A list of socially significant diseases is determined. Diseases of a social nature that cause harm to society and require social protection of a person

Introduction

2. Tuberculosis

3. Syphilis

4. Viral hepatitis

5. anthrax

6. Malaria

7. Helminthiasis

Conclusion

Introduction

Socially significant diseases are diseases caused primarily by socio-economic conditions, causing damage to society and requiring social protection person.

Social diseases are human diseases, the occurrence and spread of which largely depend on the influence of unfavorable conditions of the socio-economic system. To S. b. include: tuberculosis, sexually transmitted diseases, alcoholism, drug addiction, rickets, vitamin deficiencies and other diseases of malnutrition, some occupational diseases. The spread of social diseases is facilitated by conditions that give rise to class antagonism and exploitation of workers. The elimination of exploitation and social inequality is a necessary prerequisite for the successful fight against social diseases. At the same time, socio-economic conditions have a direct or indirect impact on the occurrence and development of many other human diseases; The role of the biological characteristics of the pathogen or the human body should also not be underestimated when using the term “social diseases”. Therefore, since the 1960-70s. the term is finding increasingly limited use.

In connection with the aggravated problem of socially significant diseases, the Government Russian Federation issued Resolution No. 715 of December 1, 2004, Moscow “On approval of the list of socially significant diseases and the list of diseases that pose a danger to others”

The Resolution includes:

1. List of socially significant diseases:

1. tuberculosis.

2. infections that are predominantly sexually transmitted.

3. hepatitis B.

4. hepatitis C.

5. disease caused by the human immunodeficiency virus (HIV).

6. malignant neoplasms.

7. diabetes.

8. mental disorders and behavioral disorders.

9. diseases characterized by increased blood pressure.

2. List of diseases that pose a danger to others:

1. disease caused by the human immunodeficiency virus (HIV).

2. viral fevers transmitted by arthropods and viral hemorrhagic fevers.

3. helminthiases.

4. hepatitis B.

5. hepatitis C.

6. diphtheria.

7. sexually transmitted infections.

9. malaria.

10. pediculosis, acariasis and others.

11. glanders and melioidosis.

12. anthrax.

13. tuberculosis.

14. cholera.

Let's look at some of the most common and dangerous diseases from the above list, included in the 1st and 2nd groups.

1. Disease caused by human immunodeficiency virus (HIV)

HIV infection, like a fire, has now engulfed almost all continents. In an unusually short time, it has become the number one problem for the World Health Organization and the UN, pushing cancer and cardiovascular diseases into second place. Perhaps no disease has asked scientists such serious mysteries in such a short period of time. The war against the AIDS virus is being waged on the planet with increasing efforts. Every month, the world scientific press publishes new information about HIV infection and its causative agent, which often forces us to radically change our point of view on the pathology of this disease. There are still more mysteries. First of all, the unexpectedness of the appearance and rapidity of the spread of HIV. The question of the reasons for its occurrence has not yet been resolved. The average and maximum duration of its latent period is still unknown. It has been established that there are several varieties of the AIDS pathogen. Its variability is unique, so there is every reason to expect that further variants of the pathogen will be discovered in different regions of the world, and this can dramatically complicate diagnosis. More mysteries: what is the connection between AIDS in humans and AIDS-like diseases in animals (monkeys, cats, sheep, cattle) and what is the possibility of integrating the genes of the causative agent of AIDS into the hereditary apparatus of germ cells? Further. Is the name itself correct? AIDS stands for acquired immunodeficiency syndrome. In other words, main feature diseases - damage to the immune system. But every year more and more data is accumulated proving that the causative agent of AIDS affects not only the immune system, but also the nervous system. Completely unforeseen difficulties are encountered in developing a vaccine against the AIDS virus. The peculiarities of AIDS include the fact that it is, apparently, the first acquired immunodeficiency in the history of medicine associated with a specific pathogen and characterized by epidemic spread. Its second feature is the almost “targeted” defeat of T-helper cells. The third feature is the first human epidemic disease caused by retroviruses. Fourthly, AIDS according to clinical and laboratory features is unlike any other acquired immunodeficiency.

Treatment and Prevention: Effective treatments for HIV infection have not yet been found. At present, at best, we can only delay the fatal outcome. Special efforts need to be focused on preventing infection. Modern medicines and measures used for HIV infection can be divided into etiological, affecting the immunodeficiency virus, pathogenetic, correcting immune disorders and symptomatic, aimed at eliminating opportunistic infections and neoplastic processes. Of the representatives of the first group, preference should, of course, be given to azidothymidine: thanks to it, it is possible to weaken clinical manifestations, improve the general condition of patients and prolong their life. However, recently, judging by some publications, a number of patients have become refractory to this drug. The second group includes immunomodulators (levamisole, isopripozine, thymosin, thymopentin, impreg, indomethacin, cyclosporine A, interferon and its inducers, tactivin, etc.) and immunosubstitutes (mature thymocytes, Bone marrow, thymus fragments). The results of their use are quite questionable, and a number of authors generally deny the advisability of any stimulation of the immune system in patients with HIV infection. They believe that immunotherapy may promote unwanted HIV reproduction. Symptomatic therapy is carried out according to nosological principles and often brings noticeable relief to patients. As an illustration, we can refer to the result of electron beam irradiation of the main focus of Kaposi's sarcoma.

The basis of the modern fight against HIV infection should be the prevention of its spread. Here, special attention should be paid to health education to change behavioral and hygiene habits. In sanitary educational work, it is necessary to reveal the ways of transmission of the disease, especially emphasizing that the main one is sexual; show the harmfulness of promiscuity and the need to use condoms, especially during casual contacts. Individuals at risk are advised not to participate in donation, and infected women are advised to abstain from pregnancy; It is important to caution against sharing toothbrushes, razors and other personal hygiene items that may be contaminated with blood and other biological fluids infected.

At the same time, infection is impossible through airborne droplets, through household contacts and through food. An important role in combating the spread of HIV infection belongs to the active identification of infected people through the use of test systems by definition antiviral antibodies. This definition includes donors of blood, plasma, sperm, organs and tissues, as well as homosexuals, prostitutes, drug addicts, sexual partners of patients with HIV infection and those infected, patients with sexually transmitted diseases, primarily syphilis. Russian citizens should undergo serological testing for HIV after a long stay abroad and living in Russia foreign students, especially those arriving from regions endemic for HIV infection. An urgent measure to prevent HIV infection remains the replacement of all syringes with disposable syringes, or at least strict adherence to the rules of sterilization and use of regular syringes.

AIDS is one of the most important and tragic problems that arose before all of humanity at the end of the twentieth century. And the point is not only that many millions of people infected with HIV have already been registered in the world and more than 200 thousand have already died, that every five minutes on the globe one person is infected. AIDS is a complex scientific problem. Even theoretical approaches to solving such a problem as cleaning the genetic apparatus of cells from foreign (in particular, viral) information are still unknown. Without solving this problem, there will be no complete victory over AIDS. And this disease has raised many scientific questions...

AIDS is a severe economic problem. Maintenance and treatment of sick and infected people, development and production of diagnostic and therapeutic drugs, carrying out fundamental scientific research etc. Already worth billions of dollars. The problem of protecting the rights of AIDS patients and those infected, their children, relatives and friends is also very difficult. It is also difficult to resolve the psychosocial issues that arise in connection with this disease.

AIDS is not only a problem for doctors and healthcare workers, but also for scientists of many specialties, statesmen and economists, lawyers and sociologists.

2. Tuberculosis

Among the diseases related to social diseases, tuberculosis occupies a special place. The social nature of tuberculosis has been known for a long time. At the very beginning of the 20th century, this disease was called “the sister of poverty,” “the proletarian disease.” In old St. Petersburg on the Vyborg side, the mortality rate from tuberculosis was 5.5 times higher than in the central regions, and in modern conditions the material well-being of people plays an important role in the occurrence of tuberculosis. As shown by a study conducted at the Department of Public Health and Healthcare of St. Petersburg Medical University named after. acad. I.P. Pavlova, and at the end of the 20th century, the financial and material situation of 60.7% of tuberculosis patients was defined as unsatisfactory.

Currently, the incidence of tuberculosis in developing countries much higher than in economically developed countries. Despite the enormous achievements of medicine in the treatment of patients with tuberculosis, this problem continues to remain very relevant in many countries. It should be noted that our country has made significant progress in reducing the incidence of tuberculosis over a certain period. However, in the last decade of the 20th century, our position on this issue noticeably weakened. Since 1991, after many years of decline, the incidence of tuberculosis in our country began to increase. Moreover, there is a rapid rate of deterioration of the situation. In 1998, the number of newly diagnosed tuberculosis patients in the Russian Federation more than doubled compared to 1991. In St. Petersburg, the incidence of active tuberculosis (per 100,000 population) increased from 18.9 in 1990 to 42.5 in 1996. A number of epidemiological indicators are used to characterize the effectiveness of tuberculosis control.

Morbidity. As noted above, the number of patients newly diagnosed with active tuberculosis has tended to increase in recent years.

Of the total number of patients newly diagnosed, 213 were men, and almost half of them were 20-40 years old. More than 40% of those identified were isolated from TB, and in more than 1/3 already advanced forms of tuberculosis were detected for the first time. Firstly, all this indicates an unfavorable epidemiological situation for tuberculosis, and secondly, that the asocial part of society (homeless people, alcoholics, people imprisoned for crimes) makes up a significant part of the contingent of newly diagnosed tuberculosis patients. When counting first-time cases, the following are not included:

a) patients registered in another region;

b) cases of relapse of the disease.

Soreness. Indicators of morbidity, in connection with the success of treatment of patients with tuberculosis, and during the period when there was a 5-fold decrease in incidence, decreased only 2-fold. That is, this indicator, with successful efforts to reduce tuberculosis, changes at a slower pace than the incidence rate.

Mortality. Thanks to advances in the treatment of tuberculosis, the mortality rate from tuberculosis has decreased by 7 times over a 20-year period. Unfortunately, in recent years, positive changes in reducing the prevalence of tuberculosis as a social phenomenon have stopped and, on the contrary, there are even negative trends. The mortality rate from tuberculosis in the Russian Federation more than doubled, amounting to 16.7 per 100 thousand population in 1998.

World experience, as well as the experience of our country, has shown that the most effective treatment and preventive institution for working with tuberculosis patients is an anti-tuberculosis dispensary. Depending on the service area, the dispensary can be district, city, or regional. The anti-tuberculosis dispensary operates on a territorial-precinct principle. The entire service area is divided into sections, and a TB doctor is assigned to each section. Depending on local conditions (the number of registered persons and foci of tuberculosis infection, the presence of large industrial enterprises etc.) the population in one TB area can range from 20-30 thousand to 60 thousand. It is important that the boundaries of several therapeutic areas of the clinic and one TB area coincide, so that the local TB doctor works closely with certain doctors - therapists, pediatricians, general practitioners.

In the structure of an anti-tuberculosis dispensary, the main part is the outpatient link. In addition to the usual offices (doctors’ offices, procedure rooms, functional diagnostics rooms, it is highly desirable to have dental office. Naturally, an integral part is a bacteriological laboratory and an X-ray room. Some dispensaries operate fluorographic stations. In addition, there may be hospitals.

The dispensary carries out all work to combat tuberculosis in the area of ​​​​operation according to a comprehensive plan. It is very important to participate in the implementation of such a plan not only from medical institutions, but also from other departments. Real success in reducing the incidence of tuberculosis can only be achieved through the implementation of the interdepartmental program “Tuberculosis”, which was also developed in St. Petersburg. The main part of the comprehensive plan consists of sanitary and preventive measures:

Organization of timely identification of patients and revaccination of uninfected;

Organization of timely identification of patients and mass targeted preventive examinations;

Improvement of foci of tuberculosis infection, housing arrangements for bacilli carriers;

Labor placement of patients;

Sanitary educational work.

A significant place in the comprehensive plan is occupied by new methods of diagnosis and treatment of patients, inpatient and sanatorium treatment, and training of doctors in phthisiology.

There are several ways to identify tuberculosis patients. The main place is occupied (80% of all identified patients) by identification when patients seek medical help. The role of clinic doctors here is very important; as a rule, the sick person goes there first. Targeted preventative measures play a role medical examinations. Observation of contacts and data from pathological studies occupy an insignificant place. The latter method indicates shortcomings in the work of treatment and prevention institutions for tuberculosis.

An anti-tuberculosis dispensary is a closed institution, i.e. the patient is referred there by a doctor who identifies such a disease. When tuberculosis is detected in any medical institution, a “Notification of a patient diagnosed with active tuberculosis for the first time in his life” is sent to the anti-tuberculosis dispensary at the patient’s place of residence.

The doctor at the anti-tuberculosis dispensary organizes a thorough examination and, when the diagnosis is clarified, registers the patient with the dispensary.

In our country, tuberculosis prevention is carried out in two directions:

1. Sanitary prevention.

2. Specific prevention.

Means of sanitary prevention include measures aimed at preventing infection of healthy people with tuberculosis, at improving the epidemiological situation (including current and final disinfection, education of hygienic skills in tuberculosis patients).

Specific prevention is vaccination and revaccination, chemoprophylaxis.

To successfully reduce the incidence of tuberculosis, significant government allocations are required to provide housing for bacilli carriers, for sanatorium treatment patients, to provide free medicines to outpatients, etc.

WHO's current leading strategy to combat tuberculosis is the DOTS (acronym English words“Directly observed treatment, short-course”, which can be translated as “controlled chemotherapy of shortened activity”). It includes sections such as identifying infectious tuberculosis patients seeking medical care through analysis of clinical manifestations of pulmonary diseases and microscopic analysis of sputum for the presence of acid-fast microbacteria; prescribing two-stage chemotherapy to identified patients.

As the main specific goal of the fight against tuberculosis, WHO puts forward the requirement to achieve recovery in at least 85% of new patients with infectious forms of pulmonary tuberculosis. National programs that succeed in achieving this have the following impact on the epidemic; the morbidity of tuberculosis and the intensity of spread of the infectious agent immediately decreases, the incidence of tuberculosis gradually decreases, drug resistance develops less frequently, which makes it easier to further treatment patients and makes it more accessible.

By the beginning of 1995, approximately 80 countries had adopted the DOTS strategy or begun to adapt it to their conditions; About 22% of the world's population lives in regions where the DOTS program is implemented, and many countries have achieved high tuberculosis cure rates.

The adoption of the Russian Federation Law “On the Protection of the Population from Tuberculosis” (1998) proposes the development of new conceptual, methodological and organizational approaches to the formation of a system of outpatient and inpatient anti-tuberculosis care. Stopping the exacerbation of the problem of tuberculosis in the changed socio-economic conditions in Russia is possible only by strengthening the role of the state in the prevention of this infection, creating a new concept for carrying out and managing anti-tuberculosis measures.

Preventive measures carried out in all outbreaks, but first of all in the most dangerous ones. The first priority is hospitalization of the patient. After inpatient treatment, patients are sent to a sanatorium (free of charge).

Persons who were in contact with patients are observed in the anti-tuberculosis dispensary according to the 4th group of dispensary registration. They are given chemoprophylaxis and, if necessary, vaccination or revaccination with BCG.

Organization of anti-tuberculosis work.

If the first principle of the fight against tuberculosis in our country is its state nature, then the second can be called treatment and prophylactic, the third principle is the organization of anti-tuberculosis work by specialized institutions, the broad participation of all health care facilities in this work.

The comprehensive plan to combat tuberculosis includes the following sections: strengthening the material and technical base, incl. equipping healthcare facilities, providing the necessary personnel and improving their qualifications, carrying out measures aimed at reducing the reservoir of tuberculosis infection and preventing its spread among the healthy population, identifying patients and treating them.

It must be remembered that tuberculosis is controlled, i.e. controllable, infectious diseases and the implementation of clear and timely measures to prevent tuberculosis can achieve a significant reduction in the prevalence of this dangerous disease.

3. Syphilis

Social and economic transformations in Russia in the 90s of the twentieth century were accompanied by a number of negative consequences. These include the syphilis epidemic, which has affected most territories of the Russian Federation. In 1997, the incidence of this infection increased by a total of 50 times compared to 1990, and the incidence of children increased by 97.3 times

The epidemic involved the population of all territories of the North-West region of Russia. The highest rates of syphilis incidence occurred in the Kaliningrad region. It should be noted that this region was the first territory where the HIV epidemic began. The incidence of syphilis in children in 1997 (the year of the maximum increase) in the territories of the North-West was characterized by different indicators.

They turned out to be the highest in the Novgorod, Pskov, Leningrad and Kaliningrad regions. Such territories are called risk territories. In recent years, the incidence of syphilis has begun to gradually decline, but it still remains at a high level. In 2000, in the Russian Federation as a whole, more than 230 thousand patients with all forms of syphilis were identified, including more than 2 thousand cases registered among children under 14 years of age (in 1997-1998, more than 3 thousand diseases were diagnosed annually, of which 700 800 cases among children under 1 year of age). According to the dermatovenerological dispensary, in the Leningrad region in 1990-1991. About 90 patients with syphilis were identified. In 2000, more than 2 thousand new cases of the disease were diagnosed. It should be noted that among the sick, 34% were rural residents, i.e. this problem is not only in large cities. A study of the age structure of people with syphilis in 2000 showed that the bulk (42.8%) were young people aged 20-29 years (Fig. 4).

More than 20% of the structure was occupied by men and women in the age group of 30-39 years. However, the group at highest risk for the disease are persons 18-19 years old. This group, which includes only two age categories, accounted for about 10% of cases of syphilis, while other groups include 10 or more age categories of the population. 133 cases of syphilis were also identified among children and adolescents.

To what has been said, it must be added that in recent years syphilis has taken first place among the causes of abortion for medical reasons. Unfulfilled life, along with the low birth rate in general in the last decade, also characterizes the incidence of syphilis as a serious social problem. The high incidence of syphilis, confirming the changes that have occurred in the sexual behavior of the population, gives reason to predict an increase in the incidence of other sexually transmitted infections, including HIV infection.

The epidemiological situation associated with the epidemic growth of sexually transmitted diseases, including syphilis, has become so serious that it served as the topic of a special discussion at the Security Council of the Russian Federation, where a corresponding decision was made (Yu. K. Skripkin et al., 1967) . Since syphilis during an epidemic outbreak has significant features that contribute to the activation of the process, attention is paid to increasing the effectiveness of treatment, rehabilitation and preventive measures. It is noteworthy that there are many factors that provoke and contribute to the increase in the incidence of syphilis.

1st factor - social conditions: extremely low level of information about sexually transmitted diseases among the country's population; a catastrophic increase in drug use; progressive increase in alcoholism; active, immoral propaganda of sex by all types and means mass media; economic distress of the country; a progressive increase in the number of unemployed; lack of legalized prostitution.

2nd factor: general medical situation in the country; a pronounced decrease in immunity in a significant part of the population due to impoverishment; an increase in the number of manifest forms of syphilis and malignant, atypical manifestations; Diagnosis of secondary fresh and recurrent syphilis is difficult due to the atypicality and small number of rashes, and rare visits to medical institutions; an increase in the number of patients with hidden and unknown syphilis; tendency to self-medicate a significant contingent of people.

Serious attention is drawn to the fact that antibiotics are widely used in the country for intercurrent diseases that contribute to immunosuppression and change the clinical picture and course of the syphilitic process. Syphilitic infection has undergone significant pathomorphism over the past decades. So, V.P. Adaskevich (1997) emphasizes the milder course of syphilis without severe consequences observed several decades ago. In recent years, tubercular and gummous syphilis have become rare, as have severe lesions of the central nervous system (acute syphilitic meningitis, tabetic pain and crises, tabetic atrophy optic nerves, manic and agitated forms of progressive paralysis, arthropathy), gumma of the bones of the skull and internal organs. Severe syphilitic lesions of the liver, aortic aneurysm, aortic valve insufficiency, etc. are much less common. However, diseases of a combined nature - tuberculosis and syphilis, syphilis and HIV infection - have become more frequent.

For the purpose of more detailed information about the features of the modern syphilis clinic, V.P. Adaskevich (1997) summarized the clinical uniqueness of the symptoms of the primary and secondary periods of syphilis, characteristic of the present time.

Clinical features of the primary period are: the formation of multiple chancre in 50-60% of patients, an increase in the number of cases of ulcerative chancre; herpetic giant chancre is registered; atypical forms of chancre have become more frequent; Complicated forms of chancre with pyoderma, viral infections with the formation of phimosis, paraphimosis, and balanoposthitis are more often observed.

The number of patients with extragenital chancre has increased: in women - mainly on the mucous membranes of the oral cavity and pharynx, in men - in the anal area; Noteworthy is the absence of regional scleradenitis in 7-12% of patients.

Clinical features of the secondary period: roseola and roseola-papular elements are more often recorded; roseola rash is observed on the face, palms, and soles. Atypical roseolous elements are possible in a significant number of patients: elevating, urticarial, granular, confluent, scaly. In patients with secondary fresh syphilis, the combination of palmoplantar syphilides with leukoderma and alopecia has become more frequent.

With secondary recurrent syphilis, a papular rash will predominate in patients, less often a roseola rash. Low-symptomatic isolated lesions of the palms and soles are common; In a significant number of patients, erosive papules and condylomas lata of the anogenital area are often recorded. Pustular secondary syphilides are detected less frequently, and if they occur, they are superficial impetiginous.

Noteworthy is the predominance of cases of secondary recurrent syphilis among the treated population of patients, which is a consequence of late presentation and late detection of fresh forms.

V.P. Adaskevich (1997) and a number of authors note certain difficulties in detecting pale treponomas in the discharge of syphilides. The frequency of detection of pale treponomas in the discharge of chancre during primary syphilis does not exceed 85.6-94% and 57-66% in the discharge of papular elements during repeated studies.

Manifestations of the tertiary period of syphilis are currently rarely recorded and are characterized by the paucity of clinical symptoms, a tendency to manifestations of a systemic nature from the internal organs, with a mild course. There are almost no cases of tertiary syphilis with abundant tuberculate rashes, gummas, and significant bone deformations.

Over the past decades, there has been a marked increase in latent forms of syphilis, which, according to some data, account for 16 to 28% of all cases of the disease detected per year, which can be complicated by significant epidemiological problems.

To successfully reduce the incidence of syphilis, the need for a set of measures has been established. Timely diagnosis with identification of sources and contacts is combined with the active prescription of modern treatment in accordance with the characteristics of the patient’s body and the uniqueness of the symptoms of the process. The work carried out by many research institutes, departments of skin and venereal diseases of medical institutes, aimed at improving methods of treating syphilis, has been repeatedly discussed at congresses and international symposiums of dermatovenerologists. At the same time, recommendations and instructions were developed for the use of theoretically substantiated and practically tested methods and regimens that ensure a full therapeutic effect over many years of clinical observations.

Principles and methods of treatment. Drugs used to treat patients with syphilis are called antisyphilitic drugs. They are prescribed after a diagnosis has been established with mandatory confirmation by laboratory data. It is recommended to start treatment as early as possible (in the case of early active syphilis - in the first 24 hours), since the earlier treatment is started, the more favorable the prognosis and the more effective its results.

Reducing the incidence of syphilis and its prevention is not only a medical task, but the state and society as a whole.

4. Viral hepatitis

Viral hepatitis is a group of nosological forms of diseases of different etiological, epidemiological and clinical nature, occurring with predominant liver damage. According to their medical and socio-economic characteristics, they are among the ten most common infectious diseases of the population of modern Russia.

Official registration according to Form No. 2 of the Federal State statistical observation in accordance with ICD-X are currently subject to:

Acute viral hepatitis, including acute hepatitis A, acute hepatitis B and acute hepatitis C;

Chronic viral hepatitis (first established), including chronic hepatitis B and chronic hepatitis C;

Carriage of the causative agent of viral hepatitis B;

Carriage of the causative agent of viral hepatitis C

The last five years have been marked by a significant increase in the prevalence of all nosological forms of viral hepatitis, which is associated both with the next cyclical rise and with wide range social conditions life of the population, contributing to the implementation of infection transmission routes. In 2000, compared to 1998, the incidence of hepatitis A increased by 40.7%, hepatitis B by 15.6% and hepatitis C by 45.1%. The rates of latent parenteral hepatitis B increased by 4.1% and hepatitis C by 20.6%. The official registration of newly diagnosed cases of chronic viral hepatitis (B and C), which began only in 1999, revealed that the rate for the year increased by 38.9%. As a result, in 2000, the country's treatment and preventive institutions identified and registered 183 thousand cases of acute viral hepatitis (including: A - 84, B - 62, C - 31, others - 6 thousand cases); 296 thousand cases of carriage of the causative agent of viral hepatitis B and C (140 and 156 thousand cases, respectively); 56 thousand cases of newly diagnosed chronic viral hepatitis B and C (21 and 32 thousand cases, respectively).

Thus, the number of all cases of viral hepatitis in 2000 exceeded 500 thousand, including the number of acute cases of hepatitis (A, B, C), occurring in manifest and latent form - 479 thousand (of which B and C - 390 thousand cases). The ratio of registered manifest to non-manifest forms was 1:2.2 for hepatitis B and 1:5.0 for hepatitis C.

The total prevalence of all forms of hepatitis B and hepatitis C per 100 thousand population is almost the same - 152.4 and 150.8. If the number of newly diagnosed cases of chronic viral hepatitis is excluded from the indicators, the values ​​will be reduced to 138.2 and 129.6, respectively. As for the prevalence of hepatitis A, it is more than 3 times less than each of the parenteral hepatitis considered.

Differences in the frequency and proportion of morbidity in children with various forms of viral hepatitis are clearly visible, which boil down to a significant prevalence of hepatitis A in children. Among parenteral hepatitis, children are 2 times more likely to suffer from hepatitis B than hepatitis C (both acute and chronic forms ).

Assessing the importance of hepatitis for public health, we also present mortality statistics: in 2000, 377 people died from viral hepatitis in Russia, including 4 from hepatitis A, 170 from acute hepatitis B, 15 from acute hepatitis C, and 15 from chronic viral hepatitis 188 people (mortality rate was 0.005%, 0.27%, 0.04% and 0.33%, respectively).

Analysis of official statistical information outlined the social, medical and demographic contours of the problem of viral hepatitis. At the same time, it is of no small importance to characterize the economic parameters of these infections, which allows us to use numbers to judge the damage caused to the economy, and ultimately make the only right choice regarding the strategy and tactics to combat them.

A comparison of economic losses associated with one case of hepatitis of various etiologies indicates that the greatest damage is caused by hepatitis B and C, which is associated both with the duration of the course (treatment) of these diseases and with the possibility of chronicity of the process.

The given values ​​of damage (per 1 case), calculated for the Russian Federation, can be used to determine the total economic losses both for the country as a whole and for its individual regions. In the latter case, the size of the error in the obtained significance values ​​will mainly depend on how different the basic parameters of damage per 1 case of illness are (ratio of sick children and adults, duration of inpatient treatment, cost of a bed day, size wages workers, etc.) in the region and on average throughout the country.

The greatest economic losses from morbidity in 2000 were associated with hepatitis B - 2.3 billion rubles. The damage from hepatitis C is somewhat less - 1.6 billion rubles. and even less from hepatitis A - 1.2 billion rubles.

In 2000, the economic damage from all viral hepatitis in the country exceeded 5 billion rubles, which in the structure of the total damage from the most common infectious diseases (25 nosological forms without influenza and ARVI) amounted to 63% (Fig. 2). These data make it possible to characterize viral hepatitis not only in general, but also to compare the economic significance of individual nosological forms.

Thus, the results of the analysis of the incidence and economic parameters of viral hepatitis allow us to consider these diseases as one of the highest priority problems of infectious pathology in modern Russia.

5. Anthrax

Anthrax is an acute infectious anthropozoonotic disease caused by Bacillus anthracis and occurs predominantly in the cutaneous form; inhalation and gastrointestinal forms are less common.

Every year, between 2,000 and 20,000 cases of anthrax are recorded worldwide. This infection acquired particular relevance after the use of Bacillus anthracis spores as a bacteriological weapon in the United States in the fall of 2001.

Bacillus anthracis belongs to the family Bacilaceae and is a gram-positive rod, nonmotile, spore-forming and capsule-forming, growing well on simple nutrient media; vegetative forms quickly die under anaerobic conditions, when heated, or exposed to disinfectants. The spores are highly resistant to factors external environment. The main reservoir for the pathogen is soil. The source of infection is large cattle, sheep, goats, pigs, camels. The entrance gates are damage to the skin, respiratory tract, and gastrointestinal tract, which determines the development of one of the three forms mentioned above, each of which can turn into septic.

The main point of pathogenesis is the reproduction of the pathogen, accompanied by the production of toxins. B. anthracis produces at least 3 pathogenicity factors that determine its high virulence: edema factor (EF), lethal factor (LF) and protective antigen (PA), which forms a polypeptide capsule. The incubation period for anthrax depends on the route of transmission of the infection, the infecting dose of the pathogen and ranges from 1 to 6-7 days (usually 2-3 days). However, sometimes when the pathogen enters the body through inhalation, the incubation period can extend to 8 weeks.

There are cutaneous, inhalational (pulmonary) and gastrointestinal (intestinal) forms of anthrax. About 95% of all sporadic cases of anthrax are cutaneous and only 5% are inhalational. The gastrointestinal (intestinal) form of anthrax occurs in developing countries. Currently, it is recorded extremely rarely: about 1% of cases.

The following are distinguished: clinical varieties cutaneous forms: anthrax carbuncle, edema, bullous and erysipeloid. Anthrax carbuncle is the most common. About 80% of cases of cutaneous anthrax occur as a self-limiting localized infection, which after a few weeks, even if untreated, ends in recovery. Typical symptom- decreased or complete absence of sensitivity in the area of ​​the ulcer. Most often, the ulcer has a round shape ranging from 1 to 3 cm in diameter and a characteristic black color. Other cutaneous forms are rare.

Inhalation form: during the prodromal period, lasting 1-3 days, a clinical picture of a moderately severe influenza-like syndrome is observed. In the second clinical phase of the disease, signs of pneumonia and exudative pleurisy are revealed. With further progression of the disease, a picture of acute respiratory distress syndrome (RDS) and septic shock is formed, leading to death within a short period (from several hours to 2 days).

The gastrointestinal form of anthrax is characterized by signs of acute inflammation of the upper and/or lower gastrointestinal tract. There are two typical variants of the gastrointestinal form - intestinal and oropharyngeal. Clinical picture intestinal variant of the gastrointestinal form of anthrax is represented by nonspecific symptoms of inflammation small intestine and to a greater extent, thick - nausea, vomiting, anorexia and fever. Gradually they are joined by abdominal pain various localizations, vomiting with blood, bloody diarrhea. With the oropharyngeal variant of the gastrointestinal form of anthrax, edema and tissue necrosis develop in the neck area.

Natural strains of B. anthracis, including those isolated in the United States in the fall of 2001, are sensitive to many antibiotics, including penicillin, amoxicillin, doxycycline, tetracycline, clarithromycin, clindamycin, rifampicin, vancomycin, chloramphenicol, and ciprofloxacin. Prevention measures include vaccination and emergency chemoprophylaxis. Currently, live attenuated and inactivated adsorbed anthrax are used to vaccinate people against anthrax. anthrax vaccines. In recent years, research has begun on the creation of new genetically engineered vaccines based on the recombinant lethal toxin of B. anthracis. Preventive antibacterial therapy (emergency chemoprophylaxis) is aimed at preventing the development of inhalational anthrax, which is the most common form of the disease when B. anthracis is used as a biological weapon. According to CDC recommendations, the same drugs are used for preventive therapy as in the treatment of inhalation anthrax in conditions of mass influx of affected people. The simultaneous use of antibiotics and a vaccine for emergency prevention of anthrax is considered the most preferable and has proven its effectiveness in animal experiments.

The use of anthrax spores as a biological weapon is due to the ease of production, the possibility of covert use, and high efficiency. The most likely method of application is spraying an aerosol containing spores, which will lead to the predominance of the pulmonary form of the disease, accompanied by high mortality. WHO experts have calculated that 3 days after the application of 50 kg of anthrax spores, over a two-kilometer zone in the direction of the wind towards a city with a population of 500,000 people, 125,000 (25%) of the population will be affected and 95,000 deaths will occur. In connection with the increasing incidence of terrorist attacks, the presence of the anthrax pathogen in the arsenal of at least 5 countries, and the possibility of selecting strains resistant to antibacterial drugs, the issues of prevention and treatment of anthrax are of particular relevance.

6. Malaria

The malaria situation in the world is not improving, and in some regions it has worsened. Malaria continues to be a major health problem in many regions of the world. More than 2 billion people live in 100 countries with tropical and subtropical climates, where the risk of infection is high. About 110 million people worldwide become ill with malaria every year, and 1 to 2 million people, mostly children under 5 years of age, die from malaria every year in these countries. In those states in whose territory it was previously eliminated, the number of “imported” cases of malaria and secondary cases from imported ones is increasing, and deaths from tropical malaria continue to be observed.

In the first half of the 20th century, malaria was the most serious tropical disease. In the 1950s, WHO launched the Global Malaria Elimination Programme. As a result of extensive anti-malarial measures, the disease was eliminated in a number of areas, and in others it was brought under control. However, even today, malaria, the most widespread tropical disease in the world, is one of the most serious health problems for almost 100 countries in Asia, Africa, and South America.

More than 2 billion people, or about half the world's population, live at risk of contracting malaria. Every year, 110 million people fall ill in the world, of which 90 million are in Africa, in areas located south of the Sahara, where tropical malaria, the most severe form of infection, predominates. According to WHO, 1 to 2 million people die from malaria every year, mostly children under 5 years of age. In general, the malaria situation in the world is not improving, and in a number of places it has worsened over the past 10 years. In many areas of the world where wars occur, in zones of social conflicts or mass concentrations of refugees, in areas of intensive economic development due to irrigation, the situation has deteriorated dramatically. The disease, largely eradicated in the 1950s, has returned, and millions of people are suffering and dying.

Malaria endemic countries:

Asia and Oceania

Azerbaijan, Afghanistan, Bangladesh, Bhutan, Vanuatu, Vietnam, India, Indonesia, Iran, Iraq, Yemen, Cambodia, China, Laos, Malaysia, Myanmar, Nepal, UAE, Oman, Pakistan, Papua New Guinea, Saudi Arabia, Solomon Islands, Syria, Tajikistan, Thailand, Philippines, Sri Lanka

Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Djibouti, Egypt, Zaire, Zambia, Zimbabwe, Cameroon, Capo Verde, Kenya, Congo, Cote d" Ivoire, Comoros, Liberia, Mauritius, Mauritania, Madagascar, Malawi, Mali, Morocco, Mozambique, Namibia, Niger, Nigeria, Sao Tome and Principe, Swaziland, Senegal, Somalia, Sudan, Sierra Leone, Tanzania, Togo, Uganda , Central African Republic, Chad, Equatorial Guinea, Ethiopia + Eritrea, South Africa

Central and South America

Argentina, Belize, Bolivia, Brazil, Venezuela, Haiti, Guyana, Guatemala, French Guiana, Honduras, Dominican Republic, Colombia, Costa Rica, Mexico, Nicaragua, Panama, Paraguay, Peru, El Salvador, Suriname, Ecuador.

An estimated 9,000 imported cases of malaria per year are reported in Europe and North America among people returning from regions where it is common. Travelers to countries where malaria is endemic are often unaware of the causes of malaria and ways to prevent it. One study found that only 30% of European travelers knew that malaria is transmitted through the bites of mosquitoes that attack at dusk and dawn.

The danger also lies in the fact that in those countries where malaria is absent, doctors may not recognize its symptoms, do not conduct an examination and do not prescribe specific chemotherapy, and this in some cases, given the appropriate epidemiological situation, can contribute to the spread of malaria, and in tropical malaria creates threat to the patient's life.

In the former Soviet Union, malaria was practically eliminated; only isolated outbreaks remained in the southern republics. However, now it has become active again in Tajikistan and Azerbaijan. In areas where refugees move across borders, malaria spreads especially quickly. In particular, it is extremely difficult to implement malaria control activities during the movement of refugees from Afghanistan and Tajikistan. Every year, hundreds of cases of “imported” malaria are registered in Russia, including in Moscow, while in some cases of tropical malaria, deaths were observed due to late diagnosis and/or misdiagnosis

7. Helminthiasis

In addition to serious disorders of the immune system, helminthiasis is especially dangerous for the body due to its toxic and mechanical effects. The toxic effect manifests itself in decreased appetite, weakened absorption of nutrients in the intestine, growth retardation and mental retardation. physical development. These phenomena are caused by a decrease in the production of insulin-like growth factor (IGF-1) and an increase in the production of tumor necrosis factor-a (TNT-a), as well as a decrease in collagen synthesis. In addition, helminths are dangerous due to their ability to induce life-threatening complications, such as blockage of the ducts of the pancreaticobiliary system, abscesses of the liver and pancreas, intestinal perforation with the development of peritonitis, obstructive intestinal obstruction, etc.

So, timely diagnosis and adequate treatment are extremely important, especially in childhood.

Main indications for examination for helminth infections:

Stomach ache;

Frequent nausea, vomiting, changes in appetite;

Diseases of the gastrointestinal tract;

Fatigue, irritability, sleep disturbances, grinding teeth in sleep (bruxism);

Allergic conditions;

Perianal itching;

Vulvovaginitis;

Urinary tract infections;

Increased level of eosinophils in the blood;

Lag in height, weight;

Low level of personal hygiene of the patient.

It should be noted here that such clinical and laboratory data are not typical only for helminthiases.

When it comes to helminthic infestations, you need to pay attention not only to the specifics of treatment, but also to the mandatory preventive measures. It is necessary to draw the attention of the patient and parent to recommendations for maintaining personal hygiene. Wash greens, vegetables and fruits thoroughly. Take thermally carefully processed fish and meat. Do not drink raw water from open reservoirs, and if you suspect contamination, boil the water. Deworming of pets (dog, cat) is mandatory. In case of infection of one person, it is recommended to treat all family members based on consultation with a doctor.

Growing up, the baby begins to actively explore the world around him not only with his senses of perception - vision, hearing, smell, taste sensitivity, but also by expanding his motor activity. How older child, the more places it happens, the sadder it may be, the higher the likelihood of infection with helminths (in common parlance, worms). At the age of 1.5-3 years, the scale of infection of children with helminths can reach 80%.

Conclusion

According to the Ministry of Health, the epidemiological situation in Russia is becoming increasingly tense. Economic and social instability in society entails an inexorable increase in the number of diseases that are called socially significant.

Epidemiological observations forced the Ministry of Health and the Government of the Russian Federation to think about compiling a list of socially significant diseases. Within the framework of the federal target program "Prevention and Combating Diseases of a Social Character (2002-2006)", financed from the federal budget, intensive work is being carried out to stabilize the epidemiological situation in the country. The program includes improving measures to provide medical care, implementing preventive measures among the population, developing a system of dynamic control over socially significant diseases, and supporting regional medical and social services working in response to this problem. However, one of the most important activities of the federal program to combat socially significant diseases is to increase the level of knowledge about the existing epidemiological situation.

A society that has a significant amount of information about these diseases, preventive measures and effective ways treatment can be of great help in the fight against socially significant diseases.

List of used literature

1. Khomenko A.G. Fundamentals of tuberculosis diagnosis // Russian Med. magazine. – 2005. – No. 1. – P. 21–5.

3.. Guide to epidemiological surveillance of malaria in the USSR (Ed. V.P. Sergiev). M., 2000; part1, 264 s; part 2, 135c.

4. Global epidemiology. B.L. Cherkassky, 2008, pp. 31-50

5. Slow infections. E.S. Belozerov, Yu.I. Bulankov, E.A. Ioanidi, 2009, p. 21-30.

6. Infectious diseases. Shuvalova E.P., 2005, pp. 253-258.

7. Sexually transmitted infections. Skripkin Yu.K., Selissky G.D., Sharapova G.Ya. 2001, p. 57-65.

Socially significant diseases are caused primarily by socio-economic conditions, cause harm to society and require social protection of a person.

The social health of an individual is related to his/her living environment. By interacting with living space, a person is included in its structure, spatial arrangement, which, in turn, shapes a person’s social health. Since a person is constantly in the living space, stereotypical patterns of behavior arise and are identified, increasing the risk of this type of disease. Despite the fact that with age, both the structural and content of the living space changes, behavior patterns, the level of awareness on various aspects of life, and the characteristics of the living environment often determine the activity of the subject, regardless of mental and social development.

The state of health of the population is a clear and objective evidence of the level of civilization of the state. It is of great socio-economic importance - as a criterion of a person’s ability to adapt to conditions environment. The changed picture of an increase in the overall level of morbidity is in a close causal connection with shifts in demographic processes, which in economically developed countries are characterized by a trend towards a decrease in the birth rate, a relative stabilization of the levels of general and child mortality and a high average life expectancy.

Of particular importance in clinical medicine are the problems of the spread of coronary heart disease (including myocardial infarction), hypertension and vascular lesions of the brain among the population of the country, which on average account for more than 80% of all deaths from cardiovascular diseases. The incidence of vascular disorders of the brain (cerebrovascular diseases, including stroke) due to arterial hypertension is 5776 cases per 100 thousand population, and mortality from vascular disorders of the brain (cerebrovascular diseases, including stroke) due to arterial hypertension is 325 cases per 100 thousand population. Factors that increase the risk of their occurrence (nervous tension, insufficient physical activity, poor nutrition, alcohol and tobacco abuse) indicate the social conditioning of the causes of these diseases.

One of the most acute problems clinical and social medicine – malignant neoplasms. Mortality from them in most economically developed countries (USA, Japan, Germany, etc.) has increased 2-3 times over the past 70 years. Every year, about 5 million people die from cancer around the world. The proportion of patients with visual localizations of malignant neoplasms detected at stages I and II of the disease in the total number of patients with visual localizations of the tumor is 67.6 percent, the proportion of those who died from malignant neoplasms within a year from the date of diagnosis among patients registered for the first time in the previous year - 31.6 percent, mortality from malignant neoplasms per 100 thousand population is 233.1 cases for men, 170.3 cases for women.

In economically developed countries, especially dangerous epidemic diseases have been eliminated, and the incidence of childhood infections has decreased. At the same time, the fight against tuberculosis, influenza, viral hepatitis, AIDS and other viral diseases remains very actual problem. It is these diseases that are associated high level morbidity of the population and causing enormous damage to the health of citizens and the economy of the state.

Tuberculosis incidence in correctional institutions Federal service execution of punishments is currently 1515 cases per 100 thousand people, mortality is 153.4 cases per 100 thousand people, the proportion of cases of cessation of bacterial excretion is 73.5 percent, mortality from tuberculosis is 22.6 cases per 100 thousand population.

The number of newly registered cases of HIV infection reached 37.7 thousand cases, in correctional institutions of the Federal Penitentiary Service - 2 thousand cases, the share of HIV-infected pregnant women included in the program for the prevention of HIV infection in newborns was 75 percent.

The incidence of syphilis is 72 cases per 100 thousand population, in correctional institutions of the Federal Penitentiary Service - 176.6 cases per 100 thousand people, the incidence of syphilis in children is 21.2 cases, gonorrhea - 23.4 cases per 100 thousand children. . At the same time, the share of specialized medical institutions monitoring the variability of sexually transmitted infections in the total number of dermatovenerological institutions is 15 percent. The total number of adolescent specialized centers for the prevention and treatment of sexually transmitted infections does not exceed 12 in the country as a whole.

The incidence of acute viral hepatitis B and C is currently 8.6 and 4.5 cases per 100 thousand population, respectively, chronic viral hepatitis B and C - 51.4 cases per 100 thousand population.

An important problem of our time is the increase in the number of neuropsychiatric disorders, which in a number of countries is called the number one problem. In the USA, Germany and other economically developed countries, on average at least 10% of the population suffers from various neuropsychiatric disorders. Among them, the first place is occupied by alcoholism and drug addiction. The share of patients covered by team forms of psychiatric care in the total number of observed patients is 5 percent, the share of patients in need of inpatient psychiatric care in the total number of observed patients is 16 percent. At the same time, the average duration of treatment of a patient in a psychiatric hospital is 75.6 days, and the proportion of repeated hospitalizations in a psychiatric hospital during the year is 20 percent.

The rate of complications in diabetes mellitus is currently 35 percent. Limb amputations were performed in 1 percent of patients. In total, for the first time during the year, 38.6 thousand people were recognized as disabled due to diabetes.

Also, one of the most pressing issues in modern social life is the problem of combating injuries.

The problem of protecting and improving the environment, the pollution of which has a negative impact on human health and can cause genetic damage to the body, has acquired particular social significance.

There is a general aging of the population, i.e. an increase in the proportion of people 60 years and older in society (in the above countries - up to 20%). The problem of demographic aging of the population affects the entire society and has become particularly relevant at the end of the 20th and beginning of the 21st centuries.

Significant efforts of the entire human community are required to maintain the proper level of functioning of elderly and old people in conditions of socio-economic upheavals and a deteriorating environmental situation.

The rapid increase in the relative size of the elderly population in most countries of the world makes it unsuitable traditional attitude to the problem of aging. Active aging is necessary not only for the person himself, but is also useful for society as a whole, since it allows for fuller use of production experience older generations and contributes to a more favorable moral and ethical climate for each individual nation and humanity.

The degree of their participation in the industrial and socially useful life of the country depends on the preservation of their personal health by older people. This circumstance makes it especially topical issues widespread introduction of preventive and health measures at earlier stages of aging. There is an urgent need to develop new forms and methods of medical and social services to the population.

Thus, socially significant diseases include those that a) arise and develop as a result of unsatisfactory social and living conditions of people (tuberculosis, alcoholism, drug addiction, vitamin deficiencies, malnutrition diseases, some occupational diseases, gastrointestinal infectious diseases, etc. ), b) are widespread and are the main cause of mortality of the population (cardiovascular and oncological diseases, injuries, infectious diseases, etc.), c) pose a danger to others (sexually transmitted diseases, acute mental disorders and etc.).

Socially significant diseases are diseases caused by the low quality of life of the population (low wages, pension provision, deterioration of living conditions, work, rest, environmental conditions, quality and structure of nutrition, etc.), a decrease in sanitary and hygienic culture, and a person’s lifestyle.

Routes of infection and transmission

Sex is the norm of our life. THE SEXUAL TRACT IS ONE OF THE MOST COMMON METHODS OF TRANSMISSION OF BEHAVIORAL DISEASES. During unprotected sexual contact, sperm or vaginal secretions enter the body from an infected person to a sexual partner. THE MOST DANGEROUS VIRUS THAT CAN BE SEXUALLY TRANSMITTED IS HIV. HEPATITIS B VIRUS, SYPHILIS, STDs, AND RARELY HEPATITIS C VIRUS CAN ALSO BE TRANSMITTED.

Parenteral route (through the blood) - when infected blood enters the bloodstream healthy person through damaged skin and mucous membranes when sharing or reusing unsterile needles, syringes and other injection equipment.

The vertical route is from an infected mother to the child during pregnancy (through the placenta), during childbirth (if the newborn’s skin is damaged), during breastfeeding (with mother’s milk).

In 90% of cases, tuberculosis infection occurs through airborne droplets when coughing, sneezing, or communicating.

Contact and household transmission occurs either through direct contact (direct) or through contaminated environmental objects (indirect contact). As a result of direct contact, pathogens of tuberculosis, herpes, and scabies are transmitted. Through indirect contact through contaminated objects, linen, toys, and dishes, tuberculosis is transmitted.

Prevention measures

· Abstinence from sexual contacts with unfamiliar partners, observing the rules of personal hygiene.

· 2 Avoid contact with other people's blood, secretions (saliva, semen, vaginal secretions) of another person.

· Say no to drugs, unprotected sex and casual sex. Answer “yes” to mutual fidelity, condoms, personal hygiene.

· An important area of ​​specific prevention of tuberculosis is vaccination. Therefore, even in the maternity hospital, everyone healthy kids On the 3rd-4th day of life, they are vaccinated against tuberculosis, which is the main preventive measure for children in the first year of life. Subsequently, revaccination is repeated at 7 and 14 years of age. Adults over 15 years of age must undergo a fluorographic examination at least once every two years.

Algorithm of volunteer actions

· In the event of a domestic emergency (contact with human blood with a violation of the integrity of the skin or mucous membranes) - contact the AIDS center within 24 hours from the moment of contact in order to examine the source possible infection and prescribing specific prevention of infection to the victim.

· Observe the rules of personal hygiene, use a mask (if you suspect tuberculosis), do not forget the following simple rules, such as thorough hand washing after contact with a sick person, before preparing food, before eating, after visiting the toilet.

· If in a personal conversation you are entrusted with information of an intimate nature, for example, about questionable sexual contact, you should explain that you should not delay contacting a medical institution. To avoid uncertainty and not be lost in doubts about your status regarding sexually transmitted diseases, you need to contact a specialist.

HIV INFECTION- infection caused by the human immunodeficiency virus. This is an infectious disease characterized by a specific lesion of the immune system, leading to its slow and steady destruction until the formation of acquired immunodeficiency syndrome (AIDS), accompanied by the development of opportunistic infections and secondary malignant neoplasms leading to death.

ROUTES OF TRANSMISSION OF INFECTION- sexual, blood contact, vertical. Other modes of transmission of infection have not been established to date.

PREVENTION: use of a condom during sexual intercourse If a domestic emergency occurs (contact with human blood with violation of the integrity of the skin or mucous membranes), contact the AIDS center within 24 hours from the moment of contact in order to examine the source of possible infection and prescribe specific infection prevention for the victim.

Viral hepatitis

The term viral hepatitis unites a group of infectious diseases manifested by damage to the liver and other organs and systems. The most studied and epidemiologically dangerous are viral hepatitis A, B, C. Hepatitis D, E, G are more rare in Russia.

HEPATITIS A is the most common and benign of all viral hepatitis. A person becomes infected with the hepatitis A virus by consuming food, water, or through household means (hands, dishes, and other household items infected with the virus). The incidence of hepatitis A registered in the Republic of Tatarstan is quite small, but many researchers believe that up to 90% of the population suffers from this hepatitis.

HEPATITIS B is the most epidemically dangerous. The virus is easily transmitted sexually, from mother to fetus, and any contact with microquantities of blood from a patient or a carrier of the virus is also dangerous.

In everyday life, a special role is played by the sharing of toothbrushes, washcloths, towels, toothpicks, razors, manicure and sewing supplies.

The greatest danger is posed by chronically ill or asymptomatic carriers of the virus. As a result of chronic viral hepatitis B (on average after 10-15 years), liver cirrhosis or primary liver cancer develops.

HEPATITIS C in its acute form is mild, the patient does not consult a doctor, however, the process becomes chronic in 60-80% of cases. As a result of chronic hepatitis C, cirrhosis or primary liver cancer rapidly develops.

In general, the symptoms of viral hepatitis are similar: heaviness and pain in the right hypochondrium, darkening of urine, a slight increase in body temperature, yellowing of the sclera and skin. Weakness, drowsiness, nausea, vomiting, diarrhea, and joint pain may occur. If these symptoms are detected, you should immediately contact a specialist.

The mechanisms and routes of transmission of HIV infection, hepatitis B and C are almost the same.

Preventive measures are:

For hepatitis A and E: consume only good-quality food and water, observe personal hygiene rules. When consuming non-alcoholic and low-alcohol drinks, semi-finished and finished food products, you should use only products from proven and well-known manufacturers. Developed against hepatitis A virus specific vaccine.

A specific vaccine has been developed for hepatitis B, which also protects against the hepatitis D virus. In case of “emergency situations”, emergency prevention of infection is carried out with a combination of a vaccine and a specific immunoglobulin, which can significantly reduce the risk of infection.

No specific preventive measures have been developed for hepatitis C, G, E.

TUBERCULOSIS is an infectious disease with the formation of specific inflammatory changes and a tendency towards a chronic course.

The main source of the spread of tuberculosis is a person who releases bacteria, dispersing tuberculosis bacilli when coughing, sneezing, or laughing. Infection occurs when tuberculosis bacilli penetrate the lungs, either directly from an aerosol of saliva and sputum, or through dust or food. For all methods of infection, the duration of contact with the source of infection and the severity of the infection are important.

The first symptoms of tuberculosis are nonspecific: a slight increase in body temperature, sweating at night, deterioration of sleep and appetite, increased fatigue, tearfulness, irritability, deterioration of health, night sweats, cough, usually dry, less often with the release of mucopurulent sputum. When the lung collapses, hemoptysis or pulmonary hemorrhage may occur. Tuberculosis may have the mask of influenza, chronic bronchitis, prolonged pneumonia or other diseases.

PREVENTION. Measures aimed at increasing the body’s resistance and a rational hygienic regime are important. For the purpose of specific prevention, vaccinations are used.

SYPHILIS is a chronic systemic venereal disease affecting the skin, mucous membranes, internal organs, bones, and nervous system with successive changes in the stages of the disease.

Syphilis is transmitted mainly through sexual contact (even in the absence of visible pathological foci on the patient’s skin and mucous membranes); syphilis can be transmitted through blood, in everyday life when using a shared toothbrush, razor, manicure accessories, dishes, towels, underwear and other things in contact with mucous membranes shells or skin of the patient with objects. It is possible for the baby to become infected with mother's milk.

The incubation period of the primary stage of syphilis is from 8 to 190 days.

The first manifestation of syphilis is usually a hard chancre-inflammatory infiltrate of tissue, in the center of which a painless ulceration appears. This formation persists in the patient from 1-2 weeks to a month. Primary manifestations syphilis can occur both on the genitals and on the fingers, in the oropharynx. Patients may experience malaise, weakness, dizziness, and fever.

In the next stage of the disease, generalized lesions of the skin and mucous membranes occur, often in the form of a pale spotty rash or in the form of multiple small hemorrhages in the skin and mucous membranes. Inflammation of the lymph nodes is characteristic. Mild malaise, sub-febrile temperature (about 37°C or slightly higher), weakness, cough, runny nose, and conjunctivitis may occur. Often the disease looks like catarrh of the upper respiratory tract (that is, the common cold).

In the third stage, deep damage to the nervous system and internal organs gradually develops.

PREVENTION. Strict adherence to the rules of personal hygiene helps to avoid the everyday route of infection. Protected sexual intercourse prevents infection of the genitals, but does not exclude the transmission of syphilis. The use of local antiseptics does not guarantee against infection.

SCABIES is a contagious skin disease caused by the scabies mite.

The disease is localized in organized groups, united by common bedrooms, or in asocial strata of society.

Infection with scabies almost always occurs through prolonged direct skin-to-skin contact, and sexual transmission predominates. Children often become infected when they sleep in the same bed with sick parents. In crowded groups, other direct skin-to-skin contacts are also realized (contact sports, children fussing, frequent and strong handshakes, etc.). Infection is less likely through household items (household items, bedding, etc.). Infection can also occur from animals with scabies; in this case, the rash is localized mainly in those areas that came into contact with the sick animal.

The characteristic signs of scabies are intense itching, which gets worse at night in the warmth of the bed. At the site of the mite's penetration, a bubble with transparent contents appears, from which an itch tract leads (a thin strip on the skin of a grayish color up to 1 cm long), a bubble is visible at the end of the itch tract. The rash is located on the flexor surfaces of the upper and lower limbs, in the interdigital folds of the hands, on the body, especially in the area of ​​the belt, abdomen and along the anterior edge of the axillary depressions. Scabies can be located on the palms, soles, and face.

PREVENTION scabies is carried out through early diagnosis of the disease and active identification of patients and persons in contact with the patient. During the treatment process and after its completion, current and final disinfection is carried out at home.

Active spread of the disease occurs in crowded places of people from various social groups, where people least expect to become infected with lice ( public transport, metro, hiking, mass celebrations, work contacts with people from disadvantaged social groups). The main symptoms of head lice include:

Constant itching, accompanied by scratching and bloody crusts;

Insomnia and irritability;

Visual detection of lice or nits on the pubis, head or clothing

With head lice, clusters of lice and nits are observed in the occipital and temporal parts of the head; with body lice, lice are found in the folds and seams of clothing and linen, rarely on the skin of the body; with pubic lice, lice are found in the hair of the lower abdomen and pubic area, sometimes in the mustache and beard, eyelashes and eyebrows

There is no specific prevention of head lice. Preventive measures for pediculosis come down to identifying and completely curing patients in the early stages of the disease, as well as mandatory treatment all sexual partners of a patient with pediculosis pubis, including examination for sexually transmitted diseases. Thorough disinfection plays an important role. bedding and the patient’s clothing, common areas and upholstered furniture, as well as strict adherence to personal hygiene rules.

As a result of studying the chapter, the student should:

know

• general characteristics of the main socially significant non-communicable diseases (diabetes mellitus, hypertension, cancer, mental disorders);
• general characteristics of the main socially significant infectious diseases (hepatitis, HIV infection, tuberculosis, sexually transmitted diseases);

be able to

Identify medical and social problems that arise in clients with socially significant non-communicable and infectious diseases;

own

The foundations of the culture of modern social thinking, methods of medical and social analysis of socially significant diseases.

General characteristics of socially significant diseases

The concept of “socially significant diseases” appeared in the 19th century. in an era of rapid industrial development. At that time, the high incidence of this form of pathology (primarily tuberculosis) was associated with difficult working conditions, unsatisfactory living conditions and the inaccessibility of qualified medical care.

As the course of the historical process has shown, social transformations aimed at improving working conditions and creating safety precautions, improving the quality of life of workers, and the development of medicine have led to a decrease in the incidence of certain types of diseases from this group. It should be noted that at that time different authors classified different diseases as socially significant diseases. Tuberculosis and sexually transmitted diseases were originally included in this group.

Sometimes socially significant diseases included vitamin deficiency (hypovitaminosis), neuroses, starvation and a number of occupational diseases.

In the 1980s the first reports appeared that in some countries of the world (USA, Spain, Brazil, Tanzania) previously unknown known form immunity disorders, clinically occurring in the form of a tumor disease. It turned out that the cause of the disease is the human immunodeficiency virus - HIV. This disease is called “acquired immune deficiency syndrome” - AIDS. It has been discovered that a large number of people are carriers of HIV, but they do not have clinical manifestations of the disease. This group of patients is called “HIV-infected”.

Quite quickly, HIV infection became an epidemic. This was facilitated solely by social factors: almost 100% of patients are homosexual men and drug addicts (both men and women). At this time, homosexuality was excluded from ICD-10 (1995) as a disease.

By the beginning of the 1990s. In Russia, the situation with sexually transmitted diseases has sharply worsened. The multiple increase in the incidence of syphilis and gonorrhea was associated with the advent of effective antimicrobial drugs, with which these diseases could be treated at home.

A significant contribution to the spread of sexually transmitted diseases is made by insufficient awareness of the general population about the causes and epidemiology, clinical manifestations, principles of therapy, and most importantly, about prevention. Apparent ease of row elimination external signs the treatment of these diseases with the help of antibiotics is the basis for the “frivolous attitude” of a large number of citizens, mainly young people, towards them. Self-medication, which has become widespread, contributes to the transition of acute types of diseases into a chronic form, which is difficult to respond to subsequent therapy and often leads to infertility.

The increase in the incidence of tuberculosis is mainly explained by the deterioration of the sanitary and epidemiological situation in Russia at the end of the last century. The increase in the incidence of active forms (newly identified) is about 2%, and the increase in cases of respiratory tuberculosis for the first time is about 3%.

Increased incidence of major non-communicable diseases, such as hypertension, mental pathology, diabetes mellitus and tumor diseases, is due to a number of reasons. Among them is the acceleration of the pace of life (most relevant for hypertension and mental illness).

Technological progress, the use of new synthetic materials in industry, construction, and everyday life, the deterioration of environmental conditions for human life, as well as changes in the quality of nutrition have contributed to an increase in the incidence of diabetes mellitus and cancer.

Age - important factor in the development of cancer. Many malignant tumors, including prostate, stomach and colon cancer, most often occurs in people over 60 years of age. More than 60% of cancers are detected after 65 years of age. In general, the likelihood of developing such diseases after a person reaches the age of 25 doubles every five years. The rise in cancer appears to be the result of a combination of greater and longer exposure to carcinogens and a weakening of the body's immune system. Both of these factors are associated with an increase average duration life.

In order to concretize the work to solve medical and social problems of those suffering from socially significant diseases, the Decree of the Government of the Russian Federation of December 1, 2004 No. 715 approved a list of socially significant diseases and a list of diseases that pose a danger to others. It states that socially significant diseases include: tuberculosis; infections transmitted primarily through sexual contact; hepatitis B and C; disease caused by human immunodeficiency virus (HIV); malignant neoplasms; diabetes; mental and behavioral disorders; diseases characterized by high blood pressure.

Diseases that pose a danger to others include: disease caused by the human immunodeficiency virus (HIV); viral fevers transmitted by arthropods and viral hemorrhagic fevers; helminthiases; hepatitis B and C; diphtheria; infections transmitted primarily through sexual contact; leprosy; malaria; pediculosis and other infestations; glanders and melioidosis; anthrax; tuberculosis; cholera; plague.

According to statistical data in the Russian Federation, the epidemiological situation is becoming more tense every year. A natural consequence of instability in society is the inexorable increase in the number of pathologies belonging to the group of socially significant diseases. The diseases included in it pose a threat to public health, which causes irreparable damage to society. Currently, effective treatment regimens for socially significant diseases are used in practice. However, the fight against them also involves carrying out preventive measures.

Signs

Socially significant diseases include illnesses that pose a threat to a large number of people at once. Their spread is associated with high mortality and even increased rate crime.

Signs socially significant disease:

• Mass character. The pathology is rapidly spreading among the population. As a rule, the real number of cases is much higher than according to official data.
• High annual increase in the number of affected people.
• A person cannot fully interact with society.
• The disease poses a danger to others.
• The nature of the pathology can be either infectious or non-infectious.

Currently, a list of socially significant diseases has been compiled and approved.

Relevance

According to statistics from the Ministry of Health of the Russian Federation, dangerous diseases are spreading mainly among young people. Illnesses recognized as socially significant require not only complex treatment, but also long-term rehabilitation. Thus, over a considerable period, the state is losing part of its working-age population.

High mortality and crime rates are associated with the spread of socially significant pathologies. Regarding the last one. Some young people do not want to receive support from the state; they believe that death is close. In this regard, they begin to commit various kinds offenses and crimes.

The Russian Ministry of Health is seriously concerned about this situation. In this regard, new methods of preventing and combating dangerous pathologies are regularly developed.

List of ailments

It consists of two sections. Clause 1 of the list of socially significant diseases includes dangerous pathologies that affect a large number of people, but do not pose a serious danger to others.

These include:

• Tuberculosis. The pathogen (Koch bacillus) affects the lungs, intestines or bone tissue. The disease is infectious in nature.
• Pathologies that are transmitted primarily through sexual contact.
• Hepatitis B. This is an inflammatory process that affects the liver. The active activity of the virus often leads to cirrhosis of the liver.
• Hepatitis C. The disease is severe. Mostly has a chronic form. Mortality from hepatitis C is growing exponentially every year.
• HIV. The retrovirus attacks the cells of the immune system. HIV is a precursor condition to AIDS.
• Neoplasms of a malignant nature. In other words, this cancerous tumors.
• Diabetes. This is a disease in which the production of the hormone insulin by the pancreas is impaired.
• Mental disorders.
• Diseases the course of which is accompanied by a persistent increase in blood pressure.

The second section of the list lists mainly infectious socially significant diseases that pose a serious danger to others:

• AIDS. This is the final stage of development of HIV infection. At this stage, the immune system practically ceases to function.
• Viral fevers. The route of transmission is through arthropod bites. This group also includes the Ebola virus, which has claimed the lives of many people in recent years.
• Helminthic infestations.
• Diphtheria. An acute infectious disease that primarily affects preschool children.
• Sexually transmitted diseases with a high rate of contagion.
• Leprosy. A pathology in which slow damage to the skin, mucous membranes and upper respiratory tract occurs.
• Malaria. The causative agents are mosquitoes. The disease is characterized by the occurrence of frequent episodes of fever.
• Infestations. They belong to the group of invasions. An example is tick bites.
• Melioidosis. An infectious disease in which abscesses form in internal organs.
• Anthrax. The source of infection is animals. Pathology has several forms. Most often the skin is damaged.
• Cholera. This is a gastrointestinal disease that is life-threatening.
• Plague. Severe infectious pathology. Has an extremely high mortality rate.

These lists were approved in 2004.

Social reasons for the spread

The Ministry of Health of the Russian Federation identifies the following provoking factors as the main ones:

• Low level of quality of life.
• Unemployment.
• Unfavorable environmental conditions.
• Small income of the population from professional activities.
• Promotion of crime and unhealthy lifestyles by the media.

In addition, the moral decline in society should be highlighted separately. At all more people completely lack any values.

Diagnostics

As a rule, there are no problems with identifying socially significant diseases. Currently, modern laboratory and instrumental diagnostic methods are successfully used in practice. If the patient contacts the patient in a timely manner, medical institution All necessary measures are taken, including hospitalization.

The situation is different with diseases that are not typical for modern society. In some cases, doctors conduct a detailed examination and, based on its results, prescribe completely ineffective treatment. This is due to the human factor - a weakening of vigilance and readiness to implement emergency measures.

Ways to fight

New treatment methods are constantly being developed. However, the main way to combat socially significant diseases is to increase the level of knowledge among the population regarding the epidemiological situation in the country. Currently, the main emphasis is on disseminating information.

Other ways to combat socially significant diseases:

• Improving diagnostic methods.
• Carrying out activities that shorten the rehabilitation period after treatment.
• Construction of specialized medical institutions, as well as reconstruction of existing clinics.

Prevention

As mentioned above, this is the main way to combat socially significant diseases. First of all, it is important to monitor compliance with sanitary and epidemiological standards in educational institutions. This is due to the fact that the spread of pathologies is typical among the young population.

The following measures also include the prevention of socially significant diseases:

• Improving the quality of life of the population.
• Motivation to switch to a balanced diet.
• Promotion of healthy lifestyles.

Currently, the incidence rate is extremely high. In this regard, it was decided to carry out measures aimed at reducing socially significant consequences. In particular, this is to ensure the interaction of the patient with society. Of course, if he has non-infectious pathologies.

In addition, work is continuously underway to identify patients who prefer not to go to a medical facility.

Finally

Socially significant pathologies are illnesses that pose a danger to a large number of people. The main reasons for their spread among the population are considered to be low income, low quality of life, and unfavorable environmental conditions. In addition, the promotion of crime and unhealthy lifestyles in the media plays a huge role. Currently, effective treatment regimens for socially significant diseases have been developed. In addition, preventive measures are continuously carried out.