SIX LECTURES ON THE PREVENTION OF ENCEPHALITIS EPIDEMICS IN SIBERIA

Abstract

This review summarizes the work of large teams of researchers to prevent two separate encephalitis epidemics in Siberia. The first three lectures sum up an extensive effort to study and control the Tick-borne enceph-alitis (TBE) epidemic in the Kemerovo region of Western Siberia. The study has helped to create a mathematical model that details the TBE epidemic process and offers a quantitative approach to the development of strategies for preventing TBE epidemics. Ten-year effort to combat TBE in the Kemerovo region led to a significant and sustained reduction in TBE morbidity and mortality. Fifty years after completion of this work, the proposed strategy has not been tested in other endemic regions, although the incidence of TBE worldwide has almost doubled, taking hundreds of lives and causing disability in thousands. The second disease described here is Viliuisk encephalomyelitis (VEM), first discovered 150 years ago in a small rural population of Eastern Siberia. The disease later spread to densely populated areas of the Republic of Sakha (Yakutia), reaching epidemic proportions. The three lectures on VEM provide an overview of multi-year studies on clinical presentation, neuropathology, pathogenesis, etiology, and epidemiology of VEM. We report here for the first time how a prolonged hospitalization of VEM patients during the acute and subacute phases of the disease prevent-ed transmission to susceptible individuals in their families and communities, which has helped to put an end to the further spread of this deadly disease. VEM is a new example of a local disease that has spread to a large territory and could potentially invade other countries if left unchecked. This review is based on a series of lectures delivered to different audiences at different times. The purpose of combining discrete topics in a single review is to emphasize approaches to solving problems, to illustrate the main results of the fight against Siberian epidemics and, when possible, reflect on the individual contribution of each researcher.