Vol 57, No 6 (2012)

The results of the clinical trial testing the efficacy of a new anti-influenza drug Triazavirin are presented in this work. The data of the trial were gathered during the 2010 influenza season. The treatment with oral Triazavirin significantly reduced the duration of the main clinical symptoms of influenza (intoxication, fever, respiratory symptoms), decreased the incidence of the influenza-related complications and the use of symptomatic drugs. The re-isolation rate of the influenza A and B viruses was significantly lower in the patients who were using Triazavirin. The analysis of the clinical data showed that the optimal prescribed dosage was 250 mg 3 times a day.

Analysis of development influenza activity season 2010-2011 is presented. Significant participation of influenza A(H1N1)pdm09 virus and influenza B of Victoria lineage virus in the epidemic morbidity structure with minor participation of A(H3N2) virus was revealed. The influenza viruses isolated in Russia according to antigenic properties were similar to the strains included in the vaccine composition. Drift variants of influenza A(H1N1)pdm09 viruses isolated in Astrakhan and St.-Petersburg were recognized using WHO CC in London as representatives of three new genetic groups.

The comparison of the first and second waves of the pandemic influenza A(H1N1)pdm09 in the world and Russia was performed on the basis of weekly reports of Regional offices for Europe and on the data of the Federal Center for Influenza on a weekly incidence of influenza and acute respiratory viral infections, hospitalization, and mortality from the influenza in the age groups of population in 49 cities of the Russian Federation. The first wave of the pandemic, which continued in the countries of the world all summer, was of mixed etiology and, in spite of the availability of imported cases, has not caused a steep increase in Russia. The second wave of the pandemic in the countries of the southern hemisphere was less intense. In the countries of the Northern hemisphere (in autumn 2009), on the contrary, it was more intensive, which was associated with different seasonality of influenza in these hemispheres. In Russia, the second wave (2011) was of a lesser intensity as compared to the first with respect to the duration in the country and in urban areas, the incidence in the entire population, including schoolchildren and adults, the rate of hospitalization and case fatality rate reduction of laboratory-confirmed influenza infection. The duration of the last pandemic of 2009 was the same as in 1957 and 1968, and longer than in 1977. The morbidity was one-half less than in the pandemic of 1957 and 1968, and was approaching the pandemic 1977. At the same time, the incidence in children 3-6 and 7-14 years was higher than in previous pandemics.

The results of molecular genetic analysis of more than 280 strains of influenza A virus subtypes H1N1 and H3N2 circulating in Russia in 2006-2012 are presented. The genetic changes underlying the evolution of the virus strains and sensitivity to antiviral drugs were analyzed. Significant changes in the genetic structure of influenza A viruses circulating in the Russian Federation and their phylogenetic affiliation are shown to occur within the studied period. The studies identifying codons under the positive selection in silico in the genes encoding surface proteins of the influenza virus were demonstrated to be efficient for the analysis of the antigenic drift and direction of evolutionary variability of the influenza viruses.