Citation: Ferenˇ cak, I.; Obrovac, M.;
Žmak, L.; Kuzle, J.; Petrovi´ c, G.;
Vilibi´ c-
ˇ
Cavlek, T.; Juri´ c, D.; Juri´ c, A.;
Hruškar, Ž.; Capak, K.; et al.
SARS-CoV-2 Omicron Variant in
Croatia—Rapid Detection of the First
Case and Cross-Border Spread.
Pathogens 2022, 11, 511. https://
doi.org/10.3390/pathogens11050511
Academic Editor: Dan O¸ telea
Received: 31 March 2022
Accepted: 24 April 2022
Published: 26 April 2022
Publisher’s Note: MDPI stays neutral
with regard to jurisdictional claims in
published maps and institutional affil-
iations.
Copyright: © 2022 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
pathogens
Communication
SARS-CoV-2 Omicron Variant in Croatia—Rapid Detection of
the First Case and Cross-Border Spread
Ivana Ferenˇ cak
1
, Mihaela Obrovac
1
, Ljiljana Žmak
1,2
, Josipa Kuzle
1
, Goranka Petrovi´ c
3
,
Tatjana Vilibi´ c-
ˇ
Cavlek
1,2,
* , Dragan Juri´ c
1
, Anita Juri´ c
1
, Željka Hruškar
1
, Krunoslav Capak
4
,
Vladimir Stevanovi´ c
5
, Maja Milanovi´ c
6
, Marija Govedarica
6
, Danijela Vujoševi´ c
6
and Irena Tabain
1
1
Department of Microbiology, Croatian Institute of Public Health, 10000 Zagreb, Croatia;
ivana.ferencak@hzjz.hr (I.F.); mihaela.obrovac@hzjz.hr (M.O.); ljiljana.zmak@hzjz.hr (L.Ž.);
josipa.kuzle@hzjz.hr (J.K.); dragan.juric@hzjz.hr (D.J.); misicanita1@gmail.com (A.J.);
zeljka.hruskar@hzjz.hr (Ž.H.); irena.tabain@hzjz.hr (I.T.)
2
Department of Microbiology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
3
Department of Epidemiology, Croatian Institute of Public Health, 10000 Zagreb, Croatia;
goranka.petrovic@hzjz.hr
4
Environmental Health Department, Croatian Institute of Public Health, 10000 Zagreb, Croatia; kcapak@hzjz.hr
5
Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University
of Zagreb, 10000 Zagreb, Croatia; vladostevanovic@gmail.com
6
Department of Epidemiology, Institute of Public Health, 81110 Podgorica, Montenegro;
maja.milanovic@ijzcg.me (M.M.); marija.govedarica@ijzcg.me (M.G.); danijela.vujosevic@ijzcg.me (D.V.)
* Correspondence: tatjana.vilibic-cavlek@hzjz.hr
Abstract: Background: Due to rapid spread, the Omicron variant has become the dominant SARS-
CoV-2 variant responsible for infections worldwide. We present the first detection of the Omicron
variant in Croatia which resulted in rapid cross-border spreading. Methods: Whole-genome se-
quencing was performed using the Illumina MiniSeq sequencing system. SARS-CoV-2 lineages were
identified using the PANGOLIN and GISAID databases. Results: The first case of the Omicron variant
(BA.1.17) emerged in Croatia after a workshop held in Zagreb in November 2021. The patient reported
a history of previous COVID-19 and received two doses of an mRNA vaccine. Three additional
cases were detected among Croatian participants of the workshop. At the beginning of December,
SARS-CoV-2 infection was confirmed in one participant from Montenegro and her husband. Phyloge-
netic analysis showed that the detected Omicron variants were closely related to the first Croatian
case, confirming the connection with the workshop outbreak and rapid cross-border spreading.
Subsequent analyses of SARS-CoV-2 positive samples in Croatia showed the rapid introduction of the
Omicron variant and depletion of the Delta variant resulting in the fifth pandemic wave. Conclusions:
Genomic monitoring and early detection of novel SARS-CoV-2 variants are essential to implement
timely epidemiological interventions and reduce further transmission in the population.
Keywords: SARS-CoV-2; Omicron variant; whole-genome sequencing; surveillance; Croatia
1. Introduction
During the past two years, from the beginning of the coronavirus disease (COVID-19)
pandemic, the World Health Organization (WHO) categorised five severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) variants to be variants of concern (VOC) [1]. These
variants possess concerning characteristics, including increased transmissibility or/and dis-
ease severity, reduction in neutralisation by antibodies produced during previous infection
or vaccination, as well as reduced effectiveness of treatments or diagnostic testing [1]. How-
ever, no variant has caused as much concern as the last variant identified on 24 November
2021, in South Africa, named Omicron, after the 15th letter in the Greek alphabet [2]. Only
two days after the identification of this new variant, the WHO designated it as a VOC [1]
due to a high number of mutations in the spike protein [3]. Omicron harbours around 30
Pathogens 2022, 11, 511. https://doi.org/10.3390/pathogens11050511 https://www.mdpi.com/journal/pathogens