Current Epidemiological Situation Research Articles

Prevalence, incidence, gender and age distribution, and economic burden of psoriasis worldwide and in Kazakhstan

<b>Aim:</b> This study aimed to conduct a literature review on the prevalence, incidence, gender and age distribution of psoriasis, as well as the economic burden of psoriasis worldwide, including Kazakhstan.<br /> <b>Material and methods: </b>A literature review was conducted using keywords in PubMed, Scopus, Web of Science, eLibrary.ru databases, and Google Scholar to identify relevant articles.<br /> <b>Results: </b>The prevalence of psoriasis varies by geographic location and race. However, psoriasis is predominantly common in Western countries and among people of European descent: in Norway (4.6%), France (4.42%), Portugal (4.4%), and the United States of America (3.0%). Significant differences in the prevalence of this disease were identified in Kazakhstan, ranging from 0.86% to 2.5%. In many Western countries, the incidence rate of psoriasis is significantly higher than the global incidence rate (57.8 cases per 100,000 population): in Denmark (199.5), Italy (230.62), and Israel (280), respectively. In Kazakhstan, the incidence rate is 35.0 per 100,000 population, which is almost 1.7 times lower than the global rate. Psoriasis affects both genders. There is a bimodal pattern of manifestation of psoriasis with early (type I) and late (type II) onset, which occurs in the age range of 30–40 years, and about 60 years. In addition, treating and providing medications to patients with psoriasis represents a significant economic burden for both the government and the patients themselves.<br /> <b>Conclusion: </b>The study made it possible to determine the current epidemiological situation of psoriasis worldwide, including Kazakhstan, as well as to assess the economic burden of this disease.

Geno-Species Composition of Borrelia Circulating on the Black Sea Coast of the Krasnodar Territory

The aim of the study was to assess the current epidemiological situation on Ixodidae tick-borne borreliosis (ITBB) (2017–2022) on the Black Sea coast of the Krasnodar Territory, to study the species composition of Borrelia.Materials and methods. Ixodidae ticks, Ixodes ricinus, Haemaphysalis concinna, H. inermis, Rhipicephalus sanguineus, were examined for infection with tick-borne borreliosis pathogens, followed by DNA sequencing of isolates. Species identification of Borrelia was carried out based on analysis of the nucleotide sequence of the 16S rRNA gene fragment using BLAST algorithm. Additionally, the OspC genotype was determined for isolates of pathogenic genovariants through comparing the obtained sequences with reference ones in the MEGA 5 program. The data were processed applying the cartographic method using the QGIS 2.18 software.Results and discussion. Between 2017 and 2022, 101 cases were registered on the Black Sea coast of the Krasnodar Territory, which accounted for 1.6 % of all ITBB cases in the Krasnodar Territory. The number of complaints with tick bites in Sochi was up to 191.4 per 100 thousand population. During the study, the predominant Borrelia geno-species on the territory of the Black Sea coast of the Krasnodar Territory was determined using sequencing – Borrelia lusitaniae (78.1 %). The circulation of geno-species B. garinii (6.8 %), B. valasiana (5.7 %), B. afzelii (3.6 %), B. miyamotoi (2.6 %), B. tanukii, B. bissettii (1.6 % each) was also observed. For Borrelia pathogenic species, appurtenance to OspC geno-groups was ascertained: four isolates were assigned to invasive OspC geno-groups, of which three B. afzelii isolates were genogroup A8, one B. garinii isolate was G7. High rate of infection of ticks with Borrelia was recorded in the surveyed area (up to 94.5 %). Borrelia of pathogenic species account for only 10.4 % of the total number of isolates studied. Mostly, genovariants that rarely cause diseases in humans (B. lusitaniae, B. valasiana, B. bissettii) and non-pathogenic Borrelia (B. tanukii) were found, which indicates a low risk of infection with ITBB pathogens.

Current epidemiological situation of mealybug wilt of pineapple disease in Ecuador

Current epidemiological situation of mealybug wilt of pineapple disease in Ecuador

Complicated pneumonia caused by group A Streptococcus in children - 2022/2023 infectious season outbreak and update on clinical characteristics

BackgroundAn increased incidence of group A Streptococcus (GAS) infections has been observed in pediatric population post-COVID-19 pandemic. While the majority of reports refer to scarlet fever or invasive GAS disease, detailed data on pulmonary manifestations such as complicated community-acquired pneumonia (CAP) are scarce. The aim of this study was to assess the contribution of GAS to complicated CAP in children during the 2022/2023 infectious season. MethodsWe retrospectively analyzed the etiology and clinical presentation of complicated CAP patients hospitalized in our tertiary care center in Warsaw, Poland, between August 2022 and May 2023. ResultsAmong 91 patients with complicated CAP, GAS was the dominant cause constituting 24.2% (22/91; 95% CI 15.8–34.3%) of the study group. 68.2% of GAS pneumonia patients presented symptoms of scarlet fever, and 27.3% had preceding or concurrent viral infection. GAS complicated CAP was associated with longer hospitalization, higher incidence of chest tube insertion, but shorter duration of chest tube drainage than complicated CAP of other etiology. Children with GAS complicated CAP had higher procalcitonin concentration (28.1 vs. 1.5 ng/dL; p<0.0001) and a lower platelets level (254.5 vs. 422 × 103/μL; p = 0.0031) than those with non-GAS infection. ConclusionsGAS is currently the predominant pathogen of complicated CAP in children. Clinicians should be aware of the current epidemiological situation and a more severe course of GAS pneumonia in this age group, and should monitor patients presenting with symptoms of scarlet fever and preceding viral infection closely.

Emergence and circulation of enterovirus B species in infants in southern China: A multicenter retrospective analysis

ABSTRACT Background Enteroviruses (EV) are common and can cause severe diseases, particularly in young children. However, the information of EV infection in infants in China is limited due to the vast population size and extensive geographical area of the country. Here, we conducted a retrospective multicenter analysis of available EV data to assess the current epidemiological situation in the infant population in southern China. Methods The study enrolled infants with suspected EV infection from 34 hospitals across 12 cities in southern China between 2019 to 2022, and the confirmation of EV was done using RT-PCR and VP1 gene sequencing. Results Out of 1221 infants enrolled, 330 (27.03%) were confirmed as EV-infected. Of these, 260 (78.79%) were newborns aged 0–28 days. The EV belonged to three species: EV-B (80.61%), EV-A (11.82%), and human rhinovirus (7.58%). Newborns were more susceptible to EV-B than older infants (p < 0.001). Within EV-B, we identified 15 types, with coxsackievirus (CV) B3 (20.91%), echovirus (E) 11 (19.70%), and E18 (16.97%) being the most common. The predominant EV types changed across different years. EV infection in infants followed a seasonal pattern, with a higher incidence from May to August. Furthermore, perinatal mother-to-child EV transmission in 12 mother-newborn pairs were observed. Conclusion Our study is the first to demonstrate the emergence and widespread circulation of EV-B species, mainly CVB3, E11, and E18, in southern China, primarily affecting young infants. This research provides valuable insights for future epidemic assessment, prediction, as well as the elimination of mother-to-child transmission.

PERTUSIS - CURRENT SITUATION

Pertussis, or whooping cough, is a contagious acute respiratory infection caused by the bacterium Bordetella pertussis. Before the widespread immunization, pertussis was one of the most common infectious causes of morbidity and death. Despite widespread immunization, the pathogen continues to circulate in the population with cyclical outbreaks. Recent data from the Institute of Public Health of Serbia "Dr Milan Jovanović Batut" for the territory of the Republic of Serbia reveals a significant rise in pertussis cases in the last year, which creates a need for careful analysis of the current epidemic. The aim of our study was to show the current epidemiological situation related to pertussis illness, along with an analysis of patients hospitalized at the Children's Hospital for Pulmonary Diseases and Tuberculosis, Clinical Hospital Center "Dr Dragiša Mišović" from August 2023 to February 2024, who were laboratory confirmed with B. Pertussis infection. During this period, 23 patients were hospitalized with confirmed B. Pertussis infection. The laboratory method for isolating the bacterium was a nasopharyngeal swab that was sent for PCR analysis. The average age of hospitalized children was 4.6 months, with the majority being 2 months old. The youngest infants were 1 month old, while the oldest patient was 35 months old. B. Pertussis infection was confirmed in children who were either not vaccinated or were incompletely vaccinated due to their age. The most commonly associated conditions with B. Pertussis infection were acute bronchiolitis and pneumonia, with SARS COV-2 virus isolated in two cases. Based on the results of our analysis and data from the literature, we observed an increase in the number of pertussis cases. Although vaccination has significantly contributed to reducing the incidence of pertussis, this analysis highlights challenges and the need for continued following of the epidemiologic situation. Additionally, it is crucial to consider factors contributing to the resurgence of the epidemic to develop more effective strategies for disease control and prevention.

On the impact of the COVID-19 pandemic on the incidence of community-acquired pneumonia on the example of the region of the European North of Russia

Rationale. During the COVID-19 pandemic, there was a sharp increase in the incidence of community-acquired pneumonia (CAP) in Russia and the Republic of Karelia (RK). Given the high significance of the problem, it is necessary to clarify the causes of the current epidemiological situation. The purpose of the work: to assess the incidence of CAP, not associated with COVID-19, in the adult population of the Republic of Karelia aged 18 years older in 2011–2019 in the administrative-territorial divisions of the republic, a comparison of its existing and projected levels in 2020–2021. Material and method. A retrospective observational epidemiological study was conducted based on the analysis of statistical data of the Republican Medical Information and Analytical Center of the Ministry of Health of the RK on the incidence of CAP, not associated with COVID-19, in the population aged 18 years and older in 2011–2021. Relative values, indicators of the dynamic series are used. To differentiate the administrative-territorial divisions of the RK by incidence in 2011–2019 the method of k-means cluster analysis was applied. To build a forecast for the incidence of CAP, not associated with COVID-19, for 2020–2021 used additive regression model for time series. Results. Among the districts, 3 clusters were identified for the incidence of non-coronavirus CAP in 2011–2019 with the worst epidemiological situation in Olonetsky. The actual incidence exceeded the predicted one in 2020 in 11 and in 2021 in 9 territories of the region, which confirms the impact of the pandemic on the incidence. Conclusion. There are territories in the republic with a “traditionally” high incidence of CAP, and the COVID-19 pandemic has made a significant contribution to its increase.

Exploring the Prevalence of Antimicrobial Resistance in Salmonella and commensal Escherichia coli from Non-Traditional Companion Animals: A Pilot Study.

Companion animal ownership has evolved to new exotic animals, including small mammals, posing a new public health challenge, especially due to the ability of some of these new species to harbour zoonotic bacteria, such as Salmonella, and spread their antimicrobial resistances (AMR) to other bacteria through the environment they share. Therefore, the objective of the present pilot study was to evaluate the current epidemiological AMR situation in commensal Escherichia coli and Salmonella spp., in non-traditional companion animal small mammals in the Valencia region. For this purpose, 72 rectal swabs of nine different species of small mammals were taken to assess the antimicrobial susceptibility against 28 antibiotics. A total of one Salmonella enterica serovar Telelkebir 13,23:d:e,n,z15 and twenty commensal E. coli strains were isolated. For E. coli strains, a high prevalence of AMR (85%) and MDR (82.6%) was observed, although neither of them had access outside the household. The highest AMR were observed in quinolones, one of the highest priority critically important antimicrobials (HPCIAs) in human medicine. However, no AMR were found for Salmonella. In conclusion, the results showed that small mammals' commensal E. coli poses a public health risk due to the high AMR found, and the ability of this bacterium to transmit its resistance genes to other bacteria. For this reason, this pilot study highlighted the need to establish programmes to control AMR trends in the growing population of new companion animals, as they could disseminate AMR to humans and animals through their shared environment.

Genetic Marker Detection of Natural-Focal Infectious Disease Pathogens in Samples of Ixodidae Ticks, Collected on the Territory of the Republic of Guinea

The circulation of a rather wide range of pathogens of natural-focal infectious diseases transmitted by ticks was detected in West Africa at different points of time: Borrelia, Rickettsia, Coxiella, Crimean-Congo hemorrhagic fever (CCHF), Bhanja, and bluetongue viruses, etc. Current epidemiological and epizootiological situation on natural-focal infectious diseases on the territory of the Republic of Guinea is not entirely clarified.The aim of this work was to identify genetic markers (RNA/DNA) of natural-focal infectious disease agents in samples of Ixodidae ticks collected in the Republic of Guinea, and to determine the spectrum of pathogens circulating in various landscape-geographical zones of the country.Materials and methods. To conduct research on the territory of all landscape-geographical zones of the Republic of Guinea, 4695 specimens of Ixodidae ticks of 11 species were collected. Taking into account the species appurtenance, gender, phase of development, as well as the site of collection, a panel of 1645 samples was compiled. Genetic markers of Crimean-Congo hemorrhagic fever and tick-borne encephalitis viruses, as well as Borrelia burgdorferi s.l., Ehrlichia chaffeensis, Ehrlichia muris, Anaplasma phagocytophilum, Coxiella burnetii, Rickettsia of the tick-borne spotted fever (TBSF) group, and Francisella tularensis were detected using polymerase chain reaction (PCR) and reverse transcription polymerase chain reaction (RT-PCR).Results and discussion. The following markers of natural-focal disease agents were found in the Ixodidae tick suspensions: DNA of Rickettsia of the TBSF group (25.6 % of all samples studied), DNA of C. burnetii (6.2 %), cDNA of B. burgdorferi s.l. (9.1 %), and RNA of the CCHF virus (2.5 %). The listed spectrum of pathogens has been registered in all landscape-geographical zones of Guinea. Genetic markers of tularemia, anaplasmosis, ehrlichiosis and tick-borne encephalitis pathogens have not been identified in this study. The results obtained made it possible to clarify the probable spectrum of tick-borne diseases in the territory of the Republic of Guinea, determined the need for further study of the circulation of natural-focal infectious disease agents in West Africa and conducting regular epizootiological monitoring.

Analysis of the incidence of lung cancer in the Krasnoyarsk Territory. Justification of the Introduction of innovative methods of early diagnosis

BACKGROUND: Lung cancer occupies a leading position in the overall structure of cancer incidence in the Krasnoyarsk Territory. Despite the positive results of the introduction of low-dose computed tomography and the current epidemiological situation caused by the new coronavirus infection COVID-19, there remains the potential to increase the detection and implementation of modern methods for the diagnosis of lung cancer.&#x0D; AIM: The aim of the study was to study the incidence of lung cancer in the Krasnoyarsk Territory over the past 2012–2021 years, to build a forecast until 2030 and to search for leads in the diagnosis of this disease.&#x0D; MATERIALS AND METHODS: The data of the regional cancer register and the data of the Territorial Body of the Federal State Statistics Service for the Krasnoyarsk Territory were used as a source of information. We calculated the intensive indicator of lung cancer incidence in the territory of the region and predicted the incidence until 2030, using Microsoft Excel.&#x0D; RESULTS: Thus, the incidence of lung cancer in the Krasnoyarsk Territory increased by 4.6%, while the female incidence increased by 31.6% and the male incidence decreased by 2.7%. Incidence rates in the region exceed those typical for the city of Krasnoyarsk for the entire period of observation. The increase in incidence in the region for the period 2012–2021 was 4.3%, and in the city — 3.1%. The male population of the region, unlike Krasnoyarsk, is characterized by a slight increase in incidence. Female morbidity increased both in the region and in the city by 23.9% and 43.3%, respectively, during the observation period. The incidence of lung cancer in the region by 2030 may amount to 54.9 per 100 thousand population and in Krasnoyarsk — 41.0 per 100 thousand population. The absence of COVID-19 would provide a higher accuracy of the forecast — 66.9 and 43.8 per 100 thousand population, respectively.&#x0D; CONCLUSION: Thus, over the past 10 years, an increase in lung cancer cases has been registered in the Krasnoyarsk Territory. The article provides examples of modern methods of screening and diagnosis of lung cancer, including the use of aptamers. The presented data indicates the need to improve approaches in detecting lung cancer and monitoring the effectiveness of antitumor therapy using innovative approaches.

Multidrug-Resistant Escherichia coli Strains to Last Resort Human Antibiotics Isolated from Healthy Companion Animals in Valencia Region.

Failure in antibiotic therapies due to the increase in antimicrobial-resistant (AMR) bacteria is one of the main threats to public and animal health. In recent decades, the perception of companion animals has changed, from being considered as a work tool to a household member, creating a family bond and sharing spaces in their daily routine. Hence, the aim of this study is to assess the current epidemiological situation regarding the presence of AMR and multidrug resistance (MDR) in companion animals in the Valencia Region, using the indicator bacteria Escherichia coli as a sentinel. For this purpose, 244 samples of dogs and cats were collected from veterinary centres to assess antimicrobial susceptibility against a panel of 22 antibiotics with public health relevance. A total of 197 E. coli strains were isolated from asymptomatic dogs and cats. The results showed AMR against all the 22 antibiotics studied, including those critically important to human medicine. Moreover, almost 50% of the strains presented MDR. The present study revealed the importance of monitoring AMR and MDR trends in companion animals, as they could pose a risk due to the spread of AMR and its resistance genes to humans, other animals and the environment they cohabit.

The burden of COVID-19 in a heterogeneous population of immunocompromised patients - realities of the postpandemic

On July 3, 2023, an interdisciplinary Council of Experts "The burden of COVID-19 in a heterogeneous population of immunocompromised patients - post-pandemic realities" was held in Moscow with leading experts in pulmonology, rheumatology, hematology, oncology, nephrology, allergology-immunology, transplantation, and infectious diseases. The aim of the meeting was to discuss the current clinical and epidemiologic situation related to COVID-19, the relevance of disease prevention strategies for high-risk patients. The experts addressed the following issues: 1) the disease burden of COVID-19 in 2023 for patients with immunodeficiency in different therapeutic areas; 2) the place of passive immunization with monoclonal antibodies as a method of COVID-19 prophylaxis among immunocompromised patients; 3) prerequisites for the inclusion of passive immunization of immunocompromised patients into routine clinical practice.

The Automated Information System “Perimeter” is a Tool for the Modernization of Information and Technical Support of Sanitary and Quarantine Control

Sanitary and quarantine control (SQC) at the state border of the Russian Federation is the first barrier to the importation and subsequent spread of diseases on the territory of the country. Every year the number of registered outbreaks of infectious diseases in the countries of the world increases, which entails an increase in published information, some of which is unreliable and requires verification. At the same time, against the background of the development of international tourism, increase in passenger traffic, the risk of infectious diseases importation into the territory of Russia rises manifold, which creates the need for modernization of information and technical support of the SQC. In connection with the above, the aim of the work was to develop a scientifically substantiated system of informatization and digitalization of SQC, which resulted in the introduction of an automated risk assessment system as regards importation of dangerous infectious diseases (AIS “Perimeter”) at all sanitary-quarantine checkpoints (SQP). Materials and methods. The information system was created using the following software platforms: Laravel, VueJs. The official websites of the Ministries of Health of the respective countries, data from the official regional websites of WHO, regional centers for disease control and prevention (CDC), and data from the ProMED-mail system were used as sources of information on infectious morbidity in the countries of the world. Results and discussion. Implementation of AIS “Perimeter” has brought about the maximum possible efficiency in the targeted informing of SQP officials about the current epidemiological situation in the countries of the world; an effective tool for monitoring the situation at the federal level in real-time mode. It facilitates the work of SQP, staff related to conducting standard operational procedures, due to considerable decrease in the volume of routine activities to keep records. The proposed in the AIS expert risk assessment as regards importation of infectious diseases allows SQP employees, based on reliable information, to make timely decisions on the need to conduct SQC and exclude erroneous actions in the essential set of measures within the framework of SQC implementation, while minimizing subjectivity with respect to decision making.

Organization of Mass Vaccine Prevention in the Conditions of a Modern Megapolis

Relevance. Thanks to decisions taken at the national level, many countries have managed to significantly increase coverage with preventive vaccination and reduce mortality from vaccine-preventable diseases. However, the COVID-19 pandemic has recaptured the relevance of organizing mass vaccination. Based on the current epidemiological situation, characteristics of the population, peculiar features of infrastructure, available resources in individual country, and individual city, various organizational vaccination solutions have been developed and implemented. The Moscow-based experience of vaccinating against influenza at mobile vaccination sites near the Moscow metro stations in 2016 became the starting point in the development of new organizational forms and technologies for mass vaccination in a megapolis, that have been successfully adapted to the new conditions of the COVID19 pandemic.Aims. is to summarize foreign and Russian (exemplified by Moscow) experience in organizing mass vaccination.Material and methods. The study is based on the publication search results in Google and PubMed. The authors selected materials published in 2017– 2023. The implemented analysis of the long-term dynamics in the influenza incidence in the Russian Federation, the Central Federal District (CFD) and Moscow was based on data of the Federal State Statistical Observation Form No. 2 «Information on infectious and parasitic diseases» for 2013–2019.Results and discussion. The analysis of foreign experience shows that the development and implementation of new forms of mass vaccination cannot become a "standard project". In each region of the world, it is organized with due regard to the local economic, legal, social, medical, organizational and even cultural conditions. Vaccination of the population against influenza at mobile vaccination sites near the Moscow metro stations contributed to a 42.3% decrease in the incidence of influenza (from 24.6 in 2016 to 14.2 per 100,000 population in 2017). In 2019, the incidence of influenza in Moscow was 28.8% lower than the CFD one and 62.2% lower than the Russian rate. The recognized successful experience of deploying mobile vaccination sites near the metro stations has been significantly expanded to control the COVID-19 pandemic with mobile teams, vaccination sites in shopping centers, etc.Conclusion. The conducted research and literature data substantiate the deployment of additional vaccination sites to ensure the necessary coverage with vaccination within a short period of time.

Seroprevalence and Risk Factors Related to Bovine Brucellosis in Continental Ecuador.

Bovine brucellosis is a worldwide zoonotic contagious disease. According to World Animal Health Information System reports Ecuador has presented an increasing number of bovine brucellosis outbreaks in the continental territory over the past years (756 in 2018 versus 964 in 2021), generating economic losses for producers and causing a risk to public health. A cross-sectional study was conducted to investigate the seroprevalence of bovine brucellosis and associated risk or protective factors between May and June 2018. This stratified random study was implemented in 290 cattle herds located in the 23 provinces of continental Ecuador, which represents a total of 3737 cows aged 24 months or older. A competitive ELISA was used to detect Brucella antibodies. Simultaneously, an epidemiological survey was implemented to assess the brucellosis risk or protective factors. The apparent prevalence of bovine brucellosis at the herd level was 21.3% (95% CI: 16.8-26.6) and 6.2% (95% CI: 5.5-7) at the animal level. Univariate and multivariate logistic regression analyses were performed to determine the relationship between the potential factors associated with the presence of bovine brucellosis. The risk factors identified after multivariate analysis were a surface in ha per herd > 70 ha (OR = 2.73; 95% CI: 1.18-6.32) and the number of parturitions per animal (two or more with OR ≥ 1.8 and p-value ≤ 0.047). On the contrary, the protective factors were the region (farms located in the eastern region) and the absence of reported clinical signs. In addition, in herds where extensive production predominates, farmers have a low level of knowledge, and the farm biosecurity level is low. These results can guide the authorities in managing the risk factors identified, understanding the current epidemiological situation in Ecuador, improving the bovine brucellosis control program and food safety, as well as increase the one-health approach.

Hospital medical care and the COVID-19 mortality in METEOR partner countries (the Netherlands, Belgium, Italy, And Poland).

Healthcare systems in European countries, including METEOR partner countries, are faced with the aging population, an increase in costs for innovative technologies and medication, a shortage of health professionals, and inequality in access to healthcare. Presented paper aimed to recognize and compare the functioning of healthcare systems between METEOR partner countries and simultaneously check if the current epidemiological situation of COVID-19 has some relationship with the number of medical staff, yearly gross domestic product, or documented percentage of fully vaccinated people. In the model of descriptive epidemiological study, available demographic, socioeconomic, and healthcare organizational data in the Netherlands, Belgium, Italy, and Poland were compared to the epidemiological situation of the COVID-19 pandemic (percentage of fully vaccinated people, incidence, and mortality) in all mentioned countries. Obtained data confirmed that the lowest number of physicians, as well as the life expectancy and gross domestic product per capita, is in Poland. Simultaneously, the lower number of medical staff and lower gross domestic product (GDP) correspond to higher mortality due to COVID-19. The percentage of fully vaccinated with the last dose of the primary series was also the lowest in Poland. Obtained results confirmed that higher mortality due to COVID-19 in METEOR participants' countries is related to a lower number of medical staff and weaker GDP. The worse situation was noted in Poland, a country with problems in the functioning healthcare system, including hospital care and a serious shortage of practicing medical staff. Int J Occup Med Environ Health. 2023;36(3):417-27.

Parents' Attitudes towards Vaccinations Regarding the Ukrainian Migration to Poland in 2022.

Background: Russia's aggression against Ukraine in early 2022 resulted in a large migration of refugees to many countries, including Poland. Vaccination coverage for some infectious diseases in Ukraine is lower than in Poland; consequently, the incidence of infectious diseases-including measles, poliomyelitis, tuberculosis, and COVID-19-is higher. We aimed to investigate whether the migration of Ukrainians had influenced decisions of Polish parents on having their children vaccinated and to examine their attitudes towards vaccinations. Material and methods: A cross-sectional online survey study was designed. Data on parents' demographics, attitudes toward vaccination, and knowledge of the current epidemiological situation in Poland were collected. Parents participating in the study were divided into two subgroups for further analysis according to their decisions to have their children vaccinated. Results: A total of 568 questionnaires were collected, of which 21 did not meet the inclusion criteria for the analysis (respondents were not parents). The Ukrainian immigrants' influx affected 54 (9.87%) participants in their decision of having their children vaccinated. Respondents in this group were more likely to have a positive attitude toward recommended vaccinations (p = 0.0428); in addition, they more often had their children vaccinated with recommended vaccinations (p = 0.0063), believed the vaccination coverage with mandatory vaccinations was higher in Poland than in Ukraine (p = 0.0014), and believed the incidence of diseases covered by mandatory (p = 0.0472) and recommended (p = 0.0097) vaccinations was higher in Ukraine. In addition, parents who declared that the migration had affected their decision regarding their children's vaccinations had more often been vaccinated due to the influx of Ukrainian immigrants (p < 0.00001) and were more likely to be aware of how migration had impacted the current epidemiological situation in Poland (p = 0.0021). Moreover, the survey more often made these participants think about getting additional vaccinations for themselves (p < 0.0001) and their children (p < 0.0001). Conclusions: The Ukrainian immigrants' influx affected nearly one tenth of surveyed parents in their decision of having their children vaccinated. This group was more aware of the differences between infectious diseases' epidemiology in Poland and Ukraine. In addition, they also had a more positive attitude toward vaccinations.

Advantages and disadvantages of maintaining the mandatory use of masks in health centers and nursing homes in Spain. How and when is it justified to maintain it?

We address the advantages and disadvantages of maintaining the mandatory use of masks in health centers and nursing homes in the current epidemiological situation in Spain and after the declaration of the World Health Organization on May 5, 2023 of the end of COVID-19 as public health emergency. We advocate for prudence and flexibility, respecting the individual decision to wear a mask and emphasizing the need for its use when symptoms suggestive of a respiratory infection appear, in situations of special vulnerability (such as immunosuppression), or when caring for patients with those infections. At present, given the observed low risk of severe COVID-19 and the low transmission of other respiratory infections, we believe that it is disproportionate to maintain the mandatory use of masks in a general way in health centers and nursing homes. However, this could change depending on the results of epidemiological surveillance and it would be necessary to reconsider returning to the obligation in periods with a high incidence of respiratory infections.

Tick-borne infections in the south of Russia: modern epidemiological situation, new approach to create “forecasting” and “explaining” morbidity models (in astrakhan rickettsiosis fever and crimean-congo hemorrhagic fever)

The article presents a description of the current tick-borne infection epidemiological situation in the south of Russia from the years 2013 to 2022, proposes a new approach to develop forecasting models for morbidity dynamics of Astrakhan rickettsial fever (ARF) and Crimean hemorrhagic fever (СCHF) in the Astrakhan region and presents data assessing 2022 explaining models for the Stavropol Territory and Astrakhan Region. Materials and methods. A comprehensive research was performed using epidemiological analysis and non-parametric statistical methods. The data assessing tick-borne infections epidemic process manifestations were retrieved from ARF and CCHF morbidity databases (developed as a project) and documents of infectious disease focus epidemiological examination provided by the departments of Rospotrebnadzor in the subjects of the Southern and North Caucasian Federal Districts. Morbidity models were developed using the Bayes theorem and Walds sequential statistical analysis, with a preliminary calculation of indicators informativeness by the Kullback method. The values of climatic factors from the database of the Center for Collective Use IKI-monitoring of the Space Research Institute of the Russian Academy of Sciences were used. Results. The results of the study indicate persistence of serious epidemiological situation regarding rickettsiosis of the tick-borne spotted fever group, Q fever, tick-borne borreliosis and CCHF in the south of Russia. Almost all tick-borne infections nosological forms in children under 14 years (including young children and infants) were widely involved in the epidemic process, which belong to patients at risk for a complicated disease course due to complicated diagnostics and treatment. The annual registration of tick-borne infections cases in the resort areas, with the subsequent occurrence of imported cases in other, including non-endemic regions poses a serious problem. The proposed forecasting models allow to predict the CСHF and ARF morbidity for each administrative district of the Astrakhan region with up to 91.7% accuracy. The explaining models CСHF accuracy for the Stavropol Territory and Astrakhan Region, when tested in 2022, was 88.5 and 83.3%, respectively, for ARF 91.7%. Conclusions. The further continuation of forecasting and explaining models verification for planning preventive measures and propose similar steps for tick-borne borreliosis and Q fever to epidemiological tick-borne infections to stabilize situation in the south of Russia.

West Nile virus infections in Hungary: Epidemiological update and phylogenetic analysis of the Hungarian virus strains between 2015 and 2022.

Following the introduction of the West Nile virus (WNV) into Hungary in 2004, it has shortly become one of the most important human arbovirus infections, with a gradually increasing number of cases. The study aimed to summarize the current epidemiological situation in Hungary and sequence the WNV PCR-positive clinical specimens and virus isolates by next-generation whole genome sequencing (NGS) to obtain a detailed phylogenetic analysis of the circulating virus strains. Whole blood and urine samples from confirmed WNV-infected patients and WNV isolates were investigated by reverse transcription PCR assays. Genome sequencing was carried out by Sanger-method, followed by NGS on the Illumina MiSeq platform. Altogether 499 human infections were diagnosed between 2004 and 2022. A particularly remarkable increase in human WNV infections was observed in 2018, while the number of reported cases significantly decreased during the COVID-19 pandemic. Between 2015 and 2022, 15WNV isolates, and 10 PCR-positive clinical specimens were investigated by NGS. Phylogenetic analysis revealed that the major European WNV lineage 2 clades, namely the Eastern European (or Russian) and the Central European (or Hungarian) clades, are presented in Hungary. Strains of the Balkan and other European clusters within the Central European clade are co-circulating in the country, following a characteristic geographical distribution. In Hungary, the presence and co-circulation of multiple lineage 2 WNV strains could be identified in the last few years. Therefore, in light of the 2018WNV outbreak, sequence-based typing of the currently circulating strains could highly support outbreak investigations.