microbeПроблемы особо опасных инфекцийProblems of Particularly Dangerous Infections0370-10692658-719XRussian Research Anti-Plague Institute “Microbe”10.21055/0370-1069-2024-1-102-112microbe-1949Research ArticleОБЗОРЫREVIEWSРезультаты работы инфекционистов и эпидемиологов Роспотребнадзора во время вспышки острых кишечных инфекций в Республике Конго (Браззавиль) в 2023 г.The Results of Work of Infectious Disease Specialists and Epidemiologists of the Rospotrebnadzor during the Outbreak of Acute Intestinal Infections in the Republic of the Congo (Brazzaville) in 2023https://orcid.org/0000-0003-2570-711XПшеничнаяН. Ю.PshenichnayaN. Yu.

111123, Москва, ул. Новогиреевская, 3а

3a, Novogireevskaya St., Moscow, 111123

crie@pcr.ruhttps://orcid.org/0000-0001-6474-3696НайденоваЕ. В.NaidenovaE. V.

Найденова Екатерина Владимировна, 

410005, Саратов, ул. Университетская, 46

Ekaterina V. Naidenova, 

46, Universitetskaya St., Saratov, 410005

rusrapi@microbe.ruhttps://orcid.org/0000-0001-8703-7671ГопацаГ. В.GopatsaG. V.

111123, Москва, ул. Новогиреевская, 3а

3a, Novogireevskaya St., Moscow, 111123

crie@pcr.ruhttps://orcid.org/0000-0002-4198-0629КузнецоваД. А.KuznetsovaD. A.

344002, Ростов-на-Дону, ул. М. Горького, 117/40

117/40, M. Gor’kogo St., Rostov-on-Don, 344002

plague@aaanet.ruДмитриеваЛ. Н.DmitrievaL. N.

410005, Саратов, ул. Университетская, 46

46, Universitetskaya St., Saratov, 410005

rusrapi@microbe.ruhttps://orcid.org/0000-0002-0087-9153ЕвтеевА. В.EvteevA. V.

344002, Ростов-на-Дону, ул. М. Горького, 117/40

117/40, M. Gor’kogo St., Rostov-on-Don, 344002

plague@aaanet.ruhttps://orcid.org/0009-0009-2889-4724ТушинскийА. А.TushinskyA. A.

344002, Ростов-на-Дону, ул. М. Горького, 117/40

117/40, M. Gor’kogo St., Rostov-on-Don, 344002

plague@aaanet.ruhttps://orcid.org/0000-0002-8334-9173ПортенкоС. А.PortenkoS. A.

410005, Саратов, ул. Университетская, 46

46, Universitetskaya St., Saratov, 410005

rusrapi@microbe.ruhttps://orcid.org/0009-0006-9744-459XObissaN.ObissaN.

Браззавиль

Brazzaville

MpompoloM.MpompoloM.

Долизи

Dolisie

Elenga-BongoSh. L.Elenga-BongoSh. L.

Пуэнт-Нуар

Pointe Noire

InanaM.InanaM.

Долизи

Dolisie

Mobousse MisseJ.-C.Mobousse MisseJ.-C.

Браззавиль

Brazzaville

https://orcid.org/0000-0003-3788-3452КутыревВ. В.KutyrevV. V.

410005, Саратов, ул. Университетская, 46

46, Universitetskaya St., Saratov, 410005

rusrapi@microbe.ruСмоленскийВ. Ю.SmolenskyV. Yu.

127994, Москва, Вадковский пер., 18, стр. 5 и 7

18, Bld. 5 and 7, Vadkovsky Lane, Moscow, 127994

ФБУН «Центральный научно-исследовательский институт эпидемиологии»РоссияCentral Research Institute of EpidemiologyRussian FederationФКУН «Российский противочумный институт «Микроб»РоссияRussian Research Anti-Plague Institute “Microbe”Russian FederationФКУЗ «Ростовский-на-Дону научно-исследовательский противочумный институт»РоссияRostov-on-Don Research Anti-Plague InstituteRussian FederationМинистерство здравоохранения и народонаселения Республики КонгоКонгоMinistry of Health and Population of the Republic of the CongoCongoГенеральный госпиталь г. ДолизиКонгоDolisie General HospitalCongoГенеральный госпиталь им. Адольфа СисеКонгоAdolphe Cissé General HospitalCongoДепартамент здравоохранения провинции НиариКонгоDepartment of Health of Niari ProvinceCongoФедеральная служба по надзору в сфере защиты прав потребителей и благополучия человекаРоссияFederal Service for Surveillance on Consumers’ Rights Protection and Human Well-beingRussian Federation20240404202401102112Copyright © Пшеничная Н.Ю., Найденова Е.В., Гопаца Г.В., Кузнецова Д.А., Дмитриева Л.Н., Евтеев А.В., Тушинский А.А., Портенко С.А., Obissa N., Mpompolo M., Elenga-Bongo S.L., Inana M., Mobousse Misse J., Кутырев В.В., Смоленский В.Ю., 20242024Пшеничная Н.Ю., Найденова Е.В., Гопаца Г.В., Кузнецова Д.А., Дмитриева Л.Н., Евтеев А.В., Тушинский А.А., Портенко С.А., Obissa N., Mpompolo M., Elenga-Bongo S.L., Inana M., Mobousse Misse J., Кутырев В.В., Смоленский В.Ю.Pshenichnaya N.Y., Naidenova E.V., Gopatsa G.V., Kuznetsova D.A., Dmitrieva L.N., Evteev A.V., Tushinsky A.A., Portenko S.A., Obissa N., Mpompolo M., Elenga-Bongo S.L., Inana M., Mobousse Misse J., Kutyrev V.V., Smolensky V.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.microbe.ru/jour/article/view/1949

Представлен анализ результатов совместной работы российских и конголезских инфекционистов и эпидемиологов по расшифровке этиологии и причин вспышки кишечных инфекций в г. Долизи (Республика Конго) летом 2023 г. Установлено, что подъем заболеваемости кишечными инфекциями вызван преимущественно возбудителями брюшного тифа и дизентерии, в качестве сочетанной патологии выступала тропическая малярия. Случаев выявления больных холерой не зарегистрировано. Активной передаче возбудителей способствовали проблемы систем водоснабжения г. Долизи, бытовая неблагоустроенность, низкая осведомленность населения о профилактике кишечных инфекций. Сочетание проявлений эпидемического процесса свидетельствовало о водном характере вспышки, также зарегистрированы случаи передачи возбудителя контактно-бытовым путем, не исключался и пищевой. Больные с тяжелыми и осложненными формами брюшного тифа и шигеллеза составляли 50 % госпитализированных. Отмечалось позднее обращение за медицинской помощью. Имеющиеся схемы антибактериальной терапии были малоэффективны, так как отсутствовала возможность лабораторного подтверждения диагноза с определением чувствительности к препаратам. Бесконтрольное лечение способствовало возникновению антибиотикорезистентности возбудителей, длительному бактериовыделению и последующему распространению инфекции. Инфекционистами и эпидемиологами Роспотребнадзора оказана консультационная и практическая помощь конголезским коллегам, разработаны и представлены рекомендации по оптимизации противоэпидемических и лечебных мероприятий с учетом результатов анализа причин возникновения и развития вспышки.

This paper provides an analysis of the results of joint work of Russian and Congolese infectious disease specialists and epidemiologists to decipher the etiology and causes of the outbreak of intestinal infections in Dolisie (Republic of the Congo) in the summer of 2023. It has been found that the increase in the incidence of intestinal infections was caused mainly by the agents of typhoid fever and dysentery; tropical malaria was a combined pathology. No cases of cholera patient detection were registered. Failure of water supply system, domestic disrepair, and low public awareness about prevention of intestinal infections contributed to the active transmission of pathogens. The combination of epidemic process manifestations testified to the aquatic nature of the outbreak. Also, cases of pathogen transmission through contact household route were recorded, food transmission was not excluded. Patients with severe and complicated forms of typhoid fever and shigellosis accounted for 50 % of those hospitalized. There was delay in seeking medical care. The available regimens of antibacterial therapy were ineffective, since there was no possibility of laboratory confirmation of the diagnosis with determination of sensitivity to drugs. Uncontrolled treatment facilitated the emergence of antibiotic resistance in pathogens, prolonged bacterial release and subsequent spread of infection. Infectious disease specialists and epidemiologists of the Rospotrebnadzor provided consulting and practical assistance to Congolese colleagues, developed and presented recommendations for optimizing anti-epidemic and therapeutic measures, taking into account the results of assessment of the causes for onset and development of the outbreak.

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The authors declare that there are no conflicts of interest present.