Epidemiological Situation of Schigеllosis in the Republic of Dagestan and Directions for Improving Epidemiological Surveillance

Abstract

Relevance. Acute intestinal infections still retain their social and medical significance in the world, with a reduction in the incidence of well-studied bacterial infections, such as salmonellosis and, especially, shigellosis.Discussion. Since 2006, the incidence of bacterial dysentery in Russia has continued to decrease, in the Republic of Dagestan it is at a high level, exceeding more than 10 times the national average. Mostly children are sick (up to 75%). Cases of shigellosis are recorded throughout the year, the seasonal increase in the incidence in the summer and autumn is associated with the activity of the main transmission pathogens – water and food. The main causes of epidemiological well-being for schigеllosis in Dagestan are determined by: poor state of the water supply system and sanitary and communal improvement of populated areas; the use of food products stored, transported and sold in the distribution network in violation of sanitary and hygienic requirements. So, in 2017 and 2018 – 67.1% and 32.69% of drinking water samples of water pipelines did not meet hygienic standards, respectively, in terms of sanitary and chemical indicators, 53.1% and 65.6% of water pipelines did not meet the requirements of sanitary legislation. The flare incidence, which is recorded annually, indicates the activity of the epidemic process of acute intestinal infections and shigellosis in the republic. The experience of various territories of the country, including those affected by adverse environmental and climatic phenomena (floods, floods, flooding), shows high efficiency along with traditional measures aimed at breaking the transmission mechanism of the pathogen, Shigellosis vaccine prophylaxis. In Dagestan, vaccination is limited, mainly in foci, where bacteriophage polyvalent dysentery S. sonnei and S. flexneri 1, 2, 3, 4, and 6 serotypes are used more widely for prevention and treatment. In this situation, the optimization of the system of epidemiological surveillance of shigellosis, which consists in improving the pre-epidemic diagnosis and epidemiological monitoring of measures aimed at each link in the epidemic process, including the creation of immunity to pathogens in individual population groups due to specific prevention, is of particular relevance to the Republic.Conclusion. The constant flare incidence of dysentery dictates the need, along with traditional measures to interrupt the transmission of the pathogen, to carry out vaccine prophylaxis more widely in risk groups. Potential sources of shigella have formed in the republic; there is a potentially high risk of the mechanism of transmission of the pathogen, as well as the population potentially susceptible to the pathogen, indicating the presence of such a danger and the need for its comprehensive study as an object of risk-oriented surveillance. Thus, the key directions in improving the surveillance of shigеllosis in the Dagestan Republic should be pre-epidemic diagnosis in a risk-based epidemiological surveillance system. The introduction of modern sensitive, specific, standardized methods of laboratory diagnostics will make it possible to effectively carry out risk-oriented epidemiological surveillance, which makes it possible to identify the transition of risk factors from potential to real, activating the epidemic process.