[Epidemiological variation of Q-fever in Zenica Doboj Canton during period 2000-2005]. / Epidemioloske varijacije Q groznice u Ze-Do Kantonu u periodu od 2000. do 2005. godine.

After the war in Bosnia and Herzegovina there is a sudden increase in number of infected with the Q-fever, which becomes huge public health and economic problem. Although this disease occurred in very different geographic areas of Bosnia and Herzegovina the Zenica-Doboj Canton was among the most affected. Infections of Q-fever at the Zenica-Doboj Canton represent very complex epidemiology problem, because it is in highest incidence rates not only for Bosnia and Herzegovina, but also for Europe. The total number of population affected by Q-fever in Zenica-Doboj Canton since the beginning of 1998 until the end of 2005 was 193, with the average morbidity rate of 48.30 %000. In Zenica-Doboj canton affected by Q-fever was the inhabitants of both genders, all ages and on wide territory, which in majority of cases did not have the contact with domestic animals. Incubation period varies from 14 to 27 days. Actual incidence rate due to asymptomatic occurrence of this disease is for sure higher. Researches of spreading manner for the Q-fever among humans showed that this disease can be spread in epidemic and sporadic manner in Zenica-Doboj Canton, and that there are many risk factors which influence its occurrence.

Human Coxiella burnetii infections in regions of Bosnia and Herzegovina, 2002.

Acute infections in humans and animals caused by Coxiella burnetii (C. burnetii) are becoming an important medical problem for Bosnia and Herzegovina (B&H). From a clinical and epidemiological aspect, Q fever represents a complex medical problem, considering that one of the highest incidence rates of Q fever in Europe has been recorded during the last few years in B&H. The first case of this disease in B&H was described in 1950, by Muray et al., and the first epidemic, with 16 infected individuals, was recorded the same year. Confirmed animal infections by C. burnetii in B&H were first reported in 1985 when, of all tested sheep, positive results were found in 12.4%. During 2001, 2.11% of tested sheep and goats were found to have a positive result, which was also confirmed by studies from the following years in particular regions of B&H. These studies suggest that endemic loci of infected animals are established in particular geographic regions in B&H, which is important to emphasize for better understanding of the sources and routes of C. burnetii transmission to the human population. This conclusion is based on the studies from 2000, when 2.17% of positive cattle, 1.85% of positive sheep, and 0.27% of positive goats were registered. During the same period, in B&H, in 6 different regions, 156 individuals with Q fever were registered as were 3 separate epidemics with 115 infected individuals. Official data on the number of detected animal C. burnetii infections during 2002 suggest that 10 positive cattle and 88 positive sheep or goats were registered. During 2003, 24 positive cattle, 29 positive goats, and 167 positive sheep were detected, while in 2004, 71 positive cattle, 4 positive goats, 37 positive sheep, and 72 positive animals from the sheep-goat group were registered. According to official reports from 2001, 19 individuals with Q fever were registered in B&H, while in 2002, the number of infected individuals increased to 250. In five cantons in B&H, 43 infected individuals were registered during 2002, while in Republika Srpska of B&H, 207 infected individuals in the region of Banja Luka were registered. From 1998 to 2003, 373 individuals with Q fever were reported in B&H, whereof 265 individuals (71.04%) were infected during epidemics, and 108 (28.95%) sporadically. Q fever incidence rates in B&H were high during 1998 (5.68%ooo) and very high in 2000, with 115 individuals with an acute clinical form and an incidence rate of 6.95%ooo. The incubation time varied between 9 and 28 days.

[Epidemiological characteristics of trichinosis in Federation of Bosnia and Herzegovina]. / Epidemioloske karakteristike trihineloze u Federaciji Bosni i Hercegovini.

The territory of Bosnia and Herzegovina, by its geographical setting and climate characteristics has the conditions for breeding and spreading the cause of trichinosis in environment. This, under certain conditions, in the context of different socio-economic, social and zoological-sanitary circumstances, can lead to the periodical epidemic outbreaks of the disease among people on a small or larger scale. Data on registered cases of human trichinosis collected during annual monitoring of trichinosis cases on the territory of Federation of Bosnia and Herzegovina in the past fourteen years, show its continual presence in this area, with a varying rate of morbidity, from 0,1 (2002) to 11,73 (1998) per 100.000 inhabitants. In the mentioned period, during 51 epidemics, 775 cases of trichinosis have been registered altogether, with approximately 10-15 cases per outbreak.

Eradication of typhus exanthematicus in Bosnia and Herzegovina.

Typhus exanthematicus in Bosnia and Herzegovina held in endemic areas from which especially quickly began spread after 1945. That year, in 1945, one hundred epidemics of typhus fever appeared, with the highest incidence rate in Europe of 215.04 per 1,000. Directions of unique program in the world were to eradicate lice of the body, but also establish monitoring of the recidivism, Brill-Zinsser disease. Since 1971, typhus exanthematicus (classical typhus) hasn't appeared in Bosnia and Herzegovina, so epidemic typhus can considered as an eradicated communicable disease.

Long term protection after hepatitis B vaccination.

A survey of persistence of anti-HBs after hepatitis B vaccination has shown that five years after vaccination on a sample of 152 persons, or 82.53%, stands at >10 IU/I. Long term immunogenicity of vaccinated children remained at 88.89%, health workers 79.41% and drug addicts 64.28%. The results of these studies in Bosnia and Herzegovina show the high level of protection hepatitis B vaccine against HBV infection. Vaccination against viral hepatitis B results in immunologic memory response among the vaccinated, and even after a decrease of anti-HB level following the third vaccine dose inoculation, a booster dose is not needed. Immunity remains steady and a booster dose is not recommended.

Vineyard pesticide induced changes in the lungs: experimental studying on rabbits.

Our intention was to analyze changes in the lungs in rabbits induced by the inhalation of the Bordeaux Mixture aerosol and determination of the time necessary for development of changes that cause respiratory failure and eventually precancerous changes. To experimental rabbits aerosol was administred for 4 months. Lungs were examined pathohistologically and histochemically with rubeanic acid for copper detection. After 4 months of everyday inhalation lung tissue showed diffuse inflammation in all experimental animals, but without granulome formation and fibrosis. The bronchial epithelia showed basal hyperplasia and ciliocytophtoria without precancerous atypical squamous metaplasia. The development of centrilobular emphysema was also observed. Numerous macrophages within the lumen of bronchi, in the interstitium as well as those within the lung alveoli, contain granules with a positive reaction on copper. A four-month-period is not enough for inducing interstitial fibrosis or granuloma foration within the lung tissue, what some authors have found in experimental animals during their longer exposure in relation to humans, as well as in vineyard sprayers during their longer exposure at work, where cytologically can be found unusual mataplastic bronchi cells. At least a six-month period of exposure influenced by Bordeaux Mixture is thought to be the minimal period needed for development of changes in the lung tissue which can cause "Respiratory Failure" as well as unplastic expansion.

Higher mortality risk of lungs carcinoma in vineyard sprayers.

This study investigated mortality rate of lungs carcinoma in professional vineyard sprayers. Clinical investigation was performed in 187 professional vineyard sprayers who had been exposed to the inhalation of the particles of Bordeaux mixture for 24 years on average. Bordeaux Mixture is used for prevention against mildew attacking vineyards. The control group was composed of 187 inhabitants of the same area who did not have any contact with the mentioned substance. A cytological investigation of the sputum specimens obtained from 104 tested inhabitants was performed. The sputum specimens were stained with standard haematoxylin-eosin method and also with special method (rubeanic acid) to prove the incidence of copper granules in macrophages. The findings show a considerable statistical difference in the frequency of occurrence of lungs carcinoma between the group of vineyard sprayers smokers and the control group (X2=4.77,p<0.01). The risk of lungs carcinoma in the vineyard sprayers was three times higher compared to the risk of smokers in the control group, with a statistical probability of 95% in the scope from 1.16

[Strategy for administering hepatitis B vaccine to newborns in Bosnia-Herzegovina]. / Strategija uvodenja neonatalne hepatitis B vakcine u Bosni i Hercegovini.

BACKGROUND: Neonatal hepatitis B vaccination is the best effective measure for prevention hepatitis B infection in the countries with intermediate to high levels of HB endemicity. METHODS: Epidemiological methods of research had the aim to follow the incidence rates of viral hepatitis B and HBsAg carriers and to determine influence on the risks of transmission hepatitis B infection in new-borns in Bosnia and Herzegovina. Serologic immunogenic quality of hepatitis B vaccine is researched. RESULTS: Bosnia and Herzegovina has high incidence of hepatitis B virus in the Europe. The incidence of HBsAg carriers is changing with increasing from 2000. to 2003. Data from this surveillance show in Bosnia and Herzegovina that in one notified case of hepatitis B there is 3.59 cases of HBsAg carriers. Hepatitis B vaccine induces anti-HBs antibodies titres > 10 IJ/ml, considered as seroprotective in 99, 10% vaccinated. CONCLUSION: Neonatal hepatitis B vaccination is new vaccine in national immunization program in Bosnia and Herzegovina. Hepatitis B vaccines are safe and effective in inducing neutralizing HBs antibodies play and have important role in protecting new-borns.

[Oxidative disinfectants--a new strategy in the prevention of viral hepatitis in hemodialysis centers] ]. / Oksidativni dezinficijensi--nova strategija u prevenciji virusnih hepatitisa u centrima za hemodijalizu.

The dialysis setting as a height risk environment for transmission to both patients and health care personnel of blood-born infections, such as hepatitis B virus and hepatitis C virus We report the results of questionnaries of the frequency of occupational exposure in dialysis units. Among 120 health care workers of dialysis units had 25.02% percutaneous injure or mucous. Introducing of oxidative new virucid dezinficients prevent high risks of spreading of viral hepatitis in dialysis units.

[Serologic diagnosis of hemorrhagic fever with renal syndrome in Bosnia and Herzegovina in 2002]. / Seroloska dijagnostika hemoragijske vrucice s bubreznim sindromom u Bosni i Hercegovini 2002. godine.

AIM: Results of the serologic confirmation of hemorrhagic fever with renal syndrome (HFRS) in patients with clinical picture and overt symptoms of the disease from particular areas in Bosnia and Herzegovina during 2002 are presented. METHODS: A total of 146 sera from 100 clinically suspected patients were tested. The sera were tested for the presence of specific IgM antibodies to Hantaan and Puumala antigens by Elisa IgM "capture" test, and for the presence of specific antibodies to Hantaan, Puumala and Dobrava antigens by Elisa IgG test. DISCUSSION: Most of the positive IgM reactions were recorded as cross reactions to Hantaan and Puumala antigens, and most of the positive IgG reactions as cross reactions to Hantaan and Dobrava antigens. The finding of antibodies in the sera of patients from Europe that react with Hantaan antigen are not associated with the infection with Hantaan, but with the infection with viruses that are genetically related with Hantaan. To date, HFRS caused by Puumala and Dobrava viruses has been verified in Bosnia and Herzegovina. CONCLUSION: Using Elisa IgM "capture" test, acute hantavirus infection was serologically confirmed in 38% of clinically suspected patients with manifested symptoms from different areas of Bosnia and Herzegovina in 2002. The distribution of human hantavirus infection in Bosnia and Herzegovina was confirmed by the presence of specific hantavirus antibodies in patient sera.