EPIDEMIOLOGICAL INSPECTION

From Big Medical Encyclopedia

EPIDEMIOLOGICAL INSPECTION — the complex method of studying of the epidemic center directed to identification of a source of an infection, factors and ways of its distribution, and also borders of the epidemic center for the purpose of definition and quick implementation of the most effective measures for its localization and elimination.

AA. the island is carried out by the doctor-epide-miologom. In some cases to E. lakes attract also other specialists: health officers, doctors-infek-tsionistov, laboratory workers, entomologists, zoologists, etc. At E. islands use results of laboratory methods of a research.

AA. lakes begin usually with poll of the patient (patients) and the surrounding his faces. Find out a residence of the patient to a disease (during the maximum incubation interval), possibilities of infection at work, at home, during rest or in a business trip. If it is established that infection could occur out of point of inspection, immediately report about it to bodies of health care in the place of estimated infection. Poll and inspection of the persons communicating with the patient allows to add the data received from the patient. It is necessary to be convinced that in the house of the patient and in the neighboring houses there are no infectious patients; to check whether was in an environment of the patient of persons with easy forms of a disease or carriers of a disease-producing factor. Laboratory inspection of the persons put risk of infection including the persons surrounding the patient for the purpose of identification among them sick with the lungs erased by forms and carriers of a contagium is of great importance. The question of the volume of laboratory researches at the persons surrounding the patient is defined by the nature of a disease and specific epidemiol. situation.

During E. the island is carried out acquaintance with medical documentation to lay down. institutions and with materials of local SES that helps to establish cases of this disease among the population during the period preceding emergence of the epidemic center (see). So, e.g., at E. lakes concerning dysentery in log-books of patients can be found such diagnoses as «dysfunction of intestines», «gastroenteritis». Persons with such diagnosis are subjected to clinical and laboratory inspection for the purpose of identification of a source of the causative agent of dysentery among them. Study also sanitary and epidemiologic descriptions (see. Sanitary and epidemiologic description), cards epidemiol. inspections of the centers of infectious diseases of the area, on a cut the inspected epidemic center is located.

Great value at E. the lake has studying a dignity. conditions of the territory, dwellings, catering services, water supply, removal of sewage and garbage in the settlement (area) where the epidemic center is found. Estimate also a dignity. the maintenance of the apartment (the house, the estate) the patient, a role of domestic animals — possible sources of a contagium (invasion), especially the animals who are contained in the dwelling (dogs, cats, etc.), existence of blood-sicking arthropods — possible carriers of the activator. At inspection of catering establishments and other food objects find out their dignity. the state, the mode of transportation, cutting and storage of products, especially fish, meat, not exposed to heat treatment, check existence of conditions for observance by personnel of these objects a gigabyte. norms and rules, system of their medical inspection, specify whether the admission to work with foodstuff of the persons which did not pass a tank-teriol took place. inspections. At the same time examine hands of personnel (existence of grazes, pustulous diseases), take washouts from hands and objects of the environment for laboratory researches. The list of the objects of the environment which are subject to a laboratory research (e.g., water, air, foodstuff, washouts from hands of workers of food), methods and frequency rate of researches is defined by the epidemiologist, to-ry carries out E. lake. In case of developing of natural and focal infectious diseases reveal possible bonds of a disease with local fauna — a role of wild vertebrate animals as sources of a contagium (invasion) and arthropods as carriers of the activator in the center. For the correct and consecutive collecting material during the carrying out E. the lake is recommended many various schemes. However practically all of them have the following sections: surname, name, middle name of the patient, address, clinical diagnosis, epidemiological anamnesis, dignity. - epid. a situation (in relation to the studied infection or an invasion), an estimated source of a contagium, probable ways and factors of transfer of a contagium, volume and methods of holding anti-epidemic actions. Results E. lakes bring in the special card, the form a cut is approved by M3 of the USSR.

Timeliness of recognition of the beginning epidemic (separate cases of an infectious disease) and efficiency of anti-epidemic actions substantially depend on completeness and care E. lake. At the same time it is necessary to establish what conditions promoted developing of diseases and what keeps development of epidemic in what limits the population is exposed to risk of new infections, what space and temporary borders of this epidemic. In this regard study klimatogeografichesky and the socio-economic factors influencing emergence and the course of epidemic process, napr such as population shift, vehicles of the population, existence of natural and focal diseases in this area, a condition of collective immunity, etc. Content of inspection at its separate stages depends also on the nature of a disease, ways inherent to it and factors of transfer of the activator, features of a course of epidemic process (see) in the studied collective.

Final stage E. the lake is studying of collected materials, the analysis and assessment of the data obtained at inspection, drawing up recommendations about holding the most rational actions for elimination of the epidemic center, to the prevention of recurrent diseases and emergence of the new epidemic centers (see. Epidemiological analysis).

Features of epidemiological inspection in field conditions are connected with specifics of service and life of troops: collective accommodation of staff, catering services, frequent movements, especially during fighting, stay in various environment, the features of a susceptibility to infections and invasions caused by age composition of troops and systematic immunization. Purposes, tasks and methods E. the same lakes, as in usual conditions. At E. lakes reveal sources and ways of transfer of a contagium in specific conditions of dislocation or fighting of troops, investigate a dignity. - epid. a condition of a part where there were diseases, and in particular features of field placement and life of staff, to-rye could exert impact on emergence and spread of this disease. Begin inspection with poll of the patient, the surrounding his faces, commanders, medical structure. Find out places of stay of the diseased to a disease (dismissal from a part, a business trip, issue), existence of similar diseases in division, reveal all communicating with the patient, a possibility of infection through water and food stuffs, and also other factors playing a role in spread of a disease to parts. Character and maintenance of tasks E. lakes are various depending on a form of a disease and it epidemiol. features.

For carrying out E. lakes of a separate case of an infectious disease recommend to use the short scheme map of epidemiological inspection. Specify a military rank, a surname and initials of the patient, age, number of a body, date of a disease, isolation and hospitalization, the diagnosis in it. Briefly state epidemiol. the anamnesis also describe a dignity. - epid. a situation in military unit, the infections assumed a source and ways of distribution of a disease-producing factor. Finish filling of the card with run-down of data on the held events in connection with the arisen disease, put date of inspection, carrying out E a surname. the lake with the indication of a position and military rank. One copy of the card is sent to the chief of medical service of army (district), another remains at the chief of medical service of a part. If the patient came to hospital, passing a part, the card E. lakes fill in hospital and send to the same addresses.

Cards primary E. lakes serve as a starting material for studying of flashes and epidemics of infectious diseases, and also by drawing up a dignity. - epid. descriptions of districts of dislocation of troops.

Bibliography: Greenberg G. D. Epidemiological inspection in the center of an infection, M., 1962, bibliogr.; Practical epidemiology for doctors of navy, under the editorship of V. I. Agafonov, page 107, M., 1975; E. N Ways.

Practical epidemiology, page 46, Chisinau, 1983; Encyclopedic dictionary of military medicine, t. 5, Art. 1222, M.,

1948. V. I. Agafonov.

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