Epidemiologic and laboratory surveillance of the measles outbreak in the Federation of Bosnia and Herzegovina, February 2014-April 2015.

A measles outbreak with two epidemic waves involving 4649 probable and laboratory-confirmed cases was recorded in six out of ten cantons of the Federation of Bosnia and Herzegovina between February 2014 and April 2015. The majority of the patients had never received measles vaccination (3115/4649, 67.00%), and the vaccination status of another 23% was unknown (1066/4649). A total of 281 blood samples were tested serologically. Virus detection was performed using 44 nasopharyngeal swabs. About 57% (161/281) of the laboratory-investigated sera were immunoglobulin M positive, and 95% (42/44) of the swabs were reverse transcriptase-PCR positive. Phylogenetic analysis of sequences obtained from 30 swab samples showed circulation of two variants of genotype D8, but no genotype D4 strains as detected in 2007. Similar involvement of all age groups indicates a problem with vaccine refusal resulting from antivaccination activities in addition to gaps in immunization coverage during the war and postwar period (1992-1998). Differences in ethnicity, vaccine coverage, compliance with review policies of vaccination records and potentially also travel habits may partially explain why only six of ten cantons were affected by the outbreak. The second epidemic wave may in part be due to large-scale migrations due to catastrophic floods in 2014. As a result of the epidemic, 6- to 12-month-old children may now be vaccinated against measles during outbreaks, and public health recommendations for interventions have been strengthened. Additional efforts are required to implement the measures throughout the cantons.

An ongoing measles outbreak in the Federation of Bosnia and Herzegovina, 2014 to 2015.

Between January 2014 and the beginning of February 2015, the Federal Institute of Public Health in the Federation of Bosnia and Herzegovina has reported 3,804 measles cases. Notable transmission has been observed in three Central Bosnia Canton municipalities: Bugojno, Fojnica and Travnik. Most cases were unvaccinated 2,680 (70%) or of unknown vaccination status 755 (20%). Health authorities have been checking vaccination records and performing necessary prevention measures. The epidemic is still ongoing.

An outbreak of rubella in the Federation of Bosnia and Herzegovina between December 2009 and May 2010 indicates failure to vaccinate during wartime (1992-1995).

A rubella outbreak involving 1900 cases was recorded in the Federation of Bosnia and Herzegovina between mid-December 2009 and the end of May 2010. Sera from 389 suspected rubella cases were examined for the presence of rubella-specific IgM and IgG antibodies. A total of 32 throat swabs from suspected rubella cases were tested by RT-PCR and were used to attempt virus isolation. Most patients (945/1900, 49·73%) had never received rubella vaccination or had an unknown vaccination status (563/1900, 29·63%). About 45% (178/389) of suspected rubella patients were IgM positive. From 13 of the throat swabs a virus isolate and E1 gene sequences attributed to genotype 2B were obtained. The rubella outbreak was due to failure to vaccinate during the war period (1992-1995) and emphasizes the need for additional vaccination opportunities.

A serosurvey reveals Bosnia and Herzegovina as a Europe's hotspot in hantavirus seroprevalence.

The extent of hantavirus seroprevalence in the healthy population from Bosnia and Herzegovina has not yet been investigated; therefore, the aim of this study was to assess the hantavirus seroprevalence in the population from different regions of Bosnia and Herzegovina and in different risk groups. The serosurvey included 1331 subjects from endemic and non-endemic regions in Bosnia and Herzegovina. All sera samples were examined using IgG ELISA, and Western blot (Bunyavirus IgG) tests. Hantavirus seroprevalence was 7.4% in the endemic region and 2.4% in the non-endemic region (P<0.05). Former soldiers from the endemic region had significantly the highest seroprevalence (16.1%) compared to the general population from the endemic region (6.2%), the occupational risk group from the non-endemic region (5.6%) and the general population from the non-endemic region (0.8%) (P<0.01). No difference in hantavirus seroprevalence between gender or age groups was observed. Hantavirus seroprevalence in different populations in Bosnia and Herzegovina was found to be highest compared to other central European countries.

Clinical research of dental erosion.

On the base of performed clinical studies of a possible appearance of dental erosion in patients, it can be concluded as follows: 1) Out of 710 treated patients, in 62 is found the appearance of erosive changes of dental tissues. 2) Erosive changes were more prevalent in patients in the third age group, more often in male than in female. 3) Patients with erosive changes are with distinctive gastrointestinal disorders, they used the hard toothbrush, soft food, and in most of them is noticed the appearance of psychic disorders with the aggressive behaving. 4) Studies have shown the justification and the need to continue them by multidisciplined approach in a higher number of patients, a longer period, in order for better discovering the aetiology of erosive changes of dental hard tissues.

[Morphologic changes in the pulp and surrounding structures of the teeth in irradiated animals]. / Morfoloske promjene pulpe i okolnih struktura zuba kod ozracenih zivotinja.

Several animals of the same breed (11 swine-white Landrace) were used in the research. Irradiation was made by radiation from the linear accelerator with lethal doses (3,68-4, 48 Gy). The changes on incisors and molars in the perished animals were observed as well as the changes on the surrounding structures of teeth. In the examined histological incisions of the dental pulp, paradontium, alveolar part of the bone and gingival part of the mucose of the oral cavity in the animals were found extensive confluent bleeding, dilatation of blood vessels with expressive edema of blood vessels intima. The endothelium showed the signs of edema, prominence toward the lumen or desquamation in the lumen. There were shallow defects in the gingival mucosa due to the necrosis and desquamation top-cover epithelium. The described changes fit into the findings of a large number of researches who accent hemorrhagic diathesis with petechial ecchymotic and confluent bleedings in many organs and tissues.

[Histologic picture of dental pulp in dogs treated with ZnOOK paste]. / Histoloska slika zubne pulpe psa tretirane ZnOOK pastom.

The activity of zinc-oxide paste on histologic changes of the pulp was examined while the indirect capping of the exposed dog tooth pulp was performed. The results showed that the histologic changes observed in dog tooth pulp were accompanied with hyperaemia and blood vessel dilatation then with the pulp oedema, slight disorder of odontoblast palisade and the presence of the traces of occurrence of tertiary dentin.

Prognostic value of some parameters of cellular immunity in breast cancer patients.

In 45 histologically verified breast cancer patients the cell-mediated immune responses were tested prior to surgical therapy. The cell immunity was assessed by the percentage of T and active T-lymphocytes and by measuring the lymphocyte reactivity to phytohemagglutin (PHA) and concanavalin A (Con A). Disease-free interval was longer and the mortality after 3, 5 and 8-year follow-up significantly lower in the group of patients with the normal number of T and active T-lymphocytes than in the group of patients with the lower number of those cells. The proliferative response of lymphocytes to Con A and PHA assessed in allogeneic and autologous serum also seemed to be a useful prognostic parameter. The survival was significantly longer in the group of patients with a normal lymphocyte reactivity to those mitogens than in the non-reactive group.

[Rotaviruses--causes of minor epidemics of diarrheal diseases in the neonatal department of the Pediatric Clinic in Sarajevo]. / Rota virusi--uzrocnici manje epidemije dijarealne bolesti na neonatoloskom odjeljenju Djecije klinike Sarajevo.

A rotavirus epidemic took place at the above mentioned department (8. V 1987 until 19. VI 1987). During that period, 36 newborn infants were treated for rotaviral symptoms and they all had their stools checked for rotaviruses or their antigen. Rotaviruses were found by 17 patients (47.2%). As a lab method we used immunoelectrophoresis. 20 patient of the overall number of 36 were boys and 16 were girls. Stool samples showed rotaviruses in 9 boys (45%) and 8 girls (50%). The age of patients was 3 to 34 days. After 1-14 days all children were well.

[Comparison of the immunoenzyme test (ELISA) with other methods in the detection of rheumatoid factor]. / Komparacija enzimskog imunoloskog testa (ELISA) sa drugim metodama u detekciji reumatoidnog faktora.

IgM rheumatoid factor was detected, beside ELISA test, by Waaler-Rose, Latex agglutination and indirect immunofluorescent test. 107 patients hospitalized in the Clinic for heart diseases and rheumatism, as well as 50 healthy subjects were examined. In the first group were 50 patients with RA, 30 patients with other rheumatic diseases and 27 with nonrheumatic diseases. According to our results there was no significant difference between sensitivity of ELISA test and other laboratory tests used. ELISA test was positive in 94% of cases of RA, 20% in other rheumatic diseases and only in one case (3,7%) of a nonrheumatic disease. Compared with the control group in which there was no specific reaction, Waaler-Rose and immunofluorescent testing showed a nonspecific reaction in 2% and Latex test in 4% of all cases. Although ELISA test was not significantly sensitive as compared with other laboratory methods, according to our results, it has high reproducibility, specificity and precision (it is measured in international units/mL serum), and it allows following of the concentration of rheumatoid factor. Besides, ELISA test can be done on 100 specimen of blood within 6 hours and the results are known the same day.