The onset of 2020 clearly demonstrated that infection agents pose a major threat to mankind. Current infectiology is shaped by resurrection of “old” seemingly forgotten infections, emergence of “new” infection agents, unusual combinations of known agents, evolving resistance of microorganisms to antibacterial drugs, transformation of human microbiome leading to distortions in herd immunity and, ultimately, emergence of healthcare-related infectious diseases, not letting alone threats of bioterror. Infection agents evolve together with mankind. Novel facets emerge in infectiology, alongside with trends in diagnosis, treatment and prevention of infectious diseases that become more diverse as the list of pathogens grows. Human and infection agent links extend beyond antagonistic relations towards symbiosis. Microorganisms adapt quickly in the new technogenic environment giving rise to novel pathogens and making it unlikely for the mankind to get free from infections any time soon.The total economic damage from infectious diseases increases by year, despite continuous improvement in therapy. Infectious mortality in children aged 0 to 14 years is the top fourth among other causes of death. The work assesses comparative dynamics of “common” childhood infections in the Russian Federation during 2018–2020. We analyse official statistics on paediatric infectious morbidity, comparative dynamics of main infectious diseases (acute respiratory diseases, intestinal infections of bacterial and viral nature, neuroinfections, anthropozoonotic infections, viral hepatitises), assess trends in morbidity of vaccine-preventable infections in children and adults in the Russian Federation, with greater detail towards selected regions, from January 2018 to April 2020.
Varicella is a significant burden on society and the healthcare system.Objective: to analyze the cost effectiveness of universal vaccination of children against varicella.Material and methods. The analysis was carried out from the perspective of the healthcare system and societal perspective, based on epidemiological data for the Russian Federation. The effect was taken into account only in the vaccinated population. The time horizon of the study is 10 years. The amount of direct medical costs for treatment of varicella was calculated based on the rates of compulsory medical insurance in St. Petersburg in 2020. The cost of drug therapy in outpatient settings was calculated based on the weighted average retail price of prescribed drugs. The analysis of direct nonmedical and indirect costs was carried out taking into account statistical data on the Russian Federation and duration of temporary disability of family members of sick children. Costs and quality-adjusted life expectancy were discounted by 3.5% per year.Results. The average cost due to the disease in the Russian Federation is 43,139 rubles / patient, of which 8,5% is direct cost. Vaccination of 100,000 children will prevent 38,551 cases of varicella in 10 years. When analyzing from a social perspective, vaccination provides a reduction in costs compared to no vaccination, and the savings will amount to 10.1 thousand rubles per 1 vaccinated person.If vaccination coverage is 90%, taking into account the fact that the cohort of children in the Russian Federation at the age of 1 year is about 1.9 million people, the cost of vaccination will amount to about 8.1 billion rubles annually. At the same time, already 6 years after vaccination, the volume of averted budgetary costs will exceed the costs of vaccination.Conclusion. Universal varicella vaccination of children will reduce the incidence of the disease and reduce the budget costs associated with this disease.
Background. Meningococcal disease is socially significant, deadly infectious disease characterized by severe and unpredictable course. Clinical case description. The article describes clinical case of repeated generalized infection and meningitis with laboratory unknown etiology, classic picture of meningococcal disease, typical vaccination history, and smooth course of the period between episodes in 6.2-year-old girl. Conclusion. The point of this case is the rare registration of recurrent cases of bacterial meningitis, as well as rare possibility of meningococcal disease diagnosis in clinical practice without laboratory confirmation of the pathogen.
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