Compliance with SanPiN 3.2.3215-14 is mandatory throughout the Russian Federation for state bodies, bodies state power subjects of the Russian Federation, municipalities, officials state bodies, officials of state authorities of the constituent entities of the Russian Federation, officials of local governments, citizens, individual entrepreneurs and legal entities.
lapses Decree of the Chief State Sanitary Doctor of the Russian Federation dated May 30, 2003 No. 105 “On the Enactment of Sanitary and Epidemiological Rules and Regulations SanPiN 3.2.1333-03”.

TABLE OF CONTENTS

Decree. SanPiN 3.2.3215-14. Prevention of parasitic diseases in the territory Russian Federation. Sanitary and epidemiological rules and regulations
I. Scope
II. General provisions
III. Measures to ensure the federal state sanitary epidemiological surveillance
IV. Identification, registration and registration of parasitic diseases
V. Requirements for measures to prevent certain groups of parasitic diseases
5. Malaria prevention activities
Table 1. Main antimalarial interventions
I. Therapeutic and prophylactic
II. Entomological and pest control measures
III. Personnel training
IV. Sanitary and educational work among the population
VI. Measures for the prevention of helminthiases transmitted through meat and meat products
6.2. Requirements for methods of disinfection of meat products
VII. Measures for the prevention of helminthiases transmitted through fish, crustaceans, molluscs, amphibians, reptiles and their processed products
7.7. Requirements for methods of disinfection and modes of processing of fish and fish products
7.7.1. Fish freezing requirements
Table 2. Modes of fish disinfection from tapeworm larvae
Table 3. Modes of fish disinfection from opisthorchid larvae
Table 4. Modes of disinfection of marine fish from anisakid larvae and other helminths dangerous to humans and animals
7.7.2. Requirements for salting fish
Table 5. Modes of salting fish during disinfection from tapeworm larvae
7.7.3. Requirements for salting fish roe
7.7.4. Requirements to heat treatment fish and fish products
VIII. Measures for the prevention of echinococcosis, alveococcosis
IX. Measures for the prevention of dirofilariasis
X. Measures for the prevention of ascariasis, trichuriasis, toxocariasis
Table 6. Types of foci of ascariasis and trichuriasis on the territory of the Russian Federation
XI. Measures for the prevention of enterobiasis and hymenolepiasis
XII. Measures for the prevention of intestinal protozoosis (giardiasis, amoebiasis, cryptosporidiosis, balantidiasis, blastocystosis and others)
XIII. Requirements for measures to prevent pediculosis and scabies
XIV. Measures for the prevention of demodicosis
XV. Measures for the prevention of parasitic diseases transmitted through the bites of insects and ticks
XVI. Requirements for security measures environment from contamination by pathogens of parasitic diseases
16.7. Measures for the disinfection of environmental objects
16.7.1. Disinfestation of sewage (faeces)
Table 9. Methods and modes of their use for the disinfestation of sewage
16.7.2. Solid household waste
16.7.3. Disinvasion / deworming Wastewater
16.7.4. Disinfestation of sewage sludge
16.7.5. Disinfestation of liquid manure and manure
16.7.6. Disinfestation of soil, sand
16.7.7. Disinfestation of vegetables, fruits, canteen greens
16.7.8. Disinfestation of household items, toys, linen
16.7.9. Disinfestation of drinking water
16.7.10. Disinfestation of skins of wild and domestic carnivores, fur and fur products
16.7.11. Disinfestation of other environmental objects
XVII. Hygienic education of the population on the prevention of parasitic diseases
Appendix. Sanitary and parasitological studies of objects external environment carried out as part of supervisory activities, social and hygienic monitoring and production control.

State sanitary and epidemiological regulation
Russian Federation

State sanitary and epidemiological
rules and regulations

SanPiN 3.2.3215-14

Moscow 2015

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

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

CHIEF STATE SANITARY PHYSICIAN
RUSSIAN FEDERATION

RESOLUTION

In accordance with the Federal Law of March 30, 1999 No. 52-FZ “On the sanitary and epidemiological well-being of the population” (Collected Legislation of the Russian Federation, 1999, No. 14, Art. 1650; 2002, No. 1 (Part I), Art. 2; 2003, No. 2, article 167; No. 27 (part I), article 2700; 2004, No. 35, article 3607; 2005, No. 19, article 1752; 2006, No. 1, article 10; No. 52 (Part I), Article 5498; 2007, No. 1 (Part I), Article 21, Article 29; No. 27, Article 3213; No. 46, Article 5554; No. 49, Article 6070; 2008 , No. 24, Article 2801; No. 29 (Part I), Article 3418; No. 30 (Part II), Article 3616; No. 44, Article 4984; No. 52 (Part I), Article 6223 ; 2009, No. 1, article 17; 2010, No. 40, article 4969; 2011, No. 1, article 6; No. 30 (part I), article 4563, article 4590, article 4591, article 4596; No. 50, item 7359; 2012, No. 24, item 3069; No. 26, item 3446; 2013, No. 27, item 3477; No. 30 (part I), item 4079; No. 48, item 6165; 2014, No. 26 (Part I), Art. 3366, Art. 3377) and Decree of the Government of the Russian Federation dated July 24, 2000 No. “On approval of the Regulations on the State Sanitary and Epidemiological Service of the Russian Federation and the Regulations on the State Sanit arno-epidemiological regulation” (Sobraniye zakonodatelstva Rossiyskoy Federatsii, 2000, No. 31, art. 3295; 2004, no. 8, art. 663; No. 47, Art. 4666; 2005, no. 39, art. 3953)

RESOLVE:

A.Yu. Popova

Sanitary and epidemiological rules and regulations
SanPiN 3.2.3215-14

I. Scope

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

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

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

II. General provisions

Identification of trends in the epidemic process;

Identification of regions, regions, settlements with a high level of morbidity and the risk of infection;

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

Planning the sequence of activities and the timing of their implementation;

Development of forecasts of the epidemiological situation.

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

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

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

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

Analysis of morbidity by territories;

Incidence analysis by age groups, gender, contingents of the population;

Conclusions and proposals for the development of preventive measures.

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

Examination for helminthiases and intestinal protozooses is subject to: children attending preschool educational organizations; personnel of preschool educational organizations; pupils lower grades, children, adolescents, decreed and equated groups of the population during medical examinations and preventive examinations; children, adolescents according to epidemic indications; children and adolescents who are registered in preschool and other educational organizations, orphanages, orphanages, orphanages, boarding schools, sanatorium treatment, health organizations, children's departments of hospitals; children of all ages of children's organizations of a closed type and year-round stay, patients of children's and adult polyclinics and hospitals according to indications, persons who communicated with patients.

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

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

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

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

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

4.16. For each infested, a dispensary observation form is filled out.

4.17. Deregistration is carried out after treatment and negative results laboratory research biological material.

Activities for the prevention of malaria.

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

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

5.3. The organization of activities for the prevention of malaria in the territory of the constituent entity of the Russian Federation is carried out by state authorities in the field of health protection of the constituent entities of the Russian Federation together with interested departments, local governments in municipalities. When organizing antimalarial measures, an irreducible supply of antimalarial drugs is ensured for the treatment of all types of malaria, including primaquine, and disinsection measures are taken to kill mosquitoes (adults, larvae), where transmission of three-day malaria is possible.

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

Key antimalarial activities

Name of events		In the absence of infection	When an infection is imported during a period when transmission is possible	In active foci
	I. Therapeutic and prophylactic
	Finding cases of malaria
	active method
	Passive Method
	Preliminary treatment of febrile persons with the likelihood of tropical malaria
	Epidemiological examination of the focus
	Chemoprophylaxis seasonal, off-season
	Validation of absence of malaria
	II. Entomological and pest control measures
	Carrier monitoring
	Calculation of effective mosquito season and malaria transmission season
	Observation of breeding sites and dynamics of their areas, certification of water bodies in the territory of settlements and within a radius of 3 km with annual data replenishment
	Prevention of the formation of anophelogenic reservoirs and reduction of the area of ​​existing
	Protecting the public from mosquito bites with repellents, protective clothing and electrofumigating devices
	Treatment of premises with insecticides
	Treatment of anophelogenic reservoirs with larvicides
	Entomological quality control of larvicidal and adulticidal treatments
III. Personnel training
IV. Sanitary and educational work among the population

5.5. Organizations that send employees to countries in the subtropical and tropical zones, or travel agencies that organize trips to these countries, inform those leaving:

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

On the need to immediately seek qualified medical care in the event of a febrile illness during a stay in an endemic country;

About the need after returning, if any febrile illness occurs, immediately consult a doctor and inform him about the duration of stay in the countries of the subtropical and tropical zone and the intake of chemoprophylactic drugs.

Specialists sent to the countries of the subtropical and tropical zones in areas where there is no first aid are provided with a course dose of antimalarial drugs.

5.6. Heads of transport organizations operating flights to countries where tropical malaria is common, as well as rescuers and military personnel temporarily stationed in these countries, are provided with packing containing antimalarial prophylactic drugs and mosquito bite protection. These individuals undergo chemoprophylaxis.

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

5.8. The following are subject to testing for malaria:

Persons who arrived from malaria endemic areas or visited endemic countries within the past three years, with an increase in temperature, with any of the following symptoms against a background of body temperature above 37 ° C: malaise, headache, enlargement of the liver, spleen, icterus of the sclera and skin, herpes, anemia;

Persons with an undiagnosed fever for 5 days;

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

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

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

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

Quality and safety of meat and meat products during their production and sale in accordance with the requirements of technical regulations;

Carrying out preventive disinfection and deratization measures on the territories of livestock farms and complexes, slaughterhouses, meat products warehouses, at food industry enterprises, public catering and food trade organizations and at other objects of particular epidemiological significance;

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

6.2. Requirements for methods of disinfection of meat products.

6.2.1. Requirements for freezing meat:

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

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

6.2.2. Meat warming requirements:

Parts of the carcass of cattle or pork carcasses are divided into pieces weighing up to 2 kg and up to 8 cm thick and boiled for 3 hours in open or 2.5 hours in closed boilers at overpressure steam - 0.5 MPa.

6.2.3. Meat salting requirements:

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

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

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

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

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

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

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

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

7.7. Requirements for methods of disinfection and modes of processing of fish and fish products.

7.7.1. Requirements for freezing fish:

Fish is disinfected from tapeworm larvae under the freezing conditions indicated in Table. ;

From the larvae of opisthorchid and other trematodes, the fish is disinfected under the freezing conditions indicated in Table. ;

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

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

7.7.2. Requirements for salting fish:

When infected with larvae of a wide tapeworm, the fish is disinfected by salting in the modes indicated in Table. ;

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

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

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

Minnow, bleak, minnow, tops - 10 days;

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

A weaker or shorter salting of fish is allowed, only after its preliminary freezing in the modes indicated in Table. 2.

Modes of fish disinfection from tapeworm larvae

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

Modes of fish disinfection from opisthorchid larvae

The temperature in the body of the fish (minus ° C)	Time required for disinfection (h)
Note. Given the significant resistance of trematode larvae to low temperatures, freezing fish at a temperature higher than indicated does not guarantee its disinfection.

Modes of disinfection of marine fish from anisakid larvae

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

Modes of salting fish during disinfection from tapeworm larvae

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

7.7.3. Requirements for the salting of fish roe.

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

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

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

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

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

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

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

Fish (fish cakes) are fried in portions in fat for 15 minutes. large pieces fish weighing up to 100 g are fried flat for at least 20 minutes. Small fish are fried whole for 15 - 20 minutes.

7.7.5. Marine fish intended for cold and hot smoking, salting and pickling, the production of preserves are pre-frozen in the modes indicated in Table. .

7.7.6. It is not allowed to dump fish products processing waste into water bodies and landfills, as well as feed them to animals without prior disinfection.

7.7.7. Responsibility for the implementation of these measures rests with individual entrepreneurs and legal entities engaged in breeding, rearing, harvesting (catch), processing, storage, sale of fish, aquatic invertebrates, aquatic mammals, and other aquatic animals located in natural environment habitats, aquaculture objects, fish food products.

VIII. Measures for the prevention of echinococcosis, alveococcosis

8.1. Groups at risk of infection with the causative agent of echinococcosis (hunters, shepherds, reindeer herders, shepherds, employees of fur farms, livestock farms, zoos, fur collectors, workers of fur workshops, veterinary workers, persons involved in trapping dogs, dog owners, employees of reserves, reserves, forestries, pickers and buyers of mushrooms, berries, as well as members of their families) during preventive and periodic medical examinations, clinical examinations are subject to examination for echinococcosis.

8.2. Organization of preventive measures for echinococcosis includes:

Operational tracking (monitoring) of the epidemic situation;

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

Hygienic education using the media;

Regulation of the content of stray dogs, their deworming.

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

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

8.4.1 Ensuring deworming of priotary, reindeer, sled and other dogs on the territory of cities and towns.

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

8.4.3. Preventive deworming against cystodes of priotary, guard, reindeer, sledding, hunting and other dogs is carried out 5 to 10 days before the transfer of animals to pastures and the hunters go hunting. Deworming of dogs is carried out on special sites, the feces isolated after treatment are collected in a metal container and treated with drugs that have an ovicidal effect. The site covered with cement, the soil is being processed.

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

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

In places of extraction of furs, in each settlement and in hunting winter quarters, special rooms for removal, primary processing of animal skins, collection of affected carcasses and their disposal, meeting sanitary and hygienic standards. The premises are provided with sufficient water. The floor, walls and equipment must have a smooth surface. Waste from the processing of hides is incinerated. Eating, storage food products in these areas is strictly prohibited.

IX. Measures for the prevention of dirofilariasis

9.1. Prevention of infection of humans and animals with dirofilaria is based on the interruption of the transmissible transmission of invasion: extermination of mosquitoes, identification and deworming of infested domestic dogs, prevention of contact of mosquitoes with domestic animals and humans.

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

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

9.4. Examination and deworming of infested domestic dogs and cats is carried out in the spring and summer. Non-infected dogs in the endemic zone are given chemoprophylaxis to prevent dirofilariasis.

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

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

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

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

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

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

Focus type	Ascariasis		trichuriasis
	afflicted people (%)	proportion of microfoci (%)	afflicted people (%)	proportion of microfoci (%)
high intensity	30 or more	50 or more	10 - 5
medium intensity	15 - 29	up to 40	3 - 9
Weak intensity	up to 15	units	units

10.4. Anti-epidemic measures for the prevention of ascariasis and trichuriasis include:

Identification of sources of invasion and establishment of microfoci;

Epidemiological examination of the outbreak in the detection of geohelminthiasis;

Improvement of microfoci and foci of geohelminthiases;

Treatment of infested (with control of effectiveness 14 days after deworming, three times with an interval of 7-10 days) and examination of the inhabitants of the microcenter (for two years annually);

Disinfestation of soil, sewage;

Prohibition of the use of feces of an infested person as fertilizer;

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

10.6. Measures for the prevention of ascariasis, trichuriasis and toxocariasis include:

Analysis of the impact, morbidity of the population;

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

Analysis and evaluation of the effectiveness of preventive measures;

Regulation of the number of stray dogs in settlements;

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

Disinfestation of sand in sandboxes and prevention of contamination with faeces of dogs and cats;

Sanitary cleaning of the territories of settlements;

Compliance with personal hygiene in everyday life, public places, as well as in contact with soil, sand and plant products;

Hygienic education and training;

XI. Measures to prevent enterobiasis and hymenolepiasis

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

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

Examination of decreed groups of the population;

Treatment of identified infested persons and chemoprophylaxis of contact persons;

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

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

Hygienic education and training of the population.

11.2.2. The following are subject to examination for hymenolepiasis:

Children of preschool educational organizations;

Personnel of preschool educational organizations;

Primary school students (1 - 4);

Children, adolescents, decreed groups of the population according to epidemic indications and during medical examinations and preventive examinations;

Children enrolled in preschool and other educational organizations, orphanages, orphanages, boarding schools, for sanatorium treatment, in health organizations;

Outpatients and inpatients of children's polyclinics and hospitals;

Persons receiving access to the swimming pool.

11.2.3. Scheduled preventive examinations of children and attendants in children's preschool organizations and educational organizations of primary school age are held once a year (after the summer period) and (or) according to epidemic indications.

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

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

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

11.5. Children infested with pygmy tapeworm are not allowed in preschool educational organizations for the period of treatment and control laboratory examination.

XII. Measures for the prevention of intestinal protozoosis (giardiasis, amoebiasis, cryptosporidiosis, balantidiasis, blastocystosis and others)

12.1. Preventive actions:

Analysis of the morbidity of the adult and child population;

Examination of epidemiologically significant contingents of the population: children and staff of educational organizations upon admission to the organization and then 1 time per year, decreed groups of the population upon admission to work and then 1 time per year, persons in contact with patients, inpatients and outpatients according to indications;

Protection of water bodies from pollution by sewage, surface runoff;

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

Compliance with regime sanitary and epidemiological requirements in medical organizations;

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

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

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

12.2. Anti-epidemic measures:

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

Epidemiological examination of the focus in case of detection of cases of intestinal protozoosis;

Treatment of patients with intestinal protozoosis with control of its effectiveness after 5-6 days. The criterion of effectiveness is three negative results of a laboratory test conducted with an interval of 1 - 2 days;

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

XIII. Requirements for measures to prevent pediculosis and scabies

13.1. Measures to prevent head lice and scabies include:

Scheduled examinations of the population for pediculosis;

Provision of organized groups (preschool educational organizations, orphanages, orphanages, stationary organizations for recreation and rehabilitation of children) with replacement bed linen, personal hygiene products, disinfectants and detergents;

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

13.2. Inspection for pediculosis and scabies are subject to:

Children attending preschool educational organizations, monthly;

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

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

Children going on vacation to health organizations - before departure;

Children in the nursery health organization, - weekly;

Patients admitted to inpatient treatment - upon admission and then 1 time in 7 days;

Persons who are in organizations of the social security system - 2 times a month;

Outpatients - when contacting;

Employees of organizations - during medical examinations and preventive examinations.

13.3. If pediculosis is detected in persons admitted to the hospital, sanitization is carried out in the admissions department. Things of patients and special clothing of the personnel who carried out the treatment are placed in an oilcloth bag and sent to the disinfection chamber for disinfection.

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

13.5. If children affected by pediculosis are identified, they are sent for rehabilitation with suspension from attending a preschool educational organization. Admission of children to preschool educational organizations after sanitation is allowed if there is a medical certificate confirming the absence of pediculosis.

13.6. If pediculosis is detected, students are suspended from visiting the organization for the duration of the treatment. They can be admitted to educational organizations only after the completion of a complex of therapeutic and preventive measures with a confirming certificate from a doctor.

13.7. For persons who have been in contact with a patient with pediculosis, medical supervision is established for a period of 1 month with examinations carried out once every 10 days with the results of the examination recorded in a journal.

13.8. The results of the examination for pediculosis and scabies of persons entering inpatient treatment and (or) applying for outpatient appointments are recorded in medical documents.

13.9. A patient with scabies coming for treatment from the admission department (or identified in the department) is isolated in a separate ward (isolator). After consulting a dermatovenereologist and confirming the diagnosis, the patient (adults and children over 1 year old) is treated and items for individual use (towel, washcloth, soap in small packaging) are issued. Meals are organized in the ward. The underwear and bed linen of the patient is processed.

13.10. Manipulations in relation to patients with scabies, as well as cleaning of premises is carried out using means personal protection- rubber gloves, separate dressing gowns. Rubber gloves and cleaning equipment are disinfected after cleaning.

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

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

13.13. If scabies is detected in children of preschool and school age for the duration of treatment, they are suspended from attending preschool educational and educational organizations. They can be admitted to educational organizations only after the completion of a complex of therapeutic and preventive measures with a confirming certificate from a doctor.

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

13.15. If scabies is detected in the organization, current disinfection is carried out.

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

XIV. Measures for the prevention of demodicosis

14.1. Preventive actions:

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

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

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

14.2. Anti-epidemic measures:

Carrying out disinfection from Demodex ticks of equipment, materials, work surfaces in hairdressing salons, beauty parlors and others;

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

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

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

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

Treatment with broad-spectrum insecticides for dogs and cats;

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

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

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

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

Collection, storage and disinfection of municipal solid waste;

Ensuring the disinfestation of sewage sludge generated at water treatment plants and treatment facilities sewers, before their disposal;

Avoiding the discharge of sewage and their sediments, livestock effluents, fan wastewater from river and sea transport into surface water bodies without continuous disinfestation (lack of viable helminth eggs and cysts of intestinal pathogenic protozoa) by industrial methods;

Use on agricultural fields for irrigation of sewage, their sludge and livestock effluents, disinfected (not containing viable helminth eggs and cysts of intestinal pathogenic protozoa) by industrial methods;

house cleaning, industrial premises for the preparation, storage, dressing of skins, tailoring of fur products;

Disinfection of skins and fur products;

Cleaning of premises of preschool and school organizations;

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

Assessment of the epidemic situation on the spot with the definition of the scale and boundaries emergency for acceptance management decisions(on the first day after the elimination of the technical causes of the accident);

Evaluation of the results of laboratory tests;

Organization of disinfestation measures, including the use of ovicide preparations of biological inhibition-stimulation with a wide range of effectiveness for treatment large areas contaminated territories;

Monitoring the incidence of the population living in the contaminated area for two years in the absence of registration of cases of diseases in the foci and microfoci of geohelminthiasis.

16.7. Measures for the disinfection of environmental objects.

16.7.1. Disinfestation of sewage (faeces).

16.7.2. Disinvasion of solid household waste.

Solid household waste is disinfected:

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

In compost heaps with dimensions of 1.5 × 1.0 meters of arbitrary length; disinfestation terms from several months to 1.5 years;

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

Processing in bio-drums at 2000 rpm - for 2 days;

Incineration and pyrolysis (decomposition) in special engineering structures.

16.7.3. Disinvasion / deworming of wastewater.

Disinvasion / deworming of wastewater is carried out:

At aero-biostations;

On artificial structures biological treatment(fields of subsoil irrigation);

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

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

On septic tanks, storage tanks, filtration gravel filters.

For disinfestation of fan drains of river and sea transport vessels, the following are used:

dry closets;

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

Measures to discharge fan effluents after pumping from ships into the city sewer system (drainage stations).

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

Methods and modes of their use for the disinfestation of sewage

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

16.7.4. Disinvasion of sewage sludge.

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

Processing in biodrums;

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

Method of aerobic stabilization for 5 - 6 days with preliminary heating of a mixture of raw sludge with activated sludge at a temperature of 60 - 65 ° C for 1.5 hours;

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

16.7.5. Disinvasion of liquid manure and manure.

For the purpose of disinfestation of liquid manure and manure runoff, the following is carried out:

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

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

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

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

(Changed edition. Rev. No. 1)

Processing of surfaces, objects, materials, cleaning equipment in the premises for keeping animals is carried out using disinfectants.

16.7.6. Disinfestation of soil, sand.

Disinvasion of soil, sand at the first stage is achieved:

Treatment with herbicide-based products;

Treatment with means based on quaternary ammonium compounds;

Treatment with biological inhibition-stimulation drugs-ovicides;

Processing with table salt (1 kg per 1 m 2). It is used for disinfestation of the most contaminated soil areas from hookworm larvae once every 10 days;

Using a crop rotation system: first, the plot is sown with radishes, radishes, garlic, onions, after harvesting - secondarily with peas. The effect is also achieved with the simultaneous sowing of crops such as garlic - radish, onion - radish and some other families of legumes, lilies. The death of eggs occurs during two summer periods.

16.7.7. Disinfestation of vegetables, fruits, greens of the dining room.

To disinfect vegetables, fruits, table greens from helminth eggs, plant products are pre-soaked in water for 20-30 minutes before thorough rinsing in a colander under running water for 5-10 minutes with occasional shaking. Onions, parsley, lettuce are pre-cleaned from the soil, then sorted into individual leaves, stems, feathers. The effect is given by washing them in soapy water, followed by rinsing. running water. For berries with a rough surface or a lobed structure (strawberries, wild strawberries, raspberries), they are washed with a 1.0% soda solution, and then clean water. A weak solution of iodine (0.2 - 0.5%) is used to disinfect vegetables from eggs and larvae of ascaris, whipworm, hookworm, strongylide.

16.7.8. Disinfestation of household items, toys, linen.

For disinfestation of bed linen, boiling and ironing on both sides is recommended. Woolen blankets, carpets, mattresses, blankets, curtains are processed with a vacuum cleaner (with subsequent dust neutralization using disinfectants approved for use), dried and shaken in the sun, ironed with a hot iron through rags. Dust from the containers of vacuum cleaners after neutralization is disposed of in the general sewerage system.

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

Linen, toys and other things are disinfested in the disinfection chamber.

Disinfestation soft toys and other objects with a rough surface, is provided by processing with a vacuum cleaner. Room surfaces, sinks, faucets, door handles, cellophane and rubber toys, etc., are disinfected by irrigation or wiping with approved products.

16.7.9. Disinfestation of drinking water.

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

Sorption ( charcoal, manganese oxide and others);

Use of ion exchange resins;

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

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

Ozonation;

Exposure to MIO radiation (powerful impulsive optical radiation);

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

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

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

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

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

The premises are provided with sufficient water for sanitary and industrial needs. Floors, walls and equipment should be smooth and easy to clean. The walls of the premises and equipment are treated with boiling water or disinfectant, and the waste from the processing of skins is burned. Eating, storing food and smoking in these rooms is strictly prohibited.

16.7.11. Disinfestation of other environmental objects.

16.7.11.1. Containers with faeces and sewage sludge during the working day are placed in enamelware, are filled with a chlorine-active agent, followed by disinfestation with agents recommended for use in accordance with sanitary rules.

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

16.7.11.3. Used glass slides, pipettes, corks, test tubes, glass rods, chemical beakers and others are stored in containers with disinfectant solution until complete vertical immersion. Final disinfection is carried out by boiling in water (from the moment of boiling for at least 30 minutes) with the addition of laundry soap or liquid detergent. Autoclaving is acceptable under appropriate conditions.

16.7.11.4. The effectiveness of disinfection and disinfection of biological material, laboratory glassware, auxiliary and packaging materials is ensured in microwave devices for the disinfection of medical waste.

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

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

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

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

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

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