Preventive actions. Meningococcal infection

General events.

Information about the sick person in the Center for Sensitive Diseases in the form of an Emergency Notification within 12 hours after identifying the patient.

Epidemiological examination of the outbreak in order to identify and sanitize carriers and patients with erased forms; determination of the circle of persons subject to mandatory bacteriological examination.

Measures regarding the source of the pathogen.

Hospitalization of the patient, isolation of carriers. Discharge from the hospital - with 2 negative bacteriological studies of nasopharyngeal mucus, carried out 3 days after the end of treatment.

Measures regarding pathogen transmission factors.

Disinfection: daily wet cleaning, ventilation, irradiation with UV rays and bactericidal lamps in the fireplace. Final disinfection is not carried out.

Measures regarding contact persons in the outbreak.

Medical observation for 10 days from the last visit to the sick team/daily examination of the skin and pharynx with the participation of an ENT doctor, thermometry/. Children, staff of preschool and school institutions, in universities and secondary specialized institutions are subject to bacteriological examination in the 1st year - the entire course where the patient is identified, in senior years - students of the group where the patient or carrier is identified. In kindergartens, biological examinations are carried out 2 times with an interval of 3-7 days.

Emergency prevention. Children from 18 months. up to 7 years of age and first-year students, in the first 5 days after contact, active immunization is carried out with a meningococcal polysaccharide vaccine of serogroups A and C. In its absence, normal human immunoglobulin is administered. Previously vaccinated children are not given immunoglobulin.

More on the topic ANTI-EPIDEMIC MEASURES IN THE FOCUS OF MENINGOCOCCAL INFECTION:

  1. Prevention of meningococcal infection, measures in the outbreak

Mandatory registration and emergency notification to the Central State Sanitary Epidemiology Center about cases of a generalized form of meningococcal infection.

Immediate hospitalization in specialized departments or boxes.

A quarantine is established in the outbreak for a period of 10 days from the moment of isolation of the patient and daily clinical observation of contacts is carried out with examination of the nasopharynx (in teams, necessarily with the participation of an otolaryngologist), skin and daily thermometry for 10 days.

Bacteriological examination of contacts in preschool institutions is carried out at least twice with an interval of 3-7 days, and in other groups - once.

Patients with bacteriologically confirmed meningococcal nasopharyngitis, identified in foci of infection, are hospitalized in a hospital according to clinical and epidemiological indications, but can be isolated at home if there are no more preschool children and people working in preschool institutions in the family or apartment, as well as when subject to regular medical supervision and treatment. Convalescents are allowed into preschool institutions, schools, and sanatoriums after one negative bacteriological examination conducted no earlier than 5 days after discharge from the hospital or recovery at home.

Carriers of meningococci identified during bacteriological examination in children's institutions are removed from the team for the period of sanitation. Carriers are not isolated from the group of adults, including educational institutions. Bacteriological examination of groups visited by these carriers is not carried out, with the exception of somatic hospitals, where, when a carrier is identified, department staff are examined once. 3 days after the end of the sanitation course, carriers undergo a one-time bacteriological examination and, if there is a negative result, are allowed into the teams.

Patients with meningococcal infection are discharged from the hospital after clinical recovery and a single bacteriological examination for carriage of meningococci, carried out 3 days after discontinuation of antibiotics. Convalescents of meningococcal infection are allowed into preschool institutions, schools, sanatoriums and educational institutions after one negative bacteriological examination conducted no earlier than 5 days after discharge from the hospital.

Final disinfection of outbreaks is not carried out. The room is subject to daily wet cleaning, frequent ventilation, and irradiation with UV or bactericidal lamps.

Prevention of meningococcal infection

The airborne transmission mechanism of meningococcal infection and the widespread nasopharyngeal carriage of meningococci in the population (4-8%) hinder the effectiveness of anti-epidemic measures against the source of infection and the causative agent of the disease.

A radical measure to prevent the spread of the disease is specific vaccine prevention.

The procedure for carrying out preventive vaccinations against meningococcal infection, the definition of population groups and the timing of preventive vaccinations are determined by the bodies carrying out state sanitary and epidemiological supervision.

Organization of immunoprophylaxis against meningococcal infection.

Preventive vaccinations against meningococcal infection are included in the preventive vaccination calendar for epidemic indications. Preventive vaccination begins when there is a threat of an epidemic rise: identification of obvious signs of epidemiological troubles in accordance with paragraph 7.3, an increase in the incidence of urban residents twice as compared to the previous year, or a sharp rise in incidence above 20.0 per 100,000 population.

Planning, organization, implementation, completeness of coverage and reliability of records of preventive vaccinations, as well as timely submission of reports to the authorities exercising state sanitary and epidemiological supervision, are ensured by the heads of medical institutions.

The plan for preventive vaccinations and the need of treatment and prophylactic organizations for medical immunobiological preparations for their implementation is coordinated with the authorities exercising state sanitary and epidemiological supervision.

Immunization of the population.

If there is a threat of an epidemic rise in meningococcal infection, vaccine prevention is primarily subject to:

Children from 1.5 years to 8 years inclusive;

First-year students of secondary and higher educational institutions, as well as persons arriving from different territories of the Russian Federation, near and far abroad countries and united by living together in dormitories.

Federal Service for Supervision of Consumer Rights Protection
and human well-being

3.1.2. PREVENTION OF INFECTIOUS DISEASES.
RESPIRATORY TRACT INFECTIONS

Prevention of meningococcal infection

Sanitary and epidemiological rules

SP 3.1.2.2156-06

1. Developed by: G.F. Lazikova, A.A Melnikova, N.A Koshkina, Z.S. Sereda (consumer rights and human well-being); I.S. Koroleva, L.D. Spirikhin (Central Research Institute of Epidemiology, Rospotrebnadzor); T.F. Chernysheva (FGUN "Moscow Research Institute of Epidemiology and Microbiology named after G.N. Gabrichevsky); I.N. Lytkina (Office of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in Moscow).

3. Approved by the resolution of the Chief State Sanitary Doctor of the Russian Federation G.G. Onishchenko dated December 29, 2006 No. 34

4. Registered with the Ministry of Justice of the Russian Federation on February 20, 2007, registration number 8974.

5. Introduced to replace the sanitary and epidemiological rules “Prevention of meningococcal infection. SP 3.1.2.1321-03”, canceled by the Decree of the Chief State Sanitary Doctor of the Russian Federation dated December 29, 2006 No. 35 (registration number in the Ministry of Justice of the Russian Federation 8973 dated February 20, 2007 1 from April 1, 2007.

the federal law
“On the sanitary and epidemiological well-being of the population”
No. 52-FZ of March 30, 1999

“State sanitary and epidemiological rules and regulations (hereinafter referred to as sanitary rules) - regulatory legal acts establishing sanitary and epidemiological requirements (including criteria for the safety and (or) harmlessness of environmental factors for humans, hygienic and other standards), non-compliance which creates a threat to human life or health, as well as a threat to the emergence and spread of diseases” (Article 1).

“Compliance with sanitary rules is mandatory for citizens, individual entrepreneurs and legal entities” (Article 39).

“For violation of sanitary legislation, disciplinary, administrative and criminal liability is established in accordance with the legislation of the Russian Federation” (Article 55).

FEDERAL SERVICE FOR SUPERVISION IN THE FIELD OF PROTECTION

CHIEF STATE SANITARY DOCTOR
RUSSIAN FEDERATION

RESOLUTION

Based on the Federal Law of March 30, 1999 No. 52-FZ “On the sanitary and epidemiological welfare of the population” (Collected Legislation of the Russian Federation, 1999, No. 14, Art. 1650, as amended on December 30, 2001, January 10, June 30, 2003 ., August 22, 2004, May 9, December 31, 2005) and the Regulations on state sanitary and epidemiological regulation, approved by Decree of the Government of the Russian Federation of July 24, 2000 No. 554 (Collected Legislation of the Russian Federation, 2000, No. 31, Art. 3295, 2005, No. 39, Art. 3953)

I DECIDE:

1. Approve sanitary and epidemiological rules “Prevention of meningococcal infection. SP 3.1.2.2156-06" ().

2. Enact sanitary and epidemiological rules “Prevention of meningococcal infection. SP 3.1.2.2156-06" from April 1, 2007

G. G. Onishchenko

FEDERAL SERVICE FOR SUPERVISION IN THE FIELD OF PROTECTION
CONSUMER RIGHTS AND HUMAN WELL-BEING

CHIEF STATE SANITARY DOCTOR
RUSSIAN FEDERATION

RESOLUTION

In connection with the approval by the Chief State Sanitary Doctor of the Russian Federation on December 29, 2006 and the entry into force on April 1, 2007 of the sanitary and epidemiological rules “Prevention of meningococcal infection. SP 3.1.2.2156-06"

I DECIDE:

From the moment of entry into force of the specified sanitary and epidemiological rules, the sanitary and epidemiological rules “Prevention of meningococcal infection” shall be considered invalid. SP 3.1.2.1321-03 ", approved by the Chief State Sanitary Doctor of the Russian Federation on April 28, 2003 and registered with the Ministry of Justice of the Russian Federation on May 29, 2003, registration number 4609.

3.1.2. PREVENTION OF INFECTIOUS DISEASES.
RESPIRATORY TRACT INFECTIONS

Prevention of meningococcal infection

Sanitary and epidemiological rules SP 3.1.2.2156-06

1 area of ​​use

1.1. These sanitary and epidemiological rules (hereinafter - sanitary rules) establish the basic requirements for a set of organizational, sanitary and anti-epidemic (preventive) measures, the implementation of which is aimed at preventing the spread of diseases of meningococcal infection.

1.2. Monitoring of compliance with sanitary rules is carried out by bodies exercising state sanitary and epidemiological supervision in the Russian Federation.

1.3. Compliance with sanitary rules is mandatory for citizens (individuals), legal entities and individual entrepreneurs.

2. General information about meningococcal infection

Meningococcal infection is an anthroponotic disease caused by meningococcus and occurring in various clinical forms.

The causative agent is Neisseria meningitidis (meningococci - gram-negative cocci). Depending on the structure of the polysaccharide, 12 serogroups are distinguished: A, B, C, X, Y, Z, W-135, 29E, K, H, L, I.

Meningococci of serogroups A, B, C are the most dangerous and can often cause diseases, outbreaks and epidemics.

Intragroup genetic subgrouping of meningococci and determination of enzyme types makes it possible to identify hypervirulent strains of meningococci (meningococci of serogroup A - genetic subgroup III-1, meningococci of serogroup B - enzyme types ET-5, ET-37), which is important in predicting epidemiological problems.

The pathogen is transmitted from person to person by airborne droplets. More often they become infected from asymptomatic carriers and less often through direct contact with a patient with a generalized form of meningococcal infection.

The risk of developing the disease is higher in children than in adults. All people are susceptible to the disease, but the risk of infection is higher in people with terminal complement deficiency and in people who have had a splenectomy.

The incubation period ranges from 1 to 10 days, usually less than 4 days.

3. Standard definition of a case of generalized
forms of meningococcal infection

Reliable accounting of diseases with generalized forms of meningococcal infection is based on objective indicators of a standard case definition with the following classification:

Presumed standard case of acute meningitis detected at the prehospital level. Main criteria: sudden rise in temperature to 38 - 39 ° C, unbearable headache, tension (rigidity) of the neck muscles, changes in consciousness and other manifestations. In children under 1 year of age, a rise in temperature is accompanied by bulging of the fontanel.

Probable standard case of acute bacterial meningitis are usually detected immediately after hospitalization, taking into account one or more of the above criteria and: cloudy cerebrospinal fluid, leukocytosis of more than 100 cells per mm 3 with a predominance of neutrophils (60 - 100%), leukocytosis in the range of 10 - 100 cells per mm 3 with a predominance of neutrophils (60 - 100%) with a significant increase in protein (0.66 - 16.0 g/l) and a decrease in glucose levels.

Possible standard case of a generalized form of meningococcal infection (meningococcal meningitis and/or meningococcemia) includes one or more of the above criteria and: identification of gram-negative diplococci in the cerebrospinal fluid and/or blood, the presence of specific hemorrhagic rashes on the skin, epidemiological indication of a repeat case from the outbreak or an unfavorable situation with meningococcal infection in the region.

A confirmed standard case of a generalized form of meningococcal infection (meningococcal meningitis and/or meningococcemia) includes one or more of the above criteria and: identification of a group-specific antigen to meningococcus in the cerebrospinal fluid and/or blood, detection of the growth of a culture of meningococci during culture of the cerebrospinal fluid and/or blood with determination of the serogroup .

The growth of a culture of meningococci from the nasopharynx and other non-sterile loci of the body does not confirm the diagnosis of a generalized form of meningococcal infection.

4. Measures for patients with generalized
form of meningococcal infection

4.1. The generalized form of meningococcal infection is a severe infectious disease that requires immediate hospitalization of the patient in a hospital for diagnosis and treatment.

4.2. Identification of patients with a generalized form of meningococcal infection and persons suspected of it is carried out by doctors of all specialties, paramedical workers of treatment and preventive, children's, adolescent, health and other organizations, regardless of departmental affiliation and organizational and legal form, medical workers engaged in private medical practice , for all types of medical care, including:

When the population seeks medical help;

When providing medical care at home;

When visiting doctors engaged in private medical practice;

During medical observation of persons who communicated with patients with meningococcal infection in the outbreak.

4.3. Upon admission to hospital, the diagnosis should be confirmed by clinical examination and laboratory analysis (clinical and microbiological) of blood and cerebrospinal fluid samples. Material for microbiological research is taken before intensive antibacterial therapy. Microbiological examination of material from patients with a generalized form of meningococcal infection and persons suspected of this disease is carried out in accordance with current regulatory documents.

4.4. About each case of disease with a generalized form of meningococcal infection, as well as suspicion of the disease, doctors of all specialties, paramedical workers of treatment and preventive, children's, adolescent and health organizations, regardless of departmental affiliation and legal form, as well as medical workers involved in private medical activities, report by telephone within 2 hours and then within 12 hours send an emergency notification in the prescribed form to the authorities exercising state sanitary and epidemiological supervision at the place of registration of the disease (regardless of the patient’s place of residence).

4.5. A treatment and prevention organization that has changed or clarified the diagnosis of a generalized form of meningococcal infection, within 12 hours, submits a new emergency notification to the authorities exercising state sanitary and epidemiological supervision at the place where the disease was detected, indicating the initial diagnosis, the changed (clarified) diagnosis and the date of establishment of the clarified diagnosis. .

4.6. Bodies carrying out state sanitary and epidemiological supervision, when receiving emergency notifications about a changed (clarified) diagnosis of a generalized form of meningococcal infection, notify the treatment and preventive organizations at the place where the patient was identified that sent the initial emergency notification.

4.7. The medical institution reports the results of microbiological examination of material from the patient on the etiological decoding of the disease and the serogrouping of meningococci to the authorities exercising state sanitary and epidemiological supervision at the place of registration of the patient (regardless of his place of residence) no later than the 4th day after his hospitalization.

4.8. A patient with a generalized form of meningococcal infection is discharged from the hospital after clinical recovery. Convalescents of the generalized form of meningococcal infection are allowed into preschool educational institutions, schools, boarding schools, health organizations, sanatoriums, hospitals, secondary and higher educational institutions after completion of the course of treatment.

4.9. The completeness, reliability and timeliness of recording diseases of meningococcal infection, as well as prompt and complete reporting of them to the bodies exercising state sanitary and epidemiological supervision are ensured by the heads of treatment and preventive, children's, adolescent, health and other organizations, regardless of departmental affiliation and organizational and legal forms.

4.10. Each case of meningococcal infection is subject to registration and registration in treatment and preventive, children's, adolescent, health and other organizations, regardless of departmental affiliation and legal form.

4.11. Reports on diseases of meningococcal infection are compiled according to established forms of state statistical observation.

5. Measures regarding persons who had contact
with a patient with generalized form of meningococcal
infections, persons suspected of having this disease
and carriers of meningococci

5.1. Persons who communicated with a patient with a generalized form of meningococcal infection in a family (apartment), preschool educational institution, school, boarding school, health institution, sanatorium, secondary and higher educational institution are subject to daily medical observation for 10 days with mandatory examination of the nasopharynx, skin covers and thermometry. The first medical examination of persons who interacted with the patient is carried out with the mandatory participation of an otolaryngologist.

5.2. In preschool educational institutions, schools, boarding schools, orphanages, children's homes and health organizations, in secondary and higher educational institutions, medical supervision of communicating persons is provided by the medical staff of these organizations. In the absence of medical workers in these organizations, this work is provided by the heads of treatment and preventive organizations serving these organizations.

5.3. During medical observation, the doctor explains to those who have had contact with the patient about the most important symptoms of the disease and indicates the need to immediately call a doctor if symptoms or signs of the disease appear. If persons with objective symptoms of the disease are identified, they are immediately hospitalized for further observation.

5.4. After a case of the disease is identified and the patient is hospitalized, all contact persons in the outbreak are given a course of chemoprophylaxis to prevent secondary cases (). In order to achieve the greatest effectiveness, chemoprophylaxis is carried out within the next 24 hours after registration of a case of the disease. This measure is used in areas during periods of sporadic non-epidemic morbidity and is of a limited nature. If a disease occurs, chemoprophylaxis in the outbreak is carried out among: family members living together; persons from institutions where there is cohabitation (students of boarding schools, roommates in a dormitory); pupils and staff of preschool institutions (all persons who had contact in classrooms and bedrooms); persons who had established contact with the patient's nasopharyngeal secretions.

5.5. In order to early identify epidemiologically significant carriers of meningococci (possible sources of infection), a bacteriological examination of persons who communicated with the patient is carried out in areas with 2 or more cases of generalized forms of meningococcal infection and in those areas where the sequential occurrence of diseases is separated by a time period exceeding the incubation period (more than 10 days). Material collection (nasopharyngeal mucus) is carried out among all those who have close contact with the patient in the first 12 hours after registration of a case of the disease before the start of chemo-preventive measures. The collection and transportation of material for bacteriological examination of the nasopharynx for the presence of meningococci is carried out in the prescribed manner.

5.6. A bacteriological examination of persons who communicated with a patient with a generalized form of meningococcal infection in foci with 2 or more cases of the disease, as well as repeated examinations of identified carriers of meningococci, are carried out by bodies carrying out state sanitary and epidemiological surveillance.

5.7. Patients with acute nasopharyngitis identified in the focus of meningococcal infection are examined bacteriologically and, depending on the severity of the clinical course, hospitalized in an infectious diseases hospital for treatment. Their treatment at home is allowed, subject to regular medical supervision, as well as in the absence of preschool children and persons working in preschool educational institutions, children's homes, orphanages and children's hospitals in the family or apartment.

5.8. Carriers of meningococci identified in foci with 2 or more cases of the generalized form of meningococcal infection are subject to clinical observation and chemoprophylactic measures at home.

5.9. Convalescents of acute nasopharyngitis are allowed into institutions and organizations after completion of the full course of treatment and when the clinical manifestations of the disease disappear.

5.10. Carriers of meningococci undergo a one-time bacteriological examination 3 days after the course of chemo-prophylaxis and, if the result is negative, they are allowed into preschool educational institutions, schools, boarding schools, health organizations, sanatoriums and hospitals. If the result of bacteriological examination is positive, the course of chemoprophylaxis is repeated until a negative result is obtained,

6. Measures in the focus of meningococcal infection

6.1. The purpose of carrying out anti-epidemic measures in the focus of meningococcal infection (the community where the disease with a generalized form of meningococcal infection occurred) is to localize and eliminate the focus.

6.2. Upon receipt of an emergency notification, specialists from the bodies exercising state sanitary and epidemiological supervision, within the next 24 hours after hospitalization of the patient, conduct an epidemiological investigation of the outbreak of infection by filling out an epidemiological investigation card, determine the boundaries of the outbreak, persons who communicated with the patient, organize bacteriological examinations of contact persons and patients nasopharyngitis, carry out anti-epidemic measures.

6.3. In the focus of meningococcal infection, after hospitalization of a patient or suspected of this disease, final disinfection is not carried out, and in the rooms where the patient or suspected of the disease previously stayed, wet cleaning, ventilation and ultraviolet irradiation of the room are carried out.

6.4. In preschool educational institutions, children's homes, orphanages, schools, boarding schools, health organizations, children's sanatoriums and hospitals, quarantine is established for a period of 10 days from the moment of isolation of the last patient with a generalized form of meningococcal infection. During this period, it is not allowed to admit new and temporarily absent children into these organizations, as well as transfers of children and staff from a group (class, department) to other groups.

6.5. In groups with a wide range of people communicating with each other (higher educational institutions, secondary specialized educational institutions, colleges, etc.), if several diseases with a generalized form of meningococcal infection occur simultaneously or 1-2 diseases per week in succession, the educational process is interrupted for a period of at least for 10 days.

7. Epidemiological surveillance of meningococcal infection

7.1. Epidemiological surveillance of meningococcal infection is the activity of bodies carrying out state sanitary and epidemiological surveillance, aimed at identifying signs of epidemiological problems and carrying out proactive anti-epidemic measures to prevent the rise and spread of infectious diseases. Identification of early signs of epidemiological problems due to meningococcal infection is carried out through constant dynamic assessment of the state and trends in the development of the epidemic process using methods of operational and retrospective epidemiological analysis.

7.2. The purpose of operational epidemiological analysis is to assess the current situation regarding meningococcal infection by registering emerging cases of diseases with recording a block of personalized information (age, gender, address, date of illness, date of treatment, method and results of laboratory diagnostics with determination of the serogroup of meningococci, involvement in organized groups, outcome diseases), allowing to identify the beginning of epidemiological troubles for the organization of timely preventive and anti-epidemic measures.

10. Organization of immunoprophylaxis against
meningococcal infection

10.1. Preventive vaccinations against meningococcal infection are included in the preventive vaccination calendar for epidemic indications. Preventive vaccination begins when there is a threat of the development of an epidemic rise: identification of obvious signs of epidemiological troubles according to clause , an increase in the incidence of urban residents twice as compared to the previous year, or a sharp rise in incidence above 20.0 per 100,000 population.

10.2. Planning, organization, implementation, completeness of coverage and reliability of recording of preventive vaccinations, as well as timely

Regular submission of reports to the bodies carrying out state sanitary and epidemiological supervision is ensured by the heads of treatment and preventive institutions.

10.3. The plan for preventive vaccinations and the need of treatment and prophylactic organizations for medical immunobiological preparations for their implementation is coordinated with the authorities exercising state sanitary and epidemiological supervision.

11. Immunization of the population

11.1. If there is a threat of an epidemic rise in meningococcal infection, vaccine prevention is primarily subject to:

Children from 1.5 years to 8 years inclusive;

First-year students of secondary and higher educational institutions, as well as persons arriving from different territories of the Russian Federation, near and far abroad countries and united by living together in dormitories.

11.2. If there is a sharp rise in incidence (over 20 per 100,000 population), mass vaccination of the entire population is carried out with a coverage of at least 85%.

11.3. Preventive vaccinations for children are carried out with the consent of parents or other legal representatives of minors after receiving complete and objective information from medical workers about the need for preventive vaccinations, the consequences of refusing them, and possible post-vaccination complications.

11.4. Medical workers inform adults and parents of children about the required preventive vaccinations, the time of their implementation, as well as the need for immunization and possible reactions of the body to the administration of drugs. Vaccination is carried out only after obtaining their consent.

11.5. If a citizen or his legal representative refuses vaccination, the possible consequences will be explained in a form accessible to him.

11.6. Refusal to undergo preventive vaccination is recorded in medical documents and signed by an adult, the child’s parent or his legal representative.

11.7. Immunization is carried out by medical personnel trained in immunoprophylaxis.

11.8. To carry out preventive vaccinations in medical and preventive organizations, vaccination rooms are allocated and equipped with the necessary equipment.

11.9. In the absence of a vaccination room in a medical and preventive organization serving the adult population, preventive vaccinations may be carried out in medical rooms that meet sanitary and hygienic requirements.

11.10. Children attending preschool educational institutions, schools and boarding schools, as well as children in closed institutions (orphanages, children's homes), are given preventive vaccinations in the vaccination rooms of these organizations, equipped with the necessary equipment and materials.

11.11. Vaccinations at home are permitted when mass immunization is organized by vaccination teams provided with appropriate means.

11.12. Medical personnel with acute respiratory diseases, sore throats, injuries on the hands, purulent lesions of the skin and mucous membranes, regardless of their location, are excluded from preventive vaccinations.

11.13. Storage and transportation of medical immunobiological preparations is carried out in accordance with the requirements of regulatory documents.

11.14. Preventive vaccinations against meningococcal infection are carried out with medical immunobiological preparations registered on the territory of the Russian Federation in accordance with the established procedure in accordance with the instructions for their use.

11.15. The meningococcal polysaccharide vaccine can be administered simultaneously with other types of vaccines and toxoids, except for the BCG vaccine and the yellow fever vaccine, but in different syringes.

11.16. Immunization is carried out with disposable syringes.

12. Recording of preventive vaccinations and reporting

12.1. Information about the vaccination performed (date of administration, name of the drug, batch number, dose, control number, expiration date, nature of the reaction to the injection) is recorded in medical documents of the established form:

For children and adolescents - in the preventive vaccination card, the history of the child's development, the child's medical card for schoolchildren, a loose leaf for a teenager to the medical card of an outpatient;

For adults - in the patient’s outpatient card, a log of preventive vaccinations;

In children, adolescents and adults - in the certificate of preventive vaccinations.

12.2. In a treatment and prevention organization, registration forms of the established form are created for all children under the age of 15 years (14 years 11 months 29 days) living in the service area, as well as for all children attending preschool educational institutions and schools located in the service area.

12.3. Information on preventive vaccinations performed for children under 15 years of age (14 years 11 months 29 days) and adolescents, regardless of the place where they were carried out, is entered into registration forms of the established form.

12.4. Accounting for local, general, strong, unusual reactions and post-vaccination complications to vaccinations against meningococcal infection in medical and preventive organizations and bodies and institutions of state sanitary and epidemiological supervision is carried out in the prescribed manner.

12.5. The report on preventive vaccinations carried out is carried out in accordance with state forms of statistical observation.

Annex 1

Chemoprophylaxis of meningococcal infection

Chemoprophylaxis of meningococcal infection is carried out using one of the following drugs:

1) rifampicin- oral administration form (adults - 600 mg every 12 hours for 2 days; children - 10 mg/kg body weight every 12 hours for 2 days);

2) azithromycin- oral administration form (adults - 500 mg 1 time per day for 3 days; children - 5 mg/kg body weight 1 time per day for 3 days);

amoxicillin - oral administration form (adults - 250 mg every 8 hours for 3 days; children - children's suspensions in accordance with the instructions for use);

3) spiramycin- oral administration form (adults - 3 million ME in two doses of 1.5 million ME over 12 hours);

ciprofloxacin - oral administration (adults - 500 mg once);

ceftriaxone - intramuscular administration form (adults - 250 mg once).

Appendix 2

(informative)

Clinical manifestations and differential diagnosis
meningococcal infection

The clinical manifestations of meningococcal infection are varied. There are: localized form - nasopharyngitis and generalized forms - meningitis, meningococcemia, combined form (meningitis + meningococcemia). Possible: meningococcal pneumonia, endocarditis, arthritis, iridocyclitis.

Acute purulent meningitis is the most common form of generalized meningococcal infection. Diagnosis of the disease is based on the assessment of cerebrospinal fluid, so lumbar puncture is performed in all cases where purulent meningitis is suspected. Meningococcemia, sometimes its fulminant form, can manifest itself independently or in combination with purulent meningitis. The first clinical manifestations of purulent meningitis are: sudden unbearable headache, temperature rise above 38 ° C, nausea, vomiting, photophobia and tension (rigidity) of the neck muscles. Neurological symptoms can manifest as stupor, delirium, coma and seizures. In infants, the first manifestations are not so pronounced, muscle rigidity, as a rule, is not pronounced, while children are excited, cry inconsolably, refuse to eat, have a tendency to gag reflex and convulsions, the skin is pale, and bulging of the fontanel is observed.

Meningococcemia, unlike meningitis, is difficult to diagnose, especially during the period of sporadic non-epidemic morbidity, since the suddenness and severity of clinical manifestations, high temperature, and shock are not always clearly expressed. Meningeal symptoms are usually absent. The most characteristic sign of meningococcemia is a hemorrhagic rash.

Lumbar puncture confirms the clinical diagnosis of purulent meningitis and makes it possible to identify meningococci, excluding other possible etiological agents of purulent meningitis, such as pneumococci, Haemophilus influenzae type "b" and other pathogens. A puncture is performed if meningitis is suspected in a hospital before starting antibacterial therapy. Cerebrospinal fluid with purulent meningitis is usually cloudy or purulent, but may be clear or bloody. Primary laboratory diagnosis of cerebrospinal fluid in case of purulent meningitis indicates: leukocytosis of more than 100 cells per mm (the norm is less than 3 cells per mm 3) with a predominance of neutrophils (more than 60%); an increase in protein level from 0.8 g/l or more (normal is less than 0.3 g/l); detection of extracellular and intracellular diplococci. Additional important laboratory criteria are: decreased glucose; isolation, identification and serogrouping of meningococcal cultures; detection of specific meningococcal antigens or their genetic fragments.

The hemogram is characterized by pronounced leukocytosis. In meningococcemia, blood culture is often accompanied by the isolation of a culture of meningococci, serological reactions reveal specific antigens, and direct bacterioscopy of blood allows the identification of extracellular and intracellular diplococci. The possibility of inoculating meningococci directly from the elements of a hemorrhagic rash cannot be ruled out.

The symptoms of meningococcal nasopharyngitis are similar to the clinical manifestations of acute respiratory disease. Observed: general weakness, headache, sore throat when swallowing, dry cough, nasal congestion, scanty mucopurulent discharge. The posterior wall of the pharynx is swollen, hyperemic, covered with mucous discharge, and from 2 to 3 days hyperplasia of the lymphoid follicles is observed. The temperature is often subfebrile, less often normal or reaches 38 - 39 ° C. To include the disease in registration reports, laboratory isolation of meningococci from the nasopharynx is required. Conducting laboratory tests to identify isolated meningococci and determine their serogroup affiliation is a mandatory component of laboratory confirmation of patients with meningococcal nasopharyngitis.

Bibliographic data

1. Federal Law “On the Sanitary and Epidemiological Welfare of the Population” dated March 30, 1999 No. 52-FZ.

2. Federal Law “On Immunoprophylaxis of Infectious Diseases” dated September 17, 1998 No. 157-FZ.

3. Fundamentals of the legislation of the Russian Federation “On the protection of the health of citizens” dated July 22, 1993.

4. Regulations on the implementation of state sanitary and epidemiological supervision in the Russian Federation, approved by Decree of the Government of the Russian Federation of September 15, 2005 No. 569.

5. Regulations on the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, approved by Decree of the Government of the Russian Federation of June 30, 2004 No. 322.

7. Orders, guidelines, recommendations, instructions and manuals for the use of vaccines and toxoids in force as of 01/01/2006, approved by the Ministry of Health and Social Development of the Russian Federation, the Federal Service for Surveillance on Consumer Rights Protection and Human Welfare.

8. Order of the Ministry of Health of the Russian Federation No. 229 of June 27, 2001 “On the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications.”

9. MUK 4.2.1887-04 “Laboratory diagnosis of meningococcal infection and purulent bacterial meningitis” - M., 2005.

10. Savilov E.D., Mamontova L.M., Astafiev V.A., Zhdanova S.N. Application of statistical methods in epidemiological analysis. -M., 2004.

11. L.P. Zueva, R.X. Yafaev. Epidemiology. - St. Petersburg, 2006.

girl from Corinth

LIST OF ANTI-EPIDEMIC MEASURES IN FOCIES OF SEROSAL MENINGITIS
1. Mandatory hospitalization of the patient if serous meningitis is suspected.

2. Carrying out final disinfection by the population in households and medical personnel in organized teams, in outbreaks with two or more cases of serous meningitis of enteroviral etiology (according to requests from epidemiologists) by the disinfection station.

3. Medical observation for 14 days for children under 14 years of age who have been in contact with a patient with serous meningitis, with daily examination of the pharynx, skin, and thermometry.

4. Examination of contact children by a neuropathologist in order to identify patients with signs of serous meningitis and their hospitalization.

5. A one-time virological examination of all contact children (taking fecal samples) when two or more cases of serous meningitis are registered at home or in a child care facility.

6. Quarantine in preschool institutions and schools is imposed for 14 days from the date of the child’s last visit to these institutions

PHYSICAL EXAMINATION OF CONVALESCENTS OF SEROUS MENINGITIS
Due to the fact that the outcomes of acute neuroinfections, both immediate and long-term, are directly dependent on timely diagnosis and the initiation of active targeted therapy, as well as on the management of patients after the end of the acute period of the disease and discharge from the hospital, dispensary observation is mandatory for convalescents from a neurologist at a polyclinic at your place of residence or at the Scientific Research Institute for Children's Diseases (for children). The main goal of medical examination is the maximum use of all means and methods for the most complete elimination of the consequences of the disease, monitoring the correctness of comprehensive rehabilitation measures, preventing complications, and when they appear, timely correction.

The minimum period of active clinical observation after discharge from the hospital: after 1 month, then once every 3 months during the first year, once every 6 months thereafter, if necessary, the frequency of examinations increases. Upon discharge from the hospital, the patient is given a certificate describing the monitoring of his condition, the treatment and laboratory examination performed, as well as recommendations for further management of convalescent care.

Within 3 weeks after discharge from the hospital, the child must undergo rehabilitation in a local clinic, following the instructions of the attending physician. Schoolchildren are exempt from physical education classes and other physical activities for 6 months.

It is necessary to provide those who have recovered with a protective regime: a calm environment, stay in the fresh air, gradual inclusion in the general regime, limiting watching TV shows and working with a personal computer to 1 hour a day. According to indications for schoolchildren, provision of either a day off in the middle of the week or a reduction in the teaching load at school during the day, depending on the neurological status.

During the clinical examination, attention is paid to the dynamics of neurological symptoms, the degree of functional compensation of motor, mental and speech abilities, liquor dynamics, compliance with the established regimen and punctuality of the recommended therapy. According to indications, an EEG or ECHO examination, ultraneurosonography (US) of the brain, as well as magnetic resonance imaging (MRI) of the brain and computed tomography (CT) of the brain are performed.

Often the issue of involving other specialists for consultation is decided: an ophthalmologist, an otolaryngologist, a psychiatrist, an orthopedist, a massage therapist, and a physical therapy methodologist.

If necessary, the issue of either re-hospitalization or regional sanatorium treatment is resolved, where convalescents can be sent at any time, but not earlier than 3 months after the acute period of the disease.

Removal from active dispensary observation of convalescents of enteroviral serous meningitis is possible 2-3 years after the persistent disappearance of residual effects.

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Do the clinics have the right to refuse to issue sick leave during quarantine in a kindergarten?
No, they don't! Even if your child is completely healthy and has not been in contact with a carrier of the infection. Although in this case you can demand to be given a place in another kindergarten group.

The law that regulates the issue of issuing sick leave, including in the event of a quarantine being declared in a kindergarten, is Federal Law No. 255-FZ of December 29, 2006.

I CONFIRM
Chief State Sanitary Doctor of the Russian Federation
G.G. Onishchenko
2008
Date of introduction

3.1.2. PREVENTION OF INFECTIOUS DISEASES.
RESPIRATORY TRACT INFECTIONS

PREVENTION OF MENINGOCOCCAL INFECTION
Sanitary and epidemiological rules
SP 3.1.2. -08

1 area of ​​use

1.1 These sanitary rules establish the basic requirements for a set of organizational, sanitary and anti-epidemic (preventive) measures, the implementation of which is aimed at preventing the occurrence and spread of diseases of meningococcal infection.
1.2 Compliance with sanitary rules is mandatory for citizens, legal entities and individual entrepreneurs.
1.3 Monitoring of compliance with these sanitary rules is carried out by the bodies exercising state sanitary and epidemiological supervision in the Russian Federation.

2.General information about meningococcal infection

Meningococcal infection is an anthroponotic acute infectious disease caused by meningococcus (Neisseria meningitidis).
According to its antigenic structure, meningococcus is divided into 12 serogroups: A, B, C, X, Y, Z, W-135, 29E, K, H, L, I.
Until now, epidemic rises of meningococcal infection of varying degrees of intensity have been caused by three serogroups - A, B and C. Special studies have shown that meningococcal serogroups are in turn divided into subgroups that differ in genetic characteristics. The latest epidemic rise in Russia was caused by meningococcus serogroup A subgroup 111-1. During the inter-epidemic period, a small number of generalized diseases can also be caused by meningococcus serogroup A, but from other subgroups.
Meningococcal infection is characterized by periodicity. Periodic increases in incidence occur after long inter-epidemic periods (from 10 to 30 years or more) and are caused by one of the serogroups of meningococcus. Major epidemics in the 20th century, simultaneously covering many countries of the world, were caused by meningococcus serogroup A. Local epidemic rises within the borders of one country were caused by meningococcus serogroups B and C.
The sporadic incidence of the inter-epidemic period is formed by different serogroups, of which the main ones are A, B and C.
During an epidemic rise, in 86–98% of outbreaks one generalized form of disease occurs, in 2–14% of outbreaks - from 2 cases or more. The lowest percentage of secondary diseases occurs in families – 2.3%. The highest (12-14%) is in preschool institutions and dormitories, respectively. The occurrence of secondary diseases is facilitated by overcrowding, increased air humidity in the room, and violations of the sanitary and hygienic regime.
With a sporadic incidence rate, in almost 100% of foci, 1 case of a generalized form of meningococcal infection is registered.
The source of meningococcal infection is an infected person. The pathogen is transmitted from person to person by airborne droplets (aerosol) during direct close contact at a distance of up to 1 m from the infected person). Meningococcus is unstable in the external environment and infection with it through household items has not been recorded. However, it can be assumed that infection can occur through a shared cup and spoon while eating and drinking.
There are 3 groups of sources of infection:
1. Patients with a generalized form of meningococcal infection (meningococcemia, meningitis, meningoencephalitis, mixed form - make up about 1-2% of the total number of infected persons).
2. Patients with acute meningococcal nasopharyngitis (10-20% of the total number of infected persons).
3. “Healthy carriers” - persons without clinical manifestations, identified only during bacteriological examination. The average duration of carriage of meningococcus is 2-3 weeks; in 2-3% of individuals it can last up to 6 weeks or more. The wide prevalence of bacterial carriage in the human population maintains the continuity of the epidemic process.
The highest incidence, both during the epidemic and in the inter-epidemic period, is recorded among children and adolescents.
Meningococcal infection is characterized by winter-spring seasonality.
An increase in the incidence of meningococcal infection is observed during the formation of teams of children's educational institutions, schoolchildren, and students after the summer holidays.
Children and recruits are at increased risk of morbidity.

3. Identification of patients with meningococcal infection, persons suspected of this disease and meningococcal bacteria carriers.

3.1. Identification of patients with a generalized form of meningococcal infection, persons with suspected disease is carried out by doctors of all specialties, paramedical workers of treatment and preventive, children's, adolescent, health and other organizations, regardless of organizational and legal forms and forms of ownership, doctors and paramedical workers involved in private medical activities, for all types of medical care, including:
- when the population seeks medical help;
- when providing medical care at home;
- when visiting doctors engaged in private medical activities.
3.2. Identification of patients with meningococcal nasopharyngitis and meningococcal bacteria carriers is carried out during anti-epidemic measures in foci of the generalized form of meningococcal infection.
3.3. Patients with a generalized form of meningococcal infection or with suspicion of this disease are immediately hospitalized in an infectious diseases hospital.
3.4. Registration and accounting of each case of meningococcal infection is carried out in accordance with established requirements.
4. Measures in the focus of a generalized form of meningococcal infection

4.1. After receiving an emergency notification in the case of a generalized form of infection or suspicion of this disease, specialists from the territorial bodies of Rospotrebnadzor, within 24 hours, conduct an epidemiological investigation to determine the boundaries of the outbreak and the circle of people who communicated with the patient, and organize anti-epidemic and preventive measures in order to localize and eliminate the outbreak .
4.2 Anti-epidemic measures in outbreaks with one case of the generalized form of the disease are limited to the circle of people from the immediate environment of the patient. These include relatives living in the same apartment with the sick person, close friends who have communicated with the sick person for the last 3 days, pupils and staff of the children's institution group, and dormitory roommates.
4.3. In outbreaks with a single disease, quarantine is not imposed. After hospitalization of the patient, during the first 24 hours, the otolaryngologist examines persons who communicated with the patient in order to identify patients with acute nasopharyngitis. Identified patients with acute nasopharyngitis are subject to hospitalization (according to clinical indications), or remain in the team for the period of treatment. All persons without inflammatory changes in the nasopharynx are given chemoprophylaxis with one of the antibiotics, taking into account contraindications. Refusal of chemoprophylaxis is recorded in the medical documentation and signed by the responsible person and medical professional.
For 10 days after hospitalization of a patient with a generalized form, the outbreak is subject to medical observation with thermometry, examination of the nasopharynx and skin.
If secondary diseases occur in the outbreak (within the incubation period), quarantine is established for a period of 10 days with medical observation of contacts. During quarantine, it is not allowed to admit new or temporarily absent children, or to transfer staff from groups (classes, departments) to other groups.
4.4. In outbreaks with simultaneous occurrence of 2 cases of the generalized form in children's preschool educational institutions, children's homes, orphanages, schools, boarding schools, children's health institutions, organizations, quarantine is established for a period of 10 days. During the quarantine period, the listed groups are not allowed to admit new or temporarily absent children, or to transfer personnel from groups (classes, departments) to other groups.
4.5. The sequence of anti-epidemic measures in outbreaks with 2 or more cases of the disease is carried out according to the scheme presented in clause 4.3. After identifying patients with nasopharyngitis and before prescribing chemoprophylaxis, a bacteriological examination of all persons who were in varying degrees of contact with the sick (children and staff in a group of a preschool institution, a school class, an educational group and a dorm room) is carried out. Persons receiving chemoprophylaxis are not removed from the team.
The emergence of foci with secondary diseases, as well as foci with simultaneously occurring diseases, is an alarming sign of a possible increase in morbidity.
Bacteriological examination in the foci is carried out to identify the circulation of the meningococcus serogroup, which is the cause of secondary diseases.
4.6. In areas with several cases of generalized forms of meningococcal infection, emergency prophylaxis is carried out with a vaccine containing an antigen corresponding to the meningococcal serogroup isolated from patients. Vaccination is carried out in accordance with the “Instructions for use of the vaccine”
Children over 1-2 years old, adolescents and adults are subject to vaccination:
- in a preschool educational institution, children's home, orphanage, school, boarding school, family, apartment - all persons who communicated with the patient;
- first-year students of secondary and higher educational institutions of the faculty where the disease occurred;
- senior students of a higher and secondary educational institution who communicated with the patient in a group and (or) dormitory room, as well as all first-year students of the faculty in which the disease occurred;
- persons who communicated with the patient in dormitories, when the disease occurred in groups staffed by foreign citizens.
The presence of nasopharyngitis without a fever reaction in the vaccinated person is not a contraindication for vaccination
4.6. In the focus of a generalized form of meningococcal infection, after hospitalization of a patient or someone suspected of this disease, final disinfection is not carried out. The premises are subject to daily wet cleaning, frequent ventilation, and maximum decompaction in the sleeping areas.
4.7.. During the period of epidemic rise in foci of a generalized form of meningococcal infection, emergency vaccination is carried out without establishing the serogroup of the pathogen, quarantine is not established, and bacteriological examination is not carried out.

5. Measures regarding convalescents of the generalized form of meningococcal infection, meningococcal nasopharyngitis, carriers of meningococcus

5.1. Convalescents with a generalized form of meningococcal infection or meningococcal nasopharyngitis are discharged from the hospital after clinical recovery.
5.2. Convalescents of the generalized form of meningococcal infection or meningococcal nasopharyngitis are admitted to preschool educational institutions, schools, boarding schools, children's health organizations, hospitals, secondary and higher educational institutions after a single bacteriological examination with a negative result, carried out no earlier than 5 days after completion course of treatment. If the carriage of meningococcus persists, sanitation is carried out with one of the antibiotics.
5.3. Convalescents of acute nasopharyngitis without bacteriological confirmation are admitted to the institutions and organizations listed in clause 5.2 after the disappearance of acute phenomena.

6. Organization of immunoprophylaxis for meningococcal infection
according to epidemic indications
6.1. Preventive vaccinations against meningococcal infection are included in the calendar of preventive vaccinations for epidemic indications
6.2.Planning, organization, implementation, completeness of coverage and reliability of records of preventive vaccinations, as well as timely submission of reports to the authorities exercising state sanitary and epidemiological supervision, are ensured by the heads of treatment and preventive organizations in accordance with established requirements.
6.3. Preventive vaccination for epidemic indications is carried out when there is a threat of an epidemic rise, namely, when the incidence of the prevailing serogroup of meningococcus increases two or more times compared to the previous year, according to the decision of the chief state sanitary doctor of the Russian Federation, the chief state sanitary doctors of the constituent entities of the Russian Federation for the following risk groups .
6.4. Vaccinations are subject to:
- children from 1 year to 8 years inclusive;
- first-year students of secondary and higher educational institutions, primarily in teams staffed by students from different regions of the country and foreign countries.
With the continuing increase in the incidence of meningococcal infection, the number of vaccinated persons for epidemic indications should be expanded due to:
- students from grades 3 to 11;
- the adult population when contacting treatment and prevention organizations for immunization against meningococcal infection.
6.5. Preventive vaccinations for children are carried out with the consent of parents or other legal representatives of minors.
Medical workers inform adults and parents of children about the need for vaccination against meningococcal infection, the timing of vaccinations, as well as possible reactions and post-vaccination complications to the administration of the drug.
6.6. Refusal to undergo preventive vaccination is recorded in the medical documentation and signed by the parent or legal representative of the child and a medical professional.
6.7. Information about the vaccination performed (date of administration, name of the drug, dose, batch number, control number, expiration date, nature of the reaction to the vaccination) is entered into the established registration forms of medical documents and the “Certificate of Preventive Vaccinations”.
6.8. Immunization is carried out by a medical worker trained in immunoprophylaxis.
6.9. Preventive vaccinations in health care organizations are carried out in vaccination rooms equipped with the necessary equipment in accordance with established requirements.
6.10. Children attending preschool educational institutions, schools and boarding schools, as well as children in closed institutions (orphanages, children's homes), are given preventive vaccinations in the medical offices of these organizations, equipped with the necessary equipment and materials.
6.11. When organizing mass immunization, vaccination at home is permitted by vaccination teams in accordance with established requirements.
6.12. Preventive vaccinations against meningococcal infection are carried out with domestic and foreign-made vaccines registered in the Russian Federation and approved for use in the prescribed manner, in accordance with the instructions for their use.
6.13. Storage and transportation of medical immunobiological preparations is carried out in accordance with established requirements.
6.14. Vaccination against meningococcal disease can be carried out simultaneously with vaccination against other infectious diseases, except vaccination against yellow fever and tuberculosis. Vaccines are administered with different syringes to different areas of the body.

7. Epidemiological surveillance of meningococcal infection
Epidemiological surveillance of meningococcal infection is carried out by bodies and institutions that carry out state sanitary and epidemiological surveillance in accordance with regulatory documents. Epidemiological surveillance includes:
- monitoring the incidence of meningococcal infection (monitoring morbidity and mortality, age structure and populations of patients, focality);
- analysis of the serogroup affiliation of strains isolated from patients with a generalized form of meningococcal infection and nasopharyngitis;
- monitoring the immunological structure of the population to meningococcus of the main serogroups A, B and C;
- assessment of the effectiveness of ongoing activities;
- forecasting the development of the epidemiological situation.

The document has become invalid or cancelled.

Resolution of the Chief State Sanitary Doctor of the Russian Federation dated May 18, 2009 N 33 "On approval of sanitary and epidemiological rules SP 3.1.2.2512-09" (together with "SP 3.1.2.2512-09. Prevention of meningococcal infection. Sanitary and epidemiological...

IV. Activities in a generalized outbreak

meningococcal infection during the inter-epidemic period

4.1. The inter-epidemic period is characterized by sporadic incidence of generalized forms caused by various serogroups of meningococcus. The overwhelming number of outbreaks (up to 100%) is limited to one case of the disease.

4.2. After receiving an emergency notification in the case of a generalized form of infection or suspicion of this disease, specialists from the territorial bodies of Rospotrebnadzor, within 24 hours, conduct an epidemiological investigation to determine the boundaries of the outbreak and the circle of people who communicated with the patient, and organize anti-epidemic and preventive measures in order to localize and eliminate the outbreak .

4.3 Anti-epidemic measures in outbreaks are aimed at eliminating possible secondary diseases and preventing the spread of infection beyond the outbreak. They are limited to the circle of people from the immediate environment of the patient with a generalized form. These include relatives living in the same apartment with the sick person, close friends (with whom they communicate constantly), students and staff of the children's organization group, neighbors in the apartment and dorm room.

The list of close contact persons can be expanded by the epidemiologist depending on the specific situation in the outbreak.

4.4. In the outbreak, after hospitalization of a patient with a generalized form or suspicion of it, quarantine is imposed for a period of 10 days. During the first 24 hours, the otolaryngologist examines persons who communicated with the patient in order to identify patients with acute nasopharyngitis. Identified patients with acute nasopharyngitis are subject to bacteriological examination before appropriate treatment is prescribed. After a bacteriological examination, persons with symptoms of acute nasopharyngitis are hospitalized in a hospital (according to clinical indications) or left at home for appropriate treatment in the absence of children under 3 years of age in the immediate environment. All persons without inflammatory changes in the nasopharynx are given chemoprophylaxis with one of the antibiotics (Appendix), taking into account contraindications. Refusal of chemoprophylaxis is recorded in the medical documentation and signed by the responsible person and medical professional.

4.5. During the quarantine period, the outbreak is under medical surveillance with daily thermometry, examination of the nasopharynx and skin. Children's preschool organizations, children's homes, orphanages, schools, boarding schools, and children's health organizations are not allowed to admit new or temporarily absent children, or transfer personnel from groups (classes, departments) to other groups.

4.6. The emergence of foci with secondary diseases of generalized forms of meningococcal infection within one month during the inter-epidemic period is an alarming sign of a possible increase in incidence. In such outbreaks, where the meningococcal serogroup that has formed the outbreak has been identified, emergency vaccination is carried out with a meningococcal vaccine, which contains an antigen corresponding to the serogroup identified in patients.

Vaccination is carried out in accordance with the instructions for use of the vaccine.

Children over 1-2 years of age, adolescents and adults are subject to vaccination:

In a children's preschool educational organization, a children's home, an orphanage, a school, a boarding school, a family, an apartment - all persons who communicated with the patient;

Persons who communicated with the patient in dormitories, when the disease occurred in groups staffed by foreign citizens.

The presence of nasopharyngitis without a fever reaction in the vaccinated person is not a contraindication for vaccination.