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613.1:616.9(497.7)(035)
613.1:616.9(035)
:
/ [ ... .]. - :
,
2011. - 80 . : . ; 21
: . 72-74
ISBN 978-608-4518-17-4
1. , []
) - -
) -
COBISS.MK-ID 88509962

iv

1.
2.
3.
3.1
3.2
3.3
4. ,
4.1
4.2
4.3
4.3.1
4.3.2
4.3.3
4.3.4
.
.
.

1
4

7
9
11
11
13
14
16
16
17
18
18
19
20
22
22
22
23

26
- CHIKUNGUNYA FEVER
27
- - CREMEAN - CONGO HAEMORHAGIC FEVER
31
CRYPTOSPORIDIUM
34
- - (DENGA)
37
- (GIARDIASIS)
39
o - 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

vi

(EWARN)
-
(BMU) -

(VL) o
-

- -
- -
(ELISA)
(ECDC)
(EHEC)
(WNF)
(IgM)
(IFA) -
(CCHF)
(LB)
-

(MSF)
(MSF)
(PCR)
(RNA)
- (RT-PCR)
(WHO)

(WMO)
(TBE)
-
(HFRS)
(CHKV)

vii


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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

3. Intergovernmental Panel on Climate Change (IPCC) (2001). Climate Change 2001: The Scientific Basis. Contribution of Working Group I to the Third Assessment Report
of the Intergovernmental Panel on Climate Change [Houghton JT, Ding Y, Griggs DJ, Noguer M, van der Linden PJ, Dai X, Maskell K and Johnson CA (eds.)]. Cambridge
University Press, Cambridge, United Kingdom and New York, NY, USA.
4. WHO, UNEP, WMO (2003). Climate change and human health - risks and responses, Geneva
5. (2003).
.
6. (2008).
. , WHO.(2002). World Health Report. Geneva

, ,
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. 66/2004 .

3.1

8. Patz, J.A., et al.,(2000). Effects of environmental change on emerging parasitic diseases. Int J Parasitol, 30 (12-13).
9. 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 Hopkins
University Press: Baltimore. p. 283-324.
10. Confalonieri and al. (2007). Human health. Climate Change Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fourth Assessment
Report of the Intergovernmental Panel on Climate Change, Cambridge University Press, Cambridge, UK.

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11


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19912008
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2008 ,
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.
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.
1991 2008 6.969
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, .

12

- 1991 2008 ,
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,
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,
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perfringens). ,
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.
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30 , 3
2009 .(287 ), 2008 .(490 ), 2007 .(381 ).
: 2009 .(290 ), 2008 .(243
), 2007 .(257 ).

3.2

, ,
, ( ,
), ,
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.
(hepatitis A), (Cryptosporidiae,
E.coli) (Guardia lamblia) - .

. , ,
, , 1989 , 400.000 .
()
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, .
, ,
.

.
, :
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.
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.
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. , ,
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.

13

3.3


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, . (WNF)
,
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(). (HFRS).

. .
2002 .
.
(Chikungunya) - Aedes,
, Aedes albopictus, .
Aedes albopictus chikungunya .
, Aedes albopictus 2010
.

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

.
.
, ,
. LB, TBE Ixodes
ricinus , . ,
,
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. 1991 2008 91
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- , .
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Aedes aegypti. , Aedes albopictus,
, ,
, , 2010 . - .
(Rickettsia conorii) - 2003 , ,
(MSF) ,
Ixodes .
(R.Conorii) .

15

4. ,

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:

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,

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4.1

:

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).
:
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).

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.

, (EWARN) , . ,
.
.

, 2009 .,
, :
(Bucellosis), (Leptospirosis), Q-, (Hantavirus),
- (CCHF), (WNF),
(TBE). -
(CCHF) , , , (CCHF) . ,
, (WNF)
(Hantavirus), ,
.
,
. ,
,
, .

4.2
10% ,

.

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.
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.

17

,
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.

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( !).

4.3
4.3.1
:

.

(, , ), (, , ,
.). Salmonella, Staphylococcus aureus, Clostridium perfringens, Clostridium
botulinum, Shigella, Listeria, : Bacillus, Proteus, Staphylococcus, Enteroccocus faecalis .
T , ,
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19

4.3.3

, .

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: E.coli, Hepatitis A virus, Legionellae, Leptospirae and Cryptosporidiae. -
5.1- .
:

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20

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21

4.3.4

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24

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.

25

27

Aedes albopictus, .
Aedes albopictus .

CHIKUNGUNYA FEVER

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

2: (Aedes Albopictus)

28

112 , 3-7 . , CHKV , : CHKV- (
) / .
.
1: (Aedes albopictus)

CHKV ( = CHKV)
Aedes (.aegypti A.albopictus). CHKV
.
. .
,
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40C,
,
( , . , , ,
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, , .
, , , , ,
, .
, , .
, . , ,
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5-7 . .
5-15 , 1 2,5 ,
. .
, .

.

29


Rt-PCR, .
,3.

IgM-. RT-PCR
IgM () .

, . ,

, , .
, Reye- .
, ,
, .
, : ,
.
( , ),
,
.

30

. 4.3.4
.

-
CREMEAN - CONGO HAEMORHAGIC FEVER

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

- Hyalomma (
marginatum marginatum, H. Marginatum rufipes). (, , )
( ). ()
,
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- (CCHF) .
Hyalomma, ,
. . , ,
31
. .
CCHF .
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: , , ,
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Adults attach to
the secondhost for
feeding and mating

Summer

Spring

, ,
.
Nymps molt into
adults and overwinter
off of a host

Winter

First Year
Second Year

Fall

Fall

, , .
( CCHF) ,
, .

Adult females
drop off host to
lay eggs

W
int

Engorged nymphs
leave first host

er

Summer
Larvae become
nymphs on the first
host after one molt

Spring

Eggs hatch into

six-legged larvae

, 4.3.4
.

infective Stage
Diagnostic Stage

3: CCHF

32

,
. , 1-3 ( 9 ),
5-6 ( 13 ). ,
, . -
, , ,
.
. 2-4 ,
, . , .
(, , ,
), , . ,
. , ,
( ).
2-50%.

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

33


CRYPTOSPORIDIUM

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

.
Coccidii, Isospori. Cryptosporidium
() .
, , , , , ,
.
.
.
, 2-5 .

.
(, .)
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, , : C. meleagridis - ,
C. muris - , C. anderson-, C. felis - , C. baileyi - ,C. canis- , C. galli- , C.
serpentis- , C. saurophilum- .
35

34

Cryptosporidium ,
, ,
, .
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.
.
1984 .
.
,
, , 1993 , 370.000 .
, , , .
.

. Cryptosporidium , ,
.
-
.
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, , , .
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4:

1-2 .
,
.
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.
, . ,
.
,
, , .
,
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 -
DENGA

5:

36

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

,
. ,
:
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- ()
. . ,
100 .

,
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.

.

4.3.3. .

3-15 ( 5-8) , ,
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. ,
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.
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. .
,
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- () :

, , , ,
.
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., ).
( 100.000 mm3 3
high power field).

37

( 20%
20%
, , , ).
.

- () - :

/,
/ ( 20 mmHg)

,
,
- - , -
, ,
- , - PCR.

38

, .
.
.

.
, 4.3.4 .

-
GIARDIASIS

, Giardia (Giardia intestinalis Giardia duodenalis) . , ,
.
, , , .
, ,
(
, ). () Lamblia Intestinalis.
(Lamblia) ,
10-20, 5-15.. ,
.
,
. ,
, . 5-30%
. ,
, , ,
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.
,
, .
( 3 )
.

. .
.
.
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.

39

 7:

6: -

40

.

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

, , .
, , , ,
, , .
, .

.
. 3
.
, (
) Giardia.

Giardia.
5- ( 250 . x 3 ,
15 ././, 3 ) , 1.52 .;
90% . .
41

4.3
.

 o ,
.

.

LEISHMANIOSIS

o , .
, Trypanosomidae. 20 . Leishmania 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).
. ,
. : , ,
.
42

5 10-
o,
, .
, .
, , .
o : , , , ,
- L. donovani.
()
o L. infantum.
-
. o,
L. tropica . - ,
13 .

43

Phlebotomus ( , ) Lutzomyia ().

9: o
8: o

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

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

 o ,
,
.

.
, . (2010
). -
.

o . 4.3.4
.

10: o

o , : ,
, , ,
, , , (/
, ),
.
44

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

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

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

45

LEPTOSPIROSIS

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

2 30 ( 10 ).
. ,
.
, .
: (4-9
) : , , ,
, , ,
, , . ,
, , , ,
, ,
, , .
,
, . ,
.
. ,
. , ,
20% , .

46

11:

.
.

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

, .
, ().
.

12:

, .
.

, .

-,
.

.

.
.
.
, - .

o . ,
.

47

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

48

(, , , , ).

.
.

,
,
.

, ( , ,
, .)

, ,
(, , ).

,
,
.

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

LYME BORRELIOSIS LYME DISEASE

/, ,
.
I.ricinus. Ixodes persulcatus.

13: Ixodes scapularis

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

()
.
, ,
.
3 32 .
.
, .
Erythema chronicum migrans
, .

49


Erythema ,
.
,
. Western
blot ELISA. ELISA-
Western blot ELISA-. , ELISA

Borrelia .

14:

erythema migrans

.
, ,
, , .

50

15%
, , ( ),
, , .
8% , ,
( , Wenckenbach ), .
, . .
60%
, .
, .
.
.

,
2 15 30 55
.
/

.

, , .

(. , ) ()
( , ).

.

. (Erythema migrans,
) ,
, 14 .
, 8 .
, 8 .

. /

, ,
51
, 28 , ,
8 , . Lyme Borreliosis
-.

4.3.4 .

,
,
.

MALARIA

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

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

, , .
,
,
.

.
:

A - ,
;

M ,
;

52

15: - Anopheles

, - (IFA) ELISA .
.
,
.

- .
. : 5 ,
65 , , ,
, , ,
.
19.12.1973 .
, ,
.

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

.

,
. ,
, -
.
.

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

53


:
.
.
. ,
.
4.3.4

Mediteraninan spotted fever - MSF

Rickettsia conorii,
Rhipicephalus sanguineus. : Haemaphysalis leachi, Amblyomma hebraeum R. Appendiculatus.

55

54

16: () - Rhipicephalus sanguineus

R. Conorii (),
. MSF ,
, .
( Citellus citellus) , (Rhipicehpalus
sanguineus). ,
.
().

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


, Weil-Felixova ,
OX2 19.

R.coonori .

7 , 8 ,
3 .

RICKETTSIOSIS

Rickettsia.mooseri .
.

4.3.4
.

17: - Amblyomma aureolatum

56

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

. 6 14
. , ,
, ,
. 5- 6-
. ,
. ,
9 13 , .
, .

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

57


7 .

SALMONELLOSIS

,
. Enterobacteriacea, 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 .
: , , , ,
,
.

,
;
(, ) /
, ,
/ .
, - ANTU ,
, , , /
, ( )
, .

() ,
.

,

.

59

58

18: Salmonella enteritidis

20 , ,
, .
, , ,
.
- .

.
,
06 . ,
, , ,

. ,
.
.
, ,

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

60

, ,
(38-39C), , , , , 12 72
.
.
. .
4-7 .
, .

,
.
. ,
.
/.
Salmonella
, .

WEST NILE INFECTIONS

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

,
.
,
.
.
,
.

.
61

.
Salmonella typhi ( ) se
WIDAL- .

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

4.3.2 .

19: Aedes Albopictus

50
.
.
; ,
40%.

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71


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ISBN 978-608-4518-17-4