engleski

Dengue virus in Croatia

Dengue (DENV) is considered to be the most important arboviral disease with an estimated 50 million infections occuring annually. It is also the fastest spreading viral disease transmitted by mosquitoes with 2.5 billion people living in endemic areas. Since 2004 one of the vectors, the invasive mosquitoe species Aedes albopictus, is present in Croatia. The first imported DENV infection was confirmed in Dubrovnik in August 2007. So far, six imported cases have been reported. However, no autochthonous DENV cases have been reported in Croatia until 2010. The first autochthonous case in Croatia, a 33-year-old woman, with fever, headache, myalgia, leukopenia, thrombocytopenia and elevated liver transaminases, appeared in August 11th, 2010, but was undiagnosed. On October 22nd, the 54-year-old mother of the previously hospitalized patient was hospitalized with similar symptoms. About two weeks before, ECDC informed us about a German patient with confirmed DENV infection after he returned from Croatia spending his holiday in the same village on the Pelješac peninsula where both female Croatian patients lived. A retrospective molecular analysis confirmed DENV infection in two female Croatian patients. The obtained sequences from the E-NS1 gene junction of two Croatian patients were identical. Phylogenetic analyses revealed these sequences as Genotype V within DENV serotype 1. A limited serological survey among regular blood donors and patients with fever of unknown origin, approximately 100 samples each, hospitalized at the General Hospital in Dubrovnik for the presence of IgG antibodies showed no positive results. In addition trapping of A. albopictus was undertaken. Trapped individuals have been pooled and tested for the presence of viral RNA, but none was detected. This is the first evidence of the autochthonous DENV infections in Croatia in a small isolated endemic niche. Strong public-health measures are necessary to monitor and prevent possible spread of DENV in other parts of Croatia.

dengue virus; autochthonous transmission; Croatia; Aedes albopictus

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