континентальные завозы холеры из региона Карибского бассейна (Кубы) и Азии в Америку (Канаду) и Европу (Великобританию, Италию, Бельгию и Германию) остаются основными эпидемиологическими рисками в распространении инфекции на глобальном уровне. В 2015 г. выявлена 21 эндемичная по холере административная территория в восьми странах Африки, Америки, в регионе Карибского бассейна и в Азии. Эпидемиологические осложнения обусловлены в основном V. cholerae О1 биовара El Tor, продуцирующими холерный токсин классического типа, а также V. cholerae O1 биовара Classical и V. cholerae О139 серогруппы. Эпидемические проявления холеры в России характеризовались завозами инфекции российскими гражданами, возвратившимися из-за рубежа; выделением из поверхностных водоемов V. cholerae О1 биовара Эль Тор ctxA-tcpA-, ctxA-tcpA + и V. cholerae О139 ctxAи tcpA-, а также единичных V. cholerae О1 биовара Эль Тор ctxA + tcpA +. Прогноз по холере на глобальном уровне и в России на 2016 г. остается неблагоприятным.
Protective immunity evoked against anthrax lethal toxin after a single intramuscular administration of an adenovirus-based vaccine encoding humanized protective antigen. Hum.
В последнее десятилетие в мире выявлен рост в динамике заболеваемости холерой (с учетом прямолинейной линии тренда). На 2013 год прогнозируется сохранение этой тенденции. Эпидемии, вспышки и завозы инфекции имели место в 109 странах Азии, Африки, Америки, Европы и Австралии с Океанией. Продолжалось расширение нозоареала за счет вовлечения в эпидемический процесс новых административных территорий и стран, в том числе впервые за период 7-й пандемии. Помимо эндемичных территорий в Индии и Бангладеш, выявлено формирование эндемичных очагов в 12 странах Африки, последовательное во времени и поэтапное в пространстве (по провинциям, округам, штатам, регионам стран) распространение эпидемической холеры, что свидетельствует о продолжении 7-й пандемии. Штаммы V. cholerae О1 Эль Тор, имеющие классический аллель ctx-B, распространяются в глобальном масштабе, что, наряду с вышеизложенным, определяет неблагоприятный прогноз по холере на глобальном уровне. Ключевые слова: холера, эпидемии, эндемичные территории, природные и социальные условия, измененные в геноме варианты V. cholerae O1, прогноз.
The current stage of development of the seventh pandemic of cholera in the world is characterized by a tendency to widespread, registration of outbreaks, epidemics and sporadic cases of diseases associated with drifts, including single drifts of this infection (without spreading) into Russia. The territory of Russia is one of the most water-supplied countries in the world; however, some of the rivers, such as the Volga, Ob, Amur, and Don are among the most important economic arteries, therefore just these rivers were the objects of study for this work. A comparative multivariate analysis of data from long-term monitoring studies on cholera showed that in all the studied reservoirs during the study period there was observed the isolation of cultures of Vibrio cholerae with diverse phenotypic characteristics. The data obtained allows us to tentatively assume that in Russia there are a number of areas with aquatic ecosystems, such as r. Volga, Ob, Amur, and Don, in which non-toxic cholera vibrios can survive during the summer period. In the microbiological aspect of cholera epidemiological surveillance, the accumulation of long-term data on the circulation of Vibrio cholera strains in environmental objects is important. From our point of view, the use of computer technologies (Geoinformational System) for analyzing the dynamics of the isolation of V. cholerae cultures in both spatial and temporal formats contributes to the timely determination of the direction and volume of preventive measures in each specific administrative territory of the country.
Objective of the study was to monitor the spread of cholera in the world, in the CIS countries and in Russia with an assessment of risks and emergencies that contribute to the activation of the epidemic process. Despite the downward trend in the global incidence rate of cholera during the period between 2010 and 2019, epidemics and major outbreaks occurred in 96 countries. WHO has reported 2013 imported cases of cholera to countries in Asia, the Americas, including the Caribbean, Europe, and Australia with Oceania; cholera-endemic administrative territories are identified in 24 countries. According to WHO, cholera burden reduction in Asia and Africa is associated with large-scale vaccination. During epidemiological surveillance of cholera, 705 strains of V. cholerae O1 and O139 serogroups were isolated from surface reservoirs in 26 constituent entities of the Russian Federation, including 10 strains of V. cholerae O1 ctxA+tcpA+, 35 strains of V. cholerae O1 ctxA–tcpA+, 655 strains of V. cholerae O1 ctxA–tcpA– , and five strains of V. cholerae O139 ctxA–tcpA–. Identification of strains with unique, previously unknown INDEL genotypes testifies to their imported nature. The forecast for cholera in the world for 2020, given the proven high degree of epidemic process activation at the expense of social and environmental risks caused by emergencies of different origin, the presence of endemic foci, infection import and other risk factors is unfavorable. For Russia, the forecast for cholera will be determined by the presence of external risks created by the ongoing 7-th pandemic, possible importation of infection to constituent entities of the Russian Federation that differ by the types of epidemic manifestations.
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