klimatski promeni i infektivni zaboluvanja.pdf

8/14/2019 klimatski promeni i infektivni zaboluvanja.pdf

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1. 72. 93. 113.1 113.2 133.3 144. , 164.1 164.2 174.3 184.3.1 184.3.2 194.3.3 204.3.4 22. 22. 22. 23

26 - CHIKUNGUNYA FEVER 27 - - CREMEAN - CONGO HAEMORHAGIC FEVER 31 CRYPTOSPORIDIUM 34 - - (DENGA) 37

- (GIARDIASIS) 39O - LEISHMANIOSIS 42 - LEPTOSPIROSIS 46 - ( LYME BORRELIOSIS LYME DISEASE) 49 MALARIA 52 (MEDITERANINAN SPOTTED FEVER MSF) 55 - RICKETTSIOSIS 57 SALMONELLOSIS 59 WEST NILE INFECTIONS 61 1 66 2 68 70 72

v


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(EWARN) - (BMU) - (VL) o - - - - - (ELISA) (ECDC) (EHEC) (WNF) (IgM) (IFA) - (CCHF) (LB)

- (MSF) (MSF) (PCR) (RNA) - (RT-PCR) (WHO) (WMO) (TBE) - (HFRS) (CHKV)


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1. Intergovernmental Panel on Climate Change (IPCC) (2005). Contribution of Working Group I to the Fourth Assessment Report of the IPCC. Draft. Cambridge:Cambridge University Press.

2. Bates BC, Kundzewicz ZW, Wu S and Palutikof JP (eds.) (2008). Climate Change and Water. Technical Paper of the Intergovernmental Panel on Climate Change,IPCC Secretariat, Geneva.


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. . -, , . (2003;Patz et al. 2000; Wilson 2001). 4,8,9

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Intergovernmental Panel on Climate Change (IPCC) (2001). Climate Change 2001: The Scientic Basis. Contribution of Working Group I to the Third Assessment Reportof the Intergovernmental Panel on Climate Change [Houghton J T, Ding Y, Griggs DJ, Noguer M, van der Linden PJ, Dai X, Maskell K and Johnson CA (eds.)]. CambridgeUniversity Press, Cambridge, United Kingdom and New York, NY, USA.WHO, UNEP, WMO (2003). Climate change and human health - risks and responses, Geneva (2003). . (2008). . , WHO.(2002). World Health Report. Geneva


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Patz, J.A., et al.,(2000). Effects of environmental change on emerging parasitic diseases. Int J Parasitol, 30 (12-13).Wilson, M.L.. (2001). Ecology and infectious disease, in Ecosystem Change and Public Health: A Global Perspective, J.L. Aron and J.A. Patz, Editors, Johns Hopkinsniversity Press: Baltimore. p. 283-324.. Confalonieri and al. (2007). Human health. Climate Change Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fourth Assessment

eport of the Intergovernmental Panel on Climate Change, Cambridge University Press, Cambridge, UK.


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19912008 . , 26.092 1.450 . 1304, 6/100.000 , 72,4/100.000, . , 4-6 , , . , ( ), / 2008 , / , .

- 5-10% . 1991 2008 6.969 , 340,3/100.000 387 , .

- 1991 2008 , 2.652 , 132,6/100.000 147 , 8 , 35 ., , , , .

- (Campylobacter) . 2-5% . , , , 18.000 .

, - : , , O157 H7 (EHEC) ( , Clostridiumperfringens). , . , , . . , , . 30 , 3 2009 .(287 ), 2008 .(490 ), 2007 .(381 ). : 2009 .(290 ), 2008 .(243), 2007 .(257 ).

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(Cryptosporidium) - , Cryptosporidium- ., Cryptosporidium- . .

(Giardia lamblia) - , Giardia . , , . Cryptosporidium- Giardia lamblia

.

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Hantavirus - (). (HFRS). . . 2002 . .

(Chikungunya) - Aedes, , Aedes albopictus, . Aedes albopictus chikun-gunya . , Aedes albopictus 2010 .

(Lyme Borreliosis) (LB), (TBE) - . . , , . LB, TBE Ixodesricinus , . , , .

o (Leishmaniosis) (VL, ) - , o . . o (VL) , , . 1991 2008 91 o 4,6/100.000 5 , . o .

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- , . - Aedes aegypti. , Aedes albopictus, , , , , 2010 . - .

(Rickettsia conorii) - 2003 , , (MSF) , Ixodes . (R.Conorii) .


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CHIKUNGUNYA FEVER

edesAegypti Aedes Albopictus . . ( CHKV, , ar-thropod bo-rne) Alphavirus Togaviridae.

1: (Aedes albopictus)

CHKV ( = CHKV) Aedes (.aegypti A .albopictus). CHKV . . . , . , .

Aedes albopictus, . Aedes albopictus .

2: (Aedes Albopictus)

112 , 3-7 . , CHKV- , : CHKV- ( ) / . .

40C, , ( , . , , ,

). 50% . , , . , , , , ,, ., , . , . , , , , (), , 5-7 . . 5-15 , 1 2,5 , . . , . .


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- CREMEAN - CONGO HAEMORHAGIC FEVER

Nairovirus, Buniaviridae (RNA ). Nairovirus 32 , : Dugbe Nairobi - (CCHF) .

- Hyalomma (marginatum marginatum, H. Marginatum rupes). (, , ) ( ). () , () .

- (CCHF) . Hyalomma, , . . , , . . CCHF . , . CCHF, .

: , , , ( ). , , , (, .). / , , (

).

- ( ) , , , . , . CCHF , 2001 , 2004 . , Hyalomma marginatum marginatum ( ) ( ).

Rt-PCR, . ,3. IgM-. RT-PCR IgM () .

, . , , , . , Reye- ., ,

, ., : , . ( , ), , .

. 4.3.4 .


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, , .

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, 4.3.4 .

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. 2-4 , , . , . (, , , ), , . ,

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. IgG IgM- . RT-PCR CCHF 10-15 , . CCHF- , .

3: CCHF

Adult femalesdrop off host to

lay eggs

First Year

Second Year

Winter

Fall

Spring

Summer

Spring

Larvae becomenymphs on the rsthost after one molt

Adults attach tothe secondhost for

feeding and mating

Nymps molt intoadults and overwinter

off of a host

Summer

Engorged nymphsleave rst host

Fall

W i n t e r

infective StageDiagnostic Stage

Eggs hatch intosix-legged larvae


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1 , . 1%, . 1%. (10-30%) . 25-35%, 80%.

4:

1-2 . , . Cryptosporidium hominis, Cryptosporidium parvum, . , . , . , , , . , ( / ).

CRYPTOSPORIDIUM

. Coccidii, Isospori. Cryptosporidium () . , , , , , , . . .

, 2-5 . . (, .)

Cryptosporidium , : C. hominis - , C. parvum - , , : C. meleagridis - ,C. muris - , C. anderson-, C. felis - , C. baileyi - ,C. canis- , C. galli- , C.serpentis- , C. saurophilum- .

Cryptosporidium , , , , . Cryptosporidium , . .

1984 .

. , , , 1993 , 370.000 .

, , , . . . Cr yptosporidium , , . - .

Cryptosporidium 1- 4% , 3-20% , , , . 5- .


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-

DENGA

Flavivirus Flaviviridae. (-, 1-4). , ,, Aedes aegypti Aedes albopictus. . , 8-12 . , , .

- () . . , 100 .

, - () - ().

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( 100.000 mm3 3 high power eld).

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( 20% 20% , , , ).

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. , 4.3.4 .

-

GIARDIASIS

, Gi-ardia (Giardia intestinalis Giardia duodenalis) . , , . , , , . , , (, ). () Lamblia Intesti-nalis.

(Lamblia) , 10-20, 5-15.. , . , . , , . 5-30% . ,, , , , , .

, , . ( 3 ) .

. . . . (, ), (, ) . .

2-10% 25% . (, ) .


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7:

Giardia. 5- ( 250 . x 3 , 15 ././, 3 ) , 1.52 .; 90% . .

4.3 .

6: -

. . 1-3, . , , . , , 3-5 . , (). . . , , . , , , ,, , . , .

. . 3 . , ( ) Giardia.


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o , . .

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() o L. infantum. - . o, L. tropica . - - , 13 .

9: o

10 . (3 18 ). . . o , , . , , .

LEISHMANIOSIS

o , . , Trypanosomidae. 20 . Leish-mania donovani Leishmania infantum . o, . () Phlebotomus.

Leishmania major L. tropica o , , o : L. amazoniensis, L.

mexicana, L. brasiliana,L. guinea L. peruana .

o . : (L. major, L. amazonensis, L. mexicana, L. braziliensis), (L. amazonensis, L. mexicana,L. braziliensis), (L. braziliensis) (L. infantum). . , . : , , .

Phlebotomus ( , ) Lutzomyia ().

8: o

o : , , , , - L. donovani.

() o L. infantum. - . o, L. tropica . - - , 13 .


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. , . (2010). - .

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o , , .

10: o

o , : , , , ,, , , (/ , ), .

, . / . - (L.brasiliensis and L .americana) , , , .

o . : , , , , . -, . - -. () o . o . o . , -.

o . 5-20% , 7-10 (20 ././, , , 28.). Amphotericin B (1 ./., 5% , ).


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2 30 ( 10 ). . , . , . : (4-9) : , , ,, , ,, , . , , , , , , ,, , . ,, . , .

. , . , , 20% , .

, . , (). .

12:

-, . .

o . , .

LEPTOSPIROSIS

, , , Leptospira. . Leptospira interrogans > 300 , 25.

11:

. . . , . : , , , . , . : , , . : , , , , ,, .

, . . , .

. . . , - .


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LYME BORRELIOSIS LYME DISEASE

/, , . I.ricinus. Ixodes persulcatus.

13: Ixodes scapularis

30-35% . , . ( , .) . , , .

() . , , .

3 32 . . , . Er ythema chronicum migrans , .

, , . . , . (2010 ). - .

(, , , , ).

.

. .

.

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.

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.

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.

.

, . . (, , , ).

, . . .


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14: erythema migrans

. , , , , .

15% , , ( ),, , . 8% , , ( , Wenckenbach ), . , . - .

60% , . , . . .

, 2 15 30 55 .

/ . , , . (. , ) () ( , ).

Erythema , . , . Westernblot ELISA. ELISA- Western blot ELISA-. , ELISA Borrelia .

.

. (Erythema migrans, ) , , 14 . , 8 . , 8 . . / , ,, 28 , , 8 , . Lyme Borreliosis -.

4.3.4 .


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, , .

, : , , , , , , , , , , , ,, ( ) . , , . , , .

. :

A - , ;

M , ;

, - (IFA) ELISA . . , .

, . , , - . . , M. Falciparum, , (M. vivax, M. ovale i M. malariae). , Chloroquine, Meoquine,Doxycycline, Primaquine, Malarone, . , Primaquine, , P. ovale P. vivax. (2010 ). - .

MALARIA

Plasmodium. 4 : Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae. P.falciparum.Plasmodium vivax, P. malariae P. Ovale, . . , , . .

15: - Anopheles

- . . : 5 ,

65 , , , , , , . 19.12.1973 . , , .

. Plasmodium falciparum, 7-14 8-14 Plasmodium vivax Plasmodium ovale ( ). Plasmodium malariae 7-30 . , .


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Mediteraninan spotted fever - MSF

Rickettsia conorii, Rhipicephalus sanguineus. : Haemaphysalis leachi, Amblyomma hebraeum R. Appen-diculatus.

16: () - Rhipicephalus sanguineus

R. Conorii (), . MSF , , . ( Citellus citellus) , (Rhipicehpalussanguineus). , . ().

7 . , , , . 3- 5- , , , . . . ( , , 2-5 ) . 7 10 , .

: . . . , . 4.3.4


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RICKETTSIOSIS

Rickettsia.mooseri . .

17: - Amblyomma aureolatum

. , (Xenopsylla cheopis) (Polypax spinulossus) , , . .

. 6 14. , ,

, , . 5- 6- . , . , 9 13 , . , .

( , ) . Weil-Felixova ProteusOX-19 Proteus OX-2 , . . .

, Weil-Felixova , OX2 19. R.coonori .

7 , 8 , 3 .

4.3.4 .


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SALMONELLOSIS

, . Enterobacte-riacea, Salmonella 2200 . : S. Enteritidis, S. typhimurium, S. Java, S. abony, S. Wien, S.Dablin, S. Abortus bovis, S. Newport, S. Infantis, S. Wirchow, S. Gallinarun, S.Saint Paul . : , , , , , .

, .

18: Salmonella enteritidis

20 , , , . , , , . - . . , 06 . , , , , . , . . , ,

7 .

:

, ;

(, ) /, , / .

, - ANTU , , , , /

, ( ) , .

() , .


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WEST NILE INFECTIONS

Flavivirus Flaviviridae. . Culex. / / ` (). , . , .

, . . , . .

19: Aedes Albopictus

50 . . ; , 40%. .

, . 30% , 20/1.000.000 . , , , , . . - , . 70% .

, , (38-39C), , , , , 12 72 . .

. . 4-7 . , . , . . , . /. Salmonella , .

. Salmonella typhi ( ) se WIDAL- .

/. .Typhoid fever ( ) septuchemy ciprooxacin, azytromycin, ceftriaxon cefotaksim. trimetoprim sulfametoxazol chloramphenicol . Ceftriaxon ( 2001) uorochinolons ( 2003)

4.3.2 .


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2-14 . (/). , : .

, ,, , . ,, , , , ., , , , , ,, . 2-6 , .

. . : , .

. , , . , / , , , , (, ). . ( ). , / , . , .

, . , , , RT-PCR. . 3 . .

, . , . .

4.3.4


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2:

65


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. 5C, 60C, . 5C.

5. !

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4. !

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.


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/

1 (Aedes albopictus)CDC/James Gathany, PhD/Michael L. Levin

http://phil.cdc.gov/phil/home.asp

2

(Aedes Albo-pictus)

http://gamapserver.who.int/ma-pLibrary/Files/Maps/Global_Chi-kungunya_ITHRiskMap.png

3 CCHF

http://www.dpd.cdc.gov/dpdx/html/imagelibrary/S-Z/Ticks/body_Ticks_il8.htm

4

CDC/Alexander J. da Silva,PhD/Melanie Moser

http://phil.cdc.gov/phil/home.asp

5

CDC/ Dr. Edwin P. Ewing, Jr. http://phil.cdc.gov/phil/home.asp

6

CDC/Alexander J. da Silva,PhD/Melanie Moser http://phil .cdc.gov/phil/home.asp

7

CDC/ Dr. Stan Erlandsen http://phil.cdc.gov/phil/home.asp

8 oCDC/ Frank Collins, JamesGathany http://phil.cdc.gov/phil/home.asp

9 o

CDC/Alexander J. da Silva,PhD/Blaine Mathison http://phil.cdc.gov/phil/home.asp

10

o CDC http://phil.cdc.gov/phil/home.asp

11

CDC/ Rob Weyant, JaniceHaney Carr http://phil.cdc.gov/phil/home.asp

12

CDC/Mrs. M Gatton http://phil.cdc.gov/phil/home.asp

13Ixodes scapularis

CDC/ PhD Michael L. Levin, Jim Gathany http://phil.cdc.gov/phil/home.asp

14 erythemamigrans CDC/ James Gathany http://phil.cdc.gov/phil/home.asp

15 Anopheles CDC/ James Gathany http://phil.cdc.gov/phil/home.asp

/

16

() Rhipiceph-alus sanguineus

CDC/ James Gathany, Wil-liam Nicholson http://phil.cdc.gov/phil/home.asp

17 Ambly-omma aureolatum

CDC/ Dr. Christopher Pad-dock, James Gathany http://phil .cdc.gov/phil/home.asp

18 Salmonella enteritidisCDC/ Bette Jensen, JaniceHaney Carr http://phil.cdc.gov/phil/home.asp

19

Aedes Albopictus CDC/ James Gathany http://phil.cdc.gov/phil/home.asp


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. . , .66/04, 139/08 99/09

(1989). . 237242. .

E, J (1995). , , , . 547-551.

. (2003). - .

. 1519 2003, .

., M (2008). . 28:1,515.

. . (2006). , IV. ,. .

(2009). , 1991 2008 ., .

(2006). , .

(2008). , , . .

, (2003). . . . .

, ea (2006). Second, Third and Fourth National Communication ofthe Republic of Croatia under the United Nations Framework Convention on Climate Change.

(2002). .

(2003). .

(2006). . .

(2008). .

., ., . (2009). HACCP, , , , 2009 .

(2001). Global surveillance of foodborne disease: developing a strategy and its interaction with risk analysis. Report of a WHOconsultation, Geneva, Switzerland 2629 November 2 001.: WHO/CDS/CSR/EPH/200 2.21. http://whqlibdoc.who.int/hq/2002/WHO_CDS_CSR_EPH_2002.21. pdf.

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