[Surveillance of communicable diseases using a computer database of reported cases]. / Pracenje zaraznih bolesti pomocu racunarske baze podataka prijave obolelih.

Epidemiology services during the surveillance of communicable diseases collects of different sorts of data, which are used for an analysis of epidemiologic situation. Those data are the starting point for timeline control and preventive activities. Data processing of notified communicable diseases cases provides information on types of diseases, number of cases, time and place of their occurrence. Manual data processing, used till 1993, was slow, unreliable and considerably decreased the efficiency of epidemiology service activities. In this paper we have set the hypothesis that is possible to form a computerized database with the following aims: to form user friendly computerized database model for those without knowledge in using computers: to get output spread sheets with information needed for epidemiologic situation analyses at any time. Database was developed in 1993 and has been used as source of the information in epidemiologic diagnosis process. The significant accuracy, reliability, timelines, and shortening of the time of data processing was achieved. The database can also serve as the initial component for designing an epidemiologic services information network in Belgrade county. In designing such a network it is necessary to form the additional databases of isolated infectious agents and their drug resistance, database of health status of persons under surveillance and database of environmental and sanitary condition in children and youth facilities.

[Etiology and pathogenesis of Lyme borreliosis]. / Etiologija i patogeneza lajm borelioze.

Some characteristics of B. burgdorferi which have crucial role in the pathogenesis of Lyme-borreliosis are described. The pathogenesis of Lyme-borreliosis is a complex process resulting from inflammation, release of interleukin-1, dissemination and adherence of borrelia to different tissues. Dissemination of borrelia is facilitated by the increased permeability of the blood vessels and active penetration of borrelia through the endothelial membranes. Invasion of different type of tissues emerges as a result of B. burgdorferi adherence to several types of cells and structures rather evenly distributed in human host. Immune response, normally protective, is not efficient in eradicating the organisms and can contribute to the illness by development of an autoreactive process. Autoreactivity is based on antigenic cross-reactivity between epitopes common to borrelia and human host, especially situated on so called "heat shock proteins".

[Modern immunologic tests in the diagnosis of Lyme borreliosis]. / Savremeni imunoloski testovi u dijagnostici lajm borelioze.

In this work we described the results that were obtained using various immunodiagnostic assays for the detection of lyme borreliosis. Sera of the patients that were in acute or chronical phase of the disease were analysed in indirect immunofluorescent, immunoenzyme and immunoblot assays which were prepared and carried out in our laboratory. As a control for the validity of these investigations, we used sera of the healthy people, as well as of the patients suffering of lues or rheumatoid illnesses. Results that we obtained pointed out the factors responsible for the nonspecific reactions in indirect immunofluorescent and immunoenzyme test. The advantage of the immunoblot analysis in detecting lyme borreliosis is described in this work.

[Lyme disease in human medicine]. / Problem i znacaj lajmske bolesti u humanoj medicini.

Six years of investigations of Lyme disease in our country has offered an opportunity for better understanding of this "new" illness, which is both a medical and a health problem. The number of patients with Lyme disease is found to be similar to the number of patients in other countries. Human infections occur in different areas, rural and urban settings. A high level of collected ticks with Borrelia burgdorferi, suggests a considerable risk of human infection after a tick bite. Difficulties in diagnosing of Lyme disease are connected with different clinical symptoms and signs of the illness a poor health service personnel knowledge og the disease, and the lack of reliable and more convenient laboratory tests for confirmation of the diagnosis. A team work and a multidisciplinary aspect in the investigations and the routine work provide a solid base for a better understanding and gathering much more experience in this field. The individual protection remains a basic control measure, and each person can do the most for self protection. An activity in the health education is also of a very great importance.

[Meningococcal carrier state and meningococcal diseases in a military unit]. / Meningokokno kliconostvo i meningokokna bolest u vojnickom kolektivu.

In four recently formed military units pharyngeal meningococcal carrier state and dynamics of nasopharyngeal meningococcal infections have been examined. Carrier state found in at least 50% of recruits at their entering the army has been increased during the first two months for 10-26.4% and it was associated with very significant dynamics of meningococcal infection: changes in carrier state during the first two months have been found in 61.3% of soldiers with very marked changes in distribution of some meningococcal serologic groups among isolated species. Two months later stagnation and lower percentage of the carrier state was observed together with reducing dynamics of meningococcal infection. Meningococcal disease did not occur in the examined environment and this was explained by the absence of virulent meningococcal serotypes. It was concluded that in the risk for meningococcal disease evaluation final identification of meningococcal species isolated from patients and their contacts should be made aiming to timely detection of species known to have significant degree of virulence.

[Use of the ELISA immunoenzyme test and indirect immunofluorescence in the diagnosis of a toxoplasmosis epidemic]. / Primena imunoenzimskog testa ELISA i indirektne imunoflurescencije u dijagnozi epidemije toksoplazmoze.

Etiologic agent of lymphadenitis outbreak in one our military environment was detected by two serologic tests: ELISA (enzyme-linked immunosorbent assay) and indirect immunofluorescence test (IIF) both specific for IgM and IgG antibody detection in toxoplasmosis diagnosis. IgM-ELISA analysis of the first serum sample taken from a group of 79 soldiers with lymphadenitis was positive in 65 examinees (82.28%) and IgG-IIF technique in 52 (65.82%). In a group of 33 soldiers from the same unit with no signs of the disease IgM-ELISA test was positive in 12 (36.36%) and IgM-IIF in 9 (27.27%). In a group of 40 officers from the unit with the disease outbreak specific IgM antibodies were found by both tests only in the head cook. IgM antibodies were not found in a control group of 102 healthy soldiers from other units of the same garrison. Results of this investigation thermal injury showed variations in immune response to infection in dependence on trauma effect duration (in dependence on the phase). In the early posttraumatic phase organism is capable to react effectively to the inoculated infective agent and in the late posttraumatic phase this reaction is much less effective. Authors conclude that these results may influence upon the thermal injury management strategy in dependence on the trauma effect duration.

[Lyme disease in Yugoslavia]. / Lajmska bolest u Jugoslaviji.

Presented are results of the last five-year period study of the lyme disease in Yugoslavia. On the basis of published papers and professional communications over 2500 cases of lyme disease.were detected in our country within this period. Presented are common epidemiologic and clinical features of the disease and particularly cases diagnosed in Belgrade. Since 1987 a group of various specialists has been working on the research project in collaboration with many centres in the country. Indirect immunofluorescence test as the diagnostic laboratory technique has been introduced in the Military Medical Academy in Belgrade in 1987. First species of Borrelia burgdorferi from ticks Ixodes ricinus have been isolated and cultivated in May and June 1990. Current problems concerning research work, medical and epidemiological aspects of the lyme disease are presented.