ENGLISH LANGUAGE ISSUE *  ELECTRONIC VERSION

COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

n    Communicable disease case notification in September

S a l m o n e l l o s i s. Incidence is higher in September than in August (719:609) but lower than in September last year (942). Clusters are seen in Rijeka (64), Benkovac (25), Split (26), Samobor (27), Zagreb Dubrava (26), Pescenica (24), Tresnjevka (54) and  Novi Zagreb (59).

D i s e n t e r i a   b a c i l l a r i s: Only 1 case registered in September.

M o r b i l l i  (measles). No cases in September, owing to  vaccination.

R u b e l l a. One case reported from Zagreb Susedgrad, in an unvaccinated young adult, immigrating from a neighboring country.

M e n i n g i t i s   e p i d e m i c a. There were 4 diseased in September, slightly less than in August (6), equal to last September (4).

M e n i n g i t i s   v i r o s a  (aseptic). Incidence is still increased in September (Aug: 158, Sep.:165), being higher than in last September (56).

S y p h i l i s. In September 3 cases were registered (Trogir 1, Tresnjevka 2) similar to August  (4) and the last September (3).

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

L e g i o n e l l o s i s. Slightly more cases were recorded in September (6:3),  similarly to last September (4).

n      No reports in September from: Cazma, Pakrac, Vukovar, Senj, Umag, Drnis and Lastovo. Total: 7 out of 113 epidemiological districts.

n      Epidemic outbreaks

        Following outbreaks were reported in September:

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

Valpovo – legionellosis. Between 15.5. and 22.5.2006 there was 1 diseased person registered, but epidemiological investigation revealed anther 21 healthy persons having serological evidence of recent exposure to legionella. However, source and mode of infection were not found.

Opatija – salmonellosis (S. enteritidis) starting on 10.7.2006 in a family. Vehicle: homemade cake with cheese, cream and eggs. No samples left for analyses. Total of 3 cases out of 6 exposed was recorded.

Dubrovnik – salmonellosis (S. enteritidis) in a hotel. Between 22.7. and 1.8.2006 there were 50 diseased out of cca 2000 guests. Vehicle epidemiologically and microbiologically: cakes from the hotel pastry shop.

Novalja – enterocolitis among guests of a beach restaurant. Between 24.7. and 30.7.2006 there were 57 diseases out of cca 3000 present persons. Vehicle epidemiologically: refreshing cocktails with ice. Etiology not certain, in one patient norovirus was detected.

Brac – salmonellosis (S. enteritidis) in a hotel. Between 24.7. and 3.8.2006 the total of 21 diseased were registered. Vehicle epidemiologically: scrambled eggs, microbiologically not examined.

Vinkovci – salmonellosis (S. enteritidis) after a family celebration on 27.7.2006.  There were 18 diseased (3 hospitalized) out of 24 exposed. Vehicle epidemiologically and microbiologically: home made ice cream cake. Source not found with certainty. Domestic eggs used for cake confectioning suspected but not examined.

Crikvenica – food poisoning in a tourist resort. Etiology not found (only one positive finding on rota virus). Between 13.8. and 14.8.2006 there were 8 cases among 940 exposed guests. Vehicle epidemiologically: sea fruit salad.

Benkovac – salmonellosis (S. enteriditids) among persons eating backed pork meat from a kiosk in the town. Between 20.8. and 22.8.2006 there were 50 diseased (8 hospitalized). Source not found. Kiosk staff negative for salmonella.

Sibenik – salmonellosis (S. senftenberg) among persons eating backed pork meat, bought in a kiosk. Total of 47 diseased were registered between 22.8. and 27.8.2006. Salmonella was found in backed meat samples, as well as among the kiosk staff

Opatija – salmonella food poisoning (S. enteritidis) in a restaurant on 25.8.2006. Total of 10 cases registered. Vehicle epidemiologically: tiramisu sweet prepared in the restaurant. No samples left for analyses.

Trogir – salmonellosis (S. enteritidis) after family celebration on 6.9.2006. There were 8 diseased (3 hospitalized) out of 16 exposed. Vehicle: birthday cake purchased in a pastry shop. Salmonella confirmed in cake samples and in pastry shop staff.

NEWS AND COMMENTS

n      Vaccine composition for the next influenza season (2006/2007)

Every year in spring, the World health organization releases its forecast on influenza activity next winter, based on the global influenza surveillance network data (the National influenza laboratory of the Croatian national institute of public health is participating too) along with the proposition for optimal vaccine composition in the forthcoming season. Based on the information published in the WHO Weekly epidemiological record bulletin N^o 9, of March 3^rd 2006, vaccines for the winter season 2006/2007 should contain the following strains (names slightly shortened, as usual in epidemiological praxis)

A/H1N1/ New Caledonia like

A/H3N2/ Wisconsin like

B/Malaysia like

The above with an addition informing that also vaccinal strains A/H3N2/Hiroshima and B/Ohio are suitable.

n      Etiology of food-born outbreaks in Croatia in 2005.

In 2005 there were 84 outbreaks caused by food, registered in Croatia, involving altogether 1,118 diseased persons. The table below shows etiologic agents detected in these outbreaks. It is visible that  salmonella was the most frequent (more on salmonellosis outbreaks circumstances see in ENEWS 2/2006.)

Table 1 Etiology of foodborn outbreaks in Croatia 2005

* imported;  diseased exposed abroad

In certain number of outbreaks the etiology  was not resolved, as microbiological examinations were negative. This in all cases means examinations on pathogenic bacteria while spectrum of virological examinations may vary depending on field laboratories capabilities. So, viral etiology in these cases could be suspected.

COMMUNICABLE DISEASES IN CROATIA                         September 2006