Search

Relevance. The Sverdlovsk district is a tense natural focus for Lyme borreliosis (LB) with a constantly recorded incidence that exceeds these indicators in the Russian Federation and the Ural Federal region several times. LB is registered on 56 of 59 administrative territories of the district. Currently, the count of LB in the Russian Federation includes both infections caused by Borrelia burgdorferi sensu lato group Borrelia and infections caused by Borrelia miyamotoi sensu lato group Borrelia.Aim. To characterize the epidemic process of LB in the territory of the Sverdlovsk district over a 20-year period (2002–2021).Materials and methods. The paper uses data from federal and regional statistical observations, reporting materials of the Department of Rospotrebnadzor in the Sverdlovsk district for 2002–2021, methods of statistical analysis.Results and discussion. During the follow–up period (2002–2021), the incidence rate of BL in the Sverdlovsk district exceeded the average long-term level in the Russian Federation by almost 3 times, and in the Ural Federal region – by 1.8 times. Among the mechanisms and ways of transmission of LB pathogens, the vector-borne mechanism dominated (84.5%), the share of the unidentified pathway was 15.4%, alimentary (when using raw goat's milk) – 0.1%. The duration of the epidemic season for LB in the district was 10 months (from March to December) with a peak incidence in June. Cases of LB were registered among people of different ages, with a predominance in the group of 60 years and older (39.1%). An analysis of the distribution of people with LB by social composition showed that pensioners prevailed among them – 36.3%, officials made up 27.8%, unemployed – 14.1%. Among the cases, a high proportion of schoolchildren and children under 7 years old were noted. It was found that erythematous and non-erythematous forms of LB are registered in the district, with a predominance of erythematous (64.5%). The main etiological agent of the erythematous form is Borrelia garinii, while the non-erythematous form is Borrelia miyamotoi and B. garinii. In the general structure of morbidity, the number of cases of LB is largely determined by the city inhabitants (92.9%). There were no fatal outcomes in LB in the territory of the district during the studied period.Conclusions. Due to the lack of vaccination of LB worldwide, the only strategy to reduce the incidence of LB is non-specific prevention and timely diagnosis of the disease, including data from epidemiological history, clinical and laboratory diagnostics. The long-term clinical and epidemiological and laboratory studies conducted by us in the Sverdlovsk district allowed us to characterize the main manifestations of the epidemic process of LB and to improve the diagnosis of the disease.

Relevance. Despite the ongoing program of mass vaccination of tick-borne encephalitis (TBE) for more than 20 years in the Sverdlovsk district, the incidence rate of TBE continues to exceed the average in Russia and the Ural Federal region.Aim. To analyze the main indicators of the manifestation of the epidemic process of TBE in the territory of the Sverdlovsk district under the conditions of planned vaccination over a 20-year period (2002–2021).Materials and methods. The article uses data from federal and regional statistical observations, reporting materials of the Department of Rospotrebnadzor in the Sverdlovsk district for 2002-2021, methods of statistical analysis.Results and discussion. During the study period (2002-2021), 3861 cases of TBE were registered in the Sverdlovsk district, while the highest incidence rate was detected in 2005 – 10.1 per 100 thousand population, and the lowest in 2020 – 1.0 per 100 thousand population. The share of the vector-borne mechanism was 78.4%, the unidentified path – 20.1%, alimentary – 1.5%. Analysis of the seasonal distribution of cases of TBE showed that the incidence is recorded from April to November. Cases of TBE were recorded in all age groups, including the child population. Most often, people aged 60 years old and older (24.6%) were ill with TBE. Among the children's population, the largest share fell on children aged 7–14 years (5.4%). Men of working age prevailed among the patients (66.0%). TBE was mainly registered among the unvaccinated population (81.5%) with a predominance of urban (86.1%). Officials predominated among the sick persons – 29.8%, pensioners made up 22.3%, unemployed – 19.8%. Persons whose work is professionally connected with the forest made up only 0.6%. The ongoing program of mass vaccination of TBE has led to a decrease in the proportion of severe and moderate forms of diseases (focal – 9.8% and meningeal – 24.0%) and an increase in the proportion of febrile (33.8%) and atypical forms (32.4%). Deaths during the studied period were recorded mainly among the adult unvaccinated population.Conclusions. The Sverdlovsk district continues to be a tense natural focus of TBE with a constantly recorded incidence among contingents of different age and social groups. In the absence of highly effective etiotropic drugs for the treatment of TBE, the only strategy for reducing the incidence of TBE, the development of severe forms and deaths in the territory of the Sverdlovsk district is mass vaccination of the population.

Introduction. With the epidemiological situation for Crimean-Congo hemorrhagic fever (CCHF) remaining tense in many countries worldwide, special attention should be focused on development and improvement of risk-based epidemiological prediction methods.The aim of the study was to build a prediction model for CCHF incidence dynamics (based on the Stavropol Territory) using satellite monitoring (remote sensing) data.Materials and methods. We analyzed the climate data obtained from the Space Research Institute of the Russian Academy of Sciences as well as the data of public statistics reports on CCHF incidence from 2005 to 2021. The prediction model incorporated the Bayes theorem and Wald sequential analysis. The information content of the factors was assessed using the Kullback method.Results. Predictions for each of 26 districts were made stepwise (compared to threshold levels) to predict whether there will be at least one case of CCHF, whether the relative incidence per 100,000 population will exceed the median level (0.9 cases) or the average rate (3.5 cases) or the third quartile rate (4.7 cases). The highest values of information coefficients were obtained for soil temperature and moisture content (at depths of 10 and 40 cm), normalized relative vegetation index, relative humidity, maximum and average air temperature, relative air humidity. During the testing of the model in 2021, false-negative (erroneous) prediction was made for 2 districts.Discussion. The model proved to be most efficient in prediction of occurrence or absence of cases. More accurate quantitative prediction may be difficult due to subjective factors (including misdiagnosing CCHF cases without hemorrhagic manifestations and administering treatment for other conditions with similar symptoms).Conclusion. The tests of the model demonstrate its potential. The practical application of the prediction will make healthcare workers more alert when screening and detecting CCHF cases.

This article is dedicated to analyzing epidemiological situation of Crimean-Congo hemorrhagic fever in the subjects of the North Caucasian Federal District (from 2005 to 2021) and developing a new approach to improve epidemiological forecasting by using an in-progress prognostic model. The study is comprehensive, using epidemiological methods and mathematical statistics. The epidemiological analysis was carried out based on information from the databases on the incidence rate for Crimean-Congo hemorrhagic fever presented as a project and maps of infectious disease focus epidemiological examination. The prognostic morbidity model is developed based on Bayes theorem and Walds sequential statistical analysis. The factors information calculation was carried out by using the Kullback method. The value of climatic factors was retrieved from the database of the Center for Collective Use IKI-monitoring of the Space Research Institute of the Russian Academy of Sciences. The data obtained indicate that the majority of patients with Crimean-Congo hemorrhagic fever within the studied long-term period in the Stavropol Territory (629) and the Republic of Dagestan (46) were revealed. Isolated cases in the Kabardino-Balkarian Republic (2), the Karachay-Cherkess Republic (3) and the Republic of Ingushetia (2) were noted. Infection by the Crimean-Congo hemorrhagic fever causative agent via the transmission mechanism occurred mainly during the care after farm animals in 59.4%. The prevalence of moderate forms of Crimean-Congo hemorrhagic fever (79%) was noted, with hemorrhagic manifestations (over the last five years) observed almost in half of the patients. The proportion of correct preliminary diagnoses during patient hospitalization was 49%. While testing the prognostic model in 2021 particularly in the Stavropol Territory, a complete exact coincidence for predicted and the actual data was obtained for 11 districts (42.3%). False positive (38.5%) and overestimated (11.5%) data at this stage of the study do not significantly reduce the predictive value of the model, since they often reflect registered infection case that occurred at the patients place of residence in another administrative region, underdiagnoses of mild forms of Crimean-Congo hemorrhagic fever in medical institutions or high efficiency of preventive measures against ticks measures carried out before the beginning of the epidemic season in individual municipal districts. False negative results were 7.7%. Thus, the results of the analysis evidence about a need to improve the training of medical personnel for the timely detection of patients with Crimean-Congo hemorrhagic fever and to enhance the effectiveness of preventive measures against ticks. The results of testing the prognostic model confirm the feasibility and hold promise to continue the study.

This article is dedicated to the analysis and generalization of the Russian and foreign research results on natural and climatic factors effect on the intensity of epidemic process manifestations and the natural focal infections pathogens vectors vital activity which are the most widespread in the Russian Federation. Over the past seven years tick-borne infections have been accounting for more than 50 per cent in the natural focal diseases general nosological structure. Among the diseases of this group Lyme borreliosis leads in prevalence and frequency of cases identification. Tick-borne viral encephalitis is still a serious danger for national health. Crimean-Congo hemorrhagic fever epidemiological situation remains unfavorable in the south of the European part of Russia. In addition to the annual patients identification, the demonstrable trend of shifting and expansion of the pathogen’s area in a northerly direction was established. It creates a risk for the spread of the Crimean-Congo hemorrhagic fever virus outside the southern regions of the country. High incidence of the dangerous vector-borne infection — West Nile fever — with the involvement of new subjects in the epidemic process and the emergence of local cases of infection in previously non-endemic territories is registered. Expansion of hemorrhagic fever with renal syndrome natural foci borders, which is the most widespread natural focal zoonosis of viral etiology in the Russian Federation and is the second by the frequency of patients identification after tick-borne infections, is noted. Research data for the dependence of the carriers pathogens number and the dynamics of the natural focal infections incidence on the values of climatic factors, confirmed using various methods of mathematical statistics (time-series analysis, autoregression integrated moving average, logistic regression, correlation analysis, one-way analysis of variance and other) were systematized. It was found that the temperature and humidity of the air and soil, the amount of precipitation, the height of the snow cover are the common abiotic factors for all of investigated infections. The values of these factors can be used for the subsequent epidemiological forecast. The further study of relationship between the incidence rate of the population, the number of arthropod vectors and small mammals with indicators of soil moisture and temperature at different depths, hydrothermal coefficient, normalized relative vegetation index, accumulated values of temperature and precipitation, as well as similar studies on other actual natural focal infections in the Russian Federation will be very promising.

Introduction. Borrelia miyamotoi is a pathogen causing erythema-free ixodid tick-borne borreliosis (ITBB), a disease widespread in Russia. The genome of B. miyamotoi contains genes of multiple variable major proteins (Vmps). Vmps fall into two families — Vsps and Vlps (with subfamilies δ, γ, α and β). At a particular time, a single B. miyamotoi expresses only one variant of Vmp gene.The purpose of the work is to develop a technique for identification of the Vmp present at the expression site.Materials and methods. The technique is designed in the format of a real-time multiplex PCR. It was tested by using B. miyamotoi DNA samples extracted from blood collected from 172 ITBB patients and 109 ticks. The samples were collected in 14 regions of Russia.Results. The new technique made it possible to identify the expressed Vmp in 82% of the examined samples, thus having demonstrated its efficiency. Negative results were much less often observed with samples from patients than with samples from ticks. At the same time, the percentage of samples with one type of Vmp is identical for clinical samples and ticks, while the percentage of samples containing concurrently two types of Vmps is significantly higher among samples from patients with the most frequent occurrence of the Vlp-δ and Vsp combination.Discussion. The frequent occurrence of the combination of two Vmp types in the blood samples can indicate the concurrent presence of several subpopulations of B. miyamotoi in ITBB patients. A new antigenic Vmp variant is synthesized after protective antibodies have been produced for the major protein of the strain transmitted by a tick. This phenomenon known as immune evasion allows the pathogen to persist within a host.Conclusion. The developed technique of real-time multiplex PCR allows to simultaneous detect of several antigenic variants of the variable basic surface proteins of B. miyamotoi. The study of the antigenic spectrum of B. miyamotoi strains in comparison with the characteristics of conserved regions of the genome by the method of multilocus sequencing will clarify the stages of evolution and distribution of B. miyamotoi sensu lato.

Aim. To study the morpho-functional parameters of the heart in convalescents of hemorrhagic fever with renal syndrome (HFRS) using echocardiography.Material and methods. The study included 27 patients without any chronic diseases who had severe or moderate HFRS (the main group) within 3 weeks after their discharge from the infection diseases hospital. The reference group consisted of 19 patients comparable by age and gender, without any chronic diseases. Transthoracic echocardiography was the basic method of heart and hemodynamics investigation. The test was performed using tissue Doppler and non-Doppler assessment of left ventricle systolic deformation method (speckle-tracking method).Results. Violation of longitudinal systolic deformation of the left ventricle was observed in 15 (55.6%) patients, which was combined with diastolic left ventricle filling by the type of relaxation violation in 8 (29.6%) cases. Mitral valve insufficiency of 1 degree was identified in 11 (40.7%) HFRS patients, insufficiency of the tricuspid valve of 1 degree was identified in 4 (14.8%) patients. Pericardial effusion was detected in 2 (7.4%) patients. In 7 (25.9%) patients in the first 3 weeks after discharge from the hospital, additional floating echoes were detected on the leaves and fibrous ring of the aortic valve, which were considered as a manifestation of thromboendocarditis.Conclusion. Further investigation is necessary to assess the prognostic value (including the risk of thromboembolic complication developing) of the changes revealed in HFRS convalescents and to support the inclusion of echocardiography in the examination program during dispensary observation of HFRS-convalescents.

Purpose: analysis of the arbovirus infections incidence in the south of the European part of the Russian Federation in 2015–2019.Materials and methods. Data from statistical documentation (epidemiological examination of the infectious disease cases, reports on the arbovirus infections incidence) reported by Departments of Rospotrebnadzor to Scientific and Methodological Center for monitoring pathogens of infectious and parasitic diseases of 1–3 risk groups for subjects of the North Caucasian and Southern Federal Districts were analyzed. The obtained data were processed using Microsoft Excel 2010 program.Results. In the south of the European part of the Russian Federation Crimean-Congo hemorrhagic fever (CCHF), West Nile fever (WNF), tick-borne viral encephalitis and dengue fever cases are registered annually.An expansion of the territory with registered epidemic manifestations of CCHF and WNF was noted, reflecting an increase in the area of circulation of their pathogens. An expansion of CCHF and WNF epidemic season with the involvement into the epidemic process of people from all age groups including young children was observed. Significant increase in number of imported cases of dengue fever was documented. Markers of tick-borne viral encephalitis, Batai, Inko, Sindbis, and Tyaginya fevers were detected in residents of a number of territories. A high levels of population humoral immunity to West Nile, Batai, Inko, Sindbis Tyaginya, Ukuniemi, Bhanja, Dkhori viruses were identified in the Astrakhan region.Conclusion. The data obtained indicate the need for epidemiological surveillance both for arbovirus infections with a pronounced epidemiological and clinical manifestations, and for infections, the proportion of which in the structure of infectious pathology in southern Russia has not been sufficiently studied, but carrying a potential risk of spreading.

Aim. Investigation of modern epizootic and epidemic situation on West Nile fever (WNF) in the south of the European part of the Russian Federation. Materials and methods. Data from statistical documentation (epidemiological survey of the infectious disease focus, annual summary reports over the period of 2009–2018) and epizootic monitoring data presented by the Rospotrebnadzor Administrations and the Centers of Hygiene and Epidemiology in the constituent entities of the Southern and the North Caucasian Federal Districts were used. Descriptive, analytical methods and retrospective epidemiological analysis were applied. Results and discusson. The activity of natural WNF focus in the south of the European part of the Russian Federation was confirmed by the results of the annual epizootiological monitoring and the annual epidemic manifestations of the disease. 74.15 per cent of the cases and all major WNF outbreaks in the country between 2009 and 2018 were noted in the territory of the southern region. Most of the patients (97.8 per cent) are registered in the Volgograd, Astrakhan and Rostov Regions. In other southern entities sporadic incidence (this represents 2.2 per cent of all WNF cases in the south of the Russian Federation) was noted. Less serious clinical forms of the disease without the damage of central nervous system were observed in most of WNF patients. Fatal outcomes were registered in 7 WNF patients (this represents 0.58 per cent of all cases) over the past 10 years. The significant expanding of the West Nile virus geographic area and activation of the natural foci of this infection in the south of the Russian Federation in 2009- 2018 has been established. The epizootic and epidemic WNF center is located in the Volgograd, Astrakhan and Rostov Regions. It was confirmed by persistent epizootic and epidemic instability in this territory. The modern epidemic WNF feature in the south of the European part of the Russian Federation during the 10-year survey period is the relatively low mortality (0.58 per cent).

Objective of the study was to determine the modem epizootic and epidemic peculiarities of hemorrhagic fever with renal syndrome in the south of the European part of Russia. Materials and methods. Data of statistical documentation (epidemiological survey of the infectious disease focus, annual summary reports dated 2009-2018) and epizootic monitoring data submitted by the Rospotrebnadzor Administrations and the Centers of Hygiene and Epidemiology in the constituent entities of the Southern and the North Caucasian Federal Districts were used. Descriptive, analytical methods and retrospective epidemiological analysis were applied. Results and discussion. The circulation of hantavirus in the Volgograd and Astrakhan Regions, Stavropol and Krasnodar Territories, Republics of Adygeya, Kalmykia and Crimea was confirmed. However, two geographically and genetically isolated groups of hantaviruses circulating in the Volgograd Region and in the mountain-foothill zone of the Krasnodar Territory and the Republic of Adygeya were the most epidemiologically significant. Over the period of 2009-2018, 152 HFRS cases with annual fluctuations from 4 to 25 cases were registered. Almost all patients lived in the Volgograd Region (44 cases), where the incidence is caused by the HFRS-Puumala virus, or in the Krasnodar Territory (98 cases), where the HFRS Hantavirus Dobrava-Ap circulates. In HFRS patients with the HFRS-Dobrava-Ap virus severe clinical forms were noted at twice the rate, a fatal outcome in one patient with HFRS-Puumala was recorded. The correct preliminary diagnosis was made for 56.3 per cent of patients in the Volgograd Region and only for 31.7 per cent of patients in the Krasnodar Territory and in the Republic of Adygeya. There are different types of natural HFRS foci in the European south of Russia, they vary by the type of hosts and hantaviruses circulating in them - Puumala, Dobrava, Tula, and Dobrava-Ap. Natural foci where of HFRS-PUU and HFRS-DOB-Ap viruses circulate have high epidemic potential. Severe forms of the HFRS are more often observed in patients with the HFRS-DOB-Ap virus.

Aim. Estimation of the prevalence of Ixodes tick-borne borreliosis (ITBB) without erythema migrans in the Krasnoyarsk Territory in comparison with the prevalence of ITBB with erythema, that is Lyme disease (LD). Detection of cases of «new» infection caused by Borrelia miyamotoi (ITBB-BM) among patients with suspected tick-borne infection, primarily among patients with ITBB without erythema (ITBB-W/O-E). Materials and methods. We analyzed the database of Rospotrebnadzor containing individualized information about cases of ITBB officially registered in the Krasnoyarsk Territory in 2011 — 2016. Blood samples from 18 patients with suspected of tick-borne infection hospitalized in the Krasnoyarsk Emergency Hospital in 2017 were collected and studied. ITBB-BM was diagnosed if B. miyamotoi DNA was found in patient’s blood and/or the antibodies to specific antigens of B. miyamotoi were detected. Results. With an average annual incidence rate of ITBB of about 10 cases per 100,000 population, the proportion of ITBB-W/O-E among all ITBB in the Krasnoyarsk Territory is about 45%. Epidemiological characteristics of ITBB-W/O-E and LD are similar, but these diseases are very different clinically. All cases of ITBBW/O-E and some cases of tick-borne infections of unknown etiology, subjected to our enhanced laboratory diagnostics, were caused by B. miyamotoi. Conclusion. ITBB-W/O-E is a widespread disease in the Krasnoyarsk Territory, caused mainly by B. miyamotoi. The results of the study significantly expand the known geographic area of the ITBB-BM.

Hemorrhagic fever with renal syndrome (HFRS) is a zoonotic infection disease caused by Orthohantavirus which belongs to Hantaviridae family. This article is a brief review of recent data about genetic factors which play a role in individual predisposition toward HFRS. There are reports discovered associations of polymorphic sites with HFRS severity and risk complications. Polymorphic sites in genes which code proteins of immune (МНС, TNF, IL1) and endothelial (VE-cadherin) systems, blood coagulation (SERPINE1, ITGA2B, NOS) and detoxification (CYP1A1, GSTP1) systems and their links with disease are described in this article. HLA haplotypes B*08-DRB1*03 and B*46-DRB1*09, B*51-DRB1*09 are associated with severe forms of HFRS-PUUV and HFRS-HTNV respectively. TNF A-allele and AA-genotype in -308G>A SNP (rs1800629), CDH5 ТТ-genotype in 1550T>C SNP, SERPINE1 G-allele in -844A>G SNP (rs2227631), alleles HPA3 b, NOS2A*11 and NOS2A*11/NOS2A*12-genotype, CYP1A1 1А2С-genotype in SNP (rs1048943) and GSTP AG-genotype in SNP (rs1695) demonstrated associations with severe HFRS. Differences in the expression levels of GATA3, T-BET, CD3, IFNβ, NFkB, STAT1 and MxA genes in cell cultures stimulated by hantavirus. Expression of GATA3 was significantly higher in cell cultures of patients with severe HFRS than with a mild form. In contrast, MxA gene expression was up-regulated in cell cultures of patients with mild HFRS-PUUV. Considering individual genetic factors of HFRS patients would allow defining the best tactic of therapy and prophylaxis in this way. And as a result of applying this treatment in the clinical practice decrease of unfavorable disease outcome would occur.

Aim. In this paper we investigate the impacts of co-incubation of Borrelia miyamotoi with neutrophils. Materials and methods. Spirochetes B. miyamotoi, strain HT31, were incubated 3 hours at 37°C with neutrophils of healthy donors (5*106 cells/ml) in a 1:1 ratio. The incubation medium contained also non-immune serum of healthy blood donors (SHD) and, in some experiments, high-immune serum of patients recovered from ITBB-BM (S-ITBB-BM). The proportion of neutrophils that bound borrelia, as well as the number and viability (mobility) of free borrelia, was estimated by dark-field microscopy. Results. Free-swimming borrelia remain viable in SHD or heat-inactivated S-ITBB-BM, but about 10% of borrelia are associated with neutrophils. In S-ITBB-BM with neutrophils, the proportion of viable borrelia among free ones decreases by approximately 10% compared to S-ITBB-BM without neutrophils; in addition about 15% of bor-relia become bound by neutrophils. If chemoattractant fMLP was added, the proportion of neutrophils binding borrelia increases to 25%, and the proportion of immobilized non-bound bor-relia reaches 40%. Conclusion. Although neutrophils are able to destroy borrelia with or without direct contact, under model conditions the combined effect of blood neutrophils and high-immune human serum does not provide 100% elimination of B. miyamotoi.

Objective of the study was to analyze epizootiological and epidemiological risks contributing to the development of anthrax outbreak in the Yamal peninsular in July-August, 2016. Materials and methods. Risks were evaluated using complex approach allowing for determination of the impact of epidemiologically significant social, natural, and biological risks, based on literature sources, archival data, and statistical reports. Special focus was on the natural-climatic factors, providing for persistence of the agent in the environment, such as NDVI index, atmospheric temperature and humidity, as well as soil temperature and moisture at different depths, in accordance with satellite monitoring. Results and conclusions. Justified was the hypothesis on sustained adversity of soil foci in Yamal, remaining hazard of aggravation of epizootiological and epidemiological situation on anthrax against the background of changing environmental and social risk factors, as well as agent ability to survive in the soils within an indeterminate amount of time.

Intensive development of DNA analysis technologies and largescale genome-wide association studies have led to accumulation of a large array of data on the relationship between genetic factors and various phenotypic manifestations, including monogenic and polygenic hereditary diseases. This greatly has extended the capabilities of clinical diagnostics and predictive medicine in the field of socially significant diseases. For example, a role of agenetic component of the risk for such a multifactorial and polyetiologic disease as stroke is now actively explored. Large-scale studies have revealed both general and specific genetic markers associated only with a certain type and subtype of stroke. This review analyzes the current state of the problem of using genetic markers for diagnosis of stroke predisposition, complex issues associated with multiplicity of risk factors for stroke, and possible development in this area.

Background. The spirochete Borrelia miyamotoi belongs to the group of borrelia causing tick-borne relapsing fevers. It is transmitted by the same tick species as Borrelia burgdorferi sensu lato and is widespread in temperate climate zones of Eurasia and North America. Previously we have shown by PCR that clinical cases presented as systemic febrile illness and diagnosed usually as «Ixodes tick-borne borreliosis without erythema migrans» were caused by B. miyamotoi. According to recent estimation in Russia there are several thousands human cases of B. miyamotoi infection annually. The investigation of this emerging human pathogen was hampered because the attempts to culture this bacterium directly from human blood failed. Results and conclusion: We here describe protocol - avoiding the inhibitory effects of anticoagulants on B. miyamotoi growth - enabling successful B. miyamotoi isolation from blood of Russian patients.

Study objective: to perform assessment of the social and economic burden (analysis of the cost of disease) of five natural focal transmitted infectious diseases in theRussian Federationon the whole and in certain regions: ixodic tick-borne borreliosis, Siberian tick-borne typhus,Astrakhanrickettsial fever, Crimean hemorrhagic fever, andWest Nileencephalitis. Materials and methods. Direct and indirect costs caused with the studied diseases and the number of lost Disability Adjusted Life Years (DALY) are calculated in the probability model. Results. The total value of social and economic losses associated with vector-borne infectious diseases comprised 909 million rubles in prices of 2011; most of the value is represented with ixodid tick-borne borreliosis. Totally, these diseases cause the loss of 16,599 DALY.