No abstract

A nationwide epidemic of hemorrhagic fever with renal syndrome (HFRS) occurred in Yugoslavia in 1989. Sera from 609 hospitalized patients, from all six Republics (Bosnia and Hercegovina, Croatia, Macedonia, Montenegro Serbia, Slovenia) and two Provinces (Kosovo and Vojvodina), who had signs and symptoms suggestive of HFRS, and sera and lung tissues from 544 small mammals belonging to 13 species were studied for evidence of hantavirus infection. Of the 226 patients with serologically confirmed HFRS, 182 resided in Bosnia and Hercegovina or in Serbia. The severity of disease differed from region to region, with an overall fatality of 6.6% (15/226). Patients from southern Yugoslavia tended to have more severe disease and exhibited two types of antibody patterns, while approximately equal numbers of clinically severe and mild cases of HFRS were registered in central Yugoslavia, where four types of antibody patterns were found. Two of these antibody patterns suggested the existence of hantaviruses which are antigenically distinct from those reported to date. Two seasonal peaks of disease, one during the summer and the other in late autumn, were found. Hantaviral antibodies and/or antigens were detected most often in the yellow-necked mouse (Apodemus flavicollis) (88/189), the wood mouse (Apodemus sylvaticus) (28/146), the striped field mouse (Apodemus agrarius) (10/64), the bank vole (Clethrionomys glareolus) (36/63), the house mouse (Mus musculus) (14/29), and the Norway rat (Rattus norvegicus) (14/21). Five other species of rodents and insectivores were infrequently infected.

It is estimated that there have been some changes in epidemiological characteristics of the natural foci of leishmaniasis in Croatia.

Our results and historical evidence, suggest that the mid-15th century epidemic could have acted as a selection pressure for the CCR5Delta32 mutation.

Introduction: Field hospitals of the Russian Center of Disaster Medicine were formed on the basis of children's surgeons and anesthesiologists. Later, a brigade of pediatrics was formed, and, at last, a children's field hospital (CFH) was founded, and began to work in the Chechen Republic. Methods: The structure of CFH included: (1) A diagnostic block containing x-ray equipment, ultrasound scanner, endoscopes, and a clinical laboratory; (2) an operational block; (3) wards for 50 patients; (4) a reanimation department; and (5) a consulting department. The medicines, as well as electricity and oxygen, were provided independently. Communication was carried out using a satellite antenna. The children's doctors included surgeons, pediatricians, neuropathologists, anesthesiologists, and endoscopic support. Among the children's surgeons were experts in orthopedics, combustology, urology, thoracic surgery, and neurosurgery. Results: Within a year of work (April 2001-April 2002, doctors at the hospital consulted 32,300 outpatients, treated 2,645 inpatients, and performed 2,054 surgical operations. Special organization of the surgery was necessary in the cases of mass delivery of the injured. For example, when 36 wounded were delivered at the same time to the hospital after a bomb explosion. A total of 339 patients were treated in reanimation; 44 died. Sixty-four telemedicine consultations for the most difficult patients were arranged with the help of the best Russian clinics of Moscow and the North Caucasus region. Seventy-three patients were transported to specialized hospitals. Conclusion: Modern equipment for diagnosis and treatment, the high qualification of the medical staff in the CFH, and telemedicine consultation made it possible to provide specialized medical care in the war region.