Year three, no. 9 - September 2003 

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

The first session of the Scientific Committee of the First Croatian Congress on Preventive Medicine and Health Promotion was held at CNIPH 23 September. It agreed on a reviewing method for the abstracts received (numbering around 250). 

The Ninth Annual Meeting of the Croatian Gastroenterologic Society held 26-28 September in Opatija had colonic carcinoma for topic. Carcinoma of the colon is a growing public health (second most common cancer site in both sexes) and clinical problem in Croatia. Consequently, the session was devoted to epidemiological subjects (M. Strnad gave a lecture “Colon cancer epidemiology in Croatia and abroad”), early detection, presentation of a national study for its early detection, diagnostic and therapeutic algorithm, and ethics in gastroenterology.


OFFICE OF THE DIRECTOR

· Health Promoting Department

This year, the World Heart Day was marked on 28 September with the slogan “Women, heart diseases and cerebral insult”, intended to stress the importance of cardiovascular diseases as the leading cause of death in women. Educational and promotional material was distributed, for the occasion, by CNIPH in collaboration with Belupo (a pharmaceutical firm) to all family physicians in Croatia. The same day, a promotion was organised at the Trg Bana Josipa Jelacica jointly with the Croatian Cardiological Society and Zagreb Office for Health, Work and Social Welfare. Interested citizens could have their blood pressure measured there and they were given advice for healthier lifestyle and prevention of cardiovascular diseases. 

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

· Infectious Disease Epidemiology Department

A meeting of all epidemiology service heads from public health institutes from all counties and the City of Zagreb took place at CNIPH 29 September. Agreed were disease prevention activities in connection with the coming influenza season, including the vaccine distribution plan across counties. A Compulsory Immunisation Schedule for 2004 prepared by this Department was proposed. Following the WHO instructions, Head of the Epidemiology Department also presented instructions covering SARS prevention and control procedures in the postepidemic period. To meet the requirements of rapid diagnosis of virological respiratory diseases, all epidemiologists received smears and transport media prepared at the Virology Division. Epidemiologists also debated the need for central distribution of vaccines and gammaglobulins for individual high-risk groups.

Conferees from Albania, Bosnia-Herzegovina, Bulgaria, Macedonia, Romania, Turkey, Slovenia, Serbia and Montenegro, Kosovo and Croatia attended the Third Regional Meeting of National Co-ordinators for Tuberculosis Control Programme, which was held 5-9 September at Ohrid, Macedonia. The Meeting heard a proposal for guidelines on future regional collaboration in the area of tuberculosis control. For Croatia, the conclusions reached require us to create bases for the introduction of so-called “treatment outcome” category, or insight into the outcome of treatment, as one of the parameters to monitor and evaluate the tuberculosis surveillance programme.

· Chronic Mass Disease Epidemiology Department

The 12th World Conference on Tobacco or Health was held 3-8 August in Helsinki. The Head of this Service attended the Conference in the capacity of a member of the International Advisory Board to the Conference. Dr Verica Kralj attended as the first author of a poster “The prevalence of smoking in Croatia”. For main theme, the Conference had a Framework Convention on Tobacco Control and Examples of “Best Practice” of the application of its guidelines on its determinants on the national and international planes. As to other themes, we would single out a presentation by R. Peto et al., of mortality trends caused by tobacco consumption, and that by J. E. Henningsfeld about the ways in which tobacco industry is trying to produce the cigarettes whose consumption leads to addiction more rapidly, and about the need to control such manufacture. The conferees also took part in a number of activities to mark the World Heart Day.

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

A course named “Media Training” and given 19-20 September at CNIPH, was attended by 16 staff members from all CNIPH’s services. At a highly interesting and dynamically organised course conducted by a radio and a TV newspaperman, participants acquired useful information about the design of messages sent through the media, and received some basic advice for successful appearance in the media. Among other, the course practical dealt with writing media communications and announcements, organising press conferences, taking part in a radio interview and giving statements for TV.

Such advice is particularly useful to the public health staff intent on successfully transmitting and making understandable to ultimate user the messages about disease prevention, health promotion and other activities connected with health maintenance and health promotion.

MICROBIOLOGY SERVICE
Head, Dr Vera Katalinic-Jankovic

Organised in Paris by the National Reference Centre for Tuberculosis of the Pasteur Institute, a “Molecular Tools and Epidemiology of Tuberculosis Course” was given on 1-12 September 2003. It was attended by Mihaela Obrovac, ChE, from the Bacteriology Department. The Course consisted in lectures and a practical directed at the application of molecular techniques required in the epidemiology of tuberculosis, and at analysis and application of the results obtained from various epidemiologic investigations of intrahospital epidemics of tuberculosis, multiresistant tuberculosis, and from results of the national and European monitoring of tuberculosis. The lectures and practical covered different techniques for molecular typing of M. tuberculosis, i.e. IS6110-RFLP and the techniques based on polymerase chain reaction (spoligotyping, LM-PCR and MIRU﷓VNTR). At completion of the Course, each participant received a Pasteur Institute diploma.

HEALTH ECOLOGY SERVICE
Head, Krunoslav Capak, MD, MSc

The opening of the first Croatian laboratory for the detection of genetically modified organisms took place at CNIPH on 4 September 2003. The fact that a legal framework is being created in Croatia to allow the marketing of foods having genetically modified ingredients or ingredients derived from these has also necessitated the setting up of a laboratory to identify the presence of genetically modified ingredients in foods. 

The initiative taken by CNIPH in 2000 to establish such laboratory met with offer of financial support by the ministries of health, agriculture and forestry. The newly opened laboratory will be instrumental in securing implementation of regulations in this area, and of protection for consumer health and consumer interests. It was built and equipped through advisory assistance from Joint Research Centre, Ispra, Italy; EU Reference Laboratory for GMO Detection; Training Centre for GMO Analysis and with the assistance of the co-ordinator of the European Network of GMO Laboratories where our laboratory staff also underwent the training. Very shortly, we shall apply for accreditation under the international norm for testing laboratories, as well as carry out the procedure for joining the European Network of GMO Laboratories, which will enable analytical findings to be recognised internationally, as well as the execution of international laboratory intercalibrations and an exchange of information among professionals. 

Identification of genetically modified organisms and genetically modified ingredients in foods will give consumers a choice, ensuring that those consumers who have opted for GMO food get in a responsible manner and in conformity with regulations the products having the properties offered by biotechnology. The laboratory will do the testing for GM raw materials, semiprocessed products, and fabricated meals for humans and animals. The testing includes qualitative and quantitative methods. Qualitative methods are the rapid “screening” methods (providing a yes/no answer) and identification methods for the unique modification in DNA. As regards quantitative methods, being exceptionally sensitive they will enable the determination of the proportion of GMOs in a food item. In this way, such food will be reliably controlled and marked on our market. Detailed requirements for labelling of new foods will be prescribed by enforcement regulations within the new Food Act.