Shakhgil'dian I V, Onishchenko G G, Schastnyĭ E I, Khukhlovich P A, Doroshenko N V, Stakhanova V M
Zh Mikrobiol Epidemiol Immunobiol. 1994 Sep-Oct(5):20-5.
The presence of great differences in the activity of the epidemic process of hepatitis A (HA) in some regions of Russia is shown and the data necessary for establishing the structure of HA foci in groups of children, as well as the proportion of different forms of the disease registered in such foci (the icteric form in 22.7% of patients, the obliterated form in 11.3% of patients, the nonicteric form in 45.5% of patients and the asymptomatic form in 20.5% of patients), are presented. The study revealed that the shedding of HA virus occurred at an early stage (5-10 before a rise in alanine aminotransferase activity in the blood was registered), its excretion lasted for a short time (till jaundice appeared) and no chronic carriership of HA virus was registered. The hospitalization of HA patients after the appearance of jaundice was proved to be unjustified, while measures aimed at the rupture of the fecal-oral mechanism of the transmission of HA virus were shown to have good prospects. The epidemiological features of hepatitis E (HE) are considered. HE cases constituted 2-3.6% of all patients with acute viral hepatitis in Moscow (all these cases were brought from Central Asia). The outbreaks of this infection in the countries of Central Asia were shown to be due to the transmission of the infective agent by the water route. The data on the first results of the use of high-titer specific immunoglobulin for the prophylaxis of HE among 135 pregnant women (only one of these women contacted HE, while in a similar group of women used for control 4 HE cases were registered) are presented.
俄罗斯部分地区甲型肝炎（HA）流行过程的活动存在巨大差异，文中展示了确定儿童群体中HA疫源地结构所需的数据，以及在此类疫源地登记的不同疾病形式的比例（黄疸型占患者的22.7%，淤胆型占患者的11.3%，无黄疸型占患者的45.5%，无症状型占患者的20.5%）。研究发现，HA病毒在早期（血液中丙氨酸转氨酶活性升高前5 - 10天）就开始排出，其排出持续时间较短（直到黄疸出现），且未发现HA病毒慢性携带者。事实证明，黄疸出现后对HA患者进行住院治疗是不合理的，而旨在阻断HA病毒粪 - 口传播机制的措施显示出良好前景。文中还探讨了戊型肝炎（HE）的流行病学特征。在莫斯科，HE病例占所有急性病毒性肝炎患者的2 - 3.6%（所有这些病例均来自中亚）。中亚国家的这种感染暴发表明是通过水传播病原体所致。文中展示了在135名孕妇中使用高滴度特异性免疫球蛋白预防HE的初步结果（这些孕妇中只有1人感染HE，而在用于对照的类似孕妇群体中有4例HE病例登记）。
