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Vol 27, No 4 (2022)

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Species spectrum of nonpolio enteroviruses in KhMAO–Yugra during the prepandemic and pandemic periods

Danshina E.A., Mironov A.Y., Suranova T.G., Kuyarov A.V.


BACKGROUND: The characteristics of the regional features of the etiological structure of nonpolio enterovirus infection before and during the coronavirus disease 2019 (COVID-19) pandemic were evaluated.

AIM: To assess the monitoring of the etiologies of enterovirus infection in the prepandemic and pandemic periods.

MATERIALS AND METHODS: Data from the forms of statistical observation for 2013–2022 and the results of molecular genetic studies of nonpolio EVI were used.

RESULTS: The dynamics of the incidence of enterovirus infection in the Khanty–Mansi Autonomous Okrug before the COVID-19 pandemic was characterized by high activity levels of the epidemic process, exceeding the average for the Russian Federation by 5–6 times. The urban population, with a predominance of children aged <6 years, mainly contributed to the total incidence of enterovirus infection. During the period with the highest incidence rates in 2017 and 2019, Coxsackie A6 viruses in combination with ECHO30, Coxsackie A9 dominated, and during the period of their decline, the proportion of enterovirus A71, Coxsackie A16 increased. During the pandemic, the calculated trends of dynamics for 2022 were confirmed for dominant viruses and enterovirus A71. In the same year, Coxsackie B2 and ECHO6 viruses were increasingly identified, which were previously circulated irregularly and in isolated cases. The prevalence of CV-A6 in the epidemic process was accompanied by clinical manifestations of infection, mainly as enterovirus vesicular stomatitis, with a high frequency of ECHO30, computer cases were recorded in most cases.

CONCLUSION: Based on the results of monitoring the etiological structure of nonpoliomyelitis enterovirus infection in the prepandemic period, a further increase in morbidity in enterovirus infection is predicted in the Khanty–Mansi Autonomous Okrug. Genotyping of the detected strains makes it possible to determine the spectrum of enterovirus strains endemic to the territory and predict their prevalence, which is necessary to prevent the spread of enterovirus infection and ensure sanitary and epidemiological well-being in the region.

Epidemiology and Infectious Diseases. 2022;27(4):217-225
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Influence of HIV infection on clinical course of the new coronavirus infection (COVID-19)

Danilov A.N., Eremin V.I., Abramyan T.L., Yaroshevskaya S.I., Sofina A.V., Mamonova I.A., Vodina E.A., Philippova N.A., Teisherskaya D.A.


BACKGROUND: Human immunodeficiency virus (HIV)-associated severe immunosuppression, high viral load, non-HIV-related comorbidities and conditions, and lack of antiretroviral therapy may exacerbate the clinical course of coronavirus disease 2019 (COVID-19).

AIM: To assess the effect of HIV infection on the clinical course of COVID-19, disease severity, and its outcomes.

MATERIALS AND METHODS: Medical records of 35,328 patients who had COVID-19 in 2020 were analyzed, including 46 cases of COVID-19 in individuals with HIV infection. Clinical variants and COVID-19 severity, frequency of COVID-19 detection by polymerase chain reaction, CD4 lymphocyte count, viral load in individuals with HIV infection, and mortality rates were assessed.

RESULTS: In 76% of patients with coinfection, signs of HIV infection progression, opportunistic infections, and concomitant diseases were noted. Moreover, 52.2% of the patients analyzed were users of psychoactive substances. Among patients with HIV and COVID-19, men predominated in groups aged >30 years, whereas among the HIV-negative population, women were predominant in groups aged >18 years. The proportion of severe COVID-19 in individuals with HIV infection (47.8%) exceeds that in the group without HIV (12.3%). The mortality rate from COVID-19 in the HIV-infected group was more than seven times higher than that in the HIV-negative group (t=1.81; p=0.01).

CONCLUSIONS: In the HIV-infected group, extremely severe COVID-19 was more common. Weakness, cough, shortness of breath, and myalgia were significantly more common in the HIV-infected group. Moreover, the HIV-infected group with an undetectable viral load and adequate CD4 lymphocyte count in the blood was exposed to the same risks of the disease and its progression as the HIV-negative group.

Epidemiology and Infectious Diseases. 2022;27(4):232-244
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Evaluation of the effectiveness of microscopy of surgical material performed by cito in patients with suspected echinococcosis

Gavrilyuk T.V., Кozlov S.S., Zakharkiv Y.F., Mokrousov V.N., Saulevich A.V., Abdulazizov I.G., Turitsin V.S.


BACKGROUND: At present, the relevance of echinococcosis is attributed to its wide prevalence in Russia. More than 30 cases were registered in the country’s 88 administrative territories. In establishing the final diagnosis of echinococcosis, instrumental (ultrasound, computed tomography, and magnetic resonance imaging) and serological methods (determination of specific antibodies based on enzyme-linked immunoassay) are important. However, imaging methods in some cases do not allow to differentiate echinococcal cysts from other volumetric formations, and serological tests can give false-negative results. Hydatidosis is characterized by a long course and is often diagnosed late, when complications develop. The surgical method is considered a radical method of treatment. The diagnosis was confirmed by the results of the pathomorphological examination of the surgical material.

AIM: To examine the effectiveness of parasitological diagnosis of echinococcosis performed by cito using microscopy of cyst contents obtained during surgical intervention.

MATERIALS AND METHODS: The surgical samples were studied in cito using microscopy of cyst contents.

RESULTS: Of the 47 samples examined according to cito, protoscolexes of Echinococcus granulosus were found in 31 (65.7%) patients. In 2 (4.3%) cases, only single hooks of the larvae were found in the samples under study. In 3 (6.4%) patients, the echinococcal nature of the cysts was confirmed by delayed pathomorphological studies of the surgical material with the preparation of histological sections. In 11 (23.4%) patients, the parasitic nature of mass lesions was excluded.

CONCLUSION: Microscopy of the surgical material by cito to detect morphological signs of the parasitic nature of the cyst is a highly effective method that allows confirming the diagnosis of echinococcosis promptly.

Epidemiology and Infectious Diseases. 2022;27(4):226-231
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Baloxavir marboxil as a new specific anti-influenza drug

Breslav N.V., Ignatjeva A.V., Mukasheva E.A., Krepkaia A.S., Burtseva E.I.


Baloxavir marboxil is the first antiviral drug with a unique single dose, registered in Russia in September 2020 under the trade name Xoflusa, for treating infection caused by influenza A and B viruses.

This article presents an overview of studies on the anti-influenza activity of baloxavir marboxil by foreign colleagues. Data from scientific articles by different authors were analyzed and in vitro results and clinical data were considered, which can help in making recommendations for the use of the drug for the treatment and postexposure prophylaxis of influenza.

Baloxavir marboxil acts as a selective low-molecular-weight inhibitor of an enzyme specific to the influenza virus in the viral RNA polymerase complex and is effective against strains resistant to oseltamivir. In the combined phenotypic analysis and analysis based on the sequence in the polymerase acidic (PA) protein, the frequency of viruses showing reduced susceptibility to the drug remains low.

Numerous studies have demonstrated the safety profile and productivity of influenza treatment in various groups (without risk factors and high-risk patients). Baloxavir marboxil stops the replication of the influenza virus in the early stages, which terminates its release during the first day and significantly relieves the patient’s condition on the second day. Monitoring of the antiviral activity of the drug, especially in children aged <12 years and people with weakened immunity, should be closely monitored to develop clinical recommendations and prevent the formation of substitutions I38(T/F/M/S/L/V) in the PA of influenza A and B viruses that reduce their sensitivity to the drug.

Epidemiology and Infectious Diseases. 2022;27(4):245-254
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Generalized tetanus: a case report

Shakhmardanov M.Z., Nikiforov V.V., Skryabina A.A., Burova S.V., Tomilin Y.N., Abusueva A.S., Antipyat N.A.


Tetanus is a rare disease caused by Clostridium tetani, causing damage to the central nervous system with the development of muscle hypertension and attacks of generalized seizures caused by the action of the pathogenic toxin. Despite the availability of safe and effective vaccines, the urgency of the problem of tetanus incidence is high because a significant part of the population is not immunized against this disease, and severe manifestations of tetanus can be fatal.

This paper presents a clinical case of traumatic generalized tetanus in an 11-year-old patient. The absence of routine immunization against tetanus and emergency active–passive immunization contributed to disease development. The disease proceeded in a typical form, with the development of muscle spasms, myoclonia, trism, and convulsions. Specific tetanus serum was administered, pathogenetic therapy with anticonvulsants and muscle relaxants was performed, and the patient had clinical recovery and was discharged from the hospital.

Epidemiology and Infectious Diseases. 2022;27(4):255-260
pages 255-260 views

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