Relevance. Hemorrhagic fever with renal syndrome (HFRS) and tick-borne encephalitis (TBE) are the most common natural focal diseases of viral etiology in Russia. The medical and social significance of these two infections is determined by the extensive foci of their spread, high annual morbidity rates, and the presence of severe forms of the disease can lead to permanent disability and even death. Aim. To assess the current epidemiological situation of HFRS and TBE in the Russian Federation. Conclusions. Over 23 years (from 2000 to 2022), 164,582 cases of HFRS were identified in Russia with an average annual rate of 4.9 cases per 100 thousand population, as well as 71,579 cases of TBE with an average annual rate of 2.5 cases per 100 thousand population; 668 (0.4%) and 1136 (1.6%) deaths from HFRS and TBE, respectively; 4030 (2.5%) and 9414 (13%) children under the age of 14 years among patients with HFRS and TBE, respectively. The incidence of HFRS and TBE per 100 thousand population of Russia was higher among rural residents than among urban residents. Most cases of HFRS were registered in the autumn-winter period, and TBE – at the end of June – the first half of July. Of the 85 administrative regions of Russia, cases of HFRS and TBE are registered in 42, in 18 – only HFRS, in 13 – only TBE, and in 12 regions no clinically diagnosed cases of HFRS and TBE have been identified.

Relevance. Hemorrhagic fever with renal syndrome (HFRS) and tick-borne encephalitis (TBE) are the most common natural focal diseases of viral etiology In Russia. The medical and social significance of these two infections is determined by the extensive fociof their spread, high annual morbidity rates in the population, and the possibility of developing severe forms of the disease leading to permanent disability and death. The causative agents of HFRS In Russia are 6 types of hantaviruses Hantaan, Amur, Seoul, Puumala, Kurkino and Sochi, which, immunologically and genetically significantly different from each other, support their existence in nature through six different species of small mammals, which are sources of infection in humans. TBE virus strains that cause disease in humans belong to five phylogenetically distinct subtypes, including: Far Eastern, European, Siberian, “178-79” and Baikal. Aim. Analysis of the role of small mammals and ticks in the ecology of HFRS and TBE pathogens. Conclusions. Small mammals retain and transmit hantaviruses to uninfected animals and ticks. At the same time, ticks retain and transmit to ticks and mammals not only the TBE virus, but also hantaviruses. Despite the taxonomic difference between the viruses that cause HFRS and TBE, some of their ecological properties are similar.

Objective. To determine the proportion of the population of the Samara Region that has antibodies to hepatitis C virus (HCV) and hepatitis B virus (HBV) surface antigen. Materials and methods. The survey was conducted by a mobile laboratory in public places, mass gatherings, etc. Blood samples were analyzed using immunochromatographic assay systems for the qualitative determination of antibodies to HCV, HBsAg, and alpha-fetoprotein (AFP) supplied by Abon Biopharm (Hangzhou) Co., Ltd, PRC, HangZhou Biotest Biotech Co. Ltd, China and Factor-Med-Production Ltd. Questionnaires were completed on the presence or absence of risk factors for infection. Results. From July 2019 to September 2023, 84 visits were conducted. A total of 3058 people were examined, all were tested for HCV antibodies, 1374 – for HBsAg and 50 – for AFR level; 3044 self-assessment questionnaires for the presence/absence of risk factors were analyzed. The frequency of HCV antibody detection was 5.9% in 2019, 2.9% in 2020, 4.8% in 2021,5.1% in 2022, and 3.9% in 2023. The highest percentage of individuals with HCV antibodies was found in the group of men aged 36–50 years – 16.3%. The frequency of HBsAg detection was 1.1% in 2021 and 0.5% in 2022. The level of AFP was determined in 50 persons who had markers of viral hepatitis; 4 persons were found to have an elevated AFP level (8%). Injecting drug use was significantly more frequently reported as a risk factor for infection in 2019, 2022, and 2023; medical manipulation in 2020 and 2023, while tattooing and piercings in 2021. Key words: chronic hepatitis C, chronic hepatitis B, mobile laboratory, testing, risk factors, elimination, alpha-fetoprotein

Relevance. Hemorrhagic fever with renal syndrome (HFRS) is an acute viral zoonosis. Being widespread in Eurasia, it holds a leading place in Russia among natural focal human diseases. The vast majority of HFRS cases in Russia, about 98%, are associated with Puumala virus. The disease is characterized by a wide range of clinical manifestations. Early specific diagnostics appears to be of a great importance for starting timely pathogenic therapy. The aim of the study was to clarify the diagnostic value of detecting hantavirus antibodies in the HFRS suspected patient urine. Materials and methods. Blood sera and urine samples from 68 patients at the Infectious Diseases Hospital in the city of Ufa, obtained with a 2-day interval, as well as urine and blood serum samples from 15 convalescents 1, 2, 3 and 6 months after disease onset were examined for hantavirus antibodies. 53 blood sera and urine samples from patients residing in Moscow, Moscow and Samara regions collected at different time points during the disease course were investigated in parallel. Antibodies were detected by the indirect immunofluorescence method. Results. On day 3, 4, 5 and 6 of disease, while specific antibodies were detected in the blood serum, antibodies in the urine were found in 85.7%, 89.4%, 93.1% and 100% of patients, respectively. The peak quantity of antibodies was excreted in the urine from days 5 to 11, which corresponds to the oliguric stage of the disease. In the convalescent period, antibodies were still detected in urine 1, 2 and 3 months afterwards in 86.7%, 46% and 20% of cases, respectively, but not detected 6 months later, which probably reflects the process of long-term restoration of the kidneys function. A moderate positive correlation between specific antibodies in serum and urine was observed only in the oliguric period of the disease. Conclusions. Detection of hantavirus antibodies simultaneously in blood serum and urine of febrile patients instead of paired blood sera allows to conduct HFRS diagnostics within the very first days of hospitalization and prevent severe complications due to timely pathogenic therapy.

Опыт тестирования населения Самарской области на инфицированность вирусом гепатита С в условиях использования мобильной лаборатории В ПОМОЩЬ ПРАКТИКУЮЩЕМУ ВРАЧУ1 Общество с ограниченной ответственностью Медицинская компания

A patient with Child-Pugh B cirrhosis as the outcome of chronic hepatitis C (HCV), genotype 1b was treated with ombitasvir/ paritaprevir/ritonavir/dasabuvir (Viekira Pak) and ribavirin (Ribavirin-SZ) for 12 weeks with achievement of sustained virological response. 48 weeks after the end of the antiviral treatment the patient developed acute viral hepatitis with high level of liver aminotransferases caused by the hepatitis C virus genotype 3a. On day 18 of hospitalization antiviral therapy with sofosbuvir 400 mg per day and daclatasvir 60 mg per day for 12 weeks was administered. Drug tolerance was good, biochemical and sustained virological response was achieved.