Malaria Plague

1. Malaria Plague

2. Disease characterized by certain febrile disturbances caused by protozoa parasites class SPOROZOA family PLASMODIAE). Clinically malaria is characterized by periodic attacks of fever, associated with anemia and enlargement of liver and spleen

3. Etiology Causative agents – elementary microorganism (1-1,5 – 40-60 mcm) • Plasmodium vivax – 3-days malaria (P. vivax vivax - “south” stam, P. vivax hibernans – “north” stam) • P. malariae – 4-days • P. ovale – oval-malaria • P. falciparum – tropic

4. Cycles of development • sexual (sporogony) – in mosquito organism • asexual (schizogony) - in human or animal spinal organisms: tissue (incubation period) erythrocyte (P. malariae - 72 hours, for others – 48)

6. Epidemiology Source – sickperson, carrier Mechanism –transmissible After the bites of female mosquito Anopheles Seasonal –- summer-autumn, in tropics – whole year Susceptibility - high Immunity – non persistent, homologous

7. Pathogenesis • Tissue schizogony (incubation period) • Erythrocyte schizogony – incorrect temperature type • Typical attack – massive destruction of erythrocytes, massive appearance of parasites and products of their metabolism • Disturbance of thermoregulation centre, increasing of vessels penetration • Disturbance of microcirculation, water-electrolytes balance, vegetative neurotic system • Development of hemolytic anemia • Hepatosplenomegaly • Development of coma

8. Malaria classification • Onparazite:three days (P. vivax), four days (P. malariae), malaria ovale (P. ovale), tropical (P. falciparum) • According to origin:hereditary , primary, inaculated (shizont), reinfection • Stage of severity:mild, moderate, severe • Duration:acute, prolonged, with early and late recidives, without recidives. • Complications:coma, hemoglobinuria fever, interruption of spleen, infectious-toxic shock,intravascular DS

9. Clinic symptoms of malaria • Incubation period: 3-days malaria – 10-14 days (south tape) or 8-14 months. (north), 4- days– 20-25 days, tropical – 8-10 days • Attack of fever (chill – hot – sweat) • with periods (for P. malariae - 72 hours, for others – 48 hours) • Hepatosplenomegaly • Hemolytic anemia(icterus) Tachycardia,hypotonia, cyanosis, herpes, diarrhea, vomiting, pain in abdomen, back. aick

11. Diagnostic • Finding of parasite in blood (parasitoskopy) – “fat” drop (plasmodies in different stages of development – ring, shizontmorula, gamets), blood smear (identification of plasmodies) Border ofidentification – 5 in 1 ml, in case of coma – till 500.000 (20-25-50 % of lesion erythrocytes) • Definition of antibodies in indirect immunofluorescent reaction 1:20-1:40(retrospective)

12. а) Pl. vivax b) Pl. malariae c) Pl. falciparum а b c

13. Differential diagnosis • Influenza • Epidemic typhys • Typhoid fever • Sepsis • Viral hepatitis • Pyelonephritis • Leptospirosis • Brucellosis • Leishmaniosis • Meningococcal meningitis

14. Treatment Liquidation of acute attacks(hematoshizotropic agents) Warning of possible relapses (histoschizotropic) Decontamination of sick person as source of the infection (gamontotropic)

16. Prophilaxis • Sanitarian patrolling of the state from delivery (quarantine infection contamination) • Mandatory registration • Sterilization of toolkit • At detection of sick or carrier – parasitoscopy examination of all family members • Ant mosquito measures (melioration, usage of insecticides, repellents) • Drug prophilaxis

17. Drug prophylaxis • One week prior to departing, all residence time in ill-behaved terrain + 6-8 weeks after homing • After homing - preventive and ant recidive courses of Primachinum 0,027 gm/day 14 days

18. Plague PESTIS (A 20)

19. Plague (Pestis)– • especially dangerous infectious disease, that is caused by a plague stick. Expressed by fever, severe intoxication, severe hemorrhagic inflammation of lymphatic nodes, lungs and other organs through sepsis

20. Yersinia pestisin the blood of patient with plague

21. Possible ways of transmission: • Tranmissive ; • Contact; • Alimentary; • Droplet;

22. Flea«Plague flea»

23. Classification: Clinical forms: skin (A 20.1), bubonic (A 20.0), skin-bubonic; primary-pulmonary (A 20.2), second-pulmonary, intestinal, primary-septic (A 20.7), second-septic, other forms (A 20.8). Degree of weight: mild, moderate, severe. Complication: infectious-toxic shock, meningitis (And 20.3), adeno-phlegmone and etc

24. Example formulation of diagnosis • Plague, skin-bubonic form: defect of upper third of right shoulder, inguinal bubo, severe duration. • Plague, second-septic form. right side inguinal bubo. infectious-toxic shock of the ІІ degree is a Disseminated intravascular coaggulopathy-syndrome.

25. Plague bubo, that ruptured

26. Laboratory diagnostics: • bacteriological (basic). • bacterioscopic (reference). • serological. • biological.

27. Anti-epidemic measures: • prevention the import of infection from abroad; • making of natural cells of plague healthy; • urgent prophylaxis in the case of exposure of patient with a plague.

28. immunization of people : • vaccinations of population of certain territories; • urgent 6-daily prophylaxis by streptomycine tetracycline on suspicion of possible infection.