№ 1 (2018)

The paper analyzes the data of serological monitoring of the community immunity to the pathogens of feral herd infections among the population of 34 municipal districts of Tatarstan. The subject of the investigation was the incidence rates of hemorrhagic fever with renal syndrome, tick-borne encephalitis, Ixodes tick-borne borreliosis, West Nile fever, monocytic ehrlichiosis, and human granulocytic anaplasmosis in the Republic of Tatarstan as a whole and in its individual areas versus serological monitoring data. Combined nosoareas of feral herd infections were identified in a number of districts in the Republic. The serological monitoring data showed the intensity of a latent epidemic process of monocytic erlichiosis, human granulocytic anaplasmosis, and West Nile fever. This investigation considerably expanded the idea of the area of feral herd infections as both the most common and frequently studied infections (hemorrhagic fever with renal syndrome, borreliosis, tick-borne viral encephalitis) and little studied and less common (West Nile fever, monocytic ehrlichiosis, human granulocytic anaplasmosis) ones.

The Kirov Region is a natural focus of echinococcosis. In recent years, there has been an increase in the incidence of this infection. Objective. To investigate the epidemiological features of echinococcosis in the region. Subjects and methods. The data of epidemiological survey maps of 36 patients treated for echinococcosis from 2007 to 2015 were used. Among them, there were 22 women and 14 men. The diagnosis in all the patients was confirmed by a serological assay (enzyme immunoassay, indirect hemagglutination test), ultrasonography, magnetic resonance imaging (MRI), and computed tomography (CT). Results. Among the patients, there were more than 50% of patients aged over 50 years. Infection more frequently occurred when gathering wild berries. Workers, white-collar workers, pensioners, and the unemployed were equally often ill. The patients mainly complained of heaviness and pain in the liver. 20% of patients had false-negative serological tests. The final diagnosis was generally established after MRI and CT. The majority of patients received surgical treatment and chemotherapy. A fatal outcome was recorded for the last time in 2002. An extract from the case history of a female patient who had died from echinococcosis was given as a clinical example. Conclusion. The epidemiological features of echinococcosis in the Kirov Region are the absence of its cases among children; the predominance of echinococcosis among female patients aged over 50 years; and the greatest risk for echinococcosis when gathering wild berries. Among the forms of echinococcosis, alveococcosis with predominant liver involvement was dominant in the region.

Objective. To estimate the diagnostic significance of identifying the antigens of influenza A and B viruses by immunochromatography (ICG) versus that of detecting influenza virus nucleic acids (NAs) by a real-time polymerase chain reaction (RT-PCR) assay, as well as to determine the optimal procedure for their use in the diagnosis of influenza. Subjects and methods. Nasopharyngeal swabs from 211 children with influenza-like symptoms were concurrently examined by ICG and RT-PCR for NAs of influenza viruses and 19 other pathogen species of acute respiratory diseases. Results. 85.8% of the children were found to have NAs in the pathogens of acute respiratory infections; influenza was confirmed in 62.6%. ICG was used to detect influenza virus antigens in 31.3% of the children. The diagnostic sensitivity of ICG for influenza A(H3N2) and B viruses was 58 and 20%, respectively; its diagnostic specificity was 97.5 and 97.7%. Conclusion. The negative result of ICG cannot be an exception to the diagnosis of influenza due to the low sensitivity of this technique. Examinations on 1-2 days of the disease allow one to increase the sensitivity of ICG for the diagnosis of influenza A; this technique is minimally informative for the diagnosis of influenza B. It is advisable to use RT-PCR to rule out the diagnosis of influenza and to determine respiratory infection of another etiology.

Objective. To investigate the prevalence of HIV infection among the representatives of northern indigenous small-numbered peoples (Khanty) living in the Surgut District of the Khanty-Mansi Autonomous Okrug-Yugra. Materials and methods. This pilot longitudinal retrospective and prospective study was conducted, with emphasis on the target group of HIV-infected patients from the indigenous ethnic group (the Khanty) in the Surgut District. The data from the maps of epidemiological investigation of HIV infection cases and outpatient medical records (Form No. 025/y-04), and the data from state statistical reporting forms (Nos. 4, 61, and 33) over the period 2000 to 2016 were used. Results. The incidence, prevalence, morbidity, and mortality rates due to HIV infection in the representatives of the Khanty in the Surgut District substantially exceed those amongst the newcomers. Of particular concern is a rise in HIV cases among the Khanty people living on the communal tribal lands. The mortality rates from HIV infection concurrent with tuberculosis were registered in 50% of cases among the Khanty. Sexual contact in the structure of HIV transmission routes prevails from the initiation of the epidemic process due to the ethnic and social characteristics of the lifestyle of the indigenous population. The excess threshold HIV affection in pregnant women suggests that the epidemic is generalized among the Khanty. Conclusion. The HIV epidemic has an obvious negative impact on the indigenous small-numbered peoples of the Surgut District; and the radical change in the adverse scenario of the epidemic process necessitates the urgent and active implementation of a package of anti-epidemic and prevention measures to stabilize HIV mortality rates among the Khanty ethnic group.

Objective. To define the role of hepatotropic (HAV, HBV, HCV, and HDV) and conventionally hepatotropic (HGV, CMV, EBV, HSV types 1, 2, and 6) viruses in the etiological structure of diseases in pregnant women, which are accompanied by enhanced blood ALAT and ASAT activities. Subjects and methods. Examinations were made in 211 pregnant women; among them there were 123 patients with chronic viral hepatitis, 74 with enhanced blood ALAT activity in the absence of viral hepatitis markers (PAlAT-OMVG) and 14 with acute viral hepatitis. The examination was conducted by current test systems, such as enzyme immunoassay, chemiluminescence, and polymerase chain reaction. Results. Among the pregnant women with chronic HBV and HCV infections, most cases were found to have blood HBV DNA and RNA, respectively, in the presence of both blood normal and increased transaminase activities. None of the conventionally hepatotropic viruses was identified in more than 7% of cases in the PAlAT-OMVG group. The genetic material from 10 patients with hepatitis of unspecified etiology exhibited no blood viruses, such as HAV, HBV, HCV, HDV, HGV, CMV, EBV, and HSV types 1, 2, and 6. Conclusion. In the absence of serological findings confirming the presence of infectious diseases, blood PCR testing for conventionally hepatotropic viruses is of low informative value in pregnant women with hepatitis of unspecified etiology. However, taking into account the fact that the spectrum of conventionally hepatotropic viruses is not limited to those included in this investigation, it is advisable to additionally examine pregnant women with enhanced blood ALAT and ASAT activities for the viruses TTV, B19V, HSV-8, SEN, and nV-F.

Botulism is registered everywhere, but it is one of the rarely encountered diseases. The trend in the incidence of botulism in the Russian Federation is uneven and reflects the influence of various social factors. Case histories from the archive of Yaroslavl Infectious Diseases Clinical Hospital One were used to analyze botulism cases registered in the Yaroslavl Region in 2005-2015. Botulism in the Yaroslavl Region was found to have typical clinical presentations. The symptoms of the disease are diverse, but the manifestations of paralytic syndrome prevail. A symptom, such as dry mouth, is present in all cases, even in the mildest forms of the disease. In some cases, its clinical manifestations are questionable; and laboratory tests are not always of informative value, so it is very important that detailed epidemiological data on botulism should be collected.