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Problems of separate stages of realisation RPI For today 3 stages RPI are allocated.
It was spent to the period since May, 1974 for 1990. During this period it was recommended to vaccinate not less than 80 % of children against 6 infections: a poliomyelitis, a measles, a diphtheria, a tetanus, a whooping cough, a tuberculosis. It is calculated on the period since 1990 for 2000. It is recommended to vaccinate by 2000 to 95 % of children. The purpose of this stage consists in liquidation of a paralytic poliomyelitis on globe by 2000, eradication of a tetanus of the newborns, essential depression of a case rate by measles. Is a strategic program for the first 10 years of 21 Viagra Reviews. Its purpose is the termination of circulation of viruses of a poliomyelitis and reproach that will allow to cancel these bacterinations. Our country has supported the specified program and has joined in its realisation. For today are summed up the first stage and the basic conclusions on the second stage of the program are drawn. Results ???-1 and ???-2
1. Application of mass immunization against a poliomyelitis has shown possibility of eradication of an endemic paralytic poliomyelitis within the limits of large region (for example, in the USA since 1979 of cases of disease is not present). 2. Experience of the USSR has shown convertibility of results of a mass vaccinal prevention of a poliomyelitis and possibility of homing of the "liquidated" infection there where planned immunization spent not in full volume (flashes of a poliomyelitis, diphtherias). 3. It is established vaktsinozavisimost mankind when it has appeared that in the conditions of mass immunization return of controlled infections is possible, if the number of the inoculated decreases below critical level (in Russia it is shown on a diphtheria and poliomyelitis example). 4. Possibility of restoration of the control over a situation with controlled infections by full coverage of the population by inoculations (also on a poliomyelitis and diphtheria example) Is shown. Besides, within the limits of RPI infectious diseases at thoracal children are traced. It has allowed to put at once under observation new patogeny, in particular, a hepatitis In and a hemophilic infection at children. In the developed countries bacterination against these infections is included into a routine calendar of inoculations.
4.1. Revision of strategy of bacterination in the nineties the XX-th centuries The best way of depression of vaccines-operated of diseases is a creation of population Viagra Reviews. Universal immunization is an important part of conservation of health. This purpose by the routine or intensive program of bacterination is reached. Standard programs of bacterination should be obligatory for the doctors working as in medical institutions, and privately practicing. Last years standard practice focuses attention on rising of level of bacterination of adults. All adults should receive busternye doses ADS each 10 years. Besides, persons are more senior 65 years and all adults with medical indications on which at them the risk of pneumococcal diseases or serious complications of a flu is enlarged, should receive corresponding vaccines - against a pneumococcus and a flu. The important role is taken away bacterinations against hepatitis B Last years BTSZH-VACCINATION strategy in uelom series of the developed countries, such as the USA, Germany, Austria, etc. [174] is reconsidered. From 1988 on 1996 there was an essential change of the nature of a tubercular infection in the country that has forced to overestimate the BTSZH-VACCINATION role in preventive maintenance and the tuberculosis control. So, for the specified period the quantity of cases of a tuberculosis has increased in the country among children and adults, there were the forms steady against several medicines. Diffusion of a tubercular infection has appeared a miscellaneous for various levels of population, however the risk mikobakterialnoj infections counting on all population is low. In this connection primary strategy for preventive maintenance and the control of a tubercular infection in the USA is reduced first of all to early revealing and treatment of patients with the active form of a tuberculosis, to revealing of persons with a latent infection and use of preventive therapy by Isoniazidum for prevention of transition from latent to the active form of disease. In this strategy BTSZH-VACCINATION use is limited because: its efficiency in preventive maintenance of infectious forms of a tuberculosis is obscure, reactance to a tuberculin which takes place after bacterination, accumulates on treatment of the people probably infected with micobacteria. Thus, in the USA BTSZH-VACCINE use as preventive measure is provided only for the selected category of the people answering to following criteria [174]: - BTSZH-VACCINATION should be spent to babies and children who are in an environment where infection with a micobacterium is possible and provided that it is impossible to apply other measures (for example, to remove the child from an infection place). - For the workers of public health services who are in conditions of a possible transmission of infection of micobacteria, refractory to Isoniazidum and rifampicin and provided that even acceptance of control measures will be unsuccessful. In too time BTSZH-VACCINATION is not recommended:
- BTSZH-BACTERINATION is not recommended to be included in programs of calendar immunization and the control of a tubercular infection to the USA. - To workers of public health services, except for specified above conditions. - To children and adults from HIV-infections. Thus, now in the USA the BTSZH-VACCINE is used very seldom.
Since 1994 routine bacterination BTSZH at newborn children in Austria is stopped. Viagra Reviews are recommended to stop use tuberkulinovogo dermal testing [156]. Experts the CART recommend other important changes in strategy of bacterination which consist in a recognition of the fact of necessity of immunization of newborns and children of early age, against other serious infections as most effectual measures for depression of an infectious case rate. For the majority of the developed countries it is offered following [173]: 1. Bacterination of all children till 5 years against Haemophilus influenzae type b and a hepatitis In as selective bacterination only at persons of high risk is insufficient. 2. Share Augmentation immunizirovannyh children against meningokokka that reduces a mortality, and level augmentation privitosti against a pneumococcus and a flu results not only in mortality depression, but also to depression of exacerbations of chronic diseases. 3. Routine immunization of children should include preventive maintenance of following infections: Viagra Reviews, a tetanus, a whooping cough, a measles, a parotitis, a rubella. 4. All patients who are on a hemodialysis, accept a staphylococcal vaccine (Fattom A.I., et.al., 1996). 5. Further the most perspective should consider including in national vaccinating calendars of bacterination against following infections: Hib-b, a hepatitis In, a poliomyelitis, a rubella, a flu, a pneumococcus, a meningococcal infection. Offers on use for prevention of a neonatal tetanus and of some other infections of immunization of pregnant women were repeatedly surveyed. However it meets aversion because of fears of possible negative influence on a foetus. Introduction of a tetanic anatoxin (1-2 doses) Was offered to women last months to pregnancy. Theoretically active moving specific IgG through a placenta in late gestatsiju can provide to the newborn a high caption of an antitoxin and effective preventive maintenance of neonatal diseases. The same strategy has been offered and for other infections menacing to the newborn, i.e. until when bacterination of the child can be spent and will quite ripen necessary components of immune system of the newborn. Such approach is surveyed for respiratorno-sintsitialnoj a virus infection, streptokkovoj infections of group of V.Dalnejshie researches in this direction proceed. In spite of the fact that the basic object of attention of the majority of programs of immunization are children of early age, nevertheless more and more accents are displaced on teenagers and young men with behaviour of high risk. One more group of persons for which immunization is necessary, are older persons. From available vaccines the most useful for elderly are influenzal and pneumococcal. Their application reduces risk of complications and a mortality.