[Characteristics of imported cases of Dengue fever and hemorrhagic Dengue fever in 2009-2019].

INTRODUCTION: In Russia, the approved morbidity statistics system is represented by the International Classification of Diseases of the 10th revision (ICD-10). This classification provides two forms of dengue fever (DF): dengue fever (A90) and hemorrhagic dengue (A91). Official statistics on the ratio of forms of DF is not published in open sources and this lack of information about the real ratio of the forms of DF makes it difficult to objectively assess the factors that determine the severity of this disease. THE AIM: compare the clinical and epidemiological features of dengue fever and hemorrhagic dengue fever in patients hospitalized in 2009-2019 to the City Infectious Clinical Hospital No. 1, Moscow. MATERIALS AND METHODS: A retrospective cohort study. We analyzed the patient database and reviewed 391 medical records of patients with diagnosed dengue fever. We compared gender, age characteristics, travel geography including information about previous visits of patients to endemic regions and dengue virus serotype. To determine the primary and re-infection rate, an analysis of IgG for the dengue virus was carried out on days 1-5 of the disease. To compare indicators, 95% confidence intervals for proportions, medians, and interquartile ranges were calculated. The significance of differences between independent samples for assessing qualitative characteristics was carried out using the criteria χ2, the odds ratio. To assess the quantitative characteristics, the Mann-Whitney test was used. Differences were considered statistically significant at p ≤ 0.05. RESULTS: The proportion of patients with dengue fever was 14.9% of all hospitalized with febrile illnesses that developed after international travel. Hemorrhagic dengue fever (DHF) was diagnosed in 15.7% of patients with dengue fever. DHF developed significantly more often in women, as well as in those who had history of repeated visits to endemic regions. However, DHF was also diagnosed in 10.9% of first-time travelers to tropical countries. We did not find significant differences in the rates of DHF development depending on age and dengue virus serotype. In a number of patients who had not previously traveled to endemic regions, IgG to the dengue virus were detected, which may indicate a previous infection with related flaviviruses. CONCLUSION: It has been established that in the regions most visited by Russians, there is a circulation of all serotypes of the dengue virus with an annual change in the predominant serotype.

Efficacy and Safety of Ergoferon in Children from 6 Months to 6 Years Old with Acute Respiratory Viral Infections in Contemporary Outpatient Practice: A Multicenter, Double-Blind, Placebo-Controlled Randomized Trial.

To evaluate the efficacy and safety of Ergoferon in combination with symptomatic therapy in children from 6 months to 6 years old with acute respiratory infections (ARI) in contemporary outpatient practice, an international, multicenter, double-blind, placebo-controlled, randomized, parallel-group clinical trial was performed. Derived by technological treatment of antibodies to interferon gamma, histamine, and CD4, Ergoferon was previously proved to modulate its molecular targets promoting effective antiviral protection. The data of 282 patients with oral temperature ≥38.0°C plus mild to moderate severity of flu-like nonspecific and nasal/throat/chest symptoms were included in intention-to-treat analysis (n = 140, Ergoferon group; n = 142, placebo group). Time to alleviation of all ARI symptoms was the primary endpoint, and 8 outcome measures were estimated as the secondary endpoints. Respiratory viruses were confirmed in 57.1% (Ergoferon) and 54.9% (Placebo) of patients. Compared to placebo, Ergoferon reduced time to alleviation of all ARI symptoms (4.5 ± 1.7 versus 5.2 ± 2.2 days in placebo; p=0.026) including fever (2.8 ± 1.5 vs 3.4 ± 2.0; p=0.031), flu-like nonspecific (4.0 ± 1.8 vs 4.7 ± 2.2, p=0.022), and nasal/throat/chest (4.3 ± 2.0 versus 5.0 ± 2.3; p=0.024) symptoms. Ergoferon add-on therapy decreased the mean total symptom severity score (according to 4-point scale for each symptom), ARI severity, frequency of antipyretic use, and percentage of complication requiring antibiotics and increased the percentage of recovered patients. The incidence of adverse events (AEs) in the Ergoferon group was significantly lower compared to the placebo group (7.0% versus 18.8%; p=0.004) including infectious diseases (3.5% vs 12.5%; p=0.008). In the Ergoferon group, AEs were mild or moderate. In 8 (57.1%) cases, AEs were unrelated to Ergoferon, in 5 (35.7%), the relationship was uncertain, and in 1 (7.1%), it was possible (mild rash on the face). Ergoferon treatment is beneficial for infants and young children with ARI in contemporary outpatient practice. Being well-tolerated, Ergoferon increases the symptomatic therapy effectiveness and improves the patient condition and disease outcomes.

[The concept of infectious diseases pathogenesis].

In this article a concept of infectious disease pathogenesis as consisted with clinical symptoms is provided. The course of disease, immediate and long-term consequences depend on the mode of entry. If the infection comes via oropharynx, airway, gastrointestinal tract or via skin, the immune system provides adequate immune response. This leads to typical symptoms, cyclical clinic progression and usually to the recovery with the formation of full sterile immunity. In case of parenteral way of infection, which includes perinatal way, there is no full mode of entry, the disease takes chronic course involving visceral organs because of different mechanisms of affinity and new tropic organ involving. For the full sanogenesis germ or its mediators should persist in the primary focus of infection. It is suggested, that HIV, HCV, hepatitis B virus, tetanus, rabies and other infectious diseases with inner organs involvement, as well as all slow infections, should be treated as infectious diseases with the parental way of infection, proceeding with affinity changings, which lead to the appearance of new tropic sites in visceral organs. The theory of the mode of entry, affinity, appearance of tropic sites in visceral organs should form the basis of modern infectology.

[The vaccination of children with severe somatic pathology]. / Vaktsinatsiia detei s tiazheloi somaticheskoi patologiei.

1,696 children were vaccinated; of these, 1,487 children had different kinds of somatic pathology, including 1,181 children with CNS lesions, 29 children with malignant tumors, 45 children with congenital defects, 82 children with allergic diseases, etc. The group of relatively healthy vaccinees consisted of 209 children. The following vaccines were used for immunization: Tetracoq 05, D.T.Vax, Rudivax, Imovax Polio, Vaxigrip (Pasteur Mèrieux Connaught, France); HBVax, MMRII (Merck Sharp & Dohme, USA); as well as vaccines against hepatitis B produced by Smith Kline Beecham (UK) and Combiotech (Russia). In no case severe vaccine-associated complications were observed. The frequency and manifestation of reactions in children with somatic pathology did nor essentially differ from those in relatively healthy children. The increase of the number of vaccine components did not lead to the increase of the number of side effects of the severity of their manifestation. These investigations demonstrated the safety of vaccination for children with somatic pathology.

[Microrheologic properties of erythrocytes and parameters of vascular-thrombocytic hemostasis in newborns with perinatal pathology]. / Mikroreologicheskie svoistva éritrotsitov i pokazateli sosudisto-trombotsitarnogo gemostaza u novorozhdennykh s perinatal'noi patologiei.

Hematocrit, thromboelastogram, aggregation capacity of platelets and red blood cells, the content of prostaglandin metabolites--prostacyclin 6-keto-PGF and thromboxane B (TxB) were studied in 70 newborns who had suffered perinatal hypoxia and localized pyo-inflammatory diseases that developed during the first week of life. It has been found that the pronounced disturbances of the peripheral blood circulation and frequent hemorrhagic complications in the infants with these diseases are closely connected with disorders in the aggregation capacity of red blood cells and platelet function due to the imbalance of the prostacyclin-thromboxane-generating system.