Infection caused by the Epstein-Barr virus (EBV) is more common in children and is transmitted through contact with saliva. The role of adults in the epidemic process has not been sufficiently studied.

The goal is to study the role of children and adults with catarrhal phenomena in the spread of EBV during the seasonal epidemic rise in the incidence of upper respiratory tract infections (URTI).

Materials and methods. In the epidemic season of 201 9—2020, 226 people with catarrhal symptoms (140 adults and 86 children) were examined by PCR for the presence of EBV and other URTI pathogens in their nasal and oropharyngeal smears.

Results. Significant differences in the frequency of detection of pathogens in children and adults have not been established. In both groups, EBV was detected as a single pathogen and in combination with other pathogens. The presence of a runny nose, sneezing and coughing is unusual for EBV, but occurs when EBV is combined with other URTI pathogens.

Discussion. The presence of EBV in the nasopharynx and oropharynx in children and adults plays an important role in the spread of the pathogen. The combination of EBV with other pathogens that cause runny nose, sneezing, and coughing contributes to the formation of a more concentrated infectious aerosol and its spread over long distances.

Conclusions. During the seasonal epidemic upsurge, children and adults are equally involved in URTI epidemic process and are sources of EBV infection with a frequency of 3 1.39 and 37.14 per 1 00 examined and an average concentration of the virus in smears of 31 199 and 33 074 copies/ ml, respectively. In children and adults, EBV was detected in combination with other U RTI pathogens with a frequency of 1 6.28 and 1 8.57 per 1 00 subjects, respectively. The presence of EBV in the upper respiratory tract, together with other pathogens, contributes to the active transmission of EBV during the seasonal epidemic rise of upper respiratory tract infections.

Objective: to study the epidemiological and clinical and laboratory features of metapneumovirus (HMPV) and bokavirus infections (HBoV) in children.

Materials and methods. We examined 772 children aged 1 month to 14 years, who were being treated for acute respiratory viral infections at the Kirov infectious diseases clinical hospital in 201 6—201 9. Diagnostics was performed by PCR in nasopharyngeal smears.

Results. Among patients with a confirmed diagnosis, 53 (6.9%) had metapneumovirus infection, and 76 (9.8%) had bokavirus infection. Both groups were dominated by boys. HMPV was more often registered among children from one to three years of age, HBoV — in patients of the first year of life. Mixed infection was more common with HBoV in children of the first three years of life. These infections are characterized by damage to both the upper and lower respiratory tracts with the development of obstruction syndrome, which was more often observed in HBoV. Pneumonia was developed in half of the cases in both groups. Gastroenteritis was registered in patients with HMPV in 1 9% of cases, and in patients with HBoV in 1 3% of cases.

The study of the genetic polymorphism rs231775 (+ 49A > G) and rs5742909 (+ 3 18С > Т) of the CTLA-4 gene in 100 children with chronic HBV infection revealed associations only with the carriage of the + 49A/ G polymorphic variant. Moreover, the carriage of the G allele in the homozygous mutant + 49GG position suggested the development of pronounced forms with a progressive course and a high probability of the outcome of the disease in cirrhosis.

The established gender differences — the boys' high expression of the minor G-allele of the CTLA-4 gene, especially in the homozygous mutant variation + 49GG — proves the phenomenon of a high incidence of hepatotropic viral infection in boys.

Therefore, the carriage of mutant variation + 49GG can be considered among the HOST factors for predicting adverse outcomes of chronic HBV infection in children.

The review discusses the current state of the use of vaccine prevention in the debarment of pneumococcal infection in patients with chronic kidney disease (CKD). Clinical and immunological features of various groups of patients with chronic kidney disease are considered, the specifics of their immunoreactivity, the features of their immune system, due to the underlying and concomitant diseases, as well as treatment. The review analyzes data on various approaches to preventive vaccination and discusses the results of various vaccination regimens and vaccines.

Based on the materials reviewed, recommendations are given for organizing the most rational vaccine prevention of pneumococcal infection in patients with chronic kidney disease.

The paper summarizes the information currently available in the literature on the etiology, life cycles, epidemiology, pathogenesis, pathomorphology, clinical manifestations, diagnosis, etiotropic therapy, and prevention of human liver, bile ducts and pancreatic ducts trematodiases: fascioliasis, opisthorchiasis, clonorchiais, metorchiasis, pseudamphistomiasis, amphimeriasis, dicrocoeliasis, eurytremiasis.

For the immunodiagnosis of tuberculosis infection, in addition to standard skin tests (Mantoux test with 2 TU PPD-L and Diaskintest), in vitro tests are currently used, one of which is the T-spot.TB test.

Purpose of research. Evaluate the T-SPOT test as a method of early detection of tuberculosis infection in children and adolescents and its role as an additional method in solving the problem of the need for chemoprophylaxis.

Materials and methods. The analysis of the results of T-SPOT.TB in 794 children aged 2 to 17 years inclusive in the period from 2016 to 2019 was carried out. Two groups were allocated: 1 group (n = 596) — children who underwent T-SPOT.TB as the main methodology; Group 2 — 198 children with positive skin test results for a recombinant tuberculosis allergen after screening. The results of T-SPOT.TB were evaluated taking into account the data of previous immunodiagnostics and associated pathology.

Results. It is established that T-SPOT.TB. can be used as an independent method in case of rejection of skin tests. The level of latent tuberculosis infection is higher among children with concomitant pathology according to the results of T-SPOT.TB twice.

Conclusion. T-SPOT.TB can be an alternative method for diagnosing tuberculosis infection during screening. In children with concomitant pathology of the T-SPOT.TB can serve as the leading method of tuberculosis immunodiagnosis. A positive T-SPOT.TB can serve as an additional method for deciding on the appointment of preventive chemotherapy.

The article provides a detailed analysis of modern publications focused on a studies an astrovirus gastroenteritis. Based on our own examination of 3470 children with acute intestinal infections aged from 1 month to 1 8 years old, who were treated at the Children's Research and Clinical Center for Infectious Diseases, FMBA of Russia, St. Petersburg, from May 201 7 to July 2018 a detailed description of the characteristic epidemiological, clinical and laboratory features of the disease is given. It was shown, that astroviruses remain a significant causative agent of acute intestinal infections in children, accounting for 1.36% of all cases of disease. Among the combined forms of astrovirus infection, associations with rotaviruses, noroviruses and campylobacter spp. are most common. It was established, that the disease is more often observed in boys aged 1 to 3 years. Clinical course of astrovirus infection in children is characterized by an acute or gradual onset with repeated vomiting, moderate intoxication and symptoms of gastroenteritis. Due to the lack of pathognomonic clinical and laboratory features of the course of viral gastroenteritis, diagnosis is necessary using laboratory methods including molecular genetic research methods.

Objective: to establish the clinical and epidemiological features of acute intestinal infections (AII) in children in the Astrakhan region, depending on the etiological factor, age, season of the year.

Materials and methods: a retrospective analysis of the incidence of acute intestinal infections in children in the Astrakhan region for 2019 and 3335 case histories of patients diagnosed with acute intestinal infections, under the age of 17 years, who were treated at the Regional Infectious Clinical Hospital, Astrakhan, during 2019.

Research results: Acute intestinal infections of established etiology in children in the Astrakhan region is 35%. Among acute intestinal infections caused by established pathogens, the viral etiology of the disease occurred in 22%, bacterial in 78% of patients. The etiological structure of аcute intestinal infections in children has changed due to an increase in the number of intestinal infections caused by opportunistic bacteria. In the age structure of patients with acute intestinal infections caused by opportunistic bacteria, children of the first year of life dominated (69%). Refined viral diarrhea in 86% of patients proceeded with a topical diagnosis of enteritis, gastroenteritis, bacterial diarrhea proceeded on the type of enterocolitis and colitis in 91% of patients.

The measles situation is still unstable — there are imported cases, the formation of nosocomial foci with the involvement of medical personnel, patients and visitors of medical institutions.

Objective of the study: to assess the level of seroprevalence of primary health care workers in St. Petersburg during the period of epidemic trouble with measles.

Materials and methods: An open retrospective randomized uncontrolled study of the intensity of specific immunity to measles in 980 employees aged 18 to 78 years, examined in July-September 2018, was carried out. The level of anti-measles IgG antibodies was determined by the method of enzyme-linked immunosorbent assay (810 people) and passive hemagglutination reactions (170 people). The results are presented with the indication of the shares (%) and the calculation of the 95% confidence interval according to Clopper — Pearson. Differences between groups were assessed using Pearson's chi-square test (%2). Differences in the groups were considered statistically significant when the criterion level was p < 0.05.

Results: It was found that 8.2% of personnel are not protected against measles infection. At the same time, the number of seronegative persons among doctors (8.1 %), nurses (7.7%) and non-medical workers (9.6%) differed statistically. Age-related differences in the immune layer were revealed — the greatest susceptibility was observed in persons under 30 years of age (1 8.3%). Anti-measles antibodies in those who had been ill persisted for a long time and at a high level. At the same time, the intensity of post-vaccination immunity decreased over time, and 20 years after immunization, the number of seronegative individuals increased significantly. Only 64.1 % of those surveyed had two vaccinations, more than a third were immunized once. Nevertheless, the proportion of people unprotected from measles exceeded the criterion of epidemic well-being with the same frequency in both groups (9.2% and 1 0.4%, respectively).

The results of a serological study showed that the presence of a record of two vaccinations in the certificate in 9.2% of cases does not guarantee protection in case of contact with a patient with measles. Only a serological examination is evidence of specific immunity to measles infection.

The article discusses modern ideas about the role of microbial agents in the pathogenesis of the most common dermatoses in pediatric practice.

The paper shows the importance of the skin microbiome and foci of chronic inflammation in the induction and maintenance of the pathological process in the dermis in atopic dermatitis, psoriasis.

Presented own clinical observations of two girls at the age of 1 2 years with a diagnosis: vulgar psoriasis with lesions of the skin, scalp, and at the age of 5 years with a diagnosis of atopic dermatitis, childhood phase, erythematous-squamous form, mild course.

The preparation of activated zinc pyrithione has anti-inflammatory, antifungal and antimicrobial activity, a high safety profile and can be used to control inflammation and correct the skin microbiome. The use of the preparation of activated zinc pyrithione significantly reduces the need for external corticosteroids.

The purpose of the study: to analyze the clinical and epidemiological condition of children infected with ascariids in 2015—201 9 on the territory of the Astrakhan region. Materials and methods. During the analyzed period, 87 cases of ascariasis in children were registered in the Astrakhan region. We observed 23 children (26.4%) diagnosed with Ascariasis.

Research result. The age of children whose eggs of Ascaris lumbricoides were found in the biomaterial ranged from 1 to 17 years, and in the age groups of children (schoolchildren — preschoolers), cases of ascariasis were recorded almost equally.

Clinically, the disease occurred in the form of complaints of children — 65.2% (п = 15) for pain in the epigastric region — 34.8% (п = 8), nausea, vomiting, cough and poor appetite — 20.0% (п = 3), liquid stool and fever to subfebrile numbers — 1 3.3% (п = 2). In isolated cases, children complained of teeth grinding at night, frequent fatigue and headache-6.7% (п = 1). Complaints about the exit of the parasite at the time of the act of defecation were made by 40.0% (п = 6). Some patients had no complaints — 34.8% (п = 8).

Conclusions: Ascariasis was registered almost equally in all age groups. The main complaints were epigastric pain, nausea, decreased appetite, and loose stools. The main cause of the disease was non-compliance with personal hygiene rules, eating unwashed fruits and vegetables, and the habit of eating without first washing your hands. Isolation of a male Ascaris lumbricoides at the time of defecation and a negative result of fecal examination indicate the absence of a female As-caris lumbricoides in the macroorganism and does not require further treatment.

A new coronavirus infectionin children in most cases is easier than in adult patients, however, some cases are characterized by a protracted course and duration of the release of SARS-CoV-2 virus.

The article presents own data monitoring of children with novel coronavirus infection with clinical case COVID-1 9- pneumonia, which appeared to slow reverse the development of infiltrative changes in the lungs according by the type of «frosted glass» on computed tomography on the background of the relief of clinical symptoms of pneumonia negative results of smears from the oropharynx and nasopharynx on the determining of RNA of SARS — Cov-2 by PCR and a positive serological response in the form of increase of IgG-antibodies to COVID-1 9 with negative IgM-antibodies.