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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.  There were less cases reported in January than in previous month as expected for the season (175:399). Last year January figure was about equal (162). Small clusters are seen in Karlovac (11), Pula (9) and Split (14).

D i s e n t e r i a   b a c i l l a r i s. Very low sporadic incidence pattern continues:  only 1 case in January. 

P e r t u s s i s  (whooping cough). For the first time there were no cases during entire month, owing to vaccination. In December there were 9 cases, in last January: 25.

M o r b i l l i (measles). No cases in January, due to mass vaccination.

R u b e l l a.  No cases in January due to mass vaccination.

V a r i c e l l a (chicken pox). Seasonal increase of incidence is observed (2325:1450);  intensity somewhat lower than in January last year (2584).

P a r o t i t i s   e p i d e m i c a (mumps). Low incidence is registered owing to vaccination. There were 4 cases in January, less than in December (11) and less than in January last year (8). No clusters.

L e p t o s o p i r o s i s. Incidence dropped in January (10:29), but  is still higher than in January last year (2).

S y p h i l i s. In January  6 cases were reported, which is abut equal to last month (5) and slightly more than in January last year.

T r i c h i n e l l o s i s. There were 22 reports in January, 20 of them from Slavonski Brod. In January last year 7 cases had been registered.

L e g i o n e l l o s i s. 3 sporadic cases were reported in January (Slavonski Brod, Samobor and Zagreb Tresnjevka), which was similar to previous month (6). No cases had been registered  in January last year.

I n f l u e n z a. Two cases of influenza syndrome were reported, but virologically not confirmed.

n      No reports in January from: Grubisno Polje, Rijeka, Korenica, Novalja, Drnis, Kastela, Makarska and Lastovo. Total: 8 out of 113 epidemiological districts.

n      Epidemic outbreaks

        Following outbreaks were reported in January:

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) on 3.6.2005. There were 6 diseased (5 hospitalized) out of 7 family members. Vehicle: home made tiramisu sweet. Salmonella confirmed in tiramisu samples. Eggs used for preparation turned salmonella negative.

Pula - family outbreak of tuberculosis with 3 diseased members found on 14.9.2005. Source: family member found microscopically positive.

Dubrovnik - family outbreak of salmonellosis (S. enteritidis) starting 20.10.2005. with 2 diseased. Vehicle not found.

Zagreb Centar - salmonellosis (S. enteritdis) in a home for elderly persons. Between 21.11. and 15.12.2005 there were 13 diseased. Epidemiological investigation revealed 3 salmonella carriers among kitchen staff. Vehicle not determined.

Vinkovci - acute gastroenteritis in a home for children. Causative agent: Noro-virus (Norwalk v.) of geno-group 1. Between 22.11. and 30.11.2005 there were 12 diseased out of 50 children present. Mode of spread: contact

Porec - acute gastroenteritis in group of persons 4.12.2005 after their return from one-day excursion abroad, where they had a meal in a restaurant. Microbiological examinations negative, viral etiology suspected. Total of 5 cases recorded.

Pula - food poisoning among group of persons that ate sandwiches bought in a street kiosk. Etiological agent not found, microbiological examinations negative.

Sibenik - food poisoning in a social institution  starting on 25.12.2005. with total of 14 diseased out of 86 exposed. Etiological agent not found (microbiological examinations negative) Vehicle epidemiologically: meal of fish with potatoes.

Kutina - acute gastroenteritis in a psychiatric hospital. Between 1.1. and 7.1.2006. there were 9 diseased out of 40 exposed. Causative agent not found (bacteriological examinations negative). Mode of spread not certain.

NEWS AND COMMENTS

n      Malaria in Croatia 2005

     There were 7 cases of malaria registered in Croatia in 2005, slightly less than in previous year (8). All cases were imported,  i.e. acquired in some of malaric countries of the world. Croatia is free of autochtonnous malaria since 1954.  Among diseased the majority were professionals working abroad (5), while 2 were sailors which usually had the first place among diseased. One patient  was  female,   others male. In one example the disease was most probably acquired through blood transfusion (road accident during stay in a malaric country). The onset was one month after transfusion, however it should be added that this patient did not take regular chemoprophylaxis either.

     In one case of tropical (P. falciparum) malaria the outcome was fatal. This reminds that malaria is very serious disease. So all possible activities for risk reduction are very important: avoiding mosquito bites by mosquito nets, repellents, adequate clothing, protective daily schedule, combined with proper chemoprophylaxis. The table gives information about those seven patients  including data about their chemoprophylaxis.

Croatia,  malaria cases 2005 (all imported)

n      Avian flu and humans, new developments

       Recently several persons got ill with influenza caused by avian A/H5N1/ virus in Turkey. Number of cases seems relatively high: basing on reports of Turkish health authorities over 20,  basing on newspaper reports several dozens. However up to now, the World health organization confirmed 12 cases of which 4 were fatal. At the same time dying of domestic poultry because of avian flu is registered in several parts of Turkey. The WHO experts who, together with Turkish experts, examined circumstances of recent events, report that no human-to-human transmission of diseases could be detected i. e. the mode of acquiring was the same as in South East Asian countries, only in very close contact with diseased poultry. This means that except in geographical aspect, no new moments in epidemiological situation occurred, and the phase of potential development of pandemic situation as postulated by the WHO remained at level 3, defined as: "no or very limited human-to-human transmission".

Avian flu virus caused disease in humans - Cumulative  2003 - 2006*

           *6^th of February

The table above  with cumulative numbers of cases, which is regularly updated on the web-page of the World health organization (www.who.int) gives all confirmed cases including the latest one, registered in Iraq, at the moment of writing this article, beginning of  February.

COMMUNICABLE DISEASES IN CROATIA              January 2006