Relevance. After smallpox eradication, in conditions of population immunity to orthopoxviruses absence, Monkeypox virus became most significant orthopoxvirus, pathogenic for humans. Therefore the generalization of data on the areas of infection outbreaks, human diseases and methods of prevention and treatment of monkey pox is important task. Aim. To characterize the problem of monkeypox in the world based on an analysis of foreign scientific publications over the past 20 years. Materials and methods. The work used publications presented in the main international medical information databases PubMed, Web of Science, Embase, etc. To analyze the publications, the analytical epidemiological method was used. Results and discussion. Monkeypox virus, obtained and identified in 1958, by genetic and phenotypic differences divides on two clades: West-African with lethality 3.6% and Central-African (Congo Basin) with lethality 10%. Monkeypox virus transmission to men happens in two ways, either from animal-to-human or human-to-human. Monkey pox is endemic only on African continent, but In 2003 year the first outbreak, numbering 47 confirmed cases, was occurred in non-endemic country – USA and the largest monkeypox outbreak began in Nigeria in September 2017 year and continue to the present. Comparison of the genome sequences of strains, isolated from patients in non-endemic countries, showed, that it genetically close to West-african strains, belong to II clades and were descended from a common ancestor. Many cases of disease in humans in the current outbreak have been traced to sexual transmission especially among men, who identify ourselves as gay or bisexual. The basis method for identification of agent in present time is PCR-RT targeting on the tumor necrosis factor (TNF) receptor gene. Usually monkeypox of human is mild, self-limiting disease. The symptoms of monkeypox are varied and non-specific. One of the most frequently observed clinical symptoms is lymphadenopathy. Most patients recover during some weeks. However, specific antiviral treatment – tecovirimat (S-246) and brincidofovir (CMX-001) – may be used for seriously ill or immunocompromised individuals. For prophylactic disease in present time are use vaccines JYNNEOSTM, ACAM2000R and Aventis Pasteur (APSV). Conclusion. General vaccination against monkeypox don't develop accordingly to modern recommendations WHO. Ring vaccination is recommended to conduct for suppression of spread virus in nidus of infection among population. Timely international coordination is needed to prevent the global spread of a disease with epidemic potential.

Relevance. The high intensity of the therapeutic and diagnostic process in medical organizations is accompanied by an increase in the manipulation load on patients and, accordingly, an increase in the risk of post-injection infectious complications. In the Russian Federation, in the structure of infections associated with medical care, post-injection complications in the last ten years before the pandemic of a new coronavirus infection occupied 7.0–11.0% [1]. The question of the impact on the prevalence of post-injection complications of medical care conditions that changed during the COVID-19 pandemic remains open for discussion and study. The purpose of this study is to give an epidemiological characterization of post–injection infectious complications in medical organizations, to determine their place in the structure of patient health losses in order to improve the monitoring system for infections associated with medical care. Materials and methods. The forms of statistical observation No. 1, 2 «Information on infectious and parasitic morbidity», No. 30 «Information on medical organizations» for the period 1994–2022, 101 forms of epidemiological investigation of cases of post-injection complications for the period 2015–2022 are analyzed. Epidemiological and statistical research methods were used in the work. Conclusions. During the study period, the prevalence of post-injection complications in outpatient polyclinic organizations of the Khanty–Mansiysk autonomous okrug – Ugra was 0.10 per 100 thousand visits and 3.85 per 100 thousand treated in hospital. The risk groups for post–injection complications were persons of older age groups, and the place of risk was procedural, vaccination rooms, and neurological departments. Abscesses prevailed in the structure of post-injection complications (85.4%), with the most frequent localization of post-injection complications in the gluteal region (47.7%). During laboratory examination of the material, gram-positive microorganisms were isolated from the focus of infection in 72.9% of cases, the largest proportion of which was Staphylococcus aureus (74.3%), including MRSA. In 80.5% of cases of post-injection complications, surgical intervention was required, including 77.8% in a hospital setting. The prerequisites for the occurrence of post-injection complications were excessive manipulation load, prescribing more than 5 drugs to patients and non-compliance with the instructions for injections in 4.8%. The complexity of monitoring post-injection complications is due to the lack of a standard definition of the case in most nosological forms, deliberate concealment of cases of infectious complications and imperfection of laboratory diagnostics.

Relevance. Urogenital chlamydia is one of the most common sexually transmitted infections. Chlamydia often presents with minimal or no symptoms. However, it can be a major cause of pelvic inflammatory disease (PID), infertility, and ectopic pregnancy in women, as well as epididymitis, orchitis, and infertility in men. Aim. To study the territorial patterns of incidence of urogenital chlamydia, gonorrhea, and their associated complications in the Russian Federation in 2011 to 2019. Materials and methods. Official statistics on the incidence of urogenital chlamydia, gonorrhea, PID, female and male infertility in the Russian Federation were analyzed. Statistical analysis, graphing, table creation, data visualization, and research results analysis were conducted using Microsoft Excel 2010 and IBM SPSS Statistics 22 software. GIS mapping was performed using the GIS «Axioma». Results and discussion. From 2011 to 2019, the Russian Federation observed a decrease in the incidence of urogenital chlamydia, gonorrhea, and PID, while there was an increase in the incidence of male and female infertility. The geographical distribution remained stable, with areas characterized by consistently low and high incidence rates. A correlation was found between the incidence of urogenital chlamydia, gonorrhea, and their complications. The association between gonorrhea and PID was found to be more significant than the association between chlamydia and PID, possibly due to the higher risk of complications associated with gonorrhea. However, no correlation was found between gonorrhea and infertility, possibly because this complication manifests with a time delay and has multifactorial causes. Conclusions. Based on the presented data, it can be concluded that the incidence of urogenital chlamydia and gonorrhea affects the frequency of male and female infertility. Therefore, the implementation of screening examinations for sexually active individuals of reproductive age using appropriate laboratory diagnostic methods, along with the development of preventive measures for sexually transmitted infections, including urogenital chlamydia, is justified and should be widely practiced.

Relevance. Surveillance of new genetic variants and manifestations of the epidemic process in SARS-CoV-2 is relevant for predicting the epidemiological situation and timely introduction of anti-epidemic measures. Aim. To evaluate changes in the intensity of the epidemic process during the long circulation of the «omicron» variant and its daughter genovariants. Materials and methods. The analysis of the computer database of the WHO National Center for morbidity, hospitalization and deaths from COVID-19 of the population as a whole and by age groups of 54 cities of the Russian Federation was carried out. Results. Since the appearance of COVID-19 in Russia in 2020, the maximum intensity was the V (winter–spring) wave of 2022. The intensity of the VI (autumn) and VII (winter–spring) waves was lower. In the VI wave, the incidence and mortality from COVID-19 of the population of the RF as a whole decreased by 2.5 and 6.5 times, St. Petersburg – by 2.6 and 29.7 times, and Moscow by 1.6 and 26.6 times. In the VII wave, compared with the VI wave, the decrease in morbidity was less. By age groups, the incidence decreased more among children aged 7–14 years (4.3 times in the VI wave) and less among children 0 –2 and people over 65 years (2.0 times), there was a tendency to increase the proportion of people over 65 years from 18% to 27%. The incidence rates of COVID-19 in the population as a whole and in age groups were higher in 4 FD (North-West, Far East, Siberia and the Center). In 2022, an interepidemic period was revealed for the first time in Russia, the duration of which was in megacities for 9 and FD – from 11 to 13 weeks. In the interepidemic period, the incidence was less than in the minimum VII (winter-spring) wave in the RF as a whole – by 4.6 times, in St. Petersburg – by 7.1 times and in Moscow – by 15 times. There were no deaths among children in the observed cities, and an increase in the total coefficient of mortality rate is associated with mortality among people over 65 years of age. Conclusion. The decrease in the intensity of the epidemicprocess in the VI and VII waves is caused by the prolonged circulation of omicron and its daughter genovarians.

Relevance. The new coronavirus infection (COVID-19) is still a public health problem and a threat to socio-economic well-being. Most studies have focused predominantly on humoral immunity, and there are no data on the cellular composition of blood in dynamics. Aim. To study the dynamics of changes in blood cellular composition depending on the type of immunity formed (natural, hybrid, breakthrough, postvaccinal) to SARS-CoV-2 virus. Materials and Methods. A total of 130 volunteers participated in the study. Immunophenotyping of peripheral blood leukocytes using flow cytometry was performed. The presence of specific IgG antibodies to N-protein SARS-CoV-2, total IgA and cytokines (IL-4, IL-10, IFN-γ, TNF-α) was assessed in serum by ELISA. Results and Discussion. A statistically significant increase in BL was recorded in volunteers with hybrid immunity 1 month (14,0% (12,3–16,4%)) after vaccination compared to healthy volunteers (9,1% (6,4–10,2%), p = 0,0007) and people with primary COVID-19 infection (10,2% (8,3–12,1%), p = 0,0134). In volunteers with natural and hybrid immunity, as well as in revaccinated people, an increase in B1-cells (CD3-CD19+CD5+CD27-) was observed during 3–9 months of observation. It is shown that the increase of B-lymphocytes with «switched» class of synthesized antibodies was detected in people with breakthrough immunity. Increased levels of T-lymphocytes expressing HLA-DR were recorded in all individuals during 6–9 months of follow-up. Volunteers with breakthrough immunity showed a significant increase in the positivity index when assessing the presence of specific IgG class antibodies to the coronavirus N-protein compared with volunteers with natural and hybrid immunity. Conclusions. Vaccination promotes protective immunity sufficient for timely activation of memory T- and B-cells in breakthrough immunity and maintenance of immunologic efficacy in hybrid immunity against COVID-19. The results help to assess the strain of innate and adaptive immunity in novel coronavirus infection and to fill gaps in the understanding of immunopathogenesis in COVID-19.

Relevance. To investigate the characteristics of the COVID-19 pandemic and introduce timely and effective measures, there is a need for models that can predict the impact of various restrictive actions or characteristics of disease itself on COVID-19 spread dynamics. Employing agent-based models can be attractive because they take into consideration different population characteristics (e.g., age distribution and social activity) and restrictive measures, laboratory testing, etc., as well as random factors that are usually omitted in traditional modifications of the SIR-like dynamic models. Aim. Improvement of the previously proposed agent-based model [23,24] for modeling the spread of COVID-19 in various regions of the Russian Federation. At this stage, six waves of the spread of COVID-19 have been modeled in the Nizhny Novgorod region as a whole region, as well as in its individual cities, taking into account restrictive measures and vaccination of the population. Materials and Methods. In this paper we extend a recently proposed agent-based model for Monte Carlo-based numerical simulation of the spread of COVID-19 with consideration of testing and vaccination strategies. Analysis is performed in MATLAB/ GNU Octave. Results. Developed multicentral model allows for more accurate simulation of the epidemic dynamics within one region, when a patient zero usually arrives at a regional center, after which the distribution chains capture the periphery of the region due to pendulum migration. Furthermore, we demonstrate the application of the developed model to analyze the epidemic spread in the Nizhny Novgorod region of Russian Federation. The simulated dynamics of the daily newly detected cases and COVID-19-related deaths was in good agreement with the official statistical data both for the region as whole and different periphery cities. Conclusions. The results obtained with developed model suggest that the actual number of COVID-19 cases might be 1.5–3.0 times higher than the number of reported cases. The developed model also took into account the effect of vaccination. It is shown that with the same modeling parameters, but without vaccination, the third and fourth waves of the epidemic would be united into one characterized by a huge rise in the morbidity rates and the occurrence of natural individual immunity with the absence of further pandemic waves. Nonetheless, the number of deaths would exceed the real one by about 9–10 times.

Relevance. Growing distrust of vaccines around the world, a decrease in vaccination rates have led to an increase in the incidence of measles and a rise in the vulnerability of people with immunodeficiency status. The aim. To study the efficacy and safety of measles vaccination in children with oncohematological diseases. Materials & methods. The study involved 107 children: 74 of them with a history of acute lymphoblastic leukemia and 33 with solid tumors. All children had a history of receiving standardized polychemotherapy. In all the subjects, the vaccination history was studied, the titers of specific antibodies to measles were determined. Children with non-protective levels of antibodies (53 children) were subsequently vaccinated against measles. Results and discussions. Of the 107 children examined, before cancer, 99 (92.5%) were vaccinated against measles, of which 68 (68.7%) patients were only vaccinated, and 31 (31.3%) had vaccination and revaccination. Protective titers of antibodies against measles were preserved in 51 people (51.5%), and 48 (48.5%) were seronegative. When assessing immunogenicity on days 14, 45 after the introduction of the vaccine, it turned out that by day 14, 27 out of 53 children (50.9%) developed measles antibodies, and by day 45, 33 out of 53 children (62.3%), the rest of the children did not developed a protective level of antibodies, including 3 of 6 revaccinated. Conclusion. Thus, children with malignant diseases, regardless of the number of previous vaccinations and the duration of the end of therapy, become unprotected or have low titers of antibodies to measles in 83.8%, and immunization after treatment is effective in 62.3% of cases.

Relevance. Myopia in students can lead to various problems with vision and affect quality of life and academic achievement. Aim. To analyze factors associated with the presence of myopia among medical students to develop effective methods of prevention of this disease. Materials and methods. A non-anonymous questionnaire was conducted on myopia among medical students of the first to sixth year. The questionnaire was developed based on the analysis of published data and included the demographic information, questions concerning the medical history, family history and lifestyle. The questionnaire data were supplemented with information from recording medical forms No. 025 «Medical records of patients receiving outpatient care». The data of 323 medical students were analyzed. Descriptive and logistic regression analyses were performed. Adjusted odds ratio (aOR) and 95% confidence intervals (95% CI) for each factor were calculated. Results. The median age of students was 21 years [Q1–Q3 = 19–23], min age = 17 years, max = 31 years. According to the ophthalmologist's examination, 68.7% of students had myopia (95% CI 63.4–73.7). Healthy weight and underweight were associated with the presence of myopia compared to those who are overweight or obese: aOR 2.433 (95% CI 1.096–5.403, p = 0.029) and aOR 2.774 (95% CI 1.231–6.253, p = 0.014), respectively. The presence of 8-hour sleep is associated with a decrease in the chances of having myopia by 2,321 times (aOR 0.431; 95% CI 0.190–0.979; p = 0.044). A large number of steps per day was associated with the absence of myopia. Those who walk 10,000 steps or more per day are 7.46 times less likely to have myopia than those who walk less than 2,000 steps per day. Conclusion. We report a high prevalence of myopia in medical students. The findings suggest that health promotion, including adequate sleep and regular physical activity, can be an effective strategy to prevent the occurrence or progression of myopia and other eye complications.

Relevance. Respiratory infections are an urgent problem for organized groups, including military ones, since the transmission of pathogens by airborne droplets and household contact routes, physical and psychological stress on adaptive mechanisms contribute to the development of the epidemic process. There is no doubt that vaccination makes a significant contribution to the prevention of respiratory infections, but the contingent remains vulnerable to other pathogens against which there are no vaccines. Therefore, the search for new methods of non-specific prevention is necessary in maintaining the health of persons permanently residing in collectives. Aim. Evaluation of the possibility of using the topical form of the recombinant interferon α-2b drug for the prevention of acute respiratory viral infections in organized groups. Materials and methods. The work was carried out according to the methodology of a multicenter (3 Centers) double-blind controlled trial involving 3,235 people aged 18 to 22 years, who were divided into three groups: 1 gy. - received a recombinant interferon α-2b (Grippferon) drug 3 drops in each nasal passage 2 times a day in for two weeks; 2 g. - saline solution intranasally according to the same scheme; 3 g. - the volunteers did not receive anything. The frequency of respiratory infections was studied. Results and discussion. Medical monitoring of the study participants, which was carried out for 2 months, showed that in the groups from the Center 1, the incidence of acute respiratory diseases for 2 months in the main group (gr. 1) was 2.3 times lower than in the control (gr. 2) and the comparison group (gr. 3). In the Center 2 The data corresponded to the dynamics of Center 1: the incidence values were 2.4-2.5 times lower in Group 1. In Center 3, the values were 2.0-2.1, respectively. The epidemic effect of intranasal administration of the topical form of the drug recombinant interferon α-2b is due to its effect on the factors of mucosal immunity, which contributes to non-specific protection and increased body resistance against respiratory infections. Conclusions. The presented advantages of the recombinant interferon α-2b drug make it possible to draw attention to the clinical feasibility of its use for preventive purposes in organized groups, including military ones, from the position of high epidemiological effectiveness, both pre-exposure and post-exposure prevention of acute respiratory viral infections.

The considerable success of vaccination against the new coronavirus infection, which has led to a decrease in morbidity and mortality in adults and children, requires the study of the problem of revaccination against SARS-CoV-2. The pathogenic properties of the virus and its unpredictable mutations continue to support an unfavorable epidemic situation in different regions of the world. Revaccination regimens against SARS-CoV-2 are being developed in different countries and populations based on epidemiological indications. The issue of introducing vaccination against a new coronavirus infection into national vaccination calendars for adults and children is debatable and requires further study.

Relevance. Lyme disease (LD) remains an important public health problem, especially in Russia, where the incidence is consistently high. To date, there is still no available vaccine against LD, and prevention involves non-specific measures. Aim: to review the literature and summarise data on progress, approaches and strategies for LD vaccine development. Conclusions. The first LD vaccines were developed in the 1990s. An OspA-based vaccine (LYMErix) was commercially available in the early 2000s but not widely distributed. An important milestone in the development of LD vaccines was the shift from the development of monovalent vaccines based on a single type of outer surface protein to the development of multivalent combinations that provide protection against different Borrelia genospecies. A multivalent OspA-based vaccine (VLA15) is in phase III clinical trials and is likely to be the next LD vaccine available on the market. New genetic strategies for vaccine development, identification of new immunogens, and development of vaccines targeting different parts of the LD transmission cycle are of broad interest for further development of LD vaccines.

The article is dedicated to outlining the conceptual directions for the development of vaccination in the Russian Federation. The provisions of the concept are formulated based on the authors' years of research on vaccination issues and analysis of data from domestic and foreign scientific literature. The main provisions of the concept aim at strengthening the state policy in the field of vaccination, reconstructing and expanding enterprises for the production of domestic vaccines, developing and improving immunobiological medicinal products against current infections, refining the National Immunization Schedule and Vaccination Schedule according to epidemiological indications; further promoting the WHO's "lifelong immunization" strategy; developing regional immunization programs; implementing a risk-oriented approach in the development of immunization programs; developing a system for monitoring post-vaccination complications; implementing epidemiological surveillance of vaccination as a methodology for assessing the strategy and tactics of immunization in accordance with the epidemiological situation; ensuring commitment to vaccination among the population, healthcare workers, and legislative and executive authorities.