[The situation regarding parasitic diseases in the USSR].
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Biomedical subjects
Publications and source records attributed to G G Onishchenko.
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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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Since the middle of 1996 the growth of HIV-infected persons and AIDS morbidity are registered in Russia. In 1997 4,300 new cases of HIV infection were registered, which exceeded 1.6 times the total number of cases for the period of 1987-1996. The highest morbidity rate was observed in the cities of the European part of Russia: Kaliningrad (west), Krasnodar and Rostov-on-Don (south), Nizhny Novgorod and Moscow (center). AIDS patients and HIV-infected persons were registered in 73 out of 89 regions of the country. 90% of HIV-infected persons were drug users in 1997. In 1992-1997 the number of drug addicts increased 3.5 fold and young women in 1987-1997, 6.5 fold. 71 HIV-infected children were registered were born from HIV-infected mothers at present time. The article deals with the main provisions of the federal laws aimed at the prevention of the spread of HIV infection in Russia and characterizes scientific research on AIDS. Evidence is presented that the early detection of HIV-infected persons, as well as rendering timely medical and social assistance to such persons, makes it possible to increase their mean survival time and check the spread of human immunodeficiency virus.
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The results of the molecular biological detection of the etiologic agent of hemorrhagic fever in Rostov Province are presented. The role of the causative agents of Astrakhan rickettsial fever, hemorrhagic fever with the renal syndrome, Q fever, leptospirosis and listeriosis has been excluded by means of such immunochemical reactions as the direct and indirect immunofluorescent tests, the solid-phase immunoenzyme assay, the complement fixation test and the agglutination test. The relationship between the cases of hemorrhagic fever in the focus of the outbreak and Crimean-Congo hemorrhagic fever virus has been demonstrated due to the use of the polymerase chain reaction with preliminary reverse transcription.
The results of the epidemiological analysis of the outbreak of hemorrhagic fever which was caused by Crimean-Congo hemorrhagic fever virus and occurred during the period of July 3-19, 1999, in the Oblivskaya district of Rostov Province are presented. The specific epidemiological features of the outbreak have been determined. The possible versions of the appearance of the focus of infection and the role of Ixodes ticks in the circulation of the infective agent are discussed.
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The data on the epidemiological situation with hepatitides B and C in the Russian Federation in 1991-1998 are presented. Morbidity rates in hepatitis B, registered during the recent 3 years, were 35.8 (1996), 36.3 (1997) and 35.7 (1998) per 100,000 of the population. Morbidity rates in acute hepatitis C were 3.2 (1996), 9.1 (1997) and 11.6 (1998) per 100,000 of the population. Different regions of the Russian Federation were noted to have pronounced differences in the activity of the epidemic processes of hepatitides B and C.
Official annual statistical data on morbidity in acute viral hepatitides (AVH), including the number of lethal cases, for 1985-1995 were analyzed. Mortality rates per 100,000 of the population at the period of 11 years were calculated for different age groups, sex and the place of residence. 396 and 99 patients were examined for the presence of serological markers of hepatitides A, B and E, respectively, at the periods of epidemic rises in morbidity and satisfactory epidemic situation. In the course of 11 years AVH caused the death of 22,405 persons. In 1985-1987 the average mortality level (ML) reached 12.3-17.8 per 100,000 of the population (with morbidity being 1,200-1,400 and was essentially higher among the rural population in comparison with the urban population. During these years the highest ML, was registered among children aged 0-2 years (190-50 per 100,000) and, among adults, mainly among women aged 20-29 years (21.4-19.6 per 100,000). During the years when the epidemic of AVH was absent, ML among these groups was essentially lower: 40-20 among children aged 0-2 years and 4-5 among women aged 20-29 years. In 1987 in the Fergana Valley hepatitis E was detected in 72.2% of all examined patients, and in the southern areas of the country in 68.7%. A sharp rise on mortality among women of the productive age at the period of the epidemic rise of AVH morbidity in the endemic region indicated that this epidemic was linked with hepatitis E. High ML among young children may be indicative of a highly unfavorable course of hepatitis E in the group of infants, which had never been registered before. This newly established regularity may be used for the retrospective diagnostics of the outbreak of hepatitis E.
Due to the joint efforts of Russian specialists, the UNAIDS program, the international nongovernmental organization "Médecins sans Frontières" (Holland) and the "Institute of Open Society" (USA), the concept of making programs on the prevention of HIV infection among the intravenous drug users has been formed in the Russian Federation. The cohort of specialists mastering modern technologies in target group has been trained, the realization of the projects of harm reduction is carried out in 25 regions. The necessity of the realization of such projects has been confirmed in 21 more regions of the Russian Federation. Taking into account the development of the epidemic of HIV in the Russian Federation with drug users being the main motive force of this epidemic, the importance and timeliness of the efforts made in this direction can scarcely be exaggerated. In working out the new federal program "Anti-HIV/AIDS" the support ans development of activities in this direction must become one of the priorities of this program.
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