[Paralytic poliomyelitis in Russian Federation in 1998-2005].

From 1998 through 2005 3,294 cases of acute flaccid paralysis (AFP) including 93 cases with clinical picture of poliomyelitis were registered in Russian Federation. From the latter cases 91 were classified as vaccine-associated paralytic poliomyelitis (VAPP): 66 were VAPP cases in oral poliomyelitis vaccine (OPV) recipients and 25--VAPP cases in contacts. VAPP rate was 1 case per 1.6 million of distributed OPV doses, 1 case per 2.2 million doses for OPV recipients, and 1 case per 186,000 doses for recipients of 1st OPV dose in children aged < 1 year. Majority of VAPP cases in recipients occurred after 1st dose (89.4%) and in contacts--in non-vaccinated children (76%). Mean interval between OPV administration and onset of VAPP in recipients was 21 days. Children aged < 1 year were predominant among VAPP cases (92.4% among recipient VAPP cases, and 80% among contact VAPP cases). Majority of the patients had unfavorable health status including defects of immunity. Most of poliovirus strains isolated from VAPP cases belonged to type 3 (52.9%) whereas to type 2 and 1--29.8% and 17.4% of strains respectively. All VAPP cases were associated with vaccine-derived polioviruses. A highly diverged poliovirus type 1 (2.65% of nucleotide substitutions in VP1 region) was isolated from patient with contact VAPP. Formation of poliovirus-neutralizing serum antibodies in children with VAPP including persons with immunodeficiency reflects the ability of the organism to produce specific antiviral immune response.

[An outbreak of poliomyelitis in Tajikistan in 1991 caused by the poliomyelitis virus type 1 in concomitant echovirus 19 infection]. / Vspyshka poliomielita v Tadzhikistane v 1991 g., vyzvannaia virusom poliomielita tipa 1 pri soputstvuiushchei infektsii virusom ECHO 19.

In 1991 in Tajikistan 36 cases of acute poliomyelitis were recorded (spinal form 27, bulbospinal 3, pontospinal 6 cases) in children ranging in ages from 6 months to 6 years. The outcome of the disease was fatal in 4 cases and with crude residual effects in 32 children. Out of 23 children examined, poliomyelitis virus type I was isolated from 13, antibodies to poliovirus type I in titres 1:16 to 1:1024 were detected in 21 children, ECHO 19 virus was isolated from 5 children and antibodies to this virus in titres 1:16 to 1:8192 were demonstrated in 13 children. The fresh isolates of poliomyelitis virus type I had rct+, DS+ and N+ markers. The strains of ECHO 19 virus were highly pathogenic for monkeys causing deaths of the animals within 3-4 days. It is assumed that the main causative agent of the Tajikistan outbreak of poliomyelitis was a virulent "wild" variant of poliovirus type I. The preceding or concomitant infection with ECHO 19 virus (considering the data from the literature and the demonstrated high virulence of this agent for monkeys) could exert an aggravating effect on the course of poliomyelitis or, in some cases, be an independent cause of the disease and, possibly, death of the children.

[The isolation of measles virus strains and the study of their hemagglutinating activity]. / Vydelenie shtammov virusa kori i izuchenie ikh gemaggliutiniruiushchei aktivnosti.

Three measles strains Gag, Il, and Buk, were isolated from a suspension of mononuclear cells derived from measles patients in the active stage of the disease. Continuous Vero cell cultures were used for virus isolation. In the infected cell culture, all the isolates produced symplasts of different sizes and star-shaped or spindle-shaped multinuclear cells. The specificity of the cytopathic effect was proved by the adsorption of monkey erythrocytes on the surface of virus-affected cells. The isolates were identified in neutralization and HI tests with different immune preparations: measles gamma-globulin (national standard), hyperimmune rabbit sera to measles (Edmonston strain), rubella, and mumps viruses, S. sonnei and S. flexneri, as well as with sera from measles patients and subjects vaccinated with live measles vaccine L-16. The results of identification attest to isolation of 3 measles virus strains, one of which (Buk) possesses particularly high hemagglutinating activity.

[Acyclovir in the treatment of severe generalized forms of herpes zoster]. / Atsiklovir v lechenii tiazhelykh generalizovannykh form opoiasyvaiushchego gerpesa.

Aciclovir administration in 8 herpes zoster patients aged 14-74 to manage resistant generalized herpetic eruption, serous meningitis, meningoencephalitis resulted in a pronounced response in 5 of them. Aciclovir has the advantage of its effectiveness in spite of late treatment (on herpes zoster day 6-22). This is particularly important for those forms of the disease which manifest severe symptoms during the second phase, i.e. disseminated eruption, involvement of brain matter, etc. Two lethal outcomes due to pulmonary artery embolism were unrelated to the drug administration.

[Clinical aspects, diagnosis and treatment of various forms of viral encephalitis in children]. / Klinika, diagnostika i lechenie nekotorykh form virusnykh éntsefalitov u detei.

The authors provide the clinical and laboratory data on the etiological structure of acute viral encephalitides in children. Special attention is devoted to the description of the clinical picture of the gravest form of encephalitis caused by type I herpes simplex virus. Present the laboratory data on the long-term preservation of type I herpes simplex virus in the CNS, which correlates to the clinical and morphological findings of the subacute or recurrent course of the disease. Discuss the results of the treatment with the antiviral drug acyclovir (zovirax).

[Study of the outcome of acute viral encephalitis in children based on the catamnestic data]. / Iskhody ostrykh virusnykh entsefalitov u detei po dannym katamnesticheskogo nabliudeniia

The paper treats of the results of a prolonged follow-up of 292 children who suffered acute viral encephalitides of different etiology. Outcomes of the disease are evaluated. Encephalitis outcome was mainly determined by etiology of the process. The most unfavourable outcomes were recorded in a group of children who suffered herpetic and cytomegaloviral encephalitides. The lingering convalescence may last up to 1.5-2 years. During that period, the children undergo not only a genuine recovery but also processes of compensation and adaptation. The residual phenomena include alterations which do not tend towards the reverse development. It is of paramount importance to take into account and to estimate properly premorbid changes on the part of the CNS. Etiology of the process determines the depth and stability of the residual phenomena.

[The molecular epidemiology of poliomyelitis: the characteristics of the strains isolated from patients in Moscow in 1973-1986]. / Molekuliarnaia épidemiologiia poliomielita: kharakteristika shtammov, vydelennykh ot bol'nykh v Moskve v 1973-1986 gg.

Eleven virus strains isolated from poliomyelitis patients in Moscow in 1973-1986 were analyzed by the method of oligonucleotide mapping of RNA. The genome of the isolates showed considerable similarity to the genomes of Sabin's vaccine strains and mainly to the vaccine strain of antigenic type 2. The conclusion was made that the sporadic cases of poliomyelitis registered in this region were etiologically linked with the vaccine strains of poliomyelitis virus. Only in one case the disease appeared in the recipient of the vaccine, in all other cases the patients were infected through contacts.

[Acute necrotic encephalitis in children (clinico-electroencephalographic study)]. / Ostrye nekroticheskie éntsefality u detei (kliniko-élektroéntsefalograficheskoe issledovanie).

Twenty-five children aged 3 months to 13 years were examined electro-encephalographically. Most of the patients (20 of the 25) were young children (under 3 years of age) with the diagnosis of acute necrotic encephalitis. The characteristic changes of the EEG expressed in the form of cyclically arising asymmetric giant slow waves were established. The nature of the EEG was shown to correlate with the gravity of the clinical course. The data obtained may be used both diagnostically and prognostically.

[Metabolism of various biogenic amines in acute viral neuroinfections]. / Ob obmene nekotorykh biogennykh aminov pri ostrykh virusnykh neiroinfektsiiakh.

The metabolism of biogenic amines was examined in 62 patients with various acute viral neuroinfections. The control group consisted of 57 persons. Depending on the process character and disease period variations of the levels of serotonin, 5-hydroxyindolylacetic acid, coeruloplasmin and histamine were discovered. A comparison of the results obtained with the clinical course of the diseases revealed a certain correlation, especially in patients with acute meningoencephalitis.

[Acute meningoencephalitis and the problem of viral persistence in complicated rubella]. / Ostrye meningoéntsefality i problema persistentsii virusa pri oslozhnennoi krasnukhe.

The results of combined clinico-virological and immunological examinations of 25 children with rubellar meningoencephalitis are presented. The meningoencephalitis was preceded by typical rubella in 24, and by rubellar infection without eruptions in 1 child. In 6 children the rubella virus was isolated from the cerebrospinal fluid in the acute period of the disease (5th to 19th days), and in 2 children it was re-isolated on the acute period of the disease (5th to 19th days), and in 2 children it was re-isolated on the 17th-19th days. A persistence of the immunoglobulins M specific to the rubella virus was revealed both in the acute period of the disease and long time after the disease onset (the observation period was 409 days). The data obtained confirm the etiological role of the rubella virus in the development of rubellar meningoencephalitis, suggesting that the rubella virus may persist in complicated post-natal rubella.

[Acute meningoencephalitis in children caused by herpes simplex virus type I]. / Ostrye meningoéntsefality u detei, vyzvannye virusom prostogo gerpesa I tipa.

In 14 observations of acute meningoencephalitis in children mainly under 3 years of the age, data pointing to an etiological role of herpes simplex type I virus, were obtained on laboratory examination. Six children died, and in the rest 8 children who survived gross residua were observed. The morphological picture showed extensive colliquation necroses in the parietal, temporal, and less frequently, in occipital lobes and the Varolian pons. In 4 cases out of 6 intranuclear inclusions were detected. The incidence of herpetic encephalitis was 16%.

[Reye's syndrome in children with acute respiratory diseases]. / Sindrom Reia u detei s ostrymi respiratornymi zabolevaniiami

The authors report a clinico-morphological traits in Ray's syndrome which occurred in 10 children with acute respiratory disorders. The prevalent symptoms were encephalopathy with fatty dystrophy of the internal organs and mainly of the liver. Literature data concerning the clinical picture, diagnosis and treatment of this disorder are discussed.