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COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

•    Communicable disease case notification in May

S a l m o n e l l o s i s. Number of cases in May was somewhat higher than in April (236:157), but lower than in May last year (386). Cases cluster in Požega (12), Vinkovci (16) and Novi Zagreb (17).

M o r b i l l i  (measles). A zero incidence situation continues, owing to vaccination.

R u b e  l l a. Number of cases in May is lower  than in April (9:19). In May last year there were no cases.

T r i c h i n e l l o s i s. There were 15 cases reported in May, all from Županja (see Epidemic outbreaks). There were no cases registered in previous month neither in May last year.

P s i t t a c o s i s. In May 3 diseased were recorded in Kaštela.

L y m e   b o r r e l i o s i s. The incidence is raising according to the season (36:6). Last year there were less cases (21).

I n f l u e n z a. The season is prolonged to May, but number registered is much lower than in April (626:1787).

•      No reports in May from:

Vis, Lastovo and Jastrebarsko. Total: 23 out of 113 epidemiological districts.

•      Epidemic outbreaks

        Following outbreaks were reported in May:

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

Dubrovnik – histamine poisoning on 29.12.2007 in a group of workers eating tuna file meal for their lunch. There were 11 diseased registered.

Cakovec – gastroenteritis in a home for elderly people. Causative agent: noro-virus. Between 16.1. and 11.2. 2007 there were 48 diseased out of 121 exposed persons. Mode of spread: contact

Cakovec – gastroenteritis in a residence for socially deprived persons starting on 29.1.2007.  Causative agent not  found; tests for bacteria, adeno viruses and rota virus negative. Mode of spread: contact. Between 29.1. and 1.2. 2007 there were 5 diseased out of 7 exposed persons.

Cakovec – hospital outbreak of acute gastroenteritis. Etiology not resolved, probably viral (all microbiological examinations negative). There were 14 diseased out of 67 exposed between 11.2. and 21.2. 2007.

Cakovec – gastroenterits in a hospital. Causative agent: noro-virus. Between 24.2. and 8.3. 2007 there were 16 diseased out of cca 1250 exposed. Mode of spread: contact.

Cakovec – gastroenteritis in a home for elderly persons with 60 diseased out of 200 exposed between 28.2. and 6.4. 2007. Causative agent not found, possibly viral;  examinations on bacteria, rota and adenoviruses negative. 

Cakovec – salmonella food poisoning in several settlements in persons eating cakes, produced on the same place by the unqualified unauthorized persons, one of them found to be a symptomless carrier by epidemiological investigation. There were 25 diseased between 11.3. and 21.3. 2007.

Sibenik – salmonella food poisoning (S. enteritidis) in a family on 29.3. 2007. There were 4 diseased out of 5 family members. Source and vehicle not found.

Pozega – family outbreak of salmonellosis (S. enteritidis) with 5 diseased out of 6 members on 9.4. 2007. Vehicle epidemiologically: homemade cake not left for analyses. Source not found.

Pula – family outbreak of salmonellosis (S. enteritidis) on 9.4. 2007. There were 4 diseased registered out of 7 exposed members. Vehicle epidemiologically: home made cakes and/or  fish meal, both probably contaminated secondarily by manipulation.

Zupanja – trichinellosis in few connected families after consummation of their home made dried pork meat products. Fresh meat was not examined on trichinella before processing. However samples taken after outbreak were trichinella positive. There were 15 diseased out of 26 exposed between 12.4. and 25.4 2007.

Cakovec – gastroenterits in a group of workers with 15 diseased out of 150 between 18.4. and 19.4. 2007. Causative agent not found,  possibly a virus (bacteriological examinations as well as examinations on rota and adeno viruses were negative). Mode of spread not found with certainty.

Novi Zagreb – gastroenteritis of unknown etiology (bacteriological and virological examinations negative) in a kindergarten. Between 19.4. and 23.4. 2007 the total of 33 diseased were recorded out of 196 exposed. Mode of spread: probably alimentary, but vehicle not determined.

NEWS AND COMMENTS

•      Avian flu in humans, recent trends

During this year (2007) until the end of May, there were 46 new confirmed human cases of avian flu (A/H5N1/) in the World. Basing on the World health organization report of 31.5. 2007 (www.who.int/csr/disease/avian_influenza/country/en/index.html) the following table is created, showing which countries registered human cases of avian flu in this period.đ

Egypt is on the second place after Indonesia, but with better recovery rate then in average. According to the same WHO report, since 2003. until the end of May 2007 the  cumulative total of 309 human cases were registered in the World, and 187 lethal outcomes (60%).

•      Salmonellae in the circulation 2007

During first five months of 2007 there were 709 diseased with salmonellosis reported through individual case notification in Croatia. In 584 reports (80%) a responsible serotype of Salmonella was noted. The table is giving the spectrum of Salmonella serovars reported during this, colder part of a year, when lessened salmonella activity is usual. Salmonella enteritidis is ranking first, followed by Salmonella typhimurium, but at much lower level. Other strains are occurring sporadically. A part of isolates was determined only to a level of sero group. These isolates were later identified in the laboratory of the National salmonella center of the Croatian national institute of public health.

•      New communicable disease case definitions on the web

Recently, the second part of case definitions, for those entities that are not included in EU documents but are on the national list was finished and put, as it was announced (see ENEWS 10/2006) on the web-page of the Epidemiology service of the Croatian national institute of public health (www.hzjz.hr/epidemiologija.htm). So, all diseases notifiable in Croatia, and their definitions can now be found at one place. Case definitions can help in a process of establishing particular diagnosis by checking microbiological criteria from the definition, as well as in making decision what and when should be reported. The entire collection of definitions will soon be published as a separate booklet and distributed to all physicians dealing with communicable diseases in the country.

COMMUNICABLE DISEASES IN CROATIA                    May 2007

Last change - 15.11.2007 - Posljednja promjena