Dangerous quarantine infections: list. Quarantine measures

In the Middle Ages, such terrible diseases as plague or black, smallpox in a short time devastated entire cities - even wars did not take away so many lives. The same terrible diseases were typhus and cholera, the epidemics of which carried away millions of human lives. Only at the end of the 19th century did the first vaccine, created by Vladimir Khavkin, a disciple of Mechnikov, appear.

Dangerous Infections

There are diseases characterized by exceptional infectiousness and a high probability of death - especially dangerous quarantine infections. The general characteristic of quarantine infections determines them as the process of interaction with the human body of pathogenic microorganisms that can lead to the emergence of infectious pathology. The presence of an infectious agent in the body does not necessarily lead to the development of an infectious process. He can stay there for a long time without any signs of presence, until some factor provokes the onset of the infectious process.

At the beginning of the 19th century, the most dangerous quarantine infections were first identified. The list of them included at that time four diseases.

1. Cholera is an infectious disease, one of the most ancient, the situation with which is still tense. Until the early 19 th century, cholera was considered characteristic of the Bengal region, where its origin was determined by such factors as hot climate, high population density, low living standards. However, with the expansion of economic ties with the countries of Southeast Asia, it became possible to spread the disease around the world. Since the beginning of the 19th century, six cholera epidemics have occurred over a hundred years, and they all originated, mainly in India, extending from there to Southeast Asia, the Middle East and further Europe and Russia. These epidemics have claimed millions of lives. In the mid-20th century, there was a marked decrease in the incidence, but in the sixties a new type of cholera vibrio , El Tor appeared. Until now, periodically in different regions there are outbreaks of cholera, which are marked by an increase in the duration of the incidence period.

2. Plague - a description of the epidemics of this terrible disease can be found in historical chronicles and even in the Bible. It should be noted that the rapid spread of the epidemic in the first millennium was possible only during wars, since there were no developed trade ties. In the 14th century, the epidemic of "black death", as the plague was then called, claimed a third of the population of Europe. Having penetrated from Asia, it quickly spread along already established trade routes. These years were terrible for Europe. Another epidemic, dubbed the Great Plague, erupted in Europe in the middle of the 17th century. It was not for nothing that people were so afraid of the plague that they considered it an anger. And now the plague remains a dangerous infection. Of the ill every year, half of people die, often due to incorrect diagnosis and mismanagement.

3. Smallpox is a dangerous disease that belongs to quarantine infections, known to mankind since ancient times. In Europe, it first appeared in the sixth century, and since then the epidemics of this disease have not ceased. In the early 16th century, the disease was brought to America by Spanish colonizers. Out of the sick, up to forty percent died. Only in the late 18th century a vaccine against smallpox appeared, however, smallpox pockets remained in some regions and represented a threat to the development of epidemics. Therefore, a decision was made by the joint efforts of international organizations to eliminate smallpox as a disease. In 1980, the victory was won, thanks to the mass vaccination of several human generations.

4. Yellow fever. It is assumed that the yellow fever originated in Africa and then spread to Asia and America. In Europe, the epidemics of yellow fever were accompanied by high mortality. The study of the disease made it possible to find out that the mosquito carries the carrier of the infection. Later, the role of monkeys in the spread of the disease was also revealed. Natural centers of yellow fever, as a rule, are tropical forests with a hot climate and too high humidity - the equatorial regions of Africa, South America.

In Russia, anthrax and tularemia are also considered especially dangerous. The first of these was known already in ancient times - it was called "sacred fire", but in Russia it was given a different name because of the greater distribution in this region. Tularemia was first recorded in the 1920s, although it is possible that it was earlier.

Conventional Diseases

All these diseases are called "quarantine infections", because when they occur, all infected persons, as well as persons who have been in contact with them, are isolated and monitored until the situation becomes clear. For the first time, quarantine infections began to fight back in the 14th century, when in Italy the ships were detained on the roadstead until they found out that there were any dangerous diseases in the team. Later, in the 15th century, medical facilities were placed on trade routes - hospitals, in which patients were placed who came from the plague foci, and also burned their clothes. However, the effective fight against infections began only after the efforts of many countries were combined. For the first time, a joint document, the International Convention for the Control of Dangerous Infections, was adopted only at the beginning of the 20th century. Infectious diseases have come to be called conventional. Measures and rules for the behavior of medical staff during the outbreak of epidemics, which periodically changed according to the new realities, were developed.

After the victory over smallpox, she was excluded from the list of dangerous infections, but at the beginning of the 21st century she was again included in the known list in connection with the assumption of the presence of the smallpox virus as a biological weapon in the laboratories of any countries. Also, the list of quarantine infections was expanded, some methodological guidelines were amended. They took into account the pace of development of modern civilization, the expansion of international contacts, the increase in the speed of the means of communication - everything that facilitates the rapid spread of it throughout the world.

Modern definition of quarantine infections

To date, the World Health Organization defines quarantine infections as such diseases that can create a state of emergency in the field of health on a global scale. The list of them is expanded and represents two groups of diseases:

• Diseases that pose a threat to human health, which include poliomyelitis, smallpox, new forms of influenza, and others;
• Diseases that can not only have a dangerous effect on human health, but also spread rapidly in large areas - they include dangerous infections, as well as new forms of fever that have appeared in recent years.

Some diseases represent a local, regional threat, since they have certain foci of origin associated with the presence of a vector or the climatic conditions of the area. These include various types of fever, in particular, the fever of Dengue, characteristic of areas with tropical climates. In Russia, anthrax and tularemia are quarantine infections. The list of them contains exactly the pulmonary form of the plague, this is due to the high rate of its spread.

After the victory over smallpox, the world was confident that it would eventually be possible to eliminate all dangerous infections in the world. However, time has shown that, unfortunately, their number only increases. Microorganisms - pathogens of infections mutate, adapting to new medicines and a new ecological situation, which gradually deteriorates and becomes an additional risk factor for the human immune system. Therefore, the new international rules do not restrict the list to a set of specific diseases, allowing the possibility of the appearance of new, still unknown.

Preventive quarantine measures

If an infection occurs, immediate action should be taken to eliminate it. The peculiarity of infections is not only their rapid spread, but also the presence of an incubation period that complicates the fight against them. An incubation period is the period during which the disease does not manifest its symptoms, this time can be several days, and several weeks, then the disease can be detected only through laboratory tests. Actions undertaken to eliminate the infection include both medical, sanitary measures for getting rid of infection, and administrative measures to prevent further spread. A complex of such events is called quarantine. Quarantine measures can be conditionally divided into two large groups.

1. The first group includes quarantine measures to prevent the emergence of foci of infection.

2. The second group includes radical measures to destroy the existing focus of infection.

All measures of quarantine nature are regulated by the Regulations on sanitary protection of the territory of the country, compiled taking into account the requirements of the World Health Organization. This international organization includes 194 countries, who report weekly on the state of the epidemiological situation in their countries and the sanitary measures being carried out. WHO monitors compliance with the rules of participating countries, summarizing the reports received. However, in 2005 she made changes in the IHR according to which she can draw conclusions about the sanitary and epidemiological situation in the country not only on the basis of reports, but also on press reports, which sometimes are much more objective.

Quarantine measures are carried out at railway stations, airports, border checkpoints. They consist of inspection of transport, cargo, passengers, international sanitary documents, identification of persons arriving from the dysfunctional in the sanitary and epidemiologic respect of the territories. They are subject to incubation, that is, the presence in hospitals during the incubation period of the disease suspected.

Quarantine measures in the focus of infection

If there are especially dangerous and quarantine infections, in the epidemic focus organization and carrying out of quarantine measures are carried out by emergency anti-epidemic commissions - CIC, their decisions are binding for execution by all population and institutions located in this territory. Quarantine measures in the focus of the infection include the following actions:

• Prohibition of movement of people and transportation of goods through the outbreak, as well as beyond it;
• Urgent hospitalization of identified patients, as well as persons who contacted him;
• Research and burial of corpses;
• Mass vaccination of the population;
• Disinfection of the territory;
• Epidemiological examination of the source of infection;
• Public health education;
• Ban on mass events;
• Establishment of a system of admissions for entry and exit.

On the perimeter of the foci of infection a cordon is set up, which is provided by the troops of the Ministry of Internal Affairs or the Ministry of Defense. They are outside the contaminated territory, and internal security is carried by representatives of the internal affairs bodies. The decision to terminate quarantine is taken only after the end of the incubation period of the last identified patient. Quarantine measures in the focus of infection may differ slightly depending on the type of disease. There may be, for example, periods of isolation or forms of exposure to sources of infection.

In order to carry out quarantine measures in a qualitative and effective manner, sufficient material resources and high professionalism of medical personnel are necessary.

Infectious diseases for children

There are childhood infectious diseases that occur mainly in childhood and have a high degree of infectiousness. Because of this, they cause epidemics in children's institutions. Such diseases include diphtheria, whooping cough, measles, scarlet fever, chicken pox and others. They are called children's because the sick children get immunity and in the future they do not get sick with these diseases. Quarantine and isolation measures for children's infections include the following actions:

• Isolation of the patient to prevent the spread of the disease;
• Prohibition of admission of children to an institution in quarantine;
• Separation - a ban on the transfer of children from one group to another until the end of the quarantine;
• Immunization of children.

Preventive measures for childhood infections are timely vaccination, as well as measures to strengthen the child's body. Quarantine and isolation measures for children's infections are aimed at breaking the continuity of the chain of the infectious process, which should accelerate the end of the epidemic.

Airborne droplet infections

Most infections caused by viruses or bacteria have an airborne spread pattern. When sneezing or coughing, the patient releases particles of infected mucus into the air, which become a source of mass infection. These include almost all childhood infections, as well as tuberculosis, influenza, salmonella and others. In these cases, the isolation of patients and the cessation of all contacts between people play a decisive role. Quarantine measures for airborne infections are as follows:

• Identification and hospitalization of patients;
• Wet cleaning, ventilation, disinfection of the room with a solution of half-percentage solution of chloramine, can be chlorine lime;
• Disinfection of dishes, linen and household items;
• Rigid restriction of contacts;
• In a children's institution, careful medical supervision of the group in which the patient was identified.

Intestinal infections

Among the many infectious diseases, a significant place is occupied by intestinal quarantine infections, which still represent a serious problem. Quarantine intestinal infections include diseases that combine the mechanism of localization of the pathogen in the intestine. Disease-causing microorganisms are also able to remain in the environment for a long time, re-entering the body with food or water. An important symptom of such infections is diarrhea, because of this, they are sometimes called diarrheal infections. They can occur in any age group, but more often they are exposed to small children, who are still unstable metabolic processes. By origin, intestinal infections are divided into four types.

1. Viral, which include poliomyelitis, rotavirus infection, certain types of hepatitis. After infection of the intestine, viruses with feces get into the external environment. In most cases, children under the age of nine fall ill. But there are viruses that cause gastroenteritis with less severe diarrhea. An example is rotavirus infection, this is the most common of them, and it often happens in young children.

2. Bacterial intestinal infections include diseases such as cholera, dysentery, typhoid fever and many others. When bacteria get into the body, immediately begins their reproduction with the release of toxins, on which the mechanism of the development of intestinal infection depends:

• Typhoid fever is an acute infectious disease, caused by bacteria from the genus Salmonella, and the source is a sick person. Recently, the incidence rate is decreasing, the disease is well treated with antibiotics.
• Cholera is a dangerous disease with a very high degree of infectiousness, the causative agent of which can for a long time maintain its vitality in the external environment, being transmitted with food or water. Cholera vibrio has long been preserved in marine and fresh water bodies. Infection can occur even with the use of unprocessed seafood.
• The group of quarantine infections is dysentery - its causative agent is dysentery sticks, which for a long time survive in dairy products. At self-treatment the dysentery can pass in the chronic form.

3. Fungal intestinal infections are represented by candidiasis, its causative agent is yeast-like fungi that live in the human body in large numbers. With high immunity fungi in the body do not multiply, so the development of the disease, in the first place, indicates its weakening or a violation in the immune system.

4. Protozoal infections - they differ in that they affect not only the intestine, but also other internal organs.

Quarantine measures for intestinal infections include:

• Neutralization of the source of infection, that is, isolation of the patient in a separate room or in a hospital;
• Measures for disinfection of the focus of infection;
• Immunization of persons in the focus of infection.

The order of work of junior medical staff

The complex of quarantine measures necessary for conducting an epidemic focuses not only on the list of measures applied, but also on the scope and timing of their conduct, the responsibilities of various services - medical, veterinary and others. The organizer and coordinator of all the works is the epidemiologist. He obeys other doctors, laboratory assistants, paramedics. The action of junior medical personnel in quarantine infections is determined by a plan of anti-epidemic measures and consists of the following:

• Current disinfection of patient discharge;
• Disinfection of all premises in which the patient was kept;
• Disinfection of medical rooms;
• Disinfection of overalls and tools that were used during the reception and examination of patients;
• Disinfection of common areas.

These activities are carried out under the supervision and under the strict supervision of a senior nurse and necessarily in protective clothing consisting of:

• Special replacement shoes, which are worn by rubber boots;
• Anti-plague dressing gown, supplemented with oilcloth apron;
• Medical respirator;
• Rubber gloves;
• Towels, which changes daily.

The entire protective suit after work is subject to disinfection. Hands are disinfected with a half-percentage solution of chlorhexidine or chloramine.

The doctor's actions when a quarantine infection is detected

If quarantine infections are found, the tactics of the doctor is determined by the plan of antiepidemic measures:

• Immediate notification of the Sanitary and Epidemiological Station about the likely occurrence of a dangerous infection;
• Isolation of the patient in the quarantine infection and providing him with emergency assistance;
• Collection of material and referral to the baklabory to clarify the diagnosis;
• Disinfection of the room where the patient was;
• Compilation of lists of persons in contact with the patient;
• Isolation of contact persons before the expiration of the incubation period and establishment of medical supervision over them;
• The implementation of restrictive measures, the establishment of observation posts, the termination of admission and discharge of patients;
• Carrying out of explanatory work with contact persons;
• Provision of quarantine brigade with necessary materials and medicines.

Diseases of quarantine infections require the most urgent control measures due to their danger to life and high rate of disease development, as well as the speed of spreading on a large territory, which is fraught with an ecological catastrophe. Currently, thanks to the joint efforts of many countries, such diseases are quickly localized and eliminated, and preventive measures help to protect the population from the emergence of epidemic outbreaks.