Relevance. The problem of vaccine hesitancy is becoming even more urgent in the light of the coronavirus pandemic, which acted as an impetus for increasing public skepticism about vaccination. In 2019, the WHO declared vaccine hesitancy as one of the global health threats. Aims. The purpose of the research is a comprehensive analysis of the factors that cause vaccine hesitancy in Russian Federation, followed by recommendations for increasing population adherence to vaccination. Materials & Methods. Statistical, factual analysis of the research objects, as well as a qualitative and quantitative analysis of open sources data carried out. The main sources of information were anti-vaccination messages on social networks and the media, information from anti-vaccination communities on Vkontakte, official websites and social networks of relevant federal executive authorities of the Russian Federation. Results. Communication space. Social networks are the main source of dissemination of false information about vaccination. The most active platforms for the dissemination of anti-vaccination messages on social networks are Odnoklassniki and Vkontakte. Semantic analysis. Anti-vaccination rhetoric on Facebook, Instagram, Vkontakte, Odnoklassniki, Telegram, Twitter, Tik Tok, You Tube, Live Journal, the media, and forums is generally similar. As the object of anti-vaccination rhetoric, the words “vaccines”, “vaccination”, “vaccinations” most often appear in posts. Such rhetoric is more directed towards childhood vaccinations. The target audience of anti-vaccination propaganda is parents. The target audience. The sample of the target audience of the doubting population, compiled on the basis of social network Vkontakte users, amounted to 90,937 people. A significant part of the doubting population is represented by women (85%). As a result, the average age of target audience representative is 35.4 years. Major part of the audience is married – 83.1% of the total sample. Almost a third (24.1%) of the Russian audience of the anti-vaccination movement are residents of the Central Federal District. Influence groups. The activity of key influence groups members is characterized by a high level of cohesion within the anti-vaccination movement, which is manifested in mutual reposts of information, joint actions, live broadcasts and announcing the events of “comrades-in-arms”. Among the main motives for participating in the anti-vaccination movement are commercial interests in promoting services and products that are alternative to vaccination, as well as attracting the attention of the audience. It is important to note that the most active representatives of the anti-vaccination movement, for the most part, do not have a medical education. Measures to increase adherence. The state policy in relation to increasing the population adherence to population, as well as the activities of the pro-vaccination movement representatives, play an important role in strengthening the public's confidence in immunization. As part of increasing adherence to vaccination, a wide range of methods and means of informational impact on citizens is used - separate information portals, social networking, face-to-face educational events, special projects, organization of hotlines on vaccine prevention. Conclusions. Solving the problem of vaccine hesitancy under the influence of the anti-vaccination movement activities, rhetoric in the media and social networks, distrust of the state and the healthcare system, and personal perception of vaccination risks require an integrated approach to organizing measures for increasing adherence at the federal and regional levels. The immunization system development should be carried out by changing the regulatory legal framework in order to effectively implement such activities at all levels of the country's health care system.

Revalence. There is increasingly prominent growth of joint pathology, which in some cases assumes epidemic spread in recent period of science advancement. This tendency brought along interscience relations also establishing of post-non-classical period of science development. These changes bring on developing of new concepts in scientific views on estimate of studying essentials which in previous periods of science formation primarily drawing from inter discipline check could never met in cognitive work. Aim. Assess the prospects for studying comorbidity in the post-nonclassical period of science development on the example of interdisciplinary interactions of epidemic processes of tuberculosis (TB) and HIV infection. Results. A problem-oriented study identified three main «pain points» in the integrative impact of HIV infection on the spread of TB: the simultaneous development of epidemic processes with involvement in the general population; high activity of one-stage development of both infections; and positive statistically significant correlations in the compared pairs of infectious pathology indicators. Conclusion. New data on the formation of negative trends in the TB epidemic as influenced by HIV infection are based on the basic assumptions of the post[1]nonclassical period of scientific development and are realized through an interdisciplinary approach to the study of comorbidity.

Relevance. Enterococcus are ubiquitous, and can cause various infections, up to endocarditis. Vancomycin-resistant enterococcus (VRE) infections are difficult and expensive to treat. According to the AMRmap (Online Platform for Analysis of Antimicrobial Resistance Data in Russia) data for 2017–2020, VRE cases were reported in all federal districts of the Russian Federation, with one of the highest VRE rates in St. Petersburg (4.27%, 95% confidence interval [95% CI] 2.1–8.6)). But further, larger studies in each region are required. Aims. The study is to identify the epidemiological features of infections/colonization caused by VRE in Saint-Petersburg hospitals in 2017–2020. Materials and methods. A retrospective analysis of the prevalence of VRE isolated from hospital patients (51 hospitals of various profiles) in St. Petersburg for the period from 2017 to 2020 was performed. Results. During the study period, VRE rate was 5.3% (95% CI 5.1–5.6). The highest proportion (11.6%, 95% CI 10.4–13)) and incidence (0.6 per 1000 patients) of VRE was observed in children hospitals, the lowest – in maternity homes 0.5% (95% CI 0.3– 0.7). Throughout the analysis period VRE were detected in clinical specimens of patients from most of the departments. In adult hospitals, the proportion of VREs was significantly higher in oncohematology 14.6% (95% CI 9.6–21.7), neurology 10.8% (95% CI 7.4–15.6), and intensive care units 10.1% (95% CI 9.4–11.0). In 2020, there was a dramatic increase in VREs in neurology, cardiology, and infection departments in adult hospitals. Neonatology and intensive care units in children hospitals had the highest proportion of VRE, 40.7% (95% CI 34–48.3) and 29.8% (95% CI 21.04–40.3), respectively. In departments of other profiles, this rate varied from year to year, which may be related with clusters in hospitals and departments. Sporadic cases were detected in both neonatal and obstetric departments of maternity homes. The most common clinical specimen with isolated VRE was urine; this was characteristic of departments of almost all profiles and for children intensive care patients also VRE was isolated in gastric fluid and feces often. Conclusions. The proportion of VRE isolated from clinical specimens from patients in St. Petersburg hospitals is at an average level compared to other regions of the Russian Federation and other countries. The highest prevalence of VRE was noted in pediatric hospitals. Risk groups are patients of neonatology and intensive care departments in children's hospitals and oncohematology, neurology and intensive care departments in adult hospitals. VRE are most commonly found in the urine of patients. Screening for VRE among patients in at-risk units and contact precautions should be taken to VRE-infected/colonized patients.

Relevance A common mechanism of resistance is the synthesis of enzymes that inactivate the antibiotic (AB). Since its discovery at the end of the 20th century, ESBLs have spread widely throughout the world. Representatives of this group of complex protein compounds have common properties of hydrolysis of ß-lactam antibiotics and differ from each other in amino acid sequence. The genetic determinants that determine their synthesis are the bla-CTX-M, bla-SHV, and bla-TEM genes. Aims. To assess the prevalence of bla-CTX-M, bla-SHV, bla-TEM genes in antibiotic-resistant strains of enterobacteria isolated from samples of patients of the perinatal center. Materials & Methods. We studied 135 strains of ESBL-producing enterobacteria isolated during microbiological monitoring from January 01, 2020 to December 31, 2021. Biological material (feces (92), blood (1), urine (5), cervical canal discharge (33), last (4)) came from patients of the perinatal center (43 women and 92 newborns), examined both for clinical indications and during local microbiological monitoring. Species identification of isolated microorganisms was carried out by bacteriological method, detection of antibiotic resistance genes was carried out using real-time PCR. Results. In 87 cases (64.4%), the studied genetic determinants of antibiotic resistance were successfully identified. Of the 26 studied strains of Klebsiella pneumonia, 24 (92.3%) were able to establish the determinants of resistance to AB, 50% of which are represented by bla-CTX-M. Out of 66 Escherichia coli, 59 (89.33%) had a genetic profile of antibiotic resistance, which was also dominated by bla-CTX-M (67.80%). However, in the Enterobacter cloacae group, it was possible to determine the presence of the studied genes only in 8.10% of cases. K. pneumoniae carrying three antibiotic resistance genes bla-CTX-M, bla-SHV, bla-TEM was isolated once from a sample of the cervical canal of a woman aged 27 years. E. coli strains carrying the CTX-M gene were isolated from 3 mother-child pairs out of 135 cases: in mothers – from the discharge of the cervical canal in the third trimester of pregnancy, in newborns – from feces in the first week of life, which can indicate possible transmission of an AB-resistant microorganism either in utero or through the birth canal. Conclusions. Thus, in the course of the study, determinants of antibiotic resistance of enterobacteria isolated from patients of the perinatal center were identified in 64.4% of cases. The dominant gene leading to the occurrence of AD among ESBL is the bla-CTX-M gene. The number of strains with an established genetic profile of resistance to AB is less among Enterobacter cloacae (p<0.001). In order to study the genetic profile in more detail and to identify the mechanisms for the formation of antibiotic resistance, it is necessary to expand the detection of observed genes

Relevance. At the beginning of the pandemic, there was regional variability in incidence rates not only for COVID-19, but also for other acute respiratory infections of the upper and lower respiratory tract (ARIs). The first cases of COVID-19 in the Irkutsk region were detected two months later than the first cases in Russia, and at the beginning of the epidemic, the disease slowly spread among the local population. A retrospective analysis of ARIs monitoring is necessary to improve epidemiological surveillance. The aim of the work is to identify annual and seasonal changes in the incidence of ARIs and the circulation of respiratory viruses in the Irkutsk region before and during the first months of the epidemic of a new coronavirus infection. Materials and methods. A retrospective descriptive study was conducted based on the results of regional monitoring for 2017–2020. The analysis included records of acute infections of the upper (J06) and lower (J20-J22) respiratory tract, influenza (J10, J11), community-acquired pneumonia (J12-J16, J18) and COVID-19 (U07.1, U07.2), as well as the results of a study of 5.5 thousand samples from patients with ARIs. Respiratory viruses (n = 10) were detected using reagent kits for polymerase chain reaction (PCR) «AmpliSense® Influenza virus A/B-FL», «AmpliSense®ORVI-screen-Fl» (Russia). The distribution of incidence rates and PCR results was analyzed by years, epidemic seasons, calendar weeks, and age groups. Results. In 2020, the incidence of COVID-19 was 3180 per 100,000 population, or 7% of all cases of ARIs of the upper and lower respiratory tract (∑ARIs). In 2020, according to epidemiological service, the number of cases of acute respiratory infections decreased by 25.7%, but the number of cases of community-acquired pneumonia (CAP) increased by 83.2% (p < 0.001) compared to 2019. The incidence of CAP reached 1400 per 100,000 population. The proportion of children in the structure of CAP incidence decreased from 39.4% to 12.6% (p < 0.001), and the proportion of adults increased from 60.6% to 87.3% (p < 0.001). These changes were most pronounced during the «second wave» of COVID-19 at the end of 2020. The share of CAP in ∑ARIs on average for 2017-2020 was 2.62% (CI 2.56–2.68). This indicator was exceeded at the end of 2020 during the COVID-19 epidemic – 8.08 (CI 8.07–8.09), and also at the beginning of 2019 during the influenza epidemic – 2.83% (CI 2.81–2.85). In 2019–2020 an increase in the frequency of positive tests for human coronaviruses (hCovs) up to 2.1–2.3% was registered, compared with 0.7–0.9% in 2017–2018 (p<0.05). Rhinoviruses continued to circulate actively during the COVID-19 epidemic. A significant correspondence between the frequency of detection of viruses and the share of CAP in ARIs was established only for influenza viruses (χ2 = 26.2, p < 0.01). For other viruses, the relationship is not statistically significant (p > 0.05). Conclusions. The start of the COVID-19 epidemic was accompanied by significant changes in the incidence of ARIs, although in 2020 the number of registered cases did not exceed 10% of ARIs. The increase in the proportion of CAP in ARIs and the change in age risk groups deserve special attention. The epidemiological analysis does not confirm the hypothesis of a possible spread of SARS-Cov2 in the Irkutsk region before 2020.

Relevance. The new coronavirus infection (COVID-19), which appeared in late 2019 in China, has spread to almost all countries of the world in just a few months. The explosive nature of its spread was accompanied by the formation of large epidemic foci in organizations of various profiles, including leisure and sports. Aims. To establish the conditions and causes of the spread of SARS-CoV-2 among the members of one of the sports clubs based on an in-depth epidemiological analysis. Materials and methods. To study the features of the spread of the SARS-CoV-2 virus in a sports organization, the following documents were used previously developed by the authors and successfully tested in practice: «Act of epidemiological investigation of group and outbreak morbidity of new coronavirus infection (COVID-19) at an enterprise/organization/institution» and «Individual card of a patient with a new coronavirus infection (COVID-19) at the enterprise / organization/institution». In the process of epidemiological investigation, in order to detect SARS-CoV-2 RNA in PCR, a laboratory examination of sports club participants (sick and contact) was conducted, followed by genome-wide sequencing of isolated SARS-CoV-2 viruses on the basis of the Laboratory of Molecular Virology of the A. A. Smorodintsev Influenza Research Institute, which performs these types of studies. Results. Within 17 days, 26 cases of COVID- 19 were registered among the sports team members and staff from the support group (coaching staff, medical staff, administrators), which was 74.3% of their actual number. The majority of patients (76.9%) had mild acute respiratory infection, two (7.7%) had no symptoms, and four (15.4%) had interstitial pneumonia. Of the clinical manifestations of the disease, the most frequent were weakness, fever, headache, muscle and joint pain, difficulty in nasal breathing and serous-mucous discharge from the nose, sore throat, cough, shortness of breath, anosmia and dyspeptic manifestations in the form of diarrhea, nausea or vomiting. The occurrence of the outbreak was the result of the introduction of infection from the opposing team at the tournament. The leading factors that contributed to the spread of COVID-19 among sports club members were the admission to games and training of athletes with acute respiratory infections, prolonged close contact between players during training and competitions, violations in the use of personal protective equipment, compliance with hygiene and hand antiseptics, disinfection measures in the premises of sports institutions and defects in the implementation of the regulations for the examination of teams for SARS-CoV-2 during tournaments. Conclusion. Based on the results of the study, data were obtained on the features of the spread of SARS-CoV-2 in sports organizations, which can be used in conducting preventive and anti-epidemic measures in sports and leisure institutions.

Relevance. Acute respiratory infections (ARI) are a serious health problem not only because of the high frequency of their occurrence, but also because of the economic damage they cause both in the form of direct costs (the cost of diagnosis and treatment) and indirect costs (disability, reduced labor productivity, etc.). Pregnant women and children under 5 years of age are included in the group of patients with risk factors for complications of influenza and other ARI, therefore, an analysis of the etiological structure of ARI and influenza in obstetric hospitals is an urgent task. In recent years, there has been an urgent need to create a national complex diagnostic test system based on molecular genetic methods for detecting infectious agents that cause ARI. Aims. The aim of the study is to analyze the etiological structure of ARI and influenza in patients with clinical symptoms and to develop and implement a new test system for rapid screening and diagnosis of infections that cause ARI. Materials & methods. When studying the etiological structure of ARI and influenza, cultural studies of the nasal and pharyngeal mucosa were carried out, followed by identification of microorganisms using MALDI-TOF mass spectrometry and molecular genetic study (real-time PCR) using an experimental test panel containing primers that allow detecting the following viruses: influenza A, B viruses, parainfluenza viruses of the 1st, 2nd, 3rd and 4th types, coronaviruses OS43, HKU1, NL63, E229, respiratory syncytial virus, metapneumovirus, rhinovirus and adenovirus, as well as bacterial pathogens of ARI: Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus pyogenes, Moraxella catarrhalis, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa. The test system was developed using the following methods: real-time PCR, a combination of reverse transcription and real-time PCR (RT-PCR) and the next generation sequencing (NGS) method. Results. The etiological structure of ARI and influenza was analyzed in patients with clinical manifestations (cough, tickling/sore throat/hyperemia of the mucous membrane of the palate and the back wall of the pharynx, shortness of breath/difficulty breathing, acute runny nose/nasal congestion). The species spectrum of bacterial and viral pathogens was revealed. A new test system based on PCR, real-time RT-PCR and NGS has been created for complex diagnostics of both viral and bacterial pathogens of ARI, consisting of three separate components: the main test system «ARI», which detects the main viral and bacterial pathogens of ARI, and two additional sets of reagents: «Oseltamivir resistance» and «Oseltamivir/ Zanamivir resistance». Conclusions. The new test system can be used to detect and differentiate nucleic acids of pathogens of ARI of humans. The test system seems to us promising for further use. As a result of the analysis of the etiological structure of acute respiratory infections and influenza, attention is drawn to a significantly smaller variety of identified pathogens in 2020 and a much more pronounced dominance of rhinovirus infection compared to our previous study in 2019.

Relevance. Determining the quality of a systematic review is known to be of the main criteria to consider when making a clinical decision. And various assessment tools allow you to determine this, both for the readers themselves and for those who write a systematic review. Aim. In this study we investigate characteristics of the AMSTAR 2 assessment tool to determine the methodological quality of systematic reviews of intervention research, as well as validated the Russian version of this questionnaire. Materials and methods. We used an adapted Russian version of AMSTAR 2 (our own translation) to conduct a descriptive study of systematic reviews which were made in the Russian language. The search for Russian-language studies was carried out in the electronic scientific library named «eLibrary», by keywords and their combinations, without chronological restrictions. The selection of publications (total 10) was carried out randomly. After that, the methodological quality was assessed independently by three authors. The agreement of expert assessments was measured by calculating the coefficient kappa according to the J. Fleiss’ method. Under the null hypothesis H0 we meant kappa equaled 0, that is, the observed agreement between the reviewers is tantamount to random agreement. When testing statistical hypotheses, p < 0.05 was used. Statistical analysis was carried out in R 4.1.2 (RStudio 1.1.463), using the kappaGUI and irr packages. Results. We have translated the AMSTAR 2 questionnaire (16 signalling questions) into Russian, as well as made terminological and methodological additions to it. The preliminary analysis showed that our Russian-language version of this evaluation tool allows us to properly assess the methodological quality of systematic reviews and meta-analyses, their potential value for consumers of evidence-based information regarding the effectiveness of medical interventions. Conclusion. The AMSTAR 2 methodology allows critical evaluation of systematic reviews not only of randomized controlled clinical trials, but of non-randomized trials. The extended functionality of the questionnaire, in particular its Russian version, makes it possible to unambiguously determine the correctness of the methodology for writing a systematic review and meta-analysis, which will help in finding a high-quality review and control at the writing stage.

Relevance According to many researchers, hepatitis D worsens the prognosis of hepatitis B in 80–90% of cases, accelerating fibrosis and leading to liver cirrhosis or hepatocellular carcinoma. Aims. To present a review of data on prevalence of hepatitis D in the Russian Federation and abroad. Conclusions. Hepatitis D is most common in such regions of the world as: Africa, South America, Middle East, North Asia and in some Mediterranean countries. Conclusions. Injecting drug users play a large role among vulnerable populations. Hepatitis B vaccination limits the spread of hepatitis D.

Relevance. Diphtheria toxoid (DT) and tetanus toxoid (TT) manufacturing appears as many steps process. On every stage of proceeding vaccine the control of critical points is being provided. The Parke Williams 8 strain of Corynebacterium diphtheriae used in Russia for producing DT, Clostridium tetani strain Harvard – for TT. Each culture's supernatant proceed being estimated in relevance of toxoid potency via in vivo and/or in vitro methods. To produce DT, the activity of the toxoid must be not less than 50 Lf/ml and 40 Lf/ml for TT. Toxoids must fit in the main safety conditions – absence of toxin and reversion to toxicity impossibility. In accordance with WHO recommendations, five guinea pigs are injected subcutaneously with at least 500 Lf/ml of purified diphtheria toxoid, animals are observed for 42 days. By the end of observation period not the least than 80% of animals must remain alive without diphtheria intoxication (red adrenals). In Russia WHO approach was modified: guinea pigs are injected subcutaneously with purified diphtheria toxoid at a dose of at least 1500 Lf. During 42 days long observation period weight loss and animals dies must not appear. In case of death purified DT is not applicable. TT specific safety control is also carried out on guinea pigs. In accordance with WHO recommendations, five animals are injected subcutaneously with 500 Lf of purified TT. The animals are observed for 21 days daily, noting clinical signs of tetanus. If during the entire observation period no tetanus symptoms are observed in a single guinea pig and after the entire observation period 80% of the animals survives, tetanus toxoid is considered suitable for use. In Russia, the test for the absence of tetanus toxin is carried out similarly, excepting tetanus toxoid dose, which is 1500 Lf. The suitability criteria for purified TT are the absence of clinical signs of tetanus intoxication, weight loss and death of animals throughout entire observation period. Toxicity reversion tests are also provided. WHO considers guinea pig intradermal test to be suitable method for detecting diphtheria toxin, while guinea-pig methods are preferred for tetanus toxin, due to mice less sensitivity to tetanus toxin. In Russia, the most sensitive methods are used to detect the presence of toxins: intradermal administration to two guinea pigs in a volume of 0.1 ml or to one rabbit in a volume of 0.2 ml when testing diphtheria toxoid. Within four days, local reactions must not appear at the injection site. In the event of reactions, hence reversal of toxicity, the substance is rejected. When testing tetanus toxoid, five guinea pigs are injected subcutaneously into both sides of ten single human doses. Animals should be free of clinical signs of tetanus for 21 days after injection. Diphtheria and tetanus toxoids, after adsorption to a suitable adjuvant are monitored for specific safety. In accordance with WHO recommendations, at least 5 single human doses are administered subcutaneously to five guinea pigs. In case of testing adsorbed diphtheria toxoid, animals are observed for 42 days, tetanus toxoid – 21 days. The criteria for evaluating the suitability of adsorbed DT and TT are similar: during the entire observation period, animals should not show signs of diphtheria or tetanus intoxication; at the end of the observation period, at least 80% of the animals remain alive. In Russia, to test adsorbed DT and TT, five guinea pigs are injected subcutaneously with 10 single human doses. The duration of observation of animals in the DT test is 21 days, in the TT test – 30 days. The drug is considered to have passed the test if, during the entire observation period, the animals did not experience weight loss, signs of tetanus or, respectively, diphtheria intoxication, and all animals remained alive. In the event of the death of at least one animal in both cases from specific intoxication, the drug is considered not to have passed the test. Modern identifying potency (immunogenicity) of diphtheria toxoid and tetanus toxoid tests are based on determining immunized animals resistance for administration challenge toxin or evaluation of protective antibodies level in serum. In Russia to assess the potency of diphtheria toxoid (DT) and tetanus toxoid the challenge lethal method has been used for more than 60 years, challenge is based on determination of potency via its possibility to defend immunized animals from lethal doses of toxins. This method is used as «golden standard». The analysis of normative documents and guidelines of the World Health Organization, the European Union, the USA and Japan, concerning the issues of safety assessment and methods for determining the immunogenicity of diphtheria and tetanus toxoids at all stages of production, was carried out. It has been established that the approach adopted in the Russian Federation meets all international requirements. Moreover, with regard to methods for detecting reversion of toxicity, the most sensitive methods and more stringent criteria for the acceptance of experience are applied. The review presents data on methods for determining the immunogenicity of vaccines for the prevention of diphtheria and tetanus in the world. The advantages and disadvantages of some methods are reflected. The results of the analysis of these methods allow us to conclude that it is necessary to harmonize domestic and international methods for assessing the safety and immunogenicity of diphtheria and tetanus toxoids, which will make it possible not only to facilitate the registration of foreign vaccines in Russia, but also to speed up the registration of domestic vaccines in other countries.

Relevance. Hand, foot and mouth disease (HFMD) is a disease that is extremely relevant for the Russian Federation. According to modern data, epidemic outbreaks of severe course involving a large number of children are registered in the Russian Federation. At the same time, the mortality rate varies worldwide and can range from 6.46 to 51.00 per 100 thousand population. In addition, the fact that the Russian Federation borders with East and Southeast Asia annually increases the risk of HFMD entering the territory of Russia. Every year, the disease causes more than 2 million hospitalizations in Asia. Aims. According to the literature, to analyze the epidemiological characteristics of HFMD in the Russian Federation and the world, as well as the prospects for vaccination of this infection. To achieve this goal, open sources hosted in the electronic databases PubMed, Medline and e-Library were used. Publications on enterovirus infection for the period from 2014 to 2022 are analyzed. The WHO (Western Pacific Region) statistics on HFMD were also used. Results. According to the modern literature, HFMD is the most common clinical form of enterovirus infection, which is characterized by high heterogeneity of pathogens. Over the past few years, the incidence of enterovirus infection in many subjects of the Russian Federation has been characterized by an upward trend. The most unfavorable epidemic situation in the Russian Federation is observed on the territory of the Far Eastern Federal District, where the largest number of cases of enterovirus infection is registered. In 2018, 1058 cases of enterovirus infection were detected in the Sakhalin region (222.6 cases per 100 thousand). The structure of enterovirus infection in the Russian Federation is dominated by exanthemic forms, herpangina and gastroenteritis. It is necessary to consider the introduction of vaccination of the child population, since rises in the incidence of enterovirus infection in various regions are registered annually on the territory of the Russian Federation. Vaccines against EV-A71 are already being used in China for epidemic indications. The active circulation of HFMD in the Asia-Pacific region may affect the spread of enterovirus infection in the territory of the Russian Federation, as the risk of imported cases of infection and the formation of epidemic foci of group morbidity increases.

Relevance. Nonspecific anti-epidemic measures against СOVID-19 (mask-wearing, social distancing, lockdowns, homework, quarantines, school closures, tourism bans, etc.) resulted in a significant decrease in the incidence of many respiratory infections. Scientific publications have reported a decrease in the incidence of bacterial purulent meningitis (BMP) during the development of the COVID-19 pandemic. Aims. To review the scientific publications on the decline in the incidence of BMP during the СOVID-19 pandemic. Conclusions. Undoubtedly non-specific anti-epidemic measures taken during the COVID-19 pandemic helped to reduce the incidence of respiratory infections regardless of their etiology and could serve as an indirect indicator of the activity of these measures.