Criteria of the epidemiological surveillance of meningococcal infection

The results of studies carried out with the use of the unified, specially developed methods in eight regions of the USSR are generalized. Basing on the analysis of the results, the leading role of serogroup A meningococci in the rise of morbidity is emphasized, the relation of the morbidity level to the serogroup composition of meningococci circulating among healthy population is revealed, the necessity of carrying out selective bacteriological surveys with a view to establish the serogroups of meningococci circulating among the population is shown. The expedient criteria to be used in the system of epidemiological surveillance of meningococcal infection are presented.     

Current epidemiological surveillance of tuberculosis

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.     

The epidemiological characteristics of meningococcal infection in the USSR

The epidemiological analysis of morbidity in meningococcal infection in the USSR in the period of 1969-1987 showed that the second rise of the morbidity level occurred in 1984 and was followed by its decrease in most of the regions of the USSR. This study also revealed that the characteristic feature of the second rise of morbidity in meningococcal infection was a considerable involvement of young children (aged up to 3 years), as well as the increased etiological role of group B meningococci in cases of meningococcal infection and the circulation of these microorganisms among the population. Besides, the preservation of the etiological importance of group A meningococci in many regions of the USSR, especially among adults, was noted. In this connection, the use of Soviet group A meningococcal polysaccharide vaccine on epidemiological indications was considered to be epidemiologically substantiated.     

Current problems of the epidemiological surveillance of poliomyelitis

A uniform program of the epidemiological supervision of poliomyelitis must be worked out for every administrative territorial unit. This program should include the early and complete detection of all cases of this infection, irrespective of their severity; the analysis of the quality of vaccination; the determination of the immune status of the child population; the characteristic of the poliovirus circulation.     

Method for the short-term prognosis of annual morbidity indices in Sonne-type dysentery

A method for making the short-term prognosis of the annual morbidity rate in Sonne dysentery, both total and among individual groups of population, is presented. The preliminary prognosis is based on the expected data on meteorological factors, supplied by the weather forecast service, and the final prognosis, on the actual prognostic factors for June-July of the current (prognosed) year.     

The principles of pre-epidemic diagnosis in the epidemiological surveillance system for HIV infection

The problem of the general introduction of the principles of the pre-epidemic diagnostics of HIV infection was discussed. These principles should be based on the observation of "model" infections (viral hepatitides B, C, D), multipurpose serological monitoring and sociological methods aimed at obtaining the necessary information. The suggestion that the age and sexual structure of HIV-infected patients would be determined by the route of HIV transmission, prevailing on a given territory, including into infection process adolescents and young women and men was made.     

International and national aspects of epidemiological plague surveillance in the USSR.

General principles and organizational forms of epidemiological surveillance of plague in the USSR both in seaports andin natural foci are discussed. On the basis of the analysis of the authors' experience over many years and taking into consideration literary data, the authors recommend a minimum, but in their opinion effective amount of a successful realization of these recommendations, it is expedient to establish a special team (or teams) consisting of 10-12 members.     

Detection of individuals within a group of risk for meningococcal infection morbidity in organized collectives

The survey of 2,500 persons in different educational organized groups has been carried out by the method based on the study of changes occurring in the standard population of group A meningococci due to its interaction with the surviving culture of human leukocytes. The heterogeneity of humans with regard to the individual antimeningococcal activity of their blood irrespective of their levels of humoral immunity and complement activity has been revealed. The survey has shown the possibility of detecting the groups of risk among the members of organized groups having, according to our data, a significantly higher level of morbidity in generalized meningococcal infection and meningococcal carriership (including epidemiologically important groups A, B and C).     

Epidemiological surveillance of meningococcal infection and the prediction of the development of an epidemic process

The signs necessary for the prognostication of the development of the epidemic process have been formulated on the basis of the epidemiological analysis of materials obtained in the process of trials of the system for the surveillance of meningococcal infection with the use of previously established characteristics. The data on the prevalence of meningococcal infection among different age groups and on the seasonal distribution of the infection as well as on the serogroups of meningococci isolated from patients, have been shown to be of importance for prognostication.     

A surveillance network for meningococcal disease in Europe

Between 1999 and 2004, the European Union Invasive Bacterial Infections Surveillance Network (EU-IBIS) received c. 50,000 reports of meningococcal disease from 27 participating countries. Analysis has demonstrated a major decline in the incidence of invasive disease in those countries that have introduced routine vaccination against serogroup C infection. The establishment of rapid reporting of W135 and B2a/B2b strains has been able to provide early reassurance that these strains are not emerging as major public health problems in Europe. Between September 2001 and February 2005, the EU-MenNet project offered further opportunities for enhancing this data resource. Collaborative projects included: improving the EU-IBIS website; reviewing case ascertainment in Europe; reviewing cost-effectiveness studies for meningococcal serogroup C conjugate (MCC) vaccination; international comparisons of MCC vaccine efficacy; and mathematical modelling studies. In addition, linking of data from the European Meningococcal Multi-locus Sequence Type Centre to epidemiological data was performed. Particular clonal complexes were found to be preferentially associated with certain serogroups. Case fatality was also found to vary with clonal complex, suggesting that genotype can be a marker for hypervirulence. The importance of close collaboration between networks of epidemiologists, microbiologists, and the wider scientific and public health community is demonstrated.     

Multilocus sequence typing for global surveillance of meningococcal disease

The global surveillance of bacterial pathogens is particularly important for bacteria with diverse and dynamic populations that cause periodic epidemics or pandemics. The isolate characterization methods employed for surveillance should: (1) generate unambiguous data; (2) be readily implemented in a variety of scenarios and be reproducible among laboratories; (3) be scalable and preferably available in a high throughput format; and (4) be cost effective. Multilocus sequence typing (MLST) was designed to meet these criteria and has been implemented effectively for a wide range of microorganisms. The 'Impact of meningococcal epidemiology and population biology on public health in Europe (EU-MenNet)' project had amongst its objectives: (1) to disseminate meningococcal MLST and sequence-based typing throughout Europe by establishing a centre for training and data generation, and (2) to produce a comprehensive Europe-wide picture of meningococcal disease epidemiology for the first time. Data produced from the project have shown the distribution of a relatively small number of STs, clonal complexes and PorA types that account for a large proportion of the disease-associated isolates in Europe. The project demonstrates how molecular typing can be combined with epidemiological data via the Internet for global disease surveillance.     

The organization of an epidemiological surveillance of HIV infection in Krasnodar Territory

For the first time a case of AIDS was detected in the Krasnodar Territory of the USSR, and the presence of HIV infection in homosexuals, foreign students, and promiscuous persons was established. To study the spread of HIV infection, 5 diagnostic laboratories were created and 5 routes for the transportation of sera were organized. This permitted the screening of the population in 1988 with the complete coverage of groups to be placed under surveillance.     

The role and place of serologic research in the system of epidemiologic surveillance of meningococcal infection

The results of serological surveys, carried out with a view to the detection of capsular meningococcal polysaccharides in the passive hemagglutination (PHA) test and covering 1,289 patients with systemic meningococcal infection, 221 patients with bacteriologically confirmed meningococcal nasopharyngitis, 2,820 persons in organized groups of children and adults with different epidemiological situation (including 650 carriers) and 4,050 residents of 8 cities with different morbidity levels, were analyzed. The patients, the carriers and the members of organized groups underwent multiple surveys. As shown in this study, the confirmation of the meningococcal etiology of the systemic forms of meningococcal infection (meningitis, meningococcemia) in all cases with the exception of children under 1 year of age, as well as the determination of the groups of meningococci, could be achieved in the PHA test twice as frequently, i.e. in 60-70% of cases, as with the use of the bacteriological method. The same regularities were observed in nasopharyngitis. The conclusion was made on the possibility of using the PHA test for more exact determination of the group of meningococci, prevailing at the initial stage of diseases, this determination playing an essential role in the epidemiological surveillance. The data obtained as the result of serological surveys in organized groups may lead to conclusions on the circulation of meningococci and their group composition, thus showing the necessity of profound epidemiological study with ensuring epidemic-control measures. The selective serological study of some hundreds of donor sera is not expedient in big cities, as it provides no data on the circulation of meningococci there.(ABSTRACT TRUNCATED AT 250 WORDS)     

Complex method for epizootiological and epidemiological surveillance

A complex method for the epizootological and epidemiological surveillance of a number of bacterial and viral infections on the territories inside and outside their natural foci has been developed. The investigation techniques are described and the data on the isolation rate of each causative agent in different geographical zones are presented. In the natural foci of plague and tularemia, as well as on the territories outside such foci, the causative agents of intestinal yersiniosis, pseudotuberculosis, salmonellosis, erysipeloid, staphylococci and streptococci, arena- and arboviruses have been isolated from the rodents and ectoparasites under study. The results of this investigation suggest that the method may be recommended for use in medical institutions dealing with the problems of infections originating from natural foci.     

The bases of epidemiological surveillance for postinjection complications

To carry out the epidemiological analysis of postinjection suppurations and to introduce the relevant prophylactic measures, the forms of registration and account for suppurative inflammatory diseases should be legitimized and the data on such cases per the number of injections made at therapeutic and prophylactic institutions and their branches should be calculated. The organization of centralized sterilization of instruments and the 100% provision of all institutions with these instruments can reduce the occurrence of postinjection suppurations.     

Some aspects of the use of the level of bacteriological confirmation in the epidemiological analysis of dysentery morbidity]

On the basis of studying the seasonality and the age composition of dysentery morbidity in comparison with the corresponding levels of bacteriological confirmation the authors suggested a method of recalculation of morbidity with consideration to this parameter. This method could be used in epidemiological analysis.     

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.     

Results of a controlled epidemiological trial of the application of placental gamma globulin in foci of meningococcal infection]

Controlled epidemiological trial was applied to the study of the use of placental gamma-globulin for prophylaxis of generalized forms of meningococcus infection in the foci (creches and kindergartens). A group of the vaccinated children (16 140) and control group (16 080) were the same age and sex. Gamma-globulin was administered in a dose of 3 ml to every other child attending creches and kindergartens not later than the 10th day after the patient's isolation. It was shown that the efficacy coefficient of gamma-globulin in the foci of meningococcus infection constituted 68% (the efficacy index was 3.2) for one month after the administration.     

Mycobacterium bovis infection in primates in Dublin Zoo: epidemiological aspects and implications for management

An outbreak of tuberculosis in non-human primates was successfully contained in the isolation area of Dublin Zoo. A Mayotte lemur, a lion-tailed macaque, a Patas monkey and a Siamang gibbon developed tuberculosis, and Mycobacterium bovis was isolated from all but the lemur, from which lesions were not cultured. Procedures for the prevention of tuberculosis in primate collections and for the management of outbreaks are discussed. The need for typing of the isolated pathogen is emphasized.     

Antibodies to meningococcal lipopolysaccharide in different forms of meningococcal infection

The results of the determination of antibodies to lipopolysaccharide (LPS) in 270 patients with different forms of meningococcal infection and in 816 healthy persons by means of the passive hemagglutination test are presented. The role of antibodies to LPS in the formation of humoral immunity to meningococci in sick children and adults is shown. Different forms of meningococcal infection have been found to have their specific features of the accumulation of antibodies to LPS. As revealed, the time of the sanation of liquor and the level of antibodies to LPS are unrelated, which indicates that antibodies to LPS may play some role in the pathogenesis of meningococcal infection.