In the work, based on a retrospective analysis of the medical documentation of a children's clinic for 2017—2022. the impact of the COVID-19 pandemic on in- fectious morbidity in children was assessed. The data obtained indicate that in the children's population of St. Petersburg, as well as throughout the world, along with low involvement in the epidemic process of a new coronavirus infection, the incidence of seasonal acute respiratory and intestinal infections, chicken pox, scarlet fever, and whooping cough has significantly decreased. The COVID-19 pandemic did not have a significant impact on the structure and seasonality of in- fectious diseases in children. The phased exit from the lockdown did not lead to the predicted explosive growth of seasonal infections — as restrictions were eased, the incidence of acute respiratory and intestinal infections over the past two years has smoothly returned to pre-pandemic levels.

Purpose: The aim of this study was to determine significant indicators of the pediatric early warning system (PEWS) in patients with common cold of moderate severity. Design and methods. The study was conducted in the children infectious disease hospital at the Moscow Multidisciplinary Clinical Center «Kommunarka» from September 1, 2022, to November 30, 2022. The analysis of 512 clinical records of children with a clinical picture of uncomplicated common cold who received treatment at the infectious disease hospital was carried out. All patients had a moderately severe form of the disease. For early detection of the risk of clinical deterioration in children, the PEWS scale, developed in the UK, was used. Results. Upon admission to the hospital, the PEWS score was counted in all children. In 63 patients (main group) the overall PEWS score was 3 points or higher, in 449 patients (comparison group) the PEWS score did not exceed 2 points. We found that in children with common cold and a moderate course of the disease, an increase in the total PEWS score in the main and comparison groups was registered due to changes in the cardiovascular system in 50 (79.4 ± 10.9%) and 108 (24, 1 ± 4.1%) patients, respectively; and respiratory system in 37 (58.7 ± 12.8%) and 40 (8.9 ± 2.6%) patients, respectively, P < 0.05.

Conclusion. In this study for the first time in the Russian Federation the PEWS scale was used in children with common cold to early identify the risk of clinical deterioration.

The purpose of the study: to establish the clinical and prognostic value of fibronectin and circulating immune complexes of blood in children with viral meningitis, depending on the period, severity, course and outcome of the disease. Material and methods.The concentration of plasma fibronectin and the total amount of circulating immune complexes were determined by enzyme immunoassay in 167 children of patients with viral meningitis of various etiologies. The etiology of meningitis was confirmed by positive results of the PCR reaction and by enzyme immunoassay. The biological material for the study was: cerebrospinal fluid and/or blood. Results: In the acute period of moderate-severity viral meningitis, the concentration of fibronectin decreased and found.

The problem of chronic viral hepatitis C is one of the most urgent in modern medicine. This cannot but concern the child population, which is the most vulnerable. Under supervision were 50 children under 18 years of age who were treated in the infectious diseases clinical hospital in Yaroslavl. Chronic hepatitis C in children in 56% is asymptomatic, and only in 44% of patients ALT values exceeded the norm. The asymptomatic course of CHC does not mean the absence of disease progression. Liver elastometry revealed fibrosis of varying severity in the absence of clinical symptoms of the disease. The distribution of genotypes in children corre- sponded to that in adults, but genotype 2 was detected more often than in adults. Viral load often had a minimum level, in contrast to the adult population of the Yaroslavl region.

The aim of the work is to improve the algorithm of management of pregnant women with HIV/HCV co-infection. The study was conducted on the basis of the Moscow City Center for AIDS Prevention and Control of the Moscow Department of Health from 2020 to 2022. 80 women diagnosed with HIV/HCV coinfection were under observation. The patients underwent a general examination and evaluation of anamnesis data, laboratory tests. The article presents statistical data on HIV/HCV-infected women who have been registered at the Moscow City Center for the Prevention and Control of AIDS for the past three years. The social characteristics of pregnant women with HIV/HCV co-infection are given and the clinical and immunological features of the course of the disease are presented.

The purpose of the study: to conduct a comparative analysis of the clinic and the course of acute diarrhea in children with HIV infection.

Research materials and methods: The research materials included 261 HIV-infected children with diarrhea, 247 children with diarrhea without HIV infection aged 0—18 years. The diagnosis was established on the basis of clinical, virological, immunological, bacteriological, serological and statistical methods.

Results. Most of the observed children (77%) with HIV infection were over the age of 3 years, and in the comparison group, more than half of the children (53.8%) were under the age of 3 years. In 86.5% of cases there was II or III stage of HIV infection. Significant differences in diarrhea in children with HIV infection com- pared with children with diarrhea without HIV infection were found in terms of the following signs: the presence of dehydration (70.5% and 50.6% of cases, re- spectively) and its severity (18.8% and 7.3% of cases, respectively, p < 0.05), the frequency of episodes of diarrhea per day more than 15 times (37.9% and 17.4%, p < 0.05) and its duration more than 6 days (56.3% and 32 .8%, p < 0.05), watery stools (39.5% and 25.9%, p < 0.05), foul-smelling feces (45.2% and 29.1%, p < 0, 05), green color (58.6% and 37.2%, p < 0.05) and the presence of pathological impurities in the form of blood (37.5% and 12.6%, p < 0.05) and pus (59 .8% and 23.1%, p < 0.05).

Purpose: analysis of the epidemic situation of rabies infection in the territory of the Donetsk People's Republic and assessment of the level of epidemic threat for this infection for 2023. Materials and methods: A retrospective epidemiological analysis of the epidemic and epizootic situation of rabies infection was carried out based on the materials of the Department of Especially Dangerous Infections Republican Center for Sanitary and Epidemiological Surveillance of the State Sanitary and Epidemiological Service of the Ministry of Health of the Donetsk People's Republic for the last 8 years. Results: For the period from 2015 to March 2023 in the Donetsk People's Republic, 4 cases of rabies infection in people were registered (in 2016, 2021, 2022), which ended in death due to the untimely appeal of those bitten for specialized medical help. The epizootic situation for rabies infection remained unfavorable for the studied period of time. This infection has been laboratory confirmed in animals: 2015 — in 33 cases, 2016 — in 50 cases, 2017 — in 50 cases, 2018 — in 42 cases, 2019 — in 56 cases, 2020 — in 44 cases, 2021 — in 33 cases, 2022 — in 32 cases.

The urgency of the problem of combined infection of COVID-19 with ARI of various etiologies is due to the high prevalence of respiratory infections during the epidemic of coronavirus infection. The prevalence of combined COVID-19 infections with ARI according to the literature varies from 0.6 to 45%. Studies devoted to the peculiarities of the course of combined COVID-19 infections with ARI of various etiologies in children are isolated, multidirectional and debatable, which requires further study of this problem.

Numerous literature data and our observations testify to the widespread permanent growth of combined infections, especially new ones, as well as combined infectious diseases with somatic ones. This is a new scientific direction in medicine, which we have designated as «complex comorbidity», and which can be considered as one of the main trends in the evolution of infectious pathology in general. The article presents an analysis of scientific articles on comorbidity with COVID-19 in children, taking into account clinical and epidemiological features in the pandemic (2020—2021) and pre-pandemic (2015—2019) periods. It has been estab- lished that the emergence of a new subtype of coronavirus at the end of 2019. An unfavorable epidemiological situation for seasonal coronavirus infection preceded by a pronounced trend towards an increase in the proportion of cases of diseases associated with coronavirus from 10.5% in the 2014—2015 epidemic season. up to 32.8% in the 2018—2019 season. The pandemic period was characterized by a lower susceptibility of children compared to adults, as well as a high proportion of «asymptomatic» and mild forms of infection. In turn, in the pre-pandemic period, «seasonal» coronaviruses preferred to infect, for the most part, precisely children's contingents with moderate onset of the disease.

It has been proven that the SARS-CoV-2 virus is able to initiate the development of a number of metabolic disorders, leading to diabetes mellitus (DM). Given the high frequency of cases of newly diagnosed type 1 diabetes in children, as well as possible adverse prospective consequences, the study of such clinical cases seems to us to be an extremely relevant practice for doctors of all specialties. The aim of the study was to to demonstrate of a clinical case of newly diagnosed type 1 diabetes in a child with COVID-19.

The article presents a general understanding of the pathogenetically bidirectional relationship between a new coronavirus infection and diabetes mellitus, presents a clinical case of type 1 diabetes diagnosed for the first time in a child 3 years 8 months with COVID-19, and describes the further stage of treatment in the specialized endocrinology department.

Conclusion. The clinical case presented by us, as well as data obtained as a result of research by domestic and foreign colleagues, confirm the existence of a pathogenetically determined relationship between COVID-19 and type 1 diabetes mellitus in children. To better understand the mechanisms underlying the devel- opment of metabolic suffering, it is necessary to create a single Global registry of patients with diabetes mellitus, first identified in connection with COVID-19.

A clinical observation of a Salmonella infection (seeding Salmonella enteritidis) in an 8-year-old child with invasive diarrhea in the form of gastroenterocolitis with se- vere toxicosis and exsicosis of II degree is described. In dynamics, this infection was complicated by acute kidney injury. Inflammatory changes (increased C-reactive protein, procalcitonin, neutrophilia), coagulopathy (increased D-dimer, fibrinogen), metabolic acidosis, azotemia (increased urea, creatinine), filtration disorders, urinary syndrome (proteinuria up to 0.495 g/l in a single serving, cylindruria, bacteriuria, erythrocyturia up to 5850/ml). Ultrasound revealed pronounced phenomena of mesadenitis, inflammatory changes in the intestine, cholestasis, an increase in the size and echogenicity of the parenchyma of both kidneys. Acute kidney injury of the 2nd degree according to KDIGO (increase in serum creatinine by more than 3 times) of prerenal origin was diagnosed. As a result of the complex treatment, a positive trend was obtained and the child was discharged under outpatient supervision.

Infectious mononucleosis of various etiologies occupies one of the leading places in the structure of childhood infectious diseases. It is known that after suffering Epstein-Barr infectious mononucleosis of viral or cytomegalovirus etiology, there is a risk of agranulocytosis, and aplastic anemia with pancytopenia may occur. The combination of two viruses in the etiology of infectious mononucleosis is usually accompanied by severe forms of the disease and a high risk of complications. A clinical case of a severe form of infectious mononucleosis of combined etiology against the background of aplastic anemia (AA) in a teenager aged 15 years and 9 months is presented. The high risk of developing septic complications in AA during the height of MI was the basis for the abolition of cyclosporine, the main treatment for aplastic anemia in a patient. The use of complex therapy, including etiotropic agents, transfusions of donor blood components, intravenous immunoglobulins, made it possible to stabilize the patient's condition for infectious mononucleosis and achieve positive dynamics. At the same time, decompensation of the state according to AA against the background of an acute infection required further treatment of the patient in a specialized hematological hospital.

The article considers the use of innovative methods of teaching in the form of a business game when studying the discipline «Infectious diseases in children» at the Children’s Infection Diseases Department of the Volgograd State Medical University, which contributes to the formation of professional skills based on knowledge and the development of creative abilities. There are presented methodology for organizing and conducting a business game is presented on the example of a simulation mannequin of a child of the first months of life with clinical symptoms of measles.