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COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

•    Communicable disease case notification in December

S a l m o n e l l o s i s. Incidence decreased compared to previous month (235:374) and is reaching a seasonal minimum. In December last year there were 262 cases registered. Small clusters exist in Osijek (23), Split (11), and Zagreb Susedgrad (18).

D y s e n t e r i a   b a c i l l a r i s.  Favorable low incidence pattern continues,  with 2 registered cases (Cres- Losinj, Rijeka). No cases reported last month, one case in December last year.

P e r t u s s i s  (whooping cough). There were 9 cases registered in December  which was slightly more than in November (5), and December last year (4). Small cluster is seen in Nova Gradiska (3).

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

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

P a r o t i t i s   e p i d e m i c a  (mumps). Incidence is slightly higher than in previous month (9:3). Last year one case was recorded I n December. The majority of cases cluster at the sea coast (Omis 2, Trogir 1, Korcula 2).

M a l a r i a. One imported (Africa) case is reported from Kostajnica in December.

B r u c e l l o s i s. In December one case reported from Split,  one in previous month from Makarska.

L y m e   b o r e l l i o s i s. There were 19 diseases in December, 18 in previous month. In December last year 13 cases were recorded. Cases cluster on Zagreb area: Sesvete (3), Susedgrad (1), Crnomerec (1), Novi Zagreb (1).  

H e p a t i t i s  C.  Number of cases registered in December is higher than in November (35:21), this was more than in December last year (14). Clusters are seen in Split (10) and on Zagreb area: Crnomerec (2), Novi Zagreb (4), Susedgrad (4). Note: newly discovered chronic cases are recorded too.

•      No reports in December from:

Drniš, Vis, Lastovo and Zagreb Trnje. Total: 4 out of 113 epidemiological districts.

•      Epidemic outbreaks

        Following outbreaks were reported in December:

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

Osijek – salmonella food poisoning (S. enteritidis) in a kindergarten on 17.10. 2007, with 4 diseases out of 83 exposed. Source possibly some of the kitchen staff (salmonella carriage discovered, manual extraction of bones from cooked chicken meat recorded). Vehicle epidemiologically: chicken meat meal. Frozen raw chicken meat samples were found salmonella positive. But,  a phage type  (4)  was different,  than the one in diseased and carriers (3 and 21). 

Zupanja – family outbreak of salmonella food poisoning  (S. enteritidis) in three connected families  eating own homemade cake called "ice cubes". Between 28.10. and 1.11. 2007 all 11 exposed persons tuned ill (3 of them living in a neighboring country). No cakes left for analyses.

Pula – viral gastroenteritis in a kindergarten. Causative agent: noro virus (Norwalk a.). Between 28.11. and 2.12.2007 there were 28 diseased out of  99 exposed (children, staff and few household contacts). Mode of spread: probably by contact. A central kitchen supplies several kindergartens in the town,  but only this one was affected.

Slavonski Brod - acute gastroenteritis after celebration on a working place on 5.12. 2007. There were 12 diseased out of 30 exposed. Causative  agent not found, bacteriological examination negative. Vehicle epidemiologically: cream cakes, bought in a pastry shop in a big shopping mall. No pathogenic bacteria found in cake samples but total bacteria count was over the acceptable limit.

Porec – viral gastroenteritis in a village elementary school. Causative agent: noro virus (Norwalk a.). Between 6.12. and 11.12. 2007 there were  51 diseased out of 161 exposed, mainly pupils, but also staff members and few preschool children from a kindergarten situated in the same building.

NEWS AND COMMENTS

•      Influenza arrived

In the last days  of the year (28.12.2007) the laboratory  of National influenza center in the Croatian national institute of public health identified first cases of influenza virus in diseased form Zagreb area. That was an influenza A virus.  Until the moment of writing this article (mid of January 2008) several dozens of isolates were obtained, almost all of A/H1N1/ subtype and only 1 strain of B virus.  Last winter, influenza waive arrived somewhat later. The first confirmed  cases were recorded in the second half of January.

•       Cancer in Croatia 2005

Recently new annual bulletin on cancer incidence in Croatia was released, based on data of the National cancer registry of the Service for epidemiology of chronic mass diseases of the Croatian national institute of public health. The latest available data on cancer incidence are presented i.e. for the year 2005. It should be noted that register data are usually somewhat delayed,  as data should be exhaustively checked, linked from various sources i.e. health institutions to the particular individual, completed with histological findings, cleaned from persons leaving the country, deceased etc. As usual,  we refer here some data from this book (see ENEWS No 12/2006). This time here  are the recent data about most frequent cancer sites in men and women.

Table 1    New  cancer cases, Croatia 2005; first ten most frequent  sites

Ranking of the most frequent sites of cancer remains similar through the last decade, but this year (2005) melanoma malignum cutis in men entered the first ten group with 303 new cases, which is an increase comparing to previous few years. Is it a consequence of changes in exposition, improved diagnostics (histological confirmation in 100%) or else, is to be assessed.

More information can be found in the book.

Data about the book

Title: Incidencija raka u Hrvatskoj; Cancer incidence in Croatia 2005. Text bilingual: Croatian and  English. Format: 28 x 20 cm, 39 pages, 13 graphs and pictures. Editor: Croatian national institute of public health, Zagreb, 2007 

•      Etiology of bacterial meningitis in 2007.

In 2007. the total of 38 cases of bacterial (purulent) meningitis (except meningococcal which is monitored separately) were reported. This was more than half of all cases reported (55). The table below shows recent spectrum of causative agents of bacterial meningitis in Croatia.

Table 1 Registered causative agents of bacterial meningitis in Croatia 2007

It can be seen that pneumococcus (Streptococcus pneumoniae) is ranking first, followed by Salmonella. Hemophilus influenzae was diagnosed in a 39 years old women (unvaccinated). No Hib meningitis cases registered among children generations covered with systematic vaccination program. Pneumococcal meningitis cases were recorded predominantly in adult age.

COMMUNICABLE DISEASES IN CROATIA                         December 2007

CONTENTS OF THE EPIDEMIOLOGICAL NEWS IN 2007

Last change - 23.04.2008 - Posljednja promjena