Modern clinico-epidemiological features of the course of some communicable infectious zooanthroponous exanthemas in times of war
Authors: Fedorenko O.Ye. , Ivanov S.V. , Stepanenko V.I. 
Published: June 2023

Objective — to study and analyze modern clinical and epidemiological features of emerging zooanthroponoses, legal and organizational measures to ensure the sanitary and epidemiological well­being of the population of Ukraine in wartime conditions and active hostilities on a large area of the south and east of the country.
Materials and methods. An analytical review of a number of scientific publications devoted to the study of zoonotic diseases of the population accompanied by the appearance of exanthems on the skin was carried out. State legislative acts on issues of ensuring sanitary and epidemic welfare of citizens of Ukraine during wartime were also considered. The search for information was carried out in the medical databases PubMed, Elsevier, High Wire Press, Google Scholar for the period 2000—2022 according to the terms of the catalog of medical topics, subject headings with keywords: «dermatozoonosis», «exanthema», «epidemio­logy», «morbidity», «outbreak». Meta-analyses and reviews of relevant literature were studied. The work presents the principles of a scientific approach to the optimization of preventive and anti-epidemic measures to combat infectious zoonotic diseases, which should contribute to the maximally rational use of the laws of classical epidemiology in the conditions of war in order to increase the practical effectiveness of the anti-epidemic and dermatological services of the Ministry of Health of Ukraine.Results and discussion. The complex socio-economic situation of martial law and forced mass resettlement created quite favorable conditions for increasing the incidence of infectious zoonotic diseases in population, including their real outbreaks in certain territories near the front. The article describes methodical and diagnostic approaches, specific epidemiological principles and dermatological criteria for building effective measures to combat zoonotic diseases. A professional justification of the role and place of each of them in various infectious diseases is given, taking into account the provisions of general epidemiology and traditional dermatological semiotics.
Conclusions. The principles of mandatory complexity and qualified impact on the main link of the epidemic process are of great importance in the fight against various groups of infectious diseases. Their clinically justified and timely administrative use is necessary to achieve the goals of eradication, elimination and control of infectious diseases. In Ukraine, there is a sufficient normative and legal framework for the proper provision of sanitary and epidemic welfare of the population. In order to prevent the spread of existing or potential infectious agents, in particular emerging pathogens, it is necessary to develop and improve the already existing emergency response plan, particularly, the infrastructure of the health care system, to create a multi-level network of diagnostic laboratories and an integrated system of epidemiological surveillance. It is proposed to increase the branching of the network of institutions capable of identifying pathogens of zoonoses, hospitalization of those who are already sick and persons suspected of having the disease in conditions that will ensure their isolation and proper treatment, and to develop specific recommendations for the prevention of the spread of pathogens with various transmission routes. The task of such centers should be the comprehensiveness of epidemiological, diagnostic and preventive measures which must be carried out professionally and promptly. Also, one of the priorities should be the retraining of doctors of various specialties (epidemiologists, general practitioners — family doctors, dermatologists) on topical issues of zoonoses surveillance.