Measles outbreak in Dubrovnik-Neretva County, Croatia, May to June 2018.

In May 2018, measles was introduced in the Dubrovnik region by an adult who recently travelled to Kosovo*. Control measures and an outbreak investigation were implemented: 15 epidemiologically-linked cases met the outbreak case definition of a visitor/resident of Dubrovnik-Neretva County with laboratory-confirmed measles and symptom onset beginning on May 19. New cases were identified through hospitals and primary care physicians. Throat swabs, urine and/or serum samples were collected from outbreak cases. RT-PCR detection of viral RNA and IgM/IgG was used to confirm infection. The median age of cases was 33 years, with one 8 month-old infant. Vaccination status was unknown for 9 cases, three were unvaccinated, one case had history of one dose and two cases reported receiving two doses of measles-containing vaccine. There were 11 hospitalisations and one person developed pneumonia. Control teams undertook an extensive search of contacts and implemented a range of control measures. Despite the outbreak occurring at the beginning of the summer tourism season, it was contained and did not spread to neighbouring regions. With continuing measles transmission in Europe, even small outbreaks create a burden on the health system in countries which have eliminated measles, and illustrate the importance of maintaining high immunisation coverage.

Enterotoxigenic and Antimicrobic Susceptibility Profile of Staphylococcus aureus Isolates from Fresh Cheese in Croatia.

Certain Staphylococcus aureus strains harbour staphylococcal enterotoxin genes and hence can produce enterotoxin during their growth in food. Therefore, food can be a source of staphylococcal food poisoning, one of the most common food-borne diseases worldwide. Epidemiological data show that S. aureus is often present in raw milk cheeses, and consequently, cheeses are often the source of staphylococcal food poisoning outbreaks. The aim of this study was to determine the phenotypic characteristics of S. aureus isolates from fresh cheese, including antibiotic susceptibility; the presence of classical sea-see enterotoxin genes through molecular methods; and the isolate's ability to produce SEA-SEE enterotoxins in vitro through reversed passive latex agglutination. A total of 180 coagulase-positive staphylococci were isolated from 18 out of 30 cheese samples, and 175 were confirmed as S. aureus through latex agglutination and API STAPH tests. All isolates possessed phenotypic characteristics typical for S. aureus, with certain variations in the egg yolk reaction (18.3% of the isolates showed a weak reaction and 28% no reaction at all) and haemolysis pattern (36.6% of the isolates produced double-haemolysis and 4.6% were non-haemolytic). Antibiotic resistance was observed in 1.1% of the isolates and to mupirocin only. Real-time PCR detected the sec gene in 34 (19.4%) isolates, but most isolates (80.6%) were not enterotoxigenic. For all 34 (19.4%) strains that carried the sec gene, the RPLA method detected the production of the SEC enterotoxin in vitro. For those enterotoxigenic strains, the possibility of enterotoxin production in fresh cheese could not be ruled out.

[The risk and protective cardiovascular factors in Dubrovnik-Neretva county in comparison with Croatia]. / Rizicni i zastitni kardiovaskularni cimbenici u Dubrovacko-Neretvanskoj zupaniji i u hrvatskoj--raspodjela i usporedba.

OBJECTIVE: To establish the prevalence of overweight, obesity, elevated systolic (SBP) and diastolic blood pressure (DBP), and adding salt to meals as cardiovascular risk factors; the prevalence of fruit and leaf-vegetable consumption; and the prevalence of physical activity at leisure time as protective factors in Dubrovnik-Neretva County (County); and to compare these data with the respective figures in the Republic of Croatia (Croatia). METHODS: We used the 2003 Croatian Health Survey (CHS 2003) to provide data for our study. The CHS 2003 was a cross-sectional survey in a random sample of the general population aged > or =18. RESULTS: In the County, the prevalence of obesity, SBP, DBP, adding salt to meals, physical activity and leaf-vegetable consumption was higher in male population, and the prevalence of fruit and other green-vegetable consumption in female population. The prevalence of SBP, DBP, physical activity and leaf-vegetable consumption was higher in the County compared with Croatia. CONCLUSION: The monitoring of all relevant indicators is required to identify the risks and protective cardiovascular factors in the County population, to allow for planning of public health programs for the prevention of cardiovascular disease.