Serologic and Genomic Investigation of West Nile Virus in Kosovo.

The prevalence of West Nile virus (WNV) is increasing across Europe, with cases emerging in previously unaffected countries. Kosovo is situated in a WNV-endemic region where the seroepidemiological data on WNV in humans remains absent. To address this issue, we have conducted a seroepidemiological investigation of 453 randomly selected sera from a hospital in Kosovo, revealing a 1.55% anti-WNV IgG seroprevalence. Comparative and phylogeographic analyses of the WNV genomes obtained by sequencing archived samples from patients with West Nile fever indicate at least two recent and distinct introductions of WNV lineage 2 into Kosovo from neighboring countries. These findings confirm the eco-epidemiological status of WNV in southeast Europe, where long- and short-range dispersion of lineage 2 strains contributes to a wider circulation via central Europe. Our results suggest an increasing risk for WNV spreading in Kosovo, underscoring the need for an integrated national surveillance program targeting vectors and avian populations for early epidemic detection, as well as the screening of blood donors to gauge the impact of virus circulation on the human population.

Infectious Abortions in Small Ruminants: Challenges for Diagnosis and Public Health.

In this study, we report an abortion outbreak in a ruminant herd consisting of goats, sheep, and cows, with scenarios in two consecutive years. In early 2017, abortions occurred in ∼70% of goats and 66% tested positive for Coxiella burnetii (C. burnetii) and 40% of goats were positive for Chlamydophila abortus (C. abortus). In February 2018, the same herd reported an abortion rate of 75%, with 55% positive for C. burnetii, 36% for C. abortus, and 22% for Toxoplasma gondii. Six goat milk samples were positive for C. burnetii by molecular analysis. Three family members were positive for C. burnetii. C. burnetii could be considered as the main cause of abortions in the first and second year. Animals that undergo an infection and abortion are prone to secondary infections. Vaccination or other rapid interventions should be initiated to protect animals and humans.

Epidemiological characteristics of tularemia in kosova in the period 2006-2011.

INTRODUCTION: Tularemia is an important zoonosis in Kosovo. The first cases of tularemia in Kosovo were reported in 1999 among civil population in the west part of Kosovo. Tularemia has become an important problem in Kosova after 1999. AIM: The aim of this study was to analyze the frequency and distribution of Tularemia in Kosovo in the period from 2006 to 2011, propose measures and activities for prevention and control of the disease. MATERIAL AND METHOD: In this descriptive, retrospective study, we used official reports on infectious diseases from National Institute of Public Health of Kosova (NIPHK), as well as epidemiological surveys. The data collected were analyzed and the corresponding statistical parameters were tested with SPSS for the level of significance for P<0.01 and P<0.05. RESULTS AND DISCUSSION: The morbidity rate over the study period ranged from 0.38 (2011) to 11.26 (2010) per 100000 inhabitants. We found statistical significance between years for the level of P<0.00001. (X(2)-test=387.5; DF=5; P<0.0001). The majority of tularemia cases occurred in female (59%) with statistical significance for P<0.001 (X(2)-test=16.07; DF=1; P<0.001) The peak of cases in age group 20-40 years, with 242 cases or 48%, with statistical significance for the level of P<0.0001 (X(2)-test=253.14; DF=3; P<0.001) The main route of human infection is consumption of no safety water from wells (50%). The majority of tularemia cases occurred in female in Kosovo with 59% of observed cases while in a study in Central Anatolia region 54.7% were female. CONCLUSION: Kosova is an endemic zone of this disease since 1954 where the first cases were registered. Tularemia is a zoonosis, so in order to avoid human infections it is very important to implement measures well as perform public health education activities.

Rehabilitation of patients with war-related lower limb amputations.

AIM: To investigate the influence of factors: the amputation type and the time lag between last surgery and prosthetic rehabilitation, on the rehabilitation duration and outcome, in patients with war-related lower limb amputations. METHODS AND SUBJECTS: We reviewed the records of 101 war-related lower limb amputees who had inpatient rehabilitation at the National Ortho-Prosthetic Centre (NOPC) of Kosovo in Pristina, from July 1999 to June 2001, a retrospective observational study. Assessment of rehabilitation outcome-ambulation grade with prosthesis, is made on a 3-point scale. RESULTS: The amputation type was shown as an important predictor for the rehabilitation duration and outcome. The analysis by comparative groups has confirmed the amputation type to be of biggest importance. Earlier prosthetic rehabilitation, was shown as a factor of influence on the rehabilitation duration in all cases (r=0.22, P=0.027). This predictor was not relevant for the rehabilitation outcome. The most frequent type of prosthesis manufactured for the amputees, was the patellar tendon bearing below-knee prosthesis with suspension band (36.9%). CONCLUSION: Amputation of the limb should be performed as low as possible. If there are possibilities for prosthetic rehabilitation, any delays must be avoided, particularly in war-related lower limb amputees.

Tularemia outbreak investigation in Kosovo: case control and environmental studies.

A large outbreak of tularemia occurred in Kosovo in the early postwar period, 1999-2000. Epidemiologic and environmental investigations were conducted to identify sources of infection, modes of transmission, and household risk factors. Case and control status was verified by enzyme-linked immunosorbent assay, Western blot, and microagglutination assay. A total of 327 serologically confirmed cases of tularemia pharyngitis and cervical lymphadenitis were identified in 21 of 29 Kosovo municipalities. Matched analysis of 46 case households and 76 control households suggested that infection was transmitted through contaminated food or water and that the source of infection was rodents. Environmental circumstances in war-torn Kosovo led to epizootic rodent tularemia and its spread to resettled rural populations living under circumstances of substandard housing, hygiene, and sanitation.