[Spread of infection with hepatitis B and C viruses in different population groups of north-western Ukraine]. / Shirota infitsirovaniia virusami gepatitov B i C razlichnykh grupp naseleniia Severo-Zapadnoi Ukrainy.

The detection rate of specific markers of hepatitides B and C among the child and adult population, including 487 children in 5 boarding schools, 338 oncological, hematological, urological patients and 206 medical staff members in Rovno and the Rovno region (North-Western Ukraine), was determined. In boarding-school the markers of HB (HBsAg, anti-HBs, summary anti-HBc) were detected 3.5 times more often than among the child population in general (in 28.3 and 8.0% respectively). In children staying in a boarding school for up to 1 year (126 children) these markers were determined in 23% of cases, and in those who stayed there for 3-5 years, in 58.1% of cases. Among the members of the groups where children with HBsAg were found the markers of HB occurred 3.3 more often then among the children in the groups having no HBsAg carriers (45.3 and 13.9% respectively). The detection rates of the markers of HB in children with various kinds of C.N.S. pathology (first of all, with mongolism) and without concomitant diseases were sharply different (they were found, respectively, in 52.9 and 19.6%, including HBsAg in 17.4 and 2.7%). At the same time the detection rate of anti-HCV among boarding-school children (including those with C.N.S. lesions) was no different from that among the child population in general, which was indicative of great differences in the activity of the nonartificial transmission routes HB and HC viruses. Patients with oncological, hematological and urological diseases who had great "parenteral load", as well as medical staff members, formed a high risk group for being infected with both HB and HC viruses.

[The risk of becoming infected with hepatitis B and C viruses in the pupils of children's boarding schools]. / Risk infitsirovanii virusami gepatitov B i C vospitannikov detskikh internatnykh uchrezhdenii.

The risk of contamination of 487 inmates of 5 boarding schools at northwestern Ukraine with hepatitis B (HB) and hepatitis C (HC) viruses was analyzed and the role of some factors facilitating the spread of these infections among the inmates of such schools was shown. In 28.3 +/- 2.2% of the inmates the presence of HB markers was detected, while these markers occurred only in 7.2 +/- 1.9% of children attending open schools. During the survey of the child population the presence of HB markers was detected in 8.0 +/- 1.1%, which was significantly lower than among the inmates of boarding schools (p < 0.001). Among such markers, HBsAg was detected in 8.3 +/- 0.5% of the inmates and in 1.6 +/- 0.5% of other children living in the area. Among inmates with CNS pathology the sum of markers was significantly higher than in inmates without such pathology (52.9 +/- 3.8%). The occurrence of the markers was shown to depend on the duration of staying in a boarding school and on the presence of the source of infection in the collective. Anti-HCV were detected in 1.4 +2- 0.6% of the inmates of boarding schools and in 0.5 +/- 0.3% of the whole child population.

[The current problems in the epidemiology and prevention of enteric viral hepatitis in Russia]. / Aktual'nye voprosy épidemiologii i profilaktiki énterial'nykh virusnykh gepatitov v Rossii.

The presence of great differences in the activity of the epidemic process of hepatitis A (HA) in some regions of Russia is shown and the data necessary for establishing the structure of HA foci in groups of children, as well as the proportion of different forms of the disease registered in such foci (the icteric form in 22.7% of patients, the obliterated form in 11.3% of patients, the nonicteric form in 45.5% of patients and the asymptomatic form in 20.5% of patients), are presented. The study revealed that the shedding of HA virus occurred at an early stage (5-10 before a rise in alanine aminotransferase activity in the blood was registered), its excretion lasted for a short time (till jaundice appeared) and no chronic carriership of HA virus was registered. The hospitalization of HA patients after the appearance of jaundice was proved to be unjustified, while measures aimed at the rupture of the fecal-oral mechanism of the transmission of HA virus were shown to have good prospects. The epidemiological features of hepatitis E (HE) are considered. HE cases constituted 2-3.6% of all patients with acute viral hepatitis in Moscow (all these cases were brought from Central Asia). The outbreaks of this infection in the countries of Central Asia were shown to be due to the transmission of the infective agent by the water route. The data on the first results of the use of high-titer specific immunoglobulin for the prophylaxis of HE among 135 pregnant women (only one of these women contacted HE, while in a similar group of women used for control 4 HE cases were registered) are presented.

[A trial of using immunoglobulins of known specificity for preventing hepatitis A in regions with high epidemic activity]. / Opyt primeneniia immunoglobulinov s izvestnoi spetsifichnost'iu dlia profilaktiki gepatita A v regionakh s vysokoi aktivnost'iu épidemicheskogo protsessa.

The economic effectiveness of immunoglobulin prophylaxis (IGP), carried out among children aged 1-3 at the beginning of a seasonal rise in hepatitis A (HA) morbidity with high coefficients of protection (80-85%), was directly related to the activity of the epidemic process. Preparations with sufficiently high content of antibodies to HA virus sharply decreased the manifestation of this infection. The detection rate of the manifest forms of the infection among children covered by prophylactic measures in the foci of HA was considerably lower than among children who had not received the preparation. IGP exerted no essential influence on the dynamics of the formation of population immunity. A high share of children aged 3-4 years, seropositive to HA virus (up to 90%), validates the inadvisability of carrying out IGP in older groups of children.

[Specific immunity in preschool children at high risk of infection with hepatitis A virus]. / Spetsificheskii immunitet u detei preshkol'nogo vozrasta v usloviiakh vysokogo riska infitsirovaniia virusom gepatita A.

The dynamics of postinfection immunity to hepatitis A (HA) in preschool children was studied for 2 years in an area with a high activity of the epidemic process. In primary examinations by radioimmunoassay, anti-HAV were found in 82% of the subjects. The degree of the immunity intensity was found to be markedly variable: in 21% of the children the titre of anti-HAV was 1:10, in 28%-1:40, in 37%-1:160, in 14%-1:640. One year later, in the group of children with titres 1:10-1:40 the antibody level increased from 4- to 64-fold in 66% of the subjects. The rate of increase expressed in mean coefficients of antibody rise were the higher the lower the initial anti-HAV titres were. In the children with the initial titre below 1:10 this value approached 100, and anti-HAV-IgM were found in half of the examined subjects, one third of them having experienced the jaundice form of HA. The children with titres of 1:10-1:40 were found to have both manifest (14% and 11%, respectively) and asymptomatic (only anti-HAV-IgM) forms of HA. In the group of children with titres of antibody of 1:160-1:640 neither manifest HA forms nor anti-NAV-IgM could be detected. In this group the anti-HAV titre increased 4-fold or more in only 9% whereas a decrease was observed in 59% (with titre of 1:160) and in 73% (with titre of 640). No changes in anti-HAV levels were observed in 32% and 18%, respectively. Thus, the results of the study indicate that at low levels of postinfection immunity reinfection with HAV is possible and may run both manifest and asymptomatic course.

[Multiyear and seasonal hepatitis A morbidity in different population age groups in certain areas]. / Mnogoletniaia i sezonnaia zabolevaemost' gepatitom A razlichnykh vozrastnykh grupp naseleniia na nekotorykh territoriiakh.

At the areas with high activity of hepatitis A (HA) epidemic process the duration of epidemic cycles was shown to differ, the intervals between the peaks of morbidity increasing in older age groups. The beginning of seasonal rises exceeding the average annual HA morbidity level in different age groups was found to depend on the activity of the epidemic process. At the areas with the highest activity of the epidemic process children aged 1-2 years were the first to be affected by the seasonal rise of HA. Stable direct correlation between HA morbidity levels at the beginning of seasonal rises and some markers indicative of unfavorable sanitary conditions (the size of the fly population, the purity of water samples deviating from the requirement of the Government Standard) during the preceding year was demonstrated.

[Prophylactic efficacy of reaferon in viral hepatitis A and acute respiratory infections in children]. / Izuchenie profilakticheskoi éffektivnosti reaferona pri virusnom gepatite A i ostrykh respiratornykh infektsiiakh u detei.

Reaferon, the analog of human alpha 2-interferon obtained by gene engineering techniques, was studied with a view to its use for the prevention of hepatitis A. The study involved children of preschool age in Tashkent. In a strictly controlled trial children aged 2-6 years received the preparation orally in a dose of 1 X 10(6) I. U. or the diluent alone used as placebo. The preparation was administered to 1,100 children and the placebo to 1,078 children. The preparation and placebo were administered twice a week for two months. On the whole, during that period hepatitis A morbidity in both test and control groups of children was the same (5.1% and 4.9% respectively), but among children of nursery age receiving Reaferon the incidence of hepatitis A and acute respiratory viral infections was lower than among those receiving the placebo, though this difference was statistically significant only for cases of acute respiratory infections.

[Effectiveness of annual booster inoculations against various influenza serotypes and the procedure for mass vaccination]. / Izuchenie éffektivnosti ezhegodnykh, povtornykh privivok protiv grippa raznykh serotipov i taktika massovoi vaktsinatsii.

The epidemiological observation during an outbreak of A (H3N2) influenza in February-March, 1983, showed that the third annual vaccination with killed influenza vaccine did not enhance the effectiveness of vaccinations in the populations under study. It was observed that 14 months after immunization, 55.9% of the subjects examined had antibody titres of 1:40 or higher to the A/Bangkok/1/79 strain antigenically related to the vaccine strain, and 41% of the subjects of this group had antibodies to the subsequent drift variant of influenza A (H3N2) virus. These values were significantly higher than those in the group of subjects given no influenza vaccine. It is suggested that after 2 years of vaccination with killed influenza vaccines with the maximum coverage of the entire population, vaccinations be given alternately to half of previously vaccinated subjects with a 2-year interval up to the emergence of a new shift variant of influenza A virus, when again vaccination of the entire population for two successive years will be required.

[Effect of multiple vaccination against influenza on the specificity of humoral immunity]. / Vliianie mnogokratnoi vaktsinatsii protiv grippa na spetsifichnost' gumoral'nogo immuniteta.

The influence of multiple vaccinations against influenza on humoral immunity specificity was studied by titration of sera from the vaccinees and non-vaccinees in radial hemolysis test (RHT). In order to determine the specificity of antihemagglutinins, the sera were adsorbed with the appropriate antigen followed by titration in RHT. The study showed the sera from vaccinees to contain the strain-specific antibody much more frequently, the titres and content being especially high to the vaccine A/Bangkok/1/79 strain used for large-scale vaccination of the human population in the three years preceeding the study. Fewer sera of the vaccinees contained cross-reacting antibodies. Both in vaccinees and non-vaccinees the total number of sera with antibody to the A/Bangkok/1/79 and A/Moscow/30/83 strains was approximately similar, however, antibody mean titre to these epidemiologically important strains was significantly higher in the vaccinees. The results of the study explain the narrow specificity of the protective effect of whole-virion inactivated vaccines used for mass immunization of the human population.

[Immunomodulating action of levamisole in its combined use with influenza vaccines]. / Immunomoduliruiushchee deistvie levamizola pri ego sochetannom primenenii s grippoznymi vaktsinami.

The immunomodulatory effect of levamisole used in combination with influenza vaccines was studied in young and senile subjects. Levamisole activated antibody production in young subjects in response to administration of a live influenza A (H3N2) vaccine and enhanced the protective effect of vaccinations. The senile subjects vaccinated with inactivated influenza A vaccine (H3N2 and H1N1) had a good immune response and the use of levamisole was not reflected in antibody rises. At the same time, levamisole alone stimulated antibody production to influenza A and B viruses which might be due to irritation of immunocompetent cells carrying "immunological memory".

[Immune structure of the population of Moscow to the strains of the influenza viruses A(H3N2), A(H1N1) and B circulating in 1977]. / Immunostruktura naseleniia Moskvy k tsirkulirovavshim v 1977 g. shtammam virusov grippa A(H3N2), A(H1N1) i B.

Examinations for the presence of antihemagglutinins to influenza A(H3N2), A(H1N1) and B virus strains in the sera from people of different ages collected in April-May and October-November, 1977, showed that influenza A(H1N1) virus began to circulate in the human population of Moscow before the onset of an overt epidemic, in the period between June and October, 1977. This conclusion has been drawn on the basis of the absence of antihemagglutinins to A(H1N1) virus in the sera from subjects of 16-20 years late in April and their detection in 25.9% of those examined on November 23, 1977. The lack of antibody both to the old A/FM/1/47 (H1N1) and a new A/USSR/90/77 (H1N1) strains of influenza A (H1N1) virus in this age group in April indirectly attests to the fact that influenza A virus of this subtype has not circulated among the population in the last 20 years. At the same time the observed significant (by 1.5-2.0 log2) rise in the geometric mean titers of antibody to A(H3N2) virus in May-October indicates its continued active circulation among the population in this period. Thermostable inhibitors of influenza A/USSR/90/77 (H1N1) virus in human sera may be most effectively removed by treatment of the sera with potassium periodate or RDE.

Investigation of the incidence of influenza A viraemia caused by virus strains circulating among children in 1968 - 1977.

Nineteen strains of Type A influenza virus isolated from the blood of small children in 1968--77 were studied. The investigation of the strains in HAIR with antisera to the antigenic components of the strains in HAIR with antisera to the antigenic components of the strains A/Hong-Kong/68,A/Anglia/72, A/Port Chalmers/73 and A/Victoria/75 made it possible to demonstrate antigenic "drive" of the haemagglutinin in the years 1968--1977 and to divide the strains into 4 varieties. A high sensitivity to inhibitors was observed in all the strains isolated. The study of pathogenicity and toxicity of the strains revealed viraemia in the strains isolated during the 1972--1973 epidemic and the subsequent epidemics with the absence of pathogenicity and toxicity for white mice. Regular finding of viraemia coincided in time with increased thermostablty of the haemagglutnin in the strains under study.

[Properties of influenza virus strains causing the influenza epidemic in Moscow in 1972-3]. / Svoistva Shtammov virusa grippa, obuslovivshikh épidemiiu grippa v Moskve v 1972-1973 ig

The antigenic and some biological properties of influenza virus strains isolated during 1972-1973 epidemic were studied. Altogether 114 strains were isolated from sick infants of the first months of life beginning from neonatality. The strains under study were found to have high adaptation and elution activity, to be highly sensitive to inhibitors and to produce polymorphous allantoic population in the adaptation period. The hemagglutinating and neuraminidase components were shown to be fairly closely related to those of the membrane of the reference A2/Hong Kong/1/68 strain (H3N2). At the same time, a low neutralizing activity of the antisera for this strain against Moscow strains of 1972-1973 in biological neutralization tests in chick embryos was observed, explaining very high susceptibility of the population to influenza type A infection in the winter of 1972-1973. The strains under study were antigenically homogenous and most closely related to the reference A2/England/42/72 (H3N2) strain.