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Рertussis is one of the common diseases in young children around the world. In 2023, the incidence of pertussis was recorded in all constituent entities of the Russian Federation, the incidence rate of pertussis in children in the first year of life increased by 13.8 times compared to last year, and the incidence rate in children aged 1 to 2 years was 159.7 per 100 thousand population of this age. Objective: assessment of the course of whooping cough in children of the first three years of life. Materials and methods: a retrospective analysis of 199 medical records of children hospitalized in St. Petersburg State Budgetary Institution Children's City Clinical Hospital No. 5 named after. N. F. Filatova in the period from 2019—2024. Results: Most often, children in the first 6 months of life require hospitalization. Immunization against pertussis was absent in almost all cases. As a rule, the source of infection was the older children in the family and parents. The preconvulsant period was often 4—6 days. The majority of children (89%) were admitted to the hospital at the end of the first — beginning of the second week of the convulsive period. In 81% of cases, the disease was of moderate severity, and severe — 19%. Respiratory rhythm disturbances were observed in 29% of patients. Pertussis was more often complicated by obstructive bronchitis; pneumonia was recorded in 9% of cases, acute bronchiolitis (2.5%) mainly in children in the first 6 months of life. The disease occurred against the background of perinatal damage to the central nervous systemin 13% of cases, atopic dermatitis in 10%, urinary tract infectionin 3.5%, and in 4 patients against the background of acquired CMV infection. Among the concomitant pathologies, ARVI was more often detected. The diagnosis was confirmed by PCR. Conclusion: the persistence of high morbidity rates in the child population and the severity of the disease in young children necessitates the need to achieve a high percentage of coverage of the child population with specific prevention.

Even when asymptomatic, intestinal parasitosis can have a significant impact on the health of children. Materials and methods. An analysis of the medical documentation of the children's clinic for 2016—2023 was carried out. Results. It has been established that enterobiasis dominates in children living in St. Petersburg (87.8%—98.8%), the proportion of ascariasis and giardiasis in different years did not exceed 5.2% and 10.0%, respectively. The maximum proportion of those affected by E. vermicularis (50.6%—66.8%) and Giardia (67.3%) was in the age group of 7—14 years, while ascariasis most often affected children 3—6 years old (51.7%). Enterobiasis was more often recorded during annual preventive examinations (September-November) (52.0%—65.9%), ascariasis was detected at a later date — November-January (41.5%), the largest number of episodes of giardiasis was observed in the spring months (53.9%). If helminthic infestations in all cases were asymptomatic and were discovered by chance during a microscopic examination of feces, then in the case of giardiasis, 46.2% of those infected complained of abdominal pain (42.3%), discomfort after eating (25.0%), diarrhea/constipation (21.2%), bloating (19.2%), frequent belching of air (13.5%). Thus, a single microscopic examination of feces is not very informative. Knowledge of the clinical and epidemiological features of parasitic infestations will allow the pediatrician to conduct an in-depth examination of the child to decide on antiparasitic treatment

The goal is to evaluate the tolerability and effectiveness of the domestic vector vaccine Gam-Covid-Vak-M in children aged 12—17 years, adherence to vaccination of adolescents and parents to improve work on the prevention of COVID-19. Materials and methods. A retrospective analysis of the medical records of 115 children aged 12—17 years who were vaccinated in 2022 with the Gam-COVID-Vac-M vaccine in two children's polyclinics in St. Petersburg was carried out. Additional information was collected through telephone interviews. A cross-sectional anonymous online survey of adolescents aged 15—17 was also conducted to study awareness of COVID-19 and adherence to vaccination. Results. Only 23.5% of those vaccinated were at risk for severe and complicated COVID-19. Parents showed low adherence to vaccination against COVID-19 — 71.3% vaccinated themselves and 73.1% considered it necessary to protect the child. Only in 14.1% of cases, a teenager aged 15—17 made the decision to be vaccinated. According to 76.9% of adolescents, COVID-19 is a dangerous disease, while 55.6% consider vaccination unnecessary, mainly due to ineffective protection and the possibility of complications. Nevertheless, side effects after the first and second components of Gam-COVID-Vac-M were observed in 24.3% and 24.2%, respectively, which is 4 times less than with foreign vaccines. Systemic and local reactions were observed on days 1—2 after immunization. All manifestations were mild or moderate and resolved within 1—2 days on average. Serious adverse events were not registered. The effectiveness of the vaccine was 97.4%. Conclusion. Preliminary results indicate good tolerance and efficacy of the domestic vaccine Gam-COVID-Vac-M.

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.

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.

Babesiosis is a natural focal infectious disease caused by protozoa of the genus Babesia, transmitted transmissibly and characterized by fever, intoxication, progressive hemolytic anemia, and often severe course in immunocompromised patients. The clinical picture of babesiosis is nonspecific. The disease should be suspected in patients with unexplained fever who have been in endemic areas for 2 months or have received a blood transfusion within 6 months. Diagnosis of babesiosis is difficult; depends on the qualifications of the doctor and the number of parasites in the blood. The aim of the work is to summarize the available information about the etiology, epidemiology, pathogenesis, clinic, diagnosis, etiotropic therapy and prevention of babesiosis in humans. A review of domestic and foreign literature over the past 30 years, including Internet resources, has been carried out.

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.

Parvovirus B19 infection is best known as erythema infectiosum. However, infection with parvovirus B19 can lead to damage to various organs and systems, the development of severe complications up to death. The infection is most dangerous for people with immunodeficiency and hematological diseases. Serious consequences are possible with intrauterine infection of the fetus. Knowledge about the characteristics of the pathogen, the pathogenesis of the disease, the variety of clinical manifestations will allow the doctor to avoid diagnostic errors and provide the patient with timely medical care.

The paper analyzes approaches to etiotropic therapy and structural assessment of the range of drugs for the treatment of campylobacteriosis in children. The methods of content analysis, grouping, data aggregation, comparative and marketing analysis were used. The information base of the study was the State Register of Medicines, federal clinical guidelines for the provision of medical care to children with campylobacteriosis, European and American clinical guidelines, as well as instructions for the medical use of drugs.Comparative analysis showed that Russian clinical guidelines contain 15 international non-proprietary names used for the etiotropic therapy of campylobacteriosis. The analysis carried out by drug producing countries shows that the leading positions in the supply structure are occupied by Russian producers (68.26%). Structuring by dosage forms makes it possible to single out tablet positions (47.46%). At the same time, 36.47% of the range of drugs are approved for use from the age of 12, which limits the implementation of modern approaches to the rational etiotropic therapy of campylobacteriosis in pediatrics. Structural analysis of the range of pharmaceutical substances identifies a significant contribution to the structure of imports of Chinese producers (46.30%), which, in turn, justifies the prospects for import substitution. Solving the problem of improving the quality of medical care for children with campylobacteriosis determines the prospects for further research based on the principles of evidence-based medicine using the tools of mathematical-statistical and pharmacoeconomic analyses.

At present, there are isolated data on the clinical outcomes of COVID-19 in children, especially those who have experienced asymptomatic and mild forms of infection.Purpose: to analyze the nature and frequency of postCOVID symptoms in children during 12 months. after recovery.Materials and methods. The influence of demographic indicators, premorbid background, severity of infection and therapy in the acute period of the disease on the nature and frequency of symptoms in 1079 children who underwent laboratory-confirmed COVID-19 was studied. The results are presented with proportions (%) and calculation of 95% confidence interval according to Klopper-Pearson. Differences between groups were assessed using Pearson’s chi-square test. Differences in the groups were considered statistically significant at p < 0,05.Results. Health disorders in the post-COVID period were observed in 8,5% of children, more often in school-children aged 7–17 years (68.4%). Concomitant conditions were found in 38,0%. In most cases, the consequences were noted after a mild form of COVID-19 (77.2%), however, 13,0% of patients experienced an asymptomatic form of infection. Among convalescents, changes in the emotional sphere (2,1%), headache (1,8%), symptoms of asthenia (1,6%), cardiovascular (1,5%), dyspeptic (1,3%) were more often observed, cognitive (1,3%) disorders, neurotic disorders (1,0%), less often respiratory (0.8%), endocrine (0,4%) and visual (0,4%) systems, musculoskeletal system were involved (0.2%). Girls were significantly more likely to have vegetative disorders, while boys were significantly more likely to suffer from cognitive functions. Various antiviral therapy options (interferon-alpha, an oral antiviral drug, or a combination thereof) in the acute period of COVID-19 did not affect the possibility of post-COVID disorders, but there was a tendency to increase the frequency in children who did not receive etiotropic treatment (control group). In 14.1% of cases, post-COVID symptoms appeared late – after 5–10 months. after recovery. The course of rehabilitation therapy, including drug treatment and non-drug methods, made it possible to quickly restore the state of health of the observed children.Conclusion. In most cases, the violations were of a functional nature, due to a disorder of autonomic regulation. Rehabilitation and dispensary observation programs will allow timely restoration of the quality of life of children who have had COVID-19, including in a mild and asymptomatic form.

The problem of the non-smooth course of COVID-19 and deaths in children with severe comorbid pathology is urgent. Among all registered cases of a new coronavirus infection in the Russian Federation, children account for up to 8,6%, of which severe forms are noted, as a rule, in patients with concomitant diseases. A clinical observation of the course of a new coronavirus infection in a child with a severe form of idiopathic aplastic anemia complicated by pancytopenia is presented. COVID-19 infection caused a sharp deterioration in the child’s condition. Despite the use of modern methods of therapy, there was a rapid deterioration of clinical and laboratory parameters: an increase in febrility, respiratory failure, interstitial changes in the lungs, a decrease in oxygen saturation to 70%, hemorrhagic, anemic syndromes and multiple organ failure with the development of a fatal outcome. Aplastic anemia is a factor predisposing to the severe course of COVID-19 and contributing to an unfavorable outcome.

Background. The use of antiviral agents can shorten the duration of the viral infection. The aim: to study the clinical and epidemiological features and the effectiveness of antiviral therapy for new coronavirus infection (COVID-19) in outpatient children.Materials and methods. From April 2020 to March 2021, 9334 outpatient children aged from 0 months to 17 years were randomly tested for new coronavirus infection. SARS-CoV-2 RNA was detected in oropharyngeal and nasal material by PCR. Patients with confirmed new coronavirus infection were prescribed interferon-alpha (IFN-α) intranasally, antiviral agents of systemic action. The control group consisted of children with COVID-19 who did not receive treatment.Results. When examining clinically healthy contact children, SARS-CoV-2 RNA was detected in 7.4 % of cases. In the structure of ARI, the specific weight of COVID-19 was 12.3 % with the peak incidence in April-May (up to 22.8 %) and NovemberDecember (up to 30.0 %). In half of the cases, children became infected in the family, and usually adults were the index patient. In 47.7 % of cases, an asymptomatic form of COVID-19 was registered without significant differences in patients of different ages. In one third of children with concomitant pathology, the disease was asymptomatic, in half it was mild, in other cases moderate severity was diagnosed. The clinical picture of COVID-19 did not differ from other ARIs. Anosmia (9.4 %) in half of the cases was combined with ageusia (4.4 %) and was significantly more common in boys. The duration of clinical manifestations in children of the control group and those who received antiviral therapy did not statistically significantly differ in mild and severity of the disease. Also, various antiviral therapy options did not significantly affect the duration of SARS-CoV-2 detection in children with various forms of COVID-19.Conclusion. In the first year of the pandemic, the novel coronavirus infection did not dominate the pattern of respiratory diseases in outpatient children. Further research is required to develop pediatric guidelines for the treatment of COVID-19 at the outpatient stage.

4—5 congenital heart defect cases per 1000 newborns are diagnosed worldwide. Some malformations require surgical methods of correction. Various risk factors contribute to the development of healthcare associated infections (HAIs). The HAIs are one of the leading causes of the prolongation of hospitalization length both in intensive care unit and in the inpatient departments, and they also play a significant role in increasing the number of lethal outcomes. A number of risk factors play an important role in the development of HAIs: the duration of post-operative mechanical ventilation, neonatal age, low birth weight, co-morbidities, including malformations of other body systems.

The new coronavirus infection (COVID-1 9) is a socially significant problem around the world. According to available statistics, complications are less common among children, asymptomatic or mild forms of the disease prevail more often.This article presents the features of the viral landscape of the upper respiratory tract in children with ARVI in a pandemic, the clinical and laboratory features of the course of COVID-1 9 in children of different ages.It was found that SARS-CoV-2 is detected only in a third (32.9%) of hospitalized patients with respiratory symptoms, in 4.3% of cases — in combination with seasonal CoV-OC43 / CoV-229E, in 1 1.6% — with other respiratory viruses. The most frequent source of infection with the SARS-Cov-2 were family members. Children with a moderate form of the disease predominated among the patients. The leading symptoms of COVID-19 were fever, catarrhal symptoms, as well as gastrointestinal manifestations and anosmia. A feature of the new coronavirus infection in newborns and children of the first month of life was the absence of fever and intoxication, the lack of expression of catarrhal manifestations when the colon is involved in the pathological process (colitis, rarely — hemocolitis). In the compete blood test in children under the age of one year, monocytosis prevailed, in children over 7 years old — leukopenia and accelerated ESR. Among the changes in the biochemical analysis of blood, the most common was an increased C-reactive protein.

The maximum incidence of pertussis in young children confirms the importance of their timely immunization.The goal is – to study the timeliness of vaccination against whooping cough, causes of violation of the vaccination schedule in young children, the effect of recombinant interferon-a on the post-vaccination period.Materials and methods: the vaccination history and data on the course of the post-vaccination period after immunization with DPT and DaPT vaccines of 469 children at the age of 3–24 months were studied.Results. The analysis showed that 14,9% of the observed children were not vaccinated against whooping cough in a timely manner. Of these: 34,3% had a written refusal to vaccinate (5.1% of the total number of observed children), in 32,8% of cases, the vaccination schedule was violated due to late arrival of parents, 32,9% of children by the start of immunization had medical challenges, and only half of them had justified contraindications. Non-serious side effects associated with immunization were observed in 11.3% of cases, statistically more often with DTP (22,0%) compared with DaPT (5.,5%). General and local reactions, in general, were recorded on DPT (6,9% and 15,1%, respectively) and less often developed with the use of DaPT (1,0% and 4,5%, respectively). Within 1 month after immunization, 16,2% of the observed children had an acute respiratory viral infection of varying severity. Those who did not receive antiviral therapy more often carried the disease in a moderate and severe form, which in all cases led to the postponement of the administration of the second and third doses of the vaccine.Conclusion. To increase the timeliness of vaccination of children against whooping cough, medical professionals should persistently remind parents about the timing of turnout for the next vaccination, when making medical withdrawals, be guided by modern methodological documents and instructions for vaccines. The use of antiviral and immunomodulatory effects of IFN-alpha drugs allows us to comply with the recommended schedule for vaccination of children with a high risk of SARS in the post-vaccination period.

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%).

In Russia, Hemorrhagic Fever with Renal Syndrome (HFRS) takes the leading place among all natural focal infections, the incidence rate in 2018 was 3,99 per 100 thousand population. In the Northwestern Federal District of the Russian Federation, HFRS occurs much less frequently – 1,46 cases per 100 thousand population. The disease is more susceptible to men aged 16–50 years, children rarely get sick. In 2019, 73 cases of HFRS (1,36 per 100 thousand population) were registered in St. Petersburg, among them only 2 episodes – in children under 18 years of age. A clinical case of HFRS in a child aged 1 year and 8 months is presented. The diagnosis was established on the basis of clinical and epidemiological data (acute onset of the disease, the presence of fever, thrombohemorrhagic syndrome, oliguria, anuria, information on cases of HFRS at the place of residence of the child) and laboratory data (detection of specific IgM antibodies to the Hantaan virus) in the later stages of the disease. The described case should alert pediatricians regarding possible natural focal diseases, including HFRS. A thorough analysis of the anamnestic, epidemiological and clinical data of the patient will help in the early stages of the disease to suggest a diagnosis, conduct laboratory diagnostics and prescribe appropriate therapy.

Objective: to evaluate the intensity of measles immunity in students of I–VI courses of the pediatric faculty of St. Petersburg State Medical University.Materials and methods: titers of antibodies to measles virus were determined in 986 students of I–VI courses in May –June 2019. The level of measles antibodies was determined by enzyme-linked immunosorbent assay.Results: positive (protective) titres of measles antibodies were detected in 555 people. (56.4%), the absence of measles immunity was found in 431 people. (43.6%), including 57 people. (5.8%) specific antibodies were not detected. The relationship between the level of collective immunity and the duration of the period after the last vaccination against measles was revealed.Conclusions: in the majority of examined students (96.2%), protective titers of measles antibodies remained for 10 years after the last vaccination. Subsequently, a significant decrease in the level of measles antibodies was noted. All students who do not have a protective IgG titer are shown measles vaccination with live measles vaccine in accordance with the instructions for use.

The measles situation is still unstable — there are imported cases, the formation of nosocomial foci with the involvement of medical personnel, patients and visitors of medical institutions.Objective of the study: to assess the level of seroprevalence of primary health care workers in St. Petersburg during the period of epidemic trouble with measles.Materials and methods: An open retrospective randomized uncontrolled study of the intensity of specific immunity to measles in 980 employees aged 18 to 78 years, examined in July-September 2018, was carried out. The level of anti-measles IgG antibodies was determined by the method of enzyme-linked immunosorbent assay (810 people) and passive hemagglutination reactions (170 people). The results are presented with the indication of the shares (%) and the calculation of the 95% confidence interval according to Clopper — Pearson. Differences between groups were assessed using Pearson's chi-square test (%2). Differences in the groups were considered statistically significant when the criterion level was p < 0.05.Results: It was found that 8.2% of personnel are not protected against measles infection. At the same time, the number of seronegative persons among doctors (8.1 %), nurses (7.7%) and non-medical workers (9.6%) differed statistically. Age-related differences in the immune layer were revealed — the greatest susceptibility was observed in persons under 30 years of age (1 8.3%). Anti-measles antibodies in those who had been ill persisted for a long time and at a high level. At the same time, the intensity of post-vaccination immunity decreased over time, and 20 years after immunization, the number of seronegative individuals increased significantly. Only 64.1 % of those surveyed had two vaccinations, more than a third were immunized once. Nevertheless, the proportion of people unprotected from measles exceeded the criterion of epidemic well-being with the same frequency in both groups (9.2% and 1 0.4%, respectively).The results of a serological study showed that the presence of a record of two vaccinations in the certificate in 9.2% of cases does not guarantee protection in case of contact with a patient with measles. Only a serological examination is evidence of specific immunity to measles infection.

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.

The purpose of the study was to analyze the structure of drug consumption in the conditions of inpatient treatment of children with acute respiratory viral infections to optimize treatment standards and reduce material costs. The paper presents the results of a retrospective study of the consumption of drugs in the inpatient treatment of children with acute respiratory viral infections. It is shown that the most vulnerable group for the occurrence and development of acute respiratory viral infections is represented by children aged 1 year to 7 years (60.0% of the total population). Evaluation of drug consumption suggests that the frequency of prescriptions is dominated by J01 category «Antibacterial drugs for systemic use» and R01 «Nasal preparations» (18.58% and 16.56%, respectively). At the same time, the group L03 «Immunostimulants» makes a significant contribution to the consumption structure according to the frequency of appointments, covering 9.31%.

Purpose of the study. Analysis of clinical and laboratory features of the course of HIV infection and antiviral therapy in children at different stages of the disease.Materials and methods. Under supervision in the department of motherhood and childhood there were 90 children with HIV infection, which were divided into 3 groups: 1st group – 35 people. with a diagnosis of HIV infection in the first 2 months of life, group 2 – 25 people. with a diagnosis at the age of 6-12 months and the 3rd group (30 people) with a diagnosis of HIV infection over the age of 2 years. Statistical processing of the research results was carried out using the software package Statistica for Windows (version 8.0).Research results. Early detection of HIV infection and the beginning of antiretroviral therapy (ARVT) led to the absence of clinical manifestations of the disease, low levels of HIV RNA in the blood and normal levels of CD4 lymphocytes, which persisted for 3 years of observation. The detection of HIV infection and the start of ART in the first 6–12 months of life of children was characterized by clinical symptoms up to CNS damage, high levels of HIV RNA in the blood, moderate decrease in CD4 lymphocytes, with normalization after 3–6 months of treatment and after 3 years of observation.Late diagnosis of HIV infection in children – over 2 years of age is characterized by severe forms of the disease with secondary manifestations – AIDS in 20,0% of cases, low rates of CD4 lymphocytes, damage to the central nervous system with the formation of spastic diplegia, and slow recovery of immunity. The use of the drug Viferon, rectal suppositories in the combined treatment of EBV-mononucleosis and a generalized form of CMV infection allows the early treatment of the main symptoms of herpes virus infections and normalization of laboratory parameters.Conclusion Our prospective study showed that mother-tochild transmission of HIV was realized due to the absence of the first stage of chemoprophylaxis (during pregnancy), and was also aggravated in 9 cases (10,0%) by breastfeeding. The severity of the clinical manifestations of HIV infection, the levels of CD4-lymphocytes and HIV RNA in the blood directly depend on the period of detection and the initiation of ART in children. The inclusion of human recombinant interferon alpha-2b with antioxidants (Viferon rectal suppositories) in the etiopathogenetic therapy of comorbid herpes virus diseases (EBV-mononucleosis, a generalized form of CMV infection) is effective and safe.

The aim is to characterize the use of medications in pediatric inpatients with community-acquired pneumonia.Materials and methods. Medical records of 547 children treated for community-acquired pneumonia in 4 medical organizations in St. Petersburg over 2015-2017 were analyzed.The results of this retrospective study (N = 547) showed that children aged 1 to 3 years were most vulnerable (31.44%). Along with that, 45.70% of patients had concomitant diseases; among those, acute respiratory infections of the upper respiratory tract prevailed (32.20%). As for the medications, the category J drugs “Antimicrobials of systemic action” were most commonly used (30.30%) and contributed the largest part in the total drug costs (80.22%). Specifically, the greatest contribution was made by the J01D group «Beta-lactam antibacterial drugs, other» (64.54%); their cost took 77.22% of the expenses and covered 48.97% of the drug list.

The article presents the results of clinical observation of 104 children hospitalized in the infectious department and having manifestations of allergies to drugs (medicines) at the prehospital stage or in the hospital. The frequency of allergic reactions to medicines in children with infectious diseases, their characteristics, as well as approaches to the choice of drugs for treatment, as manifestations of allergies, and the underlying disease in children with drug allergies are estimated. It has been shown that antibacterial drugs are a frequent cause of skin allergic reactions in patients with lacunar angina and infectious mononucleosis. In case of allergy to beta-lactams, macrolides and lincosamides serve as an alternative in most cases. As a drug of choice for fighting fever in patients with an acute allergic reaction to drugs, ibuprofen may be recommended, possibly using paracetamol, metamizole sodium.

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.

The introduction of advanced radio technologies into practical healthcare provides high-tech, qualified and reliable diagnostics. Radiation methods of visualizing the activity of organs and systems in real time are the basis of personified therapy and prevention of various pathological conditions. The evolution of telecommunication networks and mobile communication technologies has led to appearance a new direction in healthcare – distance medicine. Using of radio frequency identification systems, wireless medical telemetry, telemedicine not only improves the quality of life of patients, but also ensures the availability of medical care in any place and at any time.

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.

The paper presents clinical and laboratory study results of the immune response indicators dynamics in 199 children aged 1 year to 14 years with verified diagnosis of influenza depending on the type of immune response to the treatment with recombinant interferon alpha-2b (IFN) (Grippferon®, nasal drops). A total of 100 people received this medication, whereas 99 patients in the control group received pathogenetic therapy. The immune response type was determined on the basis of the polarisation coefficients (PC) suggested by the authors: PC1 = IL-4/IFN-γ and PC2 = IL-10/IFN-γ obtained by calculating the content ratio in the serum cytokines of IL-4 to IFN-γ and IL-10 to IFN-γ, responsible for the predominant type of immune response to antigen introduction. A good therapeutic efficacy of the intranasal medication of recombinant interferon alfa-2b was established for the treatment of influenza in children, given both the Th1and Th2-type immune response. This allows us to recommend this medication for use in children, regardless of the immune response type.

The analysis of the characteristics of the current influenza A(H1N1) pdm 09 at 624 children in the 2015/2016 season. For severe illness (5%) characterized by short incubation period, lack of initial period, acute or acute onset with rapid development of multiorgan failure, prolonged febrile body temperature (up to 5—6 days or more) in the absence of complications, a prolonged severe intoxication (4—5 days or more), a significant frequency of diarrhea syndrome (10,2%), hemorrhagic syndrome (5.3%), exacerbation of comorbidity (20%), combined with other viral infections — herpes, rotavirus, enterovirus and others (33%).In the clinical analysis of blood — leukopenia (33.9%), leukocytosis (14.5%) with neutrophilic shift (11.3%), neutrophilia (51.6%), monocytosis (45.2%), lymphocytosis (9.7%), thrombocytopenia, anemia, accelerated erythrocyte sedimentation rate moderately; in the biochemical analysis of blood, hypernatremia, increase in the concentration of lactate, hyperfermentemia (ALT, AST, ALP, LDH, CPK), hypoproteinemia, dysproteinemia, increased CRP, increased creatinine and urea, increase of procalcitonin (PCT). In the structure of complications of pneumonia was 6%, stenosing laryngotracheitis — 9.8%, obstructive bronchitis — 14.5%. Two unvaccinated against influenza in infants who become ill during the epidemic period for influenza and SARS from homes with a typical clinical picture, died from severe (toxic) form of pandemic influenza. Pandemic influenza occurred at the background of severe immunosuppression (atrophy of the thymus, depletion of follicles of peripheral organs of immunogenesis — spleen, lymph nodes, tonsils). The main cause of death was the development of multiple organ failure with rapid progressive lesion of the vital organs.

The aim of the study was to assess the clinical and immunological efficacy of recombinant interferon Alfa-2b. Examined 34 children aged from 1 year to 7 years carrying medium to heavy degree of measles. All patients were not vaccinated against measles. In the treatment of 18 people (Control group) were used only basic therapy (pathogenic, symptomatic). At 16 people (Study group) used a combination therapy (basic + Viferon). As an antiviral agent used and immunotropic preparation of human recombinant interferon alfa-2b in the form of rectal suppositories – Viferon (OOO «Feron», Russia). Immunological patient survey was conducted in the dynamics of the disease – during the height (in 1-6 days the rash) and in convalescence period (10-16 days rash). Indicators of cellular immunity (leukocytes, lymphocytes, CD3 +, CD3 + CD (16 + 56) +, CD3 + CD4 +, CD3 + CD8 +, CD4 + CD8 +, CD3-CD8 +, CD3-CD (16 + 56), CD19 +, CD25 +, CD3 + HLA DR +, CD (16 + 56) + HLA DR +, HLA DR +, CD95 +) were evaluated by flow cytometry. To assess the production of IFN-α and IFN-γ in the samples of peripheral blood were cultured in the CO2 incubator for 18 hours at 37 C and 4% CO2. The supernatants of cell culture were investigated with the purpose of studying spontaneous and induced production of interferon alpha and gamma. The concentrations of interferon α and γ (IFNα, IFNγ) in the blood serum, as well as levels of spontaneous and induced cytokine production data of blood cells of sick children was determined by ELISA. All the children at the peak of the disease found a dramatic inhibition of cellular immunity and the production of cytokines, which is consistent with the concept of «measles anergy» accepted in the scientific literature. The period of convalescence oppression immunity indices remained, but it was less pronounced in the group of children treated with the drug of human recombinant interferon alfa-2b -Viferon. Clinical efficacy of Viferon in the treatment of patients with measles children characterized by rapid positive dynamics of symptoms of acute period (normalization of body temperature, reducing intoxication, catarrhal symptoms and severity of the syndrome exanthema). It was also found reduction in the incidence of complications, reduction in the average bedday and smooth during the period of convalescence later.

Conducted clinical and immunological examination of 51 children with acute Epstein-Barr viral mononucleosis (EBV) in age from 1 year to 7 years. All children diagnosed with a moderate degree of the disease. In the treatment of 25 people (comparison group) used the standard treatment (pathogenetic, symptomatic), treatment 26 people (main group) included the use as antiviral and immunotropic means of the preparation of human recombinant interferon Alfa-2b in the form of rectal suppositories — VIFERON®. The immunological survey was conducted in dynamics: at the height of the disease and in the convalescence period. The blood was determined indicators of cellular immunity (leukocytes, lymphocytes, CD3+, CD4+, CD8+, CD56+, HLAII+, CD95+, CD1 6+, CD25+), the concentration of IFN-a, IFN-y, IL-4 levels in spontaneous and induced production, in the serum). At milestones children of the main group noted rapid regression of clinical symptoms, normalization of body temperature, reducing intoxication, positive dynamics lymphoproliferative syndrome), a significant reduction in bed-days, no layering respiratory viral infections. Interferon had also expressed a positive impact on the changed parameters of cellular immunity and cytokine links. At the same time, 80% of patients after basic treatment is established the predominance of Th2 type immune response, indicating a high risk of developing chronic course of EBV-mononucleosis.

The study included 338 HIV-infected children (B-23) and 350 children with perinatal contact HIV infection (R-75), consisting on the dispensary in the department of maternal and child the St. Petersburg City AIDS Center. In 32 persons (9.5%) diagnosed with secondary infections. In the structure of viral opportunistic infections (herpesvirus, SARS) amounted to 39.8%, bacterial (bronchitis, tonsillitis, pyoderma, tuberculosis) — 34.8%, fungal and parasitic (candidiasis of the oral mucosa, PCP) — 25.4 %. Combined therapy (causal, pathogenetic, symptomatic) SARS in children with B-23 and R-75, allows you to get in early (6th d. Treatment) regress the main symptoms of acute respiratory diseases. Modern therapy of congenital cytomegalovirus infection (VTSMI) in children with B-23 and R-75 of the first year of life with antitsitomegalovirusnogo immunoglobulin and preparation of human recombinant interferon alfa-2b in the form of rectal suppositories — VIFERON, causes persistent normalization of clinical and laboratory parameters.

The article presents information obtained from the analysis of the stories of 40 children up to 4 years old left without parental care and infected with hepatitis C through vertical transmission. Authors analyzed the results of integrated treatment of the disease with inclusion of combined antiviral immunomodulatory drug VIFERON®. The efficacy of VIFERON® in chronic viral hepatitis C in infants is confirmed.

A clinical observation and treatment of 36 children between the ages of 5 months up to 3 years old with measles. In 34 persons. (94.4%) diagnosed with typical moderate forms, from 2 people (5.6%) — atypical (mitigirovannaya) a mild form of the disease. All children are vaccinated against measles. Typical measles char-acterized by moderate forms of cyclical flow with the change of the classical period and the presence of characteristic clinical syndromes. Pathognomonic symptom found: spots Belsky — Filatov — Koplik (67.7%), stages a rash (100%), stages of pigmentation (100%). Causal therapy was VIFERON®. Revealed the rapid disappearance of intoxication and normalization of body temperature, the early decline in the severity and duration of catarrhal syndrome, reducing the severity and frequency of complications, no stratification of SARS.

The article presents information about the ways of rendering of the medical-social assistance to children born to HIV-positive women. The results of clinical examination of children living in the specialized orphanage are cited for years 2000—2012. Authors have analyzed the peculiarities of the social structure, ways of living arrangement and the health of children left without parental care.

Clinical and epidemiological research on the evolution of measles in children in Leningrad – St. Petersburg from 1927–2014 with an analysis of the effectiveness of treatment of this infection. Divided into three periods of fighting «child plague». First period – to use in the practice of specific therapies and antibacterial drugs, characterized by high morbidity, severe weight, high rates of mortality. In the second period the use of donor serum syvotrotki convalescents and sulfa drugs significantly lowered the mortality rate due to the effective treatment of pneumococcal pneumonia. The use of penicillin and broad-spectrum antibiotics led to a further reduction in the severity of measles, a sharp decline in mortality – to tenths and hundredths of a percent. The third period is due to the mass of active immunization against measles, characterized by a significant decline in incidence rates up to her absence in some years. Combined therapy of children with measles in modern conditions with the inclusion etiotropic drugs (Viferon) causes rapid regression of the symptoms of measles, warns layering respiratory viral infection contributes to the smooth course of the disease.

To study the characteristics of laboratory tests of infants born to HIV-positive women and left without parental care in the dynamics analyzed blood samples using methods of immunological and serological diagnosis of HIV infection, the qualitative and quantitative determination of HIV, as well as clinical blood analysis and screening for prenatal infection. There are informative PCR diagnostics of perinatal HIV infection in the first months of life, ELISA and western blot from the age of 9 months. Identified difference performance of a specific red blood cell and leukocyte parts of blood of hemogram in infants with perinatal HIV infection compared with those in not infected infants. Improvement in laboratory parameters is the result of appointment of HAART (highly active antiretroviral therapy).

80 years marks since the founding of the department of infectious diseases in children of St. Petersburg State Pediatric Medical Academy in 2010. The historical review presented in detail the stages and formation of oldest development in Russia the department of children’s infections. The main directions of infectious diseases and training of specialists in the field of infectious diseases in children presented.

Children and adults of any age and any social and professional groups are susceptible to the measles infection. Measles may lead to the development of severe disease forms and complications; it remains one of the main causes of death among infants around the world, despite a safe and effective vaccine. A clinical observation of children of 5 months to 14 years of age (n = 44) with measles hospitalized to a specialized in-patient department was conducted. Examination of all children included history taking and daily medical examination throughout the inpatient treatment with the evaluation of intensity of clinical symptoms. It is shown that in modern conditions measles in children is registered mainly in the age group of 5 months to 3 years (81.8%), mainly in unvaccinated children (95.5%), and typically takes a moderate-severe form (95.4%). Strenosing laryngotracheitis and obstructive bronchitis are among the specific measles complications.