B Aleraj

Croatian National Institute of Public Health, Zagreb - Centar, Grad Zagreb, Croatia

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Publications (18)3.68 Total impact

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    ABSTRACT: Aim. Description of hemorrhagic fever with renal syndrome (HFRS) diagnosed in the members of the Croatian Army (CA) deployed at the Novska battlefield, and a seroepidemiologic study of healthy CA members stationed in the area. Methods. Three groups of soldiers were studied: 120 soldiers from the autochthonous Novska population, with the mean deployment duration of 33 months (group 1); 96 soldiers from the near-by Ivanic-grad community, whose mean deployment at Novska was 7.5 months (group 2); and 47 soldiers who had neither lived nor been stationed at the Novska battlefield (group 3 - control). Sera were tested by indirect immunofluorescence using the Hantaan and Plitvice antigens. Results. In groups 1 and 2, 11.7% and 15.7% of the subjects were positive for the antibodies to hantaviruses antigens, respectively, in contrast to only 2.1% in the control group (p = 0.045). The results pointed to the presence of dormant infection of the soldiers deployed at the Novska battlefield. An overnight micromammal hunt resulted in the entrapment of 181 animals belonging to 7 species. The presence of Hantaan antigen was identified in the lungs of 12 out of 110 animals (10.9%, direct immunofluorescence). Bank vole (Clethrionomys glareolus) was the most viruliferous in this focus (22.0%). Conclusion. Seroepidemiologic and mammologic-virologic studies confirmed the presence of a natural focus of HFRS in the Novska area. The infection must have been 'triggered' by a close contact of the soldiers with rural environment, especially with the muroid rodents inhabiting the area, and acting as Hantaan virus reservoir hosts.
    No preview · Article · Jun 1996 · Croatian Medical Journal
  • A Hrabar · B Aleraj · S Ceović · D Cvoriscec · C Vacca · P W Hall
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    ABSTRACT: The diagnosis of BEN and its differentiation from other chronic interstitial nephropathies are difficult because of the insidious onset as well as nonspecific morphological changes in the kidney. Early diagnosis of this disease is by clinical and laboratory findings which have not been universally accepted. This study was designed to determine if the frequency of increased urinary beta 2-microglobulin (U beta 2m) in village populations at risk to develop BEN was significantly higher than that seen in a control population. Individuals in the two population samples were classified in one of three categories: healthy, suspect or diseased. There were 23 individuals who met the criteria for the clinical diagnosis of BEN. Twenty (87%) of these had one or more positive tests for increased U beta 2m. The prevalence of kidney disease in the endemic village population sample was 13.4 times that for the control village population sample. The data show that the healthy individuals living in a village where BEN is endemic have 6.4 times greater chance of having tubular proteinuria than those living in a control area. The coincidence of the finding of U beta 2m in the urine of 87% of those sick with BEN and in 37 of the 342 (10.8%) people judged to be free of kidney disease suggests that a positive U beta 2m test is an early indicator of exposure to a nephrotoxic agent.
    No preview · Article · Dec 1991 · Kidney international. Supplement
  • A Hrabar · S Ceović · B Aleraj · D Cvoriscec · P W Hall
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    ABSTRACT: Anemia has been reported to be an early sign of Balkan endemic nephropathy (BEN) occurring before the serum creatinine is elevated. This study was designed to determine if anemia occurred more frequently in an otherwise 'healthy' population living in an area where BEN is endemic when compared to a control population. Also, we wished to determine if any relationship existed between anemia and beta 2-microglobulinuria (beta 2mu) in these populations. The prevalence of anemia in the control village population was 7%, compared to 21.4% of the at-risk village population. These data suggest that anemia is a part of the pathophysiologic picture of endemic nephropathy, and that anemia can be found in an early, non-azotemic phase of the kidney disease.
    No preview · Article · Dec 1991 · Kidney international. Supplement
  • A Hrabar · B Aleraj · S Ceović · D Cvoriscec · C Vacca · P W Hall
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    ABSTRACT: The occurrence of elevated urinary beta 2-microglobulin (U beta 2m) has been established to be more common in village populations living in areas where BEN is endemic when compared to appropriate control population. In addition, beta 2-microglobulinuria is associated with BEN. It has been demonstrated that there is an increase in the U beta 2m in apparently healthy populations located in high risk areas. It is 15 years since the first systematic investigations of U beta 2m in the villages of Brod Posavina were conducted. The purpose of this study was to determine the value of a positive test for tubular proteinuria as defined by increased U beta 2m, in identifying individuals at risk to develop BEN. In these studies we followed two cohorts for 15 years: one group consisted of individuals who were positive for tubular proteinuria by U beta 2m testing in 1974; the second group was an age and sex matched group from the same village who were never positive after 12 testings in 1974. The results show that a positive test for U beta 2m is associated with 9.9 times greater relative risk of developing BEN when compared to controls that had no positive U beta 2m tests.
    No preview · Article · Dec 1991 · Kidney international. Supplement
  • B Borcić · B Turković · B Aleraj · N Tvrtković
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    ABSTRACT: On the territory of Lika and Gorski Kotar a group of 300 forest workers and 260 persons from the general population were screened for Hantavirus antibodies (by the indirect immunofluorescence test). In the first group of examenees a mean of 1.6% were found positive, ranging from 0% (Gospić) to 3.2% (Ogulin). In the second groups a mean of 5.4% were positive, ranging from 4.4 to 8.9% (Delnice and Slunj, respectively). It is concluded that the Hantavirus infection rate in our natural foci of HFRS is higher than officially registered. Screening of micromammals for the presence of Hantavirus in their organs (lungs), using the direct immunofluorescence test, was undertaken on three locations: Planina Gornja (hillsides of the mountain Medvednica), a case of HFRS having been registered there previously, and Plitvicka Jezera and Velika Gorica (village of Kobilić) selected because of two previous epidemics of HFRS (1967 and 1989, respectively). On the first location, all 126 animals examined (10 different species) were Hantavirus negative. On the second location, 9 of the 165 animals examined (three species) were Hantavirus positive (5.4%), namely 6 bank voles (Clethrionomys glareolus) and three yellow-necked mice (Apodemus flavicollis). On the third location, where 141 animals was caught and examined (7 different species), 7 animals were positive (4.9%): 3 striped field mice (A. agrarius), 3 wood mice (A. sylvaticus) and 1 bank vole (Cl. glareolus). The findings suggest that in our natural foci of HFRS the circulation of the Hantavirus is sustained by several species of micromammals.
    No preview · Article · Sep 1991 · Lijec̆nic̆ki vjesnik
  • B Aleraj · V Kruzić · B Borcić
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    ABSTRACT: In 1988, there was a large outbreak of enteroviral meningitis in the Republic of Croatia and in other parts of Yugoslavia as well. A total of 4079 cases of enteroviral meningitis were registered with one fatal outcome (Mb 8.7 0/ooo). The outbreak was caused by echovirus 4. Analysis of epidemiological, virologic and ecological data for 1988, as well as for a number of previous years, showed the following: an upward morbidity trend observed from 1958 to 1979 turned to a high level stationary trend with irregular annual oscillations. A cyclic morbidity trend was noticed with peaks in 9-10 years. Seasonal peak was lower in July regularly. In 1988, age and sex distribution of the diseased persons differed from the usual picture, showing greater proportion of older age and women. The probable reason is in the long absence of echovirus 4 from the target population, resulting in low herd immunity. This caused greater proportion of older cases, among which women (mothers) had probably been more exposed to infections than men (nursing ill household members, laundry handling, etc). The epidemic years 1988 and 1979 were hot during spring and summer, at above-average level. Such climatic factors (high temperature) coupled with the sufficiently low level of herd immunity probably triggered in both examples the outbreak of enteroviral meningitis.
    No preview · Article · Sep 1990 · Lijec̆nic̆ki vjesnik
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    ABSTRACT: An outbreak of legionnaires' disease and epidemic control measures taken at one of our hotels are described. Twenty (1% morbidity) hotel guests were affected with one dying. As a result of field investigations and survey the hot water supply system has been identified as the source of infection. Control measures which created conditions unfavourable to Legionella growth and replication in the hot water system stopped the outbreak.
    No preview · Article · Apr 1989 · Lijec̆nic̆ki vjesnik
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    ABSTRACT: A group of 67 health workers with no markers indicating previous hepatitis B infection were vaccinated against hepatitis B with a new DNA recombinant vaccine, Engerix B (commercially manufactured by Smith-Kline-RIT, Belgium). Three injections were given according to the 0-1-6 schedule. One month after the last injection the vaccinees were tested for anti-HBs antibodies by the enzyme-linked assay. Antibody titers equal or less than 10 mIU/ml were found only in three subjects or in 4.5% of them. Titers ranging from 11 to 99 mIU/ml were found in 7 subjects (10.4%), from 100 to 999 mIU/ml in 28 (41.8%) and those equal or more than 1000 mIU/ml in 29 subjects (43.3%). It is inferred that the seroconversion rate is 95.5%. Only one subject did not develop detectable antibodies but three subjects had titers over 10000 mIU/ml. No one developed overt hepatitis B during the trial nor did the high responders experienced inapparent infections. They were tested for anti HBc with negative results. Postvaccinal reactions were mild and almost exclusively local. There were no complications. For its high immunogenicity and acceptable reactogenicity the Engerix B vaccine has a promising future.
    No preview · Article · Feb 1989 · Acta medica Iugoslavica

  • No preview · Article · Jan 1989
  • B Borcić · H Kovacić · Z Sebek · B Aleraj · N Tvrtković

    No preview · Article · Sep 1988 · Vojnosanitetski pregled. Military-medical and pharmaceutical review

  • No preview · Article · Oct 1984 · Lijec̆nic̆ki vjesnik
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    D Cvoriscec · M Radonić · S Ceović · B Aleraj
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    ABSTRACT: Subjects living in the endemic area of Posavina round Slavonski Brod have a significantly greater incidence of proteinuria (13.6%) than those living under the same conditions in the area where endemic nephropathy has not been observed (5.5%). Following determination of the grade and type of proteinuria, physiologic proteinuria was found in 36% of subjects from the endemic area. In nonphysiologic proteinuria the incidence of tubular proteinuria was 41%. A slight selective glomerular proteinuria was found in 51%, and other types of proteinuria in 8% of subjects. Tubular proteinuria was significantly higher in the endemic area than in the control area. The subjects with tubular proteinuria from the endemic area excrete significantly greater amounts of beta 2-microglobulin and light immunoglobulin chains.
    Preview · Article · Oct 1983 · Journal of clinical chemistry and clinical biochemistry. Zeitschrift für klinische Chemie und klinische Biochemie
  • B Borcić · H Kovacić · Z Sebek · B Aleraj · N Tvrtković
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    ABSTRACT: Small mammals trapped in seven sites along the river Sava in Croatia were examined for leptospiral infection by renoculture and serological methods. Of the 1749 animals caught 702 were examined by renoculture method and 626 were tested by microagglutination-lysis. The dominant animals species caught were Microtus arvalis (672 animals) and Apodemus agrarius (552 animals). Of the 115 strains of leptospires isolated the dominant serotypes were L. grippotyphosa (40) and L. pomona (35). Five strains of L. sejroe, 9 strains of L. australis, 1 strain of L. bataviae and 25 undetermined strains were isolated, the infection rate ranging from 3 to 32%. Serologic evidence of infection was demonstrated in 91 animals, the prevalence ranging from 0 to 43% of animals depending on the trapping site. Specific agglutinins most frequently encountered were those against L. pomona (50) and L. grippotyphosa (26), though agglutinins against L. jalna (5), L. bataviae (4), L. bratislava (3) etc., were also found. A high degree if association between L. grippotyphosa and the common vole as well as between L. pomona and the field mouse was found indicating that as far as these two types of leptospires are concerned the Sava valley may be considered as their vast natural focus. It was also concluded that wild small mammals in this region of Croatia may be a source of leptospiral infection for the local population as well as for outdoor-reared domestic animals (swine, bovine).
    No preview · Article · Feb 1982 · Folia parasitologica

  • No preview · Article · Jul 1981 · Lijec̆nic̆ki vjesnik

  • No preview · Article · Dec 1980 · Acta medica Iugoslavica

  • No preview · Article · Sep 1979 · Lijec̆nic̆ki vjesnik
  • B Borcić · H Kovacić · N Tvrtković · Z Sebek · B Aleraj

    No preview · Article · Sep 1978 · Lijec̆nic̆ki vjesnik
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    ABSTRACT: A one year study of endemic nephropathy was carried out in the village of Kaniza in the Posavina region near Slavonski Brod. The methods used in the study and the results obtained are presented in this paper. The study included the entire population of the selected village. Four criteria important for the setting up of an accurate diagnosis were used: proteinuria, creatinemia, anemia and family history of endemic nephropathy. The most important criterion, proteinuria was determined by two methods: the sulphsalicylic test and an immunodiffusion test for beta2, microglobulins. These tests were performed once a month throughout the observation time (12 months). This allowed a safer distinction between real, pathognomonic and occasional or accidental albuminurias. To obtain as exact a mortality rate as possible the cause of each death was medically scrutinized, which is not an ordinary practice. In 1974 7.3% of the Kaniza population was affected by endemic nephropathy and 4.3% was suspected of it. These percentages are inversely proportional to those recorded in previous observations. The number of cases in the age group of above 40 rises at a nearly geometric progression. Endemic nephropathy was the cause of death in 1.4% of the population which is several times higher than usually reported. Women are affected more often than men (8.5% and 6.0% respectively). This is in agreement with previous observations. At first sight the autochtonous population appears to be more susceptible to endemic nephropathy than immigrants (8.3% against 5.8%). However, if the autochtonous population aged over 20 is compared with immigrants who lived at Kaniza for over 20 years, this being an approximate minimal length of exposure to the hypothetical causative agents or the latent phase of the disease, there is in fact no difference (12% against 14%).
    No preview · Article · Feb 1976 · Archives of Industrial Hygiene and Toxicology