Vaccinal prophylaxis of hepatitis A in servicemen of the Far East military district

The importance of hepatitis A (HA) for epidemiological situations among the servicemen of the Armed Forces of the Russian Federation, including the Far Eastern Military District, and the necessity of vaccinal prophylaxis have been substantiated. Vaccination against HA, made in a single injection, was shown to be capable of decreasing morbidity, on the average, 1.98 times. The epidemiological effectiveness of vaccine "Avaxim" proved to be 89.6%. The results obtained in this investigation are indicative of the expediency of vaccination not only for prophylactic purposes, but also for localization and liquidation of epidemic foci of HA.     

Immunoprophylaxis of poliomyelitis in Ukraine with the use of inactivated vaccine

In connection with the cessation of the circulation of "wild" poliovirus on the territory of the European region, including Ukraine, the strategy of the vaccinal prophylaxis of poliomyelitis is reviewed. Its main aims are the creation of a high level of the specific protection of the population, the prophylaxis of vaccine-associated paralytic poliomyelitis and a decrease in the intensity of the circulation vaccine polioviruses. These aims may be achieved only by the inclusion of vaccinations with inactivated poliomyelitis vaccine (IPV) into the immunization schedule. IPV "Imovax Polio" produced by the firm "Aventis Pasteur" (France) has been shown to have low reactogenicity and high effectiveness, especially with respect to type 3 poliovirus, under the conditions of Ukraine. On the basis of our studies all children, starting from the age of 3 months, are recommended to be vaccinated first with two injections of IPV, followed by further immunization with oral vaccine.     

Vaccination of medical personnel against hepatitis B: epidemiological and socio-economic aspects

Epidemiological and social aspects of the vaccinal prophylaxis of medical personnel against hepatitis B are discussed on the basis of the morbidity analysis in viral hepatitis, the results of dynamic screening for the presence of hepatitis B markers and the state of postvaccination immunity. The reactogenicity and immunogenicity of the vaccine "Euvax B", as well as the socio-economic effect of vaccinal prophylaxis, are evaluated.     

On the epidemiological situation in quarantine, natural focal and other infections on the territory of the Southern Federal District

The data on the sanitary and epidemiological situation in the Southern Federal District are presented. The analysis of morbidity in tuberculosis, measles, HIV infection, viral hepatitis A, typhoid fever, cholera and quarantine infections, Crimean hemorrhagic fever, West Nile fever, rabies, malaria has been carried out. Special attention has been given to "new and newly returning infections", and among them to the spread of SARS ("atypical pneumonia"). The role of regional epidemiological safety programs, in particular such program as "The prophylaxis of quarantine and natural focal infections and the sanitary protection of the territory of the Southern Federal District of the Russian Federation from the import and spread infectious diseases in 2003-2005", has been substantiated.     

Actual problems of creation of informational-analytical system for rapid control of epidemics of infectious diseases

Structure and modules of computer informational-analytical system "Electronic atlas of Russia" is presented, the object of mapping in this system is epidemiology of socially significant infectious diseases. Systemic information on processes of emergence and spread of socially significant infectious diseases (anthroponoses, zoonoses and sapronoses) in the population of Russian Federation is presented in the atlas. Detailed electronic maps of country territory filled with prognosis-analytical information created by using technological achievements of mathematic and computer modeling of epidemics and outbreaks of viral and bacterial infections are of particular interest. Atlas allows to objectively evaluate the pattern of infection spread, prepare prognoses of epidemic and outbreak developments taking into account the implementation of control measures (vaccination, prophylaxis, diagnostics and therapy) and evaluate their economic effectiveness.     

Epizootic situation and prospectives of rabies control among wild animals in the South of Western Siberia

The analysis of the epizootic situation in rabies in the south of Western Siberia during the period of 1990-1999 was carried out on the basis of the analysis of statistical data, field observations and virological investigations. Foxes were found to be the principle virus host and in the steppe areas they probably shared this role with corsac foxes. No data on other orders of mammals taking part in the virus circulation were obtained. The foxes population structure of the territory of the above-mentioned region were studied. The epizootic process was shown to have a cyclic character which corresponds to the models, proposed by foreign researchers for Western Europe. The effectiveness of different methods used for the control of rabies among wild animals was considered. As shown by this study, due to the population ecology of foxes and corsac foxes on the above-mentioned territory the best effect should be expected from measures aimed at frequency limitation of these animals, and not from vaccinal prophylaxis. As an alternative, the possibility of non-interference in the circulation of the virus within the limits of the natural focus in combination with timely measures for the protection of domestic and agricultural animals, as well as humans, from infection was considered.     

Activation of natural tularemia foci of the field-meadow and steppe types on the territory of Tula Province 1977-1978

Natural tularemia foci of the meadow and steppe type are extremely stable and become active in those years when the most favourable living conditions for rodents appear. For the first time during the last 30 years a great increase in the number of common voles, accompanied by widely spread epizooty covering the whole territory of the Tula region, was observed. House mice, common field mice, harvest mice and black rats were also involved in this epizooty and 235 tularemia patients with all clinical forms of the disease were registered, the pulmonary form of the disease being prevalent. The cases of the disease were observed among both urban and rural population. In spite of a high morbidity rate, no cases of group infection were registered in domestic conditions and among agricultural workers due to the existence of the numerous immune layer among the population. The formation of this layer resulted from planned vaccinal prophylaxis covering, on the average, 86.3% of the rural population of the region.     

Construction of variants of Yersinia pestis EV76 (RIEG line) vaccine strain differing in antibiotic resistance spectra with stage-by-stage transduction of R-transposons]

Mono- and polyresistant variants of the plague vaccinal strain Yersinia pestis EV76 (RIEG line) were constructed with stage-by-stage transduction of transposons Tn5, T, Tn10 and Tn9 located in the phage vectors. Methods for stage-by-stage selection of the transductants that preserved intact determinants of surviving, antiphagocytic activity and immunogenic properties were designed for their further testing as model vaccinal strains in combined specific and emergent medicamentous prophylaxis of plague.     

Measles: prospects of vaccine prophylaxis and decrease of morbidity in Moscow

The results of the prolonged epidemiological surveillance on measles in Moscow are presented. The detailed analysis of the influence of immunization on the level of measles morbidity has been made. Changes in the age structure of measles patients with an essential increase in the proportion of adolescents and adults due to mass vaccination of the child population are shown. High risk groups have been determined according to the data of serological screening and epidemiological surveillance. The prospects of the vaccinal prophylaxis of measles under present conditions, as the basic intervention for achieving sporadic level of morbidity in this infection and further eradication are evaluated.     

The acceptance of a strategy for decreasing the risk of contracting an HIV infection among drug abusers

The narcotization level of the country is sufficiently high. According to some expert evaluations, the number of drug users varies between 2-4 million persons. Of these, about 100,000 are registered in narcotics service of the Ministry of Health of the Russian Federation and about 250,000 are registered in the system of the Ministry of Internal Affairs of the Russian Federation. The main annual increase in drug users is given by unemployed young people and students (more than 15% of them are minors). An important task standing at present before the specialists of the service responsible for the prophylaxis of HIV infection is the steady spread of information among executive and legislative authorities, as well as the preparation of public opinion, on the necessity for the state to choose and accept the optimum variant of the strategy for the prophylaxis of HIV infection among drug users.     

Effect of a complex system of controlling influenza on a citywide scale on the etiological structure of acute respiratory diseases

Materials on the etiological structure of acute respiratory diseases (ARD) and the spread of respiratory virus infection among the population of the city under the conditions of mass vaccinal prophylaxis and chemoprophylaxis are presented. These materials indicate that the proportion of influenza A virus in the etiological structure of ARD decreased by half as the result of introducing the complex system of influenza control in the city. The proportion of other causative agents of ARD before and after introducing the complex system of influenza control irregularly varied among different age groups of the population without statistical significance. The indices characterizing the spread of influenza A virus infection among the population of the whole city were found to be significantly decreased during the second period of observation.     

Circulation of respiratory viruses in Moscow and their role in acute respiratory diseases morbidity

Statistical data obtained during prolonged investigations on the structure of infective agents isolated from patients with acute respiratory diseases (ARD) in Moscow in 1989-1999 were analyzed. The study revealed that fluctuations of ARD morbidity rates were linked with the prevailing circulation of one or another type of the virus. The absence of the dominating role of influenza viruses was confirmed. The conclusion was made on the necessity of using, in addition to influenza vaccinal prophylaxis, chemoprophylactic interventions to maintain ARD morbidity on the acceptable level.     

Quantitative research on the cyclic fluctuations of the epidemic process in a number of infectious diseases in Bulgaria

The cyclic nature of the epidemic process in Bulgaria was studied by various methods (spectral analysis, etc.), forming a system. The morbidity dynamics in 10 infectious diseases (scarlet fever, rubella, measles, epidemic parotitis, whooping cough, diphtheria, typhoid fever, enterocolitis, bacterial dysentery, viral hepatitis) over the years of 1909-1983 were studied and cycles covering the periods of 3-4, 5-6, 10-11 and over 16 years were established. The data on the relative part of cyclic processes in the registered morbidity of infectious diseases, as well as information on the prognostication of the spread of infections in the absence of vaccinal prophylaxis, are presented.     

Tularemia study in Khmel'nitski Province

The differentiated approach to carrying out the vaccinal prophylaxis of tularemia is necessary in view of the determination of the types of the natural foci of this infection and their epizootic manifestation, as well as taking into account concrete local conditions and social factors. At the same time, the level of zooparasitological investigations must be maintained for the timely determination of the activity and spread of the natural foci of tularemia.     

Modern features of the epidemiology and prophylaxis of influenza

Modern concepts concerning influenza pandemics and epidemics in different countries of the world are presented. The influenza epidemics of the last decade in different countries of the world and their specific features linked with the "drifting" variability of influenza virus have been analyzed. Information on influenza morbidity during the last 30 years is given; on the basis of this information the role of vaccinal prophylaxis and mainly the mass vaccination of school children and students, is shown. The results of the efficacy of such vaccines as live influenza vaccine, American split vaccine, Russian live recombinant vaccine and Grippovac (1995-1996), as well as new-generation vaccine Grippol (1998), are presented. The prospects of the combined use of specific and unspecific prophylaxis have been determined.     

Various problems of biotechnology

The prospects of using the methods of gene engineering for the development of viral vaccines are considered. The technological and biological barriers hampering the introduction of these biotechnological methods into the practice of vaccinal prophylaxis are analyzed. The work points out that in the near future successes may be achieved in synthetizing the internal proteins M and NP of influenza viruses and similar proteins of paramyxoviruses and rhabdoviruses, as well as in using yeast for the production of vaccine against hepatitis B.     

Prevalence and structure of acute respiratory virus infections

Information on epidemiology of acute respiratory virus infections (ARVI) is reviewed and analyzed. In addition to influenza viruses, the role of respiratory syncytial viruses (RSV), rhino- and adenoviruses, as well as other viruses, in the development of respiratory diseases, especially in newborns, young children and elderly persons, is emphasized. A high proportion of RSV in the etiology the severe forms of ARVI and in the development of intrauterine infection is pointed out. The conclusion has been made that the identification of the causative agents of ARVI with the use of modern methods makes it possible to determine the real role of each of the pathogens in the formation of the severe forms of diseases, as well as the expediency of vaccinal prophylaxis.     

Spread of hepatitis virus as a threat to national security

Information on viral hepatitis A, B and C morbidity in Russia is presented. A distinct trend to decreased viral hepatitis B and C morbidity in 2001-2002 in comparison with the 1990-ies is noted. Nevertheless, there is still unfavorable prognosis regarding high hepatitis B morbidity among the population of reproductive age, as well as among adolescents, which increases the risk for children at an early age. In addition, a new specific feature of hepatitis A spread is observed: morbidity in this infection is shifted to older age groups. The role of vaccinal prophylaxis in the decrease of hepatitis A and B morbidity, virus safety of blood and its components, the quality of the diagnostics of chronic hepatitis, especially hepatitis C, are discussed. The complex of measures for the prophylaxis of viral hepatitis is proposed.     

Prevention of epidemiological consequences during an extreme situation caused by the natural disaster in the Republic of North Ossetia-Alania

Information on the organization of interaction between different services responsible for restoration works, sanitary cleaning, disinfection under the conditions of the emergency situation is presented. The activity of the sanitary and epidemiological services in the areas in the Republic of North Ossetia-Alania, affected by high flood, is described. Measures aimed at the epidemiological surveillance of acute enteric infections, the control of the quality of drinking water and foodstuffs, the bacteriological study of material samples taken from humans, vaccinal and phage prophylaxis have taken an important place in the work of the institutions of sanitary and epidemiological surveillance. As the result of all these measures the sanitary and epidemiological service has managed to prevent the aggravation of the sanitary and epidemiological situation in the republic.     

Prevention of mumps in preschool institutions using a live mumps vaccine made from strain L-3

The effectiveness of the emergency vaccinal prophylaxis of epidemic parotitis was studied in 19 children's day-care centers. As revealed in this study, the immunological effectiveness of vaccination did not depend on the age of vaccinees, but sharply decreased if live parotitis vaccine contained less than 10,000 HADU50 per immunization dose. After a single administration of the vaccine 91.1 +/- 0.98% of children were found to produce mumps antibodies. The immunization of children with live parotitis vaccine prepared from strain l-3 immediately after the first case of parotitis had been registered proved to be a highly effective measure. The coefficient of epidemiological effectiveness was 96.4%.