Relevance. Humanity has been confronted with the global spread of dangerous viral diseases for centuries. Today a new coronavirus, SARSCoV-2, has been added to the list of potentially pandemic pathogens.

The purpose of the article is to highlight, as much as possible, the physical and chemical properties of coronavirus, its epidemiology, framework for the disease prevention and treatment in various population groups and healthcare workers. The article provides a list of regulatory documents, a detailed guidance for healthcare professionals on how to act in case of identifying a patient with suspected COVID-19 in healthcare facilities, and a description of the coronavirus disease outbreak situation in the world and in the Russian Federation.

Conclusions. The sanitary protection of the territories of the countries represents the main way to shield a population from a dangerous infectious disease. Therefore, the collaboration of physicians from all over the world and constant exchange of information among them is of crucial importance. The COVID-19 pandemic requires decisive, coordinated, global quarantine measures; biological protection of the population, collaboration on the vaccine’s development and treatment methods, and joining efforts against the panic and misinformation.

Relevance. Coronavirus SARS-Cov-2 is a novel virus demonstrating the ability to be trans¬mitted from human-to-human, via respiratory droplets or close contact, and cause the severe acute respiratory syndrome (SARS). The role of its structural proteins in the SARS pathogenesis is unknown.

Aim is to characterize the features of the SARS-Cov-2 structural proteins and their changes associated with acquiring other way of transmission and analyze the possibility of heterologous immunity emergence in its infection. Materials and method. For the computer analysis and alignment, the gene sequences of SARS-Cov-2 , SARS-CoV , MERS-CoV и bat CoV HKU3 reference strains were used from the Internet. From the primary structure of their genes it were translated their structural proteins: spike (S), envelope (E),membrane (M), and nucleocapsid (N). The genetic code of structural proteins was also defined. The search of homologous sequences in the SARS-Cov-2 S-protein, surface proteins of other viruses, and human proteins was made to find immune epitope continuum of protein relationships.

Results. In the SARS-Cov-2 structural proteins amino acid sequences of M, E, and N-proteins are conservative. The S1 subunit of the S-protein contains some large insertions, significant changes of the amino acid content with the predominance of arginine and lysine which is typical for the surface glycoproteins in the viruses possessing high contagiousness. The S2 subunit is rather conservative and retain negative polarity. The S-protein exhibits the immune epitope relationships with many proteins of viruses and human which may be associated with immune collisions.

Conclusion: The SARSCov-2 features are determined by marked changes of the S1 subunit structure in the S-protein which may be responsible for its contagiousness and many immune collisions aggravating infection process.

Relevance. Klebsiella pneumoniae is a major cause of severe healthcare-associated infections in children, representing one of the six most widespread multidrug-resistant microorganisms worldwide and requiring the implementation of population-wide treatment strategies.

Aim. To study the risk factors for Klebsiella spread in pediatric healthcare settings.

Materials and Methods. Here we performed a descriptive retrospective epidemiological study of Klebsiella spp. cases in pediatric units across the entire Kemerovo region (2012–2019). In total, we documented 27,852 treatment outcomes. We further selected 52 confirmed cases and assessed their risk profiles in comparison with 738 condition-matched control children.

Results. Average incidence of Klebsiella spp. detection in pediatric healthcare settings was 78.52 per 1,000 patients (95% CI = 75.42–81.74). We revealed a declining incidence of Klebsiella pneumoniae infection in the region, with notable 4-year cyclicity. The proportion of Klebsiella pneumoniae-infected patients increased 2-fold after 5 days of antibiotic therapy. Among the risk factors of Klebsiella pneumonia infection were artificial feeding (OR = 9,21, 95% = 3,31–35,45, р = 0,0001), assisted ventilation (OR = 7,36, 95% CI = 3,92–14,0], р = 0,0001), use of nebulizers (OR = 5,34, 95% CI =2,49 – 10,9], р=0,0001), airway management (OR = 4,62, 95% CI =2,49–8,56, р = 0,0001), preterm birth (OR = 2,55, 95% CI =1,38 – 4,69, р=0,001), low body weight (OR = 2,48, 95% CI = 1,34–4,56, р = 0,002), enema administration (OR = 1,80, 95% CI = 0,78–3,81, р = 0,088), and nasogastric intubation (OR = 1,79, 95% CI = 0,85–3,54, р = 0,065).

Conclusions. The incidence of Klebsiella pneumoniae infections is currently lowering and has 4-year cyclicity. Antimicrobial treatment is associated with 2-fold increased risk if administered for ≥ 5 days. A number of healthcare-associated risk factors of Klebsiella pneumoniae infections have been found.

Relevance Hepatitis B and tuberculosis are a serious global health problem. Babies under one are at high risk of a severe form of these diseases and mortality. Immunization of newborns plays a key role both in the individual prevention of hepatitis B and tuberculosis and in reducing the burden of these infections in general.

The purpose of the study was to assess the timeliness of vaccination newborns against hepatitis B and tuberculosis and to determine the causes of deviations from national vaccine schedule. Materials and methods. The coverage of vaccination against hepatitis B and tuberculosis was studied according to the case history of newborns (form No. 097/у, N = 672) and form No. 6 «Information on the contingents of children, adolescents and adults vaccinated against infectious diseases», the state of child morbidity - according to form No. 2 «Information on infectious and parasitic diseases» for 2006–2018. Anonymous questioning of pregnant women was conducted to assess adherence to vaccination (N = 73).

Results. The average proportion of newborns who were vaccinated against hepatitis B in the maternity hospital over a 12-year follow-up period was 82.2%, against tuberculosis was 85.1%. More than 50.0% of children weren’t vaccinated against hepatitis B and about 20% of children weren’t not vaccinated against tuberculosis due to the vaccine hesitancy of their parents. 72.6% respondents agree that vaccination is important, 73.9% one that vaccination is effectiveness and only 50.6% one that vaccination is safety. The adherence to vaccination of newborns against tuberculosis is higher than against hepatitis B (78.1 and 69.9% respectively). There is a tendency to increase the number of children from 0 to 14 years old who are not vaccinated against both tuberculosis and hepatitis B.

Conclusion. The lack of immunization of newborns in neonatology departments is a risk factor for low future immunization rates for children, infection of children with hepatitis B virus and mycobacterium tuberculosis, as well as parental distrust in vaccination in general.

Relevance. Yersinia pseudotuberculosis is a causative agent of pseudotuberculosis, a disease with polymorphism of clinical manifestation that is determined by the presence of specific virulence determinants: plasmid pVM82, pathogenicity islands HPI and YAPI, and superantigen YPM. Occurrence of new determinants depends on horizontal transfer of mobile genetic elements, hence, systems regulating horizontal transfer participate in evolution of pathogenic species. CRISPR-Cas is and adaptive protection system of prokaryotes against mobile genetic elements. Aim. The study analyzed an interaction between CRISPR-loci of Y. pseudotuberculosis and virulence determinants. Results. 86% of strains includes three CRISPR-loci: YP1, YP2, and YP3. Length of locus YP3 mostly depends on presence of virulence determinants in strains of Y. pseudotuberculosis serotype O:1b. Strains with virulence genes are able to cause a severe form of pseudotuberculosis and have longer locus than strains without determinants. Conclusion. Therefore, CRIPSRCas system of Y. pseudotuberculosis may participate in formation of a certain strain genotype that defines clinical manifestation of pseudotuberculosis.

Aims. The purpose of this study was to identify current epidemiological features of meningococcal infection in Moscow.

Materials and methods. Cases of invasive meningococcal disease in Moscow from 2014 to 2018 and the biomaterial from patients with an invasive meningococcal disease were analyzed.

Results. The features of the epidemic process of meningococcal disease in Moscow were revealed: increasing in the incidence rate involving teenagers and young adults into the epidemic process; meningococcal strains of serogroups W and A increased in the etiology of the invasive meningococcal disease; high mortality rate.

Conclusions. It seems reasonable to recommend vaccination against meningococcal disease by including adolescents, young adults and persons over 65 years old.

Relevance.The urgency of the problem of chickenpox is determined by the high incidence, severe complications and the possibility of deaths.

The aim of the work is to analyze the peculiarities of the epidemiology of chickenpox in a single territory located in the immediate vicinity of a large metropolis.

Materials and methods. A retrospective epidemiological analysis was carried out using official statistics.

Results and discussion. It is established that in the study area in 2009–2018 there was a unfavorable epidemic situation for chickenpox. The most vulnerable groups in terms of morbidity are young children, especially those who attend children's organized institutions. In recent years, there has been a trend of increasing morbidity among the adult population. Preventive measures do not have a significant impact on reducing the incidence of chickenpox.

Conclusions. The analysis showed the high relevance of the organization of a reliable system of prevention of chickenpox, which should be based on the development and implementation in the practice of health care of domestic vaccine against this infection.

Aim. Assessment of tolerability, safety and immunogenicity of the 4-valent conjugated meningococcal MenACYW-D vaccine, administered 2 times to children 1–2 years of age in the Russian Federation.

Study participants. 100 children aged 9–17 months not previously vaccinated against meningococcal infection.

Methods. Two doses of the MenACYW-D vaccine were administered intramuscularly at intervals of 3–6 months. Antibody titers for meningococci of serogroups A, C, W, and Y were determined using a serum bactericidal assay in the presence of human complement before the 1st vaccination and 28 days after the 2nd vaccination. Participants with titers ≥ 1:8 were considered protected from meningococcal infection caused by the corresponding serogroup of meningococci.

Results. After two vaccinations, the level of seroprotection in relation to these four serogroups of meningococci was achieved in 92.9–99.0% of vaccinated children. No immediate adverse events were reported after any of the 2 doses of the vaccine studied. The frequency of local and general expected adverse reactions after any of the 2 doses of the vaccine was 45% and 40%, respectively, in terms of severity they were mostly weak and disappeared within 3 days. In general, there was no increase in the reactogenicity of the vaccine after administration of the 2nd dose compared to the 1st dose. Unexpected adverse events were recorded in 10% of the study participants, of which only one (diarrhea that stopped within one day) at the conclusion of the research physician was a causally related with the vaccine. None of the adverse events led to the early termination of participation in the study. One serious adverse event has been reported, which the physician has identified as not having a causal relationship with the vaccine being studied.

Conclusions. Two dose immunization with the MenACWY-D vaccine in children 1–2 years of age in the Russian Federation was safe, well tolerated, and induced a pronounced bactericidal humoral immune response against meningococci of serogroups A, C, W, and Y.

Relevance. In recent years, the increase in the incidence of pertussis has been observed in many countries despite high vaccination coverage of the child population.

Purpose: was to study the epidemiological features of whooping cough in the Voronezh region for the period from 2008 to 2018 years.

Methods. The research material was data the annual form No. 2, 5, 6 of Rosstat for 2008 through 2018. Statistical data processing was performed using Microsoft Excel 2007.

Results. The epidemiological features of pertussis in the Voronezh region for the period from 2008 to 2018 have been studied. Despite the high coverage of preventive vaccinations in children of the first years of life, in recent years, the incidence of pertussis increased the average Russian rates by 3,5 times. In the age structure of the diseased there was a tendency to increase the proportion of schoolchildren and adults. Analysis of the reports showed that half of the cases were vaccinated at the prescribed age, but the interval after vaccination before the illness was an average of 9 years.

Conclusions. In recent years, there has been a tendency to an increase in the incidence of whooping cough in the Voronezh region. The incidence of vaccinated indicates the natural extinction of post-vaccination immunity to school age and requires a decision on the introduction of revaccination of schoolchildren with actual acellular vaccines.

Relevance. Chickenpox is one of the most common infections in Russia and retains a stable 2–3 place in the structure of infectious morbidity. The conditions of the closed adult community in the institutions of the penal correction system pose high risks for the occurrence of group cases of Chickenpox , and this disease in adults can pose a threat to life.

Aims. Incidence rate of chickenpox among convicts detained in correctional institutions of the prison system of Lipetsk region in 2009–2018.

Materials & Methods. The statistical data of the branch CGSN of the Federal Penitentiary Institution MCH-48 of the Federal Penitentiary System of Russia were to analyse the incidence of chickenpox by prisons in the penitentiary system of the Lipetsk Region for the period from 2009 to 2018.The materials of the study were forms of federal state statistical observation for 2009–2018. The method of retrospective epidemiological analysis was used. statistical data processing was performed using Microsoft Excel.

Results. Cases of chickenpox among adults serving sentences in places of deprivation of liberty of Lipetsk region are recorded annually. The incidence rates among prisoners are 2 times higher than among adults in the Russian Federation. Sources of infection were relatives and convicts, patients with herpes zoster. There are statistically significant differences in first-time and re-convicted morbidity (p < 0.05). More than half (73.6%) of the cases of chickenpox occur in autumn-winter. Between 2009 and 2018, group cases were recorded with 2 to 7 people involved in the epidemic process. Consequently, conditions exist in correctional facilities for the epidemic spread of chickenpox.

Conclusions. In order to prevent the occurrence and development of group cases of disease, it is proposed to introduce vaccine prevention of persons who have not suffered from chickenpox in history.

Relevance. Rotavirus infection (RVI) is recognized as the main cause of severe gastroenteritis in children worldwide and leads to 527 000 deaths annually.

Aim. Present study was intended to evaluate the effectiveness of anti-epidemic measures and vaccination against RVI in children in Pyt-Yakh, Khanty-Mansiysk Autonomous Okrug-Ugra in 2016–2017.

Materials and methods. An analysis of the incidence of intestinal infection and RVI was carried out within 2 years prior (2014–2015) to and 2 years after (2016–2017) the implementation of anti-epidemic measures.A separate study was conducted to evaluate the safety and efficacy of a live oral pentavalent vaccine in 593 children including 433 who received three doses of the vaccine in 2016–2017.

Results. It was shown that anti-epidemic measures including vaccination decreased the chances of RVI in children aged 0–17 years 1.68 fold in 2017–2018 compared to 2015–2016 (odds ratio (OR) 0.59, 95% confidence interval (CI) 0.49–0.71, p < 0.001). The same data were obtained for children 12 months and younger (OR 0.57, 95% CI 0.35–0.95, р = 0.037) and children aged 1–2 years old (OR 0.62, 95% CI 0.45–0.84, р = 0.002). There were no cases of moderate or severe intestinal infections or hospitalizations in vaccinated population as well as postvaccinal complications.

Conclusion. The incidence of intestinal and rotavirus infections in all population in 2018 compared to 2016decreased by 53% and 72% respectively.

Relevance. Respiratory diseases, flu and pertussis, in particular, are common causes of temporary disability at work place. Pertussis is the second most common infectious disease by incidents increase in the Russian Federation. Combined immunization is found to be an efficient method to prevent infections at work place.

Objective. Research objective is to prove safety of combined influenza and the diphtheria-tetanus-pertussis vaccines for people with occupational hazard of respiratory diseases.

Materials and methods. We have studied the vaccination process in 257 adults with 2-nd and 3-rd health groups. We evaluated post-vaccination reactions, their localization, severity, time onset, and duration. We identified two groups with weaker and stronger side effects after vaccination. We determined typical parameters of the vaccination process.

Results. 50% people in examined group showed adverse reaction. Symptoms were weak as a rule and lasted up to 4 days mostly. 29 people (11%) had more severe and long reaction. 6 patients (2%) required supportive care, 2 (0.8%) showed severe symptoms lasting from 2 to up to 5 days.

Conclusion. The application of influenza vaccination combined with diphtheria, tetanus and pertussis vaccinations simultaneously have demonstrated that it is safe to use in adults at risk of exposure for respiratory diseases at workplace. Minor side effects do not pose a health threat, and can be completely prevented.

Relevance. The past decade has been marked by rapid advances in the prevention of human papillomavirus (HPV) infections and associated diseases.

Aims. To sum up the accumulated experience and evidence base of the impact of national HPV vaccination programs on the prevalence of HPV infections, the incidence of genital warts and precancerous cervical lesions. 3.

Conclusions. To reach its full potential and have a greater and earlier impact on the population, gender-neutral and, if possible, multi-cohort HPV vaccination should be included in the national immunization calendar.