A prospective randomized observational study was conducted in cohorts of vaccinated and unvaccinated patients hospitalized in one of the Moscow hospitals and diagnozed with COVID-19 in the period from 06.23.2021 to 01.05.2022.The purpose of the study was to identify the epidemiological features of COVID-19 in vaccinated people and to present scientifically based data on the need for vaccination and its importance in stopping the epidemic process.Materials and Methods. The samples were studied in comparison for a number of indicators: age, clinical condition at admission, the presence and number of concomitant systemic chronic diseases as well as disease outcomes.Results. It was proven that the risk of COVID-19 morbidity in vaccinated people decreased by 1.5 times, mortality by 1.5 times, and hospitalization due to the severity of the condition by 3.1 times. The mortality risk among vaccinated patients shifted to older age (76.9 years), while among unvaccinated patients, the mortality risk was higher for older people (73.7 years), which indicates an increase in life expectancy of vaccinated people.

АНАЛИТИЧЕСКИЕ ОБЗОРЫ О необходимости и особенностях вакцинации против COVID-19 пациентов с патологией нервной системы1 Федеральное государственное автономное образовательное учреждение высшего образования Первый Московский государственный медицинский университет имени И.М.Сеченова Министерства здравоохранения Россий-

Background. Individuals who were vaccinated against seasonal influenza or had a history of pneumococcal vaccination were found to be less likely to become infected and tolerate COVID-19 more easily. However, it has not been sufficiently studied how vaccination against these infections, carried out during the pandemic period, can affect the incidence of COVID-19.Aims. The purpose of the investigation: to study the effect of vaccination against influenza and pneumococcal infection carried out during the pandemic of a new coronavirus infection on the susceptibility and course of COVID-19 in healthcare workers.Materials and methods. In August- Setempber 2020, after the first rise in the incidence of COVID-19, out of 547 employees (aged 18 to 70 years) of a medical organization (MO), 266 (49%) were vaccinated against influenza (group II, n = 98), pneumococcal infection (group III, n = 60) and combined vaccination (group IV, n = 108), while 281 (51%) remained unvaccinated (group 1). Follow-up period: from September 2020 to March 2021 with the registration of the incidence of acute respiratory infections (ARI) according to primary medical records and the use of PCR methods for SARS-CoV-2, epidemiological and statistical analysis.Results. Two months after the start of the study, the proportion of cases of COVID-19 in the 1st group (unvaccinated) was 5% versus 1% in the 4th group (persons vaccinated with two vaccines), after 4 months – 15% and 5%, respectively, and at the end of observation (166 days) – 16% and 8%, respectively. That is, among unvaccinated individuals, the risk of getting COVID-19 was higher by HR = 2.1 [95% CI: 1.0÷4.7] times. The time between the start of observation and a positive test for COVID-19 in study participants was significantly higher in the 4th group compared to the group I: 106 [60–136] days versus 47 [17–75] days. The distribution of patients with COVID-19 according to the severity of viral pneumonia showed that in unvaccinated patients in most (64%) cases, pneumonia had a moderate to severe course, while in the 4th group of patients with combined vaccination in 100% of cases, mild (p = 0.04 for the entire sample).Conclusions. During the COVID-19 epidemic rises, vaccination against respiratory infections remains relevant, reducing the number of cases, the severity of the coronavirus infection and preventing the occurrence of co-infections.

Pneumococcal infection remains a significant global health problem, and vaccination is the main measure for its prevention. To date, the period of use of pneumococcal conjugated polysaccharide vaccines in Russia exceeds 14 years, and 13-valent conjugated polysaccharide pneumococcal vaccine (PCV13) - more than 10 years. During this time, extensive experience has been accumulated in the use of this type of vaccines, and many studies have been carried out to evaluate their effectiveness and safety. The purpose of this review is to summarize the experience of using PCV13 in Russian Federation with an assessment of its epidemiological and clinical effectiveness. A search was made for scientific publications devoted to the study of the epidemiological efficacy, the safety as well as cost-effectiveness of PCV13 use in Russian Federation. The review included original studies published in Russian journals. The results of the studies carried out indicate the efficacy and safety of PCV13 for both adults and children. The effectiveness of immunization of children at risk (premature, suffering from congenital pathology, having chronic diseases and often ill) was demonstrated, the need and safety of the timely start of vaccination (from 2 months of age) of newborns was shown, the possibility of its combination with immunization against other infections within the framework of the national vaccination schedule, the importance of following the recommended vaccination schedule in accordance with the age of the child. The effectiveness of vaccination of adults suffering from chronic diseases has been shown both in terms of preventing the aggravation of the course of the underlying pathology and reducing the risk of pneumonia. Positive experience has been gained in immunizing adults from occupational risk groups - medical workers, conscripts and persons exposed to a harmful production factor and having occupational lung diseases. The conducted studies have shown a high cost-effectiveness of PCV13 vaccination, however, with any changes in price and epidemiological parameters, it is necessary to clarify the economic feasibility of vaccination under the changed conditions. Taking into account the positive experience gained in immunization, it seems appropriate to further maintain a high level of vaccination coverage of the child population, expanding risk groups among the adult population subject to vaccination against pneumococcal infection within the framework of the National Immunization Schedule, taking into account its epidemiological, clinical and economic efficiency.

Журнал для непрерывного медицинского образования врачей ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ Разработка вакцин против новой коронавирусной инфекции и проведение прививок против COVID-19 по эпидемическим показаниям способствовали снижению заболеваемости и летальности.Летальные случаи регистрировали преимущественно в группах риска -среди пожилых людей, в том числе привитых от COVID-19

Notonly directly detected new infection, but also determining prerequisites for associated epidemiological complications becomes relevant with growing importance of new and recurring infections. As a result, a need to assess a degree of their epidemiological threat, or epidemic potential, i.e. determining the significance of related properties that determine a potential to cause an epidemic process and complications of the epidemiological situation is emphasized. Purpose. Develop methodology for quantitative assessment of the epidemic potential universal for natural-foci viral infections. Materials and methods. А multifaceted assessment of the virological and epidemiological characteristics of causative agents for natural-focal viral infections was carried out to develop criteria for determining the epidemic potential. The developed methodology for determining the epidemic potential is based on connection between the epidemic potential and the concept of epidemiological hazard, which forms an epidemic risk, and consists of the hazards for source of infection, the mechanism of transmission and host susceptibility. Results and discussion. The platformfor quantitative assessment of the epidemic potential of natural-foci viral infections was developed. Within each link of the epidemic process, factors were identified, ranked in accordance with their significance for enabling epidemiological risk and score assigned. The epidemic virus potential is determined by the sum of points in three categories, the ratio of points between them allowing to evaluate a lead factor of epidemiological risk. To assess an epidemic virus potential in accordance with the developed criteria, it is necessary to summarize and analyze the known data on the three considered groups of factors involved in formation of epidemiological threat. To test the assessment methodology, the epidemic potential of a number of diversepathogens of natural-foci viral was determined. The values obtained on the epidemic potential for such infections is based on the degree of relevant epidemiological hazard. Thus, the evaluation system allows to quantify anepidemic potential of the pathogen, compare parameters of various pathogens with assessment of the lead epidemiological risk factor. The platform can serve as an additional tool in assessment of epidemiological threat in case of epidemiological emergencies. Meanwhile, assessment of epidemic potential fornew infections is closely associated with the need to investigate their basics. The epidemic potential is a dynamic parameter that can change with the advent of new data on ecological and genetic foundations of pathogen existence as well as mechanisms for related variability.

Annualy, SARS occupy a leading position in terms of morbidity and the magnitude of the economic damage caused both in the world and in the Russian Federation. Currently, the most widespread pandemics are caused by the influenza A (H1N1) pdm09 virus and the new SARS-CoV-2 coronavirus, which occupy a common ecological niche and require studying the manifestations of the epidemic process of ARVI for further development of measures to improve epidemiological surveillance of this group of infections. Aim of the study was to investigate the current manifestations of the epidemic process of ARVI and influenza, including in the context of a new coronavirus infection (COVID–19) pandemic, on the territory of Russia and in Moscow. Materials and methods. The assessment of the long-term dynamics of the incidence of ARVI and influenza (from 1999 to 2021), as well as its age structure in the territory of the Russian Federation and in Moscow, was carried out. The main sources of information were: WHO: «The situation with COVID-19 in the European region», the domestic information portal Stopkoronavirus.rf, as well as data from Federal State Statistical Observation forms No. 2 and No. 6. Results. During the period 2013–2019, a strong positive correlation was revealed between the incidence rates of ARVI in the Russian Federation and Moscow (p = 0.8, with p < 0.05), which became negative with the spread of SARS-CoV-2: in the country, the incidence rate of ARVI increased by 11.5% in 2020 and 15.6% in 2021., in Moscow there was a decrease of 45.1% than the average in Russia, which could be due to the quality of differential diagnosis of ARVI and COVID-19. In 2021 the incidence rate of influenza decreased by more than 2 times in all Federal Districts of the country, with the exception of the capital region, where it became the maximum - 65.9 per 100 thousand population in 2021 (against 14.1 in 2019). In the age structure of influenza incidence, as well as ARVI, for the period from 2019 to 2021. the child population prevailed with the highest rates in the age groups of 1–2 years and 3–6 years. As the circulation of SARS-Cov-2 decreased to 15–19%, the activity of influenza viruses and other pathogens of the ARVI group increased (from 0.7–3.0% during the developed pandemic to 5.6–6.6% at the stage of its decline), which indicates a pronounced interference of pathogens detected at the global level in the system of Global Hospital Surveillance for flu. Conclusion. The forecast for the upcoming epidemic season 2022–2023 largely depends on the spread of the new coronavirus SARS-CoV-2, as well as its variability and the emergence of new variants. Nevertheless, there may be a significant increase in the incidence caused by the influenza A(H1N1)pdm09 virus, whose high activity was recorded in the current epidemic season in a number of countries in the Southern hemisphere.

Relevance. At the present stage, the Russian Federation does not have a coherent system of supervision and control of infection caused by the Epstein-Barr virus (EBV), while there is an epidemiological problem with this pathology, requiring the development and adoption of a set of adequate management decisions. The goal is to scientifically substantiate the creation of an epidemiological surveillance system (ES) for EBV -infection in Russia. Materials and methods. Based on the results of previous studies, an assessment of the manifestations of the epidemic process of EBV infection and measures aimed at each of its links was carried out. Results. The structure and content of the system of epidemiological surveillance of EBV infection are presented. Conclusion. To implement and improve the effectiveness of EBV-infection control, it is necessary to adjust existing and develop new regulatory and methodological documents that allow introducing: a standard definition of the case of EBV-infection and new approaches to accounting and registration; studies of nasopharyngeal smear material for the presence of EBV genetic material as part of the monitoring of influenza and ARVI pathogens; algorithms for the examination of patients with diagnoses that do not exclude the presence of active EBV-infection, as well as organ, tissue and cell donors with the determination of a complex of nonspecific immunological markers (neopterin, melatonin, C-reactive protein, ALT); standard operating procedures for medical professionals for the identification and isolation of patients with active EBV-infection, clinical and laboratory diagnostics, registration and accounting, the use of personal protective equipment and nonspecific immunoprophylaxis. Also, improving the control of EBVinfection is impossible without continuing scientific research; professional training of medical workers on the clinic, diagnosis, epidemiology and prevention of EBV-infection; development of modern visual methods and means of informing the population about the clinic and prevention of EBV-infection.

The purpose of this study is an assessment of modern epizootic-epidemiological features of rabies in the territory of the Russian Federation with the identification of risk factors for complications of the situation for control and surveillance. The study analyzed the results of rabies surveillance in Russia based on data obtained from 2000 to 2017.

The aim of the study was to develop a unified approach to a comprehensive risk assessment of the anthrax situation deterioration based on the ranking of territories by epidemiologically significant factors. Materials and methods . For a comprehensive risk assessment of the situation complication, the statistical principles of ranking of the estimated indicators were used. These indicators comprise the presence and activity of soil foci of anthrax, the prevailing soil types and their main characteristics, as well as social risk factors associated with the peculiarities of animal husbandry and the possibility of infection of the population. The proposed assessment method has been tested on a national scale, and its content and results are described in this paper by the example of the Volga Federal District. The materials of the study were federal and regional cadastres of stationary hazardous as regards anthrax areas, an atlas and maps of soils, data of statistical accounting and reporting of Federal Service for Veterinary and Phytosanitary Surveillance, Federal Service for State Registration, Cadastre and Cartography and Rospotrebnadzor. Results and discussion . It has been established that in all constituent entities of the district there are potential risks of the situation deterioration that are associated with the presence of soil foci. In terms of the sum of ranks, the greatest potential disadvantage is noted in a number of republics and regions of the Volga Region. At the same time, the real danger is mainly due to social factors, which include the characteristics of animal husbandry, as well as the degree of susceptibility of the population. The maximum risks are currently identified in the territories of the republics of Bashkortostan and Tatarstan, as well as in the Saratov Region. The study is aimed at improving the efficiency of anthrax epidemiological surveillance in the Russian Federation, and the proposed methodology can be used at all levels of surveillance.

Climatic changes have already resulted and will continue to result in gradual degradation of active upper layers in permafrost due to increased average air temperature in summer. Anthrax is an example of a climate-depending bacterial infection; anthrax agent creates spores that remain viable for a long period of time they spend in cryptobiosis in permafrost. Apparent permafrost degradation is already detected in most arctic regions in Russia and it can lead to anthrax burials decay thus creating elevated risks of the infection among farm animals and people who live on these territories. Our research goal was to create specific zones in municipal districts via combining data on permafrost, number of anthrax cattle burials, ascending trends in average long-term temperatures, and population density. We developed two relative hazard coefficients for characterizing anthrax outbreaks probability for animals and local population. Basing on numeric values obtained for these two coefficients, 70 administrative districts located in 15 RF subjects in the Arctic zone were listed in a descending order as per risks of the infection occurrence. We created two score scales showing relative hazard; they indicated that the highest population risk was typical for urban districts as population density there was much high than in rural ones. Our calculations should be helpful for determining priorities when preventive activities are developed on arctic and sub-arctic territories that are endemic as per anthrax. It is also important to obtain an actual list of cattle burials and to develop spatial-time models showing anthrax outbreaks occurrence taking into account climatic warming and permafrost degradation.

The aim of the study was to develop a unified approach to a comprehensive risk assessment of the anthrax situation deterioration based on the ranking of territories by epidemiologically significant factors.Materials and methods. For a comprehensive risk assessment of the situation complication, the statistical principles of ranking of the estimated indicators were used. These indicators comprise the presence and activity of soil foci of anthrax, the prevailing soil types and their main characteristics, as well as social risk factors associated with the peculiarities of animal husbandry and the possibility of infection of the population. The proposed assessment method has been tested on a national scale, and its content and results are described in this paper by the example of the Volga Federal District. The materials of the study were federal and regional cadastres of stationary hazardous as regards anthrax areas, an atlas and maps of soils, data of statistical accounting and reporting of Federal Service for Veterinary and Phytosanitary Surveillance, Federal Service for State Registration, Cadastre and Cartography and Rospotrebnadzor.Results and discussion. It has been established that in all constituent entities of the district there are potential risks of the situation deterioration that are associated with the presence of soil foci. In terms of the sum of ranks, the greatest potential disadvantage is noted in a number of republics and regions of the Volga Region. At the same time, the real danger is mainly due to social factors, which include the characteristics of animal husbandry, as well as the degree of susceptibility of the population. The maximum risks are currently identified in the territories of the republics of Bashkortostan and Tatarstan, as well as in the Saratov Region. The study is aimed at improving the efficiency of anthrax epidemiological surveillance in the Russian Federation, and the proposed methodology can be used at all levels of surveillance.

One of widely used methods to detect rabies virus RNA is a reverse transcription chain polymerase reaction (RT-PCR) allowing to determine a diagnosis in 5 hours. Thus, we have elaborated the method that allows to pursue effective elicitation of RNA strains and isolates of rabies virus in pathological and clinical material as well as to decrease research timespan to 6 hours, to lower by 9.8 times the diagnostics prime cost, labor expenditures - by 40 times. The way includes performance of nested RT-PCR with oligonucleotide primers having definite nucleotide sequences and synthesized to conservative glycoprotein gene. Wherein RT-PCR is pursued in two rounds. In the case of positive reaction, fragment corresponding to the size in the first round - 755 bp, in the second round - 259 bp, is synthesized.

The article dwells on opportunities granted by application of geoinformation technologies in surveillance over anthrax, an infection that still remains rather dangerous. It was shown that, in spite of a decrease in incidence with anthrax among animals and people, risks persist on the RF territory; these risks are caused by residual activity in soil foci. A geoinformation system was applied to determine that at present areas where anthrax can be detected are predominantly located in forest-steppe zones, steppe zones, dry steppe zones, and Caucasian-Crimean mountain regions. 82 % of all the outbreaks detected in the 21st century occurred in these geographic zones. Unfavorable situation with anthrax seems to be clearly bound to territories with prevailing leached black earth, common black earth, mountain black earth, and mountain cinnamonic soil. Over the last years most anthrax outbreaks have occurred on these territories. All these territories were shown to have warm climate, with predominant stockbreeding in agriculture, as well as great numbers of cattle in private households; these cattle grazed freely on territories of natural foci with anthrax, and a lot of household work was handled manually. Territories that took leading places among unfavorable ones usually had a lot of households with cattle that nowadays remains a basic source of epidemiologic risk. We chose Tatarstan as a model region to show opportunities offered by a geoinformation system for improving epidemiologic sur-veillance over anthrax in relation to risk assessment. This territory was chosen due to high epizootologic activity and sporadic incidence among population detected there. We revealed risk territories in the region, determined basic reasons for unfavorable situation with anthrax as well as factors that made this situation even more complicated.

The aim of this work was to study modern manifestations of seasonal brucellosis among the population of the Republic of Tajikistan. The materials and methods: of the study were the official statistics, as well as the results of previously performed studies on the risk assessment of the incidence in population. A retrospective epidemiological analysis of annual incidence rate for the period from 1997 to 2016 was conducted, depending on the most significant social and environmental risk factors. Results. The article shows the impact on the annual incidence rate of socio-economic transformations, including the privatization of collective livestock farms, accompanied by the massive movement of farm animals to private ownership, the loss of practice in animal breeding, and changes in environmental and climatic conditions. Against the background of the intensification of sheep breeding, there is a tendency in seasonality smoothing and shifting the maximum levels of population incidence of brucellosis to the spring season. Conclusion. The modern features of seasonal manifestation of brucellosis infection in the Republic of Tajikistan make it necessary to apply a differentiated approach to planning and conducting preventive measures in various areas of the country.

Relevance. Socioeconomic and climatic conditions determine the nature of the epidemic situation in the Republic of Guinea, which requires further study and objective assessment. Materials and Methods. The research materials were the official statistics, the data from scientific publications, as well as the results of own researches. A complex of epidemiological, bacteriological, immunological, serological, molecular genetic and statistical research methods was applied. Conclusions. The structure and levels of morbidity and mortality in the Republic of Guinea were presented. New data were obtained on the etiology of acute suppurative otitis media, on the prevalence and epidemiological manifestations of intestinal helminthiases, typhoid fever, enteric and parenteral hepatitis, as well as sexually transmitted infections. The current situation of HIV and tuberculosis was assessed. A complex of epidemiological risk factors for a number of infectious and parasitic diseases contributing to complicated situations was revealed.