Preparedness for the detection of emerging-and re-emerging pathogens in Croatia Alemka Markotić, MD, PhD Associate professor University Hospital for Infectious Diseases Department for Research Department for Cinical Immunology Zagreb Croatia

History was founded in the spring of 1893City Hospital for Contagious DiseasesThe University Hospital for Infectious Diseases was founded in the spring of 1893, under the name of the City Hospital for Contagious Diseases

Central Diagnostic Laboratory

BSL-3

Hantaviruses

POZITIVAN GRANIČAN NEGATIVAN Serology – acute case detection and sero-survey Puumala and Dobrava viruses ELISA (IgM, IgG – reagents provided by CDC) POC Markotić et al. Nature Med 1995 Markotić et al. Nature Med 1996 Markotić et al. J Med Virol 2002 Markotić et al Scand Infect Dis 2002 Miletić Medved M et al. Lancet 2002 Markotić et al. Croat Med J 2002 BSL2

Markotić et al. J Med Virol 2002 Cvetko et al. J Med Virol 2005 Cvetko et al. Am J Trop Med Hyg 2006 Plyusnina A et al. J Med Virol 2011 Tadin A et al. VBZD (under review) Molecular detection – human and rodents samples BSL2 Puumala, Dobrava, Tula, Saarema viruses

Markotić A et al. J Gen Virol 2003 Markotić A et al. Coll Antropol 2007 Culture based techniques Vero Vero E6 MRC HEK THP-1 Prim. monocytes BSL3

Merdić E. et al., Infektološki glasnik (Croatian Journal of Infection) 2008; 1: Out of 50 mosquito species recorded in Croatia, 15 have potential medical significance. Anopheles atroparvus, An. plumbeus, An. sacharovi, Culex pipiens, and Aedes albopictus are among the most significant species that are potential vectors in Croatia. Climatic changes play an important role in changing the condition of habitats, making it possible for new species to enter certain areas. The tiger mosquito was recorded in Croatia in 2004, and it can now be found in Istria, and more increasingly in Zadar, Šibenik, Split and Dubrovnik, with new sites found on the islands of Cres and Lošinj, which are very attractive tourist destinations.

Combined Ag/Ab POC test OneStep RT-PCR Nested PCR Sequencing Virus isolation tip DENV Pozitivna kontrola Pacijentica 1 Pacijentica 2 Marker Dengue virus 1-4 (human samples, mosquitos) BSL2

Tick-borne encephalitis (human samples, ticks) ELISA PCR Sequencing Virus isolation (in the pipeline) PCR ELISA (temporary) BSL2 BSL3 West Nile Virus (human samples, mosquitos) BSL2

Chikungunya virus (human samples, mosquitos) PCR H1, H3, H1N POC PCR Sequencing BSL2 Influenza A (human samples) BSL2

In the pipeline – molecular dg CCHF Other hemorrhagic fevers Poxvirus Rickettsia Virus isolation and immunopathogenesis research – ntl and intl research resources? BSL2 BSL3

Greetings from Croatia and thank you for the attention !