1. Epidemiological aspects of enteric and droplet infectious diseases Sorokhan MD, PhD Bukovinian State Medical University Department of infectious diseases and epidemiology

26. Etiology Corynebacteria are gram-positive, catalase-positive, aerobic or facultatively anaerobic, generally nonmotile rods. Humans are the only known reservoir for the disease. The primary modes of dissemination are by airborne respiratory droplets, direct contact with droplets, or infected skin lesions. Asymptomatic respiratory carrier states are believed to be important in perpetuating both endemic and epidemic disease. Immunization reduces the likelihood of carrier status.

27. Mortality/Morbidity Mortality rates are highest at the extremes of age and in insufficiently immunized persons. However, even partial immunization confers a reduced risk of severe disease. Death usually occurs within the first week, either from asphyxia or heart disease.

28. Vaccination Childhood immunization is the prevention method of choice. Diphtheria/tetanus/pertussis (DTP) vaccine, given at ages 2, 4, and 6 months; at age 15-18 months; and at least 5 years later (age 4-6 y) is the immunization regimen.

29. INFLUENZA Influenza virus infection, one of the most common infectious diseases, is a highly contagious airborne disease that causes an acute febrile illness and results in variable degrees of systemic symptoms, ranging from mild fatigue to respiratory failure and death.

32. Mortality/Morbidity The influenza is responsible for an average of more than 20,000 deaths annually. Elderly people are at higher risk for complications of influenza A and B.

33. MEASLES Measles is a highly communicable acute disease. It is also known as rubeola and is marked by prodromal fever, cough, coryza, conjunctivitis, and pathognomonic enanthem (ie, Koplik spots), followed by an erythematous maculopapular rash on the third to seventh day.

34. Etiology and Epidemiology Measles virus , a negative-sense enveloped RNA virus, is a member of the Morbillivirus genus in the Paramyxoviridae family. The highly contagious measles virus is spread by coughing and sneezing via close personal contact or direct contact with secretions. In temperate areas, the peak incidence of infection occurs during late winter and spring.

36. Mortality/Morbidity Measles is still a leading cause of death among children, despite the availability of an effective vaccine. Highest fatality rates are among infants aged 4-12 months and in children who are immunocompromised because of human immunodeficiency virus (HIV) infection or other causes.

37. MENINGOCOCCAL INFECTIONS Meningococcal infections (known as meningococcemia) can range in severity from a transient bacteremia that is relatively benign to an overwhelming infection that is rapidly fatal. N. meningitidis is a gram-negative diplococcus that grows well on solid media supplemented with blood and incubated in a moist atmosphere enriched with carbon dioxide.

38. Epidemiology The human nasopharynx is the only known reservoir for N. meningitidis. Meningococci spread from person to person by airborne droplets of infected nasopharyngeal secretions.

40. Prevention Antimicrobial chemoprophylaxis of close contacts is the primary means of preventing secondary cases of sporadic meningococcal disease. Person-to-person transmission can be interrupted by administration of an antimicrobial that eradicates the asymptomatic nasopharyngeal carrier state. Sulfonamides, rifampin, minocycline, ciprofloxacin, and ceftriaxone are the drugs that have been shown to eradicate meningococci from the nasopharynx.

42. MUMPS Mumps or epidemic parotitis is a viral disease of the human species, caused by the mumps virus . Painful swelling of the salivary glands (classically the parotid gland ) is the most typical presentation. Painful testicular swelling ( orchitis ) and rash may also occur.

43. Etiology Mumps is a single-stranded RNA virus and a member of the family Paramyxoviridae, genus Paramyxovirus. Mumps virus is sensitive to heat and ultraviolet light.

44. Epidemiology Mumps is a contagious disease that is spread from person-to-person through contact with respiratory secretions such as saliva from an infected person. Mumps can also be spread by sharing food, sharing drinks, and kissing. The virus can also survive on surfaces and then be spread after contact in a similar manner. A person infected with mumps is contagious from approximately 6 days before the onset of symptoms until about 9 days after symptoms start. The incubation period can be from 14-25 days but is more typically 16-18 days.

45. Mortality/Morbidity Susceptible children, adolescents, and adults should be vaccinated against mumps, unless vaccination is contraindicated. MMR vaccine is the vaccine of choice for routine administration and should be used in all situations where recipients are also likely to be susceptible to measles, rubella, or both.

46. RUBELLA Rubella is generally a benign communicable exanthematous disease. Nearly one half of individuals infected with this virus are asymptomatic. Clinical manifestations and severity of illness vary with age. For instance, infection in younger children is characterized by mild constitutional symptoms, rash, and suboccipital adenopathy; conversely, in older children, adolescents, and adults, rubella may be complicated by arthralgia, arthritis, and thrombocytopenic purpura.

47. Etiology and Epidemiology The disease is caused by a single-stranded RNA rubella virus, which is a member of the Rubivirus genus of the family Togaviridae. Rubella virus is transmitted by the respiratory route. Humans are the only natural hosts. Rubella is a disease that occurs worldwide. The virus tends to peak during the spring in countries with temperate climates.

48. Mortality/Morbidity The morbidity and mortality rates of rubella disease dropped remarkably since the licensing of live attenuated rubella vaccine in 1969. In contrast to postnatal rubella, which is not a debilitating disease, congenital rubella infection may result in growth delay, learning disability, mental retardation, hearing loss, congenital heart disease, and eye, endocrinologic, and neurologic abnormalities.

49. Thank you for your attention!