Дикий І.Л., Холупяк І.Ю., Шевельова Н.Ю. та ін. Мікробіологія
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Ø âàð³àíòè êîíâåðñ³¿ õ³ì³÷íèõ ³ á³îëîã³÷íèõ ñïîëóê ó ìàëèõ
êîíöåíòðàö³ÿõ, ùî ìàþòü òîêñè÷íó àáî ³íøó ðåãóëÿòîðíó
ä³þ;
Ø åëåêòðîìàãí³òí³, ìàãí³òí³ é àêóñòè÷í³ ïîëÿ ìàëî¿ ïîòóæíîñ-
ò³, ñïðîìîæí³ êåðóâàòè ïðîöåñàìè â æèâèõ ñèñòåìàõ;
Ø ³íø³ îðãàí³çìè àáî ïðîäóêòè á³îëîã³÷íîãî ïîõîäæåííÿ.
Ó ñïèñîê íàéá³ëüø íåáåçïå÷íèõ äëÿ ìèðíîãî íàñåëåííÿ á³îëî-
ã³÷íèõ àãåíò³â â³ä³áðàíî áëèçüêî 40 á³îëîã³÷íèõ àãåíò³â (â³ðóñè àáî
â³ðóñí³ ãðóïè, áàêòåð³¿, ðèêåòñ³¿, ãðèáè ³ òîêñèíè), ùî íàëåæàòü äî
òðüîõ êàòåãîð³é: À, Â, Ñ.
Óñ³ àãåíòè êàòåãî𳿠À ñòàíîâëÿòü íàéá³ëüøó çàãðîçó äëÿ ñèñòå-
ìè îõîðîíè çäîðîâÿ, îáóìîâëåíó ìàñîâèìè æåðòâàìè, ³ âèìàãà-
þòü øèðîêîãî êîìïëåêñó çóñèëü ùîäî ï³äãîòîâêè ñòðóêòóð îõîðî-
íè çäîðîâÿ (ïîë³ïøåííÿ íàãëÿäó ³ ëàáîðàòîðíî¿ ä³àãíîñòèêè, ñòâî-
ðåííÿ çàïàñó ñïåöèô³÷íèõ ìåäèêàìåíò³â). Çäàòí³ñòü àãåíò³â ö³º¿
êàòåãî𳿠äî ìàñøòàáíîãî ïîøèðåííÿ îö³íþºòüñÿ â³ä ñåðåäíüî¿ äî
âèñîêî¿, à ³íôîðìàö³ÿ ïðî íèõ ïîøèðþºòüñÿ íàñò³ëüêè øâèäêî,
ùî ìîæå âèêëèêàòè ìàñîâó ïàí³êó ³ ïîðóøåííÿ ãðîìàäñüêîãî ïî-
ðÿäêó.
Î÷îëþþòü ñïèñîê àãåíò³â êàòåãî𳿠À çàõâîðþâàííÿ ç äàâí³õ
÷àñ³â ñóìíî â³äîì³ ñòðàøíèìè åï³äåì³ÿìè ç âåëèêîþ ê³ëüê³ñòþ
æåðòâ: â³ñïà, ÷óìà, ñèá³ðêà.
Íàéá³ëüø³ ïîáîþâàííÿ ïîâÿçàí³ ³ç çàãðîçîþ çàñòîñóâàííÿ òå-
ðîðèñòàìè â³ðóñó íàòóðàëüíî¿ â³ñïè. ³ñïà çàáðàëà íàéá³ëüøó ê³ëü-
ê³ñòü æèòò³â â ³ñòî𳿠ëþäñòâà, óáèâøè â ö³ëîìó ìàéæå ï³âì³ëüÿðäà
ëþäåé, ùî á³ëüøå, í³æ óñ³ â³éíè òà ³íø³ åï³äå쳿 ðàçîì óçÿò³. Îäèí
ç íàéäàâí³øèõ ïðèêëàä³â âèêîðèñòàííÿ â³ðóñó â³ñïè ÿê çíàðÿääÿ
òåðîðèçìó âèïàäîê çàðàæåííÿ êîð³ííèõ æèòåë³â Àìåðèêè ³í-
ä³àíö³â íàòóðàëüíîþ â³ñïîþ ÷åðåç ³íô³êîâàí³ êîâäðè, ïåðåäàí³ ¿ì
íà çíàê äðóæáè á³ëèìè êîëîí³ñòàìè â 1763 ðîö³. ϳçí³øå öåé çàõ³ä
íåîäíîðàçîâî âèêîðèñòîâóâàâñÿ áðèòàíñüêèìè ñîëäàòàìè äëÿ âè-
íèùóâàííÿ êîð³ííîãî íàñåëåííÿ Àìåðèêè. Òîä³ óñüîãî çà ê³ëüêà
ðîê³â íàñåëåííÿ êîíòèíåíòó ñêîðîòèëîñÿ ç 75 ì³ëüéîí³â äî 600 òè-
ñÿ÷ îñ³á.
³ðóñ íàòóðàëüíî¿ â³ñïè ââàæàºòüñÿ íàéíåáåçïå÷í³øèì àãåí-
òîì ÷åðåç êë³í³÷í³ é åï³äåì³îëîã³÷í³ âëàñòèâîñò³. Äëÿ â³ñïè õàðàê-
òåðíèé âèñîêèé â³äñîòîê çàðàæåíü ïðè áóäü-ÿêîìó êîíòàêò³ ç õâî-
ðèì ³ òðèâàëèé ³íêóáàö³éíèé ïåð³îä, ùî óòðóäíÿº ä³àãíîñòèêó. Öåé
â³ðóñ ìîæå íàêîïè÷óâàòèñÿ ó âåëèêèõ ê³ëüêîñòÿõ, çáåð³ãàòèñÿ òðè-
âàëèé ÷àñ ³ ìàñîâî ïîøèðþâàòèñÿ ïåðåâàæíî ïîâ³òðÿíî-êðàïëèí-
íèì øëÿõîì.
Ìîæëèâ³ñòü ïîòðàïëÿííÿ òàêîãî àãåíòà â ðóêè òåðîðèñò³â ³ñ-
íóº. Îô³ö³éíî ó ñâ³ò³ öåé â³ðóñ çíàõîäèòüñÿ ò³ëüêè â äâîõ ì³ñöÿõ:
ó Íàóêîâîìó öåíòð³ Àòëàíòè, ÑØÀ, é ó ðîñ³éñüêîìó Äåðæàâíî-
ìó íàóêîâîìó öåíòð³ â³ðóñîëî㳿 ³ á³îòåõíîëî㳿 «Âåêòîð», îäíàê
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íå ìîæíà ãàðàíòóâàòè, ùî êð³ì öèõ äâîõ îô³ö³éíèõ êîëåêö³é øòà-
ì³â â³ñïè, êîíòðîëüîâàíèõ ÂÎÎÇ, íåìຠó ñâ³ò³ ³íøèõ ï³äï³ëü-
íèõ. Êð³ì òîãî, íèí³ âèñóâàþòü ö³ëêîì îá´ðóíòîâàí³ ã³ïîòåçè çàðî-
äæåííÿ â ïðèðîä³ áëèçüêèõ ëþä-ñüê³é â³ñï³ ³ íàñò³ëüêè æ íåáåç-
ïå÷íèõ ³íôåêö³é ç â³ðóñ³â â³ñïè ìàâï, áóéâîë³â, âåðáëþä³â àáî êîð³â.
Òàê çà ïåð³îä â³ä 1996 äî 1998 ðîêó â Çà¿ð³ áóëî â³äì³÷åíî çíà÷íå
çðîñòàííÿ çàõâîðþâàíîñò³ ñåðåä ëþäåé â³ñïîþ ìàâï.
Íàñë³äêè ïîòðàïëÿííÿ â³ðóñó â³ñïè â ðóêè òåðîðèñò³â ³ çàñòîñó-
âàííÿ éîãî ÿê á³îëîã³÷íî¿ çáðî¿ ìîæóòü áóòè êàòàñòðîô³÷íèìè
íå ò³ëüêè äëÿ êðà¿íè, àëå ³ äëÿ âñ³º¿ ñâ³òîâî¿ ñï³ëüíîòè. Ïðèêëàäîì
ðîçâèòêó ïîä³é â îêðåìî âçÿò³é êðà¿í³ ç âèÿâëåííÿì ò³ëüêè îäí³º¿
³íô³êîâàíî¿ ëþäèíè º ñïàëàõ â³ñïè â êîëèøí³é Þãîñëà⳿ â 1972 ðîö³.
Äî ìîìåíòó âñòàíîâëåííÿ ïðàâèëüíîãî ä³àãíîçó â ïåðøîãî çàõâî-
ð³ëîãî ÷åðåç ÷îòèðè òèæí³ ï³ñëÿ ïî÷àòêó çàõâîðþâàííÿ áóëî âæå
³íô³êîâàíî 150 ëþäåé. ²íôåêö³ÿ ïîøèðèëàñÿ ïî êðà¿í³ ç ìàñîâèìè
åï³äåì³÷íèìè ïîêàçíèêàìè. Çàõîäè, ïðèéíÿò³ óðÿäîì ³ ñèñòåìîþ
îõîðîíè çäîðîâÿ, ïîëÿãàëè â ïðîâåäåíí³ ìàñîâî¿ âàêöèíàö³¿ ³ êà-
ðàíòèííèõ çàõîä³â. Âàêöèíóâàëè 20 ì³ëüéîí³â ëþäåé. 10 òèñÿ÷
îñ³á, ùî ìàëè êîíòàêòè ç ³íô³êîâàíèìè, ³çîëþâàëè óïðîäîâæ äâîõ
³ á³ëüøå òèæí³â, çàêðèëè êîðäîíè ³ç ñóñ³äí³ìè êðà¿íàìè. Ñïàëàõ
óäàëîñÿ ë³êâ³äóâàòè ÷åðåç äåâÿòü òèæí³â ï³ñëÿ ïåðøîãî âèïàäêó
çàõâîðþâàííÿ. Éîãî ðåçóëüòàò 175 ëþäåé çàõâîð³ëî, 35 ïîìåðëî
³ ïàí³êà òà õàîñ, ùî âèíèêëè. Ñë³ä çàçíà÷èòè, ùî ñïàëàõ â³äáóâàâñÿ
â êðà¿í³, äå ïðîâîäèëàñÿ ìàñîâà âàêöèíàö³ÿ íàñåëåííÿ ïðîòè â³ñ-
ïè. Íà ñüîãîäí³ çà îö³íêàìè ôàõ³âö³â íå á³ëüøå 1015 % íàñå-
ëåííÿ ìຠ³ìóí³òåò äî â³ñïè. Íà öüîìó ôîí³ ïðîâåäåííÿ òåðîðèñ-
òè÷íîãî àêòó ç âèêîðèñòàííÿì â³ðóñó â³ñïè âèêëè÷å äðàìàòè÷í³
íàñë³äêè.
Äðóãå ì³ñöå â ñïèñêó íåáåçïå÷íèõ àãåíò³â ïîñ³äຠBacillus
anthracis, ùî âèêëèêຠñèá³ðêó.
Äîñë³äæåííÿ çáóäíèêà ñèá³ðêè ÿê ìîæëèâîãî á³îëîã³÷íîãî àãåí-
òà ïî÷àëîñÿ áëèçüêî 80 ðîê³â òîìó. Íà êîðèñòü öüîãî âèäó á³îëî-
ã³÷íî¿ çáðî¿ ñâ³ä÷èëà çäàòí³ñòü äî ñïîðîóòâîðåííÿ (ìîæíà ëåãêî
çáåð³ãàòè ³ ñòâîðþâàòè çîíè äîâãîñòðîêîâîãî ñò³éêîãî çàðàæåííÿ),
à òàêîæ òå, ùî óðàæåíà ëþäèíà ôàêòè÷íî º ê³íöåâîþ òî÷êîþ íà
øëÿõó ³íôåêö³¿ (â³äñóòíÿ íåáåçïåêà øèðîêî¿ åï³äå쳿 ñåðåä âëàñ-
íèõ â³éñüêîâèê³â).
Ñìåðòí³ñòü â³ä ëåãåíåâî¿ ôîðìè ñèá³ðêè ñÿãຠ100 %. Îäíàê,
îñê³ëüêè õâîðîáà öÿ ï³ääàºòüñÿ ë³êóâàííþ, òî åôåêò â³ä çàñòîñó-
âàííÿ òàêî¿ çáðî¿ ïîñòóïàºòüñÿ åôåêòó â³ä çàñòîñóâàííÿ ³íøèõ âè-
ä³â çáðî¿ ìàñîâîãî çíèùåííÿ ÿäåðíî¿ àáî õ³ì³÷íî¿. Òàê, âèêèä
áëèçüêî 10 êã âèãîòîâëåíîãî ó â³éñüêîâèõ ëàáîðàòîð³ÿõ çáóäíèêà
ñèá³ðêè ç óðàõóâàííÿì ðîçïèëåííÿ â³òðîì íàä 1,2-ì³ëüéîííèì ì³ñ-
òîì, ùî â³äáóâñÿ 1979 ðîêó ó Ñâåðäëîâñüêó, ïðèçâ³â ó ï³äñóìêó äî
66 ëåòàëüíèõ ê³íö³â.
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Ïî䳿 îñåí³ 2001 ðîêó ïîêàçàëè, ùî âèêîðèñòàííÿ Bacillus
anthracis òåðîðèñòàìè ìîæå, íå âèêëèêàþ÷è çíà÷íî¿ ê³ëüêîñò³ æåðòâ,
ïîñ³ÿòè ñòðàõ ³ ïàí³êó ñåðåä íàñåëåííÿ ³ äåñòàá³ë³çóâàòè ãðîìàäñüêå
æèòòÿ. Ðîçñë³äóâàííÿ, ïðîâåäåí³ óïðîäîâæ ÷îòèðüîõ ì³ñÿö³â ôàõ³â-
öÿìè ç áàêòåð³îëîã³÷íî¿ çáðî¿, ïîêàçàëè, ùî â êîæí³é ç á³îòåðîðè-
ñòè÷íèõ àòàê, çä³éñíåíèõ ó Íüþ-Éîðêó, Âàøèíãòîí³ òà Ìàéÿì³,
âèêîðèñòîâóâàâñÿ âèñîêîâ³ðóëåíòíèé, âèñîêîñò³éêèé øòàì Àìåñ
(Ames), âèä³ëåíèé ó ëàáîðàòî𳿠âåòåðèíàðíî¿ ìåäè÷íî¿ ä³àãíîñ-
òèêè ïðè Òåõàñüêîìó óí³âåðñèòåò³ ³ íàä³ñëàíèé ó USAMRIID
ó òðàâí³ 1981 ðîêó. Çà îñòàíí³ ïÿòíàäöÿòü ðîê³â öåé øòàì áàêòåð³é
ïåðåäàâàâñÿ ëèøå â ïÿòü ëàáîðàòîð³é ÑØÀ, Êàíàäè ³ Âåëèêî-
áðèòàí³¿.
Íàñòóïíèì ó ñïèñêó íåáåçïå÷íèõ á³îëîã³÷íèõ àãåíò³â êàòåãîð³¿
À ñòî¿òü çáóäíèê ÷óìè Yersinia pestis. Ïðîòÿãîì äâîõ îñòàíí³õ òèñÿ-
÷îë³òü ÷óìà çàáðàëà âåëè÷åçíó ê³ëüê³ñòü æèòò³â ï³ä ÷àñ ê³ëüêîõ ïàí-
äåì³é, â³äâ³äàâøè ÷èìàëî êðà¿í á³ëüøîñò³ êîíòèíåíò³â.
Îäíèì ç ïåðøèõ äîêóìåíòàëüíî çàô³êñîâàíèõ åï³çîä³â á³îòåðî-
ðèçìó ç âèêîðèñòàííÿì ÷óìè ìîæíà ââàæàòè îáëîãó ãåíóåçüêî¿
ôîðòåö³ Êàôè (íèí³ Ôåîäîñ³ÿ) ó Êðèìó. Íàïàäíèêè çàêèäàëè
ó ôîðòåöþ ïàöþê³â ³ çàëèøêè òðóï³â ëþäåé, ùî ïîìåðëè â³ä ÷óìè.
Ó ðåçóëüòàò³ Êàôà çäàëàñÿ, àëå çâ³äòè ÷óìà ïîøèðèëàñÿ ïî âñ³é
ªâðîï³, âèêëèêàâøè ñòðàøíó åï³äåì³þ. Çàãàëüí³ âòðàòè îö³íþþòüñÿ
â 25 ì³ëüéîí³â ëþäåé, àáî áëèçüêî 10 % íàñåëåííÿ ñâ³òó.
Íèí³ â äåÿêèõ êðà¿íàõ À糿, Àôðèêè é Àìåðèêè ùîðîêó âèíè-
êàþòü ñïàëàõè ³ ñïîðàäè÷í³ âèïàäêè ÷óìè. ² õî÷à íàÿâí³ñòü åôåê-
òèâíèõ çàñîá³â ë³êóâàííÿ ³ ïðîô³ëàêòèêè ÷óìè çíèæóº íåáåçïåêó
ö³º¿ ³íôåêö³¿ äëÿ ëþäèíè, çàõâîðþâàí³ñòü ÷óìîþ ó ñâ³ò³ ïîñ³äàº
äîñèòü âèñîêèé ð³âåíü ³ âèíèêàþ÷³ ñïàëàõè ìîæóòü ïîñ³ÿòè ïàí³êó
ñåðåä íàñåëåííÿ. Ïðèêëàäîì º ñïàëàõ 1994 ðîêó â ²í䳿, êîëè ñîòí³
³ òèñÿ÷³ ëþäåé íàìàãàëèñÿ çàëèøèòè ì³ñòî Ñóðàò, ð³çí³ êðà¿íè ïðè-
ïèíèëè ïðèéìàòè ³ â³äïðàâëÿòè ë³òàêè â ²íä³þ, ³ áóâ çàáîðîíåíèé
³ìïîðò ³íä³éñüêèõ òîâàð³â. Îñòàíí³é ñïàëàõ íàéâàæ÷î¿ ëåãåíåâî¿
ôîðìè ÷óìè áóâ çàðåºñòðîâàíèé â ²í䳿 4 ëþòîãî 2002 ðîêó íà ñõîä³
øòàòó Õ³ìà÷àë-Ïðàäåø.
Âèêîðèñòàííÿ çáóäíèêà ÷óìè ÿê á³îëîã³÷íî¿ çáðî¿, çà ïðîãíî-
çîì ôàõ³âö³â, ìîæå ïðèçâåñòè äî íàéñåðéîçí³øèõ íàñë³äê³â. Ââà-
æàºòüñÿ, ùî â ðàç³ íàâìèñíîãî çàñòîñóâàííÿ Y. pestis íàé³ìîâ³ðí³øå
áóäå âèêîðèñòàíèé íàéá³ëüø åôåêòèâíèé àåðîçîëüíèé ñïîñ³á ïî-
øèðåííÿ. Ïðè öüîìó ðîçì³ð ñïàëàõó çàëåæàòèìå â³ä òàêèõ ÷èííè-
ê³â, ÿê ê³ëüê³ñòü çáóäíèêà, õàðàêòåðèñòèêà øòàìó, íàâêîëèøíº ñå-
ðåäîâèùå ³ ìåòîä àåðîçîëþâàííÿ. Íà øòó÷íå ïîõîäæåííÿ ñïàëàõó
ìîæå âêàçóâàòè éîãî âèíèêíåííÿ â çîí³, íåâ³äîì³é ÿê åíäåì³÷íà
äëÿ ÷óìè, ó ëþäåé, ùî íå íàëåæàòü äî ãðóïè ðèçèêó, çà â³äñóòíîñò³
ïîïåðåäíüî¿ çàãèáåë³ ãðèçóí³â.
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Çàìèêàþòü ñïèñîê àãåíò³â êàòåãî𳿠À ãåìîðàã³÷í³ ïðîïàñíè-
ö³, âèêëèêàí³ àðåíà- ³ ô³ëîâ³ðóñàìè. Íàéá³ëüøî¿ óâàãè çàñëóãîâó-
þòü âèíèêë³ íîâ³ ³íôåêö³¿, ãàðÿ÷êè Ìàðáóðãà òà Åáîëà. ³ðóñ Ìàð-
áóðãà áóâ óïåðøå âèä³ëåíèé ó ëàáîðàòî𳿠ç ìàòåð³àë³â â³ä ìàâïè.
³ðóñ Åáîëà áóâ ³äåíòèô³êîâàíèé â çàõ³äí³é ïðîâ³íö³¿ Ñóäàíó
é ó ïðèëåãëîìó ðàéîí³ Çà¿ðó (çàðàç Äåìîêðàòè÷íà ðåñïóáë³êà Êîí-
ãî) ï³ä ÷àñ âåëèêèõ åï³äåì³é ç ëåòàëüí³ñòþ äî 90 %. Âèñóâàëàñÿ
âåðñ³ÿ, ùî ïîÿâà ãåìîðàã³÷íî¿ ãàðÿ÷êè Åáîëà ïîâÿçàíà ç âèïðîáó-
âàííÿì àìåðèêàíñüêîþ â³éñüêîâî-ìåäè÷íîþ ñëóæáîþ á³îëîã³÷íî¿
çáðî¿ â óìîâàõ äæóíãë³â.
Ç ìîìåíòó ³äåíòèô³êàö³¿ â³ðóñó áóëî çàðåºñòðîâàíî ïîíàä
1500 âèïàäê³â çàõâîðþâàííÿ ãàðÿ÷êîþ Åáîëà ³ ìàéæå 1000 ñìåðòåé
(íå âðàõîâóþ÷è îñòàííüîãî ñïàëàõó).
Ïðèâàáëèâ³ñòü çáóäíèê³â ãåìîðàã³÷íèõ ïðîïàñíèöü ÿê á³îëîã³-
÷íî¿ çáðî¿ îáóìîâëåíà âèñîêîþ ëåòàëüí³ñòþ, åôåêòèâí³ñòþ ïðè
àåðîçîëüíîìó ñïîñîá³ çàðàæåííÿ ³ ìîæëèâ³ñòþ ðîçìíîæóâàòèñÿ
â êë³òèíí³é êóëüòóð³.
²ñíóþòü äàí³, ùî 1992 ðîêó ãðóïà ÷ëåí³â ñåêòè Àóì ѳíð³êüî
ï³ä êåð³âíèöòâîì Soko Asahra ïîáóâàëà â Çà¿ð³ ç ìåòîþ îäåðæàííÿ
³íôåêö³éíîãî ìàòåð³àëó, ùî ì³ñòèòü â³ðóñ Åáîëà, äëÿ éîãî âèêîðè-
ñòàííÿ â òåðîðèñòè÷íèõ ö³ëÿõ. ϳçí³øå, 1995 ðîêó, ñåêòà ïî÷àëà
ñïðîáè çä³éñíåííÿ á³îòåðîðèñòè÷íèõ àêò³â ç ðîçïèëåííÿì ð³çíèõ
á³îëîã³÷íèõ àãåíò³â, ó òîìó ÷èñë³ â³ðóñó Åáîëà. Ïðî âèïàäêè çàðà-
æåííÿ íå ïîâ³äîìëÿëîñÿ.
Á³îëîã³÷í³ àãåíòè, ùî íàëåæàòü äî ³íøèõ ãðóï, ³ íàâ³òü òàê³
çàõâîðþâàííÿ, ÿê ãðèï õî÷à ³ ìåíø íåáåçïå÷í³ äëÿ æèòòÿ ëþäèíè,
â ðàç³ ðàïòîâîãî âèêîðèñòàííÿ òåðîðèñòàìè ìîæóòü ñòâîðèòè äî-
ñòàòí³ ïðîáëåìè, íàäîâãî âèâîäÿ÷è ç 䳺çäàòíîñò³ çíà÷íó ÷àñòèíó
íàñåëåííÿ êðà¿íè. Ïðè öüîìó ïîêàçíèêè ñìåðòíîñò³ é íå â³äð³çíÿ-
òèìóòüñÿ ìàñîâ³ñòþ, àëå åêîíîì³êà äåðæàâè ïîñòðàæäàº. Ö³ âèñ-
íîâêè çðîáëåí³ â ðåçóëüòàò³ âèâ÷åííÿ ïÿòè ñïàëàõ³â ³íôåêö³éíèõ
õâîðîá, ùî ìàëè ì³ñöå â ð³çíèõ êðà¿íàõ ñâ³òó.
Íåîáõ³äí³ñòü ðîçðîáêè ìåõàí³çì³â äîñë³äæåííÿ ñïàëàõ³â, ùî
â³äáóâàþòüñÿ, äëÿ óõâàëåííÿ ð³øåííÿ ïðî «ï³äîçð³ë³» âèïàäêè îá-
ãîâîðþâàëàñÿ â ðàìêàõ Êîíâåíö³¿ ç á³îëîã³÷íî¿ çáðî¿. Ïðîïîíóâà-
ëîñÿ çãðóïóâàòè «ï³äîçð³ë³» ñïàëàõè â³äïîâ³äíî äî ïðèðîäè ¿õíüîãî
âèíèêíåííÿ, íàïðèêëàä, ÿê ðåçóëüòàò:
òàºìíî¿ á³îëîã³÷íî¿ àòàêè ³íøî¿ äåðæàâè;
àòàêè çä³éñíåíî¿ â òåðîðèñòè÷íèõ àáî ³íøèõ çëî÷èííèõ
ö³ëÿõ;
âèòîêó á³îëîã³÷íèõ àãåíò³â ç â³éñüêîâèõ îðãàí³çàö³é, ùî ïðî-
âîäÿòü ðîáîòè, ïîâÿçàí³ ç á³îëîã³÷íîþ çáðîºþ.
Íàéâ³äîì³øèì ³ ÷è íå ºäèíèì ï³äòâåðäæåíèì âèïàäêîì á³îòå-
ðîðèçìó º ñïàëàõ ñàëüìîíåëüîçó 1984 ðîêó, ùî âèíèê óíàñë³äîê
âèêîðèñòàííÿ òåðîðèñòàìè Salmonella â ñàëàòíîìó áàð³ Îðåãîíó
425
(ÑØÀ). Çàíåäóæàëî á³ëüøå 700 ëþäåé, îäíàê õàðàêòåð çàõâîðþ-
âàííÿ áóâ ñïî÷àòêó êâàë³ô³êîâàíèé ÿê ïðèðîäíèé ñïàëàõ, ³ ò³ëüêè
÷åðåç ð³ê áóëî îñòàòî÷íî äîâåäåíî, ùî â ñàëàò ðåë³ã³éí³ åêñòðåì³ñ-
òè äîäàëè Salmonella, ùîá ç³ðâàòè âèáîðè. Äî ðå÷³, ãðîìàäñüê³ñòü
ÑØÀ äîâ³äàëàñÿ ïðî öåé âèïàäîê ÷åðåç áàãàòî ðîê³â.
×àñòî á³îëîã³÷í³ àãåíòè âèêîðèñòîâóþòüñÿ â çëî÷èííèõ ö³ëÿõ.
Òàêèì ïðèêëàäîì º ñïàëàõ äèçåíòå𳿠1996 ðîêó ñåðåä ïðàö³âíèê³â
ëàáîðàòî𳿠ãîñï³òàëþ â Äàëëàñ³ (ÑØÀ). Ïðîâåäåíå ðîçñë³äóâàííÿ
óñòàíîâèëî, ùî êóëüòóðó Shigella dysenteriae âçÿâ ç ëàáîðàòî𳿠îäèí
³ç ïðàö³âíèê³â äëÿ çàðàæåííÿ ñâî¿õ êîëåã.
Íåáåçïåêà çàñòîñóâàííÿ á³îëîã³÷íî¿ çáðî¿ ïîëÿãຠâ òîìó, ùî
ïðàö³âíèêè îõîðîíè çäîðîâÿ íå çàâæäè ìîæóòü àäåêâàòíî îö³íè-
òè âèíèêëó åï³äåì³÷íó îáñòàíîâêó ³ âæèòè åôåêòèâíèõ çàõîä³â äî
¿¿ ë³êâ³äàö³¿. ϳäòâåðäæåííÿì öüîìó ñëóæàòü ñëîâà ïðîôåñîðà Äæó-
ë³óñà Óàéíáåðãà «Òàê, ìè â³äðàçó æ ïîì³òèìî ùîñü íåçâè÷àéíå,
íà çðàçîê ñèá³ðêè. Àëå ùîäî íàéçâè÷àéí³ñ³íüêèõ ³íôåêö³é Íà
òîé ÷àñ, êîëè ë³êàð³ çðîçóì³þòü, ùî öå íå ïðîñòî âèïàäêîâèé ñïà-
ëàõ ãðèïó àáî ñàëüìîíåëüîçó, ó ë³êàðíÿõ îïèíèòüñÿ ÿê ì³í³ìóì
ïîëîâèíà íàñåëåííÿ êðà¿íè».
426
ÑÎÄÅÐÆÀÍÈÅ
ÑÏÈÑÎÊ ÑÊÎÐÎ×ÅÍÜ ................................................................... 3
ÏÐÅÄÌÅÒ, ֲ˲ ÒÀ ÇÀÂÄÀÍÍß Ì²ÊÐÎÁ²ÎËÎò¯............................... 7
ÎÑÍÎÂͲ ÅÒÀÏÈ ÍÀÓÊÎÂÎÃÎ ÑÒÀÍÎÂËÅÍÍß Ì²ÊÐÎÁ²ÎËÎò¯ 9
Åòàïè ðîçâèòêó â³ðóñîëî㳿 ............................................................... 14
Ðîëü â³ò÷èçíÿíèõ ó÷åíèõ ó ðîçâèòêó ì³êðîá³îëî㳿 ........................14
ÇÀÃÀËÜÍÀ ̲ÊÐÎÁ²ÎËÎÃ²ß .................................................................. 17
ÌÎÐÔÎËÎÃ²ß Ì²ÊÐÎÎÐÃÀͲÇ̲ ...................................................... 18
Öàðñòâî ïðîêàð³îòè (Procariota) .......................................................19
Óëüòðàñòðóêòóðà ïðîêàð³îòè÷íî¿ êë³òèíè .............................. 19
Îñíîâí³ ôîðìè áàêòåð³é ......................................................... 25
L-ôîðìè ì³êðîîðãàí³çì³â ³ ¿õ ðîëü ó ïàòîëî㳿 ëþäèíè .......27
Ìîðôîëîã³ÿ ³ á³îëîã³÷í³ âëàñòèâîñò³ ì³êîïëàçì ....................29
Ìîðôîëîã³ÿ òà á³îëîã³÷í³ âëàñòèâîñò³ ðèêåòñ³é ³ õëàì³ä³é ... 31
Ìîðôîëîã³ÿ ³ á³îëîã³÷í³ âëàñòèâîñò³ àêòèíîì³öåò³â ............33
Öàðñòâî åóêàð³îòè (Eucariota) ........................................................... 33
Ìîðôîëîã³ÿ ãðèá³â................................................................... 33
Ìîðôîëîã³ÿ íàéïðîñò³øèõ...................................................... 38
Öàðñòâî â³ðóñè (Vira) ......................................................................... 44
Ìîðôîëîã³ÿ é óëüòðàñòðóêòóðà â³ðóñ³â. Îñîáëèâîñò³ êëàñèô³-
êàö³¿........................................................................................... 44
³ðóñè áàêòåð³é áàêòåð³îôàãè ............................................. 47
Ïð³îíè ................................................................................................ 49
Âëàñòèâîñò³ ïð³îí³â .................................................................50
ԲDzÎËÎÃ²ß ÏÐÎÊÀвÎҲ .................................................................... 51
Õ³ì³÷íèé ñêëàä áàêòåð³àëüíî¿ êë³òèíè ............................................ 51
Æèâëåííÿ áàêòåð³é ............................................................................ 54
Ôåðìåíòè áàêòåð³é ............................................................................ 56
Äèõàííÿ áàêòåð³é ..............................................................................57
гñò ³ ðîçìíîæåííÿ áàêòåð³é ............................................................58
Á²ÎËÎÃ²ß Â²ÐÓѲ ................................................................................... 61
Âçàºìîä³ÿ â³ðóñ³â ç êë³òèíàìè .......................................................... 61
427
Êóëüòèâóâàííÿ â³ðóñ³â ó ëàáîðàòîðíèõ óìîâàõ ............................... 66
Çáåð³ãàííÿ â³ðóñ³â ³ â³ðóñîâì³ñíîãî ìàòåð³àëó................................. 68
ÃÅÍÅÒÈÊÀ ̲ÊÐÎÎÐÃÀͲÇ̲ ........................................................... 69
Ìóòàö³¿ ............................................................................................... 72
Ãåíåòè÷í³ ðåêîìá³íàö³¿ ..................................................................... 72
Òðàíñôîðìàö³ÿ ......................................................................... 73
Òðàíñäóêö³ÿ .............................................................................. 74
Êîíþãàö³ÿ ............................................................................... 75
Ó×ÅÍÍß ÏÐÎ ²ÍÔÅÊÖ²Þ ...................................................................... 77
̳êðîîðãàí³çì ³ ³íôåêö³éíèé ïðîöåñ .............................................. 77
Ìàêðîîðãàí³çì òà ³íôåêö³éíèé ïðîöåñ ........................................... 80
Íàâêîëèøíº ñåðåäîâèùå òà ³íôåêö³éíèé ïðîöåññ ........................ 81
Ïåðåá³ã ³íôåêö³éíîãî ïðîöåñó ......................................................... 81
Ôîðìè ³íôåêö³éíîãî ïðîöåñó .......................................................... 82
Åï³äåì³÷íèé ïðîöåñ .......................................................................... 83
Êëàñèô³êàö³ÿ ³íôåêö³éíèõ õâîðîá ................................................... 85
Ó×ÅÍÍß ÏÐÎ ²ÌÓͲÒÅÒ ........................................................................ 86
Íåñïåöèô³÷íà ðåçèñòåíòí³ñòü ³ âèäîâèé ³ìóí³òåò .......................... 86
Îñíîâí³ êîìïîíåíòè íåñïåöèô³÷íî¿ ðåçèñòåíòíîñò³ ........... 87
Ôàãîöèòîç ................................................................................. 88
Íàáóòèé ³ìóí³òåò ............................................................................... 89
Àíòèò³ëà .................................................................................... 91
Àíòèãåíè ..................................................................................93
Îñîáëèâîñò³ ôîðìóâàííÿ ãóìîðàëüíîãî ³ìóí³òåòó .......................... 94
Îñîáëèâîñò³ ôîðìóâàííÿ êë³òèííîãî ³ìóí³òåòó .............................. 96
Ïðîòèâ³ðóñíèé ³ìóí³òåò ....................................................................96
Ãóìîðàëüí³ ôàêòîðè ................................................................ 97
Êë³òèíí³ ôàêòîðè .................................................................... 97
²ìóíîïàòîëîã³÷í³ ïðîöåñè ïðè â³ðóñíèõ ³íôåêö³ÿõ .............. 99
Òðàíñïëàíòàö³éíèé ³ìóí³òåò........................................................... 101
Ìåõàí³çìè â³äòîðãíåííÿ òðàíñïëàíòàòà .............................. 102
Êë³òèíí³ ôàêòîðè .................................................................. 102
Ãóìîðàëüí³ ôàêòîðè .............................................................. 103
Ðåàêö³ÿ «òðàíñïëàíòàò ïðîòè õàçÿ¿íà» ................................. 104
Ïîäîëàííÿ òðàíñïëàíòàö³éíîãî ³ìóí³òåòó ........................... 105
Òðàíñïëàíòàö³ÿ â êë³í³ö³ ....................................................... 107
Ïðîòèïóõëèííèé ³ìóí³òåò .............................................................. 108
Ïóõëèíí³ àíòèãåíè ................................................................ 108
Ìåõàí³çìè ïðîòèïóõëèííîãî çàõèñòó .................................. 109
Ðåàêö³¿ ³ìóí³òåòó òà ¿õíº ïðàêòè÷íå çíà÷åííÿ .............................. 110
²ìóíîõ³ì³÷í³ îñíîâè âçàºìî䳿 àíòèò³ë ç àíòèãåíàìè ......... 111
Ðåàêö³¿ àãëþòèíàö³¿ ............................................................... 112
Ðåàêö³¿ ïðåöèï³òàö³¿ .............................................................. 113
Ðåàêö³¿ íåéòðàë³çàö³¿.............................................................. 114
Ðåàêö³¿ ³ììîá³ë³çàö³¿ .............................................................. 115
Ðåàêö³¿ ë³çèñó ³ çâÿçóâàííÿ êîìïëåìåíòó ........................... 115
428
²ìóíîôëóîðåñöåíòíèé ìåòîä âèÿâëåííÿ àíòèãåí³â
³ àíòèò³ë .................................................................................. 116
Ðàä³î³ìóííèé ìåòîä ............................................................... 116
²ìóíîôåðìåíòíèé ìåòîä ....................................................... 116
Ìåòîä ³ìóíîáëîòèíãà (Western blot) .................................... 117
Àëåðã³ÿ .............................................................................................. 117
Àâòî³ìóíí³ ïðîöåñè ......................................................................... 121
Àâòîàíòèãåíè ......................................................................... 123
Ìîäåë³ àâòî³ìóííèõ ïðîöåñ³â ............................................... 123
Ðîëü àâòîàíòèò³ë .................................................................... 124
Àâòî³ìóíí³ çàõâîðþâàííÿ ..................................................... 125
²ìóíîäåô³öèòè ................................................................................. 127
Íåäîñòàòí³ñòü ãóìîðàëüíîãî ³ìóí³òåòó ................................. 127
Íåäîñòàòí³ñòü êë³òèííîãî ³ìóí³òåòó ..................................... 129
²ìóí³òåò ³ ñòàð³ííÿ ................................................................. 130
ÎÑÍÎÂÈ ÔÀÐÌÀÖÅÂÒÈ×Íί ̲ÊÐÎÁ²ÎËÎò¯.............................. 133
ÅÊÎËÎÃ²ß Ì²ÊÐÎÎÐÃÀͲÇ̲Â........................................................... 134
Ô³çè÷í³ ôàêòîðè .............................................................................. 135
Âïëèâ õ³ì³÷íèõ ôàêòîð³â ................................................................ 137
̳êðîôëîðà ´ðóíòó .......................................................................... 140
̳êðîôëîðà âîäè ............................................................................. 142
̳êðîôëîðà ïîâ³òðÿ ........................................................................ 143
Ðîëü ì³êðîîðãàí³çì³â ó êðóãîîá³ãó ðå÷îâèí ó ïðèðîä³ ................. 144
̳êðîá³îöåíîçè ëþäèíè ................................................................. 147
Íîðìàëüíà ì³êðîôëîðà øê³ðè .............................................. 149
Íîðìàëüíà ì³êðîôëîðà ïîðîæíèíè ðîòà ³ âåðõí³õ
äèõàëüíèõ øëÿõ³â ................................................................... 149
Íîðìàëüíà ì³êðîôëîðà òðàâíîãî òðàêòó ............................. 150
Íîðìàëüíà ì³êðîôëîðà êîíþíêòèâè îêà ........................... 152
Íîðìàëüíà ì³êðîôëîðà ñå÷îâèâ³äíèõ øëÿõ³â ..................... 153
Íîðìàëüíà ì³êðîôëîðà ï³õâè ............................................... 153
Ðîëü àâòîôëîðè â æèòòºä³ÿëüíîñò³ îðãàí³çìó ëþäèíè ....... 154
Ô²ÒÎÏÀÒÎÃÅÍͲ ̲ÊÐÎÎÐÃÀͲÇÌÈ.
̲ÊÐÎÁÍÅ ÏÑÓÂÀÍÍß
ÐÎÑËÈÍÍί ˲ÊÀÐÑÜÊί ÑÈÐÎÂÈÍÈ.
̲ÊÐÎÁÍÅ ÇÀÁÐÓÄÍÅÍÍß ÃÎÒÎÂÈÕ Ë²ÊÀÐÑÜÊÈÕ ÔÎÐÌ ....... 157
Ô³òîïàòîãåíí³ ì³êðîîðãàí³çìè ....................................................... 157
̳êðîáíå ïñóâàííÿ ðîñëèííî¿ ë³êàðñüêî¿ ñèðîâèíè.................... 159
̳êðîáíå çàáðóäíåííÿ ãîòîâèõ ë³êàðñüêèõ ôîðì......................... 160
ÎÑÍÎÂÈ Â×ÅÍÍß ÏÐΠղ̲ÎÒÅÐÀϲÞ.
ղ̲ÎÒÅÐÀÏÅÂÒÈ×Ͳ ÏÐÅÏÀÐÀÒÈ ................................................ 163
Ñóëüôàí³ëàì³äí³ ïðåïàðàòè ............................................................ 166
Àíòèá³îòèêè. Ìåõàí³çì 䳿. Ïîá³÷í³ ÿâèùà
ïðè àíòèá³îòèêîòåðàﳿ ................................................................... 171
429
ÎÑÍÎÂÈ ²ÌÓÍÎÏÐÎÔ²ËÀÊÒÈÊÈ ²ÍÔÅÊÖ²ÉÍÈÕ ÕÂÎÐÎÁ ...... 181
Âàêöèíè ........................................................................................... 181
Æèâ³ âàêöèíè......................................................................... 182
Óáèò³ âàêöèíè ........................................................................ 183
Õ³ì³÷í³ âàêöèíè ..................................................................... 185
Ðåàêòîãåíí³ñòü âàêöèí ³ ¿õ êëàñèô³êàö³ÿ
çà ìàñîâ³ñòþ òà îáîâÿçêîâ³ñòþ çàñòîñóâàííÿ ..................... 186
Ïåðñïåêòèâè â ðîçðîáö³ íîâèõ âàêöèí ............................... 188
Îñíîâè ³ìóíîïðîô³ëàêòèêè ³íôåêö³éíèõ õâîðîá.
Êàëåíäàð îáîâÿçêîâèõ ùåïëåíü .......................................... 189
Çàãàëüí³ âèìîãè äî ÿêîñò³ âàêöèí ........................................ 192
Ñèðîâàòêè. ²ìóíîãëîáóë³íè ............................................................ 199
Îäåðæàííÿ ãåòåðîëîã³÷íèõ ñèðîâàòîê ................................. 200
Îäåðæàííÿ ³ìóíîãëîáóë³í³â .................................................. 202
Åóá³îòèêè ......................................................................................... 203
Îñíîâí³ ïðèíöèïè ñòâîðåííÿ ì³êðîáíèõ á³îïðåïàðàò³â .... 204
Ñó÷àñí³ åóá³îòèêè .................................................................. 206
Îñíîâè ³ìóíîá³îòåõíîëî㳿 ............................................................. 207
Ãåííà ³íæåíåð³ÿ òà êîíñòðóþâàííÿ íîâèõ îðãàí³çì³â-
ïðîäóöåíò³â ............................................................................ 211
Ìîíîêëîíàëüí³ àíòèò³ëà ....................................................... 212
²íòåðôåðîíè ........................................................................... 214
²ìóíîòîêñèíè ......................................................................... 215
Øòó÷í³ àíòèãåíè ³ âàêöèíè .................................................. 216
ijàãíîñòè÷í³ òà ë³êóâàëüí³ ³ìóíîá³îëîã³÷í³ ïðåïàðàòè ....... 217
ÑÏÅÖ²ÀËÜÍÀ ̲ÊÐÎÁ²ÎËÎÃ²ß .......................................................... 219
ÇÁÓÄÍÈÊÈ ÁÀÊÒÅвÀËÜÍÈÕ ²ÍÔÅÊÖ²É........................................ 220
Ïàòîãåíí³ êîêè ................................................................................ 220
Ãðàìïîçèòèâí³ êîêè (ñòàô³ëîêîêè, ñòðåïòîêîêè)............... 221
Ãðàìíåãàòèâí³ êîêè (ìåí³íãîêîêè, ãîíîêîêè) .................... 226
Ðîäèíà Enterobacteriaceae ................................................................ 229
Êèøêîâà ïàëè÷êà çáóäíèê åøåðèõ³îç³â ........................... 230
Ñàëüìîíåëè çáóäíèêè ÷åðåâíîãî òèôó,
ïàðàòèô³â À ³  ...................................................................... 232
Ñàëüìîíåëè çáóäíèêè õàð÷îâèõ òîêñèêî³íôåêö³é .......... 235
Øèãåëè çáóäíèêè áàêòåð³àëüíî¿ äèçåíòå𳿠.................... 237
Ïðîòåé (Proteus) ..................................................................... 240
Êëåáñ³ºëè (Klebsiella) ............................................................. 242
Ñèíüîãí³éíà ïàëè÷êà (Pseudomonas aeruginosa) ............................. 244
Õîëåðíèé â³áð³îí............................................................................. 246
Çáóäíèêè çîîíîçíèõ ³íôåêö³é ........................................................ 251
Çáóäíèê ÷óìè ......................................................................... 251
Áðóöåëè .................................................................................. 254
Çáóäíèê òóëÿðå쳿 .................................................................. 258
Çáóäíèê ñèá³ðêè .................................................................... 261
430
Çáóäíèêè êàìï³ëîáàêòåð³îçó ................................................. 266
Çáóäíèêè ðåñï³ðàòîðíèõ ³íôåêö³é ................................................. 268
̳êîáàêòå𳿠òóáåðêóëüîçó .................................................... 268
Êîðèíåáàêòå𳿠äèôòåð³¿........................................................ 277
Áîðäåòåëè çáóäíèêè êîêëþøó .......................................... 282
Ëåã³îíåëè ................................................................................ 285
Ïàòîãåíí³ êëîñòðè䳿 ....................................................................... 288
Çáóäíèêè ãàçîâî¿ ãàíãðåíè ................................................... 289
Çáóäíèê ïðàâöÿ ...................................................................... 293
Çáóäíèê áîòóë³çìó ................................................................. 297
ÏÀÒÎÃÅÍͲ ÑϲÐÎÕÅÒÈ ..................................................................... 300
Çáóäíèê ñèô³ë³ñó ............................................................................. 300
Çáóäíèêè ëåïòîñï³ðîçó.................................................................... 304
Çáóäíèê åï³äåì³÷íîãî ïîâîðîòíîãî òèôó ...................................... 308
Çáóäíèêè åï³äåì³÷íîãî êë³ùîâîãî ïîâîðîòíîãî òèôó .................. 310
ÇÁÓÄÍÈÊÈ ÏÐÎÒÎÇÎÉÍÈÕ ²ÍÔÅÊÖ²É .......................................... 312
Çáóäíèê àìåá³àçó (àìåáíî¿ äèçåíòåð³¿) .......................................... 312
Çáóäíèêè ìàëÿ𳿠............................................................................. 314
Çáóäíèê òîêñîïëàçìîçó ................................................................... 319
Çáóäíèêè òðèõîìîíîçó .................................................................... 322
Çáóäíèêè òðèïàíîñîìîç³â ............................................................... 324
Çáóäíèêè ëåéøìàí³îçó ................................................................... 326
Çáóäíèêè øê³ðíîãî ëåéøìàí³îçó ......................................... 326
Çáóäíèê â³ñöåðàëüíîãî ëåéøìàí³îçó ................................... 328
Çáóäíèê ëÿìá³îçó ............................................................................. 329
ÏÀÒÎÃÅÍͲ ÃÐÈÁÈ ............................................................................... 332
Çáóäíèê êàíäèäîì³êîç³â.................................................................. 334
Çáóäíèêè òðèõîì³êîç³â .................................................................... 338
Çáóäíèê òðèõîô³ò³¿................................................................. 339
Çáóäíèê ì³êðîñïî𳿠.............................................................. 341
Çáóäíèê ôàâóñó ...................................................................... 341
Çáóäíèê åï³äåðìîô³ò³¿ ñòîï .................................................. 342
Çáóäíèêè ãëèáîêèõ ñèñòåìíèõ ì³êîç³â .......................................... 344
Çáóäíèê êðèïòîêîêîçó (áëàñòîì³êîç Áóññå Áóêøå) ........ 344
Çáóäíèê õðîìîì³êîçó ............................................................ 344
ÏÀÒÎÃÅÍͲ ÐÈÊÅÒѲ¯.......................................................................... 346
Çáóäíèê åï³äåì³÷íîãî (âîøèâîãî) âèñèïíîãî òèôó ..................... 348
Çáóäíèê åíäåì³÷íîãî (áëîøèíîãî àáî ùóðÿ÷îãî) âèñèïíîãî
òèôó .................................................................................................. 349
ÇÁÓÄÍÈÊÈ Â²ÐÓÑÍÈÕ ²ÍÔÅÊÖ²É .................................................... 351
Çáóäíèê ãðèïó .................................................................................. 351
Çáóäíèê êîðó.................................................................................... 355
Çáóäíèê êðàñíóõè ............................................................................ 356
Åíòåðîâ³ðóñè çáóäíèêè ãåïàòèòó À ............................................ 358