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The successes achieved in the fight against infectious diseases have led to the fact that until recently at the end of the 20th century it seemed as if the epidemiology of infectious diseases had largely solved the main problems facing it. It seemed that infectious diseases had been defeated. But, despite the fact that in the Russian Federation, like other economically developed countries, a significant reduction in the incidence of infectious diseases has been achieved, they continue to cause great damage to people’s health and the country’s economy.

The role of infections as a cause of child mortality and a factor in population disability is still significant; tuberculosis, polio, brucellosis affect musculoskeletal system; meningococcal infection, viral encephalitis can cause persistent lesions of the central nervous system; toxoplasmosis and rubella in pregnant women lead to intrauterine pathology of the fetus.

In recent decades, so-called endogenous infections have acquired leading importance in infectious pathology. Caused by various pathogens (coccal forms, especially strepto- and staphylococci, Escherichia coli, Proteus, Pseudomonas aeruginosa, certain fungi, etc.) dermatitis, pustular skin lesions, nasopharyngitis, otitis, conjunctivitis, colitis, appendicitis, bronchitis, bronchopneumonia, cystopyelonephritis, cholecystitis, diarrhea, as well as many forms of sepsis, are indirectly caused by factors in the technogenic environment and the lifestyle of modern humanity.

The problems of infectious pathology of the 21st century are: infections that we inherited from previous centuries (tuberculosis, malaria, leishmaniasis, syphilis, etc.) and to this it must be added that new, previously unknown “new infections” are being discovered, or rather newly identified infections that have become known in recent decades (more than 30): HIV infection, Lyme disease, legionellosis, ehrlichiosis, enterotoxigenic and enterohemorrhagic escherichiosis, Lassa, Ebola, Marburg viral fevers, human papillomavirus infection, etc., hepatitis E, C, D, F and G campylobacteriosis, hantavirus pulmonary syndrome.

The current evolution of the infectious process is:

●increase in the proportion of atypical, protracted and chronic forms of infectious diseases (pathogen resistance, changes in the reactivity of the macroorganism);

●more frequent development of mixed infections;

●superinfection;

●long persistence of the pathogen;

●updating opportunistic microflora;

●nosocomial (nosocomial) infections;

●increased frequency of mycoses;

●increasing role of infection in various areas of clinical medicine (surgery, gastroenterology, cardiology, urology, gynecology, etc.).

Thus, humanity in the fight against infectious diseases has not achieved the goal of eliminating infections, but, on the contrary, the range of tasks facing humanity is constantly expanding. This is due not only to the sharp changes in the socio-economic living conditions of the population that occurred in last years, urbanization, huge migration of people, pollution of the biosphere, etc., but also with the increase in infectious morbidity, as well as with the expansion of the number of nosological forms of infections deciphered in Lately thanks to scientific advances, as well as the rapid evolution of increasing pathogenicity and virulence of opportunistic pathogens.

Infection (from Latin infectio - pollution, infection)- penetration of pathogenic microorganisms into the body and the emergence of a complex set of processes of interaction between the organism (macroorganism) and the pathogen (microorganism) under certain conditions of the external and social environment, including dynamically developing pathological, protective-adaptive, compensatory reactions (united under the name “infectious process”) ,

Infectious process is a complex of mutual adaptive reactions to the introduction and reproduction of a pathogenic microorganism in a macroorganism, aimed at restoring disturbed homeostasis and biological balance with the environment.

The modern definition of an infectious process includes the interaction of three main factors - the pathogen, the macroorganism and environment, each of which can have a significant impact on its outcome.

The infectious process can manifest itself at all levels of organization of a biological system (human body) - submolecular, subcellular, cellular, tissue, organ, organismal and constitutes the essence of an infectious disease. An infectious disease itself is a particular manifestation of an infectious process, an extreme degree of its development. An example of a latent infectious process is the process that occurs as a result of vaccination.

Infectious diseases- a large group of human diseases caused by pathogenic viruses, bacteria (including rickettsia and chlamydia) and protozoa. The essence of infectious diseases is that they develop as a result of the interaction of two independent biosystems - a macroorganism and a microorganism, each of which has its own biological activity.

Risk factors contributing to the development of infectious diseases:

Wars; social, economic disasters; disturbances of ecological balance, natural disasters, catastrophes; hunger, poverty, beggary, homelessness. Their main companions are a sharp decrease in protective systems, weakening of the body, lice, typhus, plague, typhoid fever, etc.;

Moral, mental trauma, stress;

Severe long-term, debilitating illnesses;

Poor living conditions, backbreaking physical labor; insufficient, poor quality, irregular nutrition; hypothermia, overheating, accompanied by a sharp weakening of the body, especially its immune system;

Failure to comply with, violation of personal hygiene rules;

Violation of hygiene of home and office premises; poor living conditions, overcrowding;

Failure to seek medical help or untimely, poor quality medical care;

Use for drinking, as well as when washing with low-quality water;

Consumption of food contaminated with pathogens of infectious diseases:

Refusal of vaccinations;

Alcoholism, drug addiction, promiscuous sex life.

Infectious diseases have a number of features that distinguish them from non-communicable diseases. Some of these features include:

Contagiousness is the ability of a causative agent of an infectious disease to be transmitted from an infected organism to healthy ones. To characterize the degree of contagiousness, the contagiousness index is determined, i.e. the percentage of sick people out of the total number of susceptible persons exposed to the risk of infection. For example, measles is a highly contagious disease, with a contagiousness index of 95-100%;

Specificity - each pathogenic microorganism causes a disease characterized by a specific localization of the process and the nature of the lesion;

Cyclicity - a change of periods of the disease, strictly following each other: incubation period → prodromal period → height of the disease → convalescence;

Reactions of an infected organism to a microorganism - during the development of the infectious process, the macroorganism reacts as a single whole, as a result of which patients exhibit systemic reactions of the entire organism (cardiovascular, nervous, digestive, endocrine, urinary systems, etc.), and not just reactions of the affected organ or systems;

Formation of specific immunity - during the development of the infectious process, the formation of specific immunity occurs, the intensity and duration of which can vary from several months to several years and even decades. The usefulness of the emerging specific immunity determines the cyclical nature of the infectious process. With weak immunity, exacerbations and relapses of the infectious disease may develop;

The condition necessary for the development of the infectious process is the presence of the microbe itself - the pathogen, a susceptible organism and certain environmental factors under which their interaction occurs. The pathogen must have certain qualitative and quantitative characteristics necessary for the occurrence of an infectious process. Qualitative characteristics include pathogenicity and virulence.

Pathogenicity (pathogenicity) is understood as a species-specific multifactorial characteristic that characterizes the potential ability of a microbe to cause an infectious process. Despite the fact that pathogenicity is a genetically determined trait, it can change under different conditions.

The most important factors of pathogenicity are invasiveness and toxigenicity. Invasiveness refers to the ability of a pathogen to penetrate through the skin and mucous membranes into the internal environment of a macroorganism, with subsequent possible spread to organs and tissues. Toxigenicity is the ability of microbes to produce toxins. To determine the degree of pathogenicity, a concept such as “virulence” is used, which is an individual characteristic of any pathogenic strain. Depending on the severity of this trait, all strains can be divided into highly, moderately, weakly and avirulent. Quantitatively, the virulence of a microorganism strain can be expressed in lethal and infectious doses determined in experimental animals. The higher the virulence of the strain, the lower should be the infectious dose, which is the number of viable microbes that can cause the development of an infectious process in the host’s body.

The main characteristics of the macroorganism that influence the development of the infectious process are resistance and susceptibility.

Resistance is understood as a state of stability, which is determined by nonspecific defense factors. Susceptibility is the ability of a macroorganism to respond to infection by developing an infectious process. The human population is heterogeneous in resistance and susceptibility to various pathogenic microbes. The same pathogen with the same infectious dose can cause forms of the disease of varying severity - from the mildest to the extremely severe and fulminant with death.

An epidemiological process is a set of successive cases of an infectious disease, the continuity and regularity of which is supported by the presence of a source of infection, transmission factors and the susceptibility of the population.

Thus, this process consists of three parts:

1) source of infection;

2) the mechanism of transmission of pathogens of infectious diseases;

3) sensitivity of the population.

Without these links, new cases of infection with infectious diseases cannot arise. The absence of any of the spreading factors leads to breaking the chain of the epidemic process and stopping the further spread of the corresponding diseases.

A prerequisite for the development of the epidemic process is the continuous interaction of its three component parts:

1) source of infection;

2) mechanism(s) of pathogen transmission;

3) susceptible macroorganism.

The absence or elimination of any of these links leads to the elimination of the development of the epidemic process and to the cessation of the spread of the infectious disease.

The source of infection is an infected (patient or carrier) human or animal organism (an object that serves as a place of natural residence and reproduction of pathogens and from which the pathogen can infect healthy people in one way or another).

Sources of infection

A person is a patient or a carrier (end of the incubation period; prodrome; height of the disease; convalescence while the pathogen continues to be excreted) - anthroponosis. A sick person is contagious - at the end of the incubation period and prodrome (intestinal infections, viral hepatitis, measles), at the height of the disease (almost all infections, but the epidemiological danger in this period is less, since patients are usually in a hospital - hence the need for hospitalization or at least isolation infectious patients), in convalescence (while the pathogen continues to be isolated from the body, a control bacteriological examination is necessary). It is also possible to form a carrier state - transient (a healthy person “passed” the pathogen through his body in transit, for example, with dysentery, salmonellosis - through gastrointestinal tract without any reaction), convalescent (usually short-term - days, rarely weeks), chronic (sometimes lifelong).

Animals (domestic, wild) - zoonosis. Animals - domestic and wild - can be sources of zoonoses - rabies, anthrax. Rats play a significant role, transmitting about 20 infectious diseases, including plague, leptospirosis, sodoku, etc.

Saprozoonoses (the causative agents of anthrax, leptospirosis, yersiniosis, etc.) are transitional forms that have features of both zoonoses and sapronoses.

Some pathogenic microbes can live in two reservoirs, which is characteristic of transitional forms. In these cases, such microbes should be classified according to the main (leading) reservoir.

The next link in the epidemic process is the transmission mechanism. The mechanism of transmission of infection is the way the pathogen moves from the source of infection to a susceptible organism. In various infectious diseases, the transfer of a pathogen from one organism to another occurs in completely different ways, since each pathogen has adapted to a specific transmission mechanism inherent only to it.

This mechanism consists of three phases, following one after another: release of the pathogen into the environment→stay of the pathogen on environmental objects→introduction of the pathogen into a susceptible organism.

Pathogens of infectious diseases are released into the environment with varying intensity depending on the stage, period of development of the disease and its form. In fact, the release of the pathogen can occur at any period of the disease and depends on the nature of the pathology and the developing immune response.

It should be remembered that in many infectious diseases, isolation of the pathogen can occur already at the end of the incubation period. Such release of the pathogen is quite dangerous for others, since the sick person does not yet have signs of the disease and, while maintaining his social activity, contributes to the wide spread of the pathogen. However, most intense release introduction of the pathogen into the environment occurs during the height of the disease.

Bacteria carriers, which are clinically healthy people who release pathogens of infectious diseases into the environment, are of exceptional epidemic importance as a source of infection.

In zoonoses, the reservoir and source of infection are, as mentioned above, animals. Isolation of the pathogen also occurs through those organs and tissues in which the pathogen is predominantly located, however, the industrial and agricultural use of many animals contributes to changing and expanding the possibilities of human infection (consumption of contaminated meat, milk, eggs, cheese, contact with infected wool, etc. ).

With sapronoses, the release of pathogens does not occur, since they live autonomously on abiotic environmental objects and do not require the epidemic process as such.

The possibility and duration of a pathogen's presence in the environment are determined by its properties. For example, the causative agents of measles, influenza and meningococcal infection cannot survive for a long time on environmental objects, since they die quite quickly (within a few minutes). The causative agents of shigellosis can survive on environmental objects for several days, and the causative agents of botulism and anthrax persist in the soil for decades. It is this phase - the phase of the presence of the pathogen on environmental objects - that should be used to carry out anti-epidemic measures in order to interrupt the epidemic process.

Direct entry or introduction of the pathogen into a susceptible organism can occur in various ways, which are divided into fecal-oral, aerogenic (respiratory), contact, blood (transmissible) and vertical. These transmission methods are the pathogen transmission mechanisms.

Characteristics of the mechanisms and routes of transmission of the pathogen in various infectious diseases

Transmission mechanism	Transmission path	Transfer factor
Fecal-oral	Alimentary (food)
	Contact-household	Dishes, household items, dirty hands, etc.
Aerogenic (respiratory)	Airborne
	Airborne dust
Transmissible (blood)	Bloodsucking bites	Blood-sucking arthropods
	Parenteral	Blood, blood products Syringes, surgical tool
Contact
	Contact-sexual	Secretion of glands, presence of blood components
Vertical	Transplacental
	Through breast milk

As a rule, the transmission (or transfer) of a pathogen from a sick organism to a healthy one is mediated by various elements of the external environment, which are called transmission factors. These include food products, water, soil, air, dust, care and environmental items, arthropods, etc. Only in some cases is it possible to directly transmit a pathogen from a sick organism to a healthy one through direct contact. Specific elements of the external environment and (or) their combinations that ensure the transfer of the pathogen under certain conditions are called the transmission route.

The last element of the epidemic process is the susceptible organism. The role of this element in the development of the infectious process is no less important than the previous two. In this case, both individual and collective sensitivity of a person can be important. In response to the introduction of an infectious agent, the body reacts with the formation of protective reactions aimed at limiting and completely freeing the body from the pathogen and also at restoring the impaired functions of the affected organs and systems.

The outcome of the interaction depends on a number of conditions:

●state of local protection (intact skin covering, mucous membranes, state of microflora);

●functioning of specific and nonspecific protective factors (state of immunity, production of protective substances);

●the number of microbes that have penetrated, the degree of their pathogenicity, the state of the human nervous and endocrine systems, age, and nutrition are important.

Thus, the condition of the human body, especially its immune system, is decisive in the occurrence of the disease.

Immunity- a method of protecting the body from living bodies and substances that carry signs of genetically foreign information (including microorganisms, foreign cells, tissues or genetically changed own cells, including tumor cells).

Central organs of immunity - thymus gland (thymus), red Bone marrow. Peripheral organs - spleen, lymph nodes, accumulations of lymphoid tissue in the intestine (Peyer's patches).

Functions of the immune system: recognition of foreign agents (foreign antigens) with subsequent response consisting in neutralization, destruction and removal of them from the human body

Types of immunity:

Innate immunity- a hereditarily fixed system of protection of multicellular organisms from pathogenic and non-pathogenic microorganisms, as well as endogenous products of tissue destruction.

Acquired immunity- this is a specific individual immunity, i.e. it is an immunity that exists specifically in certain individuals and to certain pathogens or agents.

Acquired is divided into natural and artificial, and each of them into active and passive and, in turn, active is divided into sterile and non-sterile.

Acquired immunity for most infections is temporary, short-term, and for some of them it can be lifelong (measles, mumps, rubella, etc.). It is acquired naturally after an illness or as a result of immunoprophylaxis specific person and is caused by specific cellular and humoral factors (phagocytosis, antibodies) or cellular arereactivity only to a specific pathogen and toxin.

If immunity is acquired naturally during life, it is called natural, if artificially, as a result of medical manipulation, then it is called artificial immunity. In turn, each of them is divided into active and passive. Active immunity is called because it is produced by the body itself as a result of exposure to antigens, pathogens, etc. Natural active immunity is also called post-infectious immunity and it is produced in the human body after exposure to pathogens, i.e. as a result of illness or infection.

Artificial active immunity is also called post-vaccination immunity and it is developed after the administration of vaccines or toxoids.

Finally, active immunity, natural and artificial, is divided into sterile and non-sterile. If, after suffering an illness, the body has gotten rid of the pathogen, then the immunity is called sterile (measles, rubella, mumps, smallpox, diphtheria, etc.). If the pathogen does not die and remains in the body, immunity is called non-sterile. More often, this option is formed during chronic infections (tuberculosis, brucellosis, syphilis and some others). Thus, with tuberculosis, often after infection, a Gon focus forms in the body and mycobacteria in the body can persist for life, creating non-sterile immunity. Once the pathogen disappears from the body, immunity also disappears after a certain period of time. Often, non-sterile immunity is observed in rickettsial and viral infections (typhus, herpes, adenoviral infection, etc.).

Active immunity is developed slowly within 2-8 weeks. In terms of the rate of development of the required intensity of immunity to the same antigen, people are heterogeneous, and this heterogeneity is expressed using the formulas and curves of the normal Gaussian distribution. All people can be divided into several groups according to the speed of development of sufficiently high immunity: from very fast development within a period of 2 weeks to very slow development - up to 8 weeks or more. Active immunity, although it is developed slowly, remains in the body for a long time. Depending on the type of infection, this immunity can last for several months, within 1 year (cholera, plague, brucellosis, anthrax, etc.), several years (tularemia, smallpox, tuberculosis, diphtheria, tetanus, etc.) and even for life (measles , mumps, rubella, scarlet fever, etc.). Therefore, active artificial immunization is resorted to during planned specific immunoprophylaxis, regardless of the presence of diseases in accordance with the directives of the Ministry of Health and local health authorities (orders, guidelines, instructions).

Passive immunity is called because antibodies are not produced in the body themselves, but are acquired by the body from the outside. With natural passive immunity, antibodies are transferred to the child from the mother transplacentally or with milk, and with artificial immunity, antibodies are administered to people parenterally in the form of immune serums, plasma or immunoglobulins. Passive immunity in the body occurs very quickly: from 2-3 to 24 hours, but does not last long - up to 2-8 weeks. The rate at which passive immunity occurs depends on the method of introducing antibodies into the body. If immune serum or immunoglobulin is injected into the blood, the body will rebuild itself in 2-4 hours. If antibodies are administered intramuscularly, then it takes up to 6-8 hours for them to be absorbed and enter the blood, and if administered subcutaneously, immunity will arise within 20-24 hours.

However, no matter how the antibodies enter the body (intravenously, intramuscularly or subcutaneously), passive immunity will arise in the body much faster than active immunity. Therefore, artificial passive immunization is necessarily resorted to for the treatment of diphtheria, tetanus, botulism, gas gangrene, anthrax and some other infections, for bites of snakes and other poisonous living creatures, as well as for prevention for epidemic indications: when there is a threat of infection (influenza), contact in foci of anthrax, botulism, measles, influenza and others, with animal bites for the prevention of rabies, for emergency prevention of tetanus, gas gangrene and some other infections. Acquired (adaptive) immunity - is formed during life under the influence of antigenic stimulation.

Innate and acquired immunity are two interacting parts of the immune system that ensure the development of an immune response to genetically foreign substances.

Factors influencing the development of the epidemic process

Social factors that influence the development of the epidemic process include: economic; sanitary and communal improvement; level of development of the healthcare system; nutritional features; working and living conditions; national and religious customs; wars; population migration; natural disasters. Social factors have great importance For the development of the epidemic process, they can cause the spread of infectious diseases or, conversely, reduce the incidence.

Environmental factors (physical, chemical, biological) can also influence the development of the infectious process, but they play only an indirect role, influencing both the macroorganism and the microbes. In particular, their effect on the macroorganism can lead to both an increase and a decrease in the resistance of the macroorganism, and the effect on microbes can be accompanied by an increase or decrease in their virulence. In addition, environmental factors can contribute to the activation and emergence of new mechanisms and routes of transmission of pathogens of infectious diseases, which is important in the epidemic process. Ultimately, the influence of environmental factors may be reflected in the level of infectious morbidity in certain zones and regions.

The course of the epidemic process is also influenced by the forms of interaction between living beings (microbial competition, confrontation between microorganisms and protozoa, etc.).

Prevention of infectious diseases and measures to combat them

Measures for the prevention of infectious diseases can be divided into two large groups - general and special.

1. General measures include government measures aimed at increasing material well-being, improving medical care, working and rest conditions of the population, as well as sanitary-technical, agroforestry, hydraulic engineering and land reclamation measures, rational planning and development of settlements and much more, which contributes to the success of prevention and the elimination of infectious diseases.

2. Special are preventive measures carried out by specialists of treatment-and-prophylactic and sanitary-epidemiological institutions. The implementation of these activities, along with health authorities, often involves other ministries and departments, as well as the general public. For example, government authorities take part in the prevention of zoonotic diseases (glanders, foot and mouth disease, brucellosis, anthrax, etc.) agriculture, veterinary service, leather and wool processing enterprises. Planning preventive measures and control over their implementation is carried out by health authorities. The system of preventive measures also includes international measures when it comes to especially dangerous (quarantine) infections.

The content and scale of preventive measures may vary depending on the characteristics of the infection, the affected population and the nature of the object. They can relate directly to the source of infection or concern an entire district, city, region. Success in organizing and carrying out preventive measures against infectious diseases depends on the thoroughness of the examination of the observed object.

For the development of the epidemic process, the presence of three main links is necessary ev:

1. Source of infection.

2. Mechanism of transmission of infection.

3.Susceptible population.

The absence (or rupture) of any of them leads to the cessation of the epidemic process.

When planning and carrying out preventive measures, it is theoretically and practically justified to divide them into three groups:

1.Measures regarding the source of infection, aimed at its neutralization (or elimination).

2.Measures regarding the transmission mechanism, carried out with the aim of breaking transmission routes.

3.Measures to increase the immunity of the population.

According to this epidemiological triad, three groups of preventive (anti-epidemic) measures are distinguished.

Impact on the first link of the epidemiological process - the source of infection

An essential role is played by preventive measures aimed at the source of infection, which in anthroponotic diseases is a human patient or pathogen excretor, and in zoonotic diseases - infected animals.

Anthroponoses. This group of preventive measures for anthroponoses includes diagnostic, isolation, therapeutic and regime-restrictive measures. Active and complete identification of patients is carried out on the basis of comprehensive diagnostics, including clinical, anamnestic, laboratory and instrumental studies. For some infections (particularly dangerous infections, typhoid fever, viral hepatitis B, etc.), hospitalization of identified patients is mandatory, for others (dysentery, escherichiosis, measles, chicken pox, etc.) - in the absence of epidemiological and clinical contraindications, isolation of patients at home is allowed .

The complex of regime measures includes, occupying important place, disinfection of dishes, linen, premises and instruments. Rational complex therapy of hospitalized patients is also one of the preventive measures against infectious diseases.

Patients are discharged from the hospital after complete clinical recovery and after a period specified for each infection has passed, excluding the possibility of infection. If the disease is characterized by bacterial carriage, then convalescent drugs are prescribed only upon receipt of negative results of bacteriological examination.

Active identification of bacterial excretors and their sanitation is one of the important preventive measures. Identification of bacterial excretors is carried out at the source of infection, among convalescents upon discharge and in the long term after it, as well as among persons of decreed professions (food department, waterworks, children's institutions). Identified bacteria excretors are temporarily suspended from work, registered and routinely carried out a bacteriological examination.

Regime-restrictive measures. To prevent the further spread of infectious diseases that have arisen in the team, regime-restrictive measures taken in relation to persons who have been in contact with patients and are at risk of infection are used. Contact persons should be considered as a potential source of infection, since they may be infected and in the incubation period or be shedding pathogens. The content of regime-restrictive measures depends on the nature of the infection, the professional background of contact persons, etc. They include medical observation, separation and isolation.

Medical observation is carried out for a period determined by the maximum duration of the incubation period for a given disease. It includes a survey, examination, thermometry and laboratory examination of contact persons. Medical observation makes it possible to identify the first symptoms of the disease and promptly isolate patients.

Disunion. Children attending institutions, or adults working in child care institutions, and in some cases in food enterprises (for example, contacts of typhoid fever), are subject to separation, i.e. they are prohibited from visiting the institutions where they work for the period established by the instructions for each infectious disease.

Insulation. In case of particularly dangerous infections (plague, cholera), all those in contact with patients are subject to isolation and medical observation in an isolation ward. This event is called observation and is integral part quarantine measures carried out for these diseases. The duration of isolation corresponds to the incubation period - 6 days for plague, 5 days for cholera. In those historical times, when the incubation periods were not yet known, the isolation of contact persons during the plague and some other infections lasted 40 days, hence the name “quarantine” (Italian: quarantena, qaranta giorni - 40 days).

Measures for sanitary protection of the country's territory, carried out by sanitary-epidemiological and specialized anti-epidemic institutions stationed in sea and river ports, airports, highways and railways are also of great importance. The scope of activities and the procedure for their implementation are determined by the “Rules for sanitary protection of the territory” of our country, the drafting of which takes into account the requirements of the “International Sanitary Rules” adopted by WHO.

Infections of international concern are divided into two groups: diseases subject to regulations (plague, cholera, yellow fever and smallpox) and diseases subject to international surveillance (typhoid and relapsing fever, influenza, polio, malaria). WHO member countries are obliged to promptly inform this organization about all cases of diseases that are subject to health regulations, and about anti-epidemic measures taken in connection with this.

Zoonoses. Preventive measures regarding the source of infection for zoonoses have some features. If the source of infection is domestic animals, then sanitary and veterinary measures are taken to improve their health. In cases where the source of infection is synanthropic animals - rodents (mice, rats), deratization is carried out. In natural foci where the source of infection is wild animals, if necessary, their population size is reduced through extermination to a safe level that prevents human infection.

Impact on the second link of the epidemiological process - the mechanism of pathogen transmission

In the prevention of infectious diseases, the impact on the pathogen transmission mechanism is important event. The transmission of an infectious principle from a patient to a healthy person occurs through the external environment using various factors (water, food, air, dust, soil, household items), which determines the variety of preventive measures.

Currently, all preventive measures aimed at the second link of the epidemic process are divided into three main groups:

1) sanitary and hygienic;

2) disinfection;

3) disinfestation.

In case of intestinal infections with a fecal-oral mechanism of infection (typhoid fever, dysentery, cholera), the main factors of transmission of the pathogen are food and water, less often - flies, dirty hands, and household items. In the prevention of these infections, general sanitary and hygienic measures and various methods of disinfection are of greatest importance. General sanitary measures include municipal sanitary measures, food, school, industrial sanitary supervision, increasing the level of general and sanitary hygienic culture of the population.

Preventive measures affecting the transmission of infectious diseases also include disinfection, which is carried out in foci of infectious diseases, as well as in public places (stations, transport, dormitories, public toilets) regardless of the presence of an outbreak or epidemic of an infectious disease.

For infections respiratory tract(measles, rubella, diphtheria, scarlet fever, meningococcal infection, influenza, etc.) compared to intestinal infections, taking measures to suppress pathogen transmission routes is very difficult. The transmission of these infections through the air is facilitated by microbial aerosols (droplet and nuclear phases) and infected dust, therefore preventive measures include sanitizing the indoor air environment and using respirators. As for disinfection, it is almost not used for those respiratory tract infections whose pathogens are poorly resistant in the external environment (measles, chicken pox, rubella, mumps). Disinfection is carried out for scarlet fever and diphtheria.

Disinsection agents aimed at destroying pathogen carriers - blood-sucking mites and insects - are of great importance for the prevention of vector-borne infections. Collective and individual measures of protection against attacks and bites of vectors are also used.

Impact on the third link of the epidemiological process

Increasing the immunity of the population is carried out through the introduction of two areas of prevention - nonspecific and specific (immunoprophylaxis). Thanks to the systematic mass implementation of preventive vaccinations, the incidence of diphtheria, polio, whooping cough, measles, mumps and other vaccine-related infections has decreased to a sporadic level. No less important is the implementation of preventive vaccinations according to epidemic indicators, especially for the purpose of preventing rabies and tetanus, when immunoprophylaxis is the main means of preventing diseases.

Immunization (from Latin immunis - free, free from something) is a method of creating artificial immunity in people and animals. There are active and passive immunization.

Active immunization involves introducing antigens into the body. The most widespread form of active immunization is vaccination, i.e. the use of vaccines - preparations obtained from microorganisms (bacteria, rickettsia and viruses) or their metabolic products (toxins) for the specific prevention of infectious diseases among humans and animals. Active immunization is carried out by applying a drug (for example, a vaccine) to the skin, administering it intradermally, subcutaneously, intramuscularly, intraperitoneally, intravenously, orally and by inhalation. Vaccination remains a promising and cost-effective area of ​​prevention.

Characteristics of vaccines

Types of Vaccines

Live vaccines

They contain vaccine strains of infectious disease pathogens that have lost their ability to cause disease, but have retained high immunogenic properties. Live vaccines are used for immunization against polio, mumps, measles, tuberculosis, brucellosis, tularemia, anthrax, plague, typhus, yellow fever, Q fever, tick-borne encephalitis, rabies, chickenpox and other infections.

Inactivated vaccines

It is obtained by acting on pathogenic bacteria and viruses with physical (high temperature, ultraviolet, gamma irradiation) and chemical factors (phenol, formalin, merthiolate, alcohol, etc.). Used for immunization against whooping cough, typhoid fever, cholera, polio, rabies, tick-borne encephalitis and other infections.

Anatoxins

Passive immunization is carried out by introducing serums or serum fractions of the blood of immune animals and people subcutaneously, intramuscularly, and in emergency cases - intravenously. Such preparations contain ready-made antibodies that neutralize the toxin, inactivate the pathogen and prevent its spread.

Passive immunization creates short-term immunity (up to 1 month). Kneys are used to prevent the disease in case of contact with a source of infection for measles, diphtheria, tetanus, gas gangrene, plague, anthrax, influenza, etc. Seroprophylaxis or, if the disease has already developed, serotherapy to facilitate its course.

Order of the Ministry of Health of the Russian Federation (Ministry of Health of Russia) dated March 21, 2014. No. 125ng. Moscow “On approval national calendar preventive vaccinations and a calendar of preventive vaccinations for epidemic indications.”

Order of the Russian Ministry of Health

No. 125n dated March 21, 2014

ANNEX 1

National calendar of preventive vaccinations

	Name of preventive vaccination
Newborns in the first 24 hours of life	First vaccination against viral hepatitis B
Newborns at 3-7 days of life	Vaccination against tuberculosis
Children 1 month	Second vaccination against viral hepatitis B
Children 2 months	Third vaccination against viral hepatitis B (risk groups)
	First vaccination against pneumococcal infection
Children 3 months	First vaccination against diphtheria, whooping cough, tetanus
	First vaccination against polio
	First vaccination against Haemophilus influenzae (risk group)
Children 4.5 months	Second vaccination against diphtheria, whooping cough, tetanus
	Second vaccination against polio
	Second vaccination against Haemophilus influenzae infection (risk group)
	Second vaccination against pneumococcal infection
Children 6 months	Third vaccination against diphtheria, whooping cough, tetanus
	Third vaccination against viral hepatitis B
	Third vaccination against polio
	Third vaccination against Haemophilus influenzae (risk group)
Children 12 months	Vaccination against measles, rubella, mumps
	Fourth vaccination against viral hepatitis B (risk groups)
Children 15 months	Revaccination against pneumococcal infection
Children 18 months	First revaccination against diphtheria, whooping cough, tetanus
	First revaccination against polio
	Revaccination against Haemophilus influenzae infection (risk groups)
Children 20 months	Second revaccination against polio
Children 6 years old	Revaccination against measles, rubella, mumps
Children 6-7 years old	Second revaccination against diphtheria, tetanus
	Revaccination against tuberculosis
Children 14 years old	Third revaccination against diphtheria, tetanus
	Third revaccination against polio
Adults 18 years old	Revaccination against diphtheria, tetanus - every 10 years from the date of the last revaccination
Children from 1 to 18 years old, adults from 18 to 55 years old, not previously vaccinated	Vaccination against viral hepatitis B
Children from 1 to 18 years old, women from 18 to 25 years old (inclusive), not sick, not vaccinated, vaccinated once against rubella, who have no information about vaccinations against rubella	Vaccination against rubella
Children from 1 year to 18 years inclusive and adults under 35 years of age (inclusive), who have not been sick, not vaccinated, vaccinated once, and have no information about vaccinations against measles	Vaccination against measles
Children from 6 months; students in grades 1-11; students in professional educational organizations and educational organizations higher education; adults working in certain professions and positions (employees of medical and educational organizations, transport, public utilities); pregnant women; adults over 60 years old; persons subject to conscription military service; faces with chronic diseases, including lung diseases, cardiovascular diseases, metabolic disorders and obesity	Flu vaccination

SAMPLE TEST TASKS

Please indicate one correct answer

1.An epidemic process is called:

a) spread of infectious diseases among plants

b) spread of pathogens among blood-sucking vectors

c) the spread of infectious diseases in the human population

d) the state of infection of the human or animal body

2. Elimination of a particular infectious disease as a nosological form means:

a) absence of diseases

b) lack of conditions for the implementation of transfer mechanisms

c) lack of carrier status

d) elimination of the pathogen as a biological species

e) lack of susceptible persons

3.Vaccines and toxoids are intended for:

a) emergency prevention of infectious diseases

b) development of active immunity to infectious diseases

c) serological diagnosis of infectious diseases

d) treatment of infectious diseases

SITUATIONAL TASK

A 27-year-old patient, an oil refinery worker, sought help on the fifth day of illness. Complaints: severe headache, dizziness, general weakness, lack of appetite, fever, nausea, vomiting, dark urine, discolored feces.

The disease began acutely with high temperature, headache, nausea and vomiting. She treated herself for the flu, taking aspirin and arbidol. The condition worsened sharply, general weakness, headache increased, and there was vomiting several times. Called Ambulance- preliminary diagnosis of viral hepatitis.

Two months ago I underwent tooth extraction surgery. I rested in nature for 2 weeks and drank water from a reservoir.

Objectively. Temperature 37.6 °C. Intense yellowness of the skin, sclera and mucous membrane oral cavity. On the skin of the upper chest, in the area of ​​the shoulders and forearms, there are single hemorrhagic rashes measuring 1x1 cm. I had nosebleeds twice. The heart sounds are muffled, the rhythm is correct. Pulse 106 beats. per minute of satisfactory qualities. Hell 90/60mmHg. Lung vesicular respiration. The size of the liver - percussion, the lower limit is determined along the midline at the level of the costal arch, its edge is sharply painful, the upper limit is at the level of the 7th rib. The spleen is not palpable. Ortner's sign is positive.

EXERCISE

1.What epidemiological data should be obtained?

2. Possible route of infection?

3.What anti-epidemic measures need to be carried out in the outbreak?

State budgetary educational institution

Higher vocational education

"Kursk State medical University» Ministry of Health of the Russian Federation

Department of Polyclinic Therapy, Occupational Diseases and Military Field Therapy

Prevention of cardiovascular diseases in the activities of a general practitioner

Kursk-2013

UDC: 616.1 - 084 (075.8)

BBK: 54.101 i 73

Prevention of cardiovascular diseases in the activities of a general practitioner: tutorial/ed. prof. N.K. Gorshunova, Kursk. KSMU. 2013. - 40 p.

Assistant of the Department of Polyclinic Therapy, Occupational Diseases and Military Field Therapy of KSMU D.N. Ukraintseva;

Reviewer:

V.I. Vishnevsky- Head of the Department of Internal Medicine medical institute FSBEI HPE "Orlovsky" State University", Doctor of Medical Sciences Professor

The manual covers the issues of organizing the preventive work of a doctor in an outpatient clinic to reduce cardiovascular risk in patients of different ages.

The manual is intended for students of medical, medical and preventive faculties, residents, doctors of outpatient clinics, and general practitioners.

1. Relevance of the problem of prevention in everyday clinical practice

2. Concept of disease risk factors

3. The concept of total cardiovascular risk, methods for assessing it

4. Goals of cardiovascular prevention in the context of total risk

5. Strategy for correcting behavioral risk factors

6. Total cardiovascular risk and prevention of lipid metabolic disorders

7. Total cardiovascular risk and arterial hypertension

The future belongs to preventive medicine.

This science, going hand in hand with medicine,

It will bring undoubted benefit to humanity.

N.I. Pirogov.

The relevance of the problem of prevention in everyday clinical practice.

Cardiovascular diseases (CVDs) are the leading cause of death worldwide, with 17.3 million people dying from them in 2008, accounting for 30% of all deaths, of which 7.3 million were from coronary heart disease, 6. 2 million - from stroke. The high incidence of CVD is recorded in low- and middle-income countries, where they cause more than 80% of deaths, almost evenly distributed between men and women. By 2020, mortality from heart and vascular diseases is expected to increase to 25 million per year. An estimated 23.6 million people will die from CVDs in 2030. The CVD group includes coronary heart disease (CHD), cerebrovascular disease, peripheral artery disease, rheumatic heart disease, birth defects heart, deep vein thrombosis and pulmonary embolism.

In the Russian Federation, CVD is also the leading cause of death in the Russian population. In 2007 alone, more than 1 million 185 thousand people died from them, including 50% from ischemic heart disease and 34.5% from cerebrovascular disease. Mortality rates from diseases of the circulatory system in Russia are among the highest in the world, with about 40% of Russians dying in active working age.

Back in the 19th century, the great Russian scientist Nikolai Ivanovich Pirogov, who made an invaluable contribution to world science, attached special importance to “preventive medicine,” but only in the 21st century did active intervention aimed at protecting health become recognized as a strategic direction for the development of healthcare in the Russian Federation, which was proclaimed in all state legislative acts last decade and above all in Federal Law“On the fundamentals of protecting the health of citizens in the Russian Federation”, Article 12 of which defines the priority of prevention in the field of health protection and its goals:

1) development and implementation of formation programs healthy image life, including programs to reduce alcohol and tobacco consumption, prevent and combat the use of narcotic drugs and psychotropic substances;

2) implementation of sanitary and anti-epidemic preventive measures;

3) implementation of measures for the prevention and early detection of diseases, including the prevention of socially significant diseases;

4) carrying out preventive and other medical examinations, medical examinations, and clinical observation in accordance with the legislation of the Russian Federation;

5) implementation of measures to preserve the life and health of citizens in the process of their education and work in accordance with the legislation of the Russian Federation.

However, in the realities of practical healthcare, preventive recommendations are often declarative in nature, turning into stencil entries in outpatient cards or into unmotivating phrases: “Stop smoking”, “You need to lose weight and eat right”, “Move more”, etc. How then in routine In the work of a primary care physician, it is unspoken to apply a prevention strategy; what “tools” should a doctor of first contact with a patient be able to use in order to make preventive recommendations work and evaluate their results?

annotation

This article is devoted to the study of such a phenomenon in the school environment as bullying among teenagers. It examines the phenomenon of school violence and identifies its main types. The article identified the relevance and features of the problem of preventing school violence among adolescent students.

Keywords: school violence, bullying, mobbing, harassment, bullying, counteraction mechanisms.

Introduction. School violence is addressed in modern world how serious social problem. The scientific description of the problem of violence against children in schools has different interpretations and is difficult due to the ambiguity of terminology. The category “school violence” itself has many faces and is more modern approaches This concept includes a whole range of behavioral phenomena. Thus, school violence is understood as “the infliction of any harm (physical, moral, psychological, ideological, etc.) or any form of coercion against a student, teacher or group of schoolchildren, as well as management educational institution". The need for practical developments and specific non-violent technologies in the educational sphere is increasing, which indicates high level interest in the problem under consideration.

Various aspects of the formation of a nonviolent educational environment in modern conditions have been studied both foreign (A. Guggenthal, D. Olweus, etc.) and domestic (E.N. Volkova, N.O. Zinovyeva, T.N. Mertsalova, V.P. Ustinov, M.V. Smagina and others) scientists. Their works examine such aspects of the problem of school violence as the development of its conceptual apparatus, the identification of varieties and forms of school violence, and mechanisms to counter it.

In the course of this work, such methods of scientific and pedagogical research were used as: analysis of psychological and pedagogical works on the research problem; method of comparative analysis, modeling, thought experiment and diagnostic (questioning, interviewing) methods. The purpose of the study is to assess the current situation and identify the main trends in the problem of violence against children at school.

Main part. I.S. Cohn defined school bullying as intimidation, physical or psychological terror aimed at causing fear in another and thereby subjugating him. Aggressive behavior has its own age, sex (gender) and other psychological patterns.

In 1969 P.-P. Heymann first introduced the term “mobbing” into psychological and pedagogical literature. This term was borrowed from ethology, where it denoted group aggression in animals. Works by P.-P. Heymann helped to understand the mechanism of bullying and identify “mobbing” as only one of the subtypes of aggression. In 1973, Norwegian psychologist Dan Olweus introduced the concept of “bullying,” which became significant in subsequent research work on the topic of school violence around the world. D. Olweus later defined “bullying” as long-term repeated negative actions of one aggressor aimed at one person, while mobbing is a long-term negative impact of a group of people on the victim.

Humiliation, extortion, insults, threats, and rejection by classmates occur outside the walls of schools around the world. According to the first large-scale studies conducted by D. Olweus, which involved approximately 568,000 Norwegian students, one seventh of the students surveyed (autumn 1983) had been bullied by their classmates or had themselves been victims of childhood bullying (Olweus, 1987, 1991, 1993 a). Of these, approximately one-ninth were victims and one-tenth were aggressors and regularly bullied their classmates.

On the territory of the constituent entities of the Russian Federation, there are also local and regional statistics of various psychological and pedagogical studies of the phenomenon of school violence conducted by domestic specialists. So, N.A. Khvylya-Olinter, based on a representative study in Moscow schools, found that only three quarters of students out of 1,500 children were never humiliated or insulted, but every third child was rudely pulled back or ridiculed in front of the whole class.

For criminological diagnostics of the scale of school violence in the Voronezh region, an anonymous online survey of 200 schoolchildren was conducted. Analysis of the responses allowed us to draw the following conclusions: half of the schoolchildren surveyed witnessed violent acts of a physical nature in school time; five respondents admitted that they sometimes took money or things from other students; a third of respondents faced threats; more than a quarter of schoolchildren report instances of ridicule and insults based on nationality or religion; every tenth student experiences a feeling of insecurity while at school; finally, 10 respondents encountered cases of forced sexual relations.

In an anonymous survey conducted by A.I. Averyanov revealed the fact that 91% of respondents were aware of and constantly encountered the phenomenon of violence at school. Half of the students themselves participated in bullying their classmates. When asked about the reasons for bullying, about half of the survey participants named appearance, one-seventh said behavior, one-ninth said nationality, and 8% said financial situation. He came to the conclusion that children more often show intolerance to various kinds of differences. Speaking about forms of school bullying, students ranked fighting (44%) in first place, followed by gossip (39%), boycott (31%), insults (13%) and ridicule (11%).

Foreign researchers distinguish two types of school bullying: direct, where physical beatings are directly inflicted on the victim, and indirect, which includes the spread of negative gossip, cyberbullying, emotional manipulation of a person, as well as social isolation of the victim, which is otherwise called social aggression.

To identify the state of the problem of violence against children in school, in March 2016, we conducted a survey, the basis of which was the schools of MBOU "Boarding Lyceum No. 79", MBOU "Secondary School No. 58" in Naberezhnye Chelny, MBOU "Secondary School No. 4" in Naberezhnye Chelny. Elabuga RT. To achieve the purpose of the study, a questionnaire survey of schoolchildren aged 13 years and older was used. The number of students surveyed was 120.

The survey revealed that for modern teenagers The use of mental types of violence is more typical. In first place are ridicule and ridicule of children in front of the class (78.8%). Thus, 63.3% of the children surveyed admitted to regular frequency of ridicule. One quarter of respondents complained of insults based on clothing, belongings and place of residence, and 56% of students made fun of their peers because of mental or physical disabilities. A large percentage of fights were identified due to reactions to offensive name calling (53.3%). Humiliation and insults of children account for (13.3%). Five of all respondents saw one of the students extorting things from another.

According to the students surveyed, teachers are characterized by a biased attitude towards children and groundless lowering of grades (rarely - 18.4%, often and very often - 20.7%). 80% of students feel safe at school.

Thus, the most common forms of violence between schoolchildren are both negative psychological impact and infliction of physical pain. It should be taken into account that official statistics are not able to fully cover all types of school violence, its regularity and the level of damage caused, since facts of child abuse are usually hidden and hushed up, and violent acts of a psychological nature almost never appear in Russian statistics.

The problem of school bullying is relevant in any educational institution. Incidents of school violence affect the overall classroom environment, student well-being, and student performance. As a result, the process of preventing school violence is considered key in the organization of educational activities.

The developments of foreign and domestic scientists have identified the consequences of the violence suffered. T.G. Volkova found that, regardless of the types of violence suffered, children and adolescents experience various psychosomatic reactions, for example, a decrease in the need to communicate with peers and family, a decrease in the level of self-esteem, and subjective self-control. She revealed a natural increase in the level of suspicion and subordination in interpersonal relationships after experiencing a violent act and the fact of post-traumatic syndrome of lack of identification with school.

According to T.V. Kropaleva, the most dangerous consequence of school violence is the increasing recklessness and criminalization of behavior, as a result of which adolescents develop anxiety and suspicion, and the level of intelligence and communicative competencies decreases. Subsequently, the risk of antisocial behavior in schoolchildren may increase many times over.

D. Olweus believes that child bullying entails Negative consequences not only for the victim, but also for the persecutor. The consequences of bullying affect well-being immediately and subsequently, which is due to psychological defenses. He found that adults who experienced abusive school relationships were more likely to be depressed and had problems with assertiveness and self-esteem. Moreover, if victims of school violence were persecuted and adult life, they themselves began to show aggressive character traits in the future. Thus, in psychiatry there are examples of pathological and destructive introjection “identification with the aggressor” (A. Freud, 1936). As a result of direct observations in natural settings (Bettelheim, 1960), and empirical research (Milgram, 1963), it became known that in situations of fear or abuse, people try to master their fear and suffering by adopting the characteristics of the tormentors. Understanding this mechanism is critically important for the process of preventing and preventing violence against children at school, since this mechanism manifests itself especially clearly when the child has a characterological predisposition to sadism.

Foreign studies regularly describe school incidents of varying degrees of violence. Similar cases of school harassment have been identified, witnessed and studied in countries around the world. For example, in Australia, 1 in 6 children are bullied or bullied by their peers on a weekly basis (Rigby, 2002). According to an analysis of the results of an experiment conducted in the United States, every respondent was injured at least once during his entire education, and the level of aggression among adolescents reaches the “extreme” mark.

Different kinds aggression, school bullying and intimidation of classmates indicate unhealthy development of children and adolescents. These processes are precursors to more severe behavior in the future. In addition, a significant correlation was found between bullying and subsequent manifestations of child cruelty in aggressors, which proportionally increases away from schools, in places outside the control of adults. Experts say that strict adherence to all measures to prevent school violence among students gradually reduces the level of children's aggression in the classroom, fosters a sense of empathy in the child, strengthens the school atmosphere, and increases the degree of student trust in each other.

Conclusion. To successfully prevent school violence, it is necessary to take into account different levels of exposure to violence, not only interpersonal (horizontal), but also vertical, as well as family and community levels. Over the past 30 years, despite the growing interest of international research in the topic of school bullying, the question of an effective process for preventing educational violence remains open. Much remains unknown about assessing, measuring, developing, and implementing effective bullying prevention programs among schoolchildren. The development of measures to prevent school violence among students remains one of the most pressing problems that concerns the further development of the education system in Russia. Schools need to develop after-school programs educational work aimed at the full development of the younger generation.

Bibliography:

1. Aavik H. Prevention of deviant behavior in adolescents // World of Science and Education. – 2011. - No. 11. – P. 110-113.
2. Aaker D. School research. - M.: Peter, 2004. - 840 p.
3. Abaev V.I. Countering school bullying // First of September. – 2006. - No. 14.- P. 16-21.
4. Averyanov A.I. School bullying as a problem in the activities of a social teacher // Social and pedagogical support of a child in the process of socialization: Materials of the Russian scientific and practical conference (November 6, 2008, Moscow). – M., 2008. – P.180-182.
5. Volkova T.G. Peculiarities of the “I” image of a person who considers himself to have experienced violence: dis. ...cand. psychol. Sci. – Barnaul: Altai State. univ., 2004. – 271 p.
6. Kon I.S. What is bullying and how to fight it // Family and school. – 2006. – No. 11. – P. 15-18.
7. Kropaleva T.N. The role of violence in the genesis of unlawful behavior of adolescents: dis. ...cand. psychol. Sci. – M.: University Russian Academy Education, 2004. – 130 p.
8. McWilliams N. Psychoanalytic diagnostics. Understanding personality structure in the clinical process. - M.: Class, 2015. – 592 p.
9. Soloviev V.S. Criminological diagnostics of the scale of school violence (based on an anonymous Internet survey of schoolchildren) // Vestnik VSU. – 2014. – No. 4. – P. 220-231.
10. Khvylya-Olinter N.A. The problem of violence against children in the assessments of Moscow schoolchildren // Historical and social-educational thought. – 2012. – No. 1. – P. 143-147.

MINISTRY OF HEALTH OF THE REPUBLIC OF BELARUS

EDUCATIONAL INSTITUTION "GOMEL STATE MEDICAL UNIVERSITY"

Department of General Hygiene, Ecology and Radiation Medicine

N.V. Kartasheva, L.P. Mamchits, S.V. Klimovich

Topic: “Prevention. Medical prevention, its importance in maintaining health"

Educational and methodological manual

on “General Hygiene” for 2nd year students of medical, medical-diagnostic and faculty of training specialists for foreign countries

Gomel,

GomSMU

Prevention. Medical prevention, its importance in maintaining health

Lesson time – 4 hours

Motivational characteristics of the topic

Human health constitutes the economic potential of a country. Medical prevention belongs to socio-economic, hygienic, sanitary and anti-epidemic, immunoprophylactic, family and household, individual and personal categories. Disease prevention, ensuring the healthy development of the younger generation, preventing diseases from environmental factors, and the development of occupational pathology are priority areas of healthcare. Prevention is based on medical examinations, medical examinations, information and educational work and hygienic education of the population. At the present stage of development of medicine, such a direction in healthcare as managing the health of the population on the basis of preventive measures at the public level is becoming relevant: flu prevention days; ARI; STI infections; HIV; dental diseases; tuberculosis; alcoholism; drug addiction; days of health, healthy nutrition for schoolchildren and others.

Medical workers and the public take an active part in preventive measures with the population, which helps to increase people's awareness of their health and the formation of a healthy lifestyle.

Purpose of the lesson: Familiarize yourself with the types of medical prevention and its importance in maintaining public health.

Tasks:

1. Understand the definition of medical prevention and its role in the system of hygienic measures;

2. Understand the importance of prenosological diagnostics in the primary prevention of premorbid conditions;

3. Learn to develop primary prevention measures in lifestyle and lifestyle;

4. Develop preventive measures for personal hygiene, water consumption, movement, and nutrition.

Requirements for the initial level of knowledge of students

To master the topic, you must repeat:

Chemical factors, their metabolism in the body;

Physical factors, their physical characteristics;

Biological factors, immunity.

Test questions from related disciplines.

1. Temperature, humidity, air mobility, thermoregulation.

2. Barometric pressure.

3. Classification chemical substances, their toxicity.

4. Characteristics of microorganisms.

5. Immunity.

Test questions on the topic of the lesson

1. Definition of the concept of medical prevention

2. Primary medical prevention, its role in maintaining health

3. Hygiene measures in primary prevention

4. Secondary prevention in the system of hygienic measures

5. The importance of tertiary prevention in maintaining social status

6. Prenosological diagnostics in the prevention of premorbid conditions

7. The role of personal hygiene in primary disease prevention

8. The role of nutrition in the prevention of health problems

Educational material

Prevention (Greek prophylaktikos) precautionary, precautionary is a system of government, social, hygienic and medical measures aimed at ensuring a high level of health and preventing diseases. Prevention is the leading branch of medicine. The level of prevention in the country reflects the nature of the socio-economic, scientific and technical conditions of society.

Prevention appeared in the search for ways, means and methods of protection from diseases, accidents in the form of individual and personal hygiene, primarily from mass diseases of the population. Physical methods were used as preventive measures (burning animal corpses, clothes of sick people); the use of folk remedies (infusions of various herbs) was recommended; Mandatory physical exercise was recommended. Religious instructions lay the foundations for many preventive rites, rituals, holidays, fasting, and the beginning of eating berries and fruits (apple, nut, honey). Aqueducts (a prototype of a water supply system) were built and used for preventive purposes; thermal baths (baths); sanitary control was carried out over the products brought to the market. The outbreak of epidemics and pandemics of especially dangerous diseases (cholera, plague, tularemia) contributed to the drawing up of a plan of anti-epidemic measures (isolation of patients, observation, quarantine), and supervision of the water supply was carried out. Instructions for personal hygiene of the body, linen, and home have been drawn up. The next stage in the development of prevention is associated with the development of industry, agriculture, biology, and medicine. A professional group appeared - sanitary inspectors, who monitored working conditions and developed preventive measures to prevent occupational pathology. Teachings about the unity of the organism and the environment appeared. Prevention methods were adopted by N.I. Pirogov and G.A. Zakharyin. Measures for the hygiene of populated areas, soil, water, and air are being developed and implemented. For the first time, sanitary legislation is being created on the prevention of tuberculosis, alcoholism, STIs, public, free medical care, maternal and child health, outpatient and polyclinic care. Clinical examination of the population and health protection of agricultural workers are justified and implemented. Issues of preventive measures in lifestyle are considered.

Prevention involves not only sanitation, but also hygiene (Greek hygieinos - healthy). The main tasks of modern hygiene for a set of preventive measures are based on the stages of preventive and current sanitary supervision. Legislative and regulatory documents provide for labor and rest protection; health of children and adolescents, examination of the quality of food, clothing, footwear, furniture, building materials, environmental protection.

Methods for research and preparation of preventive measures are based on sanitary inspection; sanitary and hygienic study of physical, chemical, biological factors; hygienic and laboratory experiment; statistical data with the identification of correlations. Depending on the state of health, the presence of risk factors for the disease or severe pathology in a person, three types of prevention began to be considered: primary, secondary and tertiary.

Primary prevention – This is a system of measures to prevent the occurrence and impact of risk factors for the development of diseases (vaccination, rational work and rest, rational nutrition, physical activity, environmental improvement, etc.).

Towards primary prevention include socio-economic measures of the state to improve lifestyle, environment, education, etc. Preventive activities are mandatory for all medical workers and medical institutions at any level.

Primary prevention is aimed at a possible etiological cause, as a risk factor for health problems. For this purpose, hygiene deals with the standardization of these physical, chemical, biological factors and their combinations. Either the complete absence of these factors or their presence in safe concentrations and levels is provided. For example, the concentration of CO 2 in the air of residential, public buildings, workshops, and in the atmosphere. Carbon dioxide is a natural stimulant of the respiratory center and maintains acid-base balance in the body only at a certain concentration in the atmosphere of 0.03-0.04%. An increase in CO 2 concentration in enclosed spaces, without possible health problems, is allowed and is standardized at a concentration of 0.1%. Exceeding the CO 2 concentration by more than 0.1% is a risk factor for health problems. According to sanitary and hygienic standards and rules, it is necessary to ventilate the room through natural or artificial ventilation as a preventive measure.

One of the areas of primary prevention is prevention of infectious diseases.

Infectious diseases, the causative agents of which are pathogenic microorganisms, are transmitted from a sick person (in the acute period of the disease) or from a bacteria carrier to healthy people. Pathogens can be transmitted in various ways. The most common ways include:

Contact– through direct communication of a sick person with healthy people (direct contact) or through household items: linen, dishes, books, toys, etc. (tetanus, microsporia, scabies, intestinal infections).

Aerosol– pathogens with droplets of saliva, mucus, during forced conversation, coughing, sneezing, enter the air, settle on dust particles and are carried in different directions by air flow. This route of infection spread is typical for closed spaces; in the open air, pathogenic microorganisms die quite quickly (diphtheria, measles, rubella, whooping cough, mumps, chicken pox).

Waterway– pathogens are transmitted by drinking poor-quality water (typhoid fever, viral hepatitis A, helminthiasis).

Food route - pathogens are transmitted from food products(dysentery, salmonellosis, enterovirus infections).

Transmission path - pathogens are transmitted through living vectors (pediculosis, tick-borne encephalitis, malaria).

Prevention of infectious diseases among the population is aimed at the source of infection, breaking transmission routes and the susceptible organism. In relation to the source of infection, clinical-isolation, treatment-diagnostic and regime-restrictive measures are used. Activities aimed at interrupting the transmission of infection include sanitary and hygienic measures, disinfection and disinsection. Immunoprophylaxis, immunocorrection, and emergency prophylaxis are used for susceptible individuals. Preventive vaccinations are carried out in accordance with the vaccination calendar as planned and according to epidemic indications.