The key questions to solve the problem of congenital infection in the Russian Federation are: using in national practice over world accepted terminology adapted to the recommendations of the World Health Organization; representation of the modern concepts of an infectious process in the classification of congenital infections; scientific development and introducing in clinical practice the «standard case definitions», applied to different congenital infections; optimization of protocols and clinical guidelines for diagnosis, treatment and prevention of congenital infections; improvement a knowledge in the infectious disease for all  pecialists involved in the risk assessment of congenital infections, manage pregnancy and children. Based on our experience and analysis of publications, the authors suggest possible solutions.

The review provides information on a new zooanthroponosis – Nipah encephalitis. Characteristics of the pathogen and its ecology and clinic are presented. The purpose of the review is to get Russian specialist acquainted with new dangerous disease unknown in Russia. The research method – analytical. Infection by humans were first described in Malaysia (1999), after in Bangladesh (2004) and India (2006). The causative agent was identified as a new member of paramyxoviruses and then, together with related Hendra virus, separated in a new genus Henipavirus of the family Paramyxoviridae (2000). Reservoir in nature – fruit bats, predominantly carnivorous flying foxes of 8 species of the genus Pteropus, secondary reservoir – domestic pigs. Nipah virus is highly contagious for humans and swine. The last act as amplifying and reservoir host. The disease in
humans is characterized by symptoms and signs of acute encephalitis and pulmonary insufficiency. Rapidly developing coma, lethality – up to 92,0%. Outbreaks with transmission of the virus from person-to-person are known. Specific treatment has not been developed, prevention is nonspecific.

The article presents the problems of modern antiviral therapy of chronic hepatitis C. The effectiveness of combined therapy with pegylated interferon and ribavirin in patients infected with 1st genotype is not more than 50%. Inclusion in the therapy HCV’s protease inhibitors (telaprevir and boceprevir) increases the sustainable virological response in patients with the 1st genotype, but this treatment is more expensive and accompanied by more serious complications. There is a large group of patients in Russia, who can’t have got such treatment because of its high cost. The results of clinical studies in application of betaleukin (recombinant IL-1β) in combined antiviral therapy of chronic hepatitis C also are analyzed.

The history of the department of infectious diseases at North-Western State Medical University named after I.I. Mechnikov since its foundation to the present day is presented in this article. Key issues of educational-methodical, scientific and medical work of the department in different historical periods are highlighted.

Objective. To evaluate the distribution of markers of infectious agents in umbilical cord blood samples Pokrovskij public stem cell bank donor registry for five years (2009 – 2013).

Materials and Methods. 3533 plasma samples were investigated
after selection during cord blood processing procedure for allogeneic use in Pokrovskij stem cell bank. All plasma samples were investigated in accordance with the Order of the Ministry of Health № 325 – 2003 by enzymelinked immunoassay method. In addition, during the period from November 2011 to December 2013 1030 plasma samples of umbilical cord blood were examined for the presence of HCV RNA, the RNA of HIV and HBV DNA.

Results. Markers of the agents above have not been found in the plasma of 481 samples (13.6%). During the described period, no significant change in the share of samples containing antibodies to cytomegalovirus and toxoplasmosis (cytomegalovirus – 1978 samples (56%), Toxoplasma gondii – 112 samples (3.2%), 825 samples (23.4%) cytomegalovirus and Toxoplasma gondii simultaneously) were registered. 137 samples (3.9%) were subjected to utilization in connection with detection of antibodies to HbcorAg – 116 samples (3.3%), antibodies to HCV – five samples (0.14%), and antibodies to Treponema pallidum – 16 samples (0.45%).

Conclusion. The introduction of an additional method of polymerase chain reaction for the detection of nucleic acids of hepatitis viruses B, C, human immunodeficiency virus, along with study of cord blood samples by enzyme-linked immunoassay improve the quality of the control of the transmission of blood-borne infections.

Introduction: Despite on mandatory vaccination against rubella, the amount of pregnant women without immunity to rubella may exceed 20%. These women represent a risk group for the rubella disease.

Objectives: The goals of the presented work are to analyze the cases of anti-rubella IgM detection in pregnant women, and to develop an algorithm for management of such patients.

Materials and Methods: Screening has been performed by ELISA test systems company Radim (Italy). In total 799 patients were examined for rubella in 2013, 56 of them were pregnant women.

Results. Positive IgM antibodies to rubella in 2013 have been identified in 5 cases, including 4 pregnant women. A detailed analysis of medical history, clinical and laboratory data has been done. In none of these cases the diagnosis of rubella has been confirmed.

Conclusions. The main criterion for the diagnosis of rubella in pregnant women with rubella markers in the absence of clinical symptoms must be a dynamic examination, including study on IgM- and IgG-antibodies to rubella virus. The study must be conducted in the same laboratory at intervals of 10–14 days. In most cases, determination of IgG-antibodies avidity helps to estimate the time of infection. In complicated cases it is recommended to use PCR and immunoblot.

In the territory of the Omsk region HIV infection and tuberculosis at patients come to light at the same time (61,0%) more often. Combination of these two infectious diseases men (81,5%), aged from 30 till 39 years (45,0%) at which the parenteral way of infection (87,3%) HIV infection prevailed are subject to a thicket. Tuberculosis, in this group of patients came to light at early stages of HIV infection (74,5%) that affected frequent percent of infiltrative tuberculosis of lungs (45,5%). Among patients tuberculosis in a combination HIV infection the low motivation to treatment met, however at an assessment of efficiency of treatment of tuberculosis data similar to those at patients with the isolated tuberculosis were obtained. From treatment we explain good effect with a combination of antitubercular therapy with antiretrovirus.

The objective. To study etiological structure of acute respiratory viral diseases in the hospitalized patients of different age groups and to reveal their peculiarities in children and adults, as well as in adults of draft age (18–26 years) among civilians and military recruits.

Materials and methods. 2202 in patients with acute respiratory diseases of moderate and severe degree, including 1123 patients (51.0%) aged up to 18 years and 1079 patients (49,0%) aged 18 years and above, were examined during the epidemic season since September 2013 till July 2014. RNA or DNA of influenza A(H1N1)pdm09 and A(H3N2), influenza B, types 1–4
parainfluenza, adenoviruses, respiratory syncytial virus, rino-, metapneumo-, corona-, entero- and boca- viruses were determined
in nasopharyngeal swabs, sputum and brohchoalveolar lavage by real time PCR method. Significance of differences (p<0,05) in cases incidence of compared independent groups were assessed by the Pearson,s χ2 (chi-squared) test.

Results. Genetic material of viruses causing ARD was revealed in 1343 cases (61,0%). Influenza viruses A and B (30,3%), RS viruses (23,6%), rinoviruses (22,8%) and adenoviruses (12,5%) prevail among ARD viral pathogens. The parainfluenza virus infection was laboratory confirmed in 8,7%, coronavirus – in 4,4%, bocavirus – in 1,2%, enterovirus – in 0,7% of cases. Assessment of age-related features of ARD etiologic structure showed that RS virus (37,6%, p<0,05) and parainfluenza virus (11,3%, p<0,05) infections were registered significantly often among children. Influenza viruses (46,4%, p<0,05), adenovirus (26,3%, p<0,05) and rinovirus (25,7%, p<0,05) were verified significantly often among adults. Etiologic ARD structure of military personnel 18–26 years old was characterized by significant prevalence of adenovirus infection (53,9%, p<0,05).

Conclusion. The study has shown that acute respiratory diseases caused by RS and parainfluenza viruses predominated among children, by influenza viruses – among adults (civilians) and by adenovirus – among military personnel.

Aim: to analyze leptin and adiponectin serum levels in patients with chronic hepatitis C in comparison with metabolic syndrome components, biochemical features and stage of hepatitis.

Materials and methods: In 93 patients with chronic HCV in age 20-55 with a few symptomatic HCV-infection and minimal liver fibrosis stage serum leptin and adiponectin was measured. Associations between leptin, adiponectin and metabolic abnormalities, biochemical features, and hepatic fibrosis were determined.

Results: Abdominal obesity was revealed at 40% patients, overweight – at 41%, insulin resistance – at 36,6% cases. The leptin and adiponectin levels were within normal limits range at most patients. Patients with minimal liver fibrosis had higher index of leptin by comparison to patients with moderate and severe fibrosis (r= – 0,402, р= 0,018). In patients with HCV genotype 3a the adiponectin level was below, than in HCV genotype 1b. Patients with abdominal obesity and overweight had higher leptin and lower adiponectin indexes by comparison to patients without these metabolic abnormalities. Direct cross-correlation between the leptin level and body mass index (r=0,358, p=0,001), waist circumference (r=0,292, p=0,01); negative cross-correlation between the adiponectin level and body mass index (r=- 0,435, р <0,021), waist circumference (r=- 0,386, р =0,001) were displayed.

Conclusion: Leptin and adiponectin blood levels in HCVpatient
is associated with abdominal obesity and overweight. The connection of leptin level and liver fibrosis stage was revealed. Difference of adiponectin level in HCV-patients with 3a and 1b genotypes of virus was found.

Purpose. The aim of the study was to estimate the efficiency and economic feasibility of prescribing systemic enzyme therapy in the composition with standard etiotropic and pathogenetic therapy of erysipelas of lower extremities.

Materials and methods. For this purpose, 62 patients with erysipelas of lower extremities were investigated. Standard therapy (antibiotics, non-steroids, anti-inflammatories) was administered in the 1th group of patients (n=32), patients of the 2th group (n=30) received natural systemic proteolytic enzymes within the acute period of disease additionally to the basic scheme of therapy. The clinic-economic parameters such as cost of illness and the indicator “cost-efficiency” were estimated.

Results. The study has revealed the clinic and economic efficiency of systemic enzyme therapy in the combination therapy of erysipelas, which was confirmed by significant reduction of duration of in-patient treatment and decreasing the rate of recurrence of the disease, reduction of the full cost of the disease and the level of cost-effectivenes.

Conclusion. Use of systemic enzymes is economically feasible and can reduce the full cost of treatment andincrease its efficiency

In 2013 after two previous years when the situation had been calm the incidence rates of enterovirus infection significantly increased on certain territories of the North-West of Russia. In Novgorod and Vologda regions and in Saint-Petersburg enterovirus meningitis group cases were registered. The etiology of enterovirus infection was studied by virological and molecular methods. Enterovirus ECHO30 was identified as the principal etiological agent of the cases. Molecular study revealed that enteroviruses ECHO30 isolated in the North-West of Russia belonged to the genotype H and formed two subtypes inside this genotype. Phylogenetic analysis has shown that enteroviruses ECHO30 of both subtypes were closely related to the strains detected in different provinces of China in 2010-2013. Probably enteroviruses ECHO30 of the genotype H which largely circulated in Russia in 2013 and practically had not been detected in the country earlier had been imported on the territory of Russia from South-East Asia. Enteroviruses ECHO30 isolated in  Arkhangelsk and Novgorod regions in 2008-2009 belonged to another genotype Ec2. Enteroviruses of this genotype had circulated at that time in the European countries.