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CLINICAL AND LABORATORY ASPECTS OF VIRAL INFECTIONS
Daminov F.A.– DSc, Ass.Professor, head of the department of clinical
laboratory diagnosis with the course of clinical laboratory diagnostics of PGD;
Djabbarova N.R.- assistant of the department of clinical laboratory diagnosis
with the course of clinical laboratory diagnostics of PGD;
Do’stmurodova A.V. -
cadet of the department of clinical laboratory
diagnosis with the course of clinical laboratory diagnostics of PGD;
Samarkand state medical university
Samarkand, Uzbekistan
Annotation. Definition - anthroponotic viral acute infectious disease with
fecal-oral transmission mechanism. Characterized by predominant lesions of the
digestive tract, general intoxication, dehydration. Food poisoning The causative agent
is an RNA-containing virus from the family Reoviridae of the genus Rotavirus. The
name is derived from the Latin rota - wheel, as the virus particles under the electron
microscope look like small wheels with a wide “hub”, 20 short “spokes” and a circular
rim. Contains hemagglutinins.
Keywords: diarrhea, anthroponotic viral acute infectious, fecal-oral
transmission mechanism;
Using RSC, rotaviruses are separated into two antigenic variants. With the help
of neutralization reaction - by 4 (and possibly more). Rotaviruses are resistant at acidic
pH values to fat solvents; they remain viable on various environmental objects from
10-15 days to 1 month (depending on temperature and humidity), in feces - up to 7
months. Rotaviruses have two protein shells - outer and inner capsids. The core
contains internal proteins and genetic material represented by double-stranded
fragmented RNA. The genome of human and animal rotaviruses consists of 11
fragments that can be separated by electrophoresis in polyacrylamide gel (PAAG) or
agarose.
Four antigens have been found in rotaviruses; the main one is the group-
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specific antigen due to the protein of the internal capsid. Taking into account group-
specific antigens, all rotaviruses are divided into five groups: A, B, C, D, E [11,12,13].
Rotaviruses of the same group have a common group antigen, which is detected
by immunologic reactions: enzyme immunoassay, immunofluorescence, immune
electron microscopy, etc. Most human and animal rotaviruses belong to group A.
Reservoir and sources of the pathogen: human, sick or carrier. Cross-antigenic
relationships have been found between human, monkey, and calf rotaviruses, but the
epidemiologic significance of animal viruses has not been established. Rotaviruses are
found in the water of rivers, lakes, seas, and groundwater. The source of infection in
rotavirus gastroenteritis is an infected person - a patient with a manifest form of the
disease or asymptomatically excreting rotaviruses with feces The most frequent source
of the disease for children of the first year of life are mothers infected with rotavirus;
for adults and older children - children, mainly from children's collectives. The
possibility of human infection from animals has not been proven [6,7,8,9,10].
The most frequent source of disease for children of the first year of life is
rotavirus-infected mothers; for adults and older children - children, mainly from
children's groups. The possibility of human infection from animals has not been
proven. Period of contagiousness of the source. During the first 5 days of the disease
in 1 g of feces of patients contains up to 109 - 1011 viral particles, during the next 6-
10 days the excretion of the virus with feces sharply decreases as the stool normalizes.
In some patients, the period of virus excretion may last up to 20-30 days [1,2,3,4,5].
Persons without clinical manifestations of the disease may excrete rotaviruses
for several months or more. The mechanism of transmission of the pathogen is fecal-
oral; routes of transmission are water, food, and household. The possibility of airborne
or airborne-dust transmission is suspected. The natural susceptibility of people is high,
although mostly young children fall ill. Up to 90% of examined children of 2-3 years
of age have specific antibodies to rotaviruses. The main epidemiologic features. The
nature of the spread of the disease is ubiquitous with predominance in developing
countries, where it accounts for about half of all cases of intestinal disorders. Rotavirus
infection ranks second after acute respiratory viral infections in terms of disease
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frequency. The disease mainly affects children under the age of 1 year, less often - up
to 6 years; in adult contingents, the disease occurs in isolated cases. According to
WHO, from this infection in the world annually die from 1 to 3 million children.
Diseases are registered throughout the year, but more than 70% of patients are detected
in the winter-spring period. High focality in organized children's preschool groups is
characteristic [21,22,23,24].
Rotaviruses are also known as one of the main etiologic agents in hospital
outbreaks of gastroenteritis in maternity hospitals and pediatric medical hospitals of
various profiles.
Main clinical features: acute onset; characterized by abundant watery
stools with a pungent odor, without mucus and blood; vomiting is noted in half of
patients. Simultaneous upper respiratory tract involvement (rhinitis, rhinopharyngitis,
pharyngitis) is characteristic [18,19,20].
Lethality usually does not exceed 4%. Laboratory diagnosis is based on the
detection of virus in feces in the 1st week of the disease (electron and immunoelectron
microscopy, as well as the method of infection of cell cultures), specific antibodies and
the increase of their titer in the blood serum of patients and reconvalescents using PH,
RTGA and RSC. The first serum is tested in the first 3-4 days of the disease, the second
- 2 weeks after the disease and later [15,16,17].
Dispensary observation of the person who has contracted the disease. Children
attending pre-school child care facilities after the disease are subject to clinical
observation for one month with daily stool examination. Children who continue to
isolate rotaviruses (antigen) after discharge from the hospital are subject to a one-
month single laboratory examination by serologic methods 2-3 weeks after discharge
[10,11,12,13,14].
The necessity of laboratory examination of the rest of the infected children for
the presence of rotaviruses (antigen) in feces is determined by the pediatrician (at the
appearance of clinical symptoms of the disease) and epidemiologist (taking into
account the specific epidemiological situation). Employees of food enterprises and
persons equated to them, who have undergone rotavirus infection and continue to
excrete rotaviruses with feces, are subject to dispensary observation within one month
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after clinical recovery. In the absence of clinical symptoms of the disease or
complications at the end of the observation period, a single virological (serologic)
examination for the presence of rotaviruses (antigen) is performed [6,7,8,9].
Repeated laboratory examination of persons excreting rotaviruses (antigen)
with feces. Conducted at intervals of 5-7 days by appointment of an infectious disease
specialist and epidemiologist. Reconvalescents - workers of the above enterprises,
discharged from the hospital (or after treatment at home) with negative results of
laboratory examination are subject to clinical observation within one month.
Laboratory examination (determination of AG in feces, AT (ELISA, RSK)) is
prescribed according to clinical indications [1,2,3,4,5].
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