Ministry of Health of Ukraine Ukrainian Medical Stomatological Academy K.V. Pikul, V.І. Ilchenko, K.Yu. Prylutskiy PEDIATRIC INFECTIOUS DISEASES IN FAMILY DOCTOR’S PRACTICE Study Guide Міністерство охорони здоров’я України Українська медична стоматологічна академія К.В.Пікуль, В.І.Ільченко, К.Ю.Прилуцький ДИТЯЧІ ІНФЕКЦІЙНІ ХВОРОБИ У ПРАКТИЦІ СІМЕЙНОГО ЛІКАРЯ Навчально-методичний посібник Poltava – 2019 UDC: 616.98-053.3/.5 Навчально-методичний посібник підготовлений співробітниками кафедри ендокринології з дитячими інфекційними хворобами (зав. кафедри проф. Л.Є. Бобирьова) Української медичної стоматологічної академії, доц., к.мед.н. К.В.Пікуль, доц., к.мед.н. В.І.Ільченко, к.мед.н. К.Ю.Прилуцьким. Educational and methodical manual prepared by the staff of the Department of Endocrinology with Children's Infectious Diseases (head of the department Prof. L. E. Bobierova) of the Ukrainian Medical Stomatological Academy, Associate professor, Ph.D. K.V.Pikul, Associate Professor, Ph.D. VI Ilchenko, Ph.D. K.Yu.Prylutskіy Рекомендовано Вченою радою Української медичної стоматологічної академії як навчально-методичний посібник для англомовних студентів медичних факультетів закладів вищої освіти МОЗ України (витяг з протоколу №4, від 26 грудня 2018 року) Рецензенти: Зав. кафедри дитячих інфекційних хвороб Харківського Національного державного медичного університету д.м.н., професор С.В. Кузьнєцов. Head Department of Children's Infectious Diseases Kharkiv National State Medical University MD, professor S.V. Kuznetsov ДЗ «Дніпровська медична академія» МОЗ України д.м.н., професор Ю.К. Больбот. "Dniprovska Medical Academy" MD, professor Yu.K. Bоlbot Доцент кафедри інфекційних хвороб з епідеміологією Української медичної стоматологічної академії к.м.н., доцент В.А. Полторапавлов Associate Professor of the Department of Infectious Diseases with Epidemiology Ukrainian Medical Stomatological Academy Ph.D., associate professor V.А. Poltorapavlov Доцент кафедри іноземних мов з латинською мовою та медичною термінологією Української медичної стоматологічної академії к.ф.н., доцентІ.М. Сологор Associate Professor of the Department of Foreign Languages with Latin and medical terminology Ukrainian Medical Stomatological Academy Ph.D., Associate Professor I.M. Sologor Навчально-методичний посібник складений згідно з типовим навчальним планом та програмою для підготовки іноземних студентів медичних закладів вищої освіти для циклу «Дитячі інфекційні хвороби». Цей навчально-методичний посібник написаний англійською мовою і присвячений питанням етіології, епідеміології, клініки та диференційної діагностики найбільш частих дитячих інфекційних хвороб, наведені алгоритми діагностики та терапії, згідно з протоколами лікування, що затверджені МОЗ України. Назви розділів автори підібрали у відповідності з тематичним планом для підготовки іноземних студентів медичних закладів вищої освіти. Посібник містить запитання для самоконтролю, тести, задачі та розбір історій хвороб дітей, що лікувались у дитячому відділенні ПОКІЛ для більш глибокого засвоєння матеріалу. The teaching manual is compiled according to a typical curriculum and a program for the preparation of foreign students of medical institutions of higher education for the cycle "Children's Infectious Diseases". This teaching manual is written in English and is devoted to the issues of etiology, epidemiology, clinics and differential diagnostics of the most common infectious diseases of children, diagnostic algorithms and therapies are given in accordance with the treatment protocols approved by the Ministry of Health of Ukraine. The titles of the sections were chosen by the authors in accordance withthe thematic plan for thepreparation of foreign students of medical institutions of highereducation. The manual contains questions for self-control, tests, tasks and analysis of children's diseaserecords that were treated at the children's department for a deeper assimilation of the material. 2 CONTENTS Contents................................................................................................................. 3 Section 1. Prevention of pediatric infectious diseases............................................ 6 Section 2. Exanthematous infections in children ................................................. 14 Section 3. Streptococcal infection in children...................................................... 30 Section 4. Herpesviral infection in children......................................................... 36 Section 5. Infectious mononucleosis in children.................................................. 41 Section 6. Pediatric atypical infections................................................................ 49 Section 7. Diphtheria in children.......................................................................... 54 Section 8. Whooping cough ............................................................................... 63 Section 9. Infectious polyneuropathies in children ............................................... 69 Section 10. Meningitis in children....................................................................... 77 Section 11. Helminthoses in children ................................................................... 86 Section 12. Acute intestinal infections................................................................. 91 Section 13. Viral hepatitis ................................................................................. 100 References: ........................................................................................................ 110 Control tests ....................................................................................................... 114 3 Introduction The era of information society, which is based on knowledge, their production, tradition and acquisition, puts forward new requirements to the system of education. Implementation of the advanced technologies into teaching is crucial for contemporary medical higher education. One of the ways of integration and democratization of higher education in Ukraine is assimilation with European canons of education and ensuring the Bologna Process’s educational objectives. The implementation of these tasks is possible only on the condition of transition from the classical educational system, which aims to prepare the qualified future physician to a new system, which prepares a professional, who not only knows, but also is able to apply this knowledge in the Family Medicine practice. Infectious diseases have always been virulent, proved by its mass character, rapid proliferation and high mortality, especially in child age. Numerous infections can lead to the development of complications, requiring proper diagnosis, therapy, taking into account the etiology of pathological process. Hopefully, the present study guide will be useful in everyday practical work of pediatricians, pediatric infectiologist and family doctors, as well as for students of 5-6-year of study at medical HEIs. The authors will gratefully accept all suggestions and criticisms. 4 List of Abbreviations АS – acetonemic syndrome BBB – blood-brain barrier AEI – acute enteric infection ASLT – acute stenosing laryngotracheitis ABB – acid-base balance CVP – central venous pressure ITS – infectious toxic shock ELISA – enzymoimmunoassay BES – brain edema-swelling EPEC – enteropathogenic Escherichia coli ETEC– enterotoxigenic Escherichia coli CIGD – complex immunoglobulin drug IFA – immunofluorescence antibody assay AR – agglutination reaction CFT – complement-fixation test PR – precipitation reaction HAIR - hemagglutination-inhibition reaction PHAT - passive hemagglutination test CFR - complement-fixation reaction NR - neutralization reaction МА – membrane antigen VСА – viral-capsid antigen ЕА – early antigen-diffuse 5 SECTION 1. PREVENTION OF PEDIATRIC INFECTIOUS DISEASES Fighting infectious diseases is one of the major tasks for public health care and state. The non-specific and specific (vaccination) prophylaxis is distinguished. The system of nonspecific preventive measures is directed on strict observance of sanitary-hygienic regimen, early detection of the source of infection and its isolation, surveillance over the contact individuals and their control laboratory examination in the foci of infection, final disinfection in the foci of disease, etc. Vaccination is the artificial creation of the immune response by administration of vaccine to the human body in order to form the immunity to the infection. The beginning of successful fighting infectious diseases is considered the year of 1798, when English physician Edward Jenner invented a way of vaccination with the cowpox material to prevent the infection of smallpox. He called the procedure vaccination, and the material that was taken from smallpox of cows was vaccine (from Lat. "vacca"-cow). Formation of post-vaccine immunity Humoral immunity is the immunity of the body to infection which is caused by the presence of specific antibodies. Vaccine prophylaxis is aimed at creation of active artificial anti- infectious immunity by administration into the human body of antigens of infectious agent in the form of vaccine. In primary administration of the vaccine strain of the pathogen (vaccination) in a non-immune body, the JgМ-class antibodies appear in the blood with the subsequent switching to the synthesis of antibodies of JgG-class, and cells of the immune memory are formed. In the repeated administration of antigen (revaccination) a "booster" effect occurs due to inclusion