Vi disease measures in the cells of infections with the sullage-oral mechanism of transmission icon

Vi disease measures in the cells of infections with the sullage-oral mechanism of transmission




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VI Disease measures in the cells of infections with the sullage-oral mechanism of transmission


Duration – 2 hours.


1 Actuality of theme: infections with the sullage-oral mechanism of transmission continue to occupy leading places in many countries of the world, becoming, even, by reason of death of people. On these infections social factors, technical state of environment, have a perceptible influence. At the same time, there are clear prophylactic work, disease measures, assignments in cells, that enables to influence on intensity of epidemic process.


2 Whole lessons (with pointing of level of mastering which is planned)

2.1 A student must know:

а- 2

  • epidemiology description of group of enteroideas;

  • features of displays of epidemic process of enteroideas (shigellosis, typhoid fever, paratyphoids, salmonellosiss, viral hepatitis A, poliomyelitis, sausage-poisoning);

  • sources of exciter;

  • ways and factors of transmission of exciter;

  • terms which are instrumental in an infection;

  • displays of epidemic process (level of morbidity, displays of morbidity in time, for territories, among the different groups of population and for to the collectives);

  • disease measures, directed on every link of epidemic process.



2.2 A student must be able:

а- 3

  • to collect epidemiology anamnesis for a patient with suspicion on an intestinal infection;

  • to set the source of infection;

  • to find out ways and factors of transmission of exciter;

  • to define the limits of cell and circle of pin;

  • to organize disease measures, directed on every link of epidemic process.
^


3 Materials of before audition of independent work


3.1 Base knowledges, abilities, skills, necessary for a study themes (interdisciplines integration)

Disciplines

To know

Able

1

2

3

Previous disciplines

Microbiology


Properties of exciters of infectious diseases.


To analyse the results of microbiological researches, summarize them

Immunology and allergology


A role of the system of immunity and heterospecific factors of defence is in an infectious process, influence on the term of елімінації of exciter from the organism of man

To estimate information of immunological researches


Propedeutic of internal illnesses



Basic stages and methods of clinical inspection of patient

To collect anamnesis, conduct the clinical inspection of patient, find out basic symptoms and syndromes. To analyse findings

Dermatology


Pathogeny, clinic and stages of development of rash, for an infectious patient

To recognize a rash for an infectious patient



1

2

3

Next disciplines

Family medicine


Epidemiology, dynamics of clinical displays. Principles of prophylaxis.


To conduct differential diagnostics of illnesses of different genesis. To recognize an infectious disease. In good time to hospitalize a patient in infectious permanent establishment.

^ Intradiscipline integration

Infectious diseases


Features of infectious diseases. Principles of diagnostics, treatment, prophylaxis of infectious diseases. Pathogeny, dynamics of clinical displays, laboratory diagnostics, complications of infectious diseases are possible.

To utillize the epidemiology method of researches, conduct the analysis of infectious morbidity.

To conduct differential diagnostics of illnesses of different genesis. To plan and conduct prophylactic and disease measures.




3.2 Structurally logical chart of maintenance of theme of employment


^ DESCRIPTION OF EPIDEMIC PROCESS OF SHARP ENTEROIDEAS IS AT DIFFERENT WAYS OF TRANSMISSION

Watery way of transmission of exciters:

| Flashes: sharp and chronic.

- Precursors: weather terms are a rain, flood, failures of aqueduct, sewage system, worsening of bacteriological indexes of quality of water.

- Connection is with the source of water-supply.

- Seasonality of flash is not expressed.

- All of age-dependent groups are struck, except for children to 1 year.

- Polietiology of flash: gastroenteritises of shigellosis, typhoid fever, paratyphoid, hepatitis A, Е.

- Exciters: different serovars, phagotypes , biotpitches, аtypical variants of bacteria.

- Incubation: middle or maximal.

- Clinical forms: predominances of easy and effaced.

^ Alimentary way of transmission of exciters:


| Flashes: suddenness of origin, connection with one enterprise of public food consumption, with one product.

Seasonality not expressed.

- Defeat regardless of age of persons which consumed the infected product.

- Exciters: one serovar, phagotype, biotpitch.

- Incubation: minimum.

- Flashes rarely, usually sporadic morbidity.

- Clinical forms: predominance of manifestation.

Contact- domestic way of transmission of exciters:

amount of patients. General conditions of stay: dormitory, preschool child's establishment. Seasonality is not expressed. Defeat of all of age-dependent groups. More frequent one variant of exciter. Incubation: middle or maximal. Clinical forms: different.


DISEASE MEASURES ARE AT INTESTINAL ANTROPONOSIS
^

Exposure of source of infection


- an inspection of workers of objects of «group of epidemic risk» is at a receipt on work

- on epidemic indexes

- control after patients by enteroideas

- control for the people, that extract exciters

- bacteriological control is after persons which socialize with the source of infection.
^

Removal of ways and factors of transmission of exciters


Food way

- control of health of «workers» in the food industry

- observance of technology of preparation of meal

- observance of terms of storage of products

- observance of terms of realization of products

Water-way

- disinfestation of domestic flow waters

- disinfestation of drinking-water

contact - domestic way

- observance of sanitary terms in an apartment, sanitary maintenance of cloak-rooms

- a fight is against flies

Defence of receptive persons

- sanitary education

- observance of hygienical skills

- hygienical mode at preparation of meal

- a timely address of patient is to the doctor at a disease.



    1. Literature is made to order:

Basic:

  1. Epidemiology / Yu.D. Goca, I.P. Kolesnikovoy, G.A. Mokhorta. it is Kyiv: «Askaniya», 2007. – P.

  2. N.D. Yuschuk, M.A. Togova, V.V.Bushueva. Epidemiology. Mcode: Medicine, 1993. - p. 128-186.

  3. V.D. Belyakov, R.Kh. Yafaev - Epidemiology. M., 1989. - p. 247-289.


Additional:

  1. The methodical pointing to mastering of practical skills from epidemiology / Compilers: M.D. Chemych, N.I. Il’yina, G.S. Zayceva, V.V. Zakhlebayeva. Sumy: Publish house of SUMDU, 2008. – p.17-20, 40 – 42

  2. Official site ministry of health of Ukraine of // www. moz.gov.ua

  3. Methodical recommendations are to leadthrough of epidemiology analysis / Compilers: M.D. Chemych, G.S. Zayceva, N.I. Il’yina, V.V. Zakhlebyaeva. Sumy: Publish house of SUMDU, 2009. – 22 .

  4. An order is from 18.02.08 № 86 "About claim of the methodical pointing the "Viral monitoring in the system of epidemiology supervision after enteroviral infections and ways of his improvement"

  5. There is an order of ministry of health of the USSR from 16.08.89 № 475 "The methods for and to advance a prophylactic acute intestinal infectious in a country"

  6. An order of ministry of health of Ukraine is from 14.07.98 y № 196 "About strengthening of measures on warning of diseases on poliomyelitis in Ukraine".

  7. There is an order of ministry of health of Ukraine from 23.06.98 № 168 "About creation of laboratory network from diagnostics of poliomyelitis and sharp flabby paralyses" (with changes in obedience to an order from 06.10.00 № 246)

  8. There is an order of ministry of health of the USSR from 02.03.89 № 139 "The methods for lowering morbility by typhoid fever in a country"

  9. There is an order of ministry of health of Ukraine from 08.01.86 № 18 "A increase methods for prophylactic salmonellosis"

  10. There is an order of ministry of health of Ukraine from 19.12.2000 № 348 "About sharpening of еpidsituation from viral hepatitis A in Ukraine"

  11. There is an order of ministry of health of Ukraine from 30.07.96 № 237 "About claim of Order of organization of permanent establishments at home for adults, patients with, the easy forms of viral hepatitis A"
^


3.4 Materials are for self-control


3.4.1 A question is for self-control

1 Epidemiology features of displays of epidemic process of enteroideas (typhoid fever, paratyphoids, salmonellosiss, shigellosis, viral hepatitis A and Е, cholera, poliomyelitis, sausage-poisoning).

2 Sources of infectious disease.

3 Ways and factors of transmission of enteroideas. Description of epidemic process is depending on the ways of realization of exciter.

4 Terms of contagiousness of source of exciter at enteroideas.

5 Factors which influence on determination of limits of epidemic cell at enteroideas.

6 Terms of existence of epidemic cells at enteroideas.

7 Governed laboratory inspection of patients and persons which contacted with a patient.

8 Governed exception of patients with enteroideas.

9 Governed admittance of reconvalescents on enteroideas in a collective.

10 Organization and volumes of disease measures in the cells of enteroideas: domiciliary, at the place of work, studies, in child's preschool establishments and others like that.


3.4.2 Tests are for self-control

To choose right answers

1 A maximal term of survival of exciter of typhoid fever in food products:

a - a few hours;

b - a few days;

c - a few months;

d - more than year.


2 A latent period at typhoid fever:

a - 3-5 days;

b - 7-12 days;

c - 3-25 days;

d - 35-45 days.

3 The most effective method of laboratory diagnostics of typhoid fever in the first days of disease is:

a – coproculture;

b – hemoculture;

c – Widal’s test;

d – urinoculture.


4 At chronic bacteria carriering all of exciter of typhoid can be discovered more reliable:

a - in a neurolymph;

b - in blood;

c - in a bile;

d - in urine.


5 There is a period of maximal contagiousness of patient with typhoid:

a - latent period;

b - first week illnesses;

c - 2-3 weeks of illness;

d - period of reconvalescents.


6 Epidemically the most dangerous source of exciter of typhoid fever is:

a - healthy bacillicarrier;

b - sharp bacillicarrier;

c - chronic bacillicarrier;

d - patient by typhoid.


7 Seasonality of typhoid fever is for countries with a temperate climate:

a – spring - summer;

b – summer;

c – summer – autumn;

d - not expressed.


8 The leading way of transmission of typhoid in modern terms is:

a - water and food;

b - food and domestic;

c – water;

d – domestic;

e – food.


9 Native material is collected for research on a dysentery must be delivered in a laboratory:

a - during 2 hours;

b - during 6 please;

c - during 12 hours;

d - during 24 hours.


10 The medical looking after pin in the cell of shigellosis lasts:

a - 7 days from a moment hospitalization of patient and leadthrough of disinfection;

b - 7 days from appearance of the first symptoms of disease;

c - 7 days from the control inspection of reconvalescent (in the case of ambulatory treatment of patient);

d - 14 days.


11 Persons which act on work in food and equated with them enterprises and establishments are subject a bacteriological inspection:

a - non-permanent;

b – double;

c – triply;

d - does not inspect.


12 In the housings cells of shigellosis subject a non-permanent bacteriological inspection:

a - workers of food enterprises and establishments to them equated;

b - to put, that visit preschool establishments;

c - to put schools – boarding-schools;

d - to put to 2th;

e - to put, that visit educational establishments.


13 Most contagious patient with viral hepatitis is:

a - from the beginning of latent period;

b - closing 7 – 10 dates latent period – the first 2 weeks disease;

c - first 2 weeks disease;

d - during all of icteric period.


14 Season at viral hepatitis A:

a – absent;

b – winter – spring;

c - spring – summer;

d – fall winter.


15 Most of flashes of viral hepatitis A tie with:

a - by a domestic factor;

b - by a water factor;

c - by a food factor.


16 In housings cells it is expedient to conduct the inspection of healthy pin for an exposure:

a - in the whey of blood of specific immunoprotein of Mcode;

b - in excrements to the antigen of hepatitis A;

c - in the whey of blood of enzymes of ALT, AST;

d - in the whey of blood of virus of hepatitis A.


17 Intensity of epidemic process of poliomyelitis is in Ukraine:

a - sporadic morbidity;

b – epidemic;

c - episode morbidity;

d – pandemic.


18 The source of exciter of poliomyelitis can be:

a - healthy transmitters;

b - there are patients with paralytic and not paralytic forms;

c - to put after an inoculation a live (Sabin’s) oral vaccine;

d - to put after an inoculation a іnactivated vaccine.


19 A selection a poliomyelitis lasts with excrements:

a - to the month from the beginning of disease;

b - to the 2th months from the beginning of disease;

c - to the 6-th months from the beginning of disease.


20 By the source of exciter of salmonellosiss for a man can be:

a - sick man;

b – cattle;

c – pigs;

d - pond fish;

e – poultries.


21 Immunity after the carried infection of salmonellosis :

a - of short duration;

b - non-sterile;

c - serospecific.


22 Prophylactic measures include at sausage-poisoning:

a - non-admission is to work of transmitters of botulinic spores;

b - canning only of fresh and clean produces;

c - a brine must contain a not less than 12% kitchen salt;

d - acidity of marinade must be no more рН = 4.

23 To laboratory research for establishment of diagnosis «sausage-poisoning» subject:

a - tailings of meal;

b - vomit the masses;

c - water of gastric lavage;

d - organs of dead body;

e – blood;

f – excrement.


24 Measures provide for in the cells of sausage-poisoning:

a - a removal is from work of persons which were with a patient in a similar terms on a disease;

b - early exposure of patients and treatment of them by a antibotulinc whey;

c - exposure of persons which used one with a patient product for a timely grant them of medicare;

d - prohibition of realization of the suspected product.


Standards of right answers:

1 – c

7 - c

13 – b

19 – b

2 – c

8 – a

14 – d

20 – a, b, c, e

3 – b

9 – a

15 – b

21 – a, c

4 – c

10 – a, c

16 – a, b

22 – b, c, d

5 – c

11 – a

17 – a

23 – a, b, c, d, e

6 – c

12 – a, b, c, d

18 - a, b, c

24 -b, c, d
^




3.4.3 Task are for self-control


Task 1

For a patient K., hospitalized in an infectious separation, viral hepatitis of A. After 2 weeks after hospitalization to the district pediatrician a child appealed with complaints about head pain, increase of temperature. A sharp respiratory disease is diagnosed. After 3 days for a child appeared icteric scleroticas, urine blackout. Viral hepatitis is diagnosed.

At epidemiology investigation of case a disease is set that a supervision is after pin, them laboratory inspection, sanitary sanitary-clarification work, in a cell not conducted; a district internist and pediatrician about the presence of cell of viral hepatitis is not informed.

What measures must it was conducted in a home cell in connection with registration of the first case of viral hepatitis A?


Task 2

Among products feeds which was used by a patient with sausage-poisoning 2 days prior to beginning of disease were: mushrooms are canned, braised with a potato during 15 minutes before the use; mushrooms are pickled home-made; caviar of the dried pond fish; can food is fish industrial production.

What from the transferred products can be the credible factors of intoxication?

Why?


Task 3

During the leadthrough of inspection of cells of salmonellosis, which were registered during the last week, it was set that 80% patients were used in a meal by eggs hen (fried, omelet, boiled to semireadiness).

Must it accept what measures, that warn distribution of morbidity on a salmonellosis?


Task 4

For the worker of milk-factory at a sudden inspection was selected enteropathogen collibacillus of О124. Patients with enteroideas among the workers of enterprise during the last year are not registered. 3 workers absent in the moment of inspection (vacation).

Is it needed to accept additional disease measures on an enterprise?

What?


Task 5

25 October in profesion-technical educational establishment it is registered 34 sick students of different groups. In all the increase of temperature registered to 37,2 - 37,5 оС, nausea, vomit, in 28 persons – diarea. All of diseased had dinner in the dining-room of establishment on Octobers, 23-24. Clinical displays began in the evening on Octobers, 24 or at night from 24 to October, 25.

What disease can be suspected?

What disease measures must be accepted?


^

Standards of answer are on a task

Task 1


See the Methodical pointing to mastering of practical skills from epidemiology / Compilers: M.D. Chemych, N.I. Il’yina, G.S. Zayceva, V.V. Zakhlebayeva. Sumy: Public house of SUMDU, 2008. – p. 17-19.


Task 2

Mushrooms are pickled, caviar, as technology of preparation, condition of storage, does not eliminate the maintainance of spores of exciter and formation of botulinic toxine.


Task 3

At first, to provide the leadthrough of disease measures in every cell of salmonellosis.

Secondly, to take measures from the removal of credible leading factor of transmission – eggs:

  • to find out the place of acquisition of eggs and poultry factory which products act from;

  • to conduct laboratory research of eggs which will be realized in trade and which were purchased diseased;

  • to inform the inspection of veterinary medicine for verification of observance of the sanitary veterinary mode on poultry factories;

  • on the results of laboratory researches and verifications – to forbid the sale of eggs from unhappy on a salmonellosis economies.


Task 4

To hospitalize a patient for an inspection, diagnostics, and, at a necessity, treatment.

All of pin at the place of work to inspect an intestinal microflora on еnteropathogenic.

To conduct laboratory control of observance of the sanitary disease mode on an enterprise.

To conduct final disinfection on an enterprise.

To analyse reasons of temporal absence of workers of enterprise and rightness of admittance of them to work.


Task 5

Sharp enteroideas take a place. The complex of disease measures contains:

  • a review and questioning of students is with the purpose of active exposure of patients;

  • collection and analysis of food factors of diseased;

  • selection of daily allowance tests and food products (on industrial sterility, on the exciters of KHTI);

  • a selection of water of the centralized supply is in establishment;

  • an inspection is on a еnteropathogenic microflora after еpidindication of workers of dining-room and students, which were on a duty in a dining-room;

  • sampling disinfectantes (dry, solutions);

  • a leadthrough of final disinfection is in establishment;

  • a leadthrough of control of observance of the disease mode is in establishment.


^


4 Materials are for audience independent work


4.1 List of educational practical tasks which must be executed on practical employment:

  • To lay hands on the method of collection of epidemiology anamnesis at enteroideas.

  • Able to define a testimony to hospitalization.

  • To develop the plan of disease measures on localization and liquidation of cells of enteroideas.

  • To define the credible leading factors of transmission in every epidemic cell of enteroideas, apply measures on their removal.

  • To define the term of supervision and volume of inspection of contact persons.

  • To organize the leadthrough of final and current disinfection in the cells of enteroideas.
^

4.2 Materials of the methodical providing of the basic stage of employment

4.2.1 Professional algorithm in relation to forming of skills and abilities of realization of disease measures in the cells of infections with the sullage-oral mechanism of transmission




Task


Sequence of implementation


A remark, warning, is in relation to self-control


1

























2




3



To master epidemiology description of group of enteroideas. Features of displays of epidemic process of enteroideas (shigellosis, typhoid fever, paratyphoids, salmonellosiss, viral hepatitis A and Е, poliomyelitis, sausage-poisoning); sources of exciter; ways and factors of transmission of exciter; terms which are instrumental in an

infection.

To learn the displays of epidemic process (level of morbidity, displays of morbidity in time, for territories, among the different groups of population and for to the collectives)

To carry out disease measures, directed on every link of epidemic process


To lay hands on the method of collection of epidemiology anamnesis at enteroideas.

To define a testimony to hospitalization.

To define the credible leading factors of transmission in every epidemic cell of enteroideas, apply measures on their removal.


To expect the level of morbidity, displays of morbidity in time, for territories, among the different groups of population and for to the collectives.


To develop the plan of disease measures on localization and liquidation of cells of enteroideas.

To define the term of supervision and volume of inspection of contact persons. To organize the leadthrough of final and current disinfection in the cells of enteroideas.

Epidemiology features of displays of epidemic process of enteroideas.

Sources of infectious disease.

Ways and factors of transmission of enteroideas.

Terms of contagiousness of source of infection are at enteroideas.

Factors which influence on determination of limits of epidemic cell.

Terms of existence of epidemic cells.


Governed: laboratory inspection of patients and persons which contacted with him; excerption;

to admitting of reconvalescents to the collective.


Materials of after audition of independent work

Subject of UDRS and NDRS:

  • Features of epidemic process of viral hepatitis A to t. Sumy.


  • An epidemiology value of prophylactic medical reviews of workers of enterprises of food retail industry, public food consumption, trading in food stuffs, is for development of epidemic process of enteroideas to t. Sumy

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