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COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

n    Communicable disease case notification in October

S a l m o n e l l o s i s. There were less cases in October than previous month (865:924) but more than in October last year (714). The highest figures are in Koprivnica (61) and Novi Zagreb (62).

H e p a t i t i s  A (epidemic jaundice). Low incidence pattern continues: Oct:1, Sep:5, Oct. 2004.1.

T e t a n u s. One case reported from Zabok (old, unvaccinated person).

M o r b i l l i  (measles). No cases in October, owing to mass immunization

R u b e l l a. No cases in October, owing to mass immunization.

P a r o t i t i s   e p i d e m i c a (mumps). Incidence is low owing to systematic vaccination; Oct.: 9, Sep.: 5, Oct. 2004: 5.

L e p t o s p i r o s i s. Incidence raised in October (25:14) being higher than in October last year (5). This is connected with great floods this autumn. During last few months the incidence was as follows: May.: 0, Jun.: 3, Jul.: 5, Aug.: 4, Sep.: 14, Oct.: 25.

M o r b u s  B r i l l. After few years without any case 1 patient is reported from Sisak (old person, having typhus fever as a child). This late relapse became exceptionally rare recently, as last cases of typhus fever had been recorded more than fifty years ago.

n      No reports in October from: Cazma, Rijeka, Porec, Novalja, Gracac, Sibenik, Imotski and Lastovo. Total: 8 out of 113 epidemiological districts.

n      Epidemic outbreaks

         Following outbreaks were reported in October:

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

Rijeka - family outbreak of salmonellosis (S. enteritidis) starting on 13.7.2005. All 4 members turned ill. Vehicle epidemiologically: cakes brought from a pastry shop, but most probably contaminated at home, as no cases occurred in other consumers. No cakes left for analyses.

Opatija - family outbreak of salmonellosis (S. enteritidis) with 4 diseased out of 5 family members between 31.7. and 12.8.2005. Source not found, vehicle not certain. Eggs are suspected, but turned salmonella negative.

Split - scombrotoxism (histamine intoxication) in a family after a meal of tune fish on 28.8.2005. All 7 members turned ill. High levels of histamine were detected in tuna meat samples.

Vrbovec - salmonella food poisoning (S. enteritidis) on a wedding celebration. Between 4.9. and 6.9.2005. there were 102 cases registered out of 290 exposed. Source not found. Vehicle: roe deer stew, cooked chicken, cakes. Salmonella vas found in stew samples as well as in cooked chicken, fresh mushrooms, domestic eggs and also in few persons involved in food preparation.

Crikvenica - food poisoning after family lunch on 5.9.2005.  All 7 exposed turned ill. However, causative agent not found i.e. microbiological examinations negative.

Zagreb Centar - salmonella food poisoning (S. enteritidis) in a pizzeria on 12.9.2005, in 4 persons eating lasagna. Epidemiological investigation revealed salmonella carriership among kitchen staff, while food samples turned salmonella negative.

Zadar  - salmonella food poisoning (S. enteritidis) after a birthday party on 18.9.2005. There were 15 diseased out of 36 exposed persons. Vehicle epidemiologically: home made cream cakes.

Split - salmonella food poisoning (S. enteritidis) on a wedding banquet 23.9.2005. There were 33 diseased out of 101 exposed. Vehicle epidemiologically: home made French salad, no samples left for analyses.

Split - family outbreak of salmonellosis (S. enteritidis) on 25.9.2005. There were 19 diseased out of 23 persons eating home made cram cakes. Salmonella found in cream cake samples, as well as in fresh eggs used.

Požega - salmonella food poisoning (S. enteritidis) in a family. There were 7 diseased out of 20 exposed. Source not found. Vehicle epidemiologically: home made sweets.

Petrinja - acute gastroenteritis in an elementary school. Causative agent not found, microbiological examinations negative. There were 21 cases out of 745 exposed between 10.10. and 14.10.2005. Source not found. Mode of spread most probably: contact.

NEWS AND COMMENTS

n      II. Croatian epidemiological congress successfully held

As it was announced in ENEWS N^o 2 and 5/2005  the second Croatian epidemiological congress with international participation, organized by the Croatian epidemiological society of Croatian medical association under auspices of the  Ministry of health and social welfare, has been successfully held in the town of Rovinj between 26. and 29. October 2005. Two hundreds participants attended the congress. There where 130 scientific works presented, divided in tree congress halls during two days of work, including also interesting poster section. Such a high number of lectures reflects the fact that epidemiology developed intensively since the last  congress in Split in 1999. (see ENEWS no 5/1999) and a lot of work has been done. The congress  worked in following thematic sections:

  Theoretical epidemiology and health indicators

  Epidemiology of communicable diseases

  Immunizations

  Anhtropozoonoses

  Ecological factors, water, food, air, ....

  Epidemiology of cancer

  Epidemiology of cardiovascular diseases and diabetes

  Epidemiology of injuries and osteomuscular system diseases

  Epidemiology of psychiatric, neurological and respiratory diseases

Beside section work, both congress days had very interesting plenary lectures covering main topics of contemporary epidemiology, ranging from an instructive retrospective revue of great plagues in the history, to current preparedness plans for possible influenza pandemic, and also lectures about control of cancer, impact of chronic mass diseases, environmental factors, risk assessment methodology in food safety, lecture about actual questions of bioterrorism and a specially important one dealing with a place, role and future development of intervenitional epidemiology.  A special group of lectures (mini symposium) within the congress  was dedicated to a great anniversary i.e. 50 years since malaria eradication in Croatia. Participants had a special honor and opportunity to listen about this huge and successful project from a head of the campaign himself. At the end of congress representatives of all working sections referred about their work and conclusions in plenary. It may be concluded that presented works, majority of them from  Croatian experts, as well as valuable presentations of guests form abroad, show that epidemiology  approved its place in modern medicine, and also its place within the national health care system, hawing measurable successes in rolling back diseases and improving health of people.

A congress is not only an act of science but also act of culture trying to demonstrate and promote connection and cohesion of specific professional and scientific activity with people, society and culture in frame of which it is performed. So, this congress also had several exceptional cultural events, from optimistic song of school-chlidren quire at the opening ceremony to the concert of world famous young accordion orchestra in town theater, and in addition few brilliant performances in music, poetry and painting presented by doctors, attendees of  the congress. A tour through fascinating town of Rovinj and inner Istria, with its unique nature and historic spirit of old towns, completed this aspect of congress. Whole meeting was characterized by  warm and friendly atmosphere. Beside the Organizing committee and all subjects that financially supported the congress special thanks go to the Institute of public Health of the County of Istria  and to host town of Rovinj.

The next congress will take pace in four years, while regular scientific meetings of the Croatian epidemiological society of CMA will be held, as usual, two times a year.

n      Respiratory viruses in circulation, autumn 2005.

     The Laboratory for respiratory viruses of the Virology department of the Croatian national institute of public health reports that during last two months (September, October) 2005. adeno viruses and parainfluenza viruses were detected in circulation with low intensity i.e. low numbers of positive findings in patients, while RS virus has not been detected in that period.

COMMUNICABLE DISEASES IN CROATIA                      October  2005