In accordance with official data, 9,856,927 cases of infectious diseases were registered in Ukraine in 1998 against 10,111,669 cases in 1997. Influenza and acute infections of the upper respiratory tracts made up 90.56% of the infectious diseases.
Allowing for the present notions about the essence of an epidemic process determined as a natural phenomenon where the agent circulates steadily in the system: organism – environment – organism, a considerable effect of the environment on the spreading extent of infectious diseases is observed in cases of gastric, blood and integument infections, owing to the effect, first of all, on the mechanism of agent transfer and on infections of the respiratory tract. There, side by side with activation of agent transfer mechanism in the autumn-winter period, the harmful factors of the environment have a negative effect on the immune system of the population.
In 1998, 141,585 cases of acute intestinal infectious diseases were registered in Ukraine (280.31 per 100,000 people), which was 7.75% less than in 1997, when 153,472 cases (302.72 per 100,000 people) were registered. Intestinal infections (typhoid fever, cholera, leptospirosis and virus hepatitis A) are worthy of special attention in the epidemic situation of 1998.
The increased number of typhoid fever cases in Ukraine in 1998 is connected with a deterioration of the epidemic situation with regard to this infection in Zakarpattia Region, where 88 cases of infection transmitted through water sources (6.83 per 100,000 people) were registered in 1998 against 3 cases (0.23 per 100,000) in 1997.
In 1998, 3 cases of cholera and cholera agent carriers were registered in Ukraine (AR of the Crimea, Donetsk and Zakarpattia regions), while no such cases were registered in 1997. When evaluating the epidemic situation in respect of this infection, one should mention that it remains rather complicated and unpredictable, especially in the southern and south-eastern region of Ukraine. This is connected with the detection of cholera agents in the environment, and with still unsolved problems of water supply and wastewater disposal system.
Cases of leptospirosis continued to increase in recent years in Ukraine, and 1,600 such cases were registered in 1998 (3.17 per 100,000 people) against 1,389 cases (2.75 per 100,000) in 1997. The highest levels of leptospirosis morbidity were registered in 1998 in Ivano-Frankivsk, Kyiv, Kirovograd, Ternopil, Khmelnytskyi, Cherkasy, Chernivtsi and Chernigiv regions.
An analysis of cases of virus hepatitis A in Ukraine in 1998 shows a decrease of morbidity as compared to 1997 in all regions except for Chernivtsi Region where morbidity increased by 7.23% and was 90.04 in 1998 against 83.26 per 100,000 people in 1997. The highest levels of morbidity for virus hepatitis A in Ukraine in 1998 were registered in Volyn, Zhitomyr, Ivano-Frankivsk, Lugansk, Poltava, Rivne, Ternopil and Chernivtsi regions.
Thus the data presented prove that the epidemic situation in Ukraine as to intestinal infections (1998) may be considered unstable. Measures of sanitary-hygienic and anti-epidemic nature are necessary to improve the situation.
In 1998, 304,567 cases of infections of the upper respiratory tract were registered in Ukraine against 194,281 cases in 1997. Cases of diphtheria, measles and tuberculosis cause great anxiety, and 706 cases of diphtheria were registered in 1998 (1.40 per 100,000 people). In spite of a decrease in the number of cases by 48.24% against 1997, the epidemic situation in respect of diphtheria remains unfavourable.
In 1998 the cases of diphtheria were nonuniformly distributed in the administrative territories. The highest morbidity levels were registered in Kyiv – 138 cases (5.25 per 100,000), in Odesa Region – 77 cases (3.02 per 100,000), in the city of Sevastopol – 10 cases (5.25 per 100,000), in Zaporizhzhia Region – 44 cases (2.15 per 100,000), in Ivano-Frankivsk Region – 29 cases (1.98 per 100,000), and in the Autonomous Republic of the Crimea – 42 cases (1.95 per 100,000 people).
As for measles, 5,107 cases were registered in 1998 in Ukraine (10.11 per 100,000 people) against 7,000 cases (13.86 per 100,000) in 1997. An analysis of population morbidity dynamics with regard to measles in 1993-1998 shows a tendency towards a decrease of morbidity. The highest morbidity levels were registered in Odesa (29.95) and Kharkiv (24.10) regions and in Kyiv (23.12 per 100,000 people).
In recent years the cases of tuberculosis have increased. In accordance with official data 113,966 cases of the disease (226.8 per 100,000 people) were registered in 1998, which is 7.11% more than in 1997, when the number of tuberculosis cases was 106,391 (210.1 per 100,000). The number of patients with tuberculosis of all forms registered in 1998 increased against 1997 in all the administrative territories of the country.
The highest figures of people sick with tuberculosis in 1998 were recorded in the regions of Donetsk – 13,498 cases (267.4 per 100,000), Zhitomyr 3,731 cases (257.4 per 100,000), Zaporizhzhia – 5,082 cases (248.9 per 100,000), Odesa – 6,665 cases (235.6 per 100,000) and Kherson – 3,301 (265.4 per 100,000 people). In 1998 the number of cases of all forms of active tuberculosis was 27,763 (55.3 cases per 100,000 people), and it increased by 12.63% against 1997 when 24,883 cases (49.1 per 100,000) were recorded.
The sickness rate increased in all the administrative territories except for Ivano-Frankivsk and Chernigiv regions where it decreased from 730 cases (50.2 per 100,000) to 707 cases (48.6 per 100,000) and from 726 (54.6 per 100,000) to 707 cases (53.7 per 100,000 people), respectively. In 1998 the largest numbers of people sick with all forms of active tuberculosis were registered in the regions of Donetsk (68.5), Zaporizhzhia (72.8), Kirovograd (63.0), Mykolaiv (62.5) and Kherson (70.4 cases per 100,000 people), the average calculated numbers in Ukraine being 55.3 cases per 100,000 people.
No cases of epidemic typhus were registered in Ukraine for 1993-1998, but cases of Brill disease were registered. Thus, in 1998, 11 patients with Brill disease were registered in Odesa and Chernivtsi regions, and in the cities of Kyiv and Sevastopol. The cases of Brill disease, being etiologically similar to epidemic typhus cause concern about a possible outbreak of the latter disease.
The considerable spreading of pediculosis, being the main factor of epidemic typhus is also causing anxiety. In the current year 73,718 cases of pediculosis (145.98 per 100,000 people) were registered in the country, which exceeds by 3.90% the index of the previous year.
Pediculosis is widely spread in the Autonomous Republic of the Crimea (215.92), Donetsk (247.93), Mykolaiv (260.04), Poltava (208.57) regions and in the city of Sevastopol (286.43 cases per 100,000 people), where the sick rate index significantly exceeded the average calculated index in Ukraine, which equalled 145.98 cases per 100,000 people.
In the current year the tularaemia situation has become aggravated. During the year 104 cases (0.21 per 100,000) were registered against 4 cases (0.01 per 100,000) in 1997. The cases of tularaemia were found in 1998 in Mykolaiv, Poltava and Kharkiv regions.
Side by side with tularaemia, the natural hotbeds of such an especially dangerous infection as Q fever (3 cases; 0.01 per 100,000) and Russian tick-borne encephalitis (25 cases; 0.05 per 100,000) continued to exist in Ukraine in 1998.
One case of anthrax (0.002) was registered during 1998 against 38 cases (0.08 per 100,000) in 1997. Despite the low level of morbidity and the obvious tendency towards a decrease in 1993-1998, the considerable number of infected sites (as to anthrax) and some drawbacks in realization of antiepizootic and antiepidemic actions do not allow for optimistic predictions as to the threat of anthrax.
Two cases of rabies were registered in 1997 and 1998 (0.002 per 100,000 people).
Despite isolated cases of the disease in people one cannot evaluate the epidemic situation
as a stable one, accounting for the complicated epizootic situation in the work of certain
services (medical, veterinary, municipal services, state authorities, forestry, etc.).