ENGLISH LANGUAGE ISSUE *  ELECTRONIC VERSION

COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

n    Communicable disease case notification in JULY

T y p h u s   a b d o m i n a l i s (typhoid fever). One imported case, a sailor returning from his African trip.

S a l m o n e l l o s i s. Number of cases raised as expected for the season (515:370). But, this year the intensity is lower than in July last year (861). Clusters are seen in Požega (20), Vinkovci (20), Čakovec (24),  Zagreb Dubrava (26) and New Zagreb (26).

T e t a n u s. In July 1 case reported, an old unvaccinated person.

M e n i n g i t i s  v i r o s a. There were more cases in July than in June (26:7), slightly more than in July last year (15). No significant clusters.

M o n o n u c l e o s i s   i n f e c t i o s a. Number of cases reported in July is higher than in previous month (103:95). This was more than in last year July (89). Small clusters are visible in Slatina (4), Sisak (4), Rijeka (4), Kaštela (6), Split (12) and New Zagreb (6).

E c h i n o c o c c o s i s. The July figure (10) differs from pervious months (1) and last July (2) as a consequence of cluster in Zadar (6).

M a l a r i a. One report in July from Split, case imported  from Nigeria.

T i c k   b o r n   e n c e p h a l i t i s (TBE). There were more cases recorded in July than in June (13:3) according to the season, but less then in July last year (18).

L y m e   b o r r e l i o s i s. Like in TBE, a seasonal increase is observed (60:39), but with lower intensity  than in July last year (102).

n      No cases reported in July from: Labin, Gračac, Drniš and Lastovo. Total:  3 out of 113 epidemiological districts.

n      Epidemic outbreaks

        Following outbreaks were reported in July:

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

Beli Manastir - bacillary dysentery (Sh. sonnei) in a village. Between 21.4. and 27.4. 2004. there were 5 diseased . Mode of spread: contact

Crikvenica - salmonellosis in a family  (S. enteritidis) on 11.6. 2004. Vehicle: home made tiramisu sweet, left for several hours outside refrigerator. There were 10 diseased out of 14 exposed. Salmonella was found in cake samples. Source not found.

Požega - salmonella food poisoning (S. enteritidis) after wedding banquet on 13.6. 2004. There were 8 diseased out of 300 exposed. Source not found. Vehicle epidemiologically: cooked meat, cakes

Zadar - hepatitis B in a group of persons connected by mutual use of a blood sugar measuring device (strictly disposable i.e. for only one person) and also by sharing same shaving devices. Total of 3 diseased and 2 more inaparently infected persons out of 7 were registered.

Čakovec - salmonella food poisoning (S. enteritidis) in persons eating rests of   wedding cake on a day after wedding,  21 6. 2003. All 22 exposed turned ill.

Varaždin - hepatitis A in a suburban settlement with insufficient sanitation. Between 24.6. do 26.7. 2004 there were 5 diseased. Mode of spread: contact

Zadar - salmonella food poisoning (S. enteritidis) in a family 28.6. 2004 with 4  diseased out of 9. Vehicle epidemiologically: ground meat meal.

Poreč - salmonella food poisoning (S. thompson) in a hotel on 29.6.2004. There were 15 cases out of 193 exposed persons. Source not found. Vehicle not certain, chicken meat suspected.

Sisak - small cluster of dermatitis caused by Paederus fuscipes insects occurred again this year at the beginning of July. But, owing to preventive disinsection and experience of citizens number was very low.

Sisak - streptococcal sore throat among a restaurant staff  discovered at the  routine health check in one of staff members. Further investigation retrospectively revealed 3 more diseased i.e. the total of 4 out of 9 employed, between 15.7. and 26.7.2004. Thank to their high quality and professional work there were no cases among guests.

NEWS AND COMMENTS

n       Circulation of enteroviruses, summer 2004

         The National referral laboratory for enteral viruses from the Croatian national institute of public health, reports on their positive findings this summer. The table below shows virus strains isolated an their numbers during June-August 2004. period,  giving an information about a relative share of particular viruses.  

         Samples originated mainly from patients with serous (aseptic) meningitis and febrile rash illness from Zagreb and surrounding.

____

* in typization

         Is it evident that Coxsackie B5 is dominating. Current year (2004.) has slightly more cases of aseptic meningitis than previous year, but significantly less than in last epidemic year (2001). On the graph next page monthly dynamic of aseptic meningitis in current and previous year is presented.

n      Graph 1 - Meningitis virosa (aseptic) 2003 & 2004

n      Etiology of pneumonia in 2003

       There were 4505 cases of pneumonia reported in 2003 in Croatia, which is about equal to the previous year (4202). In the majority of cases etiology was not noted. In these cases where the etiology was known the following causative agents had been registered (table)

n COMMUNICABLE DISEASES IN CROATIA    -    JULY  2004