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Collaborative US-USSR study on the prevalence of dyslipoproteinemias and ischemic heart disease in American and Soviet populations. Prepared by the US-USSR Steering Committee for Problem Area 1: the pathogenesis of atherosclerosis.

The ongoing collaborative US-USSR study of the prevalence of dyslipoproteinemias, based on the Lipid Research Clinics Study protocol, is described. The purpose of this multidisciplinary, multiclinic program is to investigate the relation of plasma lipids and lipoproteins and other risk factors to atherosclerotic disease in selected populations. The research design, sampling strategy and general hypotheses of the study are detailed. Common quality control methods and standardized screening procedures used in data collection are reviewed. Components of the study include measurement of plasma lipids and lipoproteins, the collection of demographic and physiologic information, a 24-hour dietary recall, administration of the Rose questionnaire and resting and exercise electrocardiograms. Preliminary comparative data for total plasma cholesterol, triglycerides and high density lipoprotein cholesterol are presented for men aged 40 to 59 years.

Arteriosclerosis

Congenital rubella in the USSR.

The results of a comprehensive study of the problem of congenital rubella in Moscow and other cities of the USSR are presented. The highest rubella incidence was found among children 1-7 years of age; but 20-25 rubella cases were also recorded annually per 100 000 adults. Specific antihaemagglutinins were found in 36-70% of children and in 91-99% of adults. Investigation of the rubella foci revealed clinical rubella, confirmed by laboratory methods, in children and adults who had low initial titres of specific antihaemagglutinins. Serological screening of 1661 apparently healthy pregnant women detected antihaemagglutinins in 98.4%; however, low (1:8-1:16) titres were found in 53.3% and high (postinfection) titres and specific IgM in only 8.8% of cases.A study of 523 pregnant women who had been in contact with a source of infection revealed clinical rubella in 10.9% and inapparent infection in 0.7% of cases. A virological study of fetuses from infected pregnant women showed that there was intrauterine viral infection in 73% of cases; 38% of rubella-infected fetuses had congenital defects (unilateral or bilateral cataract, absence of one cerebral hemisphere, adhesion of the upper and lower eyelid, or diffuse damage of the crystalline lens); in one woman rubella virus was isolated from the fetuses and abortion materials received from two abortions with an interval of 6 months. Serological investigation of 519 mothers who had given birth to children with congenital defects showed that there were more frequent indications of rubella infection in the mothers of the children with CNS and cardiovascular defects, as well as in the children with congenital cardiovascular and CNS defects, than in the control groups. These data confirmed the teratogenic nature of rubella strains found in the USSR. This study indicates the need to improve rubella surveillance in pregnant women and to consider the prophylaxis of congenital rubella in the USSR. (See also Addendum.)

Child, Preschool

[Characteristics of the seasonal distribution of typhoid fever cases in different areas of the USSR].

The results of the monthly registration of typhoid cases in all union republics and in the USSR as a whole for the period of 1970--1976 were analyzed. The mathematical parameters of the monthyly distribution of morbidity rate under the influence of long-term factors for each union republic were determined. In analyzing actual morbidity rates for definite years these data may help determine to what extent such rates are influenced by incidental factors. Mathematical analysis allowed to divide the territory of the USSR into 5 groups of areas with different patterns of the seasonal distribution of typhoid cases: the RSFSR, the Ukrainian SSR and the Moldavian SSR, the Byelorussian SSR and the Soviet Baltic republics, the Transcaucasian republics, the republics of Central Asia and the Kazakh SSR. April was found to be the optimum time for the immunoprophylaxis of typhoid fever throughout the whole territory of the USSR in the presence of epidemiological indications.

Disease Outbreaks

[Subtype characteristics of the surface antigen of hepatitis B in different regions of the USSR].

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%).

Acute Disease

The epidemiology of epidemic parotitis in the USSR.

Morbidity from epidemic parotitis in the USSR in the period from 1958 to 1972 ranged within the limits of 266.6 and 521.7 cases per 100 000 inhabitants. A 3--4 years cyclic recurrence of rises and falls in morbidity was observed. The bulk of cases of disease occur in the winter-spring period. In towns, parotitis is registered 3 times more frequently, in the mean, than in rural districts. More than 95% of patients in the USSR consisted of children under 15, while in Moscow, children aged 3--5 years were the most affected group. In Moscow in the period from February 1, 1972 to January 31, 1973, the morbidity in men was 493.2 per 100 000 and in women 339.5 per 100 000 (ratio 1:1.45).

Adolescent

Investigation of some problems of virology and creation of means of specific prophylaxis of virus infections in the institute of poliomyelitis and virus encephalitis, academy of medical sciences of the USSR.

Several great problems are clearly distinguished in the development of the Soviet medical virology. The team of the Institute of Polliomyelitis and Virus Encephalitis of the AMS of the USSR actively participates in the study of these problems. They include the investigation of theoretical questions of general virology, creation and improvement of means of specific prophylaxis of virus infections, virological examination of diseases endemic for single districts of the USSR as well as the search for, discovery and exploration of new viruses, causative agents of disease. The achievements of the team of the Institute of Poliomyelitis and Virus Encephalitis in the field of liquidation of poliomyelits, creation of new effective preparations against tick-borne encephalitis, rabies and other neurovirus infections are a clear consequence of the prophylactic trend of the Soviet health care, thoughtful planning of scientific work and broad, complex conception of scientific investigations, close connection with other scientific institutions, involvement of specialists of contiguous disciplines in scientific problems, international cooperation inthe elaboration of the mentioned problems within the framework of the CMEA, the use of the most modern and most perfect methods of scientific work and the accomplishment of all socio-economic and medical measures.

Academies and Institutes

[Analysis of the trends in typhoid-paratyphoid morbidity in the USSR].

Mathematico-statistical analysis of typhoid-paratyphoid infection morbidity in the USSR during 1900--1940 revealed a regular many-year cyclic recurrence of the changes in the morbidity level. The intensity of the morbidity level reduction at the periods of decline--in 1900--1917, 1920--1928, and in 1932--1939--was similar. A successive reduction of morbidity of this group of infections, by 6.45% on the average, annually, occurred in 1930--1976. The character of reduction of typhoid-paratyphoid infections morbidity level in the USSR during that period is well described by the exponential function.

Disease Outbreaks

[Epidemiologic analysis morbidity with meningococcal infections in the USSR].

The authors present the analysis of the incidence of epidemic cerebrospinal meningitis in the USSR from 1937 to 1974, and of meningococcus infection from 1965 to 1974. A rise of the meningococcus infection incidence from 1969 to 1974 was recorded 28 years after the elevation of 1940-1942 and was 1.5 times below this latter rise. The rise in 1969-1974 was characterized by marked signs peculiar to the infection with the droplet transmission mechanism; among those who contracted the disease prevalence was seen among children aged under 14 years (63-72%). A marked affection of juveniles was noted. Three types of the dynamic of the meningococcus infection incidence in the republics located in different climatic-geographical zones of the USSR were noted: slow, gradual increase of the level, interrupted and explosive. Such character was determined in the dynamics of the seasonal elevations of morbidity. Antiepidemic measures including a complex of nonspecific measures could not be assessed as sufficiently effective. This finds reflection in the natural course of the epidemic process of the meningococcus infection which remains uncontrolled. From the patients with generalized form of the disease meningococci of group A were isolated in 80-100% of cases, from the number of those typed. The group-specific reference of the nasopharyngeal strains depended on the epidemic situation: strains of serological group A prevailed at the period of the morbidity elevation, and other serological groups (particularly of C and B) increased at its decline.

Adolescent

[Spontaneous tumors in rats from the Rappolovo Breeding Nursery of the Academy of Medical Sciences of the USSR].

The authors report the data on the incidence of neoplasms in rats of the "Rappolovo" nursery breeding (USSR Acad. Med. Sci.) and their offsprings during 4 sequential generations kept in the vivarium of the N. N. Petrov Research Institute of Oncology of the USSR Ministry of Health. The frequency of spontaneous tumors in 213 male and 230 female rats was 25.8 and 35.7% accordingly. Totally, male animals developed 65 tumors, females--114. over 80% of all neoplasms developed in animals older than 18 months. The frequency of neoplasms of separate localizations in males and females was as follows: the hypophysis--7.0 and 12.6% correspondingly; the mammary gland--0.5 and 11.7%, the thyroid (thyroidal epithelium) - 1.4 and 3.0% and (light cells) 5.6 and 8.3%; the adrenal cortex--0.5 and 1.3%; the hematopoietic system --7.0 and 5.6%; parasitic sarcomas of the abdominal cavity --5.6 and 3.0%; the skin --0.4 and 0.4%; soft tissues --0.9 and 0%; the liver--0.4 and 0.4%; the kidneys --0.4 and 0.4%. Moreover, one male showed seminal vesicle tumor, and females-solitary neoplasms of the pancreas and salivary gland, the dura mater, the ovary and uterus. Significant differences were revealed in the frequency of spontaneous neoplasms in separate rat generations.

Adenoma

[Culicoides (Avaritia) sanguisuga, a new species of biting midges for the fauna of the USSR].

The occurrence in the USSR of C. (A.) sanguisuga Coq., a species recorded earlier only from North America has been stated. The species seems to have a wide distribution throughout the USSR. The description and figures of females and males collected in the south of Krasnojorsk territory are given. In the author's opinion the male of C. sanguisuga was repeatedly described in the Soviet literature but under other names (C. obsoletus, C. seimi). Morphological characters of females of four species of the subgenus Avaritia (C. sanguisuga, C. sinanoensis, C. chiopterus and C. filicinus) recorded from the region of observations are described.

Animals