No 4 (2016)

Objective. To assess the current situation of rabies in the Russian Federation, by identifying epidemiological risks. Materials and methods. The material of the investigation was the 2001-2014 data of official statistical reporting (Federal State Statistic Observation Form 2 «Information on Infectious and Parasitic Diseases», statistical data on animal morbidity in the Russian Federation - Forms 1-VET and 1-VET A); accounts and records, information analytical data, and survey data. The investigation used descriptively assessing epidemiological, statistical studies. The epidemiological analysis of hydrophobia cases registered in the Russian Federation in 2006 to 2014 was carried out using the available medical records of 83 cases. Results. A total of 83 cases of hydrophobia were notified in 35 subjects of the Russian Federation in 2006 to 2014. Its morbidity was observed in all federal districts. In 2001-2014, the Central Federal District registered hydrophobia cases in 13 of the 18 subjects of the region. The risk areas were the Moscow Region [(n = 12 (21%)], the Tver Region [(n = 11 (19%)], and Moscow [(n = 6 (11%)]. Its cases in the South Federal District were notified in 4 of its 6 subjects. The largest number of cases (n = 8) were detected in the Astrakhan Region. Fourteen hydrophobia cases were registered in 10 of the 14 subjects of the Volga Federal District. Virtually all respondents (96%) are unaware of the fact that there are active natural foci of rabies in their habitat; 59% do not know that the disease is fatal to animals and 31% are unaware of that it is also fatal to humans. 39% of the respondents consider that there are no effective procedures for protecting animals from rabies and every five of the others are unaware of that this is vaccination. Conclusion. The current situation of rabies remains tense. The main reasons are related to the increase in epizootic tension mainly in the areas of Central Russia and the Volga Region on the one hand and to the population’s low awareness on the other.

The urgency of the problem of nosocomial infections at obstetric hospitals and the high incidence of pyoseptic infections in newborn infants and puerperas have required that the epidemic process management system should be optimized at a specialized multidisciplinary hospital. The article presents basic organizational measures aimed to improve the effectiveness of epidemiological surveillance and control, by improving the microbiological monitoring carried out to stabilize and reduce the incidence of nosocomial infections of newborns and puerperas.

Objective. To comparatively study whether there are stigmatizing sets around HIV infection, tuberculosis, schizophrenia, and cancers in the dwellers of the Moscow Central Administrative District (CAD) and to characterize factors influencing the occurrence of these sets. Subjects and methods. Anonymous surveys were conducted using specially designed questionnaires in 725 people (55% of men and 45% of women). Each of the given questions was asked to 81 to 237 respondents. Among the survey participants, there were 64 healthcare workers: 48 physicians and 16 representatives of mid-level and junior medical staff When analyzing their replies, the respondents were divided into 2 subgroups: 1) healthcare workers; 2) representatives of the so-called general population. As an indicator of stigmatization of the study diseases, the investigators used the questions about whether the respondents perceived if they could keep the diagnoses of HIV infection, tuberculosis, schizophrenia, or cancer a secret and whether they were ready to live in the same room with people with these diseases. Results. The view of the impossibility of keeping information about disease a secret was largely determined by the perception of a risk for infection. This was also true for both HIV infection and tuberculosis. The attitude towards the infectious and non-infectious diseases kept secret was dependent on the gender of the respondents: primary attention to risks for infection was given by the men and that to the sociopsychological consequences of severe diseases by the women. Higher levels of education contributed to greater tolerance in keeping the diagnosis a secret. The question about whether the respondent could live together with a sick person revealed a low stigmatization of cancer patients and a high one of those with schizophrenia and tuberculosis. HIV infection was intermediate in this indicator, by provoking the most polarized opinions. Both subgroups showed similar trends; however, the magnitude of stigmatization was lower in the medics. The old age groups tended to be greater tolerant towards HIV-infected and schizophrenic patients. Conclusion. The results of the investigation suggest the obvious stigmatization of patients with tuberculosis, HIV infection, and schizophrenia and the minimal stigmatization of those with cancer among the dwellers of the Moscow CAD. The higher educational level and old age of the respondents promoted greater tolerance towards people having the above-mentioned diagnoses.

Objective. To test donor blood for HIV infection and to identify the occult and latent forms of infection. Materials and methods. The records of people who had not been allowed to donate blood because they were HBsAg-positive, as well as HBsAG-negative with a positive anti-HBcor (overall) test result, including in conjunction with a positive IgM anti-HBcor test result and/or with excess serum ALT levels in 2010-2014, were analyzed at the Republican Blood Center, Ministry of Health of the Republic of Tatarstan (Kazan). Results. People with positive HBV infection markers are annually identified: those with ABsAg (an average of 16 persons per year); those with anti-HBcor (overall) (n = 580), of them 4.2% had IgM anti-HBcor. The higher than normal serum ALT concentrations were recorded in 1-2% of the donors with the HBV infection marker HBsAg and in 15-20% with anti-HBcor (overall). Conclusion. The detection of HBV infection among blood donors contributes to the preservation of morbidity rates and to the maintenance of virus circulation in the population, which increases the risk of infection during transfusion of blood and its components.

Objective. To substantiate the need for examining pregnant women’s sexual partners for HIV infection. Materials and methods. Examinations were made in 2013-2015, by using retrospective and prospective follow-ups, epidemiological, clinical and economic analyses, and statistical methods. Results. The HIV seronegative window period during pregnancy and the subsequent breastfeeding were a cause of the infection in 22.5% (95% CI 19.12-25.9%) of babies. 46.3% (95% CI 46.09-46.5%) of the pregnant women’s sexual partners were examined for 3 years. The HIV infection detection rate among the partners was 1.7 times higher than that in the pregnant women and 1.5 times higher than that observed during routine screening. Viral loads indicate that there is a risk for sexual transmission of HIV from a male to a pregnant female and that there is a risk for perinatal HIV transmission to a baby. When HIV infection was detected, the sexual partners were followed up in 94.1% (95% CI 91.9-96.37%) of cases; 105 [26.1% (95% CI 21.8-30.4%)] people had indications for antiretroviral therapy. The proportion of HIV-infected pregnant women when their sexual partners were diagnosed with this disease was 1.1% ( 95% CI 0.21-1.87%), that of infected children was 0.23% (95% CI 0.22-0.69%). The annual expenses on examinations of pregnant women’s sexual partners were justified at year 2. Implementation of this direction of work in maternal and child health services requires that the normative legal base should be improved and the additional performance indicators of the efficiency of the service be determined. Conclusion. The results suggest that it is necessary to examine pregnant women’s sexual partners for HIV infection and to improve the normative legal base to detect and prevent HIV infection.

Objective. To evaluate the opportunistic intestinal microflora (OIM) in acute enteric infections (AEI) in adults and the efficacy of aminodihydrophthalasindione sodium (ADPNa) as part of their combination therapy. Materials and methods. Rectal swabs were used to determine OIM in the dynamics of the disease in 2 patient groups. Each group included 30 patients of both sexes, aged 18 to 60 years, with a disease duration of no more than 48 hours at admission and a temperature less than 38.5 °C and without signs of hemorrhagic colitis. Group 1 received conventional therapy; Group 2 additionally used ADPNa. The qualitative and quantitative composition of OIM and its susceptibility to various antibacterial drugs was estimated. Results. The representatives of only OIM, that was susceptible to the main classes of antibiotics in 68-90% of cases, were isolated in all the patients with AEI. ADPNa used in addition to the standard treatment regimen assisted in reducing the duration of clinical manifestations of the disease and in recovering the normal amount of OIM and reduced antimicrobial resistance to penicillins and first-, second-, and third-generation cephalosporins. Conclusion. The results of the study can recommend ADPNa to be incorporated into the combination therapy of AEI. It is also advisable to administer ADPNa during antibiotic therapy with penicillins or cephalosporins.

The paper shows the necessity of choosing an enterosorbent for acute enteric infection (AEI) in children. It presents the basic properties of polymethylsiloxane polyhydrate as one of the drugs for enterosorption. Objective. To evaluate the efficiency of using polymethylsiloxane polyhydrate in children with AEI. Subjects and methods. A total of148 children aged 1 month to 15 years with AEI of different etiologies were examined. 50 of them received polymethylsiloxane polyhydrate (a study group), 48 took dioctahedral smectite (Comparison Group A), and 50 used colloidal silicon dioxide or kaolin (Comparison Group B). The etiology of AEI was clarified using bacteriological and molecular genetic studies. The time to relieve clinical symptoms of this condition was estimated. Results. No significant differences were found in the duration of the main symptoms of AEI in its treatment with polymethylsiloxane polyhydrate versus 71 the other tested enterosorbents. Conclusion. Polymethylsiloxane polyhydrate can be regarded as one of the effective and safe enterosorbents, which may be recommended as part of combination therapy for AEI in children in the first month of life.