Search

Community-acquired pneumonia is a polyetiological infectious disease of bacterial or viral nature. In most cases, it is caused by pathogens such as Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, Chlamydophila pneumoniae, Staphylococcus aureus, Legionella spp. However, despite that a wide range of modern diagnostic methods have been introduced into laboratory practice, the etiology of the disease can be determined only in 40–60% of cases. Here, we analyzed the causative agents of community-acquired pneumonia and relevant markers samples of clinical material collected from patients undergoing treatment in the medical facilities of the city of Saratov and the Saratov Region during the period from July to August, 2020, coupled to increase number of cases of new coronavirus infection COVID-19. Clinical material (oropharyngeal swabs, saliva, sputum, blood and blood serum) was obtained from 129 patients and investigated by using microbiological, immunoserological and molecular genetic methods. For this, there were used transport and nutrient media, diagnostic drugs, reagents, discs with antibacterial domestic and foreign drugs registered in the Russian Federation. As a result, 82 (63.6%) patients were found to have markers of the pathogen COVID-19 (viral RNA or specific antibodies of IgM and/or IgG classes), whereas 42% of cases had overlapped RT-PCR and ELISA data. There was a predominance of severe clinical forms of the disease in the group of patients with pneumonia caused by SARS-CoV-2 virus (17.1%), compared with pneumonia of another etiology (12.8%). No marked differences in specific pattern of the accompanying microflora and its sensitivity to antibacterial agents were observed in persons with/without markers of COVID-19. While being examined by bacteriological methods, S. aureus, K. pneumoniae, S. pneumoniae, M. pneumoniae, Acinetobacter spp., both in monoculture and in associations, were isolated from samples of clinical material collected from the majority of patients. In 49.6% of cases, pathogenic microflora, including pathogens causing community-acquired pneumonia, has not been identified, which may be due to the use of antibacterial drugs before the collection of clinical material and treatment applied due to comorbid chronic diseases.

The results of the joint work of a panel of experts from Rospotrebnadzor and healthcare professionals of the Republic of Uzbekistan on organizing activities to counter the spread of the SARS-CoV-2 virus are described in the paper.The goal of the study was to determine the main driving forces of COVID-19 spread in the Republic of Uzbekistan and develop an action plan to reduce the incidence of coronavirus infection caused by the SARS-CoV-2 virus.Materials and methods. The organization of work in 14 health care institutions in Tashkent and Samarkand, as well as in Tashkent and Samarkand Regions, was analyzed: in 7 laboratories, 6 hospitals and 1 polyclinic. The routes for the movement of personnel, the demarcation of green and red zones, the features of disinfection and the use of personal protective equipment were studied. Attention is drawn to the diagnosis of COVID-19, the use of therapy aimed at reducing the period of virus shedding, the criteria for lifting quarantine restrictions for patients.Results and discussion. The main factors in the organization of work of institutions that contribute to the spread of COVID-19 among medical personnel and the population have been identifed: the lack of equipped gateways between the red and green zones with the accessibility of adequate disinfection, the wrong choice of personal protective equipment, monitoring of contact persons for 10 days, discharge from hospitals based on clinical improvement. The incorrect use of antiviral therapy, the lack of differentiated approaches to the selection of optimal regimens have been noted. Proposals are formulated for organizing the work of healthcare institutions, taking into account the requirements of biological safety. The introduction of targeted measures in addition to those previously adopted has led to a signifcant improvement in the epidemic situation: the total number of active cases in the Republic of Uzbekistan, despite the increase in testing volumes, decreased from 3,686 people on August 23 to 2335 on October 27. Towards December 20, 2020, 97 % of patients recovered completely. All diagnostic triage centers in the Republic of Uzbekistan are closed due to the absence of patients with COVID-19, most of the country’s medical institutions previously re-profled for patients with coronavirus infection have returned to the routine operations.

In 2018, between June14 and July 15, final matches of the FIFA World Cup-2018 were held in 11 cities of the Russian Federation. That event was the biggest mass event with international participation in the history of Russia. During the period, in the process of sanitary-epidemiological welfare provision, developed earlier scintific-and-practical achievementds for prevention of emergency situations of sanitary-epidemiologoical character were implemented to the fullest extent. Objective of the study – analysis of evolution of the developed in Russia scientifically-substantiated approaches in the sphere of sanitary-epidemiological welfare provision of mass events and aggregation of the results of their implementation during preparation and holding of FIFA World-Cup-2018. Utilized were information-analytical materials from the Rospotrebnadzor Administrations by the constituent entities of the Russian Federatuion, Centers of Hygiene and Epidemiology in the entities of the Russian Federation, RusRAPI “Microbe” of the Rospotrebnadzor, data from Organizing Committee “Russia-2018”, Federal Turism Agency, information published in periodical press. Scientifically substantiated model of sanitary-epidemiological welfare provision during mass events was developed in the Russian Federation. It includes expert evaluation and quantification of potential epidemic hazard of mass event which allows for targeted prophylactic and anti-epidemic measures with rationalized loads and adequate frequency of repeat. The paper discusses the complex of measures carried out during preparation and holding of FIFA World Cup-2018 by the functional areas: sanitary protection of the territory; epidemiological surveillnace over relevant anthropozoonotic, natural-focal zoonotic, sapronotic infectious diseaseas; sanitary surveillance over communal facilities, catering facilities, sites of accomodation of the participants and guests; sanitary-hygienic monitoring of ambient environment objects; provision of anti-epidemic preparadeness and readiness of the Rospotrebnadzor authorities and institutions and medical organizations; provision of readiness of laboratory facilities; involvement of additional forces and capacities and interagency cooperation in response to emergency situations of sanitary-epidemiological character.

Presently Africa is one of the most affected regions of the world as regards cholera. More than 55 000 people are infected every year. The review contains the data on comparative assessment of epidemic manifestations associated with the current pandemic, caused by Vibrio cholerae biovar El Tor, and the preceding six pandemics, the agent of which was cholera vibrios of classical biovar. Studied have been the factors of large-scale cholera dissemination in Africa in the modern period and problems of its prophylaxis.

Внебольничные пневмонии являются полиэтиологическим инфекционным заболеванием бактериальной или вирусной природы. В большинстве случаев они обусловлены такими возбудителями, как Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzaе, Chlamydophila pneumoniae, Staphylococcus aureus, Legionella spp., грамотрицательными палочками, вирусами гриппа А и В, аденовирусами, PC-вирусом, вирусами парагриппа. Но, несмотря на внедрение в лабораторную практику широкого спектра современных диагностических методов, этиологию заболевания удается установить только в 40-60 % случаев. В работе приведен анализ данных по обнаружению возбудителей внебольничных пневмоний и их маркеров в пробах клинического материала от больных, проходивших лечение в медицинских организациях г. Саратова и Саратовской области в период с июля по август 2020 г., сопряженный с увеличением количества случаев заболевания новой коронавирусной инфекцией COVID-19. Клинический материал (мазки из ротоглотки, слюна, мокрота, кровь и сыворотка крови) получен от 129 больных и исследован с помощью микробиологических, иммуносерологических и молекулярно-генетических методов. Для исследований применяли транспортные и питательные среды, диагностические препараты, реагенты, диски с антибактериальными препаратами отечественного и зарубежного производства, зарегистрированные на территории Российской Федерации. В результате проведенных исследований у 82-х (63,6 %) пациентов выявлены маркеры возбудителя COVID-19 (вирусная РНК или специфические антитела классов IgM и/или IgG), при этом в 42 % случаев отмечено совпадение результатов ОТ-ПЦР и ИФА. Отмечено преобладание доли тяжелых клинических форм заболевания в группе больных пневмониями, вызванными вирусом SARS-CoV-2 (17,1 %), по сравнению с пневмониями другой этиологии (12,8%). Значительных различий в видовом составе сопутствующей микрофлоры и ее чувствительности к антибактериальным препаратам у лиц с маркерами COVID-19 и без таковых не выявлено. При исследовании бактериологическими методами из проб клинического материала большинства больных были выделены S. aureus, K. pneumoniae, S. pneumoniae, M. pneumoniae, Acinetobacter spp., как в монокультуре, так и в ассоциациях. В 49,6 % случаев патогенная микрофлора, в том числе возбудители внебольничных пневмоний, не выявлена, что может быть обусловлено приемом антибактериальных препаратов до начала сбора материала на исследование и лечением, принимаемым в связи с имеющимися сопутствующими хроническими заболеваниями.

Represented are the results of analysis of the on-going EVD epidemic, 2013-2015 in West Africa countries. Identified have been epidemiological peculiarities, the principal ones of which are: the scale of epidemic transmission; social factors of widespread occurrence; registration of EVD cases in the new territories of the African continent - West Africa (Guinea, Liberia, Sierra-Leone); genetic distinction between Ebola virus and the strains of the same virus, species Zaire ebolavirus, that caused previous outbreaks; prevalence of febrile syndrome over hemorrhagic; high risk of infection with EVD among the healthcare workers. Most probable carriers of Ebola virus may be fruit-bats of the three species - Hypsignathus monstrosus, Myonycteris torquata, and Epomops franqueti. Outlined are the key stages and factors of EVD epidemic development.

An estimated scope of measures, aimed at the prevention of Ebola virus disease importation and transmission in the territory of the Russian Federation, targets the maximum level of hazard to the population. It has a complex interagency character, whereby the Federal service for surveillance in the sphere of consumers rights protection and human welfare functions as coordinator and principal executing agency. The measures affect the following areas: regulatory compliance and methodological support, sanitary-quarantine control reinforcement at the entry points on the state border of the Russian Federation, strengthening of anti-epidemic preparedness of the Rospotrebnadzor and public healthcare institutions and authorities, including operational preparedness of the laboratory facilities, information support within the framework of epidemiological surveillance, and involvement in the activities under the international collaboration for epidemic response and control. Practices have been completed as regards series of actions conducted from the time of the case identification and further on; evacuation of the infected and suspected individuals, procedures for sanitary disinfection, interventions in the relation to contact persons, and readiness for anti-epidemic measures performance.

International public events (IPE) present some actual epidemiological problems requiring proper methodological elaboration. In this respect for the first time developed has been the scheme of assessment of their potential epidemic hazard (PEH), based on integrated evaluation of epidemiological risk as regards infectious diseases listed in the IHR (2005). On the cholera model demonstrated is the fact that high priority hazard of public events emerges when those are combined with such elements of epidemiological risk as territory and time of a threat, as well as risk factors and risk contingents. Thus the integral effect of all elements realization is manifested through high probability of infectious disease importation, which is associated with emergency situation, into the public event location and the disturbance of mass gathering progress. Reliability and functionality of the developed scheme is verified on other infections too. PEH assessment procedure allows for timely identification of priority goals, for rating means and capacities, organizational resources, methodological and technological arrays for the provision of sanitary-epidemiological welfare and biological safety when managing public event.

Local climate change (rise of mean temperatures and amount of precipitation, prolongation of frost-free season) triggers further distribution, and increase in numbers of animals – carriers and vectors of West Nile fever virus in the territory of the Saratov region. Based on the results of ecological-epizootiological monitoring (2006–2012) traced out have been the species composition, abundance dynamics, and character of distribution of birds habitant in aquatic and anthropogenic complexes, mosquitoes and Ixodidae ticks. Investigated are possible causes of West Nile fever nosoarea expansion, related to ecology of migrating birds wintering in Africa. Persistent circulation of the virus in intra-zonal inundated biocoenosis facilitates formation of secondary natural foci of West Nile fever and factors into epidemic complications as regards this particularly dangerous vector-borne infection. On the basis of analytical data concerning hydrographic network density, fauna structure, population numbers of birds and mosquitoes – potential carriers and vectors of WNF, epizootiological and epidemiological surveillance, designed has been expectation-driven forecasting map chart which illustrates possibility of sustainable WNF foci formation in various territories of the Saratov region.

Retrospective analysis of cholera spread in the early period of the seventh pandemic in Russia (1970-1973) has been carried out. It was elucidated that importation and further spread of cholera in the Astrakhan region in 1970 had been realized through the water way. The development of a large cholera focus in the territory of this region determined the unfavorable situation as regards this infection in the whole country in the period of 1970-1972. Water transport was shown to play the main role in cholera spread. The risk cohorts were the population of the Astrakhan region, shipboard personnel of the Volga steamship company, fishermen, persons without permanent residence. Molecular-genetic analysis of cholera agent strains isolated from the patients (vibriocarriers) and the environment showed that they belonged to one clone, thus the common origin of cholera cases in the basin of the Volga was confirmed.

The analysis of sickness rate carried out from 1984 to 2007 revealed the complicated epidemiologic situation with plague in the world, especially during the period of 1991-2003. The most strained situation formed in Africa. During the analyzed period the tendency to increase the plague incidence in the world - 2.4-fold, in Africa - 4.1-fold and to decrease in America - 11.1-fold and in Asia - 1.7-fold was observed. Uneven character of plague cases distribution in the world was determined: 80.1 % of cases were registered in Africa, 14.1 % - in Asia and 5.8 % - in America. From 1990 to 2006 10 local outbreaks of pneumonic plague were registered in the world: 4 - in Asia, 5 - in Africa and 1 - in America.