What is immunoprophylaxis of infectious diseases? Lecture: Immunoprophylaxis of infectious diseases

Creating immunity with the help of biological preparations is of great importance in the prevention and elimination of infectious animal diseases. Artificial immunization, with the exception of a small number of diseases, is strictly specific. Therefore, immunization in the system of anti-epizootic measures is classified as specific measures aimed at the third link of the epizootic chain - susceptible animals.

Effective biological products have been developed against most infectious diseases to protect animals, prevent the occurrence of diseases and stop their further spread. Immunization of animals, especially vaccination, has become firmly established in the complex of anti-epizootic measures, and for most infectious diseases it has no equal measures in terms of effectiveness (for anthrax, foot-and-mouth disease, emkar, erysipelas and swine fever, etc.).

The arsenal of means for the specific prevention of infectious diseases includes vaccines, serums, globulins and phages. Depending on this, there are two main types of immunization: active and passive.

Active immunization. It is the most common type of immunization and is achieved by administering vaccines and toxoids to animals. A vaccine is an antigenic preparation obtained from microbes or their metabolic products, upon the introduction of which the body forms immunity to the corresponding infectious disease. According to the method of preparation they distinguish alive And inactivated vaccines.

Live vaccines- preparations prepared from live weakened (attenuated) strains of microbes that lack the ability to cause disease, but retain the ability to multiply in the body of animals and determine the development of immunity in them. The advantage of live vaccines over inactivated ones is that they are administered once and in small doses and ensure the rapid formation of fairly stable and intense (long-term) immunity. However, some live vaccines have pronounced reactogenic properties, as a result of which a weakened animal can react to their administration with a clinically significant illness.

Inactivated vaccines obtained by inactivating pathogenic, especially virulent microorganisms, without destroying them using chemical and physical methods (thermal vaccines, formol vaccines, phenol vaccines, etc.). These are, as a rule, weakly reactogenic biological products, the epizootological effectiveness of which is inferior to live vaccines. Therefore, they are administered to animals in large doses and repeatedly.

To increase the effectiveness of both inactivated and live vaccines, the deposition method is used, which consists of adding adjuvants to them during the production process, which slow down the resorption of the vaccine introduced into the body and have a longer and more active effect on the immunization process (deposited vaccines). Depositing substances include aluminum hydroxide, alum and mineral oils.

Chemical vaccines are inactivated preparations consisting of soluble antigens extracted from bacteria. They contain the most active specific antigens (polysaccharides, polypeptides, lipids) sorbed on water-insoluble substances (for example, chemical vaccines against salmonellosis and brucellosis).

Anatoxins- these are the same inactivated vaccines, which are toxins (derivants) of microorganisms neutralized by heat and formalin, which have lost their toxigenicity, but retained their antigenic properties (for example, tetanus toxoid).

When live vaccines are administered, immunity in animals to the corresponding pathogens occurs after 5-10 days and lasts for a year or more, and in animals vaccinated with inactivated vaccines - on the 10-15th day after the second vaccination and lasts up to 6 months.

Active immunization is divided into simple And comprehensive. With simple (separate) immunization, a monovaccine is used, and the body becomes resistant to one disease. For complex immunization, mixtures of monovaccines prepared before use or factory-produced associated vaccines are used. The administration of several monovaccines can be simultaneous (in a mixture or separately) or sequential. In these cases, the body develops immunity against several diseases.

The supply of vaccines to the veterinary network is carried out through the zoo veterinary supply system and its local branches.

The success of vaccination depends not only on the quality of vaccines, but also on the most rational way of using them.

Based on the method of introducing vaccines into a living body, parenteral, enteral and respiratory methods of immunization are distinguished.

To parenteral The method includes subcutaneous, intramuscular, intradermal and other methods of administering biological products, bypassing the digestive tract. The first two methods are the most common.

At enteral method, biological products are administered orally individually or in groups with food or water. This method is convenient, but biologically difficult due to the presence of a gastric protective barrier in animals. This method of administration requires a large consumption of drugs, and not all animals develop immunity of the same intensity.

Respiratory (aerosol) The vaccination method allows you to immunize a large number of animals in a short time and create intense immunity on the 3-5th day after vaccination.

Due to large volumes of vaccinations and the transfer of livestock farming to an industrial basis, group vaccination methods have been developed by aerosols or feeding of biological products specially designed for these purposes. Group vaccination methods have found wide application in poultry farming, pig farming and fur farming.

The maximum effectiveness of preventing infectious diseases through vaccination can be achieved only with its planned use and mandatory combination with general preventive measures.

Passive immunization. This is also a specific prevention of infectious diseases, but through the administration of immunosera (specially prepared or obtained from recovered animals), globulins and immunolactone; This is essentially seroprophylaxis, capable of creating rapid (within a few hours), but short-term immunity (up to 2-3 weeks).

A type of passive immunization is the acquisition by newborn animals from immune mothers of specific antibodies through the lactogenic route and the formation in this way of collostral, or lactogenic (maternal), immunity.

For prophylactic purposes, immunosera are administered in small doses, most often when there is an immediate threat of an infectious disease, as well as before transporting animals to exhibitions and other farms. In large-scale farms, passive immunization has found wide use as a therapeutic and prophylactic measure for a number of respiratory and nutritional infections of young animals (salmonellosis, colibacillosis, parainfluenza-3, etc.).

Mixed (passive-active) immunization includes a simultaneous vaccination method, in which immunoserum and vaccine are administered simultaneously or separately. Currently, this method is rarely used, since the negative effect of immune serum on the formation of active immunity has been established.

Animal tuberculosis

A severe chronic disease of many species of animals and humans, characterized by the formation in various organs of specific nodules - tubercles - that undergo caseous necrosis and calcification.

The causative agent of tuberculosis is Mycobacterium tuberculosis. The Mycobacterium genus includes more than 30 different species of pathogenic and non-pathogenic microorganisms. Tuberculosis is caused by 3 pathogenic types:

1) Mycobacterium tuberculosis (human species) causes disease in humans. Pigs, cats, dogs, cattle, fur-bearing animals are also susceptible to it, but birds (except parrots) are not susceptible;

2) Mycobacterium bovis (bovine species) causes disease in all types of agricultural and wild animals, including fur-bearing animals, as well as humans. Birds are not susceptible;

3) Mycobacterium avium (avian species) causes disease in domestic and wild birds,

In nature, in addition to tuberculosis, there are opportunistic atypical and saprophytic mycobacteria. Animals infected with them may react to mammalian tuberculin, which causes difficulties in the allergic diagnosis of tuberculosis.

The best disinfectants are a 3% alkaline solution of formaldehyde (exposure 1 hour), a suspension of bleach containing 5% active chlorine, a 10% solution of iodine monochloride, a 20% suspension of freshly slaked lime (calcium hydroxide), 5% - nal solution of calcium hypochloride, 1% solution of glutaraldehyde and other preparations.

Epizootology. Many species of domestic and wild animals are susceptible to tuberculosis, including fur-bearing animals and birds (more than 55 species of mammals and about 50 species of birds). Cattle, pigs, and chickens are more sensitive to tuberculosis. Dogs, cats, ducks, and geese get sick less often, with the exception of horses, sheep, and donkeys. The source of the infectious agent is sick animals that secrete mycobacteria in feces, sputum, milk, and in case of damage to the genitourinary tract - with sperm. The causative agent of tuberculosis can persist in the body for a long time in the form of L-forms. Such animals often remain undetected sources of the causative agent of tuberculosis. Under unfavorable conditions, L-forms of mycobacteria can revert to their original form (the classical form of mycobacteria) and become the cause of tuberculosis.

Transmission factors for the causative agent of tuberculosis can be feed, water, pastures, bedding, manure, etc., contaminated with secretions of sick animals. Young animals become infected mainly through milk and skim milk obtained from sick animals. Intrauterine infection of calves is possible. Animals can become infected through contact with people with tuberculosis, especially milkmaids and calves. During the stalled period, adult cattle are infected mainly by aerogenic means, and on pastures - by nutritional means; pigs - nutritionally when feeding them undisinfected kitchen waste from hospitals, tuberculosis dispensaries or when in contact with sick poultry. Dogs, cats - from sick people or when eating milk, meat from sick cows.

The massive spread of tuberculosis on farms is facilitated by factors that reduce the resistance of animals. These include: inadequate feeding, increased milk production without compensation for essential microelements, vitamins, and amino acids that are vital for the body; lack of regular exercise in the fresh air, cramped and damp rooms, unsanitary conditions for keeping animals.

The duration of the incubation period for tuberculosis ranges from 2 to 6 weeks. Tuberculosis in animals is chronic or latent, so clinical signs of the disease may appear several months or years after infection. Animals infected with tuberculosis are detected mainly by allergic and serological research methods. Tuberculous lesions are usually detected only during post-mortem examination of organs, and the appearance of clinically pronounced forms indicates a long course of the disease. Clinical signs of tuberculosis are very diverse even in the same animal. Based on the location of the pathological process, pulmonary and intestinal forms of tuberculosis are distinguished; There are also lesions of the udder, serous integument (pearly mussel), genital form and generalized tuberculosis.

In cattle, tuberculosis most often affects the lungs and the tuberculosis process occurs chronically, in young animals - acutely and subacutely. Pulmonary tuberculosis is characterized by a strong dry cough, which gets worse when the animal stands up or inhales cold air; the temperature can rise to 39.5...40°C. Appetite and productivity are not reduced in the initial period. As the disease progresses, signs of inflammation of the lungs and pleura appear. The cough becomes painful, breathing is difficult and accompanied by groans. Wheezing can be heard in the chest, and areas of dullness can be heard on percussion.

Damage to the mammary gland is characterized by an enlargement of the superior lymph nodes, which become dense, lumpy, and inactive. When milking, watery milk mixed with blood or curdled mass is released. When the genital organs are damaged in cows, increased sexual heat and barrenness are noted, and orchitis in bulls. With generalized tuberculosis, superficially located lymph nodes (mandibular, retropharyngeal, superior, knee folds) enlarge and become tuberous.

Tuberculosis in pigs is asymptomatic. Sometimes there is an increase in the mandibular and retropharyngeal lymph nodes. With extensive lung damage, coughing, vomiting, and difficulty breathing occur.

Sheep suffer from tuberculosis very rarely, goats - somewhat more often, but both are asymptomatic. With a highly pronounced process, the clinical signs in goats are similar to those in cattle.

In horses, the disease is rarely recorded, mainly in farms where cattle are unfavorable for tuberculosis. If the lungs are affected, a weak cough and fatigue are noted; in the intestinal form - colic, diarrhea, followed by constipation, polyuria.

In birds (usually chickens, geese, ducks, turkeys), tuberculosis is chronic with unclear clinical signs. Sick chickens are inactive and quickly lose weight. The comb and earrings are pale, wrinkled, and atrophy of the pectoral muscles occurs. Prolonged debilitating diarrhea is possible. Birds die from exhaustion.

In fur-bearing animals (foxes, mink, nutria), tuberculosis most often affects young animals. Patients experience weakness and exhaustion; if the lungs are affected - cough, shortness of breath; in the intestinal form - profuse diarrhea.

Clinical signs of the disease in dogs and cats are uncommon; emaciation is observed, and if the lungs are affected, difficulty breathing and coughing are observed. Death occurs due to complete exhaustion.

Tuberculosis is characterized by the presence in various organs and tissues of the animal of specific nodules (tubercules) the size of a millet grain to a chicken egg or more.

In cattle suffering from long-term tuberculosis, the lymph nodes of the chest cavity are affected in 100% of cases, the lungs in 99%, the intestines in 10%, and other organs and tissues less frequently. Also characteristic are cavities in the lungs, formed during the disintegration of caseous masses and during the expansion of large bronchi. The bronchial and mediastinal lymph nodes are enlarged, dense, and riddled with tuberculous nodules. With intestinal tuberculosis, gray-yellow tubercles or ulcers of a round, oval shape with roller-like raised edges are found on the mucous membrane. Mesenteric lymph nodes are enlarged, compacted, with signs of cheesy degeneration.

In birds, tuberculous lesions are more often found in the liver and spleen, which are usually sharply enlarged, flabby in consistency, and contain numerous tubercles.

The diagnosis is established based on the analysis of epizootic data, clinical signs and the results of allergic, pathological, histological, bacteriological and biological studies.

The clinical method for diagnosing tuberculosis is of limited value, since at the onset of the disease there may be no clinical signs at all. The main method of intravital diagnosis of tuberculosis is an allergic study.

For the study, an allergen is used - tuberculin - a sterile filtrate of killed cultures of the causative agent of tuberculosis of two types: dry purified (PPD) tuberculin for mammals and PPD tuberculin for birds. The latter is prepared from the causative agent of avian tuberculosis and is used to diagnose tuberculosis in birds and pigs.

The main method of intravital diagnosis of tuberculosis in animals is an allergic study using an intradermal tuberculin test. In horses, an eye examination method (ophthalmic test) is used. If necessary, it is also carried out in cattle simultaneously with an intradermal test.

Cattle (buffaloes) are subjected to tuberculinization from the age of 2 months, camels from the age of 12 months, deer and sika deer from the age of 6 months, fur-bearing animals and birds from the age of 6 months. If necessary, sheep, dogs and cats are examined.

With the intradermal method of tuberculinization, the drug is administered to cattle, buffalo, zebu cattle, deer (deer) - in the middle of the neck, bulls - into the sub-tail fold, camels - into the skin of the abdominal wall or into the groin area at the level of the horizontal line of the ischial tuberosity, pigs - in the area of ​​the outer surface of the ear 2 cm from its base, in goats - in the thickness of the lower eyelid; for dogs, monkeys and fur-bearing animals (except minks) - in the area of ​​the inner thigh or elbow fold; minkam - intrapalpebrally into the upper eyelid; for cats - in the area of ​​the inner surface of the ear; kuram—in the beard; for turkeys - in the submandibular earring; for geese and ducks - in the submandibular fold; for male pheasants - into the cavernous bodies of the head; peacocks, parrots, pigeons, cranes, herons, storks, flamingos - in the area of ​​the outer side of the lower leg, 1...2 cm above the ankle joint.

Before tuberculin is administered, the fur (hair) at the injection site is trimmed (feathers are plucked), and the skin is treated with 70% ethyl alcohol.

Accounting and assessment of the reaction to intradermal injection of tuberculin is carried out in cattle, buffaloes, zebu cattle, camels and deer after 72 hours; in goats, sheep, pigs, dogs, cats, monkeys, fur-bearing animals after 48 hours; in birds after 30...36 hours. In areas unfavorable for tuberculosis, cattle and camels are allowed to re-inject tuberculin 72 hours after the first injection in the same dose and in the same place. The response to repeated administration is recorded and assessed after 24 hours.

When taking into account the intradermal reaction, the site of tuberculin injection is palpated in each animal under study; in minks, the eyelids of the left and right eyes are visually compared.

If thickening of the skin is detected at the site of tuberculin injection in cattle, buffaloes, zebu cattle, camels, and deer, the thickness of the fold in millimeters is measured using a cutimeter and the magnitude of its thickening is determined by comparing it with the thickness of the fold of unchanged skin near the site of tuberculin injection.

Animals are considered tuberculin-responsive:

cattle and camels - when the skin fold thickens by 3 mm or more after the first injection of tuberculin and by 4 mm after repeated administration; buffalos, zebu cattle and deer - when the skin fold thickens by 3 mm;

stud bulls, sheep, goats, pigs, dogs, cats, monkeys, fur-bearing animals, birds - in case of swelling at the site of tuberculin injection.

Intradermal tuberculin test is a highly specific reaction to tuberculosis. However, it depends on the general immunoreactivity of the body. In animals of low fatness, old, deep-pregnant animals, as well as with a generalized tuberculosis process, the reaction to tuberculin may be weakly expressed or not manifested (anergy).

It should also be taken into account that nonspecific (para- and pseudoallergic) reactions to tuberculin for mammals are sometimes possible, due to sensitization of the body by mycobacteria of the avian species, the causative agent of paratuberculosis and atypical mycobacteria, as well as other reasons. To differentiate nonspecific reactions, a simultaneous allergy test is used, which is carried out simultaneously with tuberculin for mammals and a complex allergen from atypical mycobacteria (CAM). If the intradermal reaction to the introduction of CAM is more intense than to mammalian tuberculin, the reaction is considered nonspecific, and material from such animals is examined for tuberculosis using laboratory methods.

Tuberculinization by eye method is carried out twice with an interval of 5...6 days. Tuberculin (3...5 drops) is applied with an eye pipette to the conjunctiva of the lower eyelid or to the cornea of ​​the eye. The reaction is taken into account after the first injection after 6, 9, 12 and 24 hours, after the second - after 3, 4, 6, 9, 12 hours. It is considered positive if a mucopurulent secretion begins to separate from the inner corner of the eye, hyperemia and swelling appear conjunctiva.

If animals that react to tuberculin are detected for the first time in a prosperous farm, to clarify the diagnosis, 3...5 animals with the most pronounced reactions to tuberculin are slaughtered and internal organs and lymph nodes are examined. In the absence of changes typical for tuberculosis, pieces of organs and lymph nodes are selected and sent to a veterinary laboratory for bacteriological examination.

The diagnosis of tuberculosis is considered established: 1) when a culture of the tuberculosis pathogen is isolated or 2) when a positive result of a biological test is obtained; 3) in cattle, in addition, the diagnosis is considered established when pathological changes typical of tuberculosis are detected in organs or tissues.

Immunity and specific prevention. In case of tuberculosis, phagocytosis is incomplete, non-sterile immunity is formed, as a result of which it has no protective value. Specific prevention with the BCG vaccine is possible, but in most countries farm animals are not vaccinated against tuberculosis.

Prevention. Prevention and control measures against animal tuberculosis are carried out in accordance with the current Sanitary and Veterinary Rules. In prosperous farms, farms are stocked with healthy animals from tuberculosis-free farms; feed is purchased only from prosperous farms.

Newly received animals are examined for tuberculosis during a 30-day quarantine period. The skim milk supplied for feeding young animals is pasteurized, and the collected food waste is subjected to heat treatment. People with tuberculosis are not allowed to serve animals. Livestock premises are periodically disinfected, rodents and ticks are destroyed, and the feeding and living conditions of animals are improved.

For preventive purposes, routine diagnostic tests of animals for tuberculosis are carried out annually. Cows and breeding bulls are examined 2 times a year: in the spring, before being put out to pasture, and in the fall, before placing livestock in winter housing, and young cattle (starting from 2 months of age) and fattening groups - once a year; horses, mules, donkeys, sheep and goats - depending on the epizootic situation; all adult sows and young animals after weaning in all breeding farms, poultry stations - once a year. Animals owned by citizens are tested for tuberculosis at the same time this work is carried out on farms.

Treatment. Animals with tuberculosis are sent for slaughter. In herds, on farms, in populated areas where the disease has already been established, animals that react to tuberculin are recognized as having tuberculosis and are also sent for slaughter within 2 weeks.

Control measures. When animals that react to tuberculin are identified in safe farms, they are further examined by performing an ophthalmic test or an intravenous tuberculin test; reacting animals are subjected to control slaughter; material from killed animals is sent to a veterinary laboratory for bacteriological testing for tuberculosis. When tuberculosis is detected, farms (farms, brigades, departments), as well as populated areas, are declared unfavorable for this disease, restrictions are introduced into them and an action plan is drawn up to improve the health of the affected area (farm).

The degree of disadvantage in cattle herds is determined taking into account the prevalence of the disease: limited - when a double tuberculin test detects up to 15% of sick animals from the population in the herd or on the farm; significant - when more than 15% of sick animals are detected.

The improvement of the health of cattle herds unfavorable for tuberculosis is carried out in the following ways: 1) systematically perform diagnostic studies with the isolation of sick animals or entire unfavorable groups with their subsequent slaughter; 2) simultaneously carry out a complete replacement of the population of a dysfunctional herd (farm) with healthy animals.

In both cases, it is mandatory to carry out a set of organizational, economic, veterinary and sanitary measures provided for in the instructions.

A one-time complete replacement of the livestock is carried out when tuberculosis is first established in a district, region, republic, and when the disease is significant in the herd (the disease is more than 15% of the livestock).

After the premises are cleared of livestock, they are disinfected and undergo veterinary and sanitary repairs. For disinfection on farms, the following are used: a suspension or clarified solution of bleach (5% active chlorine), a 1% aqueous solution of glutaraldehyde, a 3% alkaline solution of formaldehyde, a 5% solution of sodium phenolate. For aerosol disinfection, a 40% solution of formaldehyde is used with an exposure of 1 hour. Pastures where sick animals were grazed can be used after 2 months in the southern regions and after 4 months in the rest of the country.

After completion of veterinary and sanitary measures, final disinfection of all premises of the farm and laboratory testing of the quality of disinfection, restrictions are lifted from the unfavorable farm.

If less than 15% of the herd is infected with tuberculosis, recovery can be carried out by systematic research and slaughter of sick animals. All animals from 2 months of age are examined every 45...60 days with a double intradermal tuberculin test. At the same time, other species of animals (including dogs and cats) on the farm are tested for tuberculosis. Animals that react to tuberculin are recognized as sick, marked, isolated and slaughtered within 15 days.

If two consecutive negative test results are received throughout the herd, the animals are put on a 6-month follow-up observation, during which two studies are carried out with an interval of 3 months. Upon receiving negative results of control studies and carrying out a set of veterinary and sanitary measures, the farm (herd) is declared free from tuberculosis.

If during a control study animals that react to tuberculin are isolated, they are all subjected to diagnostic slaughter. If pathological changes characteristic of tuberculosis are detected, further studies are carried out every 30...45 days, as indicated above.

Upon receipt of negative results of allergic and laboratory tests, the herd is declared free from tuberculosis and restrictions are lifted. Before restrictions are lifted, a set of veterinary and sanitary measures are carried out.

When tuberculosis in pigs (bovine or human pathogen) is detected in pig farms, all animals that react to tuberculin, including pregnant sows, boars, and fattening livestock, are sent for slaughter. Upon completion of farrowing and fattening, all animals on the farm are handed over for slaughter - no later than 6 months from the date of diagnosis of tuberculosis. After carrying out a set of veterinary and sanitary measures, restrictions on the farm are lifted.

When tuberculosis is diagnosed in horses, sheep and goats, all reacting animals are killed; the remaining livestock is examined: horses - by ophthalmic test, and sheep and goats - by intradermal test every 45...60 days until a single negative result is obtained, after which the animals of the corresponding group are recognized as healthy.

When tuberculosis is diagnosed in fur-bearing animals, they are subjected to a clinical examination, sick females along with their offspring are isolated. During the period of maturation of the skins, the animals are fed tubazide daily in a therapeutic dose. After slaughter, the skins are used without restrictions; For the rest of the animals in the disadvantaged group, tubazide is added to the feed in a prophylactic dose. Minks are vaccinated with the BCG vaccine for preventive purposes; a fur farm is considered healthy if during the season from whelping to slaughter no changes in organs and tissues typical of tuberculosis are found in dead or killed animals; restrictions on the farm are lifted after carrying out veterinary and sanitary measures.

In poultry farms, when tuberculosis is diagnosed, all the birds from a dysfunctional poultry house (workshop) are handed over for slaughter, appropriate veterinary and sanitary measures are carried out, and after restrictions are lifted, a new flock of healthy pullets is formed. Eggs from birds from a dysfunctional poultry house (workshop) are not allowed for incubation and are used in bakery and confectionery production.

Emphysematous carbuncle

- an acute non-contagious toxic-infectious disease of cattle, characterized by the formation of rapidly increasing crepitant swellings in the muscles of the body and lameness.

The causative agent of the disease. The causative agent of emkar Clostridium chauvoei is straight or slightly curved rods with rounded ends, arranged singly, in pairs, or less often in short chains; in young cultures they are gram-positive. The spores of the pathogen are very stable: they remain viable in the soil for several years, in rotting muscles, manure - up to 6 months, at the bottom of reservoirs - over 10 years, in corned beef - more than 2 years, in a dried state, the spores lose viability when heated to 100... 105°C in 2... 12 minutes, direct sunlight kills them in 24 hours. Under appropriate conditions in the soil, the pathogen can vegetate and multiply.

The most effective disinfectants are 3...4% formaldehyde solution, 10% sodium hydroxide solution, Virkon S (1:100).

Epizootology. Cattle, including buffaloes, are susceptible to emkar. In sheep, the causative agent of emkar has no independent significance; it is often isolated during malignant edema.

A higher susceptibility to the disease in cattle of improved, cultivated, especially meat breeds (with large muscle mass), and more well-fed individuals was noted. Animals brought to the disadvantaged area from other farms or imported ones often get sick. Cattle of any age are affected, but young animals aged from 3 months to 3...4 years are most sensitive.

The source of the infectious agent is sick animals, the transmission factors are soil, feed, pastures, and water from swampy stagnant reservoirs infected with spores of the pathogen. In infection of the external environment, the main importance is untimely removal of corpses and pathogen spores in soil and water, which maintain the stationarity of epizootic foci of the disease. There is a clearly defined summer-autumn seasonality.

Infection occurs when the pathogen enters the gastrointestinal tract along with food or water.

Course and clinical manifestation. The incubation period of the disease lasts 1...3 days, in some cases up to 5 days. The disease begins suddenly and is acute, almost always ending in the death of the animal. In the acute course of the disease, the temperature rises to 41...42 "C.

Already in the early period lameness is observed. Rapidly increasing, limited, hot, painful swelling (carbuncles) appears on certain parts of the body (croup, lower back, neck, chest, mandibular region), and sometimes in the oral cavity or pharynx. Soon they become cold, painless, and lose swelling. When the swellings are palpated, a peculiar crunching sound (crepitus) is heard, when percussed, a pronounced tympanic sound is heard, the skin over them acquires a purplish-bluish color, and when the carbuncles are cut, a dirty-brown foamy liquid with the smell of rancid oil flows out of them.

Further, general depression is noted, refusal of food, lack of chewing gum, the animal has difficulty getting up, holds the sore leg up, and stops moving. At the same time, breathing becomes difficult, cardiac activity sharply weakens, the pulse reaches 100... 120 beats per minute. The disease usually ends in the death of the animal after 12...72 hours. Before death, the body temperature drops below normal.

The hyperacute course of the disease is rarely recorded - mainly in young animals up to 3 months of age. The disease manifests itself in a septic form, without the formation of carbuncles. The animal dies after 6...12 hours.

Pathological signs. The corpses are usually swollen, but decompose slowly. Foamy liquid flows from the nasal openings and mouth. There is diffuse swelling in the area of ​​the hind limbs (up to the hock), perineum, back, and groin. When the corpse is opened, the smell of rancid oil is felt. The subcutaneous tissue in the area of ​​the affected muscles is permeated with hemorrhages and gas bubbles, and a red or yellow gelatinous infiltrate is detected in it. Specific lesions are gas edema in the muscles. When cut, the muscles are porous, dry, dark red, almost black in color; when pressed, a foamy-bloody liquid with the smell of rancid oil is released from them. In the chest and abdominal cavities there is an accumulation of cloudy liquid of a dark red or brown color. Various lesions of parenchymal organs are noted.

Diagnosis and differential diagnosis. The diagnosis of emphysematous carbuncle is established on the basis of epizootic data, the symptom complex of the disease, taking into account pathological changes and the results of laboratory tests (microscopy of fingerprint smears, bacteriological examination and bioassay on guinea pigs).

To avoid the spread of the pathogen, it is not recommended to open corpses. Therefore, pieces of muscle are taken without a complete autopsy of the corpse. If the corpse is accidentally opened, pieces of parenchymal organs, subcutaneous tissue, edematous exudate, and blood are taken. When shipping, it is better to use well-dried muscles.

The final diagnosis is established when the pathogen culture is isolated from the pathological material and the death of the guinea pig after infection with the resulting culture and the presence of a typical pathological picture or a positive bioassay with a characteristic pathological picture and culture isolation.

In differential diagnosis, it is necessary first of all to exclude anthrax and malignant edema.

After illness, intense immunity is formed. Animals over 4 years of age are immune to emcar; they acquire immunity as a result of an immunizing subinfection.

The concentrated aluminum hydroxide formol vaccine against emkar (immunity lasts for 6...7 months) and the live vaccine (immunity lasting up to 1 year or more) have high immune activity. An associated live vaccine against anthrax and emkar is also used.

Prevention. To prevent the appearance of emkar, it is necessary to carry out a set of veterinary and sanitary measures. All newly received animals are kept in preventive quarantine. The main measure in disease prevention is active immunization of all susceptible livestock located in disadvantaged areas. Annually, a single or double (depending on the grazing period and the vaccine used) preventive vaccination of animals aged 3 months to 4 years is carried out.

Treatment. Since the course of the disease is usually acute, treatment of animals is not always feasible. At the onset of the disease, antibiotics are effective: chlortetracycline, dibiomycin, ampicillin, bicillin. It is advisable to inject a 1...2% solution of hydrogen peroxide, a 3...5% solution of carbolic acid, a 3...5% solution of Lysol or phenol, 0.1% into the thickness of the inflammatory edema and around it. - solution of potassium permanganate. Symptomatic treatment is used. The feasibility of surgical treatment is questionable.

Control measures. IN In the event of a disease, the farm (farm) is declared unfavorable under the emkar and quarantine is imposed. Under the terms of quarantine, it is prohibited: the export and withdrawal, as well as the import into the quarantine zone of cattle and sheep and their movement through the quarantine territory; sale, exchange and on-farm regrouping of cattle and sheep; removal of hay and other feed collected in the quarantined area. At the site of infection, all animals susceptible to the disease are subjected to clinical examination and thermometry. Animals suspected of having the disease are isolated and treated, and the rest are vaccinated regardless of the timing of previous vaccination. In case of death, the corpses are burned or placed in a biothermal pit. The slaughter of sick and disease-suspicious cattle for meat is prohibited. Animals that have recovered from emphysematous carbuncle are allowed to be slaughtered for meat no earlier than 30 days after the disappearance of clinical signs of the disease (lameness, edema, crepitus). Milk from immunized cows is used without restrictions. Before removal, manure, bedding and feed residues contaminated with secretions of sick animals are moistened with a 10% hot solution of sodium hydroxide and then burned.

To disinfect surfaces contaminated with the pathogen, use: 10% hot solution of sodium hydroxide; 4% formaldehyde solution; solutions of chloride preparations containing 5% active chlorine; 10% solution of iodine monochloride; 7% hydrogen peroxide solution with the addition of 0.2% OP-10; 2% solution of glutaraldehyde.

The soil at the site of death, forced slaughter or autopsy of an animal that died from an emphysematous carbuncle is burned, then irrigated with a solution of bleach at the rate of 10 l/m2. Then the soil is dug up to a depth of 25 cm, mixed with dry bleach containing at least 25% active chlorine, based on 3 parts of soil to 1 part of bleach. After this, the soil is moistened with water.

The farm (farm) is declared safe and quarantine is lifted 14 days after recovery or death of the last sick animal and final disinfection.

Leptospirosis

- basically an acute natural focal disease of animals of many species and humans, manifested by short-term fever, hemoglobinuria or hematuria, hemorrhages, icteric staining and focal necrosis of the mucous membranes and skin, atony of the gastrointestinal tract, abortion, mastitis, the birth of non-viable offspring, periodic ophthalmia and meningoencephalitis, decreased animal productivity.

Pathogens of the disease. The causative agents of the disease belong to the genus Leptospira (from the gr. leptos - light, speria - coil). About 30 serovars have been discovered in Russia. The most common are the following: Icterohaemorrhagiae, Canicola, Pomona, Grippotyphosa, Sejroe, Hardjo, Tarassovi. Leptospira are spiral-shaped microorganisms, 6...24 x 0.2 microns in size. The number of spiral turns reaches 20. The ends of the microbe are curved in the form of hooks, which makes them easily recognizable under microscopy.

Epizootology. TO More than one hundred species of wild and domestic animals are susceptible to leptospirosis. Leptospirosis epizootic foci are divided into natural, anthropourgic and mixed.

The main hosts (reservoirs) and sources of Leptospira in natural foci are various species of small rodents, insectivores, carnivores and others, which often develop lifelong leptospirosis carriage. Anthropourgic (household) outbreaks arise when leptospiron-carrying animals are imported into farms. In anthropurgic foci, leptospirosis affects cattle, buffaloes, pigs, horses, sheep, goats, deer, dogs, camels, cats, synanthropic rodents, fur-bearing animals, etc.

The source and reservoir of the infectious agent are clinically and asymptomatic patients, as well as recovered leptospiron-carrying animals. Leptospirosis carriage after illness or latent infection can last up to 1.5 years in animals, and for life in rodents.

Leptospira are excreted from the body of clinically sick animals and bacteria carriers in urine, feces, milk, semen, exhaled air, discharge from the genitals, as well as from an aborted fetus.

Healthy animals become infected with Leptospira through water, feed, bedding, soil, pastures and other infected environmental objects. The main route of transmission of the infectious agent is water; contact and feed are of less importance. In cattle, pigs and sheep, the possibility of infection through sexual contact, as well as transmission of the pathogen through the placenta, has been proven.

Leptospirosis is observed at any time of the year, but in large and small ruminants, horses and other species of animals using pastures, it manifests itself mainly in the summer-autumn period. When leptospirosis first appears in a previously prosperous farm, animals of various age groups become ill. The epizootic affects from 20 to 60% of susceptible animals, causing large deaths of non-immune young animals. The main epizootological feature of leptospirosis in farm animals in permanently disadvantaged farms is the predominance of asymptomatic forms of infection in the form of long-term leptospirosis.

Course and clinical manifestation. Leptospirosis affects animals of all ages, but young animals suffer more often and more severely. The disease occurs acutely, less often - hyperacutely (lightning fast), subacutely and chronically. The incubation period ranges from 4 to 14 days.

In cattle, sheep, goats, buffalo, deer lightning current characterized by a sudden increase in body temperature (41...41.5 "C), rapidly developing hemolysis, leading within 5... 12 hours to almost complete destruction of red blood cells. Refusal of food, severe depression are observed. Breathing is frequent and shallow. Death with symptoms of asphyxia, agitation and clonic convulsions occurs within 12...24 hours. Mortality 100%.

Acute course The disease is observed more often in young animals aged from 2 weeks to 1.5 years and is characterized by high fever (temperature 40...41.5 ° C), loss of appetite, unsteady gait, depression and general weakness (on pasture, sick animals lag behind the herd ). The coat is tousled and dull. Breathing is labored, shallow and rapid. Impaired cardiovascular activity is noted. By the end of the febrile period (2...6 days from the onset of the disease), a sharp yellowness of the conjunctiva, mucous membranes of the mouth, vagina, and skin appears. The mucous membranes are colored yellow in different shades; hemorrhages are noted on them. In sheep, yellowness of the mucous membranes does not always occur, but mucoserous discharge from the nose is observed. Following yellowness, small necrotic areas appear on the mucous membranes of the gums, tongue, on the skin of the back, ears, neck, tail, lips, and nipples. Limited swelling appears on the skin of the body (back, groin, dewlap), leading to desquamation of the epidermis or complete necrosis of the skin with its subsequent rejection.

Milk secretion sharply decreases and often stops completely. Urination is painful and difficult. Cherry-colored or brown urine is released in small portions. At the beginning of the disease, diarrhea appears, which is then replaced by symptoms of severe atony, complete lack of appetite, chewing gum and contractions of all proventriculuses. In pregnant animals, abortions occur mainly in the second half of pregnancy. Animals lose weight quickly.

Hematological examination reveals a sharp, initially hyperchromic, and then hypochromic anemia, sometimes persistent neutrophilic leukocytosis. The number of red blood cells decreases to 1...3 million/μl (1...3 10 12 /l). The hemoglobin concentration initially increases to 14.5 g% (145 g/l), the color index - to 1.6 (hyperchromic anemia), then, due to inhibition of erythropoiesis, the hemoglobin index decreases to 1.7...5.0 g% (17 ...50 g/l). The number of leukocytes increases to 13...18 thousand/μl (13...18 10 9 /l). Neutrophilia with a nuclear shift to the left, eosinophilia, lymphopenia, and sometimes monocytosis are detected.

The amount of serum proteins increases to 9.5... 10%, bilirubin - up to 100 mg% (1000 mg/l). Sugar disappears from the blood serum, the amount of fibrinogen decreases; the blood clotting period is prolonged.

Duration of illness is 2... 10 days. Death occurs with symptoms of severe asphyxia. In the atonal period, there may be convulsive contractions of the muscles of the limbs, back and neck. Mortality, if no medical assistance is provided, reaches 50...70%.

Subacute course Leptospirosis is characterized by basically the same symptoms as acute leptospirosis, only they are less pronounced and develop more slowly. On the contrary, emaciation is more severe; skin necrosis sometimes covers large surfaces. The duration of the disease is 10... 18 days (up to 3 weeks), mortality is 10... 15%. Relapses are possible.

Chronic course Leptospirosis is less common and is characterized by progressive emaciation of the animal, anemia of the mucous membranes, necrosis, enlargement of the inguinal lymph nodes, periodic short-term increase in body temperature with the simultaneous appearance of bloody brown urine. Sick animals become barren or have abortions at various stages of pregnancy.

Leptospirosis in pigs usually occurs latently. Acute course are registered at the initial occurrence of the disease in previously healthy farms in pregnant sows and piglets 5...90 days of age.

In 20...50% of pregnant sows, feed refusal is initially observed. On the 2nd...3rd day of illness - single, and then mass abortions in the last stages of pregnancy. At the height of the outbreak at 20...30 % sows are born dead mummified fetuses or non-viable piglets that die on the 1st...3rd day of life. The duration of the epizootic is 2...3 weeks.

Sick piglets aged 5 days to 3 months are characterized by an increase in body temperature to 40...41.5 ° C, depression, refusal to feed, and conjunctivitis. The duration of the illness is 2...7 days. Mortality can reach 30% or more.

Subacute course occurs in weaned piglets and pigs up to 6 months of age in farms with a long course of infection. They note an increase in body temperature to 41...41.5 "C, anemia, sometimes yellowness of the mucous membranes, skin, focal necrosis in various parts of the body, conjunctivitis, unsteady uncoordinated gait, convulsions. The duration of the disease is 5...7 days. Mortality reaches 20%, lethality - 3...5%.

Chronic course noted in permanently disadvantaged farms. The disease is asymptomatic and is accompanied by massive (80 % and more) long-term (up to 3 years) leptospirosis carriage, the formation of specific antibodies in most pigs.

In horses, the disease is characterized by a sharp increase in body temperature, severe weakness (a horse sweats a lot during normal work, often stumbles and falls), intense jaundice (even with fresh skin scars turning yellow), mild colic and sometimes abortion. The temperature soon drops. Myocarditis, ataxia, trembling of the limbs, lameness and muscle soreness, uneven peristalsis (diarrhea or constipation) and necrosis of the skin, especially non-pigmented parts of the body, and the oral mucosa may be observed. Urine is red, turning into bright yellow after 3...5 days. Urine contains a lot of hemoglobin, protein and bilirubin. The number of red blood cells decreases to 3.55...3.93 million/μl (3.55...3.93 10 12 /l). ESR is within 59...80mm/h. The leukocyte formula is characterized by neutrophilia with a shift to the left to band forms.

Mortality reaches 33%. Due to weakness after illness for 2...3 months, the animal cannot be used for work.

Leptospirosis in dogs (Stuttard disease, infectious jaundice, canine typhus, epizootic jaundice, Weil's disease, hemorrhagic enteritis) is predominantly acute and manifests itself as short-term fever, hemorrhagic gastroenteritis, ulcerative stomatitis, sometimes jaundice and nervous disorders. Canine leptospirosis has been described in two forms: infectious jaundice (icteric form) and canine typhus (hemorrhagic form).

Infectious jaundice is caused mainly by L. icterohaemoirhagiae, less commonly by L. pomona and L. canicola, and the sources and reservoirs of the infectious agents are rats, pigs and dogs, respectively. Puppies and young dogs are mainly affected. Canine typhus is caused by L. cards, transmitted from leptospiron-carrying dogs to healthy animals. Mostly adults are affected.

For both forms of the disease, the incubation period is 10...20 days. The temperature reaction in sick dogs first manifests itself as a short-term fever of up to 40.5...41.5 °C, and on the 2nd or 3rd day of illness - a decrease in body temperature to 36.0...38.2 °C. The dogs are slaughtered into the corner of the cage, preferring to lie down.

The main clinical symptoms of acute course characterized by general weakness, complete apathy, muscle tremors, lameness in the hind limbs and stiffness of movement. The skin is dry, the eyes are sunken, the breathing is heavy and hoarse. There is bloody discharge from the nose. The cervical and inguinal lymph nodes are enlarged. The vessels of the conjunctiva and sclera are filled with blood; icteric staining appears on the visible mucous membranes and skin (in dogs, jaundice is not always expressed, depending on the form of the disease) and hemorrhages. Sometimes purulent keratoconjunctivitis occurs. A sick dog loses its appetite, thirst increases, and suddenly and frequently vomits with bile and blood. In the oral cavity, jaundice and hyperemia of individual areas of the mucous membrane are first observed, then hemorrhages, necrotic lesions and ulcers on the gums and tongue. A specific sweetish-sweet smell spreads from the mouth. The abdomen is tucked, sometimes painful; the liver is enlarged. Initially, normal or even accelerated peristalsis subsequently slows down. The feces are liquid, foul-smelling, often streaked with blood. Sometimes there is constipation.

Most dogs experience symptoms characteristic of nephritis: the kidney area is sensitive to palpation; urine is yellow or brown, cloudy, acidic, excreted in small portions, contains albumin, renal epithelium, leukocyte mass, casts, hemoglobin and bilirubin. In severe cases, the urine turns red. Changes in the kidneys may persist for months.

The number of red blood cells and hemoglobin content in the blood decrease sharply; urea, ammonia, toxic amino acids, and indi-can accumulate; the content of phosphorus and residual nitrogen increases; there is a decrease in calcium content and reserve alkalinity.

The animal quickly loses weight, falls into a coma and, with signs of clonic convulsions, can die a few hours after the first symptoms appear. The duration of the disease is usually 2...12 days, mortality reaches 50...90%.

At chronic course body temperature is normal. Pale yellow or dirty gray scabs are found on the mucous membrane of the mouth, gums, tongue and lips, in the place of which ulcers open. Dogs remain leptospiron carriers for a long time.

Pathological signs. Pathological changes are characterized by anemia, jaundice, hemorrhagic diathesis, necrosis of the skin and mucous membranes, degenerative-inflammatory changes in parenchymal organs.

The liver in most cases is enlarged and degenerated. Its color ranges from clay-red to yellow, its consistency is elastic, flabby or brittle. Sometimes small necrotic lesions and hemorrhages are found in the parenchyma. The gallbladder is distended and filled with thick, viscous bile of a dark or brownish green color; there are single or multiple hemorrhages on the mucous membrane.

The kidneys are also enlarged and flabby; depending on the degree of blood supply, degenerative changes and pigmentation, they are colored cherry-clay, grayish-red or dark brown with a greenish tint. The perinephric tissue is edematous. The fibrous capsule is gray in color and usually easily removable. Single or multiple grayish lesions of varying sizes are found in the kidney parenchyma. The border between the cortical and medulla layers is smoothed. The cortex is expanded, pale colored, and sometimes contains small hemorrhages. The pelvis is often filled with a reddish jelly-like mass.

The morphological picture in all organs is characterized by lymphohistiocytic inflammatory infiltrates, which allows these changes to be considered specific for leptospirosis.

Diagnosis and differential diagnosis. The basis for suspecting a problem with leptospirosis on a farm is the clinical signs and pathological changes characteristic of this disease, and the detection of specific antibodies in the blood of animals. The diagnosis of leptospirosis in all cases must be confirmed by laboratory tests.

Laboratory diagnosis of leptospirosis in animals is carried out in accordance with the current Sanitary and Veterinary Rules. It is based on a complex of microbiological and immunological methods that are used in various combinations. Bacteriological research methods include direct microscopy of biomaterial, polymerase chain reaction (PCR), isolation of pure cultures and identification of the pathogen, differentiation of pathogenic leptospira from saprophytic ones and bioassay.

Of the serological methods, the leptospira microagglutination reaction (LMA) is the most widely used, which, in addition, makes it possible to determine the causative agent.

The materials for intravital diagnostics are blood and urine, for post-mortem diagnostics - the corpses of small animals. From the corpses of large animals and aborted fetuses, a heart, pieces of parenchymal organs, a kidney, transudate of the thoracic and abdominal cavities, pericardial and cerebrospinal fluid, a bladder and stomach with contents are taken. Pathological material must be taken and examined within 6 hours in the summer and 10...12 hours in the winter or if it is stored refrigerated.

Based on the results of laboratory tests, a farm (farm, department, enterprise, herd, etc.) is considered unfavorable for leptospirosis in one of the following cases:

Leptospira culture isolated from pathological material;

Leptospires were discovered during microscopic examination of pathological material;

antibodies were found in the blood serum of more than 20% of the examined animals in a titer of 1:50 in unvaccinated animals, 1:100 or more in vaccinated animals. If fewer positive reactions are detected, urine microscopy is performed. If the result of urine microscopy is negative, a repeat examination of the blood serum and urine of previously examined animals is carried out after 15-30 days. The detection of leptospira or antibodies during a repeated study in animals that did not have them in the previous study, or an increase in the antibody titer by 4 times or more indicates a problem with the farm.

Leptospirosis is considered the cause of abortion (stillbirth) when detected:

Leptospira in organs (tissues, fluids) of the fetus or amniotic fluid;

antibodies to Leptospira in fetal blood serum in PMA at a dilution of 1:5 (with antigen 1:10) or more.

Leptospirosis is considered the cause of death in animals in the presence of clinical signs and pathological changes characteristic of this infection, confirmed by the detection of leptospira in the blood or parenchymal organs (except kidneys).

In the differential diagnosis of leptospirosis in cattle and small ruminants, brucellosis, pyroplasmidosis, malignant catarrhal fever, campylobacteriosis, trichomoniasis, salmonellosis, pneumoenteritis of mixed etiology and listeriosis should be excluded; in pigs it is necessary to exclude brucellosis, salmonellosis, plague, erysipelas, dysentery; diseases arising from protein, vitamin and mineral deficiency; mycotoxicosis; in horses - infectious encephalomyelitis, infectious anemia; in dogs and fur-bearing animals - plague (intestinal form), infectious hepatitis, parvovirus enteritis and salmonellosis, as well as feed poisoning.

Immunity, specific prevention. Recovering from leptospirosis is accompanied by the formation of initially non-sterile, and then (at the end of leptospirosis) sterile immunity of high specificity, intensity and significant duration.

To create active immunity, all animals susceptible to leptospirosis are vaccinated: in farms unaffected by leptospirosis; in fattening farms where the livestock is stocked without being examined for leptospirosis; when grazing animals in the area of ​​natural focus of leptospirosis; when identifying animals on the farm whose blood serum reacts in the PMA; in areas with transhumance livestock farming.

Depending on the epizootic situation and the type of animal, various (more than 16) polyvalent and associated vaccines are used for specific immunoprophylaxis.

For passive immunization and treatment of animals with leptospirosis, hyperimmune sera are produced. Immunity in animals after administration of the serum occurs within 4...6 hours and lasts 6...8 days.

Prevention. In order to prevent animals from contracting leptospirosis, livestock owners, veterinary specialists are obliged to:

monitor the clinical condition of animals, take into account the number of abortions and, if leptospirosis is suspected, select specimens for laboratory research;

recruitment of breeding farms (farms), enterprises, artificial insemination stations should be carried out from leptospirosis-free farms;

examine all animals entering the farm for leptospirosis during the 30-day quarantine period at the RMA in a serum dilution of 1: 25. Pigs introduced into the farm for breeding purposes are examined for leptospirosis by urine microscopy, regardless of the results of serological tests (feedlot farms are allowed to complete clinically healthy animals without examination for leptospirosis, but with mandatory vaccination against leptospirosis during the quarantine period);

prevent contact of animals with livestock of farms (farms) unaffected by leptospirosis, settlements, pastures, watering places, etc.;

do not graze unvaccinated animals on the territory of natural foci of leptospirosis;

do not organize summer camps for animals on the banks of open water bodies;

systematically destroy rodents in livestock buildings, on farms, in feed storage areas, etc.

In order to timely detect leptospirosis, animal blood serum is examined in a microagglutination reaction (MAR):

at breeding enterprises, stations (points) of artificial insemination and in breeding farms (farms) of all producers 2 times a year;

pigs, large and small cattle, horses - before entry (import) and exit for breeding and use purposes (with the exception of animals for fattening) without exception;

in all cases if leptospirosis is suspected.

Treatment. For acute and subacute leptospirosis, polyvalent hyperimmune serum against animal leptospirosis, streptomycin, kanamycin, and tetracycline antibiotics are used. For the sanitation of leptospirin carriers, streptomycin is used, and in pigs, ditetracycline is used. For complications after abortion of leptospirosis etiology, symptomatic treatment is carried out. Pathogenic therapy is aimed at detoxification and treatment of complications. In small domestic animals, plasmapheresis, hemosorption, and extracorporeal dialysis are used.

Control measures. When a diagnosis of leptospirosis is made, the territorial administration makes a decision to declare a farm (part of it) or a settlement unfavorable for leptospirosis, introduces restrictions and approves a plan for improving the economy.

The plan for health measures provides for the necessary diagnostic tests of animals, restrictive, veterinary, sanitary, organizational and economic measures, indicating the timing and responsible persons (Fig. 1.3).

Under the terms of the restrictions, it is prohibited to: breed (export) animals for reproduction purposes, sell animals to the public; regroup animals without the knowledge of the veterinary specialist servicing the farm; allow animals to access the water of open reservoirs and use it for watering and bathing animals; graze unvaccinated animals on pastures where animals with leptospirosis were grazed, or on the territory of a natural focus of leptospirosis (dry areas in sunny weather can be used after 7 days, wet areas only for grazing vaccinated cattle); feed unvaccinated animals food containing rodents infected with Leptospira.

In a farm unaffected by leptospirosis, a clinical examination and measurement of body temperature in animals suspected of the disease are carried out. Sick and suspected animals are isolated and treated. Such animals are slaughtered in a sanitary slaughterhouse. The premises and equipment are disinfected after the slaughter of animals.

Slaughter products are used in accordance with the Rules for veterinary inspection of slaughter animals and veterinary and sanitary examination of meat and meat products. Milk obtained from animals with leptospirosis is used as feed after boiling. Clinically healthy animals of all species and age groups susceptible to leptospirosis are vaccinated. Treated animals are vaccinated 5...7 days after recovery.

All animals in fattening farms that are unfavorable for leptospirosis and low-value animals in breeding and commercial farms are fattened and sold for slaughter. After vaccination, breeding stock, producers and replacement young stock, which must be preserved for reproduction, are treated with leptospirocidal drugs and transferred to a disinfected room.

In service dog breeding kennels, clinically sick and suspected dogs are isolated, treated with hyperimmune serum, streptomycin, chloramphenicol (intramuscular at a dose of 15...20 mg/kg), bromide preparations, antiseptic solutions of hydrogen peroxide, potassium permanganate, etc. Clinically healthy dogs All age groups are vaccinated against leptospirosis. The sale of dogs from a nursery unaffected by leptospirosis is prohibited.

Restrictions on farms unaffected by leptospirosis are lifted in fattening farms after the livestock is handed over for slaughter and final veterinary and sanitary measures are carried out; in breeding and commercial farms after establishing their freedom from leptospirosis using laboratory research methods.

For this purpose, 1...2 months after the activities, at least 50 blood serum samples of young animals intended for sale are examined at the RMA (there should be no positive reactions), and at least 100 urine samples from every 1000 adult animals or repair group, among which there should not be leptospiron carriers. A repeat test for leptospirosis in previously unfavorable farms is carried out 6 months after the restrictions are lifted.

Immunoprophylaxis of infectious diseases- a system of measures carried out to prevent, limit the spread and eliminate infectious diseases through preventive vaccinations.

Preventive vaccinations- introduction of medical immunobiological drugs into the human body to create specific immunity to infectious diseases.

Vaccination, as a preventive measure, is indicated for acute infections that occur cyclically and quickly end in the development of immunity (measles, diphtheria, tetanus, polio).

It is important to consider the duration of immunity developed under natural conditions. For infections accompanied by the formation of long-term or lifelong immunity, after a natural encounter with the pathogen, one can expect the effect of vaccination (measles, polio, diphtheria, etc.), while for infections with short-term immunity (1-2 years for influenza A), one can count on vaccination as a leading measure is not necessary.

The antigenic stability of microorganisms should also be taken into account. In smallpox, measles and many other infections, the pathogen is antigenically stable, and immunoprophylaxis of these diseases is completely justified. On the other hand, with influenza, especially caused by type A viruses, as well as HIV infection, the antigenic variability of pathogens is so great that the pace of vaccine development may lag behind the pace of the emergence of new antigenic variants of viruses.

For infections caused by opportunistic microorganisms, vaccination cannot radically solve the problem, since the outcome of the meeting between the macroorganism and the microorganism determines the state of the body's nonspecific defenses.

Vaccine prevention is a very effective (cost-effective) measure in economic terms. The smallpox eradication program cost $313 million, but the annual cost prevented is $1-2 billion. In the absence of immunization, 5 million children would die every year, more than half of them from measles, 1.2 and 1.8 million from neonatal tetanus and whooping cough.

Worldwide, 12 million children die annually from infections potentially controlled by immunoprophylaxis; The number of children who become disabled, as well as the costs of treatment, cannot be determined. At the same time, 7.5 million children die due to diseases for which there are currently no effective vaccines, but more than 4 million die from diseases that are completely preventable with the help of immunoprophylaxis.

Section 2. Immunobiological drugs

Immunobiological drugs

TO immunobiological drugs include biologically active substances that cause a state of immunological defense, change the functions of the immune system, or are necessary for the production of immunodiagnostic reactions.

Considering the mechanism of action and the nature of immunobiological drugs, they are divided into the following groups:

vaccines (live and killed), as well as other medicines prepared from microorganisms (eubiotics) or their components and derivatives (toxoids, allergens, phages);

immunoglobulins and immune sera;

immunomodulators of endogenous (immunocytokines) and exogenous (adjuvants) origin;

diagnostic medicines.

All drugs used for immunoprophylaxis are divided into three groups:

creating active immunity- include vaccines and toxoids

providing passive protection- blood serum and immunoglobulins

intended for emergency prevention or preventive treatment infected persons - some vaccines (for example, rabies), toxoids (in particular, tetanus), as well as bacteriophages and interferons

Vaccines and toxoids

Live vaccines- alive attenuated (weakened) strains bacteria or viruses characterized by reduced virulence with pronounced immunogenicity, i.e. ability to induce the formation of active artificial immunity. In addition to the use of attenuated strains of pathogens, they are widely used for immunoprophylaxis of a number of infections. divergent strains(causative agents of cowpox and bovine mycobacterium tuberculosis).

Live vaccines include BCG, vaccines against tularemia, yellow fever, smallpox, rabies, polio, measles, brucellosis, anthrax, plague, Q fever, influenza, mumps, tick-borne encephalitis, rubella. In the group of live vaccines, in addition to previously known from attenuated strains (poliomyelitis, measles, mumps, tularemia, etc.), as well as vaccines from divergent strains of microorganisms (smallpox virus, mycobacterium tuberculosis), vector vaccines obtained by genetic engineering (recombinant vaccine) have appeared against HBV, etc.).

Killed vaccines- strains of bacteria and viruses killed (inactivated) by heat or chemicals (formalin, alcohol, acetone, etc.). It is advisable to divide inactivated, or killed, vaccines into

corpuscular (whole cell or whole virion, subcellular or subvirion) and

molecular.

Killed vaccines are usually less immunogenic than live ones, which necessitates their repeated administration. Killed vaccines include typhoid, cholera, pertussis, leptospirosis, vaccine against tick-borne encephalitis, etc.

Corpuscular vaccines are the most ancient and traditional vaccines. Currently, to obtain them, not only inactivated whole microbial cells or viral particles are used, but also supramolecular structures containing protective antigens extracted from them. Until recently, vaccines made from supramolecular complexes of microbial cells were called chemical vaccines.

Chemical vaccines are a type of killed vaccine, but in them, instead of a whole microbial cell or virus, the immunogenic function is performed by soluble antigens chemically extracted from them. In practice, chemical vaccines are used against typhoid fever, paratyphoid fever A and B.

It should be noted that vaccines are used not only for prevention, but also for the treatment of certain chronic infections (in particular, diseases caused by staphylococci, brucellosis, herpetic infections, etc.).

Anatoxins- as an immunizing factor they contain exotoxins of toxin-forming bacteria, deprived of toxic properties as a result of chemical or thermal effects. Toxoids are usually administered multiple times. Currently, toxoids are used against diphtheria, tetanus, cholera, staphylococcal infection, botulism, and gas gangrene.

Associated vaccines- medicines containing a combination of antigens.

The following associated vaccines are used: DPT (adsorbed pertussis-diphtheria-tetanus), ADS (diphtheria-tetanus), measles-mumps-rubella vaccine, divaccine (typhoid fever-paratyphoid A and B, measles-mumps), etc. Numerous studies have shown that that the simultaneous administration of several vaccines does not inhibit the formation of immune reactions to any of the individual antigens.

Immune sera and immunoglobulins

Blood serum(venous, placental) hyperimmune animals or immune people contain protective antibodies - immunoglobulins, which, after being introduced into the recipient’s body, circulate in it from several days to 4-6 weeks, creating a state of immunity to infection during this period.

For practical reasons, there is a distinction

homologous (prepared from human blood serum) and

heterologous (from the blood of hyperimmunized animals) drugs.

In practice, anti-tetanus, polyvalent anti-botulinum (types A, B, C and E), anti-gangrenous (monovalent), anti-diphtheria, anti-influenza serums, measles, anti-rabies, anthrax immunoglobulins, immunoglobulin against tick-borne encephalitis, lactoglobulin, etc. are used.

Homologous purified immunoglobulins for targeted purposes- used not only as therapeutic or prophylactic agents, but also to create fundamentally new immunobiological drugs, such as anti-idiotypic vaccines. These vaccines are very promising because they are homologous to the body and do not contain microbial or viral components.

Bacteriophages

Typhoid, cholera, staphylococcal, dysentery and other bacteriophages are produced, but the most effective are bacteriophages prepared using specific strains of pathogens.

Immunomodulators

Immunomodulators- substances that specifically or nonspecifically change the severity of immunological reactions. These drugs have one thing in common - immunomodulators have “immunological points of action”, i.e. targets among immunocompetent cells.

Endogenous immunomodulators are represented by interleukins, IFN, thymus peptides, bone marrow myelopeptides, tumor necrosis factor, monocyte activation factors, etc. Endogenous immunomodulators take part in the activation, suppression or normalization of the immune system. Therefore, it is quite natural that after the discovery of each of them, attempts were made to use them in clinical medicine. Many drugs are used in the treatment of various infections, cancer, immune disorders, etc. For example, α-IFN and γ-IFN are used to treat HBV, HVC, herpetic infections and acute respiratory viral infections (ARVI), cancer and some forms of immune pathology. Thymus preparations are widely used to correct immunodeficiency conditions.

Exogenous immunomodulators are represented by a wide group of chemicals and biologically active substances that stimulate or suppress the immune system (prodigiosan, salmosan, levamisole). As mentioned above, immunomodulators are among the drugs that are promising for increasing use, especially endogenous immunomodulators, since they are the most effective and are among the

Interferons (IFNs)- pleiotropic cytokines with a relatively low molecular weight (20,000-100,000, less often up to 160,000), causing an “antiviral state of cells”, preventing the penetration of various viruses into them. They are synthesized by lymphocytes, macrophages, bone marrow cells and spectacle gland cells in response to stimulation by certain biological and chemical agents. Currently, genetic engineering methods have been developed for the production of IFN. In this way, reaferon, α-IFN and γ-IFN are obtained, which are used in medical practice for the treatment of diseases of malignant growth, viral hepatitis B, viral hepatitis C, herpes infection and other diseases.

Methods of introducing vaccines into the body

Several are known methods of introducing vaccines into the body.

Percutaneous routes (cutaneous application) - solution, suspension - smallpox, plague, tularemia, brucellosis, anthrax, etc.

Intradermal - for immunization against tuberculosis.

Subcutaneous - solution, suspension - live measles vaccine (LMV), DTP, etc.

Intramuscular - solution, suspension - sorbed toxoids: DTP, ADS, adsorbed diphtheria-tetanus vaccine with a reduced dose of antigen (ADS-M), anti-diphtheria toxoid, immunoglobulins, anti-rabies drugs.

Oral - liquid (solution, suspension), tablets without acid-resistant coating - BCG, OPV (poliomyelitis vaccine for oral administration), plague, smallpox, etc.

Enteral - tablets with acid-resistant coating - plague, smallpox, against Q fever.

Aerosol - liquid, suspension, powder - influenza, plague, gastrointestinal tract infections.

Organization of vaccination work in healthcare institutions

The organization of vaccination work in healthcare institutions is regulated by the relevant documents of the Ministry of Health.

When organizing vaccination work, special attention should be paid to:

equipping the vaccination room and complying with the requirements for space, ventilation, sanitary equipment;

availability of the required accounting documentation;

availability of medical equipment to provide emergency medical care;

availability of medical equipment for vaccinations and compliance with asepsis and antisepsis;

transportation and storage of immunobiological agents in compliance with the “cold chain” regime;

compliance with the expiration dates of immunobiological medicinal products;

disposal of ampoules and vials containing (containing) immunobiological drugs;

organization of vaccinations (permission to work, appointment of vaccinations, vaccinations, prevention of post-vaccination complications).

Vaccination room equipment

The vaccination room of an outpatient healthcare organization should consist of:

premises for storing medical records;

premises for preventive vaccinations (1 and 2 can be combined in clinics for adults);

additional premises for carrying out preventive vaccinations against tuberculosis and tuberculin diagnostics.

On-site preventive vaccinations can be carried out in treatment rooms of healthcare organizations or other premises of organizations subject to the requirements specified above. Carrying out preventive vaccinations in dressing rooms of healthcare organizations forbidden.

Premises for preventive vaccinations vaccination room organizations must be equipped with:

supply and exhaust ventilation or natural general ventilation;

running water with hot water supply and sewerage;

sink with installation of elbow taps with mixers;

dispensers (elbow) with liquid (antiseptic) soap and antiseptic solutions.

Accounting documentation

The vaccination room should contain:

instructions for use immunobiological medicinal products (IMDs);

vaccination logs by type of vaccination;

logs of accounting and use of ILS;

refrigerator temperature log;

emergency plan in case of violations in the “cold chain”;

a list of current regulatory legal acts regulating the implementation of immunoprophylaxis among the population of the Republic of Belarus.

Medical equipment of the vaccination room

In the premises for carrying out preventive vaccinations of the vaccination room of the organization there must be:

refrigeration equipment;

cold packs;

medical cabinet;

• a set of medicines for providing emergency (emergency) medical care;

  a set of medicines for emergency prevention of HIV infection and parenteral hepatitis;

  tools;

  disposable syringes with needles;

  packs with sterile material (cotton wool at the rate of 1.0 g per injection; bandages; napkins.);

medical couch or chair;

baby changing table;

medical tables;

containers with disinfectant solution;

bactericidal lamp;

thermal container (thermal bag).

The vaccination room must be equipped with:

a container for collecting used instruments;

puncture-resistant container with a lid for disinfection of used syringes, swabs, used ampoules and vials with ILS;

tonometer;

thermometer;

transparent millimeter ruler;

5 tweezers;

2 scissors;

rubber bands in the amount of 2 pcs.;

• adhesive plaster;

  towels;

  disposable gloves (one pair per patient);

  antiseptics;

  ethyl alcohol;

Disposable syringes for preventive vaccinations should be of the following types:

volume: 1, 2, 5 and 10 ml. with an additional set of needles;

tuberculin syringes.

Transportation and storage of immunobiological drugs

Transportation and storage of immunobiological medicinal products must be carried out using a “cold chain”, with a storage temperature within 2-8 °C, unless otherwise specifically stated. The cold chain uses thermal cabinets (refrigerators), refrigerated containers, refrigerators, and thermal containers.

A portable medical thermal container is a special container that is used for storing and transporting a vaccine.

Thermal container with cold elements

When transporting ILS from a warehouse and carrying out preventive vaccinations on site, the organization must have:

at least one thermal container (thermal bag);

two sets of cold elements for each thermal container (thermal bag).

When storing and transporting ILS to an organization, the following requirements must be met:

the temperature regime must be observed - from +2 to +8°С, unless otherwise specified in the instructions for their use;

use thermal containers (thermal bags) fully equipped with cold elements;

the thermal container (thermal bag) must contain a thermometer to control the temperature;

the temperature in the thermal container (thermal bag) must be maintained for 48 hours within the range of +2°C - +8°C at ambient temperatures up to + 43°C;

use temperature indicators;

Storage and transportation of ILS in healthcare organizations should be carried out by medical workers who have undergone special training and certification at the level of healthcare organizations in compliance with the “cold chain” system.

In the organization, the ILS must be stored in a specially designated refrigerator.

Storing other medicines (with the exception of adrenaline solution for emergency medical care) and food in the refrigerator for storing ILS is prohibited.

When storing ILS in a refrigerator, the following requirements must be met:

the number of doses must correspond to the number of planned preventive vaccinations for the current month;

the duration of storage in the organization should not exceed 1 month;

the order of arrangement of packages with ILS must provide for access of cooled air to each package;

ILS of the same name should be stored in series, taking into account the expiration date;

storing the HUD on the door panel or bottom of the refrigerator is prohibited;

the volume of stored ILS should not exceed half the volume of the refrigerator;

When the freezer is located on top of the refrigerator, the ILS should be located in the following order:

2- on the top shelf of the refrigerator - live vaccines (poliomyelitis, measles, rubella, mumps, BCG, tularemia, brucellosis);

3 - on the middle shelf of the refrigerator - adsorbed vaccines, toxoids, vaccine against hepatitis B, Hib infection;

4 - on the bottom shelf of the refrigerator - solvents for lyophilized ILS;

When the freezer compartment is located in the refrigerator at the bottom, the ILS should be located in the following order:

on the top shelf of the refrigerator - solvents for lyophilized ILS;

on the middle shelf of the refrigerator - adsorbed vaccines, toxoids, vaccine against hepatitis B, Hib infection;

on the bottom shelf of the refrigerator are live vaccines (poliomyelitis, measles, rubella, mumps, BCG, tularemia, brucellosis).

Disposal

When disposing ampoules (vias) containing inactivated ILS (live measles, mumps and rubella vaccines, human immunoglobulins and heterologous sera or their residues) must comply with the following requirements:

Disinfection treatment of ampoules (vias) with ILS residues is not carried out;

the contents of ampoules (vials) are poured into the sewer;

glass from ampoules (vials) is collected in puncture-proof containers.

Ampoules (vials) with live IDPs must be disinfected by physical or chemical means.

Shelf life of immunobiological medicinal products

Opened multi-dose vials of ILS containing a preservative (other hepatitis B vaccine) should be used for preventive vaccinations for no more than four weeks, subject to the following conditions:

the HUD used has not expired;

ILS are stored at a temperature of +2 - + 8°C;

ILS was taken from the vial in compliance with aseptic rules;

the color of the thermal indicator for the bottles has not changed;

in the absence of visible signs of contamination (changes in the appearance of the HUD, the presence of floating particles).

The use of an open vial of live (oral) polio vaccine must comply with the following requirements:

when using a dropper, the vaccine should be stored for no more than two days at a temperature of +2 - + 8°C, the bottle should be tightly closed;

when removing a dose from a vial through a syringe, the ILS must be drawn up each time with a new syringe through a rubber stopper in compliance with aseptic conditions; in this case, the period of use of the ILS is limited by the expiration date.

Opened vials of ILS against measles, mumps, rubella, and tuberculosis must be disposed of 6 hours after opening or at the end of the working day if less than 6 hours have passed.

Organization of preventive vaccinations in a healthcare institution

When carrying out preventive vaccinations, the head of the organization must appoint persons responsible for:

organization of work on the section of immunoprophylaxis;

planning and carrying out preventive vaccinations;

receipt, transportation, storage and use of ILS;

compliance with the system of uninterrupted storage of ILS in conditions of constant low temperature;

collection, disinfection, storage and transportation of medical waste generated during preventive vaccinations.

Carrying out preventive vaccinations in an organization must meet the following requirements:

Prescription of preventive vaccinations should be carried out by medical workers with special training and certification in the section of immunoprophylaxis;

Newly hired medical workers in organizations should receive permission to work related to preventive vaccinations after completing on-the-job training;

the introduction of ILS to the patient must be carried out by a medical professional, trained in the technique of carrying out preventive vaccinations, methods of providing emergency (emergency) medical care in case of development of a complication, a preventive vaccination;

introduction of ILS against tuberculosis and tuberculin diagnostics must be carried out by medical workers who have been trained on the basis of anti-tuberculosis organizations and have a document issued in accordance with the legislation of the Republic of Belarus;

in the absence of additional premises for carrying out preventive vaccinations against tuberculosis and tuberculin diagnostics, the introduction of ILS against tuberculosis and tuberculin diagnostics should be carried out on separate days or separate hours on a specially designated table, with separate instruments, which should be used only for these purposes;

in patients at risk of developing complications from the introduction of ILS, preventive vaccinations should be carried out in a hospital healthcare organization;

To carry out preventive vaccinations, medical workers with acute respiratory diseases, tonsillopharyngitis, injuries on the hands, pustular skin lesions (regardless of their location) not allowed.

The introduction of ILS should provide for the following anti-epidemic requirements:

preventive vaccination should be carried out only if there is a record of its appointment in the medical documentation;

Aseptic rules must be observed when opening the ampoule, diluting the lyophilized ILS, removing the dose from the vial and when processing the injection field;

preventive vaccinations should be given to the patient in a lying or sitting position;

Only disposable or auto-disable syringes should be used;

re-administration of ILS to patients who, after a preventive vaccination, developed a strong reaction or complication to a preventive vaccination is prohibited;

when registering a strong reaction or complication to the introduction of ILS, sending an extraordinary report in accordance with the legislation of the Republic of Belarus;

Information about the use of ILS and preventive vaccination must be included in the medical documentation of the established form and transferred to organizations at the place of study or work of the patient who received the preventive vaccination.

Preventing complications

To prevent complications from preventive vaccinations, the medical worker of the organization who carried out the preventive vaccination must:

warn the patient who received the preventive vaccination, or the child’s parents, guardians and other legal representatives about the need for the vaccinated person to stay near the vaccination room for 30 minutes;

monitor a patient who has received a preventive vaccination for 30 minutes;

provide primary medical care in the event of the development of immediate allergic reactions in a patient who has received a preventive vaccination and call a resuscitator to provide specialized medical care.

Measures to prevent post-vaccination reactions and complications should include:

medical observation for three days (when administering non-live vaccines) of the specialist doctor who prescribed the preventive vaccination for the patient who received the preventive vaccination;

medical observation from the fifth to the eleventh day (when administering live vaccines) of the medical specialist who prescribed the preventive vaccination for the patient who received the preventive vaccination;

registration of post-vaccination reactions and complications to preventive vaccination in medical records;

medical observation for thirty days when a patient who has received a prophylactic vaccination applies and registers strong and moderate reactions to the prophylactic vaccination;

quarterly analysis of the reactogenicity of ILS by the medical worker of the organization responsible for organizing work on immunoprophylaxis;

development (based on analysis) and implementation of measures aimed at reducing the number of post-vaccination reactions and preventing post-vaccination complications.

Immunoprophylaxis of infectious diseases is aimed at preventing the occurrence and spread of various infections among people. Vaccines, serums, toxoids, and phages are used.

Immunoprophylaxis of infectious diseases is one of the greatest achievements of mankind. This is a whole range of measures that are aimed at preventing the occurrence and spread of various infectious processes in the human population. The global goal is the elimination of many infectious diseases, that is, stopping the circulation of the pathogen in the environment and the subsequent impossibility of infecting humans.

Immunobiological preparations are used for immunoprophylaxis of infectious diseases.

Depending on the timing and goals, various schemes and types of preventive measures are distinguished. In most developed countries, the organization of immunoprophylaxis of infectious diseases is a state task, considered as one of the components of the public health system.

Immunoprophylaxis (any) creates a fairly high titer of antibodies in the human body. These protein compounds bind and neutralize penetrating microbial agents, as a result of which an infectious disease does not develop.

Benefits of immunoprophylaxis

Modern medicine causes many patients to doubt its competence. It is necessary to know not only about the negative side of the issue, but also about the positive one in order to fully understand its significance.

Among the advantages of immunoprophylaxis, the following are highlighted:

• creation of reliable and long-lasting immunity against infectious diseases that cannot be cured (rabies, polio);
• the probability of infection with a certain microbe is extremely low, even if the disease develops, its course is mild and without complications;
• It is better to prevent any infectious disease than to cure it (for example, polio with damage to the nervous system suffered by children is sometimes impossible to cure completely).

The economic costs of any immunoprophylaxis options are significantly lower than the cost of treating even a patient with the classic course of an infectious disease.

Types of immunoprophylaxis

In practical healthcare, immunoprophylaxis is divided into planned, emergency and for epidemic indications. Depending on this moment, certain tactics of action of medical personnel are provided.

Planned immunoprophylaxis

Planned prevention is a system of gradually creating intense and long-term (ideally lifelong) immunity from a variety of infectious diseases. To implement it, a calendar of preventive vaccinations has been developed and implemented in almost every country in the world. Each child is administered immunobiological drugs according to a certain scheme. As a result of the complete implementation of the calendar of preventive vaccinations by the end of adolescence, a person is reliably protected from certain infectious diseases.

The calendar of preventive vaccinations may differ in the timing of administration of immunobiological drugs. However, infectious diseases included in the mandatory list, as a rule, do not have significant differences. These include:

• tuberculosis;
• polio;
• measles;
• parotitis;
• rubella;
• whooping cough;
• Hepatitis B;
• tetanus;
• diphtheria.

In some cases, routine vaccination also applies to the adult population. For example, many CIS countries practice maintaining a sufficient level of collective immunity against diphtheria and tetanus. To achieve this, the entire adult population undergoes routine immunoprophylaxis of these infectious diseases every 10 years.

As a result of such targeted measures, it is possible to reduce the incidence of certain infectious diseases (poliomyelitis, measles, diphtheria). Sometimes it becomes possible to completely eliminate certain infections, for example, smallpox.

Emergency immunoprophylaxis

Very true to its name. This is an algorithm of actions that is implemented after a healthy person comes into contact with an infectious patient. For example, in a kindergarten group, when children with measles appear, an action plan is developed that reduces the likelihood of developing the disease in children in the entire group.

It is advisable to carry out emergency immunoprophylaxis in cases where it is possible to create intense immunity against a specific infectious disease in the shortest possible time. As a result, by the time clinical symptoms may appear, the human body already has a sufficient titer of protective antibodies.

Emergency immunoprophylaxis of infectious diseases in children and adults is carried out to prevent the following diseases:

• tetanus;
• rabies;
• measles;
• polio.

The need and expediency of this type of immunoprophylaxis can be determined by a family doctor or an infectious disease specialist. In most cases, we are talking about administering immunotherapy to one person or a small group.

Immunoprophylaxis for epidemic indications

Such immunoprophylaxis of infectious diseases in children and adults is carried out in cases where a large group of people (village, city, region) is at risk of contracting a certain infection. This is possible, for example, in the following situations:

• violation of the preventive vaccination calendar, as a result of which the level of collective immunity falls (diphtheria, polio);
• as a result of a man-made or other disaster, compliance with sanitary standards is violated and the risk of developing intestinal infections (typhoid fever, cholera) increases;
• a new microbial agent was introduced into an uncharacteristic climatic zone (for example, plague in European countries).

In such a situation, the development of mass diseases among a large number of people is possible. It is always difficult to cope with an epidemic of infectious origin; it requires serious material costs and qualified actions of medical personnel.

To avoid the worst scenario, immunoprophylaxis is carried out for children and adults, taking into account the likelihood of an outbreak of a certain infection. For example, after a flood in hot countries, vaccination against hepatitis A and cholera is carried out as soon as possible.

In the countries of the former USSR in the 1980s, an epidemic of diphtheria was registered, which developed as a result of the refusal of many parents to vaccinate. A disease that is usually more relevant for a child has become dangerous for an adult. An unscheduled vaccination of the entire population against diphtheria was carried out, which made it possible to quickly eliminate the epidemic of this infection.

Types of immunotherapy drugs

Modern medicine has the following medications for the specific prevention of infectious diseases:

• vaccines;
• toxoids;
• heterogeneous (animal origin) serums;
• human (donor) immunoglobulins;
• bacteriophages.

Each of these drugs can only be prescribed by a doctor. Some of them are approved for use without age restrictions, others are used only for children.

Vaccine

This serious medical term comes from the Latin name for such a commonplace animal as a cow. The English doctor Edward Jenner noticed that women working with this animal do not get smallpox. This practical moment became the starting point for the start of smallpox vaccination and the subsequent elimination of this infectious disease on the globe.

The following vaccines are currently used:

• live (contain a weakened pathogen that has retained its immunogenic and antigenic properties (against tuberculosis, polio));
• killed (aka inactivated) (contain a completely neutralized microbe);
• whole virion (whooping cough);
• chemical, including only part of the microbial cell ();
• recombinant, obtained by genetic engineering methods (hepatitis B, influenza).

Immunotherapy (more correctly, immunoprophylaxis) can be carried out depending on the situation with any type of vaccine.

Anatoxin

This is a toxin that lacks toxigenic properties, but retains antigenic and immunogenic properties. It must be used in cases where the clinical picture of an infectious disease is caused not so much by the action of the entire microbe, but by its exotoxin. It is to this toxin that protective (antitoxic) antibodies are produced.

Modern medicine has toxoids:

• antitetanus
• antidiphtheria.

Anatoxin can be used for both emergency and planned prophylaxis.

Heterogeneous sera

Obtained by introducing a microbial agent to animals, in particular horses. A drug containing ready-made antibodies is isolated from their blood. Such immunotherapy can neutralize microbial cells already present in the human blood.

In modern practice, serums are used:

• against diphtheria;
• against tetanus;
• against gas gangrene;
• against botulism.

These same immune sera can be used not only for prevention, but also for the treatment of corresponding infectious diseases.

Human immunoglobulin

It is obtained from the blood of donors, therefore it is safer for humans. The following types of immunoglobulins are used:

• antiherpetic;
• anti-measles;
• antitetanus, etc.

Immunoglobulins can also be used for treatment and prevention.

Bacteriophage

Immunotherapy with bacterial phages (phage therapy) is treatment and prevention with specific viruses that destroy bacterial cells. For example, a certain virus that is not dangerous to humans can destroy the causative agent of dysentery in the intestines. Currently, monovalent (against one microbe) and polyvalent bacteriophages are used.

Immunoprophylaxis of infectious diseases, with careful adherence to all rules, allows you to create reliable protection against many microbial agents.

One-time vaccination - to form immunity, one vaccination is sufficient (for example, against measles).

Multiple vaccination - carried out if several injections of an immunobiological drug are required to form immunity (for example, against diphtheria).

The effectiveness of vaccination is influenced by the following factors:

1) properties of vaccines

Purity of drugs,

The administered dose

Antigen lifetime

Frequency of drug administration,

Presence of protective antigens.

2) properties of the human body

Age,

The state of the individual's immune system,

Genetic features,

Presence of immunodeficiency syndrome.

3) external factors

Nutritional features,

Living conditions,

Physico-chemical factors of the external environment.

Live vaccines.

They consist of living but weakened infectious agents. Strains of viruses and bacteria are taken as pathogens.

For example: rubella vaccine, influenza vaccine, Sabin polio vaccine (OPV, ZPS), mumps, tuberculosis vaccines.

Killed vaccines (inactivated).

Chemical vaccines

They consist of antigens obtained from microorganisms in various ways, mainly chemical methods. As a rule, chemical vaccines are not homogeneous, since they contain an admixture of individual organic compounds or complexes consisting of proteins, polysaccharides and lipids.

For example: polysaccharide vaccines Meningo A + C, acellular pertussis vaccines, Act - Hib (vaccine against Haemophilus influenzae type b).

Recombinant vaccines.

These are artificially created antigenic components of microorganisms. In this case, the gene of a virulent microorganism is integrated into the genome of a harmless microorganism, which accumulates and produces antigenic properties.

For example: vaccine against viral hepatitis B (Combitex or Euvax B). During its production, a subunit of the virus gene is inserted into yeast cells. The yeast is then cultured and HBsAg is isolated. It is cleared of yeast inclusions. This method of preparing a vaccine is called recombinant.

This vaccine also contains a preservative and adsorbent in the form of aluminum hydroxide.

Ribosomal vaccines

To produce them, ribosomes found in every cell are used. For example: bronchial and dysentery vaccines.

Vaccines

Monovaccines Associated vaccines

Composition of vaccines

1. Antigens - the main active principle - representing only a small part of a bacterial cell or virus and ensuring the development of a specific immune response. Antigens can be proteins, glycoproteins, lipopolysaccharide-protein complexes.

2. Preservative – its purpose is to ensure the sterility of drugs in cases where conditions for bacterial contamination arise (the appearance of microcracks during transportation, storage of opened primary multi-dose packaging). Used in the production of inactivated vaccines.

3. Filler – for example, glucose;

4. Stabilizer – used to increase the shelf life of the antigen;

5. Nonspecific impurities (substrate proteins for the cultivation of viral vaccines, trace amounts of antibiotics and animal serum proteins used in some cases for the cultivation of cell cultures).

6. Adjuvant – a nonspecific activator of increasing the immunogenicity of an antigen (strengthening the immune response). Sorbent gels (aluminum hydrate, etc.) are often used as an adjuvant.

Examples of combined (associated) vaccines:

ü The five-component Pentaxim vaccine contains only two main pertussis antigens and allows you to protect a child from 5 infections at once: whooping cough, diphtheria, tetanus, polio and hemophilus influenzae type b.

ü The four-component vaccine “Bubo-Kok” allows you to protect a child from whooping cough, diphtheria, tetanus and hepatitis B.

ü “Tetra-Kok” for the prevention of diphtheria, tetanus, whooping cough and polio (inactivated viruses).

The use of combined vaccines is very relevant for Russia. The Bubo-Kok vaccines (DTP/HBV), measles/rubella/mumps (MMR II, Priorix, Serum Institute), Pentaxim, as well as the possibility of administering the Infanrix (AaDTP) and Hiberix (Hib) vaccines in one syringe are interesting, first of all, because , which reduces the number of injections. Registration in Russia of Tetraxim (DaDPT/IPV), Infanrix-Penta (AaDPT/IPV/HBV), and hexavaccines (AaDPT/IPV/HBV/Hib) will further reduce the number of injections.

When preparing a number of vaccines, it is impossible to use the pathogen itself, so in these cases it is taken toxin. The isolated toxin is treated with formaldehyde or another chemical under special temperature conditions. In this case, the toxin is neutralized, but its immune properties are preserved.

Toxoids cause persistent antitoxic immunity; they are easy to combine and dose.

For example: tetanus, diphtheria, staphylococcal toxins.

They are used for emergency prevention, as well as for therapeutic and prophylactic purposes. They can be antimicrobial, antiviral and antitoxic.

Bacteriophages, or bacterial viruses (from the combination of “bacteria” and gr. phagos- “devouring”), are viruses that can penetrate a bacterial cell, infect it, reproduce in it and cause its destruction (lysis).

For example: Tuberculosis allergen purified liquid PPD-L (tuberculin), used when performing the Mantoux test.

Routes of vaccine administration

Post-vaccination reactions

Vaccine reactions

Remember! Basically, post-vaccination reactions are a normal reaction of the body to the introduction of a foreign antigen and in most cases reflect the process of developing immunity.

It can be:

Allergic reactions (from rash to the development of anaphylactic shock as a manifestation of an immediate allergic reaction to any component of the vaccine);

Encephalitic reactions, convulsions, neurological disorders;

Inflammatory processes in internal organs (carditis, nephritis, arthritis, etc.)

Causes:

Violation of vaccine storage conditions (overheating for a long time, hypothermia and freezing of vaccines that cannot be frozen);

Violation of the vaccine administration technique (especially relevant for BCG, which must be administered strictly intradermally);

Violation of instructions for administering the vaccine (from non-compliance with contraindications to the administration of an oral vaccine intramuscularly);

Individual characteristics of the body (unexpectedly strong allergic reaction to repeated administration of the vaccine);

Addition of infection - purulent inflammation at the injection site and infection, during the incubation period of which the vaccination was carried out.

Contraindications to vaccination.

All contraindications are divided into:

True– these are real contraindications listed in the instructions for vaccines and in guidance documents (orders and recommendations). Typically, these contraindications are caused by certain components of the vaccines.

For example, the pertussis component of DPT should never be administered for progressive neurological diseases.

False– contraindications that are not. As a rule, they arise as a result of the desire to protect a child from vaccinations on the basis of universal and general scientific considerations - “he is so small”, “he is so sick”, “since he is sick, that means his immunity is reduced”, “since there were reactions in the family, it means that there will be reactions from all family members.” On the other hand, these are contraindications that have developed due to tradition. For example, perinatal encephalopathy may still be a contraindication.

True contraindications may be:

Absolute– absolute contraindications. If there are such contraindications, this vaccination is not carried out under any circumstances!

Relative- these are true contraindications, the final decision on which is made by the doctor based on other factors - the proximity of the epidemic, the degree of likelihood of contact with the source of infection, the likelihood that the patient will be able to be vaccinated next time, etc.

Temporary– there is a contraindication in this moment, however, over time it can be removed. For example, the current presence of an acute disease (ARVI, etc.) or an exacerbation of a chronic disease, during which vaccination is not recommended, but after recovery (or remission), vaccinations are not contraindicated for the child.

Permanent - contraindications that over time will not be removed. For example, primary immunodeficiency, caused by a deep defect in the immune system, an allergic reaction to vaccine components.

Are common– these are contraindications common to all vaccinations.

Private– contraindications that apply only to a specific vaccination or a specific vaccine, but do not apply to all others. For example, pregnancy, which is a contraindication to vaccination with live vaccines (rubella, yellow fever), but not inactivated ones (influenza, hepatitis B).

Prevention of tuberculosis.

Tuberculosis- a chronic bacterial infection that initially affects the lungs. Subsequently, the bacilli spread from the alveoli with the blood and lymph flow to the nearest lymph nodes, kidneys, bones, skin and urinary tract, where foci of specific inflammation are formed.

Vaccine characteristics:

In Russia, the vaccines used are BCG and BCG-M, which are live mycobacteria of the BCG-1 vaccine strain, lyophilized in 1.5% sodium glutamate; there are no antibiotics. Calmette-Guerin vaccine.

Release form: Dark colored ampoules. There are 5 ampoules in a package. BCG vaccine 1 mg. (for 20 vaccination doses). BCG vaccine 0.5 mg. (10 vaccination doses). BCG-M vaccine 0.5 mg. (20 vaccination doses). Before use, the vaccine is reconstituted with an isotonic solution (0.9% sodium chloride solution) 2 ml. or 1 ml. (transparent, colorless, has no impurity).

The reconstituted vaccine is stored on a manipulation table, on a cold element, covered with a sterile dark cap or foil on top (it deteriorates in the light). The vaccine is consumed immediately after dilution or within 2 hours.

Vaccine storage. In the refrigerator at t = no higher than + 8 C. Shelf life of BCG - 2 years, BCG - M - 1 year.

Method of administration: The BCG vaccine is administered with a tuberculin syringe. Thin needle (No. 0415) with a short bevel. The vaccine is administered at the border of the upper and middle third of the outer surface of the left shoulder, intradermally in a volume of 0.1 ml.

At the site of vaccine administration, a papule with a diameter of 7–8 mm is formed. whitish in color in the form of a lemon peel, which disappears after 15-20 minutes.

Normal vaccination reaction.

After 4-6 weeks (after revaccinations after 2-4 weeks), the following develops at the injection site: hyperemia - infiltrate - papule - vesicle - pustule d = 5-8 mm (at this moment the child must be shown to the doctor!) and a crust, (which disappears on its own) and a scar forms at the site of vaccine administration, normally d = 2 mm. up to 10 mm. , round shape.

The whole process lasts 2-3 months. sometimes 3-4 months. and more. And with revaccination - 1-1.5 months.

Immunity produced in 1.5 - 2 months. after vaccination and persists for 5 years or more. An indicator of immunity and its tension in the body is the development of a positive tuberculin test.

Complications (rare):

Subcutaneous cold abscess(Scrofuloderma). The tumor-like formation is painless on palpation. A fluctuation, white-yellow content is detected in the center. There may be spontaneous opening and enlargement of the axillary lymph nodes. Develops over 1-8 months. after vaccination or revaccination. Reason: administration of the vaccine subcutaneously or administration of it in a larger dosage, scar diameter more than 10 mm, star-shaped.

· Superficial ulcer (granulomatous). Formed 3-4 weeks after RV

when infected or administered a vaccine to a person already infected with mycobacteria. It is characterized by superficial expression of the upper layers of the skin itself. The size of the ulcer is from 10 to 30 mm. in diameter, the edges are undermined. The bottom is covered with copious purulent discharge.

· Post-vaccination lymphadenitis. Develops 2-3 months after administration

vaccines are more common in young children. The reason is an overdose of the vaccine. It is characterized by damage to the axillary lymph nodes (axillary), but sometimes the parotid and other lymph nodes can be involved in the process. The skin over them is unchanged or pinkish. Lymph nodes are painless on palpation. Sometimes fistulas with purulent discharge are formed. Lymph nodes may subsequently become calcified (detected x-ray).

Keloid scars. A tumor-like formation that rises above the level of the skin and has a dense or cartilaginous consistency. Capillaries are clearly visible in the thickness of the keloid. Formed in 1-2 months. after vaccination, but more often after RV in girls when the vaccine is administered to the shoulder joint in the prepubertal or pubertal period. The diameter of the scar is more than 10 mm. and resembles a healed burn surface, convex. Color ranges from pale pink to pink with a bluish tint. There may be itching with pain.

Generalized BCG - infection(very rarely) develops against the background of chronic

granulomatous disease. Develops 5-6 months after vaccination. Are affected

peripheral lymph nodes, frequent pustular skin lesions and fungal

damage to the mucous membranes. Subsequently, the liver, spleen, lungs and

other organs

BCG - osteitis. This is a lesion of bone tissue. Develops from 4-35 months of a child’s life with a well-formed or pronounced post-vaccination sign.

The ribs, femur, humerus, calcaneus, radius, and tibia are affected. There is limited mobility of the affected limb, the appearance of swelling against the background of the child’s good health, absence of intoxication and changes in the blood test. In the future, there may be a local increase in temperature without hyperemia - a “white tumor”. Rigidity and atrophy of the muscles of the limb, increasing pain on palpation and axial load, gait disturbance.

Patronage: primary the next day, repeated - 1, 3, 6, 9, 12 months.

Prevention of hepatitis B

Hepatitis B is a viral disease caused by the hepatitis B virus. The mechanism of transmission of infection is parenteral. Infection occurs through natural (sexual, vertical, household) and artificial (parenteral) routes. The virus is present in the blood and various biological fluids - saliva, urine, semen, vaginal secretions, menstrual blood, etc. The contagiousness (infectiousness) of the hepatitis B virus is 100 times higher than the contagiousness of HIV.

Characteristics of vaccines against hepatitis B: To produce vaccines, recombinant technology is used by inserting a subunit of the hepatitis B virus gene into yeast cells. After completion of the yeast cultivation process, the Hbs-Ag protein is isolated from the latter, which is thoroughly purified from yeast proteins. The preparation is adsorbed on aluminum hydroxide. Preservative - merthiolate 1:20000. For children, half the vaccine dose given to adults is used.

Method of administration. The vaccine is administered intramuscularly, for children and adolescents: in the anterolateral thigh area, for adults: in the deltoid muscle.

Vaccination reactions: the vaccine is weakly reactive, some vaccinated people (up to (5%)) may develop hyperemia and thickening at the injection site, as well as short-term disturbances in health, low-grade fever. Isolated cases of immediate allergic reactions have been described, including anaphylactic shock, arthralgia, myalgia, peripheral neuropathy , facial nerve paralysis.

Contraindications: hypersensitivity to yeast and other components of the drug, decompensated forms of diseases of the cardiovascular system and lungs.

Primary patronage - the next day. Repeated patronage - by 7
day.

Neurological reactions

Encephalitis - very rarely, up to 10 days;

A continuous high-pitched scream (squeal) for several hours, accompanied by anxiety and a short-term increase in temperature. The reason is an increase in intracranial pressure;

Afebrile convulsions with loss of consciousness, sometimes in the form of “nods”, “pecking”, “absences”, “stagnation of gaze”, if they have never existed before and they appeared before 7 days.

Patronage: primary the next day. Repeated - on the 7th day.

Note.

If these reactions or complications occur, the administration of DTP vaccine is stopped, vaccination can be continued with DTP toxoid.

If a child has received one dose of the DPT vaccine and a severe reaction or complication has developed, he will need to take it after 3 months. ADS-toxoid is administered once, and R1V 9-12 months after V2 vaccination, ADS-toxoid is administered.

If a complication occurs after the 2nd dose of DTP vaccine, vaccination is considered complete. R1V in 9-12 months. from V2.vaccination, ADS - toxoid is administered.

If a severe reaction or complication developed after the 3rd dose of DPT vaccine, RVi - DPT toxoid 12-18 months after V3 vaccination.

Used for vaccination:

Combined vaccine " Tetrakok» for the prevention of diphtheria, tetanus, whooping cough and polio (inactivated viruses), France;

Vaccine " Pentaxim" against diphtheria, tetanus, whooping cough, polio and Haemophilus influenzae, SanofiAventis Pasteur, France

Adsorbed liquid pertussis-diphtheria-tetanus vaccine - DTP, FSUE NPO Microgen, Ministry of Health of the Russian Federation, Russia

Diphtheria-tetanus vaccine « Infanrix» three-component cell-free

pertussis adsorbed liquid, GlaxoSmithKline, England

Prevention of polio.

Poliomyelitis - an acute viral infection that affects the nervous system (gray matter of the spinal cord). Characterized by the appearance of flaccid paralysis, mainly of the lower extremities.

Characteristics of the vaccine.

Live attenuated oral polio vaccine is used (OPV) from Sabin strains (ZhVS). Contains weakened strains of polio viruses of 3 immunological types I, II, III. and traces of streptomycin and neomycin..

Release form. OPV is a red-orange liquid without sediment or impurities. Available in bottles of 50, 25, 10 doses.

Store at t° - 20 °C (shelf life 2 years), t from +2 °C to + 8 °C (shelf life 6 months). Repeated freezing and thawing of the vaccine reduces its potency. The opened bottle is used during the working day. If the metal seal of the bottle was not broken, the vaccine was removed using a syringe, the remaining vaccine was stored in the refrigerator and consumed within 2-3 days, provided that the date and time of removal of the first dose was indicated on the bottle.

Vaccination dose:

2 drops per 5 ml vaccine dispense = 50 doses. (1 dose = 0.1 ml)

4 drops per 5 ml vaccine dispense. - 25 doses; (1 dose of vaccine = 0.2 ml.).

4 drops per 2 ml vaccine dispense. - 10 doses (1 dose of vaccine = 0.2 ml.).

Method of administration. The vaccination dose of OPV is instilled with a sterile pipette or dropper 1 hour before meals, wash down the vaccine with water, and eating or drinking is prohibited for 1 hour after vaccination. If the child burped or vomited, he should be given a second dose; if in this case there was regurgitation, a new dose should be given only at the next visit.

Complications

Encephalitic (convulsive) reactions, agitation, drowsiness for 2 weeks after vaccine administration.

Allergic reactions (urticaria, angioedema up to 3 days, anaphylactic shock up to 4 hours)

Patronages: primary the next day. Repeated - on day 30.

Vaccines used:

Pentaxim vaccine against diphtheria, tetanus, whooping cough, polio and hemophilus influenzae, SanofiAventis Pasteur, France

Oral polio vaccine types 1, 2, 3; Federal State Unitary Enterprise “Enterprise for the production of bacterial and viral preparations of the Institute of Poliomyelitis and Viral Encephalitis named after. M.P. Chumakov", Russia

Inactivated polio vaccine “Imovax Polio”, “Sanofi Pasteur”, France

Prevention of measles.

Measles - an acute infectious viral disease with a high level of susceptibility, which is characterized by high temperature (up to 40.5 °C), inflammation of the mucous membranes of the oral cavity and upper respiratory tract, conjunctivitis and a characteristic maculopapular rash of the skin, general intoxication. Measles is caused by an RNA virus. The route of transmission of infection is airborne droplets.

Characteristics of the vaccine.

Live measles vaccine (LMV) is used to actively prevent measles. LCV is prepared from the vaccine strain of the Leningrad-16 virus (L-16), grown on a cell culture of Japanese quail embryos. Contains trace amounts of streptomycin or neomycin and traces of bovine whey protein.

Release form. Available in ampoules in the form of tightly compressed, immovable tablets. The reducing agent is included with the vaccine. The vaccine is restored within 3 minutes. The reconstituted vaccine is clear, colorless or slightly pinkish and opalescent. Consumed immediately after restoration.

Storage. t°= +6 (+2) °С. Shelf life 15 months in the refrigerator.

v There is no local reaction, but some children may have hyperemia and swelling for 3 days.

v The general reaction develops from 4 to 15 days after vaccination:

Hyperthermia up to 39°C, intoxication, febrile convulsions from 3 to 5 days; catarrhal phenomena (hyperemia of the pharynx, cough, runny nose, conjunctivitis); pale pink measles-like rash; Children with allergic chronic diseases may have an asthma attack, increased allergic dermatosis, and arthralgia for 3 days.

Complications very rare:

Allergic reactions: thrombocytopenic purpura for 7-30 days, angioedema for up to 3 days. Anaphylactic shock.

Immunity lasts from 18 to 25 years.

Patronage: primary the next day. Repeated - on days 7 - 10, day 18.

Vaccines used:

Measles cultural live dry vaccine, FSUE NPO Microgen, Ministry of Health of the Russian Federation, Russia

Measles cultural live dry vaccine, State Scientific Center for Virology and Biochemistry “Vector”

Rospotrebnadzor, Russia

Measles vaccine Ruvax (France)

Characteristics of the vaccine.

LCV is prepared from an attenuated strain of mumps virus L-3 grown on a cell culture of Japanese quail embryos. Contains trace amounts of streptomycin or neomycin and traces of bovine whey protein.

Release form. Available in ampoules in the form of tightly compressed, motionless tablets. The reducing agent is included with the vaccine. The vaccine is restored within 3 minutes. The reconstituted vaccine is clear, colorless or slightly pinkish and opalescent. Consumed immediately after restoration.

Storage temperature in the refrigerator is +6 (+2 °C). shelf life 15 months.

Vaccination dose: 0.5 ml.

Method of administration: subcutaneously (at 12 months, the middle third of the anterior surface of the thigh, at 6 years - the subscapular region).

Normal vaccination reaction:

Most children have no reaction, but some may sometimes have: 4-12 days after vaccination:

v Local hyperemia and swelling of the skin for 1-3 days.

v General reaction:

Hyperthermia up to 37.5 ° C, catarrhal symptoms from the nasopharynx: hyperemia of the pharynx, coughing, rhinitis for 1-3 days, in rare cases there may be abdominal pain (2-3 days), slight enlargement of the parotid salivary glands (usually painless and one-sided); toxic reaction with hyperthermia, severe intoxication and febrile convulsions for 8-14 days. The child is not contagious to others.

Complications:

Allergic reactions - Quincke's edema, anaphylactic shock.

Serous meningitis from 5-21 days or 10-30 days. after vaccination.

The time frame for the development of the vaccine process clinic is from 4-18 days.

Vaccines used:

Mumps cultural live dry vaccine, FSUE NPO Microgen, Ministry of Health of the Russian Federation, Russia

Mumps-measles vaccine, cultural, live, dry, Russia.

Prevention of rubella.

Rubella - an acute viral disease spread by airborne droplets and characterized by fever, mild cough, runny nose, enlarged and painful lymph nodes, and the appearance of a rash on the skin.

Characteristics of the vaccine.

Rubella vaccine, lyophilized, live, attenuated. The virus was grown in human diploid cell culture. Contains traces of aminoglycosides. MMR II vaccine contains traces of egg white.

Release form: The vaccine is available as a monovaccine or trivaccine. Vaccines are produced in dry form. Restorer included. Reconstituted vaccine cannot be stored.

Normal vaccination reaction:

v Local hyperemia, swelling of the skin infiltrate, accompanied by pain for 1-3 days.

v General reaction:

Hyperthermia, headache, cough, runny nose, nausea, enlargement of predominantly occipital and posterior cervical lymph nodes,

Complications:

Arthritis mainly of the knee and wrist joints (more often when the vaccine is administered in the postpubertal period) up to 42 days.

Thrombocytopenic purpura for 7-30 days.

Polyneuritis for 5-30 days.

Vaccination of pregnant women is strictly prohibited.

Patronage: primary the next day. Repeated - on the 7th day.

Vaccines used:

Live attenuated rubella vaccine, Serum Institute of India,

Rudivax live attenuated rubella vaccine, Sanofi Pasteur, France.

Currently, associated vaccines are mainly used against measles, mumps and rubella.

Live cultural vaccine "Priorix" against measles, mumps, rubella "GlaxoSmithKline", Belgium

Live cultural vaccine against measles, mumps, rubella M-M-P II, Merck, Sharp, Dome, USA.

Purposes of testing

• identification of children infected with tuberculosis;
• identifying sick children;
• formation of contact children for revaccination against tuberculosis.

Prepare:

tuberculin syringe, long and short (intradermal needle), ampoule with tuberculin, vial with 70% alcohol, sterile tweezers, sterile tray, sterile cotton and gauze balls, beaker, container with 5% chloramine (for disposal)

Technique: The test is performed strictly intradermally!

1. Treat your hands with a hygienic level, put on gloves, sanitize the gloves.

2. Open the package of the tuberculin syringe.

3. Put on the needle and fix it on the cannula, put the assembled syringe in the package.

4. Wipe the neck of the ampoule with a sterile cotton ball soaked in 70% alcohol.

5. Cut the neck of the ampoule with a file, treat the cut on the ampoule with a cotton ball soaked in 70% alcohol.

6. Break the ampoule with a dry cotton ball, throw the ball with the top of the ampoule into the disinfectant solution.

7. Place the ampoule in a beaker, covering the cut with a gauze ball.

8. Draw 0.2 ml of the drug into the syringe from the ampoule.

9. Return the ampoule with the residual amount of tuberculin to the beaker, covering it with a sterile gauze ball.

10. Release the air from the syringe to 0.1 ml into a sterile gauze ball.

11. Drop the ball into the disinfectant solution.

12. Treat the skin of the middle third of the inner surface of the forearm with a cotton ball soaked in 70% alcohol and let the skin dry.

13.Dump the ball into the disinfectant solution.

Creating immunity with the help of biological preparations (vaccines, serums, globulins) is of great importance in the prevention and elimination of infectious diseases. Artificial immunization, with the exception of a small number of diseases, is strictly specific, since it can only prevent the infectious disease against which it is directed. Therefore, immunization in the system of anti-epizootic work is classified as specific measures aimed at the third link of the epizootic chain - susceptible animals.

Effective biological products have been developed against most infectious diseases to protect animals, prevent the occurrence of diseases and stop their further spread. Immunization of animals, especially vaccination, has become firmly established in the complex of anti-epizootic measures, and for most infectious diseases it has no equal measures in terms of effectiveness (for example, anthrax, emkar, foot and mouth disease, swine fever, erysipelas, etc.).

The arsenal of means for the specific prevention of infectious diseases includes vaccines, serums, globulins and phages. Depending on this, there are two main types of immunization: |_active and passive] The most common type of immunization is active, which is achieved by administering vaccines and toxoids to animals. Vaccines are antigenic preparations obtained from microbes or their metabolic products, upon the introduction of which the body forms immunity to the corresponding infectious disease.

Based on the method of preparation, there are two main types of vaccines: live and inactivated.

Live vaccines are preparations prepared from live weakened (attenuated) strains of microbes that lack the ability to cause disease, but retain the ability to multiply in the body of animals and cause them to develop immunity. The advantage of live vaccines over inactivated ones is primarily that they are usually administered in small doses once. These vaccines ensure the rapid formation of fairly stable and intense (long-term) immunity. However, some live vaccines have pronounced reactogenic properties, as a result of which a weakened animal can react to their administration with a clinically significant illness.

Inactivated vaccines are obtained by inactivating pathogenic, especially virulent microorganisms without destroying them using physical or chemical methods (hence the name of such vaccines: thermal vaccines, formol vaccines, phenol vaccines, etc.). These are, as a rule, weakly reactogenic biological products, the epizootological effectiveness of which is inferior to live vaccines. Therefore, inactivated vaccines are administered to animals in large doses and repeatedly.

An important achievement was the method of obtaining deposited inactivated vaccines by adding special substances - various adsorbents and adjuvants (aluminum hydroxide, saponin, calcium phosphate, mineral oils, etc.). When immunized with such a vaccine, a delayed release of the antigen from the injection site (depot) occurs, resulting in the formation of relatively strong immunity even after a single vaccination (for example, after an emulsion vaccine for pasteurellosis).

Chemical vaccines are inactivated preparations consisting of soluble antigens extracted from bacteria. They contain the most active specific antigens of microorganisms (polysaccharides, polypeptides, lipids), sorbed on water-soluble substances (for example, chemical vaccines against paratyphoid and brucellosis).

Toxoids are the same inactivated vaccines, which are toxins (derivatives) of microorganisms neutralized by heat and formaldehyde, which have lost their toxigenicity, but retained their antigenic properties (for example, toxoid against tetanus).

When live vaccines are administered, immunity of animals to the corresponding pathogens occurs after 5-10 days and lasts for a year or more, and in those vaccinated with inactivated vaccines, immunity appears on the 10-15th day after the second vaccination and lasts up to six months.

The ever-increasing number of different vaccines designed to prevent one disease significantly complicates their use in the form of simple (separate) immunization in cases where it is necessary to vaccinate animals against two or more diseases. This circumstance has led to the need to create associated (polyvalent) vaccines and a complex method of using mono-vaccines, allowing for the simultaneous formation of immunity against several diseases. Therefore, active immunization, in turn, is divided into simple and complex. With simple (separate) immunization, a monovaccine is used, and the body becomes resistant to one disease. For complex immunization, mixtures of monovaccines prepared before use or factory-produced associated vaccines are used. The administration of several monovaccines can be simultaneous (in a mixture or separately) or sequential. In these cases, the animal’s body responds by simultaneously forming immunity against several diseases.

Associated vaccines and the complex use of existing mono-vaccines make it possible in some cases to increase both the immunological effectiveness of the biological products themselves (compared to mono-vaccines) and the epizootological effectiveness of vaccination in the system of anti-epizootic measures. Currently, a lot of information has accumulated indicating the high effectiveness of such vaccination methods. This allows us to classify them as the most promising direction in the field of specific prevention.

Based on the method of introducing vaccines into a living body, immunization methods are divided into parenteral, enteral and respiratory. The parenteral method includes subcutaneous, intramuscular, intradermal and other methods of administering biological products, bypassing the digestive tract. Subcutaneous and intramuscular immunization methods are most widely used.

With the enteral method, biological products are administered through the mouth individually or in groups with food and water. Although this method is convenient and simple, it is biologically difficult to solve due to the presence of a gastric protective barrier in animals. Enteral vaccination requires a relatively large consumption of the drug, and not all animals develop immunity of the same intensity. The respiratory (aerosol) method of vaccination is that the biological product is sprayed into the respiratory tract in the form of an aerosol. This method makes it possible to immunize a large number of animals in a short time and create intense immunity on the 3-5th day after vaccination.

Due to large volumes of vaccination and the transfer of livestock farming to an industrial basis, group vaccination methods have been developed by aerosols or feeding of biological products specially designed for this purpose. Group vaccination methods have already found application in poultry farming, pig farming and fur farming (vaccination against Newcastle disease, plague and viral gastroenteritis).

Active immunization in anti-epizootic work for most infectious diseases occupies an important place, and for some of them it is the main thing (for example, vaccination of cattle against anthrax). This depends on a number of reasons: the specificity of the epizootic process, the immunogenicity of the vaccine and the method of its use. The protective (immunological) effectiveness of the vaccine as a drug, the epizootological effectiveness of immunization as a measure in combination with other measures, double vaccination or single vaccination with distant revaccination are among the factors and conditions that determine the feasibility (rationality) of using specific prevention of a specific infectious disease. Maximum effectiveness of vaccine prevention can be achieved

Only with planned and scientifically based use and mandatory combination with general preventive measures.

Passive immunization is also a specific prevention of infectious diseases, but through the administration of immunoserum (specially prepared or obtained from recovered animals), globulins and immunolactone; this is essentially seroprophylaxis, capable of creating quick (in a few hours), but short-term immunity (up to 2 - 3 weeks).

A type of passive immunization is the acquisition by newborn animals from immune mothers of specific antibodies through the lactogenic route and thus the formation of colostral, or lactogenic (maternal) immunity.

For prophylactic purposes, immunosera are administered in small doses, most often when there is an immediate threat of an infectious disease, as well as before transporting animals to exhibitions and other farms. It is recommended to carry out active immunization of such animals no earlier than two weeks later. In large-scale farms, passive immunization has found wide use as a therapeutic and prophylactic measure for a number of respiratory and nutritional infections of young animals (salmonellosis, colibacillosis, parainfluenza-3, etc.).

Mixed (passive-active) immunization includes a simultaneous vaccination method, in which the immunoserum and the vaccine are administered either simultaneously, or first the serum and then the vaccine. In the recent past, simultaneous vaccinations were widely used (for swine fever, erysipelas). Currently, this method is rarely used, since the negative effect of immune serum on the formation of active immunity has been established.