engleski

Epidemiological Characteristics and Military Significance of Q-Fever in Croatia

Q-fever is an acute, febrile, rickettsial infection spread allover the world. In Croatia, Q-fever poses a considerable and long-standing public health program. The disease primarily involves certain animal species, which transmit it easily through various routes of exchange. Also, it is commonly spread through dust. Q-fever frequently is present as an enzootic among domestic animals, occurring sporadically in occupationally exposed individuals. Over the last 10 years (1992-2001), 406 affected persons (40 per year an average) were recorded in Croatia. The real incidence probably exceeds the number of recorded cases because of the frequently mild clinical picture, absence of suspicion of the disease, and inadequate laboratory diagnostic testing. In recent years, epidemic outbreaks of Q-fever with a high number of affected individuals over a relatively small area were observed. Although the agent causing Q-fever replicates only in living cells, like sporogenic bacteria, it is highly resistant to unfavorable environmental conditions and to most of the widely used disinfectants. It can survive for a year in a desiccated biological material at a low temperature. It can also survive for a year and a half in a sapless tick feces, or two years in an infected tick. In the soil, the agent remains infective for seven to nine months at 4-6oC, and in water for thee to 36 months. Epidemiological data are of great diagnostic importance, because the disease is highly occupation related. Data on a person's stay in a known endemic area or on contact with domestic or wild animals, especially sheep or related animals during the lambing season, are of utmost importance. However, considering the high agent resistance, transmission of the disease does not require direct human exposure to the infectious material. Epidemic outbreaks of the disease can occur quite easily in army units staying outdoors, in camps or for training. As there is no routinely used vaccination for either humans or animals, and as Croatia has a very long border with Bosnia and Herzegovina, where there is a known problem of Q-fever in sheep, the occurrence of disease cannot be completely prevented. While staying outdoors, army units should avoid endemic areas, sleeping in barns, and any contact with sheep. For the rest of the population, the risk of infection can be reduced by close cooperation with veterinary services and public health institutions. If an epidemic breaks out, control measures are limited to the elimination of the sources of the infection, monitoring of the exposed group, isolation of the affected, and antibiotic therapy.

Q fever; epidemiology; military personnel; Croatia

nije evidentirano