Manifestations of angina morbidity as a reflection of the self-regulation of the epidemic process in streptococcal infection

The data on the application of the principles of the self regulation of the epidemic process for understanding the annual dynamics of angina morbidity in organized groups of adults are presented. In this case the reservation of group A streptococci occurs in chronic (resident) carriers, whose proportion was found to be 15.8 +/- 2.6%. The epidemic manifestations of morbidity are regulated mainly by the concentration of newly arrived members in the groups, i. e. by the size of the stratum providing the optimum conditions for the parasitization of the streptococcal population. The annual morbidity levels depend essentially not only on the heterogeneity of the group members with respect to their susceptibility to streptococcal infection, but also on the conditions of their accommodation, affecting the transmission of droplet infection. The role of individual risk factors in the variation of the quantitative characteristics of the angina morbidity manifestations under study is calculated.     

The epidemic process of an acute streptococcal respiratory infection in large organized collectives of children

The study of the specific features of the development of the epidemic process of scarlet fever, tonsillitis, and acute respiratory diseases (ARD) in two large organized groups of children revealed the presence of some differences which depended on the character of prophylactic measures taken in these groups. Thus, in the absence of prophylaxis with bicillin a pronounced increase in the level of carriership, accompanied by an increase in the infective capacity of carriers, was noted. This resulted in a high level and unfavorable dynamics of morbidity in scarlet fever, tonsillitis, and ARD. On the contrary, the use of prophylaxis with bicillin ensured the stability of the level of carriership, while the infective capacity of carriers was not pronounced. At the same time a rise in ARD morbidity was insignificant, and morbidity in scarlet fever and tonsillitis was reduced to nil.     

The characteristics of HIV infection during a sharp activation of the epidemic process in Rostov Province

A considerable growth in cases of HIV infection in Rostov Province was registered in 1996-1997. Number of men was 525, number of women--196 cases, were registered. The highest index of HIV infection was noted in group of tested by epidemiological evidence (4494,4 per 100,000 tested persons), which was 57.2 times higher than the average level for this region. The growth in the number of infected persons was due to the import of HIV from the territory of Ukraine and the subsequent spread of the virus among drug addicts introducing drugs by intravenous injection.     

The plasmid composition and pathogenetic characteristics of Yersinia pseudotuberculosis strains isolated from human subjects against a background of epidemic and sporadic morbidity

112 newly isolated clinical cultures of Y. pseudotuberculosis have been studied. The strains have been characterized by the presence of plasmids and pathogenicity signs associated with plasmids. The results of the study have confirmed the decisive role of the plasmid with a molecular weight of 44-48 MD in the virulence of Y. pseudotuberculosis. The plasmid with a molecular weight of 82 MD, previously attributed the role of an epidemic marker, has also been found to be widely spread. Our study has revealed no specific features in the plasmid composition of the strains isolated under the conditions of sporadic and epidemic pseudotuberculosis morbidity. The results of the study of the pathogenicity of isogenic derivatives differing by the presence of pXV indicate that the role of plasmids with molecular weights of 3.8 and 82 MD in this process is not essential in the model systems, traditional for enteroinvasive Yersinia.     

Molecular genetic characteristics of the B. pertussis strains isolated in different periods of the pertussis epidemic process

Despite the fact that the mass immunization of the children population with the DPTs vaccine has been carried out in the Russian Federation since 1959, the pertussis infection persists to be one of the pressing problems for the children population. Although the vaccination coverage of the children population with pertussis vaccines is high in Russia, at present time the pertussis incidence rates are increasing among schoolchildren and remain high among infants younger than 12 months old. Many researchers believe that the variability of the genetic structure of the pertussis causative agent may be one of the causes of increasing pertussis incidence rates. This investigation provides the molecular genetic characteristics of 97 B. pertussis strains isolated in pertussis patients in Moscow in different periods of pertussis epidemic process since the 1950s up to present time. It shows the changes in the structures of genes, which are encoding the main protective antigens of the pertussis microbe that are the pertussis toxin (ptxS1) and the pertactin (pm). The structurre of the ptxS1 and pm gene of the B. pertussis vaccine strains was compared with the structures of these genes in the B. pertussis strains isolated from the pertussis patients at present time and also in past years. All B. pertussis strains isolated in the prevaccination period (1948-1959) and most strains (95%) isolated during the first twenty years of the mass immunization in Russia are characterized by the presence of the so called "vaccine" alleles of the pertussis toxin and pertactin genes that are ptxS1 B or ptxS1 D and pm 1 alleles that corresponds to the genetic structure of the vaccine producing strains. In the early 1970s the B. pertussis strains of another toxin and pertactin genetic structures with so-called "non-vaccinal" alleles ptxS1 A and pm 3 (pm 2 since 1980s) began to appear. The B. pertussis strains with "non-vaccinal" alleles have completely displaced the "old" strains. At present time in Moscow the pertussis disease is caused by the B. pertussis strains bearing ptxS1 A and pm 2 or pm 3 alleles of pertussis toxin and pertactin genes. There was no correlation between the genotype and serotype. Thus, the structure of the B. pertussis toxin and pertactin genes in strains which have been isolated since the 1980s up to now differs from the structure of these genes in strains which are used for producing DPTs vaccine. The data obtained in this investigation suggest that the genetic structure specificity of circulating B. pertussis strains that are producing the disease at present time should be used as one of the criteria for selecting vaccine producing strains.     

On the critical behavior of the general epidemic process and dynamical percolation

Scaling laws are formulated for the behavior of a space-dependent fluctuating general epidemic process near the critical point. Restricted to stationary properties, these laws describe also the critical behavior of random percolation. Monte Carlo calculations are used to estimate the critical exponents and the universal shape of the propagating wave, in the case of 2-dimensional space.     

Direct sequencing of hepatitis A virus strains isolated during an epidemic in France.

Direct sequencing of PCR products was used to study the VP1 region of the hepatitis A virus (HAV) genome (position 2199 to 2356) of nine strains isolated from human stools collected during a hepatitis A epidemic (western France, 1992), three strains from environmental samples (1990, 1991, and 1992), and two HAV cell culture isolates (the French strain CF53/Lyon and strain CLF). These viruses differed from CF53/Lyon (genotype I) by between 1 and 10.3%, and results indicated the existence of two groups of strains belonging to two different subgenotypes (IA and IB). With this sequencing technique it was possible to monitor the epidemiology of HAV and study its relations.     

The characteristics of the epidemic process of hospital infections in maternity hospitals influenced by an operational management system]

As shown in this investigation, the introduction of the algorithmic system of the control of the epidemiological process of hospital infections (HI) in maternity hospitals makes it possible to reduce HI-induced morbidity and mortality rates more than by half, as well as to alter their nosological and age structures, without additional economic expenditures and under the existing material conditions of maternity hospitals. Such success is achieved by the observation of infection precursors indicating the activation of the mechanisms of the transmission of Staphylococcus, Escherichia and Klebsiella infections and the risk factors (preconditions) facilitating this activation with the immediate involvement of all relevant specialists into action at the stage when an increase in the contamination of newborns and puerperal women is noted and not as late as at the stage of morbidity and mortality.     

The epidemic process as a system. The social regulators of the epidemic process

The article deals with the mechanisms of spontaneous (urbanization, the international migration of population, the anthropogenic transformation of nature) and goal-oriented regulatory action on the epidemic process. Social factors have been shown to transform into ecological ones with the subsequent transformation of information in the parasitic system and their reflection in the social subsystem as the indices of the risk of infection and its socio-economical importance. Using the processes of urbanization as an example, the present work demonstrates that the mechanism of transmission acts as a filter whose specific features are determined by a range of social factors playing the most important role in the regulation of the epidemic process on the socio-ecosystemic level of its organization.     

The manifestations of an epidemic process of typhoid infection in Moscow

The work deals with the results of typhoid morbidity in Moscow for the period of 1980-1988. The morbidity rate varied from 0.98 to 0.17 cases per 100,000 of population with a tendency towards decrease. In the structure of morbidity local cases accounted for 46.8% and cases of infection contacted outside Moscow accounted for 53.2%. The morbidity level was low throughout the whole territory, only in two districts morbidity rate was significantly higher (P = 95%) than the average morbidity rate in the whole of the city. In the group of local cases morbidity had no pronounced seasonal character, in contrast to cases due to infection contacted outside the city which were mostly registered in summer and autumn. Persons aged 21-30 years were found to be the most affected age group. The general factors, and not the contact route, are supposed to play the main role in the realization of the mechanism of infection transfer. Under modern conditions, some manifestations of the epidemic process of typhoid infection can be detected only at the level of the whole city, or even the whole country.     

The role of fibronectin in the streptococcal adhesion process

The work shows that fibronectin obtained from human plasma is capable of binding with streptococci of different groups with almost equal effectiveness. Fibronectin bound to bacterial cells inhibits the adhesion of group A streptococci onto vaginal cells, but it produces no effect on the adhesion of group B streptococci. The binding constant of fibronectin 125I is equal to 10(6) -M-1, which indicates that the level of the specificity of interaction is not sufficiently high.     

The system of the epidemic process

An original social-ecological concept of the epidemic process has been constructed on the basis of using social ecology, systemic approach and the basic principles of cybernetics. According to this concept, the epidemic process is regarded as a biosocial, hierarchic, integral system providing for the reproduction of the species of human parasites. At a higher level of organization, the epidemic process is an epidemiological social-ecological system consisting of two interacting subsystems: the biological (epidemiological ecosystem) and the social (social and economic conditions of life of the society) subsystems where the biological subsystem plays the role of the governed object and the social acts as the internal regulator of these interactions. On the basis of this concept a rational structure of the system of epidemiological surveillance over infectious diseases has been proposed according to which each level of the structure of the epidemic process should be subject to adequate monitoring.     

The epidemic process as a system. I. The structure of the epidemic process

A new epidemiological concept (socio-ecological) has been formulated on the basis of the principles of the theory of systems and the theory of information. In accordance with this concept, the epidemic process is organized on the same principle as living matter, and the stability of this process at all levels of its organization is ensured by the processes of self-regulation. The conditions of the life of human society have been shown to be organically incorporated into the structure of the epidemic process as a regulating subsystem on the socio-ecological level.