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The review gives data on the clinical manifestations, complications, and epidemiological characteristics of herpes zoster. It discusses prospects for and foreign experience with vaccination against chickenpox and exacerbations of herpes zoster.

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The paper reviews the main problems of vaccine prophylaxis of adult infectious diseases, including the organization of adult vaccination within the national calendar of immunization and that as indicated by epidemics. It gives data on vaccine-controlled adult infectious morbidity. The problems of the training of medical workers serving the adult population in vaccine prophylaxis and those of the financing of adult immunization are discussed.

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The aim of this work was to study the effect of dopamine, 20-hydroxyecdysone and chlorpromazine, drugs changing the conductance of gap junctions (GJs), on the ultrastructure of goldfish Mauthner neurons mixed synapses. It was shown that desmosome-like contacts (DLCs) were the presumable targets for dopamine, that increased the electrotonic conductance of mixed synapses. Their hypertrophy, as well as an increase in the number of bridges in their clefts suggests that neuronal actin is involved in the mechanism of dopamine-induced increase of electrotonic conductance. This assumption is further supported by the transformation of extracted monomeric muscular actin into polymeric actin in the presence of dopamine. On the contrary, GJs were shown to be damaged by dopamine treatment. Ecdysone, which is also known to increase the conductance of GJs, changed their structure, increasing their number in the zone of apposition and reducing the profile length, but practically not affecting the DLC structure. It also does not interact with isolated actin in vitro. Therefore, the mechanism of ecdysone action is mainly associated with GJ function. Chlorpromazine, which reduces the conductance of GJs, was shown to damage, partially or completely, DLC admembranous fibrillar material, thus preventing actin polymerization, as shown by in vitro experiments, but had no effect on GJs. Therefore, the mechanism of its action, appears to be based on the changes in the state of neuronal actin.

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The extensive use of adsorbed diphtheria-tetanus toxoid with reduced antigen content was found to be ineffective in the prophylaxis of diphtheria: 86.3% of diphtheria patients among those who had been immunized with this preparation fell only a year after the first booster immunization, and the proportion of those who proved to be unprotected against diphtheria on years 3, 4 and 5 after immunization reached, respectively, 21.0%, 35.5% and 49.4%. The number of children immunized with this preparation at common preschool institutions may reach 50% and more, and with an increase in the coverage of children with immunization from 10% to 50% the proportion of unprotected children may rise from 7.4% to 17.8%. The proportion of preschool institutions, insufficiently protected from diphtheria and, as a consequence, running a considerable risk of becoming (in case of the penetration of this infection) the foci of diphtheria, was found to reach 32.9%.

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Examinations of 47 patients with various forms of chronic sialadenitis have demonstrated that the epidemic parotitis virus is not the principal factor in the development of this condition. Analysis of the epidemiologic anamnesis and comprehensive examinations carried out after abatement of the acute process help eliminate diagnostic errors. Both epidemic parotitis and chronic sialadenitis may run a latent course.

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The immunoepidemiological survey of 54 foci of epidemic parotitis showed that the epidemiological effectiveness index at preschool institutions, equal to 2.7, was essentially higher than at schools (2.1). The significant difference (t = 3.35) in the epidemiological effectiveness indices was due to the presence of a large number of persons having had inapparent and faintly pronounced forms of epidemic parotitis among school children, as well as due to more close contacts of children with the foci of infection at preschool institutions. The study showed that among children immunized with some lots of parotitis vaccine elevated morbidity in epidemic parotitis was registered. In the foci of infection children, immunized in the presence of low initial titers of specific hemagglutinins in their sera, responded by a booster effect with different duration of stimulation of antibody formation. The hemagglutinin titer of 1:20 was shown to protect children from epidemic parotitis.

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Controlled study lasting 6 years showed that booster immunization against measles was highly effective in children remaining seronegative, i. e. susceptible to this infection, after primary immunization: E = 97.5 +/- 0.12% (K = 35.7). Annual serological examination of children given booster immunization revealed that 87.6% of initially seronegative children retained specific antihemagglutinins for 5.5 years (the term of observation). The effectiveness of booster immunization against measles did not depend on the age when primary immunization had been made.

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Enzyme immunoassay (EIA) for detection of antibodies to measles virus designed in the Moscow Research Institute of Viral Preparations has proved highly sensitive (98%) and specific (100%) as tested in 492 vaccinated children. Comparison of EIA and haemagglutination inhibition (HI) test allowed to determine the cut-off value of the optical density to be equal to 0.1. The serum dilution 1:10 was found appropriate for the screening.

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The reaction of the inhibition of leukocyte adhesion to a glass slide under the action of measles antigen may be used for the evaluation of the activity of antigen-specific T-lymphocytes in the process of immunization against measles and recommended, along with serological studies, for finding out persons susceptible to measles among vaccinees. The immunological effect of booster immunizations against measles can be evaluated by the degree of the inhibition of leukocyte agglutination to a glass slide.

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In the controlled epidemiological trial the reactogenic and immunogenic properties of live measles vaccine (LMV) and live parotitis vaccine (LPV) were evaluated in identical groups of children immunized in accordance with different schedules: only LMV or LPV, the injection of these preparations mixed in one syringe or with the use of separate syringes, or at an interval of 3 months. The highest number of febrile reactions, rash and catarrhal symptoms was registered among children immunized with LMV, and the lowest number of such reactions in the groups of children immunized with LPV. The injection of LMV and LPV with one syringe or simultaneously with separate syringes decreased the intensity of immune response to the injection of the antigens. Immunization against measles and parotitis by the injection of monopreparations at an interval of 3 months is believed to be most expedient.

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