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The association of pertussis with various respiratory infections in children is the leading factor determining the complicated course and unfavorable outcome of the disease.Objective. To analyze clinical and immunological features of the combined course of pertussis and rhinovirus infection.Children characteristics and research methods. The authors observed 20 patients: 10 (50%) children were under the age of 1 year, 5 (25%) children of 1–3 years old, 3 (15%) children of 4–6 years, 2 (10%) children of 7 -14 years old.Results. The rhinovirus infection developed mainly at 1-2 weeks of illness in 18 (90%) children. Bronchitis developed in 11 (55%) children, pneumonia – in 4 (20%). Special attention was drawn to the low content of NK cells in 82.4% of patients when assessing the subpopulation composition of lymphocytes. The cytokine profile was characterized by a low level of interferon-gamma and interferon-alpha production – in 94.4 and 61.1% of patients, respectively.Conclusion. The combination of pertussis and rhinovirus infection in children contributes to the uneven course of the disease, the frequent development of bronchopulmonary complications.

Acute respiratory viral infections remain the most common diseases in the world, accounting for about 90% of all infectious diseases. The possibilities of etiological decoding of ARVI using modern examination methods made it possible to establish an increase in the proportion of rhinovirus infection in the structure of ARVI.The aim of the study in this regard was to study the features of the clinical course of rhinovirus infection in children of different ages in modern conditions. The study included 50 patients with rhinovirus infection of children, among whom 1 2 children (24%) were under 1 year old; 34 children (68%) — 1—3 years old, 4 children (8%) — 3—7 years old. To confirm rhinovirus infection, a study of mucus from the nasopharynx by PCR was carried out.A thorough analysis of the symptom complex of the infection showed that in 1 3 (26%) patients the infectious process was limited to lesions of the upper respiratory tract, in 14 (28%) there were symptoms of acute stenosinglaryngotracheitis, in 1 1 (22%) children developed pneumonia, in 1 2 (24%) — bronchitis, with obstructive syndrome in 1 0 (83.3%) patients in this group.

The article presents the features of the influenza virus circulation for the period from October 2016 to May 2017 in some territories of Russia collaborating with the D.I. Ivanovsky Institute of Virology, Federal State Budgetary Institution "N.F. Gamaleya Federal Research Centre for Epidemiology and Microbiology", Ministry of Health of the Russian Federation. One of the 2016-2017 season's peculiarities in Russia and countries of the Northern hemisphere was the earlier start of an increase in ARD morbidity with peak indexes reached towards the end of December 2016 - January 2017. First, influenza A(H3N2) virus was predominant; then, it was followed by influenza B virus activity observed until the end of the season. The indexes of morbidity were higher than in the previous season, while the rates of hospitalization and mortality were lower, lethal cases being detected in persons 65 years old and older. Epidemic strains of influenza A(H3N2) virus belonged to 3c.2a genetic group, reference strain A/Hong Hong/4408/2014, and its subgroup 3c.2a1, reference A/Bolzano/7/2016, that are antigenically similar. Strains of influenza B virus were antigenically similar to the B/Brisbane/60/2008 vaccine virus. Strains were sensitive to oseltamivir and zanamivir. The share participation of non-influenza ARI viruses was similar to preliminary epidemic seasons. WHO has issued recommendations for influenza virus vaccines composition for 2017-2018 for the Northern hemisphere.Представлены данные о циркуляции вирусов гриппа в период с октября 2016 г. по май 2017 г. в отдельных регионах России, сотрудничающих с Институтом вирусологии им. Д.И. Ивановского ФГБУ «НИЦЭМ им. Н.Ф. Гамалеи». Отличительной особенностью эпидемического сезона 2016-2017 гг. в России и странах Северного полушария стало раннее начало роста заболеваемости, пиковые значения которой регистрировали уже с конца декабря 2016 г. - в январе 2017 г. В этот период наибольшую активность проявил вирус гриппа A(H3N2), на смену которому в феврале-марте 2017 г. пришел вирус гриппа В. Показатели заболеваемости были несколько выше по сравнению с прошлым эпидемическим сезоном 2015-2016 гг., в то же время число госпитализаций и летальных случаев было значительно меньше, и в основном их регистрировали в возрастной группе 65 лет и старше. Эпидемические штаммы вируса гриппа A(H3N2) принадлежали к генетической группе 3С.2а, представленной А/Гонконг/4508/2014, и его подгруппе 3С.2а1, представленной А/Бользано/7/2016, которые по антигенным свойствам имели близкое родство друг с другом. Штаммы вируса гриппа В были близкородственны вакцинному штамму В/Брисбен/60/2008. Эпидемические штаммы были чувствительными к препаратам с антинейраминидазной активностью. Долевое участие возбудителей ОРВИ негриппозной этиологии было сравнимо с аналогичным показателем в предыдущих эпидемических сезонах. Представлены рекомендации по составу гриппозных вакцин для стран Северного полушария на 2017-2018 гг.

In the 2015-2016 epidemic season, there were dominant influenza A(H1N1)pdm09 strains (over 90%) among the circulating influenza viruses in most countries of the Northern Hemisphere and in Russia. A study of the antigenic properties of influenza A(H1N1)pdm09 strains revealed no differences in those of vaccine virus. Sequencing showed that there were amino acid substitutions in hemagglutinin (receptor binding and Sa sites) and in the genes encoding internal proteins (PA, NP, M1, and NS1). The rise in the incidence in the Russian Federation, which was etiologically associated with influenza viruses, was registered in January-February 2016 with its maximum being observed at 4-5 weeks of 2016. Within the framework of the epidemiological surveillance of circulating influenza viruses in the Russian Federation, which was conducted by the WHO European Office, the D.I. Ivanovsky Institute of Virology, Honorary Academician N.F. Gamaleya Federal Research Centre for Epidemiology and Microbiology, Ministry of Health of Russia, and the Research Institute of Influenza, Ministry of Health of Russia, monitored at the Infectious Diseases Hospital One (IDH-1), Moscow Healthcare Department. Among 1491 examinees, influenza was verified in 104 (21.3%) adults, 208 (42.5%) pregnant women, and 177 (36.2%) children. Influenza A(H1N1)pdm09 was more often diagnosed in the age group of 15-40 years (63.7%); the proportion of influenza patients aged over 50 years increased (22.1%). Most adult patients had moderate influenza; pneumonia complicated the disease in 27.4%. Influenza in the pregnant women was complicated by pneumonia in 4.8% of cases. Influenza was more frequently diagnosed in infants and preschool children aged 0 to 3 years (42.9%), 4 to 6 years (41.2%), and older (15.9%), namely: 7-9 years (10%) and 10-12 years (5.9%). Influenza in the children was complicated by acute tonsillitis (19.4%) and varying degrees of laryngeal stenosis (12.4%). Bronchial obstructive syndrome developed in 2.5%, the rate of pneumonia was 6.2%. Antiviral therapy (AVT) in the early stages of the disease reduces the risk of its severity, the frequency of secondary complications, and the duration and degree of clinical symptoms of influenza. AVT with oseltamivir, zanamivir, imidazolyl ethanamide pentandioic acid (ingavirin), and interferon-a2b (viferon) has been performed in the patients hospitalized at Moscow IDH-1 in the 2015-2016 epidemic season.Среди циркулирующих вирусов гриппа в эпидемическом сезоне 2015-2016 гг. в большинстве стран Северного полушария и России доминировали (более 90%) штаммы вируса гриппа A(H1N1)pdm09. Изучение антигенных свойств штаммов вируса гриппа A(H1N1)pdm09 не выявило различий по отношению к вакцинному вирусу. Результаты секвенирования показали наличие аминокислотных замен в гемагглютинине (рецепторсвязывающем и Sa сайтах) и в генах, кодирующих внутренние белки (PA, NP, M1, NS1). Подъем заболеваемости в Российской Федерации, этиологически связанный с вирусами гриппа, регистрировали в январе - феврале 2016 г., максимальный показатель отмечен на 4-5-й неделе 2016 г. В рамках эпидемиологического надзора за циркуляцией вирусов гриппа в Российской Федерации, осуществляемого Европейским отделением ВОЗ, Институтом вирусологии им. Д.И. Ивановского ФГБУ 'Федеральный научно-исследовательский центр эпидемиологии и микробиологии им. почетного акад. Н.Ф. Гамалеи' Минздрава России и ФГБУ 'НИИ гриппа' Минздрава России, проводили госпитальный мониторинг на базе ИКБ #1 Департамента здравоохранения Москвы. Из 1491 обследованного пациента грипп верифицирован у 104 (21,3%) взрослых, 208 (42,5%) беременных и 177 (36,2%) детей. Грипп А(H1N1)pdm09 диагностировали чаще в возрастной группе от 15 до 40 лет (63,7%), увеличилась доля заболевших старше 50 лет (22,1%). Течение гриппа у большинства взрослых пациентов было среднетяжелым, пневмония осложнила грипп у 27,4%. Грипп у беременных осложнен пневмонией в 4,8% случаев. Чаще грипп диагностировали у детей раннего и дошкольного возраста: от 0 до 3 лет - у 42,9%, от 4 до 6 лет - 41,2%; более старшего возраста - 15,9% (7-9 лет - 10%, 10-12 лет - 5,9%). Грипп у детей осложнялся острым тонзиллитом (19,4%) и стенозом гортани разной степени выраженности (12,4%). Бронхообструктивный синдром развился у 2,5%, на долю пневмоний пришлось 6,2%. Противовирусная терапия (ПВТ) на ранних сроках болезни снижает риск развития тяжелого течения, способствует уменьшению частоты вторичных осложнений, сокращению продолжительности и выраженности клинических симптомов гриппа. ПВТ у пациентов, госпитализированных в ИКБ #1 Москвы в эпидемическом сезоне 2015-2016 гг., представлена осельтамивиром, занамивиром, имидазолилэтанамидом пентандиовой кислоты (ингавирин) и интерфероном-α2b (виферон).

The article provides an overview of the literature data about new pneumotropic viruses - metapneumovirus and bokavirus: taxonomy, structural features, pathogenesis, laboratory diagnosis, clinical symptoms of the diseases they cause and complications. The high incidence and bokavirus metapnevmovirus structure of SARS infections in preschool children, the authors have shown the example carried out at the Department of Infectious Diseases in Children Medical University (now RNIMU named after N.I. Pirogov) and on the basis of clinical Institute of Virology, multicenter, randomized, blind, placebo-controlled study on the therapeutic efficacy and safety of interferon inducer Kagocel in 120 children aged 2 to 6 years. The findings to point out on significant reduction in the rate of relief of basic clinical manifestations of SARS, regardless of etiology, in children taking Kagocel in compare with a group of children who took a placebo.

Among children of early age still severe forms of a disease which can lead to lethal outcomes are registered still most often. Untimely diagnostics and the wrong assessment of the severity of pertussis cause mistakes in treatment and are significantly impact on a disease outcome. The analysis of features of a course of pertussis in children of early age is based on supervision over 670 children hospitalized in Moscow Infectious Clinical Hospital No. 1. Studying of clinic picure of pertussis in comparative evolutionary aspect allowed to establish the main reasons for an adverse course of pertussis a lethality at the present stage. The main factors promoting development of severe forms of a Bordetella pertussis infection in children of early age are the anatomical and physiological features, the burdened premorbid background, accompanying infectious diseases and biological properties of circulating strains of a Bordetella pertussis microbe. Pertussis in children of early age has own the clinical features, being characterized first of all by severity of the disease course. The most significant options of a mixtinfection are a combination of pertussis with CMV infection, the RS-infection.

The performance of two doses of cold-adapted live attenuated vaccine versus one dose of whole-virus inactivated vaccine was compared in 8-15-year-old schoolchildren in two schools in Moscow, Russia, during the winter of 1987/88. Both vaccines gave rise to low frequencies of associated febrile or systemic reactions, but the inactivated vaccine, delivered by jet injector, did cause small local reactions in about half of the children. Immunogenicity was higher for both vaccines in antibody-free children, and higher levels of serum antibody were detected following use of inactivated vaccine. During the winter, influenza A (H3N2) and influenza B viruses circulated in Moscow. A clear outbreak of (H3N2) virus occurred in both schools, and infections with type B virus also occurred in one school. The influenza A/Philippines/2/82 (H3N2) component of both vaccines exhibited protective efficacy of about 40% (p < 0.05) against serologically proven infection caused by the antigenically drifted A/Sichuan/2/87 (H3N2)-like epidemic viruses in one school. In another school where illnesses associated with antibody rise were documented, efficacy was seen for both vaccines in reduction of illnesses, and of illnesses with serological evidence of infection, but statistical significance was not achieved.