Annualy, SARS occupy a leading position in terms of morbidity and the magnitude of the economic damage caused both in the world and in the Russian Federation. Currently, the most widespread pandemics are caused by the influenza A (H1N1) pdm09 virus and the new SARS-CoV-2 coronavirus, which occupy a common ecological niche and require studying the manifestations of the epidemic process of ARVI for further development of measures to improve epidemiological surveillance of this group of infections. Aim of the study was to investigate the current manifestations of the epidemic process of ARVI and influenza, including in the context of a new coronavirus infection (COVID–19) pandemic, on the territory of Russia and in Moscow. Materials and methods. The assessment of the long-term dynamics of the incidence of ARVI and influenza (from 1999 to 2021), as well as its age structure in the territory of the Russian Federation and in Moscow, was carried out. The main sources of information were: WHO: «The situation with COVID-19 in the European region», the domestic information portal Stopkoronavirus.rf, as well as data from Federal State Statistical Observation forms No. 2 and No. 6. Results. During the period 2013–2019, a strong positive correlation was revealed between the incidence rates of ARVI in the Russian Federation and Moscow (p = 0.8, with p < 0.05), which became negative with the spread of SARS-CoV-2: in the country, the incidence rate of ARVI increased by 11.5% in 2020 and 15.6% in 2021., in Moscow there was a decrease of 45.1% than the average in Russia, which could be due to the quality of differential diagnosis of ARVI and COVID-19. In 2021 the incidence rate of influenza decreased by more than 2 times in all Federal Districts of the country, with the exception of the capital region, where it became the maximum - 65.9 per 100 thousand population in 2021 (against 14.1 in 2019). In the age structure of influenza incidence, as well as ARVI, for the period from 2019 to 2021. the child population prevailed with the highest rates in the age groups of 1–2 years and 3–6 years. As the circulation of SARS-Cov-2 decreased to 15–19%, the activity of influenza viruses and other pathogens of the ARVI group increased (from 0.7–3.0% during the developed pandemic to 5.6–6.6% at the stage of its decline), which indicates a pronounced interference of pathogens detected at the global level in the system of Global Hospital Surveillance for flu. Conclusion. The forecast for the upcoming epidemic season 2022–2023 largely depends on the spread of the new coronavirus SARS-CoV-2, as well as its variability and the emergence of new variants. Nevertheless, there may be a significant increase in the incidence caused by the influenza A(H1N1)pdm09 virus, whose high activity was recorded in the current epidemic season in a number of countries in the Southern hemisphere.

Relevance. The long-term leadership of ARVI pathogens determines their significance in the damage caused to both health and the economy of the country. Aim. To identify the features of the structure of ARVI during the emergence and widespread spread of SARS-CoV-2. Materials and methods. The article uses methods used in epidemiological surveillance of acute respiratory viral infections. Results and discussion. The results of the diagnostic available ARVI pathogens monitoring during epidemic seasons 2018-2021 are presented. The tendency of greater engagement of aged group 15 y.o. and older in epidemic process by morbidity and hospitalization due to SARI was shown. 49 818 nasal swabs from patients with influenza infection, 36 044 – with ARVI and 59 062 – with SARS-CoV-2 were tested. The top three in the structure of ARVI were INF, HEV-D and HRSV (in the 2018–2019 season); INF, SARS-CoV-2 and HEV-D (2019–2020); SARS-CoV-2, HEV-D and HPIV/HCoV (2020–2021). The activity of viral pathogens also differed: for HPIV, HAdV, HEV-D, HMPV, a decrease in activity was noted during the appearance of SARS-CoV-2 (2019–2020) and some of its growth in the following season; in relation to HRSV and INF - a decrease in activity during the last two seasons, and for INF – extremely low activity in the 2020-2021 season; the activity of seasonal HCoV even increased slightly. The data of genetic analyses of SARS-CoV-2 positive samples showed the heterogeneity of its population with a representative of variants (Alfa, Delta) as well as endemic for Russia and Moscow variants only. The recommended composition of influenza virus vaccines for use in the 2021–2022 northern hemisphere influenza season and in the 2022 southern hemisphere influenza season are presented due to their drift changeability. Conclusions. SARS-CoV-2 was influenced by the activity of ARVI pathogens with the almost complete displacement of influenza viruses from the circulation in the period 2020–2021.

Relevance. The study of the incidence of medical workers with a new coronavirus infection during the COVID-19 pandemic is one of the topical areas of epidemiological research at this stage. The search for effective practices to reduce the incidence and risk of SARS-CoV-2 spread among employees of medical organizations is a promising area of research that is in demand in practice. Аim. Analysis of COVID-19 morbidity among health care staff during the pandemic and determination of the significance of selected specific and nonspecific prophylaxis measures in minimizing the risk of their occupational infection with SARS-CoV-2. Materials and methods. The reporting forms «General information about patients with positive COVID-19», «General information about patients with community-acquired pneumonia with positive COVID-19» (497 units of information), 2 176 cards of epidemiological investigation of cases of COVID-19 among employees of three municipalities were analyzed. We used epidemiological and statistical research methods. Conclusions. When analyzing the incidence of COVID-19 among employees of the medical worckers of the Khanty-Mansi autonomous оkrug – Yugra in the period from the 19th calendar week of 2020 to the 36th week of 2021, which corresponded to three epidemic rises, it was found that its level exceeded such in the unorganized adult population by 2.2 times, as well as the frequency of severe clinical forms of infection with lung damage. In the first two epidemic rises in the incidence, the highest incidence rate was recorded when the chances (OR) of getting COVID-19 among workers in the medical organizations compared to the adult population were the highest. In the first «wave» of the pandemic, they were 3.0, and in the second 2.6 times higher, as were the chances of developing clinical forms of COVID-19 with lung damage, which differed by 2.2 and 1.7 times, respectively, from those of an adult population (p<0.05). During the third epidemic rise, the situation changed radically. The incidence of new coronavirus infection in ,medical worckers as well as the chances of getting sick, were equal to those in the adult population (OR 1.1), while the frequency of clinical forms of infection with lung involvement was even lower than in the population (P=95.7‰). The reason for the positive changes in the dynamics of the epidemic process was due to the formation among medical workers of a higher stratum of people protected from infection due to active, emergency vaccination and people with post-infection immunity as a result of infection in its various clinical forms than in the population. A detailed analysis of the incidence of COVID-19 in three medical organizations of Khanty-Mansiysk autonomous okrug - Yugra made it possible to obtain information that among employees of medical organizations vaccinated against a new coronavirus infection, the incidence of COVID-19 was 4.4 times lower than among those who were not vaccinated. In the cohort of those vaccinated, the frequency of clinical forms of the disease complicated by pneumonia was 4.7 times less, and the number of those hospitalized for inpatient treatment was 20.8 times lower. In medical workers who received a booster dose of the drug after vaccination, the incidence was 5.8 times lower compared to the unvaccinated cohort. Compared with the unvaccinated, there were 12.8 times fewer complicated clinical forms of the disease and 6.25 times the number of hospitalizations among them. A correlation was also found between the incidence of COVID-19 among employees of the medical workers and the area of premises per employee. Increasing the area of the premises per employee per 1 sq. m. led to a decrease in incidence by 2.1%.

Relevance. During the ongoing pandemic of a new coronavirus infection (COVID-19), assessment of humoral immunity to vaccine preventable diseases in healthcare workers is crucial to estimate the risk of healthcare-associated infections. Aim. To assess the humoral immunity to vaccine-preventable diseases: whooping cough, influenza A, viral hepatitis A and B, new coronavirus infection (COVID-19), in healthcare professionals working with infectious patients. Materials and methods. We conducted a cross-sectional study enrolling 252 healthcare workers, which included a survey and assessment of immunoglobulins G to Bordetella pertussis, influenza A virus, hepatitis A virus, HBsAg and HBcAg of hepatitis B virus, and SARS- COV-2 by enzyme immunoassay. Results. The proportion of healthcare workers seronegative to pertussis was 46.8%, to influenza – 31.4%, to hepatitis A – 52.4%, to hepatitis B – 27.5%, to the SARS-CoV-2 virus – 29.8%. In 8.0% of cases the level of antibodies to Bordetella pertussis indicated a recent infection. The largest proportion of seronegative to pertussis (55.2%) was among individuals younger than 30 years. More than 80% of healthcare workers were vaccinated against seasonal influenza A during the previous year, 67.6% of them were seropositive. More than half (51.8%) of vaccinated but seronegative to influenza A health workers were older than 50 years. The odds of being seropositive to influenza A decreased with age, while the odds of being seropositive for viral hepatitis A increased with age. Vaccination against viral hepatitis B was received by 86.9% of people, 78.5% of them were seropositive to HBsAg, the remaining 21.5% needed revaccination. The proportion of healthcare workers seropositive for the SARS-CoV-2 virus was 57.5%, equivocal results were obtained in 12.7% of cases. The proportion of seronegative among those who had previously had COVID-19 was 40%, while among those who were vaccinated – 17.4%. Conclusion. The study showed a complex assessment of humoral immunity to the most common vaccine-preventable diseases: pertussis, influenza A, viral hepatitis А, B and novel coronavirus infection (COVID-19) in healthcare workers during the ongoing pandemic and allowed to make the following conclusions: 1. The proportion of healthcare workers susceptible to pertussis was 46.8% that required regular vaccination/revaccination of the seronegative healthcare workers to reduce the risk of infections healthcare-associated infections. 2. The proportion of healthcare workers vaccinated against influenza was 80% and exceeded the proportion of seropositive – 68.7%. 3. The proportion of healthcare workers seronegative to viral hepatitis B was 27.5%, to viral hepatitis A – 52.4%. 4. The COVID-19 seroprevalence among healthcare workers was 57.5%, regardless of whether it was obtained naturally or via vaccination. The proportion of seronegative healthcare workers among those having COVID-19 was 40%, among vaccinated – 17.4%, which confirms the necessity of vaccination / revaccination either after the infection or after the vaccination.

Relevance. The accumulation of information (statistical data and knowledge) about the COVID-19 pandemic leads to the refinement of mathematical models, to the expansion of the area of their use. The aim of this study is to build a set of models (in line with current knowledge and data) to identify the functions that drive the dynamics of a pandemic and analyze the possibilities for making predictions. Materials and methods. The work used data from open statistical and information resources relating to all aspects of COVID-19. The basis of the study is the balanced identification method and the information technology of the same name, created at the Center for Distributed Computing of the Institute for Information Transmission Problems of the Russian Academy of Sciences. The technology is used to build (select) models that correspond to the quantity and quality of data, perform calculations (forecasts) and present results (all the graphs below were prepared on its basis). Result. The constructed models satisfactorily describe the dynamics of the incidence of COVID-19 in Moscow. They can be used for a forecast with a horizon of several months, provided that new, previously absent elements do not appear in the modeled object. The main internal mechanism that determines the dynamics of the model is herd immunity and an increase in the infectivity of the virus (due to the spread of Delta and Omicron strains). Conclusion. The results of the successful use of balanced identification technology for monitoring the COVID-19 pandemic are presented: models corresponding to data available at various points in time (from March 2020 to December 2021); the acquired new knowledge - functional dependencies that determine the dynamics of the system; calculations of various epidemic indicators (morbidity, immunity, reproduction indices, etc.); various forecasts for Moscow (from 12/01/2020, 04/15/2021, 08/01/2021 and 08/01/2021).

Relevance. Combined foci of zoonotic infections are found in all regions of the Russian Federation. A feature of combined foci is the common biocenosis for populations of pathogens of various etiologies (bacteria, viruses, parasitic infections) and the formation of natural foci by them. Aim. Epizootological study of the territory in the south of the Arkhangelsk region for the presence of combined foci of zoonotic infections (tularemia, leptospirosis and hemorrhagic fever with renal syndrome – HFRS). Materials and methods. 135 small mammals were captured and examined in the Ustyansky district of the Arkhangelsk region. Established the species composition and mixed infection among small mammals pathogens of tularemia, leptospirosis, hemorrhagic fever with renal syndrome. Results. In the south of the Arkhangelsk Region in the Ustyansky District, in 2019, for the first time, a combined natural focus of the forest type was identified and characterized. The bank vole and the common shrew are the main carriers of the causative agents of these infections. Five species of small mammals are mixed-infected with the causative agents of these infections. Infected animals with one, two or three pathogens were simultaneously detected in all studied biotopes. This indicates the presence of a combined natural focus of tularemia, leptospirosis, and HFRS. Conclusion. The existence of a combined natural focus of tularemia, leptospirosis and HFRS in middle taiga ecosystems in the south in the Ustyansky district of the Arkhangelsk region was revealed for the first time. Thus, this area can be considered enzootic for tularemia, leptospirosis and HFRS. This focus belongs to the forest type in terms of landscape and geographical characteristics. Mixed infection of small mammals suggests the possibility of simultaneous infection with pathogens of two or more infections, not only animals, but also people located on the territory of natural foci. and non-simultaneous infection of humans with tularemia, leptospirosis and HFRS in combined foci.

Relevance. According to official data, in 2020 in Russia, Ixodic tick-borne borreliosis took the leading position in the prevalence and registration frequency among tick-borne infections, which amounted to 38.5% of all cases of natural focal transmissible infections. In the Tomsk region for many years, the average long-term incidence of Ixodic tick-borne borreliosis exceeds the Russian one by more than 3 times. Aim. Identify features the features of the clinical and epidemiological manifestations of the Ixodic tick borne borreliosis foci in the Tomsk region; to identify priority areas for carrying out problem-oriented research in the field of ecology, epidemiology and the clinic of borreliosis infection in the Tomsk region. Materials and methods. The material for the study was the data of the federal statistical observation form «Information on infectious and parasitic morbidity» for the 2015-2020. The materials of 713 cases of Ixodic tick-borne borreliosis disease and more than 125 thousand appeals to medical organizations of the region regarding the tick bites, registered in official registration forms, were studied. As part of the annual epidemiological monitoring for a six-year period, 1200 specimens of Ixodid ticks collected in natural biotopes of the Tomsk region were examined for the presence of Borrelia DNA, depending on their genus (Ixodes and Dermacentor). DNA detection of Borrelia burgdorferi sensu lato complex (B. burgdorferi, B. garinii, B. afzelii) and B. miyamotoi was performed by real-time PCR. Results. The high number of ixodid ticks in local areas of natural biotopes (up to 200.0 specimens/km at the height of the epidemiological season), as well as the failure to comply with personal prevention measures, determines a consistently high rate of referral of the population of the Tomsk region to medical organizations due to tick bites. The number of requests annually averages 20.8 thousand. As a result of an annual study using PCR tests of ticks taken from people who applied to emergency prevention centers, Borrelia DNA was detected on average in 40% of samples; blood samples from individuals affected by tick bites were positive on average in 3.7% of cases. In the period 2015-2019 spirochetes B. garinii and B. afzelii were most often found in the tissues of ixodid ticks. Since 2020, the species Borrelia miyamotoi has been included in the list of pathogenic borrelia species to be monitored in the Tomsk region – spontaneous infection of ticks (Ixodes) was 3%. The maximum values both in the number of patients with ixodic tick-borne borreliosis and in the density of infections per 10,000 hectares (90-110 cases) are observed in the south of the Tomsk region (Asinovskyi, Kozhevnikovskyi, Krivosheinskyi, Tomskyi, Shegarskyi districts, the city of Tomsk). In the epidemic season of 2020, the number of laboratory-confirmed cases of non-erythema ixodic tick-borne borreliosis was more than 2.5 times higher than the number of diseases with skin manifestations. Conclusion. The large number of ixode mites in natural biotopes, the high degree of their infection with pathogenic spirochetes indicate the presence of active natural foci of ixodic tick-borne borreliosis in the Tomsk region. The study of the genotypic diversity of pathogenic borrelias in relation to the species diversity of vectors, the analysis of the clinical manifestations of different etiological variants of tick-borne borreliosis (mono- and mixed infections), as well as the development of an algorithm for differential diagnostic search and a model for predicting the outcomes of the infectious process in tick-borne borreliosis and mixed infections are priority directions of problem-oriented scientific research in Tomsk region.

Relevance. Corynebacterium spp., being opportunistic microorganisms, play a role in the development of inflammatory diseases of various localization, including HCAI. Possessing multiple resistance to AMP and pathogenic properties, they cause infections that are not controlled by means of vaccine prophylaxis. The aim of the study was to evaluate the prevalence and virulent properties of Corynebacterium spp. strains isolated from patients with inflammatory diseases of the respiratory tract. Materials and methods. Strains of Corynebacterium spp. isolated from the pharynx and nose of patients with inflammatory diseases of the respiratory tract (99 pcs.) and practically healthy individuals (33 pcs.) at 2017–2021 in Rostov-on-Don. The ultrastructure of corynebacteria was studied using a TecnaiG2 Spirit BioTWIN transmission electron microscope (FEI, Czech Republic); cytopathic effect (CPE) on CHO-K1 cell culture; virulence in the larval model of the wax moth Galleria mellonella. Results and discussion. The species diversity of Corynebacterium spp. strains isolated from patients is much wider than in the examination of practically healthy individuals (16 and 6 species of Corynebacterium, respectively). An electron microscopic study revealed morphological features of the cell ultrastructure of various strains of Corynebacterium spp., possibly associated with their ability to damage. The strains of C. striatum, C. aurimucosum, C. coyleae, C. falsenii, C. argentoratense, C. afermentans, C. amycolatum, C. freneyi, C. simulans isolated from patients had the highest level of CPЕ. Corynebacterium spp. strains isolated from patients had different levels of virulence against G. mellonella larvae. This testified to the importance of establishing not so much the species as the strain of these microorganisms. Conclusion. A wide species diversity of strains of Corynebacterium spp., isolated from patients with inflammatory diseases of the respiratory tract, mainly of childhood, was found. The most frequently isolated species were C. pseudodiphtheriticum, C. propinquum and C. accolens. Strains of Corynebacterium spp., isolated from patients, were mainly characterized by a high level of cytotoxicity and virulence, which indicates their role in the development of the infectious process.

Relevance. Persons held in detention have a high risk of tuberculosis (TB), Aim. Comparative characteristics of the incidence of tuberculosis among prisoners in the penitentiary system and the population. Materials and methods. Тhe retrospective epidemiological analysis of long-term dynamics and the relationship between tuberculosis (TB) incidence rates among the population and contingents of the penitentiary institutions in the Eastern Siberian region of Russia (Irkutsk region) was carried out in 2004– 2019. Results. It has been identified that tuberculosis incidence rate (TB) of penitentiary institutions many times exceeds that in population (on average: in pretrial detention facilities by 10 times, in correctional facilities by 12 times). Increasing of tuberculosis incidence rate in the penitentiary system has signs of autonomy both in its various institutions and in comparison, with indicators of the population. Decreasing of incidence rate in the penitentiary system occurs mainly due to correctional facilities where over the analyzed period the incidence rate decreased by 5 times, and probability of tuberculosis developing decreased by 3.5 times. In the correctional facilities significant impact of incidence rate on TB situation in population (coinciding or delayed in time) has not been identified. The regression of tuberculosis incidence rate in pretrial detention facilities has been occurred at a much slower rate, with maintaining a high level of the probability of tuberculosis developing. A population impact of the TB situation in the population on pretrial detention facilities situation with a delayed time shift of 1–4 years was revealed. Conclusion. Since 2004, there has been a marked improvement in the TB situation in the penitentiary system. The incidence of TB in the penitentiary system does not have a significant impact on the spread of this infection in society. However, there remains a high risk of TB among those in prison.

Relevance. According to WHO experts, in the world every year more than 10% of children (about 15 million) are born prematurely. Premature births have a high risk of adverse course of infectious diseases, including vaccine-preventable diseases due to insufficient maternal antibodies, active transmission of which occurs in the third semester of pregnancy. Aim. To study the tolerability of Vactrivir® vaccine in infants born prematurely. Materials and methods. The children (mean age 1.7 ± 0.6 years, born prematurely with a body weight of less than 2500 g) included in the study group participated in the study. The control group consisted of years born at term and comparable in sex and age with the children in the study group. Results. The administration of Vaktrivir® vaccine to infants born prematurely confirmed the high safety profile of the drug. There were no deviations from the norm in general and biochemical blood tests, general urinalysis, and the content of immunoglobulins IgA, IgM, IgG, IgE in the dynamics. There were no undesirable side effects in the postvaccination period, which confirms good tolerability of the drug. Conclusion. In practice, the high safety profile and good tolerability of the domestic tetravaccine Vaktrivir® for immunization of premature infants have been confirmed.

Relevance. The problem of timely and effective diagnosis of COVID-19 remains one of the main problems facing healthcare. In this regard, the task of developing test systems for the etiological diagnosis of COVID-19 remains extremely relevant. Purpose To develop ELISA test system for detection of G specific immunoglobulins to SARS-COV-2 coronavirus by immunoblotting (Line Blot). Methods. Elaboration of techniques for obtaining test components and preliminary assessment of its diagnostic effectivenessin blood serums from COVID-19 patients treated at N. I. Pirogov First Gradsky Hospital, Moscow, and serums from healthy human donors. Results. The study of 104 blood serum samples from COVID-19 patients and 100 blood serum samples from healthy human donors, pre-tested by ELISA IgG to SARS-CoV-2 using «Vitrotest SARS-CoV-2 IgG» test systems (Vitrotest, Ukraine) and «ELISA-SARS-CoV-2-AB-G» (CJSC EKOlab, Russia) showed high diagnostic efficiency of the new test system. Conclusion. The new test system after state registration of the medical device can be recommended as a confirmatory test for the etiological laboratory diagnosis of COVID-19.

Relevance. The first case of COVID-19 was registered in 2019. Several months later, the local outbreak became pandemic. The only way to curb the spread of SARS-CoV-2 infection is mass vaccination that aims to form a herd immunity. The success of vaccination depends on people’s acceptance, which might be problematic. The review summarizes the main barriers to mass vaccination against COVID-19, categorizing people based on their willingness to vaccinate, and pointing out possible areas of work to overcome the barriers listed above. Aim. Analyze the problem of mass rejection of vaccination against COVID-19. Determine possible solutions. Conclusion. The main reason for refusal to vaccinate against COVID-19 is the lack of public awareness about the safety and efficacy of vaccines. This review lists possible approaches to creating a supportive information environment and ways to stimulate citizens to accelerate the rates of mass vaccination.

Relevance. To date, there is ample evidence that diabetes mellitus (DM) and obesity are predictors of a severe course and adverse outcome of COVID-19. The SARS-CoV-2 virus is known to have deleterious effects on the pancreas, exacerbating insulin resistance The SARS-CoV-2 virus is known to have deleterious effects on the pancreas, exacerbating insulin resistance. Long-term data have been accumulated regarding pneumococcal infection and influenza, both of which are severe in patients with diabetes and obesity. The aim is to analyze scientific publications on the problems of vaccinating patients with diabetes and obesity against SARS-CoV-2, pneumococcal infection, and influenza. Conclusions. Vaccination against COVID-19 in patients with DM and obesity is an effective preventive measure. Experience with vaccination against COVID-19 using the following vaccines: Moderna mRNA-1273, Pfizer BioNTech, BNT162b2, AstraZeneca COVID-19 vaccine AZD1222, SII Covishield, SK Bioscience, Sputnik V showed similar safety and efficacy profiles among obese and DM patients and those at risk. Researchers in numerous publications have emphasized the importance of routine vaccination for people living with diabetes amid a pandemic of a new coronavirus infection. Researchers in numerous publications have emphasized the importance of routine vaccination for people living with diabetes in the face of a new coronavirus pandemic. Analysis of the literature reviewed in this review suggests that vaccination against SARS-CoV-2, especially for those at risk, will be an intensive area of research in the coming years and that vaccination against coronavirus infection is likely to be routine for people with diabetes and obesity.