Objects and methods of research. Of the 580 employees of a petrochemical plant, 507 people went through survey for low back pain using the Nordic questionnaire. In the prospective part of the study, 188 workers without any back problems during 12 months before the study were followed up for 6 and 12 months using the same questionnaire. Physical load at work place, age, gender, body mass index (BMI), smoking, and gene PARK2 polymorphism were regarded as potential risk factors. 177 workers provided buccal epithelium for investigation of rs926849 polymorphism A/G in the gene PARK2 by real-time PCR.

The results of the study and their discussion. One-year prevalence of low back pain was 38.7% (95% CI 33.6–42.3%), and the incidence of new cases was 20.7% (95% CI 15.3–27.4%).

In the presence of the genotype AA the probability of developing the low back pain in the group of up to 30 years were as high as in the group of 30 years and older: OR 0,99 (95% CI 0.29–4.52). For the low back pain with reduction of physical activity or disability, in the presence of AA genotype risk of such pain in workers aged 30 years and older was significantly higher than in the younger group: OR 1.86 (95% CI 1.03–3.57). The probability of low back pain was highest in the simultaneous presence of risk factors such as AA genotype and body mass index 25 kg/m² and more: OR 3,83 (95% CI 2.34–4.88) for all cases of low back pain, OR 10.0 (95% CI 5.04–19.85) for low back pain with reduction of physical activity or disability.

Occupational risk factors of high significance (after controlling for non-occupational risk factors and their interactions) were revealed: fixed working posture of more than 25% of the work shift: OR 4.8 (95% CI 1.57–14.69), high dynamic physical load: OR 1.48 (95% CI 0.67– 3.26), as well as high physical load in general: OR 2.96 (95% CI 0.72–12.18). For the low back pain with reduction of physical activity or disability the structure of the risk factors was the same, while the odds ratios were higher and confidence intervals did not include 1.0.

Conclusion. The following risk factors of work-related low back pain have been revealed: the age (30 years and older), overweight, genetic predisposition, namely the polymorphism of the PARK2 gene, high physical load, predominantly a fixed working posture of more than 25% of the work shift, and dynamic physical load. It has been shown that interactions of the factors «age» and «genotype», as well as «BMI» and «genotype» should be considered for better understanding of the structure of risk factors of work related low back pain. 

The goal is to identify features of epidemic process of influenza depending on the etiology of epidemics to clarification of the forecast for future epidemics. Analysis of epidemics of influenza in Russia conducted according to the Federal center for influenza on morbidity, hospitalization and deaths from influenza in 59 Russian cities. The epidemic of influenza A(H1N1)pdm09 2015–16 different from the mixed epidemics of influenza (A(H3N2) and B) 2014–15 and 2016–17 high development rate, high incidence of influenza and ARI at its peak, the incidence of hospitalization with a diagnosis of «influenza» (14%) and high mortality among the infected (6,0 on 100000). The epidemic of influenza A(H3N2) and B started earlier (December). They had a longer duration and the incidence in the cities and in the country, but less than the incidence at the peak of the epidemic and the incidence of hospitalization with a diagnosis of «influenza» (7.5 and 7.3%) and smaller (8.6 and 20 times) the mortality from the influenza. In these epidemics among the dead was higher than the percentage of children under 14 years and persons over 65 years of age than in the influenza epidemic 2015–16. And among the deaths increased the proportion of persons with chronic lung disease and immunodeficiency, but decreased the proportion of individuals with obesity and diseases of the liver and kidneys. For the period from 2009 to 2017 the tendency to increase the intensity of influenza A(H3N2) epidemics was 2.4 times greater than the decrease in the intensity of epidemic of influenza A(H1N1)pdm09. 

This article presents the results of a simple, blind, randomized, placebo-controlled, single-center, prospective research of the reactogenicity, safety, and immunogenicity of the domestic influenza inactivated split vaccine «Flu-M» in immunization of the adult population of 18–60 years old. Low reactogenicity, high safety profile and immunogenicity of the Flu-M vaccine were determined. 

Pneumococcal infection is one of the main causes of acute respiratory diseases and exacerbation of chronic ones. In order to study the prevalence of community-acquired pneumonia, the etiologic role of S. pneumoniaе and effectiveness of vaccination among children under the age of 6 in the town of industrial cities, we conducted a non-interventional epidemiologic study of serotypes of circulating pneumococci and their compliance with the declared composition of vaccines recommended for prevention of pneumococcal infection in children. We also studied incidence rates of community-acquired pneumonias among children under the age of five vaccinated against pneumococcal infection, depending on the schedule and beginning of immunization. Our findings indicate a significant role of pneumococcus in the etiology of community-acquired pneumonias among children under the age of 17 (24.14%).The established spectrum of serotypes of pneumococcus from nasopharyngial swabs in children under the age of 17 with community-acquired pneumonia in the town of this city showed that such serotypes as 19F, 14, 9V/A, 15A/F, 6A/B/C, 3, and 23F contributed the most to the development of pneumonia (79.97%). Pneumococcus serotypes found corresponded to the composition of PCV13 in 76.36% of cases and to that of PCV10 – in 67.27%. Proven the effectiveness of the vaccine, the rate of epidemiologic effectiveness was 48.7% in relation to pneumonia of any etiology. Shown the largest epidemiological effectiveness (54.8%) of vaccination in children vaccinated in an early period (under the age of 1). 

The aim of the work is to study the circulation of fungi of the genus Candida in children's and adult multi purpose hospitals.

Materials and methods. A total of 61,226 studies of material obtained from patients in the children's hospital were performed. A positive result was registered in 27 060 cases (44.2%). In an adult hospital, 8647 samples were tested, of which 1988 (23.0%) were positive.

Results and discussion. Among the representatives of the fungi of the genus Candida, C. albicans 752 strains (61.3%) were isolated in the overwhelming number of patients of the children's hospital, C. papapsilosis – 15.1%, C. famata – 11.6%, and C. glabrata – 8.0%. Other representatives of the genus were rare enough, in particular: C. krusei and C. gullermondii – 1.1%, respectively. The greatest number of fungi of the genus – was allocated from patients in the Department of Resuscitation and Intensive Care – 467 strains (38.1% of all the fungi isolated), 186 strains (15.2%) in the Otorhinolaryngological department, 87 out of 87 (7.1%), in the Departments of Planned Surgery and Urology – 86 (7.0%), Surgical Intensive Care Unit – 72 (5.9%), in The Department of Infectious Diseases with Surgical Pathology – 65 (5.3%). C. albicans was sown both in monoculture – 47.4%, and in associations – 52.6%. Other representatives of fungi were also approximately equally found in mono- and in microcultures. In the children's multi purpose hospital, 11 species of Candida fungi with a predominance of C. albicans circulated. In the adult multi purpose hospital for two years was isolated from the patients 137 cultures of Candida fungi.

Conclusions. The probability of isolating fungi from a locus is determined by the profile of the Department, as well as by the primary pathology with which patients entered the hospital. In both children's and adult hospitals, the most common Candida fungi have been isolated from the Department of Resuscitation and Intensive Care patients mainly from sputum and urine, less often from blood, separated wounds, abdominal cavity and from cerebrospinal fluid (only in children). Against the background of a wide circulation of fungi in the hospital, colonization of patients is possible with the subsequent development of the infectious process, mainly in people at risk. 

Relevance The HIV epidemic, registered worldwide since the early 1980s, is currently continuing its development in most countries, and, according to the Joint United Nations Program on HIV/AIDS (UNAIDS, 2016), covers more than 36 million people (including 1.8 million children) AIDS mortality is a key indicator of the effectiveness of the response to the HIV epidemic. On the example of the Irkutsk region as a region with high lesion, an analysis of the main indicators and causes of death of patients with HIV infection was carried out.

Goal – analysis of the mortality of HIV / AIDS patients by the example of a region with a high degree of defeat in order to determine the key criteria for evaluating activities to reduce the mortality from HIV/AIDS.

Materials and methods An analysis was made of the causes of mortality of patients with HIV infection in the Irkutsk region in 2014– 2016, using comparative data of modern domestic and foreign literature (including total mortality), as well as accounting and reporting documentation of the Irkutsk Regional Center for prevention and control of AIDS and infectious diseases.

Results 1. There is an increase in the death rate of HIV-infected people, including those caused by HIV. 2. The increase in mortality practically does not lead to an increase in mortality due to a parallel increase in the number of people living with HIV. 3. The main causes of death from HIV infection (AIDS) are pathologies with primary respiratory system damage: tuberculosis and pneumonia, which requires special attention in developing approaches to diagnosis, recording, treatment and prevention of these diseases, as well as assessing the impact of vaccination of patients with HIV infection against pneumococcus on mortality from pneumonia. 4. The increase in ART coverage of all patient populations contributes to the stabilization of mortality from HIV/AIDS.

Conclusions: the most important for assessing the impact of ongoing efforts of the health system to reduce mortality among HIVinfected patients is the correct registration and diagnosis (including posthumous) of AIDS-indicative diseases, certainly associated with the progression of HIV infection. 

A retrospective descriptive epidemiological study of an incidence rate and prophylaxis of tick-borne encephalitis (TBE) was carried out in the Republic of Khakassia over 2007–2016. Also, a relative risk (RR) of the incidence rate was assessed in the cohorts of vaccinated and unvaccinated population. Over the decade, 569 TBE cases were registered. There is a distinct tendency of TBE rate reduction (slope coefficient of the regression line b = –1.1 per annum, P < 0.05) as well as an expressed irregularity in the territorial distribution of longterm average annual rates in various towns and rural districts (from 0.9 up to 44.2 cases per 100 thousand people). In the vaccinated population cohort the TBE was registered 22.8 times less than in the unvaccinated one: χ2 = 23.78 (P < 0.001); RR = 3.1 (1.9–4.9). As the extend of mass-vaccination (b = 0.06 per annum, P < 0.05) and the area of acaricide treatments (b = 0.09 per annum, P < 0.05) were increasing, the number of virus-carrying ticks was reducing (b = –0.09 per annum, P < 0.001). The results of the comparison analysis of affect to the incidence of TBEcontrollable and uncontrollable factors in the territories with various rates of incidence prove the practicability of a risk-based approach to the prophylaxis of tick-borne encephalitis. 

The threat of cholera spread beyond the borders of endemic countries and the realness of the emergence of introduced epidemic foci remain the actual problems and neccessitate continuous development of specific prophylaxis of this disease. The review is dedicated to the analysis of the effectiveness of licensed cholera vaccines as well as to possible perspectives of the advancement of cholera specific prophylaxis. 

Relevance. Pregnant women are often exposed to respiratory viruses. Occasionally, the fetus may be harmed by the virus.

Goal to present materials revealing the safety and effectiveness of local interferon therapy used in the initial stage of acute respiratory infection in pregnant women from 14 weeks of gestation.

Materials and methods. An in-depth analysis of the results of a study of the safety and efficacy of local interferon-therapy of respiratory infections presented in more than 60 literature sources, and own research.

Results. It is shown that the inclusion of interferon-α2b (Viferon®) preparation in the complex of basic ARI therapy in pregnant women leads to a decrease in the content in the nasal washout of IL-8, the growth of T-lymphocytes and T-helpers, a more pronounced tendency to decrease natural killers; positively affects the microbiocenosis of the mucous membranes of the upper respiratory tract; leads to a reduction in symptoms of acute pharyngitis, bacterial complications from the upper respiratory tract and, as a consequence, minimizes the need for systemic antibacterial therapy.

Conclusions. The conclusion is made about the expediency of including the recombinant interferon-α2b (Viferon®) preparation in intranasal gel form in the complex of basic ARI therapy in pregnant women. 

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. 

Vaccines for many years act as one of the most effective and successfully used medicines. Vaccines obtained by traditional methods contain in their composition live, weakened or killed microorganisms (bacteria, viruses, etc.). Now more often, modern, split, subunit, recombinant, polyvalent and some other types of vaccines are being used. The addition of adjuvants to vaccines generally increases the immune response to their administration. It was established that the formation of postvaccinal immunity begins immediately after the introduction of the vaccine, by activating the factors of innate immunity in the interaction of pathogen-associated molecular patterns (PAMPs), in vaccines, with the pathogen-recognition receptors (PRRs) of the immunocompetent cells of the recipient. It is also shown that PRRs activators, including TOLL-like receptor agonists (TLRs) and poly (I:C) polynucleotide oligomers of inosine and cytidylic acids, have the ability to substantially increase the immunogenicity of vaccines, and attempts are being made to use them creation of new types of adjuvants. Defective interfering viral particles (D-particles, DIPs) are also classed as effective stimulants of innate immunity and can also be considered promising vaccine adjuvants. 

The history of the study of infections attributed by the microbiologist and epidemiologist V.I. Tersky in 1958 as the class of human infectious diseases – «Sapronoses» is presented. Over the past 60 years in the world and especially in Russian science the knowledge that allows us to complete the development of an ecological and epidemiological theory of sapronoses infections was accumulated. This knowledge should be extended to the whole complex of biomedical sciences associated with the population pathology of biota. To solve the controversial and complex issues of the theory, terminology and classifications of population infectology, it is necessary to integrate the knowledge of specialists in various fields of research and practice in the medicine, veterinary medicine, parasitology, phytopathology and other disciplines. The ways and prospects of improving the general theory of infectology in the light of new approaches to understanding the essence of sapronoses are discussed. 

Interregional Scientific and Practical Conference "Prospects for the Prevention of Infections Managed by Immunoprophylaxis".

Review on the monograph by V. V. Shkarin, A. S. Blagonravova «Epidemiological features of co-infections».

V. I. Zlobin – 75.

H. К. Rafiev – 80.

The List of Endemic Territories for Tick-Borne Virus Encephalitis in 2017.

http://www.rospotrebnadzor.ru/deyatelnost/ epidemiological-surveillance/

WHO Europe/ECDC Joint Statement: Low Uptake of Seasonal Influenza Vaccination in Europe May Jeopardise Capacity to Protect People in Next Pandemic.

http://www.euro.who.int/

High Levels of Antibiotic Resistance Found Worldwide, New Data Shows.

World Leaders Join New Drive to Beat Noncommunicable Diseases.

Europe Observes a 4-Fold Increase in Measles Cases in 2017 Compared to Previous Year.

Lee N., P. K. Chan, Beigel J. H. The role of adjuvant immunomodulatory agents for treatment of severe influenza. Antiviral Research. 2018; 150: 202–216.