Research Interests: Genetics, Microbiology, Biology, Medicine, Phylogeny, and 15 moreDisease Outbreaks, Animals, Croatia, Genotype, Newcastle disease, Amino Acid Sequence, Base Sequence, Bosnia Herzegovina, Newcastle Disease Virus, Outbreak, Fusion Protein, Molecular Sequence Data, restriction enzyme, Restriction Mapping, and reverse transcriptase polymerase chain reaction
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Objectives: Birds are the main reservoir for West Nile virus (WNV) while mammals, particularly humans and horses, represent dead end hosts. Infected birds usually do not show symptoms, although few avian species can suffer from severe... more
Objectives: Birds are the main reservoir for West Nile virus (WNV) while mammals, particularly humans and horses, represent dead end hosts. Infected birds usually do not show symptoms, although few avian species can suffer from severe disease even with lethal outcome. Geese and ducks are particularly sensitive to the disease and develop high viremia and severe symptoms. Mortality in young geese can be as high as 60%. On the other hand, infection in chickens and turkeys usually remain subclinical but with development of high titre antibodies and very low viremia. Hence, chickens can be used as sentinels for seasonal incursions of WNV which is usually introduced by migratory birds and transmitted by mosquitoes. WNV can cause neurological disease and death in humans as well as in horses. The objective of this study was to use chickens and horses as sentinels for early detection of WNV in order to timely conduct appropriate anti-epidemic measures in Croatia. Materials and methods: During a three-year period (2013-2015), a total of 1, 717 serum samples from sentinel outdoor chickens and 8, 131 serum samples from horses were tested for WNV antibodies using IgG ELISA. In addition, 278 serum samples from humans suspected of WNV infection and 1, 778 serum samples from asymptomatic subjects were tested for WNV IgM and IgG antibodies. WNV positive human samples were confirmed using virus neutralization test. Positive horse sera were retested using IgM ELISA in order to confirm current/recent WNV infection. Results & Conclusion: 198 (11.53%) chickens, 665 (8.18%) horses as well as 22 (7.9%) humans suspected of WNV infection and 15 (0.84%) asymptomatic subjects were found to be positive. Of 585 positive horse sera, WNV IgM antibodies were found in 34 (5.81%) samples. A significant correlation in geographical distribution of high WNV seroprevalence in tested animals with human WNV infections was found. In addition, this coincided in regions contiguous to countries where high incidence of human neuroinvasive WNV infection was reported during the investigated period. Coordinated extensive monitoring of WNV infection in poultry and horses throughout Croatia, as an early warning system, enabled timely anti-epidemic measures, primarily thorough disinsection in affected areas. This resulted in prevention of mass occurrence of human neuroinvasive WNV infections as reported in certain neighbouring countries.
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Background: Tahyna orthobunyavirus (TAHV) is a neglected mosquito-borne bunyavirus. Although the virus is widespread in continental Europe, TAHV infections are rarely reported. We analyzed the prevalence of TAHV in humans and different... more
Background: Tahyna orthobunyavirus (TAHV) is a neglected mosquito-borne bunyavirus. Although the virus is widespread in continental Europe, TAHV infections are rarely reported. We analyzed the prevalence of TAHV in humans and different animal species as well as mosquitoes collected in urban areas of Zagreb and its surroundings in the period from 2020 to 2022. Methods: The study included 32 patients with neuroinvasive disease (NID), 218 asymptomatic individuals, 98 horses, 94 pet animals (dogs and cats), and 4456 Aedes vexans mosquitoes. Cerebrospinal fluid (CSF) and urine samples of patients with NID were tested for the TAHV RNA using a real-time reverse transcription-polymerase chain reaction (RT-qPCR). Human and animal serum samples were tested for TAHV-neutralizing (NT) antibodies using a virus-neutralization test (VNT). Mosquito pools were tested for TAHV RNA using an RT-qPCR. Results: TAHV NT antibodies were detected in 3/9.4% of patients with NID, 8/3.7% of asymptomatic indivi...
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BACKGROUND Data regarding the neuroradiology features of the West Nile virus neuroinvasive disease (WNV NID) is rather scarce. To contribute to the knowledge of the WNV NID, we present a patient with a combination of encephalitis and... more
BACKGROUND Data regarding the neuroradiology features of the West Nile virus neuroinvasive disease (WNV NID) is rather scarce. To contribute to the knowledge of the WNV NID, we present a patient with a combination of encephalitis and acute flaccid paresis, with cauda equina arachnoiditis as the main magnetic resonance (MR) finding. CASE SUMMARY A 72-year-old female patient was admitted due to fever, headache and gait instability. During the first several days she developed somnolence, aphasia, urinary incontinence, constipation, and asymmetric lower extremities weakness. Cerebrospinal fluid analysis indicated encephalitis. Native brain computed tomography and MR were unremarkable, while spinal MR demonstrated cauda equina enhancement without cord lesions. Virology testing revealed WNV IgM and IgG antibodies in serum and cerebrospinal fluid, which confirmed acute WNV NID. The treatment was supportive. After two months only a slight improvement was noticed but cognitive impairment, loss of sphincter control and asymmetric inferior extremities weakness remained. The patient died after a month on chronic rehabilitation. CONCLUSION Cauda equina arachnoiditis is a rare, but possible neuroradiological feature in acute flaccid paresis form of WNV NID.
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Najznacajniji arbovirusi pripadaju rodovima Flavivirus, Alphavirus, Phlebovirus i Nairovirus. Na podrucju Hrvatske dokazano je prisustvo virusa krpeljnog encefalitisa (KEV), virusa papataci groznice (SFV), virusa dengue (DENV), virusa... more
Najznacajniji arbovirusi pripadaju rodovima Flavivirus, Alphavirus, Phlebovirus i Nairovirus. Na podrucju Hrvatske dokazano je prisustvo virusa krpeljnog encefalitisa (KEV), virusa papataci groznice (SFV), virusa dengue (DENV), virusa Zapadnog Nila (VZN) i Usutu virusa (USUV). KEV je rasprostranjen u sjeverozapadnim hrvatskim županijama. Godisnje se prijavljuje oko 50 slucajeva KE s karakteristicnom sezonskom pojavnoscu (73% infekcija zabilježeno je u razdoblju od svibnja do listopada). Infekcije uzrokovane SFV javljaju se na podrucju priobalja. Tijekom 2014. godine, protutijela na SFV sicilijanski tip, SFV napuljski tip i virus Toscana nađena su u 4, 8% ; 6, 4% te 22, 6% osoba s podrucja Istarske, Primorsko-goranske, Splitsko-Dalmatinske i Dubrovacko-neretvanske županije. Protutijela na VZN dokazana su u ljudi, medvjeda i konja. U jesen 2012. godine zabilježeni su prvi klinicki humani slucajevi VZN infekcije. Tijekom tri uzastopne sezone (2012-2014) zabilježeno ukupno 28 slucajeva ...
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Research Interests: Medicine and Dengue fever
Arbovirusima pripada vise od 500 virusa, od kojih najveci javnozdravstveni znacaj imaju virusi iz rodova Flavivirus, Alphavirus, Phlebovirus i Nairovirus. Na podrucju Hrvatske, uz endemski prisutan virus krpeljnog encefalitisa i virus... more
Arbovirusima pripada vise od 500 virusa, od kojih najveci javnozdravstveni znacaj imaju virusi iz rodova Flavivirus, Alphavirus, Phlebovirus i Nairovirus. Na podrucju Hrvatske, uz endemski prisutan virus krpeljnog encefalitisa i virus papataci groznice te 2010. godine potvrđene autohtone slucajeve infekcije virusom dengue, posljednjih su godina dokazani i novi arbovirusi. Virus Zapadnog Nila (VZN) danas je jedan od najrasprostranjenijih arbovirusa. Cirkulacija VZN u Hrvatskoj prati se od 1970-ih godina uz sporadican nalaz protutijela u ljudi, medvjeda i konja. U jesen 2012. godine, uz asimptomatske akutne infekcije konja, zabilježeni su prvi humani klinicki slucajevi neuroinvazivne bolesti uzrokovane VZN na podrucju istocne Hrvatske. VZN infekcije u ljudi i konja dokazane su i tijekom sljedecih sezona (2013-2014. godine) u sjeverozapadnim i istocnim hrvatskim županijama. Neuroinvazivna je infekcija dokazana u ukupno 28 bolesnika, a u sest je seroloski potvrđena asimptomatska akutna/...
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U radu su opisane temeljne epidemioloske znacajke infekcija Usutu virusom s naglaskom na infekcije ljudi i metode dijagnostike. Prikazani su rezultati pracenja cirkulacije ovog zoonotskog patogena na podrucju Republike Hrvatske kao i... more
U radu su opisane temeljne epidemioloske znacajke infekcija Usutu virusom s naglaskom na infekcije ljudi i metode dijagnostike. Prikazani su rezultati pracenja cirkulacije ovog zoonotskog patogena na podrucju Republike Hrvatske kao i dokazane infekcije i klinicke manifestacije u ljudi.
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Nenad PANDAK 1,2), dr. sc., prim., dr. med., spec. infektologije Tatjana VILIBI]-^AVLEK 3,4), doc., dr. sc., dr. med., spec. mikrobiologije Ljubo BARBI] 5), prof., dr. sc., dr. med. vet. Marija SANTINI 4,6), doc., dr. sc., dr. med., spec.... more
Nenad PANDAK 1,2), dr. sc., prim., dr. med., spec. infektologije Tatjana VILIBI]-^AVLEK 3,4), doc., dr. sc., dr. med., spec. mikrobiologije Ljubo BARBI] 5), prof., dr. sc., dr. med. vet. Marija SANTINI 4,6), doc., dr. sc., dr. med., spec. infektologije Iva PEM-NOVOSEL3), dr. sc., dr. med., spec. mikrobiologije Ivica ̂ ABRAJA1), dr. med., spec. infektologije Bo`ana MIKLAU[I] 1), dr. med., spec. infektologije Jasmina KU^INAR7), dr. med., spec. mikrobiologije Vladimir SAVI] 8), dr. sc., dr. med. vet. Vladimir STEVANOVI] 5), dr. sc., dr. med. vet. Ana KLOBU^AR9), mr. sc., biolog
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West Nile virus (WNV) danas je jedan od najrasprostranjenijih arbovirusa. U posljednja se dva desetljeća WNV infekcije kontinuirano pojavljuju na području Europe u obliku manjih ili većih epidemija i epizootija. U ovom preglednom radu... more
West Nile virus (WNV) danas je jedan od najrasprostranjenijih arbovirusa. U posljednja se dva desetljeća WNV infekcije kontinuirano pojavljuju na području Europe u obliku manjih ili većih epidemija i epizootija. U ovom preglednom radu prikazujemo epidemiološke značajke WNV infekcija koje su dokazane na području Hrvatske i Srbije u kontekstu “Jednog zdravlja”. Prikazani rezultati potvrđuju značaj multidisciplinarne i regionalne suradnje u dijagnostici i praćenju ove (re-)emergentne virusne zoonoze.
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There is a high degree of variability in the serologic response to Epstein-Barr virus (EBV) infection, especially in viral capsid antigen (VCA)-IgM antibodies. Therefore, additional tests are needed to confirm primary infection.We... more
There is a high degree of variability in the serologic response to Epstein-Barr virus (EBV) infection, especially in viral capsid antigen (VCA)-IgM antibodies. Therefore, additional tests are needed to confirm primary infection.We evaluated the value of IgG avidity determination in diagnosis of EBV infection in immunocompetent and immunocompromised patients.A total of 236 serum samples from immunocompetent patients with symptoms suggestive of EBV infection were tested for the presence of VCA-IgM/IgG antibodies and IgG avidity. Using IgG avidity, acute primary infection was confirmed in 56.7% of the immunocompetent patients with positive and in 1.8% of patients with negative VCA-IgM. Recent primary infection was documented in 8.9% of the IgM positive and 3.5% of the IgM negative patients. In patients with indeterminate serology (equivocal IgM), 6.7% were classified by avidity index (AI) as acute primary infection, 10.0% as post-acute and 83.3% as past infection cases.Concerning the 3...
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Research Interests: Geography, Epidemiology, Environmental Health, Biology, Adolescent, and 15 moreMedicine, Molecular Epidemiology, Humans, Child, Female, Animals, Male, Horses, One Health, Aged, Middle Aged, Antibody, Adult, Chickens, and Outbreak
Background: Although the Bhanja bandavirus (BHAV) is widely distributed in some European countries, human infections are rarely reported. This study analyzed the prevalence of BHAV antibodies in patients with neuroinvasive diseases of... more
Background: Although the Bhanja bandavirus (BHAV) is widely distributed in some European countries, human infections are rarely reported. This study analyzed the prevalence of BHAV antibodies in patients with neuroinvasive diseases of unsolved etiology. Methods: A total of 254 Croatian patients who developed neurological symptoms during the four consecutive arbovirus transmission seasons (April 2017–October 2021) were tested. Cerebrospinal fluid (CSF) and urine samples were tested using RT-qPCR. In addition, CSF and serum samples were tested using a virus neutralization test. Results: BHAV RNA was not detected in any samples, while neutralizing (NT) antibodies were detected in serum samples of 53/20.8% of patients (95% CI = 16.0–26.3). In two patients, BHAV NT antibodies were detected in the CSF, indicating a recent infection. Both patients were inhabitants of rural areas in continental Croatia, and one reported a tick bite two weeks before symptoms onset. The seropositivity was hig...
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In the period from 2015 to 2020, an entomological survey for the presence of West Nile virus (WNV) and Usutu virus (USUV) in mosquitoes was performed in northwestern Croatia. A total of 20,363 mosquitoes were sampled in the City of Zagreb... more
In the period from 2015 to 2020, an entomological survey for the presence of West Nile virus (WNV) and Usutu virus (USUV) in mosquitoes was performed in northwestern Croatia. A total of 20,363 mosquitoes were sampled in the City of Zagreb and Međimurje county, grouped in 899 pools and tested by real-time RT-PCR for WNV and USUV RNA. All pools were negative for WNV while one pool each from 2016 (Aedes albopictus), 2017 (Culex pipiens complex), 2018 (Cx. pipiens complex), and 2019 (Cx. pipiens complex), respectively, was positive for USUV. The 2018 and 2019 positive pools shared 99.31% nucleotide homology within the USUV NS5 gene and both clustered within USUV Europe 2 lineage. The next-generation sequencing of one mosquito pool (Cx. pipiens complex) collected in 2018 in Zagreb confirmed the presence of USUV and revealed several dsDNA and ssRNA viruses of insect, bacterial and mammalian origin.
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Pretražena su 342 uzorka seruma iz ekstenzivnih uzgoja kokoši i 184 seruma iz intenzivnih uzgoja purana uzeta u razdoblju od 27. prosinca 2004. do 9. rujna 2005. komercijalnim ELISA kompletom za protutijela virusa influence ptica. Nađeno... more
Pretražena su 342 uzorka seruma iz ekstenzivnih uzgoja kokoši i 184 seruma iz intenzivnih uzgoja purana uzeta u razdoblju od 27. prosinca 2004. do 9. rujna 2005. komercijalnim ELISA kompletom za protutijela virusa influence ptica. Nađeno je 45,6% pozitivnih seruma kokoši i svega 0,5% pozitivnih seruma purana. Serumi koji su dali pozitivnu ili sumnjivu reakciju ELISA testom pretraženi su i imunodifuzijom u gelu na nazočnost protutijela za virus influence ptica. Svi uzorci pretraženi ovim postupkom dali su negativan rezultat. Provjerom specifičnosti komercijalnog ELISA kompleta dobivene su pozitivne reakcije i s monovalentim standardnim antiserumima za viruse newcastleske bolesti i CELO, dok su serumi za PMV-2 i PMV-3 dali sumnjivu reakciju. Stoga se može zaključiti da je korišteni komercijalni komplet nepouzdan u serološkom monitoringu influence u peradi. S obzirom na proširenost visokopatogene influence ptica u svijetu i opasnost koju predstavlja visokopatogeni virus podtipa H5N1 za...
Background: Tahyna orthobunyavirus (TAHV) is widely distributed in continental Europe. Very few studies have analyzed TAHV seroprevalence in Croatia. We analyzed the prevalence of TAHV RNA and antibodies in Croatian patients with... more
Background: Tahyna orthobunyavirus (TAHV) is widely distributed in continental Europe. Very few studies have analyzed TAHV seroprevalence in Croatia. We analyzed the prevalence of TAHV RNA and antibodies in Croatian patients with neuroinvasive disease (NID). Methods: A total of 218 patients with unsolved NID detected during five consecutive arbovirus transmission seasons (April 2017–October 2021) were tested. Cerebrospinal fluid (CSF) and urine samples were tested for TAHV RNA using RT-PCR. In addition, CSF and serum samples were tested for TAHV antibodies using a virus neutralization test (VNT). Results: Clinical presentations in patients with NID were meningitis (141/64.7%), meningoencephalitis (56/25.7%), myelitis (8/3.7%), and ‘febrile headache’ (13/5.9%). TAHV RNA was not detected in any of the tested CSF or urine samples; however, TAHV-neutralizing (NT) antibodies were detected in 22/10.1% of patients. Detection of NT antibodies in the CSF of two patients presenting with menin...
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Virusi influence tipa A izdvojeni su iz brojnih vrsta ptica i sisavaca, no prirodni domaćin ovih virusa su divlje ptice koje žive uz vodu, primjerice patke, guske, galebovi i njima srodne ptice. Ostale vrste koje bivaju zaražene virusima... more
Virusi influence tipa A izdvojeni su iz brojnih vrsta ptica i sisavaca, no prirodni domaćin ovih virusa su divlje ptice koje žive uz vodu, primjerice patke, guske, galebovi i njima srodne ptice. Ostale vrste koje bivaju zaražene virusima influence A, a to su poglavito kokoš, puran, svinja, konj i čovjek, smatramo aberantnim domaćinima. Velika većina virusa influence A potpuno je prilagođena upravo vodenim pticama u kojih zaražavanje ne uzrokuje znakove bolesti i takvi su virusi u ovih domaćina u evolucijskoj stazi. Nasuprot tomu, vrlo intenzivna evolucija u aberantnim domaćinima pripisuje se selekcijskom pritisku zbog prilagodbe ovih virusa novom domaćinu. Ovakva prilagodba može rezultirati i vrlo visokom virulencijom za novog domaćina, a katkad i za druge vrste.Although influenza A viruses have been isolated from a variety of birds and mammals, their natural hosts include wild waterfowl, gulls and related birds. Other species which are infected with influenza A viruses, particularl...
Lymphocytic choriomeningitis virus (LCMV) is a neglected human pathogen associated with aseptic meningitis, severe systemic infections in immunocompromised persons, and congenital anomalies. Data on the prevalence of LCMV infections are... more
Lymphocytic choriomeningitis virus (LCMV) is a neglected human pathogen associated with aseptic meningitis, severe systemic infections in immunocompromised persons, and congenital anomalies. Data on the prevalence of LCMV infections are scarce. We analyzed the seroprevalence of LCMV in continental Croatian regions. A total of 338 serum samples of professionally exposed (forestry workers, hunters, agriculture workers in contact with rodents) and non-exposed populations (general population, pregnant women) were tested for the presence of LCMV antibodies using indirect immunofluorescence assay. No participants reported recent febrile disease. LCMV IgG antibodies were detected in 23/6.8% of participants: 9.8% exposed persons and 5.1% non-exposed persons (6.1% in the general population and 3.9% in pregnant women). No participants were LCMV IgM positive. Although higher seropositivity was found in males compared to females (8.9% vs. 4.7%), inhabitants of suburban/rural areas compared to i...
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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... more
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%) s...
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Australski su gušteri, bradate agame (Pogona vitticeps), vrlo popularni kućni ljubimci koji se uzgajaju u zatočeništvu u brojnim zemljama, a međunarodna trgovina ove vrste guštera nije zanemariva. Bradate agame su osjetljive na... more
Australski su gušteri, bradate agame (Pogona vitticeps), vrlo popularni kućni ljubimci koji se uzgajaju u zatočeništvu u brojnim zemljama, a međunarodna trgovina ove vrste guštera nije zanemariva. Bradate agame su osjetljive na infekciju adenovirusom agamida tipa 1 (BDAdv-1) čiji je uzročnik usko povezan s raznim kliničkim znacima poput: iznenadne smrti, letargije, slabosti, proljeva, dehidracije, anoreksije, zaostajanja u rastu i neuroloških simptoma koji nastaju zbog oštećenja jetara. Opisana je fatalna bolest dviju juvenilnih bradatih agama u Hrvatskoj tijekom koje je detektirana infekcija adenovirusom. Osim slabosti, anoreksije, kaheksije i dehidracije, u jedne agame je bio naglašen opistotonus. U fecesu agama je postupkom lančane reakcije polimerazom dokazan adenovirus, dok je nukleotidnim sekvenciranjem i filogenijskom analizom nađena visoka podudarnost s BDAdv-1 izolatima iz bradatih agama u SAD-u, Austriji i Njemačkoj (>99,6 %-100 %), ali i s BDAdv-1 iz slob...
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Lymphocytic choriomeningitis virus (LCMV) is a neglected rodent-borne zoonotic virus distributed worldwide. Since serologic assays are limited to several laboratories, the disease has been underreported, often making it difficult to... more
Lymphocytic choriomeningitis virus (LCMV) is a neglected rodent-borne zoonotic virus distributed worldwide. Since serologic assays are limited to several laboratories, the disease has been underreported, often making it difficult to determine incidence and seroprevalence rates. Although human clinical cases are rarely recorded, LCMV remains an important cause of meningitis in humans. In addition, a fatal donor-derived LCMV infection in several clusters of solid organ transplant recipients further highlighted a pathogenic potential and clinical significance of this virus. In the transplant populations, abnormalities of the central nervous system were also found, but were overshadowed by the systemic illness resembling the Lassa hemorrhagic fever. LCMV is also an emerging fetal teratogen. Hydrocephalus, periventricular calcifications and chorioretinitis are the predominant characteristics of congenital LCMV infection, occurring in 87.5% of cases. Mortality in congenitally infected chi...
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Hepatitis E virus (HEV) is the most common cause of viral hepatitis globally. The first human case of autochthonous HEV infection in Croatia was reported in 2012, with the undefined zoonotic transmission of HEV genotype 3. This narrative... more
Hepatitis E virus (HEV) is the most common cause of viral hepatitis globally. The first human case of autochthonous HEV infection in Croatia was reported in 2012, with the undefined zoonotic transmission of HEV genotype 3. This narrative review comprehensively addresses the current knowledge on the HEV epidemiology in humans and animals in Croatia. Published studies showed the presence of HEV antibodies in different population groups, such as chronic patients, healthcare professionals, voluntary blood donors and professionally exposed and pregnant women. The highest seroprevalence in humans was found in patients on hemodialysis in a study conducted in 2018 (27.9%). Apart from humans, different studies have confirmed the infection in pigs, wild boars and a mouse, indicating the interspecies transmission of HEV due to direct or indirect contact or as a foodborne infection. Continued periodical surveys in humans and animals are needed to identify the possible changes in the epidemiolog...
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West Nile virus (WNV) is one of the most widely distributed (re-)emerging arboviruses. In Croatia, acute WNV infections as well as seropositivity were detected in humans, horses, birds and poultry. Although serologic evidence of WNV human... more
West Nile virus (WNV) is one of the most widely distributed (re-)emerging arboviruses. In Croatia, acute WNV infections as well as seropositivity were detected in humans, horses, birds and poultry. Although serologic evidence of WNV human infections dates back to the 1970s, no clinical cases were reported until 2012. WNV outbreaks, as well as sporadic infections, were continuously recorded in continental Croatian counties from 2012 to 2018. In addition, acute asymptomatic infections (IgM antibodies) in horses have been regularly notified in continental regions since 2012, while seropositive horses (seroprevalence rates 3.7–21.4%) were detected in both continental and coastal regions. Moreover, WNV seropositivity in poultry (1.8–22.9%) was reported from 2013 to 2020. During the largest WNV outbreak in 2018, WNV RNA was detected for the first time in two dead goshawks (Accipiter gentilis) from the same aviary in North-West Croatia, while WNV antibodies were found in one buzzard (Butte...
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Usutu virus (USUV) is an emerging arbovirus isolated in 1959 (Usutu River, Swaziland). Previously restricted to sub-Saharan Africa, the virus was introduced in Europe in 1996. While the USUV has received little attention in Africa, the... more
Usutu virus (USUV) is an emerging arbovirus isolated in 1959 (Usutu River, Swaziland). Previously restricted to sub-Saharan Africa, the virus was introduced in Europe in 1996. While the USUV has received little attention in Africa, the virus emergence has prompted numerous studies with robust epidemiological surveillance programs in Europe. The natural transmission cycle of USUV involves mosquitoes (vectors) and birds (amplifying hosts) with humans and other mammals considered incidental (“dead-end”) hosts. In Africa, the virus was isolated in mosquitoes, rodents and birds and serologically detected in horses and dogs. In Europe, USUV was detected in bats, whereas antibodies were found in different animal species (horses, dogs, squirrels, wild boar, deer and lizards). While bird mortalities were not reported in Africa, in Europe USUV was shown to be highly pathogenic for several bird species, especially blackbirds (Turdus merula) and great gray owls (Strix nebulosa). Furthermore, ne...
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Data on the immune response to West Nile virus (WNV) are limited. We analyzed the antiviral cytokine response in serum and cerebrospinal fluid (CSF) samples of patients with WNV fever and WNV neuroinvasive disease using a multiplex... more
Data on the immune response to West Nile virus (WNV) are limited. We analyzed the antiviral cytokine response in serum and cerebrospinal fluid (CSF) samples of patients with WNV fever and WNV neuroinvasive disease using a multiplex bead-based assay for the simultaneous quantification of 13 human cytokines. The panel included cytokines associated with innate and early pro-inflammatory immune responses (TNF-α/IL-6), Th1 (IL-2/IFN-γ), Th2 (IL-4/IL-5/IL-9/IL-13), Th17 immune response (IL-17A/IL-17F/IL-21/IL-22) and the key anti-inflammatory cytokine IL-10. Elevated levels of IFN-γ were detected in 71.7% of CSF and 22.7% of serum samples (p = 0.003). Expression of IL-2/IL-4/TNF-α and Th1 17 cytokines (IL-17A/IL-17F/IL-21) was detected in the serum but not in the CSF (except one positive CSF sample for IL-17F/IL-4). While IL-6 levels were markedly higher in the CSF compared to serum (CSF median 2036.71, IQR 213.82–6190.50; serum median 24.48, IQR 11.93–49.81; p < 0.001), no difference ...
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Toscana virus (TOSV) is an arthropod-borne virus, transmitted to humans by phlebotomine sandflies. Although the majority of infections are asymptomatic, neuroinvasive disease may occur. We report three cases of neuroinvasive TOSV... more
Toscana virus (TOSV) is an arthropod-borne virus, transmitted to humans by phlebotomine sandflies. Although the majority of infections are asymptomatic, neuroinvasive disease may occur. We report three cases of neuroinvasive TOSV infection detected in Croatia. Two patients aged 21 and 54 years presented with meningitis, while a 22-year old patient presented with meningoencephalitis and right-sided brachial plexitis. Cerebrospinal fluid (CSF), serum, and urine samples were collected and tested for neuroinvasive arboviruses: tick-borne encephalitis, West Nile, Usutu, TOSV, Tahyna, and Bhanja virus. In addition, CSF and serum samples were tested for the anti-viral cytokine response. High titers of TOSV IgM (1000–3200) and IgG (3200−10,000) antibodies in serum samples confirmed TOSV infection. Antibodies to other phleboviruses (sandfly fever Sicilian/Naples/Cyprus virus) were negative. CSF samples showed high concentrations of interleukin 6 (IL-6; range 162.32−2683.90 pg/mL), interferon...
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Over the past and the current centuries, human influenza pandemics have been attributable to viruses with an avian ancestry. Birds are the main source of influenza A viruses and harbour a variety of antigenic subtypes. Certain avian... more
Over the past and the current centuries, human influenza pandemics have been attributable to viruses with an avian ancestry. Birds are the main source of influenza A viruses and harbour a variety of antigenic subtypes. Certain avian influenza viruses are capable for cross-species transmission including human infections. Although sustained intrehuman transmission of such viruses has not been documented so far, each human infection with avian influenza viruses provides chances for the virus adaptation towards efficient transmission within human population. Here are reviewed currently circulating avian influenza viruses that are of major significance for public health.
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Few reports of human Usutu virus (USUV) infection have been reported to date. We describe the first three patients with USUV neuroinvasive infection in Zagreb and its surroundings from 30 August to 7 September 2013 during a West Nile... more
Few reports of human Usutu virus (USUV) infection have been reported to date. We describe the first three patients with USUV neuroinvasive infection in Zagreb and its surroundings from 30 August to 7 September 2013 during a West Nile virus (WNV) outbreak. Patients were aged 29, 56, and 61 years. The two older patients had several comorbidities (arterial hypertension, hyperlipidemia, and diabetes mellitus). All patients presented with meningitis and meningoencephalitis closely resembling WNV neuroinvasive disease. The main clinical features in all patients were headache, fever, nuchal rigidity, hand tremor, and hyperreflexia. Neuroimaging studies were normal and electroencephalography (EEG) revealed diffusely slow activity. The 29 years old, a previously healthy female patient, was deeply somnolent and disoriented for 4 days. Her recovery was slow and even 10 weeks after disease onset, she had memory and speech-fluency difficulties. The other two patients recovered promptly. USUV IgG...
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Several arboviruses have emerged in Croatia in recent years. Tick-borne encephalitis is endemic in continental counties; however, new natural micro-foci have been detected. Two autochthonous dengue cases were reported in 2010. West Nile... more
Several arboviruses have emerged in Croatia in recent years. Tick-borne encephalitis is endemic in continental counties; however, new natural micro-foci have been detected. Two autochthonous dengue cases were reported in 2010. West Nile virus emerged in 2012, followed by emergence of Usutu virus in 2013. Although high seroprevalence rates of Toscana virus have been detected among residents of Croatian littoral, the virus remains neglected, with only a few clinical cases of neuroinvasive infections reported. Lymphocytic choriomeningitis virus is a neglected neuroinvasive rodent-borne virus. So far, there are no reports on human clinical cases; however, the seroprevalence studies indicate the virus presence in the Croatian mainland. Puumala and Dobrava hantaviruses are widely distributing rodent-borne viruses with sporadic and epidemic occurrence. Hepatitis E virus is an emerging food-borne virus in Croatia. After the emergence in 2012, cases were regularly recorded. Seropositivity va...