In practical medicine, standards for the provision of therapeutic and preventive care have been used for a long time, but in epidemiology this concept has not yet been reflected in regulatory documents. Epidemiologists need a standard of epidemiological investigation of cases of measles and rubella infection, which must be eliminated. The use of specific terms, the interaction of specialists of various profiles, the emphasis on the classification of the case – «local», «imported from the territory of another state», «imported from another territory of Russia», the need to assess the degree of secondary spread of infection imposes its own characteristics on the epidemiological investigation of measles and rubella cases. The use of standards would optimize this process, prevent errors and minimize the time of localization and elimination of the outbreak.

The standard of epidemiological investigation of measles and rubella cases consists of three independent sections, such as examination of the focus, laboratory examination of patients and directions of information flows between medical organizations and organizations of the sanitary and epidemiological service. The main parameters of the epidemiological examination of a measles/rubella outbreak are — person, time, place, contacts; this is the sequence provided for when collecting and analyzing identification and epidemiological information about the patient. The laboratory research section determines the implementing organization, the type of clinical sample, taking into account the research method, the timing of taking the material for research, the volume, frequency, time of delivery of the material to the laboratory and the timing of obtaining the result. The epidemiological investigation ends with the execution of a number of documents, such as the «Map of the epidemiological examination of the focus of an infectious disease», «The Act of investigation with the establishment of cause-and-effect relationships», as well as the control of anti-epidemic measures. The model of the direction of information flows provides for the order of interaction of various organizations: the movement of reports, clinical samples, research results and «Maps of epidemiological examination of the focus of an infectious disease», etc., as well as regulated deadlines for the implementation of measures. Since the standard is a single, binding scheme of actions, the practical application of the standard of epidemiological investigation of measles and rubella will allow collecting and processing information in a single format throughout the country.

The article discusses the properties of the pandemic strain XBB.1.5 S protein in comparison with the 1918 and 2009 pandemic strains hemagglutinin H1. The S-protein XBB.1.5 already contains more than 40 mutations realized by substituting different amino acids through single and dinucleotide substitutions, deletions and the use of predominantly transversions. The variability of H1N1 influenza virus hemagglutinin is associated with single nucleotide substitutions at a constant length. Conditional extrapolation of influenza virus hemagglutinin variability data on coronavirus S-protein sizes suggests that new pandemic strains will emerge in the next 2-3 years, avoiding the immune defense formed by vaccination against the strains preceding them. The inability to create through the adaptive immune system a long-term immunity to pandemic coronaviruses, as well as to other respiratory viruses with a short incubation cycle, puts on the agenda the need to find new vaccine designs that provide a combination of long-term adaptive and trained immunity. The problem in the search for such vaccines is associated with the regulation of the activity of the innate immune system and ensuring the stability of trained immunity.

Aim. To assess the intensity of the epidemic process in each of the five waves of COVID-19 in Russia.

Materials and methods. The data on morbidity, hospitalization and deaths from COVID-19 of the population as a whole and by age groups from 48 (in the I rise) to 54 cities (in the V wave) and data from the website of the Russian consortium for sequencing coronavirus genomes were analyzed.

Results. The nature of the course of the first 5 waves in the incidence of COVID-19 in Russia remains undulating. The waves in morbidity began in megacities, and the direction of spread across the FD differed in different waves of morbidity. The results of gene sequencing showed the participation of the main genovariants of the coronavirus in the etiology of diseases up to 3-4 waves. Some genovariants identified earlier received maximum distribution in the following wave. In Russia, the European descendants of the Wuhan strain (74.4%) were dominant in the I wave in morbidity, in the II wave – its daughter genovariants (68.5%), in the III – AY.122 (80.1%), in the IV – AY.122 (84.7%) and in the V wave – Omicron (76.7%).

Conclusions. The features of each wave in the incidence of COVID-19 depended on the properties of the dominant genovariants: their ability to transmit from person to person and virulence. The rate of spread of the epidemic by FD, the susceptibility of all age groups and the intensity of epidemics were maximal during the period of the V wave in morbidity with the Omicron gene variant. Mortality was minimal in the I wave of morbidity, maximal in the IV with AY.122 strains and low in the V wave with Omicron genovariants. The influence of the season of the year was manifested in the summer season by an increase in the incidence of COVID-19 earlier in the Russian Federation as a whole (immediately after megacities) than in most federal districts, but with a lower incidence.

Relevance. Despite the ongoing program of mass vaccination of tick-borne encephalitis (TBE) for more than 20 years in the Sverdlovsk district, the incidence rate of TBE continues to exceed the average in Russia and the Ural Federal region.

Aim. To analyze the main indicators of the manifestation of the epidemic process of TBE in the territory of the Sverdlovsk district under the conditions of planned vaccination over a 20-year period (2002–2021).

Materials and methods. The article uses data from federal and regional statistical observations, reporting materials of the Department of Rospotrebnadzor in the Sverdlovsk district for 2002-2021, methods of statistical analysis.

Results and discussion. During the study period (2002-2021), 3861 cases of TBE were registered in the Sverdlovsk district, while the highest incidence rate was detected in 2005 – 10.1 per 100 thousand population, and the lowest in 2020 – 1.0 per 100 thousand population. The share of the vector-borne mechanism was 78.4%, the unidentified path – 20.1%, alimentary – 1.5%. Analysis of the seasonal distribution of cases of TBE showed that the incidence is recorded from April to November. Cases of TBE were recorded in all age groups, including the child population. Most often, people aged 60 years old and older (24.6%) were ill with TBE. Among the children's population, the largest share fell on children aged 7–14 years (5.4%). Men of working age prevailed among the patients (66.0%). TBE was mainly registered among the unvaccinated population (81.5%) with a predominance of urban (86.1%). Officials predominated among the sick persons – 29.8%, pensioners made up 22.3%, unemployed – 19.8%. Persons whose work is professionally connected with the forest made up only 0.6%. The ongoing program of mass vaccination of TBE has led to a decrease in the proportion of severe and moderate forms of diseases (focal – 9.8% and meningeal – 24.0%) and an increase in the proportion of febrile (33.8%) and atypical forms (32.4%). Deaths during the studied period were recorded mainly among the adult unvaccinated population.

Conclusions. The Sverdlovsk district continues to be a tense natural focus of TBE with a constantly recorded incidence among contingents of different age and social groups. In the absence of highly effective etiotropic drugs for the treatment of TBE, the only strategy for reducing the incidence of TBE, the development of severe forms and deaths in the territory of the Sverdlovsk district is mass vaccination of the population.

Relevance. The Sverdlovsk district is a tense natural focus for Lyme borreliosis (LB) with a constantly recorded incidence that exceeds these indicators in the Russian Federation and the Ural Federal region several times. LB is registered on 56 of 59 administrative territories of the district. Currently, the count of LB in the Russian Federation includes both infections caused by Borrelia burgdorferi sensu lato group Borrelia and infections caused by Borrelia miyamotoi sensu lato group Borrelia.

Aim. To characterize the epidemic process of LB in the territory of the Sverdlovsk district over a 20-year period (2002–2021).

Materials and methods. The paper uses data from federal and regional statistical observations, reporting materials of the Department of Rospotrebnadzor in the Sverdlovsk district for 2002–2021, methods of statistical analysis.

Results and discussion. During the follow–up period (2002–2021), the incidence rate of BL in the Sverdlovsk district exceeded the average long-term level in the Russian Federation by almost 3 times, and in the Ural Federal region – by 1.8 times. Among the mechanisms and ways of transmission of LB pathogens, the vector-borne mechanism dominated (84.5%), the share of the unidentified pathway was 15.4%, alimentary (when using raw goat's milk) – 0.1%. The duration of the epidemic season for LB in the district was 10 months (from March to December) with a peak incidence in June. Cases of LB were registered among people of different ages, with a predominance in the group of 60 years and older (39.1%). An analysis of the distribution of people with LB by social composition showed that pensioners prevailed among them – 36.3%, officials made up 27.8%, unemployed – 14.1%. Among the cases, a high proportion of schoolchildren and children under 7 years old were noted. It was found that erythematous and non-erythematous forms of LB are registered in the district, with a predominance of erythematous (64.5%). The main etiological agent of the erythematous form is Borrelia garinii, while the non-erythematous form is Borrelia miyamotoi and B. garinii. In the general structure of morbidity, the number of cases of LB is largely determined by the city inhabitants (92.9%). There were no fatal outcomes in LB in the territory of the district during the studied period.

Conclusions. Due to the lack of vaccination of LB worldwide, the only strategy to reduce the incidence of LB is non-specific prevention and timely diagnosis of the disease, including data from epidemiological history, clinical and laboratory diagnostics. The long-term clinical and epidemiological and laboratory studies conducted by us in the Sverdlovsk district allowed us to characterize the main manifestations of the epidemic process of LB and to improve the diagnosis of the disease.

Relevance. The identification of determinants of the human genome, such as single nucleotide polymorphisms (SNPs), in association with various disease patterns, including infectious diseases, is one of the most actively developing areas of scientific research in the world..  Hepatitis C (HC), which remains a serious global health problem, belongs to the number of infections that attract the attention of specialists.

Aims. Determination of genetic markers of hepatitis C virus (HCV) natural elimination and assessment of their role as a monitoring parameter of the epidemiological surveillance system.

Materials and methods. The study included 660 people divided into 2 groups: persons with chronic HC (CHC) and blood donors (indicator group of the healthy population). In the studied groups, the following SNPs were typed: rs1143634, rs1143627 (IL-1B); rs4251961, rs419598 (IL1RN); rs1800795 (IL6); rs1800896 (IL-10); rs4986790 (TLR4); rs4374383 (MERTK). The associative relationship between SNPs and CHC alleles was identified using logistic regression analysis within four models (codominant, dominant, recessive, and overdominant). Additionally, the significance of polymorphisms at the intragenic and intergenic levels was assessed using modern bioinformatic resources in the field of functional genomics.

Results. In this study, genotypes associated with the natural elimination of HCV were identified. Paired combinations of IL 1RA/IL-1B genotypes associated with the probability of the formation of CHC have been established. It is shown that synonymous SNPs can be associated with any characteristics of the pathological process, which can be explained by disequilibrium in coupling with functionally significant alleles of other genetic loci.

Conclusion. The detection of the association of SNPs with clinical manifestations of the pathological process is not final and requires further study taking into account ONP coupling groups.

Relevance. At present, three infections – HIV infection, tuberculosis, and COVID-19 - are spreading simultaneously in the world. Of great practical importance is the assessment of clinical and epidemiological features of COVID-19 in HIV-infected patients with tuberculosis, COVID-19. Aim. To study the risk of COVID-19 disease and identify clinical and epidemiological features in and population of patients with HIV infection complicated by tuberculosis in comparison with patients with HIV infection and the population without these diseases.

Materials and methods. Since 13.03.2020 by 31.12.2021 in the Kemerovo Region-Kuzbass, a continuous prospective analytical epidemiological study of the case-control type was performed. Of those with COVID-19, two observation groups were formed: group I (HIV +), group II (HIV/TB) and comparison group III (persons without either HIV or tuberculosis). All patients underwent: determination of SARS-CoV-2 RNA, standard examination methods in accordance with the temporary methodological recommendations «Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)», relevant at the time of treatment.

Results. The incidence of COVID-19 among patients with HIV infection complicated by tuberculosis exceeded the incidence of COVID-19 among HIV-infected by 14%. There were no gender differences between patients I (HIV +) and II (HIV/TB) groups. In the comparison group, the incidence of COVID-19 was 1.26 times higher in women compared to men. COVID-19 disease in patients with co-infection (HIV/TB) was predominantly mild. Viral pneumonia developed 1.86 times less often, oxygenotherapy was required only in 18.75% of cases, which is 2.5 times lower than in group I (HIV +) and 2.47 times less than in the comparison group (III). In labeled pairs, clinical symptoms of COVID-19 in all groups occurred with the same frequency. Metabolic disorders were evident in all groups. Co-infected patients (HIV/TB) had higher levels of D-dimer, ESR, total bilirubin.

Conclusion. Active tuberculosis in HIV-infected people is a factor that increases the risk of COVID-19 disease without affecting the severity of the infectious process.

Relevance. The incidence of HIV-associated tuberculosis (HIV/TB) continues to rise.

The aim of the work is to study the manifestations of the epidemic process of TB in HIV-infected people in comparison with a general population.

Materials and methods. The manifestations of TB incidence were studied among people living with HIV and HIV-negative population of the Perm Region and the Russian Federation for the period 2005–2021. The incidence of HIV/TB was calculated relative to all residents of the study area, the incidence of TB among HIV-infected - relative to the number of PLHIV, the incidence of TB among HIV-negative – relative to the total number of residents minus PLHIV. Comparative assessment of morbidity rates was carried out by calculating Students parametric test.

Results. The epidemic process of TB among HIV-infected people was in ten times more intensive than among HIVnegative people. The increase in the incidence of HIV/TB has been observed in recent years (2005–2021) against the background of the intensification of the epidemic process of HIV infection and a decrease in the incidence TB in the absence of HIV infection. TB among HIV-infected and HIV-negative people was registered more often among adults than children, and mainly among men. The ncidence of HIV-infected TB was higher among the urban population, while the intensity of the epidemic process of TB among HIV-negative, on the contrary, is higher among rural residents. In recent years, there has been a redistribution of the incidence of HIV/TB towards older age groups of population.

Relevance. In the 21st century, humanity is faced with a pandemic unprecedented in recent history, which brought with it huge losses. All the efforts of world science are aimed at ensuring that the new coronavirus infection becomes vaccine-controlled. The Ministry of Health of Russia included vaccination against COVID-19 in the national calendar of preventive vaccinations. The most vulnerable and significant in the epidemiological chain are representatives of socially active, intensively communicating professions, including medical workers.

Aims. The aim of the study was to assess the degree of severity of the post-vaccination immune response in employees of a medical organization vaccinated with the Gam-COVID-Vac preparation, who had not been ill and did not have antibodies before vaccination.

Materials & Methods. The post-vaccination immunity of 80 vaccinated employees was assessed 42–62 days after the start of vaccination and 6 months later; assessment of the safety of vaccination with the Gam-Kovid-Vak vector vaccine; selection of optimal screening tests for laboratory examination of persons before the planned vaccination. The results of the PCR test for the detection of SARS-CoV-2 RNA (at the post-vaccination stage four times with an interval of 7 days) and the determination of M and G immunoglobulins to SARS-CoV-2 by the ELISA method were analyzed, postvaccination complications and reactions were assessed at different stages, monitoring the state of health and assessing the dynamics of the post-vaccination immune response.

Results. A study conducted after 6 weeks showed the high immunological efficacy of the Gam-Covid-Vac vaccine; 100% of those vaccinated with one or two components of the vaccine had class G antibodies to SARS-CoV-2. Vaccination did not cause severe reactions during the observation period; among the side effects, general complaints and local pains at the injection site prevailed, which were of a short-term nature and did not have a significant impact on the health status and habitual rhythm of life of the participants. The resistance of those vaccinated to a new coronavirus infection decreased over time and amounted to 97.1% three months after vaccination and 95.6% after 6 months. COVID-19 disease in vaccinated employees (7.4% of cases of the number of vaccinated) was of moderate severity, did not lead to the development of pneumonia and respiratory failure, and did not require hospitalization.

Conclusions. The results obtained allow us to conclude that the effectiveness of vaccination against COVID-19 is quite high. Revaccination is well tolerated clinically and «amplifies» the immune response when exposed to SARS-CoV-2. Immunization of employees of medical organizations is necessary, because. this focus group is the most epidemiologically potentially dangerous in terms of the spread of infection.

Relevance. In 2020, there was a unique situation caused by the COVID-19 pandemic and the anti-epidemic measures introduced in this regard. To date, the question of how these methods affect the spread of other infectious diseases, including salmonellosis, has not been studied.

Target. To assess the impact of anti-epidemic measures during the COVID-19 pandemic on the epidemic process of salmonella infection in St. Petersburg.

Materials and methods. Reporting form No. 2 of Rospotrebnadzor «Information on infectious and parasitic diseases» for 2018–2020 and data from the State report «On the state of sanitary and epidemiological well-being of the population in St. Petersburg in 2019», «On the state of sanitary and epidemiological well-being of the population in St. Petersburg in 2020». Data processing was carried out using Microsoft Excel (Microsoft®, USA), Statistica for Windows (StatSoft®, USA) with the determination of the level of significance (p), the calculation of confidence intervals (95% CI) was carried out in the EpiTools application.

Results. The incidence of salmonellosis in 2020 was significantly lower than in the previous 2 years 28.86 (95% CI 27.45–30.34) per 100 ths population, and in 2019 and 2018 – 49.8 (95% CI 47.9–51.7) and 39.21 (95% CI 37.6– 40.9) per 100 ths of the population respectively. When analyzing the incidence of salmonellosis in 1995 to 2020, it was revealed that in 2020 the incidence rate was the lowest over the past 25 years and below the multi-year average (37 per 100 ths population) in St. Petersburg by 22%. A decrease in the incidence of salmonellosis was observed in 2020 and in the Russian Federation as a whole compared to 2019, the indicator increased 1.6 times and amounted to 14.71 per 100 ths rubles. population (multi-year average – 29.1). In 2020, there was a change in the intra-annual incidence of salmonellosis. While the peak incidence of salmonellosis persisted in the autumn period (September–October), in 2020 there was no characteristic rise in the spring period, as was observed in 2018 and 2019, which may be due to the spring lockdown (p = 0.03). The decrease in the incidence of salmonellosis was due to a significant decrease in the incidence among adults, while this was not observed in other age groups. In 2018–2020, diseases in the population were caused by 61 serotypes of Salmonella: in 2018 – 33, in 2019 – 32, and in 2020 – 39 serotypes. During the pandemic, the decrease in the incidence of salmonellosis was due to the decrease in the incidence caused by S. Enteritis, which in 2020 amounted to 19.91 (95% CI 18.73-21.14) per 100 thousand population, while in 2019 – 39, 01 (95% CI 37.4–40.7) and in 2018 – 31.24 (95% CI 29.8–32.8) per 100 ths population. At the same time, the decrease in the incidence rate was a decrease in the incidence rate among adults, while in other age groups no changes in the incidence rate were observed. The incidence due to other salmonella serotypes did not change. There were no significant differences in the incidence of salmonellosis by sex and age.

Conclusion. The measures introduced during the pandemic in 2020 led to a decrease in the incidence of salmonellosis in St. Petersburg by reducing the incidence of salmonellosis caused by S. Enteritidis among adults.

Relevance. The ineffectiveness of current methods of engaging the population in vaccine prophylaxis leads to the need to develop new means of solving the problem of vaccination abandonment.

Aims is to show the effect of applying the theory of compromise solutions to the analysis of the problem of refusal of influenza vaccination.

Materials and methods. Data on number of vaccinated and morbidity among vaccinated and unvaccinated; the research method is based on the compilation of criteria reflecting the interests of the administration and the population, followed by finding a compromise solution and evaluating it using an indicator of tensions.

Results. Based on data on morbidity among vaccinated and unvaccinated, the existence of an optimal percentage of vaccinated for the adult population and for each of the three risk groups is shown: medical staff, service employees and persons over 60 years of age; on the example of the group «persons over 60 years of age», the possibility of reducing tension in the case of replacing a single vaccination with a complex one is shown.

Conclusion. The effectiveness of the application of the theory of compromise solutions to the assessment of tensions between the sanitary and epidemiological inspection service and the population in terms of vaccination is presented; the possibility of reducing tension by switching to complex immunoprophylaxis is presented.

Relevance. Elderly people have become the fastest growing segment of the global population over the past few decades. The number of people over the working age in Russia, and with them citizens living in closed long-term care facilities (CLTFS), is growing. Residents of these organizations belong to the risk group, and CLTFS have a number of characteristics that turn these institutions into a unique environment for the spread of infectious diseases.

Aims. To analyze the CLTFS residents infectious morbidity in the "pre-covid stage" (according to literature sources). A scientific review of research in Russian and English using information portals and platforms has been carried out eLIBRARY. ru , Web of Science, PubMed, Google Academy and Scopus for the period 1981-2022. The search was carried out by keywords. Information about the most frequent infectious diseases affecting residents of closed long-term care institutions was the criterion for inclusion in the sample of publications. Out of 16171 initially identified articles, 61 publications were selected after initial analysis.

Conclusions. According to various estimates, the leading infectious diseases in CLTFS were: acute respiratory infections, pneumonia, urinary tract infections, skin and mucous infections, acute intestinal infections. The article describes pathogens and their prevalence in CLTFS including pathogens with multiple drug resistance (MDR), describes the resistance of bacteria to antimicrobial drugs formation problem in these organizations, as well as development of certain diseases risk factors. Studies conducted in various CLTFS in Europe, Russia, the USA, and Asia indicate a high prevalence of infectious diseases among their residents, high colonization of residents with antimicrobial-resistant pathogens, as well as the infection transmission probability from the CLTFS and its spread to other long-term care institutions and medical and preventive organizations.

Relevance. The process of production of outer membrane vesicles by bacteria is the main mechanism in intercellular communication and an intermediary in relationships of a very different nature (symbiosis, commensalism and parasitism), therefore, the study of the role of vesicles in the pathogenesis and immunogenesis of bacteria is an important and timely task.

Aims. The purpose of this research was the analysis of scientific publications Russian and foreign journals for the period from 2002 to 2021 from the bibliographic databases of eLibrary.Ru, PubMed®, MEDLINE, dedicated to vesicles of outer membranes formed in various types of pathogenic and non-pathogenic bacteria.

Conclusion. The study of the structure, factors of formation, functional significance of the mechanisms of action of bacterial vesicles, as well as the role of these structures in the pathogenesis and immunogenesis of various diseases, including especially dangerous ones, makes it possible to create new preventive drugs based on them. The use of vesicles as means of delivery of biological drugs and various antigens opens up new opportunities for improving the therapy and prevention of infections.