Relevance. In the context of the new SARS-CoV-2 coronavirus pandemic, the range of use of personal protective equipment (hereinafter referred to as PPE) is becoming increasingly broad, from emergency and emergency medical teams that go to patients with suspected COVID-19, to specialized covid hospitals. Aim. Identification of features in the operation of PPE in a strict anti-epidemic regime and development of recommendations on the use of PPE to improve the efficiency of medical professionals. Materials and methods. In the period from April to May 2020 in the field hospital of the Association of Alpine shooters at the exhibition centre, FIERA DI BERGAMO Italian Republic (hereinafter - the hospital), 8 medical and nursing teams, each of them included the doctors-epidemiologist, anesthesiologist-resuscitation, general practitioner, and nurse anesthetist (total number 32 professionals) conducted relevant sanitary-antiepidemic (preventive) and treatment-and-prophylactic interventions among patients with clinical manifestations of COVID-19. Conclusion. As a result of using a whole range of disposable PPE of various modifications, the features and disadvantages of their operation in the field were established. The main recommendations for using PPE when working with patients infected with SARS-CoV-2 are formulated.

Relevance. The National influenza center uses additional criteria: baselines and thresholds for epidemic intensity for early recognition of the onset and assessment of epidemic intensity. Aim. To characterize the parameters of the flu epidemic in the Russian Federation in the 2019-2020 season and assess the intensity of the last 2 epidemics and the effectiveness of baselines and intensity thresholds. Materials and methods. The database of the research Institute of influenza on weekly morbidity, hospitalization, deaths from influenza and ARVI in the cities-reference bases of the National center for influenza was used. The analysis of the flu situation is based on comparing the current incidence of influenza and ARVI with weekly epic thresholds and baselines. A comparative assessment of the intensity of the last 2 influenza epidemics was carried out using intensity thresholds calculated by the moving epidemic method (MEM). Results. The main parameters of the 2019-20 influenza epidemic compared to the previous one are described. There was an increase in the incidence of clinically diagnosed «fluenza» in the pre-epidemic period and the early onset of both epidemics and reaching a peak in the 6th calendar week. This season, the epidemic started among school children, then among adults, and in the past-among the adult population, the incidence of children 0-2 years old was below the thresholds in both epidemics. This season, the average duration of the epidemic and the incidence in cities were higher among school children and adults, and over the entire period of the epidemic, the incidence was higher in all age groups across the country. This season, the epidemic started in the North Caucasus Federal district, its intensity was medium and low, in the past - it started simultaneously in the Siberian, Ural and North Caucasus districts, and its intensity was very high (in the North Caucasus) and high (in the Siberian Federal district) and the average level of 6 districts. The intensity and duration of epidemics were higher in districts with an early onset (in the North Caucasus and Siberian Federal districts). Both epidemics in the country were of moderate intensity, but there were fewer deaths from influenza in the last epidemic. Conclusion. Comparative characteristics of epidemics using baselines and intensity thresholds allowed us to identify the features of the epidemic process in the seasons 2018-19 and 2019-20: the earlier onset of both epidemics; a noticeable increase in the incidence of fluenza before the beginning of epidemics; a decrease in the intensity of epidemics and mortality from influenza; features of the epidemic process in Federal districts. The effectiveness of using additional criteria in the analysis of the influenza epidemic in Russia and this season has been confirmed. In both epidemics, the weekly epidemic thresholds for influenza and ARVI were more sensitive when determining the start of the epidemic, and the end of it, on the contrary, were baselines, and the baselines of morbidity and hospitalization with a diagnosis «influenza» determined the beginning and end of the epidemic even more precisely.

Relevance. The actuality of the study is due to the beginning of a new rise in the incidence of COVID-19 in the autumn of 2020 in the world and the need to study the features of the COVID-19 epidemic process for monitoring and forecasting the epidemic situation for its spread. Aim. Identification of features of morbidity, from March to September 2020 was based on data from the Ministry of health of Russia on the incidence and mortality from COVID-19 and from the date Influenza Research Institute on the weekly incidence of COVID-19, hospitalization and deaths in various age groups in 48 cities located in 8 Federal districts. Results. The dynamics of weekly morbidity and mortality in the Russian population from COVID-19 is presented. A noticeable increase in the incidence began from March 30 to April 5, 2020, and the peak of the epidemic was registered 6 weeks later. Within 3 months, the incidence decreased by more than 2 times and was minimal at the end of August. The order of involvement of Federal districts in the COVID-19 epidemic has been determined. The indicators of morbidity, hospitalization, and mortality were calculated, and the role of various age groups in the morbidity and mortality of the population from COVID-19 was shown. Differences in morbidity and mortality in Federal districts are shown. Conclusion. The rise in morbidity in Russia began much later than in Europe, in the week of the peak of the epidemic in this region. The epidemic started in the Southern FD, then in the Central and Far Eastern FD, and then every week-in the Siberian, Volga and Ural FD, and 3 weeks later (in June)-in the North-Western and North-Caucasian FD. By the beginning of the seasonal rise in ARI, morbidity and mortality rates remained high, especially in the Far Eastern and North-Western districts. The incidence of the adult population was 2.5-3.4 times higher than that of children. The mortality rate among people over 65 years of age was 8.8 times higher than among those aged 15-64 years. In the total population incidence of COVID-19, the proportion of people aged 15-64 years was 74.3%, and in mortality from COVID-19 - 34.1%, and those over 65 years, on the contrary, in morbidity -18.6%, and in mortality -65.9%. The highest rates of morbidity and mortality were found in the Far Eastern, Southern, Siberian and Central districts with a high incidence, primarily of people over 65 years of age. Lethality rates were higher in districts with a low rate of hospitalization.

Relevance. Chickenpox occupies a leading position in the structure of infectious pathology in the Republic of Belarus; 50,000-80,000 cases are registered annually in the country, including 2500-4500 cases among people over 15. Aims - to study the prevalence of IgG antibodies to Varicella Zoster virus among the population of the Republic of Belarus and assess the relative risk of infection for people of different ages. Materials and methods. The blood sera of 1190 people aged 2-75 from all 7 regions of the Republic of Belarus were investigated. IgG antibodies were detected using Serion ELISA classic Varicella Zoster Virus IgG, Virion\Serion, Germany. Sera with a n antibody concentration more than 100 mIU/ml were regarded as positive. The dynamics of the proportion of immune individuals by age was determined by regression analysis and estimated by the average rate of increase. To assess the risk of infection in different age groups, an indicator of the relative risk of being infected (IRR) was used. Results. It has been established that the prevalence of IgG antibodies to Varicella Zoster virus among the population of the Republic of Belarus is 85.5%, ranging from 82.0% to 89.7% in various regions of the country. The level of seropositive increases with age (from 16.0% among children aged 2 years to 86.6% by 15-17 years), it is 95.4% at the age of 18-25 years, 97.1% at the age of 26-35 years and remains at the level of 97.1-100% among older people. In the most active childbearing age of 18-35 years, 3-5% of women are susceptible to this infection. Varicella Zoster virus infection risk assessment data for people of different ages indicate that the probability of getting this infection is highest among children 3-5 years old (IRR = 98.4). In adults, it decreases many times, but in the age group of 26-35 years, it still remains two times higher (IRR = 2.0) than in people reached 46 years of age. Conclusions. The obtained data on seroprevalence are consistent with the data on morbidity and suggest that, without social management of the epidemic process (vaccination), the infection potential remains sufficient to maintain the high-intensity epidemic process among children, and medium intensity among young adults.

The experience with the influenza pandemic caused by strain A (H1N1) 2009 and the existing gaps in standardizing and evaluating the quality and effectiveness of vaccines for influenza prevention have led the European Union (EU) to recognize the need to review / update the current guidelines on requirements for the development, quality, and preclinical and clinical research. In February 2018 Guideline on influenza vaccines -quality module (EMA/CHMP/BWP/310834/2012 Rev.l) came Into effect In the EU countries. The formation of the Eurasian Economic Union (EAEU) and the creation of a single market for pharmaceutical products entails the need to amend the current and the formation of new legislation, as well as changes in the rules and regulations regarding the pharmaceutical circulation processes in the Russian Federation: development, quality assurance in preclinical and clinical trials, monitoring the safety of medicines for medical use, in this regard, it seems appropriate to develop scientific and technical guidelines that are harmonized with international standards and approaches in the pharmaceutical field. The aim of the review was to conduct a comparative analysis of approaches to assessing the quality of vaccines for prevention influenza based regulatory requirements in the Russian Federation and European Union. Conclusion. In this article discusses the features of the requirements for the development and quality control of inactivated influenza vaccines in the Russian Federation and the EU. The article provides a comparative analysis of the requirements of the State Pharmacopoeia of the Russian Federation and the European Pharmacopoeia for quality indicators, which should be included in the regulatory documentation when registering the vaccine. The main changes in the EMA document «Guidelines for influenza vaccines - Quality module» consist of new approaches to standardizing vaccines for influenza prevention, in particular, determining the specific activity of inactivated influenza vaccines using adequate alternative methods and studying biological, immunological and physicochemical characteristics HA antigen using a wide range method. The results of the analysis of approaches to assessing the quality of vaccines for influenza prevention can be useful in developing harmonized with international norms and approaches scientific and technical guidelines in the pharmaceutical field.

Relevance. The medical and social significance of hepatitis C (HC) is determined by its widespread distribution, the involvement of the working-age population in the epidemic process, the multiplicity of transmission routes of the pathogen, a variety of clinical forms, and a high frequency of chronicity and malignancy of the process. The purpose of the study - to characterize epidemic process of HC in the Republic of Belarus, based on long-term observations. Materials and methods. Assessment of the incidence of HS in the population as a whole and in individual groups was carried out according to the data of the state statistical reporting form «Report on individual infectious, parasitic diseases and their carriers» in 1996-2019. Genotyping was carried out in the core/E1 and NS5B areas; for bioinformation analysis, BoiEdit v.7.2.5, SeqA6, SeqScape v.3, and Mega 6 were used. Statistical calculations were performed using the software Statistica V.6.1 (Statsoft, USA). Credibility of long-term assessment was proved using the Spearman correlation coefficient Rs. Results. The incidence of acute hepatitis during the 24-year epidemiological observation period decreased 3.5 times from 2.68 cases per 100 ths people in 1996 to 0.76 per 100 ths people in 2019. With a downward trend in number of carriers of hepatitis C -6.34% (p < 0.05) there is still a moderate upward tendency in the incidence of chronic hepatitis C (+4.37%, p < 0.05). The age group of 21-39 years is the main cohort in the structure of patients with acute hepatitis (1.1-2.5 per 100 ths). 68.8% of all patients with chronic as well as latently occurring forms of HC are people aged 21-49, the incidence in this age group ranges from 61.3-186.2 per 100 ths and exceeds 1.3-4.5 times the incidence among the total population of Belarus. During 2018-2019 among the selected isolates, the hepatitis C was dominated by the 1st genotype represented by 1a (10.3 ± 1.7%) and 1b (51.7 ± 2.9%) subtypes and genotype 3a (31.8 ± 2.7%). Conclusion. In the Republic of Belarus the decrease in the incidence of acute hepatitis (decrease rate of -6.09% p < 0.05) comes along with the increase in the incidence of chronic hepatitis C (increase rate + 4.37% p < 0.05). The main risk group for hepatitis C is 21-49 years old. Thus, the largest share (about 70%) of disease falls on socially active population in the reproductive age with the highest labor potential (21-49 years old). The proclaimed and widely manifested decrease in the incidence of acute hepatitis is shadowed by the continued growth of newly diagnosed chronic hepatitis C in high-risk groups and it will surely worsen epidemiological situation with a large number of chronic sources of infection. The results of molecular genetic monitoring show that in the period from 2018 to 2019 the genetic structure of hepatitis C virus isolates is not different to the period of 2004-2015, and the prevailing types are still the 1b, 1a, and 3a subgenotypes of Hepatitis C virus. This knowledge is necessary for the planning, implementation and development of the Program for Elimination of Hepatitis C in the Republic of Belarus for 2019-2028, which aims to reduce HC virus infection by its prevention, detection and antiviral treatment. An expected result of the Program is a substantial decrease in mortality, disability as well as long-term job disqualification among the population of the Republic of Belarus.

Relevance. Microbiological monitoring in medical organizations is an essential part of ensuring epidemiological safety in the provision of medical care. The study of the sensitivity of pathogens to antibacterial drugs allows us to reasonably approach the prescription of empirical therapy and form a form of antibacterial agents for medical organization. The purpose of the work was to study the species composition of pathogens of generalized purulent septic infections (GPSI) in a children's multidisciplinary hospital and determine their resistance to antibacterial drugs. Materials and methods. Analysis of microbiological analysis data of material taken from patients with GPSI treated in children's multidisciplinary hospital in the period 2013-2018 was carried out. A total of 572 cultures were studied. Results. It was found that the largest specific gravity in the structure of GPSI was occupied by gram-negative microorganisms, the proportion of which significantly decreased from 73.0% in 2013 to 48.1% in 2018. Gram-positive microorganisms were found in 27.0 ± 8.1% cases, while a significant increase in the proportion of fungi from 5.4 to 30.7% was observed. The antibiotic resistance of the main pathogens has been studied. Among non-fermenting gram-negative bacteria, the highest (p < 0.05) multi-resistivity indicator was found in Acinetobacter baumannii (50.0 ± 6.8%). Enterococcus, having high natural resistance to a number of antibiotic groups, leave the possibility of effective action of the preparation of the group of glycopeptides (vancomycin) against Enterococcus faecium. Conclusions. High pathogens to applied antibacterial preparations is shown. The obtained data make it possible to form an up-to-date form of antimicrobial drugs for use in children's hospitals, to develop measures that inhibit the development of resistance in pathogens of purulent-inflammatory diseases.

Relevance. In modern conditions, special attention is paid to preserving the health and quality of life of the working population through vaccination. The role of corporate medicine in the organization and implementation of a risk-based approach to the immunization of employees in enterprises and institutions is actively discussed. The aim of this study was to discuss the methodological and basic arrangements for the development and implementation of a new technology at an enterprise using vaccination - a corporate immunizations schedule. Materials and methods. The scientific work was carried out on the basis of generalization of our own experience and the experience of some regions of the Russian Federation on the formation and implementation of corporate immunizations schedules in industrial enterprises and in higher educational institutions. Results. The substantiation of the feasibility of introducing corporate immunizations schedules at enterprises and institutions is given, tasks, legal bases, an up-to-datelist of infections to be included in the corporate immunization schedules, conditions for its successful implementation and development prospects are presented. Conclusions. The corporate immunization schedules should be considered as one of the mechanisms for providing the working population with immunobiological drugs during the transition period (before the inclusion of actual infections in the National immunization schedule), actively discussed today in the pages of domestic literature.

Relevance. Pandemic of the new coronavirus infection has become a challenging issue for world healthcare system. Control of the epidemic process is one of the main priorities in combat against new coronavirus disease Aim. The research highlights the issue of asymptomatic carriers of the new coronavirus disease. Conclusions. It was revealed that patients with asymptomatic form of COVID-19 have a less lasting immunity response compared with those that have had clinically active forms of the infection. In order to determine pathogenetic process and fully understand formation of the immune response, it is necessary to study both humoral and cellular immune responses in patients diagnosed with COVID-19. In order to select most optimal anti-epidemic measures to contain the further spread of the disease, including asymptomatic carriage, it is necessary to establish SARS-CoV-2 reproduction index and determine minimal infective dose of SARS-CoV-2.

Relevance. Rotavirus infection (RVI) and norovirus infection (NVI) are characterized by seasonal increases in morbidity in the winter months, and for enterovirus infection (EVI) - in the summer. The aim is to study of scientific literature data regarding the reasons for the seasonality of the epidemic process of RVI, NVI and EVI. Materials and methods. The data of 52 scientific publications related to the epidemic process of RVI, NVI, and EVI were analyzed. The descriptive research method used Results. Seasonal activation of the epidemic process of RVI and NVI is observed in cold period of the year in the background of a decrease in air temperature and humidity, which leads to an increase in the survival rate of rotaviruses and noroviruses in the environment and can contribute to the implementation of domestic, water and food transmission ways of the pathogen. In addition, the increase in population density in the winter months determines the implementation of the aerosol mechanism of transmission of rotaviruses and noroviruses during this period. In contrast to RVI and NVI, seasonal activation of the epidemic process of EVI is observed everywhere in warm months, which is associated with the biological characteristics of enteroviruses, for their survival in the external environment are favorable conditions for high temperature and high humidity. Conclusion. The reasons for the seasonality of the epidemic process of RVI, NVI, EVI are substantiated.

Relevance. Among the groups at high risk of developing invasive pneumococcal infections, patients with multiple myeloma (MM) stand out among the highest rates of morbidity and mortality due to the presence of profound immunosuppression. Aims: to outline the current state of the problem of vaccine prevention of pneumococcal infection in patients receiving treatment for multiple myeloma, to present the evidence base for vaccination with conjugated pneumococcal vaccine. A continuous data review method was used to evaluate the studies on vaccination approaches against pneumococcal infection in patients with multiple myeloma. Conclusions. The article presents modern epidemiological data, as well as the results of original studies of clinical and immunological aspects of pneumococcal vaccination in patients with MM receiving new targeted agents and immunotherapy. The effectiveness of the use of the conjugated pneumococcal vaccine in patients treated with MM with bortezomib, lenalidomide, and ixazomib was indicated. An independent protective effect of pneumococcal vaccination has been shown as a preventive measure in a cohort of patients with MM, against the background of treatment with new targeted drugs.

Relevance. In the modern period, scientific works that would give a detailed assessment of the influence of certain factors on the development of the epidemic process are extremely rare. The current situation is largely due to the fact that the methodology of such studies is not sufficiently developed. Epidemiologists do not always have a clear idea of what influence certain factors have on the manifestations of the epidemic process in various infections. Purpose of research: The aim of the study is to give an epidemiological assessment of the influence of global and regional factors on the development of the epidemic process and the formation of the epidemiological situation in the region on the example of the spread of infections with different transmission mechanisms. Conclusions: Based on the analysis of publications based on the results of the author's own research and literature data, the paper substantiates the importance of identifying risk factors and evaluating them as one of the most important results of epidemiological diagnostics. A classification of risk factors is presented, which contributes to a more objective understanding of the spectrum of influence of each factor on various aspects of the development of the epidemic process. On the example of individual infections, an epidemiological assessment of the factors that can potentially influence the formation of the epidemiological situation in the region is given. It is shown that globally active factors, apparently, mainly determine the formation of trends in the long-term dynamics of morbidity, while regional factors determine the level of morbidity, the intensity of its rise and fall in the region.
Keywords: epidemic process; anthroponoses; risk factors; classification; morbidity

Relevance. Infectious complications arising in the postoperative period (nosocomial infections) have an adverse effect on the results of high-tech interventions in a cardiac surgery clinic, worsening clinical results and being a significant article of medical expenses. Aims. To analyze modern literature data on the prevalence of nosocomial infections after high-tech cardiac surgery to identify factors that affect its variability. Conclusions. The prevalence of hospital Infectious complications after cardiac surgery remains high, ranging, according to various sources, from 0.9% to 35%. The deep form, accompanied by a significant mortality rate, is more common in the range from 0.4% to 5%, the incidence of superficial forms is much more variable, leaving from 1.5% to 30%. A prerequisite for controlling infection in a cardiac surgery hospital is thorough and adequate registration of such complications. Conducting a dynamic comparison of the prevalence of nosocomial infections in the process of epidemiological control requires the consistent use of unchanged methods of statistical analysis, constant criteria for determining a standard case and the use of up-to-date classifications. An important step in the study of the prevalence of nosocomial infections is to provide the obtained information to practicing physicians in order to maintain a high level of awareness of the effectiveness of treatment and prevention.