Two years of experience in hospital surveillance for the severe influenza like illnesses in St. Petersburg: etiology, clinical characterization of diseases, antigenic and genetic properties of isolated influenza viruses

In this paper, we analyze the etiology of the diseases occurring during two consecutive influenza epidemic seasons in St. Petersburg, Russian Federation. The analysis is based on the results of the PCR diagnostics of the clinical samples collected from patients hospitalized in three St. Petersburg hospitals with influenza like illnesses (ILI). It was shown that the influenza virus A(H1N1)pdm09 was the dominant causative agent during the 2012-2013 epidemic season while, in the 2013-2014 season, A(H3N2) virus was predominant among adults and children. The influenza B virus activity was high in the 2012-2013 season and low in the 2013-2014 season. During both seasons, the main causative agent for the hospitalization of young children was respiratory syncytial virus (RSV), followed by rhinovirus and influenza virus. The rate of involvement of parainfluenza, adenovirus, metapneumovirus and coronavirus was low and was negligible for bocavirus. Children 0-2 and 3-6 years old formed the group of patients that was affected by acute respiratory infection agents the most. Children younger than 3 months old were the major group of the intensive care unit (ICUs) patients and only 27.5% of them were adults. RSV and rhinovirus were the leading cause of ILI among the children admitted to ICU. Among the adult patients admitted to the ICU, only influenza A(H1N1)pdm09, A(H3N2) and B viruses were detected during both influenza seasons.According to the results of the antigenic and genetic analysis, most influenza A(H1N1)pdm09 and A(H3N2) viruses circulating in St. Petersburg matched the vaccine strains recommended by the WHO for vaccine composition in the 2012-2013 and 2013-2014 seasons.In this paper, we analyze the etiology of the diseases occurring during two consecutive influenza epidemic seasons in St. Petersburg, Russian Federation. The analysis is based on the results of the PCR diagnostics of the clinical samples collected from patients hospitalized in three St. Petersburg hospitals with influenza like illnesses (ILI). It was shown that the influenza virus A(H1N1)pdm09 was the dominant causative agent during the 2012-2013 epidemic season while, in the 2013-2014 season, A(H3N2) virus was predominant among adults and children. The influenza B virus activity was high in the 2012-2013 season and low in the 2013-2014 season. During both seasons, the main causative agent for the hospitalization of young children was respiratory syncytial virus (RSV), followed by rhinovirus and influenza virus. The rate of involvement of parainfluenza, adenovirus, metapneumovirus and coronavirus was low and was negligible for bocavirus. Children 0-2 and 3-6 years old formed the group of patients that was affected by acute respiratory infection agents the most. Children younger than 3 months old were the major group of the intensive care unit (ICUs) patients and only 27.5% of them were adults. RSV and rhinovirus were the leading cause of ILI among the children admitted to ICU. Among the adult patients admitted to the ICU, only influenza A(H1N1)pdm09, A(H3N2) and B viruses were detected during both influenza seasons. According to the results of the antigenic and genetic analysis, most influenza A(H1N1)pdm09 and A(H3N2) viruses circulating in St. Petersburg matched the vaccine strains recommended by the WHO for vaccine composition in the 2012-2013 and 2013-2014 seasons

Результаты 5-летнего мониторинга за циркуляцией сезонных коронавирусов у госпитализированных детей в препандемическом периоде

Coronaviruses can cause damage to various parts of the respiratory system, gastrointestinal tract, and other organs and systems.The aim of the study: to monitor the circulation of seasonal coronaviruses in hospitalized children in the pre-pandemic period.Materials and methods: real-time multiplex PCR was used to test samples of nasopharyngeal mucus from 2188 patients aged 1 monthto 17 years, hospitalized with acute respiratory infection in 2014—2018. The results are presented with the indication of the fractions (%) and the calculation of the 95% confidence interval according to Klopper-Pearson. The differences between the groups were evaluated using the Pearson χ2 test. The differences in the groups were considered statistically significant at the level of the criterion p< 0.05.Results: monitoring of the circulation of pathogens of acute respiratory viral infection (ARVI) during 5 epidemic seasons showed that the appearance of a new subtype of coronavirus in 2019 was preceded by a gradual displacement of influenza, RS-and bocavirus infections from the circulation due to a statistically significant increase in the proportion of seasonal coronaviruses from 3.6% in 2014—2015 to 10.8% in the prepandemic season 2018—2019 (p= 0.007). The circulation of seasonal coronaviruses had a distinct seasonality (november-april)with the peak of registration in february (28.4%) and march (36.7%). Seasonal coronaviruses were detected in 7.3% of hospitalized children with ARVI, with a predominance in the age groups under 2 years (58.2%) and 3—6 years (25.4%). Hospitalization was more often required for patients with lower respiratory tract lesions (58.2%), a fifth of which was pneumonia (21.8%). In most children, ARVI caused by coronaviruses occurred as a monoinfection (79.9%), combined infection with other pathogens was observed in 20.1% of cases with fluctuations from 18.2% to 28.6% in different epidemic seasons. Viral associations are most common in young children (85.2%).Коронавирусы могут вызвать поражение различных отделов дыхательной системы, желудочно-кишечного тракта, а также других органов и систем.Цель исследования: провести мониторинг за циркуляцией сезонных коронавирусов у госпитализированных детей в препандемическом периоде.Материалы и методы: методом мультиплексной ПЦР в реальном времени проведено тестирование образцов носоглоточной слизи 2188 пациентов в возрасте от 1 мес. до 17 лет, госпитализированных с острой респираторной инфекцией в 2014—2018 гг. Результаты представлены с указанием долей (%) и расчетом 95% доверительного интервала по Клопперу-Пирсону. Различия между группами оценивали с помощью критерия χ² Пирсона. Различия в группах считались статистически значимыми при уровне критерия p< 0,05.Результаты: мониторинг за циркуляцией возбудителей острой респираторной вирусной инфекции (ОРВИ) в течение 5-ти эпидемических сезонов показал, что появлению нового подтипа коронавируса в 2019 г. предшествовало постепенное вытеснение из циркуляции возбудителей гриппа, РС- и бокавирусной инфекции за счет статистически значимого увеличения доли сезонных коронавирусов с 3,6% в 2014—2015 гг. до 10,8% в препандемическом сезоне 2018—2019 гг. (р= 0,007). Циркуляция сезонных коронавирусов имела отчетливую сезонность (ноябрь-апрель) с пиком регистрации в феврале (28,4%) и марте (36,7%). Сезонные коронавирусы выявлялись у 7,3% госпитализированных детей с ОРВИ, с преобладанием в возрастных группах до 2 лет (58,2%) и 3—6 лет (25,4%).Госпитализация чаще требовалась пациентам с поражением нижних отделов респираторного тракта (58,2%), пятую часть из которых составляла пневмония (21,8%). У большинства детей ОРВИ, обусловленная коронавирусами, протекала в виде моноинфекции (79,9%), сочетанное инфицирование с другими возбудителями наблюдалось в 20,1% случаев с колебаниями от 18,2% до 28,6% в различные эпидемические сезоны. Вирусные ассоциации наиболее характерны для детей раннего возраста (85,2%

ОСТРЫЙ СТЕНОЗИРУЮЩИЙ ЛАРИНГОТРАХЕИТ ПРИ РЕСПИРАТОРНЫХ ВИРУСНЫХ МОНОИНФЕКЦИЯХ У ДЕТЕЙ, ГОСПИТАЛИЗИРОВАННЫХ В СТАЦИОНАРЫ САНКТ-ПЕТЕРБУРГА

A comparative analysis of the development of acute stenosing laryngotracheitis (LSLT) in respiratory viral monoinfections in 1050 children, hospitalized in St. Petersburg hospitals. It was established that the clinical manifestations, severity and outcome of OSLT in viral monoinfections depend highly on the etiologic factor, the patient's age and his premorbid background. More often, stenoses of the larynx are provoked by parainfluenza viruses (26,7%), the next most important are the PC virus (22,3%) and adenoviruses (18,8%), but during epidemics the number of lesions of the larynx sharply increases, with influenza viruses as the main pathogen, reaching up to 31,1%. Boys (71,2%) suffer from LSLT more often than girls (28,8%). Burdened premorbid background were 88,1% of children.  Проведен сравнительный анализ развития острого стенозирующего ларинготрахеита (ОСЛТ) при респираторно-вирусных моноинфекциях у 1050 детей, госпитализированных в стационары Санкт-Петербурга. Установлено, что клинические проявления, тяжесть и исход ОСЛТ при вирусных моноинфекциях зависят с высокой долей вероятности от этиологического фактора, возраста пациента и его преморбидного фона. Чаще других стенозы гортани провоцируют вирусы парагриппа (26,7%), следующими по значимости являются РС-вирус (22,3%) и аденовирусы (18,8%), но в периоды эпид. подъема гриппа число поражений гортани возрастает, а основными возбудителями ОСЛТ становятся вирусы гриппа (31,1%). У мальчиков ОСЛТ регистрируется чаще, чем у девочек (71,2 и 28,8%). Отягощенный преморбидный фон был выявлен в 88,1% детей

Сотрудничество кафедр детских инфекций – основа успеха в борьбе за здоровье детей (к 70-летнему юбилею кафедры инфекционных болезней у детей педиатрического факультета РНИМУ имени Н.И. Пирогова Минздрава России)

For about 70 years, the Department of Pediatric Infections of the Pediatric Faculty of the Russian National Research Medical University named after N.I. Pirogov and the Department of Infectious Diseases in Children named after Professor M.G. Danilevich of St. Petersburg State Pediatric Medical University have been closely cooperating. Employees are actively studying clinical and pathogenetic, treatment and diagnostic, organizational and methodological infectious diseases in children. The results of clinical observations and scientific research have been published in monographs, teaching aids, scientific articles, guidelines.В течение 70 лет тесно сотрудничают кафедра инфекционных заболеваний у детей имени профессора М.Г. Данилевича СПбГПМУ и кафедра инфекционных болезней у детей педиатрического факультета РНИМУ имени Н.И. Пирогова. Сотрудниками активно изучаются клинико-патогенетические, лечебно-диагностические и организационно-методические аспекты инфекционных болезней у детей. Результаты клинических наблюдений и научных исследований опубликованы в монографиях, учебно-методических пособиях, научные статьях, методических рекомендациях

ЭТИОТРОПНАЯ ТЕРАПИЯ ОСТРЫХ РЕСПИРАТОРНЫХ ВИРУСНЫХ ИНФЕКЦИЙ СО СТЕНОЗИРУЮЩИМИ ЛАРИНГОТРАХЕИТАМИ

Clinical-laboratory analysis of the effectiveness of VIFERON® (suppositories rectal) in children from 1 month up to 7 years with acute respiratory viral infections (ARVI), accompanied by acute stenosing laryngotracheitis (ASLT), hospitalized in Children's City Clinical Hospital №5 named after N.F. Filatov. We have found that the drug VIFERON® helps statistically significant reduction in the duration of all major clinical manifestations of the disease as a whole, and also reduces the severity and duration of clinical symptoms ASLT, and significantly contributes to the faster elimination of viral antigens.Проведен клиническо-лабораторный анализ эффективности препарата ВИФЕРОН® (суппозитории ректальные) у детей в возрасте от 1 мес. до 7 лет с острыми респираторными вирусными инфекциями (ОРВИ), сопровождающимися острым стенозирующим ларинготрахеитом (ОСЛТ), госпитализированных в ДГКБ №5 им. Филатова. Нами установлено, что препарат ВИФЕРОН® способствует статистически значимому сокращению продолжительности основных клинических проявлений заболевания, уменьшает выраженность и продолжительность клинических симптомов ОСЛТ, способствует более быстрой элиминации вирусных антигенов

ВЭБ-мононуклеоз у детей в современных условиях

EBV-mononucleosis is a widespread infectious disease, and also it is an urgent problem of the whole world. The purpose of the research was to study the clinical and laboratory features of EBV-mononucleosis in hospitalized children of different ages in modern conditions. Under the supervision were 136 children aged from 1 year to 18 years. All of the patients had typical and mainly (85%) moderate form of the disease, and 15% of them patients had a severe form of the disease. The results: more severe fever and lymphadenopathy were observed in children older than 3 years. Acute tonsillitis was present in all hospitalized children. Adenoiditis and hepatosplenomegaly were greater in the group of patients of a younger age. Hyperfermentemia was determined in more than half of patients, more often in children over 12 years old. In the hemogram leukocytosis and monocytosis were mostly noted. Atypical blood mononuclear cells were detected in 89% of patients. Patients got complex etiopathogenetic therapy.ВЭБ-мононуклеоз является широко распространенным инфекционным заболеванием, а так же актуальной проблемой во всем мире. Цель исследования — изучить клинико-лабораторные особенности ВЭБ-мононуклеоза у госпитализированных детей различного возраста в современных условиях. Под наблюдением находились 136 детей в возрасте от 1 г. до 18 лет. У всех больных диагностирована типичная, преимущественно (85%) среднетяжелая форма заболевания, у 15% пациентов выявлена тяжелая степень болезни. Результаты: более выраженный синдром лихорадки и лимфаденопатии наблюдались у детей в возрасте старше 3 лет. Острый тонзиллит присутствовал у всех госпитализированных. Аденоидит и гепатоспленомегалия были более выраженными у пациентов младшей возрастной группы. Гиперферментемия определялась более чем у половины пациентов, чаще у детей в возрасте старше 12 лет. В гемограмме чаще всего отмечались: лейкоцитоз и моноцитоз. Атипичные мононуклеары в крови были выявлены у 89% пациентов. Пациенты получали комплексную этиопатогенетическую терапию

DETECTION OF AUTOREACTIVE CLASS M ANTIBODIES IN PATIENTS WITH RESPIRATORY VIRAL INFECTIONS

Abstract. The aim of this study was to detect some features of autoreactive IgM production that interact with IgGs and normal human cellular antigens in blood sera of patients with acute respiratory viral infections caused by various factors, dependent on their age and clinical features of disease. The antibody concentrations were determined by immunoenzyme technique in paired serum samples from 750 patients and single specimens from 97 healthy persons. The results of analysis have shown that the studied types of autoreactive IgM represent a normal component of humoral immunity, since they are detectable in sufficient number of normal sera from healthy persons over 3 years old. In acute respiratory viral infections of different etiology, the rates of appropriate seroconversions comprised 0 to 16% for age cohort of < 3 years old. Incidence of seroconversions reached 37% among older children and adult patients with respiratory syncitial virus (RSV), or adenoviral infection, thus being 1.7 to 5.1-fold higher than in patients with influenza A, or B, or parainfluenza. In cases of clinical complications of RSV or parainfluenza infections (i.e., respiratory tract obstruction, or pneumonia), the rates of seroconversions to autoreactive IgMs was 1.4 to1.8-fold higher than among the patients with uncomplicated clinical course of these infections. (Med. Immunol., 2008, vol. 10, N 2-3, pp 229-238)

ACUTE STENOSING LARYNGOTRACHEITIS IN RESPIRATORY VIRAL INFECTIONS IN CHILDREN IN THE CLINICS OF ST. PETERSBURG

A comparative analysis of the development of acute stenosing laryngotracheitis (LSLT) in respiratory viral monoinfections in 1050 children, hospitalized in St. Petersburg hospitals. It was established that the clinical manifestations, severity and outcome of OSLT in viral monoinfections depend highly on the etiologic factor, the patient's age and his premorbid background. More often, stenoses of the larynx are provoked by parainfluenza viruses (26,7%), the next most important are the PC virus (22,3%) and adenoviruses (18,8%), but during epidemics the number of lesions of the larynx sharply increases, with influenza viruses as the main pathogen, reaching up to 31,1%. Boys (71,2%) suffer from LSLT more often than girls (28,8%). Burdened premorbid background were 88,1% of children

ETIOTROPIC THERAPY FOR ACUTE RESPIRATORY VIRAL INFECTIONS WITH STENOSING LARYNGOTRACHEITIS

Clinical-laboratory analysis of the effectiveness of VIFERON® (suppositories rectal) in children from 1 month up to 7 years with acute respiratory viral infections (ARVI), accompanied by acute stenosing laryngotracheitis (ASLT), hospitalized in Children's City Clinical Hospital №5 named after N.F. Filatov. We have found that the drug VIFERON® helps statistically significant reduction in the duration of all major clinical manifestations of the disease as a whole, and also reduces the severity and duration of clinical symptoms ASLT, and significantly contributes to the faster elimination of viral antigens

EBV mononucleosis in children in modern conditions

EBV-mononucleosis is a widespread infectious disease, and also it is an urgent problem of the whole world. The purpose of the research was to study the clinical and laboratory features of EBV-mononucleosis in hospitalized children of different ages in modern conditions. Under the supervision were 136 children aged from 1 year to 18 years. All of the patients had typical and mainly (85%) moderate form of the disease, and 15% of them patients had a severe form of the disease. The results: more severe fever and lymphadenopathy were observed in children older than 3 years. Acute tonsillitis was present in all hospitalized children. Adenoiditis and hepatosplenomegaly were greater in the group of patients of a younger age. Hyperfermentemia was determined in more than half of patients, more often in children over 12 years old. In the hemogram leukocytosis and monocytosis were mostly noted. Atypical blood mononuclear cells were detected in 89% of patients. Patients got complex etiopathogenetic therapy