INFECTIOUS DISEASE EPIDEMIOLOGY SERVICE

- Head, Prof. Dr Ira Gjenero‑Margan

As required by the Public Protection from Infectious Disease Act, a Vaccination Programme Proposal for 2006 was submitted in December for approval to the minister of health and social welfare.  Croatian Medical Association’s Epidemiologic Society held its winter session on 16 December in Zagreb.  During its first part, the Epidemiologic Society had the electoral gathering.  Borislav Aleraj, MSc was elected chair, his second term, and the best recognition for the effective and self‑sacrificing work in the first.  The second part of the convention was devoted to the Obligatory Vaccinations Programme in Croatia.

CHRONIC MASS DISEASE EPIDEMIOLOGY DEPARTMENT
- Head, Pr Vlasta Hrabak-Zerjavic, MD, MSc

On 5‑10 December, Pr Vlasta Hrabak‑Zerjavic, MD, MSc attended in Helsinki a WHO Meeting of National Coordinators for a European Strategy against Chronic Diseases, leading one of its three workshops.  As a member of the WHO’s Task Force for the Elaboration of a European Strategy against Chronic Noninfectious Diseases, she worked on the first version of the document.  To the European Conference on Chronic Disease Prevention organised by the Finnish National Institute of Public Health Pr Zerjavic presented a poster named “Epidemiologic analysis as a base for developing a health care measure programme according to health priorities”, whose first author she is.  Taking place in Cambridge on 1-3 December was a Luton/Cambridge International Conference on Mental Health, organised by the Bedfordshire Centre for Mental Health Research and by the Cambridge University.  It was attended by Pr Vlasta Hrabak‑Zerjavic, MSc and by Dr Maja Silobrcic Radic as invited lecturers on the prevalence of mental disorders in Croatia and on our national registries (“The Magnitude of Mental Disorders in Croatia”, and “Croatian Mental Disorder Registries: Croatian Psychoses Registry/Croatian Committed Suicides Registry”).  Conference subjects were stigma, psychiatry in the community, early intervention, epidemiology and cultures, biological psychiatry, psychiatric practice, international prospects, and the psychic trauma‑psychosis relationship. 

SOCIAL MEDICINE SERVICE

- Head, Pr Urelija Rodin, MD, MSc

Aged 45, our beloved colleague Dr Ivan Sarac left us after a severe illness on Christmas Eve, 24 December 2005.  From 1987‑92, he worked as a primary care physician in Tomislavgrad, his birthplace.  With the outbreak of war in Bosnia‑Herzegovina as Herzeg‑Bosnia’s first minister of health, he organised health care for the whole population and its defenders.  From 1997 on, he was a medical officer in the Croatian Army where, as a colonel, he became an advisor on defence planning, health care and collaboration with NATO.  In 1998, he became a public health specialist, also completing a postgraduate course of the same name.  Representing Croatia, its army and Croatia’s war experience in humanitarian work, he attended international seminars, courses and conferences.  Dr Sarac made several such trips to the US, and then to Germany, Macedonia, Italy, and Great Britain; he underwent further training in Netherlands as well.  At the end of 2003, he joined CNIPH’s Social Medicine Service, heading its Health Policy and Health System Department.  The focus of his public health interest was on health policy definition and implementation, and on the planning and financing of health care.  Highly enthusiastically, he started a number of initiatives such as the project on systematic information and linking of health decision‑makers with politicians/parliamentarians, as well as with decision‑makers (the ministry).  Another important work that he had started involved the health legislation area and the monitoring of health regulations for the needs of harmonising Croatia with the EU’s acquis communautaire.  We shall be missing a colleague and a friend, with whom to our regret we have shared too little time, not only as a health professional, but also as a proud and honourable man.

MICROBIOLOGY SERVICE
- Head, Prof. Dr Gordana Mlinaric-Galinovic

The 69th Scientific-Technical Symposium Emergent Infectious Diseases took place on 9 December in Zagreb at Dr Fran Mihaljevic Infectious Disease Clinic.  The chief topic was the current avian and human influenza, which was covered by lectures from the clinical, epidemiologic, immunopathogenic, microbiologic, sociologic and veterinarian aspects.  Besides the Clinic’s lecturers, there were those from CNIPH.  Dr V. Drazenovic, head of the National Centre for Influenza, attended for our Service, i.e. for its Virology Department with a lecture ‘Peculiarities of the Influenza Virus’.  The National Centre for Influenza has been monitoring since 1977 the influenza viruses circulating in the population; as to the A/H5N1/, the Centre has been monitoring it since 1998.  There have been no reports of the human cases of infection with the A/H5N1/ viral subtype thus far.  Despite this subtype circulating in the world since 1949, and not having undergone significant antigenic changes, it is still considered a “candidate” for a new pandemic strain of human influenza.  

After an intermission, a programme from the project ‘Tuberculosis – renewed challenge for physicians at the beginning of the third millennium’ restarted on 10 December 2005.  It was organised by the Jordanovac Pulmonary Disease Clinic, Croatian health ministry, and by the Open Society Croatia Institute.  This time it was designed for general practitioners and paediatricians from the Zagreb area.  The Symposium heard the lecturers of professionals from various health institutions in Zagreb.  Dr Aleksandar Simunovic and Dr Vera Katalinic‑Jankovic presented their respective lectures ‘Epidemiology of tuberculosis, interventions and treatment outcome’ and ‘Microbiologic methods in TB diagnosis and proper sampling’.  The conferees took an entry knowledge tests as well as an evaluative test after the completion of all lectures and workshops.                                

ENVIRONMENTAL HEALTH SERVICE

- Head, Krunoslav Capak, MD, MSc

A Symposium on Noise and Health sponsored by the Croatian Academy of Medical Sciences and by the Ministry of Environment, Space Planning and Construction of the Republic of Croatia was held at Croatian Medical Association.  Its co‑organisers were Croatian Society for Medical Ecology and Croatian Society for Occupational Health.  One hundred twenty conferees heard eight lectures through which professionals in different technical and scientific fields exchanged their experience and knowledge about noise as an important and ubiquitous individual, public health and ecological problem, whose significance is still insufficiently recognised.  Through interdisciplinary approach, the lecturers presented their new knowledge of the type, duration and amount of noise, its influence on health, as well as on the legislation, its implementation and preventive actions aimed at preventing the development of the diseases due to noise.  Back in 1971 a WHO Working Group emphasised that noise must be recognised as a major threat to human wellbeing (Suez, 1973), which was in agreement with the conclusions of this symposium.  In fact, as a regular accompaniment in general and professional life, noise poses a major problem with expressed health (of the individual and population) and social components.  The symposium passed guidelines and harmonised technical standpoints, taking the implementation of the EU and WHO recommendations and noise control measures as a basic determinant.   Although Croatia has recognised the problem of noise, efforts to find its solution are still insufficient.  Available for the present are only the Noise Control Act of 2003 (Official Gazette of the Republic of Croatia, OGRC, 20/03) and Working and Living Environment Maximum Noise Allowance Ordinance (OGRC 145/04).  As sanitary inspectors measure noise only where a complaint has been lodged, neither noise maps nor action plans are made.    One should continue the efforts to wake an “average person”, health workers, employers and state administration to reality.  When the damage arising from noise has set in the problem is either largely irreversible or only partly capable of solution.  This reemphasises the need for timely measures and actions aimed to forestall such damage or substantially reduce it.  It is important for the individual to collaborate by his/her behaviour in the prevention of hearing damage.  This involves reducing the exposure to excessive noise at the working post, ‘corking’ one’s ears against boom  cars, using the sound‑absorbing materials, not using several noisy implements simultaneously, avoiding amplifying one sound on top of another.  The immediate environs allowing, plant seedlings (especially of broad‑ and long‑leaved plants) to absorb the noise.  Children and the adults over 70 require special protection from noise.  Individuals with an at‑risk hearing should have their hearing tested annually.  Where hearing damage has been proved to be due to noise, control examination is needed every six months; besides tonal audiometry the individual should undergo speech audiometry.