Prevention of especially dangerous infections. Primary anti-epidemic measures

(HOI) are highly contagious diseases that appear suddenly and spread quickly, covering a large mass of the population in the shortest possible time. AIOs have a severe clinical course and are characterized by a high mortality rate. Prevention of especially dangerous infections, carried out in full, can protect the territory of our state from the spread of such especially dangerous infections as cholera, anthrax, plague and tularemia.

When a patient with a particularly dangerous infection is identified, anti-epidemic measures are taken: medical and sanitary, treatment and preventive and administrative. The purpose of these measures is to localize and eliminate the epidemic outbreak. In case of zoonotic especially dangerous infections, anti-epidemic measures are carried out in close contact with the veterinary service.

Anti-epidemic measures (AM) are carried out on the basis of information obtained as a result of an epidemiological survey of the outbreak.

The organizer of the PM is an epidemiologist whose responsibilities include:

• formulation of epidemiological diagnosis,
• collection of epidemiological anamnesis,
• coordination of the efforts of the necessary specialists, assessment of the effectiveness and quality of ongoing anti-epidemic measures.

Responsibility for eliminating the source of infection rests with the sanitary and epidemiological service.

Rice. 1. Early diagnosis of the disease is an event of exceptional epidemiological importance.

The task of anti-epidemic measures is to influence all parts of the epidemic process.

The purpose of anti-epidemic measures- cessation of pathogen circulation at the site.

Direction of anti-epidemic measures:

• disinfect the source of pathogens,
• break pathogen transmission mechanisms,
• increase immunity to infection of surrounding and contact persons (immunization).

Health measures in case of especially dangerous infections, they are aimed at prevention, diagnosis, treatment of patients and carrying out sanitary and hygienic education of the population.

Administrative activities— organization of restrictive measures, including quarantine and observation in the territory of an epidemic focus of a particularly dangerous infection.

Rice. 2. In the photo, a group of specialists is ready to provide assistance to patients with Ebola fever.

Zoonotic and anthroponotic especially dangerous infections

Particularly dangerous infections are divided into zoonotic and anthroponotic infections.

• Zoonotic diseases are transmitted from animals. These include plague and tularemia.
• In anthroponotic infections, transmission of pathogens occurs from a sick person or a healthy carrier to a person. These include cholera (group) and smallpox (group of respiratory tract infections).

Prevention of particularly dangerous infections: basic concepts

Prevention of especially dangerous infections is carried out constantly and includes epidemiological, sanitary and veterinary supervision and a set of sanitary and preventive measures.

Epidemic surveillance

Epidemic surveillance of especially dangerous infections is the constant collection and analysis of information about diseases that pose a particular danger to humans.

Based on supervisory information, medical institutions determine priority tasks for providing care to patients and preventing particularly dangerous diseases.

Sanitary supervision

Sanitary supervision is a system of constant monitoring of the compliance by enterprises, institutions and individuals with sanitary and anti-epidemic norms and rules, carried out by the sanitary and epidemiological service authorities.

Veterinary supervision

In case of zoonotic especially dangerous infections, anti-epidemic measures are carried out in close contact with the veterinary service. Prevention of animal diseases, safety of animal products and suppression of violations of veterinary legislation of the Russian Federation are the main directions of state veterinary supervision.

Sanitary and preventive measures

The main goal of sanitary and preventive measures is to prevent the occurrence of infectious diseases. They are carried out constantly (even in the absence of disease).

Rice. 3. Epidemic surveillance is a shield for infection.

Neutralization of the source of pathogens

Measures to disinfect the source of pathogens in anthroponotic infections

If a particularly dangerous disease is detected or suspected, the patient is immediately hospitalized in a hospital with an anti-epidemic regime. Timely treatment begins to stop the spread of infection from a sick person into the environment.

Measures to disinfect the source of pathogens during zoonotic infections

When anthrax is detected in animals, their carcasses, organs and skin are burned or disposed of. In case of tularemia, they are disposed of.

Rice. 4. Disinsection (extermination of insects). Disinfection (destruction of bacteria, mold and fungi). Deratization (destruction of rodents).

Rice. 5. Burning the corpses of animals infected with anthrax.

Rice. 6. The photo shows deratization. Rodent control is carried out for plague and tularemia.

Maintaining a clean living environment is the basis for the prevention of many infectious diseases.

Measures aimed at breaking the transmission mechanisms of pathogens of particularly dangerous infections

The destruction of toxins and their pathogens is carried out using disinfection, for which disinfectants are used. With the help of disinfection, the number of bacteria and viruses is significantly reduced. Disinfection can be current or final.

Disinfection for particularly dangerous infections is characterized by:

• large volume of work,
• variety of disinfection objects,
• disinfection is often combined with disinsection (extermination of insects) and deratization (extermination of rodents),
• Disinfection for particularly dangerous infections is always carried out urgently, often even before the pathogen is identified,
• disinfection sometimes has to be carried out at sub-zero temperatures.

Military forces are involved in work in large outbreaks.

Rice. 7. Military forces are involved in work in large outbreaks.

Quarantine

Quarantine and observation are restrictive measures. Quarantine is carried out using administrative, medical, sanitary, veterinary and other measures that are aimed at stopping the spread of particularly dangerous infections. During quarantine, the administrative region switches to a special mode of operation of various services. In the quarantine zone, the movement of the population, transport and animals is limited.

Quarantine infections

Quarantine infections (conventional) are subject to international sanitary agreements (conventions - from lat. conventio- contract, agreement). The agreements are a document that includes a list of measures to organize strict state quarantine. The agreement restricts the movement of patients.

Often, the state uses military forces for quarantine measures.

List of quarantine infections

• polio,
• plague (pneumonic form),
• cholera,
• smallpox,
• Ebola and Marburg fever,
• influenza (new subtype),
• acute respiratory syndrome (SARS) or Sars.

Medical, sanitary and anti-epidemic measures for cholera

Epidemic surveillance

Epidemic surveillance of cholera is the constant collection and analysis of information about the disease in the country and cases of importation of a particularly dangerous infection from abroad.

Rice. 15. A patient with cholera was removed from the plane (Volgograd, 2012).

Health care measures for cholera

• isolation and adequate treatment of cholera patients;
• treatment of carriers of infection;
• sanitary and hygienic education of the population (regular hand washing and sufficient heat treatment of food will help to avoid disease);
• vaccination of the population according to epidemiological indications.

Rice. 16. Microbiological diagnosis of cholera is carried out in secure laboratories.

Preventing cholera

• To prevent cholera, cholera vaccine is used in dry and liquid form. The vaccine is administered subcutaneously. The vaccine is used to prevent the disease in disadvantaged regions and when there is a threat of the introduction of a particularly dangerous infection from other places. During the epidemic, risk groups for the disease are vaccinated: persons whose work is related to water bodies and water supply facilities, workers associated with public catering, food preparation, storage, transportation and its sale.
• Persons who have been in contact with cholera patients are administered cholera bacteriophage twice. The interval between administrations is 10 days.
• Anti-epidemic measures for cholera.
• Localization of the outbreak.
• Elimination of the outbreak.
• Burial of corpses.
• Contact persons from a cholera outbreak are subject to observation (isolation) for the entire incubation period of this disease.
• Carrying out current and final disinfection. The patient's belongings are processed in a steam or steam-formalin chamber.
• Carrying out disinfestation (fighting flies).

Rice. 17. Fighting flies is one of the components of the prevention of intestinal infections.

Preventive anti-epidemic measures for cholera

• implementation in full of measures aimed at preventing the introduction of infection from abroad, regulated by special documents;
• measures to prevent the spread of cholera from natural foci;
• measures to prevent the spread of the disease from foci of infection;
• organization of disinfection of water and public places.
• timely detection of cases of local cholera and imported infections;
• study of water from reservoirs in order to monitor circulation;
• identification of the culture of cholera pathogens, determination of toxicogenicity and sensitivity to antibacterial drugs.

Rice. 18. Actions of epidemiologists when taking water samples.

Medical, sanitary and anti-epidemic measures for plague

Epidemic surveillance for plague

Activities for epidemic surveillance of plague are aimed at preventing the introduction and spread of a particularly dangerous infection and include:

Rice. 19. In the photo there is a plague patient. The affected cervical lymph nodes (buboes) and multiple hemorrhages of the skin are visible.

Medical and sanitary measures for plague

• Plague patients and patients suspected of having the disease are immediately transported to a specially organized hospital. Patients with the pneumonic form of plague are placed one at a time in separate rooms, and patients with the bubonic form of plague are placed several in one room.
• After discharge, patients are subject to 3-month observation.
• Contact persons are observed for 6 days. When in contact with patients with pneumonic plague, contact persons are given antibiotic prophylaxis.

Prevention of plague (vaccination)

• Preventive immunization of the population is carried out when a massive spread of plague among animals is detected and a particularly dangerous infection is introduced by a sick person.
• Routine vaccinations are carried out in regions where natural endemic foci of the disease are located. A dry vaccine is used, which is administered intradermally once. It is possible to re-administer the vaccine after a year. After vaccination with an anti-plague vaccine, immunity lasts for a year.
• Vaccination can be universal or selective - only for the threatened population: livestock breeders, agronomists, hunters, food processors, geologists, etc.
• Re-vaccinate after 6 months. persons at risk of re-infection: shepherds, hunters, agricultural workers and employees of anti-plague institutions.
• Maintenance personnel are given preventive antibacterial treatment.

Rice. 20. Vaccination with anti-plague vaccine can be universal or selective.

Anti-epidemic measures for plague

Identification of a plague patient is a signal for the immediate implementation of anti-epidemic measures, which include:

There are two types of deratization: preventive and exterminatory. General sanitary measures, as the basis for rodent control, should be carried out by the entire population.

Rice. 21. Plague deratization is carried out in open areas and indoors.

Epidemic threats and economic damage caused by rodents will be minimized if deratization is carried out in a timely manner.

Anti-plague suit

Work in a plague outbreak is carried out in an anti-plague suit. An anti-plague suit is a set of clothing that is used by medical personnel when working in conditions of possible infection with a particularly dangerous infection - plague and smallpox. It protects the respiratory organs, skin and mucous membranes of personnel involved in medical and diagnostic processes. It is used by sanitary and veterinary services.

Rice. 22. The photo shows a team of doctors in anti-plague suits.

Preventing the introduction of plague from abroad

Prevention of the introduction of plague is based on constant surveillance of persons and cargo arriving from abroad.

Medical, sanitary and anti-epidemic measures for tularemia

Epidemic surveillance

Epidemic surveillance of tularemia is the continuous collection and analysis of information about episodes and vectors of the disease.

Prevention of tularemia

A live vaccine is used to prevent tularemia. It is intended to protect humans in areas of tularemia. The vaccine is administered once, starting at age 7.

Anti-epidemic measures for tularemia

Anti-epidemic measures for tularemia are aimed at implementing a set of measures, the purpose of which is the destruction of the pathogen (disinfection) and the destruction of carriers of the pathogen (deratization and disinfestation).

Preventive actions

Measures against tick bites boil down to the use of sealed clothing and repellents.

Anti-epidemic measures, carried out on time and in full, can lead to a rapid cessation of the spread of especially dangerous infections, localize and eliminate the epidemic focus in the shortest possible time. Prevention of especially dangerous infections - plague, cholera,

Particularly dangerous infections (EDI) or infectious diseases are diseases that are characterized by a high degree of infectivity. They suddenly appear and spread quickly, have a severe clinical picture and a high degree of mortality. What kind of pathologies are these, and what preventive measures to take to avoid getting infected, read on.

What kind of list is this?

Particularly dangerous infections include a conditional group of acute infectious human diseases that correspond to two characteristics:

• may appear suddenly, spread quickly and massively;
• are severe and have a high mortality rate.

The list of DPOs was first presented at the 22nd session of the World Health Organization (WHO) on July 26, 1969. In addition to the list, the assembly also established the International Health Regulations (IHR). They were updated in 2005 at the 58th session of WHO.

According to the new amendments, the Assembly has the right to draw conclusions about the state of certain diseases in the country both from official state reports and from media reports.

WHO has received significant powers for medical regulation of infectious diseases caused by acute respiratory infections.

It is important to note that today in world medicine there is no concept of “OOI”. This term is predominantly used in the CIS countries, but in world practice, AIOs mean infectious diseases that are included in the list of events that may pose an excessive danger in the health care system on an international scale.

List of DPOs

The World Health Organization has compiled a list of more than a hundred diseases that can quickly and massively spread among the population. Initially, according to data from 1969, this list included only 3 diseases:

• plague;
• cholera;
• anthrax.

However, later the list was significantly expanded and all the pathologies that were included in it were conditionally divided into 2 groups:

1. Diseases that are unusual and may affect public health. These include:

• smallpox;
• polio;
• severe acute respiratory syndrome.

2. Diseases, any manifestation of which is assessed as a threat, since these infections can have a serious impact on public health and quickly spread internationally. This also includes diseases that represent a regional or national problem. These include:

• cholera;
• pneumonic plague;
• yellow fever;
• hemorrhagic fevers (Lassa, Marburg, West Nile fever);
• dengue fever;
• Rift Valley fever;
• meningococcal infection.

In Russia, two more infections have been added to these diseases - anthrax and tularemia.

All these pathologies are characterized by severe course, high risk of mortality and, as a rule, form the basis for biological weapons of mass destruction.

Classification of especially dangerous infections

All OI are classified into three types:

1. Conventional diseases. Such infections are subject to international sanitary regulations. This:

• bacterial pathologies (plague and cholera);
• viral diseases (monkeypox, hemorrhagic viral fevers).

2. Infections that require international surveillance, but are not subject to joint activities:

• (typhoid and relapsing fever, botulism, tetanus);
• viral (poliomyelitis, influenza, rabies, foot and mouth disease);
• protozoans (malaria).

3. Not subject to WHO supervision, are under regional control:

• anthrax;
• tularemia;
• brucellosis.

The most common OOIs

The most common dangerous infections should be considered separately.

Plague

An acute, especially dangerous disease that belongs to. The source and distributor of the infection are rodents (mainly rats and mice), and the causative agent is the plague bacillus, which is resistant to environmental conditions. Plague is transmitted primarily through transmission through flea bites. From the onset of the disease, it occurs in an acute form and is accompanied by general intoxication of the body.

Distinctive symptoms include:

• intense fever (temperature can rise to 40°C);
• unbearable headache;
• the tongue becomes covered with a white coating;
• facial hyperemia;
• delirium (in advanced cases, when the disease is not treated correctly);
• expression of suffering and horror on the face;
• hemorrhagic rashes.

Plague is treated with antibiotics (streptomycin, terramycin). The pulmonary form always ends in death, as acute respiratory failure occurs - the patient dies within 3-4 hours.

Acute intestinal infection with a severe clinical picture, high mortality rate and increased prevalence. The causative agent is Vibrio cholerae. Infection occurs mainly through contaminated water.

Symptoms:

• sudden profuse diarrhea;
• profuse vomiting;
• decreased urination due to dehydration;
• dryness of the tongue and oral mucosa;
• decrease in body temperature.

The success of therapy largely depends on the timeliness of the diagnosis. Treatment involves taking antibiotics (tetracycline) and copious intravenous administration of special solutions to replenish the deficiency of water and salts in the patient’s body.

Black pox

One of the most highly contagious infections on the planet. It is an anthroponotic infection and only affects people. The transmission mechanism is airborne. The source of the smallpox virus is considered to be an infected person. The infection is also transmitted from an infected mother to the fetus.

Since 1977, not a single case of smallpox infection has been reported! However, smallpox viruses are still stored in bacteriological laboratories in the USA and Russia.

Symptoms of infection:

• sudden increase in body temperature;
• sharp pain in the lumbar and sacrum areas;
• rash on the inner thighs, lower abdomen.

Treatment of smallpox begins with immediate isolation of the patient, the basis of therapy is gamma globulin.

Yellow fever

Acute hemorrhagic transmissible infection. Source: monkeys, rodents. The carriers are mosquitoes. Distributed in Africa and South America.

Symptoms of the disease:

• redness of the skin of the face and neck in the first stage of the disease;
• swelling of the eyelids and lips;
• thickening of the tongue;
• lacrimation;
• pain in the liver and spleen, an increase in the size of these organs;
• redness gives way to yellowness of the skin and mucous membranes.

If the diagnosis is not made in a timely manner, the patient’s well-being worsens every day, bleeding from the nose, gums and stomach is noted. Possible death from multiple organ failure. The disease is easier to prevent than to treat, so vaccination of the population is carried out in areas where cases of pathology are frequent.

The infection is zoonotic and is considered a weapon of mass destruction. The causative agent is a stationary bacillus that lives in the soil, from where animals become infected. Cattle are considered the main carrier of the disease. The routes of human infection are airborne and alimentary. There are 3 types of disease, which will determine the symptoms:

• Cutaneous. The patient develops a spot on the skin, which over time turns into an ulcer. The disease is severe and can be fatal.
• Gastrointestinal. The following signs are noted: sudden increase in body temperature, bloody vomiting, abdominal pain, bloody diarrhea. As a rule, this form is lethal.
• Pulmonary. It proceeds in the most difficult way. There is a high temperature, bloody cough, and disturbances in the functioning of the cardiovascular system. A few days later the patient dies.

Treatment consists of taking antibiotics, but more importantly, administering a vaccine that prevents infection.

Tularemia

Bacterial zoonotic infection. Source: rodents, cattle, sheep. The causative agent is a gram-negative rod. The mechanism of penetration into the human body is contact, nutritional, aerosol, transmission.

Symptoms:

• heat;
• general malaise;
• pain in the lower back and calf muscles;
• skin hyperemia;
• damage to the lymph nodes;
• macular or petechial rash.

Compared to other AIOs, tularemia is treatable in 99% of cases.

Flu

The list of infectious diseases includes avian influenza, a severe viral infection. The source of infection is migratory waterfowl. A person can become ill by improperly caring for infected birds or by eating the meat of infected birds.

Symptoms:

• high fever (can last up to several weeks);
• catarrhal syndrome;
• viral pneumonia, from which the patient dies in 80% of cases.

Quarantine infections

This is a conditional group of infectious diseases for which quarantine of one degree or another is imposed. It is not equivalent to OI, but both groups include many infections that require the imposition of strict state quarantine with the involvement of military forces in order to limit the movement of potentially infected people, protect areas of infection, etc. Such infections include, for example, smallpox and pneumonic plague.

It is worth noting that WHO has recently made several statements that it is inappropriate to impose strict quarantine when cholera occurs in a particular country.

The following methods for diagnosing OI are distinguished:

1. Classic:

• microscopy - the study of microscopic objects under a microscope;
• polymerase chain reaction (PCR);
• agglutination reaction (RA);
• immunofluorescence reaction (RIF, Koons method);
• bacteriophage test;
• bioassay on an experimental animal whose immunity is artificially reduced.

2. Accelerated:

• pathogen indication;
• pathogen antigens (AG);
• reverse passive hemagglutination reaction (RPHA);
• coagglutination reaction (RCA);
• enzyme immunoassay (ELISA).

Prevention

Prevention of acute respiratory infections is carried out at the highest level in order to prevent the spread of diseases throughout the state. The complex of primary preventive measures includes:

• temporary isolation of the infected person with further hospitalization;
• making a diagnosis, convening a consultation;
• taking anamnesis;
• providing first aid to the patient;
• collection of material for laboratory research;
• identification of contact persons, their registration;
• temporary isolation of contact persons until their infection has been ruled out;
• carrying out current and final disinfection.

Depending on the type of infection, preventive measures may vary:

• Plague. In natural foci of distribution, observations of the number of rodents, their examination and deratization are carried out. In the surrounding areas, the population is being vaccinated with a dry live vaccine subcutaneously or cutaneously.
• . Prevention also includes working with hotspots of infection. Patients are identified, isolated, and all persons in contact with the infected are isolated. All suspected patients with intestinal infections are hospitalized and disinfected. In addition, control over the quality of water and food products in this area is required. If there is a real threat, quarantine is introduced. If there is a threat of spread, the population is immunized.
• . Sick animals are identified and quarantine is prescribed, fur clothing is disinfected if infection is suspected, and immunization is carried out according to epidemic indicators.
• Smallpox. Prevention methods include vaccination of all children starting from 2 years of age, followed by revaccination. This measure virtually eliminates the occurrence of smallpox.

The list of especially dangerous infections includes those diseases that are characterized by a particular epidemic danger, i.e. capable of widespread spread among the population. They are also characterized by a severe course, a high risk of mortality, and can form the basis of biological weapons of mass destruction. Let's consider which infections are included in the list of especially dangerous ones, as well as how you can protect yourself from infection.

Particularly dangerous infections and their pathogens

In world medicine, there are no uniform standards regarding which infections should be considered especially dangerous. The lists of such infections are different in different regions; they may be supplemented with new diseases and, conversely, exclude some infections.

Currently, domestic epidemiologists adhere to a list that includes 5 particularly dangerous infections:

• anthrax;
• plague;
• tularemia;
• yellow fever (as well as the similar Ebola and Marburg fevers).

anthrax

Zoonotic infection, i.e. transmitted to humans from animals. The causative agent of the disease is a spore-forming bacillus that persists in the soil for decades. The source of infection is sick domestic animals (cattle and small cattle, pigs, etc.). Infection can occur in one of the following ways:

• contact;
• airborne dust;
• nutritional;
• transmissible.

The disease has a short incubation period (up to 3 days). Depending on the clinical picture of anthrax, there are 3 types:

• cutaneous;
• gastrointestinal;
• pulmonary

Cholera

An acute bacterial disease belonging to the group of intestinal infections. The causative agent of this infection is Vibrio cholerae, which survives well at low temperatures and in the aquatic environment. The sources of infection are a sick person (including at the recovery stage) and a vibrio carrier. Infection occurs through the fecal-oral route.

The incubation period of the disease is up to 5 days. Cholera is especially dangerous when it occurs in erased or atypical forms.

Plague

An acute infectious disease characterized by extremely high contagiousness and a very high probability of death. The causative agent is the plague bacillus, which is transmitted by sick people, rodents and insects (fleas, etc.). The plague wand is very stable and can withstand low temperatures. The transmission routes are different:

• transmissible;
• airborne.

There are several forms of plague, the most common of which are pneumonic and bubonic. The incubation period can be up to 6 days.

Tularemia

Natural focal infection, which is considered especially dangerous, relatively recently became known to mankind. The causative agent is the anaerobic tularemia bacillus. Reservoirs of infection are rodents, some mammals (hares, sheep, etc.), birds. However, sick people are not contagious. The following routes of infection are distinguished:

• transmissible;
• respiratory;
• contact;
• nutritional.

The incubation period, on average, is 3 – 7 days. There are several forms of tularemia:

• intestinal;
• bubonic;
• generalized;
• ulcerative bubonic, etc.

Yellow fever

REMINDER

TO THE MEDICAL WORKER WHEN CARRYING OUT PRIMARY MEASURES IN THE OCCU

If a patient is identified who is suspected of having plague, cholera, GVL or smallpox, based on the data of the clinical picture of the disease, it is necessary to assume a case of hemorrhagic fever, tularemia, anthrax, brucellosis, etc., it is necessary first of all to establish the reliability of its connection with the natural source of infection.

Often the decisive factor in establishing a diagnosis is the following epidemiological history data:

• Arrival of a patient from an area unfavorable for these infections for a period of time equal to the incubation period;
• Communication of the identified patient with a similar patient along the route, at the place of residence, study or work, as well as the presence there of any group diseases or deaths of unknown etiology;
• Staying in areas bordering the parties that are unfavorable for these infections or in exotic territory for the plague.

During the period of initial manifestations of the disease, OI can give pictures similar to a number of other infections and non-infectious diseases:

For cholera- with acute intestinal diseases, toxic infections of various nature, poisoning with pesticides;

During the plague- with various pneumonias, lymphadenitis with elevated temperature, sepsis of various etiologies, tularemia, anthrax;

For monkeypox- with chickenpox, generalized vaccine and other diseases accompanied by rashes on the skin and mucous membranes;

For Lasa fever, Ebola, and Marburg- with typhoid fever, malaria. In the presence of hemorrhages, it is necessary to differentiate from yellow fever, Dengue fever (see clinical and epidemiological characteristics of these diseases).

If a patient is suspected of having one of the quarantine infections, the medical worker must:

1. Take measures to isolate the patient at the place of detection:

• Prohibit entry and exit from the outbreak, isolate family members from communicating with the sick person in another room, and if it is not possible to take other measures, isolate the patient;
• Before hospitalizing the patient and carrying out final disinfection, it is prohibited to pour the patient’s discharge into the sewer or cesspool, water after washing hands, dishes and care items, or remove things and various objects from the room where the patient was;

2. The patient is provided with the necessary medical care:

• if plague is suspected in a severe form of the disease, streptomycin or tetracycline antibiotics are administered immediately;
• in severe cases of cholera, only rehydration therapy is performed. Cardiovascular drugs are not administered (see assessment of the degree of dehydration in a patient with diarrhea);
• when carrying out symptomatic therapy for a patient with GVL, it is recommended to use disposable syringes;
• depending on the severity of the disease, all transportable patients are sent by ambulance to hospitals specially designated for these patients;
• for non-transportable patients, assistance is provided on site with the call of consultants and an ambulance equipped with everything necessary.

3. By telephone or by messenger, notify the head physician of the outpatient clinic about the identified patient and his condition:

• Request appropriate medications, protective clothing, personal prophylactic equipment, material collection equipment;
• Before receiving protective clothing, a medical worker who suspects plague, GVL, or monkeypox should temporarily cover his mouth and nose with a towel or mask made from improvised material. For cholera, personal prevention measures for gastrointestinal infections must be strictly observed;
• Upon receipt of protective clothing, they put it on without removing their own (except for those heavily contaminated with the patient’s secretions)
• Before putting on PPE, carry out emergency prevention:

A) in case of plague - treat the nasal mucosa and eyes with a solution of streptomycin (100 distilled water per 250 thousand), rinse the mouth with 70 grams. alcohol, hands - alcohol or 1% chloramine. Inject intramuscularly 500 thousand units. streptomycin - 2 times a day, for 5 days;

B) with monkeypox, GVL - like with the plague. Anti-smallpox gammaglobulin metisazon - in the isolation ward;

C) For cholera - one of the means of emergency prevention (tetracycline antibiotic);

4. If a patient is identified with plague, GVL, or monkeypox, the medical worker does not leave the office or apartment (in case of cholera, if necessary, he can leave the room after washing his hands and taking off the medical gown) and remain until the arrival of the epidemiological and disinfection brigade.

5. Persons who were in contact with the patient are identified among:

• Persons at the patient’s place of residence, visitors, including those who had left by the time the patient was identified;
• Patients who were in this institution, patients transferred or sent to other medical institutions, discharged;
• Medical and service personnel.

6. Collect material for testing (before the start of treatment), fill out a referral to the laboratory in pencil.

7. Carry out ongoing disinfection in the fireplace.

8. after the patient leaves for hospitalization, carry out a set of epidemiological measures in the outbreak until the arrival of the disinfection team.

9. Further use of a medical worker from the outbreak of plague, GVL, monkeypox is not permitted (sanitation and in the isolation ward). In case of cholera, after sanitization, the health worker continues to work, but he is under medical supervision at the place of work for the duration of the incubation period.

BRIEF EPIDEMIOLOGICAL CHARACTERISTICS OF OOI

Name of infection	Source of infection	Transmission path	Incubus period
Smallpox	A sick man		14 days
Plague	Rodents, humans	Transmissible - through fleas, airborne, possibly others	6 days
Cholera	A sick man	Water, food	5 days
Yellow fever	A sick man	Vector-borne - Aedes-Egyptian mosquito	6 days
Lasa fever	Rodents, sick person	Airborne, airborne, contact, parenteral	21 days (from 3 to 21 days, more often 7-10)
Marburg disease	A sick man		21 days (from 3 to 9 days)
Ebola fever	A sick man	Airborne, contact through the conjunctiva of the eyes, parapteral	21 days (usually up to 18 days)
Monkeypox	Monkeys, sick person until 2nd contact	Air-droplet, air-dust, contact-household	14 days (from 7 to 17 days)

MAIN SIGNAL SIGNS of OOI

PLAGUE- acute sudden onset, chills, temperature 38-40°C, severe headache, dizziness, impaired consciousness, insomnia, conjunctival hyperemia, agitation, tongue coated (chalky), phenomena of increasing cardiovascular insufficiency develop, within a day, characteristics characteristic of each develop forms of signs of the disease:

Bubonic form: the bubo is sharply painful, dense, fused with the surrounding subcutaneous tissue, immobile, its maximum development is 3-10 days. The temperature lasts 3-6 days, the general condition is serious.

Primary pulmonary: against the background of the listed signs, chest pain appears, shortness of breath, delirium, cough appears from the very beginning of the disease, the sputum is often foamy with streaks of scarlet blood, and there is a discrepancy between the data of an objective examination of the lungs and the general serious condition of the patient. The duration of the disease is 2-4 days, without treatment 100% mortality;

Septic: early severe intoxication, a sharp drop in blood pressure, hemorrhage on the skin, mucous membranes, bleeding from internal organs.

CHOLERA- mild form: loss of fluid, loss of body weight occurs in 95% of cases. The onset of the disease is acute rumbling in the abdomen, loose stools 2-3 times a day, and maybe vomiting 1-2 times. The patient’s well-being is not affected, and working capacity is maintained.

Moderate form: fluid loss of 8% of body weight, occurs in 14% of cases. The onset is sudden, rumbling in the stomach, vague intense pain in the abdomen, then loose stools up to 16-20 times a day, which quickly loses the fecal character and smell, green, yellow and pink color of rice water and diluted lemon, defecation without urge uncontrollable (for 500-100 ml are excreted once; an increase in stool is typical with each defect). Vomiting occurs along with diarrhea and is not preceded by nausea. Severe weakness develops and an unquenchable thirst appears. General acidosis develops and diuresis decreases. Blood pressure drops.

Severe form: algid develops with a loss of fluid and salts of more than 8% of body weight. The clinical picture is typical: severe emaciation, sunken eyes, dry sclera.

YELLOW FEVER: sudden acute onset, severe chills, headaches and muscle pain, high fever. The patients are safe, their condition is serious, nausea and painful vomiting occur. Pain in the pit of the stomach. 4-5 days after a short-term drop in temperature and improvement in general condition, a secondary rise in temperature occurs, nausea, vomiting of bile, and nosebleeds appear. At this stage, three warning signs are characteristic: jaundice, hemorrhage, and decreased urine output.

LASSA FEVER: in the early period, symptoms: - pathology is often not specific, a gradual increase in temperature, chills, malaise, headache and muscle pain. In the first week of the disease, severe pharyngitis develops with the appearance of white spots or ulcers on the mucous membrane of the pharynx and tonsils of the soft palate, followed by nausea, vomiting, diarrhea, chest and abdominal pain. By the 2nd week, diarrhea subsides, but abdominal pain and vomiting may persist. Dizziness, decreased vision and hearing are common. A maculopapular rash appears.

In severe cases, symptoms of toxicosis increase, the skin of the face and chest becomes red, the face and neck are swollen. Temperature is about 40°C, consciousness is confused, oliguria is noted. Subcutaneous hemorrhages may appear on the arms, legs, and abdomen. Hemorrhages into the pleura are common. The febrile period lasts 7-12 days. Death often occurs in the second week of illness from acute cardiovascular failure.

Along with severe ones, there are mild and subclinical forms of the disease.

MARBURG'S DISEASE: acute onset, characterized by fever, general malaise, headache. On the 3-4th day of illness, nausea, abdominal pain, severe vomiting, and diarrhea appear (diarrhea may last for several days). By the 5th day, in most patients, first on the torso, then on the arms, neck, face, a rash, conjunctivitis appears, hemorrhoidal diathesis develops, which is expressed in the appearance of pitechia on the skin, emapthema on the soft palate, hematuria, bleeding from the gums, in places of syringe Kolov, etc. The acute febrile period lasts about 2 weeks.

EBOLA FEVER: acute onset, temperature up to 39°C, general weakness, severe headaches, then pain in the neck muscles, in the joints of the leg muscles, conjunctivitis develops. Often there is a dry cough, sharp pain in the chest, severe dryness in the throat and pharynx, which interfere with eating and drinking and often lead to the appearance of cracks and ulcers on the tongue and lips. On the 2-3rd day of illness, abdominal pain, vomiting, and diarrhea appear; after a few days, the stool becomes tarry or contains bright blood.

Diarrhea often causes varying degrees of dehydration. Usually on the 5th day, patients have a characteristic appearance: sunken eyes, exhaustion, weak skin turgor, the oral cavity is dry, covered with small ulcers similar to aphthous ones. On the 5th-6th day of illness, a macular-potulous rash appears first on the chest, then on the back and limbs, which disappears after 2 days. On days 4-5, hemorrhagic diathesis develops (bleeding from the nose, gums, ears, syringe injection sites, bloody vomiting, melena) and severe sore throat. Symptoms indicating involvement of the central nervous system in the process are often observed - tremor, convulsions, paresthesia, meningeal symptoms, lethargy or, conversely, agitation. In severe cases, cerebral edema and encephalitis develop.

MONKEYPOX: high fever, headache, pain in the sacrum, muscle pain, hyperemia and swelling of the mucous membrane of the pharynx, tonsils, nose, rashes are often observed on the mucous membrane of the oral cavity, larynx, nose. After 3-4 days, the temperature drops by 1-2°C, sometimes to low-grade fever, general toxic effects disappear, and health improves. After the temperature drops on the 3-4th day, a rash appears first on the head, then on the torso, arms, and legs. The duration of the rash is 2-3 days. Rashes on individual parts of the body occur simultaneously, the rash is predominantly localized on the arms and legs, simultaneously on the palms and soles. The nature of the rash is papular-vediculous. The development of the rash is from a spot to a pustule slowly, over 7-8 days. The rash is monomorphic (at one stage of development - only papules, vesicles, pustules and roots). Vesicles do not collapse when punctured (multi-locular). The base of the rash elements is dense (presence of infiltrates), the inflammatory rim around the rash elements is narrow and clearly defined. Pustules form on the 8-9th day of illness (6-7th day of the appearance of the rash). The temperature rises again to 39-40°C, the patients' condition worsens sharply, headaches and delirium appear. The skin becomes tense and swollen. Crusts form on days 18-20 of illness. There are usually scars after the crusts fall off. There is lymphadenitis.

REGIME FOR DISINFECTION OF MAIN OBJECTS IN CHOLERA

	Disinfection method	Disinfectant	Contact time	Consumption rate
1. Room surfaces (floor, walls, furniture, etc.)	irrigation	0.5% solution DTSGK, NGK 1% chloramine solution 1% solution of clarified bleach	60 min	300ml/m3
2. Gloves	dive	3% myol solution, 1% chloramine solution	120 min
3.Glasses, phonendoscope	Wipe twice with an interval of 15 minutes	3% hydrogen peroxide	30 min
4. Rubber shoes, leather slippers	wiping	See point 1
5. Bedding, cotton trousers, jacket	chamber processing	Steam-air mixture 80-90°C	45 min
6. Dishes of the patient	boiling, immersion	2% soda solution, 1% chloramine solution, 3% rmezol solution, 0.2% DP-2 solution	15 minutes 20 minutes
7. Personnel protective clothing contaminated with secretions	boiling, soaking, autoclanning	See point 6 120°C p-1.1 at.	30 min	5l per 1 kg of dry laundry
8. Protective clothing for personnel without visible signs of contamination	boiling, soaking	2% soda solution 0.5% chloramine solution 3% misol solution, 0.1% DP-2 solution	15 minutes 60 min 30 min
9. Patient's secretions	add, mix	Dry bleach, DTSGK, DP	60 min	200 gr. per 1 kg of discharge
10. Transport	irrigation	CM. paragraph 1

ASSESSMENT OF THE DEGREE OF DEHYDRATION BY CLINICAL SIGNS

Symptom or sign	Degree of disinfection as a percentage
	I(3-5%)	II(6-8%)	III(10% and above)
1. Diarrhea	Watery stools 3-5 times a day	6-10 times a day	More than 10 times a day
2. Vomiting	No or insignificant amount	4-6 times a day	Very common
3. Thirst	moderate	Expressive, drinks greedily	Can't drink or drinks poorly
4. Urine	Not changed	Small quantity, dark	Not urinating for 6 hours
5. General condition	Good, cheerful	Feeling unwell, sleepy or irritable, agitated, restless	Very drowsy, lethargic, unconscious, lethargic
6. Tears	Eat	none	none
7. Eyes	Regular	Sunken	Very sunken and dry
8. Oral mucosa and tongue	Wet	dry	Very dry
9. Breathing	Normal	Rapid	Very frequent
10. Tissue turgor	Not changed	Each fold unravels slowly	Each fold is straightened. So slow
11. Pulse	normal	More often than usual	Frequent, weak filling or not palpable
12. Fontana (in young children)	Doesn't stick	sunken	Very sunken
13. Average estimated fluid deficit	30-50 ml/kg	60-90 ml/kg	90-100 ml/kg

EMERGENCY PREVENTION IN AREAS OF QUARANTINE DISEASES.

Emergency prevention applies to those who have contact with the patient in the family, apartment, place of work, study, recreation, treatment, as well as persons who are in the same conditions regarding the risk of infection (according to epidemiological indications). Taking into account the antibiogram of strains circulating in the outbreak, one of the following devices is prescribed:

DRUGS	One-time share, in gr.	Frequency of application per day	Average daily dose
Tetracycline	0,5-0,3	2-3	1,0	4
Doxycycline	0,1	1-2	0,1	4
Levomycetin	0,5	4	2,0	4
Erythromycin	0,5	4	2,0	4
Ciprofloxacin	0,5	2	1,6	4
Furazolidone	0,1	4	0,4	4

TREATMENT SCHEMES FOR PATIENTS WITH DANGEROUS INFECTIOUS DISEASES

Disease	A drug	One-time share, in gr.	Frequency of application per day	Average daily dose	Duration of use, in days
Plague	Streptomycin	0,5 - 1,0	2	1,0-2,0	7-10
	Sizomycin	0,1	2	0,2	7-10
	Rifampicin	0,3	3	0,9	7-10
	Doxycycline	0,2	1	0,2	10-14
	Sulfatone	1,4	2	2,8	10
anthrax	Ampicillin	0,5	4	2,0	7
	Doxycycline	0,2	1	0,2	7
	Tetracycline	0,5	4	2,0	7
	Sizomycin	0,1	2	0,2	7
Tularemia	Rifampicin	0,3	3	0,9	7-10
	Doxycycline	0.2	1	0,2	7-10
	Tetracycline	0.5	4	2,0	7-10
	Streptomycin	0,5	2	1,0	7-10
Cholera	Doxycycline	0,2	1	0,2	5
	Tetracycline	0,25	4	1,0	5
	Rifampicin	0,3	2	0,6	5
	Levomecithin	0.5	4	2,0	5
Brucellosis	Rifampicin	0,3	3	0,9	15
	Doxycycline	0,2	1	0,2	15
	Tetracycline	0,5	4	2,0	15

For cholera, an effective antibiotic can reduce the amount of diarrhea in patients with severe cholera, the period of vibrio excretion. Antibiotics are given after the patient is dehydrated (usually after 4-6 hours) and vomiting has stopped.

Doxycycline is the preferred antibiotic for adults (except pregnant women).

Furazolidone is the preferred antibiotic for pregnant women.

When vibrios cholerae resistant to these drugs are isolated in cholera foci, the issue of changing the drug is considered taking into account the antibiograms of the strains circulating in the foci.

UNIT FOR COLLECTING MATERIAL FROM A PATIENT WITH SUSPECTED CHOLERA (for non-infectious hospitals, emergency medical care stations, outpatient clinics).

1. Sterile wide-neck jars with lids or

Ground stoppers of at least 100 ml. 2 pcs.

2. Glass tubes (sterile) with rubber

small size necks or teaspoons. 2 pcs.

3. Rubber catheter No. 26 or No. 28 for taking material

Or 2 aluminum hinges 1 pc.

4.Plastic bag. 5 pieces.

5. Gauze napkins. 5 pieces.

7. Band-Aid. 1 pack

8. Simple pencil. 1 PC.

9. Oilcloth (1 sq.m.). 1 PC.

10. Bix (metal container) small. 1 PC.

11. Chloramine in a 300g bag, designed to receive

10l. 3% solution and dry bleach in a bag of

calculation 200g. per 1 kg. discharge. 1 PC.

12. Rubber gloves. Two pairs

13. Cotton gauze mask (dust respirator) 2 pcs.

Installation for each line brigade of a joint venture, therapeutic area, local hospital, medical outpatient clinic, first aid station, health center - for everyday work when serving patients. Items subject to sterilization are sterilized once every 3 months.

SCHEME FOR COLLECTING MATERIAL FROM PATIENTS WITH OI:

Name of infection	Material under study	Quantity	Method of collecting material
Cholera	A) feces B)vomit B) bile	20-25 ml. pores B and C	The material is collected in a separate bin. The Petri dish, placed in a bedpan, is transferred to a glass jar. In the absence of discharge - with a boat, a loop (to a depth of 5-6 cm). Bile - with duonal probing
Plague	A) blood from a vein B) punctate from bubo B) department of the nasopharynx D) sputum	5-10 ml. 0.3 ml.	Blood from the cubital vein - into a sterile test tube, juice from a bubo from the dense peripheral part - a syringe with the material is placed in a test tube. Sputum - in a wide-necked jar. Nasopharyngeal discharge - using cotton swabs.
Monkeypox GVL	A) mucus from the nasopharynx B) blood from a vein C) contents of rashes, crusts, scales D) from a corpse - brain, liver, spleen (at sub-zero temperatures)	5-10 ml.	We separate it from the nasopharynx using cotton swabs into sterile plugs. Blood from the cubital vein - into sterile tubes; the contents of the rash are placed into sterile tubes with a syringe or scalpel. Blood for serology is taken 2 times in the first 2 days and after 2 weeks.

MAIN RESPONSIBILITIES OF THE MEDICAL PERSONNEL OF THE ENT DEPARTMENT OF THE CRH WHEN IDENTIFYING A PATIENT WITH OOI IN THE HOSPITAL (during a medical round)

1. Doctor, who identified a patient with an acute respiratory infection in the department (at the reception) is obliged to:
2. Temporarily isolate the patient at the site of detection, request containers for collecting secretions;
3. Notify by any means the head of your institution (head of department, head physician) about the identified patient;
4. Organize measures to comply with the rules of personal protection for health workers who have identified a patient (request and use anti-plague suits, means for treating mucous membranes and open areas of the body, emergency prevention, disinfectants);
5. Provide the patient with emergency medical care for life-saving reasons.

NOTE: the skin of the hands and face is generously moistened with 70° alcohol. The mucous membranes are immediately treated with a solution of streptomycin (250 thousand units in 1 ml), and for cholera - with a solution of tetracycline (200 thousand mcg/ml). In the absence of antibiotics, a few drops of 1% silver nitrate solution are injected into the eyes, 1% protargol solution is injected into the nose, the mouth and throat are rinsed with 70° alcohol.

1. Charge nurse who took part in a medical round is obliged to:
2. Request placement and collection of material from the patient for bacteriological examination;
3. Organize ongoing disinfection in the ward before the arrival of the disinfection team (collection and disinfection of the patient’s discharge, collection of contaminated linen, etc.).
4. Make lists of your closest contacts with the patient.

NOTE: After evacuating the patient, the doctor and nurse take off their protective clothing, pack it in bags and hand it over to the disinfection team, disinfect their shoes, undergo sanitary treatment and send it to their supervisor.

1. Head of department Having received a signal about a suspicious patient, he is obliged to:
2. Urgently organize the delivery to the ward of protective clothing, bacteriological equipment for collecting material, containers and disinfectants, as well as means for treating open areas of the body and mucous membranes, emergency prophylaxis;
3. Set up posts at the entrance to the ward where the patient is identified and at the exit from the building;
4. If possible, isolate contacts in wards;
5. Report the incident to the head of the institution;
6. Organize a census of your department’s contacts in the prescribed form:
7. No. pp., surname, first name, patronymic;
8. was undergoing treatment (date, department);
9. left the department (date);
10. the diagnosis with which the patient was in the hospital;
11. location;
12. place of work.

1. Senior nurse of the department, having received instructions from the head of the department, is obliged to:
2. Urgently deliver protective clothing, containers for collecting secretions, bacteriological storage, disinfectants, antibiotics to the ward;
3. Separate patients from departments into wards;
4. Monitor the work of posted posts;
5. Conduct a census using the established contact form for your department;
6. Accept the container with the selected material and ensure delivery of samples to the laboratory.

OPERATIONAL PLAN

Department activities when identifying cases of acute respiratory infections.

№№ PP	Business name	Deadlines	Performers
1	Notify and gather department officials at their workplaces in accordance with the existing scheme.	Immediately upon confirmation of diagnosis	Doctor on duty head department, head nurse.
2	Call a group of consultants through the head physician of the hospital to clarify the diagnosis.	Immediately if OI is suspected	Doctor on duty head department.
3	Introduce restrictive measures in the hospital: -prohibit access of outsiders to the buildings and territory of the hospital; -introduce a strict anti-epidemic regime in hospital departments -prohibit the movement of patients and staff in the department; -set up external and internal posts in the department.	Upon confirmation of diagnosis	Medical staff on duty
4	Conduct instruction for department staff on the prevention of acute respiratory infections, personal protection measures, and hospital operating hours.	When gathering personnel	Head department
5	Conduct explanatory work among patients in the department about measures to prevent this disease, compliance with the regimen in the department, and personal preventive measures.	In the first hours	Medical staff on duty
6	Strengthen sanitary control over the work of the dispensing room, collection and disinfection of waste and garbage in the hospital. Carry out disinfection measures in the department	constantly	Medical staff on duty head department

NOTE: further activities in the department are determined by a group of consultants and specialists from the sanitary and epidemiological station.

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questions to convey information about the patient (vibrio carrier)

1. Full Name.
2. Age.
3. Address (during illness).
4. Permanent residence.
5. Profession (for children - child care institution).
6. Date of illness.
7. Date of request for help.
8. Date and place of hospitalization.
9. Date of collection of material for tank examination.
10. Diagnosis upon admission.
11. Final diagnosis.
12. Accompanying illnesses.
13. Date of vaccination against cholera and drug.
14. Epidemiological history (connection with a body of water, food products, contact with a patient, vibrio carrier, etc.).
15. Alcohol abuse.
16. Use of antibiotics before illness (date of last dose).
17. Number of contacts and measures taken against them.
18. Measures to eliminate the outbreak and localize it.
19. Measures to localize and eliminate the outbreak.

SCHEME

specific emergency prophylaxis for a known pathogen

Name of infection	Name of the drug	Mode of application	Single dose (gr.)	Frequency of application (per day)	Average daily dose (gr.)	Average dose per course	Average course duration
Cholera	Tetracycline	Inside	0,25-0,5	3 times	0,75-1,5	3,0-6,0	4 days
	Levomycetin	Inside	0,5	2 times	1,0	4,0	4 days
Plague	Tetracycline	Inside	0,5	3 times	1,5	10,5	7 days
	Olethetrin	Inside	0,25	3-4 times	0,75-1,0	3,75-5,0	5 days

NOTE: Extract from the instructions,

approved deputy minister of health

USSR Ministry of Health P.N. Burgasov 06/10/79

SAMPLING FOR BACTERIOLOGICAL STUDIES IN OOI.

Material collected	The amount of material and what it is taken into	Property required when collecting material
I. MATERIAL ON CHOLERA
excreta		Glass Petri dish, sterile teaspoon, sterile jar with ground stopper, tray (sterilizer) for emptying the spoon
Bowel movements without stool	Same	The same + sterile aluminum loop instead of a teaspoon
Vomit	10-15 gr. in a sterile jar with a ground stopper, filled 1/3 with 1% peptone water	A sterile Petri dish, a sterile teaspoon, a sterile jar with a ground stopper, a tray (sterilizer) for emptying the spoon
II.MATERIAL IN NATURAULAR SMALLPOX
Blood	A) 1-2 ml. dilute 1-2 ml of blood into a sterile test tube. sterile water.	Syringe 10 ml. with three needles and wide lumen
	B) 3-5 ml of blood into a sterile tube.	3 sterile test tubes, sterile rubber (cork) stoppers, sterile water in 10 ml ampoules.
	With a cotton swab on a stick and immersed in a sterile test tube	Cotton swab in a test tube (2 pcs.) Sterile tubes (2 pcs.)
Contents of rashes (papules, vesicles, pustules)	Before taking, wipe the area with alcohol. Sterile test tubes with ground-in stoppers and degreased glass slides.	96° alcohol, cotton balls in a jar. Tweezers, scalpel, smallpox inoculation feathers. Pasteur pipettes, slides, adhesive tape.
III. MATERIAL IN PLAGUE
Bubo punctate	A) the needle with punctate is placed in a sterile tube with a sterile rubber crust B) blood smear on glass slides	5% tincture of iodine, alcohol, cotton balls, tweezers, 2 ml syringe with thick needles, sterile tubes with stoppers, fat-free glass slides.
Sputum	In a sterile Petri dish or a sterile wide-mouth jar with a ground stopper.	Sterile Petri dish, sterile wide-necked jar with a ground stopper.
Discharge from the nasopharyngeal mucosa	On a cotton swab on a stick in a sterile test tube	Sterile cotton swabs in sterile tubes
Blood for homoculture	5 ml. blood into sterile tubes with sterile (cortical) stoppers.	10 ml syringe. with thick needles, sterile tubes with sterile (cork) stoppers.

MODE

Disinfection of various objects contaminated with pathogenic microbes

(plague, cholera, etc.)
Object to be disinfected	Disinfection method	Disinfectant	Time contact	Consumption rate
1.Room surfaces (floor, walls, furniture, etc.)	Irrigation, wiping, washing	1% chloramine solution	1 hour	300 ml/m 2
2. protective clothing (underwear, gowns, headscarves, gloves)	autoclaving, boiling, soaking	Pressure 1.1 kg/cm 2. 120°	30 min.	¾
		2% soda solution	15 minutes.
		3% Lysol solution	2 hours	5 l. per 1 kg.
		1% chloramine solution	2 hours	5 l. per 1 kg.
3. Glasses, phonendoscope	wiping		¾
4. Liquid waste	Add and stir		1 hour	200gr./l.
5.Slippers, rubber boots	wiping	3% hydrogen peroxide solution with 0.5% detergent	¾	2x wiping at intervals. 15 minutes.
6. Discharge of the patient (sputum, feces, food debris)	Add and stir; Pour and stir	Dry bleach or DTSGK	1 hour	200 gr. /l. 1 hour of discharge and 2 hours of solution doses. volume ratio 1:2
		5% Lysol A solution	1 hour
		10% solution Lysol B (naphthalizol)	1 hour
7. Urine	Fill	2% chlorine solution. lime, 2% solution of Lysol or chloramine	1 hour	Ratio 1:1
8. Dishes of the patient	boiling	Boiling in 2% soda solution	15 minutes.	Full immersion
9. Used utensils (teaspoons, Petri dishes, etc.)	boiling	2% soda solution	30 min.	¾
		3% solution chloramine B	1 hour
		3% per. hydrogen with 0.5 detergent	1 hour
		3% Lysol A solution	1 hour
10. Hands in rubber gloves.	Immersion and washing	Disinfectant solutions specified in paragraph 1	2 minutes.	¾
Hands	-//-//-Wipe	0.5% chloramine solution	1 hour
		70° alcohol	1 hour
11.Bed accessories	Chamber disinfection	Steam-air mixture 80-90°	45 min.	60 kg/m2
12. Synthetic products. material	-//-//- Dive	Steam-air mixture 80-90°	30 min.	60 kg/m2
		1% chloramine solution	5 o'clock
		0.2% formaldehyde solution at t70°	1 hour

DESCRIPTION OF PROTECTIVE ANTIPLAGUE SUIT:

1. Pajama suit
2. Socks-stockings
3. Boots
4. Anti-plague medical gown
5. Kerchief
6. Fabric mask
7. Mask - glasses
8. Oilcloth sleeves
9. Oilcloth apron
10. Rubber gloves
11. Towel
12. Oilcloth

1. Infectious diseases that pose the greatest danger to the population of our country are cholera, plague, malaria, contagious viral hemorrhagic fevers: Lassa, Marburg, Ebola, monkeypox, polio caused by a wild virus, human influenza caused by a new subtype, SARS, under certain conditions – a number of zooanthroponoses (glanders, melioidosis, anthrax, yellow fever, hemorrhagic fever Junin (Argentine fever), Machupo (Bolivian fever), as well as infectious disease syndromes of unknown etiology that pose a danger for international spread.

2.B primary activities include:

Temporary isolation with further hospitalization

Clarifying the diagnosis and calling consultants

Information about the patient in the established form

Providing the patient with the necessary assistance

Collection of material for laboratory research

Identification and registration of all contact persons

Temporary isolation of contact persons

Carrying out current and final disinfection

3. All healthcare facilities must have a supply of:

Medicines for symptomatic therapy, emergency prophylaxis, chemoprophylaxis

Personal emergency prevention products

Personal protective equipment

Disinfectants

4. In each health care facility there must be in visible and accessible places during the day:

Alert schemes

Information on storing installations for collecting material from people

Information on the storage of disinfectants and containers for their dilution and disinfection

5. Personal prevention is the most important in the system of primary anti-epidemic measures.

5.1. We cover the mouth and nose in the fireplace with a mask, towel, scarf, bandage, etc.

5.2. Disinfect open parts of the body (with chlorine-containing solutions, 70% alcohol)

5.3. Upon delivery, PPE is put on medical clothing (not contaminated with the patient’s biomaterial)

Protective clothing (anti-plague suit) is intended to protect medical personnel from infection by pathogens of plague, cholera, hemorrhagic viral fevers, monkeypox and other pathogens of I - II pathogenicity with all the main mechanisms of their transmission.

Protective clothing must be properly sized.

Duration of work in a type 1 suit is 3 hours, in hot weather - 2 hours

Various means are usedpersonal protection: limited-life overalls made of waterproof material, mask, medical gloves, boots (medical shoe covers), anti-plague suit "Quartz", protective overalls "Taychem S", other products approved for use.

Overalls;

Phonendoscope (if necessary);

Anti-plague robe;

Cotton-gauze bandage;

Glasses (pre-lubricated with a special pencil or soap);

Gloves (first pair);

Gloves (second pair);

Oversleeves;

Towel (on the right side - one end is moistened with a disinfectant solution).

Slowly, without haste, after each removed element, treat your hands with a disinfectant solution.

Towel;

Gloves (second pair);

Oversleeves;

Phonendoscope;

Protective glasses;

Cotton-gauze bandage;

Kerchief;

Gloves (first pair);

Overalls.

Emergency prevention schemes for dangerous infectious diseases

Emergency prevention is medical measures aimed at preventing people from getting sick when they become infected with pathogens of dangerous infectious diseases. It is carried out immediately after establishing the fact of infectious diseases, as well as mass infectious diseases of unknown etiology.

1.Doxycycline-0.2, 1 time per day, 5 days

2. Ciprofloxacin-0.5, 2 times a day, 5 days.

3.Rifampicin-0.3, 2 times a day, 5 days

4.tetracycline-0.5 3 times a day, 5 days

5. Trimethoprim-1-0.4, 2 times a day, 10 days

Otolaryngological and observator (treatment of patients with other

ophthalmology department pathology for vital reasons)

Holding after provisional

departments maximum period

Dental provisional hospital (treatment of patients

department with warning symptoms of particularly dangerous

diseases: plague, cholera, SARS, etc.)

Department of purulent isolation ward (under observation)

surgery contact persons with patients with acute infectious diseases)

Infectious diseases departments infectious diseases hospital (treatment of patients OOI)