КЛИНИЧЕСКИЕ И ЭПИДЕМИОЛОГИЧЕСКИЕ ЗАКОНОМЕРНОСТИ ВЕТРЯНОЙ ОСПЫ У ВЗРОСЛЫХ В ПРИМОРСКОМ КРАЕ

Objective: to establish clinical and epidemiological patterns of chickenpox in adults in the Primorsky Territory to improve treatment and prevention work. Materials and methods: The study used statistics on the incidence of chicken pox in the Primorsky Territory from 2009 to 2017 and demographic data on the population for the specified period. A clinical characteristic of 102 cases of varicella in patients hospitalized in the infectious disease ward of Primorsky Regional Clinical Hospital No. 2 (Vladivostok) in 2015-2017 is given. Results: From 2009 to 2017, the incidence of chickenpox in the Primorsky Territory was consistently high, with an average of 636.2 per 100,000 population. Analysis of the structure of patients showed that the maximum proportion of cases of chicken pox occur in organized children 3-6 years old (55.9%), schoolchildren (19.1%) and children 1–2 years old (11.6%). The proportion of 15–17 year olds was 3.0%. Adults, from 18 years old – 4.9%. The proportion of unorganized children 3–6 years old (2.9%) and children in the first year of life (2.6%) is not high. High risk of infection was detected in Vladivostok (57.8 per 100.000), Yakovlevsky (52.1% ooo), Olginsky (45.9% ooo), Lazovsky (42.8% ooo) and Shkotovsky (40, 2% ooo) areas. In the annual dynamics, a pronounced spring-summer seasonal rise was formed. The clinical course of varicella in the group of adults was characterized by an average duration of the initial period of the disease of 1.4 ± 0.7 days. For clinical diagnosis, an important time was the appearance of the rash, which varied within four days. The phenomenon of “spillage” was noted in 97% of patients. The rash was polymorphic, with the formation of crusts. The period of height was characterized by the presence of catarrhal manifestations. The granularity of the posterior pharyngeal wall was observed in all patients without exception. In 84.3% of patients there was a bright hyperemia of the pharynx. In 14.7% of cases, enantema was detected on the soft palate, palatine arches, and posterior pharyngeal wall. Dry cough was detected in 28 of 103 patients, which probably increased their epidemiological significance. Findings: The clinical picture of varicella was typical and was represented by a combination of intoxication, exanthema, and catarrhal syndrome. The epidemic process of varicella in adults in Primorsky Krai was characterized by relative autonomy of manifestations in adults, children up to one year old, and unorganized children. When implementing chickenpox epidemiological surveillance, priority should be given to interventions in epidemic foci.Цель: установление клинических и эпидемиологических закономерностей ветряной оспы у взрослых в Приморском крае для совершенствования лечебной и профилактической работы. Материалы и методы: в исследовании использованы статистические данные по заболеваемости ветряной оспой в Приморском крае с 2009 по 2017 г. и демографические данные по численности населения за указанный период. Дана клиническая характеристика 102 случаев ветряной оспы у пациентов, госпитализированных в инфекционное отделение Приморской краевой клинической больницы №2 (г. Владивосток) в 2015–2017 гг. Результаты: с 2009 по 2017 г. заболеваемость ветряной оспой в Приморском крае была стабильно высокой, со средним уровнем 636,2 на 100 000 населения. Анализ структуры больных показал, что максимальная доля случаев ветряной оспы приходится на организованных детей 3–6 лет (55,9%), школьников (19,1%) и детей 1–2 лет (11,6%). Доля лиц 15–17 лет составила 3,0%; взрослых (с 18 лет) – 4,9%. Невысока доля неорганизованных детей 3–6 лет (2,9%) и детей первого года жизни (2,6%). К территориям риска по заболеваемости ветряной оспой взрослых были отнесены Владивосток (57,8 на 100,000), Яковлевский (52,1%ooo), Ольгинский (45,9%ooo), Лазовский (42,8%ooo) и Шкотовский (40,2%ooo) районы. В годовой динамике формировался ярко выраженный весенне-летний сезонный подъем. Клиническое течение ветряной оспы в группе взрослых лиц характеризовалось средней продолжительностью начального периода болезни 1,4±0,7 дня. Для клинической диагностики важным являлось время появления сыпи, варьировавшее в пределах 4 суток. Феномен «подсыпания» был отмечен у 97% больных. Сыпь была полиморфной, с образованием корочек. Период разгара характеризовался наличием катаральных проявлений. Зернистость задней стенки глотки наблюдалась у всех без исключения пациентов. У 84,3% больных отмечалась яркая гиперемия зева. В 14,7% случаев выявлена энантема на мягком небе, небных дужках, задней стенке глотки. Сухой кашель выявлен у 28 из 102 больных, что, вероятно, увеличивало их эпидемиологическую значимость.Выводы: клиническая картина ветряной оспы была типичной и представлена сочетанием интоксикационного, экзантемного и катарального синдрома. Эпидемический процесс ветряной оспы у взрослых в Приморском крае характеризовался относительной автономностью проявлений у взрослых, детей до 1 года и неорганизованных детей. При осуществлении эпидемического надзора за ветряной оспой следует отдавать приоритет мероприятиям в эпидемических очагах

Clinical and epidemiological patterns of chickenpox in adults in the Primorsky territory

Objective: to establish clinical and epidemiological patterns of chickenpox in adults in the Primorsky Territory to improve treatment and prevention work. Materials and methods: The study used statistics on the incidence of chicken pox in the Primorsky Territory from 2009 to 2017 and demographic data on the population for the specified period. A clinical characteristic of 102 cases of varicella in patients hospitalized in the infectious disease ward of Primorsky Regional Clinical Hospital No. 2 (Vladivostok) in 2015-2017 is given. Results: From 2009 to 2017, the incidence of chickenpox in the Primorsky Territory was consistently high, with an average of 636.2 per 100,000 population. Analysis of the structure of patients showed that the maximum proportion of cases of chicken pox occur in organized children 3-6 years old (55.9%), schoolchildren (19.1%) and children 1–2 years old (11.6%). The proportion of 15–17 year olds was 3.0%. Adults, from 18 years old – 4.9%. The proportion of unorganized children 3–6 years old (2.9%) and children in the first year of life (2.6%) is not high. High risk of infection was detected in Vladivostok (57.8 per 100.000), Yakovlevsky (52.1% ooo), Olginsky (45.9% ooo), Lazovsky (42.8% ooo) and Shkotovsky (40, 2% ooo) areas. In the annual dynamics, a pronounced spring-summer seasonal rise was formed. The clinical course of varicella in the group of adults was characterized by an average duration of the initial period of the disease of 1.4 ± 0.7 days. For clinical diagnosis, an important time was the appearance of the rash, which varied within four days. The phenomenon of “spillage” was noted in 97% of patients. The rash was polymorphic, with the formation of crusts. The period of height was characterized by the presence of catarrhal manifestations. The granularity of the posterior pharyngeal wall was observed in all patients without exception. In 84.3% of patients there was a bright hyperemia of the pharynx. In 14.7% of cases, enantema was detected on the soft palate, palatine arches, and posterior pharyngeal wall. Dry cough was detected in 28 of 103 patients, which probably increased their epidemiological significance. Findings: The clinical picture of varicella was typical and was represented by a combination of intoxication, exanthema, and catarrhal syndrome. The epidemic process of varicella in adults in Primorsky Krai was characterized by relative autonomy of manifestations in adults, children up to one year old, and unorganized children. When implementing chickenpox epidemiological surveillance, priority should be given to interventions in epidemic foci