[The relevance and prospects of introducing a uniform federal register of patients with viral hepatitis B and C in Russia].

The article provides the current epidemiological characteristics of viral hepatitis B and C and the existing problems of registering parenteral viral hepatitides in Russia. It justifies the need for introducing a uniform federal registry of patients with viral hepatitis B and C and shows prospects for its introduction.

[Terminologic aspects of infections associated with administration of medical aid].

Evolution of key terms used in epidemiology of nosocomial infections is discussed. A modern point of view on terminology and comparison of Russian terms with foreign analogues are presented.

[Progress in gene therapy].

Recent progress in gene therapy, current status of investigations in this area of experimental medicine are reviewed. Much attention is given to gene-therapeutic approaches the efficacy of which is proved in clinical trials.

[Molecular characterization of pandemic influenza viruses A/H1N1(sw2009) isolated in Russia in 2009-2010].

AIM: Assessment of genetic diversity of influenza virus A/H1N1 (sw2009) variants circulated in Russia, study of virus' pathogenicity in humans and potential resistance to antiviral drugs. MATERIALS AND METHODS: Sequencing of PCR-fragments of genome of influenza viruses isolated from clinical and autopsy samples of 436 patients. Four full genome sequences of influenza viruses A/H1N1 (sw2009) were obtained. Phylogenetic analysis was performed. RESULTS: High degree of homology (98.9-100%) was found among influenza A/H1N1(sw2009) viruses in HA and NA genes as well as in their aminoacid sequences (1.3 and 1.4% respectively). Differences in other proteins did not exceed 1.1%. Diversity was found in position 222 of receptor-binding locus of HA and single amino acid polymorphism--in several internal proteins. Known mutations determining resistance to Tamiflu and Arbidol were not detected. All viruses were resistant to remantadine. Molecular markers of high pathogenicity were not found. CONCLUSION: High homology of influenza viruses determines low level of antigenic differences although in populations of viruses there are variants with different levels of adaptation to human organism and different affinity to receptors of upper and lower respiratory tract that can determine their different transmissibility.

["Medicine of the future is preventive medicine"--N.I. Pirogov].

The role of N.I. Pirogov is shown in the study of infectious factors significance in high mortality during the Crimean war combats. He recommended important organizational, sanitary and therapeutic measures both in war and peacetime conditions.

[Comparative characteristics of transmissive fevers in the territory of Astrakhan region (clinicoepidemiological evidence)].

Epidemiologists register a trend in the latest decades for expansion of the areas of natural-focal transmissive fevers morbidity in the Astrakhan region. This is explained by reconfiguration of natural landscapes as a result of increasing anthropogenic impact. The Astrakhan territory exclusively contains 4 types of landscape with evolutionally formed several natural foci of transmissive fevers: Crimean hemorrhagic fever, West Nile fever, Astrakhan rickettsial fever, Q-fever. Early diagnosis of these diseases determines further treatment, prophylactic policy in the infection focus.

[Structure and matter of modern epidemiology].

Key questions related to definitions of the object, subject field and methods of epidemiology. Definition and characteristic of epidemiological approach to study human diseases are formulated. Structure and matter of modern epidemiology as a basic medical science belonging to prophylactic medicine field are reviewed.

[Infectious diseases in the age of globalization].

The study was aimed to analyse effect of major globalization-related factors on clinical and epidemiological manifestations of infectious diseases. It is shown that they modify the nature of epidemic process influencing its constituent components and significantly accelerate development of infections. All the four major components of globalization, viz. economic, environmental, political, and demographic, are interrelated and influence not only the prevalence of diseases but also the possibility of their prevention. The global character of the threat dictates the necessity of combined approach to its management based on the norms and principles of international law regulating provision of medical services, human rights, environmental protection, trade, and other human activities. Epidemiological safety depends on political will of individual states, financial support of global and national infrastructures for monitoring all factors of the epidemiological process.

[Vaccine prophylaxis of infectious diseases in adults].

The paper reviews the main problems of vaccine prophylaxis of adult infectious diseases, including the organization of adult vaccination within the national calendar of immunization and that as indicated by epidemics. It gives data on vaccine-controlled adult infectious morbidity. The problems of the training of medical workers serving the adult population in vaccine prophylaxis and those of the financing of adult immunization are discussed.

[Pandemic influenza A/H1N1 (sw2009) in Russia: epidemiology, diagnosis, clinical picture, and treatment].

AIM: To study the epidemiological and clinical features of the 2009-2010 pandemic influenza in Russia. SUBJECTS AND METHODS: Materials from 874 patients, including postmortem samples from 287 subjects, were examined applying the AmpliSens Influenza virus A/H1-swine-FL PCR kit designed and produced by the Central Research Institute of Epidemiology. The clinical and postmortem characteristics of 68 patients who had died from influenza A/H1N1 (sw2009) were analyzed in detail. RESULTS: The cause of deaths was primary virus pneumonia in most cases. The major manifestation of viral pathogenicity was impaired microcirculation leading to hemorrhage. No mutations conferring resistance to oseltamivir and arbidol were found. All A/H1N1swl viruses had genetic markers of remantadin resistance. CONCLUSION: The reagent kits developed by the Central Research Institute of Epidemiology proved to be effective. It is necessary to set up PCR laboratories that differentially diagnose influenza and acute respiratory viral infections in health care facilities in order to make early laboratory diagnosis of influenza and to timely perform its specific therapy.

[The prevalence and clinicoepidemiological characteristics of diseases caused by streptococcus group A in Russia].

AIM: to assess the significance of Streptococcus group A (SGA) infection in Moscow and the Russian Federation (RF). MATERIALS AND METHODS: The materials contained in the 1996-2007 annual official statistical records (forms Nos. 12, 14, 16-BH, C-51, of the State Committee for Statistics) were analyzed. RESULTS AND DISCUSSION: An average of 3.1 million (207.1 per 10,000 population) cases of SGA infection were annually notified in Russia. In the latter, the average annual rates of the incidence and prevalence of SGA infection (other than scarlet fever) in all age groups were much greater than those in Moscow. The average annual incidence of rheumatism was 5.1 and 6.0 per 10,000 in the RF and Moscow, respectively. The cases and days of temporary disability in Moscow were 2-3 times lower than those in the RF. The incidence and prevalence of other forms of SGA infection among the RF population significantly increased from 1 to 4%. In Moscow, there was a significant reduction in the incidence and prevalence of renal diseases, a decrease in the incidence of chronic rhinitis, nasopharyngitis, and sinusitis and in their prevalence. The prevalence of chronic tonsillitis, adenoiditis and paratonsillar abscesses tended to increase while their incidence showed no significant changes. CONCLUSION: Despite the significant declining trends for its incidence, prevalence, temporary disability, and mortality, SGA infection continues to cause a substantial socioeconomic damage and to remain to be one of the urgent public health problems of the country.

[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.

[Season and age related structure of acute intestinal infections morbidity in the Russian Federation].

AIM: To study seasonal and age features of etiological structure of acute intestinal infections (AII) in the territory of the RF. MATERIAL AND METHODS: A total of 7388 AII inpatients aged from 1 day to 90 years from 7 cities (Moscow, St-Petersburg, Nizhniy Novgorod, Chelyabinsk, Tyumen, Makhachkala and Khabarovsk) of the RF participated in a trial conducted from December 2001 to September 2006 The patients were examined with diagnostic tests based on polymerase chain reaction (PCR) for detection of rotaviruses of group A (RVA), noroviruses, astroviruses, adenoviruses, salmonella, termophilic campilobacteria, shigella and enteroinvasive Escherichia coli (EIEC). RESULTS: The above agents were detected in 72% children and 52% adults. In children RVA and noroviruses occurred most frequently (29.5% and 11%, respectively). The adults carried most often salmonella (9.3%), noroviruses (8.4%), RVA (7.8%) and Schigella in combination with EIEC (7.0%). CONCLUSION: Viral agents are essential or prevailing causative agents of AII at different ages. Seasonal and age-related trends of AII morbidity are characterized.

[Development of the anti-influenza H5N1 vaccines worldwide and in Russia].

Article is dedicated to analytical investigation of the problem of current technologies in construction and manufacturing of anti-influenza vaccines. Epidemiological events in July-November 2005 in Russia (mainly in Siberia) and later in Ukraine showed that Health Care system was not ready for that turn over of epidemiological situation. It was completely the same situation in other countries. There are two general questions of a readiness in pre-pandemic situation: level of a diagnostic monitoring of epidemiological situation and preparedness to fast production of actual vaccine preparations. First task can be solved by immediate production of diagnostic sets for regional branches of National WHO Centers, and a second one depends on application of a novel approaches in construction of a anti-influenza vaccines. The construction of anti-influenza vaccines is based on genetic engineering (reverse genetics) and manipulation with plasmids carried out basic viral genes. Reassortation technology for preparation of hybrid viruses is going to the past by objective reasons. Advanced technologies are safety in laboratories and in manufacturing facilities. Moreover, genetic engineering in this field allows to planing the construction of vaccines bank, when the prognoses for actual viruses include more then two strains with different antigenic properties.