Prevention of especially dangerous infections. Primary anti-epidemic measures

(HSI) are highly contagious diseases that appear suddenly and spread rapidly, covering a large mass of the population in the shortest possible time. AIOs occur with a severe clinic and are characterized by a high percentage of mortality. Prevention of especially dangerous infections, carried out in full, is able to 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-prophylactic and administrative. The purpose of these measures is to localize and eliminate the epidemic focus. In case of especially dangerous zoonotic infections, anti-epidemic measures are carried out in close contact with the veterinary service.

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

The organizer of the PM is an epidemiologist, whose duties include:

formulating an epidemiological diagnosis,
collection of epidemiological history,
coordination of the efforts of the necessary specialists, evaluation of the effectiveness and quality of ongoing anti-epidemic measures.

Responsibility for the elimination of 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 in the focus of the circulation of pathogens.

Focus of anti-epidemic measures:

disinfect the source of pathogens,
break the mechanisms of transmission of pathogens,
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 conducting sanitary and hygienic education of the population.

Administrative arrangements- organization of restrictive measures, including quarantine and observation on the territory of an epidemic focus of a particularly dangerous infection.

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

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, the transmission of pathogens occurs from a sick person or a healthy carrier to a person. These include cholera (a group) and smallpox (a group of respiratory tract infections).

Prevention of especially 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

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

On the basis of supervisory information, medical institutions determine the priorities for providing assistance to patients and preventing especially dangerous diseases.

Sanitary supervision

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

Veterinary supervision

In case of especially dangerous zoonotic infections, anti-epidemic measures are carried out in close contact with the veterinary service. Prevention of animal diseases, safety of livestock products and suppression of violations of the 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 a disease).

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

Neutralization of the source of pathogens

Measures for disinfection of 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 regimen. Timely started treatment leads to the cessation of the spread of infection from a sick person to the environment.

Measures for disinfection of the source of pathogens in zoonotic infections

When anthrax is detected in animals, their carcasses, organs and skins are burned or disposed of. With tularemia - disposed of.

Rice. 4. Disinsection (destruction 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. In the photo, deratization is carried out. Rodent control is carried out with plague and tularemia.

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

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

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

Disinfection for especially dangerous infections is characterized by:

large amount of work
variety of objects of disinfection,
often disinfection is combined with disinsection (destruction of insects) and deratization (destruction of rodents),
disinfection in case of especially dangerous infections is always carried out urgently, often even before the pathogen is detected,
disinfection sometimes has to be carried out at negative 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, health, veterinary and other measures aimed at stopping the spread of especially 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. convention contract, agreement). The agreements are a document that includes a list of measures to organize strict state quarantine. The agreement limits the movement of patients.

Often, the state attracts military forces for quarantine measures.

List of quarantine infections

polio,
plague (pulmonary form),
cholera,
smallpox,
ebola And Marburg,
influenza (new subtype),
acute respiratory syndrome (SARS) or Sars.

Health and anti-epidemic measures for cholera

epidemic surveillance

Epidemiological surveillance of cholera is a 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 an airplane (Volgograd, 2012).

Public health interventions for cholera

isolation and adequate treatment of cholera patients;
treatment of carriers of infection;
sanitary and hygienic education of the population (usual handwashing and sufficient heat treatment of food will help to avoid illness);
vaccination of the population according to epidemiological indications.

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

cholera prevention

For the prevention of cholera, a cholera vaccine is used in dry and liquid form. The vaccine is administered subcutaneously. The vaccine is used as a prophylaxis of the disease in disadvantaged regions and with the threat of introducing a particularly dangerous infection from other places. During the epidemic, risk groups for the disease are vaccinated: people whose work is related to water bodies and waterworks, workers associated with public catering, food preparation, storage, transportation and its sale.
Persons who have been in contact with patients with cholera are administered a cholera bacteriophage twice. The interval between injections is 10 days.
Anti-epidemic measures for cholera.
Focus localization.
Elimination of the hearth.
Burial of corpses.
Contact persons from the focus of cholera 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.
Disinsection (fly control).

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

Preventive anti-epidemic measures for cholera

full implementation 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 the foci of infection;
organization of disinfection of water and common areas.
timely detection of cases of local cholera and imported infections;
study of water from reservoirs for the purpose of monitoring circulation;
identification of the culture of cholera pathogens, determination of toxicogenicity and sensitivity to antibacterial drugs.

Rice. 18. Actions of epidemiologists during water sampling.

Medical-sanitary and anti-epidemic measures in case of plague

Plague Surveillance

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

Rice. 19. Pictured 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 with suspected disease are immediately transported to a specially organized hospital. Patients with pneumonic plague are placed one at a time in separate wards, with bubonic plague - several in one ward.
After discharge, patients are subject to a 3-month follow-up.
Contact persons are observed for 6 days. In case of contact with patients with pneumonic plague, prophylaxis with antibiotics is carried out for contact persons.

Plague prevention (vaccination)

Preventive immunization of the population is carried out when a mass spread of plague among animals is detected and a particularly dangerous infection is imported by a sick person.
Scheduled vaccinations are carried out in regions where there are natural endemic foci of the disease. A dry vaccine is used, which is administered once intradermally. It is possible to re-administer the vaccine after a year. After vaccination with the anti-plague vaccine, immunity persists for a year.
Vaccination is universal and selective - only to the threatened contingent: livestock breeders, agronomists, hunters, purveyors, 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 prophylactic antibacterial treatment.

Rice. 20. Vaccination with anti-plague vaccine is universal and selective.

Anti-epidemic measures for plague

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

Deratization is of 2 types: preventive and destructive. General sanitary measures, as the basis for the fight against rodents, should be carried out by the entire population.

Rice. 21. Deratization in case of plague is carried out in open areas and indoors.

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

Anti-plague suit

Work in the focus of the plague is carried out in an anti-plague suit. The 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 the sanitary and veterinary services.

Rice. 22. In the photo, a medical team in anti-plague suits.

Preventing the introduction of plague from abroad

The prevention of the introduction of plague is based on the constant surveillance of persons and goods arriving from abroad.

Medical and sanitary and anti-epidemic measures for tularemia

epidemic surveillance

Tularemia surveillance is the continuous collection and analysis of episode and vector data.

Prevention of tularemia

A live vaccine is used to prevent tularemia. It is designed to protect people in the foci of tularemia. The vaccine is administered once, starting from the age of 7 years.

Anti-epidemic measures for tularemia

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

Preventive actions

Measures against tick bites are reduced to the use of hermetic clothing and repellents.

Anti-epidemic measures carried out in 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 (SDIs) or infectious diseases are diseases that are characterized by a high degree of contagiousness. They appear suddenly and spread rapidly, are characterized by a severe clinical picture and a high degree of mortality. What are these pathologies, and what preventive measures to take in order not to get infected, read on.

What is this list?

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

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

The list of HROs 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 the WHO.

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

WHO has been given considerable authority in the medical regulation of infectious diseases caused by AGI.

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

List of OOI

The World Health Organization has compiled a whole list of more than a hundred diseases that can quickly and massively spread among the population. Initially, according to 1969 data, 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 a severe course, a high risk of mortality, and, as a rule, form the basis for biological weapons of mass destruction.

Classification of especially dangerous infections

All OOIs are classified into three types:

1. Convention 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:

(typhus and relapsing fever, botulism, tetanus);
viral (, poliomyelitis, influenza, rabies, foot and mouth disease);
protozoan (malaria).

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

anthrax;
tularemia;
brucellosis.

The most common OOI

The most common dangerous infections should be considered separately.

Plague

An acute especially dangerous disease that refers to. The source and spreader of the infection are rodents (mainly rats and mice), and the causative agent is a plague bacillus that is resistant to environmental conditions. Plague is transmitted primarily through transmissible flea bites. Already from the beginning of the manifestation of the disease, it proceeds in an acute form and is accompanied by a general intoxication of the body.

Significant symptoms include:

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

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, a high mortality rate and an 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 intravenous plentiful administration of special solutions to make up for the lack of water and salts in the patient's body.

smallpox

One of the most highly contagious infections on the planet. Refers to anthroponotic infections, only people get sick with it. The transmission mechanism is airborne. The source of the variola virus is considered to be an infected person. The infection is also transmitted from the infected mother to the fetus.

Not a single case of smallpox has been reported since 1977! However, smallpox viruses are still stored in bacteriological laboratories in the United States and Russia.

Symptoms of infection:

sudden increase in body temperature;
sharp pains in the lumbar region and sacrum;
rash on inner thighs, lower abdomen.

Treatment of smallpox begins with the 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 course 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 is replaced by yellowness of the skin and mucous membranes.

If the diagnosis is not made in time, the patient's state of health 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 the population is vaccinated in areas where cases of pathology are frequent.

An infection of a zoonotic nature is considered as a weapon of mass destruction. The causative agent is a motionless bacillus bacillus that lives in the soil, from where animals become infected. The main carrier of the disease is considered to be cattle. The ways of human infection are airborne and alimentary. There are 3 types of the disease, which will depend on the symptoms:

Cutaneous. The patient develops a spot on the skin, which eventually turns into an ulcer. The disease is severe, possibly fatal.
Gastrointestinal. The following signs are noted: a sudden increase in body temperature, hematemesis, abdominal pain, bloody diarrhea. As a rule, this form is fatal.
Pulmonary. Runs the hardest. There is a high temperature, bloody cough, disturbances in the functioning of the cardiovascular system. A few days later the patient dies.

Treatment consists of taking antibiotics, but more importantly, the introduction of 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, alimentary, aerosol, transmissible.

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 OOIs, tularemia is 99% treatable.

Flu

The list of AEs includes avian influenza, a severe viral infection. The source of infection is migratory waterfowl. A person can get sick if the infected birds are not properly cared for or if the meat of an infected bird is eaten.

Symptoms:

high fever (may 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, in which quarantine of one degree or another is imposed. It is not equivalent to AIO, but both groups include many infections that require the imposition of strict state quarantine with the involvement of military forces in order to restrict the movement of potentially infected people, protect lesions, etc. Such infections include, for example, smallpox and pulmonary plague.

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

There are the following methods for diagnosing OOI:

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;
a bioassay on an experimental animal whose immunity is artificially reduced.

2. Accelerated:

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

Prevention

Prevention of OOI 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 with further hospitalization;
diagnosis, convening a council;
collection of anamnesis;
providing first aid to the patient;
sampling material for laboratory research;
identification of contact persons, their registration;
temporary isolation of contact persons until their infection is excluded;
carrying out current and final disinfection.

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

Plague. In natural foci of distribution, observations are made of the number of rodents, their examination and deratization. In adjacent areas, the population is vaccinated with a dry live vaccine subcutaneously or cutaneously.
. Prevention also includes work with foci of infection. Patients are being identified, isolated, and all persons in contact with the infected are being isolated. Hospitalization of all suspicious patients with intestinal infections is carried out, disinfection is carried out. In addition, it is required to control the quality of water and food in the area. If there is a real threat, quarantine is introduced. When there is a threat of spread, immunization of the population is carried out.
. Identification of sick animals with the appointment of quarantine, disinfection of fur clothes in case of suspicion of infection, immunization according to epidemic indicators is carried out.
smallpox. Prevention methods include vaccination of all children from the age of 2, followed by revaccination. This measure virtually eliminates the occurrence of smallpox.

The list of especially dangerous infections includes those diseases that are of particular epidemic danger, i.e. able to spread widely among the population. They are also characterized by a severe course, a high risk of lethality and can form the basis of biological weapons of mass destruction. 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 on which infections should be considered especially dangerous. The lists of such infections are different in different regions, may be supplemented by new diseases and, conversely, exclude some infections.

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

anthrax;
plague;
tularemia;
yellow fever (and related Ebola and Marburg).

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 (large and small cattle, pigs, etc.). Infection can occur in one of the following ways:

contact;
air-dust;
alimentary;
transmissible.

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

skin;
gastrointestinal;
pulmonary.

Cholera

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

The incubation period of the disease is up to 5 days. Especially dangerous is cholera, which 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, withstands low temperatures. 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 one of the most dangerous, has recently become known to mankind. The causative agent is anaerobic tularemia bacillus. Reservoirs of infection are rodents, some mammals (hares, sheep, etc.), birds. At the same time, sick people are not contagious. There are the following ways of infection:

transmissible;
respiratory;
contact;
alimentary.

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

intestinal;
bubonic;
generalized;
ulcerative bubonic, etc.

Yellow fever

REMINDER

TO THE MEDICAL WORKER WHEN CARRYING OUT THE PRIMARY ACTIVITIES IN THE FOCUS OF THE AE

In the case of a patient suspected of being infected with plague, cholera, GVL or smallpox, it is necessary, on the basis of the clinical picture of the disease, to suggest 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 focus of infection.

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

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

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

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

With the plague- with various pneumonia, lymphadenitis with fever, sepsis of various etiologies, tularemia, anthrax;

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

With fever Lasa, Ebola, b-ni 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 hearth, isolate communication with a sick person of family members in another room, and in the absence of the possibility to take other measures - to isolate the patient;
Before the patient is hospitalized and the final disinfection is carried out, it is forbidden to pour the patient's secretions into the sewer or cesspool, water after washing hands, dishes and care items, the removal of things and various objects from the room where the patient was located;

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 cholera, only rehydration therapy is performed. Cardiovascular agents are not administered (see evaluation of dehydration in a patient with diarrhea);
when conducting 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;
on-site assistance to non-transportable patients with the call of consultants and an ambulance equipped with everything necessary.

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

Request appropriate medicines, packing of protective clothing, personal protective equipment, packing for material collection;
Before receiving protective clothing, a medical worker in case of suspected plague, GVL, monkeypox should temporarily close his mouth and nose with a towel or mask made from improvised material. For cholera, measures of personal prevention of gastrointestinal infections should be strictly observed;
Upon receipt of protective clothing, they put it on without taking off their own (except for heavily contaminated by the secretions of the patient)
Before putting on PPE, carry out emergency prophylaxis:

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

B) with monkeypox, GVL - as with the plague. Anti-small gammaglobulin metisazon - in isolation;

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

4. If a patient with plague, GVL, monkeypox is detected, the medical worker does not leave the office, apartment (in case of cholera, if necessary, he can leave the room after washing his hands and removing the medical gown) and stay until the arrival of the epidemiological - decontamination team.

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

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

6. Take material for bakiistudy (before the start of treatment), fill in a simple pencil referral to the laboratory.

7. Carry out current disinfection in the outbreak.

8. after the departure of the patient for hospitalization, carry out a complex of epidemiological measures in the outbreak until the arrival of the disinfectant epidemiological team.

9. Further use of a health worker from the outbreak of plague, GVL, monkeypox is not allowed (sanitation and isolation). With 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 the infection	Source of infection	Transmission route	Incub. period
Smallpox	A sick man		14 days
Plague	Rodents, human	Transmissible - through fleas, Airborne, possibly others	6 days
Cholera	A sick man	water, food	5 days
Yellow fever	A sick man	Transmissive - Aedes-Egypti mosquito	6 days
Lasa fever	Rodents, sick man	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	A sick man	Airborne, contact through the conjunctiva of the eye, parapteral	21 days (usually up to 18 days)
monkeypox	Monkeys, sick person before 2nd contact	Airborne, airborne dust, household contact	14 days (from 7 to 17 days)

MAIN SIGNALS OF OOI

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

Bubonic form: the bubo is sharply painful, dense, soldered to the surrounding subcutaneous tissue, motionless, its maximum development is 3-10 days. The temperature lasts 3-6 days, the general condition is severe.

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

Septicemia: 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 own weight occurs in 95% of cases. The onset of the disease is acute rumbling in the abdomen, loosening of the stool 2-3 times a day, maybe 1-2 times vomiting. The patient's well-being is not disturbed, working capacity is maintained.

Medium form: fluid loss of 8% of its own weight, occurs in 14% of cases. The onset is sudden, rumbling in the abdomen, indefinite intense pain in the abdomen, then loose stools up to 16-20 times a day, which quickly loses its fecal character and smell, green, yellow and pink in color of rice water and diluted lemon, uncontrollable defect without urge (for 500-100 ml is allocated 1 time, an increase in stool with each defect is characteristic). Vomiting appears with diarrhea, it is not preceded by nausea. A sharp weakness develops, an unquenchable thirst appears. General acidosis develops, diuresis decreases. The blood pressure drops.

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

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

LASS FEVER: in the early period, symptoms: - the 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, tonsils of the soft palate, then nausea, vomiting, diarrhea, pain in the chest and abdomen join. During the 2nd week, diarrhea resolves, but abdominal pain and vomiting may persist. Often there is dizziness, decreased vision and hearing. A maculopapular rash appears.

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

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

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

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

Diarrhea often causes varying degrees of dehydration. Usually on the 5th day, patients have a characteristic appearance: sunken eyes, emaciation, weak skin turgor, the oral cavity is dry, covered with small ulcers similar to aphthous ones. On the 5-6th day of illness, first on the chest, then on the back and limbs, a spotty-potulous rash appears, which disappears after 2 days. On the 4-5th day, hemorrhagic diathesis develops (bleeding from the nose, gums, ears, injection sites, hematemesis, melena) and severe tonsillitis. Often there are symptoms indicating involvement in the CNS process - tremor, convulsions, paresthesia, meningeal symptoms, lethargy, or vice versa excitation. In severe cases, cerebral edema, encephalitis develops.

MONKEY POX: high temperature, headache, pain in the sacrum, muscle pain, hyperemia and swelling of the mucous membrane of the throat, 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 subfebrile, general toxic effects disappear, and the state of health improves. After a decrease in temperature for 3-4 days, a rash appears first on the head, then on the trunk, arms, legs. The duration of the rash is 2-3 days. Rashes on separate parts of the body occur simultaneously, the predominant localization of the rash on the arms and legs, simultaneously on the palms and soles. The nature of the rash is papular - vedic. The development of the rash - from spots to pustules slowly, within 7-8 days. The rash is monomorphic (at one stage of development - only papules, vesicles, pustules and roots). Vesicles do not collapse during puncture (multi-chamber). The base of the elements of the rash is dense (the presence of infiltrates), the inflammatory rim around the elements of the rash is narrow, clearly defined. Pustules form on the 8-9th day of illness (day 6-7 of the rash). The temperature again rises to 39-40°C, the condition of the patients deteriorates sharply, headaches, delirium appear. The skin becomes tense, swollen. Crusts are formed on the 18-20th day of illness. There are usually scars after the crusts fall off. There is lymphadenitis.

MODE OF DISINFECTION OF MAIN OBJECTS IN Cholera

	Method of disinfection	disinfectant	contact time	Consumption rate
1. Room surfaces (floor, walls, furniture, etc.)	irrigation	0.5% solution DTSGK, NGK 1% solution of chloramine 1% solution of clarified bleach	60 min	300ml/m3
2. Gloves	dive	3% solution myol, 1% solution chloramine	120 min
3. Glasses, phonendoscope	2 times wiping with an interval of 15 minutes	3% hydrogen peroxide	30 min
4. Rubber shoes, leather slippers	rubbing	See point 1
5. Bedding, cotton pants, 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. Protective clothing of personnel contaminated with secretions	boiling, soaking, autocloning	See point 6 120°С р-1.1 at.	30 min	5l per 1 kg of dry laundry
8. Protective clothing for personnel without visible traces of contamination	boiling, soaking	2% solution of soda 0.5% solution of chloramine 3% Mizola solution, 0.1% DP-2 solution	15 minutes 60 min 30 min
9. discharge of the patient	fall asleep, mix	Dry bleach, DTSGK, DP	60 min	200 gr. per 1 kg of secretions
10. Transport	irrigation	CM. paragraph 1

ASSESSMENT OF THE DEGREE OF DEHYDRATION BY CLINICAL SIGNS

Symptom or sign	Degrees of disinfection in percent
	I(3-5%)	II(6-8%)	III(10% and above)
1. Diarrhea	Watery stool 3-5 times a day	6-10 times a day	More than 10 times a day
2. Vomiting	None or a small amount	4-6 times a day	Very common
3. Thirst	moderate	Expressed, drinks with greed	Cannot drink or drinks poorly
4. Urine	Not changed	Small amount, dark	Not urinating for 6 hours
5. General condition	Good, upbeat	Bad, drowsy or irritable, agitated, restless	Very drowsy, lethargic, unconscious, lethargic
6. Tears	Eat	missing	missing
7. Eyes	Ordinary	Sunken	Very sunken and dry
8. Mucous cavities of the mouth and tongue	Wet	dry	Very dry
9. Breath	Normal	frequent	Very common
10. Tissue turgor	Not changed	Each crease unfolds slowly	Each fold straightened. So slow
11. Pulse	normal	More often than usual	Frequent, weak filling or not palpable
12. Fontanelle (in young children)	Doesn't sink	sunken	Very sunken
13. Average estimated liquid deficit	30-50 ml/kg	60-90 ml/kg	90-100 ml/kg

EMERGENCY PREVENTION IN THE FOCI OF QUARANTINE DISEASES.

Emergency prophylaxis is provided to those who have been in contact with the patient in the family, apartment, at the place of work, study, rest, treatment, as well as persons who are in the same conditions for the risk of infection (according to epidemiological indications). Taking into account the antibiogram of the strains circulating in the focus, one of the following devices is prescribed:

DRUGS	One-time share, in gr.	Frequency of use 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 use per day	Average daily dose	Duration of application, 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

In 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 stops.

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

Furazolidone is the preferred antibiotic for pregnant women.

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

STAYING FOR SAMPLING MATERIAL FROM A PATIENT WITH SUSPECTED CHOLERA (for non-infectious hospitals, ambulance stations, outpatient clinics).

1. Sterile wide-mouth jars with lids or

Ground stoppers at least 100 ml. 2 pcs.

2. Glass tubes (sterile) with rubber

small necks or teaspoons. 2 pcs.

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

Or 2 aluminum hinges 1 pc.

4.Polybag. 5 pieces.

5. Gauze napkins. 5 pieces.

7. Adhesive plaster. 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. secretions. 1 PC.

12. Rubber gloves. Two pairs

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

Laying for each linear brigade of a joint venture, a therapeutic area, a district hospital, a medical outpatient clinic, a FAP, a health center - for everyday work when servicing patients. Items to be sterilized are sterilized once every 3 months.

SCHEME FOR SAMPLING MATERIAL FROM PATIENTS WITH OOI:

Name of the infection	Material under study	Quantity	Material sampling technique
Cholera	A) bowel movements B) vomit B) bile	20-25 ml. por.B and C	The material is taken in a separate ster. The Petri dish placed in the bedpan is transferred to a glass jar. In the absence of secretions - by boat, loop (to a depth of 5-6 cm). Bile - with duonal sounding
Plague	A) blood from a vein B) bubo punctate B) nasopharynx D) sputum	5-10 ml. 0.3 ml.	Blood from the cubital vein - into a sterile test tube, juice from the bubo from the dense peripheral part - a syringe with the material is placed in a test tube. Sputum - in a wide-mouthed jar. Detachable nasopharynx - using cotton swabs.
monkeypox GVL	A) mucus from the nasopharynx B) blood from a vein C) the contents of the rashes of the crust, scales D) from a corpse - brain, liver, spleen (at sub-zero temperatures)	5-10 ml.	Separate from the nasopharynx with cotton swabs in sterile plugs. Blood from the cubital vein - into sterile test tubes, the contents of the rash with a syringe or scalpel are placed in sterile test tubes. Blood for serology is taken 2 times the first 2 days and after 2 weeks.

MAIN RESPONSIBILITIES OF THE MEDICAL STAFF OF THE ENT DEPARTMENT OF THE CRH WHEN DETECTING A PATIENT WITH ASI IN THE HOSPITAL (during a medical round)

Doctor who identified the patient with OOI in the department (at the reception) is obliged:
Temporarily isolate the patient at the place of detection, request containers to collect secretions;
Notify by any means the head of your institution (head of the department, head physician) about the identified patient;
Organize measures to comply with the rules of personal protection of health workers who have identified the patient (request and apply anti-plague suits, treatment of mucous and open areas of the body, emergency prevention, disinfectants);
Provide the patient with emergency medical care according to vital indications.

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

duty nurse, who took part in the medical round, is obliged:
Request laying and take material from the patient for bacteriological examination;
Organize the current disinfection in the ward before the arrival of the disinfection team (collection and disinfection of the patient's secretions, collection of soiled linen, etc.).
Make a list of the closest contacts with the patient.

NOTE: After the patient is evacuated, the doctor and nurse take off protective clothing, pack it in bags and hand it over to the disinfection team, disinfect shoes, undergo sanitization and go to the disposal of their leader.

Head of department, having received a signal about a suspicious patient, is obliged:
Urgently organize the delivery to the ward of packing of protective clothing, bacteriological packing for collecting material, containers and disinfectants, as well as means for treating open areas of the body and mucous membranes, and means of emergency prevention;
Set up posts at the entrance to the ward where the patient was identified and exit the building;
If possible, isolate contacts in wards;
Report the incident to the head of the institution;
Organize a census of the contacts of your department in the prescribed form:
No. p.p., surname, name, patronymic;
was on treatment (date, department);
dropped out of the department on (date);
the diagnosis with which the patient was in the hospital;
location;
place of work.

Head nurse of the department, having received instructions from the head of the department, is obliged:
Urgently deliver to the ward a package of protective clothing, containers for collecting secretions, bacteriological packing, disinfectants, antibiotics;
Divide the patients of the department into wards;
Monitor the work of posted posts;
Conduct a census using the established contact form of your department;
Accept the container with the selected material and ensure the delivery of samples to the bacteriological laboratory.

OPERATIONAL PLAN

activities of the department in case of detection of cases of AIO.

№№ PP	Business name	Deadlines	Performers
1	Notify and assemble department officials at their workplaces in accordance with the existing scheme.	Immediately upon confirmation of the diagnosis	duty doctor, head branch, head nurse.
2	Through the head physician of the hospital, call a group of consultants to clarify the diagnosis.	Immediately if OOI is suspected	duty doctor, head department.
3	Introduce restrictive measures in the hospital: -prohibit unauthorized access to the buildings and the territory of the hospital; - introduce a strict anti-epidemic regime in the hospital departments - prohibit the movement of patients and staff in the department; - set up external and internal posts in the department.	Upon confirmation of the diagnosis	Medical staff on duty
4	Instruct the staff of the department in the prevention of AGI, personal protection measures, and the mode of operation of the hospital.	When gathering personnel	Head department
5	Conduct explanatory work among patients of the department about measures to prevent this disease, adherence to the regimen in the department, measures of personal prevention.	In the first hours	Medical staff on duty
6	Strengthen sanitary control over the work of the distribution, collection and disinfection of waste and garbage in the hospital. Carry out disinfection activities 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.

Scroll

questions for the transfer of information about the patient (vibrio carrier)

Full Name.
Age.
Address (during illness).
Permanent residence.
Profession (for children - a children's institution).
Date of illness.
Date of request for assistance.
Date and place of hospitalization.
Date of material sampling for bacoexamination.
Diagnosis at admission.
final diagnosis.
Accompanying illnesses.
Date of vaccination against cholera and drug.
Epidanamnesis (connection with a reservoir, food products, contact with a patient, vibrio carrier, etc.).
Alcohol abuse.
Use of antibiotics before illness (date of last appointment).
The number of contacts and the measures taken to them.
Measures to eliminate the outbreak and its localization.
Measures to localize and eliminate the outbreak.

SCHEME

specific emergency prophylaxis for a known pathogen

Name of the infection	Name of the drug	Mode of application	single dose (gr.)	Multiplicity 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 nights
Cholera	Levomycetin	inside	0,5	2 times	1,0	4,0	4 nights
Plague	Tetracycline	inside	0,5	3 times	1,5	10,5	7 nights
Plague	Olethetrin	inside	0,25	3-4 times	0,75-1,0	3,75-5,0	5 days

NOTE: Extract from the manual,

approved deputy. Minister of Health

Ministry of Health of the USSR P.N. Burgasov 10.06.79

SAMPLING FOR BACTERIOLOGICAL INVESTIGATION DURING OOI.

Picked up material	The amount of material and what it gets into	Property required when collecting material
I. MATERIAL FOR CHOLERA
excreta		Glass Petri dish, sterile teaspoon, sterile jar with ground stopper, tray (sterilizer) for dropping the spoon
Bowel movements without stool	Same	The same + sterile aluminum loop instead of a teaspoon
Vomit	10-15 gr. into a sterile jar with a ground stopper, filled 1/3 with 1% peptone water	Sterile Petri dish, sterile teaspoon, sterile jar with ground stopper, tray (sterilizer) for dropping the spoon
II. MATERIAL IN NATURAL SMALLPOX
Blood	A) 1-2 ml. dilute blood into a sterile test tube 1-2 ml. sterile water.	Syringe 10 ml. with three needles and wide lumen
Blood	B) 3-5 ml of blood in a sterile tube.	3 sterile tubes, sterile rubber (cork) stoppers, sterile water in 10 ml ampoules.
	Cotton swab on a stick with immersion in a sterile test tube	Cotton swab in a test tube (2 pcs.) Sterile test tubes (2 pcs.)
Lesions (papules, vesicles, pustules)	Wipe the area with alcohol before taking. Sterile test tubes with ground-in stoppers, defatted glass slides.	96°alcohol, cotton balls in a jar. Tweezers, scalpel, smallpox feathers. Pasteur pipettes, glass slides, adhesive tape.
III. MATERIAL FOR PLAGUE
Punctate from bubo	A) the needle with punctate is placed in a sterile test tube with a sterile rubber peel B) blood smear on glass slides	5% tincture of iodine, alcohol, cotton balls, tweezers, 2 ml syringe with thick needles, sterile test tubes with stoppers, fat-free glass slides.
Sputum	In a sterile Petri dish or a sterile wide-mouthed jar with a ground stopper.	Sterile Petri dish, sterile wide-mouth jar with ground stopper.
Detachable mucous membrane of the nasopharynx	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 test tubes with sterile (cork) stoppers.	Syringe 10 ml. with thick needles, sterile tubes with sterile (cork) stoppers.

MODE

Disinfection of various objects infected with pathogenic microbes

(plague, cholera, etc.)
Object to be disinfected	Method of disinfection	disinfectant	Time contact	Consumption rate
1. Room surfaces (floor, walls, furniture, etc.)	Irrigation, wiping, washing	1% solution of chloramine	1 hour	300 ml/m2
2. protective clothing (underwear, gowns, scarves, gloves)	autoclaving, boiling, soaking	Pressure 1.1 kg/cm2. 120°	30 min.	¾
		2% soda solution	15 minutes.	¾
		3% Lysol solution	2 hours	5 l. per 1 kg.
		1% solution of chloramine	2 hours	5 l. per 1 kg.
3. Glasses, phonendoscope	rubbing		¾
4. Liquid waste	Fall asleep and stir		1 hour	200gr./l.
5.Slippers, rubber boots	rubbing	3% hydrogen peroxide solution with 0.5% detergent	¾	2-fold wiping with intervals. 15 minutes.
6. Discharge of the patient (sputum, stool, food debris)	Fall asleep and stir; Pour and stir	Dry bleach or DTSGK	1 hour	200 gr. / l. 1 hour of discharge and 2 hours of doses of solution. volume ratio1:2
		5% solution Lyzola A	1 hour
		10% solution Lysol B (naphthalizol)	1 hour
7. Urine	Pour	2% solution of chlorine. Izv., 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. Waste dishes (teaspoons, Petri dishes, etc.)	boiling	2% solution of soda	30 min.	¾
		3% solution chloramine B	1 hour
		3% per. hydrogen with 0.5 detergent	1 hour
		3% solution of Lysol A	1 hour
10. Hands in rubber gloves.	Dive and wash	Disinfectants specified in paragraph 1	2 minutes.	¾
Hands	-//-//-wiping	0.5% solution chloramine	1 hour
Hands	-//-//-wiping	70° alcohol	1 hour
11. Bedding accessories	Chamber decontaminated.	Steam-air mixture 80-90°	45 min.	60 kg/m2
12. Synthetic products. material	-//-//- Immersion	Steam-air mixture 80-90°	30 min.	60 kg/m2
		1% solution of chloramine	5 o'clock
		0.2% formaldehyde solution at t70°	1 hour

DESCRIPTION OF THE PROTECTIVE ANTIPLAGUE SUIT:

pajama suit
Stocking socks
Boots
Anti-plague medical gown
scarf
fabric mask
Mask - glasses
Oilcloth sleeves
Apron (apron) oilcloth
Rubber gloves
Towel
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, poliomyelitis caused by a wild virus, human influenza caused by a new subtype, SARS, under certain conditions - a number of zooanthroponoses (sap, melioidosis, anthrax, yellow fever, Junin hemorrhagic fever (Argentine fever), Machupo (Bolivian fever), as well as syndromes of infectious diseases of unknown etiology, which pose a danger to international spread.

2.In primary activities include:

Temporary isolation with further hospitalization

Clarification of the diagnosis and call of consultants

Information about the patient of 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 medicines must have a stock:

Medications for symptomatic therapy, emergency prophylaxis, chemoprophylaxis

Means of personal emergency prevention

Personal protective equipment

Disinfectants

4. In each lpu should be in prominent and accessible places during the day:

Alert schemes

Information about the storage of stacks for the collection of material from people

Information about 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 hearth with a mask, towel, scarf, bandage, etc.

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

5.3. Upon delivery, PPE is worn over medical clothing (not contaminated with the patient's biomaterial)

Protective clothing (anti-plague suit) is intended to protect medical personnel from infection with 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 suit of type 1 - 3 hours, in hot weather - 2 hours

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

Overalls;

Phonendoscope (if necessary);

Anti-plague robe;

Cotton - gauze bandage;

Glasses (previously lubricated with a special pencil or soap);

Gloves (first pair);

Gloves (second pair);

Armlets;

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

Slowly, slowly, after each removed element, treat your hands in a disinfectant solution.

Towel;

Gloves (second pair);

Armlets;

Phonendoscope;

Protective glasses;

Cotton - gauze bandage;

Kerchief;

Gloves (first pair);

Overalls.

Schemes for emergency prevention of dangerous infectious diseases

Emergency prevention - medical measures aimed at preventing diseases of people when they are 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 observatory (treatment of patients with other

ophthalmology department pathology for vital indications)

Holding after provisional

branch maximum period

dental provisional hospital (treatment of patients

department with signal symptoms of especially dangerous

diseases: plague, cholera, SARS, etc.)