The work is devoted to clarify the etiological aspects of the hemorrhagic fever with renal syndrome (HFRS), clinical and epidemiological features that are closely linked to the etiology, as well as to development of methods and products for specific diagnosis and vaccine prevention of hantavirus infection. That regard to hantaviruses a set of virological, immunological and molecular-genetics methods were developed significantly enhance the effectiveness of the specific diagnostics of HFRS. The features of humoral immunity in HFRS were identified and atypical clinical forms of HFRS was istablished; indicators of natural immunity to hantavirus in the population living in different regions of Russia and the former Soviet republics have been identified that allowed us to refine nosological area of HFRS; new, previously unknown natural foci of HFRS, including hantavirus RNA, in the central regions of Russia and in the subtropical zone of Krasnodar region have been identified and studied; 76 strains and 70 isolates of 9 rodent species and one species of birds, as well as from the blood of patients with HFRS and sectional materials from HFRS dead patients have been isolated and identified; new hantavirus species - Khabarovsk, Taimyr-Topografov, Adler, as well as two new genotypes Dobrava/Belgrad virus - Kurkino and Sochi have been identified; species composition of small mammals - the natural reservoir of hantaviruses was the refined; etiological role and epidemiological importance of different hantaviruse types in HFRS incidence structure was established; the existence of new etiologically distinct hantavirus infections with significant epidemiological differences has been proven; manufacturing techniques and methods of control of the culture inactivated vaccine against HFRS has been developed.
на территории россии в последние десятилетия туляремия проявляется спорадической заболеваемо-стью (от 50 до 150 случаев в год) и эпидемическими вспышками. динамика заболеваемости туляремией за [2006][2007][2008][2009][2010][2011][2012][2013][2014][2015][2016] на территории российской Федерации в 2016 г. зарегистрировано 123 случая инфицирования че-ловека Francisella tularensis, 90 % из них приходится на три федеральных округа: северо-западный, сибирский и центральный. эпизоотические проявления инфекции различной степени интенсивности выявлены в 56 регионах. значительное число больных туляремией наблюдалось в республике карелия, ненецком автономном округе, омской и рязанской областях, санкт-петербурге. обращают на себя внимание некоторые современные особенности проявления туляремии: неспецифичность клинических симптомов, особенно на ранних стадиях заболевания, их разнообразие возрастает при наблюдающих-ся в последнее время случаях микст-инфицирования возбудителями туляремии и других природно-очаговых инфекций. наиболее выраженными симптомами болезни являются лихорадка и лимфаденит; диагноз «туляремия» устанавливается в первые дни обращения за медицинской помощью у 40-45 % за-болевших. на основании анализа данных о заболеваемости людей, эпизоотологическом состоянии при-родных очагов туляремии, числе выделенных культур возбудителя, численности основных носителей и переносчиков, а также с учетом объемов вакцинопрофилактики в регионах определены территории, на которых наиболее вероятны эпидемические осложнения в 2017 г.Ключевые слова: туляремия, Francisella tularensis, природные очаги, эпидемическая ситуация, эпи-зоотическая ситуация. 123 cases of human infection with Francisella tularensis were registered in the territory of the Russian Federation in 2016. 90 % of the total number was reported by three Federal Districts: North-Western, Siberian, and Central ones. Epizootic manifestations of varying intensity were detected in 56 regions. A considerable number of tularemia cases were observed in the Republic of Karelia, Nenets Autonomous District, Omsk and Ryazan Regions, and in Saint-Petersburg. Conspicuous are some recent peculiarities of tularemia manifestations: non-specificity of clinical symptoms, especially at early stages of the disease, their increasing variability against the background of mixed infections with tularemia and other natural-focal infections agents. The most expressed symptoms are fever and lymphatic adenitis; the patients are diagnosed with tularemia during initial days of the sought treatment in 40-45 % of the cases. Based on the data on morbidity rates in humans, epizootiological condition of natural tularemia foci, the numbers of isolated cultures and incidence of the vectors and carriers of the agent, as well as taking into consideration the scope of preventive vaccination in the regions, identified were the territories in which epidemic complication are most likely to occur in 2017.
Проанализированы данные эпизоотологического и эпидемиологического обследования очагов туляремии на территориях 85 субъектов Российской Федерации. О циркуляции и активности инфекции в регионах судили по сведениям о положительных находках при исследовании мелких млекопитающих, иксодовых клещей, комаров, слепней и других объектов внешней среды, полученных при помощи иммунологических и молекулярногенетических методов исследования, по данным о выделении культур возбудителя туляремии и заболеваемости людей. В 2015 г. в стране зарегистрирован 71 случай заболевания человека туляремией. Дана краткая характеристика активности природных очагов туляремии и эпидемической ситуации на территории Российской Федерации в 2015 г. Показаны субъекты Российской Федерации, в которых низкий объем вакцинопрофилактики. Представлена дифференциация территорий по риску заболевания инфекцией в 2016 г.
The review provides the data on the epidemic condition of tularemia foci in countries neighboring Russia and ongoing preventive measures in these territories. The highest tularemia incidence in the stated countries and in the world as a whole is observed in Finland. In 2019, 42 cases of human infection with tularemia pathogen were recorded in the territory of the Russian Federation, 85 % of which occur in three Federal Districts: North-Western, Central, and Siberian. Epizootic manifestations of infection of varying degrees of intensity were detected in 51 entities of the Federation. Against this background, sporadic cases of tularemia are registered in 17 regions of the country. The most severe epidemic complications continue in Karelia – 9 patients. Seventeen Francisella tularensis cultures were isolated from environmental objects in the Tver, Yaroslavl, Vologda Regions, in the Altai Territory and the Altai Republic. The paper gives an opinion on the regions in which epidemic complications of tularemia are most likely to occur in 2020.
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