INFECTIOUS DISEASES

INFECTIOUS DISEASES

Rabies

, a viral disease with severe central nervous
the system. Mainly transmitted by the bite of infected animals (dogs,
cat, wolf, rat), saliva, which contains a virus gets into the wound.
Spreading followed by lymphatic system, and partly through krovenos-
nuyu system, the virus reaches the salivary glands and nerve cells of the cortex Goals
of the brain, the hippocampus, the bulbar centers, hitting them, causing
severe irreversible damage.

Symptoms and flow. The incubation period lasts from 15 to 55
days, but can sometimes take up to six months or more. The disease has three
the period. A. Prodrome (the period of the precursors) - lasts 1-3 days. Con-
rovozhdaetsya increase in temperature up to 37,2-37,3 AL, depression,
eating, poor sleep, insomnia, anxiety patients. Pain at the site of the bite
there, even if the wound is healed. Two. The stage of excitement - lasts
from 4 to 7 days. Expressed in sharply increased sensitivity to Maley-
PWM stimuli of the senses: bright lights, different sounds, noise-vyzy
vayut muscle spasms of the limbs. Patients become aggressive, violent,
E, there are hallucinations, delusions, feelings of fear, 3. Stage of paralysis:
ocular muscles of the lower extremities, severe paralytic illness
respiratory cause death. The total duration of 5-8 days of illness, out-
10-12 days is rare.
Recognition. Of great importance is the presence of a bite or hit
the saliva of rabid animals on damaged skin. One of the most important features
human disease - rabies with symptoms of muscle spasm of the pharyngeal-
tours only as food and water, making it impossible to drink even
glass of water. No less revealing symptom aerophobia - muscle cramps,
appearing at the slightest movement of air. Characteristically, and increased saliva-
department, some patients furnaces are constantly trickle of saliva follows
from the corner of his mouth.
Laborotornogo confirm the diagnosis is usually not required, but it is the WHO-
possible, including using the recently developed method for-
observation of a rabies virus antigen in prints from the surface shell
ki eyes.
Treatment. No effective methods, which makes most of the
problematic save the lives of patients. You have to be limited to purely
symptomatic relief funds for the painful condition. Motion
tives excitation remove calming (sedative) means
eliminate seizures curariform drugs. Respiratory disorders
offset by tracheotomy and connect the patient to the unit
artificial respiration.
Prevention. Fighting rabies among dogs, destruction of stray.
People bitten obviously diseased or suspected of rabies, Ms.
BOTH should immediately wash the wound with warm boiled water (and soap
or without it), then treat it with 70% alcohol or an alcohol tincture
iodine, and as soon as possible to contact the health facility to production-
to vaccination. It consists in the introduction of anti-rabies serum or
rabies immunoglobulin into the wound and soft tissue around the
it. You have to know that vaccines are only effective if they
made no later than 14 days from the time of the bite or rabid animals oslyuneniya
nym and conducted on strictly defined rules vysokoimmunnoy vaccine
Noah.

Bogulshm.

Zabolsvani caused, food contaminated with chopsticks
botulism. Pathogen - anaerobic widely distributed in nature, long-
Indeed the time may be in the soil as spores. Comes from the soil,
from the intestines of farm animals, as well as some freshwater
GOVERNMENTAL fish to different foods - vegetables, fruits, grains, meat, and so on.
Without oxygen, such as canned,

vapii products, bacteria, botulism, starting
nayut multiply and produce toxins that co-
tory is the strongest bacterial
nym poison. He has not destroyed the intestinal
juice, and some of its types (toxin type E)
even enhances its effect. Typically, current-
syn accumulates in products such as
canned, salted fish, sausage, ham,
Mushrooms cooked in violation of the tech-
technology, especially in the home.
Symptoms and flow. The incubation period lasts from 2-3 hours to 1-2
days. Initial symptoms - fatigue, slight headache
the pain. Vomiting and diarrhea are not always the most - stubborn constipation, do not lend themselves-
schiesya action enemas and laxatives. When botulism affects the nervous
system (blurred vision, swallowing, voice changes). The patient sees
all things as if in a fog, there is double vision, pupil-expanding
Rena, with one wider than the other. Often noted strabismus, ptosis - tumor-
schenie upper eyelid of one of his eyes. Sometimes there is no Akko-
modatsii - the reaction of pupils to light. The patient is experiencing dry mouth,
his voice is weak, slurred speech.
Body temperature is normal or slightly increased (37,2-37,3 AL), consciousness
saved. With increasing intoxication associated with spore germination in
bowel patients, ocular symptoms are increasing, there are disorders
swallowing (paralysis of the soft palate). Cardiac become deaf, pulse,
initially slow, accelerates, blood pressure drops.
Death may occur with symptoms of respiratory paralysis.
Recognition. Conducted on the basis of history - due to illness
consumption of certain foods and the development of nuclear explosion of similar-
representations in individuals who consumed the same product. In the early stages of the disease
necessary to distinguish botulism poisoning and poisonous mushrooms, methyl
alcohol, atropine. Should conduct a differential diagnosis of bulbar-
modified form of polio - of ocular symptoms and temperature data
(Polio gives znachitelnoepovyshenie temperature). Diagnosis confirmed by
allows detection of exotoxins in blood and urine.
Treatment. First Aid - saline laxative (eg, sulfate, mag-
nezii), peach or other vegetable oil to bind the toxin-
new, gastric lavage with warm 5% solution of sodium gidrokarboiata
(Baking soda). And most importantly - the introduction of urgent protivobotuliniches-
What the serum. Therefore, all patients are subject to immediate hospitalization.
In those cases, when using a biological sample can vyyasnittip
toxin the bacteria use a special monoreceptor antitoxic
serum, the effect of which is directed against one particular type
exotoxin (eg type A or E). If it is impossible to establish, apply
polyvalent - a mixture of sera A, B and E.
A thorough patient care, according to testimony used respiratory
respect to the equipment, carry out activities to maintain the physiological
functions of the body. When swallowing disorders - carry out artificial
Noah tube feeding, or nutrient enema. From the medical auxiliary
to the action has a chloramphenicol (0.5 g 4-5 times a day in the flow-
tion 5-6 days, and adenoziptrifosfornaya acid (1 mL intramuscularly
1% p-ra 1 per day) in the first 5 days of treatment. It is important to follow the regular
Nosta chair.
Prevention. Strict sanitary supervision of the food industry (howling,
PTO fish - its drying, smoking, canning, slaughtering and ne-
rerabotkoy meat).
Implementation of hygiene and always up-
canning machine interface. Remember that botulism spores of anaerobic microbe
live in the soil, and multiply and secrete a poison in an environment where there is no oxygen
kind. The danger of canned mushrooms are not enough eyes,
generalized from the ground, where they can remain a controversy, meat and canned fish
from the swollen cans. Products are strictly forbidden to recognition
Kami of poor quality: they have a sharp smell of cheese or
rancid oil.

Brucellosis.

An infectious disease caused by brucella - small
pathogenic bacteria. A person becomes infected by domestic animals (cows,
sheep, goats, pigs) when caring for them (health workers, milkmaids, and
etc..) or in the use of infected products - milk, little able to cope with-
Joan of cheese, badly cooked meat or roasted. The causative agent,
penetrating into the body through the digestive tract, cracks, scratches and
other damage to the skin or mucous membrane, covered in-
those of lymphatic and blood vessels, making it accessible
the disease of any organ. In mesenchymal and connective tissue form-
Xia granulomas. At the site of tendon attachment of the muscles occur Education
of gristly consistency (fibrositis) the size of a lentil and larger.
They cause pain in joints, bones and muscles. Pos-
quences of brucellosis can acquire stable and irreversible,
causing temporary or permanent disability.
Symptoms and flow. The incubation period is about 14 days. The body on the
infection responds to increasing number of lymph glands, liver, and village-
Sönke. In its current brucellosis can be acute (lasting 2 months.)
subacute (2 to 4-5 months.) and chronic, including relapses and
generalization of infection (bacteremia) - lasts up to two years, sometimes longer.
The beginning of the disease is manifested general malaise, loss of appetite,
poor sleep. Patients complain of joint pain, lower back and muscles. However,
body temperature gradually (3-7 days) increased to 39shS, taking into
Later wavy character. Sweat profuse, skin moisture, especially
but palms, is observed even when the temperature drops to normal.
After 20-30 days of the onset of the disease affects the health of patients,
Xia, they have intensified the pain, mainly in large joints - knees,
GOVERNMENTAL, then the hip, ankle, shoulder, elbow less. Size
and shape of the joint changes, its outlines are smoothed, soft tissue,
surrounding it, become inflamed, swollen. The skin around the joint shiny, can-
Jet to acquire a pink tint, sometimes there is the different nature
roseola-populeznye rash.
In the future, without the proper treatment of numerous disorders
the locomotor apparatus (joints, bones, muscles) are progressing,
which is caused by the spread of infection (bacteremia). Growing patho-
cal symptoms of the nervous system, patients are stimuli-
of positive, capricious, even tearful. They are plagued by neuralgic pains,
sciatica, lumbago. Some lesions observed in the genitals. Men
Brucellosis may be complicated by orchitis, epididymitis. Women may be
adnexitis, endometritis, mastitis, spontaneous abortions. From the blood -
anemia, leukopenia with lymphocytosis, monocytosis, increased erythrocyte sedimentation rate.
Recognition. Helps carefully collected history based epizoo-
tologicheskoy situation and the particular circumstances of infection, laboratory
nye analyzes (the picture peripheral blood, serum, and allergiches-
reactions of.) Confirm the diagnosis of specific bacteriological research-
gation. The disease must be distinguished from typhoid fever, sepsis, infection
tional mononucleosis, with rheumatic fever. In all cases,
to keep in mind it is typical for brucellosis complications, such as
orchitis.
Treatment. The most effective antibiotics are sred1 property. Tet-
ratsiklin into a 4-5 times a day to 0.3 g with breaks for the night
adults. The course of treatment at these doses up to 2 days of the normalization of the temperature.
Then the dose is reduced to 0.3 g 3 times daily for 10-12 days. Taking into
tyvaya duration of treatment with tetracycline, resulting in
may have an allergic reaction, a number of side effects and even oc-
complications caused by the activation of drozhepodobnyh Grizov Candida, simul-
simultaneously administered antifungal drugs (nystatin)-desensitizing
ing drugs (diphenhydramine, suprastip), and vitamins. Patients prescribed fractures
tion single-group blood or plasma. Spend vaccinotherapy that
stimulates the body's immunity to the pathogen, and helps to overcome
of infection. The course consists of eight intravenous therapeutic vaccines with 3-4
day intervals. Before the start of the course have the degree of sensitivity
sequence of the patient to the vaccine, watching for six hours response to first-
vuyu injection test, which should be moderate, with chocolate-
response curve should not be carried out vaccinotherapy.
In the stage of decay events ostrovospalitelnyh prescribe therapeutic
physical education, application of wax on the joints in the form of heat. When resistant
remission - spa treatment in the light of existing contraindications.
Prevention. It combines a number of veterinary and public health activi-
ty.
In the farms must isolate the animals suffering from brucellosis. Their
slaughter and subsequent processing of canned meat must be accompanied by
aptoklaoirovaniem. The meat can be eaten and the food after cooking, it is not-
large pieces for 3 hours or salting in brine with pyderzhivaiiem
not less than 70 days. Milk from cows and goats in areas where there are cases in-
diseases of cattle and sheep, can be consumed only after boiling,
radiation. All dairy products (yogurt, cottage cheese, yogurt, cream, butter)
should be prepared from pasteurized milk. Cheese, made from
sheep's milk, incubated for 70 days.
For the prevention of occupational infections in patient care, Ms.
BOTH need to take all precautionary measures (wearing rubber
boots, gloves, special gowns, aprons). Ms. aborted fetus-
BOTH buried in a pit to a depth of 2 m, with lime to sleep, the room
disinfected. In combating the spread of brucellosis are important
vaccination of animals with special vaccines. Immunization of people have
limited value to other preventive measures.

Typhoid fever.

An acute infectious disease caused by bacteria
of the genus Salmonella. The causative agent can persist in soil and water to 1-5
months. Killed by heating and the effect of conventional disinfectants
funds.
The only source of infection - a sick person, and
bacillicarriers. Typhoid bacilli are transferred directly
dirty hands, flies, sewage. Dangerous outbreaks associated with
consumption of infected food products (milk, cold meat
meals, etc.).
Symptoms and flow. The incubation period lasts from 1 to 3 weeks. In
typical cases of the disease begins gradually. Patients note
weakness, fatigue, mild headache. In the following
Today, these phenomena are enhanced, the body temperature begins to rise to 39 -
40 "C, decreases or disappears appetite, disturbed sleep (daytime sleepiness
and insomnia at night). There is a delay in the chair, effects of flatulence. To
9.7 day of illness on the skin of the upper abdomen and lower parts of the chest
cells, usually on the anterolateral surface, a characteristic
rash, which is a small red spots with sharp edges,
23 mm in diameter, towering above the skin (roseola). In place of use-
vanishing roseola may appear new. Characterized by a kind of mash-
can of patients, facial pallor, and slowing of heart rate reduction in arterial-
tial pressure. Above the light scattered dry listened hriny -
specific manifestation of bronchitis. Tongue dry, cracked and covered
dirty-brown or brown coating, edge and tip of the tongue free from the on-
summer, with the imprints of the teeth. There has been a rough rumble cecum and bo-
leznennost in the right iliac region, liver and spleen in the Palpa-
tion increased. Reduced the number of leukocytes in peripheral blood, espe-
especially neytrofillov and eozinofillov.
ESR is normal or increased to 15-20 mm / h By week 4 coc-
Toyan patients gradually improved, lowered body temperature, izche-
zaet headache, there is an appetite. Serious complications of typhoid
fever is intestinal perforation and intestinal bleeding.
In recognition of the disease is very important, timely detected
tion the main symptoms: fever lasting more than a body of non-
Delhi, headache, weakness - reduced motor activity, decline
forces, sleep disturbances, appetite, characteristic rash, sensitivity to
palpation in the right iliac abdomen, enlarged liver and village-
Sönke. From the laboratory tests used for diagnosis tank
teriological (immunofluorescence method) blood culture on the medium-Rappo
North or bile broth; serology - the reaction and the Widal
etc.
Treatment. The main antimicrobial agent - chloramphenicol. Assign to
0,50,75 g, 4 times a day for 10-12 days to normal temperature. Intra-
tively drip administered 5% glucose solution, isotonic sodium chloride
Sodium (500-1000 mg). In severe cases - corticosteroids (predpizolon in
dose of 30-40 ml per day). Floor must comply with strict bed re-
Assume a minimum of 7-10 days.
Prevention. Sanitary inspection of food businesses, water supplies
zheniem, sanitation. Early identification of patients and their isolation. Disinfection-
function room, laundry, dishes that are boiled after drinking, fighting
with flies. Clinical supervision for the ill with typhoid fever. Spe-
crystallographic vaccine vaccine (unnec).

Chickenpox.

An acute viral disease primarily of children from 6
months. up to 7 years in adult disease is less common. The source of infection
- A sick person represents a danger to the end of the incubation peri-
Ode to the falling away of crusts. The causative agent belongs to a group of herpes viruses and
spread by airborne droplets.
Symptoms and flow. The incubation period lasts an average of 13-17 days.
Disease begins with a rapid rise in temperature and rash in
different parts of the body. At the beginning of a pink spot size of 2-4 mm,
that within a few hours turn into pimples, then take me-
molecule - blisters filled with clear content and surrounded by a halo
hyperemia. In place of broken vesicles formed dark red and brown-
nevye crusts, which fall to 2-3 weeks. Polymorphism is characterized by
rash in a separate area of ​​skin can be found at the same time spot ve-
zikuly, papules and crusts. On the mucous membranes of the respiratory tract
(Pharynx, larynx, trachea) enantemy arise. It's the bubbles that
quickly turned into ulcer with a yellowish-gray bottom, surrounded by red
rim. Dlitelnostlihoradochnogo period of 2-5 days. The disease
benign, but may experience severe and complications:
encephalitis, myocarditis, pneumonia, false croup, various forms of pyoderma
and others
Recognition is based on a typical cyclical
elements of the rash. Laboratory tests can detect the virus in a
power of the light microscope or immunofluorescence method.
Treatment. Specific and etiotropic treatment there. Refer a proper-
Luda bed rest, monitor the cleanliness of clothes and hands. Elements of the rash
lubricated with 5% potassium permanganate solution or 1% solution of brilliant
of green. In severe forms of immune globulin administered. In introducing oc-
complications (abscesses, bullous streptoderma, etc.) prescribed antibiotics,
ki (penicillin, tetracycline, etc.).
Prevention. Isolation of the patient at home. Toddlers and preschool
age, who were in contact with the patient, are not permitted in children's
institutions to 21 days. Impaired children without a history of chickenpox,
administered immunoglobulin (3 mL intramuscularly).

Viral hepatitis.

 Infectious diseases occur with a total in-
toxication and the primary lesion of the liver. The term "viral hepatitis
tity "combines the two main nosological forms - hepatitis A
(Infectious hepatitis) and hepatitis B (serum hepatitis). Cro-
In addition, currently allocated to a group of viral hepatitis, "neither A nor
In. "Pathogens are quite stable in the environment. When viral re-
patite a source of infection are patients at the end of the incubation and
predzheltuinyugo period, as at this time the agent is excreted in
feces and is transmitted through food, water, household items
non-compliance with the rules of hygiene, contact with the patient. In viral hepatitis
Tits in the source of infection are patients in the acute stage, and no-
supports of the antigen of hepatitis B. The main route of infection - parenteral
(Through blood) using non-sterile needles, syringes, dental
ethical, surgical, gynecological and other tools. Perhaps for-
expression by blood and its derivatives.
Symptoms and flow. The incubation period for hepatitis A virus co-
lebletsya from 7 to 50 days, with viral hepatitis B - 50 to 180 days.
The disease occurs cyclically and is characterized by periods -
predzheltushnogo, jaundice, poslezheltushnogo, during the duration of the rolling-
dorovleniya. Preicteric period of hepatitis A in half the patients
proceeds in the form of flu-like variant, characterized by increased
body temperature to 38 39shS, chills, headache, pains in the bursting
joint and muscle pain, sore throat and so on. In dyspeptic variant on
fore the pain and heaviness in the epigastric region, lowering the
of appetite, nausea, vomiting, and sometimes more frequent stools. When asthenovegetative
version of the temperature remains normal, there is weakness, head-
Nye pain, irritability, dizziness, impaired performance
and sleep. For predzheltushnogo period of viral hepatitis in the most character-
thorns bursting pain in large joints, bones, muscles, especially at night
time, sometimes the appearance of puffiness and redness of joints. At the end of
predzheltushnogo period, the urine becomes dark and discolored stool.
The clinical picture of jaundice period of hepatitis A and viral
Hepatitis B is very similar: ikterichnost sclera, mucous-shells
Check the oropharynx, and then the skin. The intensity of the jaundice (icteric) on-
melts during the week. Body temperature is normal. There have been
weakness, drowsiness, loss of appetite, aching pain in the right sublattice
Berryer, in some patients, itchy skin. The liver is enlarged, sealed and
more painful on palpation, an increase in the spleen. In
peripheral blood revealed leukopenia, neutropenia, relative
Indeed lympho-and monocytosis. ESR of 2-4 mm / h In the blood, increased content of
total bilirubin, mainly due to direct (bound). Length
sequence of jaundice period of hepatitis A - 7-15 days, and virus-
tion of hepatitis B for about a month.
Threatening complication is the increase in liver failure
manifested by memory impairment, and increased general weakness, dizziness
Niemi, agitation, vomiting, more frequent, increasing the intensity of the icteric
coloration of the skin, reducing the size of the liver, hemorrhagic appearance
syndrome (bleeding vessels), ascites, fever, neutrophilic
leukocytosis, elevated levels of total bilirubin, and other indicators.
Of the end result is the development of liver failure
hepatic encephalopathy. With a favorable disease course after
jaundice, a period of convalescence with rapid disappearance of the clinical
cal and biochemical manifestations of hepatitis.
Recognition. Based on clinical and epidemiological data.
The diagnosis of viral hepatitis A is set to stay in the light of in-
infectious focus for 15-40 days prior to the disease, short preicteric
period, often for influenza-like variant, the rapid development of jaundice, Nep-
rodolzhitelny icteric period. The diagnosis of hepatitis B is established,
responds in the case at least 1.5-2 months before the appearance of yellow-
Toohey patient received a blood transfusion, plasma, were operative intervention
the proof, multiple injections. Confirm the diagnosis by laboratory-
exponents.
Treatment. Causal therapy pet. The mainstay of treatment is the treatment and
nutrition. The diet should be high-grade and high-calorie, except-
UT from a diet of fried foods, meats, pork, lamb, chocolate,
spices, alcohol is absolutely prohibited. We recommend drinking plenty of fluids
up to 2-3 liters per day, as well as a complex of vitamins.
In severe cases, carry out intensive fluid therapy (intra-
tively 5% glucose solution, gemodez, etc.) With the threat of development or liver-
failure shows a night corticosteroids.
Prevention. Given the mechanism of transmission of viral fekalnooralny
hepatitis A, you need - control of food, water, compliance-
Niemi personal hygiene. For the prevention of viral hepatitis in a careful
Indeed the observation of donors, quality sterilization of needles and other
tools for parenteral procedures.

Hemorrhagic fever.

Acute infectious diseases of viral
nature, characterized by toxicity, and hemorrhagic fever
syndrome - the expiration of the blood vessels (hemorrhage, hemorrhage).
Pathogens are a group of arboviruses, which are the reservoir
mostly rodents, and ticks. Infection-stepping
em the bite of ticks, by contact with rodents or human subjects, zag-
ryaznennymi their secretions through the air (hemorrhagic fever with in-
chechnya syndrome). Hemorrhagic fever - natural focal diseases,
Bani. Occur as isolated cases or small outbreaks in
rural areas, particularly in areas not cultivated human
com.
We describe three types of disease: 1) the hemorrhagic fever with renal Sind-
rum (hemorrhagic nefrozonefrit), 2) Crimean hemorrhagic smartly-
Radka, and 3) the Omsk hemorrhagic fever.
Hemorrhagic fever with renal syndrome. Incubation period
- 13-15 days. The disease usually begins acutely: severe headache,
insomnia, muscle pain and in the eyes, sometimes blurred vision. Tempera-
round of increases to 3940shS and kept for 7-9 days. The patient initially
excited, then lethargic, apathetic, sometimes delirious. The face, neck and upper sections
chest and back brightly hyperemic, there is redness of the mucous notation
shells and vasodilation sclera. By 04.03 the day of the disease condition worsens,
Xia, intoxication increases, there is repeated vomiting. On the skin films of
-beam waist and armpits appears haemorrhagic rash
as single or multiple small hemorrhages. These effects of
worse by the day, marked hemorrhage, often nasal.
The borders of the heart do not change, the tones are muted, sometimes there is an arrhythmia
and, rarely, there is a sudden pericardial rub (hemorrhage). Arte-
rial pressure is normal or reduced. Shortness of breath, pulmonary
stagnation. Tongue dry, thickened, thickly overlaid with gray-brown
bloom. Abdomen painful (retroperitoneal bleeding), liver, and village-
Sönke increase permanent. Especially typical renal syndrome: Res-
lightest pain in the abdomen and lower back with effleurage. Reducing the number of
urine or its complete absence. The urine becomes turbid due to the presence
in her blood and high protein content. In the future, gradually crust-
Paet recovery: pain subsides, stops vomiting, increased Diu-
res - the volume of urine. For a long time there is weakness, instability,
sustainability of the cardiovascular system.
Crimean-Congo haemorrhagic fever. The body temperature on day 1 achievement of
assumed 3940shS and lasts an average of 7-9 days. The patient is excited, the facial skin
and neck red. The sharp eyes reddening of the conjunctiva. The pulse is slow, ap-
arterial pressure is lowered. Breathing speeded in the lungs are often dry
scattered wheezes. Tongue dry, covered with dense gray-brown patina, mo-
cheotdelenie free. In the absence of complications after reducing the temperature
Tours of the body begins a gradual recovery.
Omsk hemorrhagic fever of the clinical picture resembles
Crimea, but is more benign, short-incubation
onnym period (2-4 days). The features are the undulating nature of the
temperature curve, and the frequent failure of the respiratory system.
Detection of hemorrhagic fever is based on the characteristic climate
ical symptom, blood tests and urine tests, taking into account epidemiological
České data.
Treatment. Mode of bed, careful patient care, diet, dairy
no-plant. Pathogenetic therapy is a means of cortico-
roidnye drugs. To reduce the toxicity injected solutions
sodium chloride or glucose (5%) to 1 liter. In acute renal insufficiency
Nosta conduct peritoneal dialysis.
Prevention. Storage products to protect from rodents. Ex-
uses deterrents. Patients are isolated and hospitalizations
lizatsii, conducted an epidemiological survey of the source of infection and
observation of the population. In rooms where the sick, implementation-
mented current and final disinfection.
Influenza. Acute respiratory disease caused by different types of
influenza viruses. Source them - people, especially in the initial period of bo-
it is useful. The virus is released during talking, coughing and sneezing to 4-7 days bolez-
no. Infection of healthy individuals is airborne.
Symptoms and flow. The incubation period lasts 12-48 hours.
A typical flu begins acutely, often with chills or chilliness.
The body temperature reaches its maximum 1 day (38-40shS). Clinical
manifestations consist of obschegotoksikoza syndrome (fever, weak-
Bost, sweating, muscle aches, severe headache and eye in the yab-
lokas, lacrimation, photophobia) and signs of the respiratory
bodies (dry cough, sore throat, soreness behind the sternum, hoarse
voice, nasal congestion). The examination noted decrease in arterial-
tial pressure, muffled heart sounds. Reveals diffuse lesion
upper respiratory tract (rhinitis, pharyngitis, tracheitis, larepgit).
Peripheral blood is characterized by leukopenia, neutropenia, monocyte-
tozom. ESR in uncomplicated cases is not increased. Frequent complications
influenza is pneumonia, frontal sinusitis, sinusitis, otitis, etc.
Recognition during epidemics of influenza are not difficult and is based
on the clinical and epidemiological data. At the time the flu interepidemic
is rare and diagnosis can be made using laboratory-ME
ods - the detection of the pathogen in the mucus of the nose and mouth with fluorescence
tsiruyuschih antibodies. For the retrospective diagnosis using serological-
asymptotic methods.
Treatment. Patients treated neoslozhnepnym flu at home, put in on-
individual room or isolated from the surrounding screen. During lihoradoch-
tion period - bed rest and heat (hot-water bottles to the feet, excessive grief-
Drinking chee). Assign a multivitamin. Extensive use of pathogenic and
symptomatic medications: antihistamine (Pipolphenum, suprastin, di-
Medrol), with a cold solution of 2-5% ephedrine naftizina, galazolin, self-
norip, oxolinic ointment 0.25% and others to improve the drainage function of the dy-
hatelnyh ways - expectorants.
Prevention. Used by vaccination. Can be used for prevention
tics of influenza A or rimantadine for amaptadin 0,10,2 g / day. Vyde ill-
lyayut a separate bowl, which is disinfected boiling water. Persons
caring for the sick, it is recommended to wear a gauze bandage (out of 4
layers of cheesecloth).
Dysentery. An infectious disease caused by bacteria of the genus wide-
Gell. The source of infection - a sick man and bacillicarriers. Contamination
occurs when the contamination of food, water, objects immedi-
redstvenno hands or flies. Dysentery bacteria are localized mainly
manner in the colon, causing its inflammation, surface erosion and
ulcers.
Symptoms and flow. The incubation period lasts from 1 to 7 days (more often
2-3 days). The disease begins acutely with fever, Lake-
Noba, feelings of fever, weakness, decrease in appetite. Then there are bo-
Whether in the abdomen, at first obtuse, poured around the abdomen, in the future, they
become more severe, cramping. By location - down
abdomen, usually on the left, sometimes right. Pain is usually worse before stool-
her. There are also a kind of tenesmus (dragging pain in the area of ​​direct
bowel during a bowel movement, and within 5-15 minutes after), there
false desires on the bottom. On palpation of the abdomen are marked and painful spasms,
ABILITY of the colon, more pronounced in the sigmoid colon, which
Paradise detectable in the form of thick rope. Chair speeded up, the bowel movements vnacha-
les have a fecal character, then they have an admixture of mucus and blood;
subsequently allocated only a small amount of mucus streaked with
blood. Disease duration ranged from 1-2 to 8-9 days.
Recognition. Made on the basis of epidemiological data
history, clinical manifestations: general intoxication, frequent stools
mucus and blood accompanied by tenesmus, cramping bo-
lyami in the abdomen (left iliac region). Important method of
sigmoidoscopy, which are identified with signs of inflammation
the mucous membrane of the distal colon. Isolation dizente-
microbes for trouble when a bacteriological examination of faeces
absolute confirmation of the diagnosis.
Treatment. Patients with dysentery can be treated as stationary in the infectious
bunk, and at home. Of the antibiotics used in the recently-
uses tetracycline (0.2-0.3 g 4 times daily) or chloramphenicol (0.5 g, 4
times a day for 6 days). However, the resistance of microbes to them considerable
relatively increased, and the efficiency decreased. Using well-nitrofen
Crane-inflammatory drugs (furazolidone, furadonin, etc.) of 0.1 g 4 times a day
within 5-7 days. Shows a complex of vitamins. In severe forms of pro-
lead detoxication therapy.
Prevention. Early detection and treatment, health monitoring
the sources of water, food enterprises, measures to combat
flies, personal hygiene.

Diphtheria (from the Greek. - Peel, film). 

An acute infectious disease
mostly children with lesions of the throat (at least - the nose, eyes, etc.), an-
mation fibrinous deposit and general intoxication of the organism. Excitable
Tel - Leffler selects coli toxin, which causes major
symptoms of the disease. Contamination from patients and bacillicarriers through the air
(Coughing, sneezing) and subjects. Ill, not all infected
nye. Most healthy bacteriocarrier formed. In the latter
recent years the tendency to increase in the incidence, seasonal ups
fall in the autumn.
Symptoms and flow. From the position of distinguished diphtheria throat, larynx,
the nose is rare - the eyes, ears, skin, genitals, wounds. At the site of localization
tion of a microbe is formed removable hard grayish-white coating in the form of films of
evaluations, coughs up (with the defeat of the larynx and bronchi) as a replica of the organic-
new. The incubation period of 2-10 days (usually 3-5). Currently, trans-
possesses pharyngeal diphtheria (98%). Catarrhal pharyngeal diphtheria is not always
recognized: the general condition of patients when it almost does not change. Noted,
is obtained moderate weakness, pain on swallowing, low-grade fever
body. Swelling of the tonsils and the increase in lymphatic nodes are insignificant.
This form can result in recovery, or go to a more typical
form.
Ostrovchaty kind of throat diphtheria is characterized as mild,
low-grade fever. On the tonsils single or multiple sites
fibrinous films. Lymph nodes are enlarged in moderation.
For membranous pharyngeal diphtheria is characterized by relatively acute onset,
fever, more severe symptoms of intoxication,
tion. The tonsils are swollen, on the surface of the solid dense whitish
pearlescent shade of the film - fibrinous raids. Removed them from the labor
house, then on the surface of the tonsils are bleeding erosion.
Regional lymph nodes are enlarged and somewhat painful. Without
specific therapy process can progress and move into more
severe (widespread and toxic). The raid at the same time has
tendency to spread beyond the tonsil on the bow, the tongue, lateral
ness and posterior pharyngeal wall.
Severe cases of toxic diphtheria throat starts to increase rapidly
body temperature to 39 40shS and symptoms of intoxication.
Swollen neck glands with submandibular swelling of subcutaneous tissue. At
toxic diphtheria a stele and swelling reaches the middle of s neck, at II
extent - to the clavicle, at III - below the collarbone. Sometimes swelling of the propagated
etsya face. Characterized by pale skin, blue lips, tachycardia, in-
lowered blood pressure.
With the defeat of the nasal mucosa observed sukrovichnye selection. At
severe laryngeal lesions - shortness of breath, young children in the
a stenotic breathing with the traction of the epigastric region and the intercostal space,
GOVERNMENTAL intervals. The voice is hoarse (aphonia), there is a barking ka-
shelf (the picture of diphtheria croup). If diphtheria is marked swollen eye-
smallness of age, more or less dense texture, copious pus
Age of the conjunctiva, it is difficult detachable serovatozheltye raids. When diphtheria-
theory of the vagina - swelling, redness, sores, covered gryaznoze-
lenovatym bloom, purulent discharge.
Complications: myocarditis, lesions of the nervous system, usually proyavlyayusche-
esya in the form of paralysis. More frequently observed paralysis of the soft palate, extremities,
children, the vocal cords, neck and airway. There may come a lethal
outcome due to paralysis of respiration, asphyxia (suffocation) for croup.
Recognition. To confirm the diagnosis required isolation of the
patient toxigenic diphtheria bacilli.
Treatment. The basic method of specific therapy - the immediate introduction of
antitoxic diphtheria serum is administered fractionally. At
toxic diphtheria and croup injected corticosteroids. Provo-
converges detoxification therapy, vitamin therapy, treatment with oxygen.
Sometimes when croup require urgent surgical intervention (intubation
or tracheostomy) to avoid death from asphyxia.
Prevention. The basis of prevention - immunization. Use the adsorbed
the induced diphtheria-pertussis-tetanus vaccine (DTP) and DT.

Ierspnioz. An infectious disease of humans and animals. Typical is-
horadka, intoxication, damage to the gastrointestinal tract, joints,
skin. The tendency to fluctuating course with exacerbations and relapses.
The causative agent belongs to the family epterobaktery, genus Yersinia. Role
different animals as a source of infection fall short of. The reservoir
the pathogen in nature, are small rodents that live in the wild
nature and synanthropic. A more significant source of contamination for any
action are the cows and sheep and goats, which are acutely ill, or you
determines the agent. The main route of transmission - Ceylon, the
is through food, mostly vegetables. Yersiniosis in any sick-
bong age, but most children 1-3 years. Mainly dominated by sporadic
cal cases, there is a winter-osenpe sezonchost.
Symptoms and flow. Extremely diverse. Detected in a
a sequence of signs of various organs and systems.
The most frequently yersiniosis begins with acute gastroenteritis. In the long-
shem disease can occur either as an acute intestinal infection, or
generalized - that is, spread throughout the body. All forms
share common features: acute onset, fever, intoxication, pain
in the stomach, upset the chair, rash, joint pain, liver enlargement,
tendency to exacerbations and relapses. Taking into account the duration of the differ-
chayut acute (up to 3 months), prolonged (3 to 6 months) and chronic
(More than 6 months) course of the disease.
The incubation period is 1-2 days, up to 10 days. The most pos-
toyanno symptoms of intestinal damage in the form of gastroenteritis,
gastroenterocolitis, mezentrerialnogo limfoadenita, enterocolitis, terminal-
tional ileitis, acute appendicitis. Abdominal pain constant or
cramping in nature, various locations, nausea, vomiting, liquid
cue stools with mucus and pus, sometimes blood from 2 to 15 times a day. Simpson
toms of intoxication are shown in the following: fever, in
severe cases - toxemia, dehydration and decreased body temperature. In
onset of the disease may appear dotted or melkopyatnistaya rash Tulo-
vische and limbs, liver disease, meningeal syndrome. More
Late period - mono or polyarthritis, erythema nodosum, myocarditis,
conjunctivitis, iritis. These are regarded as manifestations of an allergic reaction
function. In the peripheral blood neutrophilic leukocytosis is observed, the increase in
weighted ESR. The disease lasts from one week to several months.
Recognition. Bacteriological examination of stools, serology,
cal response in paired sera.
Treatment. In the absence of concomitant diseases, in cases of lung
erased and the flow of yersiniosis, patients can be treated at home physician-in-
fektsionistom. At the core - pathogenetic and causal therapy directed
Retained for detoxification, rehabilitation vodnoelektrolitnyh losses
normal composition of blood, the suppression of the pathogen. Drug
means - at the rate of chloramphenicol, 2.0 g per day for 12 days, from other pre-
Paratov - tetracycline, gentamicin, rondomitsin, doksitsiklip and others in
of daily doses.
Prevention. Compliance with the Regulations on public enterprises
tion power, technology, cooking and storage life of food products
elements (fruit, vegetables, etc.). Early identification of patients and carriers
Lei yersiniosis, disinfection of premises.
Infectious mononucleosis (Filatov's disease). It is believed that the excitable
Tel - filterable virus, Epstein-Barr virus. Infection is possible only if
very close contact with the patient's healthy, there is an air-ka-
pelnym way. Most sick children. The incidence of observed year-round
but higher in the autumn months.
Symptoms and flow. The incubation period of 5-20
days. Signs emerge more gradually, reaching a maximum at the end of first-
howl, beginning the second week. There is a slight malaise in the first 2-3
day of illness, accompanied by a slight rise in temperature and slightly
pronounced changes of the lymph nodes and throat. In the time-
harmonics of the disease with fever, inflammation in the throat, increased-
crease in spleen, liver and lymph nodes zadnesheynyh.
The duration of the reaction temperature from 1-2 days to 3 Beadle - the
longer period, the higher the temperature rise. Characterized by temperature swings
tours during the day in a 1-2m. Swollen lymph nodes, most of the
chetlivo and constantly in the cervical group, on the falling edge of the sterno-klyuchich-
but the muscle-liners. They may take the form of the chain or package. In diameter
individual nodes are 2-3 cm cervical tissue swelling there. The nodes are not
soldered together, are mobile.
Nasopharyngitis may manifest as sudden shortness of breath and
copious mucous discharge and mild nasal congestion, sore-
eat, and mucous discharge in the back of the throat. "Hastate" plaque
hanging from the nasopharynx, usually combined with massive overdubs on
tonsils, loose-cheesy consistency and white-yellow color. In all
patients with hepato-splenic observed syndrome (liver and village-
Sönke). Often, the disease can occur with obstructive jaundice. There are different
nye rash: the rash is different and lasts for several
days. In some cases, conjunctivitis and mucous membranes may
prevail over the rest of the symptoms.
Recognition. It is possible only through an integrated clinical and accounting
laboratory data. Usually the formula otmechayutuvelichenie blood lymphocyte
elements (not less than 15% compared with age-norm) and the appearance of blood
"Atypical" mononuclear cells. Serological studies carried out in order to
detection of heterophile antibody to the erythrocytes of various animals.
Treatment. No specific therapy, so in practice using
symptomatic. During the period of fever - Antipyretics and
Drink plenty of water. When nasal breathing difficulty - pre-vasoconstrictor
Paraty (ephedrine, galazolin, etc.). Apply desensitizing prep-
raty. We recommend gargling with warm solutions of Frc, the guide-
rokarbonata sodium. Nutrition at a safe flow of patients do not require
special restrictions. Prevention has not been developed.

Whooping cough.

Infectious disease with acute respiratory tract lesions,
children and bouts of spasmodic cough. Pathogen - a stick-Borde, Jean-
gu. The source of infection is a sick man, bacillicarriers. Oso-
particularly dangerous in patients with early stages (catarrhal period of illness).
Transmission is by droplet infection, sick
more pre-school children, especially in autumn and winter.
Symptoms and flow. The incubation period lasts 2-14 days (usually
5-7 days). Catarrhal period shows a general malaise, a slight
cough, runny nose, subfebrile temperature.
Gradually the cough increases, children become razrazhitelnymi, cap-
riznymi. At the end of two weeks of the disease begins a period of spasmodic Kash-
A. The attack is accompanied by a series of aftershocks cough, followed by deep
cue whistling breath (reprise), succeeded by a number of short convulsive crush-
Cove. The number of cycles ranged from 2 to 15. The attack zakapchivaetsya you-
dividing the viscous glassy phlegm, sometimes at the end of his notes GLR-
ta. During the attack the child is excited, dilated neck veins, the language of high-
ratories from the mouth, tongue is often injured, wasps may occur,
SETTING breathing, followed by asphyxia.
The number of attacks varies from 5 to 50 per day. The period of convulsive
cough lasts 34 Beadle, then the attacks become less frequent and finally disappear-
zayut, although the "usual cough 'lasts for 2-3 weeks.
In adults, the disease occurs without any episodes of convulsive coughing,
manifested prolonged bronchitis with persistent cough.
Body temperature remains normal. General well-being satisfactorily
Indeed.
Deleted forms of pertussis can occur in children, which are made in-
curling.
Complications: laryngitis with stenosis of the larynx (false croup), bronchitis,
brophnolity, pneumonia, pulmonary atelectasis, rarely encephalopathy.
Recognition. Perhaps only in the analysis of clinical and laboratory
the data. The basic method - abjection. At 1 week of illness
Positive results can be obtained in 95% of patients in the 4 - only in
50%. Serological methods are used for retrospective diagnosis.
Treatment. Patients under the age of 1 year, as well as complications, heavy
lymi forms of pertussis are hospitalized. Others can be treated at home. An-
tibiotiki used at an early age, with severe and complicated forms.
It is recommended to use a specific pertussis gamma globulin,
which is introduced vputrimyshechno to 3 ml daily for 3 days. In the time-
Apnea me to clear the airway of mucus through its otsasy-
Bani and perform artificial respiration.
Apply aptigistamippye drugs oksigepoterapiyu, vitamins, inhaled-
lyatsiyu aerosols of proteolytic enzymes (himopsip, chymotrypsin), co-
torye facilitate expectoration of viscous sputum. Patients should be more Naho-
ditsya outdoors.
Prevention. For active immunization against pertussis is used ad-
adsorbed diphtheria-pertussis-tetanus vaccine (DKDS). The contact
children under the age of 1 year and for the prevention of graft injected nor-
mum human immunoglobulin (measles) in 3 ml of 2 days under-
series.

Measles.

Acute vysokokoptagioznoe disease, with smartly-
Radko, inflammation of mucous membranes, rashes.
The causative agent belongs to a group miksovirusov, within its structure con-
contains RNA. The source of infection is a patient of measles during the ka-
taralnogo period and during the first 5 days of the onset of rash.
The virus is contained in a microscopically small particles of mucus nasopharyngeal
airways that are easily dispersed around the patient, especially
when coughing or sneezing. The causative agent is unstable. It is easy to die under the influence
natural environmental factors, with ventilation facilities. In the related-
su with the transmission through a third party, nursing, clothing, and
practically no toys. Susceptibility to measles unusually
high among those without a history of its all age groups, except for the first 6 children
months. (Especially under 3 months.), With passive immunity obtained
from the mother in utero and during breastfeeding. After Measles-vyraba
account by a strong immune system.
Symptoms and flow. From the moment of infection to the onset of the disease in the ti-
pichnyh cases runs from 7 to 17 days. The clinical picture of isolated
three stages: catarrhal, during the period of rash and pigmentation. Catarrhal
period lasts 5-6 days. There are fever, cough, runny nose,
conjunctivitis are redness and swelling of the mucous membrane of the pharynx,
slightly increased cervical lymph nodes, lungs auscultated
dry rales. After 2-3 days in the mucosa of the sky appears measles
enanthema as small pink items. Almost odovremenno with enantemy
on the mucosa of the cheeks can reveal a lot of point whitish
sites, which are the foci of degeneration, necrosis and keratinization
epithelium under the influence of the virus. This symptom was first described Filatov
(1895) and the American physician Koplik (1890). Spot Belsky-Filatov-cop-
saved face before the eruption, and then become less noticeable
GOVERNMENTAL disappear, leaving behind a surface roughness of the mucous membrane
(Defurfuration).
During the eruption is much more pronounced catarrhal phenomena, noted,
is obtained photophobia, lacrimation, increased runny nose, cough, a phenomenon
bronchitis. There is a new rise in temperature to 39 40shS, the state
the patient is much worse, marked lethargy, drowsiness, refusal
from eating in severe cases, delusions and hallucinations. On the face appears
pyatiisto first measles-papular rash, settling first on the forehead and
behind the ears. The value of individual items from 2-3 to 4-5 mm. Rash over the
3 days, gradually spreading from the top down: the first day of the dominance-
exists on the face, on day 2 is abundant on the trunk and arms, to 3
day covers the whole body.
Period of pigmentation (recovery). By 04.03 the day of the beginning of a rash on-
celebrated on improvement. Normalize the body temperature, reduce-
Xia catarrhal phenomena, rash fades, leaving pigmentation. By day 5 of the
beginning of rash rash all items either disappear or are replaced by pig-
fragmentation of. During the recovery observed severe fatigue, the increase in
weighted fatigue, irritability, drowsiness, decreased resistance
integrability of exposure to the bacterial flora.
Treatment. Mostly at home. It is necessary to carry out a toilet
eyes, nose, lips. Drink plenty of water should provide the body's need
in the liquid. Food - a full, rich in vitamins, easily digestible.
Symptomatic therapy consists of antitussives, antipyretics, anti-
histamine drugs. In uncomplicated measles resorting to antibiotics,
usually not necessary. They were prescribed for suspected malyshem tank
arterial complication. In severe cases apply state-kortikos
teroidy short course at a dose of 1 mg / kg body weight.
Prevention. Currently, the main preventive measure is-
etsya active immunization (vaccination).
Rubella. An acute viral disease with characteristic melkopyatnistoy
rash - exanthema, generalized lymphadenopathy, moderately pronounced
Noah fever and fetal damage in pregnant women. The causative agent belongs to
togavirusam contains RNA. In the external environment is unstable and quickly dies when
heated to 56shS, drying, under the influence of ultraviolet rays
whose, ether, formaldehyde and other disinfectants. The source of infection -
person with rubella, especially in the subclinical form, which flows
without a rash.
The disease occurs as epidemic outbreaks, which are repeat-
satisfy over 712 years old. At the time there are some interepidemic
cases. The maximum number of cases registered in apreleiyune. Oso-
buoy is dangerous disease for pregnant women because of intrauterine
Noah infection of the fetus. Rubella virus released into the environment this week
before the rash appears within a week after the rash. Infection occurs-
DIT airborne.
Symptoms and flow. The incubation period is 11-24 days. The general condition
suffers a little, so often the first symptom, drew the attention
tion is a rash, a rash resembling measles is then skarlatinoz-
nuyu. In patients observed a small weakness, malaise, headache,
pain, sometimes pain in muscles and joints. Body temperature is usually
subfebrile, though sometimes as high as 38 39shS and lasts 1-3 days. At
objective examination of observed mild symptoms of catarrh
upper respiratory tract, a little red throat, conjunctivitis. On
first days of illness arises generalized lymphadenopathy (ie, an-
schee porazhenielimfaticheskoy system). Special Features pronounced increase and bo-
leznennost zadnesheynyh and occipital l and mfaticheskih nodes. Exanthema
appears at 1-3 days of onset, first on the neck, through the bore-
How many hours is distributed throughout the body, can be itchy. Noting-
etsya a thickening of the rash on the legs razgibatelpoy,
back and buttocks. Elements of the rash spots are small-diameter
2-4 mm in diameter, usually they do not merge, stay 3-5 days and disappear without
leaving pigmentation. In 25-30% of cases of rubella occurs without a rash, ha-
umerennpym characterized by fever and lymphadenopathy. Bo-
it is useful may be asymptomatic, appearing only in viremia, and Narasimhan,
taniem in the blood titer of specific antibodies.
Complications: arthritis, rubella encephalitis.
Recognition. Carried out on set of clinical and laboratory
the data.
Virological methods not yet widely used. From serologiches-
FIR reactions used the reaction of neutralization and HAI, which put a
paired sera, taken at intervals of 10-14 days.
Treatment. When symptomatic treatment of uncomplicated rubella. At
Rubella arthritis appoint hingamin (delagil) to 0.25 g 2-3 times a
day for 5-7 days. Apply diphenhydramine (0.05 g, 2 times a day),
phenylbutazone (0.15 g 3-4 times daily), symptomatic agents. In en-
tsefalitah shown corticosteroids.
Favorable prognosis for rubella, except rubella encephalitis,
falita at which mortality reaches 50%.
Prevention. The most important among women of childbearing age. Some
recommend starting vaccinations to girls aged 13-15 years. Sick
Isolation of rubella are up to 5 days of the onset of rash.
Leyshmanpoz. Diseases caused by parasitic protozoa - leyshma-
piyami. Leishmania specific carriers - small bloodsucking insects
mye - mosquitoes.
The source of infection in the city - sick people and dogs. In rural areas
Nosta - various rodents (gerbils, hamsters). The disease occurs in a non-
which parts of Turkmenistan and Uzbekistan, the Caucasus, common in
Africa and Asia. Outbreaks are common from May to November - ta-
Kaya seasonality associated with the biology of vectors - mosquitoes. Particularly
high incidence among the newcomers in the endemic focus.
There are two main clinical forms of leishmaniasis: an internal or
visceral and cutaneous.

Internal leishmanioz. Symptoms and flow. A typical feature is-
Xia dramatically enlarged spleen, along with an enlarged liver and lymph-
cal nodes. Low remittent with two or three lifts in the
during the day. The incubation period lasts from 10-20 days to a few
months. The disease begins gradually - increasing weakness,
intestinal disorders (diarrhea). The spleen is gradually increased to
height of the disease reaches a huge size (down to the pelvis) and
high density. Increases and the liver. Appear on the skin of various
type of rash, mostly papular. The skin is dry, blednozemlistogo col-
ta. Characterized by a tendency to bleed, gradually develops ka-
Hex (weight loss), anemia, edema.
Recognition. Accurate diagnosis can be made only after a puncture
spleen or bone marrow and the presence in these bodies of leishmania.
Antropozny (urban) leishmanioz skin: the incubation period
3.8 months. Initially, on-site implementation of the pathogen occurs hump diagram
diameter of 2-3 mm. He gradually increase in size, the skin over it a hundred-
becomes burovatokrasnoy, and after 3-6 months. covered with a scaly crust.
If you delete it forms an ulcer, which has a round shape, smooth or mor-
schinistoe bottom, covered with a purulent coating. Around the ulcer is formed in-
filtrate, the decay which gradually increase the size of ulcers,
saped its edges, uneven, slight discharge. Gradually rub-
tsevanie ulcers ends in about a year since the beginning of the disease. Number
ulcers from 1-3 to 10, they are usually on exposed skin,
accessible to mosquitoes (face, hands).

Zoonotic (countryside) kozhnych leishmanioz.
Incubation period
shorter. In place of the introduction of the pathogen appears cone-shaped
mound with a diameter of 2-4 mm, which is growing rapidly and in a few days
reaches 1-1.5 cm in diameter in the center of its necrosis. After on-
torzheniya dead tissue called an ulcer, which is rapidly expanding.
Individual ulcers are sometimes quite extensive, with a diameter of 5 cm and bo-
Lee. When multiple ulcers, and in this type of leishmaniasis, their number can
reach several tens or hundreds, the size of each small ulcer. They
have rough edges saped, the bottom is covered with necrotic masses and
copious sero-purulent discharge. By the 3rd month of the bottom of the ulcer clean, one-
melt granulation. The process ends after 5 months. Often observed
given lymphangites, lymphadenitis. In both types of cutaneous leishmaniasis can-
Jet develop chronic tuberculoid form, reminiscent of lupus.
The diagnosis of cutaneous leishmaniasis is set to form the basis of charac-
thorns of the clinical picture, confirmed by detection of the pathogen in the ma-
rials, taken from a nodule or infiltrate.
For the treatment of patients with cutaneous leishmaniasis, intramuscularly administered monomitsin
muscular units to 250,000. 3 times a day for 10-12 days. Monomitsinovuyu
ointment is applied topically.
Prevention. The fight against mosquitoes - carriers of the pathogen, destruction,
mapping of infected dogs and rodents. More recently prevention
cal vaccine live cultures leishmania.

Q fever. Acute rickettsial illness characterized by general-
toxic phenomena, often with fever and SARS. Pos-
arouser - small microorganism. It is very resistant to drying, heating,
NIJ, ultraviolet irradiation. Reservoir and source of infection case-
lie a variety of wild and domestic animals, and ticks. Infection of human
is in contact with them, use of dairy products and
airborne dust by. The disease is detected during the whole year, but
usually in the spring and summer. Q fever is widespread all around the
ball, natural habitats are found on 5 continents.
Symptoms and flow. The incubation period lasts 14-19 days. Bo-
it is useful to begin acutely with chills. The body temperature rises to 38-39shS
and lasts 3-5 days. Characterized by large fluctuations in temperature, con-
rovozhdayuschiesya repeated chills and sweating. Pronounced symptoms
of intoxication (headache, muscle-joint pain, tenderness
eyeballs, poor appetite). The facial skin is moderately hyperemic,
rash is rare. In some patients with 3-5 days of illness joins
painful dry cough. Pulmonary lesions with clearly identified
X-ray focal shadows in the form of a rounded form. In
Later, typical symptoms of pneumonia. Tongue dry, coated.
There have also been an increase in the liver (50%) and spleen. Urinary output is reduced,
significant changes in the urine does not. Recovery is slow (2-4 weeks).
Long saved apathy, low-grade fever, decreased labor
dosposobnosti. Recurrences occur in 4-20% of patients.
Treatment. Apply for tetracycline 0.2-0.3 g to 0.5 g ililevomitsetin
every 6 hours for 8-10 days. Simultaneously appoint the intra-
vennoe infusion of 5% glucose, vitamins, according to testimony -
oksigepoterapiyu, blood transfusion, cardiovascular drugs.
Prevention. Carried the fight against KU-rickettsiosis pets.
Buildings for cattle disinfected 10% bleach solution. Young
from sick animals to the boil. In natural foci recommended conductivity
dit combat mites, apply the repellent means. For the spe-
What the prevention of Q fever vaccinated persons exposed to
animals. Patients with Q fever does not pose a great danger to the
people around them.
Malaria.

The group of vector-borne diseases. Characterized by acute attacks
fever and anemia. Malaria is caused by Plasmodium parasites, perenoschi-
Kami - blood-sucking female mosquito Anopheles genus.
The source of infection - a sick man, and parazitopositel. Disease-disintegrations
rostranena in South-East Asia and Africa.
Symptoms and flow. The incubation period for
falciparum malaria in the south of 14-20 days, 7-14 months in the north, in the Tropics
scopic malaria 8-16 days. Many patients often appear Prodromus-
mal (initial) symptoms: weakness, fatigue, appetite loss,
sleeping, chilling with a slight fever, headache, and
and pain in muscles and joints. It lasts 2-3 days. Then came a-
exists a typical febrile seizure. A typical attack starts with ozno-
ba: konechnostiholodnye, nose and lips bluish. Amazing chill
30-40 minutes followed by heat. The temperature rises to 4041shS.
The patient's condition deteriorates. There is anxiety, shortness of breath, severe
headache, dizziness, back pain, extremity. The skin is dry,
often serovatozheltoy color, tongue coated with white bloom. Palpation of Ms-
Vaught painful. After 6-12 hours and then replaced by the heat. The temperature curve
cally falls to subnormal. There comes a pause between attacks, continued
positivity is associated with the periodicity of the process of schizogony - disor-
Logo reproduction in the human malaria parasites: a day at
3-day or 2 days at 4-day malaria.
Seizures may occur at any time. The number of paroxysms
when fresh, the primary malaria reaches 8-12. In some cases, parasites
pogibayuti recovery occurs, in others - the circulation of the pathogen in
blood continues and possible early and late relapses.
Since the first attacks of malaria are increasing the size of the liver and spleen.
Increases anemia, leukopenia, neutropenia, increased erythrocyte sedimentation rate. Most
takes seriously the tropical malaria, which is a threat to development
malarial coma (severe general intoxication, impaired consciousness, Menin-
gealnye phenomenon) due to the impact of parasites on the central nerve-
nuyu system.
Recognition. Diagnosis is based on clinical and laboratory
data and epidemiological history. All patients with suspected
Malaria is carried out microscopic examination of blood (fat droplets and
smear). Detection of parasites is the only indisputable proof
proof. Applied research and serological methods (XRF, Phragmites).
Treatment. Directed to ensure that acute bouts of nausea, destroy-
live gametes - sex cells of malaria parasites to stop the re-
giving infection and recurrence of disease. Use drugs quinine and 4-amino-
quinoline derivatives (primaquine, delagil, fanzimif, etc.) by definition
lennym schemes.
Menpngokokkovaya infection. The disease is caused by meningococcus, pro-
implies in different clinical forms. Pathogen in the environment
dies quickly, at 55shS-for 5 minutes, under the influence of de-
zinfitsiruyuschih funds for 1-2 minutes, is sensitive to penicillin, le-
vomitsetinu, tetracyclines, sulfonamide drugs. The source of in-
ductive could be meningococcal meningitis patients, bacillicarriers.
Sick intensely isolated microbes into the environment in the initial ne-
periods of the disease. Carriage of meningococci in the recovery period continued
zhaetsya about 3 weeks. The mechanism of spread of air-ka-
pelny. Often affects children of preschool age. Maximum disease
accounts for the autumn-winter period.
Meningococcus is localized mainly in the pia mater,
causing them purulent inflammation. In the central nervous system penetration
exists, or through the nasopharynx along the olfactory nerves, or hematogenous
by.
Symptoms and flow. The incubation period of 2 to 10 days. Selects
localized form, when the agent is in a particular organ
(Meningokokkonositelstvo and acute nasopharyngitis), generalized forms
the dissemination of infection throughout the body (meningokoktsemiya, Menin-
git, meningoencephalitis); rare form (endocarditis, arthritis, pneumo-
of).
Acute nasopharyngitis may be the initial stage of purulent meningitis
or independent clinical manifestation. With a moderate increase
body temperature (up to 38.5 ind), there are signs of intoxication and lesions
of the mucosa of the pharynx and the nose (nasal congestion, redness and
swelling of the posterior pharyngeal wall).
Meningokoktsemiya - meningococcal sepsis begins abruptly, oc-
arises rapidly. There is a fever, headache, body temperature lifts to
extends to 40shS and above. Increases the permeability of blood vessels and four-
Res 5-15 hours from onset haemorrhagic rash appears, from
small petechiae to large hemorrhages, which are often combined with
necrosis of the skin, toes, ears. Symptoms of meningitis (see
below) in this form are not available. There are arthritis, pneumonia, myocarditis,
CIO endocarditis. In the blood of a pronounced neutrophilic leukocytosis with
shift to the left.
Meningitis is also growing sharply. Only some patients appear
initial symptoms in the form of nasopharyngitis. The disease begins with ozno-
ba, the rapid temperature increase to high numbers, excitation, motor-
Indeed concern. Early there is severe headache, vomiting
without preceding nausea, general hyperesthesia (increased skin, case-
hovaya, visual sensitivity). By the end of a day of illness arise and
picking up meningeal symptoms - stiff neck, a symptom
Kernig - inability to straighten the leg at a right angle, bent at the co-
county, and symptom Brudzinskogo - bending the legs at the knee joints during in-
gibanii head to his chest.
There may be delirium, agitation, convulsions, tremors, some affected
cranial nerves in infants may be a protrusion, and
Voltage fontanelles. Half of the patients for 2-5 days of illness appears
profuse herpetic eruption, sometimes petechial. The blood neutrophil
leukocytosis, increased erythrocyte sedimentation rate. With proper treatment, recovery is
at 12-14 days of therapy.
Complications: deafness due to lesions of the auditory nerve and the inner-
second ear; blindness due to lesions of the optic nerve or vascular
of the eye, brain edema (loss of consciousness, severe shortness of breath,
tachycardia, convulsions, increased blood pressure, pupillary
and the sluggish reaction to light, the extinction of meningeal syndrome).
Treatment. From etiotropic and pathogenic activities in the most ef-
tively intensive penicillin therapy. Also effective polusinteti-
cal penicillins (ampicillin, oxacillin). Spend detoxification
organism, treatment with oxygen, vitamins. If you have symptoms of edema
and swelling of the brain carry out dehydration therapy, facilitating
removal of excess fluid from the body. Assign corticosteroid pre-
Paraty. When seizures - phenobarbital.
Prevention. Early detection and isolation of patients. Extract from the steady-
nara after the negative results of bacteriological double
study. Work is underway to create a meningococcal vaccine.