The coronavirus infection is a pressing issue in modern healthcare, yet the characteristics of the SARS-CoV-2 infection course in children with comorbidities remain insufficiently studied. The aim of this study was to evaluate the clinical form, severity, and duration of SARS-CoV-2 virus shedding in pediatric patients with somatic diseases, depending on the comorbid pathology. Materials and Methods. A comprehensive single-center retrospective study was conducted, analyzing 314 medical records of patients hospitalized in the infectious diseases department of the Russian Children’s Clinical Hospital in Moscow over 11 months in 2022. The inclusion criterion was the presence of a laboratory-confirmed COVID-19 diagnosis. Results. Children with comorbidities were found to be predisposed to a more severe course of SARS-CoV-2 infection compared to the pediatric population in general. Children with hematological diseases were at the highest risk of adverse outcomes from COVID-19. Patients with oncological and hematological diseases and primary immunodeficiencies shed the SARS-CoV-2 virus significantly longer than patients with other somatic pathologies. The duration of SARS-CoV-2 RNA detection in patients with severe COVID-19 was significantly longer, which also correlated with the severity of the underlying somatic disease. Conclusion. Children with comorbidities are at risk for a more severe and prolonged course of SARS-CoV-2 infection.

The relevance of the problem of the visceral (hepatosplenic) form of bartonellosis in children is due to the fact that the disease is one of the causes of the development of the so-called «fever of unknown origin», manifested by the formation of focal lesions in the internal organs and requires antibacterial therapy. The purpose of the work is to study the data available in the literature regarding the visceral (hepatosplenic) form of bartonellosis, and to demonstrate our own clinical cases. Materials and methods: a review of domestic and foreign literature over the past 10 years was carried out, including Internet resources, and our own clinical observations of children with the visceral (hepatosplenic) form of bartonellosis were presented. Conclusion. The visceral (hepatosplenic) form of bartonellosis in children occurs with febrile fever, accelerated ESR, increased levels of C-reactive protein, visualization of multiple foci in the liver and spleen, and possible damage to the lungs and kidneys. Treatment is with antibiotics; usually a combination of different drugs.

Since the beginning of the 21st century, the number of international trips has been increasing in the world. Outbound and domestic tourism is expanding in Russia. During a trip, there are various types of health risks for the traveler, especially for children. These risks include infectious diseases, among which in children intestinal infections come first. That is why this research is important for studying the epidemiology and clinical processes of intestinal infections in childhood in patients returning from travel. The goal is to analyze the clinical and epidemiological characteristics of imported intestinal infections in children who traveled to other countries and in children who returned from Russian regions. Materials and methods. A single-center prospective study using questionnaires and clinical observation was conducted from June to September 2022 in the children's infectious diseases hospital of the Moscow Multidisciplinary Clinical Center «Kommunarka» (MMCC «Kommunarka»). An analysis of the data of 128 travelers who fell ill during or after travel and were admitted to the MMCC «Kommunarka» was carried out. 2 groups were identified — those who traveled to the regions of Russia or other countries. The clinical and epidemiological features of children's disease cases and their vaccination status were analyzed. Results. The children's ages ranged from 1 month to 17 years, and the gender distribution was even. Among the regions of departure, the Krasnodar Territory and Mediterranean coast of Turkey were the most common. There were no differences in travel duration, with a median of 10 days. In the group of people who traveled across Russia, the leading purpose was to visit friends and relatives, while tourists stayed mainly in the private sector. In the case of traveling abroad, the prevailing purpose was tourism, with equal proportions staying in a hotel or private sector. Imported intestinal infections most often occurred with symptoms of gastroenteritis, were assessed by CDS at 5 points, and rotavirus predominated in the etiological structure.

Rotavirus infection is one of the leading causes of severe diarrhea in children under five years of age worldwide and contributes significantly to child mortality. The introduction of rotavirus vaccination for epidemic indications into the Russian National Immunization Schedule has not impacted the epidemiological situation due to low vaccination coverage. This article provides a review of studies evaluating the clinical significance of rotavirus infection in the context of mass vaccination, as well as its impact on the circulation of rotavirus genotypes. We have analyzed data on the prevalence of rotavirus, the severity of clinical cases, and changes in the genetic diversity of the virus. It has been noted that vaccination reduces the severity of gastroenteritis; however, over time, changes in circulating viral strains have been observed. Despite the positive effects of vaccination, some countries have reported an increase in the prevalence of other pathogens, such as norovirus and Campylobacter. These findings emphasize the need to continue vaccination efforts and monitor changes in the structure of pathogens responsible for acute intestinal infections to improve preventive measures and control the epidemiological situation.

Purpose of the work : to conduct a clinical-epidemiological analysis of intestinal infections in a pediatric infectious diseases hospital and the effectiveness of the PEWS scale. Materials and methods : a retrospective study was conducted at the Moscow City Clinical Hospital «Communarka» and City Clinical Hospital No. 1 in the pediatric infectious disease departments from June 1, 2023, to August 31, 2023. Laboratory, clinical, and anamnestic data were obtained from the medical information system «EMIAS» and the laboratory information system (LIS) «ALISA». The study analyzed 838 medical records of children with acute respiratory infections. Results : when conducting a statistical analysis of indicators in two groups (group 1 — PEWS ≥ 3 points, recorded at least once during the entire period of hospitalization, group 2 — PEWS from 1 to 2 points, recorded at least once during hospitalization period) no significant differences were observed in terms of etiology, age, day of illness, blood test results, and length of hospital stay. All patients had a moderate form of acute respiratory infection, however, patients with PEWS ≥ 3 points required increased attention from medical staff and had a higher risk of deterioration without additional medical intervention, with the most significant risk in predicting deterioration being related to changes in the cardiovascular system. All children were discharged home in satisfactory condition with PEWS = 0. Conclusion : In our conducted research, for the first time in the Russian Federation, the experience of using the PEWS scale in pediatric practice for patients with gastrointestinal infections was applied with the aim of early detection of the risk of clinical deterioration. It can be assumed that the most significant risk in predicting deterioration in the condition of a child with acute gastrointestinal infection, as well as with acute respiratory infection, is predominantly due to disturbances in the cardiovascular system.

Timely diagnosis of Lyme-borreliosis (LB) is the key to its successful treatment. Outpatient monitoring of patients after tick bite based on the algorithm is able to optimize the early diagnosis of LB, shorten the start of treatment and improve the disease surveillance.Purpose. Creation of an algorithm for monitoring patients after tick bite for use in outpatient settings by primary care physicians. Material and methods. A retrospective, non-randomized, single-center cohort study was conducted based on the analysis of data from 660 outpatient records of patients consulted by an infectious disease specialist in the Infectious clinical hospital No.1 in Moscow. Patients were divided by age and the presence or absence of a diagnosis of LB. Confirmation of the diagnosis was carried out according to clinical and/or laboratory criteria using methods of enzyme-linked immunoassay and immune blot. Results. The analysis of the results of enzyme immunoassay of antibodies to borrelia in patients with LB was carried out. The optimal sampling time was 7 or more weeks from the moment of tick bite and 4 or more weeks from the moment of onset of symptoms. The specificity of immunological diagnostics in patients with excluded LB was evaluated. The proportion of doubtful and false positive results in such patients was high — 28.1%. False positive results were more common in adults (37.6%) compared with children (9.8%), which is associated with more frequent false positive results of IgM determination (34.1% in adults, 4.9% in children). Based on the data of our study, an algorithm for monitoring patients after tick bite has been developed, focused on use in outpatient settings by primary care physicians.

Mass immunization with H. influenzae type b (Hib) vaccines has led to a sharp decrease in the incidence of invasive and non-invasive forms of Haemophilus influenza infection. H. influenzae causes a diverse spectrum of diseases from usually asymptomatic carriage to otitis, sinusitis, epiglottitis, pneumonia, endopericarditis, inflammation of the subcutaneous tissue, arthritis, and is one of the four main causative agents of bacterial meningitis. Materials and methods . In order to identify the significance of Hemophilus influenzae infection during the vaccination period, an analysis was carried out on the spread of Hemophilus influenzae infection, its clinical forms, as well as the antibiotic resistance of the pathogen. A review of domestic and foreign publications over the past 20 years was conducted in the search engines PubMed, Google Scholar, Cochrane Library and Elibrary. Results. Studies conducted in various countries show that after the start of mass immunization, H. influenzae type b is no longer the dominant serotype of the pathogen causing invasive infections in most countries. Everywhere in the world, the leading positions are occupied by cases of infection caused by non-typable serotypes of H. influenzae type a, f, b (Hia, Hif, Hib) predominate among the capsular forms. Unprotected aminopenicillins, second-generation cephalosporins, and sulfonamides are the leading classes of antibacterial drugs to which H. influenzae strains have developed resistance. A variety of clinical forms is still relevant for hemophilic infection. Bacteremia, meningitis, and pneumonia are the main clinical manifestations of invasive Haemophilus influenzae infection caused by typed and non-typed serotypes of the pathogen.

Tropical countries have become increasingly popular destinations for Russian tourists in recent years, so this study is relevant for understanding the peculiarities of Russian travel. The purpose of the research is to analyze the awareness of Russian tourists traveling to tropical countries about the prevention of infectious diseases during travel. Materials and methods . A two-center cross-sectional study using a questionnaire was conducted from 2018 to 2021 on the basis of the Center for Medical Prevention and the Infectious Clinical Hospital No. 1). The analysis of 102 questionnaires of Russian travelers who traveled to tropical countries was carried out, the level of their awareness of the prevention of infectious diseases during travel, and adherence to vaccination were determined. Results . 102 adult travelers came to a doctor for vaccination, some of them planned to take children to a trip (24 children in total) from 2 to 18 years old. Most often, people aged 19—44 planned to go to tropical countries; there were no gender differences among travelers. Among the regions of departure of the respondents, the most common were East Africa, South America, West Africa, Latin America and the Caribbean. The most visited country was Tanzania. In the first place in terms of the purpose of travel was tourism, followed by business trips, visiting friends and relatives, education, and other purposes. In groups of travelers with and without children, there were no differences in the reasons for the trip, the organization of the trip, the duration of the trip, and accommodation during the trip. The main reasons for traveling were tourism, work, and visiting friends and relatives. The median duration of the trip was 15 days. Most often, travelers stayed at the hotel. Most travelers without children and all travelers with children planned to visit nature parks. Travelers' vaccination status and awareness of infectious diseases endemic in the country of departure were insufficient. Conclusion . The age and gender structure of travelers, the duration of trips, the main regions of departure, the place of residence during the trip, the purpose of the trip, the awareness of travelers about diseases in the region and ways to prevent them, about routine vaccination, and the commitment of travelers to vaccination and disease prevention were determined.

The long-term using of protective masks, linked with the COVID-19 pandemic, could has a significant impact on people from negativism to addiction to use them. Aim: to assess the frequency of mask use after the canceling of restrictions depending on gender and behavioral characteristics, to assess the possible impact of not wearing masks on the incidence of COVID-19. Materials and Methods: We conducted a prospective longitudinal cohort study on the Moscow Metro from 03/15/22 to 04/11/2022. Three cohorts of passengers were identified: K1 — using masks, K2 — wearing masks with defection from rules and K3 — not using masks. The shares of cohorts were determined depending on gender, travel area, time of day, occupation (use of paper information carriers, electronic devices). The proportions, their confidence intervals were determined; the comparison of the significance of differences was carried out using the Pearson chi-square method. Results: we made 28672 observations covering 225 out of 348 metro stations (67.5%). Within 5 weeks (11—15 weeks of 2022 year), the proportion of passengers not using masks (K3) increased from 74% to 94.6%. Starting from the 2nd day, significant differences between men and women were identified. The largest share of K3 passengers was among those using electronic devices. Among those using paper, the trend towards the elimination of masks was the least pronounced. The decrease in passengers using masks in Moscow did not lead to an increase in the incidence of COVID-19. Conclusion: in the absence of legal restrictions, the decision to use masks is influenced by the gender and behavioral characteristics of passengers.

The urgency of the problem of community-acquired pneumonia in children is due to the high incidence rate. In the etiological structure of bacterial pneumonia, Streptococcus pneumoniae and Mycoplasma pneumonia (Mp) prevail. Purpose: to identify clinical, laboratory and instrumental features of mycoplasmal pneumonia in children. Materials and methods. A retrospective, single-center cohort study of 266 case histories of children aged 4 months to 17 years who were in Children’s City Clinical Hospital No. 9 in 2019 with a referral diagnosis of pneumonia was carried out. To verify the diagnosis of pneumonia, the method of chest X-ray was used, for the etiological diagnosis, the method of PCR swabs from the nasopharynx, ELISA for the detection of antibodies of the IgM and IgG classes was used. Results. The diagnosis of pneumonia was confirmed in 190 children. The diagnosis of pneumonia caused by M. pneumoniae (MpP) was established in 76 (40%) children, they made up the 1st group. The remaining 114 (60%) children with community-acquired pneumonia of another etiology (CAP) made up the 2nd group – comparisons. The diagnosis of MpP was confirmed in 46 (60.5%) children by the detection of IgM, in 12 (15.8%) by the detection of Mp genetic material, and in 18 (23.7%) by positive both IgM and PCR. The median age of children in the group with MpP was 9.6 years, in the comparison group – 4 years (p<0.01). Significantly more often MpP occurs in children aged 11–17 years (p < 0.01), and CAP – up to 7 years (p < 0.01). With MpP, catarrhal phenomena in the form of hyperemia of the oropharynx, nasal congestion, and unproductive cough are observed less frequently than with CAP. With MpP, rales in the lungs are heard more often than with CAP, they are significantly more often wet (p<0.01). Respiratory failure and dyspnea are less common in MpP than in CAP. Bilateral lesions and lesions of the upper lobe of the lungs are more often detected in MpP, and in CAP – right-sided lesions. In the general blood test, leukocytosis, incl. above 15 thousand/µl, as well as leukopenia below 4 thousand/µl were significantly more frequent in the group of patients with CAP (p<0.01). Conclusion. No clear clinical and laboratory criteria for mycoplasmal etiology of pneumonia have been obtained, which dictates the need for laboratory confirmation for the choice of therapy tactics.

In the treatment of Lyme borreliosis (LB), early diagnosis is a key component. The epidemiological history of the patient plays one of the leading roles in suspected borreliosis and at the same time is an important criterion for clinical diagnosis.Purpose. Analysis of epidemiological history data in outpatient cases of LB in Moscow.Material and methods. We conducted a retrospective, non-randomized, single-center cohort study, based on the analysis of data from 660 outpatient records of patients, referred by local physician with tick bite or suspicion of LB, and consulted by an infectious disease specialist on the basis of the Infectious clinical hospital No.1 in Moscow. For further analysis, patients were divided by age and the presence or absence of LB. Confirmation of LB was based on clinical and/or laboratory criteria using methods of enzyme immunoassay and immune blot.Results. We have updated the epidemiological features of the LB for Moscow, such as: the relative number of cases in the administrative districts of Moscow, places and seasonality of tick bites. Among children, compared with adults, cases of a tick bite without the development of LB was predominant, which must be taken into account in order to avoid overdiagnosis of LB. In patients with LB, an indication of the fact of tick bite in the anamnesis was much less common than going to its habitats.Conclusion. Our data clarify the epidemiological features of LB for residents of Moscow. In the absence of a history of indications of tick bite, an informative sign for clinical diagnosis is a visit to its habitats, including not only trips to wooded areas, but also to suburban areas and parks.

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.

A clinical and laboratory examination of 62 children aged 10—17 years vaccinated against hepatitis B according to the standard scheme (0—1—6 months) in the first year of life strictly according to the National Calendar of preventive vaccinations in a standard dose (10 micrograms of recombinant HBsAg) with a monocomponent vaccine was carried out.The majority of children (58%) had indicators of seroconversion of HBsAg — anti-HBs-antibodies. This indicates the fact of long-lasting Grund immunity — 10—17 years after timely 3-fold immunization against hepatitis B according to the standard scheme at a standard dose (10 mcg of recombinant HBsAg in the first year of life in the absence of Wooster immunization (revaccination) in subsequent age periods, including children with a burdened premorbid background (87.1% among those observed). Since among those observed were children with invasive medical interventions (50%), the established fact reflects the protective effect of standard Grund immunization even in children at risk — with a positive parenteral history. At the same time, the total assessment of serological and molecular biological results found that after triple immunization against hepatitis B according to the standard scheme in the first year of life, out of 62 children aged 10—17 years, the proportion of seronegative was 42%. Low levels of antibodies (10—100 IU/l) were detected in 43% of cases, high (100—1000 IU/l) — in 15% of cases. No child had an antibody level exceeding >1000 IU/l. These results require the development of new approaches to immunization of children against hepatitis B with mandatory revaccination at an older age.

The role of various viral and bacterial pathogens in vascular damage and the development of vasculitis is known. Yersiniosis is one of such infectious diseases that is associated with the damage of various organs and systems. Authors report the clinical case of a septic form of yersiniosis in a 16 y/o male patient with the development of generalized vasculitis with thrombus formation and organ disturbances of microcirculation. Based on the epidemiological history (the patient has visited Nepal), clinical and laboratory examination (severe intoxication, prolonged febrile fever with chills, flushing of the face and neck, conjunctivitis, scleritis, maculopapular rash with petechial elements, increased dyspnea, tachypnea, hypoxemia as a manifestation of edematous syndrome in the lungs and the development of hydrothorax, hypotension, oliguria and azotemia as a manifestation of toxic kidney, meningism; neutrophilia with a stab shift, thrombocytopenia, increased CRP, urea, creatinine, cytolysis syndrome, hypoproteinemia, hypoalbuminemia, hypoprothrombinemia, increased D-dimer levels , a decrease in the levels of protein C and S, an increase in the level of protein in the cerebrospinal fluid against the background of reactive pleocytosis; echo signs of thrombophlebitis of the left leg, X-ray picture of edematous-interstitial changes in both lungs, bilateral hydrothorax); serological study (increase in antibody titer to Y. enterocolitica in RPHA) diagnosed with yersiniosis, septic form, complicated by septic shock, DIC, acute respiratory distress syndrome, bilateral hydrothorax, III degree respiratory failure, acute kidney injury, thrombophlebitis superficial veins of the left leg, posterior tibial vein.

The polymorphism of clinical manifestations of Lyme borreliosis (LB) creates significant problems in the study of this disease. In addition to the variability in classifications used in Russia and abroad, the spectrum and the frequency of symptoms in outpatient and hospitalized patients with LB differ significantly, which makes it difficult for a physician to understand the clinical picture of LB. The purpose of the study was to describe the clinical picture of LB in an outpatient infectologist appointment conditions according to the E. Asbrink, A. Hovmark classification of Lyme borreliosis in children compared with adults. Materials and methods of the research: a retrospective single-center cohort study was conducted based on the analysis of the data from 213 outpatient records of patients with confirmed LB diagnosis, consulted by infectologist at the Moscow Infectious Clinical Hospital No. 1 of the Moscow Department of Healthcare (Moscow, Russia) in Jan. 2018 - Sep. 2019. In order to compare the clinical features between children and adults the patients were divided into 2 groups by age: adults (18 years and older) and children (1 to 17 years old). The confirmation of the LB diagnosis was carried out according to the clinical and/or laboratory criteria using enzyme immunoassay and immune blotting. Results: in the group of children (n=52), the median age was 6 [3; 8] years old, the proportion of boys was 44% (n=23, 95% CI 30-57%), girls - 56% (n=29, 95% CI 43-70%). In the group of adults (n=161), the median age was 59 [49; 65] years old, the portion of males was 29.2% (n=47, 95% CI 22.2-36.0%), females - 70.8% (n=114, 95% CI 64.0-77.8 %). The most frequently diagnosed was LB at its early localized stage, both in children (n=44, 84.0%, 95% CI 74.0-93.0%) and adults (n=123, 76.4%, 95 % CI 69.7-82.6%). No statistically significant difference was found (p=0.248). Erythema migrans (EM) was the vast majority of early localized stage manifestations in children (95%, 95% CI 88-100%). The incidence of EM in adults was not statistically significantly different from that in children (94.3%, 95% CI 89.9-98.1%, p=1.000). EM in children was most often localized on the scalp (46%, 95% CI 31-60%), in adults the most common localizations were the skin of the trunk and lower extremities (total 92.9%, 95% CI 87.8-97.0; n=118). Differences in the typical localization of EM in children and adults were statistically significant (p<0.001). In the clinical picture of the early localized stage of LB the fever was rare in both children (7%, 95% CI 4-16%) and adults (8.9%, 95% CI 4.3-14.5%) (p=1.000). At the same time, the regional lymphadenitis was detected statistically significantly more often in adults than in children (50%, 95% CI 35-65% vs. 26.8%, 95% CI 19.3-34.5%, p=0.005). Both groups showed a lower incidence of regional lymphadenitis during examination by an infectologist if the patient was prescribed antibiotic therapy at the place of residence, while statistically significantly more often in the group of children (34%, 95% CI 23-46 vs. 15%, 95% CI 8-23, p=0.003). Conclusion: the authors have described the spectrum and frequency of the LB clinical manifestations according to the E. Asbrink, A. Hovmark classification in children vs. adults. The influence of research conditions and the previous antibiotic therapy on the spectrum and frequency of the LB clinical manifestations detected during the initial examination was demonstrated as well.

Over the past decade, the calendar of preventive vaccinations in Russia has undergone significant changes, concerning, first of all, the inclusion of new infections against which vaccination is carried out.Purpose: to analyze changes in the preventive vaccination calendar. An achievement was the establishment in June 2018 of an independent expert council of the Union of experts in the field of immunization and the development of the Draft «National Strategy for the Development of Immunoprophylaxis in the Russian Federation until 2035». It is expected to further expand the calendar of preventive vaccinations by including new vaccines against vaccine-preventable infections, as well as the emergence of new domestic vaccines, incl. combined.

In Moscow, as in Russia, in 2019 there was an increase in the incidence of measles in recent years. Purpose: to analyze the course of measles in children hospitalized in 2019 during the period of rising incidence. Materials and methods: a retrospective analysis and statistical processing of 30 case histories of children hospitalized with measles in the infectious diseases department of the Children's City Clinical Hospital № 9 named after G.N. Speransky in 2019. Results: More than half of the patients were under the age of 3 years (53%). In 90% of cases, the sick were not vaccinated, in 73% – due to the refusal of their parents. Only 23% of patients had measles contact, mostly familial. Measles in hospitalized children proceeds typically, in 83.3% of cases in a moderate form, with characteristic pathognomonic symptoms: in 83.3% of patients, Belsky-Filatov-Koplik spots are detected, on average, on the 4.4 ± 0.8 day of illness, spotted – papular rash on the face with staged distribution and subsequent staged pigmentation in all patients. Complications develop in 66.7% of cases, more often pneumonia (36.7%) and obstructive bronchitis (20%), which in 16.7% of cases cause the severity of the course and lead to the development of emergency syndromes and conditions (respiratory failure, obstructive syndrome). Conclusions. Failure to vaccinate against measles contributes to morbidity with possible complications.

Relevance. The rapid spread of new pathogens inevitably leads to the occurrence of joint circulation with already known infectious agents, leading to the development of mixed infections. The simultaneous circulation of the pandemic coronavirus SARS-CoV-2 with a highly contagious measles virus leads to the development of mixed infections in people who have not been sick or vaccinated against measles. Aims. Review cases of co-infection with measles and COVID-19 in Moscow. Material and methods. A retrospective study of cases of measles and COVID-19 co-infection in three children with a description of the epidemiological and clinical picture of the disease. Results. In all observed children, the manifestation of the disease was typical for measles, the diagnosis of COVID-19 was established based on a laboratory study carried out in a hospital, which gave reason to count. That the infection with SARSCoV-2 occurred after the infection of children with measles. Conclusions. Different incubation periods can lead to several options for the development of co-infection. The similarity of clinical symptoms at the onset of the disease does not allow excluding a certain infection clinically, without laboratory verification.

Chickenpox is a controlled infection, even a single vaccination effectively prevents the development of severe forms (up to 98%).Purpose — to demonstrate a case of severe chicken pox in a child aged 3.8 years with secondary infection of the skin of the right subscapular region and subcutaneous fat (phlegmon of the trunk) of streptococcal etiology.The diagnosis of varicella was confirmed by the detection of Varicella-Zoster virus DNA by PCR from the skin. Surgical treatment was performed — opening and drainage of phlegmon, purulent-serous discharge was obtained, sowing was performed, Streptococcus pyogenes was isolated.The child received antibiotic therapy — cefepime sulbactam, amikacin, acyclovir, infusion therapy, local treatment.Conclusions. The given clinical case demonstrates the development of a severe bacterial complication of chicken pox, which required surgical treatment and substantiates the need for vaccination against chicken pox and its possible complications.