О КОРИ И ЕЁ ПРОФИЛАКТИКЕ

В настоящее время ситуация по кори в Республике Беларусь контролируемая, однако с начала 2023 года на территории Витебской области установлены единичные случаи заболевания. 

Корь – острое инфекционное вирусное заболевание, представляющее угрозу инфицирования населения во всех регионах мира. Корь нельзя назвать забытой инфекцией. Вспышки кори периодически возникают в разных странах, в том числе развитых, несмотря на широко проводимую вакцинацию. 

Справочно: 

В странах Европейского региона Всемирной организации здравоохранения (далее – ВОЗ) в последние десять лет максимальное число случаев заболевания корью было зарегистрировано в 2018 и 2019 гг.: 88 693 и 104 442 случаев соответственно. 

В 2022 году в 28 странах (53%) Европейского региона ВОЗ зарегистрировано 937 случаев заболевания корью. Из 937 случаев кори 866 (92%) были выявлены в 10 странах: Таджикистан (455), Турция (126), Россия (114), Соединенное Королевство (52), Польша (27), Кыргызстан (23), Франция (19), Италия (18), Бельгия (17), Германия (15). 

В Республике Беларусь ежегодно регистрируются случаи завоза вируса кори на территорию страны (за исключением 2008, 2009, 2020, 2022 гг.). В последние десять лет наибольшая заболеваемость корью регистрировалась в 2018 и 2019 гг. – более 2 случаев на 100 тысяч населения. 

По данным ВОЗ: 

до введения противокоревой вакцины в 1963 году корь была главной причиной смерти малышей во всем мире, ее называли детской чумой. Крупные эпидемии кори происходили каждые два-три года, ежегодно приводя к 2,6 млн случаям смерти; 

возбудителем кори является один из наиболее заразных (контагиозных) вирусов человека. Один заболевший корью человек может заразить от 12 до 18 невакцинированных или не болевших ранее людей; 

в 2021 г. в мире произошло около 9 млн случаев заболевания корью и 128 тысяч случаев смерти от нее; 

если будущая мама заболеет корью, возможны выкидыш или преждевременные роды; 

невакцинированные дети раннего возраста подвергаются самому высокому риску заболевания корью и развития осложнений, включая смертельный исход; 

в настоящее время один из 20 детей с корью заболевает пневмонией, у одного из 1000 детей развивается энцефалит, один или двое из 1000 детей умирают. 

Возбудитель инфекции, источник инфекции, симптомы 

Возбудителем кори является вирус из семейства парамиксовирусов. 

Передаётся вирус от больного человека к здоровому воздушно-капельным путем при чихании, кашле, разговоре вместе с мельчайшими капельками слюны и слизи. С потоками воздуха вирус может распространяться по помещениям довольно далеко: через коридоры и вентиляционные шахты в соседние комнаты, квартиры. Вирус остается активным и контагиозным в воздухе или на инфицированных поверхностях в течение 2 часов. 

Источником инфекции является больной корью человек на протяжении периода времени, начинающегося за 4 дня до появления сыпи и заканчивающегося через 4 дня после ее появления. 

Инкубационный период составляет в среднем 9-11 дней. 

Заболевание начинается с повышения температуры тела. На начальной стадии проявляется в виде общего недомогания, катаральных явлений (насморк, першение в горле, кашель). На второй-третий день болезни появляются специфические симптомы кори: конъюнктивит (покраснение глаз, слезотечение, боязнь света), высыпания в виде мелких белых пятен на внутренней поверхности щек (схожие на крупинки манки, окруженные красной каймой). На четвертый-пятый день болезни появляется пятнисто-папулезная сыпь розового цвета, склонная к слиянию, для которой характерна этапность высыпания в течение 3-4 дней: сначала появляется за ушами, на лице, шее, затем на туловище, а на следующий день – на верхних и нижних конечностях. Период высыпаний сменяется периодом пигментации и претерпевает обратную последовательность исчезновения сыпи. 

Корь, ориентировочно в 40% случаев, может иметь осложненное течение. Обычно осложнения встречаются у детей до пяти лет и взрослых с ослабленным иммунитетом. Наиболее частыми осложнениями кори являются инфекции дыхательных путей (коревой круп, бронхит, пневмония), слепота, отит, тяжелая диарея с обезвоживанием, поражение головного мозга (энцефалит, менингоэнцефалит). Большинство смертельных случаев кори происходит из-за осложнений. 

Перенесенная корь формирует прочный пожизненный иммунитет. 

Вакцинация – лучшая защита! 

Методов специфического лечения кори не существует, но заболевание можно предотвратить при помощи вакцинации – как самого безопасного и эффективного способа защиты. 

Для борьбы с корью вакцинация используется уже более 50 лет. Вакцинация живой коревой вакциной началась в странах Европейского региона с 1967 г. В 1971 г. создана комбинированная (трехвалентная) вакцина против кори, эпидемического паротита и краснухи, которую с 1996 г. начали использовать в нашей стране. 

Вакцины против кори обладают высокой эффективностью. После введения одной дозы вакцины, содержащей коревой компонент, у более чем 95% привитых формируется долговременная иммунная защита организма, после введения второй дозы эффективность достигает практически 100%. Таким образом, для обеспечения длительной защиты требуется две дозы вакцины. 

В Республике Беларусь вакцинация против кори, эпидемического паротита и краснухи проводится согласно Национальному календарю профилактических прививок Республики Беларусь, установленному постановлением Министерства здравоохранения Республики Беларусь от 17.05.2018 № 42 «О профилактических прививках», и состоит из двух профилактических прививок в возрасте 12 месяцев и 6 лет. 

В настоящее время иммунизация против кори, эпидемического паротита и краснухи в Республике Беларусь осуществляется с использованием комбинированной вакцины «Приорикс», производства GlaxoSmithKline Biologicals s.a., Бельгия. 

Специалисты рекомендуют всем гражданам от 18 лет и старше: 

— уточнить свой прививочный статус против кори в территориальной организации здравоохранения; 

— сделать профилактические прививки против кори, если отсутствуют документальные сведения о вакцинации против кори, о перенесенной кори, о результатах серологического исследования крови, подтверждающего наличие защитных уровней IgG-антител к вирусу кори, или если имеются документальные сведения только об одной профилактической прививке против кори.

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  • 08.06.2023 в 00:17
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