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a modern epidemiological situation on SHOUT

The group of acute respiratory virus infections concerns to polietiologichnym to the diseases caused more, than 200 originators. A leading etiological role in formation SHOUT play viruses of a flu And, In
And With, a parainfluenza 1, 2 and 3 types, respiratorno-sintsitialnyj (RS), adeno-pikarna koronovirusy and other, having epidemiological features.

The clinical differentiation of respiratory infections is complicated because of a semiology generality, in communication, with what the etiological factor without application of methods laboratory diagnostics frequently remains not established (10, 29, 37, 74, 176, 184, 191).

In a number of researches it is established, that at patients SHOUT the admixed aetiology of disease is quite often observed: combinations adeno - with the Rs-virus, entero - with viruses of a flu And, a parainfluenza and the Rs-virus, and also association of adenoviruses, group viruses In, and M. Pneumoniae (145, 170, 175).

Thus, the carried out analysis of data of the literature testifies to the admixed character of epidemics of last years, bound to primary circulation of viruses of a flu And (H3N2), a flu And (H1N1), a flu In, and also adenoviruses, the Rs-virus and viruses of a parainfluenza 1, 2, 3 types. Similar polietiologichnost SHOUT dictates necessity of introduction for practice of public health services of new agents and preventive maintenance methods SHOUT at children, and also working out of effective complexes of actions, especially for the mass children's collectives referred on rising of nonspecific resistance of an organism (14, 54, 126).

The originality of a modern epidemiological situation consists in Russia that in development of epidemic process along with flu viruses active participation is accepted by adenoviruses, the Rs-virus and viruses of a parainfluenza 1, 2, 3 types which lead to appreciable depression of a role of viruses of a flu in comparison with the period of circulation of a virus of flu A (H2N2) or A (H3N2) in 70­х years (with 80 to 40 %) (66, 67, 95, 119).

The leading part in structure SHOUT undoubtedly belongs to a flu. So, in Russia with a flu annually are ill to 60-70 million persons (37, 63, 135, 182).

Flu - the acute virus infection characterised by the general intoxication. A lesion of a mucosa of the top respiratory tracts, with prevalence of the phenomenon of a tracheitis (64, 97, 135, 149, 154).

Flu viruses concern group pnevmotropnyh the RNK-CONTAINING viruses belonging to family ortomiksovirusov. Contain enzyme the RNK-POLYMERASE. On ribonukleoproteidnomu to an antigen they are classified on 3 types - And, In, by S.Virusy of type And are sectioned into subtypes. External glikoproteinovoj virus covers are included into structure specific gemagljutininy () and a neuraminidase (N), defining a virus accessory to corresponding subtype (64, 93, 135, 149, 209).

The most essential contribution to pathogenicity of viruses of a flu And is brought by fibers HA — PB1, PB2, NS1. Besides, 2 fibers (NA, M2) are bound to development of fastness of viruses to antiviral preparations. The virus And (H1N1) pdm, unlike the precursors, izoljatov 1918 and viruses A (H5N1), contains in genome 2 obvious defects which allow to carry a pandemic virus And (H1N1) pdm to moderately pathogenic. However the structure analysis ON and NА a pandemic virus has allowed to find out in structure ON "mobile" determinants to which bind features of a current of the serious, complicated forms of a flu, with high probability of a lethal outcome.

Believe, that evolution of this virus can go on a way of restoration of some signs of pathogenicity that will mean transition of a virus of a flu And (H1N1) pdm in a category highly pathogenic (70).

The flu virus causes depression of immunologic resistance. It leads to an exacerbation of chronic diseases, and also occurrence of bacteriemic complications (8, 12, 38, 86).

Viruses of a flu And play the basic role in development of epidemic process, causing sometimes epidemics in scales of the separate countries or the pandemics of a flu covering during short time the whole contingents (84).

The second for the importance is group of viruses of a flu of V.Virus of a flu In does not cause a pandemic, but is the originator of large epidemic flashes (150).

The flu caused by a virus of type With, despite data on its wide circulation among the population, does not cause large epidemics. As a rule,
The case rate has character of local flashes in children's collectives or single instances, more often caused in preepidemic or in a flu epidemic And and V.Gripp With has an insignificant specific gravity in an infectious pathology of the person and in most cases proceeds in the easy and asymptomatic form (49, 84, 125, 158, 162).

Parainfluenza viruses

The disease originator - the RNK-CONTAINING virus of family Paramixoviridae. 5 types of viruses of a parainfluenza Are known. Viruses PG infect all age groups of the population, but, mainly children. Possess tropnostju to an epithelium of a mucosa of respiratory tracts, especially a nose and a larynx, however cause various clinical implications. ПГ-1 and ПГ-2 associate with development of a croup in children, and ПГ-3 with diseases of the bottom respiratory tracts (bronchiolites, a bronchopneumonia). Etiological importance ПГ-4 and ПГ-5 is studied, insufficient, in the literature there are only individual reports that they are capable to amaze both top, and the bottom respiratory tracts (47, 152).

Respiratorno-sintsitialnyj (RS) the virus which concerns family Paramyxoviridae, to sort Pnemovirus, widely extends, causing both sporadic diseases, and flashes of respiratory infections. (63).

Children since a birth and till 2th years are ill mainly. Flashes can proceed in the form of intrahospital infections. During epidemics of 20-40 % of the newborns arriving in hospitals concerning somatic neinfektsionnyh, can appear infected with a RS-virus with development of serious lesions of the bottom respiratory tracts, including to it bind formation of a bronchial asthma. (46, 63, 65, 135, 136, 145, 173).

Rs-virus widespread and in association with other respiratory viruses. In etiological structure of the mikst-infections proceeding with participation of the Rs-virus, influenzal viruses and adenoviruses (63, 164) prevail.

Each six years sharp rising of activity of Rs-viruses among all age groups, with especially wide coverage in epidemic of children of younger age group (46, 63) is observed.

Adenoviruses concern family Adenoviridae, sort Mastadenovir which unites to 47 serotypes of the person and 80 serotypes of mammals (152).

Epidemic process at an adenoviral infection is characterised by slow development, a long current and smaller expression, than at a flu (135).

The adenoviral infection has a wide circulation, amazing all age groups of the population. The case rate tendency in these age groups is characterised by a progressive orientation while at adult population some depression of a case rate becomes perceptible. Biennial recurrence in dynamics of epidemic process (63, 121) is taped.

The case rate is registered by an adenoviral infection within all year (with the maximum indicators during the zimne-spring period), as in the form of sporadic cases, and a kind of local epidemic flashes (48, 65).

Rhinoviruses - the small RNK-CONTAINING viruses concerning family Picornoviridae, sort Rhinovirus, causing diseases with symptoms a lesion of a mucosa of a nose and a nasopharynx (33, 135).

The originator numbering 113 serotypes, gets to a human body through a nose. Feature of this infectious disease is absence or weakly expressed general intoxication (149).

According to one researchers rhinoviruses it is not enough kontagiozny and seldom cause vspyshechnuju a case rate, others, on the contrary, believe, that they are capable to induce flashes SHOUT various intensity (63).

Koronovirusy, concerning family Coronoviridae, are extended everywhere among all age groups of the population, cause insignificant seasonal liftings of a case rate, and with an interval in 2-3 years of flash. The infection extends air-drop, fecal-oral and contact by. Distinctive feature is a high specific gravity (80-85 % of cases)
The admixed forms of an infection. Most often the association with koronovirusami is entered by viruses of a flu And, Rs - and adenoviruses, sometimes flu viruses In, that leads to disease weighting (38, 152).

Reovirusnaja the infection is accompanied by a lesion of the top respiratory tracts and a small bowel lesion. The disease originator - the RNK-CONTAINING virus of family Reoviridae. An infection source is the sick person and a virus carrier. Children from 6 months till 3-5 years (73, 149) are ill mainly.

Koksaki and the ESNO-INFECTION - concern a sort of enteroviruses. Two groups of viruses Koksaki distinguish: group And, including 24 serovars, and group In, including 6 serovars. In 1951 the viruses originally named not classified, orphaned (Orphan), and in 1955 received the name intestinal (Enteric) cytopathic (Cytopathogenic) human (Human) orphaned viruses — ECHO have been found out. 34 serovars of viruses ECHO Are known. It is characterised by variety of clinical implications from easy feverish conditions and a simple carriage of a virus to serious meningocephalites, myocardites, paralytic forms (149).

Most often children at the age from 3 till 10 years are ill. Children till 3 months are ill seldom in connection with presence at them transplacental immunity. Disease proceeds in the form of sporadic cases, epidemic flashes, large epidemics (135) are described.

Last decades there were also new viruses, such as metapnevmovirus and bokavirus the person, responsible for serious diseases of the top and bottom respiratory tracts (87).

metapnevmovirus - the RNK-CONTAINING virus, concerns family of paramyxoviruses, is close to respiratorno-sintsitialnomu to a virus. According to foreign authors, metapnevmovirus tap in nasopharyngeal washouts at children, suffering diseases both top, and the bottom respiratory tracts with frequency from 2,2 % to 33,3 % (160, 171, 174, 203).

In moderate climatic widths metapnevmovirus circulates mainly in the end of winter and in the early spring, peak of its activity it is frequent
Coincides or follows behind peak of activity of a PC virus (155, 159, 160, 169, 183, 185, 187, 195, 206, 211).

metapnevmovirus identified at 1,2 % of children without symptoms SHOUT (31).

Bokavirus the person - for the first time it is described in 2005 in Sweden, belongs to family Parvoviridae. (human Bocavirus, hBoV) (156).

Among children hospitalised in a hospital apropos SHOUT, diseases bokavirusnoj aetiologies make 10,0 %. Most often bokavirusnoj with an infection children at the age of 1-3 years (62,4 %) are ill. In healthy children bokavirus it is found out in 2,6 % of cases. Bokavirus the person causes diseases of the top and bottom respiratory tracts (76, 78, 157, 190, 192, 207).

In prevention of mass infectious diseases and definition of effectual measures of specific and nonspecific preventive maintenance studying and an estimation of collective immunity is important. Its condition defines level of a susceptibility of the population of various age to originators of infectious diseases, including to respiratory viruses, specifies in intensity natural proepidemichivanija the population, defines character of changes of an immunoreactivity] of the population in development of epidemic process (30, 35, 39).

There is actual in carrying out of preventive actions a working out and introduction of methods of correction of the immune answer at separate individuals and optimum technologies of management of collective immunologic reactance of the population, especially among children, considering high level of a case rate at them and a lethality from complications (30, 39, 134, 147).

Complex of measures on specific and nonspecific preventive maintenance, laboratory diagnostics, therapy and the aftertreatment, had been ill with a flu also SHOUT should include as intensifying of epidemiological supervision, including regarding tracking circulation of the originator of a flu and others SHOUT, and carrying out of annual preventive actions for preventive maintenance, first of all among the organised children's collectives (50, 55).

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Scientific source TISHKINA IRINA SERGEEVNA. Preventive programs at often ill children of early age in establishments of a primary link. The DISSERTATION ON COMPETITION of the SCIENTIFIC DEGREE of the CANDIDATE of MEDICAL SCIENCES. Moscow - 2015. 2015

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Other medical related information a modern epidemiological situation on SHOUT:

  1. THE TABLE OF CONTENTS
  2. a modern epidemiological situation on SHOUT
  3. features of a flu epidemic
  4. THE LITERATURE LIST