Year three, no. 4 - April 2003 

Director’s introduction
Marijan Erceg, MD, MSc

The Ministry of Health, Croatia, established an interministerial Appointed Committee on SARS at Disease Prevention Headquarters. It set before it the aim of coordinating between different ministries their measures for preventing the introduction and spread of the disease. The Appointed Committee has prepared draft decisions whereby SARS would be placed on the list of infectious diseases in the Public Health Disease Protection Act and ensure the funds necessary for carrying out preventive measures.

Assistant Prof. Marija Strnad, MD, MPH, PhD, deputy general manager

On the occasion of the International Health Day (7 April), a lecture was given at the Ministry of Defense titled “Can we do more in cervical cancer prevention?” It was organised by the government-appointed committee on equality of sexes with M. Strnad and M. Grubisic as lecturers. 
It should also be mentioned that a Round Table Conference was held on the topic “Registry of Disabled” at the Zagreb City Forum. It was organised by the Zagreb Office of Health, Work and Social Policy and attended by professionals and executives of health, social, educational and other institutions and associations of the disabled. M. Strnad reported on the problems encountered in setting up the Registry of Disabled at CNIPH.
Guidelines for primary health care were discussed at Croatian Ministry of Health on 17 April 2003 during the third session of the Appointed Committee on Breast Cancer, whose member from CNIPH is Mrs. Strnad.
The minister of health has nominated the Appointed Commission on Oncology (its member from CNIPH is Mrs. Strnad). It held its first session on 25 April 2003, having on agenda the elaboration of Programme of Early Cancer Prevention and Detection in Croatia. 

EPIDEMIOLOGY SERVICE (Ministry of Health Reference Centre for Epidemiology) Head, Pr Vlasta Hrabak-Zerjavic, MD, MSc

· Infectious Disease Epidemiology Department

By 28 April 81,919 cases of influenza were reported in Croatia. According to the WHO, 4,836 cases of SARS were officially cumulatively reported by 26 April 2003. Of these 293 had died, with 2,239 people recovering by now. Not a single case of SARS was recorded in Croatia. As a precaution, the Epidemiology Department has organised on﷓duty shifts: after working hours until 17.00 hours, and on weekends from 08.00-15.00 hours. The Epidemiological Service put itself on permanent 24-hour stand-by via mobile phones. CNIPH's mobile-phone readiness number is 098 22 77 53. As to mobile phone readiness phone numbers of county public health institutes' epidemiologists, they can, among other, be found on CNIPH's web pages devoted to SARS. 
Also opened was a free phone line for citizens having questions about SARS. On working days, it operates from 00-19.00 hours. At other times, only essential information can be obtained from the automatic reply phone 0800 20 20 10.

A book named “Epidemiologija zaraznih bolesti” (infectious disease epidemiology) and published by “Medicinska naklada” was authored by Professor Darko Ropac et al. Professionals from this Department have also participated in this writing. Its festive promotion is scheduled for Thursday, 8 May, at 1 p.m., at Croatian Medical Association, Šubićeva 9, Zagreb. 

· Chronic Mass Disease Epidemiology Department

From 3-5 April, the head of service attended at Bled, Slovenia, the Ninth WHO Meeting of National Coordinators for European Action Plan against Alcohol. Its aim was to outline an implementation plan and present individual countries’ experiences in producing national action plans. Further, there was also discussion of preventative aspects of the anti-alcohol strategy, public health aspects of alcoholism-related therapies and an illustration of the European system for alcohol. Finally, general recommendations were provided for further activity. 

A portion of the Cancer Registry data was sent to the International Agency for Cancer Research in Lyon. It is intended as a supplement for EUROCIM’s (European Cancer Incidence and Mortality) database whose new edition is due in a few months. 

SOCIAL MEDICINE SERVICE
Head, Pr Marina Kuzman, MD, MSc

A Eurostat meeting on statistics of industrial accidents (ESAW) held in Luxembourg 1-2 April 2003 was attended by Pr Vlasta Deckovic-Vukres, MD, DSc, whom the State Bureau of Statistics had appointed, with the consent of the Ministry of Health, as a contact person for Eurostat for the area of industrial accident statistics and occupational diseases. 
Pr Marina Kuzman, MD, MSc took part as a member of the Croatian delegation at the 46th regular meeting of the Narcotic Drugs Commission in Vienna on 8﷓11 April. 
The third ESPAD survey on smoking, drinking and drug use is being done on a representative sample of secondary school pupils in their first and second classes.
At Rabac on 11-12 April, the Croatian Medical Association's Croatian Society for Occupational Health had its spring symposium at which a Round Table Conference dealt with the subject Regulation on Jobs with Special Working Conditions: Past Experience and New Suggestions. The Society had its regular annual assembly during the second half of the meeting. 
At CNIPH, there was in Zagreb a Training Course for Interviewers on the WHO project World Health Survey 13-15 April. Dr Alena Petrakova from WHO Regional Office for Europe in Geneva also attended it. Carried out in 73 countries, a sample of 1,000 households made by State Bureau of Statistics was run in Croatia. The questionnaire consists of three parts, the first looking into the characteristics of househoulds, the second into respondent characteristics and health service utilisation as well as into the health state of the respondent, and the third has questions for health workers, if any, living in the household. Completion of the interview will take an average of 90 minutes and require the use of the interview method. By a 19 December 2001 decree of the minister of health, Andre Vlahusic, MD, MSc, the survey is conducted in Croatia by CNIPH. To this has contributed a well-organised network of public health institutes in the field to whom CNIPH has turned for professional and logistical support anyway. The survey co﷓ordinator for Croatia is Pr Vlasta Deckovic-Vukres, MD, DSc. Dr Ivana Brkic, Dr Verica Kralj and Dr Zrinka Petrovic take care of survey running and control in the field. A pilot study should be started at the beginning of May 2003. 
The staff of CNIPH's epidemiology, microbiology and social medicine services took part 14-16 April in the invited and professional lectures at the Fifth Symposium on Sexually Transmitted Diseases in Opatija.

MICROBIOLOGY SERVICE
Head, Dr Vera Katalinic-Jankovic

Organised by INSTAND and WHO, the Fourth INSTAND/WHO Training Course (IWTC) took place in Germany on 16 February﷓2 March. It dealt with the subject of quality assurance in medical laboratories. Representatives of individual countries that take part in assuring the quality of operation of medical laboratories and heads of laboratories attended. Dr Vera Katalinic-Jankovic from CNIPH attended there on the part of Croatian Society for Medical Microbiology with Parasitology. The first week of the Course taking place in Düsseldorf was devoted to the WHO strategy and activities in the implementation and assurance of quality in medical laboratories of the developing countries. In the second week, it was held in Berlin at the medical laboratories taking part in EQAS (External Quality Assurance Scheme). The representative of Paul Erlich Institute, acquainted course participants with the EU directives on labelling, certifying of medical diagnostic tests and reagents before their first use in human diagnosis. Use was made of the opportunity to familiarize the attendees with the activity of the Institute for Infectious Diseases, Free University of Berlin, i.e. with quality assurance procedures in virology, and with laboratory activity of the Emil von Behring Clinic in the areas of molecular diagnosis in bacteriology and immunology. They were also acquainted with the implementation of guidelines in the area of mycobacteriology at the Robert Koch Institute. The Course reached a general conclusion, i.e. that there was a pressing need for national professional societies to ensure the implementation of internal and external quality control of medical laboratory operation, and future laboratory accreditation practices.

HEALTH ECOLOGY SERVICE
Head, Krunoslav Capak, MD, MSc

The 29th Symposium of Health Ecologists with International Participation was held at the Borik Hotel in Zadar 9-11 April 2003. It was organized by CNIPH and Croatian Pharmaceutical Society's Medical Ecology Chapter. Health via Food and Medicinal Plants was the subject of this traditional gathering. There were 20 oral presentations and 27 posters. The discussions were very dynamic and fruitful and the conclusions reached would be forwarded to the ministry of health, published in this “News” and in Croatian Pharmaceutical Society’s newsletter. This Service took part with 14 lectures and posters. They were on the subjects of with food and plants to health, promoting health and proper nutrition, etheric oils in aromatherapy, use of vegetable preparations in cosmetic products, lawmaker’s problems with arsenic and gluten and other topics from the areas of pesticides, heavy metals, food microbiology, mycotoxins, applicability of IR spectrophotometer in the identfication of packaging material, and problems of child poisoning with corrosive-causatic agents. The professional part of the symposium ended traditionally with a gala dinner and dance with the “Forum” group music, and an excursion to the Krka Falls and Visovac Island. At the end, we received much praise and many thanks for the very well organised, professionally useful and informative gathering.

On 3 April 2003 there was a promotion in the Zagreb Forum hall of the brochure “Prehrambene smjernice za odrasle” (nutritional guidelines for adults) under the auspices of the ministry of health. It was written by CNIPH and by Croatian Academy of Medical Sciences with the backing of a nongovernmental society Centre for Crisis Situations. The promotion was attended by some 60 representatives of the Ministry of Health, Ministry of Agriculture, Ministry of Environmental Protection, Croatian Institute for Health Insurance, county institutes of public health, Andrija Stampar School of Public Health, “Večernji List”, Croatian Chamber of Economy, Croatian Football Association, food industry, media (newspapers, radio), and the WHO Liaison Officer. The presentation also includes lectures: “Chronic noninfectious diseases in Croatia” (Assist. Prof. Marija Strnad, ScD), “Nutritional guidelines for adults” (Dr Zrinka Petrovic), “Diet and Noxious Substances” (Marijan Katalenic, MSc), “World Health Day – healthy children in healthy environment” (WHO Liaison Officer A. Kaic Rak, ScD), “Nutrition and sport” (Dr Tomislav Vlahovic, representative of Croatian Football Association). Croatian Ministry of Health published “Nutritional Guidelines” on World Health Day (April 7, 2003) as a contribution to the daily newspaper “Večernji list”.