Disease Outbreak News

1996 - Bosnia and Herzegovina

5 February 1996

Description of the situation

05 February 1996

Disease Outbreak Reported

A total of 367 cases of haemorrhagic fever with renal syndrome (HFRS) were reported to the Ministry of Health for the period January to November 1995, with a least five deaths. Cases occurred in all months of the year, with a low of six cases in February and highs of 75 in March and 54 in August. Age and sex data are not available. Examination of patient sera found evidence of infection by at least two hantaviruses, Puumala, cause of a less severe form of haemorrhagic fever with renal syndrome often called nephropathia epidemica elsewhere in Europe, and Hantaan or a closely related virus, cause of a more severe form more often leading to death. Additional hantaviruses that also cause human disease may be in circulation in the area.

The viruses which cause HFRS are maintained in nature by field rodents, and infections of humans is thought to occur when people come into contact with infectious rodent excrete, often by aerosol route. War conditions favour transmission of hantaviruses since soldiers and displaced persons are forced to live in conditions conducive to increased contact with field rodents, thereby increasing their risk of infection.