[Specific features of epidemiological situation in the Russian Federation in 1991-1996].
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Biomedical subjects
Publications and source records attributed to G G Onishchenko.
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The spread of viral hepatitides on the territory of Central Asia has been analyzed, taking into account regional and territorial factors and using the Fergana Valley as an example. The analysis, based on the use of modern immunochemical, clinico-epidemiological and biochemical criteria, has made it possible to determine the etiological structure of viral hepatitides on the territory of the Fergana Valley. The epidemic outbreak on this territory has been proved to be caused by viral hepatitis E. The necessity of organizing constant epidemiological monitoring on the interstate and territorial level has been substantiated.
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1,713,057 cases of cholera were registered in the world during the seventh pandemic of the disease at the period of 1961-1989. The pandemic still continues, being the most prolonged pandemic in comparison with earlier ones. During the period of the seventh pandemic 10,723 cases of cholera were registered in the USSR. Great outbreaks occurred in 1965 and 1970-1974. At present sporadic cases of cholera can be registered, and wide circulation of mainly avirulent, nontoxigenic strains of cholera vibrios in environmental objects is characteristic of the epidemic situation.
The critical analysis of anticholera measures carried out in the USSR since 1965 till the present time is presented. The grounds for the abolition or considerable reduction of a number of measures are considered from the viewpoint of their scientific substantiation, the adequacy of means and efforts spent for their realization and their antiepidemic effectiveness. Special attention is paid to the necessity of differentiated approach to these measures, depending on concrete local climatic and geographical, sanitary, hygienic and other factors which determine the epidemic potential of a given administrative territory.
On the basis of the analysis of cholera cases for the period of 1965-1989 three main main types of epidemic manifestations of this infection on the territory of the USSR were determined with due attention to the complex of data, characterizing the intensity and types of the epidemic process, the danger of the outbreak and spread of cholera. This made it possible to differentiate and decrease the complex of prophylactic measures, depending on the type of the territory.
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The results of epidemiological, clinical and laboratory studies revealed that the sharp rise of morbidity in viral hepatitides in Osh Province, the Kirghiz SSR in autumn 1987 was caused by hepatitis non A, non B virus with fecal-oral transmission. At this period the results of the enzyme immunoassay showed the absence of the markers of hepatitides A, B and Delta in 72.2% of viral hepatitis patients. Hepatitis non A, non B occurred only in 2.4% of viral hepatitis patients of preschool age (of these, 83.3% had hepatitis A) and was diagnosed in autumn 1987 in 50% of the patients aged 7-14 years and in 97.4% of the patients aged 15-29 years (in the latter age group 95-98% of the patients had IgG to hepatitis A virus in their blood). The appearance of the outbreak of the above-mentioned infection in Kirghizia is linked with the water route of the transmission of the infective agent. The epidemiological and clinical signs, characteristic of fecal-oral hepatitis non A, non B in Kirghizia, were not different from those registered earlier in other republics of the Central Asia and could be used for the identification of this infection.
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In this article the state of morbidity in hepatitis A and B in the USSR as a whole and in individual republics is analyzed, the causes of the preservation of high morbidity levels in some regions of the USSR are shown, the specific epidemiological features of fecal-oral hepatitis non A, non B in the republics of Central Asia are pointed out and the ways for improving separately the prophylaxis of hepatitis A and hepatitis B are considered.
The article presents original materials characterizing morbidity in acute enteric infections, such as typhoid fever and other Salmonella infections, dysentery, in the USSR. Morbidity registered in recent years is shown to be the consequence of the unsatisfactory solution of problems connected with supplying the population with epidemiologically safe water and foodstuffs. The decisive role played by sanitary and hygienic measures in the prevention and control of acute enteric infections is emphasized.
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