[Present stage of chemotherapy and chemoprophylaxis of rickettsiosis and Q fever].

The analysis of the published experimental and clinical data on chemoprophylaxis and chemotherapy of rickettsiosis and Q fever confirmed the preserved role of doxycycline, the main drug of choice in the treatment of the diseases, then followed chloramphenicol. Macrolides, such as azithromycin and clarithromycin proved to be useful in pediatric practice and the treatment of pregnant women with rickettsiosis. The treatment of acute and chronic Q fever required the use of doxycycline, fluoroquinolobes, co-trimoxazole and hydroxachloroquine in combined therapy. It is concluded that in vivo studies of novel drugs and investigation of prospective macrolides and fluoroquinolones are necessary. Clinical trials of a new glycycline, i.e. tigecycline, which experimentally showed highy strong activity against the Q fever pathogen, should be accelerated.

[Modern features of epidemiology and prophylaxis of yellow fever].

At the beginning of 21 century endemic areas of yellow fever are in tropical forests of Africa and South America, covering 43 countries of the around the world. In a period of 11 years 2005 citizens from 14 countries of Africa and 871 citizens from 8 countries of South America were taken ill with of a yellow fever. On the both continentals were observed distinct, limited (no more than 40 people) ictuses of urban of a yellow fever related to mosquito Aedes aegypti. Still, the total mortality is high--up to 35%. The systems of epidemiological surveillance and informational connection are created; the live vaccine in sufficient amount for general is delivered to the hot spots of disease. Civil wars and ethnic conflicts hinder the introduction of compulsory vaccination in national calendars of the inoculation of children in endemic countries. Because of it the vaccination is realized slowly: nowadays the vaccination is introduce in 19 among 25 countries of Africa with high risk of disease.

[Cultivation of the clothes lice adapted to feeding on rabbits].

A race of clothes lice adapted to feeding on rabbits is kept at a laboratory longer than 50 years. For this period, more than 850 insect generations undergoing no change in a number of biological tests and morphological indices have been obtained. They have retained a high susceptibility to Provacheck rickettsia infection. All infected lice die, partially with the signs of hemolytic imbibition. Their rickettsial accumulation is as high as 10(5.0) ID50 per insect for albino rats.

[Modern principles of prevention of human transmitted infections].

According to information about ecology of agents of parasitic diseases with lousy-flea mechanism of contamination, mite natural diseases and experience of battle with them, we can make a conclusion: elimination of spongers in their natural environment, lousies and fleas by washing and disinfection is not effective. Alternative is implementation of insectoacaricides of new class, based on permethrins. These insectoacaricides are secure for environment and very effective towards arthopods. Method of non-termal preventing suction of arthopods is probed in military practice and other treatment-prophylaxis institutes. It is proposed to implement new insectoacaricides in form of spray cans as part of individual contrebiological drug-locker of every service man, acting in difficult epidemiological situation, caused by virus threat of lousy or flea infection, or by beforehanded provision by impregnated uniform or clothes.

[Hemorrhagic fever with the renal syndrome: modern aspects of epidemiology and prophylaxis].

Hemorrhagic fever with the renal syndrome (HFRS) is a typical natural-and-focal virus infection having military-and-epidemiological importance for Armed Forces of most countries. Severe forms of this infection are typical for the Far East of Russia, countries of South-East Asia and especially for the American continent. The lethality from HFRS amounts to 15-50%. The main natural carriers and keepers of HFRS stimulus are various mouse-type rodents. In Russia besides well-studied natural focuses on the Far East, Siberia, Ural, Povolge other active HFRS focuses were determined not long ago (Moscow, Orel, Lipetsk, Tula and Voronezh regions, the territory of Big Sochi). A man is infected by an aerosol, forming during drying up of rodents' urine, feces, saliva containing HFRS virus. Vaccinal prevention of HFRS in Russia hasn't yet been worked out. Ribavirin is the most effective in the treatment for HFRS. The means of prevention of population and servicemen must exclude their contact with rodents both in natural conditions and in populated areas.

[Evaluation of the probability of the infection of medical personnel with Crimean-Congo hemorrhagic fever virus in cases of introduction of the infective agent to a non-endemic territory of Russia].

The data on the secondary cases of infection with Crimean-Congo hemorrhagic fever (CHF) virus during the period of 1960 - 2002 have been analyzed and the probability of the infection of medical personnel with this virus has been evaluated. The data obtained in this study may be used in the development of the mathematical model of CHF epidemics (outbreaks), taking into account not only the transmission of the infective agent, but also hospital infection, as well as for calculating the number medical personnel, necessary for the liquidation of CHF epidemics (outbreaks).

[Molecular genetic variety of rickettsiae].

In this review modern data on the study of the genome of the representatives of the family Rickettsiaceae and, as follows from the accumulated information, on changes in the nomination and hierarchical place of its pathogenic and avirulent representatives are presented.

[Diagnosis of Rickettsia prowazekii disease at the final stage of its elimination]. / Diagnostika form rikketsioza Provacheka na zakliuchitel'nom étape ego likvidatsii.

Diagnosis of Rickettsia prowazekii forms at the final stage of its elimination. 30 cases of petechial typhus occurred in Russian Federation during the period from 1973 to 1996 were subjected to retrospective analysis. On the base of this analysis the false registration of disease "epidemic" form was revealed. Indeed it appeared to be the recurrences, i.e. the Brill's disease. The authors propose to use the table of differential diagnostic signs of both forms of Rickettsia prowazekii based on their clinical-and-epidemiological special features. It will help to avoid the false reports.

[Rickettsiosis: state of the art at the turn of the 21st century]. / Rikketsiozy: sovremennoe sostoianie problemy.

Information about changes in the modern taxonomy of intracellular bacteria conditionally united within the nomination of "Rickettsioses" is presented in the paper. Due to a total hobby related with keeping home animals (pets), cats and dogs, apart from the cattle, joined the natural ecological cycles of rickettsioses stimulation. The morbidity of rickettsioses of the acaroid group has been persistently growing; like in case with other pathologies (Lyme's disease) involving the acaroid transfer factor, its obvious "urbanization" is pronounced. Absolute and relative morbidity indices in respect to rickettsioses, which are epidemiologically important for Russia, are presented. The modern knowledge database concerning the rickettsioses makes it possible to control the epidemic process for this infection category. It is noteworthy, that Prowazek's rickettsiosis of its both forms (i.e. the epidemic and relapsing ones), which does not have an independent cycle of circulation of its stimulator in wild nature, and unlike the acaroid group rickettsioses, turned into a socially controllable infection. It will be totally eliminated, during 10-15 years, both in Russia and the CIS countries. The practitioners are well supplied with a variety of drugs of tetracycline and fluorine-quinol groups, which makes it possible to arrest the infection process in patients rapidly and effectively and to prevent the lethal cases. A low incidence rate of rickettsioses, including Q fever, within the general infection morbidity, and taking into consideration the availability of methods for effective therapy and prevention, makes one consider a comprehensive vaccination against the discussed group of infections to be irrational. Obviously, such vaccination must be still applied in respect to a limited number of persons from among high-risk groups and for two or three varieties of rickettsioses only (i.e. Prowazek's rickettsioses, Rocky Mountain spotted fever and Q fever). Live vaccines, obtained on the basis of attenuated and recombined strains (which have a full-scale set of specific antigens), are recommended.

[Taxonomy and classification of Rickettsiae]. / Taksonomiia i klassifikatsiia rikketsii.

During the recent 20 years the improvement of the methodological research basis including the molecular and genetic analysis of microorganisms parasites of eukaryotic cells, led to considerable changes in the taxonomy and classification of rickettsiae. This problem was not discussed in the Russian literature. At present the term "rickettsiae" conventionally embraces the group of microorganisms of the class Proteobacteria, nominated as species belonging to the genera Rickettsia, Orientia, Ehrlichia, Coxiella and Bartonella. An original scheme of the modern taxonomy of rickettsiae, pathogenic for man, is presented. The scheme is made with due regard to their phenotypic, clinico-epidemiological and genetic features.

[Seroimmunologic monitoring of microorganisms of Rickettsia and Bartonella species microorganisms in the Moscow region]. / Seroimmunologicheski monitoring mikroorganizmov rodov Rickettsia i Bartonella v Moskovskom regione.

Serological study of 788 blood sera, taken from residents of the Moscow region was conducted using antigens of microorganisms of the genera Rickettsia and Bartonella. The first group under examination consisted of 355 patients with diagnosed diseases of nonreckettsial nature. The second group includes 433 healthy adults working at a meat processing and packing factory. The main method used for sera survey was the indirect immunofluorescence test. In the sera taken from the first group of subjects specific antibodies to R. prowazekii, R. typhi, B. quintana, B. henselae antigens were detected in 2.3%, 5.1%, 4.0% and 2.9% of serum samples respectively. In the serum samples taken from the second group the proportion of antibodies to R. prowazekii, R. typhi, B. quintana, B. henselae antigens was different: 0.5%, 3.3%, 1.7% and 4.0% respectively. In total, specific antibodies to R. typhi and B. henselae prevailed over specific antibodies to R. prowazekii and B. quintana twofold.

[The laboratory diagnosis of rickettsioses]. / Laboratornaia diagnostika rikketsiozov.

Difficulties in the clinical diagnosis of rickettsiosis and related illnesses made it necessary to develop and improve its methods (immunoferment analysis, nondirect methods of fluorescent antibodies and polimerase chain reaction). Detailed recommendations for diagnosis of Q-fever by the level and growth of antibodies of IgG and IgA subclasses.

[Ecological aspects of human pathogens Ehrlichia and Bartonella]. / Ekologicheskie aspekty patogennykh dlia cheloveka bartonell i érlikhii.

The review presents data on the natural circulation of Bartonellas and Erlichias with the participation of lice, fleas, mosquitoes, Ixodes ticks, as well as rodents, large wild mammals, and domestic animals. It outlines the human infection routes that are mainly associated with the attack of infected carriers and with the contacts with different warm-blooded animals. The risk of bartonellosis spread is evidenced by the data showing that 12.3% of clothes lice collected from homeless individuals in Moscow turned out to be infected. In a focus of erlichiasis, the infection rates of Ambliomma americanum and Ixodes scapularis were 4.9 and as high as 20%, respectively; 100% of white-tailed deers (Odocoileus virginianus) were seropositive. However, many issues associated with the preservation of these natural vectors, with the route of their transmission to human beings and animals are to be studied.

[Rickettsioses: their chemoprophylaxis and chemotherapy]. / Rikketsiozy: khimioprofilaktika i khimioterapiia.

As a result of long-standing screening of chemopreparations of anti-rickettsiosis action in-vitro and in-vivo experiments and their clinical evaluation in the treatment of R. of any etiology, it is established that the most effective ones are those of the 4 groups: tetracyclines (doxicycline, minocyclines), ansamicines (rifampicine), ftorchinolones (cyprofloxacine, ofloxacine, pefloxacine) and the new generation of macrolides (asitromicine, klaritromicine). Since all the studied preparations have only rickettsiosis-static effect, a promising way to finding a rickettsiocidic preparation capable of preventing a possible persistence of a relevant agent in a human body is a combined application of highly effective chemopreparations (doxicycline, in particular) or pefloxacine with lysosomal alkalinizing drugs (chlorochin, ammonium chloride or amantadine). Antibiotics of prolonged anti-rickettsiosis action give a real chance for prevention even with a one-time dose.