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Characteristics of the epidemic process of Lyme borreliosis in the Sverdlovsk district over a 20-year period 斯维尔德洛夫斯克地区近20年莱姆病流行过程特征
Pub Date : 2023-05-10 DOI: 10.31631/2073-3046-2023-22-2-47-54
Н. М. Колясникова, Л. Г. Чистякова, А. В. Пономарева, А. Е. Платонов, В. В. Романенко, Татьяна Александровна Чеканова, А. В. Титков, А. А. Ишмухаметов, В. Г. Акимкин, NM Kolyasnikova, LG Chistyakova, AV Ponomareva, AE Platonov, VV Romanenko, TA Chekanova, A. Titkov, AA Ishmukhametov, VG Akimkin
Relevance. The Sverdlovsk district is a tense natural focus for Lyme borreliosis (LB) with a constantly recorded incidence that exceeds these indicators in the Russian Federation and the Ural Federal region several times. LB is registered on 56 of 59 administrative territories of the district. Currently, the count of LB in the Russian Federation includes both infections caused by Borrelia burgdorferi sensu lato group Borrelia and infections caused by Borrelia miyamotoi sensu lato group Borrelia.Aim. To characterize the epidemic process of LB in the territory of the Sverdlovsk district over a 20-year period (2002–2021).Materials and methods. The paper uses data from federal and regional statistical observations, reporting materials of the Department of Rospotrebnadzor in the Sverdlovsk district for 2002–2021, methods of statistical analysis.Results and discussion. During the follow–up period (2002–2021), the incidence rate of BL in the Sverdlovsk district exceeded the average long-term level in the Russian Federation by almost 3 times, and in the Ural Federal region – by 1.8 times. Among the mechanisms and ways of transmission of LB pathogens, the vector-borne mechanism dominated (84.5%), the share of the unidentified pathway was 15.4%, alimentary (when using raw goat's milk) – 0.1%. The duration of the epidemic season for LB in the district was 10 months (from March to December) with a peak incidence in June. Cases of LB were registered among people of different ages, with a predominance in the group of 60 years and older (39.1%). An analysis of the distribution of people with LB by social composition showed that pensioners prevailed among them – 36.3%, officials made up 27.8%, unemployed – 14.1%. Among the cases, a high proportion of schoolchildren and children under 7 years old were noted. It was found that erythematous and non-erythematous forms of LB are registered in the district, with a predominance of erythematous (64.5%). The main etiological agent of the erythematous form is Borrelia garinii, while the non-erythematous form is Borrelia miyamotoi and B. garinii. In the general structure of morbidity, the number of cases of LB is largely determined by the city inhabitants (92.9%). There were no fatal outcomes in LB in the territory of the district during the studied period.Conclusions. Due to the lack of vaccination of LB worldwide, the only strategy to reduce the incidence of LB is non-specific prevention and timely diagnosis of the disease, including data from epidemiological history, clinical and laboratory diagnostics. The long-term clinical and epidemiological and laboratory studies conducted by us in the Sverdlovsk district allowed us to characterize the main manifestations of the epidemic process of LB and to improve the diagnosis of the disease.
的相关性。斯维尔德洛夫斯克地区是莱姆病(LB)紧张的自然重灾区,在俄罗斯联邦和乌拉尔联邦州,不断有记录的发病率多次超过这些指标。LB在本区59个行政地区中的56个地区注册。目前,俄罗斯联邦的LB计数既包括伯氏疏螺旋体(Borrelia burgdorferi senu lato)组的感染,也包括宫本疏螺旋体(Borrelia miyamotoi senu lato)组的感染。描述斯维尔德洛夫斯克地区20年期间(2002-2021年)LB流行过程。材料和方法。本文使用的数据来自联邦和地区统计观察,2002-2021年斯维尔德洛夫斯克地区Rospotrebnadzor部门的报告材料,统计分析方法。结果和讨论。在随访期间(2002-2021年),斯维尔德洛夫斯克地区的BL发病率超过俄罗斯联邦平均长期水平近3倍,乌拉尔联邦州的发病率超过1.8倍。在LB病原体的传播机制和途径中,媒介传播机制占主导地位(84.5%),未知途径占15.4%,食物(使用生羊奶时)- 0.1%。疫区LB流行季节为10个月(3 - 12月),6月为发病高峰。LB病例在不同年龄人群中均有记录,以60岁及以上人群为主(39.1%)。根据社会构成对LB患者分布的分析表明,其中养老金领取者占36.3%,官员占27.8%,失业者占14.1%。在这些病例中,注意到学童和7岁以下儿童的比例很高。结果发现,该地区LB有红斑型和非红斑型,以红斑型为主(64.5%)。红斑型主要病原为加里尼伯氏疏螺旋体,非红斑型主要病原为宫本氏疏螺旋体和加里尼伯氏疏螺旋体。在总体发病结构中,LB病例数主要由城市居民决定(92.9%)。在研究期间,本区境内未发生致人死亡的LB病例。由于全球缺乏LB疫苗接种,降低LB发病率的唯一策略是非特异性预防和及时诊断,包括流行病学史、临床和实验室诊断数据。我们在斯维尔德洛夫斯克地区进行的长期临床、流行病学和实验室研究使我们能够确定LB流行过程的主要表现,并改善疾病的诊断。
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引用次数: 0
Effectiveness Analysis of a Compromise Approach to Solving the Problem of Refusal of Influenza Vaccination 一种解决流感拒绝接种问题的折衷方法的有效性分析
Pub Date : 2023-05-10 DOI: 10.31631/20733046-2023-22-2-103-106
I. Kolesin, E. Zhitkova
Relevance. The ineffectiveness of current methods of engaging the population in vaccine prophylaxis leads to the need to develop new means of solving the problem of vaccination abandonment.Aims is to show the effect of applying the theory of compromise solutions to the analysis of the problem of refusal of influenza vaccination.Materials and methods. Data on number of vaccinated and morbidity among vaccinated and unvaccinated; the research method is based on the compilation of criteria reflecting the interests of the administration and the population, followed by finding a compromise solution and evaluating it using an indicator of tensions.Results. Based on data on morbidity among vaccinated and unvaccinated, the existence of an optimal percentage of vaccinated for the adult population and for each of the three risk groups is shown: medical staff, service employees and persons over 60 years of age; on the example of the group «persons over 60 years of age», the possibility of reducing tension in the case of replacing a single vaccination with a complex one is shown.Conclusion. The effectiveness of the application of the theory of compromise solutions to the assessment of tensions between the sanitary and epidemiological inspection service and the population in terms of vaccination is presented; the possibility of reducing tension by switching to complex immunoprophylaxis is presented.
的相关性。目前使人口参与疫苗预防的方法无效,因此需要开发解决放弃疫苗接种问题的新方法。目的是展示将妥协解理论应用于流感疫苗拒绝接种问题分析的效果。材料和方法。关于接种疫苗人数以及接种疫苗和未接种疫苗的发病率的数据;研究方法的基础是汇编反映政府和民众利益的标准,然后找到一个折衷的解决方案,并使用紧张指标对其进行评估。根据接种疫苗和未接种疫苗的发病率数据,成年人和三个风险群体(医务人员、服务人员和60岁以上的人)接种疫苗的最佳百分比是存在的;以“60岁以上人群”为例,说明了用复合疫苗代替单一疫苗可以减少紧张的可能性。提出了将折衷解决理论应用于评估卫生和流行病学检查部门与人口之间在疫苗接种方面的紧张关系的有效性;通过切换到复杂的免疫预防降低紧张的可能性是提出的。
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引用次数: 0
Clinical and Epidemiological Characteristics of COVID-19 in Persons Living with HIV Complicated by Tuberculosis HIV合并结核病患者COVID-19的临床和流行病学特征
Pub Date : 2023-05-10 DOI: 10.31631/2073-3046-2023-22-2-66-78
I. Lebedeva, O. D. Borodkina, T. Bondarenko, Ye. B. Brusina
Relevance. At present, three infections – HIV infection, tuberculosis, and COVID-19 - are spreading simultaneously in the world. Of great practical importance is the assessment of clinical and epidemiological features of COVID-19 in HIV-infected patients with tuberculosis, COVID-19. Aim. To study the risk of COVID-19 disease and identify clinical and epidemiological features in and population of patients with HIV infection complicated by tuberculosis in comparison with patients with HIV infection and the population without these diseases.Materials and methods. Since 13.03.2020 by 31.12.2021 in the Kemerovo Region-Kuzbass, a continuous prospective analytical epidemiological study of the case-control type was performed. Of those with COVID-19, two observation groups were formed: group I (HIV +), group II (HIV/TB) and comparison group III (persons without either HIV or tuberculosis). All patients underwent: determination of SARS-CoV-2 RNA, standard examination methods in accordance with the temporary methodological recommendations «Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)», relevant at the time of treatment.Results. The incidence of COVID-19 among patients with HIV infection complicated by tuberculosis exceeded the incidence of COVID-19 among HIV-infected by 14%. There were no gender differences between patients I (HIV +) and II (HIV/TB) groups. In the comparison group, the incidence of COVID-19 was 1.26 times higher in women compared to men. COVID-19 disease in patients with co-infection (HIV/TB) was predominantly mild. Viral pneumonia developed 1.86 times less often, oxygenotherapy was required only in 18.75% of cases, which is 2.5 times lower than in group I (HIV +) and 2.47 times less than in the comparison group (III). In labeled pairs, clinical symptoms of COVID-19 in all groups occurred with the same frequency. Metabolic disorders were evident in all groups. Co-infected patients (HIV/TB) had higher levels of D-dimer, ESR, total bilirubin.Conclusion. Active tuberculosis in HIV-infected people is a factor that increases the risk of COVID-19 disease without affecting the severity of the infectious process.
的相关性。当前,艾滋病毒感染、结核病和COVID-19三种感染在全球同时蔓延。评估艾滋病病毒感染的肺结核患者的临床和流行病学特征具有重要的现实意义。的目标。目的:探讨艾滋病合并结核病患者及其人群的新冠肺炎发病风险,并与艾滋病合并结核病患者及未合并结核病人群进行临床及流行病学特征比较。材料和方法。自2020年3月13日至2021年12月31日,在克麦罗沃地区-库兹巴斯进行了病例对照型的连续前瞻性分析流行病学研究。在COVID-19患者中,形成两个观察组:I组(艾滋病毒阳性)、II组(艾滋病毒/结核病)和比较III组(既没有艾滋病毒也没有结核病)。所有患者均接受了:检测SARS-CoV-2 RNA,标准检查方法按照临时方法学建议“新型冠状病毒感染(COVID-19)的预防、诊断和治疗”,在治疗时相关。HIV合并结核病患者中COVID-19的发病率比HIV感染者中COVID-19的发病率高出14%。患者I (HIV +)组和患者II (HIV/TB)组之间无性别差异。在对照组中,女性的COVID-19发病率是男性的1.26倍。合并感染(HIV/TB)患者的COVID-19疾病以轻度为主。病毒性肺炎的发生率降低了1.86倍,仅18.75%的病例需要氧疗,比ⅰ组(HIV +)低2.5倍,比对照组(ⅲ)低2.47倍。在标记对中,所有组的COVID-19临床症状发生频率相同。各组均有明显的代谢紊乱。合并感染患者(HIV/TB) d -二聚体、ESR、总胆红素水平较高。艾滋病毒感染者的活动性结核病是增加COVID-19疾病风险的一个因素,但不会影响感染过程的严重程度。
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引用次数: 0
Infectious Morbidity in Closed Long-Term Care Facilities in the «Pre-COVID Stage» “前covid阶段”封闭长期护理机构中的传染病发病率
Pub Date : 2023-05-10 DOI: 10.31631/2073-3046-2023-22-2-107-116
V. Akimkin, N. G. Davydova, S. Ugleva, Z. Ponezheva, S. Shabalina
Relevance. Elderly people have become the fastest growing segment of the global population over the past few decades. The number of people over the working age in Russia, and with them citizens living in closed long-term care facilities (CLTFS), is growing. Residents of these organizations belong to the risk group, and CLTFS have a number of characteristics that turn these institutions into a unique environment for the spread of infectious diseases.Aims. To analyze the CLTFS residents infectious morbidity in the "pre-covid stage" (according to literature sources). A scientific review of research in Russian and English using information portals and platforms has been carried out eLIBRARY. ru , Web of Science, PubMed, Google Academy and Scopus for the period 1981-2022. The search was carried out by keywords. Information about the most frequent infectious diseases affecting residents of closed long-term care institutions was the criterion for inclusion in the sample of publications. Out of 16171 initially identified articles, 61 publications were selected after initial analysis.Conclusions. According to various estimates, the leading infectious diseases in CLTFS were: acute respiratory infections, pneumonia, urinary tract infections, skin and mucous infections, acute intestinal infections. The article describes pathogens and their prevalence in CLTFS including pathogens with multiple drug resistance (MDR), describes the resistance of bacteria to antimicrobial drugs formation problem in these organizations, as well as development of certain diseases risk factors. Studies conducted in various CLTFS in Europe, Russia, the USA, and Asia indicate a high prevalence of infectious diseases among their residents, high colonization of residents with antimicrobial-resistant pathogens, as well as the infection transmission probability from the CLTFS and its spread to other long-term care institutions and medical and preventive organizations.
的相关性。在过去的几十年里,老年人已经成为全球人口中增长最快的一部分。俄罗斯超过工作年龄的人口以及与他们一起生活在封闭长期护理设施(CLTFS)中的公民人数正在增加。这些机构的居民属于危险群体,CLTFS有许多特点,使这些机构成为传染病传播的独特环境。分析CLTFS居民“前covid阶段”的感染发病率(根据文献来源)。利用信息门户和平台对俄语和英语研究进行了科学回顾。1981年至2022年期间,Web of Science, PubMed, Google Academy和Scopus。搜索是按关键词进行的。关于影响封闭长期护理机构居民的最常见传染病的信息是纳入出版物样本的标准。在最初确定的16171篇文章中,经过初步分析,选择了61篇出版物。根据各种估计,CLTFS的主要传染病是:急性呼吸道感染、肺炎、尿路感染、皮肤和粘膜感染、急性肠道感染。本文描述了CLTFS中的病原体及其流行情况,包括多重耐药病原体(MDR),描述了这些组织中细菌对抗菌药物的耐药性形成问题,以及某些疾病危险因素的发展。在欧洲、俄罗斯、美国和亚洲的各个CLTFS中进行的研究表明,其居民中传染病的流行率很高,具有抗菌素耐药性病原体的居民的定殖率很高,以及CLTFS的感染传播概率及其向其他长期护理机构和医疗和预防组织的传播。
{"title":"Infectious Morbidity in Closed Long-Term Care Facilities in the «Pre-COVID Stage»","authors":"V. Akimkin, N. G. Davydova, S. Ugleva, Z. Ponezheva, S. Shabalina","doi":"10.31631/2073-3046-2023-22-2-107-116","DOIUrl":"https://doi.org/10.31631/2073-3046-2023-22-2-107-116","url":null,"abstract":"Relevance. Elderly people have become the fastest growing segment of the global population over the past few decades. The number of people over the working age in Russia, and with them citizens living in closed long-term care facilities (CLTFS), is growing. Residents of these organizations belong to the risk group, and CLTFS have a number of characteristics that turn these institutions into a unique environment for the spread of infectious diseases.Aims. To analyze the CLTFS residents infectious morbidity in the \"pre-covid stage\" (according to literature sources). A scientific review of research in Russian and English using information portals and platforms has been carried out eLIBRARY. ru , Web of Science, PubMed, Google Academy and Scopus for the period 1981-2022. The search was carried out by keywords. Information about the most frequent infectious diseases affecting residents of closed long-term care institutions was the criterion for inclusion in the sample of publications. Out of 16171 initially identified articles, 61 publications were selected after initial analysis.Conclusions. According to various estimates, the leading infectious diseases in CLTFS were: acute respiratory infections, pneumonia, urinary tract infections, skin and mucous infections, acute intestinal infections. The article describes pathogens and their prevalence in CLTFS including pathogens with multiple drug resistance (MDR), describes the resistance of bacteria to antimicrobial drugs formation problem in these organizations, as well as development of certain diseases risk factors. Studies conducted in various CLTFS in Europe, Russia, the USA, and Asia indicate a high prevalence of infectious diseases among their residents, high colonization of residents with antimicrobial-resistant pathogens, as well as the infection transmission probability from the CLTFS and its spread to other long-term care institutions and medical and preventive organizations.","PeriodicalId":11736,"journal":{"name":"Epidemiology and Vaccinal Prevention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84784637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Features of the COVID-19 Epidemic Process in Each of the of the Five Waves of Morbidity in Russia 新冠肺炎疫情在俄罗斯五波发病中的流行过程特征
Pub Date : 2023-05-08 DOI: 10.31631/2073-3046-2023-22-2-23-36
L. Karpova, A. Komissarov, K. Stolyarov, N. M. Popovtseva, T. P. Stolyarova, M. Y. Pelikh, D. Lioznov
Aim. To assess the intensity of the epidemic process in each of the five waves of COVID-19 in Russia.Materials and methods. The data on morbidity, hospitalization and deaths from COVID-19 of the population as a whole and by age groups from 48 (in the I rise) to 54 cities (in the V wave) and data from the website of the Russian consortium for sequencing coronavirus genomes were analyzed.Results. The nature of the course of the first 5 waves in the incidence of COVID-19 in Russia remains undulating. The waves in morbidity began in megacities, and the direction of spread across the FD differed in different waves of morbidity. The results of gene sequencing showed the participation of the main genovariants of the coronavirus in the etiology of diseases up to 3-4 waves. Some genovariants identified earlier received maximum distribution in the following wave. In Russia, the European descendants of the Wuhan strain (74.4%) were dominant in the I wave in morbidity, in the II wave – its daughter genovariants (68.5%), in the III – AY.122 (80.1%), in the IV – AY.122 (84.7%) and in the V wave – Omicron (76.7%).Conclusions. The features of each wave in the incidence of COVID-19 depended on the properties of the dominant genovariants: their ability to transmit from person to person and virulence. The rate of spread of the epidemic by FD, the susceptibility of all age groups and the intensity of epidemics were maximal during the period of the V wave in morbidity with the Omicron gene variant. Mortality was minimal in the I wave of morbidity, maximal in the IV with AY.122 strains and low in the V wave with Omicron genovariants. The influence of the season of the year was manifested in the summer season by an increase in the incidence of COVID-19 earlier in the Russian Federation as a whole (immediately after megacities) than in most federal districts, but with a lower incidence.
的目标。评估俄罗斯五波新冠肺炎疫情中每波疫情的流行程度。材料和方法。分析了48个城市(I型上升)至54个城市(V型上升)的整体人群和年龄组的COVID-19发病率、住院率和死亡率数据,以及俄罗斯冠状病毒基因组测序联盟网站的数据。俄罗斯COVID-19发病率的前5波过程的性质仍然起伏不定。发病率的波动始于大城市,在不同的发病率波动中,整个FD的传播方向不同。基因测序结果显示,冠状病毒主要基因变异参与了3-4波疾病的病因学。一些早期发现的基因变异在下一波中得到了最大的分布。在俄罗斯,武汉毒株的欧洲后裔在I波、II波及其子基因变异(68.5%)、III - AY.122(80.1%)、IV - AY.122(84.7%)和V波- Omicron(76.7%)中占主导地位。每一波COVID-19发病率的特征取决于显性基因变异的特性:它们在人与人之间传播的能力和毒力。在Omicron基因变异发病的V波期间,FD的传播速度、各年龄组的易感性和流行强度最大。死亡率在I波发病时最低,在IV波发病时死亡率最高,而在V波发病时死亡率较低。一年中季节的影响体现在夏季,整个俄罗斯联邦(紧随大城市之后)的2019冠状病毒病发病率比大多数联邦区上升得更早,但发病率较低。
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引用次数: 2
Epidemiological Characteristics of Tick-Borne Encephalitis in the Sverdlovsk District over a 20-Year Period 斯维尔德洛夫斯克地区20年来蜱传脑炎的流行病学特征
Pub Date : 2023-05-08 DOI: 10.31631/2073-3046-2023-22-2-37-46
N. Kolyasnikova, L. Chistyakova, A. V. Ponomareva, A. E. Platonov, V. V. Romanenko, А. Ishmukhametov, V. Akimkin
Relevance. Despite the ongoing program of mass vaccination of tick-borne encephalitis (TBE) for more than 20 years in the Sverdlovsk district, the incidence rate of TBE continues to exceed the average in Russia and the Ural Federal region.Aim. To analyze the main indicators of the manifestation of the epidemic process of TBE in the territory of the Sverdlovsk district under the conditions of planned vaccination over a 20-year period (2002–2021).Materials and methods. The article uses data from federal and regional statistical observations, reporting materials of the Department of Rospotrebnadzor in the Sverdlovsk district for 2002-2021, methods of statistical analysis.Results and discussion. During the study period (2002-2021), 3861 cases of TBE were registered in the Sverdlovsk district, while the highest incidence rate was detected in 2005 – 10.1 per 100 thousand population, and the lowest in 2020 – 1.0 per 100 thousand population. The share of the vector-borne mechanism was 78.4%, the unidentified path – 20.1%, alimentary – 1.5%. Analysis of the seasonal distribution of cases of TBE showed that the incidence is recorded from April to November. Cases of TBE were recorded in all age groups, including the child population. Most often, people aged 60 years old and older (24.6%) were ill with TBE. Among the children's population, the largest share fell on children aged 7–14 years (5.4%). Men of working age prevailed among the patients (66.0%). TBE was mainly registered among the unvaccinated population (81.5%) with a predominance of urban (86.1%). Officials predominated among the sick persons – 29.8%, pensioners made up 22.3%, unemployed – 19.8%. Persons whose work is professionally connected with the forest made up only 0.6%. The ongoing program of mass vaccination of TBE has led to a decrease in the proportion of severe and moderate forms of diseases (focal – 9.8% and meningeal – 24.0%) and an increase in the proportion of febrile (33.8%) and atypical forms (32.4%). Deaths during the studied period were recorded mainly among the adult unvaccinated population.Conclusions. The Sverdlovsk district continues to be a tense natural focus of TBE with a constantly recorded incidence among contingents of different age and social groups. In the absence of highly effective etiotropic drugs for the treatment of TBE, the only strategy for reducing the incidence of TBE, the development of severe forms and deaths in the territory of the Sverdlovsk district is mass vaccination of the population.
的相关性。尽管斯维尔德洛夫斯克地区20多年来一直在进行大规模接种蜱传脑炎(TBE)的计划,但TBE的发病率继续超过俄罗斯和乌拉尔联邦区的平均水平。在20年(2002-2021年)计划接种疫苗的情况下,分析斯维尔德洛夫斯克州境内乙脑流行过程表现的主要指标。材料和方法。本文使用的数据来自联邦和地区统计观察,2002-2021年斯维尔德洛夫斯克地区Rospotrebnadzor部门的报告材料,统计分析方法。结果和讨论。在研究期间(2002-2021年),斯维尔德洛夫斯克地区登记了3861例TBE病例,2005年发现的发病率最高,为每10万人10.1例,2020年最低,为每10万人1.0例。病媒传播机制占78.4%,途径不明占20.1%,消化道感染占1.5%。对TBE病例的季节分布分析表明,发病时间为4 - 11月。在包括儿童在内的所有年龄组中都记录了TBE病例。最常见的是60岁及以上的人(24.6%)患有TBE。在儿童人口中,7-14岁的儿童所占比例最大(5.4%)。患者中以工作年龄男性为主(66.0%)。TBE主要发生在未接种疫苗人群中(81.5%),以城市人群为主(86.1%)。官员在病人中占主导地位,占29.8%,养老金领取者占22.3%,失业者占19.8%。从事与森林有关的专业工作的人数仅占0.6%。正在进行的流行性脑炎大规模疫苗接种计划已导致严重和中度形式的疾病比例下降(局灶性- 9.8%,脑膜- 24.0%),发热形式(33.8%)和非典型形式(32.4%)的比例增加。研究期间的死亡主要发生在未接种疫苗的成年人群中。斯维尔德洛夫斯克地区仍然是俄罗斯联邦的一个紧张的自然焦点,不同年龄和社会群体的特遣队不断记录发病率。在缺乏治疗TBE的高效致病性药物的情况下,在斯维尔德洛夫斯克州境内减少TBE发病率、严重形式的发展和死亡的唯一战略是大规模接种人口疫苗。
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引用次数: 0
Coronavirus XBB.1.5 as an Indicator of the Long-Term Continuation of the Covid-19 pandemic. What Next for Vaccination? 冠状病毒XBB.1.5作为Covid-19大流行长期持续的指标疫苗接种的下一步是什么?
Pub Date : 2023-05-07 DOI: 10.31631/2073-3046-2023-22-2-12-22
E. P. Kharchenko
The article discusses the properties of the pandemic strain XBB.1.5 S protein in comparison with the 1918 and 2009 pandemic strains hemagglutinin H1. The S-protein XBB.1.5 already contains more than 40 mutations realized by substituting different amino acids through single and dinucleotide substitutions, deletions and the use of predominantly transversions. The variability of H1N1 influenza virus hemagglutinin is associated with single nucleotide substitutions at a constant length. Conditional extrapolation of influenza virus hemagglutinin variability data on coronavirus S-protein sizes suggests that new pandemic strains will emerge in the next 2-3 years, avoiding the immune defense formed by vaccination against the strains preceding them. The inability to create through the adaptive immune system a long-term immunity to pandemic coronaviruses, as well as to other respiratory viruses with a short incubation cycle, puts on the agenda the need to find new vaccine designs that provide a combination of long-term adaptive and trained immunity. The problem in the search for such vaccines is associated with the regulation of the activity of the innate immune system and ensuring the stability of trained immunity.
本文讨论了大流行毒株XBB.1.5 S蛋白与1918年和2009年大流行毒株血凝素H1的特性。s蛋白XBB.1.5已经包含了40多个突变,这些突变是通过单核苷酸和二核苷酸替换、缺失和主要使用翻转来取代不同的氨基酸而实现的。H1N1流感病毒血凝素的变异与恒定长度的单核苷酸替换有关。根据流感病毒血凝素变异数据对冠状病毒s蛋白大小的条件外推表明,新的大流行毒株将在未来2-3年内出现,避免对之前毒株接种疫苗形成的免疫防御。由于无法通过适应性免疫系统产生对大流行性冠状病毒以及其他潜伏期较短的呼吸道病毒的长期免疫,因此需要寻找能够提供长期适应性免疫和训练免疫相结合的新疫苗设计。寻找此类疫苗的问题与调节先天免疫系统的活性和确保训练免疫的稳定性有关。
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引用次数: 0
Standards for the Epidemiological Investigation of Measles and Rubella Foci 麻疹、风疹疫源地流行病学调查标准
Pub Date : 2023-05-07 DOI: 10.31631/2073-30462023-22-2-4-11
O. Tsvirkun, N. Tikhonova, A. Gerasimova, N. Turaeva, L. Barkinkhoeva, N. Briko
In practical medicine, standards for the provision of therapeutic and preventive care have been used for a long time, but in epidemiology this concept has not yet been reflected in regulatory documents. Epidemiologists need a standard of epidemiological investigation of cases of measles and rubella infection, which must be eliminated. The use of specific terms, the interaction of specialists of various profiles, the emphasis on the classification of the case – «local», «imported from the territory of another state», «imported from another territory of Russia», the need to assess the degree of secondary spread of infection imposes its own characteristics on the epidemiological investigation of measles and rubella cases. The use of standards would optimize this process, prevent errors and minimize the time of localization and elimination of the outbreak.The standard of epidemiological investigation of measles and rubella cases consists of three independent sections, such as examination of the focus, laboratory examination of patients and directions of information flows between medical organizations and organizations of the sanitary and epidemiological service. The main parameters of the epidemiological examination of a measles/rubella outbreak are — person, time, place, contacts; this is the sequence provided for when collecting and analyzing identification and epidemiological information about the patient. The laboratory research section determines the implementing organization, the type of clinical sample, taking into account the research method, the timing of taking the material for research, the volume, frequency, time of delivery of the material to the laboratory and the timing of obtaining the result. The epidemiological investigation ends with the execution of a number of documents, such as the «Map of the epidemiological examination of the focus of an infectious disease», «The Act of investigation with the establishment of cause-and-effect relationships», as well as the control of anti-epidemic measures. The model of the direction of information flows provides for the order of interaction of various organizations: the movement of reports, clinical samples, research results and «Maps of epidemiological examination of the focus of an infectious disease», etc., as well as regulated deadlines for the implementation of measures. Since the standard is a single, binding scheme of actions, the practical application of the standard of epidemiological investigation of measles and rubella will allow collecting and processing information in a single format throughout the country.
在实际医学中,提供治疗和预防保健的标准已经使用了很长时间,但在流行病学中,这一概念尚未反映在规范性文件中。流行病学家需要对麻疹和风疹感染病例进行标准的流行病学调查,必须消除这种情况。具体术语的使用,不同背景专家的互动,对病例分类的强调-“本地”,“从其他国家领土输入”,“从俄罗斯其他领土输入”,需要评估感染的二次传播程度,这给麻疹和风疹病例的流行病学调查带来了自己的特点。使用标准将优化这一过程,防止错误,并最大限度地缩短定位和消除疫情的时间。麻疹和风疹病例流行病学调查标准由三个独立的部分组成,如焦点检查、患者实验室检查和医疗机构与卫生和流行病学服务机构之间的信息流动方向。麻疹/风疹暴发流行病学检查的主要参数为:人、时间、地点、接触者;这是在收集和分析有关患者的鉴定和流行病学信息时提供的顺序。实验室研究部门决定实施机构、临床样本的类型,考虑到研究方法、研究材料的时间、材料到实验室的数量、频率、时间和获得结果的时间。流行病学调查结束时,执行了一些文件,如《传染病集中流行病学检查图》、《确定因果关系的调查法》以及防治流行病措施的控制。信息流方向模式规定了各组织之间的相互作用顺序:报告、临床样本、研究结果和“传染病集中流行病学检查图”等的流动,以及规定了执行措施的最后期限。由于该标准是一项具有约束力的单一行动计划,麻疹和风疹流行病学调查标准的实际应用将允许在全国范围内以单一格式收集和处理信息。
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引用次数: 0
Features of the epidemic process and epidemic risks of COVID-19 in the subjects of the Northern Caucasus 北高加索地区新型冠状病毒病流行过程特征及流行风险
Pub Date : 2023-03-05 DOI: 10.31631/2073-3046-2023-22-1-74-81
V. Makhova, O. Maletskaya, A. Kulichenko
Relevance. The peculiarities of the course of the COVID-19 epidemic process in the regions of the world, as a rule, are determined by the epidemic risks characteristic of them. Identification and evaluation of the latter is necessary to improve measures to counter infection in a particular area. Aim. To study the features of the COVID-19 epidemic process in the regions of the North Caucasus, to identify and assess the impact of epidemic risk factors on the epidemic situation. Materials and methods. The data of the Departments of Rospotrebnadzor for the subjects of the North Caucasus, Internet resources: stopkoronavirus were used Russia, Johns Hopkins University and Our World in Data project. Statistical processing was carried out using methods of variation statistics and MS Excel software package (2016, USA). Correlation analysis was performed using Spearman's coefficient. Results. As of 01.12.2021, the incidence of COVID-19 in the Caucasus was lower than the Russian average (3890.0 and 65921.8 per 100 thousand population), and the mortality rate was higher (4.8 and 1.9%, respectively). The dynamics of the epidemic process as a whole repeated the situation in the Russian Federation, but with a delay of each phase by 2–3 weeks and had 4 periods of rising morbidity (waves), with the exception of the Stavropol Territory, the Republics of Adygea and Ingushetia, where three waves of morbidity were observed. In the Republics of Dagestan, Chechen and Adygea, a high proportion of community-acquired pneumonia was noted - 58.8, 47.0 and 34.1%, respectively. The mortality rate from a new coronavirus infection was higher than the national average in Dagestan (in the period of the 1st wave – 4.7%), Krasnodar Krai (in the period of the 2nd wave – 5.0%; 3 – 12.6%, in 4 – 9.9%), Karachay-Cherkess Republic (in the 3rd period of the rise – 9.0%) and in Stavropol Krai (in 4 – 7.6%). The lowest mortality from COVID-19 in the 3rd and 4th periods of the rise in morbidity in the North Caucasus was registered in Ingushetia – 2.2 and 2.1%, respectively. The exceptional situation in the Republic of Dagestan is due not only to a large proportion of community acquired pneumonia and high mortality from COVID-19, compared with other regions of the North Caucasus and Russia as a whole, but also to an increase in excess mortality in the republic. The excess of the average annual (over the previous 5 years) number of deaths in the Caucasus in 2020 was +19.8%, in 2021 +32.7%, in the Russian Federation as a whole 14.8 and 31.4%, respectively. Conclusion. The general epidemic risks of COVID-19 for the North Caucasus region have been identified – the level of vaccination, the implementation of non–specific prevention measures, as well as local risks for specific regions: in Dagestan – adherence to local mass ceremonies, as well as insufficient control over the implementation of restrictive measures, in Ingushetia – relatively high population density.
的相关性。新冠肺炎疫情在世界各地区传播过程的特殊性,通常是由各地区的疫情风险特征决定的。对后者进行识别和评价对于改进特定地区的抗感染措施是必要的。的目标。研究北高加索地区新冠肺炎疫情过程特征,识别和评估疫情危险因素对疫情的影响。材料和方法。北高加索地区各部门的数据、互联网资源:stopkoronavirus使用了俄罗斯、约翰霍普金斯大学和Our World in data项目。采用变异统计方法和MS Excel软件包(2016,美国)进行统计处理。采用Spearman系数进行相关分析。结果。截至2021年12月1日,高加索地区的COVID-19发病率低于俄罗斯平均水平(每10万人口3890.0例和65921.8例),死亡率较高(分别为4.8%和1.9%)。整个流行病进程的动态与俄罗斯联邦的情况相同,但每一阶段延迟2-3周,发病率有4个上升阶段(波),但斯塔夫罗波尔领土、亚的亚共和国和印古什共和国除外,它们观察到三波发病率。在达吉斯坦共和国、车臣共和国和亚的亚共和国,社区获得性肺炎的比例很高,分别为58.8%、47.0%和34.1%。新型冠状病毒感染的死亡率高于达吉斯坦(第一波期间为4.7%)、克拉斯诺达尔地区(第二波期间为5.0%)的全国平均水平;3 - 12.6%, 4 - 9.9%),卡拉恰伊-切尔克斯共和国(第三期上升- 9.0%)和斯塔夫罗波尔边疆区(4 - 7.6%)。在北高加索地区发病率上升的第三和第四阶段,印古什地区的COVID-19死亡率最低,分别为2.2%和2.1%。达吉斯坦共和国的特殊情况不仅是因为与北高加索其他地区和整个俄罗斯相比,社区获得性肺炎的比例很高,COVID-19的死亡率也很高,而且还因为共和国的超额死亡率有所上升。高加索地区2020年的年平均死亡人数比(前5年)高出19.8%,比2021年高出32.7%,比整个俄罗斯联邦高出14.8%和31.4%。结论。已经确定了北高加索地区2019冠状病毒病的总体流行风险——疫苗接种水平、非特异性预防措施的实施,以及特定地区的地方风险:在达吉斯坦,遵守当地的大规模仪式,以及对实施限制性措施的控制不足;在印古什,人口密度相对较高。
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引用次数: 0
Features of the Formation of Seroprevalence to SARS-CoV2 in the Population of the Republic of Tatarstan during the Spread of COVID-19 COVID-19传播期间鞑靼斯坦共和国人群SARS-CoV2血清阳性率形成特征
Pub Date : 2023-03-05 DOI: 10.31631/2073-3046-2023-22-1-13-21
I. Reshetnikova, E. Agafonova, N. Khakimov, Yury A Tyurin, N. D. Shaуkhrazieva, V. B. Ziatdinov
Relevance. It is relevant to study the features of the formation and duration of the humoral immune response to a new coronavirus infection in a high-risk group of infection - among medical workers. Aims. To study the dynamics of the levels of specific antibodies (IgM and IgG) to SARS-CoV2 in unvaccinated MRs of the temporary infectious diseases hospital to assess the trends of the individual humoral immune response to a new coronavirus infection. Materials and methods. We monitored IgM and IgG to SARS-CoV-2 in 68 unvaccinated healthcare workers monthly from July 2020 to July 2021 by two-stage direct solid-phase ELISA using the test systems «SARS-CoV-2-IgG-ELISA-BEST» and «SARS-CoV-2-IgM-ELISA-BEST», Russia. Among them, there were 26.5% men and 73.5% women, the average age was 43.5 ± 1.51 years, doctors 52.9%, paramedical personnel 36.8% and junior staff 10.3%. 69.1% had a history of clinical manifestations of COVID19, among them 42.7% had a mild infection, 20.6% had a moderate infection, and 5.9% had a severe infection, 30.9% were asymptomatic. Statistical processing were carried out using the methods of variation statistics using the Excel statistical package and the WinPepi software product (version 11.65). Results. A decrease in the geometric mean value of IgM titers to SARS-CoV-2 (average monthly decrease of 6.40%) and an increase in the geometric mean value of IgG titers (average monthly increase of 4.26%). An individual assessment of the dynamics of antibodies from the day with the first positive result showed a decrease in the geometric mean values of antibody titers and IgM and IgG to SARS-CoV-2 (monthly average decrease of -23.56% and -1.18%, respectively). An individual assessment of the immune response made it possible to distinguish three groups according to the dynamics of IgM: M0 -IgM in the blood were absent (50 ± 5.7446%); M1 -IgM persisted for        1–2 months, followed by a rapid decrease in titer (16.176 ± 3.7943%); M2 – IgM remained in the blood for three or more months (33.824 ± 5.1033%). By the nature of the dynamics of IgG MR were divided into four troupes. With a downward trend in IgG titer: G0 – IgG does not exceed 95% of the upper confidence limit of the individual trend in any of the samples taken (19.118 ± 4.7686%), G1 – does not exceed 95% of the upper confidence limit of the individual trend starting from 3 months after the start observations (4.412 ± 2.4903%), G2 – there is an excess of 95% of the upper confidence limit of the individual trend starting from 3 months after the start of observation (69.118 ± 5.6027%); G3 – with a trend of increasing IgG titer (7.353 ± 3.1651%). Сonclusions. The results of serological monitoring as a whole indicate the formation of herd immunity in this cohort. Monitoring the intensity of the individual immune response to SARS-CoV-2 throughout the year reflects the natural course of the infectious process and is the basis     for vaccination against COVID-19. The results of serologic
的相关性。研究新型冠状病毒感染高危人群——医务人员体液免疫反应的形成和持续时间的特点具有重要意义。目标目的研究临时传染病医院未接种SARS-CoV2疫苗的MRs患者特异性抗体(IgM和IgG)水平的动态变化,以评估个体对新型冠状病毒感染的体液免疫反应趋势。材料和方法。从2020年7月至2021年7月,我们使用俄罗斯的“SARS-CoV-2-IgG- best”和“SARS-CoV-2-IgM- best”检测系统,每月对68名未接种疫苗的卫生工作者进行SARS-CoV-2 IgM- IgG和IgM-ELISA检测。其中男性占26.5%,女性占73.5%,平均年龄为43.5±1.51岁,医生占52.9%,辅助医务人员占36.8%,初级医务人员占10.3%。69.1%有新冠肺炎临床表现史,其中轻度感染占42.7%,中度感染占20.6%,重度感染占5.9%,无症状者占30.9%。利用Excel统计软件包和WinPepi软件产品(11.65版本),采用变异统计的方法进行统计处理。结果。对SARS-CoV-2的IgM滴度几何平均值下降(月平均下降6.40%),IgG滴度几何平均值上升(月平均上升4.26%)。对首次出现阳性结果当日的抗体动态进行的个体评估显示,抗体滴度以及对SARS-CoV-2的IgM和IgG的几何平均值下降(月平均分别下降-23.56%和-1.18%)。免疫反应的个体评估可以根据IgM的动态区分三组:血液中M0 -IgM缺失(50±5.7446%);M1 -IgM持续1 ~ 2个月,随后滴度迅速下降(16.176±3.7943%);M2 - IgM在血液中存在3个月以上(33.824±5.1033%)。根据IgG MR的动力学性质分为四组。与免疫球蛋白效价下降的趋势:G0 -免疫球蛋白不超过95%的置信上限的个人趋势的样本(19.118±4.7686%),G1 -不超过95%的个人的信心上限趋势从3个月后开始观测(4.412±2.4903%),G2 -有超过95%的置信上限的个人趋势从开始的3个月后观察(69.118±5.6027%);G3 - IgG滴度呈上升趋势(7.353±3.1651%)。Сonclusions。血清学监测结果总体上表明该队列已形成群体免疫。全年监测个体对SARS-CoV-2的免疫反应强度反映了感染过程的自然过程,是接种COVID-19疫苗的基础。血清学监测结果可用于预测流行病学情况、规划特异性和非特异性COVID-19、个性化疫苗接种。
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引用次数: 0
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Epidemiology and Vaccinal Prevention
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