Phylogenetic analysis of 166 human parvovirus B19 sequences from 11 different countries attributed 91.57% to genotype 1, 5.42% to genotype 3b, and 3.01% to genotype 3a. Very similar viruses of genotype 1 circulated widely in Europe and Israel. Genotype 3b seems to show an increasing spread outside of Africa.Human parvovirus B19 (B19V) infections are usually associated with mild disease, but in immunocompromised and anemic patients, as well as during pregnancy, severe complications can occur. Based on the genetic variability of 994 nucleotides (nt) of the NS1/VP1-unique region junction, three distinct genotypes of B19V have been proposed (13). A recent report presented evidence that certain complications might be preferentially associated with certain virus genotypes (6). Several studies demonstrated that previously published or commercially available assays show differences in their diagnostic performance, including the inability to detect certain genotypes, especially genotype 3, subtype 3b (1, 5). Despite these important implications for the diagnosis of B19V, little is known about the genotypes prevalent in many countries.Serum samples collected between 2000 and 2008 mostly from rash/fever patients negative for both measles and rubella from 11 different countries were analyzed for B19V (Table 1). A nested PCR was performed with the forward primers e1855f and e1863f (13) and reverse primers B19-R1 (5Ј-GGGAACT TCCGGCAAACTTCCTTG-3Ј) and B19-R2 (5Ј-GTAGTCTT TTACTACTTGTGCTTG-3Ј), yielding fragments of 1,239 and 1,168 nt. Previously published reverse primers (13) have a maximum of three (e2953r) and four (e2960r) mismatches compared to B19V GenBank sequences, including 3Ј and 5Ј

Importation of viruses from other continents caused prolonged circulation and large outbreaks in the WHO European Region.

TOC Summary: More than 24,300 cases were identified in 22 countries.

AimTo analyze the epidemiological data for pandemic influenza A(H1N1)v in the Autonomous Province of Vojvodina, Serbia, during the season of 2009/2010 and to assess whether including severe acute respiratory illness (SARI) hospitalization data to the surveillance system gives a more complete picture of the impact of influenza during the pandemic.MethodsFrom September 2009 to September 2010, the Institute of Public Health of Vojvodina conducted sentinel surveillance of influenza-like illnesses and acute respiratory infections in all hospitalized patients with SARI and virological surveillance of population of Vojvodina according to the European Centers for Disease Control technical document.ResultsThe pandemic influenza outbreak in the province started in October 2009 (week 44) in students who had returned from a school-organized trip to Prague, Bratislava, and Vienna. The highest incidence rate was 1090 per 100 000 inhabitants, found in the week 50. The most affected age group were children 5-14 years old. A total of 1591 patients with severe illness were admitted to regional hospitals, with a case fatality rate of 2%, representing a hospitalization rate of 78.3 per 100 000 inhabitants and a mortality rate of 1.6 per 100 000. Most frequently hospitalized were 15-19 years old patients, male patients, and patients with pneumonia (P < 0.001). The highest case fatality rate was found among patients with acute respiratory distress syndrome (P < 0.001). Nasal/throat swabs were obtained for polymerase chain reaction test from 315 hospitalized patients and 20 non-hospitalized patients, and 145 (46%) and 15 (75%) specimens, respectively, tested positive on A(H1N1)v.ConclusionSentinel influenza-like illness and SARI surveillance, both followed with virological surveillance, seem to be the optimal method to monitor the full scope of the influenza pandemic (from mild to severe influenza) in Vojvodina.

Disseminated neonatal herpes simplex virus (HSV) infection is characterized by progressive multiple organ failure and high mortality rates. It can result from infection with either HSV-1 or HSV-2. We report a case of disseminated neonatal herpes that was caused by HSV-1 and HSV-2.

Between December 2010 and August 2011 an outbreak of measles occurred in Serbia with 363 reported cases. Sera and/or nose/throat swabs were collected from 193 patients and tested for measles-specific IgM antibodies by ELISA and viral RNA by RT-PCR, respectively. Epidemiological data were obtained from the surveillance database of the Institute of Public Health of Serbia. Of the 363 cases involved in the outbreak, 113 were laboratory confirmed. More than one third of the patients were hospitalized (n = 130, 35·8%) and for 15 (4·1% of the reported outbreak cases) the infection was complicated by pneumonia. Mostly pre-school children aged ⩽4 years (37·8%) and adults aged ⩾30 years (27·3%) were affected. The majority of patients belonged to the Roma population with a preponderance of female cases (57·0%). Nearly 94% of the patients were either unvaccinated or of unknown vaccination status. The main outbreak virus was the D4-Hamburg strain. The outbreak in Serbia occurred after several years of very low measles incidence despite a high routine immunization coverage in the general population, suggesting that special efforts to identify and vaccinate susceptible population groups are required even in countries with apparently good disease control.

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