Hepatitis E (HE) is an emerging public health problem in developed countries worldwide. Nowadays, it is known that the hepatitis E virus (HEV) has zoonotic potential, whereas domestic pigs and wild ...boars are recognized as the true reservoirs of the disease. Therefore, the aim of our study was to define the seroprevalence and viral persistence of HEV in pigs and wild boars in Croatia. In total, 1424 samples originating from domestic pigs from 14 counties, and 1000 samples of wild boar origin, collected from 16 counties, were tested during 2016 for the presence of HEV antibodies using a commercially available enzyme linked immunosorbent assay (ELISA). All positive samples, as well as samples originating from in-contact domestic pigs and wild boars, were further tested for the presence of HEV RNA using a real time RT-PCR protocol, followed by a nested RT-PCR protocol as a confirmatory test. In 11 of 14 counties, 469 seropositive domestic pigs were found with an overall seroprevalence of 32.94% (95% CI 30.55-35.42), ranging from 8.33% to 60.00%, depending on their geographical origin. Seropositive wild boars were found in six out of 16 counties, showing an overall seroprevalence of 31.10% (95%CI 28.31-34.04%), ranging from 7.70% to 50.60%. The highest seroprevalence was found in the Vukovar-Srijem and Osijek-Baranja Counties (North-East Croatia) where pig breeding dominates and the highest density of wild boars is recorded. While no positive HEV RNA samples were detected in tested domestic pigs, seventeen serologically positive wild boars (11.33%; 95%CI 7.19-17.14) younger than one year of age were found to be HEV RNA positive, indicating chronic infection and possible prolonged virus spread into the environment. The detected viral presence despite the immune response indicates that wild boars have a key role in HEV epidemiology. Key words: hepatitis E, domestic pig, wild boar, seroprevalence, viraemia
During July 2009 an outbreak in neonates represented with gastrointestinal and respiratory symptoms was observed at the Neonatal Postintensive Care Unit, Clinical Hospital Center, Zagreb. Human ...parechovirus type 1 (HPeV1) was isolated from seven patients, one of whom was asymptomatic. All but one were premature neonates with serious underlying conditions, and all recovered fully after several days. In order to characterize the HPeV1s, sequencing of the VP1/2A region was conducted on six isolates from the outbreak and four isolates detected in Croatia in 2008 and 2007. The analysis of sequence similarity showed that the nucleotide identity between the prototype strain (Harris) and HPeV1 isolated in Croatia was 76.5-77.5%. Croatian strains from 2007 and 2009 clustered together with strains from the Netherlands and Germany detected in 2003 and 2006, respectively, while strains from 2008 clustered with the strain from Finland detected in 2000. Change of the dominant strains each year may suggest antigenic variation as a result of viral response to specific immunity of the target population. J. Med. Virol. 83:137-141, 2011.
West Nile Virus Neuroinvasive Disease (WNV NID) requires prolonged intensive care treatment, resulting in high mortality and early disability. Long-term results are lacking. We have conducted an ...observational retrospective study with a prospective follow-up of WNV NID patients treated at the Intensive Care Unit (ICU), University Hospital for Infectious Diseases, Zagreb, Croatia, 2013-2018. Short-term outcomes were vital status, length of stay (LOS), modified Rankin Scale (mRS), and disposition at discharge. Long-term outcomes were vital status and mRS at follow-up. Twenty-three patients were identified, 78.3% males, median age 72 (range 33-84) years. Two patients (8.7%) died in the ICU, with no lethal outcomes after ICU discharge. The median ICU LOS was 19 days (range 5-73), and the median hospital LOS was 34 days (range 7-97). At discharge, 15 (65.2%) patients had moderate to severe/mRS 3-5, 6 (26.0%) had slight disability/mRS 2-1, no patients were symptom-free/mRS 0. Ten (47.6%) survivors were discharged to rehabilitation facilities. The median time to follow-up was nine months (range 6-69). At follow-up, seven patients died (30.5%), five (21.7%) had moderate to severe/mRS 3-5, one (4.3%) had slight disability/mRS 2-1, six (26.1%) had no symptoms/mRS 0, and four (17.4%) were lost to follow-up. Briefly, ten (43.5%) survivors improved their functional status, one (4.3%) was unaltered, and one (4.3%) aggravated. In patients with severe WNV NID, intensive treatment in the acute phase followed by inpatient rehabilitation resulted in significant recovery of functional status after several months.
Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The usual presentation of the disease is a common ...cold-like illness but it can present with more severe and sometimes fatal manifestations. Immunocompromised patients such as those with common variable immunodeficiency (CVID) also are among the infected population. A limited number of reports have been published concerning CVID patients with COVID-19. The main reported symptoms were fever, cough, dyspnea and fatigue while the median duration of illness was 19 (interquartile range 14-26.5) days. Total recovery rate was 88.4%. It is still unknown whether primary immunodeficiency interacts as a predisposing or protective factor against the severe forms of COVID-19. Substitute immunoglobulin (IG) therapy is the only treatment option for CVID. Some reports suggest that early administration of intravenous IGs or convalescent plasma infusion may positively influence the outcome of COVID-19 in these patients.
Koronavirusna bolest (COVID-19) novonastala je zarazna bolest koju uzrokuje SARS-CoV-2 (severe acute respiratory
syndrome coronavirus 2). Uglavnom se očituje blagim simptomima nalik na običnu ...prehladu, ali može izazvati i teške, a katkada
i smrtonosne komplikacije. Imunokompromitirani bolesnici poput onih s dijagnozom obične varijabilne imunodeficijencije
(common variable immunodeficiency, CVID) također su dio zaražene populacije. Malo je objavljenih izvještaja o COVID-19 u
bolesnika s CVID-om. Najčešće zabilježeni simptomi bili su vrućica, kašalj, dispneja i umor, dok je medijan trajanja bolesti
iznosio 19 (interkvartilni raspon 14-26,5) dana. Ukupna stopa ozdravljenja iznosila je 88,4%. Još je uvijek nepoznanica djeluje
li primarna imunodeficijencija kao predisponirajući ili zaštitni čimbenik protiv teških oblika COVID-19. Nadomjesna
terapija imunoglobulinima (IG) jedina je opcija liječenja za bolesnike s CVID-om. Najnovija istraživanja ukazuju na to da bi
u takvih bolesnika rana primjena intravenskih oblika IG ili konvalescentne plazme mogla povoljno utjecati na ishod bolesti
COVID-19.
Hepatitis E virus (HEV) infection is an emerging public health problem worldwide, mainly presenting as acute self-limiting hepatitis, but extra-hepatic manifestations, as well as chronic hepatitis in ...immunocompromised populations, have been more commonly recognized. The seroprevalence ranges from 0.6% to 52.5% in Europe, depending on the geographical region and population group tested. This narrative review focuses on HEV epidemiology in Croatia. The seroprevalence studies show that HEV is widespread in Croatia, with significant differences among population groups; healthcare professionals (2.7%), pregnant women (2.9%), general population (3.4%), injecting drug users (6.1%), animal-related professions (4.0-8.1%), alcohol abusers (8.9%), war-related PTSD patients (8.6%), patients with chronic liver diseases (15.1%), blood donors (21.5%), patients after liver transplantation (24.4%) and patients on hemodialysis (5.2-43.4%). The data show that HEV IgG positivity increases with age and is higher in continental than coastal parts of Croatia and in suburban and rural areas. Phylogenetic analysis show that all detected HEV strains in Croatia were identified as genotype 3. Since the emerging trends of HEV spreading are likely to continue, continuous surveillance is important, especially in immunocompromised persons at risk of chronic hepatitis E. Key words: hepatitis E virus, Croatia, transplant, hemodialysis, epidemiology
To assess the humoral immunity to COVID-19 in nursing home residents six months after vaccination.
This seroepidemiological research enrolled 118 residents of one nursing home in Zagreb. All ...participants received two doses of BioNTech/Pfizer COVID-19 and had no previously detected SARS-CoV-2 infection. The samples were tested for the presence of neutralizing antibodies using a virus neutralization test. A SARS-CoV-2 strain isolated in Vero E6 cells from a Croatian COVID-19 patient was used as a stock virus. Neutralizing antibody titer was defined as the reciprocal of the highest serum dilution that showed at least 50% neutralization. Neutralizing antibody titer ≥8 was considered positive.
Sixty-four (54%) participants had a positive neutralizing antibody titer, 27 (23%) had a low positive titer (titer 8), and 27 (23%) had a negative titer. Women had a significantly higher median titer than men (16 interquartile range, IQR 24 vs 8 IQR 12, Mann-Whitney U=1033, P=0.003). Age was negatively but not significantly correlated with neutralizing antibody titer (Spearman's rho -0.132, P=0.155).
Almost half of the participants (46%) had a negative or low positive titer six months after having been fully vaccinated. This study suggests that humoral immunity among nursing home residents considerably wanes six months after BioNTech/Pfizer COVID-19 vaccination. Our results could contribute to the discussion about the need for a booster dose.
Due to rapid spread, the Omicron variant has become the dominant SARS-CoV-2 variant responsible for infections worldwide. We present the first detection of the Omicron variant in Croatia which ...resulted in rapid cross-border spreading.
Whole-genome sequencing was performed using the Illumina MiniSeq sequencing system. SARS-CoV-2 lineages were identified using the PANGOLIN and GISAID databases.
The first case of the Omicron variant (BA.1.17) emerged in Croatia after a workshop held in Zagreb in November 2021. The patient reported a history of previous COVID-19 and received two doses of an mRNA vaccine. Three additional cases were detected among Croatian participants of the workshop. At the beginning of December, SARS-CoV-2 infection was confirmed in one participant from Montenegro and her husband. Phylogenetic analysis showed that the detected Omicron variants were closely related to the first Croatian case, confirming the connection with the workshop outbreak and rapid cross-border spreading. Subsequent analyses of SARS-CoV-2 positive samples in Croatia showed the rapid introduction of the Omicron variant and depletion of the Delta variant resulting in the fifth pandemic wave.
Genomic monitoring and early detection of novel SARS-CoV-2 variants are essential to implement timely epidemiological interventions and reduce further transmission in the population.
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