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This study aimed to assess epidemiological trends of Q fever in six countries of Southeast Europe by analysing surveillance data for 2002-2021 period. In this descriptive analysis, we collected and analysed data on confirmed human Q fever cases, obtained from the national Public Health Institutes of Bosnia and Herzegovina, Croatia, Greece, Montenegro, North Macedonia and Serbia. Overall, 2714 Q fever cases were registered during the 20-year period. The crude average annual notification rate was 0.82 (± 2.06) (95% CI: 0.47-1.16) per 100,000 inhabitants, ranged from 0.06 (± 0.04) (95% CI: 0.04-0.08) /100,000 in Greece to 2.78 (± 4.80) (95% CI: 0.53-5.02) /100,000 in the Republic of Srpska (entity of Bosnia and Herzegovina). Significant declining trends of Q fever age standardized rates were registered in Croatia, the Federation of Bosnia and Herzegovina, North Macedonia and Serbia, with an average annual change of -30.15%; -17.13%; -28.33% and - 24.77%, respectively. An unequal spatial distribution was observed. The highest average age-specific notification rate was reported in the 20-59 age group (0.84 (± 0.40) (95% CI: 0.65-1.02) /100,000). Most cases (53.69%) were reported during the spring. Q fever remains a significant public health threat in this part of Europe. The findings of this study revealed the endemic maintenance of this disease in the including countries, with large regional and subnational disparities in notification rates. A downward trend was found in Q fever notification rates across the study countries with the average notification rate higher than in the EU/EEA, during the same period., (© 2024. The Author(s).)

Leishmaniosis (or leishmaniasis) is a neglected parasitosis most commonly transmitted by the sandfly bite. Changes in temperature, precipitation, and humidity can greatly affect the vectors and reservoir hosts. This study aimed to determine the association between temperature, air humidity, and weather conditions with the incidence of leishmaniasis in Montenegro during a seven-decade period (1945-2014) and to statistically compare and correlate the obtained data. In the studied period, there were 165 registered cases of leishmaniosis, 96.4%, in the coastal and central region of Montenegro, with an average incidence rate of 0.45/100.000. The visceral form of leishmaniosis predominated (99% of the cases), with only one case of cutaneous disease. Climate factors (average temperature, air humidity, and precipitation) had an impact on the occurrence of leishmaniosis in Montenegro. Air temperature elevated by 1 °C in all regions of Montenegro was significantly correlated with an increased incidence of leishmaniosis, by 0.150 (0.013 to 0.287; p < 0.05). In order to improve prevention and control of this disease, it is also necessary to investigate other factors with a possible impact on the number of cases of this neglected parasitosis.

Background: In 2009, an improved influenza surveillance system was implemented and weekly reporting to the World Health Organization on influenza-like illness (ILI) began. The goals of the surveillance system are to monitor and analyse the intensity of influenza activity, to provide timely information about circulating strains and to help in establishing preventive and control measures. In addition, the system is useful for comparative analysis of influenza data from Montenegro with other countries., Aim: We aimed to evaluate the performance and usefulness of the Moving Epidemic Method (MEM), for use in the influenza surveillance system in Montenegro., Methods: Historical ILI data from 2010/11 to 2017/18 influenza seasons were modelled with MEM. Epidemic threshold for Montenegro 2017/18 season was calculated using incidence rates from 2010/11-2016/17 influenza seasons., Results: Pre-epidemic ILI threshold per 100,000 population was 19.23, while the post-epidemic threshold was 17.55. Using MEM, we identified an epidemic of 10 weeks' duration. The sensitivity of the MEM epidemic threshold in Montenegro was 89% and the warning signal specificity was 99%., Conclusions: Our study marks the first attempt to determine the pre/post-epidemic threshold values for the epidemic period in Montenegro. The findings will allow a more detailed examination of the influenza-related epidemiological situation, timely detection of epidemic and contribute to the development of more efficient measures for disease prevention and control aimed at reducing the influenza-associated morbidity and mortality.

Aim: The study aim was to analyze the epidemiology and clinical characteristics of severe acute respiratory infection (SARI) cases and to compare demographic and clinical characteristics as well as outcomes of influenza-positive SARI cases to those of influenza-negative SARI cases in Montenegro., Methods: SARI surveillance was established in 2014 in nine healthcare institutions. Retrospective analysis of case-based surveillance data pertaining to all reported SARI cases during three seasons was conducted., Results: Among the 90 identified SARI cases, 64 (71%) were influenza positive. Death outcome was reported in 25 (28%) of all registered SARI cases. Cardiovascular disease was more prevalent among the patients in the influenza-positive SARI group (36% vs. 12%, p = .021), as was concurrence of two or more chronic medical conditions (57% vs. 30%, p = .042). These patients were also more likely to be immunocompromised (16% vs. 0%, p = .057) and have viral pneumonia (14.4% vs. 20.3%, p = .017), compared to those in the influenza-negative SARI group. Younger age, presence of cardiovascular disease and being immunocompromised were patient characteristics independently associated with SARI related to influenza., Conclusion: Continued and extended monitoring of SARI is necessary in order to fully assess the burden of flu disease, define risk groups and establish better control measures.