Relevance of searching for computer methods with high efficiency of immunoepitopes recognition and predicting the longevity of the immunity they induce is determined primarily by the need to quickly create vaccines against newly emerging infections, especially during pandemic periods. Aim. To develop a new immunoinformation method for recognizing immunoepitopes, to identify in the viral proteins possible potential markers to induce long-term immunity and to evaluate by them the vaccines against Covid-19. Materials and methods. For computer analysis, an Internet-accessible databases of immunoep topes 15 and 9 amino acids long, restricted respectively by MHC I and MHC II, and peptides not binding to MHC, as well as human and virus proteins, were used. The algorithm for discriminating immunoepitopes was based on positional distinction of specific short peptides in their primary structures. Results. The «inventory» in the training samples of di- and tripeptides or pentapeptides of immunoepitopes and nonimmunoepitopes makes it possible to accurately recognize in the control samples up to 93–97% of immunoepitopes restricted by MHC I and MHC II. Comparison of the amino acid composition of proteins of subunit vaccines causing long-term immunity revealed dominance of amino acids (especially proline), which form the basis of internally disorganized regions, and proline-containing dipeptides, that allowed them to be considered as biomarkers of the potential of a viral protein to form a long-term immune memory.
In the S-protein of coronavirus SARS-CoV-2 two candidates for immunospressive domains are present and the dominance of proline and dipeptides containing it is absent. Conclusion. The immunoepitope recognition method and the biomarker for inducing longterm immune memory can be used as immunoinformative tools of computational vaccinology. Providing long-term immunity by vaccines based on the coronavirus SARS-CoV-2 protein S is unlikely.

Relevance. At the present stage, the Russian Federation does not have a coherent system of supervision and control of infection caused by the Epstein-Barr virus (EBV), while there is an epidemiological problem with this pathology, requiring the development and adoption of a set of adequate management decisions. The goal is to scientifically substantiate the creation of an epidemiological surveillance system (ES) for EBV -infection in Russia. Materials and methods. Based on the results of previous studies, an assessment of the manifestations of the epidemic process of EBV infection and measures aimed at each of its links was carried out. Results. The structure and content of the system of epidemiological surveillance of EBV infection are presented. Conclusion. To implement and improve the effectiveness of EBV-infection control, it is necessary to adjust existing and develop new regulatory and methodological documents that allow introducing: a standard definition of the case of EBV-infection and new approaches to accounting and registration; studies of nasopharyngeal smear material for the presence of EBV genetic material as part of the monitoring of influenza and ARVI pathogens; algorithms for the examination of patients with diagnoses that do not exclude the presence of active EBV-infection, as well as organ, tissue and cell donors with the determination of a complex of nonspecific immunological markers (neopterin, melatonin, C-reactive protein, ALT); standard operating procedures for medical professionals for the identification and isolation of patients with active EBV-infection, clinical and laboratory diagnostics, registration and accounting, the use of personal protective equipment and nonspecific immunoprophylaxis. Also, improving the control of EBVinfection is impossible without continuing scientific research; professional training of medical workers on the clinic, diagnosis, epidemiology and prevention of EBV-infection; development of modern visual methods and means of informing the population about the clinic and prevention of EBV-infection. 

In the article, the object of knowledge as one of the key concepts of any science is considered. Examples of understanding of this term at the present stage of the development of epidemiology are given. It is offered to take into account modern views on the epidemiology of infectious and non-communicable diseases to recognize behind them the uniform object of study and to treat it as a sore human body with a further exit to the main subject of knowledge which population morbidity is. Such understanding of an object of knowledge of epidemiology brings together it with such fundamental direction of medicine as pathological physiology. Both of these disciplines are engaged in any diseases (morbid conditions) irrespective of their origin and have identical approaches to their study at the level of generalizations. Fundamental differences take place only for the main subject of studying these sciences which are pathological processes for a pathophysiology and population morbidity for epidemiology. All this according to the principle of unity and conflict of opposites allows to prove the following conclusion. Now historical development of epidemiology in integration with a pathophysiology, promotes forming of higher levels and generalization of this preventive discipline.

Relevance. The immunization schedule of the Russian Federation for epidemic indications includes vaccinations against infections common to humans and animals. Routine vaccination is scheduled for risk groups, which include persons with a high probability of infection, and urgently – in foci of infection. Aim of the study. Evaluation of the impact of vaccine prevention on the incidence of infections common to humans and animals. Materials and methods. Evaluation of the preventive effectiveness of vaccinations was carried out by comparing the volume of vaccination with the incidence rates of the corresponding vaccine-preventable infections according to the State Statistical Observation Forms No. 2 and No. 5 for the period from 2013 to 2020. Results and discussion. The scopes of immunization of the population against tularemia, brucellosis, anthrax, leptospirosis and tick-borne encephalitis are unstable. Against the background of a decrease in the number of vaccinations against tick-borne encephalitis in 2020, the trend towards a decrease in the incidence rate was replaced by an increase in rates in all age groups. For other infectious diseases, no significant deterioration in the epidemiological situation is observed. Due to active routine vaccination of the population living in areas with active natural foci of plague, cases of this disease are not registered in Russia. Conclusions. The reduction and instability of the volume of immunization of the population against tularemia, brucellosis, anthrax, leptospirosis and tick-borne encephalitis against the background of an increased risk of infection can lead to an increase in morbidity rates. The regulatory and methodological framework of the surveillance for vaccine prevention of infections common to humans and animals needs to be improved in terms of developing algorithms for assessing the number and coverage of target population groups, introducing accounting for vaccination and revaccination vaccinations, as well as registering the incidence of vaccinated and unvaccinated persons.

Relevance. The widespread occurrence of West Nile fever (WNF) in the Russian Federation and the various intensity of epidemic process manifestations determine the relevance of developing a methodology for epidemiological zoning and differentiation of the country's territory by the level of potential epidemic hazard, which will optimize WNF pathogen monitoring and a set of preventive measures. Aims. To develop a methodology for differentiating the territory according to the degree of potential epidemic hazard of West Nile virus (WNV) infection and to test it by the example of the Volgograd region. 

Materials & Methods. The work used: information on the detection of WNF cases in the Volgograd region in 1999–2019, the results of serological and entomological monitoring for the 1999–2020 period, meteorological data (air temperatures in June-August, 1999–2020), vector maps of hydrography and land use. Results and discussion. As criteria for assessing the potential epidemic hazard of the territory, the following have determined: the number of patients, the number of years of case registration, the average air temperature during WNV transmission season, the identification of markers (antigens/RNA) of the pathogen in environmental objects (carriers, vectors, marker species of animals), the number of the main pathogen's vectors, positive results of serological screening of the population, as well as the level of organization of the epidemiological surveillance system and the level of preparedness of health authorities and institutions for the identification, diagnosis and treatment of patients with WNF. On the basis of the methodology developed by us using the spatial cluster analysis and the method of scoring indicators, an epidemiological zoning of the Volgograd region has carried out in terms of the WNV infection risk. As a result, more than 50% of the territory belongs to the zones of increased risk due to the combined action of biotic, abiotic and social factors. 

Conclusions. The results obtained indicate the need for targeted monitoring of the pathogen in the territories of the Volgograd region with unconfirmed WNV circulation (northeastern and northwestern regions). In the future, application the developed methodology in practice when carrying out zoning of WNV-endemic territories of the Russian Federation is planned, primarily the subjects of the Southern Federal District, which are characterized by the most intense course of the epidemic process.

Conclusion. The analysis showed that the concept of «monitoring» in epidemiology coincides in both languages. At the same time, there are significant differences in the definitions of the term «screening» in epidemiological and serological surveillance. For instance: methods of serological studies of the state of collective immunity of the organization of the survey differ in such parameters as orientation (cross-sectional, longitudinal), as regularity (annually, irregularly), according to the principles of stratification (by territorial, by age group, professional, vaccination history, financing). The analysis showed that the concept of «monitoring» in epidemiology coincides in both languages. At the same time, there are significant differences in the definitions of the term «screening» in epidemiological and serological surveillance. I would like to harmonize this term among different medical specialists, which will significantly simplify not only teaching foreign students of medical universities the basic definitions in the epidemiology section but will also contribute to a mutual understanding of medical workers of the same specialty in different countries when meeting with certain terms in medical publications and communication. We would like to harmonize this term among different medical specialists, which will greatly simplify not only the teaching of basic concepts in the section «epidemiology» to foreign medical students but will also facilitate mutual understanding among physicians of the same specialty in different countries, when encountering these or those terms in medical publications and for communication.

Relevance. Active mass vaccination of the population against a new COVID-19 is being carried out on the territory of the Russian Federation, which is recognized as a priority strategy for the country's healthcare for the near and long-term periods. One of the main risk groups that are subject to priority vaccination is medical workers. Aims. To evaluate the effectiveness of vaccination of medical organizations ' employees against COVID-19 based on the results of a 6-month prospective follow-up. Materials and methods. The observation group consisted of 356 employees of a medical organization who were vaccinated against COVID-19 with the drug «Gam-Covid-Vac» from December 2020 to April 2021. The effectiveness of vaccination of employees was evaluated by the coefficient of IgG positivity to SARS-CoV-2 by solid-phase enzyme immunoassay 3 weeks after the first administration and 3–4 weeks after the second administration of the vaccine and then 1 time per month. Employees who were revaccinated after 5–6 months. After the initial vaccination, they were examined 10–14 days after the introduction of the first component «Gam-Covid-Vac». A total of 1921 serum samples were studied. A specific T-cell immune response was determined in two study participants without seroprotection after administration of two components of the «Gam-Covid-Vac» vaccine and eight employees with the elimination of IgG antibodies 4–5 months after vaccination using ELISPOT technology. In addition, 92 blood serum samples of 32 employees from the observation group were examined for specific antibodies to adenovirus by indirect enzyme immunoassay. From December 2020 to June 2021, the study participants were subjected to dynamic clinical observation, once a week they were examined by PCR to detect SARS-CoV-2 RNA in smears from the pharynx and nose (a total of 5696 samples).

Results. After the completed course of immunization, the formation of both a humoral (in 99.4% of cases) and cellular immune response (100% among the studied samples) was confirmed. In the next 6 months after vaccination, cases of coronavirus infection were registered in 4.8% of those vaccinated, including 1 person – in the first month after vaccination and 16 – 3–5 months after vaccination. In all cases, the disease occurred in the form of an acute respiratory infection of mild or moderate severity and was characterized by a shorter period of virus isolation compared to similar data on the persistence of the virus in unvaccinated patients (15 days in vaccinated compared to 22 days in unvaccinated). It was found that the presence of immunity to adenovirus infection during vaccination with the drug «Gam-Covid-Vac» did not affect the possibility of forming an immune response to COVID-19. In the group of persons re-vaccinated with the first component of «Gam-Covid-Vac» after 5–6 months. after the initial vaccination, an immune response was received during the follow-up period. 

Conclusion. Thus, according to the results of the study, a high immunological and epidemiological effectiveness of vaccination against COVID-19 with the drug «Gam-Covid-Vac» was established in a group of medical workers, and the effectiveness and safety of the administration of a booster dose of the vaccine after primary vaccination was also shown.

Relevance. Despite the implementation of measures to reduce morbidity and mortality among medical workers who are in contact with patients hospitalized for a new coronavirus infection caused by SARS-CoV-2 (hereinafter – COVID-19), their level remains high today. Given the difficulty of achieving the required number of vaccinated to form collective immunity, the issue of finding additional drug-based ways to prevent COVID-19, especially in risk groups, becomes urgent. Aims. To evaluate the effect of azoximer bromide on the number of cases of confirmed COVID-19 disease among medical workers, as well as on the level of chronic fatigue in the study groups. Materials and methods: 78 men and women were included in the study. The experimental group consisted of 41 people who took azoximer bromide for 38 days. The comparison group consisted of 37 people who were not prescribed azoximer bromide. The epidemiological efficacy of the drug was evaluated. Statistical evaluation of the significance of the differences was carried out using the Student's t-test, Pearson's criterion χ². Results. The number of study participants with COVID-19 in the experimental group was significantly lower than in the comparison group. A significantly faster reduction of manifestations of chronic fatigue syndrome was noted in study participants who took azoximer bromide. There were no adverse events during the administration of the studied drug by the study participants. Conclusions. Azoximer bromide has shown epidemiological efficacy when used by medical workers directly providing medical care to patients with COVID-19 (when working in the «red zone»), including contributing to the more rapid normalization of the psychological state of medical workers

Relevance. Among cardiac surgery hospital patients, purulent-septic infections (healthcare-associated infection or further HAI) do often occur. Aim of the work is to study the frequency of detection and antibiotic resistance of certain types of microorganisms in the development of HSI in operated patients of a cardiac surgery hospital. Materials and methods. The results of bacteriological examination of 213 operated patients with signs of HAI and 836 patients without signs of HAI were studied in a cardiac surgery hospital. The sensitivity of dominant microorganisms to antibiotics was determined. Results. Among patients operated in a cardiac surgery hospital Staphylcoccus epidermidis was more often extracted from the wound discharge, K. pneumoniae and fungi of the genus Candida were extracted from sputum, S. epidermidis and fungi of the genus Candida were extracted from blood, K. pneumoniae and Escherichia were extracted coli urine. These microorganisms were found among patients with signs of HAI significantly more often than among patients without signs of HAI. Among the dominant pathogens of HAI, a significant proportion of strains with multiple antibiotic resistance was identified, and among K. pneumoniae were found extremely resistant and pan-resistant clones producing extended-spectrum beta-lactamases. Conclusion. K. pneumoniae, S. epidermidis, E. coli and fungi of the genus Candida were the leading pathogens of HAI among patients operated in a cardiac surgery hospital. A significant number of bacterial strains with multiple antibiotic resistance have been identified.

Relevance. The research of the dynamics of population immunity formation is an important component of epidemiological surveillance, especially during the pandemic period. Identifying the features of the course of the epidemic process of a particular infection provides an opportunity to make the right decisions both in the fight against the disease and in its prevention. Aims. Evaluate the dynamics of the formation of collective immunity in the population of the city of Moscow. Materials & Methods. The presence of immunity in the population was assessed by immunochemiluminescent analysis of blood serum of patients for the presence of antibodies IgM and IgG to SARS-CoV-2. Results. During the analysis of the annual dynamics of IgM detection, a gradual decrease in this indicator was recorded. The dynamics of the combined detectability of IgM/IgG has a wave-like course. It should be noted that the curves of the dynamics of the IgM detectability and the combined IgM/IgG detectability reflect multidirectional trends: the summer rise in the IgM detectability coincides with the fall and the lowest values of the IgM/IgG detectability indicator. Afterwards, the decrease in the IgM detectability is accompanied by an increase in the combined IgM / IgG detectability. Detectability of IgG has a pronounced tendency to rise with short time intervals of decline. In the first three months of testing, a gradual decrease in detectability was recorded from 15.2 to 10.8%. However, since August, there has been a new increase in detectability of IgG to 45.5% in marth and subsequent stabilization in the range of 44.3–45.5%. Conclusions. The level of seroprevalence for the period of May 2021 is 44.3%. Detection during screening of patients with IgM and partially with a combination of IgM / IgG may indicate the presence of a significant hidden component of the epidemic process, which may lead to an increase in morbidity.

Relevance. Pneumococcal disease is a common cause of morbidity and mortality in adults and children worldwide. Vaccination against pneumococcal infection was included in the National Immunization Schedule in the Russian Federation in 2014. But despite the progress made, the proportion of children who received a completed course of vaccination remains insufficient. Coverage of the adult population remains low. A significant role in this is played by confidence of the population to vaccination against pneumococcal infection. In this regard, we conducted a study to assess the effectiveness of the educational programs in the improving of confidence in vaccination against pneumococcal infection among various target groups of population. Materials and methods. The results of the developed and conducted educational campaigns, consisting of two stages, were used as material: a series of face-to-face events for young people (students of non-medical universities in Moscow) and a series of webinars for medical professionals of various specialties. In the first stage of the educational component, the total coverage of the target audience («future parents») amounted to 650 people. Face-to-face events were held with the participation of students from Sechenov University using the peer-to-peer approach. The total audience of the second phase of the educational component (a series of 5 webinars for health professionals) was more than 3,000 people (2,902 connections, some of them group). Online events for medical workers were held by leading experts in the field of epidemiology and vaccine prevention, psychology. Evaluation of the effectiveness of the campaign was carried out through measurements (surveys before and after the event). To assess the statistical significance of differences, Pearson's Chi2 test was used at the accepted level of statistical significance p < 0.05. Qualitative variables are presented as proportion and 95% confidence interval of the proportion. Statistical processing was performed using IBM SPSS Statistics v.20.0, data visualization – Microsoft Excel 2016. Results. The proportion of students who have a positive attitude towards vaccination increased by 16% – from 41.0±5.6% to 57.0±6.0%, p<0.05. The level of awareness about the availability of vaccination against pneumococcal infection increased by 75.9% – from 21.2 ± 4.5% in the initial survey to 97.1 ± 2.0% in the final one (p < 0.001). Awareness about contingents subject to vaccination against pneumococcal infection increased by 78% (the proportion of respondents who initially found it difficult to answer this question decreased from 85.3 ± 3.9% to 7.2 ± 3.1% (p < 0.001). The total audience of the second stage of the educational component (a series of 5 webinars for medical professionals) amounted to more than 3000 people (2902 connections, some of them were group). The proportion of doctors willing to recommend vaccination against pneumococcal infection increased from 82.1 ± 1.4% to 97.0 ± 0.6%, p < 0.001. Conclusion. Educational programs plays important role in the improving confidence in vaccination both among medical workers and among the population. Short-term indicators of the effectiveness of the event can be reflected in the increased awareness of participants in the issues of vaccination and infectious diseases. At the same time, a significant change in the indicator of attitudes towards vaccination should be expected when conducting a series of educational events using various formats – lectures, conversations, discussions, interactive games.

Relevance. The COVID-19 pandemic is still making adjustments to the modern realities of both healthcare and society as a whole. The incidence of COVID-19 in children and adolescents is becoming more and more urgent. At the end of January 2022, in Moscow, the number of registered cases of SARS-CoV-2 infection in minors increased 14 times (from 2,000 to 28,000), and the number of hospitalizations increased 10 times, to 120 people per day. During the pandemic, local outbreaks of COVID-19 remain relevant, especially in organized groups. Aim. Description of a local outbreak of COVID-19 in an organized educational group of common residence, preventive measures and characteristics of the infection. Materials and methods. The results of the examination of the focus of COVID-19, medical records of hospitalized patients, regulatory documents, and literary sources were used. A descriptive epidemiological method was used. Statistical data processing was not carried out due to the small sample size. Results. In the spring of 2021, an outbreak of COVID-19 was registered in one specialized educational and methodological center in Moscow with ten victims. The center is located in a five-story brick building designed for the teaching and living of pupils. When registering the first case of COVID-19 in a specialized educational and methodological center, an operating mode was established on the principle of an observatory. Nine children were hospitalized and one teenager was treated for scrap in Moscow. All hospitalized patients underwent computed tomography of the chest organs, no changes in the lungs were noted, which is a significant difference compared to adults, in whom in most cases the SARS-Cov-2 virus enters the lungs. All patients in the hospital received antiviral therapy (Umifenovir 200 mg orally 4 times a day, 5 days), decongestants, local antiseptics, antihistamines were used according to indications. At discharge, all adolescents had positive results for COVID-19 according to the results of PCR swabs from the nasopharynx and oropharynx, and therefore, with an improvement in their general condition, they were transferred for further observation to the observational rehabilitation center COVID-19 «Krylatskiye kholmy». Conclusions. Living in communal dormitories and learning at the place of residence involves close contacts at home and during classes, which predetermines a high risk of infection with the SARS-Cov-2 virus and the occurrence of foci. Promptly carried out anti-epidemic measures make it possible to interrupt the chain of infections in the outbreak. Compared to adults, adolescents experienced fewer and less severe symptoms of COVID-19. Although in most cases, children do not get severely ill from COVID-19 as adults, they can play an important role in the transmission of the infection and in the formation of its outbreak.

Relevance. The demographic future of our country depends to a large extent on the level of fertility, which is determined by the reproductive health of the population. Aim. To conduct an analysis of the literature on the problems of reproductive health disorders among the young population and scientifically sound areas of prevention of diseases affecting the reproductive functions of the body. Results. Among the causes of reproductive health disorders, sexually transmitted infections, human papillomavirus infection, cervical cancer occupy a special place. Domestic and foreign authors agree on the importance of preventive work with adolescents and the adult population, considering it effective by optimizing reproductive behavior and forming motivation for a healthy lifestyle. Conclusion. Reproductive health can be addressed by eliminating factors that hurt the human reproductive system and preventing reproductive diseases from becoming decompensated, which can contribute to infertility. The ability to have children in the future is the foundation of commitment to prevention and treatment. Awareness of the population will prevent infection with infections that have a direct impact on the reproductive system, their timely diagnosis and treatment will make it possible to minimize the negative impact of infectious-inflammatory processes on the reproductive function of women and men.