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Vilibic-Cavlek T, Kaic B, Barbic L, Pem-Novosel I, Slavic-Vrzic V, Lesnikar V, Kurecic-Filipovic S, Babic-Erceg A, Listes E, Stevanovic V, Gjenero-Margan I, Savini G. First evidence of simultaneous occurrence of West Nile virus and Usutu virus neuroinvasive disease in humans in Croatia during the 2013 outbreak. Infection 2014; 42:689-95. [PMID: 24793998 DOI: 10.1007/s15010-014-0625-1] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 04/17/2014] [Indexed: 12/14/2022]
Abstract
PURPOSE We report on first evidence of simultaneous occurrence of West Nile virus (WNV) and Usutu virus (USUV) neuroinvasive infection in humans in Croatia during the transmission season 2013. METHODS From June to December 2013, a total of 95 patients with clinically suspected WNV infection (WNV fever and neuroinvasive disease) were tested for WNV IgM/IgG antibodies using enzyme-linked immunosorbent assay. Twenty-six reactive samples were further tested by virus neutralization test for confirmation. RESULTS WNV neuroinvasive infection was confirmed in 20 patients, while in three patients USUV neutralizing antibodies were detected. Cases occurred during the 11-week interval (from 24 July to 07 October 2013). Both WNV and USUV cases were distributed in three north-western Croatian counties. In addition to human cases, recent asymptomatic WNV infection (detection of IgM antibodies) was recorded in 9/3,460 (0.3 %) tested sentinel horses. Infected animals were recorded in two eastern and one north-western county. CONCLUSIONS Our results indicate co-circulation of WNV and USUV in Croatia. WNV infection could be misdiagnosed with other emerging infectious diseases presenting with neurological symptoms such as USUV infection.
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Affiliation(s)
- T Vilibic-Cavlek
- Department of Virology, Croatian National Institute of Public Health, School of Medicine University of Zagreb, Rockefellerova 12, 10000, Zagreb, Croatia,
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2
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Ljubin-Sternak S, Slavic-Vrzic V, Vilibić-Čavlek T, Aleraj B, Gjenero-Margan I. Outbreak of hand, foot and mouth disease caused by Coxsackie A16 virus in a childcare centre in Croatia, February to March 2011. Euro Surveill 2011. [DOI: 10.2807/ese.16.21.19875-en] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We describe an outbreak of hand, foot and mouth disease (HFMD) in a childcare centre in a district of Zagreb county, north-west Croatia. A total of eleven cases of HFMD occurred in the childcare centre and another nine were reported from nearby areas in the district. Coxsackie A16 virus was diagnosed in 13 clinical specimens obtained from 11 symptomatic and asymptomatic children. All cases resolved without complications.
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Affiliation(s)
- S Ljubin-Sternak
- Department of Virology, Croatian National Institute of Public Health, and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - V Slavic-Vrzic
- Department of Epidemiology, Zagreb County Institute of Public Health, Zagreb, Croatia
| | - T Vilibić-Čavlek
- Department of Virology, Croatian National Institute of Public Health, and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - B Aleraj
- Department of Infectious Disease Epidemiology, Croatian National Institute of Public Health, Zagreb, Croatia
| | - I Gjenero-Margan
- Department of Infectious Disease Epidemiology, Croatian National Institute of Public Health, Zagreb and School of Medicine, University of Rijeka, Croatia
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3
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Ljubin-Sternak S, Slavic-Vrzic V, Vilibić-Čavlek T, Aleraj B, Gjenero-Margan I. Outbreak of hand, foot and mouth disease caused by Coxsackie A16 virus in a childcare centre in Croatia, February to March 2011. Euro Surveill 2011; 16:19875. [PMID: 21632018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
We describe an outbreak of hand, foot and mouth disease (HFMD) in a childcare centre in a district of Zagreb county, north-west Croatia. A total of eleven cases of HFMD occurred in the childcare centre and another nine were reported from nearby areas in the district. Coxsackie A16 virus was diagnosed in 13 clinical specimens obtained from 11 symptomatic and asymptomatic children. All cases resolved without complications.
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Affiliation(s)
- S Ljubin-Sternak
- Department of Virology, Croatian National Institute of Public Health, School of Medicine, University of Zagreb, Croatia.
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4
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Gjenero-Margan I, Aleraj B, Krajcar D, Lesnikar V, Klobučar A, Pem-Novosel I, Kurečić-Filipović S, Komparak S, Martić R, Duričić S, Betica-Radić L, Okmadžić J, Vilibić-Čavlek T, Babić-Erceg A, Turković B, Avsić-Županc T, Radić I, Ljubić M, Sarac K, Benić N, Mlinarić-Galinović G. Autochthonous dengue fever in Croatia, August-September 2010. Euro Surveill 2011; 16:19805. [PMID: 21392489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
After information about a dengue case in Germany acquired in Croatia, health professionals and the public in Croatia were alerted to assess the situation and to enhance mosquito control, resulting in the diagnosis of a second case of autochthonous dengue fever in the same area and the detection of 15 persons with evidence of recent dengue infection. Mosquito control measures were introduced. The circumstances of dengue virus introduction to Croatia remain unresolved.
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5
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Gjenero-Margan I, Aleraj B, Krajcar D, Lesnikar V, Klobučar A, Pem-Novosel I, Kurečić-Filipović S, Komparak S, Martić R, Đuričić S, Betica-Radić L, Okmadžić J, Vilibić-Čavlek T, Babić-Erceg A, Turković B, Avšić-Županc T, Radić I, Ljubić M, Šarac K, Benić N, Mlinarić-Galinović G. Autochthonous dengue fever in Croatia, August–September 2010. Euro Surveill 2011. [DOI: 10.2807/ese.16.09.19805-en] [Citation(s) in RCA: 208] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
After information about a dengue case in Germany acquired in Croatia, health professionals and the public in Croatia were alerted to assess the situation and to enhance mosquito control, resulting in the diagnosis of a second case of autochthonous dengue fever in the same area and the detection of 15 persons with evidence of recent dengue infection. Mosquito control measures were introduced. The circumstances of dengue virus introduction to Croatia remain unresolved.
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Affiliation(s)
| | - B Aleraj
- Croatian National Institute of Public Health, Zagreb, Croatia
| | - D Krajcar
- Public Health Institute of the City of Zagreb 'Dr. A. Štampar', Zagreb, Croatia
| | - V Lesnikar
- Public Health Institute of the City of Zagreb 'Dr. A. Štampar', Zagreb, Croatia
| | - A Klobučar
- Public Health Institute of the City of Zagreb 'Dr. A. Štampar', Zagreb, Croatia
| | - I Pem-Novosel
- Croatian National Institute of Public Health, Zagreb, Croatia
| | | | - S Komparak
- Dubrovnik–Neretva County Public Health Institute, field unit Korčula/Pelješac, Korčula, Croatia
| | - R Martić
- Dubrovnik–Neretva County Public Health Institute, field unit Korčula/Pelješac, Korčula, Croatia
| | - S Đuričić
- Dubrovnik County Hospital, Infectology ward, Dubrovnik, Croatia
| | - L Betica-Radić
- Dubrovnik County Hospital, Infectology ward, Dubrovnik, Croatia
| | - J Okmadžić
- Primary Health Care Unit Orebić, Orebić, Croatia
| | | | - A Babić-Erceg
- Croatian National Institute of Public Health, Zagreb, Croatia
| | - B Turković
- Croatian National Institute of Public Health, Zagreb, Croatia
| | - T Avšić-Županc
- Institute for Microbiology and Immunology, Medical faculty, Ljubljana, Slovenia
| | - I Radić
- Croatian National Institute of Public Health, Zagreb, Croatia
| | - M Ljubić
- Public Health Institute of Dubrovnik Neretva County, Epidemiology service, Dubrovnik, Croatia
| | - K Šarac
- Croatian National Institute of Public Health, Zagreb, Croatia
| | - N Benić
- Public Health Institute of the City of Zagreb 'Dr. A. Štampar', Zagreb, Croatia
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6
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Kaic B, Gjenero-Margan I, Aleraj B, Vilibić-Čavlek T, Santak M, Cvitković A, Nemeth-Blazic T, Ivic Hofman I. Spotlight on measles 2010: Excretion of vaccine strain measles virus in urine and pharyngeal secretions of a child with vaccine associated febrile rash illness, Croatia, March 2010. Euro Surveill 2010. [DOI: 10.2807/ese.15.35.19652-en] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We describe excretion of measles vaccine strain Schwarz in a child who developed a febrile rash illness eight days after primary immunisation against measles, mumps and rubella. Throat swabs and urine specimens were collected on the fifth and sixth day of illness, respectively. Genotyping demonstrated measles vaccine strain Schwarz (genotype A). If measles and rubella were not under enhanced surveillance in Croatia, the case would have been either misreported as rubella or not recognised at all.
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Affiliation(s)
- B Kaic
- Croatian Institute of Public Health, Department of Infectious Disease Epidemiology, Zagreb, Croatia
| | - I Gjenero-Margan
- Croatian Institute of Public Health, Department of Infectious Disease Epidemiology, Zagreb, Croatia
| | - B Aleraj
- Croatian Institute of Public Health, Department of Infectious Disease Epidemiology, Zagreb, Croatia
| | - T Vilibić-Čavlek
- Croatian Institute of Public Health,Virology Department, Zagreb, Croatia
| | - M Santak
- Institute of Immunology, Molecular Biomedicine Unit, Zagreb, Croatia
| | - A Cvitković
- Brodsko-posavska County Institute of Public Health, Slavonski Brod, Croatia
| | - T Nemeth-Blazic
- Croatian Institute of Public Health, Department of Infectious Disease Epidemiology, Zagreb, Croatia
| | - I Ivic Hofman
- Brodsko-posavska County Institute of Public Health, Slavonski Brod, Croatia
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7
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Kaic B, Gjenero-Margan I, Aleraj B, Vilibic-Cavlek T, Santak M, Cvitković A, Nemeth-Blazic T, Ivic Hofman I. Spotlight on measles 2010: excretion of vaccine strain measles virus in urine and pharyngeal secretions of a child with vaccine associated febrile rash illness, Croatia, March 2010. Euro Surveill 2010; 15:19652. [PMID: 20822734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
We describe excretion of measles vaccine strain Schwarz in a child who developed a febrile rash illness eight days after primary immunisation against measles, mumps and rubella. Throat swabs and urine specimens were collected on the fifth and sixth day of illness, respectively. Genotyping demonstrated measles vaccine strain Schwarz (genotype A). If measles and rubella were not under enhanced surveillance in Croatia, the case would have been either misreported as rubella or not recognised at all.
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Affiliation(s)
- B Kaic
- Croatian Institute of Public Health, Department of Infectious Disease Epidemiology, Zagreb, Croatia.
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8
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Kaic B, Gjenero-Margan I, Kurecic-Filipovic S, Muscat M. A measles outbreak in Croatia, 2008. Euro Surveill 2009; 14:19083. [PMID: 19161711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
We report an outbreak of measles in Croatia, involving 49 cases with onset of symptoms between end of April and June 2008. Cases occurred in Zagreb and Slavonski Brod but investigations indicated a common epidemiological link between these two geographically separate regions.
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Affiliation(s)
- B Kaic
- Department of Infectious Disease Epidemiology, Croatian Institute of Public Health, Zagreb, Croatia.
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9
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Abstract
We report an outbreak of measles in Croatia, involving 49 cases with onset of symptoms between end of April and June 2008. Cases occurred in Zagreb and Slavonski Brod but investigations indicated a common epidemiological link between these two geographically separate regions.
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Affiliation(s)
- B Kaic
- Department of Infectious Disease Epidemiology, Croatian Institute of Public Health, Zagreb, Croatia
| | - I Gjenero-Margan
- Department of Infectious Disease Epidemiology, Croatian Institute of Public Health, Zagreb, Croatia
| | - S Kurečić-Filipović
- Department of Infectious Disease Epidemiology, Croatian Institute of Public Health, Zagreb, Croatia
| | - M Muscat
- EUVAC.NET hub, Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark
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10
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Kaic B, Gjenero-Margan I, Aleraj B, Ljubin-Sternak S, Vilibic-Cavlek T, Kilvain S, Pavic I, Stojanovic D, Ilic A. Transmission of the L-Zagreb mumps vaccine virus, Croatia, 2005-2008. Euro Surveill 2008; 13:18843. [PMID: 18768116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
We report on three cases of symptomatic transmission of the L-Zagreb mumps vaccine virus from three vaccinated children to five adult contacts. The five contact cases were parents of the vaccinated children and presented with parotitis and in one case also with aseptic meningitis. The etiology of the contacts' illness was determined by viral culture, genomic sequencing, serology and epidemiological linking. Two of the vaccinated children developed vaccine associated parotitis as an adverse event three weeks following immunization. Symptoms in contact cases developed five to seven weeks after the vaccination of the children. The five contact cases, as well as the three children with adverse events recovered completely. The children had been vaccinated with MMR vaccine produced by the Institute of Immunology Zagreb, each of them with a different lot. One of the possible explanations for these adverse events is that the very low levels of wild mumps virus circulation in the last decade, combined with waning immunity in those who received one dose of vaccine or suffered from mumps in childhood, resulted in susceptible young adults and that this unique epidemiological situation allows us to detect horizontal transmission of mumps vaccine virus.
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Affiliation(s)
- B Kaic
- Croatian Institute of Public Health, Department of Infectious Disease Epidemiology, Zagreb, Croatia.
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11
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Kaic B, Gjenero-Margan I, Aleraj B, Ljubin-Sternak S, Vilibić-Čavlek T, Kilvain S, Pavic I, Stojanovic D, Ilic A. Transmission of the L-Zagreb mumps vaccine virus, Croatia, 2005-2008. Euro Surveill 2008. [DOI: 10.2807/ese.13.16.18843-en] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report on three cases of symptomatic transmission of the L-Zagreb mumps vaccine virus from three vaccinated children to five adult contacts. The five contact cases were parents of the vaccinated children and presented with parotitis and in one case also with aseptic meningitis. The etiology of the contacts' illness was determined by viral culture, genomic sequencing, serology and epidemiological linking. Two of the vaccinated children developed vaccine associated parotitis as an adverse event three weeks following immunization. Symptoms in contact cases developed five to seven weeks after the vaccination of the children. The five contact cases, as well as the three children with adverse events recovered completely. The children had been vaccinated with MMR vaccine produced by the Institute of Immunology Zagreb, each of them with a different lot. One of the possible explanations for these adverse events is that the very low levels of wild mumps virus circulation in the last decade, combined with waning immunity in those who received one dose of vaccine or suffered from mumps in childhood, resulted in susceptible young adults and that this unique epidemiological situation allows us to detect horizontal transmission of mumps vaccine virus.
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Affiliation(s)
- B Kaic
- Croatian Institute of Public Health, Department of Infectious Disease Epidemiology, Zagreb, Croatia
| | - I Gjenero-Margan
- Croatian Institute of Public Health, Department of Infectious Disease Epidemiology, Zagreb, Croatia
| | - B Aleraj
- Croatian Institute of Public Health, Department of Infectious Disease Epidemiology, Zagreb, Croatia
| | - S Ljubin-Sternak
- Croatian Institute of Public Health, Virology Department, Croatian Institute of Public Health, Zagreb, Croatia
| | - T Vilibić-Čavlek
- Croatian Institute of Public Health, Virology Department, Croatian Institute of Public Health, Zagreb, Croatia
| | - S Kilvain
- Primary health care paediatrician, Rijeka, Croatia
| | - I Pavic
- Department of Infectious Diseases, University Hospital, Rijeka, Croatia
| | - D Stojanovic
- Department of Epidemiology, Primorje-Gorski Kotar County Institute of Public Health, Rijeka, Croatia
| | - A Ilic
- Department of Epidemiology, Vukovar-Srijem County Institute of Public Health, Vinkovci, Croatia
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12
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Kosor Krnic E, Gagro A, Drazenovic V, Kuzman I, Jeren T, Cecuk-Jelicic E, Kerhin-Brkljacic V, Gjenero-Margan I, Kaic B, Rakusic S, Sabioncello A, Markotic A, Rabatic S, Mlinaric-Galinovic G, Dekaris D. Enumeration of haemagglutinin-specific CD8+ T cells after influenza vaccination using MHC class I peptide tetramers. Scand J Immunol 2007; 67:86-94. [PMID: 18052968 DOI: 10.1111/j.1365-3083.2007.02042.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
With emergence of MHC class I tetramers loaded with CD8+ T-cell viral epitopes, it is possible to study virus-specific CD8 cells in humans during infection and after vaccination. MHC class I tetramers was used to detect the frequency of haemagglutinin (HA)-specific T cells in 26 healthy influenza-vaccinated humans. Peripheral blood was collected before, and 7, 14 and 28 days after vaccination. Four-colour flow cytometry was used for monitoring of vaccine induced T-cell response. In 15 donors, two- to fivefold increase in frequency of HA-specific T cells was observed 7 days after vaccination. In addition, in 12 of these donors, this increase was accompanied with fourfold increase of H1N1 antibody titre. The increase in frequency of HA-specific CD8+/IFN-gamma+ cells was low and peaked 28 days after vaccination in three of the six donors tested. Frequencies of HA-specific CD8+ T cells and antibody titre returned to prevaccination values 1 year after vaccination. Subunit influenza vaccines have the ability to induce HA-specific CD8+ cells. As the immune response to this vaccine decreased significantly after 1 year, our results confirm the importance of annual immunization for adequate protection.
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Affiliation(s)
- E Kosor Krnic
- Institute of Immunology, Department of Research and Development, Cellular Immunology Unit, Zagreb, Croatia
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13
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Kosor Krnic E, Gagro A, Kozaric-Kovacic D, Vilibic M, Grubisic-Ilic M, Folnegovic-Smalc V, Drazenovic V, Cecuk-Jelicic E, Gjenero-Margan I, Kuzman I, Jeren T, Sabioncello A, Kerhin-Brkljacic V, Kaic B, Markotic A, Gotovac K, Rabatic S, Mlinaric-Galinovic G, Dekaris D. Outcome of influenza vaccination in combat-related post-traumatic stress disorder (PTSD) patients. Clin Exp Immunol 2007; 149:303-10. [PMID: 17511777 PMCID: PMC1941948 DOI: 10.1111/j.1365-2249.2007.03410.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is an anxiety disorder that can occur after exposure to extreme traumatic experience such as war trauma, and is accompanied by fear, helplessness or horror. Exposure to trauma can result in immune dysregulation and influence susceptibility to infectious disease as well as vaccine efficacy. The aim of the study was to determine the relation of psychological stress and the immune response to influenza vaccination in combat-related PTSD patients (n = 28). Detection of anti-viral antibody titre was performed by inhibition of haemagglutination assay. Ex vivo tetramer staining of CD8(+) T lymphocytes was used to monitor T cells specific for human leucocyte antigen (HLA)-A*0201-restricted influenza A haemagglutinin antigens before and after vaccination. Twenty patients showed a fourfold antibody titre increase to one or both influenza A viral strains, and 18 of them showed the same response for both influenza B viral strains. Ten of 15 healthy controls showed a fourfold rise in antibody titre to both influenza A viral strains and eight of them showed the same response for both influenza B viral strains. HLA-A*0201(+) PTSD patients (n = 10) showed a significant increase of influenza-specific CD8 T cells after vaccination. Although those PTSD patients had a lower number of influenza-specific CD8(+) T cells before vaccination compared to HLA-A*0201(+) healthy controls (n = 6), there was no difference in influenza A antibody titre between PTSD patients and control subjects before vaccination. The generated humoral and cellular immune response in PTSD patients argues against the hypothesis that combat-related PTSD in war veterans might affect protection following influenza vaccination.
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Affiliation(s)
- E Kosor Krnic
- Institute of Immunology, Department of Research and Development, Cellular Immunology Unit, Dubrava University Hospital, Zagreb, Croatia.
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14
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Gasparović V, Ostojić R, Gjenero-Margan I, Kes P. Sudden deaths of Croatian hemodialysis patients in October 2001. Croat Med J 2001; 42:606-10. [PMID: 11740841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
In 2001, there were 2,719 patients with chronic renal failure dialyzed in Croatia. Death rate in this patient group was 10.3%, similar to that in other countries. On October 12, 2001, the Croatian Institute of Public Health received information that four patients unexpectedly died in the dialysis center in Pozega General Hospital in a single day. Within a week, a total of 23 dialysis patients died in Croatia, of whom 5 during hemodialysis, and 18 within several hours after hemodialysis. Those events prompted us to assess the epidemiological situation in all hemodialysis centers in Croatia. We used phone contacts and reports of regional centers to collect the data. Clinical picture of the patients before death was characterized by dyspnea, hypotension, and cardiac arrest; resuscitation was unsuccessful in all cases. Analysis of all possible risk elements associated with hemodialysis revealed that dialysis devices, dialyzate, water, and personnel were different in all cases, and that the only common denominator in all events was dialyzer P-15 or P-18, manufactured by Baxter, USA, and distributed by Pliva, Croatia.
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Affiliation(s)
- V Gasparović
- Department of Medicine, Zagreb University Hospital Center, Croatia.
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15
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Grgicević D, Balija M, Pirc-Tiljak D, Mihaljević I, Gjenero-Margan I, Zupancić-Salek S, Macek P. Decreasing risk of viral transfusion-transmitted diseases in Croatia. Croat Med J 2000; 41:191-6. [PMID: 10853051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
AIM To assess the risk of viral transfusion-transmitted infections in Croatia. METHODS The following parameters were analyzed: frequency of blood donations repeatedly reactive for HBsAg and anti-HCV (1993-1999); blood donations confirmed positive for HBsAg and anti-HCV (1997-1999), anti-HIV1/2, and syphilis reactivity (1993-1999); number of registered patients with hepatitis B and C; transfusion-associated hepatitis B and hepatitis C; and frequency of HBV, HCV and HIV markers in patients with congenital bleeding disorders (1993-1998). RESULTS The frequency of repeatedly reactive HBsAg and anti HCV markers and confirmed positive HBsAg, anti-HCV, and syphilis markers in donors blood decreased during the study, whereas the frequency of anti-HIV1/2 positivity did not change. The frequency of confirmed positive donors in 1999 was 0.068% for HBsAg, 0.035% for anti HCV, 0.002% for anti HIV1/2, and 0.0056% for syphilis. The number of patients with hepatitis B, hepatitis C, and transfusion-associated hepatitis B and C steadily decreased during the 1993-1998 period. The number of transfusion-associated hepatitis patients leveled off in 1997. From the beginning of the follow-up of AIDS patients in 1987, only 7 (2%) of hemophiliacs have been HIV-infected, all before 1990 and due to non-inactivated coagulation factor concentrates. There were no cases of transfusion-associated HIV2 infection in patients with congenital bleeding disorders or transfusion-associated HIV1 infection through transfusion of labile blood components. CONCLUSION The safety of transfusion therapy in Croatia has improved, and the present risks of viral transfusion transmitted diseases are very low.
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Affiliation(s)
- D Grgicević
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia.
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16
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Rojnić N, Putarek K, Vuk T, Gjenero-Margan I, Grgicević D, Malcić I. AIDS in Croatia compared with global HIV status. Acta Paediatr 1997; 86:1025. [PMID: 9343295 DOI: 10.1111/j.1651-2227.1997.tb15199.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Abstract
Some epidemiological and clinical characteristics of Pityriasis rosea Gibert has led us to hypothesize that this disease may be the clinical manifestation of an infection caused by legionellas. We have thus tested the sera of 36 patients ill with Pityriasis rosea and 19 controls for Legionella pneumophila serogroup 1-6 and Legionella micdadei antibodies. These, who had the same age and sex distribution as study patients, were receiving treatment for other diseases in the same ward. Also tested were 200 sera from the voluntary blood donors from the same region as study patients. Legionella micdadei antibodies were detected in 12 (33.3%) Pityriasis rosea cases and in one (5.2%) control. They were significantly more common in Pityriasis rosea cases than in either controls or voluntary blood donor population. The findings to date encourage continued research into the causative relationship between the Legionella micddadei infection and the onset of Pityriasis rosea Gibert.
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Affiliation(s)
- I Gjenero-Margan
- Epidemiology Service, Croatian National Institute of Public Health, Zagreb, Croatia
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Klismanić-Nuber Z, Milas I, Smoljanović M, Sarić M, Gjenero-Margan I. [An epidemic of legionellosis at a hotel at the Makarska seashore]. Lijec Vjesn 1990; 112:152-5. [PMID: 2233111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The paper describes the epidemic of Legionellosis that occurred among guests and employees of a hotel at the Makarska littoral in May 1988. According to the so far reported data in the medical literature that was the third epidemic in our country and all three of them occurred in the Dalmatian touristic area. In this epidemic, nine foreign tourists were registered ill with the clinical picture of Legionnaires' disease. Five patients required hospitalization. The disease could be serologically proved in 4 patients and Legionella pneumophila SG1 was isolated from samples of 2 patients and from sediment of the hot-water tank. Since the opening of the hotel until the end of May, 19 hotel employees developed a febrile illness of short duration. The disease was serologically proved in 7 of them. The morbidity rate in tourists was 2.5%, while it amounted to 7.1% in the hotel employees. The epidemic lasted for 16 days. The infection spread through the hot water, and antiepidemic measures were limited to its pasteurization and hyperchloridation. The chain of infection was broken off by the application of those measures.
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Gjenero-Margan I, Drazenović V, Vrbica J, Vjerda R, Aleraj B, Borcić B. [An epidemic of legionnaires' disease in a hotel]. Lijec Vjesn 1989; 111:81-4. [PMID: 2747409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
An outbreak of legionnaires' disease and epidemic control measures taken at one of our hotels are described. Twenty (1% morbidity) hotel guests were affected with one dying. As a result of field investigations and survey the hot water supply system has been identified as the source of infection. Control measures which created conditions unfavourable to Legionella growth and replication in the hot water system stopped the outbreak.
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