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COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

n    Communicable disease case notification in SEPTEMBER

S a l m o n e l l o s i s. The incidence is higher in September than in August (929:498) but still lower than in September last year (1040). Cases cluster in Slavonski Brod (21), Rijeka (57, see Epidemic outbreaks), Labin (34), Poreč (24), Pula (47, see Epidemic outbreaks), Split (30), Čakovec (25), and Zagreb Peščenica (29), Novi Zagreb (56) Sesvete (37), Susedgrad (42) and Trešnjevka (26).

D y s e n t e r i a   b a c i l l a r i s. In September there were more ceases than in August (14:4) as the consequence of a small cluster in Korčula (1, see Epidemic outbreaks).

T e t a n u s. One case reported in September from Varaždin, an old female, unvaccinated.

P e r t u s s i s (whooping cough). The number of cases in September is higher than in August (40:10) and also higher than in September last year (16). Small clusters are seen in Požega (6), Zabok (4) and Zagreb Peščenica (5). It should be noted however that pertussis syndrome cases, and not only bacteriologically confirmed cases are notified.

M e n i n g i t i s  v i r o s a. There were more cases in September than in August (57:40) That was also more than in September last years (37).

B r u c e l l o s i s. There were 4 cases reported in September, all from Sinj. Cases clustered in a family dealing with goats. Intensive epidemiological and veterinary control measures stopped further spread 

n    No reports in September from: Šibenik, Vis, Lastovo and Jastrebarsko; total: 4 out of 113 epidemiological districts.

n    Epidemic outbreaks

         Following outbreaks were reported in September

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

Dubrovnik - acute enterocolitis 25.5.2004 in a restaurant cook, who, following good professionall praxis principles, immediately contacted his doctor. A Campylobacter infection was diagnosed. Upon this information the epidemiology service performed all necessary measures in a restaurant, preventing possible accidents

Dubrovnik - salmonellosis (S. enteritidis) in a food handler. He correctly informed his doctor about his enteric disturbances and upon this information epidemiology service again applied all necessary measures preventing thus any unwanted food poisoning accident

Varaždin - hepatitis A in a suburban settlement with pore sanitation. There were 5 diseased between 24.6. and 16.7. 2004. Mode of spread: contact

Karlovac - salmonellosis (S. enteritidis) after a family celebration in a restaurant.  Food was prepared in the restaurant while all cakes had been brought from home. Between 18.7. and 21.7. 2004. there were 19 diseased out of 40 exposed persons. Vehicle not found, no food samples left for analyses.

Vinkovci - family outbreak of salmonellosis (S. enteritidis). Vehicle: home made ice cake. There were 7 cases out of 10 exposed persons between 19.7. and 20.7. 2004. Salmonella was found in cake samples. Eggs used for cake not examined.

Pula - salmonella food poisoning (S. enteritidis) among persons eating their lunch brought from a near restaurant. There were 17 diseased out of 26 exposed between 19.7. and 26.7. 2004. Vehicle epidemiologically: beef stew with noodles, fruit cake. Food samples turned salmonella negative however, as well as the kitchen staff .

Osijek - salmonella food poisoning (S. enteritidis) in a family after a name-day celebration starting 25.7. 2004. There were 11 diseased out of 22 exposed persons. Vehicle epidemiologically: boiled ham, goat cheese, cakes, all found salmonella positive. Source not certain, most probably a salmonella carrier participating in food preparation.

Dubrovnik - salmonella food poisoning (S. enteritidis) in a food handler on 6.8.2004. Source and vehicle not clear. Necessary measures on his working place prevented further cases.

Poreč - salmonella food poisoning (S. enteritidis) among persons eating mixed grilled meat in a restaurant. Epidemiological investigation revealed salmonella in all samples of pre-prepared raw meat ready for grill taken from the restaurant refrigerator, and also in few restaurant staff members (they were symptomless).

Zadar - staphylococcal food poisoning on a local festivity on 16.8. 2004. There were 17 diseased registered. Vehicle epidemiologically: backed lamb meat.

Beli Manastir - family outbreak of salmonellosis (S. enteritidis) on 16.8. 2004. There were 6 cases registered out of 9 members, after consumming home made cream cakes. No samples left for analyses.

Slatina - salmonellosis (S. enteritidis) after family celebration on 18.8. 2004. Total of 16 cases out of 42 exposed were registered. Vehicle: home made cakes, found salmonella positive. Source not found with certainty. Person  preparing cakes was salmonella negative,  eggs not examined.

Đakovo - family outbreak of salmonella food poisoning (S. enteritidis). Source not found. Vehicle: home made cakes with cream in which salmonella was found. Some participants from another County turned ill after their return home (see next outbreak). Total of 17 diseased out of 29 exposed were registered between 21.8. and 24.8. 2004.

Petrinja - salmonellosis (S. enteritidis) among persons attending family celebration in another County (see above). There were 6 cases registered. Vehicle epidemiologically: home made cakes

Korčula - bacillary dysentery (Sh. sonnei) in a hotel. Between 21.8. and 27.8. 2004 there were 13 diseased out of 580 exposed. Source and mode of spread not certain. All hotel staff shigella negative.

Karlovac - salmonella food poisoning (S. enteritidis) in a factory canteen on 28.8. 2004. There were 32 diseased out of 60 exposed. Vehicle epidemiologically: panned hake fish. No samples left for analyses. Raw fish samples taken from the restaurant refrigerator were salmonella negative. Two symptomless salmonella carriers have been discovered among the kitchen staff.

Križevci - salmonella food poisoning (S. enteritidis) after a wedding banquet on 29.8. 2004. There were 18 diseases out of 300 exposed persons. Source not found. Vehicle epidemiologically: home made wedding cake, held for 24 hours at a room temperature. No cake samples left for analyses.

Pula - family outbreak of salmonellosis (S. enteritidis) after a birthday party. Between 1.9. and 2.9. 2004 there were 7 cases out of 13 exposed. Vehicle epidemiologically: home made cream cakes, not examined micro-biologically.

Sinj - staphylococcal food poisoning in a family on 7.9. 2004.  All 6 members turned ill after consumming fresh home made goat cheese. Staphylococcus aureus  producing enterotoxin (by a reverse passive latex agglutination test) was detected in cheese samples.

Gospić - acute gastroenteritis in a group of children attending the "school in nature", settled for a week in a coastal hotel. There were 49 cases out of 86 exposed between 7. and 10. 9. 2004. Causative agent not certain. Bacteriological examinations negative, viral etiology possible. Mode of spread not clear, epidemiologicall evidence suggests alimentary or contact route. Hotel swimming pool is also suspected as a possible place of exposure.

Rijeka - salmonellosis (S. enteritidis) in few elementary schools in the town. Between 8.9. and 14.9. 2004. there were 63 diseases out of 620 exposed, all getting their warm school meal from the same central kitchen. Vehicle not found, several different meals during several days could be responsible

Rovinj - salmonella food poisoning (S. enteritidis) on a kennel club competition, 14.9. 2004 with 12 diseased, all having sandwiches confectionated in a near restaurant.

Rovinj - salmonella food poisoning (S. enteritidis) in a group of tourists eating pizza in a restaurant on 15.9. 2004. There were 5 diseased.

NEWS AND COMMENTS

n      Etiology of helminthiasisis in Croatia in 2003

      In 2003. there were 596 cases of helminthiasis registered in Croatia, taeniasis included. In 502 of them (84%) the parasite species was noted. The table next page shows the spectrum of detected species.

        It can be seen that Ascaris lumbricoides and Enterobius vermicularis are dominant, while Trichuris trichiura was diagnosed rather rarely. Among diseased a slight female preponderance is noticed: ascaris: 54%:46%, enterobius: 56%:44%.

n      Scabies in Croatia 1994 - 2003

      During last ten years scabies incidence decreased substantially in Croatia. This fits with downward incidence trends in some other diseases of a low hygienic standard (typhoid fever, bacilary dysentery etc).

n COMMUNICABLE DISEASES IN CROATIA    -    SEPTEMBER  2004