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At least 19 recordsLinked to original sources
PubMed2002

A comparison of anthropogenic mercury pollution in Kastela Bay (Croatia) with pristine estuaries in Ore (Sweden) and Krka (Croatia).

Anthropogenic mercury pollution was studied in Kastela Bay (Croatia), 10 years after chloralkaline plant (PVC) stopped production. The concentration of total mercury determined in sediments which are composed mainly of calcite and quartz, are in the range 14,280-30,400 ng/g. The values are higher than reported in the literature for Elbe and Seine estuaries and also above 25,000 ng/g used for criterion in remediation project in Minamata Bay. The concentration of methylmercury 6.05-36.74 ng/g are typical for slightly to highly contaminated estuarine sediments. The low ratio of methylmercury to total mercury found in sediments of Kastela Bay is in the range 0.04-0.18%. It can be explained that in this region predominate conditions which do not promote in-situ methylation. Sediments were found to be highly anoxic. Concentrations of total mercury in unfiltered surface waters are in the range 69-145 ng/l and in unfiltered bottom waters in the range 230-1,418 ngl(-1). High concentrations found in bottom waters suggest that either resuspension or partial dissolution of sediments takes place. An experiment performed on filtered and unfiltered waters showed that about 85% of total mercury in surface water and almost 100% in bottom water was retained on 45 microm filters. To demonstrate contrasts, two pristine estuaries from norths and south Europe were studied. Silicious sediments of Ore estuary (Sweden) and calcareous sediments of Krka estuary (Croatia) have total mercury concentrations close to accepted background level. The ratio of methylmercury to total mercury is < or = 1% in all samples with one exception. The highest observed ratio (2.70%) was in the surface sediment from E2 station in Krka estuary measured in March 2000. This location is suitable for studying methylmercury formation in pristine environment.

Chemical Industry↗
PubMed1980

Selected aspects of the epidemiology of psychoses in Croatia, Yugoslavia. IV. Representative sample of Croatia and results of the survey.

This is the fourth paper in a series on the epidemiology of psychoses in Croatia, Yugoslavia. Data collected from 1960-1975 on a representative sample of the population of the study area, including the Istrian Peninsula and the northern Adriatic littoral, and the control area, the rest of Croatia, indicate that functional psychotic illnesses are more frequent in the study area, with the highest rates in older population groups. The finding is not associated with coastal or inland residence, with educational level, or with occupational group. Other diseases in excess in the study area are diabetes mellitus, psoriasis, and alcoholism. Nutritional disorders are about equally distributed between study and control areas. Data on extent of cigarette smoking was more prevalent in the study area, cases of functional psychoses smoked no more than the general population.

Adult↗
PubMed2006

Emergency medicine training for Croatia: a Croatia-Australia partnership.

As part of a health system improvement project, the Republic of Croatia has been conducting a pilot project aimed at rationalizing care delivery across the primary care, hospital and secondary care systems. One component was the development of an emergency department at Dr T Bardek Hospital in Koprivnica and training of its staff. This paper describes how a training programme was conducted, using an established emergency department in Australia as the training host, and the outcome of the project. This type of training programme could form a model for specialist Emergency Medicine training in the future.

Australia↗
PubMed2005

Epidemiological study of suicide in Croatia (1993-2003)--comparison of Mediterranean and continental areas.

The aim of this study is to analyze eventual differences in characteristic of suicide between two areas of the Republic of Croatia, mediterranean and continental, according to the following variables: suicidal rates, season, month, day, method, places, socioeconomic variables such as gender, ages, marital status, employment, education, and psychiatric or medical characteristic. Data were collected from the Suicide register of the Ministry of Interior, and Croatian Bureau of Statistic. Analysis was done on all suicide cases committed in the period 1993-2003. According to the Suicide Register of Ministry of Interior, 11,359 suicides were reported in period between 1993 and 2003. The average suicide rate in the Mediterranean area was lower (16.44 suicides per year) than in continental area of Croatia (26.34 suicides per year). Suicide committers in the Mediterranean area was statistically significant younger than suicide committers in the continental area of Croatia. In the continental area male suicide committers were more often than in the Mediterranean area of Croatia. In the Mediterranean area suicide committers were in most cases with high school education while in continental area of Croatia most cases of suicide committers were with elementary school education. Alcohol dependence, family conflicts, and medical disorders were more often present as suicidal motive in suicide committers in continental area of Croatia than in the Mediterranean area where undefined and unknown reason of suicide is present in majority of suicide cases. Cold steel, drowning, and jumping from height were more often present as suicidal method in the Mediterranean area of Croatia opposite to continental area of Croatia where jumping in front of car or train and suicide with firearms and explosive were more often. Also, in the Mediterranean area of Croatia suicides was mostly committed on open spaces and public places while in continental area of Croatia suicides was mostly committed in private plot.

Adolescent↗
PubMed2006

Ethics committees in Croatia in the healthcare institutions: the first study about their structure and functions, and some reflections on the major issues and problems.

OBJECTIVES: In Croatia, ethics committees are legally required in all healthcare institutions by the Law on the Health Protection. This paper explores for the first time the structure and function of ethics committees in the healthcare institutions in Croatia. DESIGN: Cross-sectional survey of the healthcare institutions (excluding pharmacies and homecare institutions) to identify all ethics committees. SETTING: Croatia six years after the implementation of the Law on the Health Protection. MAIN MEASUREMENTS: Structure and function of ethic committees in the healthcare institutions. RESULTS: 46% of the healthcare institutions in Croatia (excluding pharmacies and homecare institutions) have an ethics committee; 89% of ethics committees have 5 members 3 of whom are from medical professions and 2 come from other fields; 49% of those committees stated that their main function is the analysis of research protocols. Only a small fraction of those ethics committees sent in standing orders, working guidelines or other documents that are connected with their work. CONCLUSIONS: Although there are legal provisions for ethics committees in the healthcare institutions in Croatia, there is an evidence of discrepancies between the practice and the "Law on the Health Protection," suggesting the need for revision of the law. There is a need for creating separate networks of HECs and IRBs in Croatia. In comparison with other countries, the development of ethics committees in Croatia has some similarities with other transitional societies in Europe. Additional research should be undertaken in the work of ethics committees in Croatia in order to understand committees' group dynamics, attitudes, and knowledge.

Croatia↗
PubMed1995

Leprosy in Croatia in the twentieth century.

Even today, leprosy is a relatively frequently occurring disease, especially in tropical regions of the world. From the eleventh to thirteenth century, leprosy pandemics affected Europe, including Croatia. Probably as a consequence of such history, one can still find endemic foci of leprosy in present-day Croatia. The aim of this study was to analyse all cases of leprosy registered in Croatia during the twentieth century; therefore, we studied thoroughly existing medical documentation and published reports on sporadic leprosy cases, and went on to collect the relevant data through on-site investigation in those parts of Croatia known as putative endemic foci of leprosy. In this way, we collected data concerning the number of leprosy cases, the probable sources of infection, and traced the possible paths of spread of the disease. During the twentieth century, 17 cases of leprosy were registered in Croatia. However, due to the loss of medical documentation concerning the cases from Metković, the total number was obviously slightly greater. Concerning the 17 analysed cases, 4 patients were most probably infected during their visits (as sailors or immigrant workers) to the Middle East, South America or Africa; 3 patients developed leprosy after prolonged close contact with previously infected family members, while the exact source of infection remains unsettled for the remaining 10. However, 2 of these patients originated from the area of Cazin in Bosnia and Herzegovina, which is known to be an endemic focus of leprosy. Furthermore, the remaining 8 came from the small area of the village of Blizna in the Croatian municipality of Trogir, and therefore it seems reasonable to conclude that Blizna represents the endemic focus of leprosy in Croatia. The last case of leprosy in Blizna was registered back in 1956. Nevertheless, it is clear that sporadic cases of leprosy can reappear in Croatia, originating either from this endemic focus of Blizna, or as an infected person returning to Croatia from abroad. So, we can conclude that, even today, Croatian medical doctors (and especially dermatovenereologists) should still be acquainted with the clinical diagnosis of leprosy and basic principles of its treatment.

Adolescent↗
PubMed2002

Epidemiological analysis of tuberculosis in the Kingdom of Croatia and Slavonia during 1901-1910.

AIM: To analyze data on epidemiology and treatment of tuberculosis from the sources related to the history and epidemiology of tuberculosis in the Kingdom of Croatia and Slavonia in the 1900-1910 period. METHODS: Epidemiological data were obtained from the statistical yearbooks of the Kingdom of Croatia and Slavonia for years 1905 and 1910. A number of sources and publications on the history of medicine, especially on the history of tuberculosis in the studied period were analyzed. Mortality ratio, birth rate ratio, and population growth were calculated. Tuberculosis mortality per 100,000 inhabitants was calculated for four major cities and eight counties of the Kingdom of Croatia and Slavonia. The difference in tuberculosis mortality rates between urban and rural areas and socio-economic situation and organization of the health service were analyzed. The incidence, prevalence, and morbidity from tuberculosis were not analyzed because of the lack of data. RESULTS: The tuberculosis mortality ratio per 100,000 inhabitants in the Kingdom of Croatia and Slavonia were constantly high (above 400 on average), with higher mortality ratio in urban than in rural areas. According to the opinion of the Croatian physicians and statistical data of the period, this was due to the constant growth of population, insufficient health care system, and bad living conditions. The highest tuberculosis mortality rates were in the cities of Zemun (600-800) and Zagreb (500-700), and in the counties of Srijem (600-400), Virovitica (600-400), and Lika- Krbava (500-400). CONCLUSION: There was a concordance between the statistical data and the publications, reports, and articles written in the 19th and 20th century on tuberculosis situation in the Kingdom of Croatia and Slavonia. The analysis showed that tuberculosis was one of the major causes of death in the Kingdom of Croatia and Slavonia from 1901 to 1910. This fact had a significant influence on tuberculosis prevention and eradication efforts in the first half of the 20th century in Croatia and laid basis for further and more elaborate measures against tuberculosis epidemics.

Croatia↗
PubMed2003

[Leptospirosis and hemorrhagic fever with renal syndrome in northwestern Croatia].

UNLABELLED: Leptospirosis is a worldwide spread zoonosis, therefore being also present in northwest Croatia. It has been recently discovered that hemorrhagic fever with renal syndrome (HFRS) is present throughout Croatia, not just in the previously well known epidemic foci. Because of the similar clinical presentation and epidemiology of the two diseases, it is important to know the exact etiology of the current disease. The aim of this study was to determine the presentation of HFRS in northwest Croatia and possible coinfection in patients with leptospirosis. PATIENTS AND METHODS: During the 1988-2000 period, 42 patients with leptospirosis from northwest Croatia were analyzed. Leptospiral infection was confirmed in all 42 patients by microagglutination test. Serology for hantaviruses was done by ELISA test in a few patients with leptospirosis and severe renal failure. RESULTS: In the majority of patients (37/42: 88%) acute renal failure was mild or moderate, with creatinine values below 500 mol/l. However, 12% of the patients developed severe acute renal failure, with creatinine values over 500 mol/l. The main therapeutic regime in all patients with leptospiral infection included body fluid replacement (electrolyte and glucose infusions) and antibiotic therapy. In patients with severe acute renal failure, it was necessary to introduce hemodialysis treatment. There was no fatal outcome in our patients. Over the last few years, antibody titers to hantaviruses were assessed by ELISA testing in five patients with leptospiral infection and severe form of acute renal failure, confirming HFRS persistence in northwest Croatia Testing for specific antibodies to hantaviruses has been suggested in all patients with leptospirosis and in whole Croatia, especially in northwest Croatia.

Croatia↗
PubMed2003

[What is new in the epidemiologic characteristics of hemorrhagic fever with renal syndrome in Croatia?].

AIM: The aim was to describe epidemiologic characteristics of hemorrhagic fever with renal syndrome in Croatia. METHODS: We analyzed published data from obligatory infectious disease reports and notification of deaths due to infectious diseases, data on the hemorrhagic fever with renal syndrome epidemics in Croatia, and our own data. RESULTS AND DISCUSSION: During the 1987-2002 period, 555 cases of hemorrhagic fever with renal syndrome were recorded in Croatia, 160 (28.8%) of them in soldiers. The mortality rate was up to 15.4% (mean 1.1%) (6/555). The highest number of cases (317) were recorded during 2002. The epidemic started in winter. The highest number of cases were recorded in June and July, i.e., during the warm season characterized by an increased activity of both animals acting as infection reservoirs and humans as hosts. The epidemic spread almost throughout Croatia. The known natural foci of hemorrhagic fever with renal syndrome are Plitvice and Slunj areas, Dinara mountain, Velika and Mala Kapela mountains, Zagreb area (Velika Gorica and Jastrebarsko), Gorski kotar area (Ogulin, Delnice), west Slavonia, and Novska area. The disease has not been recorded in the littoral area and on Adriatic Islands. The disease was also recorded in the neighboring countries of Slovenia, Bosnia and Herzegovina, Serbia and Montenegro. The identified causative agents include Dobrava and Puumala viruses of the genus Hantavirus, whereas the rodents Clethrionomys glareolus, Apodemus flavicollis, Apodemus agrarius and Apodemus sylvaticus serve as the main reservoirs of the infection in Croatia. Typical biotopes of the infection in Croatia are deciduous woods. CONCLUSION: The 2002 epidemic confirms the presumption that almost all continental part of Croatia contains natural foci of hemorrhagic fever with renal syndrome.

Croatia↗
PubMedDate not supplied

[Distribution of Helicobacter pylori infection in the adult population of Croatia].

The study of the distribution of Helicobacter pylori infection was carried out among the population of Croatia aged between 20 and 70 years, in three areas of Croatia (central, northern, southern). For the detection of seroprevalence of this infection the ELISA test for IgG antibodies was used on a random sample of 3,082 serum samples. The testing showed an average rate of seroprevalence in Croatia of 60.4% (95% CI 58.7-62.1%). Higher infection rates were observed in older population of Croatia. These rates ranged from 51.6% in the third decade of life, to almost 70% in the sixth decade. In male subjects the average rate was 58.9% and in female subjects it was 65.9%. The difference was not statistically significant. The results of this study showed that distribution of this infection was not consistent in all the studied areas of Croatia. While the Helicobacter pylori infection prevalence was almost identical in the central area and in the northern counties of Croatia, 58.4% and 59.5% respectively, it showed statistically significant difference in the south, being 71.3% (chi(2) = 25.884, P < 0.001). An inconsistent distribution of this infection in Croatia was indicated also by standardized infection rates, which were 59 in the central area, 61 in the northern and 71 in the southern areas.

Adult↗
PubMed1995

Antibodies to spotted fever group rickettsiae in dogs in Croatia.

The prevalence of IgG antibodies to spotted fever group rickettsiae was studied by the indirect immunofluorescent antibody assay in a sample of 194 canine sera from different parts of Croatia. Dogs (n = 141) from urban and suburban-semirural environs from the middle part of the eastern coast of Adriatic sea, and dogs (n = 53) from Zagreb, the capital of Croatia located in the northern continental part of Croatia, were tested. The total of 88 (62.4%) dogs from southern coastal Croatia had antibodies to Rickettsia conorii, with a significantly higher prevalence (69.9%) in suburban-semirural areas. The prevalence rate of antibodies to Rickettsia conorii in canine sera from urban environment in the north of Croatia was 20.7%. The results show that the members of spotted fever group rickettsiae are present in both coastal and continental Croatia.

Animals↗
PubMed2000

[Malaria in Croatia: in the past, today and tomorrow].

Until 1964, when officially declared eradicated, malaria had been a major public health problem in Croatia. No autochthonous infections have been noted since 1958. Within ten year period after the eradication three cases were transmitted by transfusion. Until 1998, all other cases, a total of 308, were imported. Within last 10 years 119 cases were noted. The most of infections were caused by P. falciparum (n = 71, 59.66%), than by P. vivax (n = 31, 26.05%), and P. ovale, respectively (n = 1, 0.84%). Mixed infections were noted in 8 cases (6.73%), and the cause remained undetermined in 6 (1.68%). Seamen make the most of those who acquire primary malaria. There are some 30,000 seamen in Croatia. Some 10,000 are on foreign ships, therefore many data are definitely not available or incomplete. An average of 8 Croatian seamen get infected annually, but this number is supposed to be much greater. Mosquitos which are vectors for malaria exist in Croatia even today. Sporadic cases of autochthonous malaria in the neighboring countries, in which malaria was officially eradicated, are a warning that cases of autochthonous malaria might appear in Croatia, too. Due to the increased resistance to known antimalaria drugs including mefloquine, chemoprophylaxis when indicated, campaign against mosquitos, and control of persons who come from the malaria regions are determinants of control of malaria in Croatia, as in accordance with World Health Organization recommendations. Besides, further research of medically interesting insects, including the genus Anopheles, would be useful, at least in the coastal area of Croatia.

Croatia↗
PubMedDate not supplied

[Lyme borreliosis in Croatia from 1987 to 1998--epidemiologic aspects].

Lyme borreliosis is one of the most common diseases originating from natural foci in the Republic of Croatia. Some 200 cases are reported every year to the Epidemiological Department of Croatian National Institute of Public Health, but data from hospital treatment and individual limited research show that the number of infected is certainly higher. Officially reported cases have been used and analysed in this article. Although, aware of the limits of such a source, the results gained with this analysis point to certain epidemiological characteristics of Lyme borreliosis in Croatia, which can be useful. Clinical manifestations might vary, depending on the part of the world, i.e. type of Borrelia involved. In Croatia, skin manifestations are predominant--erythema (chronicum) migrans. The disease generally does not occur in Southern Croatia; it has been only sporadically reported in the area south of Zadar. Although the tick, the vector of this disease, can be found everywhere in Croatia, data about vector species and their presence in the coastal area are not complete or they are missing. Therefore, additional entomological, epidemiological, and clinical research are necessary to clarify the absence of Lyme borreliosis in Southern Croatia.

Adolescent↗
PubMed2002

Epidemiologic and ecologic characteristics of some diseases transmitted by arthropods on the littoral of the Republic of Croatia.

OBJECTIVE: To show epidemiologic and ecologic characteristics of some diseases transmitted by arthropods on the littoral of the Republic of Croatia. METHODS: The pattern of infectious diseases that are transmitted exclusively by vectors was monitored during the period 1985 to 1999. Data on the incidence of the diseases in the Republic of Croatia as a whole and available data on the presence of the vectors for the diseases on the littoral are presented for comparison. RESULTS: Mediterranean spotted fever, murine typhus, Lyme disease, cutaneous and visceral leishmaniasis, and pappataci fever occur sporadically on the Croatian littoral. Tick-borne meningoencephalitis is endemic in the northwestern part of Croatia but is not present on the littoral. Twelve cases of malaria are imported into Croatia per year on average. CONCLUSION: Diseases transmitted by arthropods are not a major public health problem in Croatia. The medically relevant entomofauna of Croatia has not yet been adequately investigated.

Animals↗
PubMed2003

[The biggest epidemic of hemorrhagic fever with renal syndrome in Croatia].

INTRODUCTION: The largest outbreak of hemorrhagic fever with renal syndrome (HFRS) to date occurred in Croatia in the year 2002. The epidemic started in winter, lasted throughout spring to summer months, ending not earlier than November. AIM: The aim of this study was to investigate and analyze the basic epidemiologic and clinical features of HFRS in Croatia by uniform and standardized prospective-retrospective analysis of all patients affected by the epidemic. PATIENTS AND METHODS: When the epidemic started, a patient questionnaire with questions on the basic demographic data, site of infection and other epidemiologic characteristics, clinical symptoms, disease severity and laboratory results was designed. Data on 401 patient with a clinical diagnosis of HFRS were collected. The etiologic diagnosis of the disease was confirmed by ELISA, and in some patients by indirect immunofluorescence test (IFT). The results were analyzed using a descriptive statistical method. RESULTS: HFRS was clinically diagnosed in 401 patients from all over Croatia. A total of 320 (79.8%) cases were reported to the Epidemiology Service of the National Institute of Public Health. The majority of patients (n = 128) were registered in June. Males were three times more affected than females. Apart from its long duration, this epidemic was characteristic for the involvement of general population, with only a small number of the affected from the potential risk groups (forestry workers 28, soldiers 14, farmers 18). The epidemic spread almost throughout inland Coratia. At least 44 patients were infected in the Plitvice Lakes area, 32 in Slunj, 27 on Sljeme, 24 in Velika, and at least 19 in the area of Kutjevo. The youngest patient was aged 4 and the oldest 80 years. The majority of patients were treated in Zagreb (University Hospital for Infectious Diseases--110, Zagreb University Hospital Center--3), followed by Karlovac (71 inpatients and 39 outpatients), Pozega (n = 79), and Rijeka (n = 37). Serologic analysis (ELISA method) detected Puumala virus in 161 and Dobrava virus in only 17 patients. The disease was confirmed by immunofluorescence method in 53 patients (mostly in Kariovac). During the 2002 outbreak, HFRS clinically manifested mostly in a milder form with general symptoms and transitory renal insufficiency, while hemorrhages were rarely recorded. According to our disease severity score, a mild form of the disease was recorded in 65%, moderately severe in 28%, severe in 5% and extremely severe form in 2% of the patients. One patient died. Two thirds of the patients were hospitalized during the febrile stage of the disease. All patients had fever, whereas headache and pain in the lumbar region were recorded in more than 90% of cases, polyuria in 75%, oliguira and vomiting in approximately 50%, respiratory symptoms in 35%, and hemorrhages (mostly on the skin and mucous membranes), vision disturbances, conjunctivitis and diarrhea in approximately 25% of patients. ESR was elevated in 64% and CRP in 93% of patients. Leukocytosis was recorded in 25% and thrombocytopenia in 70% of patients. Increased values of urea and creatinine and signs of liver damage were recorded in approximately 50% of the patients. CONCLUSION: The largest outbreak of HFRS occurred in Croatia in 2002, with more than 400 diseased throughout Croatia. This epidemic confirmed our previous assumption that the whole Croatia, apart from its narrow coastline area and islands, is a natural focus of HFRS with different causative types of hantaviruses. Efforts should be made to conduct a comprehensive ecologic and mammologic study on hantaviruses and their biologic characteristics in these areas.

Adult↗
PubMed2005

Cardiovascular diseases in Croatia and other transitional countries: comparative study of publications, clinical interventions, and burden of disease.

AIM: To determine the number of publications on cardiovascular diseases in the MEDLINE database, the rate of medical doctors and clinical interventions in cardiology, and health and socioeconomic indicators for Croatia, and to compare them with those for Slovenia, Hungary, the Czech Republic, and Austria. METHODS: PubMed was used in search for publications on cardiovascular diseases published in 1991-2004. Rates per million population and proportions of publications on cardiovascular diseases in the MEDLINE database were calculated. Gross domestic product (GDP) per capita was used as a socioeconomic indicator, whereas human resources in medicine were presented as the rate of medical doctors per million population. Standardized death rates from cardiovascular diseases and ischemic heart disease were used as indicators of cardiovascular health. Clinical interventions in cardiology, such as coronary angiograms, percutaneous transluminal coronary angioplasties (PTCA), and coronary bypass surgeries (CABG) were expressed per million population per year. RESULTS: Croatia had the lowest GDP per capita among the analyzed countries. The standardized death rate from cardiovascular diseases in Croatia was 91.7 per 100,000 population aged 0-64 in 2001, which was higher than that in Slovenia and Austria (P<0.001), similar to that in the Czech Republic, and lower than that in Hungary (P<0.001). Cardiovascular scientific output in Croatia was the lowest among investigated countries, ie, 1.1 per million population in 2003 (P<0.001). Despite a significantly lower number of medical doctors in comparison with Hungary and the Czech Republic (P<0.001), Croatia experienced a similar increment in the amount of clinical interventions in cardiology. CONCLUSION: In contrast to high cardiovascular mortality rates, cardiovascular scientific production in Croatia was significantly lower than in other investigated countries. A positive trend in cardiovascular medicine was recorded in clinical practice, but has yet to be followed by scientific production.

Adolescent↗
PubMed1998

Epidemiologic, ecologic and clinical characteristics of Lyme borrelliosis in northwest Croatia.

Investigated were the epidemiologic, ecologic and clinical characteristics of Lyme borreliosis in northwest Croatia. In a seroepidemiologic study, human sera were analyzed by indirect immunofluorescent assay (IFA), and ten out of 134 serum samples were positive for B. burgdorferi antibodies. In a seroepizootiologic study, wildlife and domestic animals were tested by inhibition ELISA. Antibodies to B. burgdorferi were found in nine out of 42 roe deer sera, and in three out of nine hare sera. Sera of wild boars (n = 10), cattle (n = 103), and dogs (n = 13) were negative for antibodies to B. burgdorferi. The presence of Borrelia burgdorferi sensu lato was assessed in ixodes ricinus ticks in the Lyme borreliosis endemic region of northwest Croatia. Ticks (n = 123) were collected at five-different locations and analyzed by polymerase chain reaction (PCR). Borrelia burgdorferi sensu lato DNA was detected in 56 out of 124 ticks (45%). Four genomic groups were identified by genotyping: B. afzelii (n = 26), B. garinii (n = 5), VS116 group (n = 5), and Borrelia burgdorferi sensu stricto (n = 1). Mixed infections of B. afzelii with VS116 group (n = 10), and B. afzelii with Borrelia burgdorferi sensu stricto (n = 1) were also detected. Eight ticks contained B. burgdorferi sensu lato that could not be typed, indicating the possible existence of a specific genomic group of B. burgdorferi sensu lato in northwest Croatia. Sex distribution of Lyme borreliosis patients in northwest Croatia showed a slight preponderance of the female gender and prevalence of the working active age range of 20 to 50 years. The persons who periodically visit the landscape, are most commonly affected, whereas those with an increased risk of tick bites are considerably less frequently involved. The most frequent clinical manifestation of Lyme borreliosis in northwest Croatia is erythema migrans with 46%, followed by neurologic manifestations, particularly peripheral neuritis, with 32%. The rest of clinical manifestations in stage II and III of Lyme borreliosis are very rarely recorded. The presence of B. afzelii and B. garinii in the highest percentage is in agreement with the local occurrence of cutaneous and neurologic manifestations of Lyme borreliosis. The presence of VS116 group in ticks from northwest Croatia in this and other studies in some European countries may indicate that VS116 group is well established in the European ixodes ricinus ticks. The role of the VS116 group in the etiology of Lyme borreliosis remains to be clarified.

Adult↗