Ringworm is a highly contagious disease of an infectious nature. It occurs most often in children who attend school or kindergarten. If you notice strange symptoms in your child, consult a doctor immediately. If the diagnosis is confirmed, the main thing is not to panic; the disease is highly treatable.

Ringworm is transmitted in the following ways:

• upon contact with a sick person;
• while in a sauna, swimming pool and other rooms with high humidity; in such conditions, pathogens multiply especially quickly;
• when using other people's personal hygiene products, common objects (stair railings, handrails in the subway).

A child can also catch the disease from a sick animal. But if the baby has a strong immune system, infection may not occur. The problem is that the immunity of most children is weakened by many factors, so the body becomes more susceptible to pathogenic microbes.

Ringworm can occur for the following reasons:

• reduced immunity;
• damage to the epidermis;
• chronic stress, overwork;
• rainy weather, high humidity;
• increased sweating (microorganisms love a wet environment);
• lack of vitamins;
• diseases of the endocrine system (diabetes mellitus), puberty.

Types of lichen

Ringworm is a general name for a whole group of diseases, mainly of a fungal nature.

There are such types of lichen:

1. Encircling. Its causative agent is the varicella zoster virus of the herpesvirus family. Shingles is characterized by a rash in the form of ulcers with fluid inside, which are localized on the chest. The baby feels weakness, fever, pain in the affected areas. The worst part is that there is no way to completely cure shingles. Once the herpes virus enters the body, it remains there forever. To reduce the number of relapses of the disease to a minimum, you need to lead a healthy lifestyle and constantly strengthen your immune system.
2. Red flat. This form of lichen is quite rare in children. It is characterized by blisters with red liquid, which are very itchy and cause a lot of discomfort to the child. Typically, lichen ruber is caused by diseases of the gastrointestinal tract, stress, and genetic predisposition.
3. Multi-colored (pityriasis). Tinea versicolor is the rarest form of the disease. It's easy to recognize. At the initial stage of development, light pink spots appear on the shoulders, chest, and arms, which become darker every day. The development of this disease is promoted by ultraviolet radiation and increased sweating. This type of lichen is considered non-contagious, therefore isolation of a sick baby from other children is not necessary. But we must not forget about the rules of hygiene. The child must have his own comb and towel, which he will not give to other children.
4. Shearer. Ringworm, also called microsporia, is the most common type. It has pronounced symptoms: the lesions peel off, itch very much, rashes do not appear on the arms, shoulders and other parts of the body, but only on the scalp. In this case, the hair in the affected areas breaks off, causing bald spots to form. In rare cases, the disease affects the nails. Microsporia is divided into two types: zoonotic (you can get it from a cat, it is not transmitted from person to person, so there is no need for quarantine); anthroponotic (affects only people; anthroponotic lichen is extremely contagious and can easily cause an epidemic).
5. Pink (dry). Pityriasis rosea has both an infectious and an allergic nature. If a child is diagnosed with an infectious form of pityriasis rosea, the school is immediately closed for quarantine.

These diseases are very different from each other and have different symptoms. But they also have common characteristics:

• light pink scaly spots at the beginning of the development of the disease;
• spots appear on the neck, thighs, buttocks, arms, sometimes on the nail plates, on the scalp;
• increased body temperature, inflamed lymph nodes (in some cases).

To make a diagnosis, the doctor examines a skin scraping. This analysis is mandatory.

Duration of quarantine in kindergartens and schools

Quarantine for shingles in kindergartens and schools is at least 45 days. In this case, all children from school (or kindergarten) undergo a mandatory examination by a dermatologist for the next 5 days. If several children are sick, the quarantine is extended. The premises of the institution are completely disinfected, soft toys are thrown away, and carpets are thoroughly cleaned.

Sick leave is terminated only when the child’s external signs of illness have disappeared. Also a decisive role is played by testing for fungi under a Wood's lamp. This test is performed 3 times and must be negative each time.

Prevention

To avoid contracting lichen and other infections, it is necessary to strengthen the immune system. The child’s diet should include fruits, vegetables, meat, fish, and dairy products. You also need to play sports, toughen up (only if the baby is completely healthy), get a good night's sleep, and treat various diseases in a timely manner, even if it is a common cough. Don't let your child become overtired or spend too much time studying. In addition to maintaining immunity, you should adhere to the following rules:

• Use only your own personal hygiene items.
• Do not contact stray animals.
• Avoid using antibacterial hygiene products. They contain the antibiotic triclosan, which can provoke various pathological conditions. Also, these agents act very aggressively and can destroy the hydrolipidic mantle of the epidermis. It is recommended to give preference to wet wipes.
• Wear only your own clothes.
• Vaccinate your pets on time.

State sanitary and epidemiological regulation
Russian Federation

State sanitary and epidemiological
rules and regulations

SanPiN 3.2.3215-14

Moscow 2015

2. Approved by Decree of the Chief State Sanitary Doctor of the Russian Federation dated August 22, 2014 No. 50.

3. Registered with the Ministry of Justice of the Russian Federation on November 12, 2014, registration number 34659.

CHIEF STATE SANITARY DOCTOR
RUSSIAN FEDERATION

RESOLUTION

In accordance with 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; 2002, No. 1 (Part I), Art. 2; 2003, No. 2, Article 167; No. 27 (Part I), Article 2700; 2004, No. 35, Article 3607; 2005, No. 19, Article 1752; 2006, No. 1, Article 10; No. 52 (Part I), Article 5498; 2007, No. 1 (Part I), Article 21, Article 29; No. 27, Article 3213; No. 46, Article 5554; No. 49, Article 6070; 2008 , No. 24, Article 2801; No. 29 (Part I), Article 3418; No. 30 (Part II), Article 3616; No. 44, Article 4984; No. 52 (Part I), Article 6223 ; 2009, No. 1, Art. 17; 2010, No. 40, Art. 4969; 2011, No. 1, Art. 6; No. 30 (Part I), Art. 4563, Art. 4590, Art. 4591, Art. 4596; No. 50, Art. 7359; 2012, No. 24, Art. 3069; No. 26, Art. 3446; 2013, No. 27, Art. 3477; No. 30 (Part I), Art. 4079; No. 48, Art. 6165; 2014, No. 26 (Part I), Article 3366, Article 3377) and the Decree of the Government of the Russian Federation dated July 24, 2000 No. “On approval of the Regulations on the State Sanitary and Epidemiological Service of the Russian Federation and the Regulations on the State Sanitary and Epidemiological standardization" (Collection of Legislation of the Russian Federation, 2000, No. 31, Art. 3295; 2004, No. 8, Art. 663; No. 47, art. 4666; 2005, No. 39, Art. 3953)

I DECIDE:

A.Yu. Popova

Sanitary and epidemiological rules and regulations
SanPiN 3.2.3215-14

I. Scope of application

1.1. These sanitary and epidemiological rules and regulations (hereinafter referred to as sanitary rules) have been developed in accordance with the legislation of the Russian Federation.

1.3. Compliance with sanitary and epidemiological rules is mandatory throughout the Russian Federation for state bodies, government bodies of the constituent entities of the Russian Federation, municipalities, officials of state bodies, officials of government bodies of the constituent entities of the Russian Federation, officials of local governments, citizens, individual entrepreneurs and legal entities.

1.4. Monitoring the implementation of these sanitary rules is carried out by bodies authorized to carry out federal state sanitary and epidemiological supervision in accordance with the legislation of the Russian Federation.

II. General provisions

Identification of trends in the epidemic process;

Identification of regions, regions, settlements with a high incidence rate and risk of infection;

Assessing the quality and effectiveness of ongoing preventive and anti-epidemic measures;

Planning the sequence of activities and timing of their implementation;

Development of forecasts of the epidemiological situation.

3.3. The main tool for epidemiological surveillance is epidemiological diagnostics.

Epidemiological diagnosis is carried out using retrospective and operational epidemiological analysis of morbidity.

3.4. A multi-year retrospective epidemiological analysis is carried out for at least the last 5 years and includes:

Analysis of long-term dynamics of morbidity (infection);

Analysis of incidence by territory;

Analysis of morbidity by age groups, gender, population groups;

Conclusions and proposals for the development of preventive measures.

3.5. Operational epidemiological analysis is carried out in conditions of an epidemic rise in morbidity or registration of epidemic foci of group morbidity. Epidemiological analysis includes constant monitoring of the dynamics of morbidity taking into account a specific etiological agent, assessment of the sanitary and epidemiological situation, formulation of a preliminary and final epidemiological diagnosis with the establishment of the causes and conditions for the rise in morbidity or the formation of an epidemic focus.

The following are subject to examination for helminthiasis and intestinal protozoa: children attending preschool educational organizations; staff of children's preschool educational organizations; primary schoolchildren, children, adolescents, maternity leave and equivalent groups of the population during medical examinations and preventive examinations; children, adolescents for epidemic indications; children and adolescents enrolled in preschool and other educational organizations, shelters, children's homes, orphanages, boarding schools, for sanatorium and resort treatment, in health organizations, in children's departments of hospitals; children of all ages in closed-type children's organizations and year-round stay, patients in children's and adult clinics and hospitals according to indications, persons who communicated with patients.

4.3. Delivery of biological material to the laboratory is carried out in sealed containers, ensuring its safety and safety of transportation.

4.5. The organization and conduct of routine examinations of children attending preschool, school educational organizations and other children's organizations is ensured by the heads of such organizations.

4.9. In the event of a change or clarification of the diagnosis, medical workers of medical organizations report by telephone, and then within 12 hours send an emergency notification in writing about the change or clarification of the diagnosis to the territorial body of the federal executive body authorized to carry out federal state sanitary and epidemiological supervision.

4.11. Infected persons are subject to treatment on an outpatient or inpatient basis on the basis of their informed voluntary consent and taking into account the right to refuse medical intervention.

4.15. All identified infected persons are provided with dispensary observation in relevant medical organizations.

4.16. A dispensary observation form is filled out for each infected person.

4.17. Removal from dispensary registration is carried out after treatment and receipt of negative results of laboratory testing of biological material.

Measures to prevent malaria.

5.1. Collection and analysis of data on local or imported cases of malaria is carried out by medical organizations and bodies authorized to carry out sanitary and epidemiological surveillance.

5.2. The bodies authorized to carry out sanitary and epidemiological supervision determine a set of sanitary and anti-epidemic (preventive) anti-malarial measures (table).

5.3. The organization of malaria prevention activities on the territory of a constituent entity of the Russian Federation is carried out by government authorities in the field of health protection of constituent entities of the Russian Federation together with interested departments and local governments in municipalities. When organizing anti-malarial measures, ensure the availability of a minimum supply of anti-malarial drugs for the treatment of all types of malaria, including primaquine, and carry out disinsection measures to destroy mosquitoes (imagoes, larvae), where transmission of three-day malaria is possible.

5.4. The period of carrying out measures for the prevention of malaria in an active focus of three-day malaria is carried out for 3 years due to the possible appearance of patients with malaria after a long incubation.

Basic antimalarial measures

Name of events		In the absence of infection	When an infection is introduced during a period when transmission is possible	In active foci
	I. Treatment and prophylaxis
	Finding malaria cases
	Active method
	Passive method
	Preliminary treatment of febrile persons at risk of contracting tropical malaria
	Epidemiological survey of the outbreak
	Chemoprophylaxis, seasonal, interseasonal
	Verifying the absence of malaria
	II. Entomological and pest control measures
	Vector monitoring
	Calculation of the timing of the effective mosquito infectivity season and the malaria transmission season
	Monitoring of breeding sites and the dynamics of their areas, certification of reservoirs in the territory of populated areas and within a radius of 3 km with annual replenishment of data
	Prevention of the formation of anophelogenic reservoirs and reduction of the area of ​​existing
	Protecting the public from mosquito bites using repellents, protective clothing and electrofumigation devices
	Treatment of premises with insecticides
	Treatment of anophelogenic reservoirs with larvicides
	Entomological quality control of larvicidal and imagocidal treatments
III. Personnel training
IV. Sanitary educational work among the population

5.5. Organizations sending employees to subtropical and tropical countries, or travel agencies organizing trips to these countries, inform travelers:

About the possibility of contracting malaria and the need to comply with preventive measures (protection from mosquito bites and the use of chemoprophylactic drugs that are effective in the country of residence);

On the need to immediately seek qualified medical care if a febrile illness occurs while staying in an endemic country;

The need to immediately consult a doctor after returning if any febrile illness occurs and inform him about the length of stay in the countries of the subtropical and tropical zone and the use of chemoprophylactic drugs.

Specialists sent to subtropical and tropical countries in areas where there is no pre-medical care are provided with a course dose of antimalarial drugs.

5.6. Heads of transport organizations operating flights to countries where tropical malaria is widespread, as well as rescuers and military personnel temporarily located in these countries, are provided with packing containing antimalarial preventive drugs and means of protection against mosquito bites. These individuals are given chemoprophylaxis.

5.7. Military personnel of border troops and combined arms formations who serve in countries where three-day malaria is common are given a course of preventive treatment against malaria 14 days before demobilization or departure from endemic areas to the territory of the Russian Federation.

5.8. The following are subject to examination for malaria:

Persons arriving from areas endemic for malaria or who have visited endemic countries within the last three years, with an increase in temperature, with any of the following symptoms against a background of body temperature above 37 ° C: malaise, headache, enlarged liver, spleen, yellowness of the sclera and skin integument, herpes, anemia;

Persons with an unknown diagnosis who have been febrile for 5 days;

Patients with an established diagnosis, but with ongoing periodic rises in temperature, despite specific treatment;

Persons living in an active outbreak, with any increase in temperature.

VI. Measures to prevent helminthiases transmitted through meat and meat products

6.1. Heads of organizations, as well as individual entrepreneurs, provide:

The quality and safety of meat and meat products during its production and sale in accordance with the requirements of technical regulations;

Carrying out preventive disinfestation and deratization measures in the territories of livestock farms and complexes, slaughterhouses, meat product warehouses, food industry enterprises, public catering and food trade organizations and other facilities of particular epidemiological significance;

Informing medical, veterinary and hunting organizations about cases of detection of helminthiasis transmitted through meat among wild and farm animals, as well as cases of human disease.

6.2. Requirements for methods of disinfection of meat products.

6.2.1. Requirements for freezing meat:

Cattle carcasses are frozen until the meat reaches a temperature of minus 12 °C (the temperature is measured in the thickness of the hip muscles at a depth of 7 - 10 cm with a special thermometer). In this case, no further aging is required. At a temperature in the meat thickness of minus 6 - 9 ° C, the carcass is kept in the refrigerator for at least 24 hours;

Pork carcasses are frozen until the meat reaches a temperature of minus 10 °C and maintained at an air temperature in the chamber of minus 12 °C for 10 days. At a temperature in the thickness of the meat of minus 12 ° C, the carcass is kept at an air temperature in the refrigerator compartment of minus 13 ° C for 4 days (the temperature is measured in the thickness of the hip muscles at a depth of 7 - 10 cm with a special thermometer).

6.2.2. Requirements for heating meat:

Parts of a cattle carcass or pork carcass are divided into pieces weighing up to 2 kg and thickness up to 8 cm and boiled for 3 hours in open or 2.5 hours in closed boilers at an excess steam pressure of 0.5 MPa.

6.2.3. Requirements for salting meat:

Parts of a cattle carcass or pork carcass are divided into pieces weighing no more than 2.5 kg, rubbed and covered with table salt at the rate of 10% relative to the weight of the meat, then filled with brine with a concentration of at least 24% of table salt and aged for 20 days.

6.2.5. Meat and its processed products obtained from the slaughter of private livestock in meat industry organizations and individual entrepreneurs are issued (returned) to the owner in a disinfected form.

6.2.6. Slaughterhouse and kitchen waste intended for feeding to domestic and fur-bearing animals are subject to mandatory heat treatment.

VII. Measures for the prevention of helminthiases transmitted through fish, crustaceans, mollusks, amphibians, reptiles and their processed products

7.1. In order to identify pathogens of helminthiases in the intended area (zone) of a freshwater reservoir, 25 individuals of each species of additional (commercial size) hosts of pathogens of biohelminthiasis are examined.

7.2. In accredited testing laboratories, 20 commercially sized individuals of additional hosts of biohelminthic pathogens common in this territory are examined. If the result is negative, the number of fish specimens studied is increased to 40. If the negative result is confirmed, the reservoir is considered safe. Fish caught in such reservoirs is allowed for sale without restrictions. Subsequent studies in this reservoir are carried out after 3 years.

7.3. If fish infected with biohelminth larvae are found in a reservoir, all fish of this species and other species that can play the role of additional hosts of biohelminths, as well as fish products, are disinfected from biohelminth larvae before sale. Fish products from such reservoirs that have not undergone disinfection are not allowed for sale.

7.6. Disinfection of fish and fish products is carried out through freezing, salting and heat treatment.

7.7. Requirements for disinfection methods and processing regimes for fish and fish products.

7.7.1. Requirements for freezing fish:

Fish is disinfected from tapeworm larvae using the freezing regimes indicated in Table. ;

Fish are disinfected from opisthorchid larvae and other trematodes using the freezing regimes indicated in Table. ;

Marine fish, crustaceans, mollusks, amphibians and reptiles containing live anisakid larvae and other helminths dangerous to humans and animals are disinfected by freezing at the temperature in the body of the fish (crustaceans, mollusks, amphibians, reptiles), the duration of this temperature and subsequent storage conditions in accordance with table. ;

If it is impossible to provide freezing regimes that guarantee the disinfection of fish products, they should be used for food purposes only after hot heat treatment or sterilization (canned).

7.7.2. Requirements for salting fish:

When infected with tapeworm larvae, the fish is disinfected by salting in the modes indicated in the table. ;

Disinfection of Far Eastern salmon from diphyllobothriid larvae is carried out using all methods of industrial salting when the mass fraction of salt in the back meat of the fish reaches 5%;

Disinfection of whitefish, salmon and grayling fish from gull tapeworm larvae is carried out using mixed weak salting (brine density 1.18 - 1.19) for 10 days when the mass fraction of salt in fish meat reaches 8 - 9%;

Disinfection of fish from opisthorchid larvae and other trematodes is carried out using mixed strong and medium salting (brine density from the first day of salting is 1.20 at a temperature of 1 - 2 ° C) when the mass fraction of salt in fish meat reaches 14%. In this case, the duration of salting should be:

Minnow, bleak, minnow, verkhovka - 10 days;

Roach, dace, rudd, chub, blue bream, white-eye, podust, sabrefish, asp, small (up to 25 cm) ide, bream, tench - 21 days.

A weaker or shorter salting of fish is allowed, only after it has been previously frozen in the modes indicated in the table. 2.

Regimes for disinfecting fish from tapeworm larvae

	Types of fish
	pike, burbot, ruff, perch	chum salmon, pink salmon, kunja, sima, Sakhalin taimen	peled, omul, whitefish, char, muksun, whitefish, salmon, tugun, grayling, lake trout
Time required for disinfection
	72 h		60 h
		50 h
	36 h
			36 h
	18 h
		16 hours
	12 h		7 hours
			6 hours

Regimes for disinfecting fish from opisthorchid larvae

Temperature in the body of the fish (minus °C)	Time required for disinfection (hours)
Note. Considering the significant resistance of trematode larvae to low temperatures, freezing fish at a temperature above the specified temperature does not guarantee its disinfection.

Regimes for disinfecting marine fish from anisakid larvae

Temperature in the body of the fish (minus °C)	Temperature duration	Subsequent storage conditions
	14 days	According to current storage rules
	24 hours	Subsequent storage at a temperature not exceeding minus 18 ° C for 7 days. Further according to the current storage rules
	10 min	Subsequent storage at a temperature not exceeding minus 12 °C for 7 days. Further according to the current storage rules

Fish salting regimes for disinfection of tapeworm larvae

Ambassador	Brine density	Temperature (°C)	Duration of salting, guaranteeing disinfection (days)	Mass fraction of salt in fish meat (%)
Strong	1,20	2 - 4		over 14
Average	1,18	2 - 4		10 - 14
Weak	1,16	2 - 4

7.7.3. Requirements for salting fish roe.

When salting fish eggs as an independent product, disinfection from tapeworm larvae is carried out in the following ways:

Warm salting (temperature 15 - 16 °C) is carried out at the amount of salt (as a percentage of the weight of caviar): 12% - 30 minutes; 10% - 1 hour; 8% - 2 hours; 6% - 6 hours;

Chilled salting (at a temperature of 5 - 6 ° C) is carried out with the amount of salt (as a percentage of the weight of caviar): 12% - 1 hour; 10% - 2 hours; 8% - 4 hours; 6% - 12 hours;

Chilled salting of caviar of whitefish and other fish infected with gull tapeworm larvae is carried out with a salt amount of 5% by weight of the caviar for 12 hours.

Salting of caviar of anadromous salmon and sturgeon fish is carried out after removal of anisakid larvae.

7.7.4. Requirements for heat treatment of fish and fish products:

Fish is cooked in portions for at least 20 minutes from the moment of boiling, fish dumplings - for at least 5 minutes from the moment of boiling, crustaceans and mollusks - for 15 minutes;

Fish (fish cutlets) are fried in portions in fat for 15 minutes. Large pieces of fish weighing up to 100 g are fried spread out for at least 20 minutes. Small fish are fried whole for 15 - 20 minutes.

7.7.5. Sea fish intended for cold and hot smoking, salting and pickling, and the production of preserves is pre-frozen in the modes indicated in the table. .

7.7.6. It is not allowed to dump fish processing waste into water bodies or landfills, or feed it to animals without prior disinfection.

7.7.7. Responsibility for the implementation of these activities rests with individual entrepreneurs and legal entities engaged in breeding, rearing, production (catch), processing, storage, sale of fish, aquatic invertebrates, aquatic mammals, other aquatic animals found in their natural habitat, aquaculture objects, food fish products.

VIII. Measures to prevent echinococcosis, alveococcosis

8.1. Groups at risk of infection with the causative agent of echinococcosis (hunters, shepherds, reindeer herders, shepherds, workers of fur farms, livestock farms, zoos, fur harvesters, workers of fur workshops, veterinarians, persons engaged in catching dogs, dog owners, workers of nature reserves, reserves, forestries, collectors and purchasers of mushrooms, berries, as well as members of their families) are subject to examination for echinococcosis during preventive and periodic medical examinations and medical examinations.

8.2. Organization of preventive measures for echinococcosis includes:

Operational tracking (monitoring) of the epidemic situation;

Epidemiological analysis of information about echinococcosis in the territory for a certain period of time (data on population morbidity, the number of surgical operations for echinococcosis, disability, mortality, economic damage, the nature and scope of sanitary, hygienic and treatment and preventive measures);

Hygiene education using the media;

Regulation of keeping stray dogs, their deworming.

8.3. The objects of sanitary and helminthological research are places where dogs are kept, livestock farms, and households.

8.4. Prevention of infection in humans and farm animals includes the following.

8.4.1 Ensuring deworming of dog dogs, reindeer dogs, sled dogs and other dogs in cities and towns.

8.4.2. Providing local government bodies and legal entities with accounting and registration of dogs, regulating the number of stray dogs by catching them and keeping them in special nurseries. When implementing regional programs and comprehensive plans for the sanitary and epidemiological well-being of the population, the organization and implementation of these activities falls within the powers of the executive authorities of the constituent entities of the Russian Federation.

8.4.3. Preventive deworming against cystodes of guard dogs, guard dogs, reindeer dogs, sled dogs, hunting dogs and other dogs is carried out 5 - 10 days before moving animals to pastures and hunters going hunting. Deworming of dogs is carried out at special sites; feces excreted after treatment are collected in a metal container and treated with drugs that have an ovicidal effect. The cement-covered soil is being processed.

8.4.4. For walking pets in populated areas, special areas must be allocated, marked with signs. In areas for walking pets, special containers are installed to collect animal feces.

8.4.6. In order to prevent infection of humans, dogs and fur-bearing animals kept in enclosures with alveococcosis, the following measures are taken:

In places where furs are extracted, in each settlement and in hunting winter quarters, special rooms are equipped for the removal and primary processing of animal skins, collection of affected carcasses and their disposal, which meet sanitary and hygienic standards. The premises are provided with sufficient water. The floor, walls and equipment must have a smooth surface. Waste from hide processing is burned. Eating and storing food in these premises is strictly prohibited.

IX. Measures to prevent dirofilariasis

9.1. Prevention of infection of humans and animals with heartworms is based on interrupting the vector-borne transmission of the infection: extermination of mosquitoes, identification and deworming of infested domestic dogs, prevention of contact of mosquitoes with domestic animals and humans.

9.2. In cities and rural settlements in places (park areas, recreation areas for people and dog walking, dog kennels) where foci of dirofilariasis are formed, specialist entomologists from Rospotrebnadzor institutions monitor the phenology, ecology and species composition of dirofilaria carriers, determine the timing of breeding and mass flight of mosquitoes.

9.3. In foci of dirofilariasis, continuous treatment of water bodies is carried out - delavation, residential and non-residential premises are treated with insecticides.

9.4. Examination and deworming of infested domestic dogs and cats is carried out in the spring and summer. To prevent dirofilariasis, non-infected dogs in an endemic area are given chemoprophylaxis.

9.5. Long-acting repellents are used to prevent pets and humans from coming into contact with mosquitoes.

9.6. Medical workers carry out explanatory work with the population about the prevention of dirofilariasis using the media.

X. Measures for the prevention of ascariasis, trichuriasis, toxocariasis

10.1. Foci of ascariasis and trichocephalosis differ in the degree of their extensiveness, determined by the level of population prevalence and the number of microfoci.

10.2. On the territory of the Russian Federation, there are several types of foci of ascariasis and trichuriasis (table).

Types of foci of ascariasis and trichuriasis on the territory of the Russian Federation

Hearth type	Ascariasis		Trichocephalosis
	affected people (%)	proportion of microfoci (%)	affected people (%)	proportion of microfoci (%)
High intensity	30 or more	50 or more	10 - 5
Medium intensity	15 - 29	up to 40	3 - 9
Low intensity	up to 15	units	units

10.4. Anti-epidemic measures to prevent ascariasis and trichuriasis include:

Identification of sources of invasion and establishment of microfoci;

Epidemiological examination of the outbreak in identifying geohelminthiases;

Improvement of microfoci and foci of geohelminthiasis;

Treatment of infested people (with monitoring of effectiveness 14 days after deworming, three times with an interval of 7 - 10 days) and examination of residents of the microfocus (annually for two years);

Disinfestation of soil, sewage;

Prohibition of the use of infested human feces as fertilizers;

10.5. The decision to carry out disinfestation of objects and the scope of measures to improve the outbreak is made by the body authorized to carry out federal state sanitary and epidemiological supervision.

10.6. Measures to prevent ascariasis, trichuriasis and toxocariasis include:

Analysis of the prevalence and morbidity of the population;

Prevention of contamination by helminth eggs of the soil, vegetables, fruits, berries, table greens grown on it, as well as dishes made from them that are eaten without heat treatment;

Analysis and evaluation of the effectiveness of preventive measures;

Regulation of the number of stray dogs in populated areas;

Allocation of areas for walking dogs on the territory of households and ensuring their proper condition;

Disinfestation of sand in sandboxes and prevention of contamination with dog and cat feces;

Sanitary cleaning of populated areas;

Maintaining personal hygiene at home, in public places, as well as when in contact with soil, sand and plant products;

Hygienic education and training;

XI. Measures to prevent enterobiasis and hymenolepiasis

11.1. Prevention of enterobiasis is carried out in accordance with sanitary rules (Resolution of the Chief State Sanitary Doctor of the Russian Federation dated October 22, 2013 No. 57 “On approval of sanitary and epidemiological rules SP 3.2.3110-13 “Prevention of enterobiasis” (registered by the Ministry of Justice of Russia on January 20, 2014, registration number 31053 ).

11.2. Prevention of hymenolepiasis includes the following set of measures:

Survey of decreed population groups;

Treatment of identified infected persons and chemoprophylaxis of contact persons;

Monitoring the circulation of the causative agent of hymenolepiasis in groups at increased risk of infection;

Implementation of sanitary and hygienic measures to comply with the anti-epidemic regime;

Hygienic education and training of the population.

11.2.2. The following are subject to examination for hymenolepiasis:

Children of preschool educational organizations;

Staff of preschool educational organizations;

Primary schoolchildren (1 - 4);

Children, adolescents, decreed groups of the population for epidemic reasons and during medical examinations and preventive examinations;

Children enrolled in preschool and other educational organizations, children's homes, orphanages, boarding schools, for sanatorium and resort treatment, and health organizations;

Outpatient and inpatient patients of children's clinics and hospitals;

Persons receiving access to a swimming pool.

11.2.3. Planned preventive examinations of children and staff in preschool organizations and educational organizations of primary school age are carried out once a year (after the summer period) and (or) according to epidemic indications.

11.2.4. Decreed groups of the population are subject to periodic preventive planned examination for hymenolepiasis - once a year.

11.3. Persons infested with dwarf tapeworm are subject to mandatory treatment on an outpatient or inpatient basis (if isolation is necessary for epidemiological reasons).

11.4. Persons infested with dwarf tapeworm belonging to decreed groups of the population are transferred to another job for the period of treatment. If it is impossible to transfer such workers, they are temporarily suspended from work (for the period of treatment and control laboratory examination) with payment of compensation.

11.5. Children infected with dwarf tapeworm are not allowed into preschool educational organizations for the period of treatment and control laboratory examination.

XII. Measures to prevent intestinal protozoa (giardiasis, amebiasis, cryptosporidiosis, balantidiasis, blastocystosis and others)

12.1. Preventive actions:

Analysis of morbidity in adults and children;

Survey of epidemiologically significant populations: children and staff of educational organizations upon admission to the organization and then once a year, decreed groups of the population upon admission to work and then once a year, persons in contact with patients, inpatients and outpatients according to indications;

Protection of water bodies from pollution by wastewater and surface runoff;

With decentralized water supply, including from natural reservoirs: boiling water, using filter devices and disinfectants, drinking bottled water;

Compliance with strict sanitary and epidemiological requirements in medical organizations;

Compliance with sanitary-hygienic and anti-epidemic regimes in preschool educational organizations;

Hygienic training of decreed groups of the population, including employees of preschool educational organizations;

Compliance with the rules for keeping animals, ensuring their protection from infection with protozoa;

12.2. Anti-epidemic measures:

Sending an emergency notification about a detected case of intestinal protozoa to the territorial department of Rospotrebnadzor;

Epidemiological examination of the outbreak in identifying cases of intestinal protozoosis;

Treatment of patients with intestinal protozoosis with monitoring of its effectiveness after 5 - 6 days. The criterion for effectiveness is three negative results of laboratory tests conducted at intervals of 1 - 2 days;

Establishing a diagnosis of carriage of intestinal protozoan pathogens in individuals belonging to decreed population groups. With their consent, the heads of organizations and individual entrepreneurs are temporarily transferred to another job for the period of treatment and control examinations after treatment. If it is impossible to transfer temporarily, for the period of treatment and examination, they are suspended from work with the payment of social insurance benefits in accordance with the legislation of the Russian Federation;

XIII. Requirements for measures to prevent head lice and scabies

13.1. Measures to prevent head lice and scabies include:

Routine examinations of the population for pediculosis;

Providing organized groups (preschool educational organizations, orphanages, children's homes, stationary organizations for children's recreation and health) with replacement bed linen, personal hygiene products, disinfectants and detergents;

Equipping with disinfection equipment and providing disinfectants to medical organizations, reception centers, organizations of social security systems, pre-trial detention centers, overnight stay homes, places of temporary stay of migrants, sanitary checkpoints, bathhouses, laundries.

13.2. The following are subject to inspection for lice and scabies:

Children attending preschool educational organizations, monthly;

Students of general education and professional educational organizations - 4 times a year;

Students of boarding schools, children living in orphanages, orphanages - in accordance with the legislation of the Russian Federation;

Children going on vacation to health-improving organizations - before departure;

Children staying in a children's health organization - weekly;

Patients admitted for inpatient treatment - upon admission and then once every 7 days;

Persons in social security organizations - 2 times a month;

Outpatients - upon treatment;

Employees of organizations - during medical examinations and preventive examinations.

13.3. If pediculosis is detected in persons admitted to the hospital, sanitary treatment is carried out in the emergency department. The patients' belongings and special clothing of the personnel who carried out the treatment are placed in an oilcloth bag and sent to a disinfection chamber for disinfection.

13.4. When children enter a preschool educational organization, they are examined for head lice and scabies.

13.5. When children affected by head lice are identified, they are sent for rehabilitation and are suspended from attending a preschool educational organization. Admission of children to preschool educational organizations after reorganization is allowed if they have a medical certificate confirming the absence of head lice.

13.6. If head lice is detected, students are suspended from visiting the organization for the duration of treatment. They can be admitted to general education organizations only after completing a set of treatment and preventive measures with a confirmatory certificate from a doctor.

13.7. Persons who have been in contact with a person with head lice are placed under medical supervision for a period of 1 month, with examinations carried out once every 10 days and the results of the examination being recorded in a journal.

13.8. The results of examinations for pediculosis and scabies of persons admitted for inpatient treatment and (or) attending outpatient appointments are recorded in medical documents.

13.9. A patient with scabies entering for treatment from the emergency department (or identified in the department) is isolated in a separate room (isolator). After consultation with a dermatovenerologist and confirmation of the diagnosis, the patient (adults and children over 1 year old) is treated and given personal items (towel, washcloth, soap in small packages). Meals are served in the ward. The patient's underwear and bed linen are processed.

13.10. Manipulations regarding patients with scabies, as well as cleaning of premises, are carried out using personal protective equipment - rubber gloves, separate gowns. Rubber gloves and cleaning equipment are disinfected after cleaning.

13.11. If scabies is detected in children attending preschool educational and general education organizations, in single people, the elderly, disabled people, people living in hostels, members of large families, migrants, people without a fixed place of residence, processing is carried out by specialized organizations at the request of organizations and individuals, including with chamber processing of underwear and bed linen.

13.12. Persons diagnosed with pubic lice are sent to a dermatovenerological dispensary at their place of residence in order to confirm the diagnosis and carry out a set of anti-epidemic measures.

13.13. If scabies is detected in children of preschool and school age, they are excluded from attending preschool educational and general education organizations for the duration of treatment. They can be admitted to educational organizations only after completing a set of treatment and preventive measures with a confirmatory certificate from a doctor.

13.14. The issue of preventive treatment of persons who have been in contact with a person with scabies is decided by the doctor, taking into account the epidemiological situation. Persons who were in contact with the patient, as well as from organizations where several cases of scabies have been registered or where new patients are identified during the process of monitoring the outbreak (period of 1 month) are involved in this treatment. In organizations where preventive treatment of contact persons was not carried out, examination of the skin of students is carried out three times with an interval of 10 days.

13.15. When scabies is detected in an organization, routine disinfection is carried out.

13.16. In the reception departments of medical organizations, underwear and clothing of incoming patients are processed in a disinfection chamber, or disinfected with an insecticide, or temporarily excluded from use (underwear and clothing are placed in plastic bags for a period of at least three days). Bedding used by patients with scabies in hospitals is treated in disinfection chambers or disinfected with an insecticide.

XIV. Measures to prevent demodicosis

14.1. Preventive actions:

Compliance with general hygiene standards (hairdressers, beauty salons, baths, saunas, swimming pools, water parks and others);

Compliance with the rules of personal hygiene when caring for facial skin and eyes;

Examination of risk groups for demodicosis: employees of medical organizations (doctors-laborators of diagnostic laboratories, ophthalmologists, dermatologists and others), hairdressers, cosmetologists.

14.2. Anti-epidemic measures:

Disinfection of equipment, materials, work surfaces from demodex mites in hairdressing salons, beauty salons and others;

Improvement of parks, squares, cemeteries, territories of recreational organizations, places of mass recreation and residence of the population;

Acaricidal treatment of areas of parks, squares, cemeteries, health organizations, recreation centers, including domestic and farm animals;

Deratization measures to reduce the number of tick hosts (wild rodents) in cleared areas;

Disinsection preventive (anti-epidemic) measures in order to reduce the number of blood-sucking insects, taking into account the results of entomological monitoring, including in places of formation of foci of vector-borne diseases (reservoirs near populated areas and recreational areas, areas for walking and keeping dogs, in residential and non-residential premises and others );

Treatment of dogs and cats with broad-spectrum insectoacaricidal preparations;

Training the population in methods of individual protection of humans and domestic animals from blood-sucking insects and ticks.

16.5. Measures to protect the environment from contamination by eggs and larvae of helminths, cysts (oocysts) of intestinal pathogenic protozoa include:

Improvement of settlements, farms, individual farms, recreational areas, areas for keeping and slaughtering livestock;

Maintaining the cleanliness of populated areas, livestock farms and complexes, farms and individual households;

Collection, storage and disinfection of solid household waste;

Ensuring the disinfection of sewage sludge generated at water treatment plants and sewage treatment plants before their disposal;

Preventing the discharge of wastewater and its sediments, livestock waste, wastewater from river and sea transport into surface water bodies without continuous disinfestation (absence of viable helminth eggs and cysts of intestinal pathogenic protozoa) by industrial methods;

Use on agricultural fields of irrigation of wastewater, its sediments and livestock wastewater, disinfected (not containing viable helminth eggs and cysts of intestinal pathogenic protozoa) by industrial methods;

Cleaning of residential premises, industrial premises for the preparation, storage, dressing of hides, sewing of fur products;

Disinfection of skins and fur products;

Cleaning the premises of children's preschool and school organizations;

Compliance with the regimes for keeping public and individual livestock, domestic animals, as well as closed animals.

Assessment of the epidemic situation on site with determination of the scale and boundaries of the emergency for making management decisions (on the first day after eliminating the technical causes of the accident);

Evaluating the results of laboratory tests;

Organization of disinfestation measures, including the use of ovicidal biological inhibition-stimulation drugs with a wide range of effectiveness for treating large areas of contaminated areas;

Monitoring the morbidity of the population living in the contaminated area for two years in the absence of registration of disease cases in the foci and microfoci of geohelminthic infections.

16.7. Measures for disinfestation of environmental objects.

16.7.1. Disinfestation of sewage (feces).

16.7.2. Disinfestation of solid household waste.

Solid household waste is disinfected:

In biothermal chambers, at a temperature of 65 - 80 ° C, the death of helminth eggs occurs after exposure from 12 to 17 days;

In compost piles measuring 1.5×1.0 meters of arbitrary length; disinfestation periods range from several months to 1.5 years;

Field composting in compost piles 10 - 25 m long with a trapezoidal cross-section with a base of 3 - 4 m, an upper side of 2 - 3 m, a height of 1.5 - 2 m, located on the soil surface or in trenches 0.5 m deep; self-heating temperature 50 - 60 °C, composting time 8 - 12 months;

Processing in biodrums at 2000 rpm - for 2 days;

Combustion and pyrolysis (decomposition) in special engineering structures.

16.7.3. Disinfestation/deworming of wastewater.

Disinfestation/deworming of wastewater is carried out:

At aero-biological stations;

At artificial biological treatment facilities (subsurface irrigation fields);

On biological filters of sewage treatment facilities (additional treatment of wastewater in irrigation fields with a capacity of up to 100 m 3 /day);

On one-, two-, three-chamber septic tanks, filter wells (for drainage of 1, 3, 15 m 3 /day of wastewater according to the specified septic tanks);

On septic tanks, storage tanks, filtration and gravel filters.

For the disinfection of sewage from river and sea transport vessels, the following are used:

Dry toilets;

Installations using active chlorine. The combined effect of a temperature of at least 50 ° C plus a dose of active chlorine 10 - 20 mg/l for 30 minutes;

Measures for the discharge of wastewater after pumping from ships into the citywide sewerage system (drainage stations).

For the disinfection of railway transport wastewater, biotoilets are used (biothermal treatment with a temperature in the biodegradation chamber of 35 - 40 ° C with an exposure of at least 4 hours; in a pasteurization chamber - 70 ° C with an exposure of at least 20 minutes).

Methods and modes of their use for disinfection of sewage

Method (method) for disinfection of sewage	Processing conditions and modes
Composting	Burying sewage with straw, sawdust and other water-absorbing components. The size of the collars is 1.5×1.0 m, the length is arbitrary. Laying piles in spring, summer, autumn	Provided that the compost temperature is guaranteed to be maintained at 60 °C for 3 months*
Dry toilets (biothermal treatment)	The temperature in the biodegradation chamber is 35 - 40 °C;	4 hours
	in the pasteurization chamber - 70 °C	20 minutes
Treatment of sewage in outhouse toilet cesspools:	Every month, a bucket of soil treated with 2 liters of prometrin (gesagart) solution is added to the contents of the cesspools at the rate of 45 g of the drug per 1 liter of water	3 months
Prometrin (gesagart)	1 kg of saltpeter per 1 m 3 of sewage	3 days
Ammonium nitrate;	0.25 kg of saltpeter per 1 m 3 of sewage	5 days
Ammonia water;	Not less than 2.5% of the drug to the volume of sewage (not less than 0.25 kg per 1 m 3 of sewage)	10 days
Carbation;	Adding one of the drugs at the rate of 8% to the volume of sewage (80 g of drug per 10 kg)	3 weeks
Nemagon;	- « -	3 - 10 days
Tiazon	0.2 - 2.0% by weight of sewage (per 10 kg 2 - 20 g of preparation)	3 - 4 weeks
Preparations based on quaternary ammonium compounds	2.0% solution in a 1:2 ratio with sewage	30 minutes
____________ * To ensure high-quality disinfestation, in the absence of guaranteed maintenance of the “pasteurization” temperature of the compost during the exposure period, it is necessary to use industrial methods, including the use of biological inhibition-stimulation ovicides.

16.7.4. Disinfestation of sewage sludge.

Pasteurization in special engineering structures at a temperature of 70 ° C for 20 minutes;

Processing in biodrums;

Combustion in special engineering structures (multi-pound or drum furnaces, suspended bed reactors, etc.);

Aerobic stabilization method for 5 - 6 days with pre-heating of the mixture of raw sludge with activated sludge at a temperature of 60 - 65 ° C for 1.5 hours;

Treatment of ovicides with biological inhibitors-stimulants with a minimum dosage of 1 liter per 60 m 3 of sludge with a moisture content of more than 85%, after which no additional disinfection of wastewater is required.

16.7.5. Disinfestation of liquid manure and manure waste.

For the purpose of disinfection of liquid manure and manure waste, the following is carried out:

Thermal treatment of liquid manure and sludge fraction with a humidity of 96 - 98% in a contact heating installation due to the supply of a high-temperature torch (over 1,200 ° C), formed during the combustion of liquid or gaseous fuel, directly into the processed mass. Processing mode: exposure for at least 3 minutes, temperature of the mass at the outlet of the installation is 48 - 50 °C. Efficiency is achieved by repeatedly mixing the processed mass with compressed air in the heat factor zone;

Thermal treatment of liquid manure and manure waste in a steam jet unit. Disinfection is provided in flow mode at a mass temperature at the outlet of the installation of 80 ° C and an exposure time of at least 5 minutes;

Treatment of liquid manure and sludge fraction with liquid ammonia in a closed container at a concentration of 2 - 3%, exposure for 2 days, at an initial temperature of the mass of 10 ° C and above;

Treatment of liquid manure, manure drains and sludge fraction with biological inhibition-stimulation preparations in accordance with the instructions for their use.

(Changed edition. Amendment No. 1)

Treatment of surfaces, objects, materials, and cleaning equipment in animal premises is carried out using disinfectants.

16.7.6. Disinfestation of soil and sand.

Disinfestation of soil and sand at the first stage is achieved:

Treatment with herbicide-based products;

Treatment with products based on quaternary ammonium compounds;

Treatment with biological inhibition-stimulation ovicidal drugs;

Treatment with table salt (1 kg per 1 m2). Used for disinfection of the most contaminated areas of soil from hookworm larvae once every 10 days;

Using a crop rotation system: the plot is initially sown with radishes, radishes, garlic, onions, and after harvesting - again with peas. The effect is achieved by simultaneous sowing of crops such as garlic - radish, onion - radish and some other legume and lily families. Egg death occurs over two summer periods.

16.7.7. Disinfestation of vegetables, fruits, table greens.

To disinfect vegetables, fruits, table greens from helminth eggs, pre-soak plant products in water for 20 - 30 minutes before thoroughly rinsing in a colander under running water for 5 - 10 minutes with periodic shaking. Onions, parsley, lettuce are first cleared of soil, then separated into individual leaves, stems, and feathers. The effect is obtained by washing them in soapy water and then rinsing with running water. For berries that have a rough surface or lobed structure (strawberries, strawberries, raspberries), they are washed with a 1.0% soda solution and then with clean water. To disinfect vegetables from eggs and larvae of roundworms, whipworms, hookworms, strongylids, a weak solution of iodine (0.2 - 0.5%) is used.

16.7.8. Disinfestation of household items, toys, linen.

To disinfect bed linen, boiling and ironing on both sides is recommended. Woolen blankets, carpets, mattresses, rugs, curtains are processed with a vacuum cleaner (followed by neutralizing the dust using approved disinfectants), dried and shaken in the sun, and ironed with a hot iron through a rag. Dust from vacuum cleaner containers after neutralization is disposed of in the general sewer system.

In areas with harsh winters, household items and linen are taken outside on frosty days, given that pinworm eggs die at a temperature of -15 ° C for 40 - 45 minutes.

Linen, toys and other things are disinfected in a disinfection chamber.

Disinfestation of soft toys and other objects with a rough surface is ensured by treatment with a vacuum cleaner. Room surfaces, sinks, taps, door handles, cellophane and rubber toys, etc. are subject to disinfection by irrigation or wiping with products approved for use.

16.7.9. Disinfestation of drinking water.

Filtration (sand, diatomite, clinoptilite, titanium, metal-ceramic materials);

Sorption (charcoal, manganese oxide and others);

Use of ion exchange resins;

Use of the combined action of sorbents and ion exchange resins;

At the second stage - treatment with ultraviolet rays with a strong oxidizing agent (hydrogen peroxide);

Ozonation;

Exposure to MIO radiation (powerful pulsed optical radiation);

The use of filter materials at water treatment plants with a pore size of at least 1 micron, ensuring the retention of cryptosporidium oocysts.

Treatment of sludge generated at water treatment plants to be disposed of for the purpose of disinfestation is carried out with biological inhibition-stimulation preparations.

16.7.10. Disinfestation of skins of wild and domestic carnivores, fur and fur products.

For processing the skins of domestic and wild animals, the technological process that ensures the complete removal of taeniid oncospheres should include primary processing, washing, soaking, rinsing, pickling, pickling, tanning, fatliquoring, drying (at a temperature of 30 - 33 ° C), drawing, rolling, shaking, breaking, sanding and shaking again. The stage of hauling away hides with sawdust should last at least 9 hours with a sawdust replacement frequency of 6 times a year. Workers involved in the primary processing of hides must wear gloves and respiratory protection.

Disinfection of skins and fur products from taeniid oncospheres is ensured by irradiation with a mercury-quartz lamp or other sources of ultraviolet radiation.

The premises are provided with sufficient water for sanitary and industrial needs. The floor, walls and equipment must have a smooth surface and should not be difficult to clean. The walls of the room and equipment are treated with boiling water or a disinfectant, and the waste from processing the hides is burned. Eating, storing food and smoking in these areas is strictly prohibited.

16.7.11. Disinfestation of other environmental objects.

16.7.11.1. During the working day, containers with feces and sewage sludge are placed in enamel containers, filled with a chlorine-active agent, followed by disinfection with means recommended for use in accordance with sanitary rules.

16.7.11.2. Spent biological material is disinfected with drugs approved for use.

16.7.11.3. Used glass slides, pipettes, stoppers, test tubes, glass rods, beakers and others are placed during the working day in containers with a disinfectant solution until completely vertically immersed. Final disinfection is carried out by boiling in water (from the moment of boiling for at least 30 minutes) with the addition of laundry soap or liquid detergent. Under appropriate conditions, autoclaving may be used.

16.7.11.4. The effectiveness of disinfection and disinfestation of biological material, laboratory glassware, auxiliary and packaging materials is ensured in ultra-high frequency installations for the disinfection of medical waste.

16.7.11.6. Working surfaces of laboratory tables are disinfected with 96% ethyl alcohol followed by flaming.

16.7.11.7. Equipment (centrifuges, microscopes, refrigerators) is treated with 70% ethyl alcohol.

16.7.11.8. Overalls, towels, and cleaning items are boiled in a 2.0% soap-soda solution or 0.5% detergent solution.

16.7.11.9. Cleaning equipment (rags, brushes) is boiled or treated with disinfectants.

16.7.11.10. Routine cleaning of laboratory premises is carried out daily using a wet method after the end of the working day: in the “clean” area of ​​the laboratory using detergents, in the “infectious” area using disinfectants. The box rooms are subject to weekly general cleaning using disinfectants. After wet cleaning, bactericidal lamps are turned on.

17.2. Hygienic education and training is carried out with professional hygienic training and certification of officials and employees of organizations whose activities are related to the production, storage, transportation and sale of food products and drinking water, the upbringing and education of children, public utilities and consumer services.

“Microsporia – sources, routes of transmission and carrying out disinfection measures in outbreaks”

Microsporia (microsporosis) is a fungal disease of the skin and hair, which is caused by various types of fungi of the genus Microsporum. There are anthropophilic and zoophilic types of fungi.

Microsporum ferrugineum is an anthropophilic fungus. Infection occurs through contact with patients or objects contaminated with the pathogen. The disease is highly contagious.

The zoophilic fungus is Microsporum canis. Infection occurs from animals: cats, more often kittens (80-85%), less often dogs as a result of direct contact with a sick animal (or carrier) or through contact with objects contaminated with the hair of sick animals. The duration of the incubation (latent) period is 5-7 days for zoonotic microsporia and 4-6 weeks for anthroponotic microsporia.

In the Volgograd region, the incidence of microsporia was registered in 2010. – 1294 cases, of which 1085 were in children under 14 years of age, 2011 - 993 cases of which 879 were in children under 14 years of age, 2012 - 2178 cases of which 1647 were children under 14 years of age.

With microsporia of smooth skin, a slightly swollen, sharply defined spot of pinkish-red color, round or oval in shape, the size of a lentil to a large coin, appears, prone to peripheral growth. When spots merge, lesions with scalloped outlines are formed. The lesions are located mainly on the smooth skin of the face, neck, torso and limbs, very often multiple.

With microsporia of the scalp, round, sharply limited, large (with a diameter of up to 2-3 cm or more) lesions are formed, the surface of which is covered with a layer of pityriasis-like scales of a grayish-white color. The most characteristic sign of microsporia is the continuous breaking off of hair at one level, approximately at a height of 3-5 mm above the skin, giving the impression of a mown meadow

The main way of spreading microsporia is through household contact (direct and indirect contact). The disease is transmitted through direct contact with a sick person, sick animal or carrier, or through contact with various environmental objects contaminated with dermatophytes. Skin scales, fragments of hair, nails containing abundant elements of a viable fungus, falling off from the lesions, infect the patient’s things - clothes, hats, bed linen, towels, household items (toys, books, carpets, upholstered furniture, etc.), toiletries (combs, combs, washcloths), shoes, gloves, cleaning equipment, bedding for animals and care items.

Disinfection measures in foci of microsporia

Routine disinfection in foci of dermatomycosis is organized by a medical institution upon suspicion or upon diagnosis.

Routine disinfection before hospitalization, recovery or cancellation of the diagnosis is carried out either by the patient himself or by the person caring for him (it is unacceptable to entrust the care of the patient to children). The person caring for the patient must observe the rules of personal hygiene (work in a robe, cap or headscarf, gloves), and after caring for the patient, his things and after cleaning the premises, wash his hands thoroughly with soap.

For disinfection, it is preferable to use the safest methods and means of disinfection:

physical method - (boiling, cleaning with brushes and a vacuum cleaner, preferably with a humidifier, repeated ironing with a hot iron).

chemical method - the safest detergents, cleaning - disinfectants, fungicidal agents, approved for use by the population in everyday life, the use of which does not require enhanced personal protective measures.

In order to maximize the isolation of the patient from others, he is allocated a separate room or part of it, contact with children is excluded, and the number of objects with which the patient can come into contact is limited.

In the outbreak, it is necessary to strictly observe the rules of personal hygiene: the patient is provided with a separate bed, a personal towel and care items (combs, washcloths, sponges, a basin for washing feet, brushes for cleaning clothes, manicure and pedicure accessories, socks, shoes, etc.).

The patient's outer clothing, including hats, shoes, and gloves should be stored separately from the clothing of family members.

The patient's dirty linen is collected in a separate bag or basket. Disinfection of linen is carried out by boiling in water or a 2% caustic soda solution for 15 minutes from the moment of boiling, or by soaking in a disinfectant solution. It is prohibited to take a patient's linen to a public laundromat for washing.

If the scalp is affected, it is necessary to wear a cap that fits tightly to the head, or a headscarf made of easily washable fabric that covers the entire scalp.

The room or apartment where the patient lives is wet cleaned daily using detergents or detergents and disinfectants approved for use by the population at home. For these purposes, separate cleaning equipment is provided (rag, mop without bristles and bucket, cleaning rags). The entire apartment is kept clean, paying special attention to the rooms where children live and common areas.

During illness, carpets and rugs are removed from the room; cover upholstered furniture or cover it with plastic wrap; bedding (mattress, pillow, blanket) is cleaned daily with a damp brush or vacuum cleaner. Brushes and the dust collector of the vacuum cleaner are disinfected after use using disinfectant solutions.

Sanitary equipment is disinfected with washing-cleaning-disinfectants or washing-disinfecting agents approved for use by the public at home, in accordance with the mode of use set out on the label.

After cleaning, cleaning equipment must be disinfected by boiling or by immersion in a disinfectant solution. After disinfection, it is rinsed, dried and stored dry in a separate container specially designated for this purpose.

Clean outerwear and furniture covers with a dampened brush or use a vacuum cleaner. It is recommended to iron clothes several times with a hot iron through a damp cloth.

Infected material (bandages, gauze wipes, etc.) is disinfected before disposal by immersion in a disinfectant solution.

Final disinfection is carried out in foci of microsporia after hospitalization of the patient in a health care facility or after recovery, treated at home, regardless of the length of hospitalization or recovery. On the day of final disinfection, wash the patient and all persons living with him (contact) with a change of linen.

The final disinfection in the outbreaks is carried out by a disinfection station.

Prepared by: doctor - disinfectologist of the department for ensuring supervision of disinfection, disinfestation and deratization of the Federal Budgetary Institution of Health "Center for Hygiene and Epidemiology in the Volgograd Region" Lapchenkova S.M.

Ringworm is a term that refers to a whole group of dermatological diseases that have similar symptoms but different etiologies. Some types of lichen are absolutely safe. They are usually caused by allergies or immune disorders. At the same time, other types of pathology are a consequence of infection of the body by various pathogenic organisms.

Common types of lichen among children are the following.

Lichen Zhibera (lichen rosea)

This type of lichen has a viral etiology, but its causative agents have not yet been fully studied. The patient develops pink, scaly spots up to 4 cm in diameter on the skin. The incubation period of the disease lasts from 2 to 21 days, depending on the person’s immunity.

Outbreaks of the epidemic of depriving Zhibera most often occur in the autumn - those who have recently suffered from a cold or flu are more susceptible to the disease.

The duration of the disease is from 1.5 to 2 months.

Shingles (herpes)

The causative agent of this disease is the varicella zoster virus. Children who become infected with it for the first time develop chickenpox, and those who have previously had it develop herpes zoster. In this case, many small itchy blisters filled with liquid form on the skin of patients. As you recover, a crust forms on the skin, which eventually falls off on its own.

The incubation period for shingles varies from person to person. This, as in the previous case, depends only on immunity. Thus, some patients may notice signs of infection within a week after infection, while others may live their entire lives with the chickenpox virus and not even know it. As a rule, shingles goes away after 2-4 weeks, but since the chickenpox virus affects the nerve endings, the itching may persist for a long time after recovery.

Trichophytosis (ringworm)

The causative agent of this disease is the fungus trichophyton or microsporium. The incubation period for ringworm depends on who was the source of infection. So, if a child became infected from another person, the incubation period will last from 2 to 6 weeks.

If the infection occurred from an animal, then it will be shorter - from 5 to 7 days. This is due to the fact that human immunity fights infection much better than animal immunity, so an infection transmitted from person to person is initially more weakened than one transmitted from an animal. Ringworm is the most contagious of all types of pathology.

Symptoms of trichophytosis include the formation of pink spots with jagged edges on the skin. The edges of these spots are white. Slight itching is possible. If hair grows in the affected area, it breaks off almost at the root. It is noteworthy that trichophytosis, unlike other varieties of the disease, can be transmitted not only from person to person, but also from animal to person (and vice versa). In severe cases, the disease may require long-term treatment (up to 2 months).

Despite the development of modern medicine, lichen still remains one of the most common dermatological diseases. According to statistics, about 70 out of 100 thousand people suffer from ringworm, 15 out of 100 thousand - from shingles, and about 5 out of 100 thousand - from Zhiber's disease. It is worth saying that a patient suffering from lichen is considered contagious from the incubation period until the complete disappearance of the skin rash.

For contagious types of lichen, quarantine in the kindergarten should last 45 days.

Routes of infection

Most often, lichen infection occurs as follows:

1. With direct physical contact of a sick person with a healthy one.
2. When using things of a sick person by a healthy person or when using things of common use (for example, handrails on a bus).
3. When a person is in warm, damp rooms (for example, in a swimming pool). Pathogenic fungi love this environment very much and multiply in it extremely quickly.

Trichophytosis can also be transmitted through physical contact between an animal and a child. It is worth saying that the very contact of a healthy person with a sick person will not necessarily lead to the development of the disease. This may not happen if a healthy child has a strong immune system. It is important to note that the immunity of modern children is often weak and fragile and cannot fully protect the body from infection.

Quarantine for lichen in kindergartens and schools (especially junior ones) is mandatory, and it should not be introduced at the time of the epidemic, but immediately after the disease is detected in at least one child.

All other children should urgently undergo a preventive examination by a dermatologist.

Prevention of pathology

To protect your child from shingles, you first need to strengthen his immune system. To do this, the child must harden himself (this can only be done for completely healthy babies), play sports, maintain a sleep and wakefulness schedule, eat right, take vitamin and mineral complexes, and treat various diseases in a timely manner. Parents should protect their child from various stressful situations as much as possible.

1. Avoid various antibacterial hygiene products. They are too aggressive and can completely wash away the hydrolipid film from the skin. You can use antibacterial soap only when you come home and you can only wash your hands and feet with it. It is worth saying that it is not recommended to wash your hands too often even with ordinary soap or gel. Wet wipes should be used whenever possible.
2. Use personal hygiene products. Don’t take someone else’s and don’t give your own.
3. Refuse to wear other people's clothes, even if they are family members' clothes.
4. Avoid contact with stray animals.
5. Vaccinate your pets on time.

If symptoms similar to lichen are detected, a person should immediately consult a specialist. If deprivation is confirmed, all family members of a sick child should also consult a doctor.

Cleaning the premises during an epidemic

If a kindergarten is quarantined, lichen is usually found over time in most of the children who attended it. That is why every parent should know what to do if their child does get sick.

In this case, cleaning the house should be carried out especially carefully. Without it, all treatment will go down the drain and the chance of infecting other family members will significantly increase.

Ideally, wet cleaning of an apartment should occur once every 3 days. After its completion, the surface of all household items must be treated with disinfectant antifungal solutions. This is very important, since the environment may contain thousands of patient skin flakes and fungal microspores. Carpets and soft toys need to be treated especially carefully, since these are where the largest number of spores accumulate.

It is important to say that common disinfectants can cause skin irritation or allergies in children. That is why it is recommended to use modern products to disinfect premises, the main active ingredient of which is organic silver. The most popular of these disinfectants include Silvester and SumerSil.

It is very important that in case of lichen, regular disinfection of the patient’s bed linen is carried out. It consists of replacing pastel linen with new, clean ones. The mattress, pillows and blankets are treated with disinfectants. Previously used linen should be boiled for 10-15 minutes in water heated to 90 degrees. There is an opinion that fungal spores can be killed by freezing things, but this is not true.

You should also disinfect the clothes worn by the patient - for this, things can also be boiled or treated with organic silver disinfectant.

All bath accessories of a person with lichen must be treated with disinfectants. It is especially important to carry out these actions with towels and washcloths. If possible, it is better to replace these products with new ones.

If there are pets in the house, all objects with which they come into contact (toys, baskets, rugs) also need to be treated with disinfectants. After this, the animal should be washed with antifungal shampoo. After six dry, it is treated with a disinfectant antifungal spray.

Find out what smooth skin microsporia is. Why, after a kitten appears in the house, several pink flaky spots may appear on the skin of the arms and neck within a few days?

Is it dangerous to health and how is effective treatment carried out?

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The site provides reference information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious doctor. Any drugs have contraindications. Consultation with a specialist is required, as well as detailed study of the instructions! .

What is microsporia of smooth skin

Microsporia is an inflammation of certain areas of the skin, hair, and rarely nails, caused by a pathogenic fungus of the genus Microsporium (more than 20 of its varieties are known).

Among adults, this pathology is registered in 9-25% of cases annually. Recently, there has been an increase in the number of reports of the identification of foci of infection in families affecting adults and the elderly.

Microsporia is a common disease; it ranks second among fungal diseases after mycosis of the feet.

In the last decade, there has been a trend towards a decrease in scalp microsporia and an increase in the number of smooth skin mycoses with additional inflammation of vellus hair - smooth skin microsporia.

The causative agents of the disease and how long the incubation period lasts

The main causative agents of microsporia in humans are:

• The zoophilic fungus Microsporium canis - about 98% in the European part of Russia - is transmitted to humans from a sick animal;
• The anthropophilic fungus Microsporium ferrugineum - about 1% - is transmitted from person to person;
• In the territories of Siberia and the Far East, on the contrary, the pathogen Microsporium ferrugineum is more widespread.

The incubation period is the time from the first contact of the fungus with the skin until the onset of clinical manifestations of the disease.


The duration of this period for microsporia is: 7 days in the case of a zoonotic infection caused by Microsporium canis. In anthroponosis - the causative agent is Microsporium ferrugineum - longer, about 45 days.

Quarantine for pathology

After identifying a sick person, you must:

• Isolate the patient from others (the child does not attend kindergarten or school);
• Disinfect clothing, work or study areas;
• Provide the patient with individual care products (soap, comb), bed linen for an infected person and thoroughly treat them daily (boiling water, washing, ironing, etc.);
• Examine relatives, employees, and classmates who were in contact with the patient;
• If you have pets, examine and treat them;
• Start antifungal treatment.

There are no clear standards for the duration of quarantine for microsporia.

1. With a common form of microsporia (3 or more lesions on the skin, inflammation of vellus hair), after 1-2 smears that do not contain fungus, quarantine for the patient can be completed. This occurs approximately 2-4 weeks of treatment. The timing may be changed by the treating dermatologist.
2. In mild cases of the disease - 1-2 small spots under clothing - you can limit yourself to exemption from physical education, visiting the pool, sports sections, provided that the necessary therapeutic and hygienic measures are carefully followed.

Reasons for the spread of the disease

The reservoir of zoophilic microsporosis for humans is:

• Sick cats, especially kittens (70-80%);
• Dogs - much less often;
• In 4-5% of cases, small rodents (rabbits).

The main source of infection is mainly kittens, because, on the one hand, they are more susceptible to the disease due to their undeveloped immunity and developed undercoat, which is the basis for the proliferation of the fungus.

On the other hand, they are highly attractive to a child as a living toy.

Infection of children and adults with a fungus of the Microsporium canis type occurs:

• By direct contact with an affected animal;
• Or indirectly - through surfaces contaminated with its fur;
• Transmission of zoophilic fungus between people may occur rarely (2-10%).

At home, the cause of infection will be:

• Towels, bed linen;
• Hats, clothing;
• Toys;
• Carpets, upholstered furniture;
• Dust, sand of staircases;
• Animal rugs and care products.

The cause of infection in newborns can be a stroller left in the entrance at night, which is visited by cats.

In hairdressing salons:

• Towels, scissors;
• Haircut and shaving equipment;
• Peignoirs.

In kindergartens and schools:

• Towels;
• Toys;
• Clothing, hats;
• Books.

The level of infection by a fungus such as Microsporium canis varies throughout the year:

1. The beginning of the increase in incidence is recorded in June.
2. Growth occurs towards the end of summer and beginning of autumn.
3. The maximum number of cases is often detected in October - November.
4. Then there is a decline in the disease with a minimum in April.

The wavy curve is associated with the development cycle of the fungus in kittens and increased communication between children and animals in spring and summer - during the holidays (trips to dachas, villages, health and sports camps).

The increase in diseases in the autumn is explained by the return of children to the city from health camps, when they are carefully examined by their parents and routine medical examinations are carried out before visiting kindergartens and schools.

The source of anthropophilic microsporia is infected people. This microsporia is more contagious than zoophilic. Previously, when it was widespread, outbreaks of this disease were recorded in boarding schools, kindergartens, schools, orphanages, and summer camps.

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Clinical manifestations of damage to the head and other parts of the body

Conventionally, there are several types of “ringworm”:

• Damage to the scalp;
• Foci of inflammation on the skin of the limbs and torso;
• Mixed form.

In recent years, the number of atypical forms of this disease has increased, which complicate diagnosis and delay prevention and effective treatment.


Skin manifestations of microsporia:

1. First, spots or papules (primary elements) appear on a piece of skin infected with a fungus.
2. Then crusts appear (secondary elements of “lichen”).

More often, elements of inflammation occur at the site of contact with an infected animal:

• Face;
• Hands.

Much less often lesions appear on the skin:

• Shins;
• Stop;
• Sometimes on the genitals.

What does inflammation look like in zoonotic species?

Microsporium canis tends to produce many small lesions tending to merge. The dimensions of these zones are about 1-2 cm. Eyelashes and eyebrows are often involved in inflammation.

In 80-90%, vellus hair also shows signs of inflammation, which indicates the severity of the disease.

Periodically, with this form, microsporidae are detected - nodules that form with concomitant allergies. Sometimes the body temperature rises and the general condition of the person is disturbed.

Zoonotic microsporia is not characterized by a chronic course.

Description of foci of inflammation in anthropogenic microsporia

When affected by a fungus such as Microsporium ferrugineum, foci of inflammation are formed from a large number of small papules, which subsequently form a marginal border.

With a significant exudative component, papules alternate with vesicles - vesicles.

The exudate later organizes into crusts. The raised edge of the inflammatory focus consists of dried elements. In the center of the spot, inflammation can end as a result of the resorption of part of the fungus, and then begin again.

This is how the typical symptoms of this disease form - a ring in a ring. The spots on the skin are usually pale pink in color and moderately flaky.

They are often located in the form of a hyperemic border of inflammation at the junction of the scalp with the smooth skin of the neck and face. Due to the ability of neighboring elements to combine, these lesions are sometimes large and uneven in outline.

Unfused zones are often small in size and round in shape.

Inflammatory changes and peeling when affected by the fungus Microsporium ferrugineum are less pronounced than when affected by Microsporium canis.

Most infected vellus hairs in the area of ​​inflammation do not have a sheath and do not break off.

This form is prone to chronicity.

Effective treatment for this disease

The main types of treatment for microsporia are:

• Local - the use of antifungal ointments and creams, removal of infected hair, many recipes for treatment with “traditional medicine”;
• Systemic - taking antifungal drugs orally;
• Sanitary and hygienic measures to limit the spread of infection.

Treatment of mild forms of the disease

The presence of single inflammatory areas on the skin (no more than 3 lesions) indicates a mild course. Treatment can only be external, in the form of antifungal ointments and hair removal.

External treatment:

• The locally infected area is lubricated with antifungal ointment daily for about 2 months;
• Epilation or shaving is carried out in areas of inflammation on the skin to mechanically remove the fungus, once every 5 days.

During therapy, scrapings from the lesion are performed once a week to monitor the quality of the therapy (the absence of fungus in 2-3 scrapings from the affected areas confirms a good effect of treatment).

Treatment of common forms of the disease

In the common form of “lichen,” more than 3 foci of inflammation and/or simultaneous inflammation of vellus hair at the site of the lesion are found on smooth skin. Such patients are prescribed combination therapy.


Its principle is to:

• Internal antifungal drugs;
• External treatment.

Any treatment is always carried out in conjunction with sanitary measures:

• Identification of the source of infection and its sanitation;
• Examination of those in contact with the sick person;
• Compliance with sanitary measures in the patient’s family (wet cleaning of the room, disinfection of the patient’s individual linen.).

The most reliable medications

The main antifungal agents for ringworm are:

• Griseofulvin, it can be used now, if it is available in the retail chain;
• Terbinofen;
• Intraconazole;
• Fluconazole.

Griseofulvin is synthesized by a number of fungi of the genus Penicillium.

Available in the following forms:

• Tablets of 500 and 125 mg (microionized and ultraionized to improve absorption);
• Suspension - 0.1 g in 1 ml of griseofulvin.

Children under 13 years of age are prescribed 22 mg/kg of griseofulvin per day, in 2-3 doses.

Take the medicine with food, adding a teaspoon of vegetable oil to improve the dissolution of the drug and increase its duration of action.

For young children - a suspension, 8 ml of which corresponds to 125 mg per tablet.

There are extended forms of this drug for a single dose.

The average duration of treatment is 8-12 weeks.

The next most commonly prescribed drug is terbinofen. Trade names: exifin, lamisil, terbizil.

Internally prescribed:

Children over 2 years old:

• Up to 20 kg - 62.5 mg;
• 20 - 40 kg - 125 mg;
• More than 40 kg - 250 mg.

Adults - 250 mg 1 time per day.

The duration of taking the drug is 8-12 weeks.

Dosage regimen:

• 100 mg/day for children weighing up to 25 kg;
• 200 mg/day for children weighing over 25 kg in 2 divided doses.

The duration of treatment for “lichen” is about 6 weeks.

All antifungal drugs are toxic. Only a doctor should prescribe treatment.

Fluconazole is often prescribed topically (ointments, shampoos, creams, solutions).

Apply 1% exifin externally once a day for 2 months.

The use of local agents with an irritating effect (iodine, sulfur) to treat ringworm leads to an increase in residual cosmetic effects and is often not effective enough. Therefore, they can be prescribed only if the effect of more gentle methods (the use of local antifungal ointments) is poor.

Help from folk remedies

Microsporia is popularly called “ringworm.” There are many ways to treat this disease, which use juices and tinctures of vegetables, decoctions of herbs with antifungal properties, and healing ointments.

We list several recipes and substances used to treat “lichen” by non-medical methods.

Apply the juice squeezed from onions to the source of the disease.

Hungarian garlic vinegar recipe

1. Peel 3 cloves of garlic and add apple cider vinegar (600 ml).
2. They insist for 14 days.
3. Treat the skin lesions with the prepared tincture.

Use compresses, baths and lotions from decoctions and tinctures of medicinal herbs:

• Wormwood;
• Celandine;
• Tansy.

Preparation of an effective ointment

Burnt sulfur ointment:

1. Choose a base for the ointment: duck or goose fat, lanolin or petroleum jelly, or boric ointment.
2. Powdered sulfur is combined with the selected base and brought to the state of thick sour cream.

The candied honey is combined with a small amount of fish oil, stirring until the mixture reaches a thick consistency.

Preparation of boric acid solution

1. Dissolve a teaspoon of acid in half a glass of water.
2. The solution is heated over a fire until the crystals completely disappear, then cooled.
3. The prepared product is used to treat the affected areas.

Preparing propolis oil

1. Grind 20 grams. Bee propolis.
2. Combine with 50 gr. Vegetable oil.
3. The components are combined and, stirring regularly, brought to a boil in a water bath.
4. The mixture is brought to a boil again, the propolis dissolves, and the wax precipitates.
5. The oil is carefully poured into a bowl.
6. Lubricate areas of inflammation.

In folk medicine, birch tar, solid oil, and kerosene in pure form or in the form of ointments are widely used to treat ringworm.

Therapy only with folk remedies raises doubts about the possibility of achieving final recovery.

How can you prevent this disease?

For effective prevention, carry out public and individual measures to limit the spread of infection:

1. Catch stray animals and prevent children from interacting with them.
2. Have farm animals regularly examined by a veterinarian.
3. Destroy mouse-like rodents.
4. Regularly conduct medical examinations in children's institutions (to prevent anthroponotic microsporia) and timely isolate sick children from healthy ones.
5. Have family members who have been in contact with the infected person examined by a doctor.
6. Equip medical institutions with diagnostic devices for microsporia.
7. Carry out high-quality final disinfection in areas of microsporia.
8. Maintain a hygienic regime in the family where an infected person has been identified.