Search

Infectious diarrhea is one of the leading causes of fatal outcomes in young children. Differential diagnostics of such infections within the first hours of illness poses significant objective obstacles. Data from laboratory studies of autopsy material and pathological studies provide valuable information for understanding the spectrum of differential diagnostics and etiological structure of infectious diarrhea with fatal outcomes in young children. Materials and methods. There were analyzed 100 cases of fatal outcomes in children under the age of six years registered in Russia from November 2011 to December 2019, who was diagnosed with infectious diarrhea at different levels of the healthcare system. The data were assessed based on available medical case reports and the laboratory testing of autopsy samples performed by using nucleic acid amplification methods. Results. The diagnosis of infectious diarrhea was revised in 24 patients, based on the data of a set of intravital and post-mortem studies. In patients with unconfirmed diagnosis of acute intestinal infections, pneumonia was the most often detected — in 45.8% (11/24), sepsis — in 29.2% (7/24), meningitis/meningoencephalitis, acute surgical pathology and asphyxiation associated with vomit aspiration — in 16.7 % (4/24) cases. The causative agents of infectious diarrhea were identified in 71 of 76 patients with confirmed diagnosis of acute intestinal infections. Most prevalent were group A rotaviruses — 52.6% (40/76), group F adenoviruses — 17.1% (13/76), and noroviruses — 13.2% (10/76). Combination of pathogens was detected in 29 cases (38.2%). Prehospital lethal outcomes in patients with infectious diarrhea were observed in 17 cases (22.4%). In total, rate of neonatal deaths due to acute intestinal infections accounted for 62.2% and 2-year-old toddlers — 20.3%. 64 of 76 (84%) children had no unfavorable premorbid background. The most common pathologies associated with infectious diarrhea with developing fatal outcomes were pneumonia (including aspiration pneumonia) in 22.4% (17/76) and aspiration asphyxia in 6.6% (5/76). Hemolytic-uremic syndrome associated with diarrhea was diagnosed in 7.9% (6/76) of children. Conclusions. Within the first years of life children comprise a risk group for developing fatal outcomes during infectious diarrhea. Lack of unfavorable premorbid background should not be considered as a reliable positive prognostic criterion. Diagnostics of pneumonia should be included in the mandatory examination plan for children with severe infectious diar rhea. Based on study of clinical and autopsy material, group A rotaviruses were the lead causative agents among those resulting in infectious diarrhea with fatal outcomes in young children. Special attention should be paid to preventing vomit aspiration within the first days after disease onset.

Aim: the goal of the study was to evaluate the heterogeneity of the Salmonella enterica subsp. enterica strains isolated from clinical specimens and various environmental sources in the Russian Federation during the period 20112019. Materials and methods. The data of 3076 non-typhoid isolates of Salmonella obtained from sporadic and outbreak cases of salmonellosis (n = 2518), food and water samples (n = 558) were used. These isolates were serotyped according to the KaufmanWhite scheme and genotyped by Pulsed-Field Gel Electrophoresis (PFGE) using XbaI and BlnI restriction endonucleases according to a standard PFGE-protocol developed by PulseNet International Network. Results. The studied Salmonella isolates were differentiated into 73 serotypes and 601 PFGE types. A comparative analysis of isolates from various sources made it possible to identify subtypes that differed significantly in their prevalence in humans and potential transmission factors (sources). A significant proportion of chicken, turkey, and pork meat samples contained PFGE-subtypes which did not occur in clinical samples. Regional differences in the heterogeneity of the Salmonella spp. were also identified. Conclusions. Genetic heterogeneity of the Salmonella population from humans and other sources shows significant variability of virulent properties and indicates the necessity of differentiated assessment of their epidemiological potential.

The outbreak of shigellosis caused by Shigella. flexneri 2a which affected a total of 42 persons was revealed by epidemiological analysis and microbiological testing in a nursing home for disabled children with a severe pathology of the nervous system. At the same time, four fatal cases among children were registered. The main purpose of our study was to perform an enhanced investigation to find potentially novel etiological agent among affected persons especially in cases with fatal outcome. We applied a broad range of commercial kits based on the nucleic acid amplification techniques as well as bacteriological methods for etiological diagnosis. Additionally, several S. flexneri 2a isolates and revealed bacterial pathogens were subjected to pulsed-field gel electrophoresis (PFGE) and Whole Genome Sequencing (WGS) for expanded genetic characterization as well as demonstration of their clonality and the presents/absence of unusual pathogenic determinants. Genetic relationship between viral pathogens was characterized by Sanger sequencing of phylogenetically informative regions. Epidemiological data and lab testing allowed considering the generalized herpes simplex virus type 1 infection (HSV-1) to be a possible cause of fatal cases.

BACKGROUND: The development of a vaccine for norovirus requires a detailed understanding of global genetic diversity of noroviruses. We analysed their epidemiology and diversity using surveillance data from the NoroNet network.METHODS: We included genetic sequences of norovirus specimens obtained from outbreak investigations and sporadic gastroenteritis cases between 2005 and 2016 in Europe, Asia, Oceania, and Africa. We genotyped norovirus sequences and analysed sequences that overlapped at open reading frame (ORF) 1 and ORF2. Additionally, we assessed the sampling date and country of origin of the first reported sequence to assess when and where novel drift variants originated.FINDINGS: We analysed 16 635 norovirus sequences submitted between Jan 1, 2005, to Nov 17, 2016, of which 1372 (8·2%) sequences belonged to genotype GI, 15 256 (91·7%) to GII, and seven (INTERPRETATION: Continuous changes in the global norovirus genetic diversity highlight the need for sustained global norovirus surveillance, including assessment of possible immune escape and evolution by recombination, to provide a full overview of norovirus epidemiology for future vaccine policy decisions.FUNDING: European Union's Horizon 2020 grant COMPARE, ZonMw TOP grant, the Virgo Consortium funded by the Dutch Government, and the Hungarian Scientific Research Fund.

In the work there was performed an analysis of the indices of recorded incidence of rotavirus infection (RVI) in the territory of 40 subjects of the Russian Federation for the period 2008-2012. For the identification of the monthly peak of the incidence there was evaluated the temporal distribution of the relative indices of the RVI incidence within each subject of the observation. There was revealed the independent beginning of the winter-spring seasonal rise of the RVI incidence in three groups of territories of the Russian Federation (1 - Kirov, Kostroma, Nizhny Novgorod region; 2- Republic of Khakassia, Kemerovo region; 3 - Amur region). In the territory of the South and the North Caucasus Federal District (Krasnodarsky and Stavropolsky Krai, Rostov region) there was noted the second, summer-autumn seasonal rise in the RVI incidence. The obtained data provide an overview of the seasonal-geographical distribution of the RVI incidence in the territory of Russia in conditions of the absence of the use of rotavirus vaccines

BACKGROUND This is a prospective, multicentered study conducted in 9 large urban areas in Russia, in order to determine the burden of rotavirus gastroenteritis in children

In the winter of 2014/15 a novel GII.P17-GII.17 norovirus strain (GII.17 Kawasaki 2014) emerged, as a major cause of gastroenteritis outbreaks in China and Japan. Since their emergence these novel GII.P17-GII.17 viruses have replaced the previously dominant GII.4 genotype Sydney 2012 variant in some areas in Asia but were only detected in a limited number of cases on other continents. This perspective provides an overview of the available information on GII.17 viruses in order to gain insight in the viral and host characteristics of this norovirus genotype. We further discuss the emergence of this novel GII.P17-GII.17 norovirus in context of current knowledge on the epidemiology of noroviruses. It remains to be seen if the currently dominant norovirus strain GII.4 Sydney 2012 will be replaced in other parts of the world. Nevertheless, the public health community and surveillance systems need to be prepared in case of a potential increase of norovirus activity in the next seasons caused by this novel GII.P17-GII.17 norovirus.

Analysis of complete capsid sequences of the emerging norovirus GII. 17 Kawasaki 308 from 13 countries demonstrated that they originated from a single haplotype since the initial emergence in China in late 2014. Global spread of a sublineage SL2 was identified. A new sublineage SL3 emerged in China in 2016.