dermatic clinics) without and with participation of dermatologists, allergologists and doctors of other specialization, in organized and non-organized labour collectives, colleges, institutes of higher education, schools and infant schools, maternity hospitals and etc.

The result of these researches were made public on the All-Union conferences of dermatologists and allergologists, taking place in Almaty in 1981-1992, on the VI all-union congress of acarologists in Frunze in 1986. We express our thanks to academicians B.A.Atchabarov and M.E.Zeltzer for their help in work. We thanks to professors T.S.Suleimenova, V.G.Uldanov, V.N.Kusov, manageress of laboratory of Almaty city skin venereal hospital Solovjeva, we thank dermatologist G.M.Dulatova for direct participation in this work. The officials of medicine, even academicians of union scale, did not understand us and often did not know what the word “acarology” means – clinical acarology was in its very infancy.

Owing to our efforts from 1981 in the union scale demodecosis and other mites researches were activated. In 2000 we sent conclusions of our work to the representative offices of World Health Organization, communities of allergologists, acarologists and dermatologists of the number countries. In 1979 - 1989 we studied almost full accessible literature, having any relation to ticks and mites and diseases resulting by them, literature on Biology, Medicine, Parasitology, Veterinary, Acarology and Zoology in the libraries of Almaty, Sankt-Petersburg and Moscow.

We thank to scientists over the world, because in their published materials we could find almost all about acarias in parts. Without their data we could not understand clearly in our unique non-stereotyped examinations and being sure in full correctness of our conclusions. The considerable role was our interest to ophthalmological operations in student years, work experience at the beginning of a medical practice in conditions of distant healthy localities, scientific activity based on gastroenterological high technically equipped departments of the Republic Clinical Hospital.

By now we have examined purposefully more than 2 million people on the subject of acariases; 22183 affected persons were examined in laboratory-clinical conditions; 33587 patients with allergy, allergic dermatitis and some other diseases received successful medical treatment; acariases development of 15 722 people in natural conditions was watched. Demodectic acarias of 49285 persons was studied and Dermathophagoidic acarias of 12590.

In 1994-1996 by the targeted research of the skin of 17 823 patients in 98,1% were found demodexes, in 0,5% - dermatophagoideses, in 0,6% cases sarcoptids were found, and in 0, 8% - other mites (onion, grain, granary, paunchy /predatory/, rooted). At that in 2,4% of the researches were found several genus’s of mites. Visual identification of mites was provided by the doctor of Biological Sciences, acarologist – V.N. Kusov. Today there are practically no people with skin unaffected by mites. Every year the complicated types of acariases are met oftener even at small children. Among people, asking for help, the numbers of intractable variants of acariases are increased. The earliest clinical masks of acariases are allergy reaction and allergic diseases.

Official medicine establishes doubling of the sickness rate of these diseases every ten years of the last three decades. But it does not know any acarias. The results of our unique researches in aggregate with the statistics of allergy sickness rate in the world allow us to state about pandemic of acariases on our planet. Now we are ready to demonstrate the correctness of our scientific position with the help of complete recovery of the group of people with allergy and allergic dermatites (Zhaxylykova et al, 2008). Does more reliable method of proof of the disease’s actual nature exist, except purposeful ethiopathogenetic medical treatment of this?

The described situation dictates necessity of more significant development of clinical medical acarology. Widespreadness of acariases among population needs a consolidation of medical workers and acarologists’ efforts to combat the widespread clinical masks of acariases. Undoubtedly, concomitant acariases complicates any clinical course with at least that it causes or maintains a sensitizing of a human.

Dear colleagues! Allow me to express once again our gratitude to a management of the European Association of acarologists and to Organizing Committee of the given Conference for the given opportunity of participation in work of conference. You are the one of first specialists who has responded to our inquiries on adjustment of contacts to experts. Work in this direction with allergists and dermatologists of some countries are continued. We hope for your understanding, support and help.

We ask you to join the further combined work. Thanks for attention. Слайды: № 1. Distribution of patients on groups № 2 By now we have examined purposefully more than 2 million people from 14 cities of the former SSSR had been as subject for purposeful clinical examination of opened parts of the body. For last period 388 780 people had been examined on clinic processing and complication of acariases. Including: The demodectic acarias was learned at 49285 people dermatophagoidic acarias was learned at 12590 people. The natural distribution and development of acariasis was examined at 15722 people.

The accordance of the clinical symptoms of degree infested skin with mites was examined at 17823 patients. Examined in laboratory-clinical conditions were 22183 affected persons. With allergy, allergic dermatitis and some other diseases received successful medical treatment 33587 patients. № 3 Researches in 1994-1996 (Zhaxylykova R.D., Kusov V.N., 2001) By the targeted research of the skin of 17 823 patients In 98,1% were found demodexes, In 0,5% - dermatophagoideses, In 0,6% cases sarcoptids were found, In 0, 8% - other mites (onion, grain, granary, paunchy /predatory/, rooted).

In 2,4% of the researches were found several genus’s of mites. № 4 Now we are ready to demonstrate the correctness of our scientific position with the help of complete recovery of the group of people with allergy and allergic dermatitis (Zhaxylykova et al, 2008). Does more reliable method of proof of the disease’s actual nature exist, except purposeful ethiopathogenetic medical treatment of this?