COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

- Communicable disease case notification in March

S a l m o n e l l o s i s. Incidence raised slightly in March (182:157). This was more than in March last year (136). Small clusters are seen in  Zagreb Trešnjevka (13) and Novi Zagreb (13).

D y s e n t e r i a    b a c i l l a r i s. There were no cases registered in March, neither in March last year. Similar, low incidence was registered in previous month (only 1 case).

A n g i n a     s t r e p t o c o c c i c a (streptococcal sore throat). The number of cases registered in March is significantly higher than in February (1446:836) and also higher than in March last year (1155).  Clusters are visible in Sisak (70), Čakovec (50), Varaždin (52), Samobor (48), Velika Gorica (64), and in Zagreb area with greatest numbers in Centar (63), Novi Zagreb (133) and Trešnjevka (118).

T e t a n u s. There were two cases in March (Čakovec, Varaždin), both in very old (80, 93 years) unvaccinated persons.

M o r b i l l i  (measles). Less reports came in March than in February (6:10), while not a single case had been recorded in March last year.

T r i c h i n e l l o s i s. Incidence is similar to previous month (Feb.: 12, Mar: 13) but lower than in March last year (46).

B o t u l i s m u s. One sporadic case reported from Županja.

I n f l u e n z a. The intensity lessened substantially in March (9400: 38531).

- No cases reported in March from: Otočac, Pag, Lastovo. Total: 3 out of 113 epidemiological districts.

- Epidemic outbreaks

        Following outbreaks were reported in March:

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

Čakovec - head lice in an elementary school. On 4.12.2003 there were 48 infested pupils and 8 more children in a preschool day care group situated in the same building.

Vinkovci - trichinellosis in a family. Between 25.12.2003 and 13.1. 2004 there were 7 diseased out of 24 persons eating their own home made pork meat products.

Vinkovci - trichinellosis among persons eating home made dried pork meat products. There were 6 diseased out of 23 exposed between 31.12. 2003. and 23.1.2004.

Poreč - salmonella food poisoning (S. enteritidis) on 1.1.2004, in a group  celebrating New Year in a restaurant. There were 9 diseased out of 48 exposed persons. Vehicle not determined.

Županja - trichinellosis in a family. Between 6.1. and 21.1. 2004 there were 2 diseased out of 16 persons eating own home made dried pork meat products.

Vrbovec - trichinellosis starting 17.1.2004 among persons eating home made dried pork meat products. Total of 7 diseased registered.

Split - food poisoning among  a sheep crew on 30.1.2004. There were 8 diseased out of 35 exposed persons. Vehicle epidemiologically: chicken meat. Causative agent most probably: Campylobacter, found in 3 patients (all other microbiological examinations negative).

Sisak - streptococcal sore throat in a kindergarten, with 7 diseased out of 33, between 6.2. and 25.2. 2004.

Zagreb Črnomerec small outbreak of respiratory disease caused by RS virus, in an obstetric - neonatology hospital ward, with 4 cases registered.

Koprivnica - acute gastroenteritis in a home for elderly people. Between 18.2. and 4.3. 2004 there were 52 cases out of 290 persons present. Mode of spread: alimentary (vehicle not found) and partly by contact. Causative agent probably a virus (all examinations on bacteria, and on rota and adeno viruses were negative) 

Varaždin - food poisoning in a school on 3.3. 2004. There were 5 diseased out of 110 exposed pupils. Causative agent not found. Vehicle epidemiologically: pasta with mushroom sauce.

NEWS AND COMMENTS

- Influenza 2004

Current influenza outbreak declined in March, but still some new cases were registered. Altogether 64895 cases were reported till the end of March. The weekly outbreak dynamic is shown on the graph below.

- Food-born outbreaks in 2003

In 2003 there were 136 different outbreaks reported in Croatia. Out of this, 54  were of the food-born type. The table next page shows particular diseases and causative agents registered, and also  food or  meals responsible (vehicles).

Table 1.  Outbreak of foodborn diseases in Croatia in 2003.

It can be seen that salmonella caused outbreaks are dominating, mainly caused by  Salmonella enteritidis*. Various home made cakes and sweets turned to be the most frequent vehicle responsible. Rather unusual was the outbreak caused by so called "hot ice" i.e. ice cream covered with the pancake mixture and fried very briefly. Among other outbreaks probably most disturbing was the outbreak of trichinelosis spread through few local meat shops (semi-dried pork sausages confectionated in a small local meat manufacture). This was however the rare exception; usually trichinellosis is connected with private home made meat processing, but enhanced again the importance of strict inspection and control over all public meat manufacturers. One more interesting curiosity: an enterocolitis outbreak, caused by Clostridium perfringens detected in chili-sauce added to meals.
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*new way of writing names of Salmonella enterica serovars
 

COMMUNICABLE DISEASES IN CROATIA                March  2004