Voronezh n.N. Burdenko State Medical Academy

I State Institution of Graduate and Postgraduate Professional Education «Voronezh N. N. Burdenko State Medical Academy» is known as one of the country's leading research and teaching institutions with the total student enrollment of 5 500 people.

It is one of the oldest educational institutions of Russia. Its history goes back to 1802 — the date of Derpt University foundation, which in 1918 moved to Voronezh. In December, 1930 the Medical Faculty of the Voronezh University became an independent medical institute consisting of two Faculties: the Faculty of General Medicine and the Faculty of Health. The Institute acquired an Academy status in 1994.

There are 6 departments at the Voronezh State Medical Academy: The Faculty of General Medicine, The Pediatric Faculty, The Faculty of Stomatology, The Faculty of Pharmacy, Medico-prophylactic Faculty (The Faculty of Preventive Medicine), The Faculty of Advanced Nursing^AThe department of in-service doctors' training and post-graduate courses are also availableAThere are more than 50 chairs at the Academy which one can find in several buildingsArThe largest multy-field medical and healthcare establishments of Voronezh serve as clinical bases for students' practical trainings/various kinds of well-equipped laboratories are at the disposal of the Academy. The Academy has an extensive library possessing about 580 000 items ./Hew information technologies are introduced successfully in the work of the library.

AThe Academy has a well-established reputation for providing high quality medical teaching, learning and research. The quality of its performance is reflected in the rating system, where the Academy was placed in the top ten higher medical schools of Russia. Since the foundation year it has prepared above 40 thousand medical specialists, including foreign specialists from 28 countries of Europe, Asia and Africa. Medical degrees received at VSMA are recognized worldwide

.25. Discuss the problem of infectious diseases transmission. What are the main transmis­sion routes? What are the ways of its prevention?

Ал infectious disease is a clinically evident illness resulting from the presence of patho­genic microbial agents, including pathogenic viruses, pathogenic bacteria, fungi, protozoa, mul­ticellular parasites, and aberrant proteins known as prions. Infectious pathologies are also called communicable diseases or transmissible diseases due to their potential of transmission from one person or species to another by a replicating agent.

An infectious disease is transmitted from some source. Defining the means of transmission plays an important part in understanding the biology of an infectious agent, and in addressing the disease it causes. Transmission may occur through several different mechanisms. Respiratory diseases and meningitis are commonly acquired by contact with aerosolized droplets, spread by sneezing, coughing, talking, kissing or even singing. Gastrointestinal diseases are often acquired by ingesting contaminated food and water. Sexually transmitted diseases are acquired through contact with bodily fluids, generally as a result of sexual activity. Some infectious agents may be spread as a result of contact with a contaminated, inanimate object (known as a fomite), such as a coin passed from one person to another, while other diseases penetrate the skin directly.

Transmission of infectious diseases may also involve a vector. Vectors may be mechanical or biological. A mechanical vector picks up an infectious agent on the outside of its body and transmits it in a passive manner. An example of a mechanical vector is a housefly, which lands on cow dung, contaminating its appendages with bacteria from the feces, and then lands on food prior to consumption. The pathogen never enters the body of the fly.

In contrast, biological vectors harbor pathogens within their bodies and deliver pathogens to new hosts in an active manner, usually a bite. Biological vectors are often responsible for serious blood-borne diseases, such as malaria, viral encephalitis, Chagas disease, Lyme disease and Af­rican sleeping sickness. Biological vectors are usually, though not exclusively, arthropods, such as mosquitoes, ticks, fleas and lice. Vectors are often required in the life cycle of a pathogen. A common strategy used to control vector borne infectious diseases is to interrupt the life cycle of a pathogen by killing the vector.

General methods to prevent transmission of pathogens may include disinfection and follow­ing common hygiene rules. In medicine hygiene practices are determined as preventative meas­ures to reduce the incidence and spreading of the disease. That is why medical hygiene practice includes cleanliness procedures, isolation or quarantine of infectious persons and sterilization or disinfection of instruments used in surgical procedures.

One of the ways to prevent or slow down the transmission of infectious diseases is to rec­ognize the different characteristics of various diseases. Some critical disease characteristics that should be evaluated include virulence, distance traveled by victims, and level of contagiousness. The human strains of Ebola virus, for example, incapacitate its victims extremely quickly and kills them soon after. As a result, the victims of this disease do not have the opportunity to travel very far from the initial infection zone.

So, the spread of Ebola is very rapid and usually stays within a relatively confined geo­graphical area. In contrast, Human Immunodeficiency Virus (HIV) kills its victims very slowly by attacking their immune system. As a result, many of its victims transmit the virus to other in­dividuals before even realizing that they are carrying the disease. Also, the relatively low viru­lence allows its victims to travel long distances, increasing the likelihood of an epidemic

.26. Describe some of the infectious diseases (causes, symptoms, detection and treatment). Dis­cuss how epidemics in hospitals may be managed.

An infectious disease is a clinically evident illness resulting from the presence of pathogenic mi- crobial agents, including pathogenic viruses, pathogenic bacteria, fungi, protozoa, multicellular parasites, and aberrant proteins known as prions. Infectious pathologies are also called communicable diseases or transmissible diseases due to their potential of transmission from one person to another by a replicating agent.

Transmission of an infectious disease may occur through one or more of diverse pathways includ­ing physical contact with infected individuals. These infecting agents may also be transmitted through liquids, food, body fluids, contaminated objects, airborne inhalation, or through vector-borne spread. Transmissible diseases which occur through contact with an ill person or their secretions, or objects touched by them, are especially infective, and are sometimes referred to as contagious diseases.

Because of great variety of agents causing the disease, and routes of its transmission we can define a lot of types of infectious diseases. I'd like to describe some of them, which are mostly wide-spread.

Tuberculosis is a common and often deadly infectious disease caused by various strains of myco- bacteria, usually Mycobacterium tuberculosis in humans. Tuberculosis usually attacks the lungs but can also affect other parts of the body. It is spread through the air, when people who have the disease cough, sneeze, or spit. The classic symptoms of tuberculosis are a chronic cough with blood-tinged sputum, fever, night sweats, and weight loss. Infection of other organs causes a wide range of symptoms. Diagnosis relies on radiology (commonly chest X-rays), a tuberculin skin test, blood tests, as well as microscopic examination and microbiological culture of bodily fluids. Treatment is difficult and requires long courses of multiple antibiotics though antibiotic resistance is a growing problem in multi-drug- resistant tuberculosis. Prevention relies on screening programs and vaccination, usually with Bacillus Calmette-Guerin vaccine.

Malaria is a mosquito-borne infectious disease caused by a eukaryotic protist of the genus Plasmo­dium. It is widespread in tropical and subtropical regions, including parts of America, Asia, and Africa. Malaria is naturally transmitted by the bite of a female Anopheles mosquito. When a mosquito bites an infected person, a small amount of blood is taken, which contains malaria parasites. These develop within the mosquito, and about one week later, when the mosquito takes its next blood meal, the parasites are injected with the mosquito's saliva into the person being bitten. After a period of between two weeks and several months spent in the liver, the malaria parasites start to multiply within red blood cells, causing symptoms that include fever and headache. In severe cases, the disease worsens, leading to coma and death.

Human immunodeficiency virus (HIV) is a lentivirus (a member of the retrovirus family) that causes Acquired Immunodeficiency Syndrome (AIDS), a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections. Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells. The four major routes of transmission are unsafe sexual contact, contaminated needles, breast milk, and transmission from an infected mother to her baby at birth (vertical transmission). Screening of blood products for HIV has largely eliminated transmission through blood transfusions or infected blood products in the developed world.

Such infectious diseases as poliomyelitis, diphtheria, measles and tetanus most commonly occur in childhood.

While discussing the problem of infectious diseases we cannot make round of the topic of epi­demics and their management in hospitals