Vol 21, No 2 (2016)


About the concept for eradication of diseases

Morozov E.N., Litvinov S.K., Zhirenkina E.N.


The programs carried out previously for the eradication of infectious diseases have been described with the special attention in regard to the reasons of its failures and/or negative experience gained. So far the global program on smallpox eradication achieved the established goal, while two other, polio eradication initiative and dracontiasis eradication, are still going on rather long period of time. The program of elimination of measles and rubella, which according to the original plan, should be movedfor eradication in the future, is facing a lot ofproblems for the time being and therefore it is difficult to predict any future developments in this area. Nevertheless a number of initiatives and/or programs are very much keen nowadays to establish the goal of eradication or elimination without, according the authors opinion, serious and deep analysis of the burden of the targeted disease, its epidemiological and clinical peculiarities, feasibility for achievement of goal etc. The criterions for the disease selection for eradication/elimination are presented in the article. The hasty decision on such matter may lead to the failure of initiative, lack of the staff motivation, loss of the public health authority prestige and discredit the disease eradication concept as such.
Epidemiology and Infectious Diseases. 2016;21(2):68-73
pages 68-73 views

The dynamics of HCV DNA and HBsAg levels in acute hepatitis B patients in monoinfection and coinfection of other hepatitis viruses

Chulanov V.P., Kostygova E.Y., Kostyushev D.S., Glebe D., Shipulin G.A., Gerlikh V., Volchkova E.V.


Introduction Changes in the levels of DNA of hepatitis B virus (HBV) infection and the quantitative content of the surface antigen (HBsAg) in acute hepatitis B, as well as the concomitant co-injection of other hepatitis viruses have been insufficiently studied so far. Materials and Methods In 21 patients with acute HBV monoinfection and 27 patients with co-infection of HBV + HCV and/ or HDV three to four serum samples were withdrawn with interval of 6-10 days and the dynamics of HBV viral load and concentration of HBsAg was examined. Results Logarithm of the concentration of DNA HBV was established to decrease from 4.0 ± 0.65 to 3.0 ± 0.59, to 2.5 ± 0.47, to 1.9 ± 0.65 (IU /ml, M ± s), the half-life of DNA HBV was increased from 1.6 days at baseline to 4 days to the end of the study. The decline of the HBsA concentration proceeded much slower: from 38 to 23, 12, 3.8 pg/ml. Half-life period of HBsAg accounted of 8 days at the beginning and 5.7 days at the end of the study, however, in 11 patients there was observed rapid elimination of HBsAg and disappearance of HBV DNA. Conclusion The fact of co-infection with hepatitis C virus (HCV) had no significant effect on the dynamics of HBV DNA and HBsAg levels. In patients infected with Hepatitis D virus (HDV) HBV viral load was significantly lower, and the concentration of HBsAg, by contrast, is significantly higher than in acute monoinfection with HBV. Thus, in acute hepatitis B DNA elimination occurs much faster than the elimination of HBsAg. In addition, in co-infection HDV inhibits replication of HBV, but at the same time stimulates the expression of HBsAg. The obtained data should be considered in the interpretation of laboratory tests in patients with acute hepatitis B, both in the earlier period, and at follow-up.
Epidemiology and Infectious Diseases. 2016;21(2):74-81
pages 74-81 views

Examination of convalescents after West Nile fever for the specific IgM, IgG and neutralizing antibodies

Azaryan A.R., Kozlova A.A., Grishanova A.P., Ivashchenko E.I., Shendo G.L., Kovtunuv A.I., Antonov V.A., Viktorov D.V., Smelyansky V.P., Snatenkov E.A., Barkova I.A., Larichev V.F., Butenko A.M.


The examination was executed in the Astrakhan region over 2013-2014 with participation of three laboratories. In 26 convalescents after West Nile Fever (WNF) with the serological confirmed diagnosis of WNF blood sera were examined. Neurological form of WNF was observed in 8 cases, and febrile form - in 8 convalescents. Sera have been collected in 243-358 days, on average, in 308 days after the beginning of a disease. For their examination there were used IFA-IgM ELISA (MAC-ELISA), IgG ELISA methods as well as neutralization test in Vero E6 cell culture. The results of the examination in 24 of 26 patients (92, 3%) for IgM antibodies to the virus WNF were negative. In two convalescents according to the laboratories in Astrakhan and Moscow in sera there were observed low titers of IgM (1:400) with minor indices of sera optical density (0.3 to 0.4) and negative results in the Volgograd Plague Control Research Institute. Serum samples of other two convalescents were weakly positive or questionable in testing in Volgograd, but were negative when examined in the Institute of Virology. Specific IgG antibodies were detected in 23 of 26 convalescents (88.5%), neutralizing in 22 of 24 (91.7 %). These data confirm the adequacy of the criteria and tactics for WNF serodiagnosis adopted in Russia based on the application of the MAC -ELISA (IFA - IgM).
Epidemiology and Infectious Diseases. 2016;21(2):82-86
pages 82-86 views

Clinical and immunological features of inflammation in lyme borreliosis

Moshkova D.Y., Avdeeva M.G.


The cytokine status was studied in 46patients hospitalized in Specialized Clinical Infectious Diseases Hospital in 2013-2014. Acute course of the infection of Ixodes tick borreliosis (ITB) was observed in the 41 (89%) case, subacute and chronic - in 5 (11%), in the dynamics of the disease there was studied the level of proinflammatory (IFN-y, IL-1β, IL-2) and anti-inflammatory ( IL-4, IL-10) cytokines. The average age of diseased patients in the acute course of the erythemalform of ITB amounted to 41,1 ± 1,83 years, men accouted for 37%, women - 63%. In 31.1% of the patients there were observed symptoms of the involvement of the peripheral nervous system PNC, in 51.1% - changes in the cardiovascular system. For the acute course of the erythemal form of ITB there is typical the significant increase ofIL-1β, IFN-y and IL-4 level, while in maintaining of normal levels of IL-2 and IL-10 low values in the majority of patients. In subacute and chronic course of Ixodes borreliosis there is persisted the elevated level of IL-1β, IFN-y, normal values of IL2 and low values of IL-10, while the level of IL-4 is also lowered. The increase of the IL-2 level in the acute course of the erythemal form of Ixodes borreliosis is associated with fever and involvement of the cardiovascular system. In the process of causal treatment with ceftriaxone (examination on the 5th and 12th day of the treatment) there was a significant decrease in the level of IL-2 (p <0,05), whereas treatment with doxycycline failed to affect the level of interleukins investigated. The revealed changes in the cytokine status in acute course of Ixodes borreliosis correspond to the development of the immune response on the type of antibody-dependent cell-mediated cytotoxicity. The decline of elevated level of IL-2 permits to evaluate the effectiveness of the causal treatment. The chronic course of the diseases is differed by low levels of IL-4.
Epidemiology and Infectious Diseases. 2016;21(2):86-92
pages 86-92 views

Acute biliary obstruction with cholestasis caused by Fasciola hepatica in a patient travelled to Turcmenistan (a case report and literature review)

Bronshteyn A.M., Malyshev N.A., Fedianina L.V., Davydova I.V.


The paper describes the case of Fasciola hepatica in patient from Turkmenistan presenting with icterus, biliary-type pain, dark urine and jaundice. Magnetic resonance (MRC) and endoscopic retrograde cholangiography (ERC) were performed and after sphincterotomy one Fasciola hepatica was extracted. After the ERC antiparasitic treatment was given with triclabendazole. Clinical outcome was favourable. In conclusion, fascioliasis should be considered in the differential diagnosis of obstructive jaundice, especially in patients travelled to endemic regions, and it should be kept in mind that ERC and triclabendazole play an important role in the diagnosis and treatment of these patients. To our knowledge, this is the first case report of Fasciola hepatica treated by ERC in Russia.
Epidemiology and Infectious Diseases. 2016;21(2):92-98
pages 92-98 views

Case of acute acquired toxoplasmosis treatment during pregnancy

Konchakova A.A., Avdeeva M.G., Kulbuzheva M.I.


There is reported an example of a clinical diagnosis and successful treatment of acute acquired toxoplasmosis, manifested in the first trimester of pregnancy. Implementation of specific antiparasitic therapy starting from the second trimester of pregnancy contributed both to the normalization of the status of women and prevention of congenital malformations of the fetus. Dynamic following up of the child showed stable positive neurological status, psychomotor development corresponded to age over 8 years. The increasing of cytochemical activity of monocytes and lymphocytes is a sensitive additional diagnostic test for acute toxoplasmosis in pregnant women.
Epidemiology and Infectious Diseases. 2016;21(2):99-102
pages 99-102 views

Achievements in diagnosis and treatment of hepatocellular carcinoma: case report and review

Chernobrovkina T.Y., Yankovskaya Y.D., Litvinova O.S., Oganesyan A.P.


In the analytical review there was performed the analysis of the epidemiological situation on hepatocellular carcinoma (HCC). There were described riskfactors of its development and mechanisms of carcinogenesis. Also here there are presented different classifications of HCC, etiology, diagnostic tactics in cases of suspicion on HCC and variants of the treatment. The HCC case is described in a patient with the outcome of liver cirrhosis
Epidemiology and Infectious Diseases. 2016;21(2):103-110
pages 103-110 views

A prominent epidemiologist and public health organizer (to the 110th anniversary of the birth of Academician O.V. Baroyan)

Knopov M.S., Taranukha V.K.


The article presents the life and career of a prominent national epidemiologist, the talented organizer of Health care, well-known public figure, academician of the USSR Academy of Medical Sciences, Professor Hovhannes Vagarshakovich Baroyan.
Epidemiology and Infectious Diseases. 2016;21(2):111-114
pages 111-114 views

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