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Low efficiency of cohort immunization and postvaccinal complication are not always connected with vaccine unsatisfactory quality or violation of vaccination requirements by medical workers. The paper demonstrates that epidemic dynamics, disease clinical manifestation typical for it, efficiency and safety of immunization, postvaccinal complications incidence also closely interrelate with relative quantity of persons with anomalies (polymorphism) of immune response genes and physiologic systems protected from disease development. Polymorphism of these genes has a spontaneous development by single nucleotide polymorphism and deletions forming apportioning in next generations according to Mendel’s laws. Polymorphism accumulation involved into infectious diseases pathogenesis is ironically a result of progress in control of contagious cycle infections, particularly natural smallpox. There was taken off a selective pressure from a population that extracted persons unable to react effectively on infectious agents invasion. Velocity of polymorphism accumulation is growing in relatively genetically homogeneous population (inhabitants of island countries) and in populations with typical intermarriages. It is impossible to refuse from control of contagious infectious agents. So we should expect of increase of registered postvaccinal complication associated rather with human genome peculiarity than with other reasons. That causes the necessity to adjust a strategy of immunization of various cohorts and methods for determining the reasons of postvaccinal complications. The paper also describes polymorphism of immune response genes significantly associated with low effectiveness of vaccination against measles, rubella, epidemic parotitis, B hepatitis and complications after live smallpox and tuberculosis vaccine Mycobacterium bovis BCG.

Background. The trigger factors of the development of rheumatoid arthritis (RA) may be infections associated with the carriage in the oral cavity of Actinomycetes, Campylobacter, Mycoplasma, Porphyromonas, Transducers, Proteus, Selemons, Streptococci, and Fusobacteria, but their role in the disease pathogenesis requires clarification. In turn, the quantity of cases of comorbid infectious pathology significantly increases in RA. The purpose was to study the qualitative and quantitative composition of the oral microbiota in RA, to assess the role of individual bacteria in the pathogenetic structures of the disease. Materials and methods. There were examined 121 RA patients aged 18–76 years (on ave­rage 49 years old), among whom there were 19 % men and 81 % women. The duration from the first manifestation of the disease averaged 10 years. The frequency of seropositivity of RA for rheumatoid factor in the blood was 81 %, and for antibodies to cyclic citrullinated peptide — 75 %. I, II, and III degrees of disease activity were determined in 13, 45, and 42 % of cases, respectively, and the ratio of I, II, III, and IV stages of the pathological process was 1 : 5 : 5 : 3. To assess the number of aerobic and facultative anaerobic microorganisms growing on the gingival mucosa, the technique of sterile paper discs was used. The kits “Mikro-La-Test”, “Streptotest-16”, “Anaero-Test 23”, “Neferm Test 24” were used. Results. The vegetation of associations of aerobes on the gums was found in 96.7 % of patients, anaerobic bacteria — in 91.7 %, the number of which is closely related to clinical, laboratory, and X-ray signs of RA, while the integral landscape of the gingival microbiota is influenced by the severity of the comorbid chronic generalized periodontitis, which affects the presence of Moraxella, Sarcina, Streptococci, and Eubacteria in the oral cavity, moreover, the number of anaerobes reflects the degree of RA activity and bone mineral density, and in the pathogenetic constructions of individual signs of the disease (the nature of the articular syndrome and damage to the periarticular tissues), Aerococci, Candida, Clostridia, Megasphaera, Propionibacteria, Sarcina, Fusobacteria, and Eubacteria are involved. Conclusions. The obtained data dictate the need to develop new approaches to medical techno­logy for individual etiopathogenetic therapy of RA with comorbid periodontitis, to identify criteria that allow assessing the activity of the pathological process, predicting the nature of the course of the disease and the effectiveness of therapeutic measures.

The paper deals with the data on the geographic distribution of leptospirosis in the most endemic areas of Odesa region. The highest prevalence of leptospirosis was established in Savranskyi district overrunning the average long-time level by dozens of times. 97.73 % of all cases fell at the seasonal pickup from July to September.

The paper presents 4 clinical cases of membranous pharyngitis caused by Corynebacterium ulcerans in subjects aged 27, 32, 44 and 46 years, with detailed analysis. The role of the zoonotic pathogen Corynebacterium ulcerans in the emergence of a disease similar to classic diphtheria is shown. The importance of vaccination against diphtheria is emphasized in order to prevent the incidence of zoonotic infection caused by Corynebacterium ulcerans.

Background. In order to eliminate measles around the world, a panel of experts from the World Health Organization recommends increased attention be paid to improving the immunization system as a whole, to carry out early detection of infections, to assess the level of immune protection of the population, and to improve the network of laboratory services for timely diagnosis and prevention of the spread of this infection. Our purpose was to study the dynamics of measles incidence in the Odesa region in 2010–2018 and to determine the impact of the number of vaccinated and seropositive persons on the epidemic process. Materials and methods. Using analytical and statistical approaches, an epidemiological analysis of the official statistical reports of State Institution “Odesa Regional Laboratory Centre of State Sanitary and Epidemiological Service of Ukraine” was performed in the paper. Results. From 2010 to 2018, the incidence of measles in Odesa and the Odesa region has coincided with the frequency of epidemic morbidity in Ukraine as a whole. The greatest number of cases was among children aged 1–4 and 5–9 years, as well as people from the age group over 30 years. The level of antimeasles IgG detected in 2018 in all age categories have averaged 69.46 %. Conclusions. It is necessary to increase the number of vaccinated persons up to 95 % to ensure the epidemic welfare of the population in Odesa and the Odesa region and for measles elimination. Increasing level of immunized people will lead to the prevention of infection spread among the population.

Background. Acute intestinal infections remain actual diseases for many countries of the world now, especially with middle and low income, in spite of improving sanitary and hygienic conditions of living, drinking water quality. Therefore, the system of epidemiological surveillance of acute intestinal infections needs to be improved. Based on the study of the dynamics of morbidity, risk factors, new ways to improve the epidemiological surveillance of acute intestinal infections were offered. Materials and methods. The paper presents the results of studies on the dynamics of the incidence of schigellosis, salmonellosis, diarrheal escherichiosis, demographic statistics and indicators of sanitary-hygienic monitoring for 2001–2017 in the Sumy region. Epidemiological and statistical methods of research, multivariate analysis were applied. Results. It was found that in the studied period, the incidence rates for shigellosis decreased from 42.3 per 100,000 population to 0.5, salmonellosis — increased from 13.0 to 17.7, diarrheal escherichiosis — varied at 3.70–2.20. At the same time, the population of the region has decreased from 1,317.8 thousand people in 2001 to 1,104.5 in 2017, the population density — from 55.3 (persons per 1 km2) to 46.3, the natural population movement — from –11.1 to –8.6 %, migratory movement — from – 5.2 to –0.7 %, the prevalence of digestive diseases has increased — from 13,004.0 per 100,000 people to 17,124.89. It has been found that in those examined for prophylactic purposes, the frequency of shigella and salmonella isolation decreased from 146.5 and 20.7 per 100,000 population to 0, enteropathogenic colibacilli — from 671.4 to 24.9. Results of sanitary-hygienic monitoring of food and drinking water showed that the frequency of detection of “substandard” water samples was 8.1 %, meat and meat products — 5.2 %, milk and dairy products — 4.3 %, sugar and confectionery products — 5.6 %, eggs — 4.2 %. The frequency of isolation of sanitary and indicative microflora from equipment, the hands of workers in public catering facilities was 4.7 %, food enterprises and enterprises for the production of confectionery with cream — 3.4 and 1.03 %, respectively, dairies — 1.6 %. Statistical analysis conducted with the help of Statistica software package showed the dependence of the morbidity on the influence of risk factors, which can be presented as a linear multivariate regression equation. Using predictive values of risk factors, as well as regression equations, predictive values of morbidity were obtained for the most significant forms of acute intestinal infections. In 2018–2020, an increase in the incidence rate of shigellosis, salmonella, diarrheal escherichiosis is expected. Among the risk factors, the greatest impact will be the increase in population density, the prevalence of digestive diseases, migration of the population, “substandard” microbiological indicators of meat and meat products. Conclusions. Thus, identifying risk factors for unfavorable epidemiological situation and using a mathematical model to predict the development of the epidemic process of acute intestinal infections, taking into account demographic indicators and socio-hygienic monitoring data, can be an important part of the system for improving epidemiological surveillance.

The paper shows the leading etiological role of rotavirus infection among the causes of acute gastroenteritis and secretory diarrhea in childhood. It describes the contribution of rotavirus in the structure of nosocomial gastrointestinal infections. In a temperate climate, the pathogen is characterized by winter seasonality and a certain age dependence (mostly at an early age). The typical clinical features of rotavirus infection are a combination of respiratory and gastrointestinal manifestations in the form of respiratory catarrh and acute gastroenteritis. In recent years, the role of rotavirus in the development of extraintestinal cerebral symptoms (meningoencephalitis, seizures, myositis, and poliomyelitis-like illnesses) has been proved.

The article deals with the history of measles virus discovery, epidemic outbreak of measles over the last 15 years in Ukraine. The paper presents the data on the features of measles clinical picture in children and adults with typical and atypical forms, criteria for diagnosis, as well as possible protection against this dangerous infectious disease.

The article gives a complete performance of parasitic diseases such as trichinosis and opisthorchiasis. These parasitic diseases rank 7th and 8th in the rate of the risk of food contamination by parasites, published by the World Health Organization and the Food Agriculture Organization in 2014. The paper deals with a historical overview of these diseases, as well as the features of pathogenesis, clinical manifestations, diagnosis and treatment.

In this paper, we consider a variant of the local anti-inflammatory therapy in acute tonsillopharyngitis in children with anti-inflammatory, analgesic effect, both as monotherapy and in combination with antibacterial agents.

The paper deals with the comparative analysis of composition of colonizing microflora in children with bronchial asthma (BA) and acute respiratory infection (ARI). The constant oropharyngeal biotopes in children with ARI and BA were Staphylococci and α-hemolytic Staphylococci. The arm groups differed by the content of secondary microorganisms: ARI were associated with Streptococcus spp. with β-hemolysis, E.coli and Candida spp., BA was associated with autochtonous microorganisms (Streptococcus spp. with β-hemolysis, Moraxella spp., Corynebacterium spp.). The variety of species composition of oropharyngeal biota was doubled in patients with ARI compared with the children with BA. Staphylococci and Streptococci prevailed at both ARI and BA.

This paper presents the results of a study of patients with nonalcoholic steatohepatitis, alcoholic steatohepatitis, and drug-induced liver injury. In patients with liver injury, changes in intestinal microflora were marked. After a combination therapy of this pathology with L-ornithine L-aspartate and symbiotic, an improvement of biochemical, clinical indicators was observed, as well as a decrease in fatty degeneration, reduction of elastographic indicators of liver fibrosis. The introduction of the drug formulation L-ornithine L-aspartate and symbiotic in the complex of conservative treatment of steatohepatitis help to prevent complications and increase the treatment efficacy of these diseases.

The paper considers the role of antigenic imprin­ting phenomena and antibody-dependent enhancement of infection in epidemic, infectious and postvaccinal processes. Based on published experimental data, it is shown that both phenomena are directly related to the laws of development and course of epide­mics, the pathogenesis of infectious diseases and safe use of vaccines. Their ignoring by researchers has led to failures in the design of vaccines against HIV/AIDS, dengue fever, influenza, malaria, hemorrhagic fever and encephalitis. These data show that, without taking into account the two phenomena, the further development of immunology and epidemiology in the direction of breakthrough discoveries in there areas of science are impossible.

Measles is an infection controlled by means of vaccination, which continues to be a great social and economic problem for the Ternopil region. The paper analyzed the materials of accounting documents of the Head Department of the State Sanitary and Epidemiological Service of Ukraine and pediatric infectious hospitals in the Ternopil region. The incidence of measles, which was registered during the time of independence, was much higher than the nationwide figures, had epidemiological rates typical for prevaccination period. In all analyzed peak periods, the school-age children were age group most vulnerable to measles. We have found a strong tendency to shifts in the incidence towards senior school age and adult population. Among patients, there was a high percentage of vaccinated individuals. The emergence of measles virus genotype D4 was laboratory-confirmed during the last outbreak in the region. Analysis of measles outbreaks reflects the need for deeper study of the characteristics of the formation of post-vaccination anti-measles immunity in the present conditions, taking into account the need to investigate specific immunological phenomena.

The paper is devoted to the problem of treatment of chronic dermatopathies. There are demonstrated the data of study of therapeutic efficiency and tolerance of Bedan cream I patients with dermatopathies. Bedan cream used in a complex therapy of chronic dermatopathies was shown to lead to earlier reduction of objective and subjective signs of chronic dermatosis and clinical regression. It was found a good tolerance of Bedan cream: its application was not associated with deterioration of general condition of skin, its irritation and allergization.

The paper deals with the problems of diagnosis, differentiated diagnosis, dispensary for disease, prevention and treatment of poliomyelitis in children. There are presented the WHO guidelines on poliomyelitis for Ukraine.

The paper evaluated the treatment of giardiasis using modern drugs. The regimen of the treatment and prevention simultaneously with albendazole and ornidazole is recommended, simultaneous treatment of contact invasions (enterobiasis and giardiasis) is proved.

In recent years, the attention of many scientists has been focused on the different aspects of immunomodulatory role of the vitamin D in the human body, and, most of all, its role in the proliferation and differentiation of immune cells, activation of non-specific immunity and antifibrotic properties. The paper presents the results of the study of the biochemical status of the active form of 25-hydroxycholecalciferol (25(OH)D3) in patients with chronic hepatitis C. Thus, it proved the presence of an absolute deficiency of 25-OH-vitamin D3 in patients with chronic hepatitis C.

The paper considers the current aspects of epidemiology, diagnosis, clinical picture and treatment of acute rotavirus-induced diarrhea in children. There are presented the basic thesis of ESPGHAN consensus (2014) about acute diarrheas. There was analyzed the effectiveness of probiotic Subalin producing interferon for the treatment of acute rotavirus-induced diarrhea. It was demonstrated its effectiveness according to the literature review and own data.

The paper presents an analysis of some epidemiological characteristics of sudden infant death syndrome (SIDS) in the Donbass region for a period of 1994–2014. The prevalence and specific relevance of SIDS, dynamics of specific gravity of SIDS in the structure of infantile mortality is shown.

The paper summarizes the results of a comprehensive survey of 120 patients with peptic duodenal ulcer combined with ischemic heart disease. In patients with combined pathology we had found common pathogenic mechanisms, including asthenoneurotic ones. Expediency of using combined herbal preparation gastritol in medical rehabilitation was pathogenetically substantiated.

The paper presents an analysis of the species composition of bloodsucking mosquitoes collected in 2011–2012 by the specialist of the laboratory for epizootiology of especially dangerous infections in Kominternivske, Berezivka, Kiliia, Bilaiivka and Bilhorod-Dnistrovskyi districts of the Odessa region. There was identified a numerical dominance of species of family Culicidae (Culex pipiens) — one of the main carriers of many dangerous human and animal diseases.

The paper presents the results of thorough examination of 100 newborns, clinical and immune features associated with early neonatal sepsis development. The most significant of them are prematurity, marginal birth weight parameters and invasive procedures and observations. It was shown that serum level of C-reactive protein > 60.0 ml/l is significantly associated with sepsis risk in a newborn aged less than 48 hours with odds ration 1.9.

The paper presents the characteristics of the course, clinical manifestations and principles of yersiniosis treatment in children. It is shown that liver damage in this disease is fairly common symptom that requires medical correction. The application of Artibel, herbal preparation on the basis of artichoke dry extract, as an agent for pathogenetic therapy is grounded.

The paper presents the results of quantitative content of HBsAg investigation in patients with HIV/chronic hepatitis В coinfection compared with the presence/absence of hepatitis В virus DNA and alanine aminotransferase level in the blood. It has been found that in patients with HIV/chronic hepatitis В coinfection, who receive treatment, the absence of hepatitis В virus DNA is significantly associated with a reduced HBsAg level, and especially with increasing duration of treatment. When compared with the content of alanine aminotransferase, it has been revealed that HBsAg level significantly increased only in patients who did not receive antiviral treatment and have alanine aminotransferase level above normal. Thus, quantification of serum HBsAg can be considered as reliable additional criterion for monitoring the treatment of patients with HIV/chronic hepatitis В coinfection using nucleoside reverse transcriptase inhibitors.

Lyme borreliosis (LB) — the most common natural focal transmissible infection which occur in the USA, Europe, including Ukraine. It is a multisystem disease affecting the skin, heart, nervous system, joints that are prone to prolonged course. Official registration of the disease in Ukraine is being carried out since 2000. Level of epidemiological registration increases every year: LB incidence in Ukraine since 2000 for 10 years has increased 29 times, in the Dnipropetrovsk region — 12 times. The disease goes through several stages: from the appearance of the primary form — erythema migrans to the formation of chronic forms, which can lead to disability. In 25–50 % of patients, in the absence of adequate antibiotic therapy, in the early LB period we defined chronic form of the disease, especially heart failure. In this paper we present an algorithm for early diagnosis of «minor», clinically silent forms of heart disorders in LB at the early stages of the disease with the aim of rational choice of antibiotic therapy. It is shown that serological markers of LB (antibodies to IgM and IgG Borrelias) can not be used to monitor the effectiveness of therapy.

The paper analyses the influence of acute respiratory infections on pregnancy course. Special attention is paid to the impact of endogenous intoxication syndrome and substantiation of a choice for a study of its presence. We have analyzed and described the role of nitric oxide in pathogenesis of inflammatory and immune processes in pregnancy complicated by acute respiratory viral infection. Attention is paid to the special requirements in the treatment of these patients. The method for treatment of acute viral rhinitis in pregnant women through the use of a combination of drugs and engystol and sinupret has been offered. It is found that conducting a comprehensive treatment of pregnant women with acute respiratory viral infection, acute rhinitis using engystol in combination with herbal drug sinupret has pathogenetic orientation due to antiinflammatory, detoxification, antiviral, antihistaminic, secretolytic and immunomodulatory effects of these drugs. We found that, among other treatments for acute respiratory viral infections in pregnant women, proposed therapy is highly effective, has no side effects and is well tolerated by pregnant women. Method is available, not harm, helps to optimize the treatment of pregnant women, providing its desirability and feasibility of mass use.

Currently epidemiological approaches to the investigation of biological terrorist attacks are based on the same concepts that are used for epidemiological investigation of epidemic processes (outbreaks) that have natural causes. Therefore, the aim of this paper — to base approaches to identification of artificially induced outbreaks of infectious diseases. It is found that artificial epidemic processes (outbreaks) have distinct epidemiologic, etiologic and clinical aspects. Currently there are two types of artificial epidemic process development: 1) when the biological agent is used once by criminals; 2) when it is used repeatedly. Characteristic features of the epidemic process of the first type can be regarded compressed epidemic curve with a peak of incidence fit into the average value of the incubation period of the disease, and localization of an epidemic outbreak (epidemiology of point source). The second type is characterized by stretched epidemic curve far exceeds the duration of the incubation period of the disease. Common to both types of artificial epidemic process will be impossible epidemiology — feature of artificial epidemic processes, indicating that in nature there are no conditions for their development, and impossible clinical form of a disease, ie clinical form not occurring under natural infection, such as pathology of fine aerosol, which may be caused only by spray with a dispersed phase of 1–5 microns. In an epidemiological investigation of artificially induced outbreak of infectious disease there are three phases: the collection of epidemiological data, descriptive and analytical stage. Analysis of features of lesions by microorganisms that are potential agents of biological weapons, has shown that clinic, pathoanatomy, pathohistology, molecular genetic research methods provide sufficient information to recognize the artificial nature of such outbreaks of infectious disease. However, their specificity is that in fact they form an independent (third) part of epidemiology, which has its own methodology, goals and objectives — epidemiology of artificial epidemic processes and biological lesions.

The use of combination antiviral therapy enables to achieve sustained virologic response in patients with chronic hepatitis C, but in some patients side effects occur during treatment. A special place among the undesirable manifestations of specific therapy for chronic hepatitis C take hematologic syndromes. In this paper we study some features of the pathogenesis of anemia that develops in patients with chronic hepatitis C receiving antiviral drugs.

The article provides a literary analysis of the current state of the problem of early diagnosis of tonsillopharyngitis in childhood, namely timely etiological diagnosis of the disease. The questions of etiology, epidemiology, clinical picture, differential diagnosis, paraclinical diagnosis, directions of treatment for tonsillopharyngitis in children were considered. Emphasis was placed on the literature review of the problems and the modern limitations of rapid etiological diagnosis of tonsillitis in children, as well as the principles of efficient antibiotic therapy and disease prevention methods from the standpoint of evidence-based medicine. The paper noted that early detection of streptococcal etiology of tonsillopharyngitis is of particular importance, it allows at the very beginning of the disease to prescribe efficient antibiotic therapy. This will reduce the duration of disease, significantly reduce the risk of early complications and significant reduce the period of contagiousness of the patient, which in turn reduces the likelihood of spreading of streptococcal infection. Gold standard for detection of β-hemolytic streptococcus for the administration of antibiotic therapy is streptotest. Using of express test systems in the clinic of children’s infectious diseases should lead to improved early etiological diagnosis of tonsillopharyngitis in children and thereby contribute to the timely adequate administration of treatment, which ultimately should significantly reduce the risk of complications and contribute to a positive economic effect.

In this paper we evaluated the content of local immune factors (lactoferrin, lysozyme, secretory immunoglobulin A) in oropharyngeal secretions and microbiological examination of the oropharynx in children with recurrent respiratory infection (RRI), as well as children with RRTI and chronic compensated tonsillitis. The findings suggest the need differentiated approach in the treatment of children, who often suffer from acute respiratory infections.

The paper presents data that characterize toxoplasmosis as an extremely important pathology essential for midwifery practice. However, for a number of sections of the problem of congenital toxoplasmosis either contradictory or insufficiently substantiated data are available that implies a need to expand the understanding of the essence of the analyzed pathology.

Researches to develop vaccines with contraceptive effect are being carried out since the 1920s. Since 1972, the contraceptive vaccines are one of the priority programs of the World Health Organization (WHO Special Programme of Research, Development and Research Training in Human Reproduction). Rockefeller Foundation participates in implementing the program. Openly declared objective of creating such vaccines — the regulation of the population in the Third World countries. There are currently three main directions of contraceptive vaccine design: 1) vaccines targeted at blocking the production of gametes; 2) impairing their function; 3) violating the fertilization process. Contraceptive vaccines for more than 10 years are widely used to reduce fertility and castration of wild and domestic animals. In the commercial realization there are veterinary vaccines Equity®, Improvac®, GonaCon®, Repro-BLOC (based on gonadotropin-releasing hormone); SpayVac™ and IVT-PZP® (based on zona pellucida antigens). Clinical studies have shown effective contraceptive action (in women) of vaccines, in which human chorionic gonadotropin is used as an antigen. At the same time, there are found the side effects of such vaccines: for vaccines containing gonadotropin-releasing hormone and luteinizing hormone as antigenic components — castration, impotence; for vaccines containing follicle stimulating hormone — oligospermia; zona pellucida antigens — irreversible oophoritis. This paper discusses approaches to detection of sterilizing components in vaccines intended for mass prevention of infectious diseases, not reported by manufacturers, and the consequences of their use. Hidden use of contraceptive vaccines, which already took place, can be detected: 1) by the presence of antibodies to their antigenic components (in unvaccinated by contraceptive vaccines people such antibodies do not exist, except infertility cases); 2) by change in the hormonal levels of the vaccinated patients; 3) by malfunction and histopathological changes in the reproductive organs.

The paper analyzes the development on the first year of life of 83 perinatally HIV-infected children with rapid and slow progression of the disease. The comparison group consisted of 52 uninfected children born to HIV-infected mothers. Psychomotor development, state of skin and mucous membranes, as well as of lymph nodes, liver and spleen were eassessed. It turned out that psychomotor retardation and oropharyngeal candidiasis are markers of rapid disease progression in HIV-positive children in the first year of life.

The paper presents the comparative analysis of antiendotoxic immunity parameters and free-radical oxidation in the blood of 34 patients with acute intestinal infections of rotavirus and rotavirus-bacterial etiology depending on the severity of the disease and its duration.

The paper presents the features of acute and chronic tonsillitis in children. We examined 52 patients with acute tonsillitis, they are divided into 2 groups: in the complex treatment of the first group of children we used Tantum Verde® gargle, in the second one — other local antiseptics and anesthetics. In the first group of reduction of pain symptom in the throat was observed earlier in comparison with the second one.

The paper analyzes the helminths-carrying in children with herpetic stomatitis according to the data of the department of maxillofacial surgery of the National center of mother and child welfare, and determines the relationship of oral diseases with disorders of various parts of the gastrointestinal tract.