Measles of evil: how hospitals hide the spread of dangerous infections
In early March, a two—year-old boy was admitted to the infectious diseases department of a children's hospital in Krasnoyarsk with intestinal infections, and from there to another medical facility with measles. He picked up this infection in the hospital corridors. The doctors, according to the child's mother, tried to hide the fact of contact and possible infection, and also did not offer to carry out any preventive measures. A criminal case on negligence has been opened into the incident. Meanwhile, the problem with nosocomial infections is systemic, and, as statistics show, measles often causes quarantine in medical institutions. Read more about the problem in the Izvestia article.
Why measles became the reason for the criminal case
On March 7, a two-year-old boy, along with his mother Daria, was admitted to the infectious diseases department of the interdistrict Children's Clinical Hospital No. 1 in Krasnoyarsk with a diagnosis of intestinal infection. The child's mother claims that three days later she and her son were sent to another ward, allegedly without any explanation. It was only on March 13 that Daria was informed that there was a measles patient in their ward. By that time, her son had also fallen ill — he had not been vaccinated against this infection. The woman and her child were transferred to another medical facility.
Daria accused the doctors of trying to hide the fact of contact and possible infection, did not offer emergency vaccination or the introduction of immunoglobulin.
It is known that the mother and child, as of early April, were in the hospital. The baby's condition has improved, but he has not recovered yet.
In response, the Ministry of Health of the Krasnoyarsk Territory stated that they had taken all "necessary measures": they informed the authorized bodies, formed a circle of contact persons, and transferred patients in need of treatment to a hospital with separate boxes. The department indicated that there were unvaccinated patients among the hospital's patients, as well as Daria's little son.
The incident came to the attention of law enforcement agencies anyway. The regional Department of the Investigative Committee opened a criminal case under the article "Negligence". Information is being checked on how doctors observed sanitary and epidemiological standards, isolated patients and informed parents.
Izvestia sent a request to the Ministry of Health of the Krasnoyarsk Territory. No response has been received at the time of publication.
What is the situation with measles in the Krasnoyarsk Territory
In the Krasnoyarsk Territory, according to official statistics, only 24 cases of measles among minors were recorded in 2023, and 39 in 2025. However, in 2024, 660 children were infected with this infection at once. The year 2024 turned out to be the most unfavorable year for measles in the country: 22.4 thousand cases in children against 13 thousand in 2023 and 6.6 thousand in 2025.
The state report of Rospotrebnadzor "On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2024" noted that in 2023-2024, the country experienced "another cyclical increase in the incidence of measles, which is registered every 4-6 years." Four children out of 22 thousand cases died, all of them were not vaccinated. The Krasnoyarsk Territory was in fourth place in terms of measles incidence per 100,000 population.
It follows from the same report that measles was one of the most common causes of the spread of nosocomial infections (ITIS) and medical care-related infections (IMDS) in 2024.
In total, 61 outbreaks of ISMP were registered in medical organizations, 954 people in 2024 were infected in hospitals. 23 outbreaks occurred in children's hospitals. At the same time, 312 patients as a result of nosocomial infections suffered from measles, which was registered in 29 foci.
Rospotrebnadzor points out in the report that the reason for the massive outbreaks of measles in hospitals was the incomplete vaccination coverage of staff.
Since July last year, there has been a steady downward trend in the incidence of measles in Russia, Vladimir Chulanov, chief freelance specialist for infectious diseases at the Russian Ministry of Health, told Izvestia. In January of this year, the number of cases of this infection was 1.6 times lower than in January 2025, and 17.5 times lower than two years ago.
How to hide cases of nosocomial infections
In total, 23,326 cases of ISM were registered in 2024. One third of them are in surgical hospitals, 17% are in obstetric hospitals. There are 1,385 cases of airborne infections. Rospotrebnadzor noted that this could indicate "insufficient vigilance with regard to the detection of such diseases" in hospitals, untimely measures to isolate or hospitalize patients with signs of infectious diseases.
The statistics of cases of purulent septic infections (HSI) in newborns in hospitals is also interesting. These are severe bacterial infections that occur in infants and women after childbirth, that is, they are directly nosocomial infections. In 2024, 1,875 of them were registered. At the same time, the number of registered intrauterine infections of newborns (IUI) significantly exceeds the number of HSI of newborns. Rospotrebnadzor, comparing the ratio of GSI and IUI in recent years, concluded that the real number of nosocomial infections in newborns is underestimated.
The fact is that it is often the diagnosis of "intrauterine infection" that is, the disease that the child received before birth, although in fact many of these cases are GSI, which the baby picked up after being born in a medical institution.
The Krasnoyarsk Territory was among the "leaders" in these statistics of alleged concealment of nosocomial infections: it is in fourth place in terms of the ratio of reported cases of IUI to HSI. With an all-Russian indicator of 1:15.62 (which is also too high a ratio to be considered normal) in the Krasnoyarsk Territory, it was 1:279.
Another report on nosocomial infections is a collection of abstracts on the results of the XII Congress with international participation (November 28-29, 2024), which was released by the Central Research Institute of Epidemiology of Rospotrebnadzor. It indicates that the average annual rate of GSI of newborns in the Krasnoyarsk Territory is very low — 0.3 cases per 1,000 infants. But at the same time, it is emphasized that low numbers may be related to selective registration: that is, rather than excellent prevention, but rather problems in case recording.
In the closed community, Doctors of the Russian Federation confirmed to Izvestia that cases of ISMP are often hidden from management due to fear of external and internal inspections, as well as sanctions from insurance organizations.
At the same time, Jan Vlasov, co-chairman of the All-Russian Union of Patients, notes that it is more correct to speak not about direct concealment, but about systemic underestimation, which is associated with the lack of uniform, clearly applied criteria for the registration of nosocomial infections and the fact that the system itself does not always encourage full transparency.
— Any outbreak carries reputational and administrative risks. As a result, many cases simply do not appear in the official statistics. And this is confirmed by the fact that expert estimates differ significantly from official data," the expert said.
Izvestia sent inquiries to the Ministry of Health of the Russian Federation and Rospotrebnadzor. The responses of the departments had not been received at the time of publication.
How hospitals should prevent infections
Nosocomial infection is dangerous because it leads to an aggravation of the underlying disease, said Andrey Matyukhin, Chief specialist in Infectious diseases at the Be Healthy clinic network. As a result, mild pneumonia turns into deadly, sepsis may develop after appendicitis is removed, etc. The mortality rate in severe forms of VBI caused by certain types of bacteria can reach 50-60%, especially in intensive care units, the expert said. At the same time, there is also a serious increase in the cost of treating the patient.
The procedure for the medical organization's actions in the spread of infections is strictly regulated by sanitary rules, Andrei Matyukhin pointed out. The sick patient is immediately transferred to a separate box or isolation unit, completely excluding his contact with other people. Within two hours, information about the VBI is urgently transmitted to Rospotrebnadzor, and then again when the diagnosis is clarified. The department or hospital stops routine hospitalization and patient visits, and daily monitoring of contact persons is established for the entire maximum incubation period (21 days for measles). At the same time, disinfection of premises is carried out, and if it is a question of infections controlled by preventive means, then emergency vaccination is carried out. This should be done, including with the spread of measles, which, judging by the statement of the child's mother from Krasnoyarsk, was not done.
— In measles, vaccination is most effective in the first 72 hours after contact. If more time has passed, vaccination is carried out anyway, and for weakened people — pregnant women, children under one year old — immunoglobulin can be used," the source explained to Izvestia.
Medical workers who do not have documented immunity are not allowed to work in the infection site.
Why infections remain a problem for hospitals
Among the causes of local epidemics in hospitals, Oleg Rukodayny, Head of the Department of Healthcare Organization, Drug Provision, Medical Technologies and Hygiene at the RUDN Medical Institute, Chairman of the Health Committee of the Moscow Chamber of Commerce and Industry, highlighted violations of the sanitary and epidemiological regime, low alertness of staff to infection symptoms and the circulation of hospital strains resistant to antibiotics. The latter point is facilitated, among other things, by self-medication, which increases the resistance of pathogens.
Outdated material and technical facilities, buildings that do not meet modern sanitary requirements, and a shortage of medical personnel are also becoming a problem, especially among middle managers and infectious diseases specialists, said Olga Shuppo, scientific director of the Grand Clinic network of immunorehabilitation and preventive medicine clinics.
In turn, Dmitry Voronin, a member of the National Association of Healthcare Managers, said there were "systemic failures."
— The staff is overloaded, the signals between the departments and the management arrive with a delay, and there are still no strict emergency notification regulations. Formally, there is control, but in practice it often works after the infection has spread," he explained.
The problem is that there are now many times fewer junior and secondary medical staff in hospitals than is provided for by the staffing standards of the Ministry of Health, said Andrei Konoval, co-chairman of the Action Health Workers' union.
— For example, in the Lipetsk region, we know of medical institutions in which there is not a single employee belonging to the junior medical staff. All this cannot but affect the quality of maintaining the sanitary and epidemiological regime," the Izvestia interlocutor noted.
The members of the professional community "Doctors of the Russian Federation" also pointed to the excessive workload of medical workers and lack of time as one of the main reasons for the occurrence of ISMP. One of the doctors told about a case when he did not recognize typhoid fever during a call to a patient and diagnosed acute respiratory infections. He managed to convince the officials of the district health department that the patient did not have any typical symptoms during the examination, but admitted that he could have assumed typhoid fever if he had not been so busy.
In the case of measles, many hospitals face the problem of being unable to isolate the "patient zero" during the incubation period, when he has no symptoms, but he is already contagious to others.
Practitioners also confirm the problems of equipment: hospitals do not have enough individual boxes for isolating patients.
Failures most often occur where several risk factors coincide at once.: The hospital has a high workload, worn-out infrastructure, weak infection control and a shortage of staff, said Yan Vlasov. These are often large multidisciplinary hospitals, maternity hospitals, and departments with serious patients. In addition, medical institutions face a systemic shortage of infection safety specialists, primarily epidemiologists.
— A separate problem is the quality and use of disinfectants. According to various estimates, up to 40% of the funds on the market are either ineffective or unsafe. At the same time, the rules of their use are often violated, which is why disinfection does not give the necessary effect. In such conditions, even formally conducted events do not provide real protection," the expert noted.
How to change the situation
The main problem lies in the fact that control often focuses on compliance with formal requirements, rather than on the real ability of the system to prevent the spread of infection, Yan Vlasov emphasized.
"At the same time, infections such as measles require a very fast, coordinated response, from diagnosis to isolation and prevention," he said.
To reduce the risks, the expert called for the return of epidemiologists to full-time medical institutions and to restore order in the field of quality of disinfection products and control over them.
Meanwhile, according to members of the Doctors of the Russian Federation community, in the case of measles, the most effective way is to solve the problem with anti-vaccination parents. Although it is also necessary to change the attitude of medical workers to the problem of ICMP, experts admitted. To do this, they proposed to cancel fines from insurance companies and fill the shortage of personnel in healthcare.
Roman Polibin, chief freelance epidemiologist at the Russian Ministry of Health, stressed in an interview with Izvestia that in case of problems with ensuring the epidemiological safety of medical care, liability measures may be applied to the management of medical institutions. However, "the priority is not punishment, but the prevention of nosocomial infections through systematic compliance with infection control requirements," he concluded.
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