Ongoing mumps outbreak in Novi Sad, the autonomous province of Vojvodina, Serbia, January to April 2012.

From 16 January to 30 April 2012, a total of 119 cases of mumps were notified in Novi Sad, Serbia. Of these cases, 89 (75%), were among students. The average age of cases was 22 years-old (range 3-37). The outbreak is still ongoing in Novi Sad and is spreading to other parts of the Vojvodina province. As of 30 April, 209 cases have been notified in the province among those 119 from Novi Sad.

Q fever outbreak in the village of Nocaj, Srem County, Vojvodina Province, Serbia, January to February 2012.

From 27 January to 10 February 2012, a total of 43 cases of Q fever were notified in the village of Nocaj, Srem county, Autonomous Province of Vojvodina, Republic of Serbia. Q fever was laboratory confirmed in 37 notified cases. Alhough, the outbreak is considered over, the outbreak investigation is still ongoing in order to identify aetiologic factors relevant for this outbreak.

[Occurrence of sexually transmitted diseases in Vojvodina during the last 20 years]. / Prisustvo polno prenosivih bolesti u Vojvodini u poslednjih dvadeset godina.

INTRODUCTION: Sexually transmitted diseases are the most often registered communicable diseases in a great number of countries. The aim of this study was to analyze dynamics and distribution of gonorrhea, syphilis and scabies in Vojvodina region during the last twenty years. MATERIAL AND METHODS: Epidemiological characteristics of gonorrhea, syphilis and scabies were analyzed on the basis of data obtained from the Section of Epidemiology of the Institute of Public Health in Novi Sad. The research included the period between 1980 and 1999, with sex and age distribution of patients. Morbidity rates were given per number of inhabitants of Vojvodina. RESULTS: In the period between 1980-1999 there were 454 registered patients with the diagnosis of syphilis in Vojvodina. The morbidity ratio was highest in 1980 (3.41/100.000), and lowest in 1991 (0.24/100.000). In the twenty-year period there were more patients with gonorrhea, than patients with syphilis. There were 44.621 registered patients with gonorrhea. The maximum morbidity ratio was in 1980 (25.09/100.000), but the minimum was in 1998 (1.68/100.000). Within the examined period scabies was recorded in 56.490 patients. The highest morbidity ratio was in 1984 (232.37/100.000) and the lowest was in 1992 (73.56/100.000). DISCUSSION: The average morbidity ratio of syphilis in USA, between 1992-1994, was 11.8/100.000 and at the same time in Vojvodina it was only 0.42/100.000. In Vojvodina most patients with this disease were 20-39 years old. In the same period in USA the ratio of gonorrhea patients was 309/100.000 and in Vojvodina it was 2/100.000. In this group also, most patients were 20-39 years old. However, scabies mostly appeared at the age of 7-14. CONCLUSION: According to the obtained results, the number of registered patients with these three diseases in Vojvodina stagnates or it decreases. In order to deal with real data, it is necessary to report these diseases regularly.

Altered epidemiological characteristics of ulcer disease.

Dynamics and distribution of ulcer disease in population in the period 1987-1996 were analyzed on the basis of morbidity and mortality rate registered at clinics and institutes in Novi Sad. During the analyzed period 4.111 cases of ulcer disease were hospitalized and 47 with lethal outcome. Duodenal ulcer (2,739) is twice as frequent as gastric ulcer (1,372). Both localisations of ulcer disease are more frequent in males, and specific morbidity shows constant rise towards the older age groups. Duodenal ulcer shows sudden increase in the age group of over 20, and gastric ulcer in the age group of over 60. Gastric ulcer mortality (1.6%) is higher in comparison to duodenal ulcer mortality (0.9%) and it increases constantly towards the older age groups. Unfavourable result is statistically significantly higher in persons over 60. During the monitored period the increasing trend in duodenal ulcer is sharp, while figures in gastric ulcer are without significant changes. Both localisations have become a frequent health problem in population over 40 years of age.

[Zoo-anthroponoses in Vojvodina. IV. Epidemiologic characteristics of trichinosis in Vojvodina]. / Zooantroponoze u Vojvodini. IV. Epidemioloske karakteristike trihineloze u Vojvodini.

Epidemiological characteristics of trichinellosis in Vojvodina have been analyzed on the basis of registered cases of the disease, registration of epidemics and also epidemiological investigation of exposed persons. In the period 1984-1993, 1802 diseased persons were registered, 958 male and 844 female. Death was registered in one case. Average morbidity was 8.9/10(5). Trichinellosis affects all age groups. At younger age the disease affects both sexes, but in the group over 20 years of age the disease is statistically more frequent in males. During the observed period 70 epidemics of trichinellosis were registered. The main source was the domestic swine. Epidemiologically the greatest risk were domestically produced sausages causing 80% of epidemics. Consequently the season for pork meat preparation is the most significant for trichinellosis. Analyzing the origin of affected meat it has been established that regions of Srem and South-West Backa are considered to be hyperendemic foci. 94.3% of epidemics were caused by affected meat from these regions.

[Zoonoses in Vojvodina. I. Epidemiologic characteristics of tetanus in Vojvodina]. / Zooantroponoze u Vojvodini. I. Epidemioloske karakteristike tetanusa u Vojvodini.

Epidemiologic characteristics of tetanus in Voivodina were analyzed on the basis of reported cases of sickness or death, during the period from 1962 to 1991, and epidemiologic investigation on 35 sick persons suffering from tetanus during the last 5 years. By compulsory immunization against tetanus this disease is practically eliminated at the age when one is protected by immunity vaccine. Abandoning domiciliary childbirth neonatorum tetanus has been eliminated. Today tetanus occurs sporadically as a result of small, naive injuries, mostly in nonimmunized elderly people. Considering number of the sick, in 6.1% it happens to persons older than 60 years of age. Tetanus remains a health problem because of its high lethality, which is statistically significantly higher in older patients. On the basis of gathered results it is realistic to expect that applying compulsory immunization against tetanus to older people in 10 year intervals will not eliminate this disease, but it will significantly reduce lethality which is still about 25% in Voivodina.

[Zoonoses in Vojvodina. II. Epidemiologic characteristics of leptospirosis in Vojvodina]. / Zooantroponoze u Vojvodini. II. Epidemioloske karakteristike leptospiroza u Vojvodini.

On the basis of reported cases of sickness--death due to leptospirosis and the epidemiologic investigation of 38 sick individuals, epidemiologic characteristics of anthropozoonosis in Vojvodina were analyzed. It has been established that this disease is registered in the form of individual cases, mostly in persons belonging to the productive population. Infection usually happens during the summer months and due to contact with contaminated water. High lethality and antibodies of leptospirosis icterohaemorrhagiae in 55.3% of samples of the serum of the sick point to the fact that only clinically severe forms of the disease were registered.

[Zoonoses in Vojvodina. III. Results of a seroepidemiologic study of leptospirosis in Vojvodina]. / Zooantroponoze u Vojvodini. III. Rezultati seroepidemioloskog ispitivanja leptospiroza u Vojvodini.

2697 persons professionally exposed to leptospira working in contaminated waters and grounds or due to contact with infected animals or their products were seroepidemiologically examined. It was established that the presence of leptospirosis in certain categories of examined persons is three to more than ten times higher in relation with it's presence in the control groups. The most frequent serotype was Leptospira pomona. None of the seropositive persons gave data about having leptospirous infection which might be the consequence of asymptomatic infection or unidentified and not registering of the clinically manifested diseases.

[HIV infection in Vojvodina]. / Istrazivanje HIV infekcije u Vojvodini.

The study of HIV infection in the population of Vojvodina was carried out in the period 1985-1991. The results obtained by the seroepidemiologic examination of some epidemiologically important groups of populations and recorded cases of AIDS are compared. It has been found that the seroepidemiologic examinations, in spite of some shortcomings, provide a more reliable insight into the epidemiologic situation of HIV infection.

[Epidemiologic characteristics of Lyme borreliosis in Vojvodina]. / Epidemiloske karakteristike Lyme borreliosis u Vojvodini.

In the period 1988-1992 in the region of Vojvodina diseases caused by Borrelia burgdorferi were investigated for the first time. This investigation encompassed 398 persons with tick bites. There were 340 clinically healthy and 58 affected by Lyme borreliosis. Lyme borreliosis was registered in all age groups. The youngest patient was 5 and the oldest 75. Erythema migrans, clinical disease marker, was found in 94.8% of affected persons. Rheumatic disorders--arthralgiae were found in 3.5% and Sclerodermia circumscripta in 1.7%. Antibodies to Borrelia burgdorferi antigen were found in 46.9% of 32 patients tested by IFA test. In 55 (94.8%) patients the infestion took place in region of Vojvodina.

[Rubella in Vojvodina. VI. Serologic status of women of reproductive age during the time of endemic manifestations of rubella 1978-1985]. / Rubela u Vojvodini. VI. Seroloski status zena generativne dobi za vreme endemicnih pojava rubele 1978-1985. godine.

In first phase of a study on congenital Rubella syndrome incidence in Vojvodina population, we examined serologic status of 1225 non-pregnant and 846 pregnant women of generative age, as well as the level of exposure to the Rubella virus. On the basis of antihemagglutinin antibody titre 93.2% of women were found to have antibody titre level above or equal to 1/8. There were no significant differences between the proportions of seropositive women in different age groups (x2 = 1.20; P = 0.88). The percentage of seropositive women varied from 82 to 97% (x2 = 29.85; P = 0.005), according to the year of the investigation. The lowest percentage was registered (1980). Rubella virus susceptibility index was 13.1%. On the basis of proven seroconversion the examination of even Rubella serum samples showed the morbidity rate of 7.18%. The level of exposure of pregnant women to the Rubella virus was 71.0%, during all the period of pregnancy. In such circumstances total Rubella morbidity of pregnant women was 2.13%; the highest level, 21%, was in persons form 18 to 19 years of age. It was not possible to make an analysis of pregnancy outcomes and the consequences in pregnant women.

[The role of Epstein-Barr virus in patients with mononucleosis syndrome and lymphadenopathy]. / Uloga Epstein-Barrovog virusa u bolesnika sa mononukleoznim sindromom i limfadenopatijom.

In a two-year period 117 patients with diagnosed mononucleosis sundrome and 207 patients with diagnosed lymphadenopathy were serologically examined. Of these 57 patients were immunodeficient and 267 immunocompetent. Acute infection with Epstein-Barr virus was proved in 17.09% of the cases with mononucleosis syndrome, 13.04% with lymphadenopathy i.e. 8.77% of the immunodeficient and 15.73% of the immunocompetent patients. The significantly highest rate was recorded among schoolchildren and adolescents (from 7 to 27 years of age). The occurrence of other viral (adeno-and cytomegalo-) and non-viral infections (toxoplasma gondii, chlamydia) in these patients has also been analyzed.

[Post-vaccination reactions and complications of pertussis, diphtheria and tetanus vaccines]. / Postvakcinalne reakcije i komplikacije na pertussis, diphtheria i tetanus vakcine.

Clinical manifestation of postvaccinal reactions and complications and the presence of sensibilizating antibodies to certain components of the applied vaccines was analyzed in 80 children immunized by Di-Te-Per, Di-Te or Te vaccine. Most children showed a mild reaction; concerning statistical significance it was most frequently limited to the site of the vaccine application if the immunization was performed by Di-Te and Te vaccines, as compared to the immunization by Di-Te-Per vaccine. Indirect basophil degranulation test revealed that 50% of the analyzed reactions were of allergic origin. Sensibilizating antibodies to pertussis antigen are statistically significantly more frequent than to other vaccinal antigens (diphtheria and tetanus toxoids) and additives contained in the vaccines (methiolate, sodium benzoate).

[Clinical manifestations of acute Q-fever]. / Klinicke manifestacije akutne Q-groznice.

The participation of asymptomatic infections and clinical forms of acute Q-fever were analysed, using the active epidemiological investigation of the population affected by Q-fever epidemics. Out of the total number of registered Q-fever cases, the asymptomatic infection was present in 8.36%. The occurrence of asymptomatic infection was statistically more frequent by significance in women than in men. Pulmonary form of Q-fever occurred in 65.20% of the diseased. This clinical manifestation was statistically more frequent by significance in men than in women. The difference between the morbidity rates of Q-fever in regard to sexes could be caused by both the difference in the intensity of exposure to the infection and the difference in clinical presentation and recognition of the disease.

[Epidemiologic characteristics of viral hepatitis. II. Hepatitis A in Vojvodina]. / Epidemioloske karakteristike virusnih hepatitisa. II. Hepatitis A u Vojvodini.

In Vojvodina, Hepatitis A occurs endemoepidemiologically. The most intensive epidemiological process takes place in schools, so the specific morbidity of the age group of 7-14 years of age is 4.6 times greater in relation to the average value. The results of bacteriological investigation, as well as those carried out on the pulps of the fingers of pupils of all ages, indicate a high degree of fecal contamination of school environment both in urban and rural communities. The high incidence of asymptomatic infections (1:18), causes the late detection of epidemics, while the inadequate maintenance of personal and general hygiene makes their occurrence and spreading possible.

[Ecological characteristics of viral hepatitis. III. Hepatitis B in Vojvodina]. / Epidemioloske karakteristike virusnih hepatitisa. III. Hepatitis B u Vojvodini.

The significance of particular risk factors for hepatitis B virus infection in persons of various ages was analyzed by active epidemiological investigation. Among the diseased children, the largest number of them were mentally retarded and accommodated in special institutions. Sexual and professional exposure to the hepatitis B virus is responsible for a considerable percentage of diseased adults, aged 20-49. In persons over 50 years of age, parenteral medical interventions are the most frequent risk factor. By carrying out proper sterilization in medical practice and vaccination of the exposed categories of the population, a significant reduction of the hepatitis B morbidity rates can be achieved.

[Epidemiologic characteristics of viral hepatitis. I. Analysis of registered cases of viral hepatitis in Vojvodina]. / Epidemioloske karakteristike virusnih hepatitisa. I. Analiza registrovanih slucajeva virusnih hepatitisa u Vojvodini.

According to reported morbidity rate, viral hepatitis still represents a major epidemiological problem in Voivodina, as well as in the entire country, although some of the epidemiological features of these diseases are changing in the course of time. The present paper contains an analysis of morbidity, changes in the age distribution, the degree of differentiation of the viral hepatitis, participation of hepatitis A and B in the total number of the differentiated cases, as well as their seasonal occurrence.