Vol 15, No 2 (2010)

There is presently a real threat of cholera importation by all modes of transport from the countries endemic for this infection. 70% of importations have been noted in type III, subtype A, areas (the Central and Volga Federal Districts) where there are the largest number of state border passage points in the Russian Federation by all modes of transport. For the epidemiological estimation of the population's migration, based on the analysis of international passenger traffic, the migration turnover coefficient was introduced and tested in the Rostov Region. This index is important in assessing the adjustment of the types of areas by the epidemic manifestations of cholera to reduce the economic cost associated with this disease. The tactics for examination of migrants with acute enteric infections from cholera-endemic countries for cholera, continuous monitoring of environmental objects, and great attention to the training of bacteriologists and the quality of laboratory tests are warranted. Vibrio cholerae comprises more than 200 serological O variants. Among them, there are virulent vibrions that are able to induce diseases and that are epidemically dangerous; vibrions that habitat in the water reservoirs, those are safe for humans or pathogenic, those that can cause some cases of diarrhea. The non-O1/non-O139 strains having the ctx gene are encountered with a certain frequency. It is necessary to interrogate such strains isolated from humans and environmental objects.

The paper provides the epidemiological characteristics of acute hepatitis B (AHB) in Tomsk and its region in 1992-2007. While examining, the authors used the records of the Russian Inspectorate for the Protection of Consumer Rights and Human Welfare in the Tomsk Region, and the data of their studies: a retrospective epidemiological analysis and an analysis of epidemiological histories and questionnaires of AHB patients. The study has led to the following conclusions: in Tomsk and its region, the intensive AHB morbidity rates constantly exceed the average Russian rates; the proportion of women is on the rise; the age of patients with AHB increased; there was a preponderance of socially disadapted population groups, such as intravenous psychoactive substance users at the beginning of the study, then their proportion noticeably decreased, but the number of workers and employees, accordingly, became larger. Over time, the sexual and medical routes of infection transmission held the lead; the importance of a contact-household route increased.

The authors evaluated the structural units of periodontal tissues in order to study the baseline periodontal status in 268 patients with diabetes mellitus, who were divided, according to the degree of glycolytic disorders, into 3 groups: 1) compensated; 2) subcompensated; and 3) decompensated forms. The study demonstrated that the patients with compensated diabetes mellitus made up a group of good periodontal status. Those with subcompensated and decompensated diabetes mellitus showed a poor periodontal status, which makes it necessary to develop differential forms of periodontological service, by bearing in mind the compensation of carbohydrate metabolic disturbances.

The paper analyzes cases of typhoid in Saint Petersburg in 2005-2007, gives the epidemiological characteristics and clinical manifestations of the present-day course of typhoid, and presents the results of bacteriological tests in typhoid and paratyphoid diseases. Fatal outcomes are analyzed. By taking into account the results of retrospective analysis of epidemiological data, the authors conclude that it is necessary to prevent typhoid and paratyphoid diseases among disadapted residents and migrants from CIS countries.

The authors made clinical, immunological, biochemical, molecular genetic, and morphological analyses of the course of chronic hepatitis (CH) B and C concurrent with opisthorchiasis and without infestation. It was found that in parasitocenoses, pain, astheno-vegetative, dyspeptic, asthenic, and hepatomegalic syndromes were 2.0-3.3 times more frequently observed; the values of ALT, AST, thymol test, and alkaline phosphatase were significantly increased; the level of cholesterol decreased. The immune system exhibited disorganization and depression of humoral and cellular links. A morphological study of liver biopsy specimens by the Knodell scale revealed significantly enhanced hepatocyte destructive processes, alleviated immune-mediated inflammation, and obvious pericellular sclerosis of hepatocytes and sinusoidal capillaries, which substantially impaired the trophics of the liver parenchyma and stimulated apoptosis and necrosis. Virus gene mutations were seen. The severe course of CH concurrent with opisthorchiasis is attributable to more pronounced destructive processes and hypoxia of hepatocytes. Mutations of "responsible" genes are more frequently responsible for hepatocellular carcinoma.

The adequacy of a mathematical model for the prediction of water-borne enteric infections and tick-borne encephalitis, which were true for the Tyumen Region, was studied. The expected morbidity from water-borne infections was calculated using a simple time series model and that from tick-borne encephalitis was estimated using a time series model with two seasonal constituents. The developed models provide a rather accurate coincidence of the expected and actual morbidity rates and may be used to predict morbidity in the next year (from 53.8 to 100% for water-borne enteric infections and from 80.7 to 93.9% for tick-borne encephalitis).

The Penza Regional Center for Specialized Types of Medical Care has organized a regional medical center for the diagnosis, treatment, and prevention of viral hepatitis on its basis in order to enhance the efficiency of care delivered to patients with chronic hepatitis in the Penza Region with the framework of the special program "Prevention and Control of Social Diseases (2009-2012). The Center's tasks are to improve and commission the currently available methods for the diagnosis, treatment, and prevention of hepatitis and for epidemiological surveillance. The center comprises an around-the-clock hospital and a day hospital, an infectious diseases room, a room for ultrasound diagnosis using a Class 1 Logik-5 ultrasonic device and a Fibroscan apparatus for non-invasive liver elastometry, an endoscopic room, an X-ray room, a clinical diagnostic laboratory (carrying out enzyme immunoassay, polymerase chain reaction for genotyping, by employing a Termocycler apparatus for real-time nucleic acid amplification with the test system sensitivity of 15 IU/ml from HCV RNA and 5 IU/ml from HBV DNA). The center is equipped with a software database and establishing a register of the patients. The patients with hepatitis B and C are treated in compliance with the federal standards. The center is financed from the regional budget. The setting up of the center, financing and implementation of the special regional subprogram "Viral Hepatitis" permit diagnostic (clinical and laboratory instrumental) and therapeutic care to be rendered qualitatively, up to date, and within the existing federal standards.