The purpose. To conduct comparative evaluation of mortality from infectious diseases and medical care quality in Russia and some European countries in different age groups. Materials and methods. Selection of mortality data was performed from various Russian and foreign databases. Ranking of countries according to mortality rates was done with a quartiles calculation method. For evaluating the adherence to preventive measures surveys of different population groups, to assess adherence to the principles of clinical epidemiology and evidence-based medicine was conducted a continuous survey of doctors, one branch of the municipal polyclinic of Moscow. The results and discussion. It is shown that the situation in the Russian Federation as a whole can be assessed as disadvantaged in mortality from infectious diseases in all age groups. Conclusions. A reduction in mortality among children as well as working-age population requires a comprehensive approach that should include both of improvement of quality of care and the formation of commitment to preventive measures.

The aim of the study was to determine the role of foreign citizens registered in Moscow region, in the maintenance of the epidemic process of measles, rubella and mumps based on the basis of their susceptibility to these infections and compare with the control group (residents of the Russia Central Federal District - donors of blood). Materials and methods. Examination included 909 samples of blood sera obtained from migrant workers and 939 blood donors (residents of the Central Federal district of Russia) which were tested for the presence of antibodies (IgG) to measles, rubella and mumps with the help of enzyme-linked immunosorbent assay. Results. Average relative density of seronegative persons among the surveyed migrants and donors to rubella virus ranged from 6.6 to 9.8%, the measles virus - 13.5 and 16.5%, respectively, statistically significant distinctions in groups were not established. The proportion of seronegative persons to mumps virus twice and more exceeded the standard documentation level among migrants and donors (32.5 and 47.5% respectively). Conclusion. There was a significant excess of the permissible level of seronegative persons to the measles, rubella and mumps viruses among migrant workers and blood donors, which creates preconditions for maintenance of epidemic process and dictates the necessity of carrying out the corrective vaccination (or revaccination) of non-immune persons

Objective. With the increase in vaccination coverage of the child population began the process of ousting children determining the incidence of measles in the country and by 2004, the children ceased to play a leading role in maintaining the epidemic process of measles. The definition of significance in the epidemic process of measles individuals of different age, including children in the first year of life, was the purpose of the work. Material and methods. Measles cases in different age groups were analyzed for the period 2003 - 2015 in the Russian Federation. 1799 cases of measles in children under 1 year were investigated. The ELISA method were examined the sera of children up to 1 year in 2002 - 22 sampls, 2016 - 31 sampls. Results. Analysis of the incidence of measles in different age groups conducted since the beginning of the program of measles elimination in Russia to date (2003 - 2015), showed that with the increase in the level of the immune stratum, the incidence of measles inculcated among the population declined markedly and even in the boom years (2012 - 2014) intensive morbidity rates of children aged 3 - 6 years, adolescents and adults averages ranged from 3.0 to 4.0 per 100 thousand of the appropriate age. The exception was children first year of life and children aged 1 - 2 years, of intense the incidence of which was several times higher (in average, respectively, was 22.0 and 19.0). If the vast majority of affected children aged 1 - 2 years had been vaccinated against measles, for various reasons, the children of the first year of life, according to the immunization calendar, the vaccination could not be. Conclusion. Detailed analysis showed that the incidence of measles in the country determined by the adult population. Comparison of incidence and state of specific immunity to measles virus in children the first year of life suggests that their involvement in the epidemic process of measles is not determinative. Changing the proportion of affected children of this age are directly linked with fluctuations in the long-term dynamics of the overall incidence of measles in the country, and high, compared with other age groups, the intensive indicator of disease is not due to a large numerical composition of this age group.

Hemorrhagic fever with renal syndrome (HFRS) has been a major concern for public health in different countries of the Euroasian continent for decades. In 1970s the disease was associated with newly discovered viruses that were to become new members (under the genus Hantavirus) of the family Bunyaviridae. During a deadly outbreak of pulmonary syndrome in the southwestern United States in 1993, it was shown that causative agents of this devastating disease (designated hantavirus cardio-pulmonary syndrome, HCPS) were also hantaviruses. By now hantaviruses are found worldwide and associated with different species of the order Rodentia , which are their natural carriers. Hantaviruses persistently infect rodents, however do not cause any disease in them and are transmitted to humans through aerosolized excreta. For a long time studies of hantaviruses were limited by their high pathogenicity, absence of animal model of infection, and poor growth in cell cultures. With the rapid development of molecular biological techniques in last several years substantial progress has been made in various fields of hantavirus research. Different aspects of hantavirus ecology, molecular biology, morphology and pathogenesis, as well as current diagnostic methods and other characteristics of hantaviruses are considered in this review.

There are 22 - 25 thousand cases of Acute Otitis Media (AOM) registered annually in children < 14 years old in Sverdlovsk region. Average annual morbidity in 2009 - 2014 is 3748.5 ± 0.27 per 100 thousand children. In 2014 - 2015 non-interventional hospital-based surveillance study has been conducted in Sverdlovsk region establishing children ≤ 5 years old to be the leading risk group for AOM with 40.6% of cases caused by S. pneumoniae. Serotypes 3 (28.6%), 19F (17.2%), 14 (11.4%), 6А/В/С (11.4%) and 23F (5.7%) are playing the major role, that in total covers 77.1% of detected serotypes. S .pneumoniae serotypes coverage by pneumococcal conjugate vaccines is 54.2% for the 10-valent and 82.9% for the 13-valent.

Background. The current epidemiology of pneumococcal meningitis in Ukraine, Georgia and countries of CIS is poorly studied. In order to ensure an effective vaccination strategy and post-vaccination surveillance, we examined the serotype distribution patterns of pneumococcal meningitis in the following regions: European (Ukraine, Belarus), Transcaucasian (Azerbaijan, Armenia, Georgia), and Asian (Uzbekistan, Kyrgyzstan, Kazakhstan). The study was performed within the program for Invasive Bacterial Diseases Sentinel Surveillance implemented in the region by WHO Regional Office for Europe. Methods. Cerebrospinal fluid (CSFs) samples were collected from patients with suspected meningitis at sentinel hospitals throughout all the regions within the period 2007 - 2016. Determination of S. pneumoniae and serogroups/serotypes in positive CSFs was performed using qPCR and mPCR. In total 3013 CSFs were tested: 2764 (91.7%) of them were collected from patients aged under 5 years, 128 (4.2%) from children aged 5 - 18 years and 121 (4.1%) from adults. Results. 6% (188) of CSFs analyzed were positive for S. pneumoniae, The PCR assay used could predict the S. pneumoniae serotypes/ serogroups for 82% (n = 154) of positive CSFs, 16% were not-typeable in our PCR scheme and for 2% serotyping was not performed. In total, 26 different serotypes/serogroups were identified. Serotypes 6A/B (21%), 14 (15%), 19F (10%), 23F (7%), 18 (A/B/C) (4%), 9V/9A (3%) and 4 (3%) were found to be the most prevalent, followed by others with a prevalence of 2% and less(6C/6D, 24(A/B/F), 19A, 5, 3,1,23A,20,2,13,31, 8, 7F/7A, 7C/7B/40, 22F/22A, 21, 15B/15C, 12F/12A/12B/44/46, 11A/11D). Conclusions. The proportion of vaccine serotypes in pneumococcal meningitis cases (vaccine coverage) amounts to 67% for PCV10 and 71% for PCV13 in all the regions, suggesting that the introduction of conjugate vaccines (PCV10 and 13) into National Immunization Programs is feasible. Post-vaccine introduction surveillance supported will be essential. Post-vaccine introduction surveillance and monitoring of changes in serotype S. pneumoniae distribution in cases with invasive pneumococcal disease and in healthy carriers is essential to assess the vaccination effectiveness and to provide a comprehensive picture of the vaccination impact on pneumococcal serotype distribution in the region.

Cholera remains a topical infection in the world, which determines the high risk of importation of the pathogen on the territory of the Russian Federation. MLVA-typing of 135 strains at 5 tandem repeats loci was carried outin order to study the clonal-population structure of the isolated from 1973 to 2016 on the Transbaikal territory V. cholerae. Analysis of the distribution patterns showed that the primary emergence of strains with new atypical for the territory genotypes in 1970s, 1980s, 1990s, occurred in sewage waters with the subsequent detection of the given genotypes generally in Ingoda river and Kenon lake. The strains firstly isolated from Borzya river and Haranor lake and found out at various times in Ingoda river and Kenon lake, Chita, Argun rivers, Haranor lake and Borzya river have been dominating since 2005 in Transbaikal territory. Finding groups of isolates with identical or similar MLVA-profile appeared in cluster complexes evidence of their long-term preservation in specific ecological niches, strains’ allelic profiles undergo minor transformation on the most variable loci in the process of adaptation. Identification of V. cholerae El Tor that variable tandem repeat loci structure materially differs from those of the dominant clones may serve as proof of their invasive origin.

Through the use of trivalent oral poliovirus vaccine made from Sabin strains of types 1, 2, 3 (tOPV), outstanding success of Global polio eradication program has been achieved. Since 1999, wild polio virus type 2 does not circulate in the world. To enhance immunity to poliovirus types 1 and 3, to reduce the risk associated with the continued use of tOPV (forming of vaccine-derived polioviruses and the emergence of cases of post-vaccination complications), the WHO proposed its replacement with bivalent oral poliovirus vaccine (bOPV) in programs of mass immunization. The results of clinical studies of tolerability, reactogenicity, safety and immunological effectiveness of the bOPV «BiVac Polio» developed in Chumakov Federal Scientific Center for Research and Development of Immune-and Biological Products of Russian Academy of Sciences are presented. «BiVac Polio» is a preparation of Sabin strains of polio virus type 1 (strain LSc 2ab) and type 3 (strain Leon 12a1b). The content of infectious viral units per vaccination dose is not less than 10^{6 0} TCD₅₀ for poliovirus type 1 and not less than 10⁵⁵ TCD₅₀ for poliovirus type 3. As a preparation of comparison, trivalent oral poliovirus vaccine from Sabin strains types 1, 2, 3 was used. The study included two stages. Comparative assessment of tolerability, reactogenicity and safety of the vaccine «BiVac Polio» and tOPV was the purpose of the first stage which included 20 adults of both sexes. At the second phase of the study, a comparative investigation of tolerability, safety and immunogenicity of the vaccine«BiVac Polio» and tOPV in children aged 18 months and 6 months was carried out (each group consisted of 60 children). Estimation of vaccine immunogenicity was carried out using the level of seroconversion - rise of neutralizing antibody titers in the sera of recipients taken before and 28 days after vaccination. The titer of neutralizing antibodies in the blood serum to poliovirus type 1 and 3 was determined by microneutralization assay on HEp-2 cells. The results of clinical studies have shown that in their basic characteristics, «BiVac Polio» vaccine is not inferior to the preparation of comparison (tOPV) and may be used for prophylaxis of poliomyelitis.

The development of universal influenza vaccine - a vaccine directed to all subtypes of human influenza A viruses - is the really actual problem task. This paper presents the comparative characteristic of the specific activity of various recombinant proteins consisting of antigenic determinants of influenza A virus - the ectodomain of the M2 protein (M2e) and a fragment of the second subunit of the hemagglutinin (the amino acid sequence 76 - 130). Flagellin - Salmonella typhimurium protein was used as carrier protein and as adjuvant. We use two forms of flagellin: full size and with deleted hypervariable region. The proteins showed high immunogenicity, and the ability to prevent lethal infection of influenza virus in mice. Full-length flagellin with HA2 (76 - 130) and M2e on the C-terminus (protein Flg-HA2-4M2e) demonstrated the most protective properties. It provides 100% survival immunized mice that were challenge with a high dose of influenza A (H3N2) - 10 LD50. Proteins containing only full sized flagellin with M2e or flagellin truncated form with M2e at the C-terminus and HA2 within the hypervariable region, protected 75% of animals from lethal infection. Protein Flg-HA2-4M2e is promising for further study as a vaccine.

The purpose: to study the level of stigmatization and attitude towards patients with chronic hepatitis В (ChHB) and chronic hepatitis C (ChHC) among students of medical and non medical university. Materials and methods. Anonymous questioning was conducted among 194 senior students of two institutions of higher education in the city of Kirov: 96 people from the Kirov State Medical University (group 1) and 98 from the Vyatka State University (group 2) in 2016. The original questionnaire included 16 questions about the socio- The demographic status of the respondent, the epidemiology of HCV and HBV-infection, and the attitude towards patients with ChHB and ChHC. Results. As a result of the study, the presence of stigmatizing devices of different severity in patients with ChHB and ChHC in both groups was revealed. It was established that the level of stigmatization and potential discrimination of patients with ChHC and ChHB in students of non-medical specialties was significantly higher compared to medical students. Respondents of the 2nd group did not sufficiently orientate themselves in the issues of epidemiology of ChHB and ChHC, which led to a negative attitude towards these patients and elements of discrimination. However, in the course of the study, it was noted that one-third of students with medical training, well aware of the ways of transmission of HB/HC-virus, also feared household contacts with such patients. In the course of the work it was shown that significantly more stigmatization and discrimination were manifested in relation to ChHB patients in comparison with ChHC and only in the respondents of the 2nd group. Conclusions. Thus, the study revealed the presence of stigmatizing settings of varying severity in patients with ChHB and ChHC in both groups. It was established that the level of stigmatization and potential discrimination of patients with ChHC and ChHB in students of non-medical specialties was significantly higher compared with medical students.To overcome this problem, it is necessary to conduct planned sanitary education among students without medical training, to deepen the knowledge of students of the medical university, since patients with ChHB and ChHC should not be discriminated.

Whereas the quality of the program depends on promptness, full coverage, vaccination schedule abidance. Taking new Moscow regions as an example there have been studied factors influencing vaccination against Pneumococcal infection (PI). Insufficient provision of the vaccine to reach the desired level of coverage has been detected: in 2014 only 67.57% of liable children could receive double vaccination; the available quantity of vaccine in 2015 was able to provide 33. 84% of children up to 12 months old with double vaccination.However, the actual number of children vaccinated turned to be much lower (0.23% in 2014 and 20.85% in 2015).The survey of the doctors with the purpose of defining the level of knowledge and commitment to the vaccination against PI has shown a modest level of epidemiology, clinical implications, PIimmunoprophylaxis method awareness. Parental attitude towards PI vaccination has been estimated as positive. Parental interest to opportunities of immunoprophylaxis against PI is worthwhile noting despite the insufficient level of knowledgeability of its effects. Hence 74.5% of parents whose children are not vaccinated against PI would like to start vaccination, however a part of them look into receiving more information (29.41% parents).

Dynamics of acidic and alkaline phosphatase activities was examined in thymus and spleen of laboratory mice immunized by cell wall preparations of Francisella tularensis of different subspecies. Cell wall preparations of two subspecies: F. tularensis subsp. mediaasiatica А-61(385) and F. tularensis subsp. novicida В-399 A-Cole (386) stimulated the rise of acidic and alkaline phosphatase activities in earlier time (7 days) after immunization than the others. It was correlated with their protective activity. On the basis of the results it is concluded that the studying of the acidic and alkaline phosphatase activities in immunocompetent organs can serve as one of the criteria for evaluation of efficiency of immunobiological preparations.

Retrospective epidemiological analysis of hemorrhagic fever with renal syndrome (HFRS) was performed in the Jewish Autonomous Region based on archival, statistical and operational data of 133 HFRS cases. Total 63 mammal samples were examined by ELISA and RT-PCR. Large-scale flooding in 2013 sharpened the epizootological condition and created the preconditions for epidemiological complications. The high increase in HFRS incidence in 2014 was characterized by the epidemiological process intensity displacement from the southern areas to least affected by flooding northern parts of the region and alteration of the seasonality corresponding to the maximum number of carriers in natural foci. Since 2015 a decrease of morbidity is observing. RNA and antigen of Hantaviruses were found in Apodemus agrarius and Microtus maximowiczii. Sequencing of L-gene fragment (334 bp) of RNA-containing samples showed their taxonomic affiliation to the three Hantaviruses: Khabarovsk, Hantaan and Puumala.

There are analyzed the incidence of whooping cough for the period of 1993 - 2016 in Republic of Moldova in this article. 210 from 280 cases of pertussis reported in 2016 and. Specific IgM antibodies of 174 patients were investigated. The epidemic process of pertussis is cyclical, with a period of 3 - 4 years, with a higher incidence in urban areas and in children up to two years, with a tendency to increase the proportion among the patients of school-age children and adults. The decrease in vaccination coverage from 95.4% in 2008 to 89.7% in 2015 led to an increased incidence. From total number of cases, 68.1% were children aged from 0 to 6 years old. The age structure of registered cases in 2016 included: 22.4% under one year old; 44.3% between 1 - 2 years, 27.1% school age children between 7 -17 years and 4.8% adults. A later uptake of medical care was registered, with an average of 10.5 days after onset of the disease, but in age group of children under one year it was 9.6 days. The bases of the diagnosis of whooping cough in 10.7% of cases were clinical data, in 16.2% were clinical - epidemiological data and in 73.1% were laboratory data. Specific IgM antibodies were detected in 77.0 ± 6.4% of patients. Among patients under one year old, 14.9% were under the age of vaccination, 34.0% received from 1 to 3 doses of vaccine, 19.1% are not vaccinated by false contraindications and 27.6% due to refusal. Among patients from the age group of 3-6 years, 56.0% received 3 - 4 doses of vaccine, 18.0% were not vaccinated because of false contraindications and 40.0% due to the failure of the vaccination. From children patients who received a full course of vaccination against pertussis, 25.0% had been vaccinated 1 - 2 years ago and other 25.0% became ill after three or four years after immunization.

Recommendations highlighted features vaccination children with hemoblastosis. It is shown how the immunization scheme may be changed according to the pathology and the age of the child.