Особливості перебігу ротавірусних гастроентероколітів в епідемічний сезон

Abstract

В роботі представлений епідеміологічний аналіз перебігу ротавірусної інфекції, під час сезонних підйомів. Відзначені вікові особливості захворілих, генетична характеристика збудників.

The paper presents epidemiological analysis of the current rotavirus infection during seasonal rises. There was made a generalization of the monthly incidence of RV HES in Odessa region for 2009-2011 and calculated the average long-term level. These data suggest that the incidence of RA GEC is recorded throughout the year, with severe winterspring seasonality. A significant rise in the incidence of epidemic curve in the group of children from 0 to 17 years old occurred in March and April (20.43 and 23.70 per 100 thousand of population), followed by the second wave - in July and August (15.57 and 11.43) and the third wave - in November and December months (8.80 and 16.10, respectively). The maximum rate was observed in April (23.70 per 100 thousand of population), it exceeded the minimum in January (4.0) 5.9 times. There was obtained a strong positive correlation (r = 0.70; p ≤ 0.01) between the average level of long-term average month incidence of RVHE and detection of RA in the drinking water. There was analyzed the incidence of rotaantigene (RA) in patients with DCI in different months of the year. The results obtained revealed the growth of positive findings of RA in February and March to nearly 60.0 % in April and May - more than 50.0 % and a sharp decrease (up to 20.70 %) - in June. The positive correlation between the incidence of moderate severity of RVI and detection of RA in the feces of patients in months (r = 0.37; p ≤ 0.05). To determine the role of RA in the structure of gastroenterocolites (GEC) of unknown etiology there was conducted a comparative assessment of the dynamics of the epidemic process of these diseases. When comparing the proportion of the disease by months for the period 1998-2011, there was found a direct strong correlation (r = 0.94; p ≤ 0.05), between GEC of unknown etiology and RVs GEC indicating the participation of the latter in the formation of GEC of unknown etiology. The overall incidence tends to increase steadily. The minimum level was recorded in 2000 - 118.45 , maximum - in 2011 - 470.84, on an average making (259.36 ± 32.06). Among adults the minimum incidence (65.38 ) was recorded in 1998, the maximum (188.28 ) - in 2011, making on an average (114.48 ± 6.09) per 100 thousand of population. Among previous RVs and other GEC of the established etiology children from 0 to 2 years old fell ill most frequently. In this group, the incidence was significantly higher than in other age groups of children and ranged from 488.43 (2000) to 4344.70 (2011), on an average - (2112.62 ± 93.69). In the group of 3 to 6 years old, the incidence ranged from 525.89 (2000) to 1959.33 (2011), making (1231.69 ± 14.65). Among adolescents aged from 7 to 14 years old, its level was significantly lower than in the group from 0 to 2 years old (t = -5.42; p ≤ 0.0001) and in the group from 3 to 6 years old (t = -11.77, p ≤ 0.0001) and ranged from 147.79 in 2000 to 862.57 - in 2011, making (468.16 ± 6.33) per 100 thousand of population. During the seasonal ups of the disease, according to the laboratory tests ( excretion in feces and RA increase in the antibody titer 4 or more times in the dynamics of the disease) GEC RV is diagnosed as monoinfection in 38.8 % of cases, mixed infection (RV and St.aureus, RV and Pr. mirabilis, RV and Ps. Aeroginosa, RVs and other opportunistic pathogens) - 7.8 %. Molecular genetic studies of RA have been conducted in 98 sick children who were hospitalized in the City Clinical Hospital of Infectious Diseases in 2009-2010. The spectrum of RV identified in 2010, was represented by five [P] G- combinations. Predominant genotype was P [8] G3 - (55.10 ± 6.25) %. Then there were genotypes P [8] G4 - (22.10 ± 5.22) %, P [4] G2 - (15.80 ± 4.60) %, P [8] G9 - (3.20 ± 2.20) % and P [8] G1 - (1.90 ± 1.72) %.

В работе представлен эпидемиологический анализ течения ротавирусной инфекции во время сезонных подъемов. Отмечены возрастные особенности заболевших, дана генетическая характеристика возбудителей.