[Postvaccinal immunity and immunological aspects of Haemophilus influenzae carrier state in children of different age groups after the administration of "Act-HIB" vaccine]. / Postvaktsinal'nyi immunitet i immunologicheskie aspekty bakterionositel'stva Haemophilus influenzae u detei razlichnykh vozrastnykh grupp posle vvedeniia vaktsiny "Akt-khib".

The article deals with H. influenzae (different serotypes) carrier state and immune response before and after the administration of the vaccine "Act-HIB" to children of different age groups. Children aged up to 1 year and over 1 year have been found to differ in the dynamics of carrier state and in the concentration of antibodies of different classes to the antigens of this infective agent, which makes it necessary to carry out their early immunization with a view to ensure their protection from H. influenzae infection.

[Diagnostic value of different laboratory methods in the diagnosis of pneumonia caused by Haemophilus influenzae type B]. / Diagnosticheskaia tsennost' razlichnykh metodov laboratornoi diagnostiki pnevmonii, obuslovlennoi Haemophilus influenzae tipa B.

Comparative analysis of the diagnostic value of different laboratory methods in the diagnosis of H. influenzae b (Hib) pneumonia in children (bacteriological method, latex agglutination, counter immunoelectrophoresis, the passive hemagglutination test and the enzyme immunoassay (EIA) was carried out. EIA proved to be the most informative method for the diagnosing Hib pneumonia. EIA makes it possible to detect specific Hib antigens in different clinical materials in 48.8% of cases, as well as high titers of antibodies to mis infective agent in 61.7% of cases. The authors propose the unified criteria of the laboratory diagnosis of Hib infection in children.

[An analysis of the epidemic cycle of meningococcal infection in Russia (1969-1993)]. / Analiz épidemicheskogo tsikla meningokokkovoi infektsii v Rossii (1969--1993).

In this work the specific features of the epidemiological rise of morbidity in meningococcal infection in Russia for the period of 25 years are analyzed. Some factors influencing the intensity of the disease, such as etiology, specific features arising from the age of patients, social and territorial factors, are analyzed. Two waves of epidemic have been established in a single epidemic cycle. The first wave of epidemic was caused by meningococci of group A and characterized by the prevalence of city-dwellers among the patients; the second wave was caused by meningococci of groups A and B with the prevalence of the latter, especially during the period of the slump of the wave. The "Asiatic" and "European" types of morbidity were distinguished (in Moscow and St. Petersburg). The analysis of the epidemic cycle of meningococcal infection indicates the expediency of the development of new specific wide-profile preparation for prophylaxis.

[The serosubtyping of serogroup B meningococci]. / Serosubtipirovanie meningokokkov serogruppy B.

The results of the study of 116 Neisseria meningitidis strains, isolated from patients at different territories of Russia at the period of 1983-1992, by the method of the enzyme immunoassay are presented. 13.8 +/- 3.2% of the strains were found to have stereotype proteins and 59.5 +/- 4.5%, subtype proteins. In the population of circulating meningococcal strains no absolute prevalence of any single serotype or subtype was established. The comparison of the tendency in the course of morbidity rate and the state of the serosubtype composition of isolated group B N. meningitidis stains is indicative of the favorable situation with respect to meningococcal infection and the importance of further observation of the circulating strains.

[The comparative characteristics of the vaginal microflora in parturient women who are carriers of Streptococcus serogroup B and in those who are free of carriage]. / Sravnitel'naia kharakteristika mikroflory vagalishcha rozhenits--nositelei streptokokkov serogruppy B i svobodnykh ot nositel'stva.

In the study of vaginal microflora in parturient women, carriers of group B streptococci (GBS), and those free of carriership a wide range of microorganisms, represented by aerobic and anaerobic species with the prevalence of lactobacteria in both groups of women, was isolated. The composition of vaginal microflora in parturient women did not depend on the presence of GBS in this biotope or on the level of colonization by lactobacteria. The colonization resistance (CR) of the vaginal mucosa had essential influence of the level of carriership with respect to GBS and a number of representatives of the symbiotic microflora of this locus. In the majority of cases GBS were isolated from parturient women with low CR.

[The type subtyping of meningococci by means of whole-cell immunoenzyme analysis]. / Tipo-subtipirovanie meningokokkov metodom tsel'nokletochnogo immunofermentnogo analiza.

In this work the method of the whole-cell enzyme immunoassay, used for the serotype-subtyping of meningococci by means of specific monoclonal antibodies, is described. High specificity of the method, the simplicity of the assay procedure and evaluation of its results, as well as the availability of this method for practical use, have been demonstrated. The results of this investigation confirm the importance of the evaluation of type-subtype appurtenance of reference and laboratory strains used in experiments. Study of 72 meningococcal strains obtained from patients has revealed their polyclonal character in respect of their type-subtype signs.

[The evolution of meningococcal infection in Mongolia]. / Evoliutsiia meningokokkovoi infektsii v Mongolii.

On the basis of the generalization and analysis of the results of bacteriological and immunological investigations the epidemic process of meningococcal infection (MI) in Mongolia was found to undergo definite changes during the last 20 years. Group A meningococci prevailing in the etiology of MI were replaced by strains belonging to group B affecting mainly young children (aged up to 3 years). MI morbidity rate caused by group B meningococci was found to be higher in Mongolia than in other countries of the world. These data substantiate the necessity of using more effective remedies for the control of this infection and, in particular, specific immunization with vaccines against group B meningococci; profound study of the properties of the circulating meningococcal strains is to be carried out.

[The characteristics of the serological diagnosis of meningococcal infection in children in the 1st years of life]. / Osobennosti serologicheskoi diagnostiki meningokokkovoi infektsii u detei pervykh let zhizni.

The results of clinico-immunological examination of 181 children, aged 1 month to 6 years, with generalized forms of meningococcal infection are presented. In children under observation antimeningococcal antibodies to group-specific meningococci of the main groups A, B and C were determined over the course of the disease by passive hemagglutination (PHA) test and enzyme immunoassay (EIA). The level and frequency of seroconversion were found to depend on the patient's age and the severity of the clinical course of meningococcal infection. Antibody level was found to increase simultaneously with respect to several meningococcal polysaccharides: A, B in 18.5% and A, B, C in 3.3% of cases. In the clinical interpretation of data obtained in the PHA test and EIA not only the patient's age, the form and duration of meningococcal infection, but also serotherapy should be taken into consideration, as the latter may distort the serological results.

[The diagnostic value of a meningococcal-B erythrocyte diagnostic agent based on the group-specific polysaccharide]. / Diagnosticheskaia tsennost' meningokokkovogo éritrotsitarnogo B-diagnostikuma na osnove gruppospetsificheskogo polisakharida.

In this work the diagnostic value of group B meningococcal erythrocyte diagnosticum was determined. 585 blood serum samples taken from adult donors were studied: 220 samples from practically healthy persons and 365 samples from 144 patients with meningococcal infection and purulent bacterial meningitis of nonmeningococcal etiology. Group B meningococcal erythrocyte diagnosticum was found to possess serological activity and to reveal the growth of specific antibodies in the sera of patients with meningococcal infection, serologically confirmed by the isolation of group B meningococcal culture, in 100% of cases on weeks 2-3 of the disease. Diagnostic characteristics--specificity and sensitivity--for group B erythrocyte diagnosticum were, respectively, 90.2% and 63.5%. The study revealed that antibodies to several group-specific meningococcal polysaccharides in blood sera can be simultaneously determined in the passive hemagglutination test with a set of erythrocyte diagnostica, which should be taken into consideration in the clinical interpretation of serological results.

[The characteristics of suppurative meningitis morbidity caused by Streptococcus pneumoniae and Haemophilus influenza type B]. / Osobennosti zabolevaemosti gnoinymi meningitami, vyzvannymi Streptococcus pneumoniae i Haemophilus influenzae tipa B.

Of the 1,018 patients with purulent bacterial meningitis, hospitalized at the 2nd Clinical Infectious Hospital in Moscow during the period of 1980-1987, the diagnosis was confirmed in 54.7%; of these, meningitis of pneumococcal etiology was established in 44.8% and meningitis caused by H. influenzae, type b, in 23.8% of the patients. In meningitis of pneumococcal etiology high risk groups included mainly adults, especially those over 50 years, and children under 3 years of age. In meningitis of H. influenzae etiology high risk groups included mainly young children under 2 years of age. Meningitis of pneumococcal etiology was characterized by considerable death rate (on the average, 20%), while in meningitis of H. influenzae etiology death rate was 3 times lower. Pneumococci of serotypes 1, 3, 6, and 19 were found to be of the highest etiological importance for adults and pneumococci of serotypes 19, 6, 12, and 1, for children. In recent years greater etiological role of serotype 42 in adults was noted. The study of the spread of meningitides of different etiology is a high-priority task for this country.

[The epidemiological characteristics of meningococcal infection in the USSR]. / Epidemiologicheskie osobennosti meningokokkovoi infektsii v SSSR.

The epidemiological analysis of morbidity in meningococcal infection in the USSR in the period of 1969-1987 showed that the second rise of the morbidity level occurred in 1984 and was followed by its decrease in most of the regions of the USSR. This study also revealed that the characteristic feature of the second rise of morbidity in meningococcal infection was a considerable involvement of young children (aged up to 3 years), as well as the increased etiological role of group B meningococci in cases of meningococcal infection and the circulation of these microorganisms among the population. Besides, the preservation of the etiological importance of group A meningococci in many regions of the USSR, especially among adults, was noted. In this connection, the use of Soviet group A meningococcal polysaccharide vaccine on epidemiological indications was considered to be epidemiologically substantiated.

[Immunological factors in the evolution of the epidemic process in meningococcal infection]. / Immunologicheskii faktor v évoliutsii épidemicheskogo protsessa pri meningokokkovoi infektsii.

The results obtained in 1987 in the study of the immunostructure of the population of Yaroslavl with respect to meningococcal polysaccharides, groups, A, B, C, and lipopolysaccharide are presented in comparison with earlier results obtained in 1976. The regulating role of the immunological factor in the evolution of the epidemic process of meningococcal infection has been confirmed. The level of antibodies to meningococcal polysaccharides, groups A and B, has been found to reflect the intensity of the circulation of the infective agent among the population. The comparison of the results of investigations carried out in 1976 and 1987 has revealed the essential role of the lipopolysaccharide antigen in the formation of the postinfection immunity of the population to meningococcal infection, irrespective of the group of the infective agent.

[Microanalytical methods: latex agglutination and immunoenzyme analysis in the diagnosis of meningococcal infection]. / Metody mikroanaliza: lateks-aggliutinatsiia i immunofermentnyi analiz v diagnostike meningokokkovoi infektsii.

Modified polystyrene latexes with high adsorption capacity, comparable to that of latexes produced by Difco Laboratories (USA), have been developed in the USSR. Diagnostic latex preparations for the detection of meningococci of serogroups A, C, Y and Haemophilus influenza, type b, prepared on the basis of these new latexes, have shown high specificity and sensitivity in experimental and clinical tests. The latex preparations for the detection of serogroup B meningococci requires further improvement. The use of latex preparations, together with other laboratory methods, in the diagnosis of meningococcal infection has promoted the etiological confirmation of the disease in 84% of cases; this method has proved to be 1.5 times more effective than the bacteriological one and not less sensitive than the enzyme immunoassay, while being more specific.

[Meningococcal serogroup B infection]. / Meningokokkovaia infektsiia serogruppy B.

The results obtained in the examination of patients with meningococcal infection during the period of 1980-1985 are analyzed. The increasing role of serogroup B meningococci in the etiology of the generalized forms of infection, especially in children aged under 3 years and in adults over 50 years, is shown. As noted in this investigation, the disease induced by group B meningococci runs a more severe course. Morbidity caused by this serogroup of meningococci does not result in epidemics in our country. The distribution of patients among different age groups and specific features of the clinical course of the disease in connection with the serogroup of the causative agent make it possible to regard the risk groups as groups with decreased reactivity, which raises doubts concerning the possibility of forming effective postvaccinal immunity against group B meningococci in such persons.

[Epidemiological surveillance of meningococcal infection and the prediction of the development of an epidemic process]. / Epidemiologicheskii nadzor za meningokokkovoi infektsii i prognozirovanie razvitiia épidemicheskogo protsessa.

The signs necessary for the prognostication of the development of the epidemic process have been formulated on the basis of the epidemiological analysis of materials obtained in the process of trials of the system for the surveillance of meningococcal infection with the use of previously established characteristics. The data on the prevalence of meningococcal infection among different age groups and on the seasonal distribution of the infection as well as on the serogroups of meningococci isolated from patients, have been shown to be of importance for prognostication.

[Epidemiological characteristics of meningococcal infection in Cuba]. / Epidemiologicheskie isibennosti meningokokkovoi infektsii na Kube.

The results of the epidemiological analysis of the morbidity rate in meningococcal infection for 1976-1984 are presented. The maximum rise of morbidity rate, equal to 14.4 per 100000 of population, was observed in 1983. Primarily, the rise of morbidity rate in 1979 was induced by meningococci of two serogroups: C (44.6%) and B (36.4%). The vaccinal prophylaxis of the population, carried out in 1979 with the use of polysaccharide vaccine A + C, did not affect morbidity caused by group B meningococci. The isolation rate of these organisms reached 98.7% from patients and 81.0% from carriers. The characteristic feature of the epidemic process of meningococcal infection in Cuba was a considerable increase in the number of patients under 1 year of age and the absence of seasonal fluctuations in morbidity rate.