No 5 (2012)

The authors analyze the anthrax epidemic situation in the Russian Federation and near and far foreign countries in 2002-2011. It is established that with a general downward trend in anthrax morbidity, the past 20 years in the Russian Federation have been marked by its upsurges associated with the group outbreaks that occurred in 2004, 2008, and 2010. The poor anthrax situation remains in the near and far foreign countries where epizootias are annually recorded among farm and wild animals, which frequently results in widespread outbreaks among humans. Thus, in 2006-2009, fifty-three countries of the world recorded 1636 outbreaks of anthrax among animals and 12606 cases of the disease, of which there were 86% among cattle. In this connection, there is a need for the interaction of the sanitary and veterinary surveillance bodies of the Russian Federation with those of near and far foreign countries to make sanitary protection of their areas from the import and spread of particularly dangerous infectious diseases.

Objective. To analyze the serum level of homocysteine, a marker of endothelial dysfunction, in patients with hemorrhagic fever with renal syndrome (HFRS), depending on the form and stage of the disease. Subjects and methods. Fifty-three male patients aged 18 to 50 years with HFRS were examined. A control group comprised 20 healthy individuals. Homocysteine concentrations were estimated using enzyme immunoassay. Results. All the examinees with HFRS were observed to have hyperhomocysteinemia, particularly high homocysteine values were found in the oligoanuric stage of the disease. Conclusion. In all three considered forms (moderate, severe, complicated), the level of homocysteine increased just in the febrile stage, by peaking in the oligoanuric stage, and decreased in the polyuric and convalescent stages, by remaining above the level in the control group.

Objective. To study the clinical and epidemiological features of norovirus infection in pregnant women. Subjects and methods. Two hundred and fifty-one women were followed up in different periods of pregnancy, 65 (25.9%) patients were diagnosed as having norovirus infection. Most (45.8%) patients were 25-30 years old. The disease was diagnosed by fecal ELISA using the Ridascreen Norwalk-like virus test system. Results. The peak incidence of norovirus infection was recorded in January and February (27.3 and 35.8%, respectively). 48% of the pregnant women had been in contact with sick family members, more often with children. Clinically, there was a preponderance of the symptoms of gastroenteritis (95.8%) and poisoning (83.3%). The leading symptoms in relation to the severity and duration of the disease were diarrhea concomitant with nausea and vomiting (95.8 and 91.6%, respectively). 70.8% of the pregnant women had a moderate disease course. The pain syndrome was present in 62.5% of the patients, with epigastric pain being in 73.3% of cases. The catarrhal symptoms were much less common (29.2%), hemograms showed leukocytosis, neutrophilia, and accelerated erythrocyte sedimentation rate. The treatment included rehydration therapy, as well as probiotics (linex and lactobacterin). Conclusion. The comprehensive studies have shown that the clinical picture of the norovirus infection in pregnant women is not substantially different from that in other population groups.

Objective. Тo establish the frequency of extrahepatic manifestations in children with HCV infection and the specific features of their disease course. Subjects and methods. The specific features of the course of HCV infection were analyzed in 68 children aged 10 to 18 years with and without extrahepatic manifestations, by comparing the clinical symptoms of the disease, the level of viral load, the genotype of the virus, and an immune response. The duration of the disease was more than 10 years. Results. The investigation indicated that chronic hepatitis C (CHC) in the children showed hepatic manifestations in 86.8% of cases and that concurrent with extrahepatic and hepatic manifestations was in 13.2%. It was found that among the systemic manifestations, there was a predominance of thyroid diseases (5.3%), skin rashes (3.6%), and arthralgias (7.1%). The immune status of patients with CHC and extrahepatic manifestations was characterized by the active inhibition of humoral defense mechanisms as a significantly stimulated IL-4 and IFN-α synthesis and by the significant suppression of IFN-γ production as compared with those with CHC without extrahepatic manifestations. Conclusion. The given data substantiate the necessity of monitoring the functions of the urinary and gastrointestinal tracts and the levels of thyroid hormones and rheumatoid factor to rule out extrahepatic manifestations in children with a more than 10-year history of CHC.

The review considers the clinical presentation and diagnostics of Crimean-Congo hemorrhagic fever (CCHF). Attention is drawn to the absence of hemorrhagic syndrome in 60-80% CCHF cases in Russia and Turkey in the XXI century. The prognostic factors for severe disease and lethal outcome are specified, which include coagulopathy markers (abnormal platelet count, hemoglobin, activated partial thromboplastin time, and international normalized ratio), significantly increased blood levels of alanine transferase and aspartate transferase, the high blood concentration of CCHF virus, as well as the wrong diagnosis at the pre-hospital stage and/or at admission. The diagnostic characteristics of widely used tools, specific ELISA for anti-CCHF IgM/IgG and PCR-based tests, are compared. We consider different approaches to the development of diagnostic PCR assays for CCHF, the results of trials and practical use of PCR-based diagnostics. It should be noted that the use of PCR assays is critical for early CCHF diagnostics and adequate treatment, whereas serological methods, having also excellent specificity and sensitivity, may be used mainly for late and retrospective diagnosis with epidemiological purposes.

The paper considers the role of hydrogen peroxide (H 2O 2) in the myeloperoxidase-dependent activity of major human protective cells, such as neutrophil leukocytes, in the formation of the strong bactericidal agent hypochlorous acid and its ionic form (HOCl/OCl -). Myeloperoxidase is present in large amounts in the specialized antimicrobial organelles — peroxidasosomes. It catalyzes reduction of H 2O 2 to H 2O, by oxidizing to the active enzyme form that is able to oxidize Cl - to HOCl/OCl - in a dielectric fashion. After fusion, peroxidasosomes and phagosomes receive a variety of cytotoxic agents, including myeloperoxidase, which is formed by the oxidase system of the phagosomal membrane of H 2O 2 /Cl - that enters through the chloride anion channels of the membranes of phagosomes. The phasosomal generation of HOCl/OCT that eliminates and destroys pathogenic microorganisms is of key value for the optimal antimicrobial activity of neutrophils.

The paper presents the results of a clinical trial of the safety and efficacy of the vaccine Grippol ® plus twice administered in doses of 0.25 ml (n=70) and 0.5 ml (n=70) at a 21-day interval in children aged 6 to 35 months. This is a randomized, double-blind controlled, parallel-group comparative study. The vaccine Grippol ® plus twice administered in doses of 0.25 and 0.5 ml in children aged 6 to 35 months has been ascertained to have a weak reactogenicity and a pronounced immunological activity.