The aim of the study is to study the epidemiological risks and features of the incidence of COVID-19 in medical organizations in order to develop proposals for optimizing preventive and anti-epidemic measures. Methods: we examined reporting forms "an overview of cases with positive COVID-19" (138 items), "an overview of cases of community-acquired pneumonia with positive COVID-19" (138 units), the card of epidemiological investigation of the disease COVID-19 health workers (386 units of information), copies of "Acts of epidemiological investigation of infectious (parasitic) diseases, establishing causal relationships" (47 units of information), copies of extraordinary reports about the emergency situation of sanitary-and-epidemiologic nature (47 items). We used epidemiological and statistical methods of information processing. Conclusion: the incidence of coronavirus infection in health care workers correlated with the incidence of adult population, had a higher indicator than among them, without differing in severity and outcomes of COVID-19. The prevalence of morbidity in medical organizations was the predominance among the affected employees of medical organizations. Conditions that contribute to infection were various violations of preventive and anti-epidemic measures, including the use of personal protective equipment.
There were established municipalities with the highest mortality rates from community-acquired pneumonia (CAP). When etiological deciphering of CAP confirmed the role of S. pneumoniae (Klein) Chester in the development and outcome of this disease. Among the risk contingents were vaccinated against pneumococcal disease, which had an impact on morbidity and mortality from CAP. It is proved that the vaccination of contingent risk against pneumococcal disease reduces the morbidity and mortality from CAP.
The paper contains the data on isolation of Francisella tularensis cultures from humans and rodents during tularemia epidemic in Khanty-Mansiisk in August-September, 2013. All the obtained F. tularensis strains (six cultures of tularemia microbe from patients, and four cultures-from small rodents caught in the territory of the city and its suburbs) fall under Holarctic subspecies, are highly virulent for the laboratory mice, resistant to erythromycin, ampicillin, and cephalosporin, but sensitive to amikacin, tetracycline, doxycycline, and gentamycin. Using 25-locus-MLVA typing it is demonstrated that the strains under study form a common cluster on the phylogenetic tree along with F. tularensis strains previously isolated in the territory of the Southern Urals and Kazakhstan. All the strains from the foci are closely related ones, and based on the investigations of hyper-variable Ft-M3 locus, fall into four groups. The strains, isolated from humans, combine into three groups, and the strains isolated from rodents-into two, and notably that one of the groups of Khanty-Mansiisk cluster comprises the strains isolated from both humans and rodents.
Natural tularemia foci in the territory of the Khanty-Mansiisk Autonomous District-Yugra are still active and sustainable ones despite of the extended periods of epidemiological welfare. Agent reservoir is the water vole. However, recently tularemia agent has been detected in the northern red-backed vole and common red-toothed shrew. Khanty-Mansiisk town, Berezovsky, Khanty-Mansiisk, Kondinsky, and Oktyabr'sky Regions are situated in the territory of the most active foci. Serious outbreaks of infection among the population occur with an interval up to 30 years. Their transmissibility preconditions the scale and intensiveness. All cohorts are under the risk of exposure, irrespective of the age and occupation, including the infants. The paper discusses tularemia outbreak impact on the population of Khanty-Mansiisk and the Khanty-Mansiisk Region in July-October, 2013. Casualty toll is 1005 cases. Given is a brief retrospective analysis of epidemiological situation on tularemia since 1930-s up to the onset of the outbreak under investigation. Described is the experience in management of the response activities.
Relevance. The study of the incidence of medical workers with a new coronavirus infection during the COVID-19 pandemic is one of the topical areas of epidemiological research at this stage. The search for effective practices to reduce the incidence and risk of SARS-CoV-2 spread among employees of medical organizations is a promising area of research that is in demand in practice.Аim. Analysis of COVID-19 morbidity among health care staff during the pandemic and determination of the significance of selected specific and nonspecific prophylaxis measures in minimizing the risk of their occupational infection with SARS-CoV-2. Materials and methods. The reporting forms «General information about patients with positive COVID-19», «General information about patients with community-acquired pneumonia with positive COVID-19» (497 units of information), 2 176 cards of epidemiological investigation of cases of COVID-19 among employees of three municipalities were analyzed. We used epidemiological and statistical research methods. Conclusions. When analyzing the incidence of COVID-19 among employees of the medical worckers of the Khanty-Mansi autonomous оkrug -Yugra in the period from the 19th calendar week of 2020 to the 36th week of 2021, which corresponded to three epidemic rises, it was found that its level exceeded such in the unorganized adult population by 2.2 times, as well as the frequency of severe clinical forms of infection with lung damage. In the first two epidemic rises in the incidence, the highest incidence rate was recorded when the chances (OR) of getting COVID-19 among workers in the medical organizations compared to the adult population were the highest. In the first «wave» of the pandemic, they were 3.0, and in the second 2.6 times higher, as were the chances of developing clinical forms of COVID-19 with lung damage, which differed by 2.2 and 1.7 times, respectively, from those of an adult population (p<0.05). During the third epidemic rise, the situation changed radically. The incidence of new coronavirus infection in ,medical worckers as well as the chances of getting sick, were equal to those in the adult population (OR 1.1), while the frequency of clinical forms of infection with lung involvement was even lower than in the population (P=95.7‰).The reason for the positive changes in the dynamics of the epidemic process was due to the formation among medical workers of a higher stratum of people protected from infection due to active, emergency vaccination and people with post-infection immunity as a result of infection in its various clinical forms than in the population. A detailed analysis of the incidence of COVID-19 in three medical organizations of Khanty-Mansiysk autonomous okrug -Yugra made it possible to obtain information that among employees of medical organizations vaccinated against a new coronavirus infection, the incidence of COVID-19 was 4.4 times lower than
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