hcdcp e-bulleting july 2012

15
Hellenic Center for Disease Control and Prevention Agrafon 3- 5, Maroussi, 15123, Tel: +30 210 5212000, [email protected], http://www.keelpno.gr July 2012 ISSN 1792-9016 Vol. 17/ Year 2nd MINISTRY OF HEALTH HCDCP HELLENIC CENTER FOR DISEASE CONTROL & PREVENTION MINISTRY OF HEALTH Beautiful and crystal-clear Greek bathing waters and beaches In the developed world, psychological (i.e. stress) and social (i.e. economic difficulties/unemployment) determinants of health play a large part in defining the health status of the population. Within this framework, a person’s close contact with nature and living, even for a short while, amid the beauty of a clean and safe natural environment, play a major, some might say crucial, role in maintaining a level of good health for the individual, and society in general. Escaping from the everyday routine, the fresh air of the countryside, bathing and playing in the crystal-clear sea contribute decisively to mental calmness, relaxation and psychological and physical ‘detoxification’ of the modern individual, and therefore are essential for the protection and improvement of a person’s health status. Taking the above into consideration, we have decided to deviate slightly from the strictly public health topics of the e-bulletin, and dedicate the second summer edition of this year’s e-bulletin to the beauties of the Greek countryside and, more specifically to the wonderful, clean and safe Greek beaches. So, we hope to provide a more refreshing and calming experience for our readers. It is well known that Greece has very mild climate conditions and is blessed with outstanding areas near the sea, thus it is not difficult to offer our readers a short trip to some of the most picturesque seashores in our country, through photographs that have been taken by members of the editorial board. This trip to beautiful and very clean sandy beaches and crystal-clear waters starts in the Ionian Sea, from the islands of Ithaca, Kefallinia and Antipaxoi, crosses to the mainland in the Thesprotia region, to Chalkidiki and Pelion to Foinikounta and Mani in the south Peloponnesus, moves to the Aegean Sea from the island of Evvoia to Samos, Chios and Nisyros, and finally ends up in the Cyclades, the islands of Amorgos and Koufonisia, to Kithira and Crete. On the other hand, public health is defined as the ‘collective action for sustained population-wide health improvement’. Meaning that the natural environmental treasure comprising the Greek beaches should be monitored continuously and protected through well-organized actions and interventions in order to maintain its unique value for people’s good health and well-being. For these reasons, the Greek state, and more specifically the Special Secretariat for Bathing Waters of the Ministry of Environment and the Public Health Laboratories Network of HCDCP (Ministry of Health), stay vigilant and perform regular sampling of the bathing waters across the country to monitor and secure their quality. The excellent results, in terms of quality and safety, of these assessments are presented in this e-bulletin and rank Greece bathing waters among the best two or three in Europe (see the relevant map on page 6). We wish you all a good holiday: enjoy the summer and the Greek beaches, and always respect the safety rules for activities in and around the water! Philip Koukouritakis Editorial: Bathing water quality in Greece 2 Our favourite Greek beaches 8 Surveillance Data 22 HCDCP’ s Departments Activities 26 Outbreaks around the world 27 News from the HCDCP’s administration 28 Contents: Follow us on twitter: ΚΕΕΛΠΝΟ_HCDCP

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Page 1: HCDCP e-bulleting July 2012

Hellenic Center for Disease Control and PreventionAgrafon 3- 5, Maroussi, 15123, Tel: +30 210 5212000,[email protected], http://www.keelpno.gr

July 2012 ISSN 1792-9016Vol. 17/ Year 2nd

MINISTRY OF HEALTH

HCDCP

HELLENIC CENTER FORDISEASE CONTROL & PREVENTION

MINISTRY OF HEALTH

Beautiful and crystal-clear Greek bathing waters and beachesIn the developed world, psychological (i.e. stress) and social (i.e. economic difficulties/unemployment) determinants of health play a large part in defining the health status of the population. Within this framework, a person’s close contact with nature and living, even for a short while, amid the beauty of a clean and safe natural environment, play a major, some might say crucial, role in maintaining a level of good health for the individual, and society in general. Escaping from the everyday routine, the fresh air of the countryside, bathing and playing in the crystal-clear sea contribute decisively to mental calmness, relaxation and psychological and physical ‘detoxification’ of the modern individual, and therefore are essential for the protection and improvement of a person’s health status. Taking the above into consideration, we have decided to deviate slightly from the strictly public health topics of the e-bulletin, and dedicate the second summer edition of this year’s e-bulletin to the beauties of the Greek countryside and, more specifically to the wonderful, clean and safe Greek beaches. So, we hope to provide a more refreshing and calming experience for our readers.

It is well known that Greece has very mild climate conditions and is blessed with outstanding areas near the sea, thus it is not difficult to offer our readers a short trip to some of the most picturesque seashores in our country, through photographs that have been taken by members of the editorial board.

This trip to beautiful and very clean sandy beaches and crystal-clear waters starts in the Ionian Sea, from the islands of Ithaca, Kefallinia and Antipaxoi, crosses to the mainland in the Thesprotia region, to Chalkidiki and Pelion to Foinikounta and Mani in the south Peloponnesus, moves to the Aegean Sea from the island of Evvoia to Samos, Chios and Nisyros, and finally ends up in the Cyclades, the islands of Amorgos and Koufonisia, to Kithira and Crete.

On the other hand, public health is defined as the ‘collective action for sustained population-wide health improvement’. Meaning that the natural environmental treasure comprising the Greek beaches should be monitored continuously and protected through well-organized actions and interventions in order to maintain its unique value for people’s good health and well-being. For these reasons, the Greek state, and more specifically the Special Secretariat for Bathing Waters of the Ministry of Environment and the Public Health Laboratories Network of HCDCP (Ministry of Health), stay vigilant and perform regular sampling of the bathing waters across the country to monitor and secure their quality. The excellent results, in terms of quality and safety, of these assessments are presented in this e-bulletin and rank Greece bathing waters among the best two or three in Europe (see the relevant map on page 6).

We wish you all a good holiday: enjoy the summer and the Greek beaches, and always respect the safety rules for activities in and around the water!

Philip Koukouritakis

Editorial: Bathing water quality in Greece 2

Our favourite Greek beaches 8

Surveillance Data 22

HCDCP’ s Departments Activities 26

Outbreaks around the world 27

News from the HCDCP’s administration 28

Contents:

Follow us on twitter:

ΚΕΕΛΠΝΟ_HCDCP

Page 2: HCDCP e-bulleting July 2012

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Editorial Editorial

Tips

Bathing water quality in Greece

The quality of bathing water in Greece has been monitored systematically since 1990 according to Directive 76/160/EEC ‘On the quality of bathing waters’ under a program organized and coordinated by the Ministry of Environment, Energy and Climate Change (MEECC). Since 2010, the quality of bathing water has been monitored in accordance with the new Directive 2006/7/EC ‘Concerning the management of bathing water quality’ as translated into Greek legislation with JMD 8600/416/E103/2009 (GG 356V/2009) under the ‘Country’s monitoring program for bathing water quality’.

Bathing water quality assessments are carried out:

• in relation to each body of bathing water• after the end of each bathing season• on the basis of the bathing water quality data compiled in relation to that current bathing

season and the three preceding seasons. The quality parameters monitored are grouped into two categories.

• Visually monitored: tarry residues, glass, plastics, rubber or any other waste.• Microbiological: Coliform bacteria (Escherichia coli) and Enterococci (intestinal

enterococci), which are used for the classification and quality status of bathing waters according to Table 1.

Table 1

Parameter Excellent quality Good quality Sufficient

qualityReference methods of analysis

Escherichia coli (CFU/100 mL) 250* 500* 500** ISO 9308-3 or ISO 9308-

2Intestinal enterococci (CFU/100 mL)

100* 200* 185** ISO 7899-1 or ISO 7899-2

*Based on a 95‑percentile evaluation. **Based on a 90‑percentile evaluation.

Bathing waters are classified as ‘excellent’, ‘good’ and ‘sufficient’ quality:

• if, in the body of bathing water quality data for the last assessment period, the percentile values for microbiological enumerations are equal to or better than the respective values set out in Table 1, and

• if the bathing water is subject to short-term pollution, on condition that• adequate management measures are being taken, including surveillance, early warning

systems and monitoring, with a view to preventing bathers’ exposure, by means of a warning or, where necessary, a bathing prohibition

• adequate management measures are being taken to prevent, reduce or eliminate the causes of pollution, and

• the number of samples disregarded because of short-term pollution during the last assessment period represented no more than 15% of the total number of samples provided for the monitoring calendars established for that period, or no more than one sample per bathing season, whichever is the greater.

The bathing water quality for 2011 was monitored and assessed within the framework of the ‘Monitoring program of bathing water quality’ that was implemented under the supervision of the Special Secretariat for Water of MEECC. Specifically, during the bathing season for 2011 (1 June 2011–31 October 2011) 2,149 coastal bathing waters were monitored, of which 2,041 (94.71%) were of excellent quality, 87 (4.04%) were of good quality, 16 (0.74%) were of sufficient quality and only five (0.23%) were of poor quality, as shown in the following map. These excellent results rank Greece bathing waters among the best two or three in Europe.

During 2012, the Registry of Bathing Water Profiles will be completed and disseminated through an interactive website to ensure that, by the end of the 2015 bathing season, all bathing waters are of at least ‘sufficient’ quality.

In the context of assessing the bathing water quality, the Central Public Health Laboratory analyzed, during the time period 2008–11 June 2012, 2,748 bathing water samples, of which 96.4% were of excellent quality, 3.3% were of good quality and 0.3% were of poor quality, as shown in Tables 2 and 3.

Table 2: Distribution of bathing water samples during the time period 2008–11 June 2012

Year

2008 2009 2010 2011 2012 2008–11 June 2012

Number of samples 610 480 568 721 369 2748

Table 3: Results of the assessment of the quality of bathing water samples during the time period 2008–11 June 2012

Number of samples Quality Percentage

2,649 Excellent 96.490 Good 3.39 Poor 0.3

Joanna Spiliopoulou, Doctor Biopathologist

Some preventive rules for safe activities in or around the water are:

1. We do not swim alone but only accompanied by others and in areas supervised by a lifeguard.

2. We do not swim earlier than 3 hours after the last meal or having consumed alcohol.

3. We do not swim far from the land, beyond the marked with buoys area, neither we overestimate our personal limits.

4. We always supervise young children.

5. If someone is in danger, we call 166 or 112 for help.

6. The correct sun protection requires the use of sunscreen, hat, remaining under the shade and the consumption of water or juices.

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Editorial Editorial

Page 4: HCDCP e-bulleting July 2012

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Editorial Editorial

Page 5: HCDCP e-bulleting July 2012

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The Kimi coast in North Evia, the balcony of the Aegean Sea, as described by the famous carver Galanis. Kimi is also the origin of the great George Papanikolaou Mr “Pap Test”.

G. Antoniou

Kimi Ithaca/ Kefalonia

Ithaca was the final destination of the ancient Greek hero Odysseus and the subject of a famous poem by the Greek poet Kavafis: ‘Once you start travelling to Ithaca’. Ithaca is an island next to Kefallinia in Greece, and both of them share wonderful, clean and numerous yellow and red sandy seashores.

Myrtos beach in Kefallinia has a rare type of very deep and turquoise water.

http://www.coolimagebank.gr/gallery/main.php?g2_view=core.DownloadItem&g2_itemId=7483&g2_GALLERYSID=5e2893a6f58a399eeee9a01ac33d451c

R.Vorou

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It is so nice to combine art with the sea. Have a beautiful summer.

A. Gavala

Kavourotrypes, Chalkidiki Foinikounta/ Kythira/Amorgos

Foinikounta hosted most of my childhood summer vacations. The essence of sage follows you from the first moment you arrive.

An old Greek song says ‘we’ll never manage to reach Kithira …’ and to that I add that if we ever do we’ll go straight for a sip of fatourada (the local spirit)!!

It was not by chance that they filmed ‘The Big Blue’ here. Plakes (= plates) beach on Amor-gos island is quite far removed from what we normally think of a beach, but it rewards any tourist who decides to visit the Small Cyclades.

E. Karatampani

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Sea water gently touches the earth. The majestic sky is watching from above.The wildness is make-believe. Because there, the absolutely pure and the real peace rule everything. Northern and southern Crete, sometime during the year, at the beginning of the 21st century.

P. Koukouritakis

North and south Crete Perdika, Thesprotia

Agia Paraskevi, Perdika/ Thesprotia

Karavostasi, Perdika/ Thesprotia

K.Mellou

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Samos Mani, South Peloponnesus

Driving from Vathi to Karlovassi, just after Kokkari village, we parked the car under some pine trees and walked down the little pathway to the sea. Shortly after, we reached the reddish, sugary beach of Tsamadou.

‘This is where Virgin Mary holds the sea inside her apron …

D, Papaventis

Deep blue, refreshing water, soft sand, many luxuries.

T. Patoucheas

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Chios, Mavra Volia Chiliadou beach, Evia

‘… Two big black pebbles safe the shutters of the blue window, always giving and never asking back, that is the place to live along with the immortals and the flowers into the glass …

Poet Manos Eleftheriou (Music adaptation by Pantelis Thalassinos)

A. Pavli

Chiliadou beach on the island of Evia is a beautiful beach with pebbles. The deep water is a deep blue.

It is an ideal place for relaxation, carefree holidays and a lot of diving.

Happy holidays to everybody! This year we stay in Greece!!

V.Roumelioti

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Pachia Ammos (Rich Sand), Nisyros Mani, Pelion

According to Greek mythology, during the Clash of Titans, Neptune was chasing the Titan Polivotis across the Aegean Sea. Neptune then caught a huge piece of the island of Kos with his trident and threw it against the Titan. The rock crushed him and shaped the island of Nisyros on top of him. Where the mouth of Polivotis has lain ever since, a volcano formed ages ago, and when the entombed Titan moves his shoulders and roars, the whole of Nisyros is shaken by earthquakes.

To reach the beautiful beach of Pachia Ammos, you need take a 10-minute walk along a picturesque path. The beach is full of dark-colored, volcanic sand.

V.Smeti

Gnospi beach, Agios Nikolaos, Mani: Unprecedented dives from perfect rocky beaches with crystal-clear waters!

Paou beach, Pelion: The sheltered beach in Pagasitikos bay rewards each visitor.

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On the way to Trikeri, Pelion: The mountain of the Centaurs with its enchanting clear blue waters ...

M.Fotinea

Pelion Agistri

These are not exotic beaches far, far away … They are Greek sandy beaches in Koufonisia and Agistri. Enjoy them!!

E. Hatzipashali

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Surveillance data Surveillance data

Table 1. Number of notified cases in June 2012, median number of notified cases in June for the years 2004−2011 and range, Mandatory Notification System, Greece.

Disease Number of notified cases

June 2012 Median number June 2004−2011 Range

Botulism 0 0 0-1Chickenpox with complications 1 3 0-11Anthrax 1 0 0-1Brucellosis 11 21.5 6‑59Diphtheria 0 0 0Arbo-viral infections 0 0 0Malaria 11 2.5 1‑5Rubella 0 0 0Smallpox 0 0 0Echinococcosis 0 1.5 0‑4Hepatitis Α 1 4.5 1‑14

Hepatitis B, acute & HBsAg(+) in infants < 12 months 7 6 1-20

Hepatitis C, acute & confirmed anti−HCV positive (1st diagnosis) 1 2.5 0-8

Measles 1 0.5 0‑52Haemorrhagic fever 0 0 0-2Pertussis 5 2.5 0-12Legionellosis 2 1.5 0‑4Leishmaniasis 4 4.5 2-9Leptospirosis 1 0 0-2Listeriosis 2 0 0-2EHEC infection 0 0 0-1Rabies 0 0 0-1Melioidosis/Glanders 0 0 0Meningitis

aseptic 38 23.5 9‑234bacterial (except meningococcal disease) 13 18 6-28unknown aetiology 0 2 1-6

Meningococcal disease 2 5 0‑14Plague 0 0 0Mumps 1 1 0-6Poliomyelitis 0 0 0Q Fever 0 0.5 0-2Salmonellosis (non typhoid/paratyphoid) 24 73.5 23-138Shigellosis 3 2 0-6Severe Acute Respiratory Syndrome 0 0 0Congenital rubella 0 0 0Congenital syphilis 0 0 0-1Congenital Toxoplasmosis 0 0 0-1

Cluster of foodborne / waterborne disease cases 0 5 2-8

Τetanus / Neonatal tetanus 1 0 0-1Tularaemia 0 0 0Trichinosis 0 0 0-1Typhoid fever/Paratyphoid 0 0.5 0-1Tuberculosis 47 68.5 41‑92Cholera 0 0 0

Table 2. Number of notified cases by place of residence (region)*, Mandatory Notification System, June 2012.Disease Number of notified cases

Region

Eas

tern

Mac

edonia

an

d T

hra

ce

Cen

tral

Mac

edonia

Wes

tern

Mac

edonia

Epirus

Thes

salia

Ionia

n isl

ands

Wes

tern

Gre

ece

Ste

rea

Gre

ece

Att

ica

Pelo

ponnes

e

Nort

her

n A

egea

n

South

ern A

egea

n

Cre

te

Unkn

ow

n

Chickenpox with complications 0 1 0 0 0 0 0 0 0 0 0 0 0 0Anthrax 0 0 0 1 0 0 0 0 0 0 0 0 0 0Brucellosis 0 0 0 1 2 0 2 1 3 2 0 0 0 0Malaria 0 0 0 1 0 0 0 1 5 4 0 0 0 0Hepatitis Α 0 0 0 0 0 0 0 0 0 0 0 0 0 1Hepatitis B, acute & HBsAg(+) in infants < 12 months 0 2 0 0 0 0 0 0 3 0 2 0 0 0

Hepatitis C, acute & confirmed anti−HCV positive (1st diagnosis)

0 0 0 0 0 0 0 0 0 0 0 0 0 1

Measles 0 1 0 0 0 0 0 0 0 0 0 0 0 0Pertussis 0 0 0 0 0 0 0 0 1 1 2 1 0 0Legionellosis 0 0 0 1 0 0 0 0 1 0 0 0 0 0Leishmaniasis 0 0 0 0 2 0 0 0 0 2 0 0 0 0Leptospirosis 0 0 0 0 0 0 0 0 0 0 1 0 0 0Listeriosis 0 0 0 1 0 0 0 0 0 1 0 0 0 0Meningitis aseptic 5 14 0 0 1 0 6 5 3 0 0 0 4 0 bacterial (except meningococcal disease) 1 3 0 0 1 0 1 0 5 0 0 1 1 0Meningococcal disease 0 1 0 0 0 0 0 1 0 0 0 0 0 0Mumps 0 0 0 0 0 0 0 0 1 0 0 0 0 0Salmonellosis (non typhoid/paratyphoid) 0 7 0 0 2 1 2 0 9 0 3 0 0 0Shigellosis 0 0 0 0 3 0 0 0 0 0 0 0 0 0Τetanus / Neonatal tetanus 0 0 0 1 0 0 0 0 0 0 0 0 0 0Tuberculosis 1 11 0 2 5 3 5 2 13 1 1 0 2 1

* place of residence is defined according to home address of cases Table 3. Number of notified cases by age group and gender*, Mandatory Notification System, Greece, June 2012.Disease Number of notified cases by age group (years) and gender

<1 1−4 5−14 15−24 25−34 35−44 45−54 55−64 65+ Unkn.

M F M F M F M F M F M F M F M F M F M F

Chickenpox with complications 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

Anthrax 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0Brucellosis 0 0 0 0 2 0 1 1 2 0 1 2 0 0 0 1 0 1 0 0Malaria 0 0 0 0 1 0 6 0 1 0 0 0 1 0 0 0 2 0 0 0Hepatitis Α 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Hepatitis B, acute & HBsAg(+) in infants < 12 months

0 0 0 0 0 0 2 1 1 0 3 0 0 0 0 0 0 0 0 0

Hepatitis C, acute & confirmed anti−HCV positive (1st diagnosis)

0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0

Measles 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Pertussis 2 2 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0Legionellosis 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0Leishmaniasis 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0Leptospirosis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0Listeriosis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0Meningitis aseptic 1 3 3 1 10 7 2 2 6 2 0 0 0 0 1 0 0 0 0 0 bacterial (except meningococcal disease)

0 1 0 0 0 0 2 0 0 0 1 0 1 1 1 1 3 2 0 0

Meningococcal disease 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0Mumps 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Salmonellosis (non typhoid/paratyphoid)

3 3 4 1 2 3 0 1 1 2 0 0 0 2 0 0 0 2 0 0

Shigellosis 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0Τetanus / Neonatal tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0Tuberculosis 1 1 0 0 0 0 5 0 4 2 3 1 1 0 7 1 11 10 0 0

*M: male, F: female

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Surveillance data Surveillance data

The presented data derive from the Mandatory Notification System (MNS) of the Hellenic Centre for Diseases Control and Prevention (HCDCP). Forty five (45) infectious diseases are included in the list of the mandatory notified diseases in Greece. Notification forms and case definitions can be found at the website of HCDCP (www.keelpno.gr).

It should be noted that data for June 2012 are provisional, and can be slightly modified/corrected in the future and also that data interpretation should be made with caution, as there are indications of under0reporting to the system.

Department of Epidemiological Surveillance and Intervention

Viral meningitis outbreak in Northern Greece, May‑July 2012

During the period 23/5/2012 to 23/7/2012, an outbreak of viral meningitis in Northern Greece was recorded, in particular at the regions of Central Macedonia, Western Macedonia, Eastern Macedonia and Thrace.

Forty seven (47) cases of viral meningitis were reported through the mandatory notifiable system, and were hospitalized at three (3) hospitals of Thessaloniki (General Hospital Papageorgiou, GN Papanikolaou and N.E.P.TH) and at the county hospitals of Alexandroupolis, and Kozani. During the same period, one (1) case and thirteen (13) cases of viral meningitis from Northern Greece were reported in 2011 and 2010 respectively.

The cases (30 males and 17 females) had mostly mild clinical presentation which was characterized by low grade fever (usually <38.50C), severe headache and retrobulbar pain, while some patients also experienced vomiting and diarrhea. Their clinical course was benign with remission of symptoms within 24‑36 hours of hospitalization. The prognosis was excellent with supportive treatment; all patients were cured and discharged from the hospitals. No death has been recorded.

Patients’ age distribution per gender is illustrated in Figure 1, showing that mainly were affected, children of 5‑14 (61.7%) years of age. Lumbar puncture, which was performed in all patients, revealed an increased number of cells (median: 154/mm3, range: 10‑1150), normal albumin (median: 45,5 mg / dl, range:10‑222) and normal glucose (median: 60 mg/dl, range:40‑87). A total of 19 cerebrospinal fluid (CSF) samples were sent to the National Reference Laboratory for Enterovirus – Hellenic Pasteur Institute and the 1st Department of Microbiology, Medical School of Aristotle University of Thessaloniki, while stool samples were also sent for some cases. Molecular analysis with PCR showed that 13 out of 19 patients (68%) were positive for enterovirus in CSF and by further analysing with sequencing Echo30 virus was identified. All cases, from whom enterovirus was isolated, aged below 14 years old. Some samples were also tested for West Nile Virus infection with none of them positive.

In conclusion, this is a viral meningitis outbreak in Northern Greece due to enterovirus Echo30 with a benign clinical course and excellent prognosis. The outbreak is in progress and is under investigation by the Department of Epidemiological Surveillance and Intervention of HCDCP.

Georgakopoulou Theano, Pipa Efthalia, Mavraganis Pantelis, Poufta Sofia, Vernardaki Alexandra, Office of Vaccine Preventable Diseases, Department of Epidemiological

Surveillance and Intervention

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Outbreaks around the world

Outbreaks around the world, July 2012

Cholera (Democratic Republic of Congo)

The Democratic Republic of Congo (DRC) has reported a sharp increase in the number of reported cholera cases in the armed conflict area of North Kivu; 368 new cases were reported for epidemiological weeks 24 (11–17 June) to 26 (25 June–1 July), mainly in the areas of Birambizo, Goma, Karisimbi, Kiroshe, Mutwanga, Mweso and Rwanguba.

There is concern that the security situation will increase the difficulty in accessing health‑care facilities and could increase the number of severe and fatal cases. The current armed conflict in North Kivu also poses a risk of spread of the disease to neighboring countries such as Burundi, Rwanda, South Sudan and Uganda.

Epidemiological investigations conducted by national authorities and partners, including Médecins Sans Frontières (MSF), Merlin and the International Rescue Committee (IRC), indicate that insufficient access to a safe water supply remains the main cause of the epidemic in North Kivu.

Hand Foot and Mouth Disease (HFMD) (Cambodia)

On 13 July 2012, the Ministry of Health of Cambodia reported that the cause of the severe illness causing deaths and affecting very young children was a severe form of hand, foot and mouth disease (HFMD).

A total of 78 cases has been identified. These include the initial 62 cases reported by Kantha Bopha hospital, and cases reported from other hospitals.

In response, health centers have been instructed by the Ministry of Health to report all patients with HFMD. In addition, the Ministry of Health, assisted by the World Health Organization (WHO), has begun enhanced surveillance for neurorespiratory syndrome, a key syndrome observed among patients with severe HFMD, caused by EV‑71. It is expected that the enhanced surveillance will identify occasional new cases of the severe form of the disease in the coming months.

Reference:

1. World Health Organization (WHO). Available at http://www.who.int/csr/don/2012_07_23/en/index.html [accessed July 2012]

Travel Medicine Office, Department for Intervention in Health Care Facilities

Drowning Prevention Rules

Worldwide, one person dies by drowning each minute. In Greece, the fatal drowning has double rates of those taking place within European Union. In Greece, like in abroad, the male: female drowning rates are 8:2. This underlines the reckless attitude, the overestimation of the personal limits and the risk taking behavior of the male population.

As the PSA of the Hellenic CDC states, each person may avoid become “a drowning statistic” while going for swimming, if consideration to the below safety tips will be given:

• We do not swim alone but only accompanied by others and in areas supervised by a lifeguard.

• We do not swim earlier than 3 hours after the last meal or having consumed alcohol.

• We do not swim far from the land, beyond the marked with buoys area, neither we overestimate our personal limits.

• We always supervise young children.

• If someone is in danger, we call 166 or 112 for help.

• The correct sun protection requires the use of sunscreen, hat, remaining under the shade and the consumption of water or juices.

Dr Stathis Avramidis, CPHL

HCDCP’s departments activities

Page 15: HCDCP e-bulleting July 2012

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News from the HCDCP Administraion

Summer Camp Program ‘Hygiene, Water Safety and Lifesaving’

The Hellenic Center for Disease Control (CDC), as part of its preventive strategy for public health, organizes educational presentations throughout the summer, on hygiene, water safety and lifesaving in the water. So far, about 3,000 campers and camp councilors have attended this popular and entertaining program, which covers hygiene guidelines and water protection, safety rules, rescue and self-rescue methods, and an ‘answer–question’ game followed by the presentation of a certification of attendance.

The summer camps that have attended the program so far are:

• 29 June 2012, Xeniasto Melissi (950 people)

• 2 July 2012, Evangeliki Kataskinosi (160 people)

• 6 July 2012, Ouranoupoli (120 people)

• 10 July 2012, Evangeliki Kataskinosi (80 people)

• 18 July 2012, Ουρανούπολη (125 people)

• 20 July 2012, Christianoupoli (200 people)

• 23 July 2012, Folia tou Paidiou (350 people)

• 24 July 2012, Evangeliki Kataskinosi (90 people)

• 25 July 2012, Xeniasto Melissi (600 people)

• 27 July 2012, Ζ Pediki Exohi Kerateas (240 people).

Dr Stathis Avramidis, CPHL

Chief Editor:Ch. Hadjichristodoulou

Scientific Board:Ν. VakalisΕ. VogiatzakisP. Gargalianos- KakolirisΜ. Daimonakou‑ VatopoulouΙ. LekakisC. LionisΑ. PantazopoulouV. PapaevagelouG. SaroglouΑ. Tsakris

Editors:Τ. Kourea‑ KremastinouHCDCP President

T. PapadimitriouHCDCP Director

Editorial Board:

M. AngelopoulouR. VorouPh. KoukouritakisΚ. MellouD. PapaventsisΤ. PatoucheasV. RoumeliotiV. SmetiCh. TsiaraΜ. FotineaΕ. Hadjipashali

Graphic Design:

Ε. Lazana

Editing:

E. KaratampaniP. Koukouritakis