[Comparison of measles incidence in different age groups with the intensity of specific humoral immunity in healthcare workers in Moscow].

INTRODUCTION: The study of the intensity of humoral immunity to the measles virus (Paramyxoviridae: Morbillivirus) (MV) remains relevant due to the ongoing registration of the cluster cases of measles (including nosocomial cases).The aim of the study was to analyze correlation between the intensity of the humoral immunity to measles virus and the measles incidence in different age groups of the Moscow residents. MATERIAL AND METHODS: A simple analytic study was carried out under the framework of measles prevention improvement program conducted in the subjects of the Russian Federation. The study included the analysis of the reasons for the increase in the proportion of seronegative individuals and the comparison of the results of seromonitoring with the data of age-related measles incidence. Throughout 2018, total 1,855 blood serum samples obtained from employees of a large hospital center in Moscow who were previously vaccinated against measles were tested for IgG antibodies (ABs) to MV. The subjects were divided into 11 groups according to their age. Statistical analysis of the obtained data was performed using nonparametric criteria. RESULTS AND DISCUSSION: The proportion of seronegative individuals among the staff of the medical facility decreased with age, from 38.5% in persons aged 19-23 to 0% among employees aged 64 and over. Persons aged 19-43 years were the most susceptible to measles infection, which was confirmed also by the highest incidence rate at these age groups (from 6.93 to 14.03 per 100,000 population). The age group most protected against measles was those over 64 years of age, who were all seropositive and had the lowest rates of incidence. This is probably due to the fact that by this age most of them have had a measles infection and have formed a sufficient immune response. At the same time, younger individuals living in the post-elimination era have only vaccine-induced ABs to MV, the level of which declines rapidly to non-protective values in the absence of boosterization due to the exposure to the wild-type strain of the pathogen. CONCLUSION: The monitoring of the MV-specific IgG- AB levels is required for employees in the medical institutions under the age of 35. Administration of the single dose of the appropriate vaccine is recommended for seronegative individuals.

[Intensity of the immunity against measles in employees of the maternity unit in Moscow].

INTRODUCTION: Measles remains an urgent problem in Russian healthcare. Despite the ongoing vaccination, there is an increase in the incidence of measles. Prevention of measles is particularly important in high-risk groups, as well as among healthcare professionals to prevent hospital-acquired outbreaks of infection. The duration of post-vaccination immunity during the elimination of measles has not been sufficiently studied, so often people who  have had measles in childhood or have 1-2 vaccinations against the disease lose their protective antibodies with age in the absence of natural boosterization.Goals and objectives. To study the intensity of specific immunity to measles in employees of the maternity unit. MATERIAL AND METHODS: The study involved 271 employees of the maternity unit aged 21 to 93 years (262 serum samples). The level of IgG antibodies (Ab) to the measles virus in the blood serum was studied by ELISA using a standard set of reagents for the quantitative determination of IgG by «VECTOR-BEST¼. The result was  considered negative if the concentration of IgG to the measles virus in tested sample was ≤ 0.18 IU/ml and  positive - if > 0.18 IU/ml. Results. The number of seronegatives ranged from 0% to 30.8% in female employees with its maximum at age of 31-35 years. The lowest proportion of seronegative and the highest proportion of seropositive women were observed among the elderly, > 60 years. DISCUSSION: There is a marked tendency for an increase of the proportion of persons with average Ab levels with age and a decrease of the proportion of persons with low Ab levels. The percentage of seronegative women among employees exceeded the recommended level, which makes it possible for an nosocomial outbreak when an infection is introduced. CONCLUSION: The authors recommend that serological testing for the intensity of the immune response against measles should be included in the standard of the pre-vaccination screening for adults.

[Analysis of the effectiveness and long-term results of formation of adaptive immunity in the use of various medications and vaccination schemes against pneumococcal infection in patients with chronic obstructive pulmonary disease]. / Analiz otdalennykh rezul'tatov éffektivnosti i formirovaniia adaptivnogo immuniteta pri primenenii raznykh preparatov i skhem vaktsinatsii protiv pnevmokokkovoi infektsii u bol'nykh s khronicheskoi obstruktivnoi bolezn'iu legkikh.

AIM: To assess the long-term clinical results of vaccination with pneumococcal polysaccharide and conjugated polysaccharide vaccines in the separate and sequential use, by determining the optimal vaccination schedule in adult patients with chronic obstructive pulmonary disease (COPD) and to investigate adaptive immunity levels. SUBJECTS AND METHODS: The clinical effects of vaccination were evaluated in patients with COPD within 1 and 4 years after immunization against pneumococcal infection using various schemes, as well as the time course of changes in adaptive immunity indicators was examined. RESULTS: Four years after vaccination, the 13-valent pneumococcal conjugate vaccine (PCV13)/23-valent pneumococcal polysaccharide vaccine (PPV23) group showed a decline in the number of patients with COPD exacerbations by 50% (p<0.001) and reductions in the number of antimicrobial chemotherapy cycles by 47.8% (p<0.001) and in that of hospitalizations by 87.5% (p<0.001). At 1 year after vaccination versus at baseline, the COPD patients vaccinated against pneumococcal disease, regardless of the drug and schedule of vaccination, displayed elevated levels of IgG antibodies to the mixture of capsular polysaccharides included in PPV23 and PCV13. CONCLUSION: It has been indicated that a complex of basic therapy for patients with COPD should include initial vaccination with PCV13, followed by administration of a booster dose of PPV23.

[Transplacental IgG against measles virus in umbilical blood of neonates from various regions of Russian Federation].

AIM: Determine content of protective transplacental IgG against measles virus in umbilical blood of neonates of various regions of Russian Federation. MATERIALS AND METHODS: Umbilical blood of 1147 neonates was studied, whose mothers had not previously had measles. 672 samples among those were from neonates of Moscow and Moscow Region, 475--from Rostov-on-Don. IgG values were determined in EIA using a standard kit from "Vector Best" (VectoKor-IgG). A kit from Euroimmun--Avidity: Anti-Measles Virus ELISA (IgG) was used for determination of avidity of IgG against measles virus. RESULTS: Protective (≥ 0.18 IU/ml) IgG against measles were registered in 79.9% of children in Moscow, Moscow Region and in 81.3% of neonates in Rostov-on-Don. Mean level of IgG in umbilical blood sera of neonates from the studied regions was within protective values (1.74 ± 0.13 IU/ml and 1.51 ± 0.09 IU/ml, respectively). Predominance of low level antibodies was noted in the studied samples (< 1.0 IU/ml), those are highly avid though (AI > 60%). In neonates from women aged 16 - 25 years in Moscow and Moscow Region protective antibodies were detected in 83.6%; 26 - 35 years--in 75%; women aged 36 - 43 years--in 88.2% of cases. Mean level of IgG in umbilical blood of neonates from mothers aged 36 - 43 years was 1.5 times higher than from mothers aged 16 - 25 years and 2 times higher than mothers 26 - 35 years of age. CONCLUSION: Neonates from Moscow, Moscow Region and Rostov-on-Don, similarly, in 79.9% and 81.3% of cases are protected from measles, respectively. Women aged 26-35 years in 25% of cases are a risk group for measles morbidity and require a closer attention during selection of vaccination tactics before conception, and their neonates--on reaching decree terms.

[Immunization of patients with chronic obstructive pulmonary disease with vaccines of Bubo-M and hepatitis B].

AIM: To assess tolerability and immunological activity of Bubo-M vaccine and hepatitis B vaccine in patients with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: Sixty-three patients with moderate and severe COPD aged 35-65 years were immunized against diphtheria, tetanus, and hepatitis B. Bubo-M vaccine as well as vaccine against hepatitis B were used for immunization. Immunologic effect of vaccination was assessed by measurement of serum antibody level to HBsAg as well as to diphtheria and tetanus toxoids. Assessment of antibody level to HBsAg was performed by ELISA, and levels of antibodies to diphtheria and tetanus toxoids--by micromethod in direct hemagglutination assay. Reactogenicity of Bubo-M vaccine was measured according to duration and intensity of local and systemic reactions. RESULTS: The local and systemic reactions were infrequent, serious adverse events after vaccination were not observed. Six months after vaccination, protective antibody titers to hepatitis B, diphtheria and tetanus were determined in all immunized persons--either healthy, or with COPD. During completion of vaccination schedule, significant reduction of acute respiratory infections rate and main disease exacerbations was noted in patients with COPD. CONCLUSION: Good tolerability and high immunogenicity of Bubo-M and hepatitis B vaccines were demonstrated in both groups of vacinees. These vaccines could be recommended for booster vaccination of adults with COPD.

[Microflora of pharyngeal mucosa in children with solid tumors].

Microbiological study of pharyngeal mucosa in 43 children with solid tumors revealed that 77.2% of isolated microorganisms belonged to Gram-positive flora. It was shown that streptococci and Staphylococcus aureus were the main species. Species composition of streptococci included both pyogenic (S. pyogenes, S. agalactiae, S. dysgalactiae, S. equi) andviridans species (S. acidominimus, S. oralis and "S. milleri" group). Nocardioform actinomycetes, corynebacteria and other staphylococci were referred to additional microflora. Accidental microflora was represented by Neisseria spp., non-fermenting Gram-negative bacteria, enterobacteria and yeast-like fungi. Microbiologic study of pharyngeal mucosa biocenosis showed that monoculture was present only in 2.3% of cases; in other cases microorganisms formed both intra-genus and inter-species associations. 2-6-component associations were revealed with predominance of 3-4-component associations (37.2% and 32.6% respectively). Relationship of distribution of microorganisms belonging to main and additional microflora was revealed.