[Modern views on the epidemiology of legionellosis: operations procedure during epidemic outbreaks and preventive monitoring].

Key aspects of legionellosis epidemiology determining the rising role of Legionella in human infectious diseases in conditions of postindustrial community were discussed. It was shown that formation of Legionella biofilms on potentially dangerous water objects with possible further aerosol or aspiration transmission of microorganisms leads to major epidemic outbreaks and sporadic cases of infection. Main principles of actions during preventive monitoring of Legionella in the environment and epidemic outbreaks of legionellosis were described.

[Standards for laboratory diagnostics of legionellosis and their application during epidemic outbreak of pneumonia in town Verkhnyaya Pyshma].

High effectiveness of application of international standards for legionellosis laboratory diagnostics was confirmed during investigation of pneumonia outbreak in town Verkhnyaya Pyshma. Use of immunochromatographic method and enzyme immunoassay for detection of Legionella antigen in urine of patients allows to confirm diagnosis of Legionella infection during several hours, promptly begin etiologic antibacterial treatment and reveal possible sources of infection in potentially dangerous environmental objects.

[Epidemiologic versions in investigation of Legionnaires' disease outbreak in town Verkhnyaya Pyshma].

Materials of investigation of Legionnaires' disease outbreak in one of the town of Sverdlovsk region in summer 2007 are presented. Outbreak arose in situation of epidemiologic welfare on majority of registered infectious diseases. Epidemiologic diagnostics of the outbreak has been performed in maximal shorttime interval, during which it was necessary to investigate variety of miscellaneous versions. Active search of the source of the infection and its transmission factors resulted in desired result and allowed to terminate the outbreak in 14 days.

[The forces and expedients of institutions of Federal Service for Surveillance for Protection of Consumers Rights and Human Welfare in Sverdlovsk region in elimination of focus of Legionnaires' disease].

Organizational issues as well as composition of forces and tools involved in elimination of focus of Legionnaires' disease were reviewed. Role of institutions of Federal Service for Surveillance for Protection of Consumers Rights and Human Welfare and their special units in general system of measures for elimination of the disease's focus was reflected.

[Epidemic process of pertussis in Moscow].

Materials reflecting the dynamics of pertussis morbidity during the period of 1958 - 2003 under the conditions of prolonged mass immunization of the child population with adsorbed DPT vaccine are presented. The planned vaccination of children led to the decrease of pertussis morbidity during the first 10 years, but groundless abstentions from vaccination during the 1980s - 1990s contributed to a sharp rise in morbidity among children of younger age groups. During the recent four years a rise in pertussis morbidity was registered in 2000 (71.79 per 100,000 of the population), followed by the most significant for the last 20 years drop in morbidity in 2002--down to 9.89. But in 2003 the growth of morbidity was again registered (38.67). Recently periodic rises and drops in morbidity occurred simultaneously with the increased coverage of children of younger age groups with vaccination. In recent years changes in the age structure of patients were observed: the specific proportion of school children increased (in 2003 morbidity rates in children aged 6 - 10 years were 288.6 - 270.7), simultaneously high morbidity among children aged up to one year (274.9) was registered. The specific proportion of pertussis-affected children aged above 7 years reached 65%. From the late 1990s until present in 87.1% of cases strains of serotype 1.0.3 prevailed in the population of B. pertussis strains. But in recent years the circulation of strains 1.2.3, spread in the prevaccination period and having toxicity similar to that of strains of serotype 1.0.3, while exceeding them in virulence, in sufficiently high proportion (7.0% in 2002) was noted. This was indicative of the possibility of the unfavorable development of the epidemic process of pertussis infection.

[Specific antibodies and their role in the formation of antidiphtheria immunity].

In human sera, studied with the use of the enzyme immunoassay, antidiphtheria postvaccinal antitoxic IgG and naturally acquired antibacterial IgG, IgM and IgA were detected. In the blood of children and adults aged up to 50 years antitoxic IgG were present at normal and high concentrations. In 50% of children antibacterial IgA were absent, while specific antibacterial IgM could be found at high concentrations. Changes in the content of antibacterial antibodies of different classes in sera were observed with age. More than 90% of adults had antibacterial IgA and IgG at normal and hig concentrations, while the level of IgM decreased. Under the influence of ecological, social, anthropogenic and other environmental factors the optimum levels of specific antibodies were replaced by anomalous ones, which led to an increased number of persons susceptible to diphtheria infection and in the intensity of the circulation of the infective agent. The deficiency of antidiphtheria antibacterial antibodies in the blood determined the necessity of correcting immunity by means of not only toxoid, but also bacterial antigens.

[A large-scale epidemic of diphtheria in Moscow in recent years: patterns of development]. / Krupnaia pidemiia difterii v Moskve v poslednie gody: zakonomernosti razvitiia.

Data on the dynamics of diphtheria morbidity in Moscow in 1958-1999 are presented. The last epidemic which started at the end of the 1980s and reached its peak in 1994, giving a 59-fold rise in morbidity in comparison with the pre-epidemic period, is characterized in detail. During the epidemic 12,267 persons fell ill, 454 of them died (mortality rate was 4%). Having started in Moscow, the epidemic gradually spread not only over the territory of Russia, but also over some other republics of the former Soviet Union (Ukraine, Belarus, etc.). Possible causes of this epidemic emergency are considered. The ever increasing share of adult population among persons affected by the epidemic (75%) is noted. The infection adults is characterized by severity of clinical manifestations and increased morbidity among adults, is shown. Under complicated social and economic conditions (crisis situation) the increase of groups of high risk which included unemployed adults of working age, retirees as well as socially non-adapted persons, was registered. Mainly these groups determined tense epidemiological situation in diphtheria in Moscow.

[Salmonellosis in Moscow: its epidemiological characteristics and the prevention tasks]. / Sal'monellezy v Moskve: épidemiologicheskaia kharakteristika i zadachi profilaktiki.

Zooanthroponotic Salmonella infections in Moscow are characterized, on the whole, by the same epidemiological characteristics as in other areas of Russia. Despite the pronounced polyetiological character of these infections, only a few Salmonella serovars were found to dominate in their dynamics for many years. The 1970s were characterized by a growth in morbidity due to a wide spread of S.typhimurium among children of early age in hospitals. This situation was stabilized by 1985, but since 1986 a sharp rise in morbidity was observed again, reaching its peak in 1989. This time its rise was determined by S.enteritidis, whose specific etiological importance grew from 13.3% to 81.3%. The growth of these bacteria was determined by a sharp increase in the epidemic role of such transmitter factors of Salmonella infection as chicken meat, prepared chicken meat products, as well as chicken eggs and their products, including confectionery, which production appreciably increased during this period simultaneously with the presence of a high level of infection among poultry in Russia with salmonellae of this serovar. High morbidity, observed all year round, with a high proportion of adults among patients (more than 60%) is the direct consequence of the preserved still present epidemic activity of the "chicken" factor and a high virulence of S.enteritidis.