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CROATIAN NATIONAL INSTITUTE OF PUBLIC HEALTH

EPIDEMIOLOGY UNIT 

ROCKEFELLEROVA 7 
10000 ZAGREB 

REPUBLIC OF CROATIA

ISSN 1334-6733

- NEWS AND COMMENTS

- COMMUNICABLE DISEASES IN CROATIA


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2008

DECEMBER

12

ENGLISH LANGUAGE ISSUE *  ELECTRONIC VERSION

COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

    Communicable disease case notification in December

S a l m o n e l l o s i s. In December, intensity is on its seasonal minimum with 297 cases registered (415 in November), but it was somewhat higher compared to December last year (235).

H e p a t i t i s   A. Very low intensity continues: Nov: 0, Dec: 1, two in last December.

P e r t u s s i s (whooping cough). There were 9 cases reported in December, similar to previous month (11), equal to December last year (9). No clusters.

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

R u b e l l a   No cases in December.

V a r i c e l l a  (chicken pox). Steep increase is observed as expected for the season (1659: 902), intensity lower than in December last year (2027).

B r u c e l l o s i s  There were 3 new cases recorded in December, making a total of 22 cases in this year. This is significantly more than in previous year. The majority of cases however, are linked to exposure abroad, by travel, or via food got from abroad. Three cases from the Karlovac county are autochthonous however, i. e. infection of domestic cattle was discovered, but promptly treated by veterinarians.

H F R S. There were 4 sporadic cases registered in December (Pozega 2, Nova Gradiska 1, Novska 1), 2 in November. In December last year 2 cases were reported.

L e g i o n e l l o s i s. In December 4 cases (Zagreb Maksimir: 2, Samobor :1, Dubrovnik:1) were reported, which was slightly more than in November (1) and in  December last year (2).

      No reports in December from:

Dvor, Glina, Kostajnica, Petrinja, Topusko, Rab, Novalja, Sibenik, Kastela, Solin, Vis, Lastovo. Total: 12 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.

Djakovo – viral gastroenteritis in a home for elderly people. Between 12.5. and 27.5. 2008 there were 72 diseased out of 232 exposed persons. Causative agent: noro virus. Mode of spread: contact.

Dubrovnik – salmonella food poisoning (S. enteritids) among persons employed in a hotel, starting on 3.6. 2008 when one of them got ill. During usual epidemiological investigation 2 more salmonella carriers without symptoms were discovered. Vehicle not clear. No cases among hotel guests.

Dubrovnik – gastroenteritis in two hotel guests 11.11. 2008. Causative agent not found, all microbiological examinations negative. Epidemiological investigation did not reveal any carriers among kitchen staff. Vehicle epidemiologically, possibly: tuna salad  or grilled chicken.

Pula – viral gastroenteritis on a ship on its first test voyage after being finished in a shipyard, statrting on 18.11.2008. There were 12 diseased out of 100 exposed persons. Causative agent: noro virus. Source not found. Mode of spread mainly by contact.

Dubrovnik – salmonella food poisoning (S. of group B), among a food shop staff, discovered at their regular health check on 8.12. 2008. There were 4 infected persons out of 13 exposed. Retrospectively vehicle might be hamburgers, bought in a near kiosk.


NEWS AND COMMENTS

       Joint meeting of Croatian epidemiological society and ECDC in Zagreb

During the official visit of representatives of the European center for diseases prevention and control (ECDC) Stockholm to the Epidemiology service of the Croatian national institute of public health in summer 2008,  among other, ten points of further professional collaboration were agreed. One of the points was an agreement that next,  regular winter scientific meeting of the Croatian epidemiological society of the Croatian medical association could be organized as a joint meeting, together with the ECDC with participation of Croatian and ECDC experts. This plan was successfully fulfilled by organizing 65th winter scientific meeting in Zagreb  in the congress hall of the Croatian medical association, Subiceva street 9 on 15th of December 2008. More than 100 doctors epidemiologists attended the meeting from all over Croatia,  as well as a representative of ECDC and guests from Macedonia and Turkey (countries accessing the EU too). In the name of Croatian Minister of health and social welfare and in the name of a national counterpart to the European  ECDC, the Croatian national institute of public health, the meeting was addressed by the director of Croatian national institute of public health. The president of Croatian epidemiological society as a host, also welcomed all the colleagues present.

In the scientific part of the meeting 18 lectures were presented, covering various aspects of epidemiology work: interesting events from the past, microbial resistance to antibiotics, mass immunization, environmental health, rodent and mosquito control, natural nidality zoonoses, chronic mass (noncommunicable) diseases epidemiology  etc. All lectures were adjusted to the international audience, providing English titles in all PowerPoint  transparencies, as well as consecutive professional translation of all speeches at the spot.

For its presentation the ECDC chose an attractive and actual topic and delegated its special senior experts for microbiology and epidemiology, who gave a lecture about activities on control of microbial antibiotic resistance in Europe,  marking thus also the recent European microbial resistance awareness day. This lecture was followed by a domestic one with the same topic, showing activities in this filed in Croatia. Beside that, the following other topics were presented and discussed at the meting:

- Antimicrobial resistance in Europe and the ECDC activities; marking the European antibiotic resistance awareness day

- Surveillance of antimicrobial resistance in Croatia

- Short history of the Croatian epidemiological society and  epidemiological  profession in Croatia

- Some important details from the history of communicable disease prevention and control in Croatia

- Results of systematic immunization Program in Croatia and the  future perspectives

- Epidemiological characteristics of pertussis

- Epidemiology of HIV/AIDS in Croatia

- Problems of parotitis elimination in Split – Dalmatia County

- The melamine problem

- Aedes albopictus  mosquito  behavior, and monitoring  and control measures in the Zagreb City area and Istra County area

- Monitoring of mosquito populations in the Zadar County area

- Epidemiology of chronic noncommunicable diseases in Croatia

- National program for diabetes

-  Epidemiology of cardial tumors

- Sanation of damaged water supply system of  a  town in the Sisak-Moslavina County

- Report from an international military medical exercise on response against disease emergencies  

- Ticks of the Zagreb area

- The onomastic approach to understanding of some epidemiological trends and events  in the past

Some pictures from this meeting can be seen at the web site of the Epidemiology service of the Croatian national institute of public health: (www.hzjz.hr/epidemiologija.htm).

       Summer meeting of Croatian epidemiological society

Due to some circumstances we could not inform about the regular summer  meeting of the Croatian epidemiological society earlier. So, we are doing it now. The summer regular 64th scientific meeting of the Croatian epidemiological society of the Croatian medical association, took place in Tuheljske toplice in Krapinsko-zagorska county on days 6th and 7th of June,  2008.  Direct organizers and hosts of the meeting were the colleagues epidemiologists and others, from the County public health institute. Over 80 doctors epidemiologists attended the meeting. At the beginning, highest representative of the Krapina-Zagorje county addressed and welcomed the meeting. First day was filled with 23 high quality lectures, while on the second day an educative excursion was organized over the Krapina-Zagorje county including, among other, a visit to the world famous place of discovery of ancient (Neanderthal era) man of Krapina (Homo krapiniensis) in Husnjakovo, near town of Krapina. Here follows  the  list of topics presented at the meeting:

- Welcome and presentation of the host, the Epidemiology service and the County public health institute of Krapina-Zagorje county.

- Daniel Rodriga, builder of historical Lazaret and Quarantine facilities in Split

- Choice of  sample size in epidemiological studies.

- One of heath priorities in Krapina-Zagorje county; a safe water supply

- Problem of turbid water on the ORL ward of the Sibenik general hospital

- Cutaneous leishmaniasis,  imported cases

- Seroprevalence and risk for  HIV, HBV and HCV infection in persons injecting drugs in 2007

- Outbreak of  norovirus gastroenteritis in a home for elderly persons in Slavonski Brod

- From the practice of an antirabic outpatient clinic

- Horizontal spread of postvaccinal parotitis – case presentation

- Novelties about HPV  vaccine

- Some characteristics of National program for early detection of breast cancer  in the Krapina-Zagorje county

- First results in implementation of new Program for early detection of colorectal cancer in Croatia            

- Heart in thyroid gland diseases

- Epidemiology of injuries in Croatia

- Measles in Croatia and Europe in  2008

- Preliminary data on adverse reactions after vaccination with newly introduced DTaP-IPV-Hib, "Pediacel" vaccine into the national Program on mass immunization in Croatia 

- Compiling monthly reports on vaccine consumption

- Quality assessment  of the violent death mortality statistical data

- National program for diabtes in Croatia

- Meningococcal sepsis in a kindergarten in Zagreb

- Salmonellosis and pet turtles

- Ship sanitation and ship sanitation control in international travel,  in the scope of  the new International health regulations (IHR) 2005, a report from Hamburg workshop, May 2008

On the web site of the Croatian national institute of public health, Epidemiology service, one can take a look at some pictures from this meeting (www.hzjz.hr/epidemiologija.htm).

       Encephalitis etiology 2004-2008

In the majority of encephalitis/meningoencephalitis cases (tick born encephalitis is registered separately) etiology is not known. An insight into those cases where etiology was determined, could give some information about actual causative agents. In the last five years period (2004-2008) there were 27 such cases (7 in 2008). The structure is given in the table bellow.

Table 1.   Causative agents of encephalitis/meningoencephalitis in Croatia 2004-2008

Causative agent

No

Herpes simplex virus

8

Varicella – zoster virus

5

Listeria monocytogenes

5

Borrelia burgdorferi

2

Streptococcus pneumoniae

2

Streptococcus beta – haemolyticus,  group B

1

Taenia solium

1

 


COMMUNICABLE DISEASES IN CROATIA                        December 2008

Salmonellosis

279

Food poisoning

679

Enterocolitis

876

Dysenteria bacillaris

1

Hepatitis A

2

Hepatitis B

12

Hepatitis C

16

Angina streptococcica

913

Scarlatina

355

Pertussis

9

Morbilli

0

Rubella

0

Varicella

1659

Parotitis epidemica

12

Meningitis epidemica

4

Meningitis virosa

20

Encephalitis

2

Leptospirosis

1

Mononucleosis infectiosa

  132

Erysipelas

 101

Tuberculosis

72

Gonorrhoea

1

Syphilis

1

Trichinellosis

1

Leishmaniasis cutanea

1

Scabies

52

Toxoplasmosis

4

Brucellosis

3

HFRS

4

Meningitis bacterial

 4

Legionellosis

4

Enterovirosis

  94

Pediculosis

38

Taeniasis

1

Pneumonia

483

Herpes zoster

284

Lyme borreliosis

13

Chlamydiasis

43

Helminthiasis

31

Rickettsiosis

2

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