ENDEMIA

From Big Medical Encyclopedia

ENDEMYYa (endemia; Greek endemos local, from ep among, between + demos the people) — the constant existence in this area of incidence of people of a certain disease caused corresponding social and an environment of this region.

The term «endemia» unlike concepts epidemic (see) and a pandemic (see), characterizing intensity of distribution of this or that inf. diseases, constancy of registration of cases of this disease reflects in the specific territory and is qualitative category.

Distinguish two look E.: true and statistical. True E. it is connected with a complex of natural factors, specific to this area: an area of animals — sources of contagiums and arthropods — carriers of the activator, and also a possibility of preservation of the activator out of an organism of an animal. Vertebrate animals, arthropods and the activator are in this case fellow members long since of the created biocenoses (see). Therefore the concept «true endemicity» corresponds to a concept a natural ochagovost (see), the doctrine about a cut was developed by E. N. Pavlovsky, and the term «local center» — to the term «enzootic center». The strict confinedness of infectious diseases, the Crimea is inherent true endemich-nvst, to certain regions in their names, napr, the African trypanosomiasis, the Bolivian hemorrhagic fever, the Marseilles fever quite often is reflected. Infectious diseases with true endemicity are, as a rule, characterized by the expressed seasonality caused by the highest activity of animals — sources of contagiums and arthropods — carriers of the activator in a certain season. This feature also found reflection in the name of separate diseases, napr, tick-borne, or spring and summer, encephalitis, mosquito, or autumn, encephalitis. Intensity of spread of infectious diseases with true endemicity clearly correlates with way of movement of arthropods — carriers of the activator (flying, jumping, creeping). As a rule, indicators of incidence inf are highest. diseases, the activator to-rykh is transferred by mosquitoes (e.g., malaria), mosquitoes (e.g., flebotomny fever) and flies (e.g., a tsetse-fly disease). Indicators of incidence of those inf are less high. diseases, the activator to-rykh is transferred by fleas (e.g., plague) and is even lower — such diseases, the activator to-rykh is transferred by mites (e.g., a tick-borne typhinia, a tick-borne encephalitis).

True E. it is characteristic also of a number of noninfectious diseases, such as a craw local (see), a fluorosis (see) etc. High rates of incidence of these diseases within specific territories are connected with deficit in the environment (e.g., in water) the iodine and fluorine necessary for a normal metabolism.

The vast majority of antro-ponoz (see), on a trope of L. V. Gromashevsky, has cosmopolitan character since everywhere accompanies the person. And if the quantitative characteristic of indicators of incidence of these ant-roponoza undergoes essential changes, up to total disappearance of separate diseases (e.g., natural smallpox), then it is not a consequence of change of an environment, but a result of influence of a complex of preventive actions. Therefore, spread of such diseases does not require a specific environment therefore they are considered as endemic for certain regions on purely statistical sign — registration of steadily high rates of incidence for a long time. E.g., so-called endemicity of a typhoid in certain territories is caused not natural, and a dignity. - a gigabyte. conditions of life of the population, and first of all, unsatisfactory water supply and bad cleaning of household drains. After commissioning of modern water handling and the sewerage indicators of incidence of this infection sharply decrease.

Bibliography: Gromashevsky JI. In *

the General epidemiology, M., 1965; Prirodnoochagovy diseases of the person, under the editorship of E. N. Pavlovsky, M., 1960.

A. A. Sumarokov.

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