Epidemiological pattern of scarlet fever in recent years

During the period of 1953-2001 scarlet fever morbidity level fluctuated from 670.3 to 65.9 per 100,000 of the population in Moscow and from 531.9 to 35.0 per 100,000 of the population of the Russian Federation. In recent years an increased morbidity was more pronounced in Moscow than in the Russian Federation as a whole. Children formed the greater part of scarlet fever patients, the cases of scarlet fever among children in Moscow occurring more often than, on the average, in Russia. As before, annual morbidity among children attending children's institutions was higher 3- to 4-fold than among children brought up at home. This difference was most sharply pronounced among young children during the first two years of their life. In contrast to morbidity observed during previous 20-30 years, a drop in morbidity among children during the first two years of their life was registered, while morbidity level among children aged 3-6 years and 7-14 years increased. Scarlet fever morbidity had a pronounced seasonal (autumn-winter) pattern. In a group of children aged 3-5 years who attended organized groups, on the average, 78.6% of scarlet fever cases fell on seasonal morbidity, the most prolonged one.     

Use of tomicid in prophylaxis of respiratory streptococcal infection in the organized groups of children of pre-school age

The results of the approbation of the use of Tomicid for the prophylaxis of scarlet fever and other manifestations of streptococcal infection in an organized group of children of pre-school age are presented. The pronounced prophylactic effect of Tomicid, manifested by a reliable decrease of group A streptococcal carrier state, as well as in a decrease in morbidity in respiratory streptococcal infection among children in the test group in comparison with those in the control one. The simplicity of the use of the preparation (as throat gargle for 5 days) makes it possible to regard this preparation as a promising remedy for the urgent prophylaxis of scarlet fever.     

Circulation of respiratory viruses in Moscow and their role in acute respiratory diseases morbidity

Statistical data obtained during prolonged investigations on the structure of infective agents isolated from patients with acute respiratory diseases (ARD) in Moscow in 1989-1999 were analyzed. The study revealed that fluctuations of ARD morbidity rates were linked with the prevailing circulation of one or another type of the virus. The absence of the dominating role of influenza viruses was confirmed. The conclusion was made on the necessity of using, in addition to influenza vaccinal prophylaxis, chemoprophylactic interventions to maintain ARD morbidity on the acceptable level.     

Hereditary blood factors and infectious diseases in children in the 1st 7 years of life

Infectious morbidity in respect to 23 nosological forms was studied in 958 children with known blood groups and Rh factors during the first 7 years of their life. The absence of statistically significant differences in morbidity rates in children with different age groups was revealed in respect to 16 nosological forms. Significant differences in morbidity rates in children with different blood groups were revealed in respect to parotitis, rubella, scarlet fever, E. coli infections, bronchitis and pneumonia; similar differences linked with Rh factor were observed only in cases of measles, rubella and tonsillitis.     

An explosive outbreak of respiratory streptococcal infection with a droplet transmission mechanism

The data obtained in the study of an explosive outbreak of acute respiratory diseases, tonsillitis and scarlet fever in one of schools in Moscow have made it possible to exclude the alimentary mechanism of its development and to demonstrate the role of the droplet mechanism of transmission in the appearance of its outbreak. The epidemiological analysis of the outbreak has permitted the formulation of the hypothesis on the conditions of the formation and spread of the epidemic variant of the infective agent; this hypothesis corresponds to the available data in literature on the qualitative changes of the infective agent in the course of the epidemic process. The study has shown that the prophylaxis of the explosive outbreaks of respiratory streptococcal infections must be ensured by the system of epidemiological surveillance with timely intervention into the epidemiological process at its early stages.     

Comparative characteristics of the immunologic structure of children's collectives as regards scarlatina in different climatic zones]

An immunological study (in respect to scarlet fever) of children in children's collective bodies was conducted in 1971-1972 simultaneously in two towns-Ashkhabad and Petrozavodsk located in the contrast climatic zones. Results of Dick's test and passive hemagglutination test indicated no significant differences in the level and intensity of antitoxic immunity in children of both cities; only during the autumn period, corresponding to the seasonal increase in the incidence of scarler fever in Ashkabad, the number of immune children in this town proved to be greater than in Petrozavodsk, this being connected with a more active process of "mute" immunization. At the same time differences were revealed in the level and dynamics of antibodies to the leading types of M-antigens of hemolytic streptococci. Consequently, a higher immunological reactivity of the organism in children in Ashkhabad (promoting rapid formation of both the antitoxic and the antimicrobial immunity and limiting of the spread of marked scarlet fever affections) underlied the differences in the level of scarlet fever morbidity in different climatic zones.     

Phase changes in the population of group A streptococci and their influence on the course of the epidemic process of tonsillitis

This work presents the data on the complex evaluation of the population of group A streptococci, studied at each of four phases (reservation, epidemic transformation, epidemic spread, reservational transformation) of the course of the epidemic process of streptococcal infection of the respiratory tracts (tonsillitis) in an organized group of adults. The characterization of the phases of the infective agent in accordance with the level of the carrier state, the size of streptococcal foci and the virulence of streptococci is given. Thus, the study shows that the heterogeneity of group A streptococci with respect to their virulence reaches its maximum level at the phases of reservation and epidemic spread and its minimum level at the phases of epidemic and reservational transformation. The size of streptococcal foci in carriers and the virulence of streptococci isolated from them are the inter-related unidirectional signs of the population of the infective agent and, at the same time, the main factors responsible for the phase character of the epidemic process and the morbidity level in tonsillitis.     

Epidemiological characteristics of meningococcal infection in a number of territories of the RSFSR (1969-1984)

In this work the dynamics and morbidity level in respect of meningococcal infection at 11 territories of the RSFSR at the period of 1969-1984 are analyzed. The study covered altogether 16 cities and 211 districts. The role of big cities as the sources of infection spreading into rural areas and further "fixation" of this infection mainly in regions with a population of 60,000 and more had been established. The data on meningococcal morbidity and carriership among different age groups are presented. The study has shown a pronounced increase in the incidence rate of meningococcal infection among children aged up to 2 years, as well as an increase in the proportion of these children among patients with meningococcal infection in recent years.     

The reactogenicity and safety of a multicomponent vaccine (VP-4) in the prevention of acute respiratory diseases in preschoolers

The reactogenicity and safety of poly-component vaccine (VP-4), prepared from the antigens of opportunistic bacteria, in the prophylaxis of acute respiratory diseases (ARD) in children aged 2.6-6 years. The vaccine was administered intranasally in 3 administrations and orally in 6-8 administrations at intervals of 3-4 days for a period of 24 +/- 4 days. The prophylaxis of ARD with the use of VP-4 was carried out in 168 children in 4 children's preschool institutions. The control group was made up of 120 children, attending the same institutions. The study revealed that VP-4 had low reactogenicity and induced short-time systemic and local reactions (common cold, cough). The administration of VP-4 at a period of the epidemic rise on influenza and ARD morbidity did not lead to an increase in the frequency and duration of ARD in the vaccinees, as well as to the exacerbation of chronic infection and the allergization of the body.     

Characteristics of the formation of the HBsAg carrier state among pregnant women and newborn infants and their role in the spread of hepatitis B

The authors analyze the incidence rate of HBsAg carriership among 8, 120 pregnant women and 261 newborn infants at different periods after birth. The levels of HBsAg carriership among pregnant women and the members of their families, as well as among the personnel of maternity clinics and blood donors, have been established. The rate and time of the detection of HBsAg in infants born to mothers found to be HBsAg carriers have been determined. Measures for the prophylaxis of hepatitis B are discussed with due regard to the specific epidemiological features of the spread of HBsAg carriership, established in this study, and to the presence of antibodies to HBsAg among the above-mentioned groups of the population.     

Quantitative research on the cyclic fluctuations of the epidemic process in a number of infectious diseases in Bulgaria

The cyclic nature of the epidemic process in Bulgaria was studied by various methods (spectral analysis, etc.), forming a system. The morbidity dynamics in 10 infectious diseases (scarlet fever, rubella, measles, epidemic parotitis, whooping cough, diphtheria, typhoid fever, enterocolitis, bacterial dysentery, viral hepatitis) over the years of 1909-1983 were studied and cycles covering the periods of 3-4, 5-6, 10-11 and over 16 years were established. The data on the relative part of cyclic processes in the registered morbidity of infectious diseases, as well as information on the prognostication of the spread of infections in the absence of vaccinal prophylaxis, are presented.     

Patterns in the epidemic process of scarlet fever in various territories differing in respect of climate and geography]

Observations carried out in Ashkhabad and Petrozavodsk permitted to reveal specific features of the epidemic process in scarlet fever at the territories differing in climato-geographic respect. This was expressed in a different level of morbidity, differences in the character of periodicity, seasonality and age structure of morbidity. Along with this there were noted differences in the spread of the carrier state of hemolytic streptococcus and of their biological properties, and also in the process of immunity formation in the population. The data obtained suggest that one of the causes of epidemiological differences in scarlet fever detected in the southern and the northern districts were peculiarities of the immunological reactivity of the population and a difference in the carrier state of the highly toxigenic streptococci.     

The efficacy of exogenous and endogenous interferonization in preventing influenza]

In this work the results of using interferon (IFN), Dibasol and the combination of these preparations for the urgent prophylaxis of influenza and acute respiratory diseases (ARD) among the employees of the Gamaleia Research Institute of Epidemiology and Microbiology (USSR Acad. Med. Sci.) are summarized. Reaferon and Dibasol decrease ARD morbidity 2 times and leukocytic IFN decreases it 1.4 times, while the combined administration of Dibasol and IFN has proved to be ineffective. Reaferon is mainly a prophylactic remedy; it has been found to bring about almost no decrease in the number of patients at the peak of morbidity, while pronouncedly decreasing it in two weeks after the administration of the preparation. Dibasol has a curative effect, sharply interrupting the beginning rise of morbidity. Reaferon normalizes the characteristics of the IFN status, decreasing the amount of circulating IFN and enhancing the capacity of leukocytes for producing alpha-IFN and gamma-IFN. For the prophylaxis of respiratory infections the use of Reaferon is advisable 3-4 weeks prior to the beginning of the epidemic and then, when the first cases of infection are registered, the course of prophylaxis with Dibasol should be carried out.     

Cross infection of guinea pigs with different pneumococcal serotypes in the presence of the carrier state

The possibility of the pneumococcal cross infection of guinea pigs in experimental conditions, the time course of the distribution of pneumococci in their organs, and the duration, within the time limits of the experiment, of persistence of the given infective agent were studied. Normal animals placed in the same room with infected ones were shown to become the carriers of definite pneumococcal serotypes. As a result, these studies revealed that nasopharyngeal carriership and infection of different organs were not directly interrelated and the method of infection of guinea pigs did not influence the time course of distribution of pneumococci in their organs. The data on the duration of persistence of the infective agent, as well as on the importance of this phenomenon for determination of the relationship between pneumococcal carriership and disease, are presented.     

The rapid diagnosis of acute streptococcal infection in children]

The present work deals with trials of the method of rapid diagnosis of streptococcal infection, carried out in children's infectious hospital, with the use of a new diagnostic kit. The proposed diagnosticum has proved to be highly sensitive and specific in scarlet fever and tonsillitis. The sensitivity and specificity of the diagnosticum depend on the duration of the disease, prehospital treatment and the quality of the bacteriological analysis.     

Side effects of antibiotics in rheumatic diseases]

Complications due to antibiotic therapy in rheumatic patients subjected to season bicillin prophylaxis in Minsk within 1965--1975 and in patients with extensive collagenoses were studied. Allergic complications mainly ih the form of allergic reactions in the patients treated with bicillin-3 or picillin-5 were observed in 7.8--16.8 per cent of the patients. Within 10 years 52 cases of anaphylactic shock due to the bicillin use were recorded. Side reactions to antibiotics were observed in 16 (17.3 per cent) out of 92 patients with extensive collagenoses. For prophylaxis of the above complications it is recommended to use rational antibiotic therapy in rheumatic patients, strict registration of allergological states in the anamnesis, testing of microbial sensitivity to the antibiotics.     

Characteristics of beta-hemolytic streptococci secreted in children in various climatic zones]

A study was made of the level of carrier-state, serological characteristics, virulence and toxigenicity of beta-hemolytic streptococci isolated from children in two towns with a different incidence of scarlet fever located in the contrast climatic zones. It was found that the level of carrier-state of beta-hemolytic streptococci and biological properties of the circulating strains were important factors associated with the incidence of scarlet fever.     

黑龙江省2010～2020年猩红热发病与气象因素的关联性研究

分析黑龙江省气象因素与猩红热发病的关系,建立时间序列模型,为今后制定更科学有效的猩红热防控策略提供参考依据。收集黑龙江省2010～2020年猩红热月发病数据以及同期气温、气压等气象资料,应用广义相加模型分析气象因素与猩红热发病之间的关联程度和形式。结果发现: 猩红热全年均有发病而且呈现出较为典型的双峰型特征,在春季的4～5月份和冬季的11～12月份发病数达到高峰;月平均气压、月平均相对湿度、月日照时数和月平均风速的P值均小于0.05,表明具有统计学意义。同时,RR(相对危险度Risk Ratio)值均小于1,即猩红热发病与四个气象因素呈负相关。黑龙江省猩红热发病每年存在两个流行高峰,主要以冬季为主,发病数随着月平均相对湿度、月日照时数、月平均风速与月平均气压的升高而降低。     

Tendency and analysis of the epidemic situation in parenteral virus hepatitis B and C in the Russian Federation and a number of its regions

As revealed in the present survey, during the last 3 years, against a background of decreased number of registered cases of acute hepatitis B (HB) and acute hepatitis C (HC), an increase in the proportion of patients with the chronic forms of these diseases was observed. The incidence rate of carriership of hepatitis B (HBV) and hepatitis C viruses (HCV) is many times greater than morbidity rates in acute and chronic forms of the disease. Such differences could be due to imperfect laboratory and clinical diagnosis. The registered statistics on HBV and HCV carriership included newly detected HBsAg and anti-HCV in the absence of clinical manifestations, which did not reflect the true spread of HBV and HCV in a given territory. The group of HBV and HCV carriers was found to include a considerable proportion of patients with asymptomatic form of HB and HC. It was testing for HBsAg, anti-HCV only without determination of virus replication markers (anti-HBc IgM, HBV DNA, anti-HCV IgM, HCV RNA) that seemingly determined the category of carriers greatly exceeding the true incidence. To obtain reliable epidemiological information, the complex detection of HB and HC infection markers is necessary.     

The general characteristics of the epidemic process and of the circulating streptococcal strains during an upsurge in scarlatina morbidity in Leningrad

The dynamics of scarlet fever morbidity in Leningrad for many years was studied and the absence of any effect produced by the existing system of preventive measures against this disease for the last 30 years was shown. On the basis of epidemiological and bacteriological data the authors came to the conclusion on the unity of the epidemic process of scarlet fever in the whole city and the relatively autonomous character of the process in individual districts. The necessity of the realization of epidemiological surveillance on streptococcal infection, with special emphasis on the multilevel social structure of the city and the wide use of the bacteriological diagnosis of streptococcal diseases, is substantiated.