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

· Infectious Disease Epidemiology Department

The Congress on Preventive Medicine, i.e., its Section on Immunisation, Prevention and Control of Infectious Diseases pointed out how successful so far the epidemiological strategy of using mass and obligatory immunisations has been. There has been a considerable reduction in the morbidity of immunisable diseases and even eradication of such as diphtheria and poliomyelitis. It was concluded that the high achievements in epidemiological surveillance of classic infectious diseases had resulted from a nation-wide establishment of a network of public health institutes with outposts and microbiological laboratory diagnostic facilities. This constitutes a solid base for the first degree of surveillance over outbreaks of unexpected incidental epidemic changes, a potential bioterrorist tool. Diseases caused by new causative agents with altered properties, e.g. multiresistant microorganisms, mutants, and newly arisen diseases should be a field of major interest, with county institutes of public health being at the front line of defence. This calls for improved monitoring of the epidemiological status in our neighbouring countries as well. The Department physicians have authored/coauthored five oral communications and four posters at the Congress.  

· Chronic Mass Disease Epidemiology Department

On 15-18 November, the head of service attended in Tirana, Albania, a meeting of Health Development Action for South-Eastern Europe programme national programme coordinators. Presented there was a report on ongoing projects (mental health, infectious disease surveillance, health safety of foods). Also discussed were the projects in preparation (emergency medical care, strengthening of tobacco use prevention and control, development of a health and social welfare information collection and exchange system etc.). 

Eleventh Congress of the European Union Public Health Asscoiation (EUPHA) was held in Rome 20-22 November 2003. It dealt with the topic of globalisation and health in Europe: harmonising activities in public health. As a coauthor, Ariana Znaor, MSc, took part in the Health Indicators Section II of the Congress with the paper “Development of the population-level disease recording system in Europe”. 

Dr Maja Silobrcic attended the Thirteenth International Conference on Depression, organised by the Papal Council on Pastoral Health taking place at Vatican 13-15 November 2003. The Conference chaired by Cardinal Xavier Lozano Barragan aimed at presenting the problem of depression not only from the medical, but also psychological, sociological, and mainly theological aspect. For each of these approaches it provided guidelines on the feasibility of preventive action. At the close of the Conference, the conferees had an audience with the Pope. 

At the Prevention and Control of Chronic Noncommunicable Disease Section (cardiac, malignant neoplastic and mental diseases) of the First Croatian Congress on Preventive Medicine, conferees from this service gave six oral communications and seven posters. 
 

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

The School Medicine Section of the First Croatian Congress on Prevention Medicine called attention to the increased incidence of risk behaviour and risk habits among children and to their consequences. It took note of the growing problems of violence against children and of violence amongst children, and of the problem of including Romany children into regular schools. The Section sought to sensitize conferees to the problem of freeing from stress; the conclusion reached being that optimum stress protection required collaboration among school doctors, gynaecologists, psychologists and psychiatrists. Speaking of information and communication technologies, attention was called to the importance of transforming the information system from ineffective to a functional and effective one, which would be based on the use of Internet technologies and the building of necessary infrastructure. This could be a means to establish communication among all concerned in health, and for making new information available. At the Congress, our service staff gave six oral communications and nine posters. 

MICROBIOLOGY SERVICE
Head, Dr Vera Katalinic-Jankovic

The Fifth European Congress on Chemotherapy and Infections, organised by the Federation of European Societies for Chemotherapy and Infection (FESCI), took place 17﷓20 October 2003 on Rhodes, Greece. Thematically, there were three parts: most common infections in the general population, infections among surgical patients, and regional problems with bacterial resistance in the Southern and Eastern Mediterranean countries. B. Hunjak, MSc, from our Bacteriology Department presented the paper “Drug resistance analysis of E. coli isolates in North Croatia”. The Congress noted that the bacterial resistance-related problems are roughly the same in every part of Europe and that new antibiotic drugs needed to be developed. From many interesting topics, we would single out the newly discovered molecular methods for the detection of resistance in Gram-negative bacteria and the molecular methods for uncovering the resistance mechanisms. Communications covered the experience of the European countries using use on a larger scale some newer antibiotics, and some drugs at the experimental stage of development, which promised progress in the treatment of infections caused by drug-resistant bacteria. 

In conclusion, because of the growing global problem of bacterial drug resistance the Conference called attention to the neeed for professionals in this field from all over Europe (and Russia) to improve their collaboration. 

The microbiology section of the First Croatian Congress on Preventive Medicine emphasised the importance of diagnostic and clinical work of microbiological laboratories within public health institutes. It stressed the need for rapid diagnosis and prevention of congenital toxoplasmosis and sexually transmitted chlamydial/urealplasmic/mycoplasmic infections among the risk population. Another point emphasised was the key role of rapid detection of the causative agent of tuberculosis for controlling this disease. From a public health standpoint, the problem of bacterial antibiotic resistance requires not only an adequate monitoring, but also the provision of information to and supplementary training of medical workers. For the population at large the need is the same if one is to achieve a rational use of antibiotic therapy. The staff of this service illustrated their activity through five oral communications and four posters.

HEALTH ECOLOGY SERVICE
Head, Krunoslav Capak, MD, MSc

On the subject of environmental protection (water and food safety surveillance), the need for the protection of water as a strategic health and economic resource of the 21st century was stressed at the First Croatian Congress on Preventive Medicine; in this, health service should play a key role in the surveillance, legislation and education. Achieving this goal necessitates a change in the habits of social community and population with regard to environment and water. In connection with toxicology and other topics, the conferees emphasised the need for better collaboration among public health laboratories and their continuing sophistication in order to create an effective system for the monitoring, prevention and sanitation of health risks. It also called attention to the fact that with the coming into force of the Food Act the labelling of foods containing genetically modified raw materials became obligatory. The Service staff took part as exhibitors and as authors of 12 lectures and 9 posters.