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The heavy burden of meningococcal infection is associated not only with life-threatening complications in the acute period and high mortality in invasive forms of the disease, but also with severe consequences in survivors, who are not recorded in our country.The aim of study: to analyze clinical manifestations, complications of the acute period and outcomes of invasive forms of meningococcal disease in children in various regions of the Russian Federation.Materials and methods: an analysis of data from 1327 inpatient medical records of children with an invasive meningococcal infection from 14 regional centers of the Russian Federation for 2012-2021 was carried out (28.3% of cases of the disease in children in the represented federal districts).Results: it was found that young children predominated among the patients – the median was 27.4 (10.7-70.4) months. Complications of the acute period, often combined, were observed in 47.6% of cases. The development of septic shock was noted in 30.4%, Waterhouse-Friderichsen syndrome in 6.6%, carditis in 2.9%, cerebral edema in 15.7%, arthritis in 1.4% of cases; the formation of hydrocephalus, subdural effusion, sensorineural hearing loss in 1.8%, 0.6%, 1% of children, respectively. The presence of soft tissue necrosis requiring surgical intervention was noted in 3.5% of cases. Mortality rate was 10.1%. At the time of discharge from the hospital, 30% of children had complications associated with meningococcal infection: organ dysfunction/ failure in 13.2% of patients (severe in 1.3%), cerebral insufficiency in 19.6%; severe psycho-neurological deficits, sensorineural hearing loss, problems associated with the need for orthopedic/surgical interventions accounted for 0.7%, 0.6% and 0.8%, respectively.Conclusion. Considering the epidemiological features of meningococcal infection – the risk of a sharp increase in morbidity in short periods of time, the life-threatening nature of the disease itself, it is necessary to remain alert to these risks and take all possible measures to prevent the disease using all available means, the most effective of which is vaccine prevention.

Objective: to conduct a comparative assessment of the effectiveness of immunomodulatory drugs in infectious mononucleosis of mixed etiology (EBV and CMV) in children, using the principles of evidence-based medicine.Materials and methods: a comprehensive comparative assessment of the effectiveness of immunomodulatory drugs in children with infectious mononucleosis EBV+CMV-etiology in 3 groups: group I-20 patients receiving recombinant interferon α-2β, group II-20 children receiving interferon – meglumin inducer acridonacetate and group III-20 children treated with a synthetic immunomodulator-inosin pranobex. The comparison group (IV) consisted of 20 children who received basic therapy.Results: Analysis of key intervention indicators for the outcome «fever Duration less than 5 days» showed the highest effectiveness of recombinant interferon α-2β, less effective were meglumina acridonacetate and inosine pranobex. According to the outcomes «Reduction of lymph nodes by 2 or more times» and «Reduction of the liver and spleen by 2 or more times», data on the advantage of meglumin acridonacetate were obtained. The recombinant interferon α-2β was the second most effective. All the studied drugs do notsignificantly affect the severity of the hematological syndrome. The expediency of using immunomodulatory therapy in infectious mononucleosis of EBV+CMV-etiology is shown, the deviation from the norm of the integral outcome indicator is significantly higher in the group of children who were on symptomatic therapy. The overall effectiveness of the studied immunomodulatory drugs with all clinical outcomes does not have statistically significant differences.Conclusion: the obtained data allow us to rationally approach the choice of immunomodulatory therapy, taking into account the effectiveness of clinical outcomes and the overall effectiveness of the drug.

Objective: to study the features of the clinical and epidemiological characteristics of whooping cough in children in the Samara region.Materials and methods: 389 cases of pertussis in the Samara region for 2015–2016 were analyzed.Results: it is shown that in spite of 95–98% vaccination coverage, in recent years there has been an increase in the incidence of whooping cough. Seasonality of morbidity remains. Among the children observed, the youngest children were not vaccinated against pertussis. The clinical picture of the disease remains typical with the classic course of catarrhal and spasmodic periods. Moderately severe forms of the disease predominate. Complications were noted mainly in unvaccinated children of the first year of life. The most frequent complications were pneumonia and apnea. There is a hypodiagnosis of pertussis in outpatient conditions. Infection often occurs under the mask of ARVI, while the sensitivity of the bacteriological method of diagnosis is zero. Of the methods for confirming the diagnosis, the most reliable is ELISA and PCR.Conclusion: these epidemiological and clinical features of pertussis current testify to the need to further improve methods of early diagnosis, especially express methods, etiopathagenetic treatment, specific prevention, antiepidemic measures in the foci of infection.

Objective. To study the peculiarities of trichinosis on the material of the group flashes.Materials and methods. Described and analyzed outbreak of trichinosis in 14 adolescents aged 13 to 18 years, were hospitalized in pediatric infectious ward of the city of Samara.Results. The source of infection – infected meat badger. The severity of illness depend on the amount of meat eaten, that is, the infectious dose of the pathogen. In severe cases, the incubation period of trichinosis was minimal (7 days), and if less severe – the maximum (from 19,5 to 21 days). Mild course also contributed to the early administration of antiparasitic therapy. Most of the children the disease begins with fever and dyspepsia, half recorded rash.At the height of the disease is predominant myalgias, half of cases – swelling. The peculiarity of the current severe trichinosis were pronounced toxic-allergic syndrome, generalized edema, myalgia and myasthenia gravis, up to a full adinamii, organ destruction: infectious-toxic kidney, cardiomyopathy, fulminant hepatitis, polyserositis with ascites, hydrothorax 3 weekdisease. The temperature in most of the patients wore a doublewavelength character with rises in the disease onset and disease for 2–3 weeks. It noted the duration of the clinical symptoms. The longest was myalgic, half of the patients remained at the time of discharge from the hospital. The features of laboratory parameters (leukocytosis, eosinophilia, ALT, AST, CRP) in various forms of the disease. The diagnosis was confirmed by serology (IgM, Ig G to Trichinella spiralis) in different phases of the disease. All patients received a specific antiparasitic therapy albendazolom secondary therapeutic dosage for 10 days, as well as detoxication, allergen and symptomatic therapy is indicated.Conclusion. Thus, health education among the population and will be a true prevention of trichinosis.