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COMMUNICABLE DISEASE SURVEILLANCE IN CROATIA

•    Communicable disease case notification in November

T y p h u s   a b d o m I n a l I s. (typhoid fever). After rather a long period of zero incidence, one case was registered in November in  Novi Marof. Source of infection not discovered.

S a l m o n e l l o s i s . As expected the number of cases decreased further in November (251:300). Intensity was higher in November last year (415). Small clusters are detected in Rijeka (11) and Zagreb Susedgrad (21).

H e p a t i t i s  A (epidemic jaundice). Low incidence continues. Three sporadic cases registered in  November.

T e t a n u s. One cases reported in November from Ivanec in an old unvaccinated person.

P e r t u s s i s  (whooping cough) Only 2 cases were reported in November which is less than in previous month (13) and also less than in November last year (11).

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

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

M e n i n g i t i s   e p i d e m i c a. Number of cases in November is slightly higher than in October (5:2). In November last year the number was similar (4).

I n f l u e n z a. In November a sharp increase of incidence of pandemic flu occurred. As already known pandemic flu  was  present in the country since July (see ENEWS no 8/2009),  but at a relatively low level. Basing on weekly cumulative reports from all counties,  the total of 34732 cases were registered in November. (See News and comments).

•      No reports in November from:

Cazma, Dvor, Glina, Kostajnica, Topusko, Pula, Rovinj, Drnis, Vis, Vrgorac, Lastovo, Metkovic and Velika Gorica. Total: 12 out of 113 epidemiological districts.

•      Epidemic outbreaks

Following outbreaks were reported in November:

Note: in all outbreaks presented here the epidemiology service conducted epidemiological investigation and applied measures preventing thus further spread and more cases.

Zadar – streptococcal sore throat in a kindergarten. Between 14.10 and 21.10. 2009 there were 12 diseases out of 71 exposed.

Bjelovar – aseptic meningitis among members of a sports club. There were 9 diseases out of 90 club members between 22.10. and 8. 11. 2009. Causative agent not found, microbiological examination were not performed. Mode of spread epidemiologically: by contact and partly via droplets. Some possible  favorable element were detected during the epidemiological investigation: sharing drinking water bottles during training and use of special glue on the palms for better adherence and control of the ball.

NEWS AND COMMENTS

•       Pandemic development

In November a sharp increase of incidence was documented (Graph 1). However  weekly numbers and  the total number  did not exceeded seasonal numbers until now.  Weekly dynamic is presented in Graph 1.  

Graph 1 Pandemic influenza in Croatia

In the last week of November certain decreases is registered, also seen in some other European mostly northern countries.

Age specific affection with pandemic flu is given in Graph 2 showing July - November cumulative figures. 

Graph 2 Age specific morbidity, pandemic flu , Croatia

All viral isolates were of pandemic AH1N1/pdm2009 type. No seasonal strains detected up to now.

•       Chapter 28  closed

In November the information came that  Chapter 28, named Health and consumers protection in the frame of negotiation process for Croatian accession to the European Union (domain of the EC DG SANCO) has been closed, i.e. work on the alignment of the Croatian and the EU legislature and praxis in this field  was finished successfully. For our epidemiology service this is of exceptional importance, because in this chapter, communicable disease surveillance and control was screened, along with some other topics (blood safety, organ and tissues management, public health preventive programs like smoking and tobacco control, the Croatian system of communicable disease surveillance and control is fully compatible wit the European legislature and praxis in all its parts, like outbreak investigations and interventions, mass vaccination program, communicable disease notification, also the profile, education and training of professionals working in this field i. e. epidemiologists and others, as well as organization of the service itself, having and sharing the world highest standards, that are currently implemented in the European legislature and praxis. Since the beginning of the screening process in 2006 it was assessed that Croatian system is well organized and efficient and already practically completely compatible to the European aquis with only few minor details to be aligned, which has been done until now. Within such an assessment good collaboration between health and veterinary sector in a filed of zoonoses in Croatia, regarding legislative and praxis was also recognized.

For experts epidemiologists of the Croatian national institute of public health,  the central institution of national communicable disease surveillance and control system, to whom the task and honor of presenting the Croatian system at the screening was given, this was a reason for satisfaction because this work was successfully completed, contributing thus to the health of the people.  Namely as already reported (see ENEWS 4/2008, 8/2008) since 2006 and up to now Croatia is included in all communicable diseases control systems in the EU, participating in all important information exchanges,  currently most  intensive communication is  on pandemic flu, as well as in the exchange of experiences and mutual collaboration.

COMMUNICABLE DISEASES IN CROATIA                   November 2009

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