Relevance. The influenza vaccine can reduce the incidence and mortality from influenza if that are antigenically the same or related to the viruses. There are at least 3 levels of prediction: vaccine strains for the upcoming epidemic season; the trend of influenza viruses for 2–3 years ahead, the emergence of pre-pandemic virus strains. The aim of the work was to analyze the potential of bioinformatics to implement prediction at these 3 levels for subtypes H1N1 and H3N2. Materials and methods. For the computer analysis, the database of the hemagglutinin (HA) primary structures of the H1N1 and H3N2 strains isolated in the influenza epidemiological season 2016–2017 – 2018–2019 was used from the Internet. At the first prediction level, an adapted hidden Markov model was used, at the second, invariants were searched for НА H1N1 and its antigenic sites, and at the third level, prediction was based on identifying invariants in structural proteins of pandemic strains. Results. The circulation of several dominant strains in the epidemiological season 2018–2019 was predicted, the existence of invariants in НА Н1 and its antigenic sites НА H1N1 was shown, and it was concluded that the threat of an influenza pandemic caused by avian influenza viruses was unlikely. Conclusion The bioinformatics approach can be considered as a valuable tool in predicting, at different levels of circulation, certain strains of the influenza virus in the epidemic season.

Relevance. In the context of high coverage of the population with preventive measles vaccination (more than 90% according to official statistics), in recent years there has been a complication of the epidemic situation for this infection, which necessitates an in-depth study of the causes and factors that contributed to the increase in morbidity. The aim of the study was to assess the susceptibility of the population of Moscow to measles on the basis of preventive vaccinations coverage data in a planned immunization and on epidemic indications. Materials and methods. To achieve this goal, epidemiological, statistical methods and Geographic Information System (GIS) technologies were used; the electronic database of materials of sanitary and epidemiological investigation in measles foci was created. Results. Тhe practical applicability of the proposed approach was shown, risk groups for measles incidence were identified. Due to the low coverage of routine preventive vaccinations and epidemic indications (compared with official statistics), the most vulnerable to measles are the age groups from one to two years and from three to six years, where these indicators were the lowest among the total population surveyed (routine and epidemic indications: about 55.9%, 10.8% and 75.3%, 40% respectively). Among the adult population, a decrease in the coverage of preventive vaccinations was revealed as the age of contact persons increased from 81.3% in the age group 20–35 to 51.0% in the age group 36 years and older. With the help of GIS technology, the possibility of visualization of the disease spread in a specific period of time in a certain area of the observed city was shown. Conclusions. According to the results the situation with measles in Moscow remains tense. There is a need for correction of the population immunization with the aim of increasing vaccination coverage in the individual age groups, and correction of statistical accounting of the facts of vaccination.

A research objective – definition of the main directions of improvement of epidemiological control of a pertussis on the basis of studying of manifestations of epidemic process and its determinants. Materials and methods. The analysis of incidence is carried out according to official statistics in 19 years, the population antipertussoid immunity is studied by results of routine serological monitoring and specially organized screening researches. At discussion of results and development of recommendations WHO recommendations and the published articles of domestic and foreign authors are used. Results. Activation of epidemic process of pertussis in modern conditions in all age groups of the population is revealed. Risk factors of incidence of children about one year and the main sources of their infection, low level of a seroprotektion at children of 3–4 years old, the hidden circulation of Bordetella pertussis in group of children of 6-7 years, high susceptibility to whooping cough of adult population, including pregnant women are established. Conclusion. The directions of optimization of vaccinal prevention of pertussis are defined: strengthening of supervising functions behind completeness and timeliness of immunization of children of the first year of life; wider use for immunization of children from risk groups of the combined vaccines containing an acellular component; to enter into the National schedule according to epidemic indications a revaccination against pertussis of children of of 6–7 years and adults from groups of epidemiological and social risk with the subsequent step-by-step introduction of a revaccination of teenagers and adult each 10 years along with diphtheritic and tetanic anatoxins.

Background. Ixodid tick-borne borrelioses (ITBB) is the most prevalent in Northern Hemisphere group of transmissible Spirochaetal infections, ecologically connected with Ixodid ticks. ITBB are etiologically associated with several agents, which determine epidemiological and clinical manifestations of these diseases. Research aim - the detection of ecological and epidemiological peculiarities of ITBB manifestations in the Baikal Region during the long-term period by comparison with that in the other parts of geographic range and the analysis of the manifestations dynamics. Material and methods. The database, developed by the authors, with information about ITBB cases in Irkutsk (1995-2017, n = 867) have been used in the work, and the similar studies in Russian and world literature have been reviewed. Statistical analysis was computed in Microsoft Excel Software. The map of infecting sites is made in ArcGis Soft (ESRI, USA). Results. The data have been analyzed on ecological and geographical (place and time of the infected tick bite), epidemiological (gender, age, localization of the tick bite, form of the disease), social and behavior (employment and circumstances of the infecting, including professional risk activities) signs. The interrelationship of some of them and their temporal evolution was studied. Similarities and differences of the ITBB manifestations in Baikal Region and other parts of the disease area have been revealed. The following peculiarities of ITBB in Baikal Region were found: 1) the average age of the patients is over 40; 2) a slightly higher number of males between the patients (57.3%); 3) increase (from several cases up to 40-47%) in the proportion of ITBB form without skin manifestations from the beginning to the end of the analyzed period; 4) the significant age difference between patients with and without skin manifestations (primarily persons over 50 and mainly the children respectively).

The purpose of this study is to assess the dynamics of the incidence of prostate cancer in the Omsk region for the period 2006– 2017. Materials and methods. A retrospective epidemiological analysis of data from statistical reports (Form No. 7) of the Omsk Oblast health authorities for the period 2006–2017 was carried out. Results and its discussion. In the structure of oncological morbidity in the male population of the Omsk Region, the proportion of prostate cancer was 16.3% and was lower than the average Russian average (17%). In rural areas, compared with the regional center, higher rates of increase in the incidence of prostate cancer were observed (by 1.2 times). In general, the situation on the territory of the Omsk Region is similar to the global trend, characterized by an increase in the incidence of the male population of prostate cancer, which is a reflection of insufficient attention to primary cancer prevention, features of the socio-economic situation in the Russian Federation. Findings. 1. In the long-term dynamics of incidence of prostate cancer in the region for the period 2006–2017. there was a moderately pronounced upward trend in indicators (Tpr. = 3.94%; p < 0.05), with higher growth rates (1.2 times) in rural areas compared to the regional center (respectively, 3.56% and 3.04%; p < 0.001). 2. From 2006 to 2017 incidence of prostate cancer in the Omsk region increased 2.3 times in total (from 29.2 to 66.2 per 100 ths) and 1.8 times in standardized indicators (from 24.8 to 44.4 per 100 ths). 3. Despite the obvious relevance of the pathology, the prevalence of known risk factors for the development of prostate cancer in the Omsk Region has not been studied sufficiently, which requires scientific justification and improvement of approaches to primary prevention with regard to regional characteristics. 

Background:  Hemodialysis is the most common method of renal replacement therapy (RRT), however, its use is associated with risk of catheter-associated bloodstream infections (CABSI). Aims: diagnosis of epidemic trouble on CABSI in multidisciplinary adult hospital associated with the epidemic outbreak of CABSI in patients in RRT, and evaluation of complex of anti-epidemic measures. Materials and methods: in the framework of risk-oriented  epidemiological surveillance retrospective and operational epidemiological analysis of morbidity of CABSI and integrated clinical-epidemiological and microbiological examination of cases of outbreak was carried out. The study included patients with central venous catheter (n = 1295), patients receiving renal replacement therapy (n = 235), patients with CABSI (n = 48). 47 S aureus strains were studied, 520 researches were conducted. Results: An outbreak of CABSI of staphylococcal etiology (morbidity 33.01 per 1000 catheterized patients, 95% CI 21.31–44.71), had occurred from September to October 2016, involving 4 departments, manifested as 7 cases of CABSI in patients with RRT and actively identified 4 cases asymptomatic carriers of S. aureus in patients and one staff member of the Office of dialysis (incidence rate – 33.01 per 1000 catheterized  patients, 95% CI 44.71–21.31). Sources of infection have served as carriers of S. aureus among patients and staff. Contact pathway of transmission. Place of infection – dialysis department. Cause of the outbreak was the infection of patients in the RRT the hospital S. aureus strain circulating in this hospital with contamination of environmental objects and the formation of a reservoir among personnel and patients. To eliminate the outbreak, a set of measures was carried out, including optimization of monitoring of invasive manipulation of central venous catheterization, elimination of violations of epidemiological safety requirements, disinfection regime change, biological disinfection by bacterial phagocyte, decolonization of  S. aureus carriers by  bacterial phagocytes. The incidence rate decreased 1.8 times in 2017 compared to 2016, respectively, 12.5 per 1000, 95% CI 10.23–14.77) vs 22.8 per 1000  (95% CI: 22.5–23.1) of catheterized patients. Conclusion: the epidemic outbreak of CABSI in multidisciplinary hospital was identified and eliminated, The outbreak was the result of the circulation in the hospital of S. aureus hospital strain, which formed a reservoir among personnel and patients.

Background. Brucellosis is an acute infectious-allergic zoonotic disease in which sick farm animals are the main source of infection for humans. Immunization of animals and people on the territory of Russia is carried out by live vaccines, which, having a high immunogenicity, can cause clinical, hematological and immune changes. Therefore, the work on the design of new vaccines that provide high protection and do not possess reactogenicity, agglutinogenic and sensitizing activity is the current direction of the study. Methodology. The study was performed on 72 outbred white mice immunized with inactivated B. abortus 19 ВA vaccine and thermal extracts (TE) of B. abortus I-206 in L- and S-form. Morphofunctional changes in the regional lymph node, spleen, and thymus of experimental animals were examined on days 3, 7, 14, and 21 of the time of immunization. Results.The influence of single introductions thermoextracts B. abortus I-206 in L-and S-form in comparison with inactivated vaccine B. abortus 19 ВА. the removal or the morphohistologic indices of immune organs of experimental animals. Found that thermoextracts have the ability to activate immune adjustment within the structures of the spleen and lymph nodes, without causing side effects, including allergic reactions. Conclusions. Preparations obtained from B. abortus in the L- and S-forms have the ability to activate immunological rearrangement in immunocompetent organs without causing any side effects. The results indicate the promise of further research in this direction.

The aim of the study was to assess the level of vaccination and the state of tension of diphtheria antitoxic immunity in the population. Materials and methods. The level of inoculation and the state of tension of anti-diphtheria antitoxic immunity were determined for the period 2013–2017 among the population of Rostov-on-Don and the Rostov region (children 3–4 years old (1075 people), teenagers 16–17 years old (1107 people), adults 18 and older (1818 people). Discussion. The vaccination coverage of the child population was 98.5–99.2%, adolescents – 98.8–99.8%, adults – 98.0–98.7%. When assessing the level of anti-diphtheria antitoxic immunity, it was established that the number of seropositive to diphtheria among children was 96.1 ± 0.6% of the examined, adolescents – 98.0 ± 0.4% of the examined, adults – 91.5 ± 0.6% of the examined. The highest indices of the level of antitoxic immunity to diphtheria, assessed by the number of both seropositive and persons with high antitoxin titers (82.3 ± 1.1% of the examined) were found among adolescents. The results of the serological monitoring of anti-diphtheria antitoxic immunity as a whole confirmed the data on the almost complete vaccination coverage of the population and indicated a high level of its tension. Conclusion. Vaccination and timely vaccination against diphtheria ensured a successful diphtheria situation in the region.

Hepatitis A (HA) is one of the most widespread intestinal infections. At present, selective and planned vaccination strategies against HA are used in different regions of the Russian Federation. The goal is to characterize the peculiarities of the manifestation of the epidemic process of HA at the regional level before and after the start of selective vaccination of the population. Materials and methods. A descriptive retrospective epidemiological study on the materials of the Irkutsk region for 1955–2017 was conducted. The incidence in the years before and after the start of vaccination were compared (2003). Municipalities with different incidence of HA were compared by the nature of water sources, bacteriological and chemical indicators of water.  Resutls. Long-term movement of the incidence was divided into three periods. In 1955–1980 there was a growth trend, then the incidence decreased until 2005, after which it stabilized (annual average growth rates + 2.4%, – 2.5%, – 0.2%). Until 1992, the incidence exceeded 100 per 100 thousand population. After 2003, 1-7 thousand people were vaccinated per year (no more than 0.3% of the total population). The total number of vaccinated people for 2003–2017 exceeded 30 thousand (1.3%). A weak correlation was observed between the number vaccinated people and HA incidence in the following year (ρ = 0.154, p >  0.05). After 2005, the incidence did not exceed 10 per 100 thousand; the structure of morbidity changed due to an increase in the proportion of children and the rural population. Seven high-risk and moderate-risk areas for HAV were identified, which had higher ranks in terms of bacteriological indicators of drinking water compared to areas with low incidence. The relationship between the characteristics of water supply sources and the HAVincidence rate in these groups of areas (х² = 2,527 р = 0.471) was identified.  Conclusion. The results of the study are in favor of the need to move from a selective to a planned strategy for vaccinating the population against HAV in rural areas, where it is not possible to quickly organize the supply of drinking water of guaranteed quality to the population.

Aim of research. To analyze the results of the examination of children diagnosed with EVI, meningeal form in the period 2010–2017 and to assess the level of production of viral neutralizing antibodies to enterovirus 71 in children against the background of increasing epidemiological significance of this pathogen. Materials and methods. Nasopharyngeal flushes and faecal samples (2–3 samples) served as the material for virological research. In total for the period 2010–2017 into work were taken the clinical materials from 3558 people hospitalized in infectious diseases departments of hospitals of the city of Ekaterinburg. Enteroviruses were isolated using the method of infection of transplanted cell lines (RD, ner-2 and L20B). For serological studies (PH with reference strain EV71) were used paired serum samples of the same patients (n = 3336), taken at intervals of 14–21 days. Results and discussion. The percentage of positive results (the presence of specific antibodies in the titer 1:8 and above) among all the examined persons as a whole was 35.5%. Proportion of patients with of titers of specific antibodies to EV71 in the annual section ranged from 41.9% (2013) to 24.4% (2015). The maximum number among the examined patients (n = 2634) was children aged 1–14 years. The largest number of children with the viral neutralizing antibodies to EV-71 was in the group of patients 12 years and older (45.6%). In young children (3–7 years), the proportion of persons with serum antibodies was 28.9%. Conclusion. The results of our studies confirm the presence of type 71 Enterovirus circulation in the territory of Ekaterinburg. The maximum risk of possible infection is in the group of children in the age of 1–7 years.

The objective of the research was to conduct a comparative analysis of HIV detection frequency in blood donors, medical practitioners and general population of the Far Eastern Federal district. Materials and methods. Analysis of the obtained data included general statistical methods involving parametric and nonparametric statistics. Results. During the years 2008–2017, an increase in medical examination coverage concerning citizens HIV-status was detected. The index in the Far Eastern Federal district in 2017 averaged 22.81 ± 0.02%. A moderate accession rate (2.86%) of HIV-infection cases detection was registered among blood donors during the studied period of time. In the group of medical practitioners HIV-infection accession rate was low (0.8%) and the trend can be characterized as relatively stable. Should be noted that HIV-infection among medical staff was not associated with professional performance. No correlation was registered between HIV abundance in general population, blood donors and medical practitioners of the Far Eastern Federal district. This fact potentially indicates on the isolation of the epidemiological process in blood donors and medical practitioners. Conclusion. Preventive work against HIV-infection and other hemotransmissive diseases among medical staff and general population needs to be strengthened in order to increase awareness concerning transmission routs of the infections and existing preventive measures.

Many issues concerning the organization of vaccination of the population in polyclinics still require improvement. The aim of the study is to assess the completeness and timeliness of vaccination of children in an outpatient setting and to identify factors affecting the adherence to vaccination of parents and medical staff. Materials and methods. The authors analyzed the history of child development and maps of preventive vaccinations of 631 children under 18 months of age to establish the completeness and timeliness of vaccinations against infections, approved by National immunization schedules. The authors analyzed the reasons for the lack of vaccinations and violations of the start and end of vaccination. To assess the population's attitude to vaccination, a survey of 865 parents and 1325 employees of medical organizations were conducted. In order to study the activity of discussion on the Internet issues related to vaccination, the number of records in the network on this topic and their content for 2007–2017 were analyzed. Results. The authors found that the coverage of children with vaccinations in the decreed age is insufficient and does not meet the requirements of National immunization schedules. The reasons for unvaccinated children in the maternity hospital were refusal of vaccination and medical contraindications (prematurity and low birth weight, respiratory failure, neonatal jaundice, HIV infection in the mother). In the clinic the leading causes of violation of the schedule of vaccination was temporary medical branches (the acute diseases), the late turnout at vaccination and refusals of immunization of parents. In assessing the attitude of parents to vaccination, the authors found that 79.3% of parents were positive, 6.4% – negative and 14.3% expressed doubts about the effectiveness and safety of vaccination. The main source of information was the opinion of health workers, among whom the survey revealed 187 people who are negative about vaccination. The opinion of relatives, friends and information received on the Internet were less authoritative. In assessing the monitoring data on the Internet, there was a significant increase in the number of people interested in and discussing the issues of vaccine prevention in social media, including their negative feedback. Conclusion. Authors recommend increasing the compliance of vaccine prophylaxis of medical workers, to form a positive attitude to vaccination among the population and to increase the coverage of vaccinations.

Objective: To estimate the registration quality of neonatal healthcare-associated infections (HAI) and intrauterine infections in separate maternity hospitals in Moscow. Material and methods: We carried out a retrospective epidemiological analysis neonates HAIs and intrauterine infections. In this study was conducted patients from Moscow during 2008–2017 and three maternity hospitals in Moscow during 2009–2017. These case study maternity hospitals would be known as MH № X01, № X02 and № X03. Also in this study we assessed postpartum woman’s HAIs morbidity in MH during 2009–2017. From these patients we selected cases where not only newborn suffered the disease but mother got sick neither. Then we analyzed on which day after day birth the child got the diagnosis HAIs or intrauterine infections. In addition, the quality of registration was established on the basis on Rospotrebnadzor order № 29 dated on 16.03.2018 «About an order of case registration of infectious and parasitic diseases in the city of Moscow». The data selection was from Statistical Reporting Form № 2 in Moscow. Also, were used data from infectious and parasitic diseases accounting and registration department of The Hygiene and Epidemiology Center in Moscow. The morbidity rate of HAIs and intrauterine infections of newborns was counted on 1,000 births newborns. The morbidity rate of HAIs of postpartum women was counted on 1000 births. For this purpose «Microsoft Office Excel 2010» software packages were used. The calculation of the increase/decrease rate was made by the method of least squares. Results: On basis of conducted analysis it was determined that morbidity HAIs newborn has tended to be on the decline, especially compared with a sharp and considerable increase in the intrauterine infections morbidity. This trend can be observed both in Moscow and in the three described MH. The incidence of HAIs of postpartum woman is represented by a single registration. It had been identified a minimal number of cases, when the disease was being recorded in both the mother and the baby. Analyzing the timing of intrauterine infections and HAIs diagnosis from the moment of birth, it was found that about a quarter of all cases of intrauterine infections should have been registered as nosocomial infections. According to the Order № 29 on the basis on the nosology list (diseases which can only be registered as HAIs) it was established that about 10% of cases of intrauterine infections was misdiagnosed. Thus, the analysis indicators once again do not refute, but only proves the poor-quality registration of moving the newborn HAIs and cases of intrauterine infections from one category to another. The identified problem is extremely relevant and requires action to solve it. Conclusion: Multi-criteria analysis, revealing the quality of newborns HAIs and intrauterine infections registration, such as an incidence rate, the ratio intrauterine infections and HAIs newborns, the number of the disease in mother and baby’s cases registration, compliance with normative documents, showed that official statistics are unreliable. The register system for the described infections is in needed of be reformed. First of all, it is necessary to standardize the diagnostic process, that mean the development of a standard case definition for each nosology among the HAIs and intrauterine infections.

Hemorrhagic fever with renal syndrome (HFRS) is a zoonotic infection disease caused by Orthohantavirus which belongs to Hantaviridae family. This article is a brief review of recent data about genetic factors which play a role in individual predisposition toward HFRS. There are reports discovered associations of polymorphic sites with HFRS severity and risk complications. Polymorphic sites in genes which code proteins of immune (МНС, TNF, IL1) and endothelial (VE-cadherin) systems, blood coagulation (SERPINE1, ITGA2B, NOS) and detoxification (CYP1A1, GSTP1) systems and their links with disease are described in this article. HLA haplotypes B*08-DRB1*03 and B*46-DRB1*09, B*51-DRB1*09 are associated with severe forms of HFRS-PUUV and HFRS-HTNV respectively. TNF A-allele and AA-genotype in -308G>A SNP (rs1800629), CDH5 ТТ-genotype in 1550T>C SNP, SERPINE1 G-allele in -844A>G SNP (rs2227631), alleles HPA3 b, NOS2A*11 and NOS2A*11/NOS2A*12-genotype, CYP1A1 1А2С-genotype in SNP (rs1048943) and GSTP AG-genotype in SNP (rs1695) demonstrated associations with severe HFRS. Differences in the expression levels of GATA3, T-BET, CD3, IFNβ, NFkB, STAT1 and MxA genes in cell cultures stimulated by hantavirus. Expression of GATA3 was significantly higher in cell cultures of patients with severe HFRS than with a mild form. In contrast, MxA gene expression was up-regulated in cell cultures of patients with mild HFRS-PUUV. Considering individual genetic factors of HFRS patients would allow defining the best tactic of therapy and prophylaxis in this way. And as a result of applying this treatment in the clinical practice decrease of unfavorable disease outcome would occur.