Vol 19, No 4 (2014)


Molecular genetic factors of pathogenicity of influenza A virus (H1N1) pdm09

Tsvetkov V.V., Deeva E.G., Danilenko D.M., Sologub T.V., Tikhonova E.P.


Unlike influenza epidemics which affect the population almost yearly, pandemics occur much less frequently, but have more severe medical and social consequences. The investigation of the nature of the course of all modern epidemics and pandemics are acquiring the particular rationale. Pandemic influenza A (H1N1) 2009 was caused by the virus of the mixed (triple) origin. In Russia, the first three cases of disease have been identified in Moscow from 21 to 10 June 2009. In the Far East - 2-2,5 months later compared to the European part of Russia. However, the epidemic of influenza in Russia caused by influenza virus A (H1N1) pdm09, began and developed more rapidly just in the Far East. The highest morbidity rate (10,2-10,3 per 100 people) was registered in the cities of the Far Eastern and Siberian regions. The phylogenetic analysis allowed to reveal the origin of the triple reassortant virus A (H1N1)pdm09 out of H1N1, H1N2, H3N2 avian/porcine/human virus. The performed analysis of functional domains of proteins of the influenza virus A (H1N1) pdm09 showed that modern pandemic influenza viruses have several principal genetic defects, the totality of which permits to rank them to moderately pathogenic viruses. High risk of the severe course of influenza and occurrence of complications was noted in three groups ofpatients: pregnant women, especially in the 3 trimester ofpregnancy, children under 2 years of age and patients with concomitant chronic respiratory and cardiovascular systems, as well as patients with endocrine disorders and obesity.
Epidemiology and Infectious Diseases. 2014;19(4):4-11
pages 4-11 views

Clinical significance of genetic diversity of hepatitis A virus

Chulanov V.P., Karandashova I.V., Pimenov N.N., Molochniy V.P., Tomilka G.S., Sleptsova S.S., Semenova V.K., Malyi V.P., Boiko V.V., Kamolov B.D., Volchkova E.V.


Aim: to identify features of the clinical course of hepatitis A (HA) caused by viruses of different subtypes. Patients and methods: In the study there were included 195 patients with hepatitis A (130 males and 65 females) at the age from 15 to 72 years residing in the territories with various manifestations of the epidemic process of HA (Moscow, the Khabarovsk region, the Republic of Sakha (Yakutia), the Republic of Tajikistan and Ukraine). All patients were examined for the presence of Hepatitis A virus (HAV) RNA in blood, with following determination of the genotype of the virus by PCR. Biochemical blood tests (concentration of total and direct bilirubin, ALT activity) were performed from 2 to 9 times depending on the duration of hospital stay and severity of infection. The dynamics of biochemical indices was evaluated in accordance with the period of the disease: the first period -from the 1 st to 10 th day, the second -from 11 th to 20 th day, the third -from the 21 st day and later. Results: A direct moderate correlation (The Spearman correlation coefficient r = 0,3; p = 0,002) between the duration of jaundice and patients ’ age has been revealed. A significant relationship was observed in the group ofpatients with subtype IIIA (r = 0,4; p = 0,003) and was absent in patients with subtype IA. There were no statistically significant differences between the groups of patients with subtypes IA and IIIA, in dependence on the duration of hospitalization, the variant of the course ofprejaundice period, severity of the course disease, duration of the persistent jaundice and symptoms of intoxication. Absolute values and the dynamics of the reduction of total and direct bilirubin, as well as the dynamics of decrease of ALT activity in groups of patients with various subtypes were not differed significantly. Cholestatic forms of HA were observed only in patients with HAV isolates belonging to subtype IIIA. Conclusion: HAV subtype has no effect on the severity of the course of the disease neither major clinical symptoms and laboratory indices in patients from different age groups. A direct correlationship between the duration ofjaundice syndrome and age in patients with subtype IIIA may indicate a trend towards the formation of cholestatic forms of HA in patients with this subtype of the virus in older age groups.
Epidemiology and Infectious Diseases. 2014;19(4):12-17
pages 12-17 views

Features of the replication of hantaviruses - pathogens of hemorrhagic fever with renal syndrome in cell cultures of different origin

Malkin G.A., Dzagurova T.K., Korotina N.A., Balovneva M.V., Konyushko O.I., Sotskova S.E., Tkachenko E.A.


There are presented results of the adaptation ofpathogens of hemorrhagic fever with renal syndrome (HFRS) virus Puumala and Dobrava strains, to the reproduction in cell cultures of the simian origin - Green monkey kidney (Vero, 4647), Green monkey spleen (455), calf kidney (PT-1) and sheep kidney (4184). Hantaviruses were shown to be able to adapt to the replication in the new cellular system differing in species origin from the culture of Vero E6 origin in which the strains were isolated. This fact demonstrates the heterogeneity of hantavirus population, with the existence of «quasispecies» which can recognize and bind to ligands (b3 integrins) of the other species specificity. The highest yield of the virus, which is comparable with the culture of Vero E6, culture Vero provides. In Vero cells after 3-4 passages Puumala and Dobrava-Belgrade viruses replicate also actively as in a permissive culture Vero E6, that proposes the use of Vero culture cell allowed for the production of immunobiological drugs administered to people as a substrate in the delivery of vaccines against HFRS.
Epidemiology and Infectious Diseases. 2014;19(4):18-24
pages 18-24 views

Clinical - pathogenetical features of Cryptococcus meningoencephalitis in patients with HIV infection

Volkova O.E., Vengerov Y.Y., Safonova A.P., Svistunova T.S., Tishkevich O.A.


The purpose of research - the study of clinical and pathogenetical features of cryptococcal meningoencephalitis (CME) in patients with HIV infection for the improvement of the efficiency of diagnosis and treatment. Materials and Methods. There are presented the results of the study of 67 cases of cryptococcal meningoencephalitis in patients with HIV infection. There was performed an assessment of the clinical picture and the cerebrospinal fluid (CSF), which was consisted of direct microscopy, cultural method and PCR. Also pathomorphological data of deceased patients have been analyzed. Results of the study. The clinical picture of CME was mildly pronounced and not constant. Dominant complaint is constant headache diffuse in character. Meningeal symptoms are uncertain or absent. CSF changes are not specific, most informative methods are PCR and mycological study of CSF. The fatality was causedfirst ofall by the development of edema-brain swelling and the dislocation of stem structures. Conclusion. The clinical picture of cryptococcal meningoencephalitis is caused first of all by destructive processes in brain tissue and progression of the development of edema-brain swelling. The clinical picture is poorly pronounced and is not constant, therefore to all patients with HIV infection in the presence of long-term headache the CSF examination is indicated even in the absence of meningeal symptoms.
Epidemiology and Infectious Diseases. 2014;19(4):25-29
pages 25-29 views

Vaccine therapy of chronic tick-borne encephalitis

Pogodina V.V., Shcherbinina M.S., Bochkova N.G., Bezrukova E.G., Naumov E.I., Snigur T.A., Levina L.S.


Chronic tick-borne encephalitis (CTBE) is a severe form of the disease, leading to permanent disability and death. Most cases of CTBE caused Siberian subtype of a virus of tick-borne encephalitis virus (TBEV), dominant in the Russian Federation. The pathogenesis of CTBE associated with persistence of TBEV in the central nervous system and the organs of the immune system. Specific vaccine therapy with using of inactivated full-virion vaccines prevents immunosuppression, leading to activation of persisting tick-borne encephalitis. The article describes various schemes of CTBE vaccinotherapy. Dynamics of humoral immunity in CTBE caused by Siberian subtype of TBEV. In the early stages and during remission antibodies against this subtype are detected. Vaccine therapy increases the level of immunity to all subtypes of TBEV, slowing the progression of the disease. In seronegative status of the patient vaccine therapy is not effective: from the central nervous system of a deceased patient severe strain «Zausaev» was isolated. Mechanisms of high immunity after 30-32 years after vaccine therapy and advantages of vaccine therapy compared with treatment of CTBE using specific immunoglobulin are discussed.
Epidemiology and Infectious Diseases. 2014;19(4):30-37
pages 30-37 views

The features of tick-borne encephalitis in the Yaroslavl region at the present stage. The problem of evolution of the infection

Gerasimov S.G., Druzhinina T.A., Karan L.S., Kolyasnikova N.M., Baranova N.S., Levina L.S., Malenko G.V., Pogodina V.V., Bochkova N.G.


In the Yaroslavl region (Central Federal District of Russia), endemic of tick-borne encephalitis (TBE), the features of epidemiology of this infection were studied during 1992-2012. Cyclical fluctuations in the incidence of TBE, the lack of the trend to decrease of the incidence were observed, the average annual incidence was 1,6 ± 0,32 per 100 thousand ofpopulation. The prevalence offebrile forms of disease was 62,2%, meningeal forms - 16,3%, the total percentage offocal forms was 13,9%. Manifestations of evolution of TBE were: the increase of the epidemiological significance of anthropogenically transformed natural foci, anthropurgical foci of TBE, until 81% of TBE cases were unvaccinated citizens, the high lethality of 4% and the high frequency of cases of alimentary infection of TBE of 7,8% with lethality of 10,8%. The aethiological agent of 10 lethal cases was Siberian subtype of TBE virus.
Epidemiology and Infectious Diseases. 2014;19(4):37-44
pages 37-44 views

Epidemiological features of cholera at the present stage of the seventh pandemic

Moskvitina E.A., Mazrukho A.B., Areshina O.A., Adamenko O.L., Nazaretyan A.A., Anisimova G.B.


In 2013 the cholera incidence remains on an upward trend in the world (with the rate of 1,127per cent and 1,765 per cent relatively to 1961 and 2004 respectively). The features determining the positive tendency in the dynamics of cholera incidence is for the first time involvement of several countries of Northern America (Haiti, The Dominican Republic and Cuba) in the epidemic process. The use of the criterion «infection density» made it possible to reveal the peculiarities of territorial cholera distribution in 109 countries of the world. Apart from the endemic territories in India and Bangladesh, there was revealed the formation of endemic foci in twelve African countries, as well consecutive in time as stepwise spacing (in accordance with provinces, districts, states and regions of countries), dissemination of epidemic cholera which could serve the evidence of continuation of the seventh cholera pandemics. The spread of modified in genome variants of Vibrio cholerae El Tor with epidemic and pandemic potential, along with the above mentioned, determines the unfavorable forecast for cholera at the global level.
Epidemiology and Infectious Diseases. 2014;19(4):44-49
pages 44-49 views

Whooping cough: epidemiology, biological features of Bordetella Pertussis, laboratory diagnostics and specific prophylaxis

Tyukavkina S.U., Kharseeva G.G.


The problem of epidemiology, laboratory diagnosis and specific prophylaxis of pertussis remains to be relevant because the level of the morbidity rate of this infection ‘managed’ by vaccination is rising, despite the wide coverage of immunization of the child population. Knowledge of the distribution and the course ofpertussis infection, Bordetella pertussis strains circulating in modern conditions, factors of pathogenicity of the causative agent and mechanisms of pathogenesis of the disease is important as wellfor medical students as for physicians ofvarious specialties - not only pediatricians, but also therapeutists, pulmonologists, microbiologists, epidemiologists and etc. It is worth to consider principles of laboratory diagnosis of pertussis and difficulties to which the laboratory service is faced at this as well as the comparative characteristics of traditional and express methods for diagnosing of pertussis infection - possible and regulated for implementation by basic bacteriological labotories in the territory of Russian Federation. Fundamentals of pertussis vaccination as the only effective means for prevention of mass outbreaks of this disease are also considered in the framework of the proposed lecture.
Epidemiology and Infectious Diseases. 2014;19(4):50-59
pages 50-59 views

The case of imported Japanese encephalitis (JE) in a Russian traveler (2014)

Petrova I.S., Muravev O.B., Kuzmenko T.N., Sayfullin M.A., Boytsov P.V., Larichev V.F., Akinshina Y.A., Butenko A.M.


In the article there is considered the case of imported Japanese encephalitis in Russian tourist after his return from Thailand. There is reported the dynamics of development of the disease, laboratory indices, as well as there are presented the changes in the brain revealed by MRT.
Epidemiology and Infectious Diseases. 2014;19(4):60-62
pages 60-62 views

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