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V Borne Zoo Dis. First Outbreak of West Nile Virus Neuroinvasive Disease in Humans, Croatia, 2012

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  • V Borne Zoo Dis. First Outbreak of West Nile Virus Neuroinvasive Disease in Humans, Croatia, 2012

    [Source: Vector-Borne and Zoonotic Diseases, full page: (LINK). Abstract, edited.]


    First Outbreak of West Nile Virus Neuroinvasive Disease in Humans, Croatia, 2012


    To cite this article: Iva Pem-Novosel, Tatjana Vilibic-Cavlek, Ira Gjenero-Margan, Nenad Pandak, Ljiljana Peric, Ljubo Barbic, Eddy Listes, Ante Cvitkovic, Vladimir Stevanovic, and Giovanni Savini. Vector-Borne and Zoonotic Diseases. -Not available-, ahead of print. / doi:10.1089/vbz.2012.1295.

    Online Ahead of Print: November 27, 2013 / Full Text HTML / Full Text PDF (79.2 KB) / Full Text PDF with Links (80 KB)

    Author information: Iva Pem-Novosel,<SUP>1,</SUP><SUP>* </SUP>Tatjana Vilibic-Cavlek,<SUP>2,</SUP><SUP>*</SUP> Ira Gjenero-Margan,<SUP>1</SUP> Nenad Pandak,<SUP>3</SUP> Ljiljana Peric,<SUP>4</SUP> Ljubo Barbic,<SUP>5</SUP> Eddy Listes,<SUP>6</SUP> Ante Cvitkovic,<SUP>7</SUP> Vladimir Stevanovic,<SUP>5</SUP> and Giovanni Savini<SUP>8* </SUP>
    <SUP></SUP>
    <SUP>1</SUP>Communicable Diseases Epidemiology Service, Croatian National Institute of Public Health, Zagreb, Croatia.; <SUP>2</SUP>Department of Virology, Croatian National Institute of Public Health, Zagreb, Croatia; School of Medicine University of Zagreb, Zagreb, Croatia. <SUP>3</SUP>Department of Infectious Diseases, General Hospital ?Dr Josip Bencevic?, Slavonski Brod, Croatia. <SUP>4</SUP>Department of Infectious Diseases, Clinical Hospital Centre, Osijek, Croatia. <SUP>5</SUP>Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine University of Zagreb, Croatia. <SUP>6</SUP>Croatian Veterinary Institute, Regional Veterinary Institute Split, Split, Croatia. <SUP>7</SUP>Epidemiology Service, Brod-Posavina County Institute of Public Health, Slavonski Brod, Croatia. <SUP>8</SUP>National Reference Center for West Nile Disease, Istituto G. Caporale Teramo, Teramo, Italy.

    Address correspondence to: Iva Pem-Novosel, Department of Communicable Diseases Epidemiology Service, Croatian National Institute of Public Health, Rockefellerova 2, Zagreb 10000, Croatia, E-mail: ipemnovo@gmail.com


    ABSTRACT

    Between September 6 and 21, 2012, seven human cases of West Nile virus (WNV) neuroinvasive infection were laboratory confirmed in Croatia. The median patient age was 62 years (range 48?77). Five patients presented with meningoencephalitis and two patients with meningoencephalitis followed by acute flaccid paralysis. Four of them had an underlying disease (hypertension). Using enzyme-linked immunosorbent assay (ELISA), WNV-specific immunoglobulin M (IgM) and IgG antibodies of low avidity were detected in six patients, whereas one showed only IgM antibodies. All samples were confirmed using plaque-reduction neutralization and microneutralization tests. Five patients recovered fully. Before human cases were reported, acute asymptomatic WNV infection was demonstrated by detection of IgM antibodies in sentinel horses. Moreover, an increased WNV IgG seropositivity in horses was detected in counties where human cases occurred. Adulticidal and larvicidal treatments were administered immediately in the respective places of residence. The end of the warm season contributed to the fact that there were no new cases of WNV disease recorded.


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