Pavlenko O., Khaytovych O.

Public Institution “Ukrainian Anti-Plague Station” of

Ministry of Health of Ukraine,

Public institution “Crimean State Medical University named after S.I. Georgievsky”, Simferopol, Ukraine

Public health management of infectious diseases: risk assessment of human leptospirosis in Ukraine

Risk assessment is a road map to strengthen the core capacities required for effective preparedness planning, prevention, prompt detection, characterization, containment and control of zoonotic diseases that can threaten national, regional and global health security. Implementation of the Risk assessment in Public health management of infectious diseases is an important stepping stone in fulfilling many of the requirements of the international regulations. Risk assessment is the process of evaluating the probability and consequences of injury or illness arising from exposure to identified hazards. It is an iterative process that continues from the time the event is first detected to the time the event is “closed” [1].

Leptospirosis is a zoonotic, natural-focal disease. Infection of human can be carried out in various ways: contact with sick animals (agricultural, domestic and wild animals) or contact with contaminated food, soil, water or other environmental abiotic factors [2].

Due to the variability in the ways of infection transmission, the risk of human leptospirosis exposure should evaluate during the study of the epidemic process and the investigation of the causes of each disease case.

Thus, for each possible source of infection should be evaluated: 1) individual risk (infection of the individual as a result of contact with the source of infection); 2) the potential territorial risk (the frequency and the possibility of infection in the evaluated areas) (pic.1); 3) the collective risk (the risk of illness for a team, for a social group), and 4) the occupational risk (professional human activities).

Picture 1. Risk level of leptospirosis in regions of Ukraine (1981-2011) per 100 000 people.

The risk assessment of human leptospirosis in every type of risk should be considered a source of Leptospira species; particulars of leptospirosis epidemic process in some area with exacting reference to suspected place of infection, social and professional status, age, gender; data on morbidity (infection) of agricultural, domestic and wild animals; annual number of small mammals (the potential vectors of infection), the spatial arrangement of leptospirosis natural foci; the possibility of human contact with natural foci (frequency, type of human activity in the natural focus), etc.

The outcome of Risk assessment supports one or more of the following actions at any point in time:

1. Discard – no risk, close the event.

2. Monitor – the event is currently of no public health importance but requires continuous assessment.

3. Assist – provision of technical assistance is required, or likely to be required.

4. Disseminate – event information to the community to prepare for or prevent similar events in future.

5. Escalate – reporting to Ministry of Health of Ukraine for action and intervention.

Thereby, the risk assessment of human leptospirosis is crucial for determining priorities of prophylaxis and carrying out preventive and control measures.

References:

1. Early qualitative risk assessment of the emerging zoonotic potential of animal diseases/Stephen Palmer, David Brown, Dilys Morgan// British Medical Journal/ –2005. – Vol. 331 – P.1256–1260.

2. Zavitsanou A., Babatsikou F. Leptospirosis: epidemiology and preventive measures/ Health Science Journal. – 2008. – Vol. 2, Issue 2. – P.75-82.

3. John T.J. The prevention and control of human leptospirosis /J Postgrad Med. – September, 2005. –Vol.51, Issue 3 – P.205-209.