[PROBLEMS TOWARDS MEASLES ELIMINATION IN RUSSIAN FEDERATION].

Introduction of live measles vaccines into daily practice resulted in a pronounced reduction of measles morbidity in many countries, that allowed WHO to develop the measles eradication program. Russian Federation has commenced realization of the eradication program for local measles cases in the country, (measles elimination) in 2002. and had achieved significant success by 2007. For 4 years (2007 -2010) the parameter of measles morbidity in Russian.Federation did not exceed the WHO measles elimination criteria - no more than 1 measles case per 1 million population. However, the situation for measles began to deteriorate from 2011, reflecting the growth of measles morbidity in many regions of the world. The main reason for measles morbidity growth was accumulation of a contingent,of individuals not immunized against measles against the background of internal and external population migration. Under the condition ofconstant maintenance of a high vaccination coverage of the population (above 95%) on thewhole territory of Russia, the objective of measles elimination in the country can be successively met.

[Epidemiologic control for rubella in pregnant women].

AIM: Evaluate effectiveness of measures specified by epidemiologic control for rubella in pregnant women. MATERIALS AND METHODS: 585 pregnant women with suspected measles were laboratory examined in 10 Regional Centers of Control for Measles and Rubella by EIA. RESULTS: 24 rubella infected pregnant women aged 16-36 years were detected among the examined pregnant women, most of those (91.7%) were either not immunized against rubella or had unknown immunization anamnesis: 16 women terminated pregnancy, in 8 women pregnancy ended with delivery at term. Of the 8 newborns only a single child had innate rubella infection (the child was clinically healthy). CONCLUSION: Epidemiologic investigation of each rubella case in pregnant women with obligatory laboratory examination of women and source of infection revealed a significant number of women at childbearing age susceptible to rubella virus that retains the possibility of birth of children with innate rubella syndrome.

[Tactics of measles epidemiologic surveillance during elimination period].

AIM: Evaluation of effectiveness of new tactics of measles epidemiologic control in measles elimination in Russian Federation. MATERIALS AND METHODS: Analysis of active search of measles patients among patients with fever and maculopapular rash is presented. Range of primary diagnosis and rate of detection of measles cases is studied. 45 cards of measles patients were analyzed, that were actively detected by taking age and measles anamnesis into account. RESULTS: A reasonable evidence of absence of measles cases in most of the territories of Russian Federation was obtained by active search of measles patients among patients with fever and maculopapular rash. Moreover, active epidemiologic control increases the results of routine epidemiologic control, significance of which increases by many times during measles elimination, and this requires strict adherence to principles of the control. CONCLUSION: By using the tactics of active epidemiologic control a true number of measles cases may be determined, and absence of measles in the region maybe confirmed. Results of active epidemiologic control are reasonable evidence of achievement of elimination phase in the country.

Enhanced surveillance for measles in low-incidence territories of the Russian Federation: defining a rate for suspected case investigation.

The rate of case investigation for measles-like illness (MLI) is an important indicator for the quality of measles surveillance in countries targeting measles elimination. However, a benchmark rate is still being discussed. We assessed different rates of investigation in 11 territories of the Russian Federation with low reported measles incidence during the previous 4-7 years. Each territory maintained their existing surveillance activities and also undertook additional surveillance activities for MLI over a 3-year period. The annual routine rate of investigation varied from 0·06 to 1·8/100,000 population; the overall rate of investigation, including enhanced surveillance, varied from 1·4 to 7·2/100,000. Forty-nine (30·8%) of 159 measles cases detected were identified through enhanced surveillance. Based on the results of this study, the Russian Federation concluded that a rate of routine investigation of 2/100,000 provided the best balance between available resources and sensitivity for detection of measles cases.

Phylogenetic analysis of human parvovirus b19 sequences from eleven different countries confirms the predominance of genotype 1 and suggests the spread of genotype 3b.

Phylogenetic analysis of 166 human parvovirus B19 sequences from 11 different countries attributed 91.57% to genotype 1, 5.42% to genotype 3b, and 3.01% to genotype 3a. Very similar viruses of genotype 1 circulated widely in Europe and Israel. Genotype 3b seems to show an increasing spread outside of Africa.

Genetic variability of wild-type measles viruses, circulating in the Russian Federation during the implementation of the National Measles Elimination Program, 2003-2007.

Genetic characterization of wild-type measles viruses (MVs) is an important component of laboratory surveillance of measles. In this study, a phylogenetic analysis was performed of the nucleoprotein gene sequences of 228 MVs isolated in the Russian Federation between 2003 and 2007. Five genotypes, D4, D5, D6, D8, and H1, were detected. From 1999 through the first 6 months of 2003, the most prevalent genotype in the European part of Russia was D4. All genotype D4-type viruses were closely related to each other (with overall sequence diversity of