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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">actabiomedica</journal-id><journal-title-group><journal-title xml:lang="ru">Acta Biomedica Scientifica</journal-title><trans-title-group xml:lang="en"><trans-title>Acta Biomedica Scientifica</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2541-9420</issn><issn pub-type="epub">2587-9596</issn><publisher><publisher-name>Scientific Centre for Family Health and Human Reproduction Problems</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.29413/ABS.2025-10.5.9</article-id><article-id custom-type="elpub" pub-id-type="custom">actabiomedica-5666</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ИНФЕКЦИОННЫЕ БОЛЕЗНИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>INFECTIOUS DISEASES</subject></subj-group></article-categories><title-group><article-title>Летальный случай геморрагической лихорадки с почечным синдромом, обусловленный заражением хантавирусом Сеул</article-title><trans-title-group xml:lang="en"><trans-title>Fatal case of hemorrhagic fever with renal syndrome associated with hantavirus Seoul</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5082-8071</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сметанникова</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Smetannikova</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сметанникова Наталья Анатольевна – кандидат медицинских наук, старший научный сотрудник отдела геномных исследований</p><p>630559, р.п. Кольцово, Новосибирская область, Россия </p></bio><bio xml:lang="en"><p>Natalia A. Smetannikova – Cand. Sc. (Med.), Senior Researcher at the department of genomic research </p><p>Koltsovo, Novosibirsk Region 630559, Russian Federation </p></bio><email xlink:type="simple">smetannikova@vector.nsc.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-9812-6747</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Яровенко</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Yarovenko</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Яровенко Валентина Васильевна – заведующая лабораторией вирусологии</p><p>680031, г. Хабаровск, Санитарный пер., д. 7, Россия </p></bio><bio xml:lang="en"><p>Valentina V. Yarovenko – Head of the Laboratory of Virology</p><p>Sanitarniy Lane, 7, Khabarovsk 680031, Russian Federation</p></bio><email xlink:type="simple">chum27@bk.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-6230-3889</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бахметьева</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Bakhmetyeva</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бахметьева Светлана Васильевна – кандидат ветеринарных наук, биолог лаборатории вирусологии</p><p>680031, г. Хабаровск, Санитарный пер., д. 7, Россия </p></bio><bio xml:lang="en"><p>Svetlana V. Bakhmetyeva – Cand. Sc. (Vet.), Biologist of the Laboratory of Virology</p><p>Sanitarniy Lane, 7, Khabarovsk 680031, Russian Federation</p></bio><email xlink:type="simple">chum27@bk.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7857-6822</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Карташов</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Kartashov</surname><given-names>M. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Карташов Михаил Юрьевич – кандидат биологических наук, старший научный сотрудник отдела молекулярной вирусологии</p><p>630559, р.п. Кольцово, Новосибирская область, Россия </p></bio><bio xml:lang="en"><p>Mikhail Yu. Kartashov – Cand. Sc. (Biol.), Senior Researcher at the department of molecular virology </p><p>Koltsovo, Novosibirsk Region 630559, Russian Federation </p></bio><email xlink:type="simple">kartashov_myu@vector.nsc.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0000-3173-6254</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ковальский</surname><given-names>А. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Kovalsky</surname><given-names>A. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ковальский Андрей Григорьевич – директор </p><p>680031, г. Хабаровск, Санитарный пер., д. 7, Россия </p></bio><bio xml:lang="en"><p>Andrey G. Kovalsky – Director</p><p>Sanitarniy Lane, 7, Khabarovsk 680031, Russian Federation </p></bio><email xlink:type="simple">chum27@bk.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2844-7835</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Яшина</surname><given-names>Л. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Yashina</surname><given-names>L. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Яшина Людмила Николаевна – доктор биологических наук, ведущий научный сотрудник отдела геномных исследований</p><p>630559, р.п. Кольцово, Новосибирская область, Россия </p></bio><bio xml:lang="en"><p>Liudmila N. Yashina – Dr. Sc. (Biol.), Leading Scientist at the department of genomic research</p><p>Koltsovo, Novosibirsk Region 630559, Russian Federation </p></bio><email xlink:type="simple">yashina@vector.nsc.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФБУН «Государственный научный центр вирусологии и биотехнологии «Вектор» Роспотребнадзора</institution></aff><aff xml:lang="en"><institution>State Research Center of Virology and Biotechnology “Vector”, Rospotrebnadzor</institution></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФКУЗ «Хабаровская противочумная станция» Роспотребнадзора</institution></aff><aff xml:lang="en"><institution>Khabarovsk Plague Control Station, Rospotrebnadzor</institution></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>17</day><month>12</month><year>2025</year></pub-date><volume>10</volume><issue>5</issue><fpage>86</fpage><lpage>92</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Сметанникова Н.А., Яровенко В.В., Бахметьева С.В., Карташов М.Ю., Ковальский А.Г., Яшина Л.Н., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Сметанникова Н.А., Яровенко В.В., Бахметьева С.В., Карташов М.Ю., Ковальский А.Г., Яшина Л.Н.</copyright-holder><copyright-holder xml:lang="en">Smetannikova N.A., Yarovenko V.V., Bakhmetyeva S.V., Kartashov M.Y., Kovalsky A.G., Yashina L.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.actabiomedica.ru/jour/article/view/5666">https://www.actabiomedica.ru/jour/article/view/5666</self-uri><abstract><p>Ортохантавирус Сеул (SEOV) является одним из возбудителей геморрагической лихорадки с почечным синдромом (ГЛПС) на Дальнем Востоке России. Очаги циркуляции SEOV в серых крысах выявлены в городах Владивосток и Хабаровск.Цель работы. Исследование клинического случая ГЛПС с летальным исходом, выявленного в г. Комсомольске-на-Амуре в 2025 году.Материалы и методы. Образцы сыворотки крови и аутопсийного материала (кровь, ткани легких, селезенки, печени, почек) от жительницы г. Комсомольска-на-Амуре с предварительным диагнозом «ГЛПС, завершившаяся летальным исходом», были исследованы методами иммуноферментного анализа (ИФА) и обратной транскрипции – полимеразной цепной реакции (ОТ-ПЦР) с последующим секвенированием.Результаты. Проведенные исследования подтвердили клинический диагноз. Методом ИФА в сыворотке крови обнаружены антитела к хантавирусам в титре 1:3200 (IgM) и 1:1600 (IgG). При исследовании методом ОТ-ПЦР с использованием тест-системы «ОМ-Скрин-ГЛПС-РВ» в сыворотке крови и аутопсийном материале (крови, тканях легких, селезенки, печени, почек) выявлена РНК SEOV. Анализ фрагментов генома показал высокую гомологию SEOV из Комсомольска-на-Амуре с вариантами вируса, выявленными ранее в Хабаровске, а также широко распространенными в Китае. Впервые получено генетическое доказательство инфицирования человека вирусом Сеул, циркулирующим в г. Комсомольске-на-Амуре, и выдвинуты две гипотезы формирования очага: завоз с инфицированными крысами из Китая либо Хабаровска и возможное существование материкового варианта вируса на обширной территории, включающей восточные районы Китая и Хабаровский край.Заключение. В РФ выявлен третий городской очаг хантавируса Сеул. Летальный исход ГЛПС мог быть обусловлен фоновым заболеванием: хронической алкогольной интоксикацией с полиорганными проявлениями.</p></abstract><trans-abstract xml:lang="en"><p>Seoul orthohantavirus is one of the causative agents of hemorrhagic fever with renal syndrome (HFRS) in the Russian Far East. Foci of SEOV in Norway rats have been identified in the cities of Vladivostok and Khabarovsk.The aim. Study of a clinical case of HFRS with a fatal outcome, from Komsomolsk-on-Amur in 2025.Materials and methods. Samples of blood serum and autopsy material (blood, lung, spleen, liver, kidney tissues) from a resident of Komsomolsk-on-Amur with a clinical diagnosis of HFRS were examined using enzyme-linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction (RT-PCR) followed by sequencing.Results. The laboratory studies confirmed the clinical diagnosis. Antibodies to hantaviruses in a titer of 1:3200 (IgM) and 1:1600 (IgG) were detected by the ELISA in the blood serum. SEOV RNA was detected in blood serum and autopsy material (blood, lung,spleen, liver, kidney tissues) studying by the RT-PCR and using the OM-Screen-GLPSRV test system. Analysis of genome fragments showed high homology of SEOV from Komsomolsk-on-Amur with virus strains previously identified in Khabarovsk, as well as those widespread in China. Genetic evidence of human infection, associated with the Seoul virus circulating in the city of Komsomolsk-on-Amur has been obtained, and two hypotheses have been put forward for the formation of the focus: importation with infected rats from China or Khabarovsk, and the possible existence of a mainland variant of the virus in a vast territory, including the eastern regions of China and Khabarovsk Krai.Conclusion. Third urban focus of Seoul hantavirus was detected in Russia. The fatal outcome of HFRS could be caused by a comorbidity: chronic alcohol intoxication with multiple organ manifestations.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>хантавирус</kwd><kwd>вирус Сеул</kwd><kwd>ГЛПС</kwd><kwd>Россия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>hantavirus</kwd><kwd>Seoul virus</kwd><kwd>HFRS</kwd><kwd>Russia</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование выполнено в рамках государственного задания ФБУН ГНЦ ВБ «Вектор» Роспотребнадзора.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Tkachenko EA, Ishmukhamedov AA, Tkachenko PE, Morozov VG, Kruger DH, Klempa B, et al. Hemorrhagic fever with renal syndrome, Russia. Emerging Infectious Diseases. 2019; 25: 2325-2327. doi: 10.3201/eid2512.181649</mixed-citation><mixed-citation xml:lang="en">Tkachenko EA, Ishmukhamedov AA, Tkachenko PE, Morozov VG, Kruger DH, Klempa B, et al. Hemorrhagic fever with renal syndrome, Russia. Emerging Infectious Diseases. 2019; 25: 2325-2327. doi: 10.3201/eid2512.181649</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Yashina LN, Patrushev NA, Ivanov LI, Slonova RA, Mishin VP, Kompanez GG, et al. Genetic diversity of hantaviruses associated with hemorrhagic fever with renal syndrome in the Far East of Russia. Virus Research. 2000; 70(1-2): 31– 44. doi: 10.1016/s0168-1702(00)00203-3</mixed-citation><mixed-citation xml:lang="en">Yashina LN, Patrushev NA, Ivanov LI, Slonova RA, Mishin VP, Kompanez GG, et al. Genetic diversity of hantaviruses associated with hemorrhagic fever with renal syndrome in the Far East of Russia. Virus Research. 2000; 70(1-2): 31– 44. doi: 10.1016/s0168-1702(00)00203-3</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Яшина Л.Н., Сметанникова Н.А., Компанец Г.Г., Здановская Н.И., Иванов Л.И. Молекулярная эпидемиология патогенных хантавирусов на Дальнем Востоке России, 2015–2018 гг. Проблемы особо опасных инфекций. 2019; 4: 102–108. doi: 10.21055/0370-1069-2019-4-102-108</mixed-citation><mixed-citation xml:lang="en">Yashina LN, Smetannikova NA, Kompanets GG, Zdanovskaya NI, Ivanov LI. Molecular Epidemiology of Pathogenic Hantaviruses in the Far East of Russia, 2015–2018. Problems of Particularly Dangerous Infections. 2019; 4: 102–108. (In Russ.). doi: 10.21055/0370-1069-2019-4-102-108</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Яшина Л.Н., Сметанникова Н.А., Здановская Н.И., Полещук Д.Н., Лапин А.С., Ковальский А.Г. Новый очаг хантавируса Сеул на Дальнем Востоке России. Проблемы особо опасных инфекций. 2024; (3): 170–177. doi: 10.21055/0370-1069-2024-3-170-177</mixed-citation><mixed-citation xml:lang="en">Yashina LN, Smetannikova NA, Zdanovskaya NI, Poleshchuk DN, Lapin AS, Koval’sky AG. New Focus of Hantavirus Seoul in the Far East of Russia. Problems of Particularly Dangerous Infections. 2024; (3): 170–177. (In Russ.). doi: 10.21055/0370-1069-2024-3-170-177</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Lin XD, Guo WP, Wang W, Zou Y, Hao ZY, Zhou DJ, et al. Migration of Norway rats resulted in the worldwide distribution of Seoul hantavirus today. Journal of Virology. 2012; 86(2): 972–981. doi: 10.1128/JVL00725-11</mixed-citation><mixed-citation xml:lang="en">Lin XD, Guo WP, Wang W, Zou Y, Hao ZY, Zhou DJ, et al. Migration of Norway rats resulted in the worldwide distribution of Seoul hantavirus today. Journal of Virology. 2012; 86(2): 972–981. doi: 10.1128/JVL00725-11</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Yashina LN, Hay J, Smetannikova NA, Kushnareva TV, Iunikhina OV, Kompanets GG. Hemorrhagic fever with renal syndrome in Vladivostok city, Russia. Frontiers of Public Health. 2021; 9: 620279. doi: 10.3389/fpubh.2021.620279</mixed-citation><mixed-citation xml:lang="en">Yashina LN, Hay J, Smetannikova NA, Kushnareva TV, Iunikhina OV, Kompanets GG. Hemorrhagic fever with renal syndrome in Vladivostok city, Russia. Frontiers of Public Health. 2021; 9: 620279. doi: 10.3389/fpubh.2021.620279</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Tariq M, Kim DM. Hemorrhagic Fever with Renal Syndrome: Literature Review, Epidemiology, Clinical Picture and Pathogenesis. Infection and Chemotherapy. 2022; 54(1): 1–19. doi: 10.3947/ic.2021</mixed-citation><mixed-citation xml:lang="en">Tariq M, Kim DM. Hemorrhagic Fever with Renal Syndrome: Literature Review, Epidemiology, Clinical Picture and Pathogenesis. Infection and Chemotherapy. 2022; 54(1): 1–19. doi: 10.3947/ic.2021</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Clement J, LeDuc JW, McElhinney LM, Reynes JM, Van Ranst M, Calisher CH. Clinical characteristics of ratborne Seoul hantavirus disease. Emerging Infectious Diseases. 2019; 25(2): 387–388. doi: 10.3201/eid2502.181643</mixed-citation><mixed-citation xml:lang="en">Clement J, LeDuc JW, McElhinney LM, Reynes JM, Van Ranst M, Calisher CH. Clinical characteristics of ratborne Seoul hantavirus disease. Emerging Infectious Diseases. 2019; 25(2): 387–388. doi: 10.3201/eid2502.181643</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Jiang H, Du H, Wang LM, Wang PZ, Bai XF. Hemorrhagic Fever with Renal Syndrome: Pathogenesis and Clinical Picture. Front Cell Infect Microbiol. 2016; 6: 1. doi: 10.3389/fcimb.2016.00001</mixed-citation><mixed-citation xml:lang="en">Jiang H, Du H, Wang LM, Wang PZ, Bai XF. Hemorrhagic Fever with Renal Syndrome: Pathogenesis and Clinical Picture. Front Cell Infect Microbiol. 2016; 6: 1. doi: 10.3389/fcimb.2016.00001</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Klempa B, Fichet-Calvet E, Lecompte E, Auste B, Aniskin V, Meisel H, et al. Hantavirus in African wood mouse, Guinea. Emerging Infectious Diseases. 2006; 12(5): 838–840. doi: 10/3201/eid1205.051487</mixed-citation><mixed-citation xml:lang="en">Klempa B, Fichet-Calvet E, Lecompte E, Auste B, Aniskin V, Meisel H, et al. Hantavirus in African wood mouse, Guinea. Emerging Infectious Diseases. 2006; 12(5): 838–840. doi: 10/3201/eid1205.051487</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Kim WK, No JS, Lee SH, Song DH, Lee D, Kim JA, et al. Multiplex PCR-Based Next-Generation Sequencing and Global Diversity of Seoul Virus in Humans and Rats. Emerging Infectious Diseases. 2018; 24(2): 249–257. doi: 10.3201/eid2402.171216</mixed-citation><mixed-citation xml:lang="en">Kim WK, No JS, Lee SH, Song DH, Lee D, Kim JA, et al. Multiplex PCR-Based Next-Generation Sequencing and Global Diversity of Seoul Virus in Humans and Rats. Emerging Infectious Diseases. 2018; 24(2): 249–257. doi: 10.3201/eid2402.171216</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Морозов В.Г., Ишмухаметов А.А., Дзагурова Т.К., Ткаченко Е.А. Клинические особенности геморрагической лихорадки с почечным синдромом в России. Медицинский совет. 2017; 5: 156-161. doi: 10.21518/2079-701X-2017-5-156-161</mixed-citation><mixed-citation xml:lang="en">Morozov VG, Ishmukhametov AA, Dzagurova TK, Tkachenko EA. Clinical manifestations of hemorrhagic fever with renal syndrome in Russia. Meditsinskiy sovet. 2017; 5: 156-161. (In Russ.). doi: 10.21518/2079-701X-2017-5-156-161</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Shimabukuro-Vornhagen A, Gödel P, Subklewe M, Stemmler HJ, Schloßer HA, Schlaak M, et al. Cytokine release syndrome. Journal for Immunotherapy of Cancer. 2018; 6: 559–570. doi: 10.1186/s40425-018-0343-9</mixed-citation><mixed-citation xml:lang="en">Shimabukuro-Vornhagen A, Gödel P, Subklewe M, Stemmler HJ, Schloßer HA, Schlaak M, et al. Cytokine release syndrome. Journal for Immunotherapy of Cancer. 2018; 6: 559–570. doi: 10.1186/s40425-018-0343-9</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Забродский П.Ф., Лим В.Г., Гришин В.А., Кузьмин А.В. Механизмы нарушения иммунного статуса при хронической интоксикации этанолом. Бюллетень экспериментальной биологии и медицины. 2011; 152(7): 97–100.</mixed-citation><mixed-citation xml:lang="en">Zabrodskii PF, Lim VG, Grishin VA, Kuzmin AV. The mechanisms of influence of the immune status at the chronic intoxication of ethanol. Bulletin of Experimental Biology and Medicine. 2011; 152(7): 97–100. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Газатова Н.Д., Юрова К.А., Гаврилов Д.В., Литвинова Л.С. Алкоголь и иммунитет. Гены и клетки. 2018; 13(1): 47–55. doi: 10.23868/201805005</mixed-citation><mixed-citation xml:lang="en">Gazatova ND, Yurova KA, Gavrilov DV, Litvinova LS. Alcohol and immunity. Genes and Cells. 2018; 13(1): 47–55. (In Russ.). doi: 10.23868/201805005</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Нафеев А.А., Савельева Н.В., Сибаева Э.И. Иммунологический (серологический) мониторинг в системе эпидемиологического надзора за природно-очаговыми инфекциями. Эпидемиология и инфекционные болезни. 2016; 21(5): 286–289. doi: 10.18821/1560-9529-2016-21-5-286-289</mixed-citation><mixed-citation xml:lang="en">Nafeev AA, Savelyeva NV, Sibaeva EI. Immunological (serological) monitoring in the epidemiological surveillance system of natural focal infections. Epidemiology and Infectious Diseases. 2016; 21(5): 286–289. (In Russ.). doi: 10.18821/1560-9529-2016-21-5-286-289</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Дзагурова Т.К., Ткаченко Е.А., Транквилевский Д.В., Колясникова Н.М., Теодорович Р.Д., Курашова С.С., и др. Эпидемиологический анализ заболеваемости геморрагической лихорадкой с почечным синдромом и клещевым энцефалитом в Российской Федерации. Эпидемиология и Вакцинопрофилактика. 2024; 23(5): 84–91. doi: 10.31631/2073-3046-2024-23-5-84-91</mixed-citation><mixed-citation xml:lang="en">Dzagurova TK, Tkachenko EA, Trankvilevsky DV, Kolyasnikova NM, Teodorovich RD, Kurashova SS, et al. Epidemiological analysis of the incidence of hemorrhagic fever with renal syndrome and tick-borne encephalitis in the Russian Federation. Epidemiology and Vaccinal Prevention. 2024; 23(5): 84–91. (In Russ.). doi: 10.31631/2073-3046-2024-23-5-84-91</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
