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HFRS in 2003: serologic test results at Croatian Institute of Public Health

Haemorrhagic fever with renal syndrome (HFRS) is a natural focus zoonosis caused by Hantavirus genus viruses. Since its first description in 1954, the occurrence of this zoonosis in Croatia has been either sporadic or in the form of small outbreaks. The first larger outbreak with 125 cases was described in 1995. The largest outbreak of HFRS to date, involving more than 400 cases occurred in Croatia in 2002. Aim: The aim of this study was to determine the incidence and epidemiologic characteristics of HFRS in Croatia in 2003. Patients and methods: Serum samples from 67 patients (4 paired and 63 single specimens) aged 15-69 years with clinical diagnosis of HFRS were analyzed from January to December 2003 at Zoonosis Unit, Croatian Institute of Public Health. The diagnosis was confirmed by demonstration of specific antibodies (IgM+IgG) using the indirect immunofluorescence assay (Hantavirus antibody-IF test, Progen Biotechnik). A fourfold or greater titer increase in paired specimens as well as titer  1:32 in single specimen were considered positive findings. Results: Etiologic diagnosis of HFRS was confirmed in 11 (16.4%) patients ; 10 male and one female. The mean patient age was 36.5 years. The youngest patient was aged 22 years and the oldest 48 years. The disease occurred sporadically from January to October. Five patients (45.4%) were recorded in the Vukovarsko-Srijemska County, two in the Zagreb County with the Karlovačka, Primorsko-Goranska, Požeško-Slavonska and Brodsko-Posavska Counties recording one case each. Conclusion: Our results confirmed an endemic presence of HFRS in Croatia, except Dalmatia, islands and the coastal area. The sporadic occurrence of disease in a small number of patients in 2003 indicates an interepidemic year.

HFRS; incidence; epidemiology; Croatia

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