Order of the Ministry of Defense 475 of 11.08. On approval of the procedure for generating a state contract identifier for a state defense order. Application. The procedure for generating a state contract identifier for a state o

In accordance with Part 1 of Article 6.1 of the Federal Law of December 29, 2012 No. 275-FZ “On State Defense Order” (Collection of Legislation Russian Federation, 2012, No. 53 (part I), art. 7600; 2013, No. 52 (part I), art. 6961; 2015, No. 27, Art. 3950; No. 29 (part I), art. 4342) we order:

Approve the attached Procedure for generating a government contract identifier for a government defense order.

Application
to the order of the Ministry of Defense of the Russian Federation
and the Federal Treasury
dated August 11, 2015 No. 475/13n

Order
formation of a government contract identifier for a state defense order

The concepts used in this Procedure have the meanings defined by Federal Law No. 275-FZ and Federal Law of April 5, 2013 No. 44-FZ “On the contract system in the field of procurement of goods, works, services to meet state and municipal needs” ( Collection of Legislation of the Russian Federation, 2013, No. 14, Article 1652; No. 27, Article 3480; No. 52 (Part I), Article 6961; 2014, No. 23, Article 2925; No. 30 (Part I), Article 4225; No. 48, Article 6637; No. 49 (Part VI), Article 6925; 2015, No. 1 (Part I), Articles 11, 51, 72; No. 10, Article 1418; No. 14 ; Article 2022; No. 27, Article 4001; No. 29 (Part I), Articles 4342, 4346, 4352, 4375) (hereinafter referred to as Federal Law No. 44-FZ).

2. The government contract identifier is used to identify all contracts concluded for the purpose of executing a government contract, and settlements under the government defense order as part of the accompanied transaction.

3. State contract identifier: formed by the state customer independently in compliance with the structure established by this Procedure;

cannot be reassigned to another government contract;

indicated by the state customer through the symbol “/” before the number of the state contract (if any) concluded with the main contractor;

indicated by the head contractor through the “/” symbol before the contract number (if any) concluded with the contractor;

indicated by the contractor through the “/” symbol before the contract number (if any) concluded with other performers;

indicated by the state customer, the main contractor, the contractor in the order on the transfer of funds in the manner established Central Bank Russian Federation* to indicate a unique payment identifier.

4. The government contract identifier is a twenty-five-digit digital code and has the following structure:

a) 1, 2 digits - the last two digits of the year of conclusion of the state contract;

b) 3, 4 digits - the last two digits of the year of expiration of the government contract;

c) 5 - 7 categories - identification code of the state customer, which for the purposes of this Procedure is recognized as corresponding to the code of the main manager of budget funds according to the budget classification of the Russian Federation;

d) 8th category - procurement information, which for the purposes of this Procedure is indicated based on the following values:

1 - competitive methods of determining a supplier (performer, contractor), which are competitions ( open competition, competition with limited participation, two-stage competition, closed competition, closed competition with limited participation, closed two-stage competition), auctions (electronic auction, closed auction), request for quotations, request for proposals;

2 - procurement in connection with the recognition of the determination of the supplier (performer, contractor) by competitive means as failed and the adoption by the state customer of a decision to conclude a state contract with a single supplier (performer, contractor) in agreement with the federal executive body authorized by the Government of the Russian Federation to carry out these functions;

3 - procurement from a single supplier (performer, contractor), determined by decree or order of the President of the Russian Federation, or in cases established by instructions of the President of the Russian Federation, from a supplier (performer, contractor), determined by decree or order of the Government of the Russian Federation;

4 - conclusion of a state contract for the supply of Russian weapons and military equipment, which have no Russian analogues and the production of which is carried out by a single manufacturer, with a supplier of such weapons and military equipment included in the register of the only suppliers of such weapons and military equipment;

5 - procurement for work on mobilization preparation in the Russian Federation;

6 - procurement of work or services, the performance or provision of which can only be carried out by an executive body in accordance with its powers or a state institution subordinate to it, a state unitary enterprise, the corresponding powers of which are established by federal laws, regulatory legal acts of the President of the Russian Federation or regulatory legal acts of the Government Russian Federation;

7 - purchase from a single supplier (performer, contractor) of certain goods, works, services due to an accident, other emergency situations natural or man-made, force majeure, if there is a need to provide medical care in an emergency form or in the provision of emergency medical care (provided that such goods, works, services are not included in the list of goods, works, services approved by the Government of the Russian Federation necessary for the provision of humanitarian assistance or liquidation of the consequences of emergencies of a natural or man-made nature ) and the use of other time-consuming methods for identifying a supplier (performer, contractor) is impractical;

8 - production of goods, performance of work, provision of services are carried out by institutions and enterprises of the penal system in accordance with the list of goods, works, services approved by the Government of the Russian Federation**;

9 - other procurement cases not specified in values 1 - 8;

e) 9 - 12 digits - the serial number of the state contract, assigned sequentially in accordance with continuous numbering within the calendar year in relation to each state customer, which is the main manager of budget funds;

f) 13th category - type of price for goods, works, services under the state defense order. This code category is indicated based on the following values on the day of concluding the government contract:

1 - approximate (specified) price;

2 - fixed price;

3 - cost-reimbursing price;

g) 14-25 categories - codification is carried out by each government customer independently. In this case, the codes must have an exclusively digital designation.

If the digital characters of digits 14 to 25 are not used in the government contract identifier, then the free characters are designated as zeros.

5. The assigned state contract identifier is retained for the entire period of validity of the state contract.

______________________________

* Part 4 of Article 6.1 of Federal Law No. 275-FZ.

** Clause 11 of Part 1 of Article 93 of Federal Law No. 44-FZ.

Document overview

Each government contract under the state defense order is assigned a unique identifier. The rules for its formation have been established.

The identifier is used, among other things, for settlements under state defense orders as part of a supported transaction.

It is formed by the government customer and is a 25-digit digital code. It contains information about the identification code of the state customer, the method of identifying the supplier (executor, contractor), the years of the conclusion of the state contract and the expiration of its validity, the serial number of the state contract.

Document's name:
Document Number:	475/13n
Document type:	Order of the Russian Ministry of Defense Order of the Treasury of Russia
Receiving authority:	Russian Ministry of Defense Treasury of Russia
Status:	Active
Published:
Acceptance date:	August 11, 2015
Start date:	05 September 2015

On approval of the Procedure for generating a state contract identifier for a state defense order

MINISTER OF DEFENSE OF THE RUSSIAN FEDERATION

FEDERAL TREASURY

ORDER

On approval of the Procedure for generating a state contract identifier for a state defense order

In accordance with Part 1 of Article 6_1 of the Federal Law of December 29, 2012 N 275-FZ “On State Defense Order” (Collected Legislation of the Russian Federation, 2012, N 53 (Part I), Art. 7600; 2013, N 52 (Part .I), Art. 6961; 2015, N 27, Art. 3950; N 29 (Part I), Art. 4342)

we order:

Approve the attached Procedure for generating a government contract identifier for a state defense order.

Minister of Defense
Russian Federation
army General
S. Shoigu

Supervisor
Federal Treasury
R. Artyukhin

Registered
at the Ministry of Justice
Russian Federation
August 24, 2015,
registration N 38641

Application. The procedure for generating a government contract identifier for a state defense order

Application
to the order
Minister of Defense
Russian Federation
and the Federal Treasury
dated August 11, 2015 N 475/13n

1. This Procedure was developed in accordance with Federal Law No. 275-FZ of December 29, 2012 “On State Defense Order” (hereinafter referred to as Federal Law No. 275-FZ) and establishes the rules for the formation (assignment) of a state contract identifier.

The concepts used in this Procedure have the meanings defined by Federal Law N 275-FZ and Federal Law of April 5, 2013 N 44-FZ "On the contract system in the field of procurement of goods, works, services to meet state and municipal needs" (Meeting Legislation of the Russian Federation, 2013, N 14, Art. 1652; N 27, Art. 3480; N 52 (Part I), Art. 6961; 2014, N 23, Art. 2925; N 30 (Part I), Art. .4225; N 48, art. 6637; N 49 (part VI), art. 6925; 2015, N 1 (part I), art. 11, 51, 72; N 10, art. 1418; N 14; Art. 2022; N 27, Art. 4001; N 29 (Part I), Art. 4342, 4346, 4352, 4375) (hereinafter referred to as Federal Law N 44-FZ).

3. Government contract ID:

is formed by the state customer independently in compliance with the structure established by this Procedure;

cannot be reassigned to another government contract;

indicated by the state customer through the symbol “/” before the number of the state contract (if any) concluded with the main contractor;

indicated by the main contractor through the "/" symbol before the contract number (if any) concluded with the contractor;

indicated by the contractor through the symbol "/" before the contract number (if any) concluded with other contractors;

indicated by the state customer, the main executor, the executor in the order for the transfer of funds in the manner established by the Central Bank of the Russian Federation* to indicate a unique payment identifier.
________________
* Part 4 of Article 6_1 of Federal Law N 275-FZ.

4. The government contract identifier is a twenty-five-digit digital code and has the following structure:

a) 1, 2 digits - the last two digits of the year of conclusion of the state contract;

b) 3, 4 digits - the last two digits of the year of expiration of the government contract;

c) 5-7 categories - identification code of the state customer, which for the purposes of this Procedure is recognized as corresponding to the code of the main manager of budget funds according to the budget classification of the Russian Federation;

d) 8th category - procurement information, which for the purposes of this Procedure is indicated based on the following values:

1 - competitive methods for determining a supplier (executor, contractor), which are tenders (open tender, competition with limited participation, two-stage competition, closed competition, closed competition with limited participation, closed two-stage competition), auctions (electronic auction, closed auction ), request for quotations, request for proposals;

5 - procurement for work on mobilization preparation in the Russian Federation;

7 - purchase from a single supplier (performer, contractor) of certain goods, works, services due to an accident, other emergencies of a natural or man-made nature, force majeure, in the event of a need for emergency medical care or emergency medical care (provided that such goods, works, services are not included in the list of goods, works, services approved by the Government of the Russian Federation necessary for the provision of humanitarian assistance or liquidation of the consequences of natural or man-made emergencies) and the use of other methods of determining the supplier (performer, contractor ), requiring time, is impractical;

9 - other procurement cases not specified in values 1-8;

e) 9-12 categories - the serial number of the state contract, assigned sequentially in accordance with continuous numbering within the calendar year in relation to each state customer, who is the main manager of budget funds;

1 - approximate (specified) price;

2 - fixed price;

3 - cost-reimbursing price;

g) 14-25 categories - codification is carried out by each government customer independently. In this case, the codes must have an exclusively digital designation.

If the digital characters of digits 14 to 25 are not used in the government contract identifier, then the free characters are designated as zeros.

5. The assigned state contract identifier is retained for the entire period of validity of the state contract.

Electronic document text
prepared by Kodeks JSC and verified against:
Official Internet portal
legal information
www.pravo.gov.ru, 08.25.2015,
N 0001201508250025

On approval of the Procedure for generating a state contract identifier for a state defense order

Document's name:
Document Number:	475/13n
Document type:	Order of the Russian Ministry of Defense Order of the Treasury of Russia
Receiving authority:	Russian Ministry of Defense Treasury of Russia
Status:	Active
Published:	Official Internet portal of legal information www.pravo.gov.ru, 08/25/2015, N 0001201508250025 Bulletin of normative acts of federal executive authorities, N 44, 02.11.2015
Acceptance date:	August 11, 2015
Start date:	05 September 2015

Application. The procedure for generating a government contract identifier for a state defense order

Order of the Minister of Defense of the Russian Federation and the Federal Treasury of August 11, 2015 N 475/13n
"On approval of the Procedure for the formation of a state contract identifier for a state defense order"

In accordance with Part 1 of Article 6.1 of the Federal Law of December 29, 2012 N 275-FZ “On State Defense Order” (Collected Legislation of the Russian Federation, 2012, N 53 (Part I), Art. 7600; 2013, N 52 ( Part I), Article 6961; 2015, N 27, Article 3950; N 29 (Part I), Article 4342) we order:

Approve the attached Procedure for generating a government contract identifier for a state defense order.

Each government contract under the state defense order is assigned a unique identifier. The rules for its formation have been established.

The identifier is used, among other things, for settlements under state defense orders as part of a supported transaction.

Order of the Minister of Defense of the Russian Federation and the Federal Treasury of August 11, 2015 N 475/13n “On approval of the Procedure for the formation of a state contract identifier for a state defense order”

Order of the Minister of Defense of the Russian Federation and the Federal Treasury of August 11, 2015 N 475/13n
“On approval of the Procedure for the formation of a state contract identifier for a state defense order”

Approve the attached Procedure for generating a government contract identifier for a state defense order.

Minister of Defense
Russian Federation
army General

Supervisor
Federal Treasury

Each government contract under the state defense order is assigned a unique identifier. The rules for its formation have been established.

The identifier is used, among other things, for settlements under state defense orders as part of a supported transaction.

Order of the Minister of Defense of the Russian Federation dated October 9, 1999 N 455 “On approval of the Regulations on the medical examination of aviation flight personnel of the Armed Forces of the Russian Federation” (with amendments and additions)

Order of the Minister of Defense of the Russian Federation of October 9, 1999 N 455
“On approval of the Regulations on medical examination
flight personnel of the aviation of the Armed Forces of the Russian Federation"

With changes and additions from:

Approve the attached Regulations on the medical examination of flight personnel of the Armed Forces of the Russian Federation.

Minister of Defense of the Russian Federation
Marshal of the Russian Federation

Registration N 1973

Order of the Minister of Defense of the Russian Federation of October 9, 1999 N 455 “On approval of the Regulations on the medical examination of aviation flight personnel of the Armed Forces of the Russian Federation”

Registration N 1973

This order comes into force 10 days after the day of its official publication

The text of the order was published in Rossiyskaya Gazeta (weekend issue No. 17) dated April 28, 2000, No. 84, in the appendix to Rossiyskaya Gazeta No. 20, 2000, in the Bulletin of regulatory acts of federal executive authorities dated December 6 1999, N 49

This document is amended by the following documents:

The changes come into force 10 days after the official publication of the said order.

Order of the Ministry of Defense of the Russian Federation dated August 1, 2015 No. 470.

Medal, insignia and memorial sign.

I was thinking about this in my spare time. It turns out that the orders of the HF units according to the signs of affiliation need to be changed. Especially the wreaths on badges, because... By this order they are no longer in use.

If you introduce a different bar for each insignia, how many bars will there be on the tunic?!

We waited. The average emblem of the Aerospace Forces on the insignia of belonging to the military formations of the Aerospace Forces

They waited, but it seems that again it cannot do without errors. The propeller and cannon must be gold. But they only made a star.

According to 240 it was: “. The middle emblem is an image of a golden double-headed eagle with outstretched wings, holding in its paws a crossed silver propeller and an anti-aircraft gun. “, and according to 470” - the middle emblem is a golden double-headed eagle with outstretched wings, holding an anti-aircraft gun in its right paw, a propeller in its left, with an eight-pointed star at their intersection. “Well, the order clearly shows that the gun and propeller are gold.

to the order of the USSR Ministry of Health dated

Basic principles of organizing sanitary and epidemiological

surveillance of acute intestinal infections

Sanitary and epidemiological surveillance of acute intestinal infections refers to the collection of information and dynamic assessment of risk factors, living conditions, morbidity of the population of a particular territory, justification and implementation of the necessary preventive and anti-epidemic measures. The purpose of sanitary and epidemiological surveillance is to prevent the occurrence of acute intestinal infections among the population.

These guidelines are compiled on the basis of the experience of the sanitary and epidemiological services of various territories and contain the basic principles of organizing sanitary and epidemiological surveillance, which can be used taking into account the specifics of local conditions.

Functional components of the system

sanitary and epidemiological surveillance are the following subsystems:

1. Information support

1.1. The information support subsystem solves the problem of collecting necessary information, its rational distribution among specialists and the functioning of feedback. The collection of primary information is carried out by the district (city) SES. The amount of information for the regional and republican levels is determined by each union republic (region) and depends on local conditions and existing technical capabilities.

1.2. In large regional and city SES, it is advisable to organize groups to collect and process data for sanitary and epidemiological analysis (see regulations on the group).

If it is not possible to organize a group, functional responsibilities for collecting and analyzing information are distributed among specialists from the sanitary-hygienic and epidemiological departments.

1.3. Feedback— this is information about the epidemiological situation throughout the territory under control, an assessment of the activities of the lower-level SES based on the results of an analysis of the work of the entire sanitary and epidemiological surveillance system, information from interested departments on the progress of implementing the action plan for the prevention of intestinal infections.

2. Epidemiological diagnosis

Within the framework of the epidemiological diagnostics subsystem, retrospective and operational epidemiological analysis is carried out.

2.1. Retrospective epidemiological analysis includes:

— analysis of long-term and seasonal dynamics of morbidity;

— analysis of morbidity by territory;

— analysis of morbidity by population groups in general and in disadvantaged areas;

— epidemiological assessment of the sanitary reliability of facilities located in a specific territory;

— assessment of the quality and effectiveness of preventive and anti-epidemic measures;

— comprehensive analysis to identify the causes of trouble.

2.1.1. Analysis of long-term dynamics of incidence is aimed at identifying its trends in a specific territory, taking into account cyclicality and seasonality. This analysis is carried out both for the sum of acute intestinal infections and for individual nosological forms (Sonne's shigellosis, Flexner's shigellosis, salmonellosis, etc.). Based on the results of the analysis, an assessment of the situation and a forecast are given.

2.1.2. Analysis of morbidity by territory is carried out on the basis of calculating average long-term morbidity rates for selected territorial units (districts, micro-areas, settlements, etc.). Taking into account the level and dynamics of morbidity, territories are identified that are persistently unfavorable either in terms of morbidity levels or in terms of growth trends. These territories are subject to more in-depth study, primarily taking into account the epidemiological assessment of their sanitary reliability and identification of the most affected population groups.

2.1.3. Analysis of morbidity by population groups is carried out mainly in disadvantaged areas. The incidence is assessed in different age and socio-professional risk groups (i.e., which population groups are most affected by one or another nosological form of intestinal infections).

2.1.4. At the next stage, an assessment is made of the epidemiological reliability of facilities (enterprises in the dairy, meat, food industries, public catering and trade, water supply, sewerage and cleaning of populated areas, children's and adolescent institutions of all profiles). This makes it possible to identify enterprises and institutions that require urgent measures to improve their sanitary and technical condition, and to determine the frequency and volume of state sanitary supervision over them.

The USSR Ministry of Health approved and sent for local implementation “Guidelines for the epidemiological assessment of sanitary and hygienic conditions for the prevention of intestinal infections” dated 06.06.86. N 28-6/20.

In a number of union republics (RSFSR, Ukrainian SSR, BSSR), criteria and methods for epidemiological assessment of other surveillance objects (dairies, milk factories, public catering establishments, etc.) have been developed and are being successfully implemented.

Regional and republican sanitary and epidemiological stations are entrusted with the task of developing epidemiological reliability criteria for all epidemiologically significant objects and differentiating surveillance tasks by level of sanitary and epidemiological service.

2.1.5. To establish the reasons for differences in morbidity levels in individual territories, it is recommended to compile a sanitary and epidemiological passport of the territory (characteristics of microdistricts, areas). The sanitary-epidemiological passport reflects the demographic, social and professional characteristics population, water supply, cleaning of the territory, receipt and distribution of food products, provision of children's and adolescent medical institutions, etc. In addition, comprehensive information is provided on the epidemiological background of the territory, morbidity in all its aspects, biological properties of pathogens, etc.

Drawing up and maintaining a sanitary and epidemiological passport (characteristics) of the territory helps solve the problem of monitoring the conditions for the development of the epidemic process, the factors of transmission of pathogens of intestinal infections.

2.1.6. The final stage of retrospective analysis is a comprehensive analysis, during which hypotheses about the causes and conditions of high morbidity rates are put forward and tested. Such an analysis must necessarily be carried out in conjunction with the results of an epidemiological assessment of the sanitary reliability of the territory, an analysis of demographic data and the state of medical care.

A comprehensive analysis of epidemiological data and risk factors for infection in different territories is key in identifying the main causes and conditions of transmission of pathogens of acute intestinal infections. Hypotheses (assumptions) are formulated to explain the dynamics of morbidity and its differences in levels in different population groups and in different territories. Then the hypotheses put forward are tested. If the differences in indicators do not reach statistical significance, then they may be random in nature, and then the attempt to find the reason that determines the differences in morbidity is poorly justified.

To test the hypothesis, logical and statistical methods of analysis are used. Statistical methods include the calculation of compliance indicators (X_2 criterion) and the correlation coefficient. Statistical methods are described in detail in dedicated manuals.

Based on the results of the analysis, measures are proposed to reduce the incidence of intestinal infections in this area. It may happen that the information collected is not enough to make a final judgment about the correctness of the proposed primary hypothesis. In this case, it is necessary to organize additional receipt the required data and return to their analysis at the appropriate stage (at the stage of morbidity analysis for the territory or at the stage of epidemiological assessment of the sanitary reliability of objects, or at the stage of comprehensive analysis).

2.2. Operational epidemiological analysis. The objectives of this analysis are:

— monitoring the dynamics of the epidemic process;

— monitoring the sanitary background (the occurrence of risk factors);

— prompt assessment of the situation;

— establishing the reasons for the rise in morbidity and correcting the measures taken.

2.2.1. Monitoring the dynamics of the epidemic process is carried out according to four criteria:

— the level of incidence of acute respiratory infections in the territory (or territories, if tracking is carried out in micro-areas, settlements, etc.);

— incidence rates in different age groups;

— level and nature of focality;

2.2.2. Monitoring of the sanitary background is carried out with the aim of timely detection of risk factors according to the following criteria:

- quality drinking water;

— the quality of dairy products produced by the dairy plant and in the retail chain;

— quality of soft drinks;

— the quality of food products widely supplied to the population through trading network or catering establishments;

- emergence emergency situations on the territory or objects (here, first of all, emergency situations on water supply and sewerage networks, on objects of epidemiological significance (dairy processing plants, children's dairy kitchens, etc.) are taken into account and assessed).

2.2.3. A rapid assessment of the situation is carried out by comparing epidemiological indicators calculated for a certain period of time (5 days, a week) for a specific territory with the initial level and with the long-term average (normative) level. The standard level is calculated as the average number of diseases registered on the corresponding day, week, month. It is calculated based on data from the last 5-7 years with the exception of outbreak incidence. It is advisable to calculate the standard indicator separately for years with high and low incidence rates. The normative level is calculated for a specific territory and age groups of the population based on initial registration data.

Determine the boundaries of the confidence interval and standard level.

When assessing, two fundamental options are possible:

a) the situation is normal;

b) deterioration of the situation compared to the initial or normative levels, when an increase in incidence is noted.

To identify the reasons for the increase in morbidity and the leading factor of transmission, an in-depth analysis and epidemiological examination of the emerging outbreaks is carried out. The scope of this work and the nature of the information collected is determined in each specific case by the epidemiologist.

2.2.4. An in-depth epidemiological analysis is carried out if the epidemiological situation worsens and consists of several stages. Firstly, the change in the dynamics of morbidity in micro-areas is assessed, taking into account its growth in relation to the initial level. Secondly, changes in the incidence rate in various age and socio-professional groups of the population are analyzed, and special attention is paid to the degree of their involvement in the epidemic process. To do this, you should also use data characterizing the infection rate of these groups: the results of bacteriological examination of contact or decreed contingents.

Family focality and focality in organized groups of adults and children are analyzed. At the same time, the recorded and initial focality indicators are also compared.

To identify a specific infection transmission factor, it is necessary to compare the degree of change in morbidity in a specific territory and among certain population groups with maps of the distribution of food products and water supply (“alternative maps”). These maps allow you to quickly identify control areas and population groups.

Help in identifying factors of infection transmission is a survey of patients with acute intestinal infections and the control group conducted during the period of increasing incidence about the nature of nutrition and water consumption. The infection transmission factor will be that food or water, which is much more common among patients with acute intestinal infections than in the control group.

2.2.5. On final stage operational epidemiological analysis formulates a hypothesis about the reasons for the deterioration of the epidemic situation, which is tested logically taking into account the action of a specific factor. The correct hypothesis must fully explain why exactly at a given time and in these territories there was an increase in incidence and why exactly these institutions, these specific groups of the population were most affected. If there is no complete information for such an explanation or there are no materials that allow one to clearly formulate a hypothesis, then additional collection of the required information is carried out. Statistical methods can be used to test the correctness of the hypothesis.

The control subsystem includes the following components:

3.1. Planning of measures for the prevention of infectious diseases, material support for their implementation and monitoring of execution. In the complex of preventive measures, the main role belongs to sanitary and hygienic measures, carried out by the relevant departments and aimed at increasing the degree of sanitary reliability of epidemically significant, primarily disadvantaged, objects. For this purpose, the State Sanitary Inspection authorities, together with interested departments for each territory, should develop measures for the prevention of acute intestinal infections, which are included in the plan for the socio-economic development of the national economy of the district, city, region, republic. The basis for the development of these measures is the sanitary and epidemiological passport of the territory. Control over the completeness and timeliness of implementation of measures is carried out by the sanitary and epidemiological service.

3.2. Organization and implementation of anti-epidemic measures when the epidemiological situation worsens. The scope and nature of these activities depends in each specific case on the specifics of the epidemiological situation.

3.3. Organization of a sanitary and epidemiological surveillance system, assessment of the quality of the system and its correction in order to increase efficiency. The transition to sanitary and epidemiological surveillance of acute intestinal infections requires specifying the functions of all units of the SES at various levels. Regulations on the functional responsibilities of the SES different levels to ensure sanitary and epidemiological surveillance of OKI should be developed taking into account the specific conditions of each republic and secured by order of the Ministry of Health. Taking this into account, it is necessary to reconsider the functional responsibilities of specialists in various fields within each sanitary and epidemiological station.

The effectiveness of the sanitary and epidemiological surveillance system should be assessed annually and appropriate adjustments made if necessary.

Approximate regulations on the group for collecting and processing data for sanitary and epidemiological analysis

The group is formed within the existing staffing table (the composition of the group is determined by the head of the institution).

The main task of the group is to provide information to SES specialists for conducting operational and retrospective sanitary and epidemiological analysis. The group provides statistical processing of input information of a sanitary and epidemiological nature on any of the nosoforms and the issuance of output information for specialists of the sanitary-hygienic and epidemiological departments to carry out operational (daily, weekly) analysis of the epidemiological situation.

The input information for the group is the following data:

Nature of information. Sources of receipt.

1. Incidence of acute intestinal infections Treatment and prophylaxis

institutions (form N 58)

2. Etiology of acute intestinal infections (data on bacteriological, viral isolation of pathogens, logical laboratories of SES and medical institutions, results of serodiagnosis)

3. Sanitary and hygienic Materials of the current sanitary characteristics subject to supervision. Data from bacteriological objects of logical, virological, sanitary and hygienic laboratories of SES and departments

4. Circulation of pathogens Bacteriological, viral in the external environment logical laboratories of SES and departments

5. Survey materials Maps of epidemiological surveys of outbreaks, results of a survey of patients

6. Results of sudden bacteriological laboratory examinations and according to epidemiological indications, SES

7. Natural and climatic Hydrometeorological Service, hydrogeological factors (temperature, amount of precipitation, standing level groundwater and etc.)

8. Circulation of pathogens of the Gosvetnadzo Bacterial Laboratory among animals, birds, departmental laboratories of the State Agricultural Industry

9. Alarm information from regional, city, district and other sanitary and epidemiological stations and departmental SES, departmental SES, etc. about infectious morbidity,

contaminated food products, emergency release Wastewater into open waters and other data

10. Information about deviation Higher SES (in the case of using an automated control system at the level of incidence)

The data collection and processing group monitors:

— the level of morbidity in the territory (by region, micro-area, etc.);

— morbidity by age and socio-professional groups;

— etiological structure of dysentery and acute intestinal infections;

— the quality of drinking water, dairy and other food products, the results of sanitary and bacteriological control over the state of the external environment at controlled facilities;

— occurrence of emergency situations on the territory and facilities.

The epidemiological situation is assessed daily based on the above-mentioned criteria. If the situation worsens, the group prepares additional analytical materials: morbidity by micro-areas (for comparison with alternative maps), changes in morbidity in age and socio-professional groups, supposed factors of transmission of acute respiratory infections, sanitary characteristics of the surveyed objects. At the same time, the group uses alternative maps to test hypotheses about the current factors of transmission of pathogens of ACI.

The output information of the group is received by the heads of the epidemiological and sanitary-hygienic departments, who carry out its joint assessment and analysis, attracting the necessary specialists, and develop proposals for making management decisions.

Approximate responsibilities of SES specialists to ensure

sanitary and epidemiological surveillance of AEI

1. Epidemiological specialists:

1.1. A retrospective epidemiological analysis of morbidity is carried out (identification of territories, risk factors).

1.2. A prompt epidemiological analysis of morbidity is carried out for each nosoform.

1.3. Together with specialists from the sanitary department, they conduct an expert assessment of hypotheses about the causes of the increase in morbidity and prepare proposals for making management decisions.

1.4 Examine epidemic foci of acute intestinal infectious diseases.

1.5. They take part in the development of long-term action plans for the prevention of acute intestinal infections and monitoring their implementation.

1.6. Develop plans for operational and anti-epidemic measures in case of changes (deterioration) of the epidemic situation in the area.

1.7. Conduct instructional and methodological meetings with medical workers of medical institutions on issues of epidemiology and prevention of acute intestinal infections.

1.8. They maintain contact with the epidemiological departments of territorially adjacent sanitary and epidemiological stations, as well as with departments and services that are in charge of epidemiologically significant objects.

1.9. Maintain contact with higher SES.

2. Sanitary and hygienic specialists:

2.1. Assess the potential danger of epidemiologically significant objects.

2.2. Conduct ongoing sanitary and hygienic inspections of epidemiologically significant objects (the frequency of inspection is determined taking into account local specific conditions).

2.3. Coordinate the work of departments and services, monitor their implementation of long-term plans for the prevention of acute intestinal infections.

2.4. Submit daily information to the data collection and processing group or directly to the epidemiological department about deviations in the sanitary condition of epidemiologically significant objects and quality (according to laboratory tests) food products and water, as well as information about violations in the operation of equipment and technological processes.

2.5. They accumulate materials on the sanitary and hygienic characteristics of epidemiologically significant objects.

2.6. Take prompt measures to eliminate identified violations using the full rights granted to state sanitary inspection bodies.

2.7. Prepare materials and proposals to improve the work of epidemiologically significant facilities for submission to party, Soviet authorities, departments and services.

2.8. Maintain contacts with sanitary and hygienic departments of territorially adjacent sanitary and epidemiological stations.

3. Specialists of bacteriological, sanitary and hygienic laboratories perform the following functions:

3.1. They take part in planning the production activities of laboratories together with specialists from the operational departments of the sanitary and epidemiological station.

3.2. Conduct the necessary laboratory tests using classical, express and accelerated methods to establish possible factors of transmission of pathogens of acute intestinal infections.

3.3. New modern research methods are introduced into the work of laboratories.

3.4. They take part in the training of personnel in laboratories of sanitary and epidemiological stations, treatment and prevention and departmental institutions.

3.5. Provide methodological guidance and advisory assistance to departmental laboratories.

3.6. The operational departments of the sanitary and epidemiological station are promptly informed about the results of the studies.

Alternative surveillance maps

Alternative epidemiological surveillance maps make it possible to quickly identify existing routes and factors of infection transmission and implement targeted measures to suppress their activity.

The main epidemiological meaning of creating a surveillance map(s) is to highlight on it alternative territories (population groups) for water supply and food supply (primarily milk and dairy products).

Alternativeity (allowing one of two or more possibilities) of territories for potential factors of transmission of intestinal pathogens, in particular Shigella (water, food products), allows us to provide an objective assessment of the activity of these factors, timely identify and control it, since with such a methodological approach to When carrying out surveillance, along with the experimental territory (population group) where this factor operates, control territories contrasting with this same factor, where it does not exist, are selected.

Based on normal administrative geographical maps territories, surveillance maps are being developed at the district (city) and regional levels, functionally complementing each other in solving common problems of prevention.

At each level, the serviced surveillance area is conventionally divided into contrasting areas (the so-called experimental and control), differing in the nature of the water supply to the population (for example, from different household and drinking water supply systems, from centralized and non-centralized water supply sources, etc.) and the organization of food supply products (for example, they receive products from different dairies).

The surveillance maps also take into account the frequent situation when part of the local population uses water supplied through water pipelines from other administrative territories, and vice versa, water from a given territory is supplied to other populated areas. Similarly, part of the products of a local dairy plant (in a different assortment, about which there should be complete information) is sent to another locality (others) or, conversely, comes from another locality, and it is used by all or only part of the local population. Areas of the settlement and various objects (enterprises, preschool institutions, shops) that receive and do not receive milk and dairy products of various assortments from local (local) and other dairies (experimental control objects) are also identified.

Drawing up full-fledged alternative epidemiological surveillance maps for the entire wide range of intestinal infections is a very labor-intensive task and requires the joint efforts of many specialists from sanitary and epidemiological stations, one way or another involved in their work with their prevention.

These maps should reflect all food products of mass consumption (real risk factors for intestinal infections), including a wide variety of soft drinks. This work pays off handsomely, since the sanitary and epidemiological service receives a reliable idea of the epidemiological background on the ground and can easily navigate when the epidemic situation becomes more complicated.

As a result of the compilation and constant maintenance of surveillance maps, the most important task of reliable monitoring of the epidemiological background is solved, i.e. behind the causative factors of the spread of intestinal infections. Activation of routes and specific factors of infection transmission, registered on alternative maps even before the increase in morbidity (for example, accidents on the water supply network, violation of the water disinfection regime, deterioration of sanitary and bacteriological indicators of its quality, violation of the milk pasteurization regime at the dairy plant, washing containers, release of bacterially contaminated products that do not meet established sanitary standards, etc.) and which is then reflected in the intensification of morbidity in the experimental territory (in its absence - in the control territory), indicates the high sensitivity of surveillance, the results of which, thus, can be used for a real forecast expected morbidity levels. It becomes possible to comprehensively observe the epidemiological background, quickly analyze information based on the principle of alternativeness, equivalent control, and carry out the necessary correction.

to the order of the USSR Ministry of Health

dated 08/16/89 N 475

on anti-epidemic measures

against acute intestinal infections

1. Procedure for identifying patients

1.1. Identification of patients suspected of having ACI is carried out by doctors (paramedics) of all healthcare institutions during outpatient appointments, home visits, medical examinations, medical examinations, etc. The diagnosis is established on the basis of the clinical manifestations of the disease, laboratory test data, and epidemiological history.

For each identified patient with OCI (or if suspected), an emergency notification (form 58u) is filled out and sent to the territorial SES or reported by telephone.

1.2. Identification of patients among workers of food enterprises and persons equivalent to them using laboratory examination methods.

1.2.2. Upon entry to work, a one-time bacteriological examination is carried out for a group of enteropathogenic bacteria. The examination for the carriage of typhoid fever is carried out in accordance with the order of the USSR Ministry of Health dated March 2, 1989 N 139 “0 measures to reduce the incidence of typhoid fever and paratyphoid fever in the country.” No scheduled examination is carried out.

1.2.3. When the incidence of acute intestinal infections rises in a particular territory, or epidemiologically significant violations are identified at sites, the population to be examined and the scope of research are determined by an epidemiologist.

1.2.4. If there is an increase in morbidity in the territory associated with the products of a particular enterprise, the operation of this enterprise or site is stopped. A 2-fold bacteriological examination of all workers is prescribed. It is possible to use a full clinical examination in a clinic or hospital setting.

1.3. Identification of patients among children of preschool institutions, boarding schools, summer health institutions.

When registering for children's preschool groups, children are accepted without a bacteriological examination if they have a certificate from a local pediatrician about their state of health and the absence of contact with patients with acute respiratory infections.

Admission of children returning to children's institutions after any illness or long-term (5 days or more) absence is permitted only if they have a certificate from the local doctor or from the hospital indicating the diagnosis of the disease or the reason for the absence.

When taking a child in the morning, it is necessary to survey the parents about the general condition of the child and the nature of the stool. If there are complaints and clinical symptoms characteristic of intestinal diseases, the child is immediately isolated; if there is stool (vomiting), material is taken from him for laboratory testing. Further observation and treatment (at home or in a hospital) is carried out by a local pediatrician or infectious disease specialist.

2. Collection of material for laboratory research and delivery to the laboratory

The collection of material from a patient with acute intestinal infection is carried out after the start of etiotropic treatment and is entrusted to the doctor (paramedic) who made the primary diagnosis of acute intestinal infection.

Collected material (vomit, gastric lavage, feces) is sent for research to determine the causative agents of the group of enteropathogenic bacteria.

The need for testing for other groups of pathogens (viruses, opportunistic bacteria, Yersinia, campylobacter, etc.) is determined by the doctor depending on the specific conditions (clinical picture, epidemiological situation, seasonality, etc.) and is indicated separately in the referral.

When treating a patient at home, material for research is collected by the staff of medical institutions.

In all cases, the collection of material for research from persons entering work in food and similar enterprises and institutions is carried out by medical workers of treatment and preventive or sanitary institutions.

Collection of material from persons who communicated with a patient with acute intestinal infections is carried out by medical workers of treatment and preventive institutions, preschool institutions, schools, boarding schools, summer health institutions and other institutions and enterprises.

For patients admitted to hospitals for hospitalization, material for bacteriological culture is collected in the emergency department.

Stool is collected into test tubes containing a glycerin mixture or semi-liquid Carey-Blair medium. Vomit, gastric lavage, etc. are collected in sterile containers. For virological testing, the material is taken into a sterile dry tube.

Material for bacteriological research is delivered to the laboratory in containers that prevent damage to the test tubes, and is accompanied by a special direction. Delivery of material to the laboratory by the subjects themselves is strictly prohibited. Delivery time to the laboratory is no later than 2 hours after collection.

If it is impossible to deliver the material on time, it is placed in the refrigerator and sent for examination no later than 12 hours after collection. Fecal samples for testing for rotaviruses, enteroviruses, and campylobacters must be stored in freezer refrigerator.

It is advisable, if necessary, to supplement a comprehensive laboratory examination of patients with AEI in order to determine the etiology of the disease with existing modern diagnostic methods (RPGA, ELISA, coagglutination, immunofluorescence, etc.). Blood collection and delivery to the laboratory are routine, as with any serological test.

3. Hospitalization of patients with acute intestinal infections

Hospitalization of patients with AEI is carried out according to clinical and epidemiological indications.

3.1. Clinical indications:

3.1.1. all severe and moderate forms in children under one year of age with a burdened premorbid background;

3.1.2. acute intestinal diseases in severely weakened and burdened persons with concomitant diseases;

3.1.3. protracted and chronic forms of dysentery (with exacerbation).

3.2. Epidemiological indications:

3.2.1. inability to comply with the necessary anti-epidemic regime at the patient’s place of residence;

3.2.2. workers of food enterprises and persons equated to them are subject to hospitalization in all cases where clarification of the diagnosis is required.

4. The procedure for discharging patients from the hospital

4. 1. Employees of food enterprises and persons equivalent to them, children attending preschool institutions, boarding schools, summer health institutions, are subject to a one-time bacteriological examination 1-2 days after the end of treatment in a hospital or at home.

4.2. Categories of patients not related to clause 4.1 are discharged after clinical recovery. The need for their bacteriological examination before discharge is determined by an infectious disease specialist.

4.3. When discharging a person who has recovered, the hospital doctor is obliged to prepare and submit to the clinic an extract from the medical history, including the clinical and etiological diagnoses of the disease, data on the treatment performed, the results of all studies, and recommendations for medical examination.

5. The procedure for admitting sick people to work, preschools, boarding schools, and summer health centers

5.1. Employees of food facilities and persons equivalent to them, children attending kindergartens, boarding schools, summer health institutions, are allowed to work and visit these institutions after discharge from hospital or treatment at home on the basis of a certificate of recovery and in the presence of a negative bacteriological result analysis. No additional bacteriological examination is performed.

5.2. Children from boarding schools and summer health institutions are not allowed to be on duty at the catering unit for a month after an illness.

5.3. If the bacteriological examination performed before discharge is positive, the course of treatment is repeated. If the results of the control examination carried out after a second course of treatment are positive, dispensary observation is established with transfer to another job not related to the production, storage, transportation and sale of food products.

If the dysentery causative agent is detected in such persons for more than three months after the illness, then by decision of the VKK they, as patients with a chronic form of dysentery, are transferred to work not related to food.

5.4. Children who have suffered an exacerbation of chronic dysentery are admitted to the children's group if their stool has normalized within 5 days, their general condition is good and their temperature is normal.

6. Organization of epidemiological survey

The purpose of an epidemiological survey is to identify conditions conducive to the emergence and spread of diseases, early identification of sources of infection and contact persons, determination of the boundaries of the outbreak and implementation of the necessary set of anti-epidemic measures to limit and eliminate it.

Epidemiological survey is carried out:

6.1. in apartment centers:

6.1.1. in case of illness (bacteria carriage) of acute respiratory infections of workers of food enterprises and persons equated to them;

6.1.2. in case of illness of children attending preschool institutions and unorganized children under 2 years of age;

6.1.3. in all foci of infection, both with simultaneous and repeated cases of the disease.

With an increase in the incidence of acute intestinal infections, a 100% examination of foci is carried out to establish the routes and factors of transmission of infection, with a survey of patients in a hospital setting or at home.

In other cases, the need to examine residential outbreaks is determined by the epidemiologist, taking into account the epidemiological situation and retrospective analysis materials;

6.1.4. in apartment outbreaks, employees of food enterprises and persons equivalent to them, children attending preschool institutions, boarding schools, summer health groups, as well as unorganized children under 2 years of age are subject to a one-time bacteriological examination. The above-mentioned contingent is not excluded from work and from visiting organized groups.

6.2. In preschools, medical and preventive institutions, at food enterprises and similar facilities, at the place of work, study, when the first case of AEI appears, the need for an epidemiological examination is decided by an epidemiologist. When recurrent diseases occur, an epidemiological examination is carried out comprehensively with the participation of specialists of the appropriate sanitary and hygienic profile.

When conducting an epidemiological examination of outbreaks, both at home and in preschool institutions, at food facilities, it is recommended to take samples of food products, water, and swabs to determine the enteropathogenic and sanitary-indicative group of bacteria.

A bacteriological examination of those who interacted with patients with acute intestinal infections is carried out upon registration:

— simultaneous diseases in groups of adults and children;

— the first case of acute intestinal disease in nurseries, nursery groups of preschool institutions, and epidemiologically significant facilities.

In other cases, the volume and frequency of bacteriological examination is determined by an epidemiologist.

Sigmoidoscopy is used as an additional method of clinical examination in hospitals and clinics. For children, sigmoidoscopy is performed only for clinically justified indications.

7. Medical observation of those communicating with patients with acute intestinal infections

7.1. Observation of those communicating in preschool institutions, hospitals, sanatoriums, boarding schools, summer health institutions, at facilities associated with the production, storage and sale of food products is carried out by medical workers of these institutions and territorial treatment and preventive institutions.

7.2. Persons belonging to the contingent of workers of food enterprises and persons equivalent to them, children attending preschool institutions, summer health groups are subject to medical observation in residential outbreaks.

Medical observation is carried out at the place of work or study of those in contact.

7.3. The duration of medical observation for dysentery and acute intestinal infections of unknown etiology is 7 days; A daily survey, examination, observation of stool character, and thermometry are carried out.

7.4. The duration and nature of observation for acute intestinal infections of established etiology are determined by appropriate recommendations depending on the pathogen isolated.

7.5. Observation data is reflected in outpatient records and histories of the child’s development.

7.6. In areas of intestinal infections for children early age For premature, weakened and aggravated conditions (hypotrophy, rickets, anemia, etc.), the use of biological preparations (bifidumbacterin) and baby food products enriched with bifidobacteria (bifidin) can be recommended.

7.7. For older children and adults working at epidemiologically significant facilities, in order to increase the body's nonspecific resistance, prevent dysbiosis and prevent infection with acute respiratory infections, it is recommended to use drugs and food products with a specially selected complex culture of acidophilus bacillus (acidophilus milk, acylact, biofructolact, etc.) .

8. Disinfection measures

8.1. Disinfection measures are carried out in accordance with the “Guidelines for organizing and carrying out disinfection measures for acute intestinal infections”, approved on April 18, 1989 N 15-6/12.

8.2. Disinfection measures for acute intestinal infections of viral etiology should be carried out according to the regimes and using the means recommended in Appendix 3 to Order No. 408 of July 12, 1989 “On measures to reduce the incidence of viral hepatitis in the country.”

9.1. Employees of food enterprises and persons equated to them who have had acute intestinal infections are subject to dispensary observation for 1 month with a 2-fold bacteriological examination carried out at the end of observation with an interval of 2-3 days.

MISSING ONE SHEET 220-221.

For the vast majority, the release of the virus stops or sharply decreases; the danger of persons in this phase of infection to others is low; hospitalization of patients in this case has no epidemiological significance. In rare cases, virus shedding may take up to 2-3 weeks. Viremia is short-lived and has no epidemiological significance. Chronic virus carriage has not been established.

The mechanism of transmission of the pathogen is fecal-oral. Its implementation occurs through factors inherent in intestinal infections: water, food, “dirty” hands and household items. In children's and other organized groups, the contact and household route of transmission of the pathogen is of greatest importance. The spread of infection is facilitated by overcrowding, failure to isolate groups in children's institutions, the formation of “combined” round-the-clock and extended-day groups, violation of the sanitary and anti-epidemic regime, and late identification and isolation of patients. Waterway transmission of the pathogen occurs when using poor-quality drinking water, bathing in contaminated water bodies, with intensive contamination of water sources near water intakes with the GA virus, the absence or periodic violation of water treatment and disinfection regulated by GOST, supplied to the population, when using technical water pipelines, violation of the sanitary and technical condition of the distribution water supply networks in combination with water shortages and suction of sewage or groundwater, poor sanitary and communal amenities of the territory.

Contamination of food products with the virus at food enterprises, public catering and retail establishments can occur from personnel with undiagnosed forms of HA who do not comply with personal hygiene rules. Food can also become contaminated with the virus when poor-quality water is used for processing, cooking or washing dishes. Berries and vegetables become contaminated with the virus when they are grown in irrigated fields or in gardens fertilized with the contents of toilets.

Human susceptibility to infection is universal. Immunity after an illness is long-lasting, possibly life-saving. Asymptomatic forms form a less intense immune system than clinically expressed ones. The level of collective immunity of the population is one of the factors influencing the course of the epidemic process. There is a tendency for immune individuals to increase with age. In areas with high incidence (Central Asia, Kazakhstan), most people acquire anti-HAV by 4-6 years, and in areas with average and low rates - by 20-30 years.

The epidemic process of GA is characterized by a number of features: widespread distribution; uneven intensity in certain areas; the cyclical nature of long-term dynamics; pronounced autumn-winter seasonality; predominantly affects children preschool age, adolescents and young adults; low familial frequency. Periodic increases in incidence are observed at intervals from 3 to 10 years and vary in different territories and in certain age groups of the population. At intervals of 15-20 years, synchronous rises occur, covering all territories of the country.

In areas with high incidence rates, the most affected population group is toddlers. Children who attend preschool institutions tend to get sick more often than those who do not attend. IN last years There is an equalization of morbidity rates among the population of cities and villages. The greatest intensity of development of the epidemic process in certain territories also depends on the action of socio-demographic factors (fertility, age structure, the proportion of large families and the “organization” of children, population density, migration activity, etc.).

The increase in the incidence of GA usually begins in July-August and reaches a maximum in October-November, followed by a decrease in the first half of the next year. There are unequal timing of the onset and severity of seasonal increases in incidence in different socio-age groups of the population. In areas with average incidence rates, the seasonal rise begins among schoolchildren, and in areas with high incidence rates, among children of younger age groups.

Non-A, non-B hepatitis is an independent disease with a fecal-oral transmission mechanism, in which markers of hepatitis A and B are not detected. It is registered mainly in the republics of Central Asia. This infection is characterized by a number of epidemiological signs, which include:

1) pronounced unevenness of the territorial distribution of morbidity;

2) the explosive nature of outbreaks with a high incidence rate in areas with poor water supply;

3) the most common lesion is in adults 15-30 years old;

4) low familial focality.

GNANV is characterized by a severe course of the disease and high mortality in pregnant women, usually in the second half of pregnancy. All known epidemic outbreaks of this disease are caused by the action of the water factor. The true extent of this infection is unknown.

Preventive and anti-epidemic measures

The main preventive measures for hepatitis A and non-A, non-B are sanitary and hygienic, aimed at breaking the fecal-oral mechanism of transmission of the pathogen, providing the population with good-quality water, epidemic-safe food products, creating conditions that guarantee compliance sanitary rules and requirements for the procurement, transportation, storage, technology of preparation and sale of food products; ensuring widespread and constant implementation of sanitary, technical and hygienic standards and rules of the sanitary and anti-epidemic regime in children's institutions and educational institutions; observance of personal hygiene rules, hygienic education of the population.

Based on this, sanitary and epidemiological service institutions must carry out the following activities: monitoring the condition of all epidemiologically significant objects (water supply sources, wastewater treatment plants, water supply and sewerage networks, public catering facilities, trade facilities, children's, educational and other institutions); widespread use of laboratory control over objects environment using sanitary-bacteriological and sanitary-virological methods (determination of coliphages, enteroviruses, GA virus antigen); assessment of epidemiologically significant socio-demographic and natural processes; assessment of the relationship between morbidity, sanitary and hygienic conditions; morbidity forecasting; assessment of the quality and effectiveness of ongoing activities.

The planning of specific measures for the prevention of GA should be based on the results of in-depth retrospective and operational analysis and morbidity forecast data.

The objectives of retrospective epidemiological analysis include:

1) analysis of long-term morbidity dynamics;

2) analysis of seasonal dynamics of morbidity;

3) identification of socio-age groups of the population with high, medium and low levels of morbidity, taking into account their epidemiological significance;

4) identification of individual groups in which morbidity is systematically recorded;

5) assessment of the quality and effectiveness of ongoing anti-epidemic measures;

6) formulation and substantiation of conclusions about the factors determining the manifestations of the epidemic process.

The basis for operational analysis is information received by the SES about all cases of registered diseases based on primary diagnoses. It is advisable to carry out operational analysis of morbidity at weekly or two-week intervals by comparing the current actual level with the “normative” (control) level per year with cyclical rises and declines in morbidity. Operational epidemiological analysis includes: monitoring the implementation of planned activities; dynamic assessment of the state of epidemically significant objects, as well as conditions contributing to the activation of the epidemic process. During the operational analysis, special attention is paid to microterritories (contingents, groups) identified in the process of retrospective epidemiological analysis. Under the supervision of relevant SES specialists are processes such as the formation, departure and return of preschool, school, and student groups, as well as population migration associated with agricultural and other work.

Taking into account the results of the analysis and forecast of morbidity, specific sanitary and hygienic conditions, comprehensive plans of preventive measures to reduce the incidence of viral hepatitis are developed, approved by the Councils of People's Deputies.

Identification of patients with viral hepatitis is carried out by doctors and paramedics of all healthcare institutions during outpatient visits, visiting patients at home, during periodic examinations of the population, and monitoring persons who communicated with patients. It is important to take into account clinical features initial period, the presence of erased and anicteric forms, the diagnosis of which requires special attention. In the absence of jaundice and insufficient severity of other symptoms, it is advisable to conduct a blood test to determine the activity of ALT and, if possible, anti-HAV class IgM.

All patients with acute form of hepatitis A are subject to registration with the SES.

In apartments with good living conditions in case of suspicion of GA, short-term (no more than 3 days) isolation of sick people at home is allowed to carry out the necessary laboratory tests. Patients with suspected hepatitis who live in unfavorable living conditions (communal apartments, dormitories, etc.), as well as persons with etiologically undifferentiated hepatitis, are subject to mandatory hospitalization.

In hospitals for hospitalization, it is necessary to separate the accommodation of patients with hepatic and hepatitis B, they must comply with the anti-epidemic regime provided for by the “Instructions on the sanitary and anti-epidemic regime and occupational safety of personnel of infectious diseases hospitals (departments)”, approved by order of the USSR Ministry of Health dated 04.08.84 N 916 .

Immunoglobulin prophylaxis (IGP) is integral part complex of anti-epidemic measures, is carried out only among the populations most affected by this infection.

The main criterion for determining the tactics of using IGP are the incidence rates and the intensity of the formation of epidemic foci of GA among preschoolers and schoolchildren. Depending on the incidence rates in the most affected age groups in different areas of the country, a differentiated system of using IGP is recommended:

- if the rate is less than 5 per 1000, carrying out mass IGP is epidemiologically unprofitable;

- from 5 to 12 per 1000 - the use of immunoglobulin is epidemiologically justified only for children who communicated with a sick person within the children's group preschool, school class or family;

- with indicators of 12 and above per 1000 - one-time administration of immunoglobulin to preschoolers or students is justified primary classes schools at the beginning of the seasonal rise with the implementation of this event within 10-15 days.

Immunoglobulin is administered according to age in the following doses:

- older children and adults, depending on weight, up to 3.0 ml.

Data on IGP is entered into accounting forms 63/у and 26/у. Administration of immunoglobulin is allowed no more than 4 times at intervals of at least 12 months. After administration of immunoglobulin, vaccinations can be carried out after 4-8 weeks. Administration of immunoglobulin after vaccinations is allowed after 2 weeks.

Considering that IHP tactics depend on the incidence of hepatitis in specific territories, it is advisable when planning this event to use the results of short-term and long-term forecasts (“Guidelines for forecasting the incidence of viral hepatitis”, Ministry of Health of the USSR, 07/04/89, N 15/6-18) .

Cases of viral hepatitis at the place of residence are subject to examination by an epidemiologist or an assistant epidemiologist. In some cases, it is allowed to collect information from hospitalized patients in a hospital, followed by going to the “hotbed” and filling out an epidemiological survey card (f. 357/u). Foci of GA in groups (children's institutions, hospitals, rest homes, sanatoriums, etc.) are examined by an epidemiologist. The results of the examination are documented in the form of a report.

Persons suspected of being the source of infection should be subjected to in-depth clinical and biochemical examination, and, if possible, examination for GA markers. Groups in which the patient could have been at the end of the incubation period and in the first days of the disease (hospitals, sanatoriums, temporary children's groups, etc.) are also identified in order to carry out anti-epidemic measures in them. Persons who have been in contact with patients with HA are subject to systematic (at least once a week) medical observation (thermometry, questioning, examination to determine the size of the liver, spleen, etc.) for 35 days from the date of separation from the patient. If indicated, children in preschool institutions are observed daily, and in schools - weekly. When repeated diseases occur, the observation period increases, the duration of observation is counted from the last case.

Medical personnel of children's institutions or health centers are informed about persons in contact with a patient with HA at the place of residence. Contact persons associated with the preparation and sale of food products are reported to the head of the relevant institution and the departmental sanitary and epidemiological service to strengthen control over such person’s compliance with the rules of personal and public hygiene, and timely removal from work at the first signs of illness.

Laboratory examinations of people who interacted with patients with HA (determination of alanine aminotransferase in the blood, and, if possible, specific markers of HA), if indicated (the appearance in the team of an increased number of acute respiratory infections, especially accompanied by liver enlargement, the presence of hepatolienal syndrome of unknown etiology, dyspeptic symptoms, fever and etc.) are carried out in preschool institutions as prescribed by a pediatrician and epidemiologist.

According to epidemic indications, the population of those examined can be expanded, including group and catering staff. The examination interval is 15-20 days.

If HA is detected in a preschool children's institution, the transfer of children from this institution to others, as well as to another group within this institution, is prohibited within 35 days from the date of isolation of the last patient. Admission of new children to these institutions is allowed with the permission of the epidemiologist, subject to the preliminary administration of immunoglobulin to a child who has not previously been reliably ill with GA. The staff of the child care facility, as well as parents, should be instructed in detail about the first symptoms of the disease and the need for immediate notification. medical workers about all deviations in the child’s condition.

During the observation period, the quarantine group of the children's institution should not take part in events held in common premises with other groups; groups are separated during walks. For the quarantine group, the self-service system and cultural events are canceled.

Within 2 months from the date of isolation of the last patient with HA in a child care institution (preschool group, school class), routine vaccinations should not be carried out. The question of the advisability of emergency IGP is decided by an epidemiologist in consultation with the medical service of the institutions. As a rule, IGP is carried out within the quarantine group of a preschool institution, but according to epidemic indications it can be extended to other groups. Conducting IGP among schoolchildren is advisable in case of multiple cases of GA. Disinfection and disinfestation measures in GA outbreaks are carried out in accordance with Appendix 3.

Children who have had contact with GA in the family are allowed into groups with the permission of the epidemiologist, in the case of previous GA, the administration of immunoglobulin and the establishment of regular monitoring of these children for 35 days.

If a case of GA occurs in a somatic children's hospital or sanatorium, the transfer of children from ward to ward and to other departments is stopped. Newly admitted children are recommended to be placed in separate rooms. Supervision over the implementation of anti-epidemic measures and compliance with the sanitary and hygienic regime is being strengthened.

Prevention of outbreaks of GNANV diseases is carried out on the basis of the implementation of sanitary and hygienic measures and is based on an analysis of the territorial and age structure of morbidity, taking into account the epidemiological characteristics of this infection. Particular attention is paid to the state of water supply. The results of a retrospective epidemiological analysis of the incidence of GNANV and the sanitary and hygienic condition of the territories are used to specify preventive and anti-epidemic measures. Highest value attached to measures to improve water supply, sewerage, sanitary and hygienic improvement of territories (Methodological recommendations “Non-A, non-B viral hepatitis with a fecal-oral mechanism of transmission of infection (epidemiology, clinic, treatment and prevention”, Moscow, 1987). Adoption of current decisions are made taking into account morbidity indicators, features of the development of the epidemic process in GNANV.

It does not work Editorial from 07.10.2000

ORDER of the Minister of Defense of the Russian Federation dated October 7, 2000 N 475 "ON INCREASING SALARY OF MILITARY SERVANTS"

Order

In pursuance of the Decree of the Government of the Russian Federation of September 14, 2000 N 680 “On the increase monetary allowance military personnel, employees of internal affairs bodies of the Russian Federation, institutions and bodies of the criminal executive system of the Ministry of Justice of the Russian Federation, customs authorities Russian Federation and the salary of employees of the federal tax police authorities" (" Russian newspaper" dated September 19, 2000 N 180) I order:

a) monthly salaries in accordance with military positions held by military personnel (including those appointed to military positions military departments at educational institutions of higher professional education, as well as those who are at the disposal of those who have left for training in military educational institutions, courses, centers, classes and sent abroad to provide technical assistance and perform other duties) in the amounts:

officers - in accordance with Appendix No. 1 to this Order;

military personnel undergoing military service under a contract in military positions subject to replacement by soldiers, sailors, sergeants, foremen, warrant officers and midshipmen, as well as cadets and officers who do not have military ranks, military students educational institutions the Ministry of Defense of the Russian Federation, which has entered into a contract for military service, - in accordance with Appendix No. 2 to this Order;

soldiers, sailors, sergeants and foremen undergoing conscription military service - in accordance with Appendix No. 3 to this Order;

cadets and officers without military ranks, students of military educational institutions of the Ministry of Defense of the Russian Federation (except for cadets and students who have entered into a contract for military service), cadets of training military units and units, citizens studying in the Suvorov military, Nakhimov naval, military - music schools, cadet (naval cadet, music cadet) corps, students of the Military Music School and military units - in accordance with Appendix No. 4 to this Order;

b) monthly salaries in accordance with the assigned military ranks to military personnel (except for soldiers, sailors, sergeants and foremen undergoing military service upon conscription) - in amounts in accordance with Appendix No. 5 to this Order.

To pay military personnel temporarily stationed abroad in foreign currency according to established standards, without taking into account the increase in salaries stipulated by this Order.

2. Declaring that Order of the Minister of Defense of the Russian Federation of January 30, 1999 No. 40 has lost force (according to the conclusion of the Ministry of Justice of the Russian Federation of April 5, 1999 No. 2478-VE does not require state registration).

3. The order should be sent to a separate military unit and organization of the Armed Forces of the Russian Federation, as well as to the military (naval) department at the state educational institution higher professional education.

Minister of Defense
Russian Federation
Marshal
Russian Federation
I. SERGEEV

According to the conclusion of the Ministry of Justice of the Russian Federation No. 9038-UD dated October 24, 2000, it does not require state registration.

Applications

Appendix No. 1
to the Order of the Minister of Defense
Russian Federation
dated October 7, 2000 N 475

SALARY SIZES FOR MILITARY POSITIONS OF OFFICERS

Tariff categories		Tariff categories	Salaries (in rubles per month)
1	622 - 662	26	1172 - 1217
2	643 - 686	27	1195 - 1241
3	662 - 709	28	1217 - 1264
4	686 - 731	29	1241 - 1283
5	709 - 755	30	1264 - 1304
6	731 - 774	31	1327
7	755 - 797	32	1351
8	774 - 818	33	1373
9	797 - 841	34	1396
10	818 - 865	35	1415
11	841 - 887	36	1439
12	865 - 906	37	1460
13	887 - 929	38	1483
14	906 - 953	39	1507
15	929 - 974	40	1528
16	953 - 997	41	1549
17	974 - 1021	42	1571
18	997 - 1040	43	1594
19	1021 - 1062	44	1615
20	1040 - 1085	45	1639
21	1062 - 1108	46	1662
22	1085 - 1129	47	1681
23	1108 - 1151	48	1703
24	1129 - 1172	49	1727
25	1151 - 1195	50	1750
		51	1771

For military positions of the head of a department (service), deputy heads of a direction and directorate of the central bodies of military administration, for which the states provide tariff categories from 23 to 30, the salaries provided for in this appendix for these tariff categories in the maximum amount are subject to payment.

Appendix No. 2
to the Order of the Minister of Defense
Russian Federation
dated October 7, 2000 N 475

SALARY SIZES FOR MILITARY POSITIONS OF MILITARY SERVICE PERSONS PASSING MILITARY SERVICE UNDER CONTRACT IN POSITIONS SUBJECT TO REPLACEMENT BY SOLDIERS, SAILORS, SERGEANTS, STRATEGERS, WARRANTS AND MICHMANS, AS WELL AS CADETS AND OFFICERS WHO DO NOT HAVE MILITARY RANKS OF MILITARY EDUCATIONAL INSTITUTIONS OF THE MINISTRY OF DEFENSE OF THE RUSSIAN FEDERATION WHO HAVE CONCLUDED THE CONTRACT ABOUT MILITARY SERVICE

Tariff categories	Salaries (in rubles per month)
I	502 - 511
II	511 - 524
III	524 - 536
IV	536 - 548
V	548 - 560
VI	574 - 583
VII	583 - 595
VIII	595 - 605
IX	605 - 618

Appendix No. 3
to the Order of the Minister of Defense
Russian Federation
dated October 7, 2000 N 475

SALARY SIZES FOR MILITARY POSITIONS OF SOLDIERS, SAILORS, SERGEANTS AND STRATEGERS PASSING OUT MILITARY SERVICE BY CONTRACT

Soldiers, sailors, sergeants and foremen undergoing military service upon conscription, appointed to military positions subject to replacement by officers, are paid the minimum salary according to the first tariff category provided for in Appendix No. 2 to this Order.

Appendix No. 4
to the Order of the Minister of Defense
Russian Federation
dated October 7, 2000 N 475

SALARY SIZES FOR MILITARY POSITIONS OF CADETS AND OFFICERS WHO DO NOT HAVE MILITARY RANKS OF STUDENTS OF MILITARY EDUCATIONAL INSTITUTIONS OF THE MINISTRY OF DEFENSE OF THE RUSSIAN FEDERATION (EXCEPT FOR CADETS AND STUDENTS WHO HAVE CONCLUDED A TRAINING CONTRACT MILITARY SERVICE), CADETS OF TRAINING MILITARY UNITS AND DIVISIONS, CITIZENS STUDYING IN SUVOROV MILITARY, NAKHIMOV NAVAL, MILITARY MUSICAL SCHOOLS, CADET (MARINE CADET, MUSICAL CADET) CORDS, MILITARY MUSICAL SCHOOL STUDENTS AND MILITARY UNITS

Categories of cadets, listeners, students	Salaries (in rubles per month)
1. Cadets from among those who did not undergo military service before enlistment:
a) to military educational institutions for training:
according to higher military special education programs	72
according to secondary military special education programs	54
b) for training courses for junior officers	54
2. Cadets from among those enrolled for training directly after conscription for military service in military training units and units	36
3. Cadets from among the military personnel enrolled in training during the period of military service under conscription (except for the cadets specified in paragraph 2)	According to the latest regular positions V military units, but not less than the salaries provided for in paragraph 1
4. Students of higher military educational institutions who do not have military ranks of officers and are not kept in barracks conditions	248
5. Citizens studying in Suvorov military, Nakhimov naval, military music schools, cadet

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