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COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

n    Communicable disease case notification in June

S a l m o n e l l o s i s. Incidence raised in June (504:332) as expected for the season, but last June the number was lower (370). Clusters are seen in Osijek (17), Rijeka (42), Sibenik (15), Varazdin (15), Ivanic Grad (30), Novi Zagreb (26), and Susedgrad (17).

T e t a n u s. One case reported in June form Daruvar: elderly unvaccinated person.

P a r o t i t i s   e p i d e m i c a (mumps). There were more cases recorded in June than in May (31:7), also more than in June last year  (6), because of a cluster  in Dubrovnik (30). Younger unvaccinated adults (belonging to cohorts not covered by vaccination program) were diseased.

S y p h i l i s. There were 4 sporadic cases registered  in June.

M a l a r i a. In June 2 cases were reported (Opatija, Novi Zagreb) both imported (Congo, Tanzania).

A n t h r a x (cutaneous). There were 3 clinical cases reported from Rab among  sheep handlers, but without microbiological confirmation (examination turned negative).

K a l a   a z a r. One case reported from Split.

I n f l u e n z a. Certain number of delayed reports about cases occurring earlier during the influenza season, arrived in June. So, the definitive total now is 123836 cases.

n      No reports in June from: Labin, Gracac, Kastela, Makarska, Solin, Vrgorac, and Lastovo. Total: 7 out of 113 epidemiological districts.

n      Epidemic outbreaks

         Following outbreaks were reported in June:

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

Sisak - family outbreak of tuberculosis in a small village. Since autumn 2004 there were 3 cases detected out of 5 family members. Source: family member feeling sick for almost a year before asking medical help, and when TB has been diagnosed.

Rijeka - hepatitis A in a family. Between 1.2. and 1.6. 2005. there were 2 cases registered. Mode of spread: contact. Those cases can be linked to the small outbreak occurring same time in the town suburban surrounding   

Sibenik - salmonella food poisoning (S. enteritidis) after a wedding banquet on 1.5. 2005. There were 19 diseased out of 42 exposed persons. Source not found. Vehicle epidemiologically: home made cakes with eggs. Eggs were found salmonella negative however.

Nova Gradiska - salmonella food poisoning (S. enteritdis) on a wedding banquet, 1.5. 2005. There were 21 diseased out of 150 exposed persons. Source not found. Vehicle epidemiologically: home made wedding cake.

Knin - salmonella food poisoning (S. enteritidis) after a family celebration on 2.5. 2005. There were 8 cases out of 30 exposed persons. Source not found. Vehicle epidemiologically: home made cakes with fresh egg cream.

Osijek - salmonella food poisoning (S. enteritidis) among participants of a family celebration on 8.5. 2005. Total of 8 cases were recorded out of 24 exposed. Vehicle epidemiologically: backed lamb meat. Source most probably: some of persons handling the food. Salmonella was found in cakes served, but not in meat samples.

Zupanja - salmonella food poisoning (S. enteritidis) in a family, after eating home made cream cakes on 16.5. 2005. All 5 members turned ill. No cakes left for analysis.

Petrinja - hepatitis A in a family after they visited their relatives in a neighboring country (incubation period fits). Between 22.5. and. 1.6. 2005. there were 2 cases. 

Sibenik - salmonella food poisoning (S enteritidis) after a family celebration among personas eating domestic tiramisu sweet. There were 7 diseased out of 9 exposed persons between 22.5. and 1.6. 2005. Salmonella confirmed in tiramisu samples. Source not found.

Sibenik - salmonella food poisoning (S. enteritidis) in a family on 25.5. 2005. There were 4 diseased out of 6 family members, all eating panned bread. Source not found.

Pozega - salmonella food poisoning (S. enteritidis) after family celebration with 6 diseases out of 35 exposed persons between 29.5. and 31.5. 2005. Vehicle epidemiologically: home made fruit cake.

Vukovar - salmonella food poisoning (S. enteritidis) starting on 11.6. 2005. All 4 members turned ill after eating home made cake. No cake samples left for analysis.

Sisak - family outbreak of salmonellosis (S. enteritidis) on 17.6. 2005 with 6 diseased. Vehicle: home made cream cakes. Salmonella confirmed in cake samples examined, while eggs were found salmonella negative.

NEWS AND COMMENTS

n      Realization of the immunization program in Croatia in 2004

      As usual, we are presenting here the main results of annual mass vaccination program. The table shows coverage rates (%) for the primary vaccination achieved in 2004 compared with previous years.

Primary vaccination coverage (%) in Croatia 2004.

       It can be seen that  the overall result is very good, in fact the best since. Among other, for the first time a 95% coverage for measles was achieved. The only vaccination with unsatisfactory coverage (it should be over 90%) is the ana-Te vaccination for the cohort  60 years old,  but this is also gradually improving.

       As a result of such high and stabile vaccination coverage, a very low incidence of target diseases is registered. Diseased are mainly unvaccinated (contraindications, cohorts not included in vaccination program, migrations

n      Analysis of salmonella food poisoning outbreaks in 2004

         In 2004 there were 46 salmonellosis outbreaks registered in Croatia with 713 diseased persons involved. Tables below are giving some epidemiological data about these outbreaks. It can be seen that sweets and cakes are more frequent as  vehicles,  than the meat meals. The analysis of circumstances and place of occurrence shows that outbreaks occurred mainly within families i.e. in  households or at self organized family celebrations like weddings, birthday parties etc., while rather seldom in public restaurants, canteens  etc. This suggests that entire system of prevention and control measures for public food supply safety is acting successfully.

Table 1.  Types of food causing outbreaks (vehicle)

Table 2.  Circumstances / place of occurrence

n      II Croatian epidemiological congress

Congress information:

http://www.depolkomunikacije.hr/kongres/epidemioloski.htm

COMMUNICABLE DISEASES IN CROATIA                June 2005