ENGLISH LANGUAGE ISSUE *  ELECTRONIC VERSION

COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

•    Communicable disease case notification in September

S a l m o n e l l o s i s. Incidence increased (413:386) but in  last September intensity was significantly higher (719). Cluster is seen in Koprivnica (48, see Epidemic outbreaks).

D y s e n t e r i a   b a c i l l a r i s. There were 5 cases registered in September, slightly more than in previous month (1) and in September last year (1). Cases are sporadic,  except 2 linked cases in Zagreb Tresnjevka (initial case imported).

P e r t u s s i s (whooping cough). There were more cases in September than in August (21:14), also more than in September last year (18). Small clusters are seen in Osijek (3) and Rijeka (5).

M o r b i l l i  (measles). No cases in September

R u b e l l a. No cases in September

M e n i n g i t i s   v i r o s a (aseptic). Expected seasonal decrease in observed (83:132). The intensity is much lower than in September last year. (165)

M a l a r i a. One imported cases (Ghana) reported from Zagreb Centar.

L y m e   b o r r e l i o s i s.  Number of cases registered in September is lower than in August (19:46) as expected for the season. In September last year there were less cases (25).

•      No reports in September from:

Novalja, Obrovac, Vis, Lastovo, Klanjec, Zabok, Samobor and Zagreb Trnje. Total: 8 out of 113 epidemiological districts.

•      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.

Šibenik – salmonella food poisoning (S. senftenberg) starting 22.7.2007. There were 11 diseased among persons eating backed pork meat from a small shop.  Meat samples turned salmonella negative however, but two Salmonella senftenberg carriers have been found during the epidemiological investigation.

Cres-Lošinj – acute gastroenteritis after a village fest. Causative agent: Vibrio parahaemolythicus. Vehicle epidemiologically: sea food (octopus salad, sea fruit risotto, fish burger) served on a boat in village port. No samples left for analyses.  Epidemiological investigation revealed the lack of necessary hygienic preconditions on the boat, and uneducated persons participating in food preparation. 

Rovinj – salmonellosis (S. enteritidis) among participants of a birthday party on 7.8.2007. There were 9 diseased out of 24 exposed persons. Vehicle epidemiologically: a cake bought in a pastry shop, no samples left for analyses. Salmonella not found among the staff, neither in cakes taken from the pastry shop, however.

Umag - gastroenteritis in a group of young members of a sport club settled in a camp, starting on 22.8.2007. with 11 diseased out of 27 group members. Causative agent not found, microbiological examinations negative. There were no other cases among 300 camp-guests eating in the same restaurant. Mode of spread not found.

Koprivnica – salmonella food poisoning (S. enteritidis) after family celebration starting on 27.8. 2007.  There were 18 diseased registered out of 40 exposed persons. Vehicle epidemiologically home made cream cakes. Source not found.

Umag – salmonella food poisoning (Salmonella of E group) in a group of foreign tourists arriving to an auto-camp on their bicycles and having their first meal prepared by their own cook in their own mobile camp – kitchen.  Cook found to be a symptomless carrier of same salmonella. Epidemiological investigation revealed pore conditions for food handling in the mobile kitchen. Vehicle epidemiologically: pasta and noodles with tomato sauce and with meat from a tin.

Umag – gastroenteritis in a group of young foreign tourists  in a camp, using their own mobile kitchen.  Between 4.9. and 6.9.2007. there were 10 diseased out of 39 group members. At the same time 600 other camp gests were well. Causative agent not found; bacteriological examination as well as examinations on rota viruses and adenoviruses were negative. No common food detected. Mode of spared might be by a contact.

Šibenik – histamine poisoning after a meal of fried sardines in a restaurant on 5.9.2007. There were 5 diseased registered.

Koprivnica – salmonella food poisoning (S. enteritidis) in a large family on 9.9.2007. with 17 diseased out of 40 exposed persons eating fried chicken. No samples left for analysis. Source not found.

NEWS AND COMMENTS

•      Foodborn outbreaks in Croatia in 2006

In 2006 there were 66 outbreaks caused by food consumption. The first table is showing circumstances of these outbreaks.  It can be seen that the majority of them   occurred in families i.e. in domestic environment involving thus rather small numbers of diseased. Few outbreaks were connected with public food distribution (restaurants, pastry shops hotels etc). There were no outbreaks caused by the industrially produced food.

Table 1    Place and circumstances of foodborn outbreaks in 2006.

The next table gives the information about causative agents  as well as types of food found responsible for outbreaks.

Table 2     Causative agent and vehicles in outbreaks

*probable

As in previous years salmonella food poisoning was most frequent, predominantly caused by Salmonella enteritidis. Cakes, cookies and sweets were the most frequent vehicle, because several delicate ingredients like eggs, milk and sugar are usually used and mixed, while not all cakes pass a thermic treatment (backing) especially  fillings; in addition sweets are often eaten subsequently through several days. Salmonella can enter the food through contaminated ingredients but also through contaminated,  not washed hands of persons preparing food.

All four outbreaks of trichinellosis were in families, caused by own homemade dried pork products. There were no cases caused by meat or meat products offered in public distribution i.e. in shops.

Enterocolitis caused (possibly) by DSP (diarrhetic shellfish poison) after eating mussels, was not proven in incriminated food, but considered as probable, as at the same time few samples of shells routinely tested, revealed DSP presence, while all microbiological examinations performed in that outbreak turned negative.  

•      Vaccine composition for the influenza season 2007/2008

As every year the World health organization released the recommendation for optimal composition of influenza vaccines for the forthcoming season on the northern hemisphere. The recommendation is based on global monitoring of influenza virus activity and properties through the WHO FluNet network, Croatian National influenza center of the Croatian national institute of public health participating in the network too. The WHO Weekly epidemiological record N^o 9, of 2^nd. March 2007 published this recommendation as follows ( full names of strains are slightly simplified here):

A/H1N1/ Solomon Islands -like

A/H3N2/Wisconsin  - like

B/Malaysia -like

 It is also added, that beside the A/H3N2/Wisconsin, the A/H3N2/Hiroschima strain is also adequate.

COMMUNICABLE DISEASES IN CROATIA                          September 2007

Last change - 15.11.2007 - Posljednja promjena