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Background/Aim. Q fever occurs worldwide and can be found in humans as well as in domestic mammals. The aim of this study was to describe the epidemiological characteristics of Q fever and evaluate correlation between the Q fever occurrence and weather conditions. Methods. We conducted a descriptive epidemiological study using data of the Institute of Public Health of Vojvodina, Scientific Veterinary Institute, Novi Sad, and the Republic Hydrometeorological Service of Serbia, from 2006 to 2015. Results. Out of 272 human Q fever cases, 114 (41.9%) patients were aged between 20 and 39 years. Between January and May, a total of 193 (71.0%) cases of disease were registered. In the Central Banat and South Banat, a strong positive correlation between an increase in Q fever detection and an increase of average wind speed (ρ= 0.69719 and ρ=0.62303, respectively) was observed, while a strong negative correlation was determined between the average rainfall with the number of Q fever cases in the Central Banat, the South Banat and Srem district (ρ = -0.78033, ρ = -0.70675 and ρ = -0.70431, respectively). During a 10-year period, a strong positive correlation was found between the human Q fever cases compared to the number of cattle and sheep Q cases in the Srem district (r = 0.7989 and r = 0.7966, respectively). Direct contact with domestic animals was the most frequent route of Q fever transmission in Vojvodina. Conclusion. The timely sharing of information between the animal and human health sectors as well as between neighbouring countries is crucial for an appropriate and an early outbreak response, especially during windy and dry months of the year. Additionally, it is essential that people who are exposed to a risk of infection must be permanently educated about reducing the risk of transmission of infection.

Background/Aim. After pandemic 2009/10 influenza season, influenza A (H1N1)pdm09, A(H3N2) and B viruses have continued to circulate in the population. The aim of this study was to describe the epidemiological and virological characteristics of influenza and evaluate values of proposed case definitions of influenza like illness (ILI), severe acute respiratory illness (SARI) and acute respiratory distress syndrome (ARDS) for detecting laboratory-confirmed influenza cases in Vojvodina. Methods. We conducted a descriptive epidemiological study using surveillance reports and laboratory data from October 2010 to May 2015 (five surveillance seasons). Results. Out of 1,466 samples collected, 720 (49.1%) were laboratory confirmed as influenza. Influenza A infection was more frequently detected than influenza B infection. Using the case definition of ILI was a good predictor for influenza confirmation (p < 0.05) during 5 influenza seasons. The predominant age-range of patients with confirmed influenza A (42.2%) and B (43.0%) infections was 30 to 64, but the patients aged from 15 to 29 years were more likely to have influenza A (p = 0.0168). In the period from December to January, influenza A (17.8%) was more frequently registered than influenza B (7.6%). The highest number of deaths (19/38) and hospitalized patients (128/402) was registered during the last influenza season (2014/15). The immunosuppressed patients with confirmed influenza infection were more likely to have influenza B than influenza A (p = 0.0110). Conclusion. Our results indicate that influenza surveillance should be continued and expanded in order to fully assess the burden of the disease in given population.

Background/Aim. Despite the fact that brucellosis occurs sporadically in the epidemic form, this disease is still one of the world's most widespread zoonoses. Methods. Data from the register of infectious diseases of the Institute of Public Health of Vojvodina and Scientific Veterinary Institute in Novi Sad were used in this study. Using descriptive statistics, data were analyzed for the period 2000 to 2014. Results. In the observed period in Vojvodina 102 cases of brucellosis were registered with different frequency of notification cases by districts of province. Most frequent modes of transmission of brucellosis were consumption of contaminated food (especially sheep cheese) or direct contact with domestic animals. In 70.2% of the patients, occupational exposures to the agent or direct daily contact with animals were noted. The dominant source of infection in the urban area was food, whereas a direct contact with sick animals was dominant mode of transmission in the rural area. Overall, 14 epidemic outbreaks of brucella were registered with direct contact as dominant mode of transmission. The predominant age-range of patients with brucella confirmed infections was 30–59 years (50.0 male %), and 2.5 times more males than females were affected. Seasonal distribution was highest during spring, with 50.0% of all confirmed cases. During the period 2004–2005, prevalence of serum positive patients in the South Bačka District coincided with the highest number of laboratory confirmed serum samples among animals. Conclusion. Although the incidence of brucellosis shows a declining trend, education and improving of surveillance of disease of all relevant institutions seems as necessary for better recognition and notification of the disease.

Background/Aim. To evaluate ultrasound criteria based on a node size, shape, vascularity and cytology findings with respect to their value for the comparative determination of metastatic lymph nodes in laryngeal carcinoma. Methods. A prospective study included 30 patients with laryngeal squamous cell carcinoma without node enlargement on computerized tomography, at the Department of Otorhinolaryngology, the University Hospital, Zemun. Thirty-six neck lymph nodes were evaluated sonographically and aspirated with an ultrasound-guided fine-needle. They were examined cytologically and/or histopathologically and compared to the sonographic assessment of their malignancy. Results. Of the 36 neck lymph nodes evaluated cytologically, the 13 were found to be with a metastatic deposit. The assessment of a lymph node malignancy using the parameter of size had the sensitivity of 84%, the specificity of 70%, and the reliability of 75%. Using the criteria of a lymph node shape for the assessment of malignancy, the sensitivity of 61%, specificity of 65%, and the reliability of 64% were achieved. The evaluation of a lymph node vascularity by the use of the effect of Doppler showed the sensitivity of 69%, the specificity of 95%, and the reliability of 86%. Concluson. Ultrasound and ultrasound-guided fine-needle aspiration cytology should be always used for the preoperative staging and for the postoperative follow-up of the status of the neck with cancer of the larynx becouse of their high accuracy, availability and semiinvasivity, and in order to enhance the reliability of the evaluation of the malignant disease progression.

Background. Sjögren's syndrome (SS) represents autoimmune disease characterized by chronic inflammation, destruction and insufficiency of exocrine glands, particularly salivary and lacrimal glands, accompanied by dryness of mouths and eyes. Diagnostic work-up involves clinical laboratory tests, radiography, scintigraphy and bioptic histopathological examination. Examination of small salivary glands in the biopsy of the lower lip represents a 'golden standard' of diagnosis of SS, concerning the fact that the growth and the disfunction of salivary and lacrimal glands occurs in different pathologic states. Methods. Resected specimens of the lower lip were obtained from 47 patients with clinical diagnosis of SS. After standard histopathological treatment, slices were hematoxylin and eosin stained. Immunohistochemistry against smooth muscle actin was performed using LSAB+ method (AHSMA-M7558, DAKO 1:50). On the basis of generally accepted histopathological diagnostic criteria the results were categorized as: findings suspicious for SS; findings compatible with the diagnosis of SS (mild, moderate and high degree of inflammation); nonspecific inflammatory reaction and nonrepresentative biopsy samples. Results. Diagnosis of SS was confirmed in 32% of cases. In 2% of cases findings were suspected for SS, in 36% of cases findings were compatible with the diagnosis of nonspecific inflammation, and in 30% of cases material was not representative. Conclusions. By the biopsy of salivary glands of the lower lip the diagnosis of SS was confirmed in 50-60% of cases. Upon the precise diagnostic criteria it was also possible to determine the intensity of inflammation and tissue destruction in SS and identify other pathological conditions, which justified the biopsy. Surgical technique had to be adequate in order to obtain representative number of small salivary glands. In the presented material 30% of specimens were nonrepresentative which was very high percentage compared with literature data. This was most probably the reason why the diagnosis of SS was confirmed in only 32% of cases, i.e., in every third patient.