Some present-day specific epidemiological, microbiological and clinical features of tuberculosis are presented. A variant of the epidemiological surveillance morbidity scheme, comprising 3 blocks, viz. information, analysis and management, is proposed. In the information block the basic data necessary for epidemic analysis is listed, while the diagnostic block contains the stage-by-stage analysis of the information block data. In the block of management decisions the main directions of the tuberculosis prophylaxis interventions are listed.
Data on HIV infection in pregnant women in Chelyabinsk are presented. Starting from 1999, a considerable rise in the number of HIV-infected persons was registered in this city. The social and epidemiological characteristics of HIV-infected pregnant women, as well as the main routes and factors of the infective agent transmission, are given. Relationship between the spread of HIV-infection and drug addiction is revealed. The occurrence of different opportunistic infections in HIV-infected pregnant women is determined.
The authors provide the results of observing 150 patients with acute pneumonia verified on x-ray. Comprehensive serological studies enabled the legionellosis etiology of pneumonia to be established in 17.3% of cases in sporadic morbidity of children. The disease was marked by the peculiarity of the clinical manifestations, demanding nonstandard treatment approaches.
The etiology of the outbreaks of acute pneumonia in Belgorod was established and their epidemiological features were studied. The mycoplasmal etiology of all cases of acute pneumonia in children and adults, appearing alongside acute respiratory infections resulting from the preceding outbreaks caused by influenza viruses A/Prague/, B/Leningrad/369/75, and all types of parainfluenza viruses, was shown. The droplet mechanism of the transfer of infection was established, which was confirmed by the severity of the outbreak and a high rate of infection of the medical staff at hospitals for children and adults, where patients with mycoplasma-induced pneumonia were treated.
A method of preparation of subtypical antisera to two determinants of hepatitis B surface antigen (anti-HBs Ag/ay and anti-HBs Ag/ad) is described. The test system obtained was approbated on 1400 antigen-positive sera collected from blood donors and patients suffering from acute and chronic virus hepatitis in various geographical zones of the USSR. HBs Ag/ay proved to prevail (84--100%), HBs Ag/ad was distributed irregularly--from 16% in the European part of the USSR to 0--4% in the republics of the Middle Asia and Siberian regions. HBs Ag/ad was mostly determined in the population of Western regions of the European part of the USSR (the Baltic republics, 43.4%, Moldavia 24.3%).
The immune structure of different professional groups with respect to L. pneumophila has been studied. A wide spread of Legionella infection among subway construction workers, subway personnel and railroad conductors has been established, which makes it possible to regard these professions as high risk groups susceptible to Legionella infection. The risk factors for this group are as follows: work in the atmosphere of high dust content with air supply by means of air conditioners, contact with soil in the process of earthwork. The bacteriological study of water samples obtained in dining cars has resulted in the isolation of two strains of L. pneumophila, serogroup I, which confirms the possibility of cases of Legionella infection among railroad personnel.
The potentialities of computers for the study of the effectiveness of immunization have been demonstrated and the mathematical model for the prediction of the proportion of children, seronegative to measles, derived on the basis of the data on the average measles morbidity in different groups for a given period. A multifactor analysis of a large scope of data obtained in seroepidemiological survey and a retrospective analysis of measles morbidity on the basis of data collected in two districts of Moscow have been carried out with the use of computers and mathematical methods.
The use of the method of cluster selection in mass serological examination makes it possible to obtain statistically significant results with very low expenditures. The coincidence of the results on the number of seronegative children, obtained by the method of cluster selection, with the results of mass serological examination of all children aged 6-7 years in the district (children found to be seronegative to measles constituted 5.5% and 5.0% respectively) is indicative of the statistical significance of the method used in this investigation. The results obtained by the method of cluster selection indicate that the level of protection among the children of the district was high both with respect to measles (94.5 +/- 1.8%) and tetanus (96.5 +/- 1.7%); with respect to diphtheria, the immune stratum was found to be less (91.1 +/- 2.3%). These data may be helpful in working out scientifically substantiated administrative decisions contributing to an increase in the effectiveness of planned mass immunization.