Aim of the study: to assess the measles immunity level among employees of medical organizations of various specialties, young subjects, and neonates. Materials and Methods: The measles immunity status was assessed for all the employees of St. Petersburg State Budgetary Healthcare Institution “Maternity Hospital No. 10” (386 subjects), civilian medical staff of the clinics of the Military Medical Academy named after SM Kirov (Military Medical Academy) (1399 subjects), cadets of the Military Medical Academy (304 subjects) and 34 neonates. Laboratory testing was performed by using ELISA with test kits "VektoKor-IgG" (RF). Results: Medical workers displayed high total level of protection against measles virus serologically confirmed in 87.5% of the maternity hospital staff and 81.6% of the employees at the Military Medical Academy clinics. No differences in the immune status between the varying categories of medical personnel from the departments of various specialties were revealed. Lower population immunity was observed in the 20-40-year age group. Among the employees of the maternity hospital, the proportion of measles virus seropositive subjects aged 20–40 years was 75.9% (95% CI 67.2% –82.9%), 40–59 years – 91.5% (95% CI 86 , 7% -94.7%), 60 year and older subjects were all seropositive (95% CI 94.6% -100%). Dual vaccination did not guarantee emergence of effective measles immunity. The majority of seronegative subjects were dually vaccinated, hence, even in case of previous dual measles vaccination, it is necessary to perform a serological examination prior to recruitment to medical facilities. Females comprised more than 90% of medical workers. Therefore, women of fertile age previously dually vaccinated, but immunologically seronegative, are at risk of measles and intrauterine fetal infection, as well as increased risk of its development in vaccination age children. It was confirmed by demonstrating that as few as 70.6 ± 15.3% of neonates were immune to the measles virus. The proportion of seronegative infants (29.4 ± 15.3%) was comparable to that one in seronegative subjects aged 20-40 years (24.1 ± 8.1%) working at the maternity hospital. Among the younger age group (aged 18-23 years) such as cadets of the military medical academy, a significantly higher proportion of seronegative individuals was found - 48.3 ± 5.6%, thereby increasing probability for measles outbreak therein. Conclusions: In order to eradicate measles, it is necessary to develop a screening program for detecting anti-measles antibodies among young and middle-aged subjects.

Objective.The frequency of diagnosing intrauterine infections is increasing every year. assessment of the frequency of intra-amniotic infection of the fetus using the standard case definition.Subject and methods: a study, conducted in one of the maternity hospitals of St. Petersburg, included 110 newborn children with an established diagnosis of intra-amniotic infection. To clarify the diagnosis, we have applied the probable and confirmed standard definitions of the case.Results:a study showed that the diagnosis of intraamniotic infection was consistent with the standard case definition in 30.9% of cases.Conclusion:  the introduction of standard case definitions will make it possible to unify the registration and notification of the intrauterine infections by different specialists in all types of healthcare settings and will allow a unified approach to identification of the intrauterine infections, both in maternity hospitals and in the neonatal units of children's hospitals.

Определение подходов к эпидемиологическому надзору за внутриамниотической инфекцией плода Резюме В последние годы отмечается неуклонный рост регистрации инфекций, специфичных для перинатального периода, при этом в Санкт-Петербурге в структуре инфекций перинатального периода 60% приходится на внутриамниотическую инфекцию (ВАИ) плода. Цель исследования-выявление частоты и факторов риска внутриамниотической инфекции плода, не классифицируемой в других рубриках (код МКБ-10 P39.2). Материалы и методы. В исследование, проведенное в одном из родильных домов Санкт-Петербурга, были включены 240 новорожденных детей с клинически установленными диагнозами из группы P39 «Другие инфекционные болезни, специфичные для перинатального периода». Результаты исследования. Предложено определение случая ВАИ плода, не классифицированной в других рубриках (код МКБ-10 P39.2)-наличие признаков ВАИ при гистологическом исследовании плаценты и наличие системного воспалительного ответа у новорожденного ребенка. С использованием определения подтвержденного случая частота ВАИ плода составила 0,42 на 100 детей родившихся живыми, что в 3,5 раза ниже частоты клинически поставленных диагнозов. Факторами риска подтвержденного случая явились: бессимптомная бактериурия, пиелонефрит, кольпит, тонзиллит, эрозия шейки матки в анамнезе, заболевания сердечно-сосудистой системы у матери. Заключение. При проведении эпидемиологического надзора за внутриамниотической инфекцией плода необходимо использовать определение случая с дальнейшей стратификацией данных по массе тела новорожденного при рождении. С целью снижения частоты данной патологии необходима разработка программ, направленных на выявление и устранение факторов, увеличивающих риск возникновения ВАИ матери и плода.