Search

Acute stages of parasitic diseases are rare diagnosed and therefore, clinicians have limited knowledge of their clinical features. We describe five autochtnonous acute cases of opisthorchiasis in Moscow region acquired from eating raw ides (L. idus). The most frequent clinical symptoms were febrile, eosinophilic syndrome with cholestasis. The patients were positive for IgG antibodies to Opisthorchis felineus. Eggs of O. felineus were found in one patient. As egg production O. felineus starts 1 month after exposure and opisthorchiasis cases in Moscow region have low numbers of worms, the sensitivity of microscopy is low. Therefore we consider opisthorchiasis in all patients of unexplained acute fever, pain in upper right abdominal quadrant, and eosinophilia with cholestasis, when patients confirm the ingestion of raw fish. We recommend one day of praziquantel 25 mg/kg TID to patients infected with O. felineus. In previous publications describing the autochtnonous cases of opisthorchiasis in Moscow region the authors supposed that cases of local infection will be found again in Moscow region and this is just a matter of time. The cases reported here confirm that this infection is endemic in Moscow region. The local people living close to rivers especially those who eat raw fish are at risk of infection O. felineus. There is a clear need to undertake special studies pertaining to the ways of promoting people living in Moscow region become aware of opisthorchiasis and to be motivated in preventive measures and treatment.

BACKGROUND: Currently, brucellosis continues to pose a serious problem for public health and agriculture in Russia. In 2019, the number of Russian cases of bovine brucellosis increased by 14%, and the number of first-time identified poor points for small cattle brucellosis increased by 52%. Epizootics of the disease are registered mainly in North Caucasus and Southern Federal districts, and the maximum number of newly detected brucellosis in humans is recorded in the Republic of Dagestan (RD). AIMS: This study aimed to present the characteristics of brucellosis incidence in the RD in 2019 and optimization of preventive measures. MATERIALS AND METHODS: The study used state information on the incidence of brucellosis, mechanisms, ways, factors of pathogen transmission, and epidemic control activities of the infection in 2019 in the RD, provided by the S.M. Magomedov Republican Center of Infectious Diseases, Prevention and Fight Against AIDS and the Office of the Federal Service for Veterinary and Phytosanitary Surveillance of the RD. Statistical and epidemiological research methods were applied. RESULTS: In 2019, 163 new cases of brucellosis were registered in the RD, which was 52 (+47%) cases more than those in the same period in 2018, and the number of new cases of chronic brucellosis significantly increased (p 0.05). Individuals aged 41 years were more likely to get sick, patients were predominantly men (n = 135, 82.8%), rural residents accounted for 84.2%, and 56.1% were owners of personal livestock. Brucellosis was registered in 40 territories of the RD. The incidence rate was six times higher in rural areas than in urban areas. In humans, the source of infection was sheep and goats in 58.8% and cattle in 41.2% of cases. The main factor in the persistently high incidence of brucellosis in the RD was unsatisfactory examination and specific prevention among cattle, goats, and sheep. CONCLUSIONS: Thus, the epizootological and epidemiological situation of brucellosis in the RD should be considered unstable at present. With respect to the future of the brucellosis situation in the RD, the incidence of brucellosis in animals and humans will depend on the completeness of the implementation of plans for disease prevention.

Anthrax continues to pose a serious problem for the healthcare and agricultural industries of Russia. Since 1900, over 70,000 outbreaks of human and animal infection have been recorded in Russia. Despite ongoing anti-epidemic measures, epizootics and epidemic foci of anthrax are recorded annually. Over the past 10 years, 23 anthrax outbreaks among people have been recorded in the Russian Federation with a morbidity rate of 90 people, and three fatal outcomes were observed. The Caucasus region ranks first in the Russian Federation in the incidence of anthrax in people and animals. The Republic of Dagestan is a region that is highly prone to anthrax. The spread is aggravated by landscape and environmental conditions that are favorable to the formation and long-term existence of anthrax foci. In most cases, the disease arises in areas previously considered safe for this infection, which indicates the presence of unregistered animal burial sites and the lack of proper control over sanitary condition. People become infected with anthrax due to the uncontrolled and forced farm slaughter of sick animals resulting from the lack of facilities for sanitary slaughter. Human infection occurs mainly during the slaughter of sick cattle, carving, and contact with animal raw materials. This article illustrates a group of anthrax outbreaks that occurred as a result of contact with a sick animal during slaughter and carving. Four local residents of one village fell ill, and in all of them, anthrax manifested in the form of a moderate skin course. The last case of anthrax in cattle in the said locality was recorded in 1958. This fact highlights the importance of compliance with anti-epidemic measures, including the so-called settlements that are safe for anthrax.

The incidence of acute intestinal infections in the Russian Federation remains high and does not tend to decrease. The General susceptibility of the population, the variety of pathogens of infectious diseases accompanied by diarrhea syndrome, necessitates the improvement of clinical diagnosis and differential diagnosis in the treatment of patients with diarrhea at the primary stage of medical care. The article presents the etiological and epidemiological aspects of the most common in the Russian Federation acute intestinal infectious diseases accompanied by diarrhea syndrome: food toxicoinfections, viral gastroenteritis, salmonellosis, shigellosis, campylobacteriosis, pseudomembranous colitis. The sources of infection and pathways of pathogens are characterized. The pathogenesis of the main types of diarrhea caused by various pathogens of intestinal infections is described. It is shown that the action of enterotoxins of pathogens that activate adenylate cyclase contributes to the development of secretory type of diarrhea; the place of localization of the pathological process is the small intestine. Pathogens exhibiting high invasive activity contribute to the development of inflammatory type of diarrhea; the pathological process is localized in the colon. With direct damage to enterocytes of the small intestine by pathogens of viral gastroenteritis, an osmotic type of diarrhea is formed, associated with a violation of the digesting and absorption function of the small intestine. Presented distinctive clinical criteria of three types of diarrhea: color, consistency of the stool, the presence of pathological impurities in it. The differences of abdominal syndrome in the analyzed nosology: the nature and localization of abdominal pain. The presented differential diagnostic signs of diarrhea and abdominal syndrome allow for early diagnosis of infectious disease before laboratory confirmation and contribute to the improvement of the algorithm of medical care in acute intestinal infections accompanied by diarrhea syndrome.

The liver flukes Opisthorchis felineus, O. viverrini and Clonorchis sinensis are endemic in Russia, Southeast Asia and Far East where more than 18 million people are estimated to be infected. Opisthorchiasis remains the public health significance in Russia, and Western Siberia must be considered as highly endemic region for opisthorchiasis in the Russian Federation. High infection rates result from hazardous behaviours, centuries-old raw-food culture, a poor knowledge of opisthorchiasis, ecological complexities and complex biology. The infection is associated with several hepatobiliary diseases, including cholangiocarcinoma. Praziquantel is the only option for treatment of Opisthorchiasis . The detection the parasite’s eggs in stool still referred as gold standard. Recent research has provided new diagnostic technologies applicable to diagnosis, treatment and control. Despite some progress in their control, liver flukes continue to be a major public health problem in endemic areas.

In areas with high prevalence, intensity and incidence of soil-transmitted helminthosis four main soil-transmitted helminth infections, ascariasis, trichuriasis, strongyloidiasis and hookworm, are common clinical disorders in man. Mebendazole, albendazole, ivermectin and pyrantel are commonly used to remove these infections. The use of these drugs is not limited to treatment of symptomatic soil-transmitted helminth infections, but also for large-scale prevention of morbidity in children living in endemic areas. Recent research has provided new diagnostic technologies applicable to diagnosis, treatment and control. Despite some progress in their control, intestinal nematode infections continue to be a major public health problem in many regions.

Two cases of New World cutaneous leishmaniasis acquired by Russian tourists in Peru and possibly in Bolivia are presented. L. viannia ( L.braziliensis complex) was identified in Liverpool School of Tropical medicine in the patient travelled to Bolivia. The present study aimed to investigate Balsamum peruvianum one of the product of folk medicine of Indians of Amazon region against local species of Leishmania resulted in healing the ulcers. Leishmaniasis is a major public health problem, and the alarming spread of parasite resistance has increased the importance of discovering new therapeutic products.

Cases of acute and chronic Strongyloides stercoralis are presented as tourists travelled to Thailand, the coast of Black sea in Russia and Abkhazia. A high level of clinical suspicion is required to make the diagnosis of strongyloidiasis in at-risk patients presenting with peripheral eosinophilia, unexplained intermittent diarrhea, abdominal discomfort and skin rashes. Owing to increased risk of developing disseminated disease or hyperinfection syndrome, early detection and treatment of strongyloidiasis are extremely important. Strongyloidiasis should be routinely investigated in patients with chronic diseases who will undergo immunosuppressive therapy. Ivermectin or thiabendazole currently is the treatment of choice which are more effective than albendazole.

Dirofilaria repens is an emergent parasitic disease of dogs and man in Russiania. It infects humans accidentally via vectors. Occurrence D.repens in humans is most often in subcutaneous locations. Herein, we present autochtonous cases In Russiania of human dirofilariasis repens in almost all visceral organs with special attention to pulmonary dirofilariasis. Our data confirms the concept that the human being is a facultative host of Dirofilaria repens. Dirofilariasis prevalence is probably underestimated because of its non-specific clinical presentation. A national Russian prevalence study on dirofilariasis in animals and humans is called for in order to improve the management of the disease, both in veterinary and human medicine.

Cases of arthropod dermatoses acquired by Russian tourists in tropical countries Brazil, Sri Lanka, Peru and Thailand are presented. These dermatoses were associated with trombiculidae mites infesting alligator, Hydrochaeris hydrochaeris, elephants and parrots. Because of widespread travel, trombiculiasis has become more common in European countries. Awareness of dermatoses associated with mites other than Sarcoptes for clinicians should be considered for a patient who has recently returned from endemic area. Misdiagnosis and mismanagement can occur owing to limited awareness of the condition outside endemic areas.

In the work there was followed the evolution of the etiotropic treatment of shigellosis patients and there were outlined main principles of therapy of this pathology. With taking into account the variability of the causative agent, the use of fluoroquinolones with the etiotropic purpose in the 90s of the last century was justified. The dynamics of shigellosis infection in the Russian Federation over the past 15 years is shown against the background of their use.

The article tells about the evolution of the etiotropic treatment of patients with shigellosis. The key principles of treatment of the disease are demonstrated. Taking into account the variability of the pathogen, the etiotropic use of fluoroquinolones in the 90s of the 20th century is substantiated. The dynamics of shigella infection in the Russian Federation over the past 15 years against a background of fluoroquinolones is highlighted.