ENGLISH LANGUAGE ISSUE *  ELECTRONIC VERSION

COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

n    Communicable disease case notification in March

E n t e r o c o l i t i s.  Incidence increased slightly in March (691:643) being visibly higher than in March last year (457).

D y s e n t e r i a    b a c i l l a r i s.  Low incidence pattern continues with only 3 cases registered in March.

H e p a t i t i s   A (epidemic jaundice). Low incidence pattern with only 6 registered cases continues in March.

T e t a n u s.  There were 2 reports in March both in old unvaccinated persons (Cazma 1, Cakovec 1).

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

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

P a r o t i t i s    e p i d e m i c a (mumps). There were 7 sporadic cases registered in March, less than February, similar to March last year (8).

S y p h i l i s. There were 3 sporadic cases registered in March (Rijeka,  Kastela and  Zagreb-Maksimir). Situation does not differ from previous month and year respectivelly.

T r i c h i n e l l o s i s.  Number of cases in March (25) is similar to previous month (21) Cases cluster in Garesnica (8), and Osijek (16).

L e i s h m a n i a s i s.   One case is reported from Drnis (exposed most probably in Splitsko-dalmatinska county).

I n f l u e n z a. There were 197 reports in March, while 84006 cases had been reported in march last year (see News and comments).

n      No reports in March from Dvor, Imotski and Lastovo. Total: 3 out of 113 epidemiological districts. 

n      Epidemic outbreaks

        Following outbreaks were reported in March:

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

Rijeka - salmonellosis in a family (S. enteritidis) on 29.11.2005. There were 3 diseased out of 4 family members. Vehicle epidemiologically: home made cakes made with domestic eggs ( microbiologically not examined).

Karlovac - salmonella food poisoning (S. thompson) in a family, with 4 diseased out of 8 on 8. 12 .2005. Vehicle epidemiologically: home made "press vurst". No samples left for analyses.

Rijeka - salmonella food poisoning (S. enteritidis)  in a kindergarten. There were 8 diseased out of 36 exposed between 9.12. and 27. 12. 2005.  Vehicle not found.

Vinkovci - food poisoning in an elementary school with 18 diseased on 20.12. 2005. Causative agent: Staphylococcus aureus. Vehicle epidemiologically: mini-pizza bought individually at a backers shop near the school. Pizza samples turned negative, but in few persons preparing pizzas Staphylococcus aureus has been found in nasopharyngeal swabs.

Osijek - trichinellosis in a village. Between 7.1. and 20.2. 2006. there were 14 diseased in few connected families all eating domestic dried pork sausages of same origin. Trichinella found in dried meat samples. But preliminary examination of fresh meat has been negative.

Porec - trichinellosis in a family starting 7.2. 2005. There were 9 diseased out of 12 that ate home made dried swine sausages obtained from their relatives from another county (Vukovarsko-srijemska). Trichinella found in meat samples.

Zagreb Pescenica - hepatitis A in a family living in a suburban settlement. Between 7.2. and 13.3. 2006  there were 4 diseased out of 6 family members. Source: a family member. Mode of spread: contact.

Sibenik - acute gastroenteritis, etiology unknown (microbiological examinations negative) on 19.2. 2006  in a group of school children returning from one-day excursion to another county. There were 22 diseased out of ca 100 exposed. Source and mode of spread not certain.  Some  meal taken during the trip is suspected.

Jastrebarsko - salmonella food poisoning (S. enteritidis) in a group of workers eating their warm meal, taken from a near restaurant. There were 39 diseased out of 80 exposed persons  between 20. and 25. 2. 2006. Vehicle epidemiologically: panned pork meat, panned fish, bean salad. Food samples not microbiologically examined.

Varazdin - had lice in an elementary school. On 9.3. 2006 the total of 59 infested children were detected in first and second class and in preschool (so called "small school") group.

NEWS AND COMMENTS

n      Influenza arrived

Rather late this year the influenza outbreak started. The National influenza center at the Croatian national institute of public health detected influenza virus of A/H3N2/ subtype in diseased. The outbreak intensity seems however very low, comparing to previous years.

n      Etiology of pneumonia 2005.

Usually the majority of pneumonia cases reported do not have an information  about etiology. In 2005, similarly, 86 out of 6352 registered cases had the etiology mentioned. However these partial data still can give some light to our knowledge of recent pneumonia etiology trends and relative proportions of main etiological agents circulating. The table below shows causative agents and their proportions in 2005. 

The distribution of these cases by month, shows clusters at the beginning and at the end of the year. This was greatly a consequence of Mycoplasma pneumoniae activity which last year had an activity higher than usual.

n      Effects of systematic immunization against hepatitis B

Systematic immunization of school children attending 6th class of elementary school (12 years of age) had been introduced into Croatian national program of mass immunization in 1999. So seven generations of pupils are covered until now, making current 15-19 age group almost completely vaccinated (only 19 years old are missing). Hawing constantly more than 97 % coverage of target age cohorts, it could  now already be a proper time for first analytic insight into possible effects of this work. This specifically for the 15-19 age group, while effects on overall incidence could be expected somewhat later.

Graph1    Hepatitis B cases in age group 15-19 in Croatia

Looking the 1999 - 2005 period one can notice that age group 15 - 19 has experienced a significant decrease of incidence of hepatitis B with only 4 cases registered in 2005. Such a positive effect promises further improvements in the future.

COMMUNICABLE DISEASES IN CROATIA              March 2006