Risk characterization for mercury, dichlorodiphenyltrichloroethane and polychlorinated biphenyls associated with fish consumption in Serbia.

The aim of this work was to assess the risk due to mercury (Hg), dichlorodiphenyltrichloroethane (DDT) and non-dioxin-like polychlorinated biphenyls (ndl PCBs) intake via fish consumption in Serbia. We have developed 24 scenarios using four concentration levels (mean, maximum, 50th and 95th percentile) of contaminants, determined in 521 samples of fish products available on Serbian market; two consumption levels (Food and Agriculture Organization/World Health Organization data and recommendation of American Heart Association); and three body weights (5th, 50th and 95th percentile). All the values concerning the intake of DDT are below the corresponding health based guidance value. Calculated weekly intake of Hg using maximal concentration, intake of 340g/week and 5th percentile of body weight exceeded the provisional tolerable weekly intake (PTWI). When maximal and 95th percentile concentration of ndl PCBs was used, weekly intakes exceeded a "guidance value" with one exception i.e., when 95th percentile of concentration along with 95th percentile of body weight were used. Concerning Hg and ndl PCBs, when extreme concentrations were used, HIs exceeded the value of 1, indicating that fish and fishery products may pose a threat to consumer's health.

Simulated impact of a fish based shift in the population n--3 fatty acids intake on exposure to dioxins and dioxin-like compounds.

Due to the favourable health effects of LC n-3 PUFAs, marine products have been recognised as a food group of special importance in the human diet. However, seafood is susceptible to contamination by lipophilic organic pollutants. The objective of this study was to evaluate intake levels of PCDDs, PCDFs and dioxin-like PCBs, by a probabilistic Monte Carlo procedure, in relation to the recommendation on LC n-3 PUFAs given by Belgian Federal Health Council. Regarding the recommendation, two scenarios were developed differing in LC n-3 PUFAs intake: a 0.3 E% and a 0.46 E% scenario. Total exposure to dioxins and dioxin-like substances in the 0.3 E% LC n-3 PUFAs scenario ranges from 2.31 pg TEQ/kg bw/day at the 5th percentile, over 4.37 pg TEQ/kgbw/day at the 50th percentile to 8.41 pg TEQ/kgbw/day at the 95th percentile. In the 0.46 E% LC n-3 PUFAs scenario, 5, 50 and 95th percentile are exposed to 2.74, 5.52 and 9.98 pg TEQ/kgbw/day, respectively. Therefore, if the recommended LC n-3 PUFAs intake would be based on fish consumption as the only extra source, the majority of the study population would exceed the proposed health based guidance values for dioxins and dioxin-like substances.

[Epidemiology of Lyme borreliosis]. / Epidemiologija Lyme borreliosis.

Our prospective study covered 1093 patients with epidemiological features and demonstrable clinical manifestations of Lyme borreliosis from 1987 to 1992. Basic criteria for the inclusion of our patients in the study were: tick bite, erythema migrans and antibodies to B. burgdorferi in each patient's serum. Various clinical manifestations were found un 1034 (94.6%) patients out of whom 829 (80.2%) had a history of tick bite, 901 (87.1%) had erythema migrans and 217 (21.0%) had serologic confirmation of the diagnosis. Inapparent infection was discovered in 59 (5.4%) patients. Other Types of skin changes (II and III stage) were found in 123 (11.9%) patients. The disease resulted in neurologic, joint and cardiac manifestations in somewhat lower percentage of patients (6.3%, 6.6% and 1.5%, respectively). In the three-year period (1990-1992) microscopic examination of the ticks (Ixodes ricinus) collected at several green areas of Belgrade confirmed the presence of B. burgdorferi in 29.1 per cent.

[Clinical characteristics of patients with Lyme disease treated at the Institute for Infective and Tropical Diseases 1988-1992]. / Klinicke karakteristike obolelih od lajmske bolesti lecenih u Institutu za infektivne i tropske bolesti od 1988. do 1992. godine.

In the Institute for infectious and tropical diseases in Belgrade in the period 1988-1992, 680 patients with Lyme borreliosis have been examined. In most cases illness was recognised in the first stage as Erythema migrans. In seven patients second and third stage of Lyme borreliosis was cured in hospital.

[Clinico-laboratory diagnosis of Lyme borreliosis--personal experience]. / Klinicko-laboratorijska dijagnoza Lyme borreliosis--nasa iskustva.

Between May 1992 and February (second half) 1993 two hundred patients with the history of tick bite have been examined at the Institute for Infectious and Tropical Diseases "Dr Kosta Todorovic". Of the above 200 persons, 103 of them have had clinical/epidemiological evidence of Lyme disease (i.e. Erythema migrans). In order to establish the degree of seroconversion in this stage of Lyme disease, blood of each patient has been tested by PHA and IFA methods. Blood from each patient has been drawn in pairs, immediately before and after the treatment. By method of PHA we have analyzed 186 sera and found 23 positive results. By method of IFA we have analyzed 10 sera and found one positive result. By Comparative testing we have analyzed 10 sera, obtaining 5 positive results by PHA and 3 positive results ba IFA.

[Borrelia burgdorferi seropositivity in the region of Cacak]. / Prokuzenost stanovnika regiona Cacak Borelijom burgdorferi.

Seropositivity to Borrelia burgdorferi found in the population of Cacak area, suggests that the illness in different forms is present in this population. Failure in detection of early symptoms contributes to development of the second and the third stage of illness, in which the treatment is connected with more difficulties. A high natural focus activity has been confirmed by seropositivity found in sera of 11% of patients tested.

Hemorrhagic fever with renal syndrome in Yugoslavia: epidemiologic and epizootiologic features of a nationwide outbreak in 1989.

A nationwide epidemic of hemorrhagic fever with renal syndrome (HFRS) occurred in Yugoslavia in 1989. Sera from 609 hospitalized patients, from all six Republics (Bosnia and Hercegovina, Croatia, Macedonia, Montenegro Serbia, Slovenia) and two Provinces (Kosovo and Vojvodina), who had signs and symptoms suggestive of HFRS, and sera and lung tissues from 544 small mammals belonging to 13 species were studied for evidence of hantavirus infection. Of the 226 patients with serologically confirmed HFRS, 182 resided in Bosnia and Hercegovina or in Serbia. The severity of disease differed from region to region, with an overall fatality of 6.6% (15/226). Patients from southern Yugoslavia tended to have more severe disease and exhibited two types of antibody patterns, while approximately equal numbers of clinically severe and mild cases of HFRS were registered in central Yugoslavia, where four types of antibody patterns were found. Two of these antibody patterns suggested the existence of hantaviruses which are antigenically distinct from those reported to date. Two seasonal peaks of disease, one during the summer and the other in late autumn, were found. Hantaviral antibodies and/or antigens were detected most often in the yellow-necked mouse (Apodemus flavicollis) (88/189), the wood mouse (Apodemus sylvaticus) (28/146), the striped field mouse (Apodemus agrarius) (10/64), the bank vole (Clethrionomys glareolus) (36/63), the house mouse (Mus musculus) (14/29), and the Norway rat (Rattus norvegicus) (14/21). Five other species of rodents and insectivores were infrequently infected.

[Epidemiologic characteristics of human parvovirus B19. Report of an epidemic of erythema infectiosum in the area of Belgrade]. / Epidemioloske osobenosti humanog parvovirusa B19. Prikaz epidemije Erythema infectiosum otkrivene na teritoriji Beograda.

During the period 29.10.1987-10.5.1988 an outbreak of an illness with rash resembling Erythema Infectiosum occurred among school children in one part of Belgrade-Mladenovac. This is the first outbreak of Erythema Infectiosum reported in Yugoslavia and confirmed in University College of Middlesex School of Medicine, London, in November 1989. Of 720 school children exposed to infection of Human Parvovirus B 19 two hundred and eighty four (39.4%) have had clinical symptoms and 166 (58.4%) of them were in the age group 10-14. The sero-epidemiologic investigations excluded infection of Rubella virus, Cytomegalovirus and Coxsackie viruses A 9 and B 5. To detect the infection Elisa IgM antibody, complement fixation, inhibition of hemagglutination and isolation have been used. Clinical symptoms of illness have been manifested as Rubella like exanthemas on extremities in 92.5%, extremities and body in 26.5% and the phenomenon "slapped Cheek" was discovered in 76.25% of all patients. Reappearance of rash has been observed in 25% of cases.

Simplified sample preparation for fluoride determination in biological material.

A simple and rapid preparation method for the determination of fluoride in biological materials (blood and food) of various origins, is described. A homogenized sample was placed in a plastic diffusion cell and calcium phosphate added, it was then dried at 55 degrees C and treated with 70% HClO4 and 40% AgClO4. After digestion for 24 h at 55 degrees C, the fluorides released were fixed on the upper part of a diffusion cell containing a thin layer of NaOH. The analyses of the diffused fluoride were carried out with an ion-selective electrode. The proposed microdiffusion method, without mineralization, enables quantitative separation of the fluoride from the biological samples.

Hemorrhagic fever with renal syndrome in Yugoslavia: detection of hantaviral antigen and antibody in wild rodents and serological diagnosis of human disease.

Lung tissues from 547 rodents and 26 insectivores captured between 1981 and 1984 in central Bosnia (Fojnica) and central Serbia (Cacak), 2 regions known to be endemic for hemorrhagic fever with renal syndrome (HFRS), were examined for hantaviral antigen by the indirect immunofluorescent antibody technique. Antigen was detected in 17/231 Apodemus flavicollis, 3/187 A. sylvaticus, 1/46 A. agrarius, 4/32 Mus musculus, and 3/28 Clethrionomys glareolus. In addition, antibodies against Hantaan and Puumala viruses were found in serum pooled from 2 C. glareolus captured in Fojnica and 6 Pitimys subterraneus caught in Cacak. Sera of 27 HFRS patients from different parts of Yugoslavia were tested against 3 serotypes of hantavirus. Patients from Bosnia and Serbia had highest titers against Hantaan virus, while patients from Croatia had highest titers against Puumula virus, the agent of nephropathia epidemica.