Structure and modules of computer informational-analytical system "Electronic atlas of Russia" is presented, the object of mapping in this system is epidemiology of socially significant infectious diseases. Systemic information on processes of emergence and spread of socially significant infectious diseases (anthroponoses, zoonoses and sapronoses) in the population of Russian Federation is presented in the atlas. Detailed electronic maps of country territory filled with prognosis-analytical information created by using technological achievements of mathematic and computer modeling of epidemics and outbreaks of viral and bacterial infections are of particular interest. Atlas allows to objectively evaluate the pattern of infection spread, prepare prognoses of epidemic and outbreak developments taking into account the implementation of control measures (vaccination, prophylaxis, diagnostics and therapy) and evaluate their economic effectiveness.
Polyhexamethyleneguanidine hydrochloride (PHMG) is an antimicrobial biocide of the guanidine family. In the period from August 2006 to May 2007, more than 12500 patients were admitted to hospital with a history of drinking illegal cheap "vodka" in 44 different regions in Russia, of whom 9.4% died. In reality, the "vodka" was an antiseptic liquid composed of ethanol (˜93%), diethyl phthalate, and 0.1-0.14% PHMG (brand name "Extrasept-1").
We performed an analysis of the clinical features and outcome in four poisoning treatment centers in the cities of Perm, Ekaterinburg, Irkutsk, and Khabarovsk. A total of 579 patients (215 females and 364 males) with similar symptoms were included.
The main symptoms on admission included jaundice (99.7%), skin itch (78.4%), weakness (96%), anorexia (65.8%), dizziness (65.3%), nausea (54.8%), vomiting (22.6%), stomach ache (52.7%), diarrhea (32%), and fever (50%). Mild symptoms were found in 2.5% of cases, moderate in 63%, and severe in 34.5%. Laboratory results were (mean ± SD): total bilirubin 249 ± 158 µmol/L, direct bilirubin 166 ± 97 µmol/L, cholesterol 14 ± 8 mmol/L, alanine aminotransferase 207 ± 174 IU/L, aspartate aminotransferase 174 ± 230 IU/L, alkaline phosphatase 742 ± 751 IU/L, and gamma-glutamyltranspeptidase 1199 ± 1095 IU/L. Patients generally recovered over a period of 1-5 months, although high levels of alkaline phosphatase and gamma-glutamyltranspeptidase were still found in all patients examined after 6 months. Sixty-one patients (10.5%) died between 23 and 150 days after poisoning. Local cholestasis, inflammatory infiltration, and fibrosis developing into cirrhosis were found by liver biopsy.
Acute liver injury caused by PHMG-hydrochloride or PHMG in combination with either ethanol or diethyl phthalate can be characterized as cholestatic hepatitis with a severe inflammatory component causing high mortality.
Poststreptococcal acute glomerulonephritis often follows impetigo and can occur in epidemics. From 1975 through 1977, an epidemic of poststreptococcal acute glomerulonephritis occurred in Alaska. Fifty children required hospitalization, while 25 less seriously ill children were treated as outpatients. Sixty-seven percent of these 75 children had direct evidence of recent skin infections. Serotypes 49-14 and NT-14 were the most common streptococcal isolates. In villages in the epidemic area, approximately 15% of children had impetigo and more than 60% of lesions cultured were positive for group A streptococci. Impetigo rates in the epidemic area were similar to those found in nonepidemic areas. However, the introduction of the nephritogenic streptococcal serotypes not recently present in this population apparently led to the development of the epidemic.
From: Fortuine, Robert et al. 1993. The Health of the Inuit of North America: A Bibliography from the Earliest Times through 1990. University of Alaska Anchorage. Citation number 2627.
Previous attempts to study the 1918-1919 flu in three small communities in central Manitoba have used both three-community population-based and single-community agent-based models. These studies identified critical factors influencing epidemic spread, but they also left important questions unanswered. The objective of this project was to design a more realistic agent-based model that would overcome limitations of earlier models and provide new insights into these outstanding questions.
The new model extends the previous agent-based model to three communities so that results can be compared to those from the population-based model. Sensitivity testing was conducted, and the new model was used to investigate the influence of seasonal settlement and mobility patterns, the geographic heterogeneity of the observed 1918-1919 epidemic in Manitoba, and other questions addressed previously.
Results confirm outcomes from the population-based model that suggest that (a) social organization and mobility strongly influence the timing and severity of epidemics and (b) the impact of the epidemic would have been greater if it had arrived in the summer rather than the winter. New insights from the model suggest that the observed heterogeneity among communities in epidemic impact was not unusual and would have been the expected outcome given settlement structure and levels of interaction among communities.
Application of an agent-based computer simulation has helped to better explain observed patterns of spread of the 1918-1919 flu epidemic in central Manitoba. Contrasts between agent-based and population-based models illustrate the advantages of agent-based models for the study of small populations.
Alaska Medical Library - From: Fortuine, Robert et al. 1993. The Health of the Inuit of North America: A Bibliography from the Earliest Times through 1990. University of Alaska Anchorage. Citation number 343.