ENGLISH LANGUAGE ISSUE *  ELECTRONIC VERSION

COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

n    Communicable disease case notification in May

S a l m o n e l l o s i s. Incidence raised in May (332:196) being similar to the last year May figure (330). Clusters are seen in Slavonski Brod (18), Zadar (16), Zagreb Tresnjevka (18) and Novi Zagreb (21).

P e r t u s s i s (whooping cough). A low incidence pattern,  with 12 registered cases in May similarly to April (10) and May last year (10). No significant clusters.

M o r b i l l i  (measles) & r u b e l l a.  Nor measles neither rubella cases registered in May, owing to systematic vaccination.

M e n i n g i t i s   e p i d e m i c a. There were less cases registered in My than in April (5:8) but more than in May last year (2). No clusters or secondary cases. 

M e n i n g i t i s    v i r o s a (aseptic). A slight increase is registered in May (12:4) which is also slightly more than in May last year (1).

T u b e r c u l o s i s  a c t i v a. Number of reports is similar to previous month (Apr: 86, May 94) but lower than in May last year (115).

M a l a r i a. Two imported cases (Ghana, Mozambique) are reported from Labin and Novi Zagreb respectively.

P n e u m o n i a. Incidence  decreased visibly comparing to April (391:602) but in May last year incidence was lower (362).

L y m e   b o r r e l i o s i s. Spring is coming and usual seasonal increase of incidence begins (15:1). In May last year there were more cases however.

I n f l u e n z a. During  May cases were still reported (1546), but majority refers to  previous months. However until the end of May a total of 112172 influenza cases were recorded.

n      No reports in May from: Grubisno Polje, Dvor, Imotski, Lastovo. Total: 4 out of 113 epidemiological districts.

n      Epidemic outbreaks

         Following outbreaks were reported in May:

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

Vukovar - salmonella food poisoning (S. enteritidis) starting on 3.5. 2005. in a family with 5 diseased out of 7 exposed. Vehicle epidemiologically: home made cake. No cake left for analyses.

Gospic - acute enterocolitis in a kindergarten infant group. Between 10.4. and 22.4. 2005. there were 14 diseased out of 26 exposed. Causative agent: Rota virus. Mode of spread: mainly contact.

Nova Gradiska - acute enterocolitis in two infant groups in a kindergarten with 8 diseased out of 23 exposed between 4.4. and 10.4. 2005. Causative agent : Rota  virus. Mode of spread: contact

Sisak - salmonella food poisoning (S. enteritidis) in a family on 20.4. 2005. There were 4 diseased out of 6 family members eating backed rabbit meal prepared three days ago. The rest of family members that consumed same meal on the day when it was prepared stayed well.

Opatija - gastroenterocolitis in a hotel. Etiology unresolved, all bacteriological and virological examinations turned negative. Between 15.4. and 28.4. 2005. there were 26 diseased out of 200 exposed persons. source not found. Mode of spread most probably mixed i.e. alimentary and by contact but common vehicle was not found.

NEWS AND COMMENTS

n      New International health regulations (IHR) adopted

      The new version of International health regulations (IHR) was adopted on World health assembly meeting this May in Geneva, Switzerland, by the high representatives of all WHO member states, Croatian minister of health and social welfare too. This was a successful finish of several year preparatory work of health experts and other relevant representatives of all WHO member states, aimed to produce a new contemporary replacement to the old IHR being in use since 1969. In this work Croatian representatives were participating too, among them an epidemiologist from the Epidemiology service of the Croatian national institute of public health,  as a national IHR focal point.

Between important characteristics of the new IHR it should be mentioned that it covers now not only few important communicable diseases (plague, yellow fever etc.) but all potentially internationally important health events i. e. events that might be spread internationally by international traffic and communication. In this respect a new decision making instrument is a part of new regulations, as an aid to asses the importance of a particular event and a need for sharing the information with rest of the world through the WHO global informative network. The new IHR also require appropriate health service standard within each member state, capable to recognize important health events (outbreaks etc.), resolve the etiology, treat the patients and apply promptly appropriate control measures. We can say that such main prerequisites Croatia has, trying constantly to improve them further.

n      Ethiology of helminthiasis in 2004

   There were 671 cases of helminthiasis reported in 2004 in Croatia (echinococcosis and trichinellosis monitred separately). In 540 (80.5%) of them, a type of invasive agent was noted.

The table below shows species detected and their relative proportions.

It can be seen that Enterobius vermicularis and Ascaris lumbricoides are the most common. Regarding the first ranking - enterobius,  female cases prevail (161:134), while the ratio is almost 1:1 in ascaris cases (119 females : 113 males). Taeniasis is rare, all 4 cases were female.

Detection of enterobius is decreasing during the last decade (Graph). In the same period ascaris cases showed an increase first and then, since 2000, declined along with enterobius cases,  as well as all helminthiasis cases registered (Table).

n      II Croatian epidemiological congress, second announcement

At the moment of writing this number of ENEWS (mid of June) the second announcement for the forthcoming 2^nd Croatian epidemiological congress with international participation in Rovinj 26. - 29. Oct. 2005. was released and distributed. For all interested congress informations are available also on the Internet, at the web-site address http://www.depolkomunikacije.hr/ The principal organizer of the congress is the Croatian epidemiological society of the Croatian medical association, under the auspices of the Croatian ministry of health and social welfare.

COMMUNICABLE DISEASES IN CROATIA                May 2005