Relevance. Differences in case definition criteria and diagnostic recommendations of pertussis between different countries, pose challenges in the analysis and effective control of disease. An important component of successful surveillance is laboratory diagnostics, which, if used in a timely and quality manner, can influence the rate of reported cases. In addition, current criteria for epidemiological surveillance do not sufficiently take into account the severity of the disease and the vaccination status of the patient, which makes it difficult to take effective preventive measures. Aims. Assess the epidemiological situation regarding pertussis infection in Russia to propose criteria for epidemiological surveillance. Materials and methods. The data was obtained from official state statistics (form No. 2 «Information on infectious and parasitic diseases», No. 5 «Information on preventive vaccinations», No. 6 «Information on the contingents of children and adults vaccinated against infectious diseases») and analytical tables developed at G.N. Gabrichevsky Research Institute of Epidemiology and Microbiology, including information on each case of pertussis and collected from the Rospotrebnadzor Directorates in the Russian Federation (in 2017–2022). Statistical data processing and plotting were carried out with R version 4.1.2. Results. From 2002 to 2017, the incidence of pertussis in Russia did not exceed the established norms. However, in 2019 there was an increase in incidence. In 2023, the incidence of pertussis reached record levels over the past 22 years – 19.0 per 100 thousand population. Vaccination rates against pertussis have remained high since 2003. The structure of cases shows that the majority of pertussis cases occur among unvaccinated children in the first year of life; deaths from pertussis are recorded annually, mainly among unvaccinated children under 2 years of age. From 2017 to 2019, the incidence among the unvaccinated was significantly higher than among the vaccinated; in 2020-2022, incidence among the unvaccinated decreased, but remained higher than among the vaccinated during the period of COVID-19 restrictive measures. There was no statistically significant difference in the distribution of pertussis severity in the periods before and after the COVID19 pandemic. Outbreaks of infection are mostly without spread, and in 2020-2022 the proportion of such outbreaks has increased. Schools remain the main site of infection, but the proportion of cases in kindergartens has increased. Conclusions. The following criteria for epidemiological well-being are proposed: subject to the achievement of timely vaccination coverage in 95% of people of decreed ages and timely implementation of anti-epidemic measures, there should be no deaths from pertussis, the incidence of pertussis should be sporadic and registered predominantly (more than 50% of cases) in the form of mild forms, the majority of pertussis cases occur among unvaccinated children in the first year of life (no more than 30% of vaccinated cases) and outbreaks without the spread of infection should prevail (more than 50% of cases) over outbreaks with spread.

Relevance. Prisoners have a high risk of contracting hemocontact viral infections (including HIV, viral hepatitis B and C, etc.), which creates an additional infectious burden on the entire population living in the territory. Aims. To study the level of immune protection to viral hepatitis B in risk groups (age, HIV status, and injection drug use) of persons held in places of detention to identify those in need of vaccine prophylaxis. Materials & Methods. 343 blood serum samples obtained in 2021 from males with negative HBsAg status were studied. Anti-HBs antibodies to HBsAg were determined using a set of reagents “VectoHBsAg-antibodies” (Vector-Best, Russia). Results and discussion. The protective titer of anti-HBs antibodies was detected in 44.0% (n = 151) of cases, and was absent in 56.0% of the subjects. At the same time, anti-HBs was significantly more often detected in people living with HIV/AIDS (p = 0.038), injecting drug users (p = 0.002), as well as young people born after 1984 (p = 0.019). Conclusion. The lack of a significant level of collective immunity among prisoners, primarily the older age group before 1984, their risky behaviors (sexual, injection) indicate the need for active identification of seronegative persons serving sentences in places of detention and specific immunoprophylaxis.

Relevance. Demyelinating diseases of the central nervous system and multiple sclerosis, in particular, make their debut at a young age and can lead to profound disability and death within a few years. In the last decade, there has been an increase in the number of cases of demyelinating diseases in Russia and in the world, which necessitates an in-depth study of these pathologies. Goal. To study the dynamics and features of the formation of morbidity, prevalence and mortality from demyelinating diseases of the central nervous system, including multiple sclerosis in various population groups in the Russian Federation. Materials and methods. The study design is a descriptive retrospective epidemiological study (continuous). The data was sampled from the forms of the federal state statistical observation on the distribution of the deceased by gender, age groups and causes of death of Rosstat (FSN S-51), as well as from the statistical collections of the Federal State Budgetary Institution "Central Research Institute of the Ministry of Health of the Russian Federation "Morbidity of the population" from 2009 to 2021. Results. The analysis of the data showed that in 2009-2021 in Russia there was an increase in idiopathic inflammatory demyelinating diseases (IDD) and multiple sclerosis (MS) among the adult population and adolescents aged 15 to 17 years. There is no tendency to increase or decrease the incidence among children under 14 years of age. The highest average long–term incidence rates of IDD and MS among adults are observed in the Ufa region (7.13 ± 0.27 and 5.31 ± 0.23 per 100 thousand adults, respectively), among children under 14 - IDD in the Central Federal District (1.88 ± 0.18 per 100 thousand contingent) and MS in the Central Federal District and Volga Federal District (0.22 ± 0.07 per 100 thousand contingent). Among children from 15 to 17 years of age, the highest incidence of IDD is noted in the Northwestern Federal District (4.41 ± 1.10 per 100 thousand contingent) and the Ural Federal District (4.40 ± 1.09 per 100 thousand contingent), RS – in the Central Federal District (2.67 ± 0.51 per 100 thousand contingent). IDD and MS are the least common among all age groups in the Far Eastern Federal District. Over the period from 2000 to 2020, there has been a decrease in MS mortality in the Russian Federation by 34%, from 0.72 to 0.48 per 100,000 population. The average annual mortality rate from MS among men was 0.4 ± 0.021 cases per 100 thousand of the contingent, among women 0.5 ± 0.023 cases per 100 thousand of the contingent. Conclusion. The increase in the incidence of demyelinating diseases and MS, in particular, is an important medical and social problem. These pathologies significantly reduce the quality of life and shorten the duration of work, due to the development of persistent disability in the young population. The study showed the uneven distribution of the disease across the territories of the Russian Federation, which in the future will improve the logistics of drug delivery and the provision of medical personnel, which confirms the relevance of constant and in-depth study of the epidemiology of idiopathic inflammatory demyelinating diseases in Russia.

Relevance. The spread of the new coronavirus infection throughout the world has led to expressed interest in studying, among other things, the patterns of territorial distribution of cases of the disease. Aim. To investigate the spatial distribution of cases of COVID-19 infection and develop proposals for the use of GIS technologies in the epidemiological supervision system for the new coronavirus infection at the regional level. Materials and methods. The study was conducted on the territory of the closed administrative- territorial entity of Zelenogorsk, Krasnoyarsk Territory. 4176 cases of COVID-19 infection were reported during the study period of 57 weeks (04/12/2020 to 06/18/2021). Each case of the disease was geocoded by the residence of the sick person using a projection coordinate system from the open data of the Open Street Map resource. The spatial distribution of COVID-19 cases was studied with geographic information system QGIS Desktop version 3.28.0. Spatial autocorrelation analysis was carried out using the Getis-Ord index. Results. During the application of GIS technologies, the density of distribution of COVID-19 infection cases was estimated, six zones with an average core density were discovered, the outbreaks in the northern part of the city had the greatest epidemiological significance. When assessing the clustering of cases within the specified territorial zones, eleven clusters were identified, three of which were characterized by the highest density of cases - 1210.1 cases per 1 sq. km, 1155.9 and 1116.7 cases per 1 sq. km. The Getis-Ord index value ranged from 0.00 to 2.576, the majority of cases was recorded in territorial clusters located in the northern part of the city. Conclusions. New knowledge obtained on the basis of modern GIS technologies about the presence of “hot spots” or clusters in the administrative territory will make the adjustment of preventive measures in micro-areas with a high prevalence of infection possible and develop strategies for more effective control of COVID-19 infection.

Introduction. The evolutionary association of Vibrio cholerae with chitin provided resistance to stress and protection from predators. The most important mechanism that provided V. cholerae with the effectiveness of association with chitin is biofilm formation. The ability to form a biofilm in V. cholerae depends on the presence of a factor, toxin-corrected adhesion pili (TCP), which are synthesized by the tcp A-F genes. One of the key methods for studying biofilms is microscopy. It allows one to visualize the structural elements and study various parameters of biofilms and the effects of various factors on them. Aim. To determine the epidemiological significance of the biofilm-forming ability of toxigenic strains by their morphological characteristics on chitin-containing substrates. Study of structural differences in biofilms of Vibrio cholerae tcpA+– and tcpA– strains on chitin-containing substrates. Results. It has been shown that Vibrio cholerae tcpA+– and tcpA– strains are able to form biofilms on the surface of chitin-containing substrates. The intensity of biofilm formation is more pronounced in tcpA+ strains, because V. cholerae ctxA+ tcpA+ cells in the biofilm are predominantly singly located and the surface of the chitinous exoskeleton with which they are in contact is intact, V. cholerae ctxA– tcpA– cells form chains in the biofilm, which indicates division processes, and scattered chitin of the endocuticle indicates activity of metabolic processes. Conclusion. The strains of V. cholerae used in the work, regardless of the presence or absence of the ctx and tcp genes, form bioplecs on a chitin substrate. The indicator of biofilm formation in terms of the thickness of the biofilm matrix is higher in V. cholerae ctxA+ tcpA+ , in terms of the degree of degradation of the chitin substrate it is higher in V. cholerae ctxA– tcpA– .

Relevance. The etiological structure of community-acquired pneumonia (CAP) with the widespread COVID-19 as backdrop is poorly studied. Aim. Comparative study of community-acquired pneumonia etiological structure in patients with and without a new coronavirus infection. Materials and methods. The etiology of CAP was estimated on the base of the results of bacteriological and molecular genetic studies of sputum samples and swabs from the posterior pharyngeal wall in 142 children and 190 adults in 1- 2 days from the moment they were hospitalized to two medical organizations of Perm in the period of 2021-2022 with a primary diagnosis of CAP. There were 131 negative and 11 positive for SARS-CoV-2 among pediatric patients. There were 84 negative and 106 – positive for SARS-CoV-2 among the adults. Results. It was found that in patients with CAP in the presence of COVID19, compared with SARS-CoV-2-negative patients, a more frequent isolation of K. pneumoniae, S. aureus, S. haemolyticus and H. influenzae DNA, as well as microbial associations of bacterial etiology. Conclusion. The results of the study can be used when choosing treatment tactics for combined infections.

Relevance. The growth of distrust in vaccination in recent years has become a problem that impedes the improvement of the epidemic situation in the world, including in Russia. This requires the adoption of adequate response measures. Aim. Find out the attitude of parents to the vaccination of children and the reasons for its formation, to determine the directions of work to overcome distrust in vaccination. Materials and methods. The vaccination coverage of children aged 3–14 years in Petrozavodsk (Republic of Karelia) in 2019–2020 and the reasons why children remain unvaccinated in comparison with 2007 data were analyzed. In 2021, a survey was conducted of 3110 parents of children attending preschool educational institutions and schools about their attitude to vaccination, about the reasons for refusal to vaccinate, sources of information about vaccinations, knowledge about vaccines, immunity and the importance of vaccination. Results and discussion. Vaccination coverage of children exceeds 96%, but in the last decade there has been an increase in the number of unvaccinated children, which is primarily due to an increase in parents' refusals to vaccinate. For this reason, children were not vaccinated 12.9–27.2 times more often than for medical contraindications. Most often, parents did not want to vaccinate their children against hepatitis B and rubella. Concerns about the safety of vaccines are more often based on personal experience or the experience of other parents (56.6 ± 1.2%) than on information from Internet sites (41.0 ± 1.2%). Before make a decision to refuse vaccination, 36.9 ± 1.5% of parents consulted doctors, while 19.2 ± 0.9% of parents who refuse vaccination received negative information from doctors. The results of the survey revealed an overestimated self-assessment of the ability to analyze the information read, distrust of official information, a biased attitude towards vaccines, a lack of understanding of the importance of forming population immunity in a significant part of parents, as well as an insufficient level of professional training in vaccine prevention among pediatricians. Conclusions. Results of assessing the reasons for the increase in the number of parents' refusing childhood immunization indicate necessary improving the work on identifying and investigating adverse events following immunization, informing the population about the safety and effectiveness of vaccination, training and periodic monitoring of doctors' knowledge about vaccination.

Relevance. As is known, the presence of some concomitant diseases may be directly related to the severe course of Coronavirus infection and high mortality among the sick. However, the question of the possible impact of bronchial asthma and COPD on outcomes and survival rates in patients with COVID-19 remains relevant. Aim. To evaluate, according to the literature, the prevalence of bronchial asthma and COPD in the general population and among COVID-19 patients in the Russian Federation and in the world, and to determine the degree of their influence on outcomes. Materials and methods. The results of 1080 previously conducted domestic and foreign studies were studied, from which 46 papers were selected that meet the inclusion criteria. Based on the data presented in the studies on the prevalence of bronchial asthma and COPD, the analysis of survival rates, mortality and severity of the consequences of COVID-19 in patients with these pathologies was carried out. Results and discussions. Patients with COPD often had a more severe course of COVID-19, as well as high mortality rates due to the rapid progression of the pulmonary process. Earlier it was reported that patients with bronchial asthma did not notice a negative effect of COVID-19, but the results of recent studies prove the opposite, and therefore further observations are required in this cohort of patients. Conclusion. The presence of COPD has a significant impact on the severity of the course and outcomes of the disease in patients with COVID-19. Timely diagnosis of an infectious disease, qualitative examination, appointment of effective therapy and subsequent rehabilitation with supervision by a specialist have a great importance for patients with COPD. According to the latest data, the presence of bronchial asthma in a number of patients may contribute to a more severe course of COVID-19, but this issue requires further research. At the same time, all patients with chronic lung diseases, without exception, must comply with the basic measures for the prevention of COVID-19 infection and carry out vaccination on time.

Relevance. Pneumococci are among the most common causative agents of severe bacterial infections in humans. The prevalence of invasive pneumococcal infections among people with autoimmune inflammatory rheumatic diseases is 3–4 times higher than in the general population. Aim. To evaluate the effectiveness of vaccination with 13-valent pneumococcal conjugate vaccine (PCV 13) in patients with rheumatoid arthritis (RA). Materials and Methods. The data of scientific publications PubMed, Web of Science, elibrary, the National Inpatient Database of the USA, the Moscow Unified Register of Arthritis, the V. A. Nasonova Research Institute of Rheumatology were used in the review. V. A. Nasonova Research Institute of Rheumatology. Conclusion. In the presented review in adult patients with rheumatoid arthritis (RA) receiving various antirheumatic drugs, the immunogenicity (humoral response, opsonophagocytic activity), safety of vaccines of 13-valent conjugated pneumococcal vaccine (PCV13) was assessed. Based on the data presented, a conclusion was made about the safe management of PCV13 and the formation of antibodies to pneumococcus in RA patients with targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs), biologic (bDMARDs) and Glucocorticoids (GCs < 15 mg daily). Methotrexate (MTX) in RA patients reduced the pneumococcal response and the functional activity of antibodies.