[(THE CURRENT SITUATION OF DIPHYLLOBOTHRIASIS: EPIDEMIOLOGY AND EPIDEMIOLOGICAL SURVEILLANCE)].

The paper analyzes the etiology of diphyllobothriasis pathogens and their distribution in the world. It estimates the infection rate of the population with tapeworms, the value of different fish species and procedures for their cooking as factors for transmission of Diphyllobothrium to the population and the risk for infection with tapeworms through infected foods. Epidemiological surveillance measures in different (synanthropic and natural) foci of diphyllobothriasis and with various types of pathogens are considered.

[EXPERIENCE IN TREATING HELMINTHISM WITH MICRONIZED ALBENDAZOLE (GELMODOL)].

The paper gives the results of treatment with micronized albendazole (Gelmodol-BM, World Medicine, UK) in 87 patients of the Department of Medical Parasitology and Tropical Diseases, Clinical and Diagnostic Center, Clinical Center, I.M.Sechenov First Moscow State Medical University. Thirty-two patients with echinococcosis 8 with alveococcosis (including 4 inoperable patients), 10 with ascariasis, 10 with toxocariasis, 15 with enterobiasis, and 12 people diagnosed with larva migrans were treated in 2013-2014. The drug's routine doses and dosage regimens were used. Albendazole (Gelmodol, World Medicine, UK) showed a high efficacy with good tolerability, which is highly competitive with that of the drugs manufactured by IPCA Laboratories Ltd., India (such as nemozole). Both medicaments above-mentioned may be successfully used in the treatment of many helminthisms.

[THE EPIDEMIOLOGICAL SITUATION OF LEISHMANIASIS IN THE RUSSIAN FEDERATION: THE FIRST VALID CASES OF LOCAL TRANSMISSION].

The authors have analyzed the data available in the literature and statistical offices and the results of their observations of the epidemiological situation of leishmaniasis in the Russian Federation (RF). In October 1991 to December 2014, the RF registered 89, leishmaniasis cases, including 83 imported cases from 24 countries and 6 local cases. Out of the 83 imported cases, there were those diagnosed with anthroponotic cutaneous leishmaniasis (n=31), zoonotic cutaneous leishmaniasis (n=20), visceral leishmaniasis (n=31), and mucocutaneous leishmaniasis (n=1). The Republic of Dagestan and Eastern Crimea are visceral Ieishmaniasis-enderpic, areas. The obtained data on the local cases of visceral leisimaniasis in Dagestan and on its sporadic cases in Crimea suggest that it is necessary to conduct epidemiological, epizootological, and entomological surveys in the above areas and to develop a system for visceral leishmaniasis epidemiological surveillance encompassing the whole package of antiepidemic measures. The effective treatment of leishmaniases requires that the RF Ministry of Health should register some current antileishmanial drugs (such as Glucantime) as soon as possible.

[A local case of acute opisthorchiasis in the Moscow Region].

The paper describes a case of acute opisthorchiasis in a 31-year-old female patient after ingestion of dried fish of the family Cyprinidae caught in the Oka River basin on the border of the Moscow and Ryazan Regions. This case could convince of that there was a risk of human Opisthorchis infection despite the zoonotic pattern of circulation of the pathogen in European Russia. The dietary intake of unsterilized fish of the family Cyprinidae caught in the Moscow and neighboring regions may give rise to Opisthorchis invasion and, it a large infectious dose, to acute opisthorchiasis.

[Alveococcosis of liver: retrospective analysis of treatment of 51 patients].

51 patients with liver alveococcosis were operated on: radical operations with the whole hydatid tumor removal, cytoreductive operations with 50-80% of the tumor removal and alveococcal nodes' preserving on vital organs; and palliative manipulations, aimed the relief of complications were performed. According to the treatment results, the radical liver resection proved to be the most effective. When the complete tumor removal is impossible, cytoreductive operations are possible. Combination with antiparasitic therapy is required.

[Tourism, imported parasitic diseases, and their prevention].

The paper gives the results of observations of 1558 patients before and after tourist travels to tropical countries and 368 individuals visiting the north areas of the Russian Federation. Different conditions (malaria, amebiasis, leishmaniasis, intestinal and tissue helminthiasis, insect bites, venomous fish pricks, medusa burn, tick bites, etc.) were found in 402 persons. Prophylactic immunization included vaccination against hepatitis A and B viruses, meningitis, typhus, yellow fever, tick-borne encephalitis in more than 2500 patients (not including influenza vaccination in the epidemic season). The performed observations reinforce the statement that imported pathology is urgent to Russia and suggest that it is necessary to develop this section of medicine and to set up a network of health care facilities with a necessary therapeutic and diagnostic base to render skilled care to tourists. It is essential to improve medical staff training in travel medicine.

[Heterogeneity of parasitic contamination of megalopolis soils].

A morphological group ofwhipworm (Trichuris trichiura) eggs, which is detectable in the soil samples from the city's different control lands, shows that their origin is heterogeneous and it is possible to differentiate them by morphometric signs. At the same time is necessary to consider the specific biological factors contributing to soil contamination. Priority in parasitic soil contamination should be given to animals, dogs in particular, which is supported by the fact that the dog walking grounds exhibit the highest contamination rates.

[The structure of the geographic range of opisthorchiasis and the tasks in controlling this invasion]. / Struktura areala opistorkhoza i zadachi bor'by s invaziei.

Our own investigations in the Yenisei, Ob, Dnieper, Northern Dvina river basins and the analysis of the literary data served as the basis for establishing the relationship between the area of the pathogen dissemination and the area of opisthorchiasis distribution (the map scheme is attached). 4 degrees of endemicity characterized by quantitative indices of general affection, children's infestation, the invasion intensity and manifestation have been suggested as a criterion for division of territories into regions. The map of 3 territories in the Dnieper River basin (the Ukraine) most unfavourable for opisthorchiasis is presented. According to the endemicity, differential anti-invasion goals and measures are suggested.

[The structure of the nosogeographic range of opisthorchiasis in the Ob-Irtysh basin]. / Struktura nozoareala opistorkhoza v Ob'-Irtyshskom basseine.

Results of our own investigations and available data in the literature concerning the epidemiology of opisthorchiasis in Ob-Irtysh river basin have been gathered, and geographic ranging have been established. The prevalence of infection, children's infection rate, the intensity of infection and clinical manifestation rate have been suggested as a criterion for division of territories into areas. 4 degrees of endemia was established: areas with sporadic incidence rate (prevalence is less than 1%); hyperendemic (prevalence 1-10%, intensity of infection 1-20 egg/gr., children's infection and clinical manifestation are absent), mesoendemic (prevalence 10-40%, children's infection rate 1-25%, intensity of infection about 300 egg/gr., clinical manifestation rate about 50%) and hyperendemic area (prevalence above 40%, children's infection rate 25-60%, intensity of infection above 300 egg/gr., clinical manifestation rate about 80%). Original map of pattern of opisthorchiasis distribution area is presented. The decreasing of transmission of O. felineus to periphery of basin is noted.

[The characteristics of the circulation of the causative agent of opisthorchiasis in the tributaries of the Ob]. / Osobennosti tsirkuliatsii vozbuditelia opistorkhoza na pritokakh Obi.

Opisthorchiasis morbidity is reviewed in the area of the Vasyugan River, an Ob tributary. Intermediate hosts have been found in 3 settlements situated at various distances from the ostium. The infestation of intermediate and additional hosts with Opisthorchis larvae is investigated. The above data and the results of previous population surveys (establishing infestation and contamination) served the basis for elucidating the nature of helminth circulation on the territory along the Vasyugan River. The role of infected fish migration is discussed as a source of human infection in areas where helminth circulation is altogether absent or is at an extremely low level.

[Seroepidemiologic characteristics of opisthorchiasis foci with various endemic levels]. / Seroépidemiologicheskaia kharakteristika ochagov opistorkhoza s raznym urovnem éndemii.

Combined coprological (by an ether-formol method) and serological (by solid-phase enzyme immunoassay--EIA) screening of the population to detect opisthorchiasis was performed in the settlements situated in the Ob, Dnieper and Northern Dvina basins. Disease rate in the hyperendemic area on the Ob exceeded 80%, by the results of coprological population screening, while annual infestation rate established on the basis of specific antibodies determination in the blood was 70%. Infestation and disease rates in mesoendemic area, at the Ob tributary and in the Dnieper basin were practically equal and accounted for 30-40%. Infestation rates in hypoendemic areas of the Dnieper and Northern Dvina basins exceeded those of the disease rate. Causes of this phenomenon are discussed. Double serological screening of population in the foci performed in summer-autumn and spring seasons demonstrated a considerable increase in infestation rate parameters in autumn and their decrease in spring. Seasonal character of infestation is better expressed in the mesoendemic areas than in the hyperendemic ones. Infestation and disease rates are discussed for various age groups in different areas.

[Opisthorchiasis at left Dnieper watersheds]. / Opistorkhoz na levykh pritokakh Dnepra.

Present state of opisthorchosis infestation in the Dnieper watershed (rivers Vorskla, Psyol, Khorol, Sula, Seym, Snov, Desna water basins), situated in the Sumy, Chernigov, and Poltava regions of the Ukraine, is assessed. 7909 humans from 37 villages, 94 cats, 1134 carp fishes, 20013 mollusca and 30 soil samples were screened for the presence of Opisthorchis eggs. Opisthorchosis foci with an over 36% infection rate of population remain in the watersheds of the Dnieper left confluents (rivers Desna, Seym, Vorskla and Khorol). Infestation rate varies between various rivers as well as along one and the same river which is due to several ecological and social factors. Opisthorchis circulation is established at all the rivers but in most areas it didn't involve human population. Distribution pattern of human opisthorchosis in evidently focal and patchy which should be taken into account in the planning and implementation of opisthorchosis control measures.

[The procedure for the wide use of praziquantel in a complex of measures to control opisthorchiasis. 1. The tolerance and efficacy of different doses of biltricide during outpatient use in foci]. / Taktika shirokogo primeneniia prazikvantelia v komplekse mer bor'by s opistorkhozom. Soobshchenie 1. Perenosimost' i éffektivnost' razlichnykh doz biltritsida pri ambulatornom primenenii v ochagakh.

The results of wide uses of praziquantel (bilthricide, Bayer, Merck) to treat 2,440 persons in the outpatient setting of the endemic foci of opisthorchiasis in Tomsk Province suggest that the agent is highly effective (on the average of 97%) and well tolerable. There are no great differences in the efficiency of treatment, the frequency and magnitude of adverse reactions during out- and inpatient treatments. There are no either basic differences in the efficacy of praziquantel doses of 30, 40, and 60 mg used in the treatment of patients with Opisthorchis infection in whom 1 to 1.00 eggs per g feces are found. The use of praziquantel in a daily dose of 30 or 40 mg/kg in the outpatient setting permits the mass drug therapy of the population in the endemic foci, by reducing expenses on treatment. It is advisable to continue investigations of praziquantel used in small doses among the populations at low infection risk.

[The epidemiological efficacy of opisthorchiasis control measures in Dnieper River basin foci]. / Epidemiologicheskaia éffektivnost' protivoopistorkhoznykh meropriiatii v ochagakh bacceina Dnepra.

The authors assess the epidemiologic efficacy of wide-scale antiopisthorchiasis measures taken in the basin of the Dnepr River in 1984-1990. The structure of the population morbidity and the time course of this morbidity under the effect of a complex of measures taken were analyzed in low-, medium, and highly-endemic foci of the disease. Hygienic education and adequate detection and treatment of the invaded subjects were found to be the principal factors contributing to sanitation of the population. These measures are the most effective in subjects aged under 40, in whom the share of cured subjects is the highest and reinvasions are the least frequent. Health education detection and chloxyl treatment of the patients helped reduce more than twofold the disease incidence over 5 years even in highly endemic foci and permitted complete sanitation of the children.

[The procedure for the wide use of praziquantel in a complex of measures to control opisthorchiasis. 2. The tolerance and efficacy of Russian-made azinox in mass treatment in foci]. / Taktika shirokogo primeneniia prazikvantelia v komplekse mer bor'by s opistorkhozom. Soobshchenie 2. Perenosimost' i éffektivnost' azinoksa otechestvennogo proizvodstva pri massovom lechenii v ochagakh.

Whether the Russian praziquantel analog azinox can be widely used in the foci of opisthorchiasis was first assessed. The outpatient treatment of 7405 patients with the agent in doses of 30, 40, 60 mg/kg body weight revealed that azinox tolerance did not depend upon the intensity and degree of clinical infection signs but it was slightly worse when a dose of 60 mg/kg was given. Children virtually showed no adverse reactions, in adults their frequency was no more than 52 +/- 1.4%. The parasitological efficiency of azinox in the used doses was 96-99% in children and 82-86% in adults. There was a clinical improvement in 65% of the treated. Thus, the national drug azinox is not inferior to the imported agent bilthricide in tolerance, parasitological and clinical efficiency. Bearing in mind the equal efficiency, but the better tolerance and less cost of the drug doses of 30 and 40 mg/kg body weight, it is advisable to use them in the foci for outpatient treatment.