<p>U radu je ispitana zastupljenost influenca A virusa, njihova antigenska i genetička svojstva i osetljivost na antivirotik oseltamivir.</p><p>Ispitivanje je sprovedeno u toku četiri uzastopne sezone, od 2010/2011 do 2013/2014 &nbsp;i obuhvatilo je 887 briseva nosa i grla pacijenata sa simptomima gripa, sa teritorije Južnobačkog okruga. Svi uzorci su&nbsp;testirani na prisustvo influenca A(H1N1)pdm09, A(H3N2), A(H1N1), A(H5) i A(H7) i influenca B virusa, real-time RT PCR testom. Pozitivni uzorci iz sezona 2012/2013 i 2013/2014, podvrgnuti su izolaciji na MDCK ćelijskim kulturama, a zatim je izvr&scaron;eno ispitivanje sposobnosti dobijenih izolata da aglutiniraju eritrocite koko&scaron;ke, čoveka i zamorca u reakciji virusne hemaglutinacije. Antigenska svojstva izolata sa hemaglutinacionim titrom &ge;40, ispitana su reakcijom inhibicije hemaglutinacije. Genetičkoj karakterizaciji, sekvenciranjem hemaglutinin i neuraminidaza gena, podvrgnuti su reprezentativni izolati iz sezona 2012/2013 i 2013/2014. Za ispitivanje osetljivosti odabranih izolata virusa na oseltamivir upotrebljen je hemiluminiscentni test inhibicije aktivnosti neuraminidaze.</p><p>Ukupno 46,3% (411/887) uzoraka bilo je influenca pozitivno, od čega je 73% (300/411) bilo influenca A pozitivno, a 27% (111/411)influenca B pozitivno (p&lt;0,0001). &nbsp;Influenca A(H1N1)pdm09 podtip je detektovan u 48% (144/300), a A(H3N2) podtip u&nbsp;52% (156/300) influenca Apozitivnih uzoraka. Najveći procenat influencaA pozitivnih zabeležen je u uzrastnoj grupi 5-14 godina (48,2%, 77/160) i kod pacijenata sa lak&scaron;im kliničkim manifestacijama gripa (43,7%, 153/350).</p><p>Influenca A(H1N1)pdm09 podtip preovladavao je u uzrastnoj grupi 15-29 godina (66%, 31/47, p=0,0400) i 30-64 godina (55,9%,71/127, p=0,0215), kao i kod pacijenata sa te&scaron;kom akutnom respiratornom bole&scaron;ću (63,5%, 80/126, p&lt;0,0001), fatalnih slučajeva (100%,9/9, p=0,0039) i pacijenata sa hroničnim bolestima i stanjima (68,8%, 84/122, p&lt;0,0001).&nbsp;</p><p>Influenca A(H3N2) podtip dominirao je kod dece uzrasta do 4 godine (72,2%,13/18, p=0,0381) i 5-14 godina (75,3%, 58/77, p&lt;0,0001), kod pacijenata sa lak&scaron;im oblikom bolesti (69,3%,106/153, p&lt;0,0001) i bez hroničnih bolesti ili stanja (66,3%, 118/178,&nbsp;p&lt;0,0001).</p><p>Najznačajniji predikcioni faktori komplikacija influence bili su: prisustvo hroničnih bolesti ili stanja i uzrast &ge;15 godina. Prisustvo hroničnih bolesti ili stanja nosilo je 34 puta, a uzrast &ge;15 godina 10 puta veći rizik od nastanka te&scaron;kih oblika bolesti.</p><p>Izolacija influenca virusa na MDCK ćelijskim kulturama, bila je uspe&scaron;na u 34,3% (70/204) slučajeva, pri čemu je u grupi uzoraka sa real-time RT-PCR Ct vrednostima &lt;30 ona iznosila 80,5% (62/77), kod uzoraka sa Ct vrednostima 30-34 svega 8,7% (8/92), a izolacija iz uzoraka sa Ct vrednostima &gt;34 nije bila moguća. U reakciji hemaglutinacije, najbolji rezultati su postignuti sa eritrocitima zamorca, koje je u titru &ge;40 aglutiniralo 56% (14/25) A(H1N1)pdm09 virusa i 62,5% (15/24) A(H3N2) virusa. Sa humanim eritrocitima dobar titar dalo je 16% (4/25) influenca A(H1N1)pdm09 i 8,3% (2/24) A(H3N2) virusa, a sa koko&scaron;ijim eritrocitima 8% (2/25) A(H1N1)pdm09 virusa i nijedan virus A(H3N2) podtipa.</p><p>Rezultati antigenske karakterizacije pokazali su da je svih 23 influenca virusa A(H1N1)pdm09 podtipa, iz sezona 2012/2013 i 2013/2014, antigenski bilo slično referentnom, vakcinalnom virusu A/California/7/2009. Nasuprot tome, samo 1 od 7 ispitanih A(H3N2) virusa iz sezone 2012/2013, antigenski je bio sličan vakcinalnom virusu A/Victoria/361/2011, a samo 2 od 20 iz sezone 2013/2014 antigenski je bilo slično vakcinalnom A/Texas /50/2012 virusu.</p><p>Filogenetska analiza hemaglutinin gena influenca A(H1N1)pdm09 virusa iz sezone 2012/2013, pokazala je da su u na&scaron;oj sredini, bili prisutni virusi iz dve različite genogrupe, 6C i 7, dok su naredne sezone svi analizirani virusi pripadali genogrupi 6B. Virusi iz na&scaron;e sredine bili su filogenetski srodni A(H1N1)pdm09 virusima iz drugih evropskih zemalja. Svi ispitani A(H3N2) virusi iz sezone 2012/2013 i2013/2014, pripadali su genetičkoj grupi&nbsp; 3C.3.Filogenetski su bili srodni sa virusima iz drugih gografskih regiona Evrope.</p><p>Svih 20 izolata influenca A(H1N1)pdm09 podtipa i 23 A(H3N2) podtipa pokazali su normalnu inhibiciju aktivnosti neuraminidaze pod dejstvom oseltamivira.ekvenciranje neuraminidaza gena jednog A(H3N2) virusa, koji je imao 8 puta redukovanu inhibiciju aktivnosti neuraminidaze oseltamivirom, ukazalo jena prisustvo retke mutacije Q391H, povezane sa rezistencijom na inhibitore neuraminidaze.</p><p>Rezultati ovog rada ukazali su na značaj influenca A virusa kao etiolo&scaron;kih uzročnika akutnih respiratornih obolenja u na&scaron;oj sredini, naročito za osobe sa hroničnim bolestima koje su pod povećanim rizikom od razvoja te&scaron;kih oblika gripa. U ovom istraživanju stečena su i saznanja koja imaju praktičnu primenu u postupku antigenske karakterizacije influenca A virusa, koja je jedna od ključnih faza u procesu pripreme vakcine protiv gripa. Značajna antigenska razlika A(H3N2) virusa koji su cirkulisali u sezonama 2012/2013 i 2013/2014 u odnosu na viruse koji su bili u sastavu vakcina u datim sezonama, ukazala je na neophodnost unapređenja proizvodnje vakcine protiv gripa. Dobijeni su i prvipodaci orezistenciji na antivirotik oseltamivir, kao i o filogenetskim odnosima i genetičkim grupama virusa koji su&nbsp; cirkulisali u na&scaron;oj sredini.</p> / <p>In this study we investigated the representation, antigenic and genetic properties, and sensitivity to antiviral drug oseltamivir of influenza A viruses. The study was conducted&nbsp; during 4 consecutiveseasons 2010/2011 - 2013/2014, and included 887 nasal and throat swabs taken from patients with influenza-like symptoms from South&nbsp; Backa district. All samples were tested for influenza A(H1N1)pdm09, A(H3N2), A(H1N1), A(H5), A(H7) and influenza B viruses, by real-time RT-PCR. Isolation on MDCK cell culture was performed with positive samples from seasons 2012/2013 and 2013/2014, and virus isolates were tested for ability&nbsp; to agglutinate guinea pig, chicken and human red blood cells in reaction of virus hemagglutination. Antigenic properties of isolates with hemagglutination titre &ge;40, were investigated using reaction&nbsp; of hemagglutination inhibition. Genetic characterization was performed by sequencing of neuraminidase and hemagglutination genes of representative isolates from seasons 2012/2013 and 2013/2014. Testing for sensitivity to oseltamivir was done with chemiluminescent neuraminidase inhibition assay.</p><p>Total of 46,3% (411/887) of samples were influenza positive, out of which 73% (300/411) were influenza A positive and 27% (111/4111, p&lt;0,0001) were influenza&nbsp; B positive. Influenza A(H1N1)pdm09 subtype was detected in 48% (144/300), and A(H3N2) subtype in 52% (156/300) of influenza A positive samples. The highest proportion of influenza A positive samples wasfound in age group 5-14&nbsp; years (48,2%,&nbsp; 77/160) and among patients with uncomplicated influenza (43,7%, 153/350).</p><p>Influenza A(H1N1)pdm09 subtype predominated in age group 15-29 years (66%, 31/47, p=0,0400) and 30-64 years (55,9%,71/127, p=0,0215), in patients with severe acute respiratory illness (63,5%, 80/126, p&lt;0,0001), in fatal cases (100%, 9/9, p=0,0039), and among patients with underlying chronic diseases and conditions (68,8%,84/122, p&lt;0,0001).</p><p>Influenza A(H3N2) subtype predominated in age group &le;4 years (72,2%, 13/18, p=0,0381) and 5-14 years (75,3%,58/77, p&lt;0,0001), in patients with mild form of influenza (69,3%,106/153, p&lt;0,0001), and in group of patients without chronic diseases and conditions (66,3%,60/478, p&lt;0,0001).</p><p>The most significant risk factors for severe influenza were: the presence of underlying diseases and conditions and age &ge;15 years. Patients with chronic illnesses and conditions had 34 times higher and patients &ge;15 years of age 10 times higher risk from severe influenza.</p><p>Isolation rate of influenza A viruses in MDCK cell cultures was 34,3% (70/204). For samples with real time RT-PCR Ct values &lt;30 isolation rate was 80,5% (62/77), for samples with Ct values 30-34 it was 8,7% (8/92), while isolation of viruses from samples with Ct values &gt;34 was not successful. In the reaction of virus hemagglutination, the best results were achieved with guinea pig red blood cells which agglutinated in titre &ge;40, 56% (14/25) of influenza A(H1N1)pdm09 viruses and&nbsp; 62,5% (15/24) of A(H3N2) viruses. With human erythrocytes, good titre gave 16% (4/25) of influenza A(H1N1)pdm09 and 8,3% (2/24)of A(H3N2) viruses and with chicken erythrocytes 8% (2/25) A(H1N1)pdm09 viruses and none of the A(H3N2) viruses.</p><p>Results of the antigenic characterization of 23 influenza A(H1N1)pdm09 viruses, showed that they were antigenically similarto referent, vaccine virus A/California/7/2009. On the contrary, only 1 out of 7 influenza A(H3N2) viruses from season 2012/2013,was antigenically similar to A/Victoria/361/2011 vaccine virus, and only 2 out of 20 from season 2013/2014 were antigenically similar to A/Texas/50/2012&nbsp; vaccine virus.</p><p>Filogenetic analysis of hemagglutinin genes indicated co-circulation of 2 distinct genetic groups, 6C and 7, of A(H1N1)pdm09 viruses during the season 2012/2013, while during the season 2013/2014 all tested viruses were from genetic group 6B. Influenza A(H1N1)pdm09 viruses from our region, were closely related to viruses from other European countries. All influenza A(H3N2) viruses from season 2012/2013 and 2013/2014 belonged to genetic clade 3C.3 and were closely related to viruses from different European countries.</p><p>Total of 20 A(H1N1)pdm09 isolates and 23 A(H3N2) isolates were tested for sensitivity to oseltamivir, and all of them showed normal inhibition of neuraminidase activity with oseltamivir. Sequencing of&nbsp; neuraminidase gene of one A(H3N2) virus with 8-fold reduced inhibition by oseltamivir, revealed rare mutation Q391H associated with antiviral resistance.</p><p>Results of this study indicate the significance of influenza A viruses as etiological factors of acute respiratory diseases in our area, especially for persons with chronic medical conditions who are at higher risk for severe influenza. Data gathered during&nbsp;the process of virus isolation and investigation of hemagglutination abilities of&nbsp; isolated viruses, have practical application in antigenic testing of influenza A viruses which is one of the key points of process of anti-flu vaccine production. Significant &nbsp;antigenic difference between influenza A(H3N2) viruses from seasons 2012/2013 and&nbsp; 2013/2014 and vaccine viruses, emphasis the importance of vaccine production improvement. During this study, the first data about antiviral resistance, filogenetic relationships and genetic groups of influenza viruses from our region, were obtained.</p>

<p>Dokazivanje virusnih infekcija pĉela od velikog je interesa za pravilnu procjenu odnosa izmeĊu domaćina i potencijalnog patogena. Do izrade ove doktorske teze, na teritoriji Bosne i Hercegovine nije bilo prouĉavanja koja bi dokaz virusnih infekcija pĉela dovela do mogućnosti kliniĉke procjene patolo&scaron;kog odnosa za eko-genotip prilagoĊene pĉelinje zajednice. Evolucijski adaptirani virusi medonosne pĉele Apis mellifera carnica, sa stanovi&scaron;ta veterinarske entomologije, veterinarske virusologije i infektivnih bolesti, te saznanja veterinarskog servisa uop&scaron;te, nisu bili dovoljno prepoznati. Pojava i dostupnost molekularnih dijagnostiĉkih metoda omogućile su senzitivno i specifiĉno dokazivanje dijela genoma virusa koji inficiraju pĉelinje zajednice. Iz ekstrahovanih uzoraka templata razliĉitih uzoraka homogenizata sluĉajno uzorkovanih pĉela, RNK, sa jednim parom prajmera za svaki virus, pojedinaĉno, redoslijedom: BQCV, DWV, SBV, ABPV, KBV, CBPV uraĊeni su amplifikacijski protokoli i dobijeni rezultati za klasiĉan, end point, RT-PCR. Ovom doktorskom disertacijom dobijeni su prvi rezultati koji se odnose na utvrĊivanje prisustva i ra&scaron;irenosti virusnih infekcija kod vrste Apis mellifera u pĉelinjacima Bosne i Hercegovine. Od oko dvadeset virusa koji inficiraju pĉele i pĉelinje zajednice, metodama primjenjive molekularne dijagnostike u ovoj doktorskoj tezi dokazivali smo prisustvo virusnih infekcija za &scaron;est najvi&scaron;e prouĉavanih virusa pĉela. Dobijeni rezultati dokazali su prisustvo pet od &scaron;est traţenih virusa sa razliĉitim kombinacijama koinfekcija te raznolikom prostornom distribucijom virusa. Poznavanje sloţenih mehanizama virusnih infekcija pĉelinjih zajednica neophodnost je koja sa novim saznanjima progla&scaron;ava neke od virusa emergentnim patogenima, koji bitno naru&scaron;avaju opstanak pĉelinje zajednice. U patolo&scaron;ko-sinergistiĉkom odnosu sa nametnikom pĉelinje zajednice Varroa destructor neki pĉelinji virusi uzroci su globalno registrovanih gubitaka. Dio istraţivanja u radu odnosio se na terensko prouĉavanje dinamike prisustva grinje Varroa destructor u pĉelinjim zajednicama. Za pravilno dono&scaron;enje suda o uzroku ugibanja pĉelinjih zajednica, pored postojećih zahtjeva kontrole patogena pĉela definisanih procedurama dijagnostiĉkog manuala i Koda OIE-a, bilo bi potrebno imati i rezultate kojim bi se dokazalo kvalitativno i kvantitativno prisustvo virusa kod vrste Apis mellifera. UvoĊenje i standardizacija molekularno-biolo&scaron;kih metoda u rutinskoj dijagnostici virusnih bolesti pĉela je opravdano. Samo je pitanje vremena kada će virusne infekcije pĉela biti predmet rutinske dijagnostike kojim se kontroli&scaron;ezdravstveni status pĉelinje zajednice.</p> / <p>Evidence of viral infection of bees is of great interest for the proper assessment of the relationship between host and pathogen potential. By making this doctoral thesis on the territory of Bosnia and Herzegovina, where before was no present study of evidence of viral infections, lead to ability on clinical evaluation of pathological relations for eco-genotype adapted colonies. Evolutionarily adapted viruses honeybee Apis mellifera, from the veterinary entomology, veterinary virology and infectious diseases, and knowledge of the veterinary services in general, have not been recognized enough. The appearance and availability of molecular diagnostic methods have allowed sensitive and specific detection part of the genome of the virus that infects the colonies. Templates were extracted from samples of different patterns, homogenisate, randomly sampled bees, RNA, with a pair of primers for each virus, respectively, in the order: BQCV, DWV, SBV, ABPV, KBV, CBPV amplification protocols were done and the results obtained by conventional, end point, RT -PCR. This doctoral dissertation obtained the first results concerning the determination of the presence and spread of viral infections in the species Apis mellifera in Bosnia and Herzegovina. From about twenty viruses that can infect bees and hives using diagnostic methods applicable in this doctoral thesis we demonstrate the presence of viral infections of six most studied viruses of bees. The obtained results showed the presence five of the six essential viruses in forms of co-infection with different combinations and varied virus spatial distribution. Awareness of the complex mechanisms of viral infections in colonies is that the new knowledge proclaimed a virus as &quot;emergent pathogen&quot; that significantly impairs the survival of honeybee colonies. The pathogenic synergistic relationship with the parasite Varroa destructor causes that bee viruses are globally listed as reasons for losses. Part of the research work was related to the field study of the dynamics of the presence of Varroa destructor mites in honey bee colonies. For a accurate judgment of the deaths of bee colonies, in addition to existing requirements bee pathogen control procedures defined by diagnostic Manuals and Code of the OIE, it would be necessary to have the results to prove the qualitative and quantitative presence of the virus in the species Apis mellifera. The introduction and standardization of molecular biological methods in routine diagnosis of viral diseases of bees is justified. It is only a matter of time before the virus infections of bees will be subject to routine diagnostics which controls the health of bee colonies</p>

<p>Profesionalna infektivna oboljenja nastaju kao posledica izloženosti mikroorganizama u radnoj sredini. Cilj ovog istraživanja je utvrđivanje vrsta profesionalnih &scaron;tetnosti koje dovode do profesionalnih infektivnih oboljenja i njihove incidencije u privrednim delatnostima Autonomne Pokrajine Vojvodine, kao i predloga adekvatnih mera za njihovu prevenciju. Profesionalna infektivna oboljenja su činila 13,4% od ukupno 464 slučaja utvrđenih profesionalnih oboljenja u Autonomnoj Pokrajini Vojvodini u toku dvadesetogodi&scaron;njeg perioda od 1992. do 2011. godine. Od ukupno utvrđenih 62 slučaja profesionalnih infektivnih oboljenja dve trećine su činili profesionalni virusni hepatitisi, 31% profesionalne antropozoonoze i 3% profesionolana tuberkuloza. Dve trećine obolelih od profesionalnih infektivnih bolesti bile su osobe ženskog pola &scaron;to je statistički značajno vi&scaron;e u poređenju sa osobama mu&scaron;kog pola, dok su zaposleni mu&scaron;kog pola činili 57%, a ženskog 43% ukupno zaposlenih na teritoriji Vojvodine. Najče&scaron;ća profesionalna infektivna oboljenja bila su virusni hepatits B 52%, kju groznica 18%, virusni hepatitis C 15%, lajmska bolest 6%, leptospiroza 5%. Utvrđeno je da je do&scaron;lo do statistički značajnog sniženja incidencije profesionalnog virusnog hepatitisa B u<br />periodu nakon dono&scaron;enja odluke o obaveznoj imunizaciji 2002. godine, sa 6,27 na 1,35 na 100.000 zaposlenih, dok nije bilo statistički značajne razlike kada je u pitanju incidencija virusnog hepatitisa C. Profesionalna infektivna oboljenja su u vi&scaron;e od dve trećine slučajeva registrovana kod zdravstvenih radnika (69%) sa prosečnom incidencijom od 5,18 na 100.000 zaposlenih, znatno niža bila je incidencija u proizvodnji prehrambenih proizvoda (1,36) i poljoprivredi sa lovom, ribolovom i &scaron;umarstvom (1,11). Ne&scaron;to vi&scaron;e od trećine radnika bilo je privremeno nesposobno za rad u toku utvrđivanja profesionalnog oboljenja, jer je lečenje bilo u toku. Kod ovih radnika značajno je naknadno oceniti radnu sposobnost i utvrditi eventualne posledice oboljenja. Pored primene specifičnih mera imunizacije ukoliko postoje, kao i ličnih mera za&scaron;tita koje sprečavaju kontakt sa uzročnicima, značajno je sprovođenje edukacije radnika o rizicima i preventivnih lekarskih pregleda radi rane identifikacije obolelih radnika.</p> / <p>Occupational communicable diseases are caused by exposure to microorganism&rsquo;s in working environment. The aim of this study is to determine the types of occupational hazards that lead to occupational communicable diseases and their incidence in the economic activities of the Autonomous Province of Vojvodina, as well as the proposal of adequate measures for their prevention. Occupational communicable diseases accounted for 13.4% of the total of 464 cases of occupational diseases identified in the Autonomous Province of Vojvodina during the twenty-year period from 1992 to 2011. In the total of 62 identified cases of occupational communicable diseases, occupational viral hepatitis accounted for two-thirds, occupational anthropozoonoses for 31%, occupational tuberculosis for 3%. Two-thirds of patients with occupational communicable diseases were females, significantly more compared to male, while male accounted for 57% and female for 43% of the total employees in Vojvodina. The most frequent occupational communicable diseases were viral hepatitis B 52%, Q fever 18%, viral hepatitis C 15%, Lyme disease 6%, leptospirosis 5%. It was found that there was a statistically significant decrease in the incidence of occupational viral hepatitis B in the period after the decision on obligatory immunization in 2002, from 6.27 to 1.35 per 100,000 employees, while there were no statistically significant differences in the incidence of viral hepatitis C. In more than two-thirds of the cases occupational communicable diseases were registered in health care workers (69%) with the average incidence of 5.18 per 100,000 employees, substantially lower the incidence was in the production of food (1.36), as well as in agriculture, hunting, fishing and forestry (1.11). Just over a third of workers were temporarily unable to work during the verification of occupational disease due to the ongoing treatment. In these workers it is important to assess working ability afterwards and identify the possible consequences of the disease. In addition to the application of specific measures of immunization if any available, as well as personal protection measures that prevent contact with pathogens it is important to implement risk education of workers and preventive medical examinations for early identification of affected employees.</p>