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CIP - . , 613.1:616.9(497.7)(035)613.1:616.9(035) : / [ ... .]. - : ,2011. - 80 . : . ; 21 : . 72-74ISBN 978-608-4518-17-41. , []) - - ) - COBISS.MK-ID 88509962
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1. 72. 93. 113.1 113.2 133.3 144. , 164.1 164.2 174.3 184.3.1 184.3.2 194.3.3 204.3.4 22. 22. 22. 23
26 - CHIKUNGUNYA FEVER 27 - - CREMEAN - CONGO HAEMORHAGIC FEVER 31 CRYPTOSPORIDIUM 34 - - (DENGA) 37
- (GIARDIASIS) 39O - LEISHMANIOSIS 42 - LEPTOSPIROSIS 46 - ( LYME BORRELIOSIS LYME DISEASE) 49 MALARIA 52 (MEDITERANINAN SPOTTED FEVER MSF) 55 - RICKETTSIOSIS 57 SALMONELLOSIS 59 WEST NILE INFECTIONS 61 1 66 2 68 70 72
v
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(EWARN) - (BMU) - (VL) o - - - - - (ELISA) (ECDC) (EHEC) (WNF) (IgM) (IFA) - (CCHF) (LB)
- (MSF) (MSF) (PCR) (RNA) - (RT-PCR) (WHO) (WMO) (TBE) - (HFRS) (CHKV)
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1. Intergovernmental Panel on Climate Change (IPCC) (2005). Contribution of Working Group I to the Fourth Assessment Report of the IPCC. Draft. Cambridge:Cambridge University Press.
2. Bates BC, Kundzewicz ZW, Wu S and Palutikof JP (eds.) (2008). Climate Change and Water. Technical Paper of the Intergovernmental Panel on Climate Change,IPCC Secretariat, Geneva.
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Intergovernmental Panel on Climate Change (IPCC) (2001). Climate Change 2001: The Scientic Basis. Contribution of Working Group I to the Third Assessment Reportof the Intergovernmental Panel on Climate Change [Houghton J T, Ding Y, Griggs DJ, Noguer M, van der Linden PJ, Dai X, Maskell K and Johnson CA (eds.)]. CambridgeUniversity Press, Cambridge, United Kingdom and New York, NY, USA.WHO, UNEP, WMO (2003). Climate change and human health - risks and responses, Geneva (2003). . (2008). . , WHO.(2002). World Health Report. Geneva
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Patz, J.A., et al.,(2000). Effects of environmental change on emerging parasitic diseases. Int J Parasitol, 30 (12-13).Wilson, M.L.. (2001). Ecology and infectious disease, in Ecosystem Change and Public Health: A Global Perspective, J.L. Aron and J.A. Patz, Editors, Johns Hopkinsniversity Press: Baltimore. p. 283-324.. Confalonieri and al. (2007). Human health. Climate Change Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fourth Assessment
eport of the Intergovernmental Panel on Climate Change, Cambridge University Press, Cambridge, UK.
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:
19912008 . , 26.092 1.450 . 1304, 6/100.000 , 72,4/100.000, . , 4-6 , , . , ( ), / 2008 , / , .
- 5-10% . 1991 2008 6.969 , 340,3/100.000 387 , .
- 1991 2008 , 2.652 , 132,6/100.000 147 , 8 , 35 ., , , , .
- (Campylobacter) . 2-5% . , , , 18.000 .
, - : , , O157 H7 (EHEC) ( , Clostridiumperfringens). , . , , . . , , . 30 , 3 2009 .(287 ), 2008 .(490 ), 2007 .(381 ). : 2009 .(290 ), 2008 .(243), 2007 .(257 ).
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3.3
, , . . . , . , ,, . , , , . , ( ), ( ). :
- (CCHF) 2000 2008 , CCHF (, , , (ECDC2009) 11 ). , . . (H. marginatum rupes). , , 13 , ., .
(WNF) - , . , . () . , , , - - . , . (WNF) , - .
Hantavirus - (). (HFRS). . . 2002 . .
(Chikungunya) - Aedes, , Aedes albopictus, . Aedes albopictus chikun-gunya . , Aedes albopictus 2010 .
(Lyme Borreliosis) (LB), (TBE) - . . , , . LB, TBE Ixodesricinus , . , , .
o (Leishmaniosis) (VL, ) - , o . . o (VL) , , . 1991 2008 91 o 4,6/100.000 5 , . o .
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- , . - Aedes aegypti. , Aedes albopictus, , , , , 2010 . - .
(Rickettsia conorii) - 2003 , , (MSF) , Ixodes . (R.Conorii) .
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4.3.3
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CHIKUNGUNYA FEVER
edesAegypti Aedes Albopictus . . ( CHKV, , ar-thropod bo-rne) Alphavirus Togaviridae.
1: (Aedes albopictus)
CHKV ( = CHKV) Aedes (.aegypti A .albopictus). CHKV . . . , . , .
Aedes albopictus, . Aedes albopictus .
2: (Aedes Albopictus)
112 , 3-7 . , CHKV- , : CHKV- ( ) / . .
40C, , ( , . , , ,
). 50% . , , . , , , , ,, ., , . , . , , , , (), , 5-7 . . 5-15 , 1 2,5 , . . , . .
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- CREMEAN - CONGO HAEMORHAGIC FEVER
Nairovirus, Buniaviridae (RNA ). Nairovirus 32 , : Dugbe Nairobi - (CCHF) .
- Hyalomma (marginatum marginatum, H. Marginatum rupes). (, , ) ( ). () , () .
- (CCHF) . Hyalomma, , . . , , . . CCHF . , . CCHF, .
: , , , ( ). , , , (, .). / , , (
).
- ( ) , , , . , . CCHF , 2001 , 2004 . , Hyalomma marginatum marginatum ( ) ( ).
Rt-PCR, . ,3. IgM-. RT-PCR IgM () .
, . , , , . , Reye- ., ,
, ., : , . ( , ), , .
. 4.3.4 .
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, , .
, , . ( CCHF) , , .
, 4.3.4 .
, . , 1-3 ( 9 ), 5-6 ( 13 ). , , . - , , , .
. 2-4 , , . , . (, , , ), , . ,
. , , ( ). 2-50%.
. IgG IgM- . RT-PCR CCHF 10-15 , . CCHF- , .
3: CCHF
Adult femalesdrop off host to
lay eggs
First Year
Second Year
Winter
Fall
Spring
Summer
Spring
Larvae becomenymphs on the rsthost after one molt
Adults attach tothe secondhost for
feeding and mating
Nymps molt intoadults and overwinter
off of a host
Summer
Engorged nymphsleave rst host
Fall
W i n t e r
infective StageDiagnostic Stage
Eggs hatch intosix-legged larvae
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1 , . 1%, . 1%. (10-30%) . 25-35%, 80%.
4:
1-2 . , . Cryptosporidium hominis, Cryptosporidium parvum, . , . , . , , , . , ( / ).
CRYPTOSPORIDIUM
. Coccidii, Isospori. Cryptosporidium () . , , , , , , . . .
, 2-5 . . (, .)
Cryptosporidium , : C. hominis - , C. parvum - , , : C. meleagridis - ,C. muris - , C. anderson-, C. felis - , C. baileyi - ,C. canis- , C. galli- , C.serpentis- , C. saurophilum- .
Cryptosporidium , , , , . Cryptosporidium , . .
1984 .
. , , , 1993 , 370.000 .
, , , . . . Cr yptosporidium , , . - .
Cryptosporidium 1- 4% , 3-20% , , , . 5- .
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-
DENGA
Flavivirus Flaviviridae. (-, 1-4). , ,, Aedes aegypti Aedes albopictus. . , 8-12 . , , .
- () . . , 100 .
, - () - ().
3-15 ( 5-8) , , () . . 40C . , . . 2-4 , / . , , , . , . .
, - . , .
- () :
, , , , .
( , , ., ).
( 100.000 mm3 3 high power eld).
5:
, . , : , , (.)
. .
4.3.3. .
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( 20% 20% , , , ).
.
- () - :
/, / ( 20 mmHg)
,
, - - , - , , - , - PCR.
, . . .
. , 4.3.4 .
-
GIARDIASIS
, Gi-ardia (Giardia intestinalis Giardia duodenalis) . , , . , , , . , , (, ). () Lamblia Intesti-nalis.
(Lamblia) , 10-20, 5-15.. , . , . , , . 5-30% . ,, , , , , .
, , . ( 3 ) .
. . . . (, ), (, ) . .
2-10% 25% . (, ) .
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7:
Giardia. 5- ( 250 . x 3 , 15 ././, 3 ) , 1.52 .; 90% . .
4.3 .
6: -
. . 1-3, . , , . , , 3-5 . , (). . . , , . , , , ,, , . , .
. . 3 . , ( ) Giardia.
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o , . .
5 10- o, , . , . , , . o : , , , , - L. donovani.
() o L. infantum. - . o, L. tropica . - - , 13 .
9: o
10 . (3 18 ). . . o , , . , , .
LEISHMANIOSIS
o , . , Trypanosomidae. 20 . Leish-mania donovani Leishmania infantum . o, . () Phlebotomus.
Leishmania major L. tropica o , , o : L. amazoniensis, L.
mexicana, L. brasiliana,L. guinea L. peruana .
o . : (L. major, L. amazonensis, L. mexicana, L. braziliensis), (L. amazonensis, L. mexicana,L. braziliensis), (L. braziliensis) (L. infantum). . , . : , , .
Phlebotomus ( , ) Lutzomyia ().
8: o
o : , , , , - L. donovani.
() o L. infantum. - . o, L. tropica . - - , 13 .
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. , . (2010). - .
o . 4.3.4 .
o , , .
10: o
o , : , , , ,, , , (/ , ), .
, . / . - (L.brasiliensis and L .americana) , , , .
o . : , , , , . -, . - -. () o . o . o . , -.
o . 5-20% , 7-10 (20 ././, , , 28.). Amphotericin B (1 ./., 5% , ).
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2 30 ( 10 ). . , . , . : (4-9) : , , ,, , ,, , . , , , , , , ,, , . ,, . , .
. , . , , 20% , .
, . , (). .
12:
-, . .
o . , .
LEPTOSPIROSIS
, , , Leptospira. . Leptospira interrogans > 300 , 25.
11:
. . . , . : , , , . , . : , , . : , , , , ,, .
, . . , .
. . . , - .
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LYME BORRELIOSIS LYME DISEASE
/, , . I.ricinus. Ixodes persulcatus.
13: Ixodes scapularis
30-35% . , . ( , .) . , , .
() . , , .
3 32 . . , . Er ythema chronicum migrans , .
, , . . , . (2010 ). - .
(, , , , ).
.
. .
.
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.
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14: erythema migrans
. , , , , .
15% , , ( ),, , . 8% , , ( , Wenckenbach ), . , . - .
60% , . , . . .
, 2 15 30 55 .
/ . , , . (. , ) () ( , ).
Erythema , . , . Westernblot ELISA. ELISA- Western blot ELISA-. , ELISA Borrelia .
.
. (Erythema migrans, ) , , 14 . , 8 . , 8 . . / , ,, 28 , , 8 , . Lyme Borreliosis -.
4.3.4 .
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, , .
, : , , , , , , , , , , , ,, ( ) . , , . , , .
. :
A - , ;
M , ;
, - (IFA) ELISA . . , .
, . , , - . . , M. Falciparum, , (M. vivax, M. ovale i M. malariae). , Chloroquine, Meoquine,Doxycycline, Primaquine, Malarone, . , Primaquine, , P. ovale P. vivax. (2010 ). - .
MALARIA
Plasmodium. 4 : Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae. P.falciparum.Plasmodium vivax, P. malariae P. Ovale, . . , , . .
15: - Anopheles
- . . : 5 ,
65 , , , , , , . 19.12.1973 . , , .
. Plasmodium falciparum, 7-14 8-14 Plasmodium vivax Plasmodium ovale ( ). Plasmodium malariae 7-30 . , .
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Mediteraninan spotted fever - MSF
Rickettsia conorii, Rhipicephalus sanguineus. : Haemaphysalis leachi, Amblyomma hebraeum R. Appen-diculatus.
16: () - Rhipicephalus sanguineus
R. Conorii (), . MSF , , . ( Citellus citellus) , (Rhipicehpalussanguineus). , . ().
7 . , , , . 3- 5- , , , . . . ( , , 2-5 ) . 7 10 , .
: . . . , . 4.3.4
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RICKETTSIOSIS
Rickettsia.mooseri . .
17: - Amblyomma aureolatum
. , (Xenopsylla cheopis) (Polypax spinulossus) , , . .
. 6 14. , ,
, , . 5- 6- . , . , 9 13 , . , .
( , ) . Weil-Felixova ProteusOX-19 Proteus OX-2 , . . .
, Weil-Felixova , OX2 19. R.coonori .
7 , 8 , 3 .
4.3.4 .
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SALMONELLOSIS
, . Enterobacte-riacea, Salmonella 2200 . : S. Enteritidis, S. typhimurium, S. Java, S. abony, S. Wien, S.Dablin, S. Abortus bovis, S. Newport, S. Infantis, S. Wirchow, S. Gallinarun, S.Saint Paul . : , , , , , .
, .
18: Salmonella enteritidis
20 , , , . , , , . - . . , 06 . , , , , . , . . , ,
7 .
:
, ;
(, ) /, , / .
, - ANTU , , , , /
, ( ) , .
() , .
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WEST NILE INFECTIONS
Flavivirus Flaviviridae. . Culex. / / ` (). , . , .
, . . , . .
19: Aedes Albopictus
50 . . ; , 40%. .
, . 30% , 20/1.000.000 . , , , , . . - , . 70% .
, , (38-39C), , , , , 12 72 . .
. . 4-7 . , . , . . , . /. Salmonella , .
. Salmonella typhi ( ) se WIDAL- .
/. .Typhoid fever ( ) septuchemy ciprooxacin, azytromycin, ceftriaxon cefotaksim. trimetoprim sulfametoxazol chloramphenicol . Ceftriaxon ( 2001) uorochinolons ( 2003)
4.3.2 .
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2-14 . (/). , : .
, ,, , . ,, , , , ., , , , , ,, . 2-6 , .
. . : , .
. , , . , / , , , , (, ). . ( ). , / , . , .
, . , , , RT-PCR. . 3 . .
, . , . .
4.3.4
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1:
2:
65
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. 5C, 60C, . 5C.
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!
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/
1 (Aedes albopictus)CDC/James Gathany, PhD/Michael L. Levin
http://phil.cdc.gov/phil/home.asp
2
(Aedes Albo-pictus)
http://gamapserver.who.int/ma-pLibrary/Files/Maps/Global_Chi-kungunya_ITHRiskMap.png
3 CCHF
http://www.dpd.cdc.gov/dpdx/html/imagelibrary/S-Z/Ticks/body_Ticks_il8.htm
4
CDC/Alexander J. da Silva,PhD/Melanie Moser
http://phil.cdc.gov/phil/home.asp
5
CDC/ Dr. Edwin P. Ewing, Jr. http://phil.cdc.gov/phil/home.asp
6
CDC/Alexander J. da Silva,PhD/Melanie Moser http://phil .cdc.gov/phil/home.asp
7
CDC/ Dr. Stan Erlandsen http://phil.cdc.gov/phil/home.asp
8 oCDC/ Frank Collins, JamesGathany http://phil.cdc.gov/phil/home.asp
9 o
CDC/Alexander J. da Silva,PhD/Blaine Mathison http://phil.cdc.gov/phil/home.asp
10
o CDC http://phil.cdc.gov/phil/home.asp
11
CDC/ Rob Weyant, JaniceHaney Carr http://phil.cdc.gov/phil/home.asp
12
CDC/Mrs. M Gatton http://phil.cdc.gov/phil/home.asp
13Ixodes scapularis
CDC/ PhD Michael L. Levin, Jim Gathany http://phil.cdc.gov/phil/home.asp
14 erythemamigrans CDC/ James Gathany http://phil.cdc.gov/phil/home.asp
15 Anopheles CDC/ James Gathany http://phil.cdc.gov/phil/home.asp
/
16
() Rhipiceph-alus sanguineus
CDC/ James Gathany, Wil-liam Nicholson http://phil.cdc.gov/phil/home.asp
17 Ambly-omma aureolatum
CDC/ Dr. Christopher Pad-dock, James Gathany http://phil .cdc.gov/phil/home.asp
18 Salmonella enteritidisCDC/ Bette Jensen, JaniceHaney Carr http://phil.cdc.gov/phil/home.asp
19
Aedes Albopictus CDC/ James Gathany http://phil.cdc.gov/phil/home.asp
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