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[Conditions and factors determining the etiological structure of dysentery and its changes. Report 1. Epidemiological theory of etiological selectivity of the main (primary) pathways of infection and their differences in various nosological forms of dysentery].

The authors present the elaborated and formed epidemiological theory ("conformity theory") according to which the etiological structure of dysentery is determined by the etiological selectivity of the main (primary) waves of transmission of the infection differing in various nosological forms of dysentery. In Grigoriev-Shiga dysentery the domestic way of the spread of infection plays the main role, in Flexner and Newcastle dysentery--the water way, and in Sonne dysentery--the food way (particularly through the milk). Evolution of the etiological structure of dysentery serves as the reflection of evolution of the principal ways of transmission. The complex of prophylactic and antiepidemic measures in individual noslogical forms of dysentery should be differentiated and be directed in epidemiological sense to the neutralization of the corresponding main (primary) way of transmission of the infection.

Dysentery, Bacillary

Prevention of swine dysentery with a combination of lincomycin and spectinomycin and resistance of swine dysentery to tylosin and sodium arsanilate.

The addition of a combination of lincomycin and spectinomycin to feed at the total concentrations of 44 and 77 mg/kg, beginning at the time of exposure and continuing for 8 weeks, prevented experimentally induced swine dysentery in swine. The disease did not develop after the medication was withdrawn. In contrast, swine dysentery, similar to that seen in the nonmedicated swine, did develop in simultaneously exposed swine treated with feed containing either 44 mg of tylosin or 99 mg sodium arsanilate/kg. The swine fed sodium arsanilate and which developed hemorrhagic diarrhea had a more severe form of this type of diarrhea than did the nonmedicated swine. After reexposure to inefective inoculum of swine dysentery 86 days after initial exposure, all remaining swine previously medicated with either tylosin or sodium arsanilate and all nonmedicated swine were immune; whereas 17 of the 24 swine fed the combination of lincomycin and spectinomycin were susceptible to swine dysentery and developed diarrhea.

Aniline Compounds

Immune processes in the course of infection with dysentery bacilli. III. Protective activity of spleen cells and serum from mice immunized with killed dysentery bacilli.

Killed dysentery bacilli induce immunity in mice which can be transferred to other mice with serum. Spleen cells do not transfer this immunity, in contrast to spleen cells from mice immunized with live dysentery bacilli. The results of this and previous studies 5,17 suggest that immunity in mice infected with dysentery bacilli depends on two coexisting effector mechanisms--cell-mediated and humoral immunity. Live bacilli induce both, however killed bacilli stimulated humoral immunity and protect mice equally effectively against lethal infection with dysentery bacilli.

Animals

[Epidemiology of dysentery in Dagestan].

Analysis of material on bacterial dysentery and other acute intestinal infections morbidity in the Dagestan ASSR for a period of 15 years showed high morbidity level and its variations, with reduction and elevation in individual years, and the leading role played by Shigella flexneri among the causative agents of dysentery. The greatest incidence of dysentery was revealed among children aged under one year and between 1 and 2 years. A high bacterial dysentery incidence was recorded in Dagestan throughout the whole year. However analysis of the seasonal dysentery curve showed the beginning of elevation in July, reaching the maximum in August, and lasting four months with a decline beginning in October. The persisting activity of the water route of dysentery transmission in the Dagestan ASSR requires particular attention to the organization of good-quality water-supply to the population of the republic.

Adolescent

Studies on the pathogenesis of swine dysentery. I. Characterization of the lesions in colons and colonic segments inoculated with pure cultures or colonic content containing Treponema hyodysenteriae.

Swine dysentery was induced in pigs and in ligated colonic segments by inoculation of pure cultures of, or colonic contents containing, Treponema hyodysenteriae. The mildest changes, best seen in ligated segments 48 or 72 hours after inoculation, were congestion and leucocytic margination in mucosal capillaries and depletion of mucigen from goblet cells lining the base of the crypts of Lieberkühn. Superficial mucosal necrosis and crypt cell hyperplasia were later changes. Perfusion studies with India ink did not demonstrate occlusive mucosal ischemia in acute swine dysentery. Mucosa with lesions of swine dysentery contained at least 10(5) colony forming units of T. hyodysenteriae per gram. Mucosa without lesions had 10(5) or fewer T. hyodysenteriae per gram. Segments with acute swine dysentery were distended with clear mucoid fluid with electrolyte composition indicative of net colonic secretion. No increase in the concentration of volatile fatty acids was detected in content from intact colons or colonic segments with lesions of acute swine dysentery.

Animals

[Quantitative characteristics of the immunocompetent cells of the large-intestinal mucosa in acute dysentery].

Histological and immuno-morphological examinations of the large intestine mucosa obtained by aspirational biopsy from 38 adult patients with acute dysentery in the mild, moderately severe and severe forms and from 4 normal subjects were carried out. In each case, a per cent ratio of immunocompetent cells in deep and superficial parts of the mucous membrane proper, the content of interepithelial lymphocytes, the cell density of infiltrate per 1 mm2 of the mucous membrane, the number of cells producing IgA, IgM, and IgG per 1 mm2 of the mucous membrane were determined. As the severity of clinical and morphological manifestations of dysentery increased, the number of cells actively producing immunoglobulins was found to increase and epithelium infiltration with lymphocyte to be enhanced. The main role in the development of local immune response in dysentery is played by IgA-producing cells, and in the moderately severe and severe forms of dysentery the number of IgM-producing cells increases.

Adult

[Experience with the diagnosis of dysentery in adults by determining antibodies to Shigella in the saliva].

Concentration of immunoglobulins and titres of antibodies to Sh. sonnei, Sh. flexneri and enteropathogenic E. coli 0111 was determined in mixed saliva and the blood serum of patients suffering from Sonne dysentery, acute intestinal diseases of unknown etiology, and healthy individuals. The sum total immunoglobulin concentration in mixed saliva proved to be 53--81 times less than in the blood serum, but in the first substrate there was 53--75, and in the second--15% of immunoglobulin A. There proved to be distinct changes in the specific IgA-antibodies in the saliva of patients with Sonne dysentery. A preponderant accumulation of IgG-antibodies was noted in the blood serum. Elevation of both types of antibodies was maximal during the second week of the disease. Sonne dysentery was diagnosed in 80% of the patients by recording the intensity of shifts in the specific antibodies in the saliva, and in 63%--in the blood. The expediency of immunological testing of saliva for the diagnosis of dysentery is substantiated.

Adult

[Immunoglobulin and antibody content in the blood serum, coprofiltrate and saliva of patients with Sonne dysentery].

The authors studied the immunoglobulin and specific antibodies content of various classes in the serum, coprofiltrates and the saliva of 68 patients suffering from Sonne dysentery and in 48 healthy adult persons. Mancini's test demonstrated a significant elevation of IgG and IgM content in the blood of dysentery patients in comparison with that in healthy persons, and the absence of any changes in the IgA content. The titres of specific IgG-, IgA- and IgM-antibodies in determination in the modified Coombs' test increased consideerably during dysentery infection and were found in high titres during the first week of the disease; they reached the maximum during the second week and persisted at this level for 3 weeks. The greatest antibody elevation was in the IgA-class. Antibodies revealed in the coprofiltrates and the saliva of dysentery patients belonged to IgA- and IgG-class. There proved to be a correlation of the antibody changes in these two secretions.

Adult

[Cellular immunity factors in dysentery].

Cellular immune response was studied in 89 adult patients suffering from various clinical forms of acute dysentery, with the use of the lymphocyte blast-cell transformation reaction under the action of a specific antigen (dysenterin) and a nonspecific mitogen (phitohemagglutinin). Functional value of T-lymphocytes proved to be retained in patients with acute dysentery; there was also lymphocyte stimulation by a specific antigen in patients with moderately severe and severe forms of dysentery during the first week of the disease. Specificity of blast-cell transformation of sensitized lymphocytes under the action of dysenterin was shown. Patients with a high percentage of the lymphocyte blast forms displayed a more rapid positive progress of the main clinical indices at the height of the disease than analogous patients with a low blast percentage in the blood. The expediency of using the blast-cell transformation reaction for differential diagnosis and prognosis of moderately severe and severe forms of acute dysentery is discussed.

Acute Disease

[Data to substantiate the early immunological diagnosis of dysentery].

The interaction of the whole blood from patients with dysentery and gastrointestinal diseases of non-dysenteric etiology, with the causative agents of dysentery, Sh. sonnei and Sh. flexneri, and saprophytic, staphylococci labeled with radioactive isotopes was studied in vitro. In dysentery an increase in the capacity of the blood for Shigella fixation was observed from the beginning of the disease. During the 1st week of the disease this reaction was strictly specific and accompanied by a decrease in the fixation of staphylococci, but later the reaction became relatively specific. An increase in Shigella fixation occurred considerably earlier than immune antibody formation, as revealed by the indirect hemagglutination test. This research substantiates the possibility of an earlier immunological diagnosis of dysentery as compared with the serological methods.

Acute Disease

[Seasonal problems of bacterial dysentery in the Dagestan ASSR].

During the period of 1959-1973 bacterial dysentery showed high morbidity rate in Daghestan in all seasons, this tendency existing both in urban and rural areas. The peculiarity of the monthly distribution of dysentery cases, observed all over the repulic, was the shift of the morbidity peak from August to September-October, and in some years even to November; this could be clearly observed from the analysis of the material as a whole and from the analysis of dysentery morbidity rates in rural and urban areas separately. This rise in dysentery morbidity rate in August--September might be due to the reassembling of children at various institutions after their mass return from summer resorts in the country, as well as to thhe influx of new children to crèches and kindergartens. Moreover, as the period of August--September is the bathing and fruit-harvesting season in Daghestan, a rise in morbidity rate in these months was obviously caused by the unsatisfactory level of sanitation and hygiene due to an acute deficiency of water.

Acute Disease

[The cathode bound group antigen of dysentery-provoking escherichieae (author's transl)].

Antigens from disrupted cells of dysentery-provoking and of non-enteropathogenic Escherichieae were submitted to immunoelectrophoresis on cellulose acetate stripes at pH 8.0. Among 6 immune sera produced for this purpose by immunizing rabbits against desintegrated dysentery bacteria, only one contained a precipitine reacting with an antigen similar to the "generic antigen" of BELAYA. This - at pH 8.0 - cathode-bound group antigen (KGA) could not only be found in virulent but also in 5 attenuated cultures and in 5 from 6 avirulent strains of several dysentery types. Only the - apathogenic - type culture 1111/55 of dysentery-provoking E. coli O 136 showed no KGA-reaction. Some sources of methodical errors responsible for false outcomes of immunopherogrammes have been discussed.

Antigens, Bacterial

[Etiology of porcine dysentery].

The etiological agent of swine dysentery is an anaerobic spiralshaped microorganism of the Treponema genus. Examination of a scraping from the mucous membrane of the large intestine or the examination of faeces in a native preparation by phase contrast are the fastest diagnostical methods of determining swine dysentery. Large treponemas, as predominating microflora, 6--9 micrometer long, 0.3--0.4 micrometer in diameter, spiralshaped and moving in a serpentine way are found in faeces and the mucous membrane in the case of acute swine dysentery. These large treponemas were identified in 14% of clinically healthy pigs but in very small numbers. Treponemas are sensitive to their habitat. Treponemas survive for up to five days only in faeces which are suitably reduced. This finding is important both for subduing the infection and for diagnosis.

Animals

[Experimental study of the effectiveness of antibacterial preparations in treating dysentery].

It was found that for successful elaboration of effective schemes for the use of antibacterial drugs in treatment of dysentery it was necessary to exploit various experimental models providing consideration of the drug toxicity and effect on the extra- and intracellular growth of the bacteria in addition to the other factors. The administration of enteroceptol for 3 days followed by furazolidon showed the best therapeutic effect in the treatment of guinea pigs with Shigella keratoconjunctivitis and Syrian hamsters with dysentery. The above drugs had low toxicity which was shown in the experiments with Hep-2 cell cultures. It was concluded that the use of the drugs with different modes of action was advisable in treatment of dysentery.

Animals

[Formation of the dysentery epidemic process in three small towns].

Data are presented concerning the epidemiological analysis of Sonnei dysentery outbreaks in three towns connected by common nutrition and water supply. The epidemic processes in these populated localites were strongly interrelated. Possibilities of the effect of the water factor on the extent of Sonnei dysentery incidence were studied as well. The results of studies led to the conclusion on the presence of numerous action forms of the water factor which should be taken into consideration in carrying out prophylactic and antiepidemic measures in Sonnei dysentery.

Dairy Products

[Results of treatment of dysentery patients with streptomycin-dependent vaccine in comparison with other methods of treatment].

Comparative study of various methods of treatment was carried out on 777 patients suffering from acute dysentery with a bacteriologically confirmed diagnosis. To assess the therapeutic efficacy, along with consideration of clinical signs of the disease, immunoglobulin level was examined in the blood and coprofiltrates; also the state of reparative processes in the mucosa was appreciated by the histological examination of the biopsy material. Results of the work carried out indicated the inexpediency of the treatment of this disease with a combination of levomycetin and phthalazol. The use of live streptomycin-dependent dysentery vaccine was indicated in protracted torpid dysentery and was of no avail in acute form of the disease. A good therapeutic effect was observed with the application of pathogenetic therapy alone.

Acute Disease

[Treatment of dysentery in children with a combination of monomycin and Eleutherococcus].

An acute dysentery process was studied in 100 children at the age of 1 to 14 years treated with monomycin; 54 patients (the 1st group) were treated with monomycin in combination with eleuterococcus and 46 patients (the 2nd group) were treated with monomycin alone. The dysentery process in the both groups was close. However, the increase in the levels of gamma-globulin, antidysentery antibodies and the phases of changes in the index of phagocytosis completeness during the disease were more pronounced in the patients of the 2nd group than those in the children of the 1st group. Recovery of the patients of the 1st group was registered earlier. It was concluded that eleuterococcus as an adaptagen provided recovery of the patients at lower efforts of the protection mechanisms. Wide use of eleuterococcus in combination with monomycin for the treatment of children with dysentery is recommended.

Acute Disease

[Experimental study of the pathogenesis of dysentery].

It was shown that experimental dysentery could be produced against the background of various pathologic conditions of experimental animals (avitaminosis, concurrent diseases, etc). The studies in vivo and in vitro showed that intraepithelial parasitising of Shigella occurred in dysentery but did not play the leading role in the pathogenesis of the disease. Macrophages played a more important role, particularly in formation of the bacterial carrier state. In order to resolve some disputable problems of the pathogenesis of dysentery it is necessary to take into account the biological properties of the causative agent which change under the influence ov various effects, as well as the state of reponsiveness of the host.

Animals