ENGLISH LANGUAGE ISSUE *  ELECTRONIC VERSION

COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

n    Communicable disease case notification in January

S a l m o n e l l o s i s. Rather low incidence, typical for a winter season, continues with less cases registered in January than previous month (162:302). This was also less than in last year January (257). Small clusters are seen in Cres-Lošinj (14) and Rijeka (13).

D y s e n t e r i a   b a c i l l a r i s.  No cases in January.

P e r t u s s i s (whooping cough). Incidence similar to the previous month i.e. slightly more cases (25:21), but  higher than in January last year (4). Cases cluster in Nova Gradiška (8) and Slunj (5).

V a r i c e l l a  (chickenpox). There were more cases in January than previous month (2584:2016) as expected for the season. Intensity is similar to January last year (2376).

M e n i n g i t i s  e p i d e m i c a. In January 4 cases were reported, which is less than in previous month (7) and also less than last January (10).    

S y p h i l i s. The incidence returned to low values in January (2:15), which is similar to January last year (2).

M a l a r i a. Two imported cases in January : Zadar: 1, Zagreb Susedgrad: 1.

P n e u m o n i a. High incidence registered in previous month lessened substantially (962:1305), but was still higher than in January last year (431).

I n f l u e n z a. Influenza arrived in January (see News and comments). Total of 347 cases recorded. But at the same time last year, the outbreak was far more advanced  with 16964 registered cases in January.

n      No reports in January from: Gračac, Obrovac, Drniš, Kaštela, Solin; Split and Lastovo. Total: 7 out of 113 epidemiological districts.

n      Epidemic outbreaks

Following outbreaks were reported in January:

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

Slavonski Brod - trichinellosis. Between end of October and end of November 2004 the total of 64 cases were recorded. The diseased (majority) consumed dried pork sausages purchased in a shop, originating from a local meat manufacture, or were employed in the same manufacture as meat handlers. Sausages of same origin caused also the outbreak in Pula (see Epidemic outbreaks in last number of ENEWS). Trichinella found in sausage samples.

Nova Gradiška - scarlatina in a kindergarten. Between 2.12. and 25.12. 2004 there were 6 diseased out of 18 exposed.

Sisak - febrile enterocolitis in a settlement. Etiology unclear, bacteriological examinations all negative. No common food of drink established. A total of 10 cases was registered between 31.12. 2004 and 10.1.2005. Mode of spread: probably contact.

Drniš - salmonellosis (S. enteritidis) after a wedding party on 20.11. 2004 with 9 diseased out of 14 exposed persons. Vehicle epidemiologically: home made wedding cake. Source not found. 

Zabok - gastroenteritis in a hotel with 11 diseased out of 110 exposed on 17.12.2004. Bacteriological examinations negative, viral etiology possible. Mode of spread most probably combined: alimentary and by contact.

Pula - salmonellosis (S. enteritidis)  in a village after two birthday parties, one in a family, another in a kindergarten, starting same day (20.12.2004),   epidemiologically connected by two birthday cakes obtained each from the same pastry shop. However several home made cakes were served on both places too. Total of 12 diseased out of 70 exposed were registered.

Benkovac - salmonella food poisoning  (S. enteritidis) on 23. 12. 2004, with 8 diseased. Vehicle epidemiologically: fried chicken bought in a butcher shop. Fresh chicken meat samples examined, turned salmonella negative however.

NEWS AND COMMENTS

n      Influenza arrives

         In the second half of January  first cases of influenza were registered. Until the end of the month, the laboratory of the National influenza center at the Croatian national institute of public health detected viral strains of influenza A and B among diseased. Further viral laboratory determination in progress. During January Influenza activity remained rather low.

n      New Health statistic annual

        Recently a new issue of regular annual edition of the Croatian national institute of public health was published. Like every year, it brings an exhaustive and objective overview of current Croatian health care system status, as well as a status of health of the Croatian population basing on reports from all health institutions in the country, collected, processed  and analyzed at the Croatian national institute of public health. Data are presented through more than 250 numeric tables and through 50 graphic presentations, accompanied by textual expert analyses and comments, all organized in ten large chapters. Among them we are here pointing   to chapters with the information about national health facilities and health manpower then to those with data about work and casuistics in primary health care, in outpatient clinics and in hospitals, then chapters with data on communicable diseases, national mass vaccination Program results and microbiological diagnostics, as well as special reports of Institute national registers of chronic diseases, and the chapter with overview of current health ecology situation.

Data about the book: title: Hrvatski zdravstveno statistički ljetopis /Croatian health service year book. Text: Croatian and partly English: summary analysis, tables and graphs. Format: 20 x 28,5 cm, 354 pages. Publisher: Croatian national institute of public health, Zagreb, 2004. Along with the book a CD (compact disc) with entire book in an electronic version is added. Book and CD can be ordered at the publisher.

n      Results of systematic testing of pregnant women on HBs antigen in 2003.

      According to the national Communicable disease control law, since 1999 all pregnant women in Croatia should be tested on presence of active hepatitis B infection i.e.  presence of HBs antigen, in order to immunize their newborns and protect them thus against hepatitis B infection. All maternity units report annually about this work to the Epidemiology service of the Croatian national institute of public health. Basing on these reports here we are showing some data about the realization of this task (table next page)

Total positive pregnant women:  142

Total newborns immunized:  141

      It can be seen that coverage values are high almost everywhere; few exceptions are to be corrected. It can be seen also that all live-born children of HBsAg positive mothers have been immunized (vaccine and hyperimmune gamaglobuline). A proportion, i.e. prevalence (%) of HBsAg positives among all pregnant women (this represents young adult female population) in 2003 turned to be similar to previous years (see ENEWS 5/2002) i.e. 0.4% in average, ranging from 0% to 1.3% (median: 0.4%) with single exception of 3.0% positives in a small maternity unit caring for only 60 pregnant women. 

COMMUNICABLE DISEASES IN CROATIA                                January  2005