Dijagnostika HCV infekcije

Hepatitis C virus (HCV) infekcija, jedna od najčešćih kroničnih zaraznih infekcija zahvaća 3% svjetske populacije, oko 170 milijuna ljudi. Prevalencija HCV je primarno ovisna o socioekonomskom statusu. U Egiptu, nekim predjelima Japana, Italije i Tajvana je ona visoka i iznosi 10-30%. Kod nas je prevalancija niska (1-2,4%), a incidencija iznosi u općoj populaciji 0,005% (kod davatelja krvi 0,02%). Putevi prijenosa infekcije jesu: parenteralni (transfuzija krvi i krvnih derivata, i.v. ovisnost, tetovaža), perinatalni, seksualni, nozokomijalni (odjeli hemodijalize, transplantacija organa, operativni i invazivni dijagnostički zahvati, ubod zaraženom iglom...). Ipak, za oko 40% slučajeva se ne zna točno put nastanka infekcije

Epidemiology of hepatitis C in Croatia in the European context

We analyzed prevalence, risk factors and hepatitis C virus (HCV) genotype distribution in different population groups in Croatia in the context of HCV epidemiology in Europe, with the aim to gather all existing information on HCV infection in Croatia which will be used to advise upon preventive measures. It is estimated that 35000-45000 of the Croatian population is chronically infected with HCV. Like in other European countries, there have been changes in the HCV epidemiology in Croatia over the past few decades. In some risk groups (polytransfused and hemodialysis patients), a significant decrease in the HCV prevalence was observed after the introduction of routine HCV screening of blood/blood products in 1992. Injecting drug users (IDUs) still represent a group with the highest risk for HCV infection with prevalence ranging from 29% to 65%. Compared to the prevalence in the Croatian general population (0.9%), higher prevalence rates were found in prison populations (8.3%-44%), human immunodeficiency virus-infected patients (15%), persons with high-risk sexual behavior (4.6%) and alcohol abusers (2.4%). Low/very low prevalence was reported in children and adolescents (0.3%) as well as in blood donors (0%-0.009%). In addition, distribution of HCV genotypes has changed due to different routes of transmission. In the general population, genotypes 1 and 3 are most widely distributed (60.4%-79.8% and 12.9%-47.9%, respectively). The similar genotype distribution is found in groups with high-risk sexual behavior. Genotype 3 is predominant in Croatian IDUs (60.5%-83.9%) while in the prison population genotypes 3 and 1 are equally distributed (52.4% and 47.6%). Data on HCV prevalence and risk factors for transmission are useful for implementation of preventive measures and HCV screening

Screening for HbsAg, HCV and HIV among pregnant women, Istria County, 2011.-2012.

Tijekom dvogodišnjega razdoblja (2011. – 2012. godine), testirano je ukupno 1596 uzoraka seruma trudnica na prisutnost HBsAg, anti-HCV i anti-HIV protutijela. HBsAg je dokazan u 11/1596 (0,7%; 95%CI = 0,34 - 1,23) testiranih žena. S obzirom na dob, prevalencija HBsAg bila je najviša (1,9%) u skupini mlađih od 26 godina.U dobi od 26-30 i 31-35 godina bilo je pozitivno 0,5%, odnosno 0,4% ispitanica. Razlike između dobnih skupina nisu bile statistički značajne (p = 0,096). Uspoređujući dobne skupine, nađena je značajno niža prevalencija HBsAg u skupini od 31 - 35 godina u usporedbi s najmlađom dobnom skupinom (< 26 godina) (OR = 0,19; 95%CI = 0,04 - 0,97). Anti-HCV protutijela nađena su u 12/960 testiranih žena (1,3%; 95%CI = 0,64 - 2,17). Opažen je značajan porast HCV seropozitiviteta s dobi od 0,3% do 3,1%, počevši s dobnom skupinom od 26-30 godina (p = 0,03). Ovisno o mjestu prebivališta (urbano ili ruralno područje), nije bilo značajne razlike u prevalenciji HBsAg (0.8% u urbanoj te 0% u ruralnoj sredini; p = 0,616) niti anti-HCV (1,8% u urbanoj, te 1,2% u ruralnoj sredini; p = 0,641). Niti jedna ispitanica nije bila HIV pozitivna. Rezultati ovoga istraživanja ukazuju na nisku prevalenciju HBV, HCV i HIV infekcije u Hrvatskoj.During a two year period (2011 - 2012), a total of 1,596 consecutive serum samples from pregnant women were tested for the presence of HBsAg, anti-HCV and anti-HIV antibodies. HBsAg was detected in 11/1596 (0.7%; 95% CI = 0.34 - 1.23) tested women. All of them were HBeAg negative/anti-HBe positive. According to age, HBsAg prevalence was highest in the age group of less than 26 years (1.9%). In the age groups 26-30 and 31-35 years, prevalence rates of 0.5% and 0.4% were found. Differences among age groups were not significant (p = 0.096). Comparing age groups, a significantly lower prevalence of HBsAg was found in 31 - 35 age group compared to the youngest age group (< 26 years) (OR = 0.19, 95% CI = 0.04-0.97). Anti-HCV antibodies were detected in 12/960 tested women (1.3%, 95% CI = 0.64-2.17). HCV seropositivity increased significantly with age from 0.3% to 3.1% beginning with the 26-30 age group (p = 0.03). Place of residence was not associated with HBsAg (0.8% in urban areas vs. 0% in rural areas, p = 0.616) or anti-HCV positivity (1.8% in urban vs. 1.2% in rural areas, p = 0.641). None of the 1,002 participants were HIV positive. The results of this study suggest that Croatia is a low-prevalence country for HBV, HCV and HIV infection

Foodborne viruses

Patogeni koji se mogu prenositi hranom uključuju crijevne bakterije, viruse, parazite, bakterije koje proizvode toksine i prione. Od navedenih patogena najčešći uzročnici bolesti koje se prenose hranom jesu virusi. U ovom su radu pregledno prikazani virusi koji se prenose hranom s posebnim naglaskom na načine širenja i mogućnosti profilakse kao najvažnijim područjima u kojima sudjeluje veterinarska struka. U navedenom području, kao i u javnom zdravstvu u cjelini, samo bliska suradnja veterinarske i liječničke struke može rezultirati uspostavom cjelovitog sustava nadzora i suzbijanja zaraznih bolesti s ciljem očuvanja zdravlja ljudi. Prvi korak pritom jest dostupnost najnovijih spoznaja i informacija o rizicima i mjerama zaštite širem krugu stručnjaka u svrhu sprečavanja nastanka epidemija uzrokovanih virusima koji se prenose hranom, što je i bio cilj ovog preglednog prikaza.Foodborne pathogens include bacteria, viruses, parasites, toxin producing bacteria and prions. Of these, by far the most common causes of foodborne illness are viruses. In this article a review is given of the most important food borne viruses with the emphasis on the modes of transmission and prophylaxis as the most important areas where veterinary practitioners are included. In these areas and in protecting public health in general only close collaboration between human and veterinary medical specialists will result in establishing an optimal system for surveillance and prevention of foodborne infections in humans. The aim of this article is to present new information regarding risk factors and protection measures to a wide number of professionals, as a step in the prevention of epidemics caused by foodborne viruses

How much and what do we know about the West Nile virus infection?

Iako virus Zapadnog Nila (engl. West Nile virus, WNV) poznajemo gotovo 80 godina, intenzivnija istraživanja o njemu se provode unatrag petnaestak godina, nakon što je u SAD-u uzrokovao veliku epidemiju infekcija središnjeg živčanog sustava. WNV je virus koji spada u porodicu Flaviviridae, rod Flavivirus. Radi se o jednom serotipu, ali se virus genotipski može podijeliti u najmanje osam linija od kojih su linije 1, 2 i 5 medicinski najbitnije. Afrika je postojbina WNV-a odakle se proširio cijelim svijetom. Prirodni rezervoari virusa su ptice, a vektori su mu komarci. Najčešćii način prijenosa virusa na čovjeka je ubod komarca, ali se virus može prenijeti i transfuzijama krvi te transplantacijom solidnih organa. Nakon inkubacije od 3 – 14 dana može se razviti bolest koja najčešće prolazi asimptomatski ili kao blaža febrilna bolest. U manjeg broja inficiranih se razvije neuroinvazivna bolest. Simptomatska terapija je osnov liječenja, a dugotrajni oporavak uz ponekad trajne sekvele su nerijetko prisutni nakon preboljele bolesti.Although we have been familiar with the West Nile virus (WNV) for the last 80 years more intense research has been conducted in the past fifteen years, just after the huge central nervous system infection outbreak. WNV is a member of the Flaviviridae family, genus Flavvirus. Though WNV consists of a single serotype, genetically it can be divided in at least eight lineages where lineages 1, 2 and 5 are medically the most important ones. The virus originated from Africa and spread worldwide. Birds are natural reservoirs of the virus and mosquitoes are their vectors. The most usual transmission to humans is the mosquito bite but the virus can also be transmitted via blood transfusion or solid organ transplantation. After 3 –14 days of the incubation period, usually an asymptomatic or mild febrile disease occurs while a neuroinvasive disease develops in a rather small number of patients. Symptomatic therapy is the basis for treatment, however prolonged recovery and neurological sequalae are sometimes seen as well

"One health" – detection and surveillance of emerging and re-emerging arboviruses in Croatia

Posljednjih desetljeća jasno je uočljiv globalni trend porasta učestalosti emergentnih i re-emergentnih zaraznih bolesti koje ugrožavaju čovječanstvo. Najzastupljenije među njima su zoonoze i to ponajprije vektorima prenosive zoonoze. Ovi trendovi pojave novih i širenja postojećih emergentnih i re-emergentnih zoonoza zasigurno će se nastaviti pod utjecajem čimbenika emergencije koji su posljedica današnjeg modernog načina života. Složenost procesa emergencije zaraznih bolesti, koja je posljedica promjena u međuodnosu ljudi, životinja i okoliša, naglasila je potrebu za uvođenjem cjelovitog pristupa očuvanju javnog zdravlja pod nazivom "Jedno zdravlje". U posljednjih nekoliko godina dokazane su po prvi put na području Republike Hrvatske infekcije ljudi dengue virusom, virusom Zapadnog Nila i Usutu virusom, što nedvojbeno potvrđuje promjenu epidemiološke situacije u našoj zemlji. Način otkrivanja i uspostave sustava nadzora navedenih bolesti ističe značaj i učinkovitost zajedničkog multidisciplinarnog rada. Nastavak uvođenja pristupa "Jedno zdravlje" u svakodnevni rad, obveza je svih srodnih struka i jedino jamstvo uspješnog osiguravanja javnog zdravlja u današnjem modernom svijetu.Emerging and re-emerging infectious diseases have increased in incidence over the last several decades and represent a significant threat to global health. The vast majority of emerging pathogens are zoonotic, especially arthropod-borne ones. Increase in the number of outbreaks and geographical range of emerging and re-emerging zoonoses will continue because their emergence is driven by factors resulting from changes in modern lifestyle. These complex and rapidly changing interactions of humans, animals and environment highlighted the need for integrated approach to public health protection under the "One Health" initiative. Recently confirmed autochthonous human cases of dengue virus, West Nile virus and Usutu virus infections have drawn attention to change of epidemiological situation in our country. Detection and the introduction of surveillance program for these diseases point out the importance and efficiency of multidisciplinary collaboration. Enforcing the introduction of "One Health" approach in the everyday work is the obligation of all involved professions and the warranty of successful prevention and public health protection in modern world

"One health" – detection and surveillance of emerging and re-emerging arboviruses in Croatia

Posljednjih desetljeća jasno je uočljiv globalni trend porasta učestalosti emergentnih i re-emergentnih zaraznih bolesti koje ugrožavaju čovječanstvo. Najzastupljenije među njima su zoonoze i to ponajprije vektorima prenosive zoonoze. Ovi trendovi pojave novih i širenja postojećih emergentnih i re-emergentnih zoonoza zasigurno će se nastaviti pod utjecajem čimbenika emergencije koji su posljedica današnjeg modernog načina života. Složenost procesa emergencije zaraznih bolesti, koja je posljedica promjena u međuodnosu ljudi, životinja i okoliša, naglasila je potrebu za uvođenjem cjelovitog pristupa očuvanju javnog zdravlja pod nazivom "Jedno zdravlje". U posljednjih nekoliko godina dokazane su po prvi put na području Republike Hrvatske infekcije ljudi dengue virusom, virusom Zapadnog Nila i Usutu virusom, što nedvojbeno potvrđuje promjenu epidemiološke situacije u našoj zemlji. Način otkrivanja i uspostave sustava nadzora navedenih bolesti ističe značaj i učinkovitost zajedničkog multidisciplinarnog rada. Nastavak uvođenja pristupa "Jedno zdravlje" u svakodnevni rad, obveza je svih srodnih struka i jedino jamstvo uspješnog osiguravanja javnog zdravlja u današnjem modernom svijetu.Emerging and re-emerging infectious diseases have increased in incidence over the last several decades and represent a significant threat to global health. The vast majority of emerging pathogens are zoonotic, especially arthropod-borne ones. Increase in the number of outbreaks and geographical range of emerging and re-emerging zoonoses will continue because their emergence is driven by factors resulting from changes in modern lifestyle. These complex and rapidly changing interactions of humans, animals and environment highlighted the need for integrated approach to public health protection under the "One Health" initiative. Recently confirmed autochthonous human cases of dengue virus, West Nile virus and Usutu virus infections have drawn attention to change of epidemiological situation in our country. Detection and the introduction of surveillance program for these diseases point out the importance and efficiency of multidisciplinary collaboration. Enforcing the introduction of "One Health" approach in the everyday work is the obligation of all involved professions and the warranty of successful prevention and public health protection in modern world

"One health" – detection and surveillance of emerging and re-emerging arboviruses in Croatia

Posljednjih desetljeća jasno je uočljiv globalni trend porasta učestalosti emergentnih i re-emergentnih zaraznih bolesti koje ugrožavaju čovječanstvo. Najzastupljenije među njima su zoonoze i to ponajprije vektorima prenosive zoonoze. Ovi trendovi pojave novih i širenja postojećih emergentnih i re-emergentnih zoonoza zasigurno će se nastaviti pod utjecajem čimbenika emergencije koji su posljedica današnjeg modernog načina života. Složenost procesa emergencije zaraznih bolesti, koja je posljedica promjena u međuodnosu ljudi, životinja i okoliša, naglasila je potrebu za uvođenjem cjelovitog pristupa očuvanju javnog zdravlja pod nazivom "Jedno zdravlje". U posljednjih nekoliko godina dokazane su po prvi put na području Republike Hrvatske infekcije ljudi dengue virusom, virusom Zapadnog Nila i Usutu virusom, što nedvojbeno potvrđuje promjenu epidemiološke situacije u našoj zemlji. Način otkrivanja i uspostave sustava nadzora navedenih bolesti ističe značaj i učinkovitost zajedničkog multidisciplinarnog rada. Nastavak uvođenja pristupa "Jedno zdravlje" u svakodnevni rad, obveza je svih srodnih struka i jedino jamstvo uspješnog osiguravanja javnog zdravlja u današnjem modernom svijetu.Emerging and re-emerging infectious diseases have increased in incidence over the last several decades and represent a significant threat to global health. The vast majority of emerging pathogens are zoonotic, especially arthropod-borne ones. Increase in the number of outbreaks and geographical range of emerging and re-emerging zoonoses will continue because their emergence is driven by factors resulting from changes in modern lifestyle. These complex and rapidly changing interactions of humans, animals and environment highlighted the need for integrated approach to public health protection under the "One Health" initiative. Recently confirmed autochthonous human cases of dengue virus, West Nile virus and Usutu virus infections have drawn attention to change of epidemiological situation in our country. Detection and the introduction of surveillance program for these diseases point out the importance and efficiency of multidisciplinary collaboration. Enforcing the introduction of "One Health" approach in the everyday work is the obligation of all involved professions and the warranty of successful prevention and public health protection in modern world

Dijagnostika HCV infekcije

Hepatitis C virus (HCV) infekcija, jedna od najčešćih kroničnih zaraznih infekcija zahvaća 3% svjetske populacije, oko 170 milijuna ljudi. Prevalencija HCV je primarno ovisna o socioekonomskom statusu. U Egiptu, nekim predjelima Japana, Italije i Tajvana je ona visoka i iznosi 10-30%. Kod nas je prevalancija niska (1-2,4%), a incidencija iznosi u općoj populaciji 0,005% (kod davatelja krvi 0,02%). Putevi prijenosa infekcije jesu: parenteralni (transfuzija krvi i krvnih derivata, i.v. ovisnost, tetovaža), perinatalni, seksualni, nozokomijalni (odjeli hemodijalize, transplantacija organa, operativni i invazivni dijagnostički zahvati, ubod zaraženom iglom...). Ipak, za oko 40% slučajeva se ne zna točno put nastanka infekcije

Foodborne viruses

Patogeni koji se mogu prenositi hranom uključuju crijevne bakterije, viruse, parazite, bakterije koje proizvode toksine i prione. Od navedenih patogena najčešći uzročnici bolesti koje se prenose hranom jesu virusi. U ovom su radu pregledno prikazani virusi koji se prenose hranom s posebnim naglaskom na načine širenja i mogućnosti profilakse kao najvažnijim područjima u kojima sudjeluje veterinarska struka. U navedenom području, kao i u javnom zdravstvu u cjelini, samo bliska suradnja veterinarske i liječničke struke može rezultirati uspostavom cjelovitog sustava nadzora i suzbijanja zaraznih bolesti s ciljem očuvanja zdravlja ljudi. Prvi korak pritom jest dostupnost najnovijih spoznaja i informacija o rizicima i mjerama zaštite širem krugu stručnjaka u svrhu sprečavanja nastanka epidemija uzrokovanih virusima koji se prenose hranom, što je i bio cilj ovog preglednog prikaza.Foodborne pathogens include bacteria, viruses, parasites, toxin producing bacteria and prions. Of these, by far the most common causes of foodborne illness are viruses. In this article a review is given of the most important food borne viruses with the emphasis on the modes of transmission and prophylaxis as the most important areas where veterinary practitioners are included. In these areas and in protecting public health in general only close collaboration between human and veterinary medical specialists will result in establishing an optimal system for surveillance and prevention of foodborne infections in humans. The aim of this article is to present new information regarding risk factors and protection measures to a wide number of professionals, as a step in the prevention of epidemics caused by foodborne viruses