[Paralytic poliomyelitis in Russian Federation in 1998-2005].

From 1998 through 2005 3,294 cases of acute flaccid paralysis (AFP) including 93 cases with clinical picture of poliomyelitis were registered in Russian Federation. From the latter cases 91 were classified as vaccine-associated paralytic poliomyelitis (VAPP): 66 were VAPP cases in oral poliomyelitis vaccine (OPV) recipients and 25--VAPP cases in contacts. VAPP rate was 1 case per 1.6 million of distributed OPV doses, 1 case per 2.2 million doses for OPV recipients, and 1 case per 186,000 doses for recipients of 1st OPV dose in children aged < 1 year. Majority of VAPP cases in recipients occurred after 1st dose (89.4%) and in contacts--in non-vaccinated children (76%). Mean interval between OPV administration and onset of VAPP in recipients was 21 days. Children aged < 1 year were predominant among VAPP cases (92.4% among recipient VAPP cases, and 80% among contact VAPP cases). Majority of the patients had unfavorable health status including defects of immunity. Most of poliovirus strains isolated from VAPP cases belonged to type 3 (52.9%) whereas to type 2 and 1--29.8% and 17.4% of strains respectively. All VAPP cases were associated with vaccine-derived polioviruses. A highly diverged poliovirus type 1 (2.65% of nucleotide substitutions in VP1 region) was isolated from patient with contact VAPP. Formation of poliovirus-neutralizing serum antibodies in children with VAPP including persons with immunodeficiency reflects the ability of the organism to produce specific antiviral immune response.

[Epidemic outbreak of meningitis and meningoencephalitis, caused by West Nile virus, in the Krasnodar territory and Volgograd region (preliminary report)]. / Epidemicheskie vxpyshki meningita i meningoéntsefalita v Krasnodarskom krae i Volgogradskoi oblasti, vyzvannye virusom Zapadnogo Nila (Predvaritel'noe soobshchenie).

Sera from 102 inpatients from the Volgograd region (64) and Krasnodar region (38) were tested for antibodies to West Nile (WN) virus in hemagglutination inhibition (HI) test and for IgM and IgG antibodies in enzyme immunoassay (EIA). Diseases etiologically associated with WN virus were diagnosed in 81 patients: in 50 out of 64 in the Volgograd region and in 31 out of 38 in the Krasnodar region, which makes 79.4%. Specificity of antibodies to WN virus was confirmed in HI and EIA with WN antigens, related flaviviruses (Japanese encephalitis and yellow fever), and Sindbis alfavirus. A considerable number and the incidence of WN infection suggest that an epidemic caused by WN virus occurred in the Krasnodar and Volgograd regions in summer 1999.

[Japanese encephalitis in citizens of Russia who travel abroad]. / Iaponskii éntsefalit u grazhdan Rossii, vyezzhaiushchikh za rubezh.

Typical and atypical forms of Japanese encephalitis (JE) in the Russians visiting Asian countries endemic for JE are described. A patient who contracted the disease in China developed 5 months after returning to Russia acute meningoencephalitis with mental disorders and a lethal outcome on day 5 with bulbar symptoms. JE virus (strain SP-69) was isolated from his brain. By antigenic and genetic properties this strain occupies an intermediate position between Jagar-01 and Nakayama serotypes. A pregnant woman (6 months gestation) who lived in Birma for 3 years suffered from encephalitis running a protracted (more than 6 months) course; mildly manifest pyramidal signs were detected in her one-year-old infant with a normal mental status. Serologic studies showed that the disease was caused by infection with Jagar-01 serotype of JE virus. A patient contracting the disease 1 month after arrival in Japan developed a recurrent pattern of the illness: the diagnosis of JE was confirmed by repeated detection of virus-neutralizing anti-bodies in the blood and liquor. None of the patients was vaccinated against JE. Indications to prophylactic vaccination of subjects leaving for countries endemic for JE are discussed.

[The isolation of measles virus strains and the study of their hemagglutinating activity]. / Vydelenie shtammov virusa kori i izuchenie ikh gemaggliutiniruiushchei aktivnosti.

Three measles strains Gag, Il, and Buk, were isolated from a suspension of mononuclear cells derived from measles patients in the active stage of the disease. Continuous Vero cell cultures were used for virus isolation. In the infected cell culture, all the isolates produced symplasts of different sizes and star-shaped or spindle-shaped multinuclear cells. The specificity of the cytopathic effect was proved by the adsorption of monkey erythrocytes on the surface of virus-affected cells. The isolates were identified in neutralization and HI tests with different immune preparations: measles gamma-globulin (national standard), hyperimmune rabbit sera to measles (Edmonston strain), rubella, and mumps viruses, S. sonnei and S. flexneri, as well as with sera from measles patients and subjects vaccinated with live measles vaccine L-16. The results of identification attest to isolation of 3 measles virus strains, one of which (Buk) possesses particularly high hemagglutinating activity.

[Acyclovir in the treatment of severe generalized forms of herpes zoster]. / Atsiklovir v lechenii tiazhelykh generalizovannykh form opoiasyvaiushchego gerpesa.

Aciclovir administration in 8 herpes zoster patients aged 14-74 to manage resistant generalized herpetic eruption, serous meningitis, meningoencephalitis resulted in a pronounced response in 5 of them. Aciclovir has the advantage of its effectiveness in spite of late treatment (on herpes zoster day 6-22). This is particularly important for those forms of the disease which manifest severe symptoms during the second phase, i.e. disseminated eruption, involvement of brain matter, etc. Two lethal outcomes due to pulmonary artery embolism were unrelated to the drug administration.

[Clinical aspects, diagnosis and treatment of various forms of viral encephalitis in children]. / Klinika, diagnostika i lechenie nekotorykh form virusnykh éntsefalitov u detei.

The authors provide the clinical and laboratory data on the etiological structure of acute viral encephalitides in children. Special attention is devoted to the description of the clinical picture of the gravest form of encephalitis caused by type I herpes simplex virus. Present the laboratory data on the long-term preservation of type I herpes simplex virus in the CNS, which correlates to the clinical and morphological findings of the subacute or recurrent course of the disease. Discuss the results of the treatment with the antiviral drug acyclovir (zovirax).

[Study of the outcome of acute viral encephalitis in children based on the catamnestic data]. / Iskhody ostrykh virusnykh entsefalitov u detei po dannym katamnesticheskogo nabliudeniia

The paper treats of the results of a prolonged follow-up of 292 children who suffered acute viral encephalitides of different etiology. Outcomes of the disease are evaluated. Encephalitis outcome was mainly determined by etiology of the process. The most unfavourable outcomes were recorded in a group of children who suffered herpetic and cytomegaloviral encephalitides. The lingering convalescence may last up to 1.5-2 years. During that period, the children undergo not only a genuine recovery but also processes of compensation and adaptation. The residual phenomena include alterations which do not tend towards the reverse development. It is of paramount importance to take into account and to estimate properly premorbid changes on the part of the CNS. Etiology of the process determines the depth and stability of the residual phenomena.

[The molecular epidemiology of poliomyelitis: the characteristics of the strains isolated from patients in Moscow in 1973-1986]. / Molekuliarnaia épidemiologiia poliomielita: kharakteristika shtammov, vydelennykh ot bol'nykh v Moskve v 1973-1986 gg.

Eleven virus strains isolated from poliomyelitis patients in Moscow in 1973-1986 were analyzed by the method of oligonucleotide mapping of RNA. The genome of the isolates showed considerable similarity to the genomes of Sabin's vaccine strains and mainly to the vaccine strain of antigenic type 2. The conclusion was made that the sporadic cases of poliomyelitis registered in this region were etiologically linked with the vaccine strains of poliomyelitis virus. Only in one case the disease appeared in the recipient of the vaccine, in all other cases the patients were infected through contacts.

[Characteristics of endemic foci of hemorrhagic fever with renal syndrome in various regions of the USSR]. / K kharakteristike éndemicheskikh ochagov gemorragicheskoi likhoradki s pochechnym sindromom v raznykh regionakh SSSR.

Clinical, epizootological, and laboratory data for 9 endemic foci of hemorrhagic fever with renal syndrome (HFRS) were compared. The analysis covered 5120 cases of HFRS. It was established that in the foci, where the leading role is played by field mouse and Japanese field mouse, HFRS is caused by the 1st serotype of HFRS virus, and the clinical course of the disease is quite severe. In the natural foci with the predominance of redbacked vole, the 2nd serotype of the virus circulates and the disease is of moderate severity or mild. In each individual case, however, both serotypes of the virus may produce both mild and severe diseases.

[Dhori virus--a causative agent of human disease. 5 cases of laboratory infection]. / Virus Dkhori--vozbuditel' zabolevaniia cheloveka. Piat' sluchaev laboratornoi infektsii.

The materials presented in the paper are first indications of the pathogenicity of Dhori virus for man and prove the role of this agent in the occurrence of 5 cases of the disease in laboratory workers accidentally infected during the preparation of cultural agents. Clinically, Dhori infection was characterized by an acute course with marked general toxicity and a febrile period of 2 to 4 days. Two out of 5 patients had changes on the part of the nervous system of the type of encephalitic reaction predominantly with subcortical symptoms and mild involvement of the pyramidal system or in the form of encephalopolyradiculoneuritis with paresthesia and sensitivity disorders.

[Diagnostic significance of detecting respiratory virus antigens in cerebrospinal fluid and brain cells]. / Diagnosticheskoe znachenie obnaruzheniia antigenov respiratornykh virusov v likvore i kletkakh mozga.

Cerebrospinal fluid (CSF) from 202 patients (114 children and 88 adults) was studied by immunofluorescent techniques. Antigens of respiratory viruses in the CSF were most frequently encountered (22%) in patients with the involvement of the central nervous system (usually meningoencephalitis) in the presence of acute respiratory disease. In lethal outcomes in the same group viral antigens in brain cells were also identified. Clinical and morphological findings suggest that these lesions are infectious-allergic in nature. In rare cases (4%) viral antigens in the CSF and brain cells may also be found in patients with acute respiratory diseases without central nervous system involvement which happens when patients' blood-brain barrier is especially permeable.

[Acute necrotic encephalitis in children (clinico-electroencephalographic study)]. / Ostrye nekroticheskie éntsefality u detei (kliniko-élektroéntsefalograficheskoe issledovanie).

Twenty-five children aged 3 months to 13 years were examined electro-encephalographically. Most of the patients (20 of the 25) were young children (under 3 years of age) with the diagnosis of acute necrotic encephalitis. The characteristic changes of the EEG expressed in the form of cyclically arising asymmetric giant slow waves were established. The nature of the EEG was shown to correlate with the gravity of the clinical course. The data obtained may be used both diagnostically and prognostically.

[Serologic examination of patients with hemorrhagic fever with renal syndrome in the European part of the USSR]. / Serologicheskoe obsledovanie bol'nykh gemorragicheskoi likhoradkoi s pochechnym sindromom v evropeiskoi chasti SSSR.

Certain features of humoral immunity in patients suffering from hemorrhagic fever with renal syndrome (HFRS) in the territory of the European USSR were established: a trend for increasing antibody levels for a long time after convalescence (approximately 6 months) and the lack of significant decline of antibody levels for many years (5-10). Comparative clinico-serological studies revealed the occurrence of subclinical and atypical forms of HFRS disease.

[Metabolism of various biogenic amines in acute viral neuroinfections]. / Ob obmene nekotorykh biogennykh aminov pri ostrykh virusnykh neiroinfektsiiakh.

The metabolism of biogenic amines was examined in 62 patients with various acute viral neuroinfections. The control group consisted of 57 persons. Depending on the process character and disease period variations of the levels of serotonin, 5-hydroxyindolylacetic acid, coeruloplasmin and histamine were discovered. A comparison of the results obtained with the clinical course of the diseases revealed a certain correlation, especially in patients with acute meningoencephalitis.

[Acute meningoencephalitis and the problem of viral persistence in complicated rubella]. / Ostrye meningoéntsefality i problema persistentsii virusa pri oslozhnennoi krasnukhe.

The results of combined clinico-virological and immunological examinations of 25 children with rubellar meningoencephalitis are presented. The meningoencephalitis was preceded by typical rubella in 24, and by rubellar infection without eruptions in 1 child. In 6 children the rubella virus was isolated from the cerebrospinal fluid in the acute period of the disease (5th to 19th days), and in 2 children it was re-isolated on the acute period of the disease (5th to 19th days), and in 2 children it was re-isolated on the 17th-19th days. A persistence of the immunoglobulins M specific to the rubella virus was revealed both in the acute period of the disease and long time after the disease onset (the observation period was 409 days). The data obtained confirm the etiological role of the rubella virus in the development of rubellar meningoencephalitis, suggesting that the rubella virus may persist in complicated post-natal rubella.

[Acute meningoencephalitis in children caused by herpes simplex virus type I]. / Ostrye meningoéntsefality u detei, vyzvannye virusom prostogo gerpesa I tipa.

In 14 observations of acute meningoencephalitis in children mainly under 3 years of the age, data pointing to an etiological role of herpes simplex type I virus, were obtained on laboratory examination. Six children died, and in the rest 8 children who survived gross residua were observed. The morphological picture showed extensive colliquation necroses in the parietal, temporal, and less frequently, in occipital lobes and the Varolian pons. In 4 cases out of 6 intranuclear inclusions were detected. The incidence of herpetic encephalitis was 16%.