The term “hepatitis” usually refers to an inflammatory disease of the liver (in past years this disease was called “infectious jaundice”, “Botkin’s disease”). Currently, viral hepatitis is an extremely common and dangerous disease. Based on the characteristics of the pathogen, causes of occurrence and routes of spread, acute viral hepatitis is divided into hepatitis A, B, C, E and D (delta); in recent years, a report has appeared about the sixth virus of this group - the hepatitis G virus. But I would like to note that there are In addition to acute forms of the disease, there are chronic forms, which can be a complete surprise for a person during examination in a medical institution before surgery, during pregnancy, during transfusion of blood and its components and donation of blood as a donor. The listed pathogens have certain differences, but they are all united by the fact that the source of infection with these infections is always a sick person or a chronically ill person. The greatest danger is posed by patients with mild or erased forms of the disease.

Acute and chronic viral hepatitis B, C and D, both among adults and children, have been and continue to be an acute socio-medical problem.

According to the World Health Organization (WHO), two billion of the world's population have been exposed to hepatitis B virus (HBV), of which 350 million are chronic carriers and at risk of infection with hepatitis D virus (HDV), about 170 million people are infected with hepatitis B virus C (HCV) and more than 10 million - hepatitis D virus (HDV).

The incidence of viral hepatitis A, B and C is recorded. Both urban and rural populations, both non-working and working, are affected.

The incidence of acute viral hepatitis in 2017 was not registered in the Zhitikarinsky district.

During the 1st quarter of 2018, 1 case of viral hepatitis A was registered in the Zhitikarinsky district, which was confirmed by ELISA. One sample of tap water was taken from this outbreak for laboratory testing for the presence of coli phages, the result of which met hygienic standards. Also, swabs were delivered to the bacteriological laboratory for the presence of Escherichia coli bacteria in the amount of 10 pieces, of which coliform bacteria were found in 3 swabs. This suggests that this case of infection may have been transmitted through household contact.

Incidence of viral hepatitis for 2016 in Zhitikarinsky district

The incidence of viral hepatitis has been reported among people aged 19 years, 24 years, 31 years and 47 years.

The Republic of Kazakhstan belongs to a region with high endemicity of viral hepatitis. Every year in different regions of the republic, from 60 to 90% of cases of the disease are due to hepatitis A, the highest level is registered among young children. In a number of regions, water outbreaks are recorded, with the subsequent spread of infection through contact and household contact.

For all known types of hepatitis, the transmission mechanism is different. Thus, HAV is transmitted through contact and household contact (in families, in organized groups), as well as through contaminated water and food. In 2016, in the Zhitikarinsky district, according to epidemic indications from foci of viral hepatitis A, 8 samples of tap water were laboratory tested for the presence of coliphages; all samples met hygienic standards. Coliphages are an indirect indicator of viral contamination of water, which makes it possible to obtain a relatively quick answer regarding the potential danger of viral contamination. Also, the bacteriological laboratory examined swabs from foci of viral hepatitis A for the presence of Escherichia coli bacteria. In 2016, 65 analyzes were performed for this type of research, of which 3 samples did not meet hygienic standards. Coliform bacteria are sanitary indicator microorganisms, i.e. indicators of fecal contamination. Detection of coliform bacteria in swabs serves as an indirect indicator of the possible presence of the causative agent of viral hepatitis A.

Hepatitis B, C and D are predominantly suffered by drug addicts who use the same syringe and homosexuals. Infections are transmitted through blood through transfusion of blood or its preparations from a patient or a virus carrier, as well as through the use of insufficiently sterilized medical equipment infected with a virus and through sexual contact. You can become infected in cosmetology, dental offices, and hairdressers. Infection is also possible during tattoos, ritual ceremonies, and other procedures performed with shared instruments (earlobe piercings, shaving, manicures, etc.). Factors in the transmission of HBV can be personal hygiene items (toothbrushes, razors and manicure utensils, washcloths, combs, scissors, etc.) used by several family members.

Natural transmission of HBV can occur from mother to child, mainly during childbirth.

Particularly dangerous sources of infection are chronic patients without clinical manifestations of the disease.

Infection with viral hepatitis E occurs mainly through drinking water contaminated with feces of the patient.

The incubation period or infection period can range from 35 to 780 days, depending on the type of pathogen. Those. The disease can sometimes manifest itself 2 years after infection.

The disease can begin as a viral infection, sore throat, runny nose, weakness, headaches. Those. This is the so-called pre-icteric period. Then pain is noted in the right hypochondrium, possibly in the epigastric region. The main signs of the disease are yellowness of the skin and mucous membranes, darkening of the color of urine, they say the color of “beer”, discoloration of feces. There may be an increase in body temperature.

Early diagnosis and hospitalization in an infectious diseases hospital of a patient with viral hepatitis A reduces the risk of infection of family members in contact with him. After isolating the patient at the source of infection, final disinfection should be carried out.

Compliance with basic sanitary and hygienic rules sharply reduces the likelihood of infection with the hepatitis A virus. We are talking about the need to wash hands after visiting the toilet and before eating, and using boiled water for drinking.

Vaccination against hepatitis A and B is the most effective method of preventing viral hepatitis. In the Zhitikarinsky district in 2016, 491 people were vaccinated against HAV (coverage percentage was 89.6), and 472 people were vaccinated against HBV (coverage percentage was 89.7).

It must be emphasized that drug addicts who use drugs intravenously can spread not only viral hepatitis, but also a number of other dangerous infections, such as HIV infection. About 90% of all HIV-infected people in recent years are infected through this route.

Bacteriologist of Zhitikarinsky

district branch of the RSE on the PVC "National"

Center of Expertise" of the Security Committee

public health of the Ministry of Health of the Republic of Kazakhstan

in Kostanay region

Murzabulatova R.K