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The aim of this review was to assess the peculiarities of distribution and epidemiological risk of rabies in the extreme northeast of Asia. The systematic review was prepared through synthesizing publications on rabies over 1860–2022 (n=22) and previously unpublished data for 2009–2023. From the late 19th century until the 1980s, rabies epizootics were consistently observed in Chukotka and Kamchatka. A correlation was found between the time of occurrence of rabies in those territories with a lag period of 1–2 years (r=0.349; p=0.054). In 2009–2023, 24 animal rabies cases were confirmed in Chukotka; rabies has not been registered in Kamchatka since 1981. Until 1982, 5 confirmed human rabies cases were described in Chukotka, as well as 4 lethal cases presumably due to rabies (Chukotka – 3, Kamchatka – 1). The similarity of the spatial distribution of epizootics in different periods of time was established. Rabies was detected mainly in the area of the permanent polar fox (Vulpes lagopus) habitation, in the coastal tundra from the mouth of the Kolyma River to the Anadyr Gulf. Outside this territory (the valleys of the Anadyr and Penzhina Rivers, the Kamchatka Peninsula), rabies was reported in red foxes (Vulpes vulpes). At present, the importance of the polar fox in the spread of rabies in Chukotka has decreased, while the significance of the red fox has increased substantially. Due to vaccination, rabies among dogs is recorded sporadically. Rabies virus isolates from Chukotka belong to the Arctic genetic lineage (Arctic-3 group), which has a circumpolar distribution. The possibility of independent circulation of the rabies virus in the Kamchatka Peninsula is doubtful because of the limited size of the red fox population. Based on the mapping, possible directions for the introduction of rabies to Kamchatka from Chukotka have been identified. Barrier oral rabies vaccination of foxes is recommended during the years of high abundance of red and polar foxes in Chukotka.

Background. About 40 % of patients diagnosed with coxarthrosis annually seek medical help and receive social support due to this disease. Increased use of an expensive surgery for treatment of coxarthrosis and projected growth of its prevalence in the population determine the relevance of socio-economic analysis.The aim of the study. To assess the value and structure of economic damage caused by the delivering health and social care to patients with coxarthrosis at the state level of the Russian Federation.Methods. To assess economic damage, we used the average annual number of various categories of patients and disabled people with coxarthrosis in the Irkutsk region for 2008–2017. Three main categories were identified: patients who visited the outpatients’ clinic; patients with total hip replacement; disabled people due to coxarthrosis. For each category, we calculated weighted average damage per 1 conventional patient, taking into account direct and indirect costs and subsequent multiplication by the average annual number of individual categories of patients. Calculations were performed in 2017 prices.Results. The average annual socio-economic damage from coxarthrosis amounted to 1.39 (1.34÷1.43) billion rubles or 0.1 % of the gross regional product. The most of the damage (64.4 %) were indirect costs associated with disability due to coxarthrosis, 22.2 % of the total amount were the costs of hip replacement surgery, 13.4 % were the costs of outpatient visits. Indirect economic losses due to disability in patients of working age were 4.2 times higher than losses due to disability of oldage pensioners.Conclusion. The results of the study confirm the economic feasibility of surgical treatment of coxarthrosis, especially in patients of working age.

Retrospective descriptive epizootological study was conducted in the Amur Oblast (Russian Far East), where a rabies outbreak was reported in 2018. The aim of the study was to analyze probable routes of rabies introduction and features of its spatial and temporal spread in the territory that remained free from this infection from 1972 to 2018. In 2018–2021, altogether 1,416 animals were examined for the infection with the rabies virus. Forty-seven animal rabies cases were confirmed; the proportion of wild animals (Vulpes vulpes, Nyctereutes procyonoides, Canis lupus) amounted to 66%. The first cases were detected within 30 km from the state border with China. Nucleotide sequences of the nucleoprotein gene of three rabies virus isolates were determined and their belonging to the Arctic-like-2 genetic lineage was established. Genetically closest rabies virus isolates have been found in Heilongjiang Province (China, 2011, 2018) and Jewish Autonomous Oblast (Russia, 1980). GIS and open Earth remote sensing data were used to map the rabies cases. After 2018, the epizootic spread within the forest-steppe landscapes of the Zeya-Bureya Plain, where human and animal rabies cases had been earlier reported (until 1972). The front of the epizootic spread in a north-eastern direction at an average speed of 59 (16–302) km during one epizootic cycle. The introduction of the rabies virus was most likely along the Amur River valley from downstream regions of Russia and China that are rabies infected.

Background. The spread of community-acquired pneumonia (CAP) in children and adults is interconnected and conditioned by natural, climatic and social factors.The aim. To assess the relationship between the incidences of CAP in different seasons of the year with the location of educational institutions in the urban settlement.Materials and methods. A cross-sectional study of the spatial distribution and seasonal dynamics of CAP cases in 2015 in a Siberian city with a population of more than 600 thousand people was carried out. Using GIS, 787 cases of CAP were analyzed among children of preschool and school age and adults. For statistical processing, 111 analyzed territorial units (ATUs) with an area of 250 m2 each were allocated on the maps. The dynamics of morbidity was assessed by weeks and seasons of the year among different age groups.Results. There was a direct moderate correlation between the number of CAP cases registered during the year with the number of schools and preschool educational institutions in ATU (r = 0.59; p < 0.001). ATUs with the presence and absence of educational institutions differed in the number of epidemic foci of CAP among the total population in winter and spring. The maximum number of cases of CAP among children and adults was registered in the second half of winter (weeks 3–13), the minimum – in the summer months (weeks 25–34).Conclusions. GIS analysis confirms the more frequent registration of CAP diseases among the total population in urban areas with educational institutions. There was established a direct moderate correlation between the incidence of CAP in children and adults by weeks of the year. Statistically significant differences in the number of cases in areas with and without educational institutions were noted in seasons with a higher incidence (autumn and winter).

Relevance. At the beginning of the pandemic, there was regional variability in incidence rates not only for COVID-19, but also for other acute respiratory infections of the upper and lower respiratory tract (ARIs). The first cases of COVID-19 in the Irkutsk region were detected two months later than the first cases in Russia, and at the beginning of the epidemic, the disease slowly spread among the local population. A retrospective analysis of ARIs monitoring is necessary to improve epidemiological surveillance. The aim of the work is to identify annual and seasonal changes in the incidence of ARIs and the circulation of respiratory viruses in the Irkutsk region before and during the first months of the epidemic of a new coronavirus infection. Materials and methods. A retrospective descriptive study was conducted based on the results of regional monitoring for 2017–2020. The analysis included records of acute infections of the upper (J06) and lower (J20-J22) respiratory tract, influenza (J10, J11), community-acquired pneumonia (J12-J16, J18) and COVID-19 (U07.1, U07.2), as well as the results of a study of 5.5 thousand samples from patients with ARIs. Respiratory viruses (n = 10) were detected using reagent kits for polymerase chain reaction (PCR) «AmpliSense® Influenza virus A/B-FL», «AmpliSense®ORVI-screen-Fl» (Russia). The distribution of incidence rates and PCR results was analyzed by years, epidemic seasons, calendar weeks, and age groups. Results. In 2020, the incidence of COVID-19 was 3180 per 100,000 population, or 7% of all cases of ARIs of the upper and lower respiratory tract (∑ARIs). In 2020, according to epidemiological service, the number of cases of acute respiratory infections decreased by 25.7%, but the number of cases of community-acquired pneumonia (CAP) increased by 83.2% (p < 0.001) compared to 2019. The incidence of CAP reached 1400 per 100,000 population. The proportion of children in the structure of CAP incidence decreased from 39.4% to 12.6% (p < 0.001), and the proportion of adults increased from 60.6% to 87.3% (p < 0.001). These changes were most pronounced during the «second wave» of COVID-19 at the end of 2020. The share of CAP in ∑ARIs on average for 2017-2020 was 2.62% (CI 2.56–2.68). This indicator was exceeded at the end of 2020 during the COVID-19 epidemic – 8.08 (CI 8.07–8.09), and also at the beginning of 2019 during the influenza epidemic – 2.83% (CI 2.81–2.85). In 2019–2020 an increase in the frequency of positive tests for human coronaviruses (hCovs) up to 2.1–2.3% was registered, compared with 0.7–0.9% in 2017–2018 (p 0.05). Conclusions. The start of the COVID-19 epidemic was accompanied by significant changes in the incidence of ARIs, although in 2020 the number of registered cases did not exceed 10% of ARIs. The increase in the proportion of CAP in ARIs and the change in age risk groups deserve special attention. The epidemiological analysis does not confirm the hypothesis of a possible spread of SARS-Cov2 in the Irkutsk region before 2020.

Background. Coxarthrosis prevalence rates are necessary to assess the socio-economic significance of this pathology and to calculate the need for endoprosthetics. Information about the provision of medical care to patients with coxarthrosis is presented in the reports of various medical organizations, but in state statistical reports at the regional level this nosological form is not taken into account as a separate line.The aim. To estimate the prevalence of coxarthrosis based on the combined use of medical records from various sources in a region with a specialized clinic for prosthetics of large joints.Materials and methods. A retrospective descriptive epidemiological study based on materials from the Irkutsk region for 10 years (2008–2017) was carried out. Three main sources of data on patients with coxarthrosis were used: continuous and randomized samples based on population visits to polyclinics (n = 24 029), information from the bureau of medical and social expertise on disability (n = 19 081) and information from a specialized clinic on total hip arthroplasty (THAP) (n = 6227). The dynamics of indicators by years, the distribution of patients by sex, age and groups of disabilities have been analyzed. Regional indicators of incidence and prevalence of coxarthrosis were calculated based on extrapolation of sample data.Results. The following average annual regional indicators for patients with coxarthrosis were calculated: primary visits to polyclinics (incidence) – 73.8 (71.9–75.7) with a frequency of visits 1.9 times a year, the frequency of THAP operations – 3,3 (3,0÷3,6), disability – 10.1 (10.0÷10.3). The median age of patients at the initial visit was 61 years (Q1 = 46; Q3 = 76). The proportion of men among different groups of patients ranged from 41 to 44%, the proportion of disabled people among patients of the polyclinic and surgical hospital – from 45.2 to 47.1%. The estimated prevalence of coxarthrosis among the adult population was 413.5 (410,6÷416,4) / 10000.Conclusions. The epidemiological analysis algorithm described in the article is proposed as the first stage in assessing the social and economic significance of coxarthrosis and the regional need for arthroplasty of large joints.

The trophic relationships between bats (Chiroptera) and Lake Baikal biota have been assessed based on microscopic studies of Myotis petax feces (n = 22). From 82 to 86% of samples had fragments of exoskeletons of caddis flies (Trichoptera) and dipterans (Diptera). These taxa include mainly aquatic and semiaquatic species. Many species from these taxa are endemic to Lake Baikal. Terrestrial insects are found in studied samples less frequently (Hymenoptera 41%, Neuroptera 27%, and Heteroptera 9%). Morphological analysis has revealed fragments of Baikal amphipods in two fecal samples of M. pretax. Further molecular studies will make it possible to detect greater invertebrate taxa diversity in fecal samples of bats feeding near Lake Baikal. [ABSTRACT FROM AUTHOR]

Relevance. Post-exposure prophylaxis (PEP) is the most effective method for reducing the morbidity and mortality of human rabies. Since 2000, in Russia, domestically produced cultural purified and concentrated rabies vaccine (COCAV) and equine immunoglobulin (AIG) are used as the main drugs for PEP.Aims. To assess the epidemiological effectiveness of post-exposure rabies prophylaxis and possible causes of failure in the Russian Federation in 2001–2018.Materials & methods. A comprehensive retrospective epidemiological study of 167 cases of rabies in humans and PEP statistics in the Russian Federation was carried out. To test the hypotheses about the relationship between PEP failures and risk factors, namely (gender, age, place of residence of the sick, nature of the injuries received, source of infection), two main comparison groups were formed: «vaccinated» (n = 28) and «not vaccinated» (n = 139). In addition, we compared the groups who received PEP correctly and those vaccinated with violations of instructions. The failure rate was assessed in relation to the total number of vaccinated and the number of vaccinated after contact with rabid animals.Results. During the analyzed period, the incidence of human rabies decreased from 0.015 to 0.0013 per 100 thousand population. Of the patients, 83.2% did not receive PEP (did not apply, vaccinations were not prescribed, refused). In the group «vaccinated» in 53.6% (n = 15), the schemes of PEP prescribing and administering were violated, including in 35.7% (n = 10) of cases AIG was not administered. The rest 46.4% (n = 13), received vaccinations in accordance with the instructions. Before the end of the vaccination course, 85.7% (n = 24) fell ill; the rest fell ill with an incubation period of more than three months. Only one person received AIG and all 6 vaccine injections. The group «vaccinated» differed from the group «not vaccinated» by a higher frequency of category III injuries (χ2 = 9.99, p = 0.019) and injuries caused by wild animals, especially wolves (χ2 = 22.24, p < 0.001).Conclusions. Among people who developed rabies in 2001–2018, 16.8% received PEP. The proportion of the number of cases and the total number of those who received PEP was 1: 240.0 thousand. The failure rate of PEP after contact with rabid animals was 0.03% (excluding the nature of the contact and the animal species). More than 70% of all failures are associated with wolf and fox bites, more than 85% with category III injuries.

The aim of the study was to improve monitoring of natural foci of rabies based on the use of modern technologies of cartographic analysis.Materials and methods. A retrospective study was carried out on the data of official registration of rabies in the Trans-Baikal Territory (Eastern Trans-Baikal Region) for 1950–2020. The spatial spread of rabies among animals was compared for two time periods: 1972–1978 (n=157 cases) and 2014–2020 (n=61 cases). Software packages QGIS 3.16.0, ArcMap 10.8.1, ArcScene 10.8.1 and electronic landscape-geographical maps of the world “Natural Earth”, “OpenStreetMap” were used for the mapping. Analyzed territorial units (ATUs) tied to a degree grid (0,5º × 0,5º) were marked on the cartograms. The interdependence between the localization of rabies cases and landscape elements was assessed statistically, comparing between the rabies free and the rabies affected ATUs.Results and discussion. Differences in the landscape confinedness of rabies epizootics in Eastern Trans-Baikal Region at different periods of time have been established. Until 1983, dog rabies prevailed, and epizootics spread beyond the forest-steppe zone. In 1984–2013 rabies among animals was not recorded. In 2014–2020 red foxes (Vulpes vulpes) were the main source of the rabies virus. The area of the epizootic has more than halved in comparison with 1972–1978. The main manifestations of rabies were observed at the junction of lowland and mountainous, steppe and forest areas. The rabies affected ATUs were characterized by more pronounced landscape variables. Possible routes of cross-border spread of the rabies virus have been identified. The connection between the features of the spatiotemporal spread of rabies and genetic variants of the virus, climate change, animal migrations and anthropogenic factors in Eastern Trans-Baikal Region in 1950–2020 is discussed. The results of the study are proposed to be used to adjust the programs for barrier oral vaccination of the foxes.

Relevance. The experience of combating rabies in Europe has shown that the tactics of preventive measures in mountains must be modified. At the beginning of the 21st century, the spread of fox rabies into the previously rabies-free mountain areas in southern Siberia was noted. The aim is to trace the spread of rabies in the Altai Mountains after the introduction of the virus. Materials and methods. A retrospective descriptive study using GIS was carried out. For mapping, information on 55 laboratory confirmed cases of rabies in the Altai Republic, QGIS 3.16.0, ArcMap 10.8.1, ArcScene 10.8.1 programs and an electronic landscape-geographical maps "Natural Earth" and "Open street map" were used. The spatial-temporal distribution of rabies was compared with changes in postexposure prophylaxis (PEP). Results. In 2007, rabies was detected for the first time since 1948 in the Altai Mountains. Wild animals (fox, wolf, badger) accounted for 52.7% (95% CI 39.5–65.9). Most of the cases were found in the foothills and river valleys at an altitude of less than 1,000 meters above sea level and only 16.4% (0.0–26.2) – in areas with heights from 1,000 to 2,000 m. Rabies was not recorded in the mountains above 2,000 m. Two different directions of the virus introduction are assumed: from the forest-steppe plains of the Altai Territory (Russia) and from the mountainous steppes of Mongolia. In 2007–2019 the annual number of patients seeking medical attention after animal bites increased by 86%. A correlation between the animal case number in different areas and the average annual PEP was noted (r = 0.649, p = 0.03). 4. Conclusions. Features of the fox rabies spread in the Altai Mountains allows to use the experience of fighting this disease in the mountainous regions of Central Europe.

Abstract Background Palearctic bats host a diversity of lyssaviruses, though not the classical rabies virus (RABV). As surveillance for bat rabies over the Palearctic area covering Central and Eastern Europe and Siberian regions of Russia has been irregular, we lack data on geographic and seasonal patterns of the infection. Results To address this, we undertook serological testing, using non-lethally sampled blood, on 1027 bats of 25 species in Bulgaria, the Czech Republic, Poland, Russia and Slovenia between 2014 and 2018. The indirect enzyme-linked immunosorbent assay (ELISA) detected rabies virus anti-glycoprotein antibodies in 33 bats, giving an overall seroprevalence of 3.2%. Bat species exceeding the seroconversion threshold included Myotis blythii, Myotis gracilis, Myotis petax, Myotis myotis, Murina hilgendorfi, Rhinolophus ferrumequinum and Vespertilio murinus. While Myotis species (84.8%) and adult females (48.5%) dominated in seropositive bats, juveniles of both sexes showed no difference in seroprevalence. Higher numbers tested positive when sampled during the active season (10.5%), as compared with the hibernation period (0.9%). Bat rabies seroprevalence was significantly higher in natural habitats (4.0%) compared with synanthropic roosts (1.2%). Importantly, in 2018, we recorded 73.1% seroprevalence in a cave containing a M. blythii maternity colony in the Altai Krai of Russia. Conclusions Identification of such “hotspots” of non-RABV lyssavirus circulation not only provides important information for public health protection, it can also guide research activities aimed at more in-depth bat rabies studies.

Rabies is endemic on the considerable part of the Russian Federation, and it is associated with current natural outbreaks of the infection. The highest animal morbidity rates are reported in the central and southern regions of the European part of Russia and in the southern part of Western Siberia. The Irkutsk Oblast is among the few regions of our country, which are rabies free for several decades. The research was aimed at the analysis of factors aiding to the maintenance of the rabies free status of the region. Retrospective study of archive and previously published reports on human and animal rabies cases in the Irkutsk Oblast starting from 1954 was performed. Epidemics of urban rabies ceased in the region in 1970s. Sporadic rabies cases in dogs, reported in 1976 and later, could be imported or could result from the infection from bats. Diagnostic errors were also possible. Rabies is reported in foxes in the Subjects bordering the Irkutsk Oblast: Krasnoyarsk Krai and Republic of Buryatia. It is supposed that in case of the infection introduction the forest-steppe agricultural areas near the Angara River are likely to be affected due to high population of foxes. Relative geographic isolation of the Irkutsk Oblast favors to the long animal rabies freedom of this territory. The vast area of mountain taiga with low fox population serves as an ecological barrier. In 2007–2009 and in 2019, barrier oral vaccination was carried out along the border with the Krasnoyarsk Krai and on the west coast of Baikal Lake. Measures for anti-rabies vaccination of dogs and cats were intensified. Active virological monitoring is performed on a regular basis. The paper demonstrates cartograms of fox and wolf population density along with designation of sites, where oral vaccination of wild carnivores was performed.

Objective: To evaluate the historical long-term forecast of the spatial spread of rabies in Siberia and Far East and to characterize modern approaches to spatial forecasting. The concept of spatial spread of rabies in the Asian part of Russia, developed in the 80s of the twentieth century, is subjected to critical analysis based on information on rabies registration for 1881–1980 and zoogeographic data. At that time, 5 rabies enzootic regions were identified, and the most probable directions of further exportation of infection suggested. At first, a review of published data on human and animal rabies cases for the period of 1985–2019 was undertaken (including reference publications). Data on cases of rabies among humans and animals were selected for which geographical coordinates could be determined. Mapping was performed using GIS (QGIS 3.12.0 software and “Natural Earth” and “OpenStreetMap” electronic maps). Comparison of maps for different time periods demonstrated that rabies incidence was recorded mainly within the previously identified risk areas. However, the occurrence of human disease in different regions did not always correspond to the intensity of epizootics and the predicted risk. Next, in an attempt to correct the prognosis of the spatiotemporal rabies spread, we reviewed publications that incorporated virus genetic data along with GIS technology and modeling application. The distribution of the three major rabies virus lineages (“steppe”, “Arctiс-like”, “Arctic”) corresponded to the regions that were previously identified. The spread of fox rabies (the “steppe” rabies virus lineage) in the north-east direction was described. In several instances, rabies outbreaks in southern Siberia and Far East were associated with cross-border movement of the virus from Kazakhstan, Mongolia and China. Data on the speed of the epizootic waves, pathways, and natural barriers for virus spread are discussed. The correction of the forecast for rabies virus circulation and spread is important for the development of control strategies in the region, including oral vaccination of wildlife virus reservoirs.

Publications, directive and instructionalmethodical papers of WHO, Government and Ministry of Public Health of Russian Federation prepared due to SARS epidemics are reviewed. A brief characteristics of the new disease is represented, the history of the virus discovery, the disease dynamics and SARS dissemination in the world in 2003 are described. Information about SARS suspected cases in Russia and main data on laboratory and clinical epidemiological diagnostics are represented. Measures undertaken for the new disease control are considered in the concluding part of the review. Peculiarities of Siberia and Far East (the region closely connected with the most SARS affected Asian countries) are marked.

Hepatitis A (HA) is one of the most widespread intestinal infections. At present, selective and planned vaccination strategies against HA are used in different regions of the Russian Federation. The goal is to characterize the peculiarities of the manifestation of the epidemic process of HA at the regional level before and after the start of selective vaccination of the population. Materials and methods. A descriptive retrospective epidemiological study on the materials of the Irkutsk region for 1955–2017 was conducted. The incidence in the years before and after the start of vaccination were compared (2003). Municipalities with different incidence of HA were compared by the nature of water sources, bacteriological and chemical indicators of water. Resutls. Long-term movement of the incidence was divided into three periods. In 1955–1980 there was a growth trend, then the incidence decreased until 2005, after which it stabilized (annual average growth rates + 2.4%, – 2.5%, – 0.2%). Until 1992, the incidence exceeded 100 per 100 thousand population. After 2003, 1-7 thousand people were vaccinated per year (no more than 0.3% of the total population). The total number of vaccinated people for 2003–2017 exceeded 30 thousand (1.3%). A weak correlation was observed between the number vaccinated people and HA incidence in the following year (ρ = 0.154, p > 0.05). After 2005, the incidence did not exceed 10 per 100 thousand; the structure of morbidity changed due to an increase in the proportion of children and the rural population. Seven high-risk and moderate-risk areas for HAV were identified, which had higher ranks in terms of bacteriological indicators of drinking water compared to areas with low incidence. The relationship between the characteristics of water supply sources and the HAVincidence rate in these groups of areas (х² = 2,527 р = 0.471) was identified. Conclusion. The results of the study are in favor of the need to move from a selective to a planned strategy for vaccinating the population against HAV in rural areas, where it is not possible to quickly organize the supply of drinking water of guaranteed quality to the population.

The system of epidemiological surveillance of community-acquired pneumonia (VP) in the Russian Federation (RF) has changed since 2011. As a result, additional opportunities have emerged for a comparative analysis of the incidence of EP and ARVI. The goal is to give a comparative description of the incidence of CAP and ARVI by age groups, territories and seasonality, taking into account the results of a selective laboratory examination of patients.Materials and methods. A retrospective descriptive epidemiological study on the results of epidemiological surveillance at the regional level (Irkutsk Region, 2012–2016) was conducted. For 2016, the dynamics of the patient’s number with influenza and acute respiratory viral infections (n = 706460) and VP (n = 15279) reported by weeks, as well as the results of selective PCR examination of 1788 patients for 13 viral and bacterial pathogens were analyzed.Results. Over 5 years, the incidence of the VP increased from 377.6 (370.0–385.2) per 100 thousand to 588.3 (578.7–597.9), the average annual growth rate was + 35.8%. At the same time, the incidence of ARVI decreased at an average annual rate of –2.9%. When comparing the incidence of CAP and ARVI in municipalities, it was found weakly correlation only (ρ = 0.172, p> 0.05). In contrast, in the analysis of seasonality, a direct strong correlation was found between SARS and EP by weeks of the year (ρ = 0.887, p

Notwithstanding the availability of effective vaccines, 40 - 60 thousand rabies cases in humans are reported every year. Almost always the disease is fatal because therapeutic treatment of lyssavirus encephalitis has not been developed. Since 1970 the number of reports on rare cases of convalescence including those using experimental treatment protocols has been gradually increasing 20 cases of convalescence, “partial” convalescence or long-term survival of humans (1970-2015) were selected as they were complaint with laboratory criteria of active lyssavirus infection. Children and teenagers were predominant in the analyzed group (85%). The cases were irregularly spread between the continents: Asia - 6 cases, North America - 6 cases, Africa - 2 cases and Europe - 1 case. India and the USA were on the top of the list of countries by the number of described cases. More than 60% humans were infected from dogs, three cases got infection from bats and 2 cases were allegedly associated with an unknown lyssavirus and an unidentified infection source. 70% cases were vaccinated and 10% cases were treated with gamma globulin before the disease onset. Serological tests for detection of antibodies to lyssaviruses in cerebrospinal fluid of infected humans were typically used for diagnostic laboratory verification. Less than 30% IFA and PCR positives were obtained. Lyssaviruses were never detected. Only 4 convalescent patients were treated using experimental protocols. 80% cases demonstrated severe neurological consequences, four (may be more) patients died afterwards within the period from two months to four years. Different perspectives on prospects of Milwaukee protocol use and other therapeutic techniques are given.

White-nose syndrome (WNS) is a fungal disease caused by Pseudogymnoascus destructans that is devastating to Nearctic bat populations but tolerated by Palearctic bats. Temperature is a factor known to be important for fungal growth and bat choice of hibernation. Here we investigated the effect of temperature on the pathogenic fungal growth in the wild across the Palearctic. We modelled body surface temperature of bats with respect to fungal infection intensity and disease severity and were able to relate this to the mean annual surface temperature at the site. Bats that hibernated at lower temperatures had less fungal growth and fewer skin lesions on their wings. Contrary to expectation derived from laboratory P. destructans culture experiments, natural infection intensity peaked between 5 and 6°C and decreased at warmer hibernating temperature. We made predictive maps based on bat species distributions, temperature and infection intensity and disease severity data to determine not only where P. destructans will be found but also where the infection will be invasive to bats across the Palearctic. Together these data highlight the mechanistic model of the interplay between environmental and biological factors, which determine progression in a wildlife disease.

Abstract Background Spatiotemporal distribution patterns are important infectious disease epidemiological characteristics that improve our understanding of wild animal population health. The skin infection caused by the fungus Pseudogymnoascus destructans emerged as a panzootic disease in bats of the northern hemisphere. However, the infection status of bats over an extensive geographic area of the Russian Federation has remained understudied. Results We examined bats at the geographic limits of bat hibernation in the Palearctic temperate zone and found bats with white-nose syndrome (WNS) on the European slopes of the Ural Mountains through the Western Siberian Plain, Central Siberia and on to the Far East. We identified the diagnostic symptoms of WNS based on histopathology in the Northern Ural region at 11° (about 1200 km) higher latitude than the current northern limit in the Nearctic. While body surface temperature differed between regions, bats at all study sites hibernated in very cold conditions averaging 3.6 °C. Each region also differed in P. destructans fungal load and the number of UV fluorescent skin lesions indicating skin damage intensity. Myotis bombinus, M. gracilis and Murina hilgendorfi were newly confirmed with histopathological symptoms of WNS. Prevalence of UV-documented WNS ranged between 16 and 76% in species of relevant sample size. Conclusions To conclude, the bat pathogen P. destructans is widely present in Russian hibernacula but infection remains at low intensity, despite the high exposure rate.

A retrospective descriptive epidemiological study of an incidence rate and prophylaxis of tick-borne encephalitis (TBE) was carried out in the Republic of Khakassia over 2007–2016. Also, a relative risk (RR) of the incidence rate was assessed in the cohorts of vaccinated and unvaccinated population. Over the decade, 569 TBE cases were registered. There is a distinct tendency of TBE rate reduction (slope coefficient of the regression line b = –1.1 per annum, P < 0.05) as well as an expressed irregularity in the territorial distribution of longterm average annual rates in various towns and rural districts (from 0.9 up to 44.2 cases per 100 thousand people). In the vaccinated population cohort the TBE was registered 22.8 times less than in the unvaccinated one: χ2 = 23.78 (P < 0.001); RR = 3.1 (1.9–4.9). As the extend of mass-vaccination (b = 0.06 per annum, P < 0.05) and the area of acaricide treatments (b = 0.09 per annum, P < 0.05) were increasing, the number of virus-carrying ticks was reducing (b = –0.09 per annum, P < 0.001). The results of the comparison analysis of affect to the incidence of TBEcontrollable and uncontrollable factors in the territories with various rates of incidence prove the practicability of a risk-based approach to the prophylaxis of tick-borne encephalitis.

After the epidemic in the middle of 1990-s, incidence of syphilis in Irkutsk region reduced from 432.4 in 1997 to 66.4 in 2013. At the same time incidence of gonorrhea reduced from 375.9 in 1993 to 75.8 in 2013 per 100,000 of population. About 10 000 cases of gonorrhea and 12 000 cases of syphilis are reported annually during the pick of the epidemic. We used cost-benefit analysis to estimate the economic efficiency of regional morbidity reduction. The costs were adjusted to 2013 year prices. Average direct and indirect costs per case were as follows: syphilis 23.2 and gonorrhea 7.1 thousand rubles. Reductions in syphilis and gonorrhea from maximum in the middle of 1990-s to 2013 have saved about 300 million rubles approximately. In 2005-3013 the costs reduction was estimated as 10 million rubles per year. This sum composed about 20 % of total subsidy from federal budget to Irkutsk region for struggle with sexually transmitted infections (STI). Per year correlation between sum of subsidy for struggle with STI and number of syphilis cases composed -0.54 and -0.55 of gonorrhea cases (p > 0.05). Social factors also were discussed among reasons of morbidity reduction. In 2005-2013 regional income and birth-rate in Irkutsk region were increasing in contrast with the middle of 1990-s.

Mortality from pneumonias in Russia stays on high level with periodical increase. In order to study this occurrence is necessary the complex approach with obligatory regards for results of postmortem pathological investigations. In the paper are analyzed 8 lethal outcomes coded as pneumonias and 30 due to influenza with different role of bacterial component. Was demonstrated that death in cases of pneumonia usually occurred in patients with severe background pathology (alcohol abuse, chronic hepatitis etc) and in combination with viral lesions as well. Development of bacterial complications of influenza doesn’t correspond directly neither with the age of the patients, nor the duration of the illness or hospitalization. In Irkutsk were investigated 30 cases with the use of morphological, bacteriological, and PCR. Was proved the high value of information due to PCR which correlated with clinical and pathological data. Importance of pneumococci in etiology of community acquired pneumonia was shown (11 cases versus 1 positive culture). Was assumed that the course of pneumonias depends upon the properties of their pathogen.

The prevalence of coxarthrosis in Ust-Ordynsk Buryat Region was defined as 19,8 ‰0 This article gives complex characteristics of coxarthrosis in the named region.