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

Manage epidemiological risk for HIV infection in the maritime transport and shipments

AIDS is a disease which is caused by the human immunodeficiency virus - HIV. Today HIV / AIDS is a global health, social and economic problem and a cause of high mortality. There are three main ways of HIV transmission: sexual transmission; blood and vertical. Lead is sexually transmitted - 87 percent in various forms of sexual intercourse without a condom. In particular, the use of services of prostitutes and nonuse of condom. Traveling abroad (mobile population) as economic migrants, on the occasion of trips, work, business trip, vacation is a vulnerable group for HIV / AIDS. Analyzing the spread of HIV / AIDS in the world and the country - 45% of new HIV infections occur in African Americans, 35% of whites and 17% for Hispanics. (10) our geographical location, the development of tourism, our status as a port city and describing the epidemiological risk for HIV among sailors and travelers have the need to study the epidemiology of HIV / AIDS in terms of shipping and transportation

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

Environmental Epidemiology of Listeria Infection in Bulgaria // Екологична епидемиология на листерийната инфекция в България

Listeriosis is qualified as zoonosis of increasing medical, social and economic importance because of its severe course, high mortality and specific diagnostics - serological and cultural. Pregnant women and their new-borns, people over 65 years of age and people with poor immunity are most affected. The incubation period varies from 24 hours to 70 days. The lack of epidemiological studies in Bulgaria on listeriosis necessitates a comprehensive study and evaluation of the ecological and epidemiological system of the parasitic cycle, with the aim of offering a system of activities to improve epidemiological monitoring and control. The development of a “Lister epidemiologic study map for patients with listeriosis” with detailed information on the nutritional factors of possible contamination can be used in the study of an epidemic outbreak of infections associated with foods.[BG] Листериозата се определя като зооноза с нарастващо медицинско, социално и икономическо значение, заради тежкото си протичане, високата смъртност и специфичната диагностика – серологична и културелна. Боледуват най-често бременни жени и техните новородени, възрастни над 65 години и хора с незадоволителен имунитет. Инкубационният период варира от 24 часа до 70 дни. Липсата на епидемиологични изследвания в България върху листериозата, налагат комплексното изучаване и оценка на еколого-епидемиологичната система на паразитарния цикъл, с цел предлагане на система от дейности за усъвършенстване на епидемиологичния надзор и контрол. Разработването на „Карта за епидемиологично проучване на болен от листериоза“ с подробна информация за хранителните фактори на евентуалното заразяване може да се използва при проучване на епидемичен взрив от инфекции, свързани с храна

Miscibility of hBest1 and sphingomyelin in surface films – a prerequisite for interaction with membrane domains

Human bestrophin-1 (hBest1) is a transmembrane Ca2+- dependent anion channel, associated with the transport of Cl−, HCO3- ions, γ-aminobutiric acid (GABA), glutamate (Glu), and regulation of retinal homeostasis. Its mutant forms cause retinal degenerative diseases, defined as Bestrophinopathies. Using both physicochemical - surface pressure/mean molecular area (π/A) isotherms, hysteresis, compressibility moduli of hBest1/sphingomyelin (SM) monolayers, Brewster angle microscopy (BAM) studies, and biological approaches - detergent membrane fractionation, Laurdan (6-dodecanoyl-N,N-dimethyl-2-naphthylamine) and immunofluorescence staining of stably transfected MDCK-hBest1 and MDCK II cells, we report: 1) Ca2+, Glu and GABA interact with binary hBest1/SM monolayers at 35 °C, resulting in changes in hBest1 surface conformation, structure, self-organization and surface dynamics. The process of mixing in hBest1/SM monolayers is spontaneous and the effect of protein on binary films was defined as “fluidizing”, hindering the phase-transition of monolayer from liquid-expanded to intermediate (LE-M) state; 2) in stably transfected MDCK-hBest1 cells, bestrophin-1 was distributed between detergent resistant (DRM) and detergent-soluble membranes (DSM) - up to 30 % and 70 %, respectively; in alive cells, hBest1 was visualized in both liquid-ordered (Lo) and liquid-disordered (Ld) fractions, quantifying protein association up to 35 % and 65 % with Lo and Ld. Our results indicate that the spontaneous miscibility of hBest1 and SM is a prerequisite to diverse protein interactions with membrane domains, different structural conformations and biological functions