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COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

•    Communicable disease case notification in September

S a l m o n e l l o s i s.  There were more cases registered in September than in August (556:412) which was also higher than in September last year (413). The highest numbers are seen in Koprivnica (31), Osijek (59), Sibenik (46; see Epidemic outbreaks), Zagreb Susedgrad (31) and Novi Zagreb (30).

D y s e n t e r i a   b a c i l l a r i s. A favorable situation with low incidence continues, with 2 sporadic cases in September, just like previous month, similar to last year September (3).

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). incidence dropped in September (38:41) being lower than in September last year (83). No clusters.

L y m e   b o r r e l i o s i s. Incidence decreased in September (65:94), however being significantly higher than in September last year (19). Small clusters are seen in Pula (4), Čakovec (7), Zagreb Dubrava (5), Susedgrad (7) and Tresnjevka (9).

B r u c e l l o s i s. There were 9 cases registered in September which was more than in previous month (1), while no cases had been recorded in September last year. The majority of cases are from Zagreb area: Dubrava 5, Tresnjevka 1, few more sporadic cases registered in Topusko (1), Split (1) and Ploce (1).  All diseased have been exposed in a neighboring foreign country, or ate the food originating from mentioned foreign countries.

•      No reports in September from:

Delnice, Korenica, Kastela, Solin,  Vrgorac Lastovo, Jastrebarsko and Zapresic. 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.

Rab - family outbreak of salmonellosis (S. enteritidis) on 5.6. 2008. with 6 diseased. Vehicle: home made cream cakes. Microbiological examination of eggs used, revealed salmonella presence on outer layer of egg shell.

Sinj - campylobacteriosis. (C. jejuni) starting on 13.6. 2008. There were 5 cases registered in a family after a meal of chicken meat, insufficiently thermically processed and kept on a room temperature.

Dubrovnik - salmonella food poisoning (S. enteritidis)  starting on 24.6. 20087. There were 4 diseased in two hotels sharing common catering kitchen. Vehicle epidemiologically probably: grilled chicken.

Zagreb Dubrava - brucellosis in a family exposed abroad. Between 25.6. and 12.9. 2008 there were 9 diseased out of 14 family members. Epidemiological inquiry suggests that diseased have been exposed to domestic cheese made from uncooked milk during their visit to a neighboring country

Sibenik - salmonellosis (S. enteritidis) on 11.7. 2008. There were 32 diseased (guests and staff) in a hotel. Vehicle epidemiologically: several meals: backed chicken, cakes, mayonnaise. Microbiological tests showed Salmonella presence in fresh eggs, backed chicken, hard boiled eggs with mayonnaise, cream cakes, chocolate cake, cream cake and white cake.

Varazdin - scabies in a social institution. On 12.8. 2008. there were 9 infested out of 180 exposed.

Rab - head lice in a kindergarten. On 3.9 .2008. there were 8 infested out of 35 exposed children.

Sv. Ivan Zelina - gastroenteritis of unknown etiology starting on 6.9. 2008. all examinations in patients negative. There were 6 diseased out of 33 employees of two companies having their hoot meal in a  near restaurant.  Vehicle epidemiologically: panned steak, potato salad In a potato salad sample Staphylococcus aureus was detected.

NEWS AND COMMENTS

•       Antirabic treatment in 2007 in Croatia

In 2007 the total of 1461 persons had received immunological protection against rabies. That was lesser  part  (27, 8%) of a total of 5238 persons asking for medical help because of some risky exposure to animals,  in one of 29 antirabic station in the country. After a thorough examination and epidemiological anamnesis 1461 persons had received rabies vaccine, while 82 (5,6%) of them got also hyperimmune rabies gammaglobuline (HRIG). The number of persons protected in 2007 was somewhat lower than in previous year (1501). The table 1 shows anatomic localization of injuries that asked for antirabic treatment.

Table 1 Anatomic distribution of injuries

   The table 2 is showing animal species that caused antirabic treatment

Table 2

Owing to highly specialized and responsible work of doctors epidemiologists in all antirabic stations in our institutes of public health, as well as to a good vaccination coverage of dogs, no human rabies cases has been recorded in Croatia in 2007. (the last autochthonous human case was registered in 1964).

Beside permanent need for better care for domestic dogs in order to avoid such a high number of vaccinated persons because of dogs without known owner  (ENEWS 4/2007), a further improvement of the situation could be achieved by reducing intensity of sylvatic rabies in foxes. As it is known, this can be achieved by eliminating foxes and keeping their populations at a low level, but also, more acceptable, by active immunization of foxes. Such actions were already accomplished in several European countries  with excellent results (see ENEWS 8/2004).

•       Salmonellae in circulation, summer 2008.

From individual reports of salmonellosis cases it can be assessed which serotypes of Salmonella  are circulating among population. Such an analysis was done for the Summer season of this year (May –September) and is shown in the Table 1.

Table 1  Data from individual case reports

As in previous years S. enteritidis was dominant, followed by S. typhimurium.

Additionally, in the same period the laboratory of the National salmonella center of the Croatian national institute of public health, has identified, beside several strains from the above table, also these salmonella strains in humans (Table 2)

 Table 2  From  the report of the National slamonella center

                  May –September 2008 (humane isolates)

COMMUNICABLE DISEASES IN CROATIA                         September 2008

Last change - 25.05.2009 - Posljednja promjena