Social and economic significance of enterovirus infection and its role in etiologic structure of infectious diseases in the world

Human enteroviruses comprised by more than 100 serotypes, they spread everywhere and can cause wide spectrum of diseases as well as significant social and economic loss. Influenza-like illness and mild forms of enterovirus infection (herpangina, exanthema) are widespread and causes of significant number of visits in clinics. Economic cost of mild form of enterovirus infection is not high although great number of cases (10 - 15 mln cases yearly in USA) determines its important economic significance. Single cases and outbreaks of enterovirus aseptic meningitis occur less frequently but lead to significant economic burden due to hospitalization costs. Enteroviruses are also cause up to 30% of sepsis-like disease in newborns and play important role in infant morbidity and mortality. Potential of enteroviruses as a source of new diseases in humans has a special significance for practical healthcare. In XX century enteroviruses became a cause of pandemics of paralytic poliomyelitis, hemorrhagic conjunctivitis, and foot-and-mouth-like disease, which caused vast social and economic loss, and emergence of new forms of enterovirus infection is quite possible in XXI century.     

成人急性感染性腹泻治疗新进展

成人急性感染性腹泻与儿童感染性腹泻在发病率、严重程度、预后等方面有所不同,其治疗以补液、止泻为主,必要时使用抗微生物药物。近年来,成人急性感染性腹泻在补液治疗和益生菌、新止泻药物应用等方面更新了一些新的循证医学证据,在进一步确保现有药物安全性的同时促进了腹泻治疗思路与手段的发展。     

Monitoring of etiological agents of acute enteric infections in the Moscow region

The fecal microflora of patients with acute enteric infections (AEI) has been examined on the territory of the Moscow region. The pathogens of high, moderate and low priority levels have been detected. As revealed in this study, shigellae, salmonellae, enteropathogenic and enteroinvasive Escherichia are the etiological agents of bacterial diarrheas on the territory of the Moscow region. The dynamics of the etiological agents of AEI in the region has been established.     

Types of immune response in acute infectious diseases

The author's concept on the system of self regulation of immune response is described. Four types of this response are proposed, which differ by total intensity of cytokine reaction, the development time as well as manifestation degree of non specific immunosuppression, and, most importantly, the profile of specific immune response to the antigens of the infective agent. These four types of immune response are closely linked with increased severity of clinical manifestations.     

Use of the dot-immunogold assay for the rapid diagnosis of acute enteric infections

A simple method based on an immunodot assay using colloidal gold labels is proposed for the rapid diagnosis of a range of acute enteric infections. Owing to its rapidity, high sensitivity, and specificity, the method can be recommended for routine use in the laboratory diagnosis of enteric infections.     

Detection of tissue specific antigen-binding lymphocytes in patients with acute enteric infections

A total of 88 patients with salmonellosis, acute dysentery, alimentary toxicoinfection, acute gastroenterocolitis were examined. The study was aimed at early determination of the involvement of organs and tissues into the inflammatory process and detection of antigen-binding lymphocytes with the use of erythrocytic immunoreagents prepared from tissue antigens of mucous membranes of small and large intestine, duodenum, stomach, gall bladder, as well as liver and pancreas. The study demonstrated that as early as on day 1-3 of the disease the development of the inflammatory process in different organs was accompanied by the appearance of the corresponding tissue specific (organ specific) antigen-binding lymphocytes in all patients. As a rule, patients with different acute enteric diseases significantly differed by the frequency and spectrum of the involvement of such organs and tissues into pathological process.     

Integrating data mining and transmission theory in the ecology of infectious diseases

Our understanding of ecological processes is built on patterns inferred from data. Applying modern analytical tools such as machine learning to increasingly high dimensional data offers the potential to expand our perspectives on these processes, shedding new light on complex ecological phenomena such as pathogen transmission in wild populations. Here, we propose a novel approach that combines data mining with theoretical models of disease dynamics. Using rodents as an example, we incorporate statistical differences in the life history features of zoonotic reservoir hosts into pathogen transmission models, enabling us to bound the range of dynamical phenomena associated with hosts, based on their traits. We then test for associations between equilibrium prevalence, a key epidemiological metric and data on human outbreaks of rodent‐borne zoonoses, identifying matches between empirical evidence and theoretical predictions of transmission dynamics. We show how this framework can be generalized to other systems through a rubric of disease models and parameters that can be derived from empirical data. By linking life history components directly to their effects on disease dynamics, our mining‐modelling approach integrates machine learning and theoretical models to explore mechanisms in the macroecology of pathogen transmission and their consequences for spillover infection to humans.     

Accuracy of diagnostic content of hospital activity analysis in infectious diseases.

Hospital activity analysis (HAA) was used to identify 2151 patients in whom the diagnostic code fell within the infectious disease categories of the International Classification of Disease. The clinical notes of these patients were examined by a doctor and in 414 (19.2%) the diagnostic coding was incorrect. Diarrhoea and viral infections were miscoded most often. The possibility of inaccuracy must be considered when HAA aggregated data are used for planning purposes. Accuracy could be improved if clinicians routinely completed the diagnostic sections of the HAA form.     

A Bayesian approach for inferring the dynamics of partially observed endemic infectious diseases from space-time-genetic data

We describe a statistical framework for reconstructing the sequence of transmission events between observed cases of an endemic infectious disease using genetic, temporal and spatial information. Previous approaches to reconstructing transmission trees have assumed all infections in the study area originated from a single introduction and that a large fraction of cases were observed. There are as yet no approaches appropriate for endemic situations in which a disease is already well established in a host population and in which there may be multiple origins of infection, or that can enumerate unobserved infections missing from the sample. Our proposed framework addresses these shortcomings, enabling reconstruction of partially observed transmission trees and estimating the number of cases missing from the sample. Analyses of simulated datasets show the method to be accurate in identifying direct transmissions, while introductions and transmissions via one or more unsampled intermediate cases could be identified at high to moderate levels of case detection. When applied to partial genome sequences of rabies virus sampled from an endemic region of South Africa, our method reveals several distinct transmission cycles with little contact between them, and direct transmission over long distances suggesting significant anthropogenic influence in the movement of infected dogs.     

Sputum microflora in acute pneumonia based on the data from a quantitative study

In this work the data obtained in the quantitative investigations of sputum samples from 106 miners having acute pneumonia are presented. These investigations were carried out twice at the peak of the disease to determine the possible infective agent. The virological study of nasal impression smears by immunofluorescence and the serological study of paired sera made it possible to establish the viral and bacterial nature of the disease in 12% of cases. The expediency of the quantitative investigations of sputum, carried out twice, in combination with the study of the biological properties of opportunistic microorganisms was shown. Streptococcus pneumoniae proved to play the most important etiological role in the appearance of acute pneumonia in miners. This infective agent was detected in 82% of patients by the inoculation of sputum samples in "diagnostic" dilutions (10(-5) and higher). The associations of pneumococci with staphylococci, hemolytic bacteria and Neisseria were found to be capable of playing a significant role in the development of acute inflammation in pulmonary tissue, especially in those cases when these associations were isolated from highly diluted sputum (10(-5)).