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G OO 6 S GS SO OO f e s ata se pa ea

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G OO 6 S GS SO OO f e s ata se pa ea

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    1. ???????? ???????? ???G??? ????O??O? 6? ???S???????? ??????? ???G??S ??S????????O? ????O??O? ???f?”??e?? ??s?”ata se ?????? pa????? ??e?a? ?a??a ????????? ??d???? ?a??????? – ???”?????????, G.?.?????? «?pp????te??» 3 ??e”ß???? 2006

    2. ???f?”??e?? ??s?”ata

    3. ??sa????-?p?d?”??????a ? ???f?”??e?? ??s?”ata p??sß????? pe??p?? 76 e?at?”???a ?t?”a ”e 325000 ??s??e?e? ?at’ ?t?? st?? ?.?.?. (?p?????s”?? CDC) ??? ? ??s???t?ta e??a? p??? ”e???? ? ???t?t?ta e??a? ”???? (pe??p?? 5000 ?t?”a pe?a????? ?at’ ?t??). S?????? p??? ??a ? ??????”??a ?t?”a ? ?t?”a ”e ?p??e?”e?? a??s??atast???. ?? p??sfate? a??a??? st?? t??p? ???? (ta??t?ta ”etaf????) ?a??? ?a? ?? te??st?e? a??a??? p?? e??a? ?? ap?t??es”a t?? ”a????p???s? st?? pa?a???? ?a? st?? d?a??”? t??f?”?? ?p?? ep?s?? ?a? ? a?t??? t?? ”????ß??? ????? ?? ap?t??es”a t?? e”f???s? ???? ”a?? ”e t?? p???? pa?ad?s?a??? ”??f?? t?? t??f?”??e??? ???”??e??. Practice Guidelines for the Management of Infectious Diarrhea. IDSA. CID 2001;32:331-351

    4. ??sa????-?p?d?”??????a ?? ?? ????? pa????? ??e?a? ???? ”a????? pa?a????? ?a? d?a????s?? t??f?”?? ?a? pa???s?a? ?d?a?te?a e?pa??? at?”?? e??a? s???? ped?? e”f???s?? e???se?? ????s”?t?? t?f?”??e??? ???”??e??. ?a t??f?”??e?? ??s?”ata de? d?af????? ?? p??? t?? e?d???se?? e?te af????? t?? ?????t?ta e?te ?????? pa????? ??e?a?. ????te?? d?af????? d?????s? st??? ?????? pa????? ??e?a? d??t? ?p?????? p???? ???a a?t?a ?ast?e?te??t?da?-?d?a?te?a p??ß??”ata ????? d??t?a ep?t???s?? ?a? ?ata??af?? pa?????? s?st?”at??? ep?d?”???????? st???e?a p?? af????? t?? ?????t?ta se p????? ???e?.(p?.FOOD-NET st?? ???, ???????, ?F??) ?p? ?????? pa????? ??e?a?: p????? ”e”???”??e? pe????af?? ”????ep?d?”??? ”e t?? e?a??es? ”e????? p???? s?st?”at???? st???e??? ap? ???s”??e? ???e?( ?e?. ??etta??a ? ??st?a??a)

    5. ?p?d?”??????a-??st?? ??st??: St?? ?e?. ??etta??a $ 1.488 e? ?? ???”??e?? s?et???”e?e? ”e ?????? pa????? ??e?a?. ?p?d?”???? e???se?? ?ast?e?te??t?da?: 12,5% t?? s???????? ??st??? (sta ep?peda t?? ???????”??e??): $ 184 e?. (2002-2003)

    6. ?p?pt?se?? ????a e?d???s? e??a? ? ?ast?e?te??t?da p??????? e?t?se?? (?????? ??s???t?ta-? ???t?t?ta e??a? s?????? ”????) ?? ???”?de?? pa?????te? p?? p???a???? t??f?”??e?e?? ???”??e?? s?????? ”etad?d??ta? p??? e????a ”e ?”es? ? ?”es? epaf? ap? ?t?”? se ?t?”? e?te ”e t? ?e?? ?a? ta t??f?”a (t??f?”??e?e?? ???”??e??) ?a? s???? p???a???? de?te???e?e?? ep?d?”???? e???se?? ????s”?t?? a? de? a?a?????s???? ???a??a Current Opinion in Pharmacology 2005;5:559-565

    7. ???e? ep?pt?se?? S?st?”at??? ??s?? ?p?? ? t?f?e?d?? p??et??, ??ste???s? (”??????t?da, s???), ?e??ta??? p??et??, ????p?as”a, t??????s? ?e????????? ??s??: ???a?t?as?, ??ste???s? (”??????t?da), nvCreutzefelt-Jakobs(??s?? t?e??? a?e??d??), ”a??t???a, tet?ad?t????? S?ßa??? ”a????????e? ep?p????? : a?”???t??? ???a?”??? s??d??”? ?a? ?ef???? a?ep???e?a s?et???”e?? ”e E.Coli 0-157 ?:7 (STEC ? e?te??a?”???a???? ? VTEC) s??d??”? Guillain-Barre ”et? ap? ???”??? ”e C. jejuni Diagnosis and Management of foodborne illnesses CDC MMWR 2004;53(No RR-4)

    8. S?”pt?”ata

    9. ???f???? d???t????se??

    10. ?a?????a p?? p???a???? t??f?”??e?e?? ???”??e?? ?p? ta 250 ?a? p???? pa?????a p?? p???a???? t??f?”??e?e?? ???”??e?? ta s????te?a e??a?: ?a?t???a: Salmonella spp ,Shigella spp, .Campylobacter spp E Coli ?:157 ?7. Listeria spp Yersinia, Clostiridium perfingens ?a??s?ta: Cryptosporidium, Giardia Lamblia, Entamoeba histolytica ???: Norwalk virus Rotavirus, Adenovirus,, ?epatitis A virus S????te?a ta?t?p?????ta? ?? ”????ß?a??? pa?????te? a? ?a? s????te?e? e??a? ?? ???e?e?? t?f?”??e?e?? ???”??e?? a??? ?? ??? ta?t?p?????ta? d?s???a. Diagnosis and Management of foodborne illnesses CDC MMWR 2004;53(No RR-4)

    11. S????? a?t?a t??f?”??e??? ???”??e??

    12. S????? a?t?a t??f?”??e??? ???”??e??

    14. ?? ???”?d? a?t?a t??f?”??e??? ???”??e??

    15. ?p?d?”???? e???se?? (outbreak) ??????? st?? ?????a ?a? ?e?. ??etta??a 1990-5

    16. ?p?d?”???? e???se?? ??????? st?? ?????a ?a? ?e?. ??etta??a 1990-5

    17. ?p?d?”???? e???se?? ???”?d??? ?ast?e?te??t?da? sta ??s???”e?a st?? ?????a ?a? ?e?. ??etta??a 1992-200

    19. ?p?d?”???? e???se?? ???”?d??? ?ast?e?te??t?da? sta ??s???”e?a st?? ?????a ?a? ?e?. ??etta??a 1992-2000 ???f?”??e?e?? ???”??e??

    20. ?p?d?”???? e???se?? ???”?d??? ?ast?e?te??t?da? sta ??s???”e?a st?? ?????a ?a? ?e?. ??etta??a 1992-2000 T??t?t?ta

    24. ???s”?? ???????a: ????s? t?? ß????? t?? ??p????? > 250gr a?? 24???. ????s? t?? ?e?st?t?ta? t?? ??p????? (”a?a?? ? ?da?? ??p?a?a) e?te a???s? t?? ????? t??? e?te a???s? t?? s????t?ta? t?? ?e??se?? se pe??ss?te?e? ap? t?e?? ?”e??s??? ??s???”e?a?? ???????a: ?”f???s? 72 ??e? ”et? t?? e?s?d? t?? as?e???? st? ??s???”e?? «??? d?a?????? s??d??”?»: ?????e?a < 14 ?”??e? (? ?a? ”???? t?e?? ßd?”?de? ?at’ ???s”?????). «?p?”??? d?a?????? s??d??”?»: >14 ?”??e? «?????? d?a?????? s??d??”?»: > 1 ”??a «F?e?”???d?? d??????a»: ?????a?? ?????, te??es”??, pa???s?a a?”at?? , ?e?????t???? st? ??p?a?a

    25. ???t???a ??a t? d?????s? t?? ?ast?e?te??t?da? ???t?? ??????? ??d???? ???”??e?? ???t???? 1 (???a??): ? as?e??? e”fa???e? ap?t?”? d??????a (?da?? ??p?a?a ??a pa?ap??? ap? 12 ??e?) ”e ? ????? e”?t??? ? p??et? (>38 ?C), ?a? ????? t?? pa???s?a e”fa???? ”? ???”?d??? a?t?a? (p?. ??????s? fa?”????, ??e?a pa?????s? ?????a? ??s?? ? ?????????? stress)

    26. ???t???a ??a t? d?????s? t?? ?ast?e?te??t?da? ???t?? ??????? ??d???? ???”??e?? ???t???? 2 (?eßa??”???):? as?e??? e”fa???e? 2 t??????st?? ap? ta a??????a s?”e?a s?”e?a ? s?”pt?”ata ????? ?a ?p???e? ???? a?a?????s”??? a?t?a: ???et?? (>38 ?C,?a?t?a, ?”et?? ,?????a?? ????? ,? e?a?s??s?a) ?a? t??????st?? 1 ap? ta a??????a 1. Tet??? ?a??????e?a ??a e?te???? pa?????? ap? ta ??p?a?a ? ap? de??”at?????a ????? ”e st??e? 2. ??e??es? e?te????? pa??????? ”e ”????s??p?s? (”e ????? ? ??e?t?????? ”????s??p?? ) 3. ??e??es? e?te????? pa??????? ”?s? a?t???????? ? a?t?s?”at???? a????s?? st? a?”a ? sta ??p?a?a 4. ??de??e?? ??a t?? pa???s?a e?te????? pa??????? p?? a????e?eta? d?a ?st???? ?a??????e?a? (a????e?s? t??????) 5. ??a???st??? ”????? t?t?? a?t?s?”?t?? (IgM) ? tet?ap?as?as”? t?? t?t??? t?? e?d???? ??a t? pa?????? a?t?s?”?t?? .(IgG)

    27. ??e?e???s? s?????? ????s”?t?? t??f?”??e??? ???”??e?? ???e ??a?s? ????s”?t?? a????e? ”e ??a as?e?? p?? ”p??e? ?a ”?? e??a? ?d?a?te?a p?s??? ?a s?”pt?”ata e??a? s?????? p??? ????? (e?d???se?? ?ast?e?te??t?d??) ????? ?a ap???e???ta? ?a? p???? s?st?”at???. S?”a?t??? st???e?a: ?????? ep?as?? (p??s??? a? e??a? ”a????) ?????e?a ?p???e?””at???? ??s?? ????a ??????? s?”e?a ?a? s?”pt?”ata ?p?pte? t??f?? ? p????s”?? p?? e?t????e ???a ?t?”a ”e s????? se ?????, ???? ”e pa??”??a s?”pt?”ata ?p???????? ??s??-f??e?a

    28. ?ata????s? ?p?pt?? t??f?? ???f?? p?? ?ata?a?????ta? f??s??e? ? a?epa???? ??”??e?: F??s?a ? ”?s???”??a a??? (”a??????a), ?st?a?a, ???ata (??t?p???a, ??”??), ????a, ”? paste???”??a ???ata ? p?????ta ???a?t?? ? f???t???”??, ???s??ße?, ?a?a???? ? ”a?a?? t???? ap? ”? paste???”??? ???a

    29. ??de??? ??s???”e?a??? ep?d?”?a? ?ast?e?te??t?da? ? e”f???s? d?? ? pe??ss?te??? pe??pt?se?? ??s???”e?a??? ???”?d??? ?ast?e?te??t?da? p?? p????????a? ap? t?? ?d?? ”???????a??s”? ”?sa se ”e????? ßd?”?de? ?a p??pe? ?a ??t??? ?p????a t???? s?s??t?s?? ”eta?? t???. ? d?e?e???s? t?? pe??stat???? ”p??e? ?a ”?? a?ade??e? t?? p??? t?? ???”??e??. ? pa?a???????s? t?? ?a???e??e??? ????? ??s??e??”???? as?e??? st?? ?d?e? pe?????? ??s??e?t???? f???t?da? t?? as?e?? ”e ?ast?e?te??t?da, ß???? st?? a?a?????s? t?? as?”t?”at???? as?e???. S???pa??? pe??pt?se?? ?ast?e?te??t?da? se p??s?p??? ?a? as?e?e?? ??????????ta? ?? ?a???e? d?e?e???s?? ??s???”e?a??? ep?d?”?a?

    30. ??????s?

    31. ??????s?

    32. ????????s? as?e???? ”e ?p????a t??f?”??e???? ??s???”e?a??? ?ast?e?te??t?da?

    33. ??te p??pe? ?a st???eta? ?a??????e?a ??p?????; ???? e??a? t? s?st?;

    34. ??te p??pe? ?a st???eta? ?a??????e?a ??p????? ??a ????? e?te???? pa?????a;

    35. ??te st????”e ?a??????e?a ??p?????? ??te s???st?ta? d?a???st??? d?e?e???s??

    36. ??a??t?s? p???”??f?p??????

    37. ??a???st??? p??s????s? se s?ßa?? d?a?????? s??d??”? ? s?”as?a t?? ?a??????e?a? ??p?????

    38. ??a???st??? p??s????s? se s?ßa?? d?a?????? s??d??”? ? s?”as?a t?? ?a??????e?a? ??p?????

    39. ??????s? ?e t?? ?a??????e?a ??p????? ap?”??????ta? ??????: Salmonella spp , Campylobacter jejuni, Shigella spp., ste???? ?. Coli. ?e t?? s????e?? ?a??????e?e? ??p????? de? d?a???????ta? ta ??te??a?”???a???? (STEC) ap? t? ETEC ?a? EAEC ap? t?? ”? pa?????? E. Coli. ???pe? ?a a?a??t???ta? ”e e?d???? te?????? ?p?? ?a? ?? t????e? ”????ß??? ?? ??? ep?s?? de? ?a???e?????ta? se ?a??????e?a ??p?????.

    40. ??a???st??? p??s????s? se ?p????a t??f?”??e???? ??s???”e?a??? ?ast?e?te??t?da?-?

    41. ??a???st??? p??s????s? se ?p????a t??f?”??e???? ??s???”e?a??? ?ast?e?te??t?da?-??

    42. ??a???st??? p??s????s?-Real time PCR

    43. ??????s? Se pa?ateta”??a p??e??????ta s?”pt?”ata ap? t? a??te?? pept??? (?a?t?a ,e?????) pa?as?t??????? ??p????? ??a G. lamblia ?a? cyclospora . ?et? ap? pa???e?s? ?”e??? ?a? e””??? s?”pt?”?t?? > 7 ?, ???s? ??e??t??? ? t?p?p???”??? ??e??t???? Cryptosporidium, Isospora, and Cyclospora. Se a??s??atesta?”??a ?t?”a (AIDS ”e CD4 c<100 cells/”L, t?????”?? ???s? ??a Microsporidium

    44. Te?ape?t??? p??s????s? se t??f?”??e???? ??s???”e?a??? ?ast?e?te??t?da?

    45. Te?ape?t??? p??s????s? t??f?”??e???? ??s???”e?a??? ?ast?e?te??t?da? S?”pt?”at??? a?t?d?a?????? a????. ??te;

    46. Te?ape?t??? p??s????s? t??f?”??e???? ??s???”e?a??? ?ast?e?te??t?da? ?”pe????? a?t?ß??t??? a????. ??te;

    47. Te?ape?t??? p??s????s? t??f?”??e???? ??s???”e?a??? ?ast?e?te??t?da? ?”pe????? a?t?ß??t??? a????. ????;

    48. Te?ape?t??? p??s????s? t??f?”??e???? ??s???”e?a??? ?ast?e?te??t?da? ??t?ß??t??? a????. Se p??? pa?????a e??a? apa?a?t?t?;

    49. Te?ape?t??? p??s????s? se d?a?????? s??d??”? ??t?ß??t??? a????. ??te de? ?????e?ta?;

    50. Salmonella enterica Gast?e?te??t?da

    51. Salmonella enterica Gast?e?te??t?da

    52. Salmonella-2004 Whonet. gr

    53. ????pa??? d??t?? ep?t???s?? Sa?”??e???se?? ?a? E.coli (STEC ? VTEC ? e?te???a?”???a????)

    54. Salmonella-2004 Whonet. gr

    58. Shigella A??”? ?a? ?a”??? d?s? t?? ???a??s”?? a?t?? e??a? ???”??????. ?p??e? ?a pa???s???eta? ”e a?”at???? d??????e? Ge???? s?”pt?”ata ???et?. ????t?da, te??es”? , t?s? ??a af?de?s?, ?????a?? ?????.

    59. Campylobacter jejuni Campylobacter :e”fa?????ta? ”e a?”at??? d??????a ?a? p??et?. ???ß??”a ? a?t?stas? t?? ????????? ?a? a?????”??????. ????t?da,te??es”? ,t?s? ??a af?de?s?,?????a?? ????? ?a? a?”a sta ??p?a?a (s????)

    62. Meat Products Associated with Transmission of E. coli O157(e?te??a?”???a????) Ground beef products Other red meats Roast beef Dry cured salami Cooked meat products Turkey meat

    63. Dairy Products and other Foods Associated with Transmission of E. coli O157 (e?te??a?”???a????) Raw milk “Pasteurised milk” Yoghurt Cheese Cream

    64. ?aӧ??as?

    65. Vibrio spp. ?? ????? Vibrio parahaemolyticus ?a? non-O-group 1 Vibrio cholerae ”p??e? ?a s??d?eta? ”e t? ß??s? ?”?? ? ?a?? ”a?e??e”???? ?a????. .

    66. ?a??s?ta ?? s????te??? ???a??s”?? t?? ?at?????a? a?t?? e??a? : Giardia intestinalis, Cryptosporidium parvum, Cyclospora cayetanensis, Entamoeba histolytica, ?a? Dientamoeba fragilis. Entamoeba histolytica

    69. ???????

    70. S???st?”e??? (recommended) ??f?e?d?? p??et??: ?. ?s?a (pe????? ??d???), ?f???? (a??”? ?a? ???e???) ?a? ?at????? ?”e????. ????a??e?t??? ste???? Salmonella. ??te??st?”at??? ?d?? ”etad?se??. S????t?ta: 6 -118 pe??pt?se?? /106 ta??d??te? a??”a ?a? ”???? d????e?a ta??d??? se ???a ?????? ???d???? ?????? ?a??d??te? se a?apt?ss?”e?? ???a ”e pa?ateta”??? ???es? se ”???s”??a t??f?”a ?a? ?e??. ???”a ?a? business travelers (?e????? ??d??? > 2 ßd?”?de?) ?”ß???a 1. ?p? t?? st?”at?? (Viv?tif Berna). ??? e?as?e??”??? Ty21 st??e??? S. Typhi > 6 et??. 4 ??????e?. ???a pa?? ”??a d?? ßd?”?de? p?? t?? a?a????se??. ???s???! ???e??. ??? ”a?? ”e a?t?ß??t??? ? ”ef?????? 2. ????sa??a??d??? e”ß???? ????? ??a pa?e?te???? ???s? (Typhim Vi, Aventis Pasteur 1 d?s? e?d?”????? > 2 et?? ?p?te?es”at???t??: 50-80% ??f?e?d?? p??et??

    71. ??? eӧ???? ??a?t? t?? ??ta???

    72. ???: www.who.int London school of hygiene and tropical medicine www. lshtm.ac.uk Eurosurveillance www.eurosurv.org/update Centers for disease Control and www.cdc.gov/foodsafety prevention (CDC) H?? Foodsafety Information www.foodsafety.gov ??????? mednet/whonet.gr whone ??de??t???? p???? p????f????? ??? t?? ??at??

    73. S?”pe??s”ata-? ???a??? a?a?????s? t?? p??a??t?ta? t??f?”??e???? ???”??e?? st? ??s? e??? as?e??. ??a??t?s? ?a? ????? ????s”?t??. ???t?????? d?e?e???s?? ??s???”e?a??? ep?d?”?a? ?at? ?a???a a??? ??? p??ta ????a????? ta ?ast?e?te???? s?”pt?”ata ???a??? ap?st??? ?a???e??e??? ??p????? a??? ?a? a?aa??t?s? e?d???? pa??????? ”e e?d???? d?a???st???? d???”as?e? (E.Coli 0157-H7, Vibrio spp.) ?at? pe??pt?s? ?a??????e?a ?p?pt?? t??f?? ? a?a??t?s? t??????

    74. S?”pe??s”ata-?? ??af??? st?? ep?t??p? ??s???”e?a??? ???”??e?? ?a? st?? ?p??es?e? ??”?s?a? ??e?a? ???e as?e??? ”e t??f?”??e?? ???”??? ”p??e? ?a ap?te?e? t?? p??t? e?de??t??? pe??pt?s? ”??? ”e?a??te??? s?????? ????s”?t?? ?pa?a???????s? t?? ”?t??? e?????? ?a? p???????

    75. S?”pe??s”ata ?e t?? pa???s”??p???s? ?a? t?? ”a????p???s? t?? pa?a????? t?? pa?a????? t??f?”?? ?a? t?? a?t??? sta a?t?ß??t??? ta t??f?”??e?? ??s?”ata st??? ?????? pa????? ??e?a? ap?te???? ??a s?ßa?? pa???s”?? p??ß??”a ??e?a? p?? af??? e??s?? a?apt??”??e? ?a? a?apt?ss?”e?e? ???e?

    76. ?as???? p??f????e?? (standards precautions)

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