Инфекция и иммунитет. 2021; 11: 249-264
Туляремия в мире
https://doi.org/10.15789/2220-7619-TTW-1380Аннотация
В обзоре представлены данные о распространении в мире туляремии — природноочаговой особо опасной инфекции человека и животных, которая вызывается бактерией Francisella tularensis. Штаммы наиболее вирулентного для человека и животных подвида F. tularensis subsp. tularensis циркулируют только в Северной Америке. Гораздо шире распространены штаммы менее вирулентного подвида F. tularensis subsp. holarctica: кроме Северной Америки, они встречаются в Европе, Азии (Япония), Австралии (включая Тасманию). Изоляты данного подвида выделяются на территориях различных климатических зон — от субарктических до субтропических, биоценозы природных очагов самые разные — от водных до пустынных, со своими хозяевами и переносчиками. Широкое распространение в мире штаммов подвида F. tularensis subsp. holarctica, в сравнении с другими подвидами возбудителя туляремии, связано со способностью существовать в водной среде, что значительно расширяет ареалы распространения подвида и показывает его более высокую экологическую пластичность и стабильность. Заражение человека возбудителем инфекции происходит в результате укусов инфицированными кровососущими членистоногими (комарами, слепнями, клещами), употребления инфицированной грызунами пищи и воды, при вдыхании воздушно-пылевого аэрозоля, контаминированного возбудителем туляремии от больных грызунов, а также после прямого контакта с инфицированными животными (охота, уход за домашними животными, разделка туш). В данной статье описаны различия путей передачи возбудителя в разных странах. Наибольшее количество случаев заболевания людей туляремией наблюдается в Северной Америке — в США, в Европе — в Швеции и Финляндии, а в Азии — в Турции. На территории Российской Федерации и Казахстана отмечено значительное снижение заболеваемости в результате проводимой с середины прошлого века иммунопрофилактики населения, проживающего на энзоотичных по туляремии территориях, а также лиц, подвергающихся профессиональному риску заражения этой инфекцией. В последнее время в 31 стране Европы, а также в Турции и Японии проводится обязательная регистрация случаев заболевания туляремией в связи с возможностью использования возбудителя в качестве агента биотерроризма. В обзоре показано географическое распределение основных филогенетических популяций и субпопуляций штаммов туляремийного микроба. Самый высокий уровень разнообразия штаммов F. tularensis subsp. holarctica в одной стране зарегистрирован на территории Китая. Также отмечены главные особенности экологии и эпидемиологии возбудителя туляремии.
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Russian Journal of Infection and Immunity. 2021; 11: 249-264
Tularemia in the world
https://doi.org/10.15789/2220-7619-TTW-1380Abstract
Here we review the data on the global spread of tularemia — a natural focal, especially dangerous human and animal infection caused by the bacterium Francisella tularensis. Strains of the most virulent F. tularensis subspecies tularensis circulate solely in the North America, whereas less virulent F. tularensis subspecies holarctica is found in Europe, Asia (Japan), North America, Australia (especially Tasmania). Isolates of this subspecies are isolated in territories of various climatic zones — from subarctic to subtropical, featured with diverse biocenoses in natural foci — from water to desert, with their unique hosts and carriers. Compared with the remaining subspecies of the tularemia causative agent, subspecies holarctica has a wide spread due to its ability to live in aquatic environment that markedly expands its distribution areas and shows higher ecological plasticity and stability. Infection of people by such causative agents occurs due to infected blood-sucking arthropods biting (mosquitoes, horseflies, ticks), intake of rodent-contaminated food and water, inhalation of air-dust aerosol bearing tularemia pathogen transmitted from sick rodents, as well as after direct contact with infected animals (hunting, pet care, carcass cutting). Different routes of the pathogen transmission in various countries are discussed. The peak prevalence of tularemia is observed in the North America (USA) and Europe (Sweden and Finland), as well as in Asia (Turkey). Since the mid-20th century, incidence rate of tularemia has been profoundly decreased in the Russian Federation and Kazakhstan due to preventing populations in tularemia-enzootic territories as well as those at risk of contact. In the last years, 31 European countries as well as Turkey and Japan have begun to conduct mandatory registration of tularemia cases due to an opportunity of using the pathogen for bioterrorism. The geographical distribution of the main tularemia microbe phylogenetic populations and subpopulations is demonstrated. The peak diversity of F. tularensis subsp. holarctica strains in a single country was registered in China. The major ecology- and epidemiology-related features of the tularemia causative agent are noted.
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