Vii disease measures are in the cells of infections with the aerosol mechanism of transmission icon

Vii disease measures are in the cells of infections with the aerosol mechanism of transmission




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VII Disease measures are in the cells of infections with the aerosol mechanism of transmission


Duration – 2 hours.


1 Actuality of theme: the infections of respiratory tracts, because of complication of influence on the mechanism of transmission, remain most widespread in the world. Weight of motion of many diseases of this group, complication, negatively influence on the state of health of population, especially children. It requires subsequent perfection of іmmunoprophylaxis which remains the basic mean of prophylaxis of infections with the aerosol mechanism of transmission.


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

2.1 A student must know:

а- 2

  • features of displays of epidemic process of respiratory infections (diphtheria, measles, meningococcal infection, epidemic parotitis);

  • sources of exciter;

  • ways and factors of transmission of exciter;

  • terms which are instrumental in an infection;

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

  • 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).


2.2 A student must be able:

а- 3

  • to collect epidemiology anamnesis for a patient with suspicion on a respiratory 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 (interdiscipline 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 еlimination of exciter from the organism of man

To estimate information of immunological researches


Propedevtic 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


^ 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.

^ Interdiscipline integration

Infectious diseases


Features of infectious diseases. Principles of diagnostics, treatment, prophylaxis of infectious diseases. Laboratory diagnostics.


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

To conduct differential diagnostics of illnesses of different genesis.


3.2 Structurally logical chart of maintenance of theme of employment


^ EPIDEMIC DESCRIPTION

INFECTION OF RESPIRATORY TRACTS


Those WHICH FOLLOW

by facilities of IMMUNOPROPHYLAXIS:

Diphtheria: toxoid (mono- or the associated vaccine).

Whooping-cough: іnactive vaccine (associated).

Measles : living vaccine (mono- or associated).

Meningococus infection: chemical vaccine.

Parotitis infection: living vaccine (mono- or associated).

German measles: living vaccine (mono- or associated).

Hemophilic infection: chemical (polisaccharide) vaccine (mono- or associated).

Tuberculosis: living vaccine.


Those WHICH do not FOLLOW

by facilities of immunoprophylaxis:

Sharp respirator viral infections.

Scarlatina.

Infectious mononucleosis and other.


^ PROPHYLACTIC WORK IS AT FLU AND OTHER ARVD

Pre-epidemic period

Population

Sanitary educational work

Tempering

Vaccination

Policlinics

Vaccination of personnel

Reading is with doctors from diagnostics, treatment of ARVD

Providing of individual defence facilities

^ Permanent establishments are uninfectious

Vaccination of personnel

Reading is with doctors from diagnostics, treatment of flu and ARVD

Providing of individual defence facilities

Providing of supply of аrbidol, remantadine, to the interferon and others like that

^ Period of the epidemic getting up

Population

Sanitary educational work

A timely appeal is for medical help

Limitation of mass measures

Closing of educational establishments

Policlinics

Expansion of register office and certificate telephones

Bringing in of additional transport

Bringing in of doctors of other type, іnternes, is for maintenance of patients with a flu

Selection of apartments for the reception of patients with a fever with a private entrance

Work of personnel is in masks

^ Permanent establishments are uninfectious

Sanitary educational work. A filter is for admition. An insulator is for patients with a flu. Limitation (stopping) of visits sick. Work of personnel is in masks. Ventilation and OOH irradiation of chambers. Use of facilities of heterospecific prophylaxis


^ 3.3 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. it is Epidemiology. Mcode: Medicine, 1993. - P. 202-259.

3 V.D. Belyakov, R.Kh. Yafaev – Epidemiology . M., 1989. - p. 183-246.

Additional:

4 The methodical pointing is 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.

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

6 An order of ministry of health of Ukraine is from 20.11.08 № 661 «About claim of methodical recommendations the «Epidemiology supervision and control after the cases of seasonal and bird flu for people»

7 There is an order of ministry of health of Ukraine from 08.08.09 № 463 «About claim of methodical recommendations «Epidemiology, laboratory diagnostics and prophylaxis of legionellosis»

8 There is an order of ministry of health of Ukraine from 17.05.05 № 188 "About claim of instruction in relation to organization of epidemiology supervision after measles"

9 There is an order of ministry of health of Ukraine from 15.04.05 № 170 "About claim of the methodical pointing from microbiological diagnostics of meningococcus infection and festerings bacterial meningitises"

10 There is an order of ministry of health of Ukraine from 15.04.05 № 169 "About claim of the methodical pointing from microbiological diagnostics of whooping-cough and parapertussis"

11 An order of ministry of health of Ukraine is from 03.03.99 р № 192"About measures on the improvement of bacteriodiagnosis of diphtheria in Ukraine"

12 There is an order of ministry of health of Ukraine from 09.02.98 № 30"About measures on a prophylaxis and fight against a flu and other ARD in Ukraine"

13 There is an order of ministry of health of the USSR from 1.12.88 № 858"The methodes for to advance treatment-diagnostical and prophylactic methodes for fight against meningoccus infectious and use epidemic monitor"

14 An order of ministry of health of the USSR is from 2.04.86 № 450 "a mayors for prevention diphtheria"
^



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 respiratory infections (diphtheria, measles, meningoccus infection, epidemic parotitis).

2 Sources of infection. Terms of contagiousness of patients.

3 Ways and factors of transmission of respiratory infections.

4 Factors which influence on determination of limits of epidemic cell at respiratory infections.

5 Terms of existence of epidemic cells are at respiratory infections

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

7 Organization and leadthrough of іmmunoprophylaxis of pin is in cells.

8 Governed excerption of patients with respiratory infections.

9 Governed admittance of reconvalescentes on respiratory infections in a collective.

10 Organization and volumes of disease measures is in the cells of respiratory infections: 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 An exciter has the greatest firmness in an environment:

a – bark;

b - meningococcus infection;

c - to diphtheria;

d - to the flu.


2 What infection of respiratory tracts are the additional ways of infection possible at?

a – flu;

b – tuberculosis;

c - meningococcus infection;

d – diphtheria;

e - windy pox.


3 Subject for obligatory hospitalization:

a - there are patients with diphtheria;

b - patients are with suspicion on diphtheria;

c - patients with a quinsy to put from child's collective;

d - there are patients with laryngotracheitis;

e - transmitters of toxigenic corynebacterium.


4 At an exposure in child's collective of transmitter of toxigenic culture of corynebacterium conduct:

a - bacteriological inspection of contact people;

b - serum inspection of contact people;

c - analysis of vaccination of contact people;

d - a medical supervision for contact people during 7 days.


5 In the presence of exciter of diphtheria subject an obligatory inspection:

a - to put, which enter houses of child, school, – boarding-schools;

b - patients which are hospitalized in psychoneurological permanent establishments;

c - patients which are hospitalized in child's hospitals;

d – a contact people from the cells of diphtheria.


6 An inoculation in the cells of diphtheria is conducted:

a - uninstiled against diphtheria;

b - to the persons which do not have duty revaccination;

c - to the persons which are instiled fully against diphtheria, but more than 3 years passed after the last inoculation.


7 At a disease on the meningococcus infection of child of kindergarden set a medical supervision a contact people:

a - on a group by a term on 7 days;

b - on a group by a term on 10 days;

c - on kindergarden on 7 days;

d - on kindergarden on 10 days.


8 Most dangerous for environment is a patient:

a - on meningococcus nasopharyngitis;

b - healthy transmitter of meningococcus;

c - on meningococcus meningitis;

d - with the displays of meningococcemia.


9 For a meningococcus infection characteristic seasonality:

a - spring summer;

b – summer – autumn;

c – fall winter;

d – winter – spring.


10 Chemical disinfection in the hearth of meningococcus infection does not conduct, as:

a - an exciter well survives in a near-by environment;

b - an exciter is unsteady to the permanent action physical factors;

c - an exciter resistance to chemical disinfectants;

d - an exciter is not selected in circumferential an environment.


11 Basic directions of warning of distribution of meningococcus infection:

a - planned іmmunoprophylaxis;

b - іmmunoprophylaxis is after epidemic testimonies;

c - active exposure and isolation of sources of infection;

d - timely disease measures are in a cell.


12 For a contact people which communicated from two patients with measles in child's establishment, a medical supervision is set during:

a - 21 day from the day of disease of 1th patient;

b - 21 day from the day of hospitalization of 2-th patient;

c - 21 day from the day of the last visit of child's establishment by a 2-th patient;

d - 21 day from the day of the last contact with a 2-th patient.


13 A patient of measles is dangerous for environment:

a - 1-2 closing dates of incubation;

b - from 4 days to the rash to 4 days of rash;

c - 5-7 days after a rash;

d - all of period of disease.


14 To the group of kindergarten, the case of measles is incorporated in which, children can be accepted:

a - what reconvalescentes of measles;

b - what reconvalescentes a german measles;

c - what got an antimorbillous immunoprotein;

d - what are instiled against measles on age.


15 Inoculation pin a morbillous vaccine it is possible to conduct in the epidemic cell of measles:

a - to all of persons which do not have an age-old inoculation;

b - to the persons which do not have an age-old inoculation, if passed not more than 72 hours from the beginning of contact with a patient;

c - to the persons which do not have an age-old inoculation, if passed not more than 72 hours from the last contact with a patient;

d - conducting is impossible.


16 A patient with epidemic parotitis is dangerous for environment:

a - first 10 days from the beginning of disease;

b - from 1-2 days of latent period to 9 days of disease;

c - in a prodromal period.


17 An epidemiology supervision after the cell of epidemic parotitis is set on:

a - 9 days from the beginning of disease;

b – 21 day is from the leadthrough of epidemiology inspection of cell;

c - 21 day is from a leadingout sick from a cell.


18 In the cell of epidemic parotitis conduct:

a – disinfection;

b - moist cleaning up of apartments, ventilation;

c - a daily medical review of children is with a thermometery;

d - passive іmmunoprophylaxis pin;

e - inoculation of children which do not have age-old immunization, for terms, if not more than 72 hours passed from a contact.


Standards of right answers:

1 – c

7 - b

13 – b

2 – b, d

8 – a

14 – a

3 – a, b, c, e

9 – d

15 - b

4 – a, c, d

10 – b

16 – b

5 – a, b, d

11 – d

17 - c

6 – b

12 – d

18 - b, c, e
^


3.4.3 Tasks are for self-control


Task 1

For a child which visits child's establishment, epidemic parotitis is diagnosed.She was illed on 8 of March. Closing date of visit of establishment – on 5 of March. Cases of epidemic parotitis in establishment during the last month not registered. In a group 20 children, all of healthy.

What disease measures must be conducted?


Task 2

9 October for the pupil of a 8 class (14 years) diphtheria is suspected. A child was ill on 7 of October, closing date at school – on 8 October, hospitalized on 9 of October. At the review of pin yet for 2th children found out a quinsy. A contact at home: mother - 30 years, against diphtheria instiled on age, last inoculation in 28 years; dad – 32 years, information about an inoculation against diphtheria absent; sister – 18 years, last age-old inoculation in 14 years.

What disease measures must be conducted?

Task 3

The 10 of October, the laboratory assistant of clinical laboratory set a diagnosis «measles». on 6 of October. Closing date at work on 9 of October. A rash appeared on 9 of October. Hospitalized on 10 of October. During the last month conducted the fence of material for policlinic patients, worked in a mask. Lives in the dormitory of family type. A contact for families: man 45 years, was illing on a measles 5 years ago; son – 7 years, instiled on age, last inoculation 3 months ago; son – 15 years, was in a sanatorium, returned home on 9 of October, instiled on age; daughter – 5 years, not instiled through contra-indication.

What disease measures must be accepted?


Task 4

By the doctor of first-aid for a patient A. meningitis is suspected. He was ill on 1 of October, hospitalized on 5 of October, in a neurological separation. Diagnosis at a review in an induction centre is a meningococcus infection. Directed on hospitalization in an infectious separation.

Lives in the dormitory of cell-type on 4 rooms, in apartments moistly, a room and corridor does not get some fresh air. Studies on the 2th course of university. Closing date of visit – on 4 of Octobers.

What disease measures must be accepted?


Task 5

At the bacteriological inspection of children of school-boarding-school with a prophylactic purpose for one child toxigenic is selected corynebacterium. In this connection by the medical workers of establishment the followings measures were conducted:


  • a child was translated for sanation in the insulator of establishment;

  • in all of apartments of establishment conducted the moist cleaning up from 2% by soapy soda solution;

  • after pin set the medical supervision of medical sisters;

  • conducted the repeated laboratory inspection of children of establishment.
^

What errors were here suffered?


Standards of answer are on a task

Task 1


As in the period of contagiousness (2 days prior to beginning of illness) a sick child did not visit child's establishment are threats of infecting by it other children are not. Restrictive measures are not conducted.


Task 2

Medical looking for a contact people on family and school during 7 days.

A laboratory inspection of contact people of family and school.

There is hospitalization of patients with a quinsy.

Estimation of vaccinal anamnesis of schoolboys and workers of school, leadthrough, subject inoculations after еpidindication.

In a home cell quickly to conduct an inoculation against diphtheria the sister of diseased, father, – after liquidation of cell.

Sanitary-enlighten work is among contact people.


Task 3

In an epidemic cell at the place of work:

- a medical daily supervision is after pin (by the workers of laboratory) for 30 of October ;

- from 14 of October, maintenance of patients by the workers of laboratory only in masks;

- to the expectant mothers which were not ill measles and more than 8 years passed after the last inoculation – during 6 days from a contact to enter a normal human immunoglobulin;

- ventilation, moist cleaning up.

In an epidemic cell domiciliary:

- a medical supervision is after pin (depending on planning of dormitory, use of general apartments, degree of contact, with other resident – a list of pin can be different) for 31 of October;

- to enter a normal human immunoprotein daughter of sick;

- ventilation, moist cleaning up.


Task 4

Medical supervision after contact (resident in a block, students of group) during 10 days from the day of the last contact: thermometery 2 times per a day, review, bacteriological inspection, a otolaryngologist.

Ventilation, moist cleaning up, in apartments.


Task 5

  • A people , that extract toxigenic corynebacterium it is necessary to hospitalize in infectious permanent establishment for treatment;

  • in apartments within the limits of cell it is necessary to conduct final disinfection after the mode for the respiratory infections of bacterial nature;

  • after contact people to set a medical supervision with the obligatory review of otolaryngologist;

  • to overcome not only children but also personnel of establishment bacteriological inspections.
^


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 respiratory infections.

  • Able to define a testimony to hospitalization.

  • To develop the plan of disease measures for localizations and liquidations of cells of respiratory infections.

  • To define the credible sources of infecting in every epidemic cell of respiratory infections, apply measures on their removal.

  • To conduct the selection of material for a bacteriologic examination on a diphtherial infection.

  • 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 respiratory infections.


^

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

4.2.1 A professional algorithm is in relation to forming of skills and abilities of diagnostics of infectious diseases




Task


Sequence of implementation


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


1





2




3


4



To master the features of displays of epidemic process of infections of respiratory tracts.

To learn the sources of exciter; ways and factors of transmission of exciter; terms which are instrumental in an infection.

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


To find out intensity 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 lay hands on the method of collection of epidemiology anamnesis at the infections of respiratory tracts.


To define a testimony to hospitalization.

To develop the plan of disease measures on localization and liquidation of cells of respiratory infections


To define the credible sources of infecting in every epidemic cell of respiratory infections, apply measures on their removal.

To conduct the selection of material for a bacteriologic examination on diphtheria.

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

To organize the leadthrough of final and current desinfection in the cells of respiratory infections


Epidemic process, sources of infection, term of contagiousness, ways and factors of transmission, at diphtheria, bark, meningococcus infection, epidemic parotitis.

Factors which influence on verge of epidemic cell.

Terms of existence of epidemic cells.

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

Organization and leadthrough іmmunoprophylaxis of contact people in cells.

Governed excerption, admittance of reconvalescentes|, in a collective.

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



Materials of after audition of independent work

Subject of UDRS and NDRS:

  • The epidemiology features of morbidity of population t. Sumy on festerings meningitises.


  • Influence of іmmunoprophylaxis is on motion of epidemic process of measles to t. Sumy.

  • Efficiency of application of restrictive measures is in child's preschool establishment for warning of distribution of windy pox.

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