RESUMO
We describe the first reported outbreak of West Nile virus (WNV) infection in humans in Serbia in August to October 2012 and examine the association of various variables with encephalitis and fatal outcome. Enzyme-linked immunosorbent assay (ELISA) was used for detection of WNV-specific IgM and IgG antibodies in sera and cerebrospinal fluid. A total of 58 patients (mean age: 61 years; standard deviation: 15) were analysed: 44 were from Belgrade and its suburbs; 52 had neuroinvasive disease, of whom 8 had meningitis, while 44 had encephalitis. Acute flaccid paralysis developed in 13 of the patients with encephalitis. Age over 60 years and immunosuppression (including diabetes) were independently associated with the development of encephalitis in a multivariate analysis: odds ratio (OR): 44.8 (95% confidence interval (CI): 4.93408.59); p=0.001 (age over 60 years); OR: 10.76 (95% CI: 1.06109.65); p=0.045 (immunosuppression including diabetes). Respiratory failure requiring mechanical ventilation developed in 13 patients with encephalitis. A total of 35 patients had completely recovered by the time they were discharged; nine patients died. The presence of acute flaccid paralysis, consciousness impairment, respiratory failure and immunosuppression (without diabetes) were found to be associated with death in hospital in a univariate analysis (p<0.001, p=0.007, p<0.001 and p=0.010, respectively).
Assuntos
Surtos de Doenças , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Febre do Nilo Ocidental/diagnóstico , Febre do Nilo Ocidental/epidemiologia , Vírus do Nilo Ocidental/isolamento & purificação , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/sangue , Anticorpos Antivirais/líquido cefalorraquidiano , Encefalite/complicações , Encefalite/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Infecções por Flavivirus/complicações , Infecções por Flavivirus/epidemiologia , Humanos , Imunoglobulina G/líquido cefalorraquidiano , Imunoglobulina M/líquido cefalorraquidiano , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Paralisia/complicações , Paralisia/epidemiologia , Vigilância da População , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sérvia/epidemiologia , Distribuição por Sexo , Febre do Nilo Ocidental/virologia , Vírus do Nilo Ocidental/imunologiaRESUMO
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.
Assuntos
Surtos de Doenças , Controle de Infecções/métodos , Caxumba/epidemiologia , Medição de Risco/métodos , Adolescente , Adulto , Distribuição por Idade , Criança , Serviços de Saúde da Criança/organização & administração , Pré-Escolar , Notificação de Doenças , Feminino , Humanos , Disseminação de Informação , Masculino , Caxumba/diagnóstico , Caxumba/fisiopatologia , Caxumba/prevenção & controle , Vigilância da População , Administração em Saúde Pública/métodos , Sérvia/epidemiologia , Distribuição por Sexo , Estudantes/estatística & dados numéricos , Fatores de Tempo , Vacinação/estatística & dados numéricosRESUMO
Preparedness planning for two large mass gatherings events were considered in Serbia in the context of pandemic influenza (H1N1) 2009. Planning included approaches to prevention, detection and response in order to mitigate the situation at this early stage of the epidemic in Serbia. Cases of influenza A(H1N1)v were identified nationally immediately prior to the mass gatherings but also identified in association with both events, as expected in the context of the pandemic situation. This article describes the experiences of planning and the epidemiological situation during the period of the mass gathering events.