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.
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.
Summary
The aim of the study was to investigate the epidemiology of dermatophyte infections in Split and Dalmatia County, Croatia, between 1996 and 2002. Of 5792 samples 1318 (23.8%) were positive. ...Tinea corporis and tinea cruris were the most common types of dermatophytoses. Microsporum canis (36.5%), Trichophyton mentagrophytes (24.8%), and T. rubrum (21.5%) were the main etiologic factors.
Zusammenfassung
Ziel der Studie war, die Epidemiologie von Dermatophytosen in Split und Dalmatien, Kroatien, in der Zeit von 1996 bis 2002 zu erfassen. Von 5792 Untersuchungsproben waren 1318 (23.8%) positiv. Tinea corporis und Tinea cruris waren die vorherrschenden Dermatophytosen. Microsporum canis (36.5%), Trichophyton mentagrophytes (24.8%) und T. rubrum (21.5%) waren die häufigsten Errerger.
This paper analyzes the Croatian Adult Health Survey data, collected in 2003 with a total of 9,070 respondents aged 18+. Based on an average of two measurements, respondents with the mean systolic ...arterial pressure > or = 140 mmHg or mean diastolic pressure > or = 90 mmHg were classified as hypertensive. The data for men and women were analyzed separately, according to regions. Prevalence of hypertension in men was 40.5% (95% confidence interval CI 37.9-43.01; coefficient of variability CV = 3.2), women 34.9% (95% CI 33.2-36.7; CV 2.5). There were no significant differences in regional prevalence in men, except in the Northern and Eastern region. In women we did not detect any significant regional difference. Non-controlled arterial hypertension is an important public health problem in all monitored regions of Croatia. Raising awareness about the problem, early detection and encouraging the population to adhere to the therapy for elevated arterial pressure, in addition to a healthy life style, are important for successful control and harm reduction.
In recent years, several European countries reported cases of imported chikungunya infection. We present the first imported clinically manifested chikungunya fever in Croatia. A 27-year-old woman ...returned to Croatia on 21 March 2016, after she stayed in Costa Rica for two months where she had noticed a mosquito bite on her left forearm. Five days after the mosquito bite she developed severe arthralgias, fever and erythematous papular rash. In next few days symptoms gradually subsided. After ten days she felt better, but arthralgias re-appeared accompanied with morning stiffness. Two weeks after the onset of the disease she visited the infectious diseases outpatient department. The physical examination revealed rash on the trunk, extremities, palms and soles. Laboratory findings showed slightly elevated liver transaminases. Serological tests performed on day 20 after disease onset showed a high titer of chikungunya virus (CHIKV) IgM and IgG antibodies which indicated CHIKV infection. CHIKV-RNA was not detected. Serology to dengue and Zika virus was negative. The patient was treated with nonsteroid anti-inflammatory drugs and paracetamol. Her symptoms ameliorated, however, three months later she still complaint of arthralgias. The presented case highlights the need for inclusion of CHIKV in the differential diagnosis of arthralgia in all travelers returning from countries with documented CHIKV transmission.
The aim of the study was to establish whether the physicians' strike, which took place in Croatia in 2003, had an impact on the mortality of the population. Mortality data from the National Bureau of ...Statistics relating to the strike period (15 January - 14 February 2003) were selected and compared with the previous and subsequent periods of the same duration in 2001, 2002 and 2004. Of the 52,575 deaths in 2003, Croatia recorded 4,682 (8.9%, 95% Confidence interval 8.4-9.4) in the strike period from the 15th of January to the 14th of February 2003 or 1.1 deaths per 1000. No deviations of the 15th of January to the 14th of February period's share of the death total in relation to other observation periods were noted. It is impossible to associate the strike based on the figures shown in this paper with either an increase or decrease in population mortality.
The aim of this study was to determine the distribution of uropathogens isolated from outpatients living in South Croatia and the in vitro susceptibility of these organisms to antimicrobial agents. ...Of 5080 enrolled uropathogen isolates, 82.28% isolates were Gram-negative, the most frequent isolates being
Escherichia coli (62.62%), enterococci (10.18%),
Proteus mirabilis (5.31%),
Streptococcus agalactiae (3.84%),
Staphylococcus spp. (3.70%),
Pseudomonas spp. (3.46%),
Klebsiella spp. (2.38%). The
E. coli resistance rate was 42.17% to amoxycillin, 20.59% to trimethoprim–sulphamethoxazole and 6.09% to norfloxacin. Almost all
Klebsiella spp. isolates were resistant to amoxycillin and the resistance rate to trimethoprim–sulphamethoxazole was over 20%, and 14.15% to the fluoroquinolones. A high methicillin-resistance rate was found among
S. aureus (61.22%) and coagulase negative staphylococci (41.48).
In January 2002, an outbreak of Yersinia enterocolitica O:3 infections occured on 'Asirat', an oil tanker, during its return test voyage from Split, Croatia to Trieste, Italy. Of the 120 crewmembers ...and workers 22 (18%) suffered from gastrointestinal symptoms. In 17 patients Y. enterocolitica O:3 was isolated from stool samples. All available food and water samples were negative and the source of infection was not determined. Probably a foodborne transmission was involved, although person to person transmission could not be excluded.
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