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Means of personal prevention for OOI. Tactics of a nurse in identifying especially dangerous infections and features of work in an epidemiological outbreak

Especially dangerous infections(HOI) are highly contagious diseases that appear suddenly and spread quickly, covering as soon as possible a large mass of the population. OI occur with a severe clinical picture and are characterized by high percentage lethality.

Today, the concept of “particularly dangerous infections” is used only in the CIS countries. In other countries of the world, this concept refers to those that pose an extreme risk to health on an international scale. The World Health Organization's list of particularly dangerous infections currently includes more than 100 diseases. A list of quarantine infections has been determined.

Groups and list of especially dangerous infections

Quarantine infections

Quarantine infections (conventional) are subject to international sanitary agreements (conventions - from the Latin conventio - treaty, agreement). The agreements are a document that includes a list of measures to organize strict state quarantine. The agreement restricts the movement of patients. Often, the state uses military forces for quarantine measures.

List of quarantine infections

polio,
plague (pneumonic form),
cholera,
smallpox,
Ebola and Marburg fever,
influenza (new subtype),
spicy respiratory syndrome(SARS) or Sars.

Rice. 1. Declaration of quarantine in the outbreak of the disease.

Despite the fact that smallpox is considered a defeated disease on Earth, it is included in the list of especially dangerous infections, since the causative agent of this disease can be stored in some countries in the arsenal of biological weapons.

List of especially dangerous infections subject to international surveillance

typhus and relapsing fever,
influenza (new subtypes),
polio,
malaria,
cholera,
plague (pneumonic form),
yellow and hemorrhagic fevers (Lassa, Marburg, Ebola, West Nile).

List of especially dangerous infections subject to regional (national) surveillance

AIDS,
anthrax, glanders,
melioidosis,
brucellosis,
rickettsiosis,
psittacosis,
arbovirus infections,
botulism,
histoplasmosis,
blastomycosis,
Dengue fever and Rift Valley.

List of especially dangerous infections in Russia

plague,
cholera,
smallpox,

Microbiological confirmation of an infectious disease is the most important factor in the fight against especially dangerous diseases, since the quality and adequacy of treatment depends on it.

Particularly dangerous infections and biological weapons

Particularly dangerous infections form the basis of biological weapons. They are capable of short time hit a huge crowd of people. The basis of bacteriological weapons are bacteria and their toxins.

The bacteria that cause plague, cholera, anthrax and botulism and their toxins are used as the basis for biological weapons.

The Research Institute of Microbiology of the Ministry of Defense is recognized to provide protection to the population of the Russian Federation from biological weapons.

Rice. 2. In the photo there is a sign of biological weapons - nuclear, biological and chemical.

Particularly dangerous infections in Russia

Plague

Plague is a particularly dangerous infection. Belongs to the group of acute infectious zoonotic vector-borne diseases. About 2 thousand people become infected with the plague every year. Most of them die. Most cases of infection are observed in the northern regions of China and Central Asian countries.

The causative agent of the disease ( Yersinia pestis) is a bipolar, nonmotile coccobacillus. It has a delicate capsule and never forms spores. The ability to form a capsule and antiphagocytic mucus does not allow macrophages and leukocytes to actively fight the pathogen, as a result of which it quickly multiplies in the organs and tissues of humans and animals, spreading through the bloodstream and through the lymphatic tract and further throughout the body.

Rice. 3. The photo shows the causative agents of the plague. Fluorescence microscopy (left) and computer imaging of the pathogen (right).

Rodents are easily susceptible to the plague bacillus: tarbagans, marmots, gerbils, gophers, rats and house mice. Animals include camels, cats, foxes, hares, hedgehogs, etc.

The main route of transmission of pathogens is through flea bites (transmissible route).

Infection occurs through an insect bite and rubbing of its feces and intestinal contents when regurgitating during feeding.

Rice. 4. In the photo, the small jerboa is a carrier of the plague in Central Asia(left) and the black rat - a carrier not only of plague, but also of leptospirosis, leishmaniasis, salmonellosis, trichinosis, etc. (right).

Rice. 5. The photo shows signs of plague in rodents: enlarged lymph nodes and multiple hemorrhages under the skin.

Rice. 6. The photo shows the moment of a flea bite.

The infection can enter the human body when working with sick animals: slaughter, skinning and dressing ( contact path). Pathogens can enter the human body with contaminated food products as a result of their insufficient heat treatment. Patients are especially dangerous pulmonary form plague The infection spreads from them by airborne droplets.

Cholera

Cholera is a particularly dangerous infection. The disease belongs to the acute group. Pathogen ( Vibrio cholerae 01). There are 2 biotypes of vibrios of serogroup 01, differing from each other in biochemical characteristics: classic ( Vibrio cholerae biovar cholerae) and El Tor ( Vibrio cholerae biovar eltor).

Rice. 9. In the photo, the causative agent of cholera is Vibrio cholerae (computer visualization).

Carriers of Vibrio cholerae and patients with cholera are a reservoir and source of infection. The most dangerous for infection are the first days of the disease.

Water is the main route of transmission of infection. The infection also spreads from with dirty hands through the patient’s household items and food products. Flies can become carriers of infection.

Rice. 2. Water is the main route of transmission of infection.

Cholera pathogens enter gastrointestinal tract, where, unable to withstand its acidic contents, they die en masse. If gastric secretion is reduced and the pH is >5.5, vibrios quickly penetrate into the small intestine and attach to the cells of the mucous membrane, without causing inflammation. When bacteria die, an exotoxin is released, leading to hypersecretion of salts and water by the cells of the intestinal mucosa.

The main symptoms of cholera are related to dehydration. This is caused by profuse (diarrhea). The stool is watery, odorless, with traces of desquamated intestinal epithelium in the form of “rice water.”

Rice. 10. In the photo, cholera is an extreme degree of dehydration.

The result of simple microscopy of stool helps to establish a preliminary diagnosis in the first hours of the disease. The technique of sowing biological material on nutrient media is classical method identification of the causative agent of the disease. Accelerated methods for diagnosing cholera only confirm the results of the main diagnostic method.

Treatment of cholera is aimed at replenishing fluid and minerals lost as a result of the disease and combating the pathogen.

The basis of disease prevention is measures to prevent the spread of infection and the entry of pathogens into drinking water.

Rice. 11. One of the first therapeutic measures– organization of intravenous administration of solutions to replenish fluid and minerals lost as a result of the disease.

Read more about the disease and its prevention in the following articles:

Anthrax

Pathogen anthrax— the bacterium Bacillus anthracis (genus Bacillaeceae) has the ability to form spores. This feature allows it to survive for decades in the soil and in tanned skin from sick animals.

Smallpox

Smallpox is a particularly dangerous infection from the group of anthroponoses. One of the most contagious viral infections on the planet. Its second name is black pox (Variola vera). Only people get sick. Smallpox is caused by two types of viruses, but only one of them - Variola major - is especially dangerous, as it causes a disease, the mortality rate of which reaches 40 - 90%.

Viruses are transmitted from a patient by airborne droplets. Upon contact with a patient or his belongings, viruses penetrate the skin. The fetus is affected by a sick mother (transplacental route).

Rice. 15. The photo shows the variola virus (computer visualization).

People who survive smallpox partially or completely lose their vision, and scars remain on the skin at the sites of numerous ulcers.

The year 1977 is significant in that the last patient with smallpox was registered on planet Earth, or more precisely in the Somali city of Marka. And in December of the same year, this fact was confirmed by the World Health Organization.

Rice. 16. The photo shows smallpox. Ulcers on the skin appear as a result of damage and death of the germ layer of the epidermis. Destruction and subsequent suppuration leads to the formation of numerous blisters with pus, healing with scars.

Rice. 17. The photo shows smallpox. Numerous ulcers on the skin, covered with crusts, are visible.

Yellow fever

Yellow fever is included in the list of particularly dangerous infections in Russia due to the danger of importing the infection from abroad. The disease is included in the group of acute hemorrhagic transmissible diseases of a viral nature. Widely distributed in Africa (up to 90% of cases) and South America. Viruses are transmitted by mosquitoes. Yellow fever is included in the group of quarantine infections. After the disease, persistent lifelong immunity remains. Vaccination of the population is an essential component of disease prevention.

Rice. 18. The photo shows the yellow fever virus (computer visualization).

Rice. 19. The photo shows the mosquito Aedes aegypti. Carries fever settlements, which is the cause of the most numerous outbreaks and epidemics.

Rice. 1. The photo shows yellow fever. In patients on the third day of the disease, the sclera, oral mucosa and skin.

Rice. 22. The photo shows yellow fever. The course of the disease is varied - from moderate febrile to severe, occurring with severe hepatitis and hemorrhagic fever.

Rice. 23. Before traveling to countries where the disease is common, you must be vaccinated.

Tularemia

Tularemia is a particularly dangerous infection. The disease is included in the group of acute zoonotic infections that have a natural focality.

The disease is caused by a small bacterium Francisella tularensis, gram negative stick. resistant to low temperature and high humidity.

Rice. 24. The photo shows the causative agents of tularemia - Francisella tularensis under a microscope (left) and computer visualization of the causative agents (right).

In nature, tularemia bacilli affect hares, rabbits, water rats, and voles. Upon contact with a sick animal, the infection is transmitted to humans. The source of infection can be contaminated food and water. Pathogens can be acquired by inhaling infected dust that is formed during the grinding of grain products. The infection is carried by horseflies, ticks and mosquitoes.

Tularemia is a highly contagious disease.

Rice. 25. The photo shows carriers of tularemia pathogens.

The disease occurs in the form of bubonic, intestinal, pulmonary and septic forms. The lymph nodes most often affected are the axillary, groin and femoral areas.

Tularemia bacilli are highly sensitive to aminoglycoside and tetracycline antibiotics. The suppurating lymph nodes are opened surgically.

Rice. 26. The photo shows tularemia. Skin lesions at the site of a rodent bite (left) and the bubonic form of tularemia (right).

Disease surveillance activities are aimed at preventing the introduction and spread of infection. Timely identification of natural foci of disease among animals and implementation of deratization and disinfestation measures will prevent diseases among people.

Particularly dangerous infections pose an exceptional epidemic danger. Measures to prevent and spread these diseases are enshrined in the International Health Regulations, which were adopted at the 22nd session of the WHO World Health Assembly on July 26, 1969.

Particularly dangerous infections (EDI)- highly contagious diseases that appear suddenly and spread quickly, covering a large mass of the population in the shortest possible time. AIOs have a severe clinical course and are characterized by a high mortality rate.

On at the moment The term “particularly dangerous infections” refers to infectious diseases that pose an extreme threat to health on an international scale. The World Health Organization's list of particularly dangerous infections currently includes more than 100 diseases. A list of quarantine infections has been determined.

List of quarantine infections

polio
plague (pneumonic form)
cholera
smallpox
yellow fever
Ebola and Marburg fever
influenza (new subtype)
acute respiratory syndrome (SARS) or Sars.

List of especially dangerous infections subject to international surveillance

typhus and relapsing fever
influenza (new subtypes)
polio
malaria
cholera
plague (pneumonic form)
yellow and hemorrhagic fevers (Lassa, Marburg, Ebola, West Nile).

Particularly dangerous infections

Plague

Plague- spicy infectious disease, belonging to the group of zoonoses. Source of infection are rodents (rats, gophers, gerbils, etc.) and sick people. The disease occurs in the forms of bubonic, septic (rare) and pulmonary. The most dangerous form of plague is pneumonic. The causative agent of the infection is the plague bacillus, resistant to external environment, well tolerated low temperatures.

There are two types natural foci plague: foci of “wild” or steppe plague and foci of rat, city or port plague.

Transmission routes Plague is associated with the presence of insects (fleas, etc.) - transmissible. In the pneumonic form of plague, the infection is transmitted by airborne droplets (by inhaling droplets of sputum from a sick person containing the plague pathogen).

Plague symptoms appear suddenly three days after infection, and severe intoxication of the entire body is observed. Against the background of severe chills, the temperature quickly rises to 38-39 “C, and severe headache, facial hyperemia, tongue covered with a white coating. In more severe cases, delusions of a hallucinatory nature, cyanosis and sharpness of facial features develop with the appearance of an expression of suffering, sometimes horror. Quite often, with any form of plague, a variety of skin phenomena are observed: hemorrhagic rash, pustular rash, etc.

In the bubonic form of plague, which usually occurs from the bite of infected fleas, the cardinal symptom is a bubo, which is an inflammation of the lymph nodes.

The development of a secondary septic form of plague in a patient with the bubonic form can also be accompanied by numerous complications of a nonspecific nature.

The primary pulmonary form is the most dangerous in epidemic terms and a very severe clinical form of the disease. Its onset is sudden: body temperature rises quickly, cough and copious discharge sputum, which then becomes bloody. In the midst of illness characteristic symptoms are general depression, and then an excited-delusional state, high temperature, presence of signs of pneumonia, vomiting mixed with blood, cyanosis, shortness of breath. The pulse quickens and becomes thread-like. General condition sharply worsens, the patient’s strength fades away. The disease lasts 3-5 days and without treatment ends in death.

Treatment. All forms of plague are treated with antibiotics. Streptomycin, terramycin and other antibiotics are prescribed individually or in combination with sulfonamides.

Prevention. In natural foci, observations of the number of rodents and vectors are carried out, their examination, deratization in the most endangered areas, examination and vaccination of healthy populations.

Vaccination is carried out with a dry live vaccine subcutaneously or cutaneously. The development of immunity begins on the 5-7th day after a single injection of the vaccine.

Cholera

Cholera- acute intestinal infection, characterized by severity clinical course, high lethality and the ability to bring large number victims. The causative agent of cholera- Vibrio cholerae, which has a curved comma-shaped shape and is highly mobile. Latest cases cholera outbreaks are associated with a new type of pathogen - Vibrio El Tor.

The most in a dangerous way cholera is spread by water. This is due to the fact that Vibrio cholerae can survive in water for several months. Cholera also has a fecal-oral transmission mechanism.

The incubation period for cholera ranges from several hours to five days. It may be asymptomatic. There may be cases when, as a result of severe forms of cholera, people die in the first days and even hours of illness. The diagnosis is made using laboratory methods.

Main symptoms of cholera: sudden watery profuse diarrhea with floating flakes, resembling congee, turning over time into mushy, and then into loose stool, profuse vomiting, decreased urination due to fluid loss, leading to a condition in which one falls blood pressure, the pulse becomes weak, severe shortness of breath, cyanosis of the skin, and tonic muscle spasms of the limbs appear. The patient's facial features are sharpened, the eyes and cheeks are sunken, the tongue and mucous membrane of the mouth are dry, the voice is hoarse, the body temperature is reduced, the skin is cold to the touch.

Treatment: massive intravenous administration special saline solutions to replenish the loss of salts and fluids in patients. Antibiotics (tetracycline) are prescribed.

Control measures and prevention against cholera. To eliminate foci of the disease, a set of anti-epidemic measures is carried out: through so-called “door-to-door visits”, patients are identified, and those who were in contact with them are isolated; provisional hospitalization of all patients with intestinal infections, disinfection of foci, control over the quality of water are carried out, food products and their neutralization, etc. In the event of real danger To prevent the spread of cholera, quarantine is used as a last resort.

When there is a threat of disease, as well as in areas where cases of cholera have been reported, the population is immunized with killed cholera vaccine subcutaneously. Immunity to cholera is short-lived and not of sufficiently high intensity; therefore, after six months, revaccination is carried out by a single injection of the vaccine in a dose of 1 ml.

Anthrax

Anthrax- a typical zoonotic infection. The causative agent of the disease is a thick, immobile rod (bacillus) - it has a capsule and a spore. Anthrax spores persist in soil for up to 50 years.

Source of infection- pets, large cattle, sheep, horses. Sick animals excrete the pathogen in urine and feces.

The ways in which anthrax spreads are varied: contact, food, transmission (through bites blood-sucking insects- horseflies and burner flies).

The incubation period of the disease is short (2-3 days). By clinical forms differentiate cutaneous, gastrointestinal and pulmonary anthrax.

At cutaneous form Anthrax first forms a spot, then a papule, vesicle, pustule and ulcer. The disease is severe and in some cases ends in death.

In the gastrointestinal form, the predominant symptoms are sudden onset, rapid rise in body temperature to 39-40 ° C, acute, cutting pains in the abdomen, bloody vomiting with bile, bloody diarrhea The illness usually lasts 3-4 days and most often ends in death.

The pulmonary form has an even more severe course. It is characterized by high body temperature, disturbances in activity cardiovascular system, severe cough with the release of bloody sputum. After 2-3 days, patients die.

Treatment. The most successful is early application specific anti-anthrax serum in combination with antibiotics. When caring for patients, it is necessary to observe personal precautions - work in rubber gloves.

Ulcer prevention includes identifying sick animals with the appointment of quarantine, disinfection of fur clothing if infection is suspected, and immunization according to epidemic indicators.

Smallpox

This is an infectious disease with an airborne transmission mechanism. Smallpox causative agent- “Paschen-Morozov body” virus, which has relatively high resistance in the external environment. The source of infection is a sick person throughout the entire period of illness. The patient is contagious for 30-40 days, until the smallpox crusts completely fall off. Infection is possible through clothing and household items that the patient has come into contact with.

The clinical course of smallpox begins with an incubation period lasting 12-15 days.

There are three possible forms of smallpox:

mild form - varioloid or smallpox without rash;
smallpox of the usual type and confluent smallpox
heavy hemorrhagic form, which occurs during the phenomena of hemorrhages in the elements of the rash, as a result of which the latter become purple-blue (“black smallpox”).

Mild form of smallpox characterized by the absence of rash. General lesions are poorly expressed.

Smallpox of the usual type begins suddenly with a sharp chill, a rise in body temperature to 39-40 ° C, headache and sharp pain in the sacrum and lumbar region. Sometimes this is accompanied by the appearance of a rash on the skin in the form of red or red-purple spots or nodules. The rash is localized in the area inner surface thighs and lower abdomen, as well as in the area pectoral muscles and the upper inner part of the shoulder. The rash disappears after 2-3 days.

During the same period, the temperature decreases and the patient’s well-being improves. After which a smallpox rash appears, which covers the entire body and the mucous membrane of the nasopharynx. At first, the rash has the character of pale pink dense spots, on top of which a vesicle (pustule) forms. The contents of the bubble gradually become cloudy and suppurate. During the period of suppuration, the patient feels a rise in temperature and acute pain.

Hemorrhagic form of smallpox(purpura) is severe and often ends in death 3-4 days after the onset of the disease.

Treatment is based on the use of specific gamma globulin. Treatment of all forms of smallpox begins with the immediate isolation of the patient in a box or separate room.

Prevention of smallpox consists of universal vaccination of children starting from the second year of life and subsequent revaccinations. As a result, cases of smallpox are practically non-existent.

When smallpox occurs, the population is revaccinated. Persons who were in contact with the patient are isolated for 14 days in a hospital or in a temporary hospital deployed for this purpose.

Yellow fever

Yellow fever is included in the list of especially dangerous infections in Belarus due to the danger of importing the infection from abroad. The disease is included in the group of acute hemorrhagic transmissible diseases of a viral nature. Widely distributed in Africa (up to 90% of cases) and South America. Viruses are transmitted by mosquitoes. Yellow fever is included in the group of quarantine infections. After the disease, persistent lifelong immunity remains. Vaccination of the population is an essential component of disease prevention.

The incubation period is 6 days. The disease is characterized by an acute onset, fever, severe intoxication, thrombohemorrhagic syndrome, liver and kidney damage.

About half who develop severe disease die. Specific treatment yellow fever does not exist.

Vaccination against yellow fever is carried out with vaccines certified by WHO. Immunity after vaccination is developed within 10 days. Adults and children from 9 months of age are subject to vaccination.

Vaccinations against yellow fever in the Republic of Belarus are carried out centrally at the base 19 district clinic Minsk (Independence Avenue, 119; contact phone number 267-07-22. Vaccination is carried out after presentation of a certificate of the established form, issued by a doctor from a health care organization at the citizen’s place of residence, stating that there are no contraindications to vaccination.

List of countries where yellow fever is endemic

Angola	Liberia
Argentina	Mali
Benin	Mauritania
Bolivia	Nigeria
Burkina Faso	Panama
Burundi	Paraguay
Venezuela	Peru
Gambia	Rwanda
Gabon	Senegal
Guyana	Sierra Leone
Ghana	Sudan
Guinea	South Sudan
Guinea-Bissau	Suriname
Equatorial Guinea	Trinidad and Tabago
French Guiana	Togo
Cameroon	Uganda
Kenya	Central African Republic
Colombia	Chad
Congo	Ecuador
Democratic Republic of the Congo	Ethiopia
Ivory Coast

Upon entry into these countries, every traveler is recommended to be vaccinated against yellow fever.

Published: March 10, 2017

The list of especially dangerous infections includes those diseases that are characterized by a particular epidemic danger, i.e. capable of widespread spread among the population. They are also characterized severe course, high risk lethality and may form the basis of biological weapons of mass destruction. Let's consider which infections are included in the list of especially dangerous ones, as well as how you can protect yourself from infection.

Particularly dangerous infections and their pathogens

In world medicine, there are no uniform standards regarding which infections should be considered especially dangerous. The lists of such infections are different in different regions; they may be supplemented with new diseases and, conversely, exclude some infections.

Currently, domestic epidemiologists adhere to a list that includes 5 particularly dangerous infections:

anthrax;
plague;
tularemia;
yellow fever (as well as the similar Ebola and Marburg fevers).

Anthrax

Zoonotic infection, i.e. transmitted to humans from animals. The causative agent of the disease is a spore-forming bacillus that persists in the soil for decades. The source of infection is sick domestic animals (cattle and small cattle, pigs, etc.). Infection can occur in one of the following ways:

contact;
airborne dust;
nutritional;
transmissible.

The illness has a short duration incubation period(up to 3 days). Depending on clinical picture There are 3 types of anthrax:

cutaneous;
gastrointestinal;
pulmonary

Cholera

Acute bacterial disease belonging to the group intestinal infections. The causative agent of this infection is Vibrio cholerae, which survives well at low temperatures and in aquatic environment. The sources of infection are a sick person (including at the recovery stage) and a vibrio carrier. Infection occurs through the fecal-oral route.

The incubation period of the disease is up to 5 days. Cholera is especially dangerous when it occurs in erased or atypical forms.

Plague

Acute infectious disease characterized by extremely high infectiousness and a very high probability fatal outcome. The causative agent is the plague bacillus, which is transmitted by sick people, rodents and insects (fleas, etc.). The plague wand is very stable and can withstand low temperatures. The transmission routes are different:

transmissible;
airborne.

There are several forms of plague, the most common of which are pneumonic and bubonic. The incubation period can be up to 6 days.

Tularemia

Natural focal infection, which is considered especially dangerous, relatively recently became known to mankind. The causative agent is the anaerobic tularemia bacillus. Reservoirs of infection are rodents, some mammals (hares, sheep, etc.), birds. However, sick people are not contagious. The following routes of infection are distinguished:

transmissible;
respiratory;
contact;
nutritional.

The incubation period, on average, is 3 – 7 days. There are several forms of tularemia:

intestinal;
bubonic;
generalized;
ulcerative bubonic, etc.

Yellow fever

(HOI) are highly contagious diseases that appear suddenly and spread quickly, covering a large mass of the population in the shortest possible time. AIOs have a severe clinical course and are characterized by a high mortality rate. Prevention of especially dangerous infections, carried out in full, can protect the territory of our state from the spread of such especially dangerous infections as cholera, anthrax, plague and tularemia.

When a patient with a particularly dangerous infection is identified, anti-epidemic measures are taken: medical and sanitary, treatment and preventive and administrative. The purpose of these measures is to localize and eliminate the epidemic outbreak. In case of zoonotic especially dangerous infections, anti-epidemic measures are carried out in close contact with the veterinary service.

Anti-epidemic measures (AM) are carried out on the basis of information obtained as a result of an epidemiological survey of the outbreak.

The organizer of the PM is an epidemiologist whose responsibilities include:

formulation of epidemiological diagnosis,
collection of epidemiological anamnesis,
coordination of efforts necessary specialists, assessment of the effectiveness and quality of ongoing anti-epidemic measures.

Responsibility for eliminating the source of infection rests with the sanitary and epidemiological service.

Rice. 1. Early diagnosis diseases is an event of exceptional epidemiological importance.

The task of anti-epidemic measures is to influence all parts of the epidemic process.

The purpose of anti-epidemic measures- cessation of pathogen circulation at the site.

Direction of anti-epidemic measures:

disinfect the source of pathogens,
break pathogen transmission mechanisms,
increase immunity to infection of surrounding and contact persons (immunization).

Health measures in case of especially dangerous infections, they are aimed at prevention, diagnosis, treatment of patients and carrying out sanitary and hygienic education of the population.

Administrative activities— organization of restrictive measures, including quarantine and observation in the territory of an epidemic focus of a particularly dangerous infection.

Rice. 2. In the photo, a group of specialists is ready to provide assistance to patients with Ebola fever.

Zoonotic and anthroponotic especially dangerous infections

Particularly dangerous infections are divided into zoonotic and anthroponotic infections.

Zoonotic diseases are transmitted from animals. These include plague and tularemia.
In anthroponotic infections, transmission of pathogens occurs from a sick person or a healthy carrier to a person. These include cholera (group) and smallpox (group of respiratory tract infections).

Prevention of particularly dangerous infections: basic concepts

Prevention of especially dangerous infections is carried out constantly and includes epidemiological, sanitary and veterinary supervision and a set of sanitary and preventive measures.

Epidemic surveillance

Epidemic surveillance of especially dangerous infections is the constant collection and analysis of information about diseases that pose a particular danger to humans.

Based on supervisory information medical institutions determine priority tasks for providing care to patients and preventing particularly dangerous diseases.

Sanitary supervision

Sanitary supervision is a system of constant monitoring of the compliance by enterprises, institutions and individuals with sanitary and anti-epidemic norms and rules, carried out by the sanitary and epidemiological service authorities.

Veterinary supervision

In case of zoonotic especially dangerous infections, anti-epidemic measures are carried out in close contact with the veterinary service. Prevention of animal diseases, safety of animal products and suppression of violations of veterinary legislation Russian Federation— main directions of state veterinary supervision.

Sanitary and preventive measures

The main goal of sanitary and preventive measures is to prevent the emergence of infectious diseases. They are carried out constantly (even in the absence of disease).

Rice. 3. Epidemic surveillance is a shield for infection.

Neutralization of the source of pathogens

Measures to disinfect the source of pathogens in anthroponotic infections

When identifying or suspecting a particularly dangerous disease the patient is immediately hospitalized in a hospital with an anti-epidemic regime. Timely treatment begins to stop the spread of infection from a sick person into the environment.

Measures to disinfect the source of pathogens during zoonotic infections

When anthrax is detected in animals, their carcasses, organs and skin are burned or disposed of. In case of tularemia, they are disposed of.

Rice. 4. Disinsection (extermination of insects). Disinfection (destruction of bacteria, mold and fungi). Deratization (destruction of rodents).

Rice. 5. Burning the corpses of animals infected with anthrax.

Rice. 6. The photo shows deratization. Rodent control is carried out for plague and tularemia.

Maintaining a clean living environment is the basis for the prevention of many infectious diseases.

Measures aimed at breaking the transmission mechanisms of pathogens of particularly dangerous infections

The destruction of toxins and their pathogens is carried out using disinfection, for which we use disinfectants. With the help of disinfection, the number of bacteria and viruses is significantly reduced. Disinfection can be current or final.

Disinfection for particularly dangerous infections is characterized by:

large volume of work,
variety of disinfection objects,
disinfection is often combined with disinsection (extermination of insects) and deratization (extermination of rodents),
Disinfection for particularly dangerous infections is always carried out urgently, often even before the pathogen is identified,
disinfection sometimes has to be carried out at sub-zero temperatures.

To work in the hearths large sizes military forces are involved.

Rice. 7. Military forces are involved in work in large outbreaks.

Quarantine

Quarantine and observation are restrictive measures. Quarantine is carried out using administrative, medical, sanitary, veterinary and other measures that are aimed at stopping the spread of particularly dangerous infections. During quarantine administrative district goes to special treatment activities of various services. In the quarantine zone, the movement of the population, transport and animals is limited.

Quarantine infections

Quarantine infections (conventional) are subject to international sanitary agreements (conventions - from lat. conventio- contract, agreement). The agreements are a document that includes a list of measures to organize strict state quarantine. The agreement restricts the movement of patients.

Often, the state uses military forces for quarantine measures.

List of quarantine infections

polio,
plague (pneumonic form),
cholera,
smallpox,
Ebola and Marburg fever,
influenza (new subtype),
acute respiratory syndrome (SARS) or Sars.

Medical, sanitary and anti-epidemic measures for cholera

Epidemic surveillance

Epidemic surveillance of cholera is the constant collection and analysis of information about the disease in the country and cases of importation of a particularly dangerous infection from abroad.

Rice. 15. A patient with cholera was removed from the plane (Volgograd, 2012).

Health care measures for cholera

isolation and adequate treatment of cholera patients;
treatment of carriers of infection;
sanitary and hygienic education of the population (regular hand washing and sufficient heat treatment of food will help to avoid disease);
vaccination of the population according to epidemiological indications.

Rice. 16. Microbiological diagnostics cholera is carried out in secure laboratories.

Preventing cholera

To prevent cholera, cholera vaccine is used in dry and liquid form. The vaccine is administered subcutaneously. The vaccine is used to prevent the disease in disadvantaged regions and when there is a threat of the introduction of a particularly dangerous infection from other places. During the epidemic, risk groups for the disease are vaccinated: persons whose work is related to water bodies and water supply facilities, workers associated with public catering, food preparation, storage, transportation and its sale.
Persons who have been in contact with cholera patients are administered cholera bacteriophage twice. The interval between administrations is 10 days.
Anti-epidemic measures for cholera.
Localization of the outbreak.
Elimination of the outbreak.
Burial of corpses.
Contact persons from a cholera outbreak are subject to observation (isolation) for the entire incubation period of this disease.
Carrying out current and final disinfection. The patient's belongings are processed in a steam or steam-formalin chamber.
Carrying out disinfestation (fighting flies).

Rice. 17. Fighting flies is one of the components of the prevention of intestinal infections.

Preventive anti-epidemic measures for cholera

implementation in full of measures aimed at preventing the introduction of infection from abroad, regulated by special documents;
measures to prevent the spread of cholera from natural foci;
measures to prevent the spread of the disease from foci of infection;
organization of disinfection of water and public places.
timely detection of cases of local cholera and imported infections;
study of water from reservoirs in order to monitor circulation;
identification of the culture of cholera pathogens, determination of toxicogenicity and sensitivity to antibacterial drugs.

Rice. 18. Actions of epidemiologists when taking water samples.

Medical, sanitary and anti-epidemic measures for plague

Epidemic surveillance for plague

Activities for epidemic surveillance of plague are aimed at preventing the introduction and spread of a particularly dangerous infection and include:

Rice. 19. In the photo there is a plague patient. The affected ones are visible cervical lymph nodes(buboes) and multiple hemorrhages of the skin.

Medical and sanitary measures for plague

Plague patients and patients suspected of having the disease are immediately transported to a specially organized hospital. Patients with the pneumonic form of plague are placed one at a time in separate rooms, and patients with the bubonic form of plague are placed several in one room.
After discharge, patients are subject to 3-month observation.
Contact persons are observed for 6 days. In contact with patients with pneumonic plague contact persons prophylaxis with antibiotics is carried out.

Prevention of plague (vaccination)

Preventive immunization of the population is carried out when a massive spread of plague among animals is detected and a particularly dangerous infection is introduced by a sick person.
Routine vaccinations are carried out in regions where natural endemic foci diseases. A dry vaccine is used, which is administered intradermally once. Maybe reintroduction vaccines in a year. After vaccination with an anti-plague vaccine, immunity lasts for a year.
Vaccination can be universal or selective - only for the threatened population: livestock breeders, agronomists, hunters, food processors, geologists, etc.
Re-vaccinate after 6 months. persons at risk of re-infection: shepherds, hunters, workers agriculture and employees of anti-plague institutions.
Maintenance personnel are given preventive antibacterial treatment.

Rice. 20. Vaccination with anti-plague vaccine can be universal or selective.

Anti-epidemic measures for plague

Identification of a plague patient is a signal for the immediate implementation of anti-epidemic measures, which include:

There are two types of deratization: preventive and exterminatory. General sanitary measures, as the basis for rodent control, should be carried out by the entire population.

Rice. 21. Plague deratization is carried out in open areas and indoors.

Epidemic threats and economic damage caused by rodents will be minimized if deratization is carried out in a timely manner.

Anti-plague suit

Work in a plague outbreak is carried out in an anti-plague suit. An anti-plague suit is a set of clothing that is used medical personnel when carrying out work in conditions of possible infection with a particularly dangerous infection - plague and smallpox. It protects the respiratory organs, skin and mucous membranes of personnel involved in medical and diagnostic processes. It is used by sanitary and veterinary services.

Rice. 22. The photo shows a team of doctors in anti-plague suits.

Preventing the introduction of plague from abroad

Prevention of the introduction of plague is based on constant surveillance of persons and cargo arriving from abroad.

Medical, sanitary and anti-epidemic measures for tularemia

Epidemic surveillance

Epidemic surveillance of tularemia is the continuous collection and analysis of information about episodes and vectors of the disease.

Prevention of tularemia

Used to prevent tularemia live vaccine. It is intended to protect humans in areas of tularemia. The vaccine is administered once, starting at age 7.

Anti-epidemic measures for tularemia

Anti-epidemic measures for tularemia are aimed at implementing a set of measures, the purpose of which is the destruction of the pathogen (disinfection) and the destruction of carriers of the pathogen (deratization and disinfestation).

Preventive measures

Measures against tick bites boil down to the use of sealed clothing and repellents.

Anti-epidemic measures, carried out on time and in full, can lead to a rapid cessation of the spread of especially dangerous infections, localize and eliminate the epidemic focus in the shortest possible time. Prevention of especially dangerous infections - plague, cholera,