Epidemiological situation in the world on cholera and preventive measures

Epidemiological situation

According to the World Health Organization (hereinafter referred to as WHO), there is a high activity of the cholera epidemic process in the world, including in endemic countries of Asia (India, Bangladesh, Thailand) and Africa (Somalia, Burundi, Zambia, Zimbabwe, Nigeria, Ethiopia, Kenya, Cameroon, Democratic Republic of the Congo, Mozambique).

According to global According to the 2023 cholera statistics released by WHO in early September 2024, the 7th cholera pandemic continues to gain momentum, with an increase in the number of cases and deaths. The number of reported cholera cases in 2023 (535,321 cases, 103 countries) increased by 13% compared to 2022. The geographic pattern of outbreaks continued to change, with the number of cases reported in the Middle East and Asia decreasing by 32%, while cases increased by 125% in Africa. In 2023, large outbreaks (more than
10,000 suspected and confirmed cases per country) were reported in 9 countries on 3 continents (Afghanistan, Bangladesh, Democratic Republic of the Congo (DRC), Ethiopia, Haiti, Malawi, Mozambique, Somalia and West Africa).

As of 01.08.2024,
312,135 cases of cholera have been registered worldwide in 2024, including 2,284 deaths.

According to the latest data:

In Bulgaria, for the first time in 103 years, a case of cholera was registered in an Indian citizen living in Bulgaria and visiting New Delhi;

An outbreak of cholera has been registered in Nigeria, as of 09/06/2024, 40 cases of the disease have been registered, including 3 deaths;

As of 09/05/2024, 4,190 cases of cholera have been registered in Sudan.

For reference: cholera is an acute intestinal infection that occurs as a result of human infection with cholera vibrios. It can be transmitted in several ways:

water: when drinking water, using ice, swimming in bodies of water, washing dishes;

food: when consuming products that have not been sufficiently heat treated;

contact-household: through unwashed hands and household items.

The source of infection is a person. He can be either a patient (with a clinical picture) or an asymptomatic carrier.

Often, the infection causes diarrhea or has no obvious symptoms. However, in some cases, patients develop severe watery diarrhea and vomiting 12 hours to 5 days after the bacteria enters the body. In these cases, the loss of large amounts of fluid can quickly lead to severe dehydration. Without proper treatment, this can be fatal.

Clinical symptoms: nausea, loose stools (diarrhea), vomiting.

Prevention

- use boiled or bottled water for drinking and household purposes (for example, brushing teeth), washing fruits and vegetables (it is important to refrain from using ice to cool various drinks);

- avoid eating raw and undercooked foods (especially fish and seafood), do not buy food products from street or random vendors;

- use for swimming only water bodies permitted for organized recreation. When swimming in open water bodies, swimming pools, avoid getting water in the mouth;

- observe personal hygiene rules (wash hands with soap, use antiseptic after visiting sanitary facilities, public places, before eating).

!!!Travelers must familiarize themselves with the epidemiological situation in the destination country and preventive measures in advance!!!

More detailed information can be found on the website of the Ministry of Health of the Republic of Belarus,
the State Institution "Republican Center for Hygiene, Epidemiology and Public Health".

Epidemiological situation in the world on monkeypox and preventive measures

Epidemiological situation

08/14/2024 The World Health Organization has declared the monkeypox epidemic in Africa a public health emergency.

Currently, cases are registered in African countries. According to the African Centers for Disease Control and Prevention, as of 10.09.2024, more than 24 thousand cases of monkeypox have been registered in the African region in 2024, including 643 deaths.

At the same time, in the second half of August 2024, cases were registered:

Sweden has one case of infection with the new strain of monkeypox, the first outside Africa. As of September 5, no secondary cases have been identified;

In Australia (New South Wales), more than 90 new cases of monkeypox have been reported in two months;

Pakistan reports 2 cases of monkeypox in people returning from the United Arab Emirates;

The Philippines has recorded 1 case of monkeypox infection in the country ;

A case of monkeypox has been reported in Thailand in a traveler returning from an African country.

According to ProMEDmail, as of 09/09/2024, monkeypox has been registered in the following countries: Burundi, Cameroon, Central African Republic, Democratic Republic of the Congo, Ghana, Côte d'Ivoire, Kenya, Liberia, Mozambique, Nigeria, Pakistan, Philippines, Republic of the Congo, Rwanda, South Africa, Sweden, Thailand and Uganda - a total of 18 countries.

According to information from the Ministry of Health of the Republic of Belarus, there have been no cases of monkeypox registered in the country to date.

General rules of prevention

To reduce the risk of person-to-person transmission, close physical contact with people infected with monkeypox or with similar symptoms should be avoided.

It is necessary to observe the rules of general hygiene, including washing hands with soap and using alcohol-containing antiseptics.

Travelers should familiarize themselves with the epidemiological situation in the country of destination in advance; when visiting countries where monkeypox is registered, avoid contact with animals that may be infected with the causative agent of this disease (rodents, marsupials), and refrain from eating the meat of wild animals.

For reference: infection occurs as a result of direct contact with blood, biological fluids, as well as affected skin or mucous membranes of infected animals (some species of monkeys or rodents.

The main routes of transmission from person to person are:

contact-household: occurs as a result of close contact with secretions from the respiratory tract, damage to the skin of an infected person, or with objects infected with biological fluids;

sexual.

Key warning signs that do not rule out monkeypox

fever;

enlarged lymph nodes;

muscle pain;

with rash.

The rash usually appears within 1-3 days after the onset of fever. The rash is most often localized on the face, as well as the palms of the hands and soles of the feet. The mucous membranes of the mouth, genitals, conjunctiva and cornea are also affected.

The rash progresses sequentially from flat-based primary lesions to vesicles/bubbles filled with clear or yellowish fluid. The rash resolves with crusts that dry up and fall off. The number of skin lesions varies from a few to thousands. In severe cases, the lesions may be confluent.

More detailed information can be found on the website of the Ministry of Health of the Republic of Belarus, the State Institution "Republican Center for Hygiene, Epidemiology and Public Health".

Prevention of acute respiratory diseases, influenza and coronavirus infection

Acute respiratory disease (ARI) — is a general name for all types of acute respiratory diseases caused by viral or bacterial infection.

Acute respiratory viral infection (ARI) — a general term for clinically and morphologically similar acute inflammatory diseases of the respiratory tract and lungs caused by viruses tropic to the ciliated epithelium of the respiratory tract. It is the most common group of diseases in the world, combining influenza, coronavirus, respiratory syncytial, rhinovirus, adenovirus and other infections causing catarrhal changes in the respiratory tract (runny nose, cough, sneezing, headache, sore throat, fatigue).

The circulation of respiratory viruses in our region is increasing annually autumn-winter period. The infection is quickly transmitted from person to person by airborne droplets, causing mass morbidity of the population up to her epidemic level. ARVI refers to the number of the most widespread infectious diseases, their the share annually falls to 90-95% in the structure of registered infectious diseases.

Flu — a type of acute respiratory viral infection caused by one of three types of influenza virus (A, B or C). Flu is characterized by a sudden rise in temperature to 39-40°C, severe chills, muscle and headaches, and intoxication. Sore throat and dry cough may occur from the very beginning of the disease. High temperature can last for 3-4 days and be accompanied by delirium, severe headaches, insomnia, neuralgia. This infection is characterized by a particularly severe course, the presence of severe complications (viral myocarditis, damage to the brain, liver, in pregnant women, influenza often leads to thrombosis, gestosis , intrauterine death and loss of the fetus) and can end in death.

Coronavirus infection ( COVID -19) is a potentially severe acute respiratory infection caused by the SARS-CoV-2 coronavirus . It can occur in the form of a mild acute respiratory viral infection or in a severe form. The most common symptoms of the disease include fever, fatigue, and dry cough. The most common complication of the disease is viral pneumonia, which can lead to acute respiratory distress syndrome and subsequent acute respiratory failure. Complications include multiple organ failure, septic shock, and venous thromboembolism.

Prevention of acute respiratory viral infections, including influenza and coronavirus infection, involves a set of measures aimed at strengthening the body's defenses and limiting contact with the source of infection.

All preventive measures can be divided into specific and non-specific. 

Non-specific prevention – these are methods of prevention aimed at increasing the protective (reactive) forces of the body to counteract respiratory viruses penetrating the human body. Non-specific prevention is carried out both in the pre-epidemic period and directly during the period of epidemic increase in morbidity.

During the period of increased incidence of acute respiratory viral infections, including influenza and coronavirus infection, The following current recommendations must be followed:

• avoid close contact with people who have symptoms of acute respiratory disease;
• if possible, minimize visits to public places or limit the time spent in them;
• use a mask if necessary;
• observe hand hygiene (wash hands with soap and water or use hand sanitizers);
• ventilate the premises as often as possible and carry out wet cleaning if necessary;
• observe "respiratory etiquette";
• treat common items with disinfectants;
• use bactericidal air recirculators in places where large numbers of people congregate, especially in small spaces;
• adhere to the principles of a healthy lifestyle: adequate sleep, balanced nutrition, physical activity, regular walks in the fresh air.

"Respiratory Etiquette" – a set of simple rules of conduct aimed at limiting the spread of respiratory diseases, which includes the following measures:

- when coughing and sneezing, you must use a handkerchief, preferably disposable paper handkerchiefs, which are thrown away immediately after use;

- if you don’t have a handkerchief, sneeze and cough into your elbow, not into your palms;

- try not to touch your face with unwashed hands.

Masks People with signs of respiratory diseases and those caring for sick people should wear them first. It is also recommended to use masks when visiting public places. Preference should be given to disposable masks. The mask should not be used for more than two hours. The mask should be replaced immediately if it gets wet (moistened), even if less than two hours have passed since use. Disposable masks cannot be reused.

  Formation specific immunity against influenza viruses and coronavirus infection is achieved by early vaccination (before the epidemic), which is especially recommended for vulnerable groups of the population. For influenza, these are pregnant women, children aged 6 months to 5 years, people over 65 years old, people with chronic health problems, and healthcare workers. Vaccination against COVID-19 is necessary for people with chronic diseases and people with immunosuppression , people over 60 years old, and people who are and work in institutions with a 24-hour stay regime.

Vaccination not only dramatically reduces the incidence rate, but also significantly softens the course of the infection, prevents the occurrence of severe complications and deaths. Immunization against influenza and coronavirus infection is carried out before the start of the epidemic season (optimal dates are September-November) so that by the beginning of the epidemic spread of the infection, a person has formed an immune response to the administered drug. After vaccination, antibodies in the body of the vaccinated person appear after 12-15 days.

Flu vaccines are produced for each season, they include current strains of influenza viruses (at least 3), the circulation of which is predicted annually by the World Health Organization. The composition of the vaccine against COVID -19 in the 2024/2025 season has also been updated and includes the glycoprotein of the Omicron HBV virus, which allows for the highest level of protection against diseases and COVID -associated deaths.

Vaccination has a number of contraindications: allergic reactions to vaccine components - chicken protein, allergic reactions to a previous vaccination, acute febrile conditions or exacerbation of a chronic disease. Residual effects of a previously suffered acute respiratory disease (nasal congestion, cough, etc. in the absence of fever) are not a contraindication for vaccination, but the final decision on its appropriateness should be made by a doctor at an in-person appointment.

 Prevention of acute respiratory viral infections, flu and coronavirus infection is the key to maintaining health. The main thing is to approach this matter with full responsibility and not to forget about simple rules that allow you to protect yourself and your loved ones from infection. Rational nutrition, a healthy lifestyle, hardening and active sports will increase the body's resistance to colds and prevent the occurrence of many other health problems.

Take care of yourself and your loved ones.