Sanitary rules for pediculosis in kindergarten. New sanpin for the prevention of pediculosis

State sanitary and epidemiological
rules and regulations

SanPiN 3.2.3215-14

Moscow 2015

2. Approved by the decision of the Main State sanitary doctor Russian Federation dated August 22, 2014 No. 50.

3. Registered with the Ministry of Justice of the Russian Federation on November 12, 2014, registration number 34659.

CHIEF STATE SANITARY PHYSICIAN
RUSSIAN FEDERATION

RESOLUTION

In accordance with the Federal Law of March 30, 1999 No. 52-FZ “On the sanitary and epidemiological well-being of the population” (Collected Legislation of the Russian Federation, 1999, No. 14, Art. 1650; 2002, No. 1 (Part I), Art. 2; 2003, No. 2, article 167; No. 27 (part I), article 2700; 2004, No. 35, article 3607; 2005, No. 19, article 1752; 2006, No. 1, article 10; No. 52 (Part I), Article 5498; 2007, No. 1 (Part I), Article 21, Article 29; No. 27, Article 3213; No. 46, Article 5554; No. 49, Article 6070; 2008 , No. 24, Article 2801; No. 29 (Part I), Article 3418; No. 30 (Part II), Article 3616; No. 44, Article 4984; No. 52 (Part I), Article 6223 ; 2009, No. 1, article 17; 2010, No. 40, article 4969; 2011, No. 1, article 6; No. 30 (part I), article 4563, article 4590, article 4591, article 4596; No. 50, item 7359; 2012, No. 24, item 3069; No. 26, item 3446; 2013, No. 27, item 3477; No. 30 (part I), item 4079; No. 48, item 6165; 2014, No. 26 (Part I), Art. 3366, Art. 3377) and Decree of the Government of the Russian Federation dated July 24, 2000 No. “On Approval of the Regulations on the State Sanitary and Epidemiological Service of the Russian Federation and the Regulations on State Sanitary arno-epidemiological regulation” (Sobraniye zakonodatelstva Rossiyskoy Federatsii, 2000, No. 31, art. 3295; 2004, no. 8, art. 663; No. 47, Art. 4666; 2005, no. 39, art. 3953)

RESOLVE:

A.Yu. Popova

Sanitary and epidemiological rules and regulations
SanPiN 3.2.3215-14

I. Scope

1.1. These sanitary and epidemiological rules and regulations (hereinafter referred to as the sanitary rules) have been developed in accordance with the legislation of the Russian Federation.

1.3. Compliance with sanitary and epidemiological rules is mandatory throughout the Russian Federation for state bodies, bodies state power constituent entities of the Russian Federation, municipalities, officials of state bodies, officials of state authorities of constituent entities of the Russian Federation, officials of bodies local government, citizens, individual entrepreneurs and legal entities.

1.4. Monitoring the implementation of these sanitary regulations carried out by bodies authorized to exercise federal state sanitary and epidemiological supervision in accordance with the legislation of the Russian Federation.

II. General provisions

Identification of trends in the epidemic process;

Identification of regions, regions, settlements with a high level of morbidity and the risk of infection;

Assessment of the quality and effectiveness of ongoing preventive and anti-epidemic measures;

Planning the sequence of activities and the timing of their implementation;

Development of forecasts of the epidemiological situation.

3.3. The main tool of epidemiological surveillance is epidemiological diagnostics.

Epidemiological diagnosis is carried out using a retrospective and operational epidemiological analysis of morbidity.

3.4. A multi-year retrospective epidemiological analysis is carried out for at least the last 5 years and provides for:

Analysis of long-term dynamics of morbidity (affection);

Analysis of morbidity by territories;

Incidence analysis by age groups, gender, contingents of the population;

Conclusions and proposals for the development of preventive measures.

3.5. An operational epidemiological analysis is carried out in the condition of an epidemic rise in morbidity or the registration of epidemic foci of group morbidity. Epidemiological analysis includes constant monitoring of the dynamics of the incidence, taking into account a specific etiological agent, assessment of the sanitary and epidemiological situation, formulation of a preliminary and final epidemiological diagnosis with the establishment of the causes and conditions for an increase in the incidence or the formation of an epidemic focus.

Examination for helminthiases and intestinal protozooses is subject to: children attending preschool educational organizations; personnel of preschool educational organizations; elementary school students, children, adolescents, decreed and equated groups of the population during medical examinations and preventive examinations; children, adolescents according to epidemic indications; children and adolescents enrolled in preschool and other educational organizations, orphanages, orphanages, orphanages, boarding schools, sanatorium treatment, health organizations, children's departments of hospitals; children of all ages of children's organizations of a closed type and year-round stay, patients of children's and adult polyclinics and hospitals according to indications, persons who communicated with patients.

4.3. Delivery of biological material to the laboratory is carried out in sealed containers, ensuring its safety and transportation safety.

4.5. The organization and conduct of scheduled examinations of children attending preschool, school educational organizations and other children's organizations is provided by the heads of such organizations.

4.9. In the event of a change or clarification of the diagnosis, medical workers of medical organizations report by phone, and then within 12 hours send an emergency notification to writing about changing or clarifying the diagnosis in territorial authority federal body executive power authorized to carry out federal state sanitary and epidemiological supervision.

4.11. Infected persons are subject to treatment on an outpatient or inpatient basis on the basis of their informed voluntary consent and taking into account the right to refuse medical intervention.

4.15. All identified infested persons are provided with dispensary observation in the relevant medical organizations.

4.16. For each infested, a dispensary observation form is filled out.

4.17. Removal from dispensary registration is carried out after treatment and obtaining negative results of a laboratory study of biological material.

Activities for the prevention of malaria.

5.1. The collection and analysis of data on local or imported cases of malaria is carried out by medical organizations and bodies authorized to carry out sanitary and epidemiological surveillance.

5.2. The bodies authorized to carry out sanitary and epidemiological supervision determine a set of sanitary and anti-epidemic (preventive) antimalarial measures (Table ).

5.3. The organization of activities for the prevention of malaria in the territory of the constituent entity of the Russian Federation is carried out by state authorities in the field of health protection of the constituent entities of the Russian Federation together with interested departments, local governments in municipalities. When organizing antimalarial measures, an irreducible supply of antimalarial drugs is ensured for the treatment of all types of malaria, including primaquine, and disinsection measures are taken to kill mosquitoes (adults, larvae), where transmission of three-day malaria is possible.

5.4. The period of carrying out measures for the prevention of malaria in the active focus of three-day malaria is carried out for 3 years due to the possible appearance of patients with malaria after a long incubation.

Key antimalarial activities

5.5. Organizations that send employees to countries in the subtropical and tropical zones, or travel agencies that organize trips to these countries, inform those leaving:

About the possibility of contracting malaria and the need to comply with preventive measures (protection from mosquito bites and the use of chemoprophylactic drugs that are effective in the host country);

On the need to immediately seek qualified medical care in the event of a febrile illness during a stay in an endemic country;

About the need after returning, if any febrile illness occurs, immediately consult a doctor and inform him about the duration of stay in the countries of the subtropical and tropical zone and the intake of chemoprophylactic drugs.

Specialists sent to the countries of the subtropical and tropical zones in areas where there is no first aid are provided with a course dose of antimalarial drugs.

5.6. Heads of transport organizations flying to countries where tropical malaria is common, as well as rescuers and military personnel temporarily stationed in these countries, are provided with packing containing antimalarial prophylactic drugs and mosquito bite protection. These individuals undergo chemoprophylaxis.

5.7. Servicemen of the border troops and combined-arms formations who serve in the territory of countries where three-day malaria is common, 14 days before demobilization or departure from endemic areas to the territory of the Russian Federation, they are given a course of preventive treatment against malaria.

5.8. The following are subject to testing for malaria:

Persons who have arrived from malaria endemic areas or visited endemic countries within the past three years, with an increase in temperature, with any of the following symptoms against the background of body temperature above 37 ° C: malaise, headache, enlargement of the liver, spleen, yellowness of the sclera and skin, herpes, anemia;

Persons with an undiagnosed fever for 5 days;

Patients with an established diagnosis, but with continuing periodic rises in temperature, despite the ongoing specific treatment;

Persons living in an active focus, with any increase in temperature.

VI. Measures to prevent helminthiases transmitted through meat and meat products

6.1. Heads of organizations, as well as individual entrepreneurs provide:

The quality and safety of meat and meat products in the process of its production and sale in accordance with the requirements technical regulations;

Carrying out preventive disinfection and deratization measures on the territories of livestock farms and complexes, slaughterhouses, warehouses of meat products, at enterprises Food Industry, public catering and food trade organizations and other facilities of particular epidemiological significance;

Informing medical, veterinary and hunting organizations about cases of detection of helminthiases transmitted through meat among wild and farm animals, as well as cases of human disease.

6.2. Requirements for methods of disinfection of meat products.

6.2.1. Requirements for freezing meat:

Cattle carcasses are frozen until a temperature of minus 12 °C is reached in the thickness of the meat (the temperature is measured in the thickness of the hip muscles at a depth of 7-10 cm with a special thermometer). In this case, no further holding is required. At a temperature in the thickness of the meat of minus 6 - 9 ° C, the carcass is kept in the refrigerator for at least 24 hours;

Pork carcasses are frozen until a temperature of minus 10 °C is reached in the thickness of the meat and kept at an air temperature in the chamber of minus 12 °C for 10 days. At a temperature in the thickness of the meat of minus 12 ° C, the carcass is kept at an air temperature in the refrigerator of minus 13 ° C for 4 days (the temperature is measured in the thickness of the hip muscles at a depth of 7-10 cm with a special thermometer).

6.2.2. Meat warming requirements:

Parts of the carcass of cattle or pork carcasses are divided into pieces weighing up to 2 kg and up to 8 cm thick and boiled for 3 hours in open or 2.5 hours in closed boilers at an excess steam pressure of 0.5 MPa.

6.2.3. Meat salting requirements:

Parts of the carcass of cattle or pork carcasses are divided into pieces weighing no more than 2.5 kg, rubbed and covered with table salt at the rate of 10% in relation to the mass of meat, then poured with brine with a concentration of at least 24% of table salt and aged for 20 days.

6.2.5. Meat and products of its processing, obtained from the slaughter of private livestock, are issued (returned) to the owner in a decontaminated form in the organizations of the meat industry and from individual entrepreneurs.

6.2.6. Slaughterhouse and kitchen waste intended for feeding to domestic and fur animals are subject to mandatory heat treatment.

VII. Measures for the prevention of helminthiases transmitted through fish, crustaceans, mollusks, amphibians, reptiles and their processed products

7.1. In order to identify pathogens of helminthiases in the designated area (zone) of a freshwater reservoir, 25 individuals of each type of additional (commercial size) hosts of pathogens of biohelminthiasis are examined.

7.2. In accredited testing laboratories 20 individuals of the commercial size of additional hosts of pathogens of biohelminthiasis, common in this territory, are examined. If the result is negative, the number of studied fish specimens is brought to 40. If the negative result is confirmed, the reservoir is considered safe. Fish caught in such reservoirs is allowed for sale without restrictions. Follow-up studies in this reservoir are carried out after 3 years.

7.3. If fish infected with biohelminth larvae are found in the reservoir, all fish of this species and other species capable of playing the role of additional hosts of biohelminths, as well as fish products, are subjected to disinfection from biohelminth larvae before sale. Fish products from such reservoirs that have not undergone disinfection are not allowed for sale.

7.6. Disinfection of fish and fish products is carried out by freezing, salting and heat treatment.

7.7. Requirements for methods of disinfection and modes of processing of fish and fish products.

7.7.1. Requirements for freezing fish:

Fish is disinfected from tapeworm larvae under the freezing conditions indicated in Table. ;

From the larvae of opisthorchid and other trematodes, the fish is disinfected under the freezing conditions indicated in Table. ;

Marine fish, crustaceans, molluscs, amphibians and reptiles containing live anisakid larvae and other helminths dangerous to humans and animals are disinfected by freezing at the temperature in the body of the fish (crustaceans, mollusks, amphibians, reptiles), the duration of this temperature and subsequent storage conditions in accordance with the table. ;

If it is impossible to provide freezing conditions that guarantee the disinfection of fish products, they should be used for food purposes only after hot heat treatment or sterilization (canned food).

7.7.2. Requirements for salting fish:

When infected with larvae of a wide tapeworm, the fish is disinfected by salting in the modes indicated in Table. ;

Disinfection of Far Eastern salmon from diphyllobothriid larvae is carried out by all methods of industrial salting when the mass fraction of salt in the meat of the back of the fish reaches 5%;

Disinfection of whitefish, salmon and grayling fish from gull tapeworm larvae is carried out by mixed weak salting (brine density 1.18 - 1.19) for 10 days when the mass fraction of salt in fish meat reaches 8 - 9%;

Disinfection of fish from opisthorchid larvae and other trematodes is carried out using mixed strong and medium salting (brine density from the first day of salting 1.20 at a temperature of 1 - 2 ° C) when the mass fraction of salt in fish meat reaches 14%. In this case, the duration of the salting should be:

Minnow, bleak, minnow, tops - 10 days;

Roach, dace, rudd, chub, blue bream, white-eye, podust, sabrefish, asp, small (up to 25 cm) ide, bream, tench - 21 days.

A weaker or shorter salting of fish is allowed, only after its preliminary freezing in the modes indicated in Table. 2.

Modes of fish disinfection from tapeworm larvae

Modes of fish disinfection from opisthorchid larvae

Modes of disinfection of marine fish from anisakid larvae

Modes of salting fish during disinfection from tapeworm larvae

7.7.3. Requirements for the salting of fish roe.

When salting fish roe as an independent product, disinfection from the larvae of the wide tapeworm is carried out in the following ways:

Warm salting (temperature 15 - 16 ° C) is carried out with the amount of salt (as a percentage of the caviar weight): 12% - 30 minutes; 10% - 1 hour; 8% - 2 hours; 6% - 6 hours;

Chilled salting (at a temperature of 5 - 6 ° C) is carried out with the amount of salt (as a percentage of the caviar weight): 12% - 1 hour; 10% - 2 hours; 8% - 4 hours; 6% - 12 hours;

Cooled salting of caviar of whitefish and other fish infected with gull tapeworm larvae is carried out at a salt amount of 5% by weight of caviar for 12 hours.

Salting of caviar of anadromous salmon and sturgeon fish is carried out after the removal of anisakid larvae.

7.7.4. Requirements for heat treatment of fish and fish products:

Fish is cooked in portions for at least 20 minutes from the moment of boiling, fish dumplings - for at least 5 minutes from the moment of boiling, crustaceans and mollusks - for 15 minutes;

Fish (fish cakes) are fried in portions in fat for 15 minutes. Large pieces of fish weighing up to 100 g are fried flat for at least 20 minutes. Small fish are fried whole for 15 - 20 minutes.

7.7.5. Marine fish intended for cold and hot smoking, salting and pickling, the production of preserves are pre-frozen in the modes indicated in Table. .

7.7.6. It is not allowed to dump fish products processing waste into water bodies and landfills, as well as feed them to animals without prior disinfection.

7.7.7. Responsibility for the implementation of these measures rests with individual entrepreneurs and legal entities engaged in breeding, growing, harvesting (catching), processing, storing, selling fish, aquatic invertebrates, aquatic mammals, other aquatic animals in their natural habitat, aquaculture, food fish products.

VIII. Measures for the prevention of echinococcosis, alveococcosis

8.1. Groups at risk of infection with the causative agent of echinococcosis (hunters, shepherds, reindeer herders, shepherds, workers of fur farms, livestock farms, zoos, fur collectors, workers of fur workshops, veterinary workers, persons involved in trapping dogs, dog owners, employees of reserves, reserves, forestries, collectors and buyers of mushrooms, berries, as well as members of their families) during preventive and periodic medical examinations, clinical examinations are subject to examination for echinococcosis.

8.2. Organization of preventive measures for echinococcosis includes:

Operational tracking (monitoring) of the epidemic situation;

Epidemiological analysis of information on echinococcosis in the territory for a certain period of time (data on the incidence of the population, the number surgical operations about echinococcosis, disability, mortality, economic damage, the nature and scope of sanitary and hygienic and therapeutic and preventive measures);

Hygienic education using the media;

Regulation of the content of stray dogs, their deworming.

8.3. The objects of sanitary and helminthological research are places where dogs are kept, livestock farms, as well as households.

8.4. Prevention of infection in humans and farm animals includes the following.

8.4.1 Ensuring deworming of priotary, reindeer, sled and other dogs on the territory of cities and towns.

8.4.2. Provision by local self-government bodies and legal entities of accounting and registration of dogs, regulation of the number of stray dogs by catching and keeping them in special kennels. When implementing regional programs, comprehensive plans for the sanitary and epidemiological well-being of the population, the organization and conduct of these activities falls within the powers of the executive authorities of the constituent entities of the Russian Federation.

8.4.3. Preventive deworming against cystodes of priotary, guard, reindeer, sled, hunting and other dogs is carried out 5 to 10 days before the animals are moved to pastures and hunters go hunting. Deworming of dogs is carried out on special sites, the feces isolated after treatment are collected in a metal container and treated with drugs that have an ovicidal effect. The site covered with cement, the soil is being processed.

8.4.4. For walking pets in settlements, special areas should be allocated, marked with signs. In areas for walking pets, special containers are installed to collect animal feces.

8.4.6. In order to prevent infection of humans, dogs and fur-bearing animals with alveococcosis, the following measures are taken:

In places of fur extraction, in each settlement and in hunting winter quarters, special facilities are equipped for the removal, primary processing of animal skins, collection of affected carcasses and their disposal, which meet sanitary and hygienic standards. The premises are provided with sufficient water. The floor, walls and equipment must have a smooth surface. Waste from the processing of hides is incinerated. Eating, storage food products in these areas is strictly prohibited.

IX. Measures for the prevention of dirofilariasis

9.1. Prevention of infection of humans and animals with dirofilaria is based on the interruption of the transmissible transmission of invasion: extermination of mosquitoes, identification and deworming of infested domestic dogs, prevention of contact of mosquitoes with domestic animals and humans.

9.2. In cities and rural settlements in places (parks, recreation areas for people and dog walking, dog kennels) where dirofilariasis foci are formed, entomologists of Rospotrebnadzor institutions monitor the phenology, ecology and species composition of dirofilaria carriers, determine the timing of breeding and mass departure of mosquitoes.

9.3. In the foci of dirofilariasis, continuous treatment of water bodies is carried out - delaration, residential and non-residential premises treated with insecticides.

9.4. Examination and deworming of infested domestic dogs and cats is carried out in the spring and summer. Non-infected dogs in the endemic zone are given chemoprophylaxis to prevent dirofilariasis.

9.5. Long-acting repellents are used to prevent pets and humans from coming into contact with mosquitoes.

9.6. Medical workers conduct explanatory work with the population about the prevention of dirofilariasis using the media.

X. Measures for the prevention of ascariasis, trichuriasis, toxocariasis

10.1. Foci of ascariasis, trichuriasis differ in the degree of their extensiveness, determined by the level of the affected population and the number of microfoci.

10.2. On the territory of the Russian Federation, several types of foci of ascariasis and trichuriasis are distinguished (Table).

Types of foci of ascariasis and trichuriasis on the territory of the Russian Federation

10.4. Anti-epidemic measures for the prevention of ascariasis and trichuriasis include:

Identification of sources of invasion and establishment of microfoci;

Epidemiological examination of the outbreak in the detection of geohelminthiasis;

Improvement of microfoci and foci of geohelminthiases;

Treatment of infested (with control of effectiveness 14 days after deworming, three times with an interval of 7-10 days) and examination of the inhabitants of the microfocal (for two years annually);

Disinfestation of soil, sewage;

Prohibition of the use of feces of an infested person as fertilizer;

10.5. The decision to carry out the disinfestation of objects and the scope of measures to improve the focus is made by the body authorized to carry out federal state sanitary and epidemiological supervision.

10.6. Measures for the prevention of ascariasis, trichuriasis and toxocariasis include:

Analysis of the impact, morbidity of the population;

Prevention of soil pollution by helminth eggs, vegetables, fruits, berries, table greens grown on it, as well as dishes from them eaten without heat treatment;

Analysis and evaluation of the effectiveness of preventive measures;

Regulation of the number of stray dogs in settlements;

Allocation of areas for walking dogs on the territory of households and ensuring their proper condition;

Disinfestation of sand in sandboxes and prevention of contamination with faeces of dogs and cats;

Sanitary cleaning of the territories of settlements;

Compliance with personal hygiene in everyday life, public places, as well as in contact with soil, sand and plant products;

Hygienic education and training;

XI. Measures to prevent enterobiasis and hymenolepiasis

11.1. Prevention of enterobiasis is carried out in accordance with sanitary regulations(Resolution of the Chief State Sanitary Doctor of the Russian Federation dated October 22, 2013 No. 57 “On approval of the sanitary and epidemiological rules SP 3.2.3110-13 “Prevention of enterobiasis” (registered by the Ministry of Justice of Russia on January 20, 2014, registration number 31053).

11.2. Prevention of hymenolepiasis includes the following set of measures:

Examination of decreed groups of the population;

Treatment of identified infested persons and chemoprophylaxis of contact persons;

Monitoring the circulation of the causative agent of hymenolepiasis in groups with an increased risk of infection;

Implementation of sanitary and hygienic measures to comply with the anti-epidemic regime;

Hygienic education and training of the population.

11.2.2. The following are subject to examination for hymenolepiasis:

Children of preschool educational organizations;

Personnel of preschool educational organizations;

Primary school students (1 - 4);

Children, adolescents, decreed groups of the population according to epidemic indications and during medical examinations and preventive examinations;

Children enrolled in preschool and other educational organizations, orphanages, orphanages, boarding schools, for sanatorium treatment, in health organizations;

Outpatients and inpatients of children's polyclinics and hospitals;

Persons receiving access to the swimming pool.

11.2.3. Scheduled preventive examinations of children and service personnel in children's preschool organizations and educational organizations primary school age are held once a year (after the summer period) and (or) according to epidemic indications.

11.2.4. Decreed groups of the population are subject to periodic preventive planned examination for hymenolepiasis - once a year.

11.3. Persons infested with pygmy tapeworm are subject to mandatory treatment on an outpatient or inpatient basis (if isolation is necessary for epidemiological indications).

11.4. Persons infected with dwarf tapeworm belonging to decreed groups of the population are transferred to another job for the period of treatment. If it is impossible to transfer such workers temporarily (for the period of treatment and control laboratory examination) they are suspended from work with payment of compensation.

11.5. Children infested with pygmy tapeworm are not allowed in preschool educational organizations for the period of treatment and control laboratory examination.

XII. Measures for the prevention of intestinal protozoosis (giardiasis, amoebiasis, cryptosporidiosis, balantidiasis, blastocystosis and others)

12.1. Preventive actions:

Analysis of the morbidity of the adult and child population;

Examination of epidemiologically significant contingents of the population: children and staff of educational organizations upon admission to the organization and then 1 time per year, decreed groups of the population upon admission to work and then 1 time per year, persons in contact with patients, inpatients and outpatients according to indications;

Protection of water bodies from pollution by sewage, surface runoff;

With decentralized water supply, including from natural reservoirs: boiling water, using filter devices and disinfectants, drinking bottled water;

Compliance with regime sanitary and epidemiological requirements in medical organizations;

Compliance with sanitary-hygienic and anti-epidemic regimes in preschool educational organizations;

Hygiene training for decreed groups of the population, including employees of preschool educational organizations;

Compliance with the rules for keeping animals, ensuring their protection from infection with protozooses;

12.2. Anti-epidemic measures:

Sending an emergency notification of a detected case of intestinal protozoosis to territorial administration Rospotrebnadzor;

Epidemiological examination of the focus in case of detection of cases of intestinal protozoosis;

Treatment of patients with intestinal protozoosis with control of its effectiveness after 5-6 days. The criterion of effectiveness is three negative results of a laboratory test conducted with an interval of 1 - 2 days;

Establishment of the diagnosis of carriage of pathogens of intestinal protozooses in persons belonging to decreed population groups. With their consent, the heads of organizations and individual entrepreneurs temporarily, for the period of treatment and follow-up examinations after treatment, are transferred to another job. If it is impossible to transfer temporarily, for the period of treatment and examination, they are suspended from work with the payment of social insurance benefits in accordance with the legislation of the Russian Federation;

XIII. Requirements for measures to prevent pediculosis and scabies

13.1. Measures to prevent head lice and scabies include:

Scheduled examinations of the population for pediculosis;

Provision of organized groups (preschool educational organizations, orphanages, orphanages, stationary organizations for recreation and rehabilitation of children) with replacement bed linen, personal hygiene products, disinfectants and detergents;

Equipping with disinfection equipment and providing disinfectants to medical organizations, reception centers, organizations of systems social security, pre-trial detention centers, night houses, places of temporary stay of migrants, sanitary checkpoints, baths, laundries.

13.2. Inspection for pediculosis and scabies are subject to:

Children attending preschool educational organizations, monthly;

Students of general educational and professional educational organizations - 4 times a year;

Students of boarding schools, children living in orphanages, orphanages - in accordance with the legislation of the Russian Federation;

Children going on vacation to health organizations - before departure;

Children who are in a children's health organization - weekly;

Patients admitted to inpatient treatment - upon admission and then 1 time in 7 days;

Persons who are in organizations of the social security system - 2 times a month;

Outpatients - when contacting;

Employees of organizations - during the medical examination and preventive examinations.

13.3. If pediculosis is detected in persons admitted to the hospital, sanitization is carried out in the admissions department. Things of patients and special clothing of the personnel who carried out the treatment are placed in an oilcloth bag and sent to the disinfection chamber for disinfection.

13.4. When children enter a preschool educational organization, they are examined for pediculosis and scabies.

13.5. If children affected by pediculosis are identified, they are sent for rehabilitation with suspension from attending a preschool educational organization. Admission of children to preschool educational organizations after sanitation is allowed if there is a medical certificate confirming the absence of pediculosis.

13.6. If pediculosis is detected, students are suspended from visiting the organization for the duration of the treatment. They can be admitted to educational organizations only after the completion of a complex of therapeutic and preventive measures with a confirming certificate from a doctor.

13.7. For persons who have been in contact with a patient with pediculosis, medical supervision is established for a period of 1 month with examinations carried out once every 10 days with the results of the examination recorded in a journal.

13.8. The results of the examination for pediculosis and scabies of persons entering inpatient treatment and (or) applying for outpatient appointments are recorded in medical documents.

13.9. A patient with scabies coming for treatment from the admission department (or identified in the department) is isolated in a separate ward (isolation room). After consulting a dermatovenereologist and confirming the diagnosis, the patient (adults and children over 1 year old) is treated and items for individual use (towel, washcloth, soap in small packaging) are issued. Meals are organized in the ward. The underwear and bed linen of the patient is processed.

13.10. Manipulations in relation to patients with scabies, as well as cleaning of premises is carried out using means personal protection- rubber gloves, separate dressing gowns. Rubber gloves and cleaning equipment are disinfected after cleaning.

13.11. If scabies is detected in children attending preschool educational and general educational organizations, in lonely, elderly, disabled people, persons living in hostels, members large families, migrants, persons without a fixed place of residence, processing is carried out by specialized organizations at the request of organizations and individuals, including chamber processing of underwear and bed linen.

13.12. Persons who have been diagnosed with pubic lice are sent to the dermatovenerological dispensary at the place of residence in order to confirm the diagnosis and carry out a set of anti-epidemic measures.

13.13. If scabies is detected in children of preschool and school age for the duration of treatment, they are suspended from attending preschool educational and general educational organizations. They can be admitted to educational organizations only after the completion of a complex of therapeutic and preventive measures with a confirming certificate from a doctor.

13.14. The issue of preventive treatment of persons who have been in contact with a patient with scabies is decided by the doctor, taking into account the epidemiological situation. Persons who have been in contact with the patient, as well as from organizations where several cases of scabies have been registered or where new patients are detected in the (period of 1 month) process of monitoring the focus, are involved in this treatment. In organizations where preventive treatment of contact persons was not carried out, examination of the skin of students is carried out three times with an interval of 10 days.

13.15. If scabies is detected in the organization, current disinfection is carried out.

13.16. In the reception departments of medical organizations, underwear and clothes of incoming patients are processed in a disinfection chamber, or disinfected with an insecticide, or temporarily excluded from use (underwear and clothes are placed in plastic bags for a period of at least three days). Bedding used by patients with scabies in hospitals is treated in disinfection chambers or disinfected with an insecticide.

XIV. Measures for the prevention of demodicosis

14.1. Preventive actions:

Compliance with general hygiene standards (hairdressers, beauty parlors, baths, saunas, swimming pools, water parks and others);

Compliance with the rules of personal hygiene when caring for the skin of the face and eyes;

Examination for demodicosis of risk groups: employees of medical organizations (laboratory doctors of diagnostic laboratories, ophthalmologists, dermatologists and others), hairdressers, cosmetologists.

14.2. Anti-epidemic measures:

Carrying out disinfection from Demodex ticks of equipment, materials, work surfaces in hairdressing salons, beauty parlors and others;

Improvement of parks, squares, cemeteries, territories of health organizations, places of mass recreation and residence of the population;

Acaricidal treatment of the territories of parks, squares, cemeteries, health organizations, recreation centers, including domestic and farm animals;

Deratization measures to reduce the number of hosts for ticks (wild rodents) in the cleared areas;

Disinsection preventive (anti-epidemic) measures to reduce the number of blood-sucking insects, taking into account the results of entomological monitoring, including in places of formation of foci of vector-borne diseases (reservoirs near settlements and recreational areas, areas for walking and keeping dogs, in residential and non-residential premises and others) );

Treatment with broad-spectrum insecticides for dogs and cats;

Education of the population in methods of individual protection of humans and domestic animals from blood-sucking insects and ticks.

16.5. Protection measures environment from contamination with eggs and larvae of helminths, cysts (oocysts) of intestinal pathogenic protozoa include:

Improvement of settlements, farms, individual farms, recreation areas, areas for keeping and slaughtering livestock;

Maintaining the cleanliness of the territories of populated areas, livestock farms and complexes, farms and individual farms;

Collection, storage and disinfection of municipal solid waste;

Ensuring the disinfestation of sewage sludge generated at water treatment plants and sewage treatment plants before their disposal;

Avoiding the discharge of sewage and their sediments, livestock effluents, fan wastewater from river and sea transport into surface water bodies without continuous disinfestation (lack of viable helminth eggs and cysts of intestinal pathogenic protozoa) by industrial methods;

Use on agricultural fields for irrigation of sewage, their sludge and livestock effluents, disinfected (not containing viable helminth eggs and cysts of intestinal pathogenic protozoa) by industrial methods;

house cleaning, industrial premises for the preparation, storage, dressing of skins, tailoring fur products;

Disinfection of skins and fur products;

Cleaning of premises of preschool and school organizations;

Compliance with the regimes for keeping public and individual livestock, domestic animals, as well as closed animals.

Assessment of the epidemic situation on the spot with the definition of the scale and boundaries emergency for making management decisions (on the first day after the elimination of the technical causes of the accident);

Evaluation of the results of laboratory tests;

Organization of disinfestation measures, including the use of ovicide preparations of biological inhibition-stimulation with a wide range of effectiveness for the treatment of large areas of contaminated areas;

Monitoring the incidence of the population living in the contaminated area for two years in the absence of registration of cases of diseases in the foci and microfoci of geohelminthiasis.

16.7. Measures for the disinfection of environmental objects.

16.7.1. Disinfestation of sewage (faeces).

16.7.2. Disinvasion of solid household waste.

Solid household waste is disinfected:

In biothermal chambers, at a temperature of 65 - 80 ° C, the death of helminth eggs occurs during exposure from 12 to 17 days;

In compost heaps with dimensions of 1.5 × 1.0 meters of arbitrary length; disinfestation terms from several months to 1.5 years;

Field composting in compost heaps 10-25 m long with a trapezoidal section with a base of 3-4 m, an upper side of 2-3 m, a height of 1.5-2 m, located on the soil surface or in trenches 0.5 m deep; self-heating temperature 50 - 60 °C, composting time 8 - 12 months;

Processing in bio-drums at 2000 rpm - for 2 days;

Incineration and pyrolysis (decomposition) in special engineering structures.

16.7.3. Disinvasion / deworming of wastewater.

Disinvasion / deworming of wastewater is carried out:

At aero-biostations;

At the facilities of artificial biological treatment (fields of subsoil irrigation);

On biological filters of sewage treatment facilities (post-treatment of wastewater in irrigation fields with a capacity of up to 100 m 3 / day);

On one-, two-, three-chamber septic tanks, filtering wells (for drainage, respectively, to the indicated septic tanks 1, 3, 15 m 3 / day of wastewater);

On septic tanks, storage tanks, filtration gravel filters.

For disinfestation of fan drains of river and sea transport vessels, the following are used:

dry closets;

Installations using active chlorine. The combined effect of a temperature of at least 50 ° C plus a dose of active chlorine 10 - 20 mg / l for 30 minutes;

Measures to discharge fan effluents after pumping from ships into the city sewer system (drainage stations).

Dry closets are used for the disinfection of railway transport effluents (biothermal treatment with a temperature in the biodegradation chamber of 35-40 ° C with an exposure of at least 4 hours; in a pasteurization chamber - 70 ° C with an exposure of at least 20 minutes).

Methods and modes of their use for the disinfestation of sewage

16.7.4. Disinvasion of sewage sludge.

Pasteurization in special engineering facilities at a temperature of 70 ° C for 20 minutes;

Processing in biodrums;

Incineration in special engineering structures (multi-ton or drum furnaces, suspended bed reactors, etc.);

Method of aerobic stabilization for 5 - 6 days with preliminary heating of a mixture of raw sludge with activated sludge at a temperature of 60 - 65 ° C for 1.5 hours;

Treatment with ovicides with biological stimulant inhibitors with a minimum dosage of 1 liter per 60 m 3 of sediment with a moisture content of more than 85%, after which no additional wastewater disinfection is required.

16.7.5. Disinvasion of liquid manure and manure.

For the purpose of disinfestation of liquid manure and manure runoff, the following is carried out:

Thermal treatment of liquid manure and silt fraction with a moisture content of 96 - 98% in a contact heating installation by supplying a high-temperature torch (over 1,200 °C), formed during the combustion of liquid or gaseous fuel, directly into the treated mass. Processing mode: exposure for at least 3 minutes, the temperature of the mass at the outlet of the installation is 48 - 50 °C. Efficiency is achieved by repeated mixing of the processed mass with compressed air in the zone of the thermal factor;

Thermal treatment of liquid manure and manure in a steam jet. Disinfection is provided in line mode at a mass temperature at the outlet of the installation of 80 °C and an exposure time of at least 5 minutes;

Treatment of liquid manure and silt fraction with liquid ammonia in a closed container at a concentration of 2 - 3%, exposure for 2 days, at an initial temperature of the mass of 10 ° C and above;

Treatment of liquid manure, manure runoff and sludge fraction with biological inhibition-stimulation preparations in accordance with the instructions for their use.

(Changed edition. Rev. No. 1)

Processing of surfaces, objects, materials, cleaning equipment in the premises for keeping animals is carried out using disinfectants.

16.7.6. Disinfestation of soil, sand.

Disinvasion of soil, sand at the first stage is achieved:

Treatment with herbicide-based products;

Treatment with means based on quaternary ammonium compounds;

Treatment with biological inhibition-stimulation drugs-ovicides;

Processing with table salt (1 kg per 1 m 2). It is used for disinfestation of the most contaminated soil areas from hookworm larvae once every 10 days;

Using a crop rotation system: first, the plot is sown with radishes, radishes, garlic, onions, after harvesting - secondarily with peas. The effect is also achieved with the simultaneous sowing of crops such as garlic - radish, onion - radish and some other families of legumes, lilies. The death of eggs occurs during two summer periods.

16.7.7. Disinfestation of vegetables, fruits, greens of the dining room.

To disinfect vegetables, fruits, table greens from helminth eggs, plant products are pre-soaked in water for 20-30 minutes before thorough rinsing in a colander under running water for 5-10 minutes with occasional shaking. Onions, parsley, lettuce are pre-cleaned from the soil, then sorted into individual leaves, stems, feathers. The effect is given by washing them in soapy water, followed by rinsing with running water. For berries with a rough surface or a lobed structure (strawberries, strawberries, raspberries), they are washed with a 1.0% soda solution, and then with clean water. A weak solution of iodine (0.2 - 0.5%) is used to disinfect vegetables from eggs and larvae of ascaris, whipworm, hookworm, strongylide.

16.7.8. Disinfestation of household items, toys, linen.

For disinfestation of bed linen, boiling and ironing on both sides is recommended. Woolen blankets, carpets, mattresses, plaids, curtains are processed with a vacuum cleaner (with subsequent dust neutralization using disinfectants approved for use), dried and shaken in the sun, ironed with a hot iron through rags. Dust from the containers of vacuum cleaners after neutralization is disposed of in the general sewerage system.

In areas with severe winters, household items and linen are taken out on frosty days, given that pinworm eggs die at a temperature of -15 ° C for 40 - 45 minutes.

Linen, toys and other things are disinfested in the disinfection chamber.

Disinfestation of soft toys and other objects with a rough surface is ensured by processing with a vacuum cleaner. Room surfaces, sinks, faucets, door handles, cellophane and rubber toys, etc., are disinfected by irrigation or wiping with approved products.

16.7.9. Disinfestation of drinking water.

Filtration (sand, diatomite, clinoptilite, titanium, metal-ceramic materials);

Sorption (charcoal, manganese oxide and others);

Use of ion exchange resins;

Use of the combined action of sorbents and ion-exchange resins;

At the second stage - treatment with ultraviolet rays with a strong oxidizing agent (hydrogen peroxide);

Ozonation;

Exposure to MIO radiation (powerful impulsive optical radiation);

The use of filter materials at water treatment plants with a pore size of at least 1 micron, which ensures the retention of cryptosporidium oocysts.

The treatment of sludge generated at wastewater treatment plants to be disposed of for the purpose of disinfestation is carried out with biological inhibition-stimulation preparations.

16.7.10. Disinfestation of skins of wild and domestic carnivores, fur and fur products.

For processing the skins of domestic and wild animals technological process, ensuring the complete removal of teniid oncospheres, should include primary processing, washing, soaking, rinsing, pickling, pickling, tanning, fatliquoring, drying (at a temperature of 30 - 33 ° C), broach, rolling, shaking, breaking, grinding and re-shaking. The stage of hauling the skins with sawdust must be at least 9 hours with a frequency of replacement of sawdust 6 times a year. Workers involved in the primary processing of skins must work with gloves and respiratory protection.

Disinfection of skins and fur products from oncospheres teniid is provided by irradiation with a mercury-quartz lamp or other sources of ultraviolet radiation.

The premises are provided with sufficient water for sanitary and industrial needs. Floors, walls and equipment should be smooth and easy to clean. The walls of the premises and equipment are treated with boiling water or disinfectant, and the waste from the processing of skins is burned. Eating, storing food and smoking in these rooms is strictly prohibited.

16.7.11. Disinfestation of other environmental objects.

16.7.11.1. Containers with feces and sewage sludge during the working day are placed in enameled dishes, filled with a chlorine-active agent, followed by disinfection with agents recommended for use in accordance with sanitary rules.

16.7.11.2. Spent biological material is disinfected with drugs approved for use.

16.7.11.3. Used glass slides, pipettes, corks, test tubes, glass rods, chemical beakers and others are stored during the working day in containers with a disinfectant solution until they are completely vertically immersed. Final disinfection is carried out by boiling in water (from the moment of boiling for at least 30 minutes) with the addition of laundry soap or liquid detergent. Autoclaving is acceptable under appropriate conditions.

16.7.11.4. The effectiveness of disinfection and disinfestation of biological material, laboratory glassware, auxiliary and packaging materials is ensured in microwave devices for the disinfection of medical waste.

16.7.11.6. The working surfaces of laboratory tables are disinfected with 96% ethyl alcohol, followed by flaming.

16.7.11.7. Equipment (centrifuges, microscopes, refrigerators) is treated with 70% ethyl alcohol.

16.7.11.8. Overalls, towels, cleaning items are boiled in a 2.0% soap-soda solution or a 0.5% detergent solution.

16.7.11.9. Cleaning equipment (rags, brushes) is boiled or treated with disinfectants.

16.7.11.10. The current cleaning of laboratory premises is carried out daily by a wet method after the end of the working day: in the “clean” area of ​​the laboratory using detergents, in the “infectious” area using disinfectants. In the box rooms, a weekly spring-cleaning using disinfectants. After wet cleaning, bactericidal lamps are switched on.

17.2. Hygienic education and training is carried out during professional hygienic training and certification of officials and employees of organizations whose activities are related to the production, storage, transportation and sale of food and drinking water, the upbringing and education of children, public utilities and consumer services.

State sanitary and epidemiological regulation
Russian Federation

State sanitary and epidemiological
rules and regulations

SanPiN 3.2.3215-14

Moscow 2015

2. Approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation dated August 22, 2014 No. 50.

3. Registered with the Ministry of Justice of the Russian Federation on November 12, 2014, registration number 34659.

CHIEF STATE SANITARY PHYSICIAN
RUSSIAN FEDERATION

RESOLUTION

In accordance with the Federal Law of March 30, 1999 No. 52-FZ “On the sanitary and epidemiological well-being of the population” (Collected Legislation of the Russian Federation, 1999, No. 14, Art. 1650; 2002, No. 1 (Part I), Art. 2; 2003, No. 2, article 167; No. 27 (part I), article 2700; 2004, No. 35, article 3607; 2005, No. 19, article 1752; 2006, No. 1, article 10; No. 52 (Part I), Article 5498; 2007, No. 1 (Part I), Article 21, Article 29; No. 27, Article 3213; No. 46, Article 5554; No. 49, Article 6070; 2008 , No. 24, Article 2801; No. 29 (Part I), Article 3418; No. 30 (Part II), Article 3616; No. 44, Article 4984; No. 52 (Part I), Article 6223 ; 2009, No. 1, article 17; 2010, No. 40, article 4969; 2011, No. 1, article 6; No. 30 (part I), article 4563, article 4590, article 4591, article 4596; No. 50, item 7359; 2012, No. 24, item 3069; No. 26, item 3446; 2013, No. 27, item 3477; No. 30 (part I), item 4079; No. 48, item 6165; 2014, No. 26 (Part I), Art. 3366, Art. 3377) and Decree of the Government of the Russian Federation dated July 24, 2000 No. “On Approval of the Regulations on the State Sanitary and Epidemiological Service of the Russian Federation and the Regulations on State Sanitary arno-epidemiological regulation” (Sobraniye zakonodatelstva Rossiyskoy Federatsii, 2000, No. 31, art. 3295; 2004, no. 8, art. 663; No. 47, Art. 4666; 2005, no. 39, art. 3953)

RESOLVE:

A.Yu. Popova

Sanitary and epidemiological rules and regulations
SanPiN 3.2.3215-14

I. Scope

1.1. These sanitary and epidemiological rules and regulations (hereinafter referred to as the sanitary rules) have been developed in accordance with the legislation of the Russian Federation.

1.3. Compliance with sanitary and epidemiological rules is mandatory throughout the Russian Federation for state bodies, state authorities of the constituent entities of the Russian Federation, municipalities, officials of state bodies, officials of state authorities of the constituent entities of the Russian Federation, officials of local governments, citizens, individual entrepreneurs and legal entities.

1.4. Control over the implementation of these sanitary rules is carried out by bodies authorized to exercise federal state sanitary and epidemiological supervision in accordance with the legislation of the Russian Federation.

II. General provisions

Identification of trends in the epidemic process;

Identification of regions, regions, settlements with a high level of morbidity and the risk of infection;

Assessment of the quality and effectiveness of ongoing preventive and anti-epidemic measures;

Planning the sequence of activities and the timing of their implementation;

Development of forecasts of the epidemiological situation.

3.3. The main tool of epidemiological surveillance is epidemiological diagnostics.

Epidemiological diagnosis is carried out using a retrospective and operational epidemiological analysis of morbidity.

3.4. A multi-year retrospective epidemiological analysis is carried out for at least the last 5 years and provides for:

Analysis of long-term dynamics of morbidity (affection);

Analysis of morbidity by territories;

Analysis of morbidity by age groups, sex, contingents of the population;

Conclusions and proposals for the development of preventive measures.

3.5. An operational epidemiological analysis is carried out in the condition of an epidemic rise in morbidity or the registration of epidemic foci of group morbidity. Epidemiological analysis includes constant monitoring of the dynamics of the incidence, taking into account a specific etiological agent, assessment of the sanitary and epidemiological situation, formulation of a preliminary and final epidemiological diagnosis with the establishment of the causes and conditions for an increase in the incidence or the formation of an epidemic focus.

Examination for helminthiases and intestinal protozooses is subject to: children attending preschool educational organizations; personnel of preschool educational organizations; elementary school students, children, adolescents, decreed and equated groups of the population during medical examinations and preventive examinations; children, adolescents according to epidemic indications; children and adolescents enrolled in preschool and other educational organizations, orphanages, orphanages, orphanages, boarding schools, sanatorium treatment, health organizations, children's departments of hospitals; children of all ages of children's organizations of a closed type and year-round stay, patients of children's and adult polyclinics and hospitals according to indications, persons who communicated with patients.

4.3. Delivery of biological material to the laboratory is carried out in sealed containers, ensuring its safety and transportation safety.

4.5. The organization and conduct of scheduled examinations of children attending preschool, school educational organizations and other children's organizations is provided by the heads of such organizations.

4.9. In the event of a change or clarification of the diagnosis, medical workers of medical organizations report by phone, and then within 12 hours send an emergency notice in writing about the change or clarification of the diagnosis to the territorial body of the federal executive body authorized to exercise federal state sanitary and epidemiological surveillance.

4.11. Infected persons are subject to treatment on an outpatient or inpatient basis on the basis of their informed voluntary consent and taking into account the right to refuse medical intervention.

4.15. All identified infested persons are provided with dispensary observation in the relevant medical organizations.

4.16. For each infested, a dispensary observation form is filled out.

4.17. Removal from dispensary registration is carried out after treatment and obtaining negative results of a laboratory study of biological material.

Activities for the prevention of malaria.

5.1. The collection and analysis of data on local or imported cases of malaria is carried out by medical organizations and bodies authorized to carry out sanitary and epidemiological surveillance.

5.2. The bodies authorized to carry out sanitary and epidemiological supervision determine a set of sanitary and anti-epidemic (preventive) antimalarial measures (Table ).

5.3. The organization of activities for the prevention of malaria in the territory of the constituent entity of the Russian Federation is carried out by state authorities in the field of health protection of the constituent entities of the Russian Federation together with interested departments, local governments in municipalities. When organizing antimalarial measures, an irreducible supply of antimalarial drugs is ensured for the treatment of all types of malaria, including primaquine, and disinsection measures are taken to kill mosquitoes (adults, larvae), where transmission of three-day malaria is possible.

5.4. The period of carrying out measures for the prevention of malaria in the active focus of three-day malaria is carried out for 3 years due to the possible appearance of patients with malaria after a long incubation.

Key antimalarial activities

5.5. Organizations that send employees to countries in the subtropical and tropical zones, or travel agencies that organize trips to these countries, inform those leaving:

About the possibility of contracting malaria and the need to comply with preventive measures (protection from mosquito bites and the use of chemoprophylactic drugs that are effective in the host country);

About the need to immediately seek qualified medical care in the event of a febrile illness during a stay in an endemic country;

About the need after returning, if any febrile illness occurs, immediately consult a doctor and inform him about the duration of stay in the countries of the subtropical and tropical zone and the intake of chemoprophylactic drugs.

Specialists sent to the countries of the subtropical and tropical zones in areas where there is no first aid are provided with a course dose of antimalarial drugs.

5.6. Heads of transport organizations flying to countries where tropical malaria is common, as well as rescuers and military personnel temporarily stationed in these countries, are provided with packing containing antimalarial prophylactic drugs and mosquito bite protection. These individuals undergo chemoprophylaxis.

5.7. Servicemen of the border troops and combined-arms formations who serve in the territory of countries where three-day malaria is common, 14 days before demobilization or departure from endemic areas to the territory of the Russian Federation, they are given a course of preventive treatment against malaria.

5.8. The following are subject to testing for malaria:

Persons who arrived from malaria endemic areas or visited endemic countries within the past three years, with an increase in temperature, with any of the following symptoms against a background of body temperature above 37 ° C: malaise, headache, enlargement of the liver, spleen, yellowness of the sclera and skin covers, herpes, anemia;

Persons with an undiagnosed fever for 5 days;

Patients with an established diagnosis, but with continuing periodic rises in temperature, despite the ongoing specific treatment;

Persons living in an active focus, with any increase in temperature.

VI. Measures to prevent helminthiases transmitted through meat and meat products

6.1. Heads of organizations, as well as individual entrepreneurs provide:

Quality and safety of meat and meat products during their production and sale in accordance with the requirements of technical regulations;

Carrying out preventive pest control and deratization measures on the territories of livestock farms and complexes, slaughterhouses, meat products warehouses, food industry enterprises, public catering and food trade organizations and other facilities of particular epidemiological significance;

Informing medical, veterinary and hunting organizations about cases of detection of helminthiases transmitted through meat among wild and farm animals, as well as cases of human disease.

6.2. Requirements for methods of disinfection of meat products.

6.2.1. Requirements for freezing meat:

Cattle carcasses are frozen until a temperature of minus 12 °C is reached in the thickness of the meat (the temperature is measured in the thickness of the hip muscles at a depth of 7-10 cm with a special thermometer). In this case, no further holding is required. At a temperature in the thickness of the meat of minus 6 - 9 ° C, the carcass is kept in the refrigerator for at least 24 hours;

Pork carcasses are frozen until a temperature of minus 10 °C is reached in the thickness of the meat and kept at an air temperature in the chamber of minus 12 °C for 10 days. At a temperature in the thickness of the meat of minus 12 ° C, the carcass is kept at an air temperature in the refrigerator of minus 13 ° C for 4 days (the temperature is measured in the thickness of the hip muscles at a depth of 7-10 cm with a special thermometer).

6.2.2. Meat warming requirements:

Parts of the carcass of cattle or pork carcasses are divided into pieces weighing up to 2 kg and up to 8 cm thick and boiled for 3 hours in open or 2.5 hours in closed boilers at an excess steam pressure of 0.5 MPa.

6.2.3. Meat salting requirements:

Parts of the carcass of cattle or pork carcasses are divided into pieces weighing no more than 2.5 kg, rubbed and covered with table salt at the rate of 10% in relation to the mass of meat, then poured with brine with a concentration of at least 24% of table salt and aged for 20 days.

6.2.5. Meat and products of its processing, obtained from the slaughter of private livestock, are issued (returned) to the owner in a decontaminated form in the organizations of the meat industry and from individual entrepreneurs.

6.2.6. Slaughterhouse and kitchen waste intended for feeding to domestic and fur animals are subject to mandatory heat treatment.

VII. Measures for the prevention of helminthiases transmitted through fish, crustaceans, mollusks, amphibians, reptiles and their processed products

7.1. In order to identify pathogens of helminthiases in the designated area (zone) of a freshwater reservoir, 25 individuals of each type of additional (commercial size) hosts of pathogens of biohelminthiasis are examined.

7.2. In accredited testing laboratories, 20 individuals of the commercial size of additional hosts of pathogens of biohelminthiasis common in this territory are examined. If the result is negative, the number of studied fish specimens is brought to 40. If the negative result is confirmed, the reservoir is considered safe. Fish caught in such reservoirs is allowed for sale without restrictions. Follow-up studies in this reservoir are carried out after 3 years.

7.3. If fish infected with biohelminth larvae are found in the reservoir, all fish of this species and other species capable of playing the role of additional hosts of biohelminths, as well as fish products, are subjected to disinfection from biohelminth larvae before sale. Fish products from such reservoirs that have not undergone disinfection are not allowed for sale.

7.6. Disinfection of fish and fish products is carried out by freezing, salting and heat treatment.

7.7. Requirements for methods of disinfection and modes of processing of fish and fish products.

7.7.1. Requirements for freezing fish:

Fish is disinfected from tapeworm larvae under the freezing conditions indicated in Table. ;

From the larvae of opisthorchid and other trematodes, the fish is disinfected under the freezing conditions indicated in Table. ;

Marine fish, crustaceans, molluscs, amphibians and reptiles containing live anisakid larvae and other helminths dangerous to humans and animals are disinfected by freezing at the temperature in the body of the fish (crustaceans, mollusks, amphibians, reptiles), the duration of this temperature and subsequent storage conditions in accordance with the table. ;

If it is impossible to provide freezing conditions that guarantee the disinfection of fish products, they should be used for food purposes only after hot heat treatment or sterilization (canned food).

7.7.2. Requirements for salting fish:

When infected with larvae of a wide tapeworm, the fish is disinfected by salting in the modes indicated in Table. ;

Disinfection of Far Eastern salmon from diphyllobothriid larvae is carried out by all methods of industrial salting when the mass fraction of salt in the meat of the back of the fish reaches 5%;

Disinfection of whitefish, salmon and grayling fish from gull tapeworm larvae is carried out by mixed weak salting (brine density 1.18 - 1.19) for 10 days when the mass fraction of salt in fish meat reaches 8 - 9%;

Disinfection of fish from opisthorchid larvae and other trematodes is carried out using mixed strong and medium salting (brine density from the first day of salting 1.20 at a temperature of 1 - 2 ° C) when the mass fraction of salt in fish meat reaches 14%. In this case, the duration of the salting should be:

Minnow, bleak, minnow, tops - 10 days;

Roach, dace, rudd, chub, blue bream, white-eye, podust, sabrefish, asp, small (up to 25 cm) ide, bream, tench - 21 days.

A weaker or shorter salting of fish is allowed, only after its preliminary freezing in the modes indicated in Table. 2.

Modes of fish disinfection from tapeworm larvae

Modes of fish disinfection from opisthorchid larvae

Modes of disinfection of marine fish from anisakid larvae

Modes of salting fish during disinfection from tapeworm larvae

7.7.3. Requirements for the salting of fish roe.

When salting fish roe as an independent product, disinfection from the larvae of the wide tapeworm is carried out in the following ways:

Warm salting (temperature 15 - 16 ° C) is carried out with the amount of salt (as a percentage of the caviar weight): 12% - 30 minutes; 10% - 1 hour; 8% - 2 hours; 6% - 6 hours;

Chilled salting (at a temperature of 5 - 6 ° C) is carried out with the amount of salt (as a percentage of the caviar weight): 12% - 1 hour; 10% - 2 hours; 8% - 4 hours; 6% - 12 hours;

Cooled salting of caviar of whitefish and other fish infected with gull tapeworm larvae is carried out at a salt amount of 5% by weight of caviar for 12 hours.

Salting of caviar of anadromous salmon and sturgeon fish is carried out after the removal of anisakid larvae.

7.7.4. Requirements for heat treatment of fish and fish products:

Fish is cooked in portions for at least 20 minutes from the moment of boiling, fish dumplings - for at least 5 minutes from the moment of boiling, crustaceans and mollusks - for 15 minutes;

Fish (fish cakes) are fried in portions in fat for 15 minutes. Large pieces of fish weighing up to 100 g are fried flat for at least 20 minutes. Small fish are fried whole for 15 - 20 minutes.

7.7.5. Marine fish intended for cold and hot smoking, salting and pickling, the production of preserves are pre-frozen in the modes indicated in Table. .

7.7.6. It is not allowed to dump fish products processing waste into water bodies and landfills, as well as feed them to animals without prior disinfection.

7.7.7. Responsibility for the implementation of these measures rests with individual entrepreneurs and legal entities engaged in breeding, growing, harvesting (catching), processing, storing, selling fish, aquatic invertebrates, aquatic mammals, other aquatic animals in their natural habitat, aquaculture, food fish products.

VIII. Measures for the prevention of echinococcosis, alveococcosis

8.1. Groups at risk of infection with the causative agent of echinococcosis (hunters, shepherds, reindeer herders, shepherds, workers of fur farms, livestock farms, zoos, fur collectors, workers of fur workshops, veterinary workers, persons involved in trapping dogs, dog owners, employees of reserves, reserves, forestries, collectors and buyers of mushrooms, berries, as well as members of their families) during preventive and periodic medical examinations, clinical examinations are subject to examination for echinococcosis.

8.2. Organization of preventive measures for echinococcosis includes:

Operational tracking (monitoring) of the epidemic situation;

Epidemiological analysis of information on echinococcosis in the territory for a certain period of time (data on the incidence of the population, the number of surgical operations for echinococcosis, disability, mortality, economic damage, the nature and volume of sanitary and hygienic and therapeutic and preventive measures);

Hygienic education using the media;

Regulation of the content of stray dogs, their deworming.

8.3. The objects of sanitary and helminthological research are places where dogs are kept, livestock farms, as well as households.

8.4. Prevention of infection in humans and farm animals includes the following.

8.4.1 Ensuring deworming of priotary, reindeer, sled and other dogs on the territory of cities and towns.

8.4.2. Provision by local self-government bodies and legal entities of accounting and registration of dogs, regulation of the number of stray dogs by catching and keeping them in special kennels. When implementing regional programs, comprehensive plans for the sanitary and epidemiological well-being of the population, the organization and conduct of these activities falls within the powers of the executive authorities of the constituent entities of the Russian Federation.

8.4.3. Preventive deworming against cystodes of priotary, guard, reindeer, sled, hunting and other dogs is carried out 5 to 10 days before the animals are moved to pastures and hunters go hunting. Deworming of dogs is carried out on special sites, the feces isolated after treatment are collected in a metal container and treated with drugs that have an ovicidal effect. The site covered with cement, the soil is being processed.

8.4.4. For walking pets in settlements, special areas should be allocated, marked with signs. In areas for walking pets, special containers are installed to collect animal feces.

8.4.6. In order to prevent infection of humans, dogs and fur-bearing animals with alveococcosis, the following measures are taken:

In places of fur extraction, in each settlement and in hunting winter quarters, special facilities are equipped for the removal, primary processing of animal skins, collection of affected carcasses and their disposal, which meet sanitary and hygienic standards. The premises are provided with sufficient water. The floor, walls and equipment must have a smooth surface. Waste from the processing of hides is incinerated. Eating, storing food in these rooms is strictly prohibited.

IX. Measures for the prevention of dirofilariasis

9.1. Prevention of infection of humans and animals with dirofilaria is based on the interruption of the transmissible transmission of invasion: extermination of mosquitoes, identification and deworming of infested domestic dogs, prevention of contact of mosquitoes with domestic animals and humans.

9.2. In cities and rural settlements in places (parks, recreation areas for people and dog walking, dog kennels) where dirofilariasis foci are formed, entomologists of Rospotrebnadzor institutions monitor the phenology, ecology and species composition of dirofilaria carriers, determine the timing of breeding and mass departure of mosquitoes.

9.3. In the foci of dirofilariasis, continuous treatment of water bodies is carried out - delaration, residential and non-residential premises are treated with insecticides.

9.4. Examination and deworming of infested domestic dogs and cats is carried out in the spring and summer. Non-infected dogs in the endemic zone are given chemoprophylaxis to prevent dirofilariasis.

9.5. Long-acting repellents are used to prevent pets and humans from coming into contact with mosquitoes.

9.6. Medical workers conduct explanatory work with the population about the prevention of dirofilariasis using the media.

X. Measures for the prevention of ascariasis, trichuriasis, toxocariasis

10.1. Foci of ascariasis, trichuriasis differ in the degree of their extensiveness, determined by the level of the affected population and the number of microfoci.

10.2. On the territory of the Russian Federation, several types of foci of ascariasis and trichuriasis are distinguished (Table).

Types of foci of ascariasis and trichuriasis on the territory of the Russian Federation

10.4. Anti-epidemic measures for the prevention of ascariasis and trichuriasis include:

Identification of sources of invasion and establishment of microfoci;

Epidemiological examination of the outbreak in the detection of geohelminthiasis;

Improvement of microfoci and foci of geohelminthiases;

Treatment of infested (with control of effectiveness 14 days after deworming, three times with an interval of 7-10 days) and examination of the inhabitants of the microfocal (for two years annually);

Disinfestation of soil, sewage;

Prohibition of the use of feces of an infested person as fertilizer;

10.5. The decision to carry out the disinfestation of objects and the scope of measures to improve the focus is made by the body authorized to carry out federal state sanitary and epidemiological supervision.

10.6. Measures for the prevention of ascariasis, trichuriasis and toxocariasis include:

Analysis of the impact, morbidity of the population;

Prevention of soil pollution by helminth eggs, vegetables, fruits, berries, table greens grown on it, as well as dishes from them eaten without heat treatment;

Analysis and evaluation of the effectiveness of preventive measures;

Regulation of the number of stray dogs in settlements;

Allocation of areas for walking dogs on the territory of households and ensuring their proper condition;

Disinfestation of sand in sandboxes and prevention of contamination with faeces of dogs and cats;

Sanitary cleaning of the territories of settlements;

Compliance with personal hygiene in everyday life, public places, as well as in contact with soil, sand and plant products;

Hygienic education and training;

XI. Measures to prevent enterobiasis and hymenolepiasis

11.1. Prevention of enterobiasis is carried out in accordance with sanitary rules (Resolution of the Chief State Sanitary Doctor of the Russian Federation dated October 22, 2013 No. 57 “On approval of the sanitary and epidemiological rules SP 3.2.3110-13 “Prevention of enterobiasis” (registered by the Ministry of Justice of Russia on January 20, 2014, registration number 31053 ).

11.2. Prevention of hymenolepiasis includes the following set of measures:

Examination of decreed groups of the population;

Treatment of identified infested persons and chemoprophylaxis of contact persons;

Monitoring the circulation of the causative agent of hymenolepiasis in groups with an increased risk of infection;

Implementation of sanitary and hygienic measures to comply with the anti-epidemic regime;

Hygienic education and training of the population.

11.2.2. The following are subject to examination for hymenolepiasis:

Children of preschool educational organizations;

Personnel of preschool educational organizations;

Primary school students (1 - 4);

Children, adolescents, decreed groups of the population according to epidemic indications and during medical examinations and preventive examinations;

Children enrolled in preschool and other educational organizations, orphanages, orphanages, boarding schools, for sanatorium treatment, in health organizations;

Outpatients and inpatients of children's polyclinics and hospitals;

Persons receiving access to the swimming pool.

11.2.3. Scheduled preventive examinations of children and attendants in preschool organizations and educational organizations of primary school age are carried out once a year (after the summer period) and (or) according to epidemic indications.

11.2.4. Decreed groups of the population are subject to periodic preventive planned examination for hymenolepiasis - once a year.

11.3. Persons infested with pygmy tapeworm are subject to mandatory treatment on an outpatient or inpatient basis (if isolation is necessary for epidemiological indications).

11.4. Persons infected with dwarf tapeworm belonging to decreed groups of the population are transferred to another job for the period of treatment. If it is impossible to transfer such workers temporarily (for the period of treatment and control laboratory examination) they are suspended from work with payment of compensation.

11.5. Children infested with pygmy tapeworm are not allowed in preschool educational organizations for the period of treatment and control laboratory examination.

XII. Measures for the prevention of intestinal protozoosis (giardiasis, amoebiasis, cryptosporidiosis, balantidiasis, blastocystosis and others)

12.1. Preventive actions:

Analysis of the morbidity of the adult and child population;

Examination of epidemiologically significant contingents of the population: children and staff of educational organizations upon admission to the organization and then 1 time per year, decreed groups of the population upon admission to work and then 1 time per year, persons in contact with patients, inpatients and outpatients according to indications;

Protection of water bodies from pollution by sewage, surface runoff;

With decentralized water supply, including from natural reservoirs: boiling water, using filter devices and disinfectants, drinking bottled water;

Compliance with regime sanitary and epidemiological requirements in medical organizations;

Compliance with sanitary-hygienic and anti-epidemic regimes in preschool educational organizations;

Hygiene training for decreed groups of the population, including employees of preschool educational organizations;

Compliance with the rules for keeping animals, ensuring their protection from infection with protozooses;

12.2. Anti-epidemic measures:

Sending an emergency notification of a detected case of intestinal protozoosis to the territorial department of Rospotrebnadzor;

Epidemiological examination of the focus in case of detection of cases of intestinal protozoosis;

Treatment of patients with intestinal protozoosis with control of its effectiveness after 5-6 days. The criterion of effectiveness is three negative results of a laboratory test conducted with an interval of 1 - 2 days;

Establishment of the diagnosis of carriage of pathogens of intestinal protozooses in persons belonging to decreed population groups. With their consent, the heads of organizations and individual entrepreneurs temporarily, for the period of treatment and follow-up examinations after treatment, are transferred to another job. If it is impossible to transfer temporarily, for the period of treatment and examination, they are suspended from work with the payment of social insurance benefits in accordance with the legislation of the Russian Federation;

XIII. Requirements for measures to prevent pediculosis and scabies

13.1. Measures to prevent head lice and scabies include:

Scheduled examinations of the population for pediculosis;

Provision of organized groups (preschool educational organizations, orphanages, orphanages, stationary organizations for recreation and rehabilitation of children) with replacement bed linen, personal hygiene products, disinfectants and detergents;

Equipping with disinfection equipment and providing disinfectants to medical organizations, reception centers, organizations of social security systems, pre-trial detention centers, overnight stays, places of temporary stay of migrants, sanitary checkpoints, baths, laundries.

13.2. Inspection for pediculosis and scabies are subject to:

Children attending preschool educational organizations, monthly;

Students of general educational and professional educational organizations - 4 times a year;

Students of boarding schools, children living in orphanages, orphanages - in accordance with the legislation of the Russian Federation;

Children going on vacation to health organizations - before departure;

Children who are in a children's health organization - weekly;

Patients admitted to inpatient treatment - upon admission and then 1 time in 7 days;

Persons who are in organizations of the social security system - 2 times a month;

Outpatients - when contacting;

Employees of organizations - during medical examinations and preventive examinations.

13.3. If pediculosis is detected in persons admitted to the hospital, sanitization is carried out in the admissions department. Things of patients and special clothing of the personnel who carried out the treatment are placed in an oilcloth bag and sent to the disinfection chamber for disinfection.

13.4. When children enter a preschool educational organization, they are examined for pediculosis and scabies.

13.5. If children affected by pediculosis are identified, they are sent for rehabilitation with suspension from attending a preschool educational organization. Admission of children to preschool educational organizations after sanitation is allowed if there is a medical certificate confirming the absence of pediculosis.

13.6. If pediculosis is detected, students are suspended from visiting the organization for the duration of the treatment. They can be admitted to educational organizations only after the completion of a complex of therapeutic and preventive measures with a confirming certificate from a doctor.

13.7. For persons who have been in contact with a patient with pediculosis, medical supervision is established for a period of 1 month with examinations carried out once every 10 days with the results of the examination recorded in a journal.

13.8. The results of the examination for pediculosis and scabies of persons entering inpatient treatment and (or) applying for outpatient appointments are recorded in medical documents.

13.9. A patient with scabies coming for treatment from the admission department (or identified in the department) is isolated in a separate ward (isolation room). After consulting a dermatovenereologist and confirming the diagnosis, the patient (adults and children over 1 year old) is treated and items for individual use (towel, washcloth, soap in small packaging) are issued. Meals are organized in the ward. The underwear and bed linen of the patient is processed.

13.10. Manipulations in relation to patients with scabies, as well as cleaning the premises, are carried out using personal protective equipment - rubber gloves, separate gowns. Rubber gloves and cleaning equipment are disinfected after cleaning.

13.11. When scabies is detected in children attending preschool educational and general educational organizations, in lonely, elderly, disabled people, people living in hostels, members of large families, migrants, people without a fixed place of residence, processing is carried out by specialized organizations at the request of organizations and individuals, including with chamber processing of underwear and bed linen.

13.12. Persons who have been diagnosed with pubic lice are sent to the dermatovenerological dispensary at the place of residence in order to confirm the diagnosis and carry out a set of anti-epidemic measures.

13.13. If scabies is detected in children of preschool and school age for the duration of treatment, they are suspended from attending preschool educational and general educational organizations. They can be admitted to educational organizations only after the completion of a complex of therapeutic and preventive measures with a confirming certificate from a doctor.

13.14. The issue of preventive treatment of persons who have been in contact with a patient with scabies is decided by the doctor, taking into account the epidemiological situation. Persons who have been in contact with the patient, as well as from organizations where several cases of scabies have been registered or where new patients are detected in the (period of 1 month) process of monitoring the focus, are involved in this treatment. In organizations where preventive treatment of contact persons was not carried out, examination of the skin of students is carried out three times with an interval of 10 days.

13.15. If scabies is detected in the organization, current disinfection is carried out.

13.16. In the reception departments of medical organizations, underwear and clothes of incoming patients are processed in a disinfection chamber, or disinfected with an insecticide, or temporarily excluded from use (underwear and clothes are placed in plastic bags for a period of at least three days). Bedding used by patients with scabies in hospitals is treated in disinfection chambers or disinfected with an insecticide.

XIV. Measures for the prevention of demodicosis

14.1. Preventive actions:

Compliance with general hygiene standards (hairdressers, beauty parlors, baths, saunas, swimming pools, water parks and others);

Compliance with the rules of personal hygiene when caring for the skin of the face and eyes;

Examination for demodicosis of risk groups: employees of medical organizations (laboratory doctors of diagnostic laboratories, ophthalmologists, dermatologists and others), hairdressers, cosmetologists.

14.2. Anti-epidemic measures:

Carrying out disinfection from Demodex ticks of equipment, materials, work surfaces in hairdressing salons, beauty parlors and others;

Improvement of parks, squares, cemeteries, territories of health organizations, places of mass recreation and residence of the population;

Acaricidal treatment of the territories of parks, squares, cemeteries, health organizations, recreation centers, including domestic and farm animals;

Deratization measures to reduce the number of hosts for ticks (wild rodents) in the cleared areas;

Disinsection preventive (anti-epidemic) measures to reduce the number of blood-sucking insects, taking into account the results of entomological monitoring, including in places of formation of foci of vector-borne diseases (reservoirs near settlements and recreational areas, areas for walking and keeping dogs, in residential and non-residential premises and others) );

Treatment with broad-spectrum insecticides for dogs and cats;

Education of the population in methods of individual protection of humans and domestic animals from blood-sucking insects and ticks.

16.5. Measures to protect the environment from pollution by eggs and larvae of helminths, cysts (oocysts) of intestinal pathogenic protozoa include:

Improvement of settlements, farms, individual farms, recreation areas, areas for keeping and slaughtering livestock;

Maintaining the cleanliness of the territories of populated areas, livestock farms and complexes, farms and individual farms;

Collection, storage and disinfection of municipal solid waste;

Ensuring the disinfestation of sewage sludge generated at water treatment plants and sewage treatment plants before their disposal;

Avoiding the discharge of sewage and their sediments, livestock effluents, fan wastewater from river and sea transport into surface water bodies without continuous disinfestation (lack of viable helminth eggs and cysts of intestinal pathogenic protozoa) by industrial methods;

Use on agricultural fields for irrigation of sewage, their sludge and livestock effluents, disinfected (not containing viable helminth eggs and cysts of intestinal pathogenic protozoa) by industrial methods;

Cleaning of dwellings, industrial premises for the procurement, storage, dressing of skins, tailoring of fur products;

Disinfection of skins and fur products;

Cleaning of premises of preschool and school organizations;

Compliance with the regimes for keeping public and individual livestock, domestic animals, as well as closed animals.

Assessment of the epidemic situation on the spot with the determination of the scale and boundaries of the emergency for management decisions (on the first day after the elimination of the technical causes of the accident);

Evaluation of the results of laboratory tests;

Organization of disinfestation measures, including the use of ovicide preparations of biological inhibition-stimulation with a wide range of effectiveness for the treatment of large areas of contaminated areas;

Monitoring the incidence of the population living in the contaminated area for two years in the absence of registration of cases of diseases in the foci and microfoci of geohelminthiasis.

16.7. Measures for the disinfection of environmental objects.

16.7.1. Disinfestation of sewage (faeces).

16.7.2. Disinvasion of solid household waste.

Solid household waste is disinfected:

In biothermal chambers, at a temperature of 65 - 80 ° C, the death of helminth eggs occurs during exposure from 12 to 17 days;

In compost heaps with dimensions of 1.5 × 1.0 meters of arbitrary length; disinfestation terms from several months to 1.5 years;

Field composting in compost heaps 10-25 m long with a trapezoidal section with a base of 3-4 m, an upper side of 2-3 m, a height of 1.5-2 m, located on the soil surface or in trenches 0.5 m deep; self-heating temperature 50 - 60 °C, composting time 8 - 12 months;

Processing in bio-drums at 2000 rpm - for 2 days;

Incineration and pyrolysis (decomposition) in special engineering structures.

16.7.3. Disinvasion / deworming of wastewater.

Disinvasion / deworming of wastewater is carried out:

At aero-biostations;

At the facilities of artificial biological treatment (fields of subsoil irrigation);

On biological filters of sewage treatment facilities (post-treatment of wastewater in irrigation fields with a capacity of up to 100 m 3 / day);

On one-, two-, three-chamber septic tanks, filtering wells (for drainage, respectively, to the indicated septic tanks 1, 3, 15 m 3 / day of wastewater);

On septic tanks, storage tanks, filtration gravel filters.

For disinfestation of fan drains of river and sea transport vessels, the following are used:

dry closets;

Installations using active chlorine. The combined effect of a temperature of at least 50 ° C plus a dose of active chlorine 10 - 20 mg / l for 30 minutes;

Measures to discharge fan effluents after pumping from ships into the city sewer system (drainage stations).

Dry closets are used for the disinfection of railway transport effluents (biothermal treatment with a temperature in the biodegradation chamber of 35-40 ° C with an exposure of at least 4 hours; in a pasteurization chamber - 70 ° C with an exposure of at least 20 minutes).

Methods and modes of their use for the disinfestation of sewage

16.7.4. Disinvasion of sewage sludge.

Pasteurization in special engineering facilities at a temperature of 70 ° C for 20 minutes;

Processing in biodrums;

Incineration in special engineering structures (multi-ton or drum furnaces, suspended bed reactors, etc.);

Method of aerobic stabilization for 5 - 6 days with preliminary heating of a mixture of raw sludge with activated sludge at a temperature of 60 - 65 ° C for 1.5 hours;

Treatment with ovicides with biological stimulant inhibitors with a minimum dosage of 1 liter per 60 m 3 of sediment with a moisture content of more than 85%, after which no additional wastewater disinfection is required.

16.7.5. Disinvasion of liquid manure and manure.

For the purpose of disinfestation of liquid manure and manure runoff, the following is carried out:

Thermal treatment of liquid manure and silt fraction with a moisture content of 96 - 98% in a contact heating installation by supplying a high-temperature torch (over 1,200 °C), formed during the combustion of liquid or gaseous fuel, directly into the treated mass. Processing mode: exposure for at least 3 minutes, the temperature of the mass at the outlet of the installation is 48 - 50 °C. Efficiency is achieved by repeated mixing of the processed mass with compressed air in the zone of the thermal factor;

Thermal treatment of liquid manure and manure in a steam jet. Disinfection is provided in line mode at a mass temperature at the outlet of the installation of 80 °C and an exposure time of at least 5 minutes;

Treatment of liquid manure and silt fraction with liquid ammonia in a closed container at a concentration of 2 - 3%, exposure for 2 days, at an initial temperature of the mass of 10 ° C and above;

Treatment of liquid manure, manure runoff and sludge fraction with biological inhibition-stimulation preparations in accordance with the instructions for their use.

(Changed edition. Rev. No. 1)

Processing of surfaces, objects, materials, cleaning equipment in the premises for keeping animals is carried out using disinfectants.

16.7.6. Disinfestation of soil, sand.

Disinvasion of soil, sand at the first stage is achieved:

Treatment with herbicide-based products;

Treatment with means based on quaternary ammonium compounds;

Treatment with biological inhibition-stimulation drugs-ovicides;

Processing with table salt (1 kg per 1 m 2). It is used for disinfestation of the most contaminated soil areas from hookworm larvae once every 10 days;

Using a crop rotation system: first, the plot is sown with radishes, radishes, garlic, onions, after harvesting - secondarily with peas. The effect is also achieved with the simultaneous sowing of crops such as garlic - radish, onion - radish and some other families of legumes, lilies. The death of eggs occurs during two summer periods.

16.7.7. Disinfestation of vegetables, fruits, greens of the dining room.

To disinfect vegetables, fruits, table greens from helminth eggs, plant products are pre-soaked in water for 20-30 minutes before thorough rinsing in a colander under running water for 5-10 minutes with occasional shaking. Onions, parsley, lettuce are pre-cleaned from the soil, then sorted into individual leaves, stems, feathers. The effect is given by washing them in soapy water, followed by rinsing with running water. For berries with a rough surface or a lobed structure (strawberries, strawberries, raspberries), they are washed with a 1.0% soda solution, and then with clean water. A weak solution of iodine (0.2 - 0.5%) is used to disinfect vegetables from eggs and larvae of ascaris, whipworm, hookworm, strongylide.

16.7.8. Disinfestation of household items, toys, linen.

For disinfestation of bed linen, boiling and ironing on both sides is recommended. Woolen blankets, carpets, mattresses, plaids, curtains are processed with a vacuum cleaner (with subsequent dust neutralization using disinfectants approved for use), dried and shaken in the sun, ironed with a hot iron through rags. Dust from the containers of vacuum cleaners after neutralization is disposed of in the general sewerage system.

In areas with severe winters, household items and linen are taken out on frosty days, given that pinworm eggs die at a temperature of -15 ° C for 40 - 45 minutes.

Linen, toys and other things are disinfested in the disinfection chamber.

Disinfestation of soft toys and other objects with a rough surface is ensured by processing with a vacuum cleaner. Room surfaces, sinks, faucets, door handles, cellophane and rubber toys, etc., are disinfected by irrigation or wiping with approved products.

16.7.9. Disinfestation of drinking water.

Filtration (sand, diatomite, clinoptilite, titanium, metal-ceramic materials);

Sorption (charcoal, manganese oxide and others);

Use of ion exchange resins;

Use of the combined action of sorbents and ion-exchange resins;

At the second stage - treatment with ultraviolet rays with a strong oxidizing agent (hydrogen peroxide);

Ozonation;

Exposure to MIO radiation (powerful impulsive optical radiation);

The use of filter materials at water treatment plants with a pore size of at least 1 micron, which ensures the retention of cryptosporidium oocysts.

The treatment of sludge generated at wastewater treatment plants to be disposed of for the purpose of disinfestation is carried out with biological inhibition-stimulation preparations.

16.7.10. Disinfestation of skins of wild and domestic carnivores, fur and fur products.

For processing the skins of domestic and wild animals, the technological process that ensures the complete removal of teniid oncospheres should include primary processing, washing, soaking, rinsing, pickling, pickling, tanning, fatliquoring, drying (at a temperature of 30 - 33 ° C), broaching, hauling, shaking, breaking, grinding and re-shaking. The stage of hauling the skins with sawdust must be at least 9 hours with a frequency of replacement of sawdust 6 times a year. Workers involved in the primary processing of skins must work with gloves and respiratory protection.

Disinfection of skins and fur products from oncospheres teniid is provided by irradiation with a mercury-quartz lamp or other sources of ultraviolet radiation.

The premises are provided with sufficient water for sanitary and industrial needs. Floors, walls and equipment should be smooth and easy to clean. The walls of the premises and equipment are treated with boiling water or disinfectant, and the waste from the processing of skins is burned. Eating, storing food and smoking in these rooms is strictly prohibited.

16.7.11. Disinfestation of other environmental objects.

16.7.11.1. Containers with feces and sewage sludge during the working day are placed in enameled dishes, filled with a chlorine-active agent, followed by disinfection with agents recommended for use in accordance with sanitary rules.

16.7.11.2. Spent biological material is disinfected with drugs approved for use.

16.7.11.3. Used glass slides, pipettes, corks, test tubes, glass rods, chemical beakers and others are stored during the working day in containers with a disinfectant solution until they are completely vertically immersed. Final disinfection is carried out by boiling in water (from the moment of boiling for at least 30 minutes) with the addition of laundry soap or liquid detergent. Autoclaving is acceptable under appropriate conditions.

16.7.11.4. The effectiveness of disinfection and disinfestation of biological material, laboratory glassware, auxiliary and packaging materials is ensured in microwave devices for the disinfection of medical waste.

16.7.11.6. The working surfaces of laboratory tables are disinfected with 96% ethyl alcohol, followed by flaming.

16.7.11.7. Equipment (centrifuges, microscopes, refrigerators) is treated with 70% ethyl alcohol.

16.7.11.8. Overalls, towels, cleaning items are boiled in a 2.0% soap-soda solution or a 0.5% detergent solution.

16.7.11.9. Cleaning equipment (rags, brushes) is boiled or treated with disinfectants.

16.7.11.10. The current cleaning of laboratory premises is carried out daily by a wet method after the end of the working day: in the “clean” area of ​​the laboratory using detergents, in the “infectious” area using disinfectants. In the box rooms, a weekly general cleaning is carried out with the use of disinfectants. After wet cleaning, bactericidal lamps are switched on.

17.2. Hygienic education and training is carried out during professional hygienic training and certification of officials and employees of organizations whose activities are related to the production, storage, transportation and sale of food and drinking water, the upbringing and education of children, public utilities and consumer services.

The new SanPiN for pediculosis in 2016 defines the rules, the procedure for preventive measures, and the algorithm for processing pediculosis. The same document lists the rules for the prevention of scabies, the abdominal type, the distributors of which are lice. The SP on typhus and pediculosis and scabies is mandatory throughout the Russian Federation.

Key points

The news about the change in legislation on the prevention of lice instantly spread throughout Russia. Order - immediately read in order to know how to act in a given situation. Sanitary rules on describe the actions that health workers must take to prevent the epidemic of the disease and prevent:

• examinations of the population for prevention are carried out according to the approved, agreed in higher authorities plan
• all preschool educational institutions, kindergartens, orphanages, sanatoriums, rest homes, stationary organizations, the purpose of which is to ensure the maintenance of the child's health, are provided with washing, disinfestation, personal hygiene products;
• first-aid posts, other organizations that are engaged in disinfestation of premises, things, provide special equipment, machinery, means;

SanPiN for pediculosis is mandatory, requirements are taken into account new version law.

Signs of infection

The causative agents of infection are several:

Symptoms of pediculosis:

• severe itching provoked;
• discoloration of the skin, the appearance of spots, rashes;
• scratches on the skin;
• sores, wounds, inflamed scratches indicate the addition of a secondary infection;
• coarsened areas of the epidermis;
• hair, knocked down in tangles from pus, constant itching.

The order on pediculosis obliges medical workers to conduct routine examinations and take measures to eliminate lice.

Inspection procedure

Responsibility for conducting preventive examinations rests with medical worker. The results are entered in a special form, a number is put.

Pediculosis in preschool, school institutions

It is forbidden to attend a kindergarten, school for children who have been diagnosed with pediculosis. Immediately after the child is isolated. The teacher, the class teacher, the administration of the institution are notified about the situation. Inform parents.

The health worker is obliged to advise parents about the fast. Treatment is carried out at their own expense. It is allowed to visit an educational institution after a full recovery, with the provision of a supporting certificate.

If several infected children are found in a class or group, quarantine is declared. Maximum duration 30 days. During this time, a complete disinfestation of the premises, beds, furniture, bedding, prevention of re-infection is carried out. SES can extend the quarantine.

Parents have the right to write a complaint to the state sanitary and epidemiological service if the management of the institution, organization does not respond to the problem properly.

Fighting methods

The chemical method of control involves the use of preparations containing insecticides. Substances disrupt the functioning of the nervous system, provoke paralysis, quick death. It is allowed to process special head, things, clothes, premises.

Lice warning

Prevention of pediculosis consists in carrying out explanatory work among the leadership of organizations, teachers, and educators. Parents are required to monitor the condition of the child, check the head every week. If pediculosis is detected, take emergency measures to cure it. It is necessary for prevention:

• use your personal hygiene items, towels;
• it is forbidden to exchange clothes, combs, hats;
• be sure to wash your body every week;
• hygiene procedures every evening;
• change of bedding twice a month;
• pollution on clothes in public places is not allowed, according to the law;
• regular haircut, neat, neat hairstyle;
• cleaning the house for prevention using disinfectants containing bleach, or with the addition of vinegar.

Elementary rules of hygiene, behavior in public places will protect against infection, stop the outbreak of the disease.

Instructions for conducting are sent to each organization, educational institution, and enterprise. According to the decree, every new employee and child should be examined for prevention before being introduced into the team.

From 30.03.1999 N 52-FZ "On the sanitary and epidemiological well-being of the population" (Collected Legislation of the Russian Federation, 1999, N 14, art. 1650; 2002, N 1 (part 1), art. 2; 2003, N 2, 167; No. 27 (part 1), art. 2700; 2004, No. 35, art. 3607; 2005, No. 19, art. 1752; 2006, No. 1, art. 10; No. 52 (part 1) , item 5498; 2007, N 1 (part 1), item 21, item 29; N 27, item 3213; N 46, item 5554; N 49, item 6070; 2008, N 24, item 2801; N 29 (part 1), item 3418; N 30 (part 2), item 3616; N 44, item 4984; N 52 (part 1), item 6223; 2009, N 1 , item 17; 2010, N 40 item 4969; 2011, N 1, item 6; N 30 (part 1), item 4563, item 4590, item 4591, item 4596; N 50, item 7359; 2012, N 24, item 3069; N 26, item 3446; 2013, N 27, item 3477; N 30 (part 1), item 4079; N 48, item 6165; 2014, N 26 (part 1), article 3366, article 3377 and the Government of the Russian Federation dated July 24, 2000 N 554 "On approval of the Regulations on the State Sanitary and Epidemiological Service of the Russian Federation and the Regulations on the State Sanitary and Epidemiological Rationing" (Collection of Laws Government of the Russian Federation, 2000, N 31, art. 3295; 2004, N 8, art. 663; No. 47, art. 4666; 2005, N 39, art. 3953) I decree:

1.1. These sanitary and epidemiological rules and regulations (hereinafter referred to as the sanitary rules) have been developed in accordance with the legislation of the Russian Federation.

1.3. Compliance with sanitary and epidemiological rules is mandatory throughout the Russian Federation for state bodies, state authorities of the constituent entities of the Russian Federation, municipalities, officials of state bodies, officials of state authorities of the constituent entities of the Russian Federation, officials of local governments, citizens, individual entrepreneurs and legal entities.

1.4. Control over the implementation of these sanitary rules is carried out by bodies authorized to exercise federal state sanitary and epidemiological supervision in accordance with the legislation of the Russian Federation.

3.5. An operational epidemiological analysis is carried out in the condition of an epidemic rise in morbidity or the registration of epidemic foci of group morbidity. Epidemiological analysis includes constant monitoring of the dynamics of the incidence, taking into account a specific etiological agent, assessment of the sanitary and epidemiological situation, formulation of a preliminary and final epidemiological diagnosis with the establishment of the causes and conditions for an increase in the incidence or the formation of an epidemic focus.

3.6. According to epidemic indications (unscheduled) officials authorized to carry out federal state sanitary and epidemiological supervision, a decision is made on the frequency and volume of laboratory studies of soil, wastewater and their sediments, waters of surface water bodies that are used for recreation purposes and as sources of domestic and drinking water supply, waters of swimming pools, drinking water at various stages of water treatment.

Examination for helminthiases and intestinal protozooses is subject to: children attending preschool educational organizations; personnel of preschool educational organizations; elementary school students, children, adolescents, decreed and equated groups of the population during medical examinations and preventive examinations; children, adolescents according to epidemic indications; children and adolescents enrolled in preschool and other educational organizations, orphanages, orphanages, orphanages, boarding schools, sanatorium treatment, health organizations, children's departments of hospitals; children of all ages of children's organizations of a closed type and year-round stay, patients of children's and adult polyclinics and hospitals, persons who communicated with patients.

Causes of infection

Even one child infected with lice poses a serious danger to the entire group in kindergarten. There are several reasons for pediculosis. The main ways how lice are transmitted:

• direct contact - hugging, playing together or touching the head;
• the exchange of things, hats, as well as hair care items (combs, hairpins, hoops or elastic bands) contributes to the transfer of lice and their eggs to the child’s clean head;
• common bed - quite often during a quiet hour, children can toss and turn, lying on someone else's bed.

Types of lice

Prevention of pediculosis and typhus, measures taken in accordance with order 342 on the territory of the Russian Federation, as well as resolutions and orders of regional health services provide for the timing of regular examinations of the population and especially children in groups in order to identify cases of pediculosis.

Prevention of head lice and typhus Preventive measures include periodic examinations of children:

• in preschool institutions - 1 time per month;
• in schools and professional educational organizations - 4 times a year;

SanPin 2.4.1. 3049-13 are the sanitary and epidemiological requirements for preschool educational institutions.

Sanpin for kindergartens includes complete list requirements for organizations of preschool education:

• requirements for the placement of preschool educational institutions;
• conditions of maintenance and equipment of the territory;
• maintenance and equipment of internal premises;
• lighting of premises (natural and artificial);
• rules for the provision, equipment and repair of ventilation, heating, water supply and sewerage;
• conditions for the preparation and supply of food;
• admission of minors to the group;
• sleep and wakefulness;
• physical education;
• employee hygiene rules.

Most of the rules that are regulated by SanPiN are mandatory. However, some of them are recommended for use or apply to kindergartens built or reconstructed after 2013.

In Moscow, SanPiN should be posted on the official websites of each organization.

In the prevention of infection with helminths, it is the prevention of enterobiasis that plays a huge role. Prevention measures are necessary, since pinworm infestation causes a violation of metabolic processes in a person, anemia, and complications in work. internal organs, vitamin deficiency and a number of unpleasant symptoms.

A pinworm prevention plan is especially necessary in kindergarten and school, as children are constantly re-infected with pinworms, and unknowingly pass helminth eggs to other babies with dirty hands, which leads to mass infestation.

Pediculosis in childhood is a common problem, because they are in constant contact with each other.

It is believed that the disease occurs against the background of dirt. But actually it is not. The disease can occur both in orphans and in children of high status.

What are the first signs of pediculosis and how to deal with this pathology?

Lice spread at an incredible rate in crowded places, so it only takes one child to contract the disease and an entire epidemic can be triggered. For this reason, there is a clearly approved prevention of pediculosis sanpin for kindergartens and schools.

Pediculosis is most often diagnosed in children, as they are in close contact with each other and cannot take proper precautions on their own. Responsibility for the health of the child lies with the parents and, to a certain extent, with the administration of kindergartens and schools.

Lice cause great discomfort to children, so their symptoms are very pronounced. The kid practically does not stop scratching the affected areas and thereby contributes to a faster reproduction of insects.

The greatest danger of the disease lies in the fact that infection of a healthy child occurs almost immediately after contact with an infected one. It is for this reason that teachers and educators should pay attention to each pupil on a daily basis, and in case of suspicion of infestation with lice, immediately take appropriate measures.

At the same time, the prevention of pediculosis in children in kindergarten and schools should be carried out strictly according to the previously developed and approved plan.

Prevention of lice in kindergarten is carried out by the administration forcibly, according to the law of the Ministry of Health (MoH) number 342 "on the prevention of pediculosis and typhus."

Signs of infection

Symptoms of pediculosis:

• severe itching provoked by lice bites;
• discoloration of the skin, the appearance of spots, rashes;
• scratches on the skin;
• sores, wounds, inflamed scratches indicate the addition of a secondary infection;
• coarsened areas of the epidermis;
• hair, knocked down in tangles from pus, constant itching.

The order on pediculosis obliges medical workers to conduct routine examinations and take measures to eliminate lice.

Symptoms of pediculosis

Scabies is a serious skin disease. The incubation or asymptomatic period lasts 2-7 days. You can recognize the disease yourself, as the disease proceeds with characteristic symptoms. Consider the clinical manifestations of scabies:

Consider a population group that is required to be examined for lice and scabies:

1. Children in kindergartens are examined monthly.
2. Students of professional institutions are examined 4 times in 12 months.
3. Children of boarding schools and children who go on vacation to camps, sanatoriums and so on.
4. In camps and sanatoriums, the population is examined weekly.
5. Patients admitted to hospital for treatment.
6. Outpatients.
7. Preventive examinations of employees of organizations.

If lice or scabies mites are detected, all things and clothing of the personnel who carried out the treatment are sent for disinfection for disinfection. attend preschool educational institution, work or school is prohibited. Only upon receipt of a certificate from a physician that he does not have a disease, a person can return to the team.

Let's consider the algorithm of actions, which, according to the sanpin, should be carried out by doctors. During a preventive examination, the doctor must comply with the standards, because lice is an unacceptable phenomenon, mass infection is possible. If lice are found in a student, according to Sanpin, he cannot attend an educational institution until he recovers. Moreover, recovery is confirmed by a special certificate from a doctor. Only after that the child can return to the team.

The main signs of damage to the head of a child with lice are:

• lice bites cause severe itching;
• the presence of wounds and scratches in places of damage to the skin;
• upon careful examination, you can find not only insect eggs (nits), but also the lice themselves.

How lice and nits look on the hair is clearly demonstrated by the photo.

Having found the symptoms of pediculosis in a child, caregivers should immediately take appropriate measures.

Appendix N 3. Serological methods for diagnosing an epidemic
typhus and Brill's disease (Brill-Zinsser) (Methodological
directions)

Appendix N 2 to the order of the Ministry of Health of the Russian Federation dated November 26, 1998 N 342

1) initial period -
the first 4-5 days of illness from the onset of fever to
the appearance of a characteristic rash;

2) the period of the peak of the disease
- lasts 4 to 8 days from the onset of the rash to the end
feverish state;

3) recovery period -
from the beginning of the drop in temperature and lasts until the complete disappearance of all
clinical manifestations of the disease. INITIAL PERIOD.
No prodromal events, sometimes at the end of incubation
slight headache, body aches,
chilling. The disease is usually
begins acutely with an increase in temperature to high numbers, the appearance
feelings of heat, weakness, sometimes slight chilliness and possible
sweating, dizziness, headache, aches all over the body,
thirst and loss of appetite.

All these phenomena are progressively increasing,
especially the headache, which from the first days becomes
painful. Body temperature rises by 2-3 days of illness and
is set within 38.5-40.5 degrees C and even higher (sometimes it
reaches its maximum value by the end of the first day).
further fever is permanent, less often - remitting
(with a slight decrease on the 4th, 8th and 12th day of illness).
Insomnia, pain in the muscles, joints of the arms and legs,
sharpness of perception, irritability and anxiety,
turning into a state of euphoria and excitement, as a result of which
the first 1-2 days patients can remain on their feet.

Sometimes instead
euphoria is a state of lethargy. May be repeated
vomiting. Objectively detected
severe hyperemia of the face, conjunctiva (scleritis, "rabbit eyes",
"red eyes on a red face"), skin of the neck and upper part
trunk, slight amimia, puffiness of the face, moderate cyanosis of the lips.
The skin is hot to the touch, increased moisture, a positive symptom
pinch. Possible herpetic eruptions on the lips and skin of the nose. Language
dryish and lined with white bloom.

These phenomena are progressing
during the first 2-3 days.
3 days of the disease, you can observe the symptom of Chiari-Avtsyn, i.e.
conjunctival rash located on transitional folds
conjunctiva in the form of single petechiae, as well as enanthema on the soft
sky (Rosenberg's symptom), which precedes the appearance
exanthema. Moderate tachycardia and muffled tones are noted
heart, hypotension, moderate shortness of breath. There is a tremor of the tongue
(symptom of Govorov-Godelier).

Sometimes patients have little
pronounced general trembling syndrome. Percussion is determined
enlargement of the liver and spleen. From the first days it can be observed
initial delirium, which often manifests itself at the height of the disease.
The peak of the disease occurs on the 4-5th day of the disease from the appearance
profuse roseolous-petechial rash. The first elements of the rash
appear behind the ears, lateral surfaces of the neck, followed by
spread to the skin of the lateral surfaces of the trunk, chest,
abdomen, flexor surfaces of the arms and internal surfaces
hips.

The dimensions of the elements are usually no more than 3 mm. There are primary
petechiae - on unchanged skin and secondary - in the center of roseola.
Sometimes the rash can be found on the palmar surface and almost
there is never a rash on the face. Roseola and petechiae are located
intradermally, so they appear flat and blurry, with
jagged edges, the elements of the rash do not merge. Dotted petechiae
can be detected using the tourniquet phenomenon even from the 3rd day of illness.
The elements of the rash within 3-5 days are pink, bright red or
somewhat cyanotic color, after which the roseolas turn pale, and
petechiae become pigmented.

7-9 days from start
rash disappears, leaving a fuzzy
pigmentation. New rashes, as a rule, do not happen, in severe
cases, there may be a hemorrhagic rash, which is
poor prognostic sign.
in rare cases, the rash may be only roseolous or
roseolous-papular or completely absent. More
the symptom of pinching, Chiari-Avtsyn spots and
enanthema, as well as disorders of the vascular apparatus and
central nervous system.

Significantly enhanced
headache and insomnia, increasing weakness, typhoid status.
Possible infectious delirium with hallucinations and delusions. Characteristic
agitation of the patient, anxiety, fussiness. Sometimes sick
behave aggressively, jump out of bed, try to run.
Infectious psychoses and delusions sometimes acquire a systematized
character, often reflecting professional activity or
everyday negative situations (delusions of jealousy).

May be observed
moderate meningeal symptoms, with mild pleocytosis and
mild stiff neck muscles, Kernig's symptoms and
Brudzinsky. There is a clearer symptomatology of the lesion
some cranial nerves - slight flattening of one of the
nasolabial folds; puffiness of the face and trembling of the tongue are typical,
sometimes deviation (deviation to the side), the patient shows the tongue
jerks "symptom of stumbling tongue over teeth", hyperesthesia is noted
skin.

Almost all patients in
more or less pronounced general tremor, there may be
hearing loss, polyneuritis.
circulation. The pulse is frequent, weak filling and tension,
sometimes filiform, arrhythmic. Blood pressure drops
diastolic pressure decreases especially sharply. Heart borders
dilated, heart sounds become muffled, auscultated
systolic murmur at the apex. The ECG shows signs
diffuse myocarditis: a decrease in the total voltage of the teeth, lengthening
PQ interval, widening and serration of the QRS complex, flattened
or negative T wave, atrial or ventricular
extrasystoles, high systolic rate.

At this time it may
collapse develops: the patient is in prostration, the skin is covered with cold
then, the lips are cyanotic, breathing is frequent, shallow, the pulse is frequent and
thready, diastolic blood pressure is low or not
determined, heart sounds are not audible. From the organs
breathing is almost always recorded shortness of breath. At the height of illness
tracheobronchitis and focal pneumonia come to light. Appetite significantly
reduced or completely absent, thirst is very disturbing.

Language
dry, neo-edematous, lined with a thick gray-dirty coating, may
take on a brown color, often deep cracks appear. Stomach
normal form, the liver and spleen are enlarged in most patients,
stool retention, flatulence are noted. Diuresis is reduced, but
increases mainly simultaneously with "temperature crises", in
some patients have paradoxical ischuria, when
urination occurs in drops when the bladder is full,
in seriously ill patients, involuntary urination is possible.

in the urine
find protein, single granular and hyaline cylinders,
erythrocytes and leukocytes (in a small amount).
the initial period of the disease, from 3-5 days, and during the peak of the disease
thrombocytopenia, moderate leukocytosis, or a tendency to
him, a neutrophil reaction, often with some stab
shift, eosinopenia, lymphopenia, ESR acceleration. peak period
illness lasts 8-12 days in untreated cases. During
convalescence, blood normalizes, passing through the stage
postinfectious lymphocytosis.

RECOVERY PERIOD.
The first signs of recovery are a decrease in temperature
accelerated lysis or crisis, which is normalized during
2-3 days, which is accompanied by a decrease in intoxication and
respectively typhoid status (enlightenment of consciousness) and
signs of delirium. Symptoms - harbingers of a decrease in fever
are blanching or extinction of the roseolous elements of the rash.
3-5 days of normal temperature, the pulse rate and
respiration, the size of the liver and spleen are reduced to normal,
normal blood pressure is restored.

However, despite
improvement in the general condition of patients, moderate adynamia is noted
and weakness, hyperesthesia of the skin persists. These phenomena keep 7-8
days.In
during the recovery period, mental asthenia can be observed with
manifestations of nervousness, capriciousness, tearfulness, easy
excitability. Memory and logic remain reduced for a long time, associations
superficial, speech is often slow, words are selected with difficulty. On the 12th day of normal
temperature, in the absence of complications, patients may be
discharged.

Full recovery occurs about a month after
temperature normalization. Muscle weakness persists 2-3
months. CLINICAL FORMS
TIFA. The disease can occur in the lungs (in 10-20% of patients), most
typical moderate (in 60-65% of patients), severe (in 10-15%
patients) and very severe forms (fulminant typhus). With a mild form
temperature usually does not exceed 38.5 degrees. C, intoxication phenomena
insignificant, the typhoid state is always absent, consciousness is not
changed or patients are somewhat inhibited, headache and
insomnia is moderate.

A roseolous rash predominates, with a slight
the number of petechiae. The liver and spleen are enlarged in about a third
sick. The fever lasts up to 9 days and only sometimes 10-12 days.
The sick always get well. Easy flow is characteristic of persons
young age and especially children. Moderate form
most typical in terms of severity of symptoms and
occurs in most patients. The phenomena of intoxication are bright
expressed. The temperature rise reaches 39.5 degrees. FROM.

Often
typhoid status, hallucinations and delirium are recorded. Liver and
spleen enlarged. The feverish period lasts an average of 12-14
days. Severe form
characterized by a more intense development of symptoms, especially
vascular and cerebral, due to significant intoxication. Pulse
frequent - up to 140 beats per 1 min. (ahead of temperature).
Blood pressure drops to 70-80 mm Hg. Heart sounds are muffled
observed acrocyanosis, tachypnea, possible pathological rhythms
breathing.

In addition to the early onset of sharp excitement,
typhoid delirium, which are quickly replaced by inhibitory
reaction, meningeal syndrome can be noted up to the appearance
convulsions, swallowing disorders, dysarthria, etc. Body temperature
reaches 40-41.5 degrees. C. The rash is predominantly petechial, with
possible true hemorrhages, which is threatening
sign. Possible hemorrhage in the adrenal glands with the development
infectious-toxic shock.

With a very severe form
(fulminant typhus) due to severe intoxication and changes in
adrenal glands, patients die with symptoms of infectious-toxic
shock. Severe and very severe course is more common in the elderly
people. Sometimes there are
atypical forms of the disease, when certain symptoms are absent or
appear in a form uncharacteristic of typhus. Similar forms
may result from early use of antibiotics. RECURRENT TYPHUS OR
BRILL'S DISEASE (BRILL-ZINSSER) is an acute cyclic infectious
a disease that manifests itself after many years in people who have been ill
epidemic typhus, characterized by a milder course
and a typical clinical symptom complex.

The recurrent nature of this
disease is proven by the isolation of rickettsia from the lymphatic tissue
deceased with a history of previous epidemic
typhus. Pathogenesis and clinical
the picture in Brill's disease is the same as in epidemic rash
typhoid, but relatively less pronounced rickettsial
intoxication. Like epidemic
typhus, Brill's disease begins acutely with the appearance of a feeling
fever, sometimes with slight chilliness, weakness, headache,
insomnia, loss of appetite.

These phenomena increase within 2-3
days when patients are still on their feet. Headache from the first
days becomes almost always very strong and painful.
Persistent insomnia is characteristic. The temperature reaches
maximum by 4-5 days of illness (39-40.5 degrees C). Average duration
febrile period of 8-10 days. From the first days of illness usually
hyperemia and puffiness of the face, hyperemia of the neck and upper
third of the body, moderate cyanosis of the lips, positive pinching sign,
Chiari-Avtsyn symptom, enanthema on slightly hyperemic mucosa
soft palate.

At
most patients have abundant typical
roseolous-petechial rash, roseolas may be larger,
than with typhus, roseolous-papular elements are also observed;
petechial elements may be scarce or even absent.
The rash persists for 3-7 days. Shortness of breath is observed, but
more often breathing corresponds to temperature. Often noted
tachycardia and hypotension. Heart sounds are muffled, sometimes significantly,
systolic murmur may be heard.

Phenomena come to light
myocarditis. Appetite is reduced or absent, the tongue is lined. Liver and
the spleen is moderately enlarged. Often there is oliguria, occasionally -
paradoxical ischuria. There is a slight albuminuria. Serious mental
disturbances are rare, but there may be euphoria and agitation
sick or lethargic, moderate delirium, sometimes
depersonalization, motor excitation to one degree or another
frequently noted.

Possible general tremor (trembling of the lips and
limbs, especially fingers, slight dysarthria),
slight flattening of the nasolabial folds, deviation of the tongue, symptom
Govorova-Godelier, symptoms of meningism. One or more of these
symptoms, more often Govorov-Godelier symptom and skin hyperesthesia,
appear already on the 3-4th day of illness. Often there is neuritis
auditory nerve. Severe course occurs only in the elderly
persons. Changes from
of the cardiovascular system disappear by 5-7 days of normal
temperature.

convalescence
proceeds easier and shorter than with epidemic typhus.
Cardiovascular activity is restored by 5-7 days
normal temperature and only in some patients in later
terms observed post-infectious myocarditis. Recovery
functions of the central nervous system occurs by 15-17 days
normal temperature. The size of the liver and spleen normalize to
3-4 days of the convalescence period (temperature normalization).

With uncontrolled
very early start of antibiotic therapy (1-2 days of illness) are possible
early relapses of typhus.
conditions of lice, patients with Brill's disease may be
source of diseases with epidemic typhus. COMPLICATIONS occur when
late initiation of treatment and poor patient care. Possible development
collapse, thrombosis, thromboembolism, rupture of cerebral vessels, with
phenomena of paresis and even paralysis, intestinal bleeding,
myocarditis, heart attack, psychosis of the convalescence period and more
late, polyradiculoneuritis, lesions of the nuclei of the cranial
nerves, as well as secondary pneumonia, otitis and parotitis, abscesses,
furunculosis, pyelitis, pyelocystitis.

The use of antibiotics is abrupt
reduces the possibility of complications. DIAGNOSTICS OF TYPE.
In the initial period of the disease, up to 6-7 days, typhus can
be diagnosed only clinically. Laboratory
diagnosis is confirmed using
highly sensitive serological tests (RSK and RNGA with
Rickettsia Provacek), which become positive not earlier than
8-10 days of illness. The complement fixation reaction (CFR) is
one of the most commonly used for recognition as a clinical
expressed cases, and erased forms of typhus infection.

Complement-fixing antibodies are detected from the 5-7th day of illness in
50-60%, and from day 10 - in 100% of patients with typhus. Maximum
antibody titers (1:320-1:5120) are recorded at 2-3 weeks of illness.
The diagnostic titer in a single determination should be considered
1:160. The determination of antibodies in dynamics is considered more reliable.
(5-7 days after the previous study). For
retrospective diagnosis of typhus by diagnostic titers
are 1:10-1:20, since complement-fixing antibodies to
Provachek's rickettsiae last up to 10 years or more.

Reaction indirect
hemagglutination (RNHA) makes it possible to diagnose fresh
cases of typhus, it is positive in most patients since
3-5 days of illness. Maximum antibody titers (1:6400-1:12800)
registered on the 2-3rd week of illness. Diagnostic titer at
single determination in RNGA - 1:1000. More reliable is
determination of antibodies in dynamics. The simplest reaction
agglutination (RA), but it is rarely used, since less
more sensitive than RSK and RNGA: diagnostic titer of the reaction -
1:160.

It is highly sensitive when using the antigen obtained
from rickettsia grown in lice (Weigl reaction). To detect
specific antibodies against rickettsia can be used
indirect immunofluorescence reaction (RNIF), enzyme-linked immunosorbent assay
(IFA). To detect rickettsia antigens, Provacheka can
apply polymerase chain reaction(PCR). With primary typhus
antibodies of the IgM class are detected, and in Brill's disease - IgG class.

Cysteine ​​is used to differentiate between IgM and IgG antibodies.
sample or sample with 2-mercaptoethanol. DIFFERENTIAL DIAGNOSIS.
In the initial period, typhus must be differentiated from
influenza, focal pneumonia, meningitis, hemorrhagic
fevers, and in the midst of the disease - with typhoid fever and paratyphoid fever,
tick-borne typhus, drug disease, trichinosis,
various erythema, ornithosis, etc. Despite the presence
similar complaints and some objective data (hyperemia of the face, neck and
conjunctiva, tachycardia), FLU has a more acute onset
(the patient calls not only the day, but also the hour of the onset of the disease), a sharp
weakness developing on the first day of illness, the presence of
constant profuse sweating, lack of puffiness of the face and
its amimia, as well as the symptom of Govorov-Godelier.

Doesn't happen with the flu
rash and enlargement of the spleen. Headache is usually located in
forehead, superciliary arches and temporal areas, pain is characteristic
when pressing on the eyeballs and when moving them. With rash
typhoid there is no catarrhal syndrome (rhinitis, tracheitis, bronchitis).
typhoid fever with LOCAL PNEUMONIA is carried out taking into account the characteristics
respiration, physical data, divergence of the wings of the nose during breathing,
cough, moderate sweating, possible pain in the area
chest, absence of rash, Chiari-Avtsyn symptom, lesions symptoms
central nervous system and radiological data.

MENINGITIS
differentiated from typhus by the presence of severe
meningeal syndrome (neck muscle stiffness, positive
Kernig and Brudzinski symptoms). The key to diagnosis is
analysis of cerebrospinal fluid.
FEVER, especially with renal syndrome, hyperemia is more pronounced
face and conjunctiva, the rash is in the nature of mild pinpoint
hemorrhages, more often detected on the lateral surfaces of the trunk and
axillary areas.

Characterized by vomiting, hiccups, back pain and
abdomen, thirst and oliguria are typical. Erythrocytosis is seen
normal or accelerated ESR, increased residual blood nitrogen,
hematuria, albuminuria, cylindruria. With TYPHUS
pallor of the skin of the face, general adynamia and
lethargy. The tongue is flattened, lined, with imprints of teeth along the edges and on
tip. Often marked bradycardia with dyscrotic pulse. Common
flatulence and rumbling in the right iliac region, later
enlargement of the liver and spleen.

Rash scanty roseolous, appears
not earlier than 8 days of illness on the chest, abdomen and lateral surfaces
torso, followed by sprinkling. In the blood, leukopenia with
eosinopenia, stab shift with relative lymphocytosis,
thrombocytopenia.
typhus and tick-borne typhus found in regions of Siberia and
Far East, is based on characteristic symptoms: the presence of
most patients with primary affect at the site of a tick bite,
which is a dense infiltrate of brown or brown
colors up to 1.5 cm in diameter with possible necrosis in the center,
regional lymphadenitis, developing almost simultaneously with
primary affect.

Roseolous-papular rash in this disease
bright, distributed throughout the body, appears early - for 2-4 days
diseases. Allergic form
DRUG DISEASE arising from the treatment with sulfonamides and
antibiotics for various diseases accompanied by acute
fevers (flu, pneumonia, etc.), often mixed with rash
typhus, especially when a rash appears on the 4-5th day of illness. However
elements of the rash are more often of an exudative nature, sometimes
roseolous-papular, protrude above the surface of the skin, very
abundant in all parts of the body, but more on the extensor
joint surfaces tend to merge.

noted
lymphadenopathy, the spleen is usually not enlarged. In
The clinical picture of TRICHINELLOSIS is characterized by swelling of the face and eyelids,
headache and pain in all muscle groups during movement and palpation,
moderate conjunctivitis, soreness with eye movement. Rash
profuse, may be roseolous-papular, urtical and even
petechial. Spills are possible. Hypereosinophilia is typical. AT
history - an indication of eating raw pork and
group morbidity.

Various erythemas -
exudative and multiforme - differ from typhus in that
the rash covers the whole body, including the face.
Erythematous-exudative elements are usually large and often
merge with each other. Increased peripheral lymphatic
nodes and spleen. Sweating and chills are pronounced. Typical pain in
joints. Erythema multiforme is characterized by symmetry
location of the rash. After flowering, peeling is noted. TREATMENT.

sick
typhus are subject to mandatory hospitalization. Treatment of the sick
should be complex - etiotropic, pathogenetic and
symptomatic with proper care. Etiotropic treatment
carried out with the help of tetracycline drugs
(tetracycline, oxytetracycline, doxycycline) and chloramphenicol.
Tetracycline drugs are prescribed at 0.3-0.4 g, and levomycetin -
0.5 g 4 times a day for adults (medication is prescribed for children
according to age).

It has been shown that a single dose of 100 mg
doxycycline ensured the interruption of the course of typhus. Patients who
oral administration of the drug is difficult, parenteral
the introduction of the same drugs in the indicated doses and schemes. With severe
and very severe disease, tetracyclines can be administered
intramuscularly or intravenously, 250 mg 2 times a day. When treated with antibiotics
the temperature returns to normal in 1.5-2 days and therefore usually from 3
days of normal temperature they are canceled, and only when
secondary complications, treatment can be delayed for several days.

The duration of the course of treatment is usually 4-5 days. Pathogenetic therapy
includes intravenous administration of detoxification solutions (5%
glucose solution or isotonic sodium chloride solution, 500-600
ml). Oxygen therapy is used (oxygen is administered through nasal
catheters or masks). In case of circulatory disorders, cardiac
and vascular agents (camphor, cordiamine, norepinephrine, ephedrine,
mezaton, as well as corglicon and strophanthin), which are prescribed according to
testimony.

In case of severe excitation of patients and delirium
bromides, chloral hydrate, chlorpromazine, barbiturates, seduxen and
other tranquilizers. Rubbing has a calming effect
warm water (37-38.5 degrees C). For severe and very severe
diseases are intensively treated using
antibiotics, with infectious-toxic shock, hormones are indicated
(prednisolone, dexamethasone) in short courses.
bromides, barbiturates, chlorpromazine, haloperidol or sodium oxybutyrate.

Signs of infection

Typhus or rickettsiosis is a serious infectious disease in which destructive changes in blood vessels and the development of generalized thrombovasculitis occur. The symptoms of this disease are:

• fever and temperature;
• intoxication of the body;
• roseolous-petechial rash.

The disease often causes complications; special laboratory tests are carried out to confirm the diagnosis. Treatment is with antibiotics.

Brill's disease is a recurrence or exacerbation of previous typhus, and it can manifest itself without infection with pediculosis. Its causative agent is able to persist for a long time in the body of people who have previously had typhus.

The 342nd number of the order on pediculosis contains, as an appendix, methodological instructions on how to properly carry out activities in the focus of the epidemic in case of mass infection of people with typhus or Brill's disease. The main points of these instructions are:

fever and temperature;

intoxication of the body;

roseolous-petechial rash.

Recommendations for doctors and health care workers of medical institutions on the timely detection of patients with typhoid or those who are suspected of having this disease.

It is obligatory to submit monthly and yearly reports on morbidity statistics.

When a focus of the epidemic is detected in the area of ​​residence, rest and work of the patient, mandatory disinfection of the premises is carried out, and all places where the patient has been over the past 21 days (incubation period) are taken into account.

The contacts of the sick person, the belonging of his belongings are identified, and he himself is subject to hospitalization in a local infectious diseases hospital for examination and treatment.

When pediculosis is detected, special therapeutic and disinsection measures are carried out.

All things must be processed in a disinfection chamber;

Blood tests are taken from all people who have been in contact with the patient, serological diagnostics are carried out in a special laboratory to identify the sick, and in the future it is necessary to monitor their condition.

All data are entered into the focus epidemiological examination card, which then passes registration and registration in a special body dealing with especially dangerous infections of the State Sanitary and Epidemiological Surveillance in this region of Russia.

Pediculosis treatment

Three methods are used to kill lice: mechanical, physical and chemical.

With a slight defeat of people with head lice, a mechanical method is used: insects and their eggs are combed out with a fine comb; cut or shave off hair. An oilcloth or paper is placed to collect the hair, which is then burned along with the hair and insects. Before combing out the nits, the head is washed, rinsed with a warm 4.5% aqueous solution of table vinegar or a warm 5-10% solution of acetic acid. Nits are combed with a fine comb, through the teeth of which a cotton flagellum or thread is passed, abundantly moistened with vinegar.

The physical method is recommended mainly against body lice and consists in the destruction of insects by exposure to high or low temperatures. In practice, boiling clothes and ironing clothes with a hot iron are used. Things that cannot be washed are processed in steam-air-formalin, steam and combined disinfection, as well as in air disinfestation chambers.

The chemical method is based on the use of pediculicides.

In the treatment of head lice, the scalp is treated with a pediculicide in accordance with the instructions for its use. After the end of the procedure, the pediculicide is washed off the treated parts of the body with warm running water and soap. The hair is rinsed with a 4.5–5% solution of acetic acid and combed with a fine comb to remove dead insects and nits. The consumption rate of the product can be from 10 to 60 ml or more, depending on the infestation with insects, the length and thickness of the hair.

The most stringent requirements are imposed on pediculicides, which are applied directly to human skin in the treatment of head and pubic lice. They must belong to class 4 of low-hazard substances, according to the Hazard Classification of substances according to the degree of impact on the body (Appendix 2 to Guidelines“Toxicity and hazard assessment of disinfectants. MU 1.2.1105-02, approved. Chief State Sanitary Doctor of the Russian Federation 10.02.1002).

To prevent the occurrence of pediculosis and its spread in the family and the team, it is necessary to carry out hygiene measures. These include: regular body washing; change and washing of underwear and bed linen at least once every 7-10 days or as it gets dirty; regular haircut, daily combing of hair with an individual comb; systematic cleaning of clothes, bedding and their neat maintenance; regular cleaning of the premises and keeping the furnishings clean (clause 4.1 of Appendix 4 to Order No. 342).

What disinfection measures are carried out in the focus of pediculosis?

Head of the Department of Maternal and Child Health D.I. Zelinskaya

Appendix 1 to the order of the head of the Department of Health of the city of Moscow dated September 26, 2005 N 383

1.1. Identification of patients with scabies during treatment and provision of medical care, during preventive, planned, upon admission to work and periodic examinations and other examinations in in due course.

If available in staffing medical institution of the position of a dermatovenereologist, this work is carried out by him, and information about the identified patients is transferred to the ATC at their place of residence. Information about the patient (suspicious) is recorded in the register of infectious diseases in the form N 060 / u. , suspicion of it (Emergency notification of an infectious disease, food, acute occupational poisoning, unusual reaction to vaccination) (form N 058 / y) are sent to the ATC at the location of the medical institution (place of treatment and identification of the patient) or at the place of residence of the patient (in case of his discharge).

2. The diagnosis of scabies is made on the basis of a set of clinical and epidemiological data, necessarily confirmed by laboratory tests for the presence of scabies mites. Laboratory tests for the presence of scabies mite are carried out for each patient (suspicious) with scabies.

3. All identified patients are treated in the prescribed manner (treatment of patients in one focus is carried out simultaneously), as well as a single prophylactic treatment with one of the anti-scabies drugs for all healthy individuals in family foci and invasive-contact in organized groups, including sexual partners outside the focus .

4. Suspended from work with registration and issuance of a certificate of incapacity for work for the period of treatment with the payment of social insurance benefits in accordance with the legislation of the Russian Federation to decreed contingents in the prescribed manner. The issue of admission to work is decided by the attending physician, depending on the dynamics of the disease and the working conditions of the patient.

5. The patient is sent for treatment to a dermatovenereological hospital or scabiozorium: - if the patient has a mental, neurological or other disease, due to which the patient, in the absence of a person caring for him, cannot independently fully fulfill all the necessary appointments; - in the absence of the possibility of isolating the patient ( for example, in the case of scabies in a person living in a hostel, boarding school, etc.). Treatment of the patient in all other cases is carried out in outpatient facilities (at home).

The exception is persons who are inpatient treatment in somatic hospitals, if for health reasons they cannot be sent to the ARC and scabiozoria. who are unable to carry out treatment themselves, they are sent to the city scabiozorium of the disinfection station N 2 of the Moscow City Disinfection Center (Izhorskaya st., 21, tel. 485-40-34).

6. Ensure timely submission of applications for final disinfection in scabies foci to the territorial disinfection stations of the Moscow City Disinfection Center (Appendix 2 to this Order), as well as monthly reconciliation of the incidence of scabies with the territorial disinfection stations of the Moscow City Disinfection Center.

7. Carry out examinations for scabies: - children living in orphanages, orphanages, students of boarding schools - weekly; - children re-entering educational institutions or returning after a long (more than a week) absence; - children traveling to health organizations , camps - in the clinic at the place of residence before leaving, and in places of rest - weekly before bathing and 1-3 days before returning; - students of general and vocational education- quarterly after the holidays and monthly selectively (4-5 groups), as well as before the end of the academic year;

8.1. Mandatory examination and referral for treatment in case of detection of scabies of all family members of patients, persons who communicated with them, including sexual partners in the family and outside the family.

8.2. Carrying out treatment for identified patients in the family focus of scabies, prescribing healthy prophylactic treatment with one of the anti-scabies drugs.

8.3. Treatment of patients and treatment of healthy people are carried out simultaneously. The control of cure is carried out after the course of treatment and after two weeks.

8.4. The attending physician instructs the family on the timing of washing the patient, washing and changing bed and underwear, and cleaning the premises in compliance with a certain technology (see Appendix 2 to this order).

9.1. If scabies is detected in schoolchildren and children, they are suspended from attending educational institution for the duration of the treatment and are sent for treatment to the KVD at the place of residence.

Therapy

There are a sufficient number of drugs to combat lice. The main methods of treatment are selected depending on the type of pathogen. If the invasion is not strong, doctors recommend combing lice and eggs with special combs, you can cut your hair along with insects. In this case, the human hairline is burned.

Against lice that live in bed and on the things of patients, doctors recommend boiling all things, then ironing them on both sides. If such processing is not possible, it is required to take them to a special organization.

As part of the styling, the following tools are effective:

• acetic solution;
• 20% benzyl benzoate emulsion;
• pyrethrum powder;
• 5% boric ointment;
• 0.15% solution of karbofos;
• dust or tar soap;
• Medifox;
• lotion "Nitilon", "Loncid", "Nittifor".

For things:

• soda ash;
• "Medifox-Super";
• 50% concentrate of sulfidos, karbofos;
• pyrethrum powder;
• 20% water-kerosene-soap emulsion.

The solution is sprayed over the entire length of the hair. After that, the child's head is covered with a plastic cap or bag and left in this state for the time indicated in the description (its duration depends on the brand of the product). Then the hair is washed using a daily shampoo, and dead lice and nits are removed from the hair with a special comb.

Pediculicidal shampoo is the safest remedy, which is often used for preventive purposes. To protect yourself from the epidemic of pediculosis, it is enough for them to regularly wash their hair not only for the child, but for all family members.

Useful tips on what to do if there is pediculosis in the kindergarten are presented in this video.

The use of anti-pediculosis styling

According to the Pediculosis Order No. 342, the anti-pediculosis styling is recommended to be used as follows:

• The person carrying out the treatment must wear a gown, a protective scarf and gloves.
• The patient is wrapped in oilcloth.
• The eyes of the sick person are protected with a towel folded in several layers to protect against the ingress of drugs.
• Carefully treat the patient's hair with a remedy, then cover his head with a cap for the time indicated in the instructions for the drug.
• After treatment, the hair must be rinsed under running water.
• Next - the use of shampoo, which is part of the styling.
• After the hair is dried, each strand should be combed out with a rare comb for eggs, dead lice.
• Re-examination of the patient for the success of the procedure.
• Treatment of the comb with alcohol or boiling water.
• Treatment of the premises with a disinfectant composition.
• The patient's things are put into a special bag for their further disinfection.
• The dressing gown, gloves, scarf of the processor, as well as other disposable items used in the procedure, are placed in a separate bag and disposed of.

Inspection procedure

Responsibility for conducting preventive examinations rests with the medical worker. The results are entered in a special form, a number is put.

Appendix No. 4 to this order prescribes the following measures to prevent the spread of lice:

• Scheduled examinations of the population by health workers in kindergartens, schools, hostels, boarding schools, nursing homes, etc.
• Creation necessary conditions that prevent the spread of lice during collective living: baths, showers, laundries with hot water, sanitary checkpoints.
• Availability of proper staff of medical staff for examinations.
• Appropriate measures in the foci of pediculosis infection.
• Explanatory educational program among the population.

We dismantled Order No. 342, anti-pediculosis styling. Finally, let's see what effective preventive measures this document recommends:

• Periodic bathing with obligatory shampooing - at least once every 10 days.
• Change of bed linen - at least twice a month.
• Systematic washing of clothes, personal belongings as they get dirty, followed by ironing with the “steam” function.
• Daily combing of hair, haircut as needed.
• Cleaning of outerwear, compliance with the rules for its storage.
• Periodic wet cleaning in the house.
• Keeping your home clean.

Order No. 342 of the Ministry of Health of the Russian Federation offers effective measures for the prevention, treatment, detection of pediculosis and typhus. It also contains the composition of a special anti-pediculosis styling that helps to quickly deal with the problem.

To prevent the spread of lice and scabies in schools and kindergartens, there are simple rules for prevention:

1. Washing of the body and hair is carried out daily.
2. Every week there is a change of bed linen.
3. Timely cutting of hair and nails.
4. Use only personal items when caring for hair.
5. Washing things at high temperatures.
6. It is required to regularly carry out wet cleaning in the house.
7. Maintaining cleanliness in student accommodation.
8. Children should be made aware of the risk of spreading the disease.

Helminthiases, pediculosis and scabies are common pathologies. When the first symptoms appear, a general malaise is required to visit a doctor for a diagnosis. Timely therapy allows you to quickly cope with the invasion, return people to their usual way of life.

It consists in the observance of sanitary and hygienic standards. According to the order of the Ministry of Health, it is recommended:

• regular wrinkling of the body, head at least 1 time in 10 days;
• change of bed linen as it gets dirty, but at least 2 times a month;
• regular washing of things with ironing with steam;
• haircut, daily combing;
• cleaning of outerwear, their proper storage;
• wet cleaning in the house;
• keeping interior items clean.

Upon detection of lice, nits, the fight against pediculosis is carried out simultaneously on the body, clothing, and indoors. All people living under the same roof are processed, and sanitation of the apartment is also necessary.

The issue of combating lice and treating pediculosis is on the agenda of every children's institution. After all, you can pick up lice even if you follow the rules of personal hygiene. Therefore, the Ministry of Health has developed a special order on pediculosis in educational institutions, according to which it is prohibited to take children infected with lice and nits to kindergartens.

For medical examination. the worker must use a special comb with frequent teeth, which subsequently without fail disinfected. Only regular examination of children for pediculosis in kindergarten will help prevent the spread of the disease. According to the decision of the sanitary and epidemiological service, it should be carried out monthly. The data are recorded in the examination log for pediculosis.

Information about pediculosis should be brought to the attention of parents at specially organized parent-teacher meetings. There is also an instruction on pediculosis for educators and teachers. It contains information about preventive rules that contribute to the prevention of the disease.

About what to do if there is pediculosis in kindergarten, every employee of a children's institution who has medical education. The actions of a nurse with pediculosis should be carried out in the following order:

1. Having found lice in a child, the nurse is obliged to isolate him, informing the parents and the administration of the preschool educational institution about this.
2. It is mandatory to examine children who have had contact with an infected child.
3. Recommend to parents a program of preventive measures at home.
4. It is mandatory to disinfect the premises, including the processing of bed linen, which provide for quarantine measures in the preschool educational institution.
5. The duration of quarantine for pediculosis is 30 days.
6. It is allowed to visit a kindergarten for a child who has had pediculosis after visiting the clinic, as evidenced by a specialist's certificate.

Amended document: Decree of the Chief State Sanitary Doctor of the Russian Federation of December 5, 2017 N 149 (Official Internet portal legal information www.pravo.gov.ru, December 28, 2017, N 0001201712280059). ________________________________________________________________________

1. Approve the sanitary and epidemiological rules SP 3.1.1.3108-13 "Prevention of acute intestinal infections" (Appendix).

2. Recognize as invalid the sanitary and epidemiological rules “Prevention of acute intestinal infections. SP 3.1.1.1117-02"

Registered with the Ministry of Justice of the Russian Federation on May 8, 2002, registration N 3418.

G.G.Onishchenko

Registered by the Ministry of Justice of the Russian Federation

registration N 31602

Appendix

1. Approve the sanitary and epidemiological rules SP 3.2.3110-13 "Prevention of enterobiosis" (Appendix).

2. Recognize as invalid the sanitary and epidemiological rules SP 3.2.1317-03 "Prevention of enterobiosis"._______________ Registered with the Ministry of Justice of the Russian Federation on May 20, 2003, registration N 4576.

G.G.Onishchenko

Registered by the Ministry of Justice of the Russian Federation on January 20, 2014, registration N 31053

Appendix

AT
connection with a high level of population susceptibility to pediculosis, including
including clothes, the Russian Federation retains real
prerequisites for the worsening of the epidemiological situation in
incidence of epidemic typhus.

Every year in the country
up to 300 thousand affected by pediculosis are registered, of which more than
75% are detected in preschool and general education
institutions, during hospitalization of patients in treatment and prophylactic
institutions. high levels the prevalence of pediculosis in the population is
place in the Republics of Tyva, Karelia, Vologda, Kaliningrad,
Kostroma, Pskov, Tomsk regions. Special Concern
causes an increase in body lice. More than 20% of persons affected
head lice, are at the same time carriers of clothing
pediculosis, in 80% of persons without a fixed place of residence,
combined defeat of head and body pediculosis.

Such a position is
a consequence of the decline in the standard of living of the population, the reduction in the number of
sanitary checkpoints, bath facilities and high cost
bath services, detergents, pediculicides.

AT
unlike developed countries in the Russian Federation continue
to register epidemic typhus. Per
the last 2.5 years in the Kabardino-Balkarian Republic, Primorsky
region, Astrakhan, Kemerovo, Leningrad, Lipetsk,
Pskov, Perm and Ryazan regions, Moscow
25 cases of this infection. During this period, 109 cases were also detected.
recurrent form of epidemic typhus - Brill's disease.