Abstract | Flebovirusi čine dio velike skupine arbovirusa koje na ljude prenose flebotomi (nevidi). Infekcije uzrokovane ovim virusima u ljudi se očituju kao febrilna bolest, tzv. "trodnevna groznica" ("papatači groznica"), dok virus Toscana (TOSV) može uzrokovati i neuroinvazivnu bolest (serozni meningitis/encefalitis). Flebovirusi su rasprostranjeni u mediteranskim zemljama gdje uzrokuju infekcije, osobito u ljetnim mjesecima. Na području Hrvatske dokazani su sicilijanski (SFSV), napuljski (SFNV) i ciparski (SFCV) virus papatači groznice te TOSV. Cilj rada je odrediti seroprevalenciju na fleboviruse u stanovnika kontinentalnog područja Hrvatske i priobalja. Tijekom dvogodišnjeg razdoblja, od siječnja 2017. godine do prosinca 2018. godine, na fleboviruse je testirano ukupno 214 ispitanika u dobi od 18 do 89 godina. U ispitivanoj je skupini bilo 113 (52,8%) muškaraca i 101 (47,2%) žena. Ovisno o geografskom području, 92 ispitanika (43,0%) su bila s područja priobalja, a 122 (57,0%) s područja kontinentalne Hrvatske. Svi su ispitanici bili asimptomatski u vrijeme testiranja te nisu naveli anamnestički podatak o nedavnoj febrilnoj bolesti. IgG protutijela na SFSV, SFNV, SFCV i TOSV određena su pomoću indirektnog imunofluorescentnog testa (IFA; Sandfly Fever Mosaic, Euroimmun, Lübeck, Njemačka). Protutijela na SFSV dokazana su u 5 (2,3%) ispitanika, SFNV u 7 (3,3%), SFCV u jednog (0,5%) te TOSV u 22 (10,3%) ispitanika. Seroprevalencija se nije značajno razlikovala s obzirom na spol (muškarci 14,2%; žene 13,9%) te dob ispitanika (11,1-19,4%). Statistički značajno viša seroprevalencija (p<0,001) dokazana je u stanovnika priobalja (25,0%) u odnosu na stanovnike kontinentalnih područja (5,7%). Rezultati logističke regresije pokazali su da je prebivalište u priobalju značajan rizični čimbenik za seropozitivitet na fleboviruse (OR=5,476; 95%CI=2,232-13,430). Akutne flebovirusne infekcije nisu dokazane. Rezultati ovog istraživanja potvrdili su prisutnost flebovirusa na području Hrvatske, no obzirom na relativno mali broj ispitanika, potrebna su daljnja istraživanja kako bi se potvrdila ova opažanja te odredila točna seroprevalencija u obje ispitivane regije Hrvatske. |
Abstract (english) | Phleboviruses belong to a large group of arboviruses that are transmitted to humans by sandflies (Phlebotomus). Infections by these viruses in humans manifest as a febrile disease, so-called “three-day fever” (“Pappataci fever”), while the Toscana virus (TOSV) may also cause neuroinvasive disease (aseptic meningitis/encephalitis). Phleboviruses are widespread in the Mediterranean countries, where they cause diseases, especially during the summer months. In Croatia, TOSV, Sicilian (SFSV), Naples (SFNV) and the Cyprus (SFCV) sandfly fever viruses were detected. The aim of this study was to determine the seroprevalence of phleboviruses in residents of the continental and coastal Croatian areas. During a two-year period, from January 2017 to December 2018, a total of 214 participants aged 18 to 89 were tested for phleboviruses. The study group included 113 (52.8%) men and 101 (47.0%) women. Depending on the geographic area, 92 (43.0%) participants were from the coastal and 122 (57.0%) from the continental Croatian regions. All participants were asymptomatic at the time of testing and did not report recent febrile illness. IgG antibodies to SFSV, SFNV, SFCV and TOSV were determined using an indirect immunofluorescent assay (IFA; Sand-fly Fever Mosaic, Euroimmun, Lübeck, Germany). Antibodies to SFSV were found in 5 (2.3%) participants, SFNV in 7 (3.3%), SFCV in one (0.5%) and TOSV in 22 (10.3%) participants. There was no significant difference in the seroprevalence according to gender (men 14.2%; women 13.9%) and age of participants (11.1-19.4%). Statistically significant higher seroprevalence (p<0.001) was found between inhabitants of the coastal areas (25.0%) compared to the inhabitants of continental regions (5.7%). The results of logistic regression have shown that residence in the coastal area is a significant risk factor for flebovirus seropositivity (OR=5.476; 95%CI=2.232-13.430). Acute phlebovirus infections were not detected. Results of this study confirmed the presence of phleboviruses in Croatia. Due to a relatively small number of participants, further researches are needed to confirm these observations and determine the exact seroprevalence in both studied Croatian regions. |