Infection of respiratory syncytial viruses (RSV) in the Czech Republic - analysis of hospitalizations and deaths in 2017-2022.

OBJECTIVES: Given the lack of data on the seriousness of respiratory syncytial virus (RSV) infections in the Czech Republic, an analysis was made of available data on hospitalizations and the hospitalization risk was estimated by age group. METHODS: Data from the National Registry of Reimbursed Health Services and the National Registry of Hospitalizations were used for the analyses. Hospitalizations and deaths due to RSV infection (diagnoses J12.1, J20.5, J21.0) from 2017-2022 were analyzed by age group. RESULTS: Over the six-year period, there were 6,138 hospitalizations with the above diagnoses, ranging between years from 307 to 2,162. The estimated overall hospitalization risk per 100,000 population and year for diagnoses J12.1, J20.5, and J21.0 was 9.64, varying between 2.87 (2020) and 20.56 (2021). Age-group analysis showed the highest risk for children under 6 months of age (891.6/100,000 population and year) and the lowest for 20-34-year-olds (0.1/100,000 population and year). Children under 1 year of age accounted for 63.1% of hospitalizations with the above diagnoses. For patients 65 years and older, the annual hospitalization rates varied between 3.3-15.3%. The most frequent cause of RSV-associated hospitalizations was bronchitis, diagnosed in 55.4% of patients. Among those hospitalized with diagnoses J12.1, J20.5, and J21.0, 38 deaths were reported, representing a case fatality rate of 0.62%. The highest case fatality rate (6.5%) was observed in the age group 35-49 years. CONCLUSIONS: RSV-associated hospitalizations have been reported in all age groups in the Czech Republic. The highest RSV-associated hospitalization risk in 2017-2022 was estimated among children under 6 months of age. Passive surveillance using the available registries could currently provide the basis for measures specifically tailored to the youngest age categories. Data on the hospitalization of adults, particularly senior citizens, must be improved and complemented with active surveillance.

Norovirus infections in the Czech Republic in 2008-2020.

INTRODUCTION: Noroviruses, together with rotaviruses, are the most common cause of viral gastroenteritis in the Czech Republic (CR). The aim of this study was to analyse data on the incidence of norovirus gastroenteritis in the CR and thus to add to the body of knowledge about its significance. MATERIAL AND METHODS: A descriptive analysis was performed of the basic characteristics of norovirus gastroenteritis reported under ICD-10 code A08.1 to the Epidat or ISIN electronic infectious diseases information system between 2008 and 2020. On the basis of reports from five microbiological laboratories, weekly data on confirmed cases of norovirus infection from 2010-2020 were analysed. Databases of microbiology laboratories from across the Czech Republic were searched to determine the number of the laboratories where norovirus infections were diagnosed and the methods used for this purpose in 2008-2020. RESULTS: From 2008 to 2020, 33,575 cases of norovirus gastroenteritis were reported to the infectious diseases information systems, which equates to an annual incidence of 24.5/100,000 population, varying between years from 8.2 to 77.1/100,000. Men accounted for 40.2% of cases with an incidence of 20.1/100,000 compared to 28.8/100,000 recorded in women. Of the total of reported cases, 14,282 patients (42.5%) required hospital admission. Over the whole study period, 7,431 cases of norovirus gastroenteritis were recorded in children under 5 years of age. This age category accounted for 13.7-38.9% of the annual totals of reported cases. The incidences were 101.8/100,000 in children under 5 years of age, 40.1/100,000 in 5-14-year-olds, 12.7/100,000 in 15-64-year-olds, and 38.2/100,000 in the age group 65 years and over. Twenty-four deaths (case fatality rate of 0.07%) were reported as associated with norovirus gastroenteritis at the ages 42-94. In the age categories 15-64 years and 65 years and over, the case fatality rates were 0.02% and 0.24%, respectively. Over the study period, 274 epidemics occurred, during which 16,893 (50.3%) of the total of 33,575 cases were reported. In the epidemic outbreaks, 1,694 (10.0%) patients required hospital admission. The largest outbreak with 5,248 reported cases in 2015 was associated with contamination of the Prague water supply system. Norovirus infections were laboratory diagnosed year-round, peaking in the autumn and winter months. They are currently diagnosed by 81 laboratories in the Czech Republic, 90.1% of which use immunochromatographic tests. CONCLUSION: The study confirmed the highest incidence of norovirus gastroenteritis among children under 5 years of age and the highest case fatality rate in the age group 65 years and over. Over half of the reported cases were outbreak associated. Most laboratories use immunochromatographic tests. The use of more sensitive laboratory methods would improve diagnosis.

Analysis of disability for HIV disease in 2010-2018.

The present paper analyses the development of invalidity in people living with HIV over a nine-year period from 2010 to 2018. The disability assessment criteria currently in place were introduced in 2010 and are legally regulated. The paper draws from the Czech Social Security Administration data to analyse the incidence of invalidity as a result of HIV infection compared to other diseases in the Czech population. The authors illustrate the invalidity assessment criteria with a case study. In the final part, updating the current assessment criteria is recommended, also because of the envisaged ICD-11 implementation in the Czech Republic.

Genotyping of noroviruses from patients of the Pilsen University Hospital in the Czech Republic, 2017-2020.

OBJECTIVE: Noroviruses are members of the Caliciviridae family and are currently segregated into at least 10 genogroups. The distribution of these viruses in the Czech Republic has not yet been investigated in detail. A pilot study was performed to contribute to the overall knowledge and understanding of norovirus circulation in the population. Clinical specimens from patients diagnosed with norovirus infection during their hospitalization at the Pilsen University Hospital were genotyped. MATERIAL AND METHODS: A total of 118 patients were diagnosed with norovirus infection between July 2017 and March 2020. Stool samples from patients presenting with gastroenteritis were routinely screened by the RIDA®QUICK Norovirus Test (R-Biopharm AG), a rapid chromatographic immunoassay for the qualitative detection of Norovirus genogroups I and II, according to the manufacturers instructions. Norovirus positive samples were subsequently analysed by molecular biological methods. Stool suspensions (10%) were prepared with phosphate-buffered saline, and nucleic acid was extracted using the QIAamp Viral RNA kit (Qiagen) according to the manufacturers instructions. To investigate the genotype distribution, RT-PCR targeting specific sections of the norovirus genome (region C) was employed, followed by purification of PCR products using the QIAquick PCR Purification Kit (Qiagen) and sequencing (Eurofins Genomics). The sequences obtained were analysed by the MEGA X software, and the results of phylogenetic analyses were confirmed by Norovirus Typing Tool Version 2.0 (https://www.rivm.nl/mpf/typingtool/ norovirus/. RESULTS: During the study period, 14 norovirus genotypes or genogroup variants NoV GI, NoV GII and NoV GIX (previously NoV GII.15) were identified. The major genotype NoV GII.4 Sydney-2012 accounted for a total of 70.3% of norovirus gastroenteritis cases. This norovirus variant was detected in 24 months out of 34 months of the study period. In general, the number of norovirus infections increased during autumn and winter months (October to March) when 68 (57.6%) cases were diagnosed. Although norovirus infection was confirmed in all age categories (age range 0-96 years, median 8, mean 27.9), the statistical analysis revealed a significant difference in the incidence of NoV GII.4 infection between the age group 0-4 years and older patients (χ2 = 3.95, P = 0.047). Many patients (51) were residents of the Pilsen-city district. The case history data showed that 35 of them (29.7%) had another family member who developed symptoms of gastroenteritis at the time of the onset of their infection. CONCLUSION: The pilot study is the first attempt to map the molecular epidemiology of noroviruses, not only in the Pilsen Region but also in the whole Czech Republic. Despite the relatively low number of officially reported cases, noroviruses are undoubtedly one of the most important causes of gastroenteritis in this country. Further studies are therefore necessary to expand the body of knowledge of their ecology and circulation.

Health literacy on HIV infection among adolescents in the Czech Republic: a case study of two Czech cities Plzeň and České Budějovice.

Despite health literacy being an important assumption for maintaining a healthy population, there are not many studies focusing on health literacy concerning HIV infection among adolescents in the Czech Republic and among Czech authors. In contrast, there are plenty of scientific papers and researches focused on awareness and susceptibility of adolescents in most affected regions of the world, Sub-Saharan Africa and India particularly. Adolescents belong to a high-risk group of the population. Education is one of the most important factors that influence the level of risk of HIV infection. However, increasing health literacy is only implemented in some types of secondary schools in the Czech Republic. The goal of this study is to verify health literacy concerning HIV infection among adolescents in two types of Czech secondary schools (grammar school and vocational school) in two Czech regional cities (Plzeň and České Budějovice). To determine the level of health literacy of HIV infection, a questionnaire (13 open and 9 closed questions) was compiled. A descriptive cross-sectional study was implemented among students (N = 1 942) of 16 chosen schools in two cities of the Czech Republic in 2015. The questionnaire was pre-tested and it took about 15 minutes to complete. The association was tested by a chi-square test, the averages were then compared with an independent t-test, the p-value (0,05) was used in all tests. Most of the students (67,3%) had good health literacy about HIV/AIDS, statistically significant differences were found between students of grammar schools and vocational schools (p = 0,012). Differences were also found between men and women (p = 0,037). The respondents showed the best knowledge about transmission (94,3%), the poorest about epidemiological questions (18,3%). Gender and the type of school had a statistically significant influence on the level of knowledge (gender x2; p = 0,042, types of a school x2; p = 0,031). In this cross-sectional study, women studying at grammar schools had the best knowledge of HIV/AIDS. In contrast, the lowest level of knowledge was found in men studying in vocational schools. The school types and gender had a statistically significant influence on the level of knowledge. However - knowledge is not enough. To reduce infection risk potential will mean to help adolescents to transform knowledge into diminishing of their risky behaviour. The implementation of prevention in all types of schools is crucial for the reduction of exposure from HIV infection. We consider educating adolescents about sexually transmitted diseases important. Despite that our research showed differences among schools and gender. Those differences can make a particular group be more at risk of being infected. Based on the findings, it would be suitable to unify and improve the approach to the education of this topic in all types of schools and to target preventive and educational techniques to boys more, since men are the biggest group of the HIV positive people in the Czech Republic.

[Enterovirus sequencing as a new approach to the laboratory diagnosis for clinical and epidemiological purposes]. / Sekvenace enteroviru jako nový prístup k laboratorní diagnostice pro klinické i epidemiologické úcely.

OBJECTIVE: Introducing enterovirus sequencing as an advanced approach to classify the viruses isolated according to the novel nomenclature and to characterize isolates in detail. MATERIAL AND METHODS: Seventy-five specimens collected from 64 patients in two hospitals, Liberec Regional Hospital, and Plzen University Hospital, were analyzed. The study patients' age ranged from four to 54 years, with a median of 15 years in males and 16 years in females. In most patients, the reasons for admission were intense headache, fever, vomiting, tiredness, meningeal symptoms, intestinal symptoms (in two patients), and skin symptoms (in one patient). The specimens collected were rectal and throat swabs, cerebrospinal fluid (CSF) and stool specimens. Molecular detection and typing were performed using the RT-PCR method. A segment of the 5´non-coding RNA was selected for typing. Specimens were amplified using single-step PCR with external primers and with the same primers extended to include M13 sequences (Generi-Biotech). The LASERGENE software (DIASTAR) was used in sequence editing, alignment, and quality check. The sequences obtained were checked against the central GenBank sequence database using the BLAST algorithm. RESULTS: The identification of the study isolates resulted in 61 ECHO viruses 30, three coxsackie viruses B1, one coxsackie virus B3, one coxsackie virus A9, one enterovirus 86, one enterovirus 71, Two ECHO viruses 13/coxsackie virus B5, one ECHO virus 7/30/coxsackie virus B4, one coxsackie virus B4/enterovirus B, one enterovirus 87/ECHO virus 30/enterovirus B, and one ECHO virus 3. All viruses isolated, except enterovirus 71 classified into group A, were of group B. CONCLUSION: The enteroviruses were identified unambigously, although the sequencing only targeted a short, conserved segment that showed considerable variability. The sequencing was an effective alternative to enterovirus identification by the neutralisation test and allowed for detailed characterization of the isolates. The predominance of ECHO 30 as the cause of aseptic meningitis is in accordance with the literature data.

[Mumps outbreak in the Plzen Region in 2011]. / Epidemie príusnic v Plzenském kraji v roce 2011.

AIM: The mumps outbreak in the Plzen Region in 2011 was analysed retrospectively using the epidemiological, clinical, and laboratory data. Vaccine efficacy analysis was also conducted in various population groups. MATERIAL AND METHODS: The routine procedure and standard form were used by the epidemiologists to collect data on the age, sex, place of residence, presence in collectivities, date of disease onset, type of complications and date of their onset, hospital admission, vaccination, and results of laboratory analyses. Based on the records of general practitioners for children and adolescents, data on the vaccination of children born in the previous three years have been provided to the epidemic control departments every year by 30 June since 1989. To estimate the vaccination coverage rate, the numbers of single-dose or two-dose recipients are related to the number of children registered in a given year. The first year of vaccine recipients were children born in 1986 who were aged 25 in 2011. The data collected on the population of the Plzen Region were used for the primary analyses. To estimate the efficacy of the mumps vaccine, age and vaccine coverage cohort analysis was performed using the screening method. To analyse categories, the chi-square test with Yates correction was applied at a significance level of p = 0.05 % (EPIINFO version 6.04d). RESULTS: In 2011, 721 mumps cases were reported in the Plzen Region (incidence: 126.1 cases per 100 000 population). The average patient age was 19.4 years, with a median of 18 years (age range 1-77 years). Four hundred and seventeen (57.8%) patients were males. Biological specimens from 375 (52.0%) patients were investigated serologically in the virology laboratory and mumps were laboratory confirmed in 316 (43.8%) of them - in 222 patients, one blood specimen was analysed. The most afflicted area was the Klatovy district with the incidence of 449.3/100 000 population. The most affected age group were 15-19 year-olds with the incidence of 1008.2/100 000 population. Forty-two (5.8%) patients were diagnosed with complications and 68 (9.4%) patients were admitted to the hospital. No statistically significant difference was found in the incidence of complications between the vaccinated and non-vaccinated patients. The assessment of hospitalisation risk showed a statistically significant difference between the vaccinated and non-vaccinated persons in both the whole study cohort and subcohort of patients who received the mumps vaccine within the childhood immunization schedule (p = 0.000 and p = 0.004, respectively). The average age of the vaccinated patients was 16.1 years (median of 17) and that of the non-vaccinated patients was, 29.3 years (median of 27). At the six to ten-month interval, as laid down by the legislation, the second dose of the vaccine was only given to 83.6 % of the patients. The screening method showed a high efficacy of the vaccine in the age group 20-25 years (97.6% in two-dose recipients), declining to 29.6% in the most affected age group of 15-19 years. CONCLUSIONS: Mumps outbreak may has been a result of the accumulation of high numbers of susceptible individuals in the population. The most affected area was the Klatovy district where the last epidemic outbreak occurred 23 years ago. To make the favourable epidemiological situation with occasional local outbreaks continue, the high two-dose vaccine coverage rate needs to be maintained.

Cluster of three cases of invasive meningococcal disease in a preschool facility in West Bohemia, the Czech Republic.

From 1993 to 2009, there was only one cluster of invasive meningococcal disease (IMD) reported in a community of children in the Czech Republic. This exceptional cluster that occurred in a preschool facility is the focus of this report. In response to the announcement of the disease, anti-epidemic precautions were put in place. Neisseria meningitidis isolates were delivered from local laboratories to the National Reference Laboratory for Meningococcal Infections in Prague. Phenotyping was performed there along with multilocus sequence typing. Related factors and microbiological results were analyzed retrospectively. In October 2009, three girls contracted IMD within a period of 1 week in a 42-member group in a preschool facility attached to the elementary school in Starý Plzenec-Sedlec. In relation to three cases of the disease, another 66 people were registered of which 58 underwent a microbiological examination. N. meningitidis was detected in a total of five (8.6 %) people. The National Reference Laboratory for Meningococcal Infections defined the type of the strain to be C: P1.18-1,34-2,38: F1-7: ST-467 (cc269) and penA27. Tests showed the precise identity of all strains obtained from the three sick children and of two strains contracted through contact with the preschool facility. Despite the complete recovery of all patients with no permanent damage, the need for rapid cooperation between clinical sites, diagnostic laboratories, and epidemiologists was confirmed.

Seroprevalence of hantavirus antibodies among chronic hemodialysis patients in the Czech Republic.

A total of 348 serum samples were collected from 301 hemodialysis patients with chronic renal failure of four healthcare settings in Western Bohemia. The sera were screened for the presence of hantavirus antibodies using ELISA kits (PROGEN Biotechnik GmbH) with Hantaan and Puumala antigens. Specific anti-Puumala antibodies were detected in five patients (1.7%). Although hantaviruses are known to cause primarily acute renal damage (interstitial nephritis) in Eurasia, chronic effects of hantavirus infection and the detection of specific antibodies in hemodialysis patients have also been reported. Nonetheless, the detection of seropositivity is not proof of an etiological link between hantaviruses and chronic renal failure. The hantavirus seropositivity rate in hemodialysis patients was not significantly higher than that in the general population. Our findings are consistent with the literature data and do not contradict the contribution of hantaviruses to the pathogenesis of chronic renal damage in the Czech Republic.

The diagnosis of norovirus infections in hospitalized children and adolescents with acute gastroenteritis: a study from Pilsen, Czech Republic.

BACKGROUND: Norovirus-associated sporadic gastroenteritis is an important cause of illness in Western Europe. However, at present, little information on the role of norovirus in sporadic gastroenteritis in Central Europe is available. Our study aimed at providing an assessment of their significance in hospitalized children and adolescents with acute gastroenteritis using ELISA test at the time of their introduction. METHODS: A prospective hospital based study of the etiology of acute gastroenteritis was undertaken in a total of 618 patients (mean age 39.8 months, range 0-228), who were hospitalized at the Charles University Hospital in Pilsen. All subjects were monitored in six fragmented periods during the years 2003 and 2004, 2006 and 2007. Clinical and laboratory data were processed, norovirus antigens in stools were detected using the EIA kits IDEIA Norovirus, DakoCytomation. RESULTS: A norovirus infection was confirmed in 62 cases, i.e., 10.0% of all patients with acute gastroenteritis. Vomiting was the most common symptom, recorded in 95.2 % of all the patients with norovirus infection. No severe extragastrointestinal complications were detected. The average interval between initial symptoms and the beginning of hospitalization was considerably shorter in patients with norovirus infection (1.3 days) compared with patients with rotavirus infections (2.4 days). The frequency of Salmonella spp., rotavirus, Campylobacter spp. and enteric adenovirus was 15.4%, 11.2%, 3.9%, 3.6%, respectively. CONCLUSIONS: Our findings confirm the clinical importance of noroviruses as a causative agent of acute gastroenteritis in children and teenagers in the region of a Central European country. Identification of norovirus infection should be included in the routine screenings of sporadic cases of acute gastroenteritis.

G-serotypes of group A rotaviruses in Pilsen region (Czechia).

A total of 260 feces samples from children with confirmed rotavirus infection collected during 1999-2002 were serotyped, using enzymoimmunoassay with VP7 specific monoclonal antibodies for G1-G4 serotypes. The serotypes were identified in 185 feces, i.e. 71.2 %. Individual serotypes occurred in 43, 2, 16 and 2 %; 8 % samples reacted with 2 type-specific monoclonal antibodies. The G1 serotype was prevalent over the whole period. The G3 type occurred with a statistically higher significance in children of up to 36 months (chi2 = 4.6, p = 0.028). In 4 children a different serotype was demonstrated in the first and second, or in the second and third stools, respectively. No dominant serotype was found in children with nosocomial infection.

First experience with diagnosing astroviral infections in children hospitalized in Pilsen (Czechia).

Between the years 2000-2002 astroviral infection was confirmed in 0.8 % of 2606 children admitted for a diarrheal disease to the University Hospital in Pilsen (Czechia). Astrovirus infections most frequently occurred in the age group between 49-60 months, and 77.3 % of the infections occurred in winter. When the incidence was calculated for these most susceptible age groups, the positive rates were 2.4 % (between 49-60 months) and 1.2 % (between 7-12 months) respectively. On average the hospitalization lasted for 5 d, the diarrhea 3.7 d, vomiting 1.1 d, and 40.9 % of infected children had a raised temperature. In 7 out of 872 stool samples (0.8 %), astrovirus antigen has appeared in the course of the monitored period, i.e. nosocomial astrovirus infection was recorded. In view of the rarity of detecting astroviral infections it is probably not effective to include the diagnosis of these infections in the routine panel when examining the children admitted for gastrointestinal infections. The diagnosis of these infections should, however, be performed within the framework of epidemic incidence and in nosocomial infections.

[Long-term experience with testing family and sexual contacts of HBsAg positive persons]. / Dlouhodobé zkusenosti s vysetrováním rodinných a sexuálních kontaktu HBsAg+ osob.

UNLABELLED: The study objectives were to identify HBsAg positive persons and to offer free vaccination against the infection to their family and sexual contacts found negative in screening for viral hepatitis B (VHB) postinfection markers. MATERIAL AND METHODS: Any person testing HBsAg positive in the Plzen region was registered in cooperation with laboratories. The collected data included reason for testing, clinical diagnosis and ethnicity. Contacts were screened for postinfection markers and vaccinated. RESULTS: Between 1997 and 2004, 939 HBsAg positive persons were registered by laboratories in the Plzen region. Their mean age was 42.2 (0-90) years. As many as 63.4 % of the infected persons appeared to be "healthy" carriers. Nevertheless, a significant upward trend in HBsAg positivity was recorded among immigrants (mainly those from Vietnam). Altogether 18.2 % of 829 family and sexual contacts tested positive for VHB postinfection markers (HBsAg, anti-HBc). The highest percentages of infected contacts were detected among siblings and parents of HBsAg positive persons (36.5 % and 27.3 %, respectively). Free vaccination has been requested by 82.2 % of susceptible contacts. CONCLUSION: Systematic vaccination of family and sexual contacts of HBsAg positive persons can contribute to more rapid VHB elimination in the Czech Republic. Currently, special attention in detecting infected persons is to be paid to immigrants from Asia.

[Current epidemiological and clinical issues regarding Helicobacter pylori infection in childhood]. / Soucasná epidemiologicko-klinická problematika infekce Helicobacter pylori v detském veku.

H. pylori infection is common worldwide, and is acquired primarily during childhood. The mechanism of acquisition is not clear. In recent years the main focus of interest has been on the transmission of infection from family members to children. The main risk factor for acquiring the infection seems to be low socioeconomic status. H. pylori is associated with gastritis, duodenal ulcers, MALT lymphoma, and gastric adenocarcinoma. Extra-intestinal clinical manifestations have also been reported. However, the infection is often asymptomatic in children and the role of H. pylori infection in gastric manifestations is the subject of conflicting reports. Methods for the diagnosis of H. pylori infection in children are subdivided into invasive and noninvasive. There is a lack of consensus on treatment. The treatment of H. pylori is hampered by high macrolide-resistance. Treatment with proton pump-based triple therapy for 1-2 weeks gives the best eradication rates when combined with supplements containing probiotics. Multinational, multicentre studies in childhood are essential to extend current knowledge to avoid long-term gastroduodenal disease sequelae.

[Diagnosis of rotavirus infections in 2004, major characteristics in 1998-2004 in the Czech Republic]. / Diagnostika rotavirových infekcí v r. 2004, jejich základní charakteristiky v letech 1998-2004 v CR.

In 2004, 3,821 rotavirus infections were laboratory confirmed in 59 laboratories of the Czech Republic. Latex agglutination test is used by 34, i.e. 57.6%, of these diagnostic laboratories. Children under 3 years of age prevailed among the persons tested and positivity was confirmed in 20.8% of these children. Specific morbidity in this age group was 675 cases/100.000 population/year. As many as 2,146 sporadic cases and 413 cases from 17 outbreaks were reported to the Public Health Service in 2004. Altogether 57.9% of laboratory confirmed infections were reported. Nine probably imported cases and two fatal cases (in a 96-year-old woman and a 8-month-old boy) were recorded. Data from 1998-2004 confirm concern about rotavirus infections. The incidence rates of rotavirus infections peaked between January and May during the study period.

[Dynamics of antibody formation after vaccination against tick-borne encephalitis]. / Dynamika tvorby protilátek po ockování proti klíst'ové encefalitide.

In the period of 2000-2002 the authors examined antibodies in 143 persons, having been vaccinated with the FSME-Immun vaccine in the past, before the administration of 3rd to 6th dose of the vaccine against tick born encephalitis using the ELISA Immunozym set. One hundred and sixteen of them were subsequently examined after the vaccination with the Encepur vaccine. In the group of younger individuals the pre-vaccination level higher than 126 VIEU/ml was determined in 70.6-100% of subjects, the range in the older persons being 33.3-90.5%. Post-vaccination antibodies higher than 126 VIEU/ml were in 100% of younger and 92.6-100% of older vaccinated persons. Based on the results obtained it seems possible to recommend combination of vaccination with both available vaccines. It is necessary, however, to observe the three-year interval for re-vaccination.

Prevalence of STDs among prostitutes in Czech border areas with Germany in 1997-2001 assessed in project "Jana".

BACKGROUND: The STD problem emerged in the Czech Republic as a result of geopolitical and social and economic changes in the state. Prostitution is concentrated mainly around border areas with Austria and Germany, contributing to the increase in STDs. The Czech-German project "Jana," based on a project umbrella network of the WHO, was organised. OBJECTIVES: To prevent STDs, including HIV/AIDS, and assessment of STD prevalence in the target group. METHODS: Prostitutes working in night clubs and in the streets and roads of three districts in the West Bohemian Region of the Czech Republic bordering on Germany were studied. Interactions included street work, venereology check up, psychology and sociology counselling, psychological preparation on possible treatment, and continuous and regular contact. RESULTS: The number of "love clubs" involved in project "Jana" increased from 46 in 1997 to 72 in 2000. Of 561 street girls registered in the project during 1997-2001, there was one HIV positive, every 11th prostitute had syphilis, and one in 93 women had gonorrhoea, whereas incidence of syphilis in the Czech Republic was 10.2/100000 and that of gonorrhoea 9.5/100000 inhabitants in 2001, 31 women had Chlamydia trachomatis urinary tract and genital infection, and 25 were HBsAg positives. STD frequency revealed in project participants significantly exceeds numbers of STDs in the other inhabitants of the Czech Republic. The majority of prostitutes were foreigners, mostly Ukrainians and Russians. CONCLUSION: The situation in the border areas is alarming. The priority must be to concentrate efforts on prevention of spread of venereal diseases in borders of economically disparate states.

[HIV/AIDS positive patients in surgery. Part I: Epidemiologic situation]. / HIV/AIDS pozitivní pacient v chirurgii. Cást I: Epidemická situace.

INTRODUCTION AND MATERIAL: The paper is mostly based on materials and experience of the first author, who took part in an expert action, together with an international team of surgeons, treated more than 6000 HIV-positive patients in Botswana and performed more than 3,200 interventions himself. The co-authors corrected the African experience by a brief survey of experience in this country and reviewed the presently valid legislation. METHODS: The first two parts deal with literature knowledge on HIV/AIDS and confront it with the author's experience over three years of his expert stay in a hospital in Gabarone. The first part deal with epidemiological situation in the place of study and the second part analyzes in a general aspect the problems of surgical intervention in HIV-positive patients and the occupational risk. This part also includes a corresponding description of conditions in the Czech Republic including Czech legislation. The third, principal, part of the contribution is a prospective study where the author, under limited local conditions, investigated 3,200 HIV-positive patients undergoing surgery. The relation between HIC and tuberculosis is also analyzed from various other minor aspects and there are mainly the levels of CD4+ T lymphocytes followed from the standpoint of course of therapy and prognosis of the patients. The fourth part of the paper describes briefly twelve cases confirming and illustrating the results. RESULTS: HIC-positive individuals with the CD4 value below 200/mm3 represent the critically endangered patients. The values between 200 and 499 represent a distinct risk, which may be overcome, and values between 500 and 799 represent a minimum risk, whereas the value over 800 is exceptionally favorable. Tuberculosis is a very frequent opportune infection in African conditions (over 53% in the cohort under study), but rather than to influence the prognosis itself it act in relation to the values of CD4+ T lymphocytes. The main risk for surgical patients related to decreased immunity is not due to complications in the wounds and anastomoses, but in severe opportune infections. CONCLUSIONS: This most comprehensive surgical survey on HIV/AIDS, worked out by Czech authors, is very well applicable in conditions of the Czech Republic.

[Diagnosis of rotavirus infections and their reporting in the Czech Republic in 2001]. / Diagnostika rotavirových nákaz a jejich hlásení v CR v r. 2001.

In 2001 in 44 laboratories in the CR by laboratory methods 2,250 rotavirus infections were confirmed. From the total number of diagnostic departments 37, i.e. 84.1% use latex agglutination. Among the examined subjects children under 3 years predominated a positive finding being confirmed in 23.0%. The specific morbidity in this age group was 651.3 cases/100,000/year. The hygiene service received in the course of the year 851 notifications of sporadic cases and 72 infections which developed in three epidemics. As to infections confirmed by laboratory examinations only 39.3% were notified. Probably also one imported case of the disease was recorded, no death was reported.