Infections: general characteristics. Risk factors for infection of surgeons with viral hepatitis and types of prevention Infection factors

04.10.2020

Such large objects inside the body often lead to rather large discomfort:

rather unstable condition of the abdomen: bloating, pain, unstable stools, frequent constipation;
allergic manifestations: rash or runny nose;
general weakness and loss of appetite;
disturbed sleep and, as a result, increased excitability;
increased anemic skin;
shortness of breath and trouble breathing;
dry cough, sometimes with sputum;
enlarged lymph nodes;
enlarged liver.

Disease development

Ascaris eggs are surprisingly viable: they live even under the snow, moreover, even a temperature of 30 degrees below zero will not kill them. But in this state, an unfertilized egg cannot cause disease. But the temperature above 38 degrees will definitely kill the larva.

Egg ripening occurs exclusively in the ground. Most infections occur in summer or early autumn, when the crop is ripe.

How are worm larvae transmitted? As soon as the temperature and humidity reach the optimum values \u200b\u200bfor ripening, the fertilized eggs turn into a full-fledged larva. Now the roundworm is mobile and is already capable of provoking a disease.

The disease is possible only when mature fertilized eggs enter the esophagus.

Once in the body, the larva goes to the walls of the intestine, from where it enters the capillaries, where, together with the blood, it moves along the circulatory system of the body: from the mesenteric vessels to the portal vein of the liver, where roundworms strive in the first place.

in the liver;
in the lungs (by their presence in the lungs, they cause a painful cough);
in the pancreas;
in the heart muscle.

Larvae can linger in any organ.

cause an allergic reaction due to the strong allergenicity of waste products;
the larvae are very mobile and often physically damage the walls of the intestines and capillaries.

Causes of infection with ascariasis

Summarizing all of the above, we can conclude that if you do not allow feces, sand, earth, water and other non-food products that may contain ascaris larvae to enter the body with food, then the infection will definitely bypass you and your loved ones.

In the history of medicine, there have been cases of intrauterine infection with this disease. Such cases are quite rare, and ascaris milk is not transmitted at all, so the unborn baby is out of danger, and with the mother's treatment it will be necessary to wait, given the possible consequences of drug treatment of ascariasis.

Worm infestation can cause other problems in the body. Ascariasis leads to:

the development of pneumonia;
inflammatory processes in the biliary tract;
disorders in the functioning of the kidneys and brain;
appendicitis;
clogging of the lacrimal canals.

In very rare cases (0.5% of 100% diseased), ascaris larvae can penetrate:

a heart;
genitourinary system;
bile ducts and bladder;
spleen;
ears and eyes.

Ascaris infection of young children can cause mental retardation, as well as physical development.

Symptoms of ascariasis

Absorbing nutrients intended for the host, Ascaris releases metabolic products and toxins into the human body, with which adults and children experience:

malaise;
nausea after eating;
lack of appetite or constantly increasing hunger.

Taste preferences change, taste accents shift - intolerance to some foods and dishes appears. Stool delays and disturbances, flatulence often occur.

Ascariasis can cause dysseptic reactions to toxins, resulting in fever. Children infected with worms appear lethargic and often naughty. From the poisonous secretions of ascaris, an allergic reaction in the form of skin rashes can occur. The immune system of babies is depressed due to a deficiency of vitamins and minerals. Without symptoms of colds, sweating, coughing and shortness of breath may occur. Even a nursing mother is capable of transmitting toxic toxins to a newborn through mother's milk.

Features of the external and internal structure of ascaris

These are bisexual organisms; differences between males and females are expressed primarily in size, which varies from 20 to 40 cm. Females are larger than males. Males can be recognized by the characteristic bend at the posterior end of the trunk in the abdominal direction.

The presence of resistant outer coverings, such as the cuticle, protects the worms from lysing digestive enzymes and promotes the formation of anti-enzymes on the surface of the roundworm's body. Tactile cells located in the tubercles and pits provide the worms with chemosensitivity, thanks to which the roundworms inside the human body can find their optimal location in a particular loop of the intestine. In helminths, a body cavity with a liquid inside appears, which gives elasticity to all nematodes. The contents of the cavity facilitate the transport of substances and gas exchange, and the internal organs are located in it.

The internal organs of the human roundworm have a special structure (see photo above):

One of the most important adaptations is the features of the reproductive system of the human roundworm. Dissolved reproductive organs of the female and male produce over 200 thousand eggs daily. Like all geohelminths, these worms are distinguished by increased fertility, because the females of the human roundworm have 2 elongated and flattened ovaries connected to 2 uterus, and the males have a long threadlike testes.

Ascaris females lay eggs, which enter the external environment with feces. Ascaris zygote, protected by dense covers, from the human body must get to the ground. The complex life cycle of geohelminths involves special life stages of reproduction and migration.

Before entering the host's body, the roundworm egg matures in the environment. It is most often stored on soil particles, unwashed vegetables, green crops at certain temperature parameters (12-37 ° C) and soil moisture (at least 5-8%). In the warm season, a larva forms inside the egg, which breathes oxygen. Through dirty hands, raw water and plant foods, it enters the small intestine.

The alkaline environment helps to dissolve the shells and free the larva of the human roundworm from the integument. To turn into a sexually mature adult, it needs to get into the lungs: the next stage of development is carried out only under aerobic conditions. With a sharp elastic end of the body, the geohelminth is drilled into the mucous epithelium of the intestinal tube and enters the lumen of the blood vessels. With the bloodstream, it travels through the chambers of the heart and reaches the lungs. The cycle is almost complete, the young roundworm needs to get back into the digestive tract.

At night, when the owner is sleeping, the geohelminth enters the trachea through the airways. During coughing, it enters the pharynx and mouth. When saliva is swallowed, the larva enters the stomach through the esophagus, then finally settles in the intestine. The internal habitat of the human roundworm allows it to live for about a year.

The danger of helminthic invasion lies not only in the poisoning of an adult and a child with toxic products of metabolic reactions. Thanks to the well-developed musculocutaneous fibers and the intracavitary pressure of the elastic body, the larva easily resists the peristaltic movements of the intestinal tube and blood flow. Released cytolytic substances contribute to the penetration of roundworms into the tissues, therefore roundworms actively move to various organs and cavities, causing their mechanical damage, blockage of the intestines and bile ducts. Adults and children infected with ascaris experience intestinal colic.

Ensuring the cleanliness of dwellings and carrying out the fight against flies, do not forget about outbuildings:

There is no place for sewage in personal plots, pastures, meadows, reservoirs.
Yard toilets must be kept away from animals and flies.
It is necessary to carry out disinfection by regularly scalding wooden walls with boiling water, cleaning the cesspools in time.
When human feces are used as fertilizers, they must be pretreated by putting them in compost in the fall, so that in winter all the eggs of the worms are frozen.

There is hardly a person who, at least once in his life, has not faced such a problem as infectious diseases. The list of these pathologies is large and includes the well-known flu and colds, outbreaks of which are recorded in a particular region every year.

Infections can be dangerous, especially if the person has not been given adequate treatment or has not sought help at all. That is why it is worth learning more about the types of infectious diseases, their features, main symptoms, methods of diagnosis and therapy.

Infectious diseases: list and classification

Infectious diseases have accompanied humanity throughout history. One has only to recall the plague epidemics that destroyed more than 50% of the population of Europe. Today, medicine, of course, has learned how to cope with a huge number of infections, many of which were considered fatal several centuries ago.

There are several systems for classifying infectious diseases. For example, they secrete intestinal ailments and blood diseases, lesions of the respiratory tract and skin. But most often pathologies are classified depending on the nature of the pathogen:

prions (fatal familial insomnia, kuru);
bacterial (salmonellosis, cholera, anthrax);
viral (influenza, measles, mumps, HIV infection, hepatitis);
fungal, or mycotic (thrush);
protozoal (malaria, amebiasis).

Routes of transmission and risk factors

Infectious agents can enter the body in different ways. There are such methods of infection:

Alimentary route in which pathogens enter the body through the digestive tract (for example, together with unwashed food, contaminated with water, due to dirty hands).
Airborne transmission, in which pathogens are introduced through the respiratory system. For example, pathogens can be in dust. In addition, microorganisms are released into the external environment along with mucus during coughing and sneezing.
Contact infection occurs when sharing household items or toys, direct contact with the skin of a sick person. When it comes to sexually transmitted diseases, the transmission of infection occurs during intercourse.
Pathogenic microorganisms are often transmitted from person to person along with blood. Infection can occur during blood transfusion, as a result of the use of non-sterile instruments, and not only medical ones. For example, you can catch an infection by doing a manicure. Often, pathogenic microorganisms are passed from a sick mother to a child during pregnancy or childbirth. Insects can also be carriers.

It is impossible to completely exclude the possibility of infection entering the body. But some people are more prone to this type of disease, and their course of such diseases is much more severe. Why? When infectious agents spread throughout the body, the state of the immune system is of great importance. Dysbacteriosis, anemia, vitamin deficiency, weakened immunity - all this creates ideal conditions for the rapid multiplication of pathogens.

Risk factors include severe hypothermia, a sedentary lifestyle, unhealthy diet, bad habits, hormonal disruptions, constant stress, non-compliance with personal hygiene rules.

Varieties of viral diseases

There are a huge number of viral infections. Here are just a few of them:

All types of flu, colds (in particular, rhinovirus infection), which are accompanied by general weakness, fever, runny nose, cough, sore throat.
It is worth mentioning the so-called childhood infections. This group includes rubella, accompanied by damage to the skin, respiratory tract, cervical lymph nodes. Mumps (known as mumps), a disease that affects the salivary glands and lymph nodes, is also viral. The list of such infections includes measles, chicken pox.
Hepatitis is a disease accompanied by inflammation of the liver. In most cases, the virus is transmitted through blood (types C and D). But there are also strains that are spread by household and alimentary routes (hepatitis A and B). In some cases, the disease leads to the development of liver failure.
Pneumonia is an inflammation of the lungs that can have serious consequences. The causative agent may be adenoviruses, cytomegaloviruses, influenza and parainfluenza viruses. By the way, the inflammatory process can be caused by bacteria, but the symptoms in this case are different. Signs of viral pneumonia - fever, runny nose, general weakness, unproductive cough, shortness of breath. Viral forms of inflammation are characterized by a more rapid course.
Infectious mononucleosis is considered quite common. The symptoms, treatment and consequences of this disease are of interest to many readers. The causative agent is the Epstein-Barr virus, which is transmitted from an infected person by airborne droplets, most often with saliva (by the way, this is why the disease is often called "kissing disease"). The infection affects the throat tissues, lymph nodes, liver and spleen. Against the background of the disease, a change in the composition of the blood is observed - atypical mononuclear cells appear in it. There is currently no specially developed therapy regimen. Doctors provide symptomatic treatment.

Prion diseases and their features

Prions are quite specific infectious agents. In fact, they are a protein with an abnormal tertiary structure. Unlike viruses, prions do not contain nucleic acids. Nevertheless, they can increase their number (multiply) using living cells of the body.

Most often, it is in animals that prion infectious diseases are diagnosed. The list is not that long. Infected cows can develop so-called mad cow disease, or spongiform encephalopathy. Prions affect the nervous system of cats, antelopes, ostriches and some other animals.

A person is also susceptible to this type of infection. Against the background of prion activity, people develop Creutzfeldt-Jakob disease, Gerstmann syndrome, and fatal familial insomnia.

Bacterial infections

The number of bacterial organisms that, if ingested, can lead to the development of a disease is enormous. Let's consider just a few infections.

Salmonellosis. This term unites a whole group of acute infectious diseases that affect the human digestive tract. The causative agents are bacterial microorganisms of the genus Salmonella. The incubation period lasts from 6 hours to 8 days. The first symptoms are abdominal pain. As the disease progresses, pathogenic agents can affect the organs of the central nervous system and the cardiovascular system.

Botulism... Another disease from the group of intestinal infections. The causative agent is the bacterium Clostridium botulinum. This microorganism, penetrating into the wall of the digestive tract, begins to release botulinum toxin, which is dangerous for humans. Signs of botulism are severe abdominal pain, weakness, vomiting, diarrhea, and fever. By the way, most often the pathogen enters the body with food.

Dysentery - acute infectious bowel disease caused by bacteria of the genus Shigella. The disease begins with a simple malaise and a slight increase in temperature, but then other disorders appear, in particular, severe diarrhea. The disease is dangerous, as it can damage the intestinal mucosa and dehydration.

anthrax is a very dangerous disease. It begins acutely and develops very quickly. What are the symptoms of the disease? Anthrax is characterized by serous-hemorrhagic inflammation of the skin, serious lesions of internal organs and lymph nodes. The disease often ends with the death of the patient, even with the correct therapy.

Lyme disease... Symptoms of the disease are fever, fatigue, skin rash, headaches. The causative agents are bacteria of the genus Borrelia. The infection is transmitted by ixodid ticks. Sometimes, against the background of infection, inflammatory damage to the heart, joints and nervous system is observed.

Venereal diseases... It is impossible not to mention sexually transmitted infections. Bacterial diseases include gonorrhea, ureaplasmosis, chlamydia, mycoplasmosis. Sexual syphilis is also dangerous. In the initial stages, this disease is easily treatable, but if untreated, the pathogen affects almost all organs, including the brain.

Diseases caused by meningococci are quite common. These pathogens are spread by airborne droplets. Forms meningococcal infection may be different. Against the background of infection of the body, pneumonia, meningitis, meningoencephalitis develops. Much less often, patients are diagnosed with endocarditis and arthritis.

Mycoses: fungal infections of the body

Mycoses are infectious diseases caused by the penetration of pathogenic fungi into the human body.

Perhaps the most common and well-known disease in this group is candidiasis (thrush). The infection affects the mucous membranes of the genitals, oral cavity, and less often the skin in the area of \u200b\u200bnatural folds of the body. A characteristic feature is the formation of a white cheesy coating with a sour odor.

Onychomycosis - a group of common ailments caused by dermatophyte fungi. Microorganisms infect fingernails and toenails, gradually destroying the nail plate.

Other fungal diseases include seborrhea, pityriasis versicolor, dermatomycosis, sporotrichosis and many others.

Protozoal diseases

Malaria - a disease caused by plasmodium. The disease is accompanied by the development of anemia, repeated attacks of fever, and an increase in the size of the spleen. The causative agent of malaria enters the body when bitten by an anopheles mosquito. These protozoa are common in some countries in Africa, Asia and South America.

The group of protozoal diseases also includes amoebiasis (causative agent - amoeba), leishmaniasis (the causative agent is Leishmania, which enters the human body through a mosquito bite), sarcocystosis, toxoplasmosis, trichomoniasis, sleeping sickness, giardiasis (accompanied by damage to the digestive tract and skin).

Common signs of infectious diseases

There are a huge number of symptoms that can accompany infectious diseases. The list of them can be discussed endlessly, because each ailment has its own, unique characteristics. Nevertheless, a number of common signs can be distinguished that are present in any infectious disease:

An increase in body temperature is observed in almost any infectious lesion of the body.
It is worth mentioning the symptoms of intoxication - these are headaches, body aches, muscle pains, weakness, drowsiness, fatigue.
Cough, runny nose, sore throat appear when the respiratory tract is infected (for example, rhinovirus infection can lead to such symptoms).
The appearance of a rash and redness on the skin that does not disappear with the use of antihistamines.
Digestive system disorders, including abdominal pain, stool disorders, nausea and vomiting. With liver damage, the color of the skin and sclera of the eyes changes (this is how hepatitis A develops).

Of course, each ailment has its own characteristics. An example is Lyme disease, the symptoms of which are the appearance of a migratory ring redness on the skin, an increase in body temperature, damage to the nervous system with further development of depressive conditions.

Diagnosis of infectious diseases

As you can see, infectious diseases are very diverse. Of course, for proper treatment, it is extremely important to determine the nature of the pathogen in time. This can be done using laboratory research. They can be divided into three groups:

Direct diagnostic methods

The purpose of research is to accurately identify the pathogen. Until recently, the only way to carry out such an analysis was to sow samples taken from a patient on a special medium. Further cultivation of a culture of microorganisms made it possible to identify the pathogen and even assess the degree of its sensitivity to certain drugs. This technique is used to this day, but it takes a long time (sometimes 10 days).

A faster way is PCR diagnostics, aimed at detecting certain fragments of the pathogen (usually DNA or RNA) in the patient's blood. This technique is especially effective for viral diseases.

Indirect diagnostic methods

This group includes laboratory research, in which not the pathogens are studied, but the reaction of the human body to them. When an infection hits, the immune system begins to produce antigens, in particular immunoglobulins. These are specific protein substances. Depending on the structure of antibodies present in the blood, the doctor can judge the development of one or another infectious disease.

Paraclinical methods

This includes studies that can determine the symptoms of the disease and the degree of damage to the body. For example, a blood test confirms the presence of an inflammatory process in the body. Infectious kidney damage affects the functioning of the excretory system - any failures can be detected by examining urine samples. The same methods include ultrasound, X-ray, MRI and other instrumental studies.

What does the treatment depend on?

How are infectious diseases treated? The list is huge, and the therapy regimens are varied. In this case, it all depends on the nature of the pathogen, the general condition of the patient, the severity of the disease and other factors.

For example, broad-spectrum antibiotics are used for bacterial infections. These drugs will be useless for viral diseases, because in such cases, the patient needs to take antiviral drugs, interferon and immunomodulators. The presence of mycoses is an indication for taking antifungal agents.

Of course, symptomatic therapy is also carried out. Depending on the symptoms, it includes taking anti-inflammatory, antipyretic, pain relieving and antihistamines. A rhinovirus infection, for example, will get better with nasal drops. With lesions of the respiratory system, accompanied by a cough, experts prescribe expectorant syrups and antitussive drugs.

It should be understood that self-medication should not be done in any case. For example, if you find signs of botulism in yourself, you should immediately consult a doctor, as this is a serious disease - in the absence of therapy, serious consequences are possible, especially when it comes to the child's body.

Preventive actions

It is much easier to prevent an infection than to treat it later. Prevention of infectious diseases should be comprehensive. A person is constantly in contact with pathogenic microorganisms - they are present in the air and in water, get into food, settle on doorknobs and household items. Therefore, it is important to strengthen the body.

A strong immune system is able to suppress the reproduction of pathogenic microbes that have already entered the human body. Proper nutrition, regular physical activity, walking in the fresh air, hardening, proper sleep and rest, lack of stress - all this helps to increase the body's defenses.

Do not give up vaccinations. A timely vaccination can protect against pathogens such as mumps, polio and hepatitis, etc. The drugs used for vaccination contain samples of a dead or weakened pathogen of a particular disease - they cannot cause serious harm to the body, but help to develop strong immunity.

Many people go to their doctors after traveling. The fact is that in some regions of the planet various infectious diseases are rampant. For example, the causative agent of malaria (Plasmodium) enters the human bloodstream only when bitten by an anopheles mosquito, which lives only in some regions of Africa, Asia and South America. If you are going to spend some time in a particular country (especially when it comes to countries with a tropical climate), be sure to ask about the level of spread of this or that infection - it is quite possible that it is better to get vaccinated or stock up on medicines before the trip.

Of course, it is very important to observe hygiene standards, buy quality food, wash them before eating, and cook them correctly. During epidemic outbreaks of influenza or other colds, one should avoid crowded places, take special medications to strengthen the immune system (for example, "Aflubin"). To protect against genital infections during contact, it is imperative to use a condom.

Wide tapewormis a large centenarian, the length of one individual is up to 10 meters, the lifespan in the human body is up to 25 years. Can you imagine what happens in a person if there are several such large centenarians inside?

Imagine how the worm is twisted in the intestine, how little space remains in the lumen of the human intestine! If the worm "straightened", then half of its length would hang outward. By the way, the worm draws in all the necessary and useful substances for itself the entire surface of the body.

You can get infected by eating raw, insufficiently salted fish, crayfish and caviar. Symptoms of the presence of a tapeworm may be anemia, exhaustion, abdominal pain, especially signs such as increased salivation in the morning, vomiting, nausea, weakness, lethargy, drowsiness should be alerted. Intestinal obstruction is possible.

In order to prevent infestation by a broad tapeworm, fishermen, river transport workers, residents of coastal villages are laboratory-examined with compulsory treatment of identified patients. Fish (15 specimens of each species) from natural reservoirs are examined every 3 years. It is important to promote the rules for heat treatment of fish among the population: fry in laminated pieces weighing up to 100 g for at least 25 minutes or cook for at least 20 minutes from the moment of boiling.

Of great importance are the sanitary improvement of populated areas and river vessels and the prevention of pollution of water bodies with feces.

3. The goals and objectives of the sanitary and epidemiological examination of food raw materials and food products. The objectives and principles of ensuring the sanitary and epidemiological well-being of the population are:

1. Realization of the rights and obligations of citizens to health protection, favorable living conditions and sanitary and epidemiological well-being;

2. Preventive nature of activities to ensure the sanitary and epidemiological well-being of the population, prevention of the harmful effects of environmental factors on the health of the population;

3. Publicity in the field of sanitary and epidemiological welfare of the population;

4. Implementation of sanitary and anti-epidemic (preventive) measures and mandatory compliance by officials, individuals and legal entities with the legislation of the Russian Federation on the sanitary and epidemiological well-being of the population;

5. Scientific and practical validity of measures to ensure the sanitary and epidemiological well-being of the population;

6. Responsibility for violation of the legislation of the Russian Federation in the field of sanitary and epidemiological welfare of the population;

7. Obligation to compensate for damage caused to the health of a person or a group of people by individuals and (or) legal entities as a result of violation of the legislation of the Russian Federation on sanitary and epidemiological well-being of the population.

The following are subject to sanitary and epidemiological examination:

Certain types of products that pose a potential danger to humans, produced when putting into production, when changing the composition, configuration, design, production process, when changing the regulatory or technical documentation for the product;

Certain types of products that pose a potential danger to humans, imported into the territory of the Russian Federation;

Certain types of products that pose a potential danger to humans, upon expiration of the previously issued opinion, certificate of state registration;

Certain types of activities (work, services) that pose a potential danger to humans.

Design documentation, land plots for construction (reconstruction);

Objects during their commissioning.

Sanitary and epidemiological expertise includes:

Acceptance and registration of an application for a sanitary and epidemiological examination of products;

Determination of the required volume of sanitary and epidemiological expertise;

Execution of an agreement for a sanitary and epidemiological examination at the Federal State Institution "Center for Hygiene and Epidemiology" and its branches;

Examination of documentation;

Conducting laboratory and instrumental research and testing;

Decision-making based on the results of the sanitary and epidemiological examination of products;

Inspection of the facility, carried out according to the instructions, orders, orders of the Territorial Administration of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, its territorial departments;

Issuance of a sanitary and epidemiological conclusion and its entry into the register of sanitary and epidemiological conclusions on compliance (non-compliance) with state sanitary and epidemiological rules and standards of activities (work, services), products, project documentation.

To conduct a sanitary and epidemiological examination of products, the applicant submits the following documents:

For domestic products:

Regulatory and / or technical documents (technical specifications, technological instructions, recipes, etc.) for products, agreed in the prescribed manner, or regulatory and / or technical documents (technical conditions, technological instructions, recipes, etc.), not previously agreed, according to which it is supposed to carry out industrial production of products;

Sanitary and epidemiological conclusion on the compliance of technical documents with the requirements of state sanitary and epidemiological rules and standards (if any);

Sanitary and epidemiological conclusion on the compliance of production conditions with the requirements of state sanitary and epidemiological rules and standards (if necessary);

Product test reports (if any);

Other documents confirming product safety;

Product samples required for sanitary and epidemiological examination;

A copy of the certificate of making an entry in the Unified State Register of Legal Entities, Individual Entrepreneurs.

For imported products:

Documents from the manufacturing organization, according to which the manufacture of imported products is carried out;

Documents issued by the authorized bodies of the country of origin of the product, confirming its safety for humans;

Product test (research) reports (if any);

Samples of products in the amount required for sanitary and epidemiological examination;

The act of sampling products received for sanitary and epidemiological examination;

Consumer (or container) label (for products subject to mandatory labeling - samples or mock-ups of labels);

Technical description of products indicating the conditions of use (use), other regulatory and technical documents on the composition and conditions of use;

A copy of the certificate of making an entry in the Unified State Register of Legal Entities, Individual Entrepreneurs (if the applicant is not a manufacturer);

Contract (agreement) or information about the contract (agreement) for the supply of products (if necessary).

Documents in foreign languages \u200b\u200bprovided for the purpose of conducting a sanitary and epidemiological examination must be translated into Russian, copies of documents and their translations must be certified in the prescribed manner.

To conduct a sanitary and epidemiological examination of project documentation, the applicant submits an application and project documentation with its justification.

The decision to issue a sanitary and epidemiological conclusion on the materials of supervision (control) is made by the chief state sanitary doctors (their deputies).

For the examination of activities (works, services), the applicant submits the following documents:

For an operating facility - a statement;

For a newly commissioned object - an application and a copy of the certificate of making an entry in the Unified State Register of Legal Entities, Individual Entrepreneurs, a copy of the document for the right to use the premises (lease agreement, certificate of ownership, etc.).

The validity period of the sanitary and epidemiological conclusion is:

For products - five years;

For an experimental batch of products - up to one year;

For types of activities (work, services), objects when they are put into operation - indefinitely, with the exception of temporary and seasonal work;

For design documentation, land plots for construction (reconstruction) - indefinitely, or for a specific period in case of justified need.

Today, immunodeficiency is a dangerous and incurable disease that is constantly spreading among the world's population. Most people know how HIV is transmitted. The factor that affects the rate of development of the disease is immunity, it is on it that the rate of transition of the disease to the AIDS stage depends.

The transmission factors of HIV infection are the conditions for the spread of the disease. This concept should not be confused with the transmission of the disease.

Determine the main factors on which the risk of HIV infection depends:

drug use when using one syringe by several people;
the practice of promiscuous sexual relations regardless of orientation and without the use of contraception is one of the main factors of HIV infection;
a person's conscious desire for infection, the choice of an infected partner;
introduction of untested donor material;
infection of medical staff during work through contact with infected patients;
the presence of venereal, infectious diseases, prostitution.

Regardless of these factors, HIV infection can be contracted if the following conditions are met:

The presence of an infection. It is possible to bring an infection into the body only from a patient or a virus-carrier object.
The concentration of the virus in the partner's blood. Only a certain concentration of infection can lead to infection, however, even in this situation, the probability of infection is not 100%.
Mandatory entry of the virus into the blood. The integrity of the skin and mucous membranes protects the body from retrovirus penetration.

The main factor in the emergence of HIV infection in the world is sexual transmission of pathology (more than half of cases of infection). The parenteral route makes up a tenth of the total. The main factor of HIV disease in Russia is parenteral infection. Recently, there has been a rapid increase in the number of sexual transmission of infection.

There are also secondary mechanisms and factors of HIV transmission:

constant contact with the patient;
the presence of inflammatory processes and infectious diseases significantly increases the risk of infection;
the susceptibility of a particular organism to infection.

In the process of researching the disease, the influence of co-factors for HIV infection, that is, the reasons contributing to its spread, is increasingly revealed. One of the most important is the number of sexual partners. The second place in the list is given to sexually transmitted diseases. The virus penetrates through damaged areas of the skin and mucous membranes, and the weakened immune system is not able to overcome pathogens. It also includes: the presence of infections and inflammatory processes, the person's age (people from 25 to 45 years old are at greatest risk), childhood (due to a weak immune system).

Social factors contributing to the spread of HIV infection

There are also mechanisms in society that increase the risk of developing immunodeficiency. These include:

frequent divorces leading to a change in the second half;
unemployment, urbanization;
ample opportunities against the background of modern medical advances to increase the duration of sexual life;
factors of HIV infection (prostitution, drug addiction, homosexuality and others);
freedom of morals, early sexual intercourse, deviation from generally accepted moral and ethical standards.

A blood test for retrovirus can be done at home or in the laboratory. For these purposes, an express test for HIV Factor Med is used. The manufacturer has a wide production and technical base that ensures the use of modern technologies and clear control systems. The test is very easy to use and is intended for anyone with no specific experience in this kind of testing. Also, to detect a retrovirus, you can simply go to a medical facility.

. Infectious process- a complex of mutual adaptive reactions in response to the introduction and reproduction of a pathogenic microorganism in a macroorganism, aimed at restoring disturbed homeostasis and biological equilibrium with the environment. As a result of the infectious process, it often develops infectious diseasewhich represents a new quality of the infectious process. In most cases, an infectious disease ends with recovery and complete liberation of the macroorganism from the pathogen. Sometimes there is a carriage of a live pathogen against the background of a qualitatively changed infectious process. A distinctive feature of infectious diseases is their infectiousness, i.e. the patient can be a source of pathogens for a healthy macroorganism.

In accordance with the dynamics of the infectious process, it is possible to distinguish the initial stages (infection) associated with the introduction of the microorganism into the macroorganism, the period of adaptation at the site of penetration or in the border areas. Under favorable conditions for the pathogen, it spreads beyond the primary focus (colonization). All these events represent the incubation period of an infectious disease.

At the end of the incubation period, there is a generalization of the infectious process and its transition either during the period of p about-m, which is characterized by nonspecific signs common to many infectious diseases, or immediately during the period of acute manifestations, when one can find characteristic this infectious disease symptoms.

After the end of the period of acute manifestations of the disease, its gradual or, conversely, rapid (crisis) completion begins - a period of convalescence, recovery and a period of rehabilitation.

The infectious process, however, does not always go through all its inherent periods and may end with recovery in the early stages. Often, clinical manifestations of the disease are absent and the infectious process is limited to a sub-clinical short course.

In addition to the acute cyclical, i.e. having certain phases or periods of development and course, there are acyclic infectious processes (diseases), for example sepsis, apparently, the only nosological form that is caused by various pathogens, including opportunistic pathogens.

In addition to an acute infectious process (illness), a chronic infectious process (illness) is distinguished, including primary chronic.

The group of infectious diseases, caused not by a living pathogen, but by the products of its vital activity, which are outside the macroorganism in various structures (food products, raw materials for them), stands apart. In the pathogenesis of these conditions, there is no infectious process as such, but only its component part is present - the process of intoxication, the severity of which is determined by the type and amount of toxin or a combination of toxins. During such intoxications, there is no cyclicity, since there is no participation of a living microorganism. Nevertheless, this group of pathological conditions is referred to as infectious pathology of a person or animals in connection with the presence of a certain etiological agent, the formation of immunity (antitoxic, and therefore defective), as well as the possibility of developing an infectious process caused by the same pathogen. This group includes, for example, botulism, diseases caused by other representatives of toxin-forming bacteria, some types of fungi.

The most important method of studying infectious diseases is epidemiological analysis, which pursues at least 10 goals: 1) to describe the types of manifestations of infections in the population; 2) recognize outbreaks and unusual manifestations of the disease; 3) facilitate laboratory recognition of the pathogen; 4) describe the manifestations of the asymptomatic course of the infection; 5) to increase the specificity of the diagnosis of the disease; 6) assist in understanding the pathogenesis; 7) identify and characterize the factors that are involved in the transmission of an infectious agent and the development of the disease; 8) develop and evaluate the clinical effectiveness of treatment; 9) develop and evaluate primary, secondary and tertiary prevention and control over the individual; 10) describe and evaluate the preventive measures carried out in the community.

The main tasks of epidemiological analysis are the study and control of epidemics and outbreaks of infectious diseases. Specificity and sensitivity are guiding principles in any laboratory test.

FACTORSINFECTIOUSPROCESS

1. Pathogen. Throughout their life, higher organisms are in contact with the world of microorganisms, however, only an insignificant part (about 1/30 000) of microorganisms is capable of causing an infectious process.

The pathogenicity of pathogens of infectious diseases is a distinctive feature, fixed genetically, and is a toxonomic concept that makes it possible to subdivide microorganisms into pathogenic, opportunisticand saprophytes.Pathogenicity exists in some microorganisms as a species trait and consists of a number of factors: virulence - a measure of pathogenicity inherent in a particular strain of pathogens; toxicity - the ability to produce and release various toxins; invasiveness (aggressiveness) - the ability to overcome and spread in the tissues of a macroorganism.

The pathogenicity of pathogens is determined by the genes that are part of the mobile genetic elements (plasmids, transposes, and moderate bacteriophages). The advantage of the mobile organization of genes lies in the realization of the possibility of rapid adaptation of bacteria to changing environmental conditions.

Immunosuppression in infections can be general (suppression more often of T- or / and T- and B-cell immunity), for example, in measles, leprosy, tuberculosis, visceral leishmaniasis, infection caused by the Epstein Bappa virus, or specific , most often with long-term persistent infections, in particular with infection of lymphoid cells (AIDS) or induction of antigen-specific T-suppressors (leprosy).

An important mechanism of cell and tissue damage during infections is the action of exo- and endotoxins, for example, enterobacteria, the causative agent of tetanus, diphtheria, and many viruses. Toxic substances have both local and systemic effects.

Many infections are characterized by the development of allergic and autoimmune reactions, which significantly complicate the course of the underlying disease, and in some cases, they can further progress almost independently of the agent that induces them.

Pathogens have a number of properties that prevent the host's protective factor from acting on them, and also have a damaging effect on these protective systems. So, polysaccharides, protein-lipid components of the cell wall and capsules of a number of pathogens prevent phagocytosis and digestion.

The causative agents of some infections do not cause an immune response, as if bypassing the acquired immunity. Many pathogens, on the contrary, cause a vigorous immune response, which leads to tissue damage both by immune complexes, which include the pathogen antigen, and antibodies.

The protective factors of the pathogens are anti-gene mimicry. For example, the hyaluronic acid of the streptococcus capsule is identical to the antigens of the connective tissue, the lipo-polysaccharides of enterobacteriaceae react well with transplantation antigens, the Epstein-Barr virus has a cross-antigen with the human embryonic thymus.

The intracellular location of the infectious agent can be a factor that protects it from the host's immunological mechanisms (for example, the intracellular arrangement of Mycobacterium tuberculosis in macrophages, the Epstein-Barr virus in circulating lymphocytes, and the causative agent of malaria in erythrocytes).

In some cases, there is an infection of parts of the body that are inaccessible to antibodies and cellular immunity - kidneys, brain, some glands (rabies viruses, cytomegalovirus, leptospira), or in cells the pathogen is not available for immune lysis (herpes viruses, measles).

The infectious process involves the interaction of a pathogenic principle and a macroorganism susceptible to it. The penetration of pathogenic pathogens into a macroorganism does not always lead to the development of an infectious process, and even more so to a clinically manifested infectious disease.

The ability to cause infection depends not only on the concentration of the pathogen and the degree of virulence, but also on the gateway for pathogens. Depending on the nosological form, the gates are different and are associated with the concept of "transmission pathways". The state of the macroorganism also affects the effectiveness of the implementation of transmission routes of infection, especially pathogens related to opportunistic microflora.

The interaction of infectious agents and a macroorganism is an extremely complex process. It is due not only to the properties of the pathogen described above, but andthe state of the macroorganism, its specific and individual (genotype) characteristics, in particular, those formed under the influence of pathogens of infectious diseases.

2. Macroorganism defense mechanisms.An important role in ensuring the protection of the macroorganism from pathogens is played by general or nonspecific mechanisms, which include normal local microflora, genetic factors, natural antibodies, morphological integrity of the body surface, normal excretory function, secretion, phagocytosis, the presence of natural killsron cells, nutritional pattern, non-antigen-specific immune response,fibronectin and hormonal factors.

Microfloraa macroorganism can be divided into two groups: normal constant and transitory, which is not constant in the body.

The main mechanisms of the protective action of microflora are considered to be "competition" with foreign microorganisms for the same food products (interference), for the same receptors on the host cells (tropism); bacteriolizin products that are toxic to other microorganisms; production of volatile fatty acids or other metabolites; constant stimulation of the immune system to maintain a low but constant level of expression of class II molecules of the tissue compatibility complex (DR) on macrophages and other antigen-presenting cells; stimulation of cross-protective immune factors such as natural antibodies.

The natural microflora is influenced by such environmental factors as diet, sanitary conditions, dustiness of the air. Hormones are also involved in its regulation.

The most effective means of protecting a macroorganism from a pathogen is morphological integrity of the surfacebody.Intact skin forms a very effective mechanical barrier on the path of microorganisms, in addition, the skin has specific antimicrobial properties. Only a very few pathogens are able to penetrate the skin, therefore, in order to open the way for micro-organisms, physical factors such as trauma, surgical damage, the presence of an internal catheter, etc., must be exposed to the skin.

The secretion secreted by mucous membranes, which contains lysozyme, which causes lysis of bacteria, also has antimicrobial properties. The secretion of the mucous membranes also contains specific immunoglobulins (mainly IgG and secretory IgA).

After penetrating the external barriers (integuments) of the macroorganism, microorganisms encounter additional defense mechanisms. The level and localization of these humoral and cellular defense components are regulated by cytokines and other products of the immune system.

Complementis a group of 20 whey proteins that interact with each other. Although most often the activation of complement is associated with specific immunity and is realized through the classical pathway, complement can also be activated by the surface of some microorganisms through an alternative pathway. Complement activation leads to lysis of microorganisms, but also plays an important role in phagocytosis, cytokine production and leukocyte adhesion in infected areas. Most of the complement components are synthesized in macrophages.

Fibronectin- a protein with a high molecular weight, which is found in plasma and on the surface of cells, plays a major role in cell adhesion. Fibronectin coats receptors on the surface of cells and blocks the adhesion of many microorganisms to them.

Microorganisms entering the lymphatic system, lungs, or bloodstream are captured and destroyed phagocytic cells,the role of which is played by polymorphonuclear leukocytes and monocytes, circulating in the blood and penetrating through the tissues to the places where inflammation develops.

Mononuclear phagocytes in the blood, lymph nodes, spleen, liver, bone marrow and lungs are a system of monocytic macrophages (previously it was called the reticuloendothelial system). This system removes from the blood andlymph microorganisms, as well as damaged or aging cells of the host organism.

The acute phase of the response to the introduction of microorganisms is characterized by the formation of active regulatory molecules (cytokines, prostaglandins, hormones) by phagocytes, lymphocytes andendothelial cells.

Cytokine production develops in response to phagocytosis, adhesion of microorganisms and substances secreted by them to the cell surface. Mononuclear phagocytes, natural killer cells, T-lymphocytes and endothelial cells are involved in the regulation of the acute phase of the response to the introduction of microorganisms.

The most common symptom of the acute phase is fever, the occurrence of which is associated with increased production of prostaglandins in and around the hypothalamic center of thermoregulation in response to increased release of cytokines.

3. Mechanisms of penetration of microorganisms into the bodyowner.Microorganisms cause the development of an infectious disease and tissue damage in three ways:

Upon contact or entry into host cells, causing
their death;

By releasing endo- and exotoxins that kill cells at a distance, as well as enzymes that cause the destruction of tissue components, or damage blood vessels;

By provoking the development of hypersensitivity reactions, which
rye lead to tissue damage.

The first way is associated primarily with the impact of viruses.

Viral cell damagethe host arises as a result of the penetration and replication of the virus in them. Viruses have proteins on their surface that bind specific protein receptors on host cells, many of which perform important functions. For example, the AIDS virus binds a protein involved in the presentation of antigen by helper lymphocytes (CD4), the Epstein-Barr virus binds the complement receptor on macrophages (CD2), the rabies virus binds acetylcholine receptors on neurons, and rhinoviruses - the adhesion protein ICAM- 1 on mucosal cells.

One of the reasons for the tropism of viruses is the presence or absence of receptors on the host cells, which allow the virus to attack them. Another reason for the tropism of viruses is their ability to replicate within certain cells. Virion or its portion, containing the genome and special polymerases, penetrate into the cytoplasm of cells in one of three ways: 1) by translocation of the entire virus through the plasma membrane;

2) by fusing the envelope of the virus with the cell membrane;

3) with the help of the endocytosis of the virus caused by the receptor and its subsequent fusion with the endosome membranes.

In the cell, the virus loses its envelope, separating the genome from other structural components. The viruses then replicate using enzymes that are different for each of the virus families. Viruses also use host cell enzymes for replication. The newly synthesized viruses are collected in the form of virions in the nucleus or cytoplasm, and then excreted outside.

A viral infection can be abortive(with an incomplete virus replication cycle), latent(the virus is located inside the host cell, for example herpes zoster) and persistent(virions are synthesized constantly or without dysfunction of the cell, for example, hepatitis B).

There are 8 mechanisms of destruction of cells of a macroorganism by viruses:

1) viruses can cause inhibition of the synthesis of DNA, RNA or protein by cells;

2) the viral protein can penetrate directly into the cell membrane, leading to its damage;

3) cell lysis is possible in the course of viral replication;

4) with slow viral infections, the disease develops after a long latency period;

5) host cells containing viral proteins on their surface can be recognized by the immune system and destroyed by lymphocytes;

6) host cells can be damaged as a result of a secondary infection that develops after the viral one;

7) the destruction of cells of one type by the virus can lead to the death of cells associated with it;

8) viruses can cause cell transformation, leading to tumor growth.

The second pathway of tissue damage in infectious diseases is associated mainly with bacteria.

Bacterial cell damagedepend on the ability of bacteria to adhere to or penetrate the host cell or release toxins. The adhesion of bacteria to host cells is due to the presence of hydrophobic acids on their surface, capable of binding to the surface of all eukaryotic cells.

Unlike viruses that can penetrate into any cells, facultative intracellular bacteria mainly infect epithelial cells and macrophages. Many bacteria attack host cell integrins - plasma membrane proteins that bind complement or extracellular matrix proteins. Some bacteria cannot penetrate host cells directly, but enter epithelial cells and macrophages through endocytosis. Many bacteria are capable of multiplying in macrophages.

Bacterial endotoxin is a lipopolysaccharide, which is a structural component of the outer shell of gram-negative bacteria. The biological activity of lipopolysaccharide, manifested by the ability to induce fever, activate macrophages and induce mitogenicity of B cells, is due to the presence of lipid A and sugars. They are also associated with the release of cytokines, including tumor necrosis factor and interleukin-1, by the host cells.

Bacteria secrete various enzymes (leukocidins, hemolysins, hyaluronidases, coagulases, fibrinolysins). The role of bacterial exotoxins in the development of infectious diseases is well established. Also known are the molecular mechanisms of their action aimed at destroying the cells of the host's organism.

The third path of tissue damage during infections - the development of immunopathological reactions - is characteristic of both viruses and bacteria.

Microorganisms are able to escape from immune defense mechanismsthe host due to the inaccessibility for the immune response; resistance and complement-related lysis and phagocytosis; variability or loss of antigenic properties; development of specific or non-specific immunosuppression.

CHANGESINORGANISMOWNER,EMERGINGINANSWERONINFECTION

There are five main types of tissue reaction. Inflammation, among the forms of which purulent inflammation prevails. It is characterized by increased vascular permeability and the development of leukocyte infiltration mainly by neutrophils. Neutrophils enter the sites of infection in response to the release of chemoattractants by so-called pyogenic bacteria - gram-positive cocci and gram-negative rods. In addition, bacteria indirectly attract neutrophils by releasing endotoxin, which causes the release of interleukin-1 and tumor necrosis factor by macrophages. The accumulation of neutrophils leads to the formation of pus.

The sizes of exudative tissue damage vary from microabscesses located in different organs in sepsis to diffuse damage to the lobes of the lung in pneumococcal infection.

Diffuse, mainly mononuclear and n-terstitial infiltration occurs in response to the penetration of viruses, intracellular parasites or helminths into the body. The predominance of one or another type of mononuclear cells in the focus of inflammation depends on the type of pathogen. For example, in a hard chancre in primary syphilis, plasma cells predominate. Granulomatous inflammation occurs with large (schistosomal eggs) or slowly dividing (mycobacterium tuberculosis) pathogens.

In the absence of a pronounced inflammatory reaction on the part of the host organism, during a viral infection, the so-called cytopathic-cytoproliferative inflammation develops. Some viruses, multiplying inside the host cells, form aggregates (detected as inclusions, for example, adenoviruses) or cause cell fusion and the formation of polycarions (herpes viruses). Viruses can also cause proliferation of epithelial cells and the formation of unusual structures (condylomas caused by papilloma viruses; papules formed by the action of molluscum contagiosum).

Chronic inflammation resulting in scarring develops at the end of many infections. In some relatively inert microorganisms, scarring can be considered as the main response to the introduction of the pathogen.

PRINCIPLESCLASSIFICATIONSINFECTIOUSDISEASES

Due to the variety of biological properties of infectious agents, mechanisms of their transmission, pathogenetic characteristics and clinical manifestations of infectious diseases, the classification of the latter according to a single criterion presents great difficulties. The most widespread classification is based on the mechanism of transmission of the causative agent of infection and its localization in the body.

Under natural conditions, there are 4 types of transmission mechanisms:

Fecal-oral (for intestinal infections);

Aspiration (for respiratory tract infections); - transmissible (for blood infections);

Contact (for infections of the external integument).
The transmission mechanism in most cases determines the advantages
significant localization of the pathogen in the body. When k-
intestinal infections, the causative agent throughout the disease or in
For certain periods, it is mainly localized in the intestines;
for respiratory tract infections - in the mucous membranes
pharynx, trachea, bronchi and in the alveoli, where inflammation develops
tive process; with blood infections - circulates in
blood and lymph, with infections of the external integument, including
wound infections, primarily the skin and slime
zeny shells.

Depending on the main source of e-l, infectious diseases are subdivided into:

Anthroponosis (human source of pathogens);
- zoonoses (the source of pathogens is animals).