Relevance. Life expectancy of cystic fibrosis patients mostly depends on the degree of respiratory system damage caused by opportunistic microorganisms, which is due to the fact that 90-95% of deaths of cystic fibrosis patients are caused by lung infections. Goal. To define epidemiologic characteristics of chronic lung infection caused by the most common agents (S. aureus, P. aeruginosa, B. cepacia-like bacteria (Bcc) and Achromobacter spp.) using a novel chronic lung infection in cystic fibrosis patients microbiological diagnosis algorithm. Materials and methods. Over a period of 7 years (2008-2016) 300 children with cystic fibrosis living in Moscow, Moscow region and several other regions of Russian Federation have been checked-up. 260 sputum samples from 100 adult patients, who were under care at the Pulmonology Research Institute, were studied. Sputum samples from children were taken before and after antibiotic therapy with intervals of 15-45 days and over 6 months. 30 of the children were also subjected to a microbiologic monitoring of the state of chronic infection in the period between 4 and 15 months. Sputum sample from adult patients were also taken before and after antibiotic therapy with intervals of 0, 15-45 days and over 6 months. Results. P. aeruginosa, S. aureus, H. influenzae and Burkholderia cepacia-like bacteria were confirmed to be the most common agents of lung infection in cystic fibrosis patients. Children with cystic fibrosis over the years develop foci of chronic lung infection, mainly caused by P. aeruginosa and S. aureus. Conclusions. Chronic lung infection can be caused by community-acquired or nosocomial S. aureus и P. aeruginosa. Chronic lung infection is a complex, dynamically changing disease which requires constant monitoring and is mainly caused by S. aureus, P. aeruginosa, Bcc bacteria and Achromobacter spp. As populations of the agents can be diverse, it is necessary to study all colonies with differing phenotypes (mucoid and non-mucoid variants, small colony variants, variants with different pigments) and to take samples of several colonies when testing antibiotic resistance. Bcc and Achromobacter spp. cannot be eradicated with antibiotics, thus the only effective measure against these bacteria can only be vaccination which requires developing a vaccine.

Objective: evaluate the passive specific immunity to measles and rubella in newborns and their mothers. Materials and metods: a study was made by the ELISA of the state of specific immunity to measles and rubella in 226 puerperas aged 15 to 44 without taking into account the vaccination status and their newborns in maternity hospitals in Moscow and Moscow Region. Results - the seropositive of measles proportion - 73.9 ± 2.9%, the rubella - 84.5 ± 2.4%. Comparison of the results of the study of immunity to rubella in puerperas and newborns with the results of previous years did not reveal any significant differences. The results of the examination of 226 newborns for the presence of antibodies to the rubella virus showed that the proportion of seropositive measles to the virus turned out to be 177 (78.3 ± 2.7%) children, rubella - 83.6 ± 2.4%, comparable to results of a survey of their mothers. Conclusion: high level of protection of the puerperas and their newborns from these infections. However, the organization and carrying out of vaccinations requires increased attention and control, since only high and timely coverage with vaccinations will prevent the increase in the incidence of infection when meeting with the pathogen of infection, including children of the first year of life.

The tick-borne encephalitis (TBE) and Ixodid tick-borne borreliosis (ITBB) have joint vectors and form combined natural foci throughout all their area, but their epidemiology differs. The risk for Irkutsk city residents to get infected with these diseases, and its relationship with ecological, geographical, demographic and social factors during last 20 years have been analyzed. The change of the diseases proportion is shown; electronic case map and places of most risk are presented. Considerable sex-age and social differences between patients have been revealed. The cases of repeated TBE and ITBB have been found.

Total 728 Ixodes ticks of four species: Ixodes persulcatus, I. pavlovskyi, Haemaphysalis concinna, H. japonica douglasi collected at the Russian island in 2011-2012 were investigated. Common Rickettsia infection rate in the tested vectors varied from 4.1 to 27.9%, and the most infected representatives turned out I. persulcatus and I. pavlovskyi - 27.9 and 10.0%, respectively. Sequencing and the phylogenetic analysis of fragments of citrate synthase genes (gltA) and ompA and ompB surface proteins revealed Rickettsia DNA in ticks of Ixodes genus belonging to Candidatus Rickettsia tarasevichiae, and in ticks of Haemaphysalis genus - to Candidatus R. principis. DNA of tick-borne epidemic typhus agent - R. sibirica and R. heilongjiangensis, failed to find in the ticks tested.

At present there is strong evidence of the long-term persistence of Yersinia pestis in soil during interepizootic period in nonculturable and L-forms of bacteria. This information helps to reveal the mechanisms of emergence, establishment and extinction of plague foci. Deciphering causes of transformation of plague microbe in rodent burrows is possible only under condition of detailed study of biocenotic relations of plague causative agent with each of the multiple biocenosis components, including microorganisms -permanent inhabitants of the burrow microbiotopes in natural plague foci. Purpose of the study: Study of interactions of microscopic fungi-micromycetes iso-lated from burrow microbiotopes of great gerbil and little souslik in the Ural-Emba interfluve and in Nogai steppe with plague agent and its vectors. Materials and methods: The effect of 74 micromycete species, isolated in natural plague foci, on Yersinia pestis virulent strains was studied in vitro and in vivo (in organisms of X. skrjabini fleas). In the experiments in vitro fungi metabolites were applied on the lawns of Y. pestis test-cultures with subsequent recording of the size of lysed zones. Fleas were challenged in tubes with filtering-paper strips impregnated by fungal cultural liquid and then LT100 value was calculated. In the experiments in vivo fungus conidia were applied on the surface of insect cuticle; flea challenging with plague was carried out on agonizing white mice infected by plague microbe. Insect challenge with plague and fungal conidia was alternated in different succession. Results and discussion: Of 74 micromycete strains 78.4% produced antagonistic effect in relation to 1-5 Y. pestis strains. Ashergillus versicolor, A. clavatus, A. sulfereus, Mucor racematus, Penicillium baarnensens, P. sp. relative to P. charlesii, P. sp. relative to P. martensii, P. insectus, P. chrysogenum fungi induced growth suppression of all five test strains of Y. pestis. High antibiotic activity of fungi metabolites was accompanied by insecticidal activity against Xenopsylla skrjabini fleas. Microscopic fungi P. funiculosum, P. cyclopium, P. chrisogenum, P. charlesii. P. canescens, A. versicolor induced 100% flea death on 4-6 day. As a result of insect pretreatment by conidia of P. funiculosum with subsequent challenging with plague microbe block formation in fleas decreased 14 times, and the number of Y. pestis cells after 12 days was 25-33 times less independent of succession, in which insects were challenged with microorganisms. Conclusion. It is supposed that micromycetes could play an important role in natural plague foci, adjusting epizootic activity of plague vectors and causative agent.

Since 1933 in the Rostov region, the official registration of tularemia began. In 1964-1949 the highest incidence was noted. Since 1947, they have been vaccinated against tularemia. In 1966 to 1973, there were no cases of tularemia. In July-August 1993, a large outbreak of tularemia (more than 200 people) was recorded. Until early 2017, the epidemic situation in tularemia in the Rostov region, according to the data of long-term monitoring, was assessed as stable, but low coverage with vaccinations against tularemia, both in the population of endemic territories and in individuals of certain professional categories was recorded. In january 2017, two residents of Rostov-on-Don received a clinical diagnosis of «tularemia». In june and july 2017, three cases of tularemia were reported. The most effective mechanism for preventing the spread of tularemia remains vaccination of the population from the contingent of risk. We consider it advisable to conduct studies of the immunity to tularemia in the population vaccinated in the last five years, to significantly increase the reliability of short- and long-term prognosis for tularemia in the region.

The paper estimates the prevalence of the main risk factors for breast cancer (BC) in different age groups of the female population of the Omsk Region. Priority groups for the correction of risk factors in five age intervals were identified. According to the results of an integrated assessment of the aggregate of risk factors at different ages of women, the age group 60-69 years old was in the first ranking place for the priority of preventive measures, the second group was 70 years or more, the third group included a group of 30-39 year old women. The specific weight of the corrected risk factors in this group of respondents was 85.7%, which determines the potential of preventive measures.

The retrospective analysis of incidence of epidemic parotitis in Russia in 1995-2016 is carried out. It is shown that growth of this infection incidence in 2016 was caused by the poor vaccination and revaccination coverage in the past, as well as the poor immunization quality (vaccination failures) and the decrease in post-vaccination immunity at some vaccinated persons due to absence of natural «booster effect» in the condition of sporadic incidence for a number of years, untimely and not in full holding the response and preventive actions in foci of the infection, and also delivery of the epidemic parotitis virus from epidemic area. Recommendations are formulated to hold actions for improvement of the epidemiological situation.

Introduction. Measles still poses a threat to the inhabitants of the planet. In different regions of the world and the Russian Federation are recorded instances of contamination and subsequent infection with formation of foci with a significant number of victims. Measles has a high reproduction rate of the infection. The purpose of this study was to determine the main characteristics of the epidemic process of measles and its determinants in realtime for direct and indirect control of epidemic process. Materials and methods. The authors analyzed the data of official registration of the incidence of measles the population of Ekaterinburg from 1988 to 2016, and medical records of cases of measles in 2016. We used epidemiological, clinical and statistical research methods. Results. The authors found that the epidemic process of measles has undergone significant changes. Measles was not registered in the city from 2001 to 2015, the unit drifts measles-endemic territories didn't leak. However, the situation changed at the end of 2016. It was 72 clinically and laboratory confirmed case of measles in a period of 11 weeks. The largest proportion of cases were in children who are not vaccinated against measles. The average age of infection in children was 3.8 years. 59 measles epidemic foci were formed during the flash. Foci were registered in families, educational institutions and health care organizations. The most active spread of the infection was in medical organizations. The spread was associated with the presence of susceptible children and adults, serious shortcomings in terms of timely diagnostics of measles in the first and subsequent cases, violations in the organization of antiepidemic measures. Conclusion. 1. Despite positive shifts in the direction of measles elimination, it remains an actual infection, reserving opportunities for distribution among unvaccinated adults and children. 2. A special feature of the outbreak of measles in the territory of Yekaterinburg was the spread in medical organizations with the formation of secondary foci along the routes of following sick children and adults. The share of foci in medical organizations was 15.2% of the number of all foci, and the number of cases in any - 70.8% of registered cases.3. The significance of previously vaccinated cases as potential sources of infection in the foci is not high, the incidence rate when in contact with them is 0.53 ± 0.15, whereas in contact with previously not vaccinated - 7.94 ± 0.56.

The aim of the study was to evaluate the effectiveness of the programme of Human papillomavirus (HPV) vaccination and cervical cancer in girls and women in the Moscow region. Materials and methods. The statistical reports of the specialists of the Moscow region, as well as on the basis of data of state statistics to assessment of the incidence of anogenital warts in girls, as well as the dynamics of the incidence of cervical cancer in women in the Moscow region. Results. Based on the analysis of statistical reports of the Moscow region as a result of vaccination of girls observed a reduction in the incidence of anogenital warts in 2016 compared to 2009, from 14.2 to 5.9 (per 100 000 for girls). Based on date of the state ststistics there has been a reduction in the incidence of anogenital warts in the population in the Moscow region with up 56.7 to 20.2 (per 100-000 population). But the most important effect of vaccination in 2015 was the lack of a rise in the incidence of cervical cancer in women in the region, as well as the reduction in the incidence in young women aged 1524 years. Conclusion. Held in Moscow region the program of HPV vaccination and cervical cancer after 9 years resulted in a reduction of HPV-associated pathology, which determines the need to continue vaccination programs, including inclusion of vaccination in the immunization schedule.

Described four cases of illness in children hospitalized for one month after vaccination with live vaccines. In all cases the options considered in differential diagnosis between vaccinates reaction; undercurrents infections; separately shown the possibility of development of mumps in post-vaccination period vaccination party. The difficulties of differential diagnostics of diseases of post-vaccination period were analyzed. The necessity of laboratory examination in such cases to establish the etiological factor. The comparison of the system of registration of such events in the Russian Federation and abroad. The need to change the system of registration of adverse events in post-vaccination period.

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.

In the submitted report from modern theoretical positions the concept of risk of epidemiology is surveyed. Definitions are given to categories: «epidemiological risk», «risk factor», «risk group», «territory of risk» and «risk time». Hierarchical systematization of the discussed concepts is given.

The article presents the results of the activities of the National Association of Specialists for the Control of Healthcare -Associated Infections of ensuring epidemiological safety of medical care. Educational projects, development and the statement of federal clinical guidelines, participation in development of criteria of an assessment of epidemiological safety and audit of the healthcare settings for system of ensuring quality and safety of medical care are discussed. Priority tasks to safety of patients and the medical staff, assistance in improving immunization programs and the National Schedule of preventive vaccinations, transition to new risk-to the focused strategy of an epidemiological surveillance and prevention of infections in the healthcare settings are defined.