Reasons for the decrease in viral hepatitis morbidity in Orekhovo-Zueve]

Factors of action on the epidemic process in viral hepatitis in Orekhovo-Zuevo leading to a sharp reduction of the incidence of this disease (which before failed to differ from the mean level in the USSR) -- from 154.0 per 100 thousand residents in 1970 to 36.5 per 100 thousand residents in 1975 are considered from the point of view of discussion of the work of Gromashevsky and Birinboim (ZMEI No. 11, 1976). The decisive significance of measures directed to reduction of the incidence of intestinal infections and gamma-globulin vaccinations is refuted. There was revealed a direct 100% correlation between the incidence of positive benzidine tests for blood contamination of medical instruments and the changes in the viral hepatitis morbidity. Planned measures directed to the elimination of factors of parenteral transmission of the infection carried out intensively from 1970 led to reduction of the incidence of viral hepatitis.     

Experience in the detection of the latent course of the epidemic process of viral hepatitis in children in preschool groups]

A complex study of 1273 healthy children of creches and kindergartens where no viral hepatitis occurred for a long time revealed 39 children (3.1%) with an increased activity of glutamine-pyroracemic transaminase in the blood serum. Viral hepatitis was diagnosed in 12 (0.94%) of them as a result of clinical examination (an icteric form in 1, and a nonicteric form in 11 cases). The presence of asymptomatic form of infection could be supposed in 17 other children (1.3%). The incidence of increased activity of the enzyme in the serum of "healthy" children was definitly connected with the viral hepatitis incidence registered in the town during the year as a whole, and by seasons. This permitted to prognosticate the spread of viral hepatitis in the given populated locality. By complex laboratory examination of children in collective bodies it was possible to detect the latene foci and the latently coursing epidemic process of viral hepatitis.     

Zonal characteristics of the dynamics of viral hepatitis A morbidity over a period of many years (based on data from the Ukrainian SSR)

The previously established zonal character of the prevalence of viral hepatitis A in the Ukraine is a stable epidemiological regularity observed for more than 30 years (1952-1985). Zonal differences in the dynamics of the epidemic process of viral hepatitis A were established. These differences became particularly hepatitis manifest in the years of periodic rises in the morbidity rate which is also irregular within zonal and regional boundaries. The main typological variants of the dynamics of the epidemic process ("urban" and "rural") were defined. Typological approach appears to be useful in the provision of information necessary for the proper functioning of epidemiological surveillance and for taking measures aimed at epidemics control.     

Spread of viral hepatitis in organized children's collectives and the methods for its early diagnosis]

The authors present the results of observations over 407 children aged from 2 months to 16 years from the foci of viral hepatitis in children's collective bodies. During the quarantine a determination was made in children of the glutamic-pyroracemic, glutamic-oxalic transaminases (GPT and GOT, respectively) and of the hepatitis B antigen (HBAg). A necessity of using the enzymatic tests for the purpose of early diagnosis of viral hepatitis was shown, since 84% of the cases developing in the next focus coursed as an unicteric form without any markked clinical signs; HBAg was revealed in 6.1% of the children examined. A complex examination of the personnel and of the persons who came in contact with the patients with viral hepatitis showed the ways of spread of hepatitis B in a collective body; it was found that the viral hepatitis B infection took place both by parenteral and enteral routes. The expediency of active observation over the children, recipients of blood and plasma, with determination in them of the activity of the enzymes and HBAg for early diagnosis of parenteral infection was substantiated. It was also shown that the incidence of the unicteric forms of viral hepatitis in a focus of infection depended not on the periods of gamma-globulin administration but on the age of children who contracted the infection. Thus, the prevalence of the unicteric forms of the disease over the icteric ones in children under 3 years of age was more pronounced than in older children.     

Possibilities of viral hepatitis diagnosis by immunofluorescent examination of patient blood smears]

The authors demonstrate possibilities of viral hepatitis diagnosis by means of fluorescent antisera labeled phiiTts. The antisera were obtained from the blood of convalescents after infectious hepatitis (with an uncomplicated course) on the 25th--30th day of the disease, and also from the placental gamma-globulin of persons who had had viral hepatitis (in the anamnesis). Both diagnostic preparations proved to be highly specific, although the first of them was somewhat more sensitive. Blood smears were stained with fluorescent antisera. The fluoresence was revealed in the cytoplasm of the white blood formed elements--lymphocytes and neutrophils; the nucleus was dark. Materials of this investigation permit experimental substantiation of a possibility of prolonged antigenemia in the blood leukocytes of patients suffering from viral hepatitis.     

肝炎和伤寒流行过程的混沌分维研究

以辽宁省本溪市１９５５－１９９６年的肝炎、伤寒逐月发病的数据为根据，利用混沌动力学中“相空间技术”，对流行病过程进行能量谱分析及混沌分析。发现伤寒的流行过程是混沌的，混沌迭代模型是Ｘｔ＋１＝ｒＸｔｅｘｐ｛－０．０００９２８７（Ｘｔ－３３．２５３３２）＾２｝；肝炎的流行过程是非混沌的。在模型参数变化范围内，经历了周期状态、混沌状态之间的转换，这表明伤寒的流行过程是复杂的，给出了流行病的“阈值”，以控制它们的流行涨落，求出伤寒的关联分维是３．０８７。     

A trial to decrease hepatitis A morbidity in Dzerzhinsk, Gorki Province

The results of experience in the comparative evaluation of the preseasonal immunoglobulin prophylaxis in two towns of the Gorki Province are presented. The work substantiates the economic and epidemiological effectiveness of immunoglobulin prophylaxis at the territory, relatively safe with respect to hepatitis A, under the conditions of its realization in the year of the predicted rise of morbidity, the timely organization of immunoglobulin prophylaxis (from July to the first half of October) and the coverage of "organized" children, exceeding 90%.     

Problems of the epidemiology of viral hepatitis in Ryazan Province

The analysis of some features of the course of the epidemic process of viral hepatitis on the territory of the Ryazan region is presented. Periodic rises and falls in viral hepatitis morbidity, varying in their regularity (4-6 years), have been registered in the region. The general level and the seasonal distribution of viral hepatitis morbidity are determined by the morbidity rate among children, the increase in the proportion of children of senior school age being observed in recent years.     

Various epidemiological principles of the spread of viral hepatitis in the Astrakhan district]

Analysis of many-year changes in the vitral hepatitis incidence in the Astrakhan region showed a significant cyclicity of the epidemic process: its incidence rose 4 times during the period of from 1957 to 1976; four of these elevations were comparatively high (in 1960, 1964, and 1974). Lately the group of children aged from 3 to 7 years has been of the greatest epidemiological significance, but at present greatest incidence of the disease fell on the group of persons aged from 8 to 14 years. This can be connected with gamma-globulin vaccinations given to children aged under 10 years. Seasonal distribution of morbidity in different are groups was about the same and reflected the general automn-winter seasonal prevalence.     

Classification and sensitivity analysis of the transmission dynamic of hepatitis B

Background

Hepatitis B infection caused by the hepatitis B virus is one of the most serious viral infections and a global health problem. In the transmission of hepatitis B infection, three different phases, i.e. acute infected, chronically infected, and carrier individuals, play important roles. Carrier individuals are especially significant, because they do not exhibit any symptoms and are able to transmit the infection. Here we assessed the transmissibility associated with different infection stages of hepatitis B and generated an epidemic model.

Methods

To demonstrate the transmission dynamic of hepatitis B, we investigate an epidemic model by dividing the infectious class into three subclasses, namely acute infected, chronically infected, and carrier individuals with both horizontal and vertical transmission.

Results

Numerical results and sensitivity analysis of some important parameters are presented to show that the proportion of births without successful vaccination, perinatally infected individuals, and direct contact rate are highest risk factors for the spread of hepatitis B in the community.

Conclusion

Our work provides a coherent platform for studying the full dynamics of hepatitis B and an effective direction for theoretical work.

     

Monthly dynamics of the epidemic process in viral hepatitis B

Monthly fluctuations in the number of registered cases of acute viral hepatitis B and HBsAg carriership have been studied. The study has revealed that, similarly to other infectious diseases, viral hepatitis is characterized by monthly fluctuations in the intensity of the epidemic process. Such fluctuations are characteristic of all known clinical forms of this infection; they are determined by the specific pathogenetic features of the process and by the ways of the transfer of the virus. The vernal rise of the infection is explained by activation of the manifest and asymptomatic chronic variants of the infectious process and, as the consequence of a rise in the number of asymptomatic cases, by a higher incidence rate of post-transfusion hepatitis infection. The autumnal rise of the infection results from the action of natural factors contributing to the transfer of the virus. Both rises are interrelated and interdependent. The seasonal fluctuations of the epidemic process should be taken into consideration when planning and implementing prophylactic and epidemic-control measures.     

Morbidity and mortality in acute viral hepatitides in a hyperendemic region. The role of viral hepatitis E

Official annual statistical data on morbidity in acute viral hepatitides (AVH), including the number of lethal cases, for 1985-1995 were analyzed. Mortality rates per 100,000 of the population at the period of 11 years were calculated for different age groups, sex and the place of residence. 396 and 99 patients were examined for the presence of serological markers of hepatitides A, B and E, respectively, at the periods of epidemic rises in morbidity and satisfactory epidemic situation. In the course of 11 years AVH caused the death of 22,405 persons. In 1985-1987 the average mortality level (ML) reached 12.3-17.8 per 100,000 of the population (with morbidity being 1,200-1,400 and was essentially higher among the rural population in comparison with the urban population. During these years the highest ML, was registered among children aged 0-2 years (190-50 per 100,000) and, among adults, mainly among women aged 20-29 years (21.4-19.6 per 100,000). During the years when the epidemic of AVH was absent, ML among these groups was essentially lower: 40-20 among children aged 0-2 years and 4-5 among women aged 20-29 years. In 1987 in the Fergana Valley hepatitis E was detected in 72.2% of all examined patients, and in the southern areas of the country in 68.7%. A sharp rise on mortality among women of the productive age at the period of the epidemic rise of AVH morbidity in the endemic region indicated that this epidemic was linked with hepatitis E. High ML among young children may be indicative of a highly unfavorable course of hepatitis E in the group of infants, which had never been registered before. This newly established regularity may be used for the retrospective diagnostics of the outbreak of hepatitis E.     

High Prevalence of HIV-1 CRF01_AE Viruses among Female Commercial Sex Workers Residing in Surabaya,Indonesia

Background

Human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) cause serious health problems and have an impact on the Indonesian economy. In addition, the rapid epidemic growth of HIV is continuing in Indonesia. Commercial sex plays a significant role in the spread of HIV; therefore, in order to reveal the current HIV prevalence rate among commercial sex workers (CSWs), we conducted an epidemiological study on HIV infection among CSWs residing in Surabaya, the capital of East Java province of Indonesia with large communities of CSWs.

Methodology/Principal Findings

The prevalence of HIV infection among 200 CSWs was studied. In addition, the subtype of HIV type 1 (HIV-1) and the prevalence of other blood-borne viruses, hepatitis B virus (HBV), hepatitis C virus (HCV) and GB virus C (GBV-C), were studied. The prevalence rates of HIV, hepatitis B core antibody, hepatitis B surface antigen, anti-HCV antibodies and anti-GBV-C antibodies were 11%, 64%, 4%, 0.5% and 0% among CSWs involved in this study, respectively. HIV-1 CRF01_AE viral gene fragments were detected in most HIV-positive samples. In addition, most CSWs showed low awareness of sexually transmitted diseases and had unprotected sex with their clients.

Conclusions/Significance

The HIV prevalence rate among CSWs was significantly higher than that among the general population in Indonesia (0.2–0.4%). In addition, CSWs were at a high risk of exposure to HBV, although chronic HBV infection was less frequently established. Our results suggest the necessity of efficient prevention programs for HIV and other blood-borne viral infections among CSWs in Surabaya, Indonesia.     

Late observations in a familial foci of hepatitis B using a full set of specific markers of the infection

The complete set of specific markers of hepatitis B has been identified, thus making it possible to evaluate the spread of this infection in family foci, as well as the intensity and dynamics of the epidemic process, under the conditions of prolonged observations. The study has shown that the spread of hepatitis B infection is determined by the presence of HBeAg in antigen-positive patients with viral hepatitis B and HBsAg carriers.     

The territorial and age-related characteristics of the distribution of patients with non-A, non-B viral hepatitis infected via the fecal-oral mechanism in foci of elevated viral hepatitis morbidity in the Uzbek SSR

The study of patients from 10 foci of acute viral hepatitides for the presence of HBsAg (in the passive reverse hemagglutination test) and anti-hepatitis A virus IgM (in the radioimmunoassay) has shown high frequency and variability in the spread of hepatitis non-A, non-B, the prevalence of adults aged 20-29 years and children aged 2-4 years among persons involved into the epidemic process and the tendency towards an increase in the proportion of hepatitis non-A, non-B in the total number of cases of viral hepatitides in the republic.     

Risk of vertical transmission of hepatitis B virus in Tunisia

The risk of vertical transmission of hepatitis B virus (HBV) varies with type of viral endemicity, degree of maternal infection and genomic characteristics of the virus. The aim of this study is to estimate this risk in Tunisia using serological and molecular methods to evaluate HBV replication, to determine viral genotypes and to detect presence of occult hepatitis in 2709 pregnant women. Serological markers were detected by ELISA methods, Genotype was determined by PCR-RFLP and occult hepatitis by nested-PCR. Four percent of women were positive for HBsAg; only 3% of them were also positive for HBeAg. Viral replication, over than 10(3) copies/ml, was detected in 61% of positive HBsAg patients. Three viral genotypes were detected: D (95%), B (3%) and A (3%). Occult hepatitis was detected in 4% of sera with "anti-HBc isolated" profile. In conclusion, the risk of vertical transmission of HBV exists in Tunisia. It increases by frequency of precore mutants, predominance of the genotype previously associated with high levels of replication and possibility of occult hepatitis B. These results show the importance of screening by serological HBV markers systematically during pregnancy with evaluation of viral replication in order to prevent vertical risk by efficient tools.     

History of the research on differentiating Hepatitis A and B]

The numerous researches devoted to 'jaundice' during the Second World War have brought to light the existence of an infectious type of hepatic jaundice or 'homologous serum jaundice' following parenteral injection of vaccines containing human serum and blood transfusions, which were carried out on a large scale at the time. This type of serum jaundice was then gradually differentiated from 'catarrhal', contagious or epidemic jaundice by clinical trials along with large series of animal studies. Finally, the epidemiological, clinical and biological data obtained made it possible to establish, between 1944 and 1954, the viral etiology of these two types of jaundice: the A virus, present in the patients' blood and stools, was considered to be the agent responsible for epidemic hepatitis; the B virus, present primarily in the blood, was held to be responsible for serum hepatitis.     

Manifestations of influenza-virus variability during its cultivation in the system of passively immunized chick embryos]

A method of immunological actions on the influenza virus in the system of chick embryos passively immunized with isologous sera was elaborated. With the aid of the suggested method it was possible to induce in strains (with different hemagglutinin type and different degree of attenuation) the transformation of signs characterizing the virus variability in the epidemic process. Variants of the vaccine strains of the influenza virus with increased immunogenic activity and signs of antigenic "outrunning" were obtained. Experimental vaccines from these variants were nonreactogenic for humans and caused a more frequent seroconversion than the initial strain. The diagnostic agents from the variants revealed antibodies in human sera and gamma-globulin, similarly to the "new" viruses isolated from man. The theoretical significance and the aspects of practical utilization of the data obtained are discussed.     

Applying the scientific method when assessing the influence of migratory birds on the dispersal of H5N1

Background

The epidemiology of viral hepatitis during pregnancy is essential for health planners and programme managers. While much data exist concerning viral hepatitis during pregnancy in many African countries, no proper published data are available in Sudan.

Aim

The study aimed to investigate the sero-prevalance and the possible risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among antenatal care attendants in central Sudan.

Methods

During 3 months from March–June 2006, sera were collected from pregnant women at Umdurman Maternity Hospital in Sudan, and they were tested for markers of hepatitis B virus (HBVsAg) and HCV.

Results

HBVsAg was detected in 41 (5.6%) out 728 women, Anti-HCV was detected in 3 (0.6%) out of 423 women, all of them were not aware of their condition. Age, parity, gestational age, residence, history of blood transfusion, dental manipulations, tattooing and circumcision did not contribute significantly to increased HBVsAg sero-positivity.

Conclusion

Thus 5.6% of pregnant women were positive for HBVsAg irrespective of their age, parity and socio-demographic characteristics. There was low prevalence of Anti-HCV.     

Use of a radioimmune method for determining HBsAg in preparations of human gamma-globulin

The work presents the results of studies made with a view to improve the method of testing gamma-globulin preparations for the presence of hepatitis B virus surface antigen (HBsAg) by means of radioimmunoassay (RIA). The work shows that this method requires the use of specially selected negative control samples made up of pooled gamma-globulin samples. Standard RIA techniques intended for detecting the presence of HBsAg in human plasma and blood serum is not suitable for the analysis of the preparations of human gamma-globulin.