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COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

•      Communicable disease case notification in December

S a l m o n e l l o s i s.  Incidence decreased further in December according to the season (149:196). In December last year intensity was slightly higher (171). The only cluster is registered in Šibenik (14).

E n t e r o c o l i t i s. This constantly frequent disease shows higher figures in December that in previous month (583:493), also higher  than in December last year (516). Clusters are seen in Vinkovci (22), Kutina (28), Sisak (24), Zadar (23), Varaždin (24), Velika Gorica (25), Sesvete (20) and Zagreb Trešnjevka (20).

T e t a n u s. In December 1 case was reported from Valpovo: an old unvaccinated woman.

M o r b i l l i  (measles). There were 3 cases reported in December from Osijek, all in the same family.   

R u b e l l a. No cases in December.

V a r i c e l l a (chicken pox). In December a steep seasonal increase of incidence  continued (2070:966). Intensity was higher than last year (1669).

S y p h i l i s. There were 2 cases registered in December (Krk 1, Zagreb Trešnjevka: 1).

•      No reports in December from:

Novalja, Senj, Gračac, Obrovac, Makarska and Lastovo. Total: 6 out of 113 epidemiological districts.

•      Epidemic outbreaks

Following outbreaks were reported in December:

Note: in all outbreaks mentioned here, the epidemiological investigation and all necessary measures were undertaken preventing thus more cases.

Dubrovnik - small cluster of campylobacteriosis among a hotel restaurant staff. On 7.9. 2011. one member got ill with rather intensive symptoms requiring hospitalization. Epidemiological investigation among staff members revealed one more symptomless carrier. Possible vehicle epidemiologically: "Bolognese" sauce, pizza, not microbiologically examined.

Dubrovnik - family cluster of giardiasis. After one family member turned ill on 13.9.2011. another one was found infested among four family members. Source and mode of spread not found.

Slavonski Brod - noro viral gastroenteritis in a hospital.  Between 28.11. and 6.12. 2011. there were 15 diseased patients of two hospital wards. Source determined with certainty: a patient with enteral symptoms at the admittance.  

NEWS AND COMMENTS

•       Influenza arrives

At the moment of writing this number of ENEWS (first half of January 2012) it is known that in the first week of 2012 the Laboratory of National influenza center of the Croatian national institute of public health made its first seasonal isolate of influenza virus in a patient from Zagreb, identified as an A/H3N2/ strain.

•       New Ordinance on specialization in epidemiology

In the Official Gazette (OG) N^o100 (5.9.2011) a new Ordinance on specializations for medical doctors in Croatia was published. Among others, the new plan and program of specialization of medical doctors in epidemiology is presented. According to the new program, duration of specialization is extended to four years (old program lasted three years). This becouse of increased demands for specific epidemiology specialist knowledge and skills in current developments of health care services in the country, as well as in order to respond to needs emerging from Croatian access to the European union. The most important novelties are the following. During the specialization, beside standard scheduled training in epidemiological methods, general and special epidemiology of diseases and in field (intervention) epidemiology as provided by the Program, each candidate additionally has to attend one international course of epidemiology and epidemiological methods to gain closer experience of characteristics of epidemiological work in other countries of the European union and the World together with practice in international group work and communication in foreign languages, necessary for collaborative work in the EU. Further, some new fields are covered: molecular and genetic epidemiology, oncology, geriatrics, along with increased amount of work in internal medicine as a response to emerging health situation with aging of population and increased importance of chronic mass diseases. By all means, like before, the fields of infectology, immunology and microbiology are equally well covered in the Program; all topics and knowledge enhanced with more time scheduled for practical work on the particular working place a candidate is specializing for, under guidance of a personal specialization mentor. This is expected to assure the final shape of doctor specialist in epidemiology, upon the needs of each particular type of epidemiologic work or working place. As it is known, this may be in institutes of public health on communicable diseases epidemiology i.e. surveillance and control, in epidemiology of chronic mass diseases, then in health ecology i.e. environmental health service, in social medicine and public health services, also in hospitals as clinical epidemiologists covering also the important task of nosocomial  i.e. hospital infection control, also  in sanitary inspection,  border sanitary inspection  etc.

For the new candidates and their future mentors two other Ordinances are also important i.e. about official forms and logbooks for candidates, published in the OG N^o 123 (2.11.2011).

•       Meeting of the Croatian epidemiological society

On 9^th of December 2011 the 71^st in line regular winter scientific meeting of the Croatian epidemiologic association of the Croatian medical association took place in Zagreb. Over seventy doctors epidemiologist all over the country attended the meeting together with other interested experts of related specialties. Total of 12 lectures were given on the meeting, covering communicable disease epidemiology and epidemiology of chronic mass diseases. The leading topic of the meeting this time was fairly practical i.e. the modes of implementation of DDD (disinsection, disinfection, deratization) measures in the community, as an important part of field epidemiological work. All topics presented and discussed were the following:

• Anniversary of Epidemiological news bulletin; presentation of 30 years of editing of the bulletin of the Epidemiology service of the Croatian national institute of public health, accompanied with CD edition of the Collection of best articles of ENEWS in the 1980 – 2010 period, a copy given to each attendant

• Presentation of a new textbook: Public health, with possibility for convenient purchase after the meeting

• Report from the meeting organized by the WHO in Dubrovnik this autumn on mosquito born diseases

• DDD (Disinsection, deratization and disinfection) in Croatia; legal framework, planning, implementation

• Education of the public, regarding successful preventive behavior against mosquitoes.

• Role of epidemiology services in the DDD implementation activities, some opened   questions

• Intracerebral hemorrhages;  an epidemiological view

• Relation between immunogenicity and efficiency of vaccines

• Comments on some recent antivaccinal articles in the media

• Biomonitoring  – epidemiology or health ecology (environmental health) field

• Noroviral gastroenteritis outbreak in an elementary school in Popovača (Sisak-moslavina county)

• Epidemiology of HIV/AIDS in Croatia; use of social marketing in HIV/AIDS prevention; own experiences.

• Report from recent  Symposium on chronic mass diseases epidemiology in Zagreb

After the end of scientific program of the meeting, the annual meeting of recently established Division for chronic mass disease epidemiology of the Croatian epidemiological society was organized

In the evening, all discussions and friendly reunion of colleagues epidemiologists  that have not seen each other for half a year or more (nevertheless they all communicate daily by phone, e-mails etc as a part of the national epidemiological network dealing with disease surveillance and control), continued  at the dinner. 

COMMUNICABLE DISEASES IN CROATIA                  December 2011

CONTENTS OF THE EPIDEMIOLOGICAL NEWS

IN 2011

Work and problems of epidemiology services

Graphs and pictures

Permanent titles

Individual case notification dynamics in Croatia (commentary)

Epidemiological districts without notifications

Epidemic outbreaks reported in a current month

Communicable diseases notified in a current month (numeric table)

Last change - 16.01.2012 - Posljednja promjena