Relevance. Early recognition of the beginning of the epidemic in the country and its individual Federal Districts determines the possibility of timely introduction of anti-epidemic measures in the country as a whole and at the regional level, which helps to reduce the incidence rate and socio-economic damage from influenza. The aim of the study was to improve the traditional surveillance of influenza and common cold in Russia in accordance with the requirements of the World Health Organization. Materials and methods. Weekly epidemic thresholds (NEP), as well as baseline (BL) and epidemic intensity thresholds, were calculated on average for the entire population of the cities and individual federal districts observed. Results and discussion. For the first time, as an additional criterion of the epidemic and its intensity, the baselines and intensity thresholds for the incidence of «influenza» and hospitalization with a diagnosis of «influenza» for the entire population and different age groups of the Russian Federation and the total incidence of influenza and ARI at the regional level were calculated and tested. Epidemic 2019, in terms of the total incidence of influenza and ARI, separately «influenza» and hospitalization with a diagnosis of «influenza», was average in terms of intensity, as the previous (2018). The baselines and thresholds of the intensity of the epidemic on the total incidence of influenza and ARI for the Federal districts and, in addition, separately influenza for different age groups of the population of the country revealed the order of involvement in the epidemic and the different intensity of the epidemic in the Federal districts and age groups. This season in the country as a whole at the beginning of the epidemic was more sensitive weekly epidemic threshold, and at the end – post epidemic baseline of influenza and ARI. Сonclusion. The baseline incidence of «influenza» and a hospitalization with a diagnosis of «influenza» was more sensitive than the weekly epidemic thresholds and the baseline cumulative incidence. Baseline «influenza» morbidity and hospitalization with a diagnosis of «influenza» may be additional signs of the epidemic, revealing the initial and residual circulation ofinfluenza, mainly at a sporadic level.

Relevance. HIV-infection continues to be one of the unsolved issues of modern healthcare. In the Russian Federation, an annual increase in the number HIV-infected people including co-infected with HIV and viral hepatitis is registered. This is associated with common transmission mechanisms of the diseases. Objective: to conduct a retrospective analysis of the main HIV-infection epidemiological indices that included prevalence of viral hepatitis B and C among people living with HIV in the Far Eastern Federal district during years 2006–2018. Materials and methods: the conducted retrospective epidemiological analysis was based on evaluation of materials provided by AIDS prevention and control regional centers as well as in the official statistical data form № 61 «Data on HIVinfected contingents». Analysis of the obtained data included parametric and nonparametric statistics. Results. A deterioration of the epidemic situation concerning HIV-infection with and without viral hepatitis B and C was registered in the Far Eastern Federal district. The fraction of HIV-positive people aged 40 years and older increased up to 24.68 ± 0.26% in 2018. Feminization of HIV-infected population was observed. The fraction of HIV-positive women increased from 32.30 ± 0.50 % in 2006 to 36.82 ± 0.29% in 2018. The fraction of sexual transmission mechanism of the HIV has increased during the observed period of time and totaled 40.60 ± 0.30% in 2018. This fact plays a significant part in the spread of HIV in the Far Eastern Federal district. Conclusion. The revealed tendencies indicate a necessity of changing the preventive measures strategy against HIV.

Relevance Natural tularemia foci are widespread in Altai Krai and Republic Altai and characterized by high functional stability. Aim. To study modern epidemiological and epizootological features of natural foci of tularemia in the Altai region Russia. Materials and Methods The current state of small mammal number in the region is examined. Results of complex studying of 14 Francisella tularensis strains isolated in Republic Altai from 1950 to 2015 (from the collection of Museum of live cultures in Irkutsk Antiplague Research Institute of Rospotrebnadzor) and 21 strains isolated in 2016–2018 in the Altai region are presented. For the first time the tularemia causative agent was isolated at this territory in 1940s. Water vole (Arvicola amphibius) is the most epidemiologically significant as the infection source in these foci. Ixodes ticks: Dermacentor silvarum, D. reticulatus, D. marginatus, Haemaphysalis concinna, Ixodes persulcatus are the main vectors. Now Francisella tularensis subspecies holarctica circulates at Altai territory, and since 2011 additionally F. tularensis mediasiatica. Conclusions The functioning of the natural center of tularemia in the territory of the Altai region in the modern period is characterized by coupled circulation of the causative agent of tularemia of two subspecies, sporadic cases of tularemia diseases and infection by the causative agent of environmental objects (bloodsucking arthropods, open water, small mammals). All this indicates a high activity of natural foci with respect to this especially dangerous natural focal infection.

Relevance Measles continues to be one of the priorities of health care worldwide, due to it high contagiosity, still widespread, severity of the disease and complications. A high degree of population migration contributes to the spread of infection, i.e. global measles virus circulation, clinical change and late diagnosis, inadequate immunization coverage. Aim. Analysis of measles incidence in the Republic of Moldova in 2000–2018. and features of the epidemic process. Materials and Methods. Statistics on measles incidence and immunization coverage in 2000–2018 were used. 340 cases of measles registered in the country in 2018 were subjected to a detailed analysis Results There is a decrease in measles vaccination coverage, in 2017–87.1%. In the same year, the coverage with the first revaccination at 6–7 years was 92.4% and the second at 14–15 years is 94.9%, which is not enough to maintain epidemiological well-being. There are territorial differences in vaccination coverage. In 2018, imported cases of measles were in 62.5% from Ukraine, 25.0% from Russia and 12.5% from Romania. There have been isolated measles cases (14), and epidemic foci or outbreaks (7), with from 2 to 252 cases of measles. The largest measles outbreak in 2018 was registered among those who rest in a religious camp unvaccinated against measles. The average age of the diseased is 14 years, and in outbreaks with a significant number of cases (9 and more) within 7.9–14.9 years. In the age structure of the diseased, children from 1 to 10 years old prevail (66.1%), children under one year old make up 8,2%, teenagers 17,5% and adults 8.2%. Only 11.0% received one dose of measles vaccine, and 3.6% of the relevant age groups received two doses of vaccine. The reason is the refusal of vaccination for religious motive. In 196 (57.6%) cases, the diagnosis was confirmed by laboratory methods, and in the remaining 144 (42.4%) by clinical and epidemiological data. Conclusions Measles remains a childhood infection, but cases of the disease occur among adolescents (17.5%) and adults (8.2%). The uneven of vaccination coverage throughout the country, the low level of responsibility of the population, the increased incidence of measles in neighboring countries, the high level of population migration are risk factors for the importation and spread of measles.

Relevance. The problem of the cyclical nature of the epidemic process (EP) in various infections, including tuberculosis, remains poorly understood. Aim. To study the cyclical nature of the epidemic process of tuberculosis using the example of the territories of the Primorsky Territory and the Republic of Sakha (Yakutia). The accounting and reporting documents of official medical statistics were used. The incidence of tuberculosis in the population of Primorsky Krai was analyzed from 1951 to 2016, the Republic of Sakha (Yakutia) – from 1962 to 2016. For comparison, we used data on the incidence of tuberculosis in the Russian Federation for 1960–2016. Results and discussion. On the basis of data for more than a 60-year period, the dynamics of the development of EP of tuberculosis among the population of the Primorsky Territory and the Republic of Sakha (Yakutia) was studied in comparison with that of the Russian Federation as a whole. Conclusion. It is shown that the dynamics of the incidence in the analyzed territories is characterized by synchronism and two periods of an increased incidence rate are distinguished in it: the 50s – the beginning of the 70s of the last century and from the end of the 80s to the present.

The First Russian Conference with International Participation «Malignant Tumors Associated with HPV. Primary Prevention and Screening».

Relevance. Hemorrhagic fever with renal syndrome (HFRS) is a non-transmissible viral zoonosis widespread in Eurasia, and in Russia it occupies a leading position among zoonotic viral infections and one of the first places among all natural focal human diseases. Aim. Obtaining evidence of the safety, quality and efficacy of a polyvalent vaccine against HFRS as a result of its preclinical studies using scientific assessment methods that meet the requirements and rules of good laboratory practice. Materials and methods. For preclinical studies of the polyvalent vaccine against HFRS, the materials and methods were used in strict accordance with the requirements of the regulatory documents, as well as previously described methods used to control the vaccine at the technological stages of its manufacture. Results. The data obtained as a result of preclinical studies of the polyvalent vaccine agains HFRS indicate a high immunogenicity and stability of the vaccine, the absence of: acute and chronic toxicity, allergenic, immunotoxic and mutagenic, as well as toxic effects on the reproductive organs of animals, embryo development and offspring, born to females who received the vaccine within 20 days of gestation. Conclusion. The obtained results of preclinical studies comply with the requirements for immunobiological medical preparations designed for humans, and are the basis for conducting the 1st phase of clinical trials the polyvalent vaccine against HFRS.

Relevance. Acute respiratory diseases (ARD) occupy a leading position in infectious pathology. Patients who often suffer from the acute respiratory diseases, in most cases have an ENT pathology against the background of immunodeficiency state. Large groups of people are often affected by such diseases. As a rule, the causative agents of such diseases are pathogenic and conditionally pathogenic microorganisms. To solve this problem, therapeutic immunomodulatory vaccines have been proposed. The goal of such drugs is to enhance specific resistance to a large number of conditionally pathogenic microorganisms. Aims. The purpose of this work is to demonstrate the prophylactic, therapeutic efficacy and immunomodulating safety of a metabiotic preparation produced from symbiotic corynebacteria. Materials and methods. A medicine Kodivak, a structural component of the cell wall of the symbiotic corynebacterium (Corynebacterium diphtheriae (tox +) was used in the work. The study on long term Cd tox + bacteria carriers examined the therapeutic efficacy as well as immunomodulating safety of Kodivak compared with some vaccines. Results and discussion. All carriers who have undergone the treatment with Kodivak stopped the release of Cd tox +, which was confirmed by a bacteriological analysis, and the condition of the oropharynx corresponded to the physiological norm. The quantitative indicators of the content of lymphocytes in the blood of the long-term carriers of C. diphtheriae tox + were determined before and after the course of treatment with Kodivak. Selective immunocorrecting effect of Kodivak on the human immune system is shown. A comparative analysis of post-vaccination changes in the number of immunocompetent cells of patients immunized with different vaccines showed that medicines containing antigens that are responsible for pathogenicity stimulate the state of immunodeficiency at a certain stage. While Kodivak does not cause significant deviations in the composition of the subpopulation of lymphocytes from the physiological norm. Conclusions. The findings confirm the possibility and necessity of using Kodivak not only for the rehabilitation of long-term carriers, but also both for therapeutic and prophylactic purposes in the risk groups of ARD morbidity of microbial and viral etiology as well as a nonspecific immunomodulating agent for the restoration of microsymbiogenesis in the upper respiratory tract biotopes.

Aim. To compare by flow cytometry the cellular immune status indicators in persons, living on the territory of the Caspian sandy natural plague focus for epidemic indications. Materials and methods. Whole blood leukocytes of 120 people were examined by flow cytometry with using the two four-color labeled monoclonal antibody reagents (Cyto-Stat CD45-FITC, CD4-PE, CD8-ECD, CD3-PC5 и Cyto-Stat CD45-FITC, CD56-PE, CD19-ECD, CD3-PC5) and by means of CD95-FITC reagent. The results were taken into account before and in a month and 6 months after vaccination. We were determined in the blood the relative content of lymphocytes, monocytes, granulocytes, leukocytes carrying an early apoptosis marker (CD95), T and B- lymphocytes, NK cells as well T – lymphocyte helpers (Th) and cytotoxic T-lymphocytes (Tcyt) for immunoregulatory index (IRI) calculation. Results. Before anti-plague vaccination in 14 people (11,7%) were found abnormally low immunoregulatory index values characterized the immunodeficiency state (IRI <1) and noted less intensive and less prolonged immune system cell reaction in response to anti-plague vaccination. In the other surveyed persons IRI were registered before vaccination in the range 1,4-1,5 with a smooth increase in it a month after vaccination and with preservation of the established IRI interval in a range 1,6-1,8 later 6 months after an inoculation. Conclusion. To estimate the effectiveness of anti plague vaccination within the framework of the ongoing measures quality monitoring to ensure sanitary and epidemiological welfare of the population, living on territory of the natural plague foci, the timely immune status monitoring is important in persons at risk for plague infection (hunters, shepherds, agricultural workers, medical workers).

Relevance. The rotavirus infection (RI) is one of the leading causative agent in the structure of acute enteric infections, established etiology. Long term epidemiological monitoring RI was shown that Podolsk-city in Moscow region was unfavorable place concerning prevalence of RI. Aims. Studying epidemiological efficiency and collective immunization safety of infancy children in Podolsk-city, Moscow region. Materials and methods. Registration rates of this morbidity and coverage of RI prophylactic immunization were analyzed on the basis of formal registration forms, epidemiological detection cards, out-patient cards for observation over a patients, medical reports, case register in policlinics and hospitals, vaccination documents (f. № 5, f. № 6, f. 025/a, f. 058/a, f. 060/a, f. 063/a, f. 064/a). RI data have been provided over a period of time from 2008 to 2018. Data coverage of vaccination have been given from 2015 to 2018. Used method is statistic observation. Results. Vaccination program concerning RI has been implemented in Podolsk-city from 2008 till 2018. Babies at breast in their first being were vaccinated. Live pentavalent was used for immunization. The coverage target contingent of vaccination reached 68%. This preparation was withstood by children well, unwanted effects and intestines invaginations during the vaccination were not registered. During vaccination, the number children gone to hospital with acute intestinal infections was decreasing annually. The number of children to hospital admissions at the age of one year decreased from 15.8 to 12.5%, at the age of 2–3 decreased from 43.8 to 36.3%, with small increase in specific weight of patients of an age group of 7–14 years from 7.70 to 11.2%, but at the reduced total number of inpatients of this age category. Reduction of RI morbidity marked as in target age group as in another groups which were not vaccinated. Thus, formation of population benefits was confirmed. Conclusion. Clinicoepidemiologic research paper was studied in 2014–2018 allowed to make a conclusion that the cohort immunization of infancy children with the rotavirus infection, contributes to decreasing rate morbidity in certain territory Moscow region which had surpassing factors of this infection in comparison with other cities. The number of covering collective immunization was not lower 60% of infancy children and assisted falling enteric infections in their 0–6 years, made a big impression on reducing of acute intestinal diseases among all age groups during immunization implementation company within three years.

Relevance. For decades, many aspects of aerosol transmission of hospital pathogens have been and remain the subject of scientific debate. Despite fairly detailed studies of the mechanism of microbial aerosols formation, distribution, the role of particulate matter in the formation of antibiotic resistance and multidrug-resistant hospital clones of microorganisms is still unclear. Aim. To investigate physicochemical properties and microbiological diversity of hospital particulate matter. Materials and Methods. Shape and size of particulates was assessed by means of scanning electron microscopy and dynamic light scattering while elemental analysis was performed using energy-dispersive X-ray spectroscopy and high-temperature catalytic oxidation. Microbial profiling was conducted using polymerase chain reaction and Vitek 2 biochemical analyzer. Results. Hospital particulate matter included globular and fibrillary particles consisting of carbon, oxygen, calcium, silicon, aluminium, and sulfur. Intriguingly, microfiber particles had higher oxygen and calcium content along with the lower level of carbon in mineral but not organic component. Differential localisation of silicon and calcium in elemental mapping suggested that hospital particulate matter was composed of aluminosilicate minerals and calcium compounds. Among the microorganisms, we found multidrug-resistant strains Raoultella ornithinolytica, Staphylococcus pseudintermedius, Pantoea spp., Pseudomonas aeruginosa, Enterococcus faecium and additionally Pasteurella canis in hospital particulate matter samples. Conclusions. Particulate matter in the hospital environment might be considered as a potential reservoir for the evolution of antibiotic resistance and multidrug-resistant strains.

Relevance. Bronchial asthma is widespread in the world, according to WHO estimates, 235 million people suffer from it. In Russia, according to official figures, 1.3 million cases of bronchial asthma have been reported. Domestic experts reasonably believe that these data are underestimated at least 4 times. Considering that patients with bronchial asthma undergo significant changes in the immune system and are especially difficult to tolerate respiratory and other infectious diseases, determining the effect of vaccination on the clinical course of bronchial asthma is very important. The purpose of the review is to show how vaccinations against pneumococcal infection and influenza affect the condition of patients with bronchial asthma. Conclusion. Features of formation of protective immunity at various schemes of immunization against pneumococcal infection are analyzed. In patients with bronchial asthma, the justification of the vaccination scheme with the advantage of the priority administration of conjugated polysaccharide vaccine with the subsequent introduction of a polysaccharide pneumococcal vaccine after 8 weeks is given. Vaccination against pneumococcal infections has led to the elimination of sputum S. рneumoniae. In vaccination against pneumococcal infection, there was an improvement in the level of disease control, which was confirmed by the ACQ-5 test-a decrease in the indicator from 2 [1,5;1,8;3] points (lack of asthma control) to 0,6 [0;1] points (asthma control) during the year of observation, p < 0,001. Vaccination against influenza in patients with bronchial asthma leads to a decrease in the frequency and duration of exacerbations, there is a decrease in the level of markers of systemic inflammation. Combined vaccination against influenza and pneumococcal infection is not accompanied by a reliable difference in tolerability in comparison with monovaccination only against pneumococcal infection or influenza.

Relevance. Vaccination remains the basis for the prevention of the most severe infectious diseases, including the prevention of influenza. The large number of vaccines have been developed and applied currently. The role of adjuvant vaccines is growing. Aims: To look back to the history of adjuvant vaccines and review the literature on clinical trials of influenza vaccines Grippol family. Conclusions: This review summarized principal data on adjuvanted vaccines containing Polyoxidonium as adjuvant which has been used for the production of Grippol family vaccines for more than 22 years. Grippol family vaccines show a high safety profile and good immunogenicity for vaccineers, including those with low responsiveness. In 2008 the vaccine Grippol® plus was approved in Russia. It contains a reduced antigen doses and adjuvant Polyoxidonium, but unlike the vaccine Grippol® is free from preservative thiomersal. There are no serious post-vaccination events, unexpected reactions, post-vaccinal complications to the vaccine were reported for Grippol regardless of the examined contingent. The Grippol® plus vaccine effectively induces the immune response. Adjuvanted lowdosed vaccines Grippol® and Grippol® plus are proved to be safe and effective and to have a good prophylactic efficacy being applied for mass immune prophylaxis. In 2018 new tetravalent influenza vaccine of Grippol family – Grippol® Quadrivalent was approved in Russia. Clinical studies (Phase I-II-III) have shown that the vaccine meet the immunogenicity criteria for inactivated influenza vaccines. Phase 3 clinical trials to expand the indications are continuing. The polymer adjuvant in the vaccine is shown to provide a high immunogenicity of low doses of subunit antigens; all Grippol family vaccines have a high safety profile; the dose reduction of viral antigens reduces the risk of adverse reactions for immunized. The adjuvant in the vaccine effectively stimulates an immune response and has no negative impact on the human health. The physicochemical properties of Polyoxidonium (INN: Azoximer bromide) let to consider Polyoxidonium as an universal adjuvant for different antigens.