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The article presents the results of clinical studies on the comparative effectiveness of different forms of the drug Cytovir-3 (syrup and powder for solution for oral administration) and Immunal l in the treatment of acute respiratory viral infections in children. It was found in a comparative randomized parallel-group study of 90 children aged two through six years that the drug Cytovir-3 (syrup and powder) became active faster than the comparison drug Immunal, providing normalization of body temperature, reduction of some manifestations of the general intoxication and respiratory syndrome, as well as elevated levels of serum immunoglobulin A. All drugs in the study had an equally normalizing effect on the content of peripheral blood leukocytes and erythrocyte sedimentation rates. The compared products were characterized by good tolerability, lack of side effects and high preventive efficacy against respiratory disease complications. Cytovir-3 drugs (syrup and powder for oral solution) and Immunal had similar ratios of clinical and laboratory safety, efficacy and tolerability. Both products can be used for the treatment of respiratory diseases in children aged two through six years.

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Comparative analysis of the clinical laboratory data from 419 children and 468 adults hospitalized during the pandemic of A (H1N1pdm 2009) and pre- and post-pandemic periods (2010-2013) showed that the clinical presentation of the pandemic influenza in patients of all ages is generally typical for influenza, and its character is determined by the degree of involvement of lungs in the process. Besides, the incidence of pneumonia in adults is statistically significantly higher than in children. During all compared periods hyperthermia (≥ 39 degrees C), hemorrhagic and dyspeptic syndrome were observed. Some differences in the main clinical manifestations of pneumonia in recovered patients and patients who died of the severe pandemic influenza were observed. The regularities of the cytokine reactions depending on the intensity of intoxication and occurrence of complications were determined in patients of all ages. Medical efficacy of inclusion of antiviral chemotherapeutic agents into complex influenza treatment was proved.

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Prophylactic efficiency and safety of anaferon (pediatric formulation) in children aging 1?month to 4 years, including sickly children, was proven. The use of the preparation in children reduced the incidence of acute respiratory infections, alleviated the course of the disease, and decreased the incidence of detection of viral antigens in nasal meatuses.

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We studied interferon status in children during acute respiratory infections and found that it depends on etiology, course of the disease, and individual features of the organism. The efficiency of IFN inductor anaferon (pediatric formulation) and the possibility of its application in the therapy of children with acute respiratory infections were demonstrated.

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We evaluated the percent of acute respiratory viral infections with gastrointestinal syndrome in the structure of morbidity in babies aging 6 months and elder. Therapeutic efficiency and safety of anaferon (pediatric formuation) as a component of complex therapy of acute respiratory viral infections with involvement of the gastrointestinal tract were proven; more rapid disappearance of all symptoms and improvement of the immune status parameters were demonstrated.

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As the result of prolonged (17 years) observations of patients with acute respiratory infections hospitalized in basic departments of clinics of the Research Institute of Influenza, coronavirus infection was found to be the cause of respiratory diseases, on the average, in 12% of cases (in some years in 6.8% to 28.6% of cases). The analysis of extensive morbidity rates among different age groups of the population showed that children were affected by coronavirus infection 5-7 times more often than adults. Three year cycles of this infection were established. The periods of coronaviruses activation were accompanied by their detection in patient material by electron-microscopy, a sharp increase of immune response of patients as well as in the number of nosocomial infections and the proportion of the monoinfection of the coronavirus nature. Coronaviruses played the leading role among other viruses in the etiology of hospital respiratory infections. Mucosal antibodies to coronaviruses in the secretions of the nasal cavity proved to be more important than serum antibodies not only in protection from infection, but also in the pattern of clinical manifestations of the disease.

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Therapeutic efficacy of remantadine and arbidole was studied in the clinical and laboratory observation of pediatric in- and outpatients with grippe and mixed viral infections in various seasonal epidemic. In the trial of remantadine 742 school children and 60 children at the age of 3 to 6 years with type A, B or A + B grippe, grippe in association with other acute viral respiratory tract infections or acute viral respiratory tract infections of nongrippe etiology were observed. 402 and 400 of them were given remantadine and placebo respectively. The drug was used in a single dose of 1.5 mg/kg body weight 3 times a day for 3 days. In the trial of arbidole 158 children at the age of 1 to 14 years with type A grippe, grippe + acute viral respiratory tract infection and acute viral respiratory tract infection of nongrippe etiology were observed. The arbidole daily dose of 10 mg/kg body weight was given in 4 portions for 5 days. Both the drugs were shown to be therapeutically efficient in all the grippe types and acute viral respiratory tract infections. The highest efficacy was observed when the use of the drugs was started at the early stages. With the use of the drugs the periods of fever, other intoxication signs and virus isolation decreased. No adverse reactions were recorded. The drugs had no inhibitory effect on the cellular and humoral immunity and on production of antiviral antibodies. The dynamics of the indices of the cellular immunity and macrophages confirmed the arbidole immunostimulating action.

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Respiratory syncytial (RS) virus is the main cause of severe respiratory infections in newborns and infants during the first year of life. In the recent years, search is under way for chemo- and immune replacement therapy preparations for etiotropic RS-infection therapy. Procedures have been developed to prepare immunoglobulins and Chigain preparations having a target-oriented action. They were clinically tested. There was a positive dynamics in the clinical manifestations of the disease and a positive influence on immunological parameters in children.

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Acute respiratory superinfections (ARS) induced by secondary nosocomial respiratory pathogens and characterized by the subsequent generalization of the process have been reported as one of the main contributions to pediatric inpatient mortality. The recurrent infections were observed in all types of hospitals; they might be induced by the whole group of respiratory pathogens, but adeno-, coronaviral and pneumococcal ones are predominating. The ARS clinical picture showed various patterns determined both by the etiology of basic and recurrent infection and by a child's immunity. There was a correlation between the severity of ARS and the level of specific immunoglobulins, especially of secretory origin.

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Analysing the X-ray picture of childhood pneumonias from 8 X-ray parameters chosen by the authors has ascertained that bacterial pneumonias are most characterized by 2 X-ray signs: total segmentation and homogenicity of the lesion, whereas viral pneumonias by 4-5 or more out of the 8 chosen signs, among which there is partial segmentation and unhomogeneity of the lesion with increased lung outline within the lesion focus. This enables at least 96% probability to differentiate viral and bacterial pneumonias. The differences between pneumonic changes in viral respiratory infections are not so well-defined. But at the same time the X-ray pattern of RS infection most commonly includes an obstructive component (most infrequently in influenza and parainfluenza), partial segmentation and a limited area of infiltration (only 1-2 segments are involved). Adenoviral infections are most frequently characterized by increased lung outline beyond the pneumonic focus, indicating concomitant bronchitis beyond the pneumonic area, as well as by the atelectasis and extensive infiltration (involving 3-5 segments). Thus, the X-ray technique enables etiological rapid diagnosis during the first three days of the onset of the disease, providing timely initiation of etiothropic therapy.

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The protective role of secretory antibodies in the development of adenovirus infection has been established. More severe and prolonged course of adenovirus infection, accompanied by the involvement of the lower respiratory tract in the process, has been noted in patients with low titers of antibodies, or their absence, in secretions (O to 1:4). The presence of secretory antibodies in a titer of 1:8 considerably alleviated the course of the disease. The antibody titer 1:16 (according to the data of the passive hemagglutination test) has proved to be protective for children and adults in adenovirus infection. The results of the determination of antibodies in the secretions of the upper respiratory tract in the passive hemagglutination test may be used for the purposes of prognostication.

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To evaluate the safety, reactogenicity and immunogenicity of inactivated chromatographic influenza vaccine A(H3N2) produced by the Pasteur Research Institute of Epidemiology and Microbiology in Leningrad, children aged 7-15 years received the vaccine intradermally in doses of 114-228 IU, and 152 children received placebo. In this study inactivated influenza vaccine introduced parenterally to children aged 11-15 years in a dose of 228 IU proved to be nonreactogenic. The reactogenicity index of the preparation injected in a dose of 114 IU to children aged 7-10 years was 0.6%. Immunization in a single injection was accompanied by significant seroconversions in 87.5%-96.0% of children with the highly pronounced growth of antibody titers (21.1-34.6 times). The complex of clinico-laboratory tests showed the safety of this preparation for both age groups.

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