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Video: Diarrhea Season
Summer is the season of acute intestinal infections, from which, according to WHO, 500 adults and 4,300 children die every day in the world. Leading causes of infectious diarrhea are the rapidly multiplying noroviruses, salmonella, and pathogenic E. coli in poorly processed animal products, as well as aflatoxin in moldy bread.
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Summer is not only a great time of the year, but also the season of acute intestinal infections, from which, according to WHO, 500 adults and 4,300 children die every day in the world. Leading causes of infectious diarrhea are the rapidly multiplying noroviruses, salmonella, and pathogenic E. coli in poorly processed animal products, as well as aflatoxin in moldy bread.
According to the World Health Organization, diarrhea is one of the ten leading causes of death. Why, despite the modern level of development of medicine, the problem does not lose its relevance, said leading experts of the Central Research Institute of Epidemiology of Rospotrebnadzor and practicing doctors at a scientific and practical seminar on the problem of diagnosis, prevention and treatment of acute intestinal infections.
Causes and pathogens
Every year, WHO registers about 1-1.2 billion cases of acute intestinal infections (ACI) around the world. In Russia, this figure is more than 500 cases per 100 thousand population. At the same time, according to experts, a significant part of infectious diarrhea in adults is not included in statistics.
Most of the outbreaks of acute respiratory infections in recent years have been primarily associated with poor quality water or food. According to the latest WHO report, diarrhea often results from the consumption of raw or undercooked meat and dairy products, eggs and other foods contaminated with norovirus, campylobacter, nontyphoid salmonella and pathogenic E.
Other causes of intestinal infections are typhoid fever, hepatitis A, pork tapeworm (tapeworm), and aflatoxin produced by a fungus on improperly stored grain products.
A number of diseases (for example, diseases caused by nontyphoid salmonella) occur throughout the world. But in general, the incidence of AEI is higher in disadvantaged countries. In low- and middle-income countries, general hygiene and food production and storage conditions are poorer, and people are more likely to use unsafe water for cooking. In addition, WHO notes the low level of public awareness and imperfect legislation in the field of food safety in such countries.
Not just infection
According to the Deputy Director of the Central Research Institute of Epidemiology, Professor of the Department of Pediatrics with Infectious Diseases Antonina Ploskireva, 500 thousand cases of antibiotic-associated diarrhea (AAD) are annually registered in Russia. The incidence of AAD in adults who received antimicrobial drug therapy is 5-30% and 8-26% in children.
Risk factors for developing AAD include:
age under 5 and over 65;
- severe somatic diseases;
- chronic diseases of the digestive system;
- irrational antibiotic therapy, high doses of antibiotics.
Antibiotic-associated syndrome includes the development of not only diarrhea, but also other changes in the digestive system and extraintestinal manifestations. The incidence of antibiotic-associated syndrome is 64.7%.
Diagnosis of AEI and their complications is based on clinical symptoms and data of available laboratory and instrumental examinations. According to the head. laboratory of molecular diagnostics and epidemiology of intestinal infections OMDiE Central Research Institute of Epidemiology Alexander Podkolzin, there are different ways to assess the etiological structure of AEI, and it is very important to learn how to analyze them correctly. The expert listed the main questions that a specialist should answer when interpreting the findings of "new pathogens": whether this pathogen is active or passive, whether it is capable of reproduction in the human body, whether it is associated with human pathology and, in particular, the gastrointestinal tract.
With regard to the detection of pathogens, modern molecular genetic studies with the identification of the pathogen's DNA make it possible to conduct etiological diagnostics of AEI in a short period of time, said Alexander Gorelov Gorelov, Deputy Director for Research of the Central Research Institute of Epidemiology, Corresponding Member of the Russian Academy of Sciences. According to him, the most modern method for diagnosing intestinal infections today is PCR with real-time detection. The advantage of this method is the ability to simultaneously detect pathogens of both bacterial and viral infections. Today, the Central Research Institute of Epidemiology has developed a series of tests "Multiprime", which allows to significantly optimize the procedures of laboratory examination for infections.
Specialists also paid attention to the "fashionable" topic of the human microbiota and its interaction with the immune and nervous systems. According to the head of the laboratory of infections associated with the provision of medical care, RAS Corresponding Member Alexei Tutelyan, there is a huge amount of information about the participation of the microbiota of the gastrointestinal tract in the regulation of metabolic, immune and psychoemotional reactions of a person. And this allows you to manage health, adjusting the composition and functioning of microflora with the help of probiotic microorganisms (especially lactic acid bacteria, LAB) in the composition of food and special medicines. According to Tutelyan, the efforts of science are aimed at developing a unified methodology for creating new synbiotic functional products. I.e,combining viable microbial cells with proven probiotic properties and predetermined prebiotic activity. Means for normalizing the composition and functioning of microflora are important not only for the treatment of gastrointestinal diseases, but also for the prevention of pathological changes and oncological diseases, Tutelian noted.