Transmission mechanism in COVID-19 and the management of the epidemic process

The health significance, determined by the severity of the clinical course, the mass systemic nature of the epidemic process and the high intensity of coverage of the population worldwide, posed to epidemiological science the problem of studying and clarifying the peculiarities of the epidemic process in COVID-19 and its management. In this epidemiological study, we set out to examine the mechanisms and routes of transmission of SARS-CoV-2 in human society and the possibilities for managing the epidemic process. Theoretical and epidemiological methods, analysis and prognosis were used. A theoretical-epidemiological and applied analysis of the peculiarities of the process of the transmission mechanism in COVID-19 has been performed and the specific practical directions for the effective and rational anti-epidemic behavior are indicated

Diphtheria in Europe, Bulgaria and Varna district - past, present and future

Diphtheria is an acute infectious disease, which is described as a serious poisoning, fibrinous mucosa inflammation of the upper respiratory tract, and high lethality. There are many different kinds of complications and they are severe and occur frequently- infectious toxic shock, nephrotoxic­ity, respiratory tract obstruction, myocarditis, polyneuropa­thy, respiratory failure, or pneumonia. In Europe, diphtheria is largely under control thanks to the intensive vaccination strategy, but there are countries, where the endemic viral contamination still exist. The basic prevention remedy con­sists in the full systematic antidiphtheritic immunization coverage of the subject quotes. In the present study, we ex­amine the epidemiological problems and prospects of diph­theria infection in Europe and the Varna region under the conditions of active immunization with diphtheria anatoxin

Patient safety - concept and characteristics of safety. The human factor impact

INTRODUCTION: We have learned over the past 15 years that patients can be harmed by many factors in the healthcare system or factors associated with healthcare providers. Healthcare emerges as one of the most un­safe industries. Studies show that in the developed countries approximately 10% of the hospitalized patients suffer an adverse event or incident. The global survey of unexpected harm conducted by WHO and the World Alliance for Patient Safety indicates that the most frequent incidents result from: healthcare-associated infec­tion (HCAI), medication errors, unsafe surgery, clinical handovers, injection safety.AIM: The aim of this study is to do a systematic review on the existing practices and solutions applied in the period 2001 - 2016 with regard to patient safety. The issue has been systematically analyzed based on published results from the research work of WHO teams and leading authors on the subject.RESULTS AND CONCLUSION: All applied programs of WHO concerning patient safety aim to coordinate actions, disseminate knowledge and accelerate improvements in patient safety worldwide. Patient safety is an issue that impacts all countries and all governments who provide health services

The Knowledge Of Medical Professionals On The Prevention Of Hiv/Aids Infection In Conditions Of Occupational Risk

Рискът от професионално придобити инфекции е неизбежна част от ежедневната грижа за пациентите. Професионално придобитите инфекции причиняват значителни заболявания сред здравните работници.Целта на настоящото изследване е да се проучат знанията на медицинските специалисти за вземане на адекватни решения след рискова експозиция за превенция на ХИВ/СПИН.Материал и методи. Чрез анонимна анкетна карта са изследвани 230 медицински лица с различна професионална ангажираност. Резултатите са обработени статистически с SPSS v. 20.0, като са използвани анализ на риска, вариационен и сравнителен анализ.Резултати и обсъждане: Резултатите от нашето изследване показват, че медицинските специалисти не са запознати с нормативните уредби относно рисковите на професионалната експозиция. Въпреки че повече от 1/3 от изследваните лица са били изложени на рискова експозиция, като рискът се увеличава с нарастването на стажа, близо половината не са запознати с правилата за докладване в случай на инцидент.Изводи: Тези резултати показват необходимостта от организирането и провеждането на адекватно обучение както на практикуващите специалисти, така и на обучаващите се такива с цел превенция на риска и ограничаването на кръвнопреносимите инфекции, включително и ХИВ/СПИН.Introduction: The risk of professionally acquired infections is an inevitable part of the day-to-day care for patients. Professionally acquired infections cause significant illnesses among health workers.Aim: The aim of this study is to investigate the medical professionals' knowledge of taking adequate decisions for HIV/AIDS prevention after risk exposure.Materials and Methods: Anonymous questionnaire surveyed 230 physicians with different professional engagement. The results were statistically processed with SPSS v. 20.0, using risk analysis, variance and comparative analysis.Results and Discussion: The results of our study show that medical professionals are not familiar with the regulations on the risks of occupational exposure. Although more than one third of the surveyed have had risk exposure, with the risk increasing with the increase of work experience, nearly half are unaware of the reporting rules in the event of an accident.Conclusion: These results show the need to organize and conduct adequate training of both practitioners and trainees to prevent the risk and limit blood-borne infections, including HIV/AIDS

Ecological And Epidemiological Aspects Of The Listeria Infection In Bulgaria

Листериозата е рядко диагностицирана инфекция сред хората. Причинител на заболяването е Listeria monocytogenes, устойчив в околната среда грам-положителен микроорганизъм. Честотата на заболяването сред хората е 0,52 на 100 000 и нараства. В България се отбелязва трайна тенденция на нарастване броя на установените заболявания, леталитетът достига до 60%. Болестта протича с обща интоксикация и полиорганна симптоматика и се регистрира като менингит, сепсис, листериоза на новороденото. При бременните рядко се засяга ЦНС, но през плацентата инфекциозният агент уврежда мозъка, белите дробове и други органи на плода. Заболяемостта в България варира от 0,04 до 0,18 на 100 000 през 2017 г. През периода 2009-2017 г. са установени 62 болни от листериоза, като общо 29 или 46,77% от тях, са свързани с бременност. В последните години епидемичният процес се отдалечава значително от епизоотичния процес. Нараства делът на заболяванията, свързани с консумация на определени храни – съхранявани в хладилник и консумирани без термична обработка. Изследването на екологичните аспекти на епидемичния процес на листериозата има значение за подобряване диагностиката и лечението на болните, както и за профилактиката на заболяването чрез намаляване риска при производство и съхранение на храните.Listeriosis is a rarely diagnosed infection in humans. The cause of the disease is Listeria monocytogenes, an environmentally resistant gram-positive microorganism. The incidence of the disease among people is 0.52 per 100,000 and increases. In Bulgaria there is a steady trend of increasing the number of established cases with the lethality reaching 60%. The disease occurs with general intoxication and multiple organ symptoms and is often registered as meningitis, sepsis, listeriosis of the newborn. Pregnant women’s central nervous system (CNS) is rarely affected, but through the placenta the infectious agent damages the brain, lungs and other organs of the fetus. Morbidity in Bulgaria ranges from 0.04 to 0.18 per 100,000 in 2017. During the period 2009-2017, 62 patients were diagnosed with listeriosis, with a total of 29 or 46.77% associated with pregnancy. In the last few years, the epidemic process has receded significantly from the epizootic process. The number of diseases related to the consumption of certain foods - refrigerated and consumed without thermal treatment - is increasing. Examination of the environmental aspects of the listeriosis epidemic process is important for improving the diagnosis and treatment of patients as well as for disease prevention by reducing the risk in food production and storage

Contemporary aspects of the epidemiological surveillance of socially significant tick-borne infections (TBIS) in Varna region

The modern system for epidemiological surveillance of tick-borne infections (TBIs) in the Varna region requires a systematic analysis of the epidemic process.Aim: The aim of this article is to trace the evolution in parameters of the parasitic system in Lyme Borreliosis, Boutonneuse fever, Crimean-Congo hemorrhagic fever, and Q-fever in the Varna region for the period 2001-2017 and the activities of the epidemiological surveillance system.Materials and Methods: Data from active epidemiological studies and analyses of TBIs in the region of Varna and Bulgaria for the period 2001-2017 were used; as well as epidemiological and entomological methods, statistical and graphic analyses, nosogeographic analyses and others.Results: Data from the epidemiological analysis determined the continuing health and social significance of registered TBIs in the Varna region during the considered period. High levels of morbidity in Lyme disease (LD) and Boutonneuse fever (BF) with characteristic summer seasonality, correlated with the activity of vectors - reservoirs (Ixodes ticks), have been established. The system of epidemiological surveillance includes events for effective dispensary monitoring of the bitten by a tick; collecting complete epidemiological information about the area where the bite has occurred; preparation of epidemiological analysis of the morbidity of transmissible infections on the territory of the Varna region with emphasis on Lyme borreliosis, Boutonneuse fever, Q fever, Crimean-Congo hemorrhagic fever (CCHF), surveillance over the species composition and territorial distribution of tick populations and expanding the tick control activities in the region. There is a timely diagnosis and treatment of the registered patients. It is necessary to expand and deepen the system of epidemiological surveillance with the proposed strategy for surveillance and control of socially significant TBIs in the Black Sea region of the Republic of Bulgaria

Spectral epidemiological analysis of infectious diseases treated in the Clinic of Infectious Diseases in Varna for the period 2015-2017

Приемът на пациенти в Инфекциозния стационар, за лечение на остри инфекциозни заболявания, се основава на специфични критерии и нормативни изисквания при отчитане клиничната, епидемиологичната тежест и инфекциозния риск. Изискват се конкретни ангажименти към лечебно-диагностичния и противоепидемичен режим на обслужване. Приемът на болни с ОЗБ в Инфекциозния стационар, по диагнози и по месеци в годината разгледахме и анализирахме, съпоставяйки с общата заразна заболеваемост във Варненска област. Обсъдихме резултатите в сравнителен план с друго наше аналогично проучване за периода 1979-1983 г. Аналитичните изводи отнесохме към бъдещата организация на лечебно-диагностичния, изолационен и противоепидемичен режим в клиниката, гарантиращи безопасни грижи за инфекциозно болните.The admission of patients to the Clinic of Infectious Diseases for the treatment of acute infectious diseases is based on specific criteria and regulatory requirements for clinical, epidemiological and infectious risk assessment. There are specific requirements for the treatment and diagnosis, and the anti-epidemic treatment regimens. We examined and analyzed the admission of patients with AID at the Clinic of Infectious Diseases, according to diagnoses and months of the year, comparing them with the general contagious morbidity in the Varna region. We discussed the results in a comparative plan with another similar survey conducted by us for the period between 1979 and 1983. We applied the analytical conclusions to the future organization of the medical-diagnostic, isolation and anti-epidemic regimens in the Clinic, which ensure safe care for the patients

Border health control in ports of the republic of Bulgaria and programmes for the management of infectious risk

According to the International Health Regulations as a risk for the public health are determined infectious diseases, radiation and chemical pollution. Urbanization and technological progress are a prerequisite for increasing the importance of these risks. The border crossing is facilitated, the area of spread of some infectious diseases expanded, they emerged new ones. We are witnesses of intensive migration of large groups of people without information about their health status. The system of medical control has as a basic order not to hinder the transport of goods and cargo, not to hinder people in their professional and personal trips. There remains the need to control the medical and health risk. Underway are several international projects and programs in this area. Inspectors carrying out border health control at the port of Varna actively participate in these activities. The trainings have aim to exchange experience, best practices and research for objectification of control. It must be optimization of administrative procedures, unification of issued international documents, a providing of ongoing training for border medical services, manning companies and ships` crews.Materials and methods: We used official documents of the WHO and the Republic of Bulgaria, working materials of international programs, official statistics RHI Varna for 2013 and 2014.Results and discussion: The border health control is essential for communicable disease surveillance - the preventing of import and spread of quarantine and especially dangerous infections, timely assessment and response to health risks for public health. It is done in accordance with the International Health Regulations (2005), Regulations on border crossings and border health control. Electronic systems are introduced for exchanging information, which requires good professional training of border medical services. The responsibility of seafarers increases because completing and bringing specific information into the electronic system. The importance of experience and communication between crews and medical services in order preparedness for rapid reaction grows. Realized are various education and training projects, optimized are health documents and protocols. It is necessary a development of target programs on particular problems of border health control to maintain the preparedness of seafarers and institutions for timely identification of health risks and adequate response

Sea epidemiology in teaching maritime medicine - prevention of infectious diseases, being subject to international health regulation and controlled by WHO

Naval Medicine is a scientific and practical direction with a complex interdisciplinary character and is a state policy in countries like Spain, Britain, Poland and the USA. Naval Medicine is defined as a system of scientific knowledge and practical activities, whose purpose is to protect and to gain in health of seafarers, life extension, prevent and treat diseases in humans. Sea epidemiology is a very important part of the medical disciplines. It is formed as a separate direction of epidemiology and as a section of maritime medicine in the 70s-90s of the twentieth century. During a trip the parasitic system, which interacts with the crew of the ships, operates completely differently than in conditions of residence on land, which requires specific approaches for the organization of prevention of infectious diseases during the journey and on land. The control of diseases, which are subject to the international health regulation, is an essential aspect of the marine epidemiology. In the directions for work on the implementation of the International Health Regulations (2005) in 2007 is said, that we should be ready for response in infectious diseases, which may arise as a result of sudden and rapid environmental and climatic changes as a result of industrial pollution and accidents that can put at risk millions of people in many countries and that is why they require measures of worldwide importance to be taken. The measures to protect public health are a significant section in the travel and the transport. Тhe management of infections by means of vaccine agents takes an important place in the system of actions. It finds systemic application in terms of maritime epidemiology as a tool for managing the infectious risk according to the number of vaccination avertible infections. Maritime training epidemiology should include the main sections of the general and private epidemiology in a constantly changing ecological and social environment of sea travel and transport

Importans of the epidemiological control of insects and rodents for the navigation and limitation of infectious risk

The study of the characteristics of monitoring and control of epidemiologically significant insects and rodents in terms of navigation is a key to achieving effective ship‘s disinsection and deratisation (deratting). The success is a result of systematic and timely performed pest control. In international perspective ever closer the institutions work for the unification of these measures and the criteria for certification. In the contemporary conditions of globalization and intensive exchange of goods and passenger the vessels and vehicles can play an important role in the spread of infected rodents and insects in the world.Objective: To present to the medical and non-medical professionals related with navigation, the importance of bloodsucking insects and rodents for the spread of infectious diseases and to emphasize the importance of control measures against them to prevent „ship-associated infections`. Tasks: To present the targeted persons the specifics of control of insects and rodents in the vessels.Materials and Methods: The included teaching is consistent with the International Health Regulations (IHR 2005). They were studied historical materials, articles, epidemiological studies and analyzes of the WHO for the spread of communicable diseases. Manuals for anti-epidemic control and certification of vessels were used.Results and Discussion: Epidemiological significant rodents and insects can penetrate active or passive on vessels. They appear a risk factor for human health and the technical condition of the ship. It is essential the management, monitoring and actions related to pest control