Zdravstveni statistični letopis 2001 Spremljanje gibanja nalezljivih bolezni 3. SPREMLJANJE GIBANJA NALEZLJIVIH BOLEZNI / SURVEILLANCE OF COMMUNICABLE

Transkripcija

1 Zdravstveni statistični letopis 2001 Spremljanje gibanja nalezljivih bolezni 3. SPREMLJANJE GIBANJA NALEZLJIVIH BOLEZNI / SURVEILLANCE OF COMMUNICABLE DISEASES 3-0 Uvod Introduction 3-1 Prijavljene nalezljive bolezni po zdravstvenih regijah, 2001 Registered communicable diseases by health region, Prijavljene nalezljive bolezni po starostnih skupinah, 2001 Registered communicable diseases by age group, Prijavljeni primeri okužb s HIV, aidsa, sifilisa, gonoreje in spolno prenesene klamidijske okužbe glede na spol in starostno skupino, 2001 Reported cases of HIV infection, aids, syphilis, gonorrhoea and sexually transmitted chlamydial infection by sex and age groups, Umrli zaradi nalezljivih bolezni po diagnozah, 2001 Deaths due to communicable diseases by diagnoses,

2 Spremljanje gibanja nalezljivih bolezni Zdravstveni statistični letopis SPREMLJANJE GIBANJA NALEZLJIVIH BOLEZNI / COMMUNICABLE DISEASE SURVEILLANCE Zakon o nalezljivih boleznih opredeljuje nalezljive bolezni, za katere je v Sloveniji prijava obvezna. Prijava poteka skladno s Pravilnikom o prijavi nalezljivih bolezni in posebnih ukrepih za njihovo preprečevanje in obvladovanje in zajema nabor podatkov, opredeljen z Zakonom o zbirkah podatkov s področja zdravstvenega varstva. Prijave nalezljivih bolezni sistematično zbirajo območni zavodi za zdravstveno varstvo, ki jih s pomočjo računalniškega programa analizirajo in pošiljajo v Center za nalezljive bolezni na Inštitutu za varovanje zdravja, kjer se tako zberejo podatki za celo Slovenijo. Podatke se preverja, analizira in pripravlja mesečna in letno poročilo o gibanju nalezljivih bolezni in njihovih epidemioloških značilnostih. Nekatere bolezni se poleg sistematičnega spremljanja dodatno spremljajo tudi z laboratorijsko podprtimi občutljivimi sistemi, ki omogočajo pridobitev dodatnih informacij, potrebnih za oblikovanje programov obvladovanja nalezljivih bolezni in vrednotenje njihove učinkovitosti. Podatki o HIV/aids in drugih spolno prenosljivih okužbah (SPO) se zbirajo ločeno od ostalih nalezljivih bolezni. Prijavljanje SPO sodi v okvir ustrezne zdravstvene oskrbe bolnikov s spolno prenosljivimi okužbami. Ta obsega postavitev diagnoze, zdravljenje, svetovanje za varnejšo spolnost, obveščanje kontaktov in beleženje podatkov za namene epidemiološkega spremljanja. Kljub zakonski obveznosti je prijavljanje nalezljivih bolezni nepopolno. Večina kliničnih diagnoz je brez laboratorijske potrditve povzročitelja. Pomanjkljivo prijavljajo nalezljive bolezni tudi mikrobiološki laboratoriji in ne-infekcijski oddelki bolnišnic. Oceno, kolikšen delež nalezljivih bolezni ostane neprijavljen, je težko podati in je v veliki meri odvisna tudi od same diagnoze. Ocenjujemo, da je prijava relativno dobra za resnejše bolezni, t.j. bolezni s hujšim potekom, redke bolezni in bolezni, ki jih spremljamo aktivno. V tabelah so prikazane prijavljene nalezljive bolezni po nekaterih epidemioloških značilnostih. Celokupno število prijavljenih nalezljivih boleznih se v Sloveniji v zadnjih letih pomembneje ne spreminja. Incidenca nalezljivih bolezni je okrog primerov na prebivalcev. Med prijavljenimi boleznimi prevladujejo norice, gastroenterokolitisi neznane etiologije, borelioza, mikrosporija, salmoneloze in virusne črevesne bolezni. V letu 2001 je zaradi nalezljivih bolezni umrlo 93 ljudi, največ zaradi sepse in pljučnice nedoločenih povzročiteljev. Med najpogostejšimi znanimi vzroki smrti sta bila aids (6) in sepsa povzročena s Staphylococcus aureus (5). Večina umrlih je bila starejših od 55 let. Prijavljenih je bilo 65 epidemij nalezljivih bolezni, med katerimi so bile najpogostejše epidemije rotaviroz in epidemije okužb s hrano. Situacija nalezljivih bolezni v letu 2001 je bila v Sloveniji primerljiva s situacijo v zadnjih nekaj letih in jo ocenjujemo kot relativno ugodno. COMMUNICABLE DISEASE SURVEILLANCE The communicable diseases for which the notification is compulsory in Slovenia are defined by the Law on communicable diseases. The notification system is based also on the Act on Communicable Disease Notification, Surveillance and Control and the Law on Databases in Health Care. Data on communicable diseases are systematically collected and analysed by the Regional Institutes of Public Health, then sent to the Communicable Diseases Centre at the Institute of Public Health of the Republic of Slovenia, where data for the whole country are collected. Here the data are checked, analysed and evaluated. Monthly reports and the annual report on the incidence and epidemiological characteristics of communicable diseases in Slovenia are prepared. Besides being under systematic surveillance, some diseases are also followed up with sensitive laboratory supported investigative systems, in order to obtain the information necessary for decision making on the domain of public health assurance and for their evaluation. Data about HIV/aids and other sexually transmitted infections (STI) are collected separately from other communicable diseases. STI reporting is one of the components of adequate sexually transmitted infections case management, which includes correct diagnosis, effective treatment, counselling for safer sex behaviour and partner notification. Despite the compulsory notification, there is still the problem of underreporting of communicable diseases. The majority of clinical diagnoses are still without a laboratory confirmed causative agent. The notification of communicable diseases from microbiological laboratories and some hospitals is also very incomplete so far. But it is estimated that the notification is good for serious diseases. The reported communicable diseases are presented in tables according to certain epidemiological characteristics. There has not been a significance change in the number of reported diseases in the last few years. The incidence is about cases per inhabitants. Varicella, gastroenterocolitis, borreliosis, microsporosis, salmonellosis and viral intestinal diseases represent the highest proportion of reported diseases. In 2001, 93 patients died due to communicable diseases, mostly because of sepsis and pneumonia of unknown origin. Most frequent known causes of deaths were aids (6) and sepsis due to Staphylococcus aureus (5). Majority of death cases was older than 55 years. 65 outbreaks of communicable diseases were reported; the most frequent among them were rotaviral outbreaks and outbreaks of food-borne diseases. In general it is estimated, that the situation of communicable diseases in Slovenia in 2001 was relatively favourable and was similar to the one in last few years. 68

3 Zdravstveni statistični letopis 2001 Spremljanje gibanja nalezljivih bolezni 3-1 PRIJAVLJENE NALEZLJIVE BOLEZNI PO ZDRAVSTVENIH REGIJAH, 2001 REGISTERED COMMUNICABLE DISEASES BY HELATH REGION, 2001 TOTAL DIAGNOZE, DIAGNOSIS CE NG KP KR LJ MB MS NM Ravne SKUPAJ A01 TYPHOID AND PARATYPHOID FEVERS A02 SALMONELLA INFECTIONS A03 SHIGELLOSIS A04 BACTERIAL INTESTINAL INFECTION A05 BACTERIAL FOODBORNE INTOXICATIONS A06 AMOEBIASIS A07 PROTOZOAL INTESTINAL DISEASES A08 VIRAL AND OTHER SPECIFIED INTESTINAL INFECTIONS A09 DIARRHOEA AND GASTROENTERITIS(ENTEROCOLITIS) A21 TULARAEMIA A23 BRUCELLOSIS A26 ERYSIPELOID A27 LEPTOSPIROSIS A32 LISTERIOSIS A35 TETANUS A37 PERTUSSIS A38 SCARLATINA A39 MENINGOCOCCAL INFECTION A40 STREPTOCOCCAL SEPTICAEMIA A41 SEPTICAEMIA A46 ERYSIPELAS A48 BACT. DISEASES, NOT ELESWHERE CLASSIFIED A49 BACTERIAL INFECTION OF UNSPECIFIED SITE A56 SEXUALLY TRANSMITTED CHLAMYDIAL DISEASES A69 LYME BORELIOSIS A74 DISEASES CAUSED BY CHLAMYDIAE A79 OTHER RICKETTSIOSES A81 SLOW VIRUS INFECT. OF CENTRAL NERVOUS SYSTEM A84 TICK-BORNE VIRAL MENINGO-ENCEPHALITIS- TBE A86 UNSPECIFIED VIRAL ENCEPHALITIS A87 VIRAL MENINGITIS A90 DENGUE A98 VIRAL HAEMORRHAGIC FEVERS, HFRS B00 HERPESVIRAL (HERPES SIMPLEX) INFECTION B01 VARICELLA B02 ZOSTER B06 RUBELLA B15 ACUTE HEPATITIS A B16 ACUTE HEPATITIS B B17 ACUTE VIRAL HEPATITIS B18 CHRONIC VIRAL HEPATITIS B19 UNSPECIFIED VIRAL HEPATITIS B24 AIDS B26 MUMPS B27 INFECTION MONONUCLEOSIS B30 VIRAL CONJUNCTIVITIS B33 VIRAL DISEASES, NOT ELSEWHERE CLASSIFIED B35 DERMATOPHYTOSIS (MIKROSPOROSIS) B37 CANDIDASIS B49 UNSPECIFIED MYCOSIS B50 PLASMODIUM FALCIPARUM MALARIA B51 PLASMODIUM VIVAX MALARIA B58 TOXOPLASMOSIS B67 ECHINOCOCCOSIS B68 TAENIASIS Tabela se nadaljuje / Table continues 69

4 Spremljanje gibanja nalezljivih bolezni Zdravstveni statistični letopis PRIJAVLJENE NALEZLJIVE BOLEZNI PO ZDRAVSTVENIH REGIJAH, 2001 REGISTERED COMMUNICABLE DISEASES BY HELATH REGION, 2001 TOTAL DIAGNOZE, DIAGNOSIS CE NG KP KR LJ MB MS NM Ravne SKUPAJ B79 TRICHURIASIS B80 ENTEROBIASIS B86 SCABIES B97 VIRAL AGENTS AS THE CAUSE OF DISEASES IN CLASS G00 BACTERIAL MENINGITIS G02 MENINGITIS IN OTHER INF. AND PARASIT. DISEASES G03 MENINGITIS DUE TO OTHER AND UNSPECIFIED CAUSES G04 ENCEPHALITIS, MYELITIS AND ENCEPHALOMYELITIS J01 ACUTE SINUSITIS J02 ACUTE PHARYNGITIS J03 ACUTE TONSILLITIS J04 ACUTE LARYNGITIS AND TRACHEITIS J06 ACUTE UPPER RESP. INF. OF MULTIP. AND UNSP.SITES J12 VIRAL PNEUMONIA J13 PNEUMONIA DUE TO STREPTOCOCCUS PNEUMONIAE J14 PNEUMONIA DUE TO HAEMOPHILUS INFLUENZAE J15 BACTERIAL PNEUMONIA, NOT ELSEWHERE CLASSIFIED J16 PNEUMONIA DUE TO OTHER INFECT. ORGANISMS J18 PNEUMONIA, ORGANISMS UNSPECIFIED J20 ACUTE BRONCHITIS J21 ACUTE BRONCHIOLITIS J22 UNSPECIFIED ACUTE LOWER RESPIRATORY INFECTION J40 BRONCHITIS, NOT SPECIFIED AS ACUTE OR CHRONIC Z22 CARRIER OF INFECTIOUS DISEASE SKUPAJ / TOTAL

5 Zdravstveni statistični letopis 2001 Spremljanje gibanja nalezljivih bolezni 3 2 PRIJAVLJENE NALEZLJIVE BOLEZNI PO STAROSTNIH SKUPINAH, 2001 REGISTERED COMMUNICABLE DISEASES BY AGE GROUP, 2001 STAROSTNE SKUPINE / AGE GROUPS TOTAL DIAGNOZA, DIAGNOSIS > <1 SKUPAJ A01 TYPHOID AND PARATYPHOID FEVERS A02 SALMONELLA INFECTIONS A03 SHIGELLOSIS A04 BACTERIAL INTESTINAL INFECTION A05 BACTERIAL FOODBORNE INTOXICATIONS A06 AMOEBIASIS A07 PROTOZOAL INTESTINAL DISEASES A08 VIRAL AND OTHER SPECIFIED INTESTINAL INFECTIONS A09 DIARRHOEA AND GASTROENTERITIS(ENTEROCOLITIS) A21 TULARAEMIA A23 BRUCELLOSIS A26 ERYSIPELOID A27 LEPTOSPIROSIS A32 LISTERIOSIS A35 TETANUS A37 PERTUSSIS A38 SCARLATINA A39 MENINGOCOCCAL INFECTION A40 STREPTOCOCCAL SEPTICAEMIA A41 SEPTICAEMIA A46 ERYSIPELAS A48 BACT. DISEASES, NOT ELESWHERE CLASSIFIED A49 BACTERIAL INFECTION OF UNSPECIFIED SITE A56 SEXUALLY TRANSMITTED CHLAMYDIAL DISEASES A69 LYME BORELIOSIS A74 DISEASES CAUSED BY CHLAMYDIAE A79 OTHER RICKETTSIOSES A81 SLOW VIRUS INFECT. OF CENTRAL NERVOUS SYSTEM A84 TICK-BORNE VIRAL MENINGO-ENCEPHALITIS- TBE A86 UNSPECIFIED VIRAL ENCEPHALITIS A87 VIRAL MENINGITIS A90 DENGUE FEVER (CLASSICAL DENGUE) A98 VIRAL HAEMORRHAGIC FEVERS, HFRS B00 HERPESVIRAL (HERPES SIMPLEX) INFECTION B01 VARICELLA B02 ZOSTER B06 RUBELLA B15 ACUTE HEPATITIS A B16 ACUTE HEPATITIS B B17 ACUTE VIRAL HEPATITIS B18 CHRONIC VIRAL HEPATITIS B19 UNSPECIFIED VIRAL HEPATITIS B24 AIDS B26 MUMPS B27 INFECTION MONONUCLEOSIS B30 VIRAL CONJUNCTIVITIS B33 VIRAL DISEASES, NOT ELSEWHERE CLASSIFIED B35 DERMATOPHYTOSIS (MIKROSPOROSIS) B37 CANDIDASIS B49 UNSPECIFIED MYCOSIS B50 PLASMODIUM FALCIPARUM MALARIA B51 PLASMODIUM VIVAX MALARIA Tabela se nadaljuje / Table continues 71

6 Spremljanje gibanja nalezljivih bolezni Zdravstveni statistični letopis PRIJAVLJENE NALEZLJIVE BOLEZNI PO STAROSTNIH SKUPINAH, 2001 REGISTERED COMMUNICABLE DISEASES BY AGE GROUP, 2001 STAROSTNE SKUPINE / AGE GROUPS TOTAL DIAGNOZA, DIAGNOSIS > <1 SKUPAJ B58 TOXOPLASMOSIS B67 ECHINOCOCCOSIS B68 TAENIASIS B79 TRICHURIASIS B80 ENTEROBIASIS B86 SCABIES B97 VIRAL AGENTS AS THE CAUSE OF DISEASES IN CLASS G00 BACTERIAL MENINGITIS G02 MENINGITIS IN OTHER INF. AND PARASIT. DISEASES G03 MENINGITIS DUE TO OTHER AND UNSPECIFIED CAUSES G04 ENCEPHALITIS, MYELITIS AND ENCEPHALOMYELITIS J01 ACUTE SINUSITIS J02 ACUTE PHARYNGITIS J03 ACUTE TONSILLITIS J04 ACUTE LARYNGITIS AND TRACHEITIS J06 ACUTE UPPER RESP. INF. OF MULTIP. AND UNSP.SITES J12 VIRAL PNEUMONIA J13 PNEUMONIA DUE TO STREPTOCOCCUS PNEUMONIAE J14 PNEUMONIA DUE TO HAEMOPHILUS INFLUENZAE J15 BACTERIAL PNEUMONIA, NOT ELSEWHERE CLASSIFIED J16 PNEUMONIA DUE TO OTHER INFECT. ORGANISMS J18 PNEUMONIA, ORGANISMS UNSPECIFIED J20 ACUTE BRONCHITIS J21 ACUTE BRONCHIOLITIS J22 UNSPECIFIED ACUTE LOWER RESPIRATORY INFECTION J40 BRONCHITIS, NOT SPECIFIED AS ACUTE OR CHRONIC Z22 CARRIER OF INFECTIOUS DISEASE SKUPAJ / TOTAL

7 Zdravstveni statistični letopis 2001 Spremljanje gibanja nalezljivih bolezni 3 3 PRIJAVLJENI PRIMERI OKUŽB S HIV, AIDSA, SIFILISA, GONOREJE IN SPOLNO PRENESENE KLAMIDIJSKE OKUŽBE GLEDE NA SPOL IN STAROSTNO SKUPINO, 2001 REPORTED CASES OF HIV INFECTION, AIDS, SYPHILIS, GONORRHOEA, SEXUALLY TRANSMITTED CHLAMYDIAL INFECTION BY SEX AND AGE GROUPS, 2001 SPOL < SKUPAJ HIV OKUŽBA* MOŠKI ŽENSKE SKUPAJ AIDS MOŠKI ŽENSKE SKUPAJ ZGODNJI SIFILIS MOŠKI A51 ŽENSKE SKUPAJ POZNI SIFILIS MOŠKI A52 ŽENSKE SKUPAJ NEOPR. SIFILIS MOŠKI A53 ŽENSKE SKUPAJ GONOREJA MOŠKI A54 ŽENSKE SKUPAJ KLAMIDIJSKA OK. MOŠKI A56 ŽENSKE SKUPAJ *Novo diagnosticirani primeri okužbe s HIV (vključno s primeri aidsa, kjer je bila okužba s HIV prvič odkrita) *Newly diagnosed HIV infections (including AIDS cases where HIV infection was diagnosed first) 73

8 Spremljanje gibanja nalezljivih bolezni Zdravstveni statistični letopis UMRLI ZARADI NALEZLJIVIH BOLEZNI PO DIAGNOZAH, 2001 DEATHS DUE TO COMMUNICABLE DISEASES BY DIAGNOSES, 2001 DIAGNOZA, DIAGNOSIS ŠTEVILO / NUMBER A02.0 SALMONELLA ENTERITIS 1 A02.1 SALMONELLA SEPTICAEMIA 1 A04.7 ENTEROCOLITIS (Clostridium difficile) 1 A32.1 LISTERIAL MENINGITIS AND MENINGOENCEPHALITIS 1 A32.7 LISTERIAL SEPTICAEMIA 1 A39.2 ACUTE MENINGOCOCCAEMIA 2 A40.0 SEPTICAEMIA DUE TO STREPTOCOCCUS, GROUP A 2 A40.3 SEPTICAEMIA DUE TO STREPTOCOCCUS PNEUMONIAE 2 A41.0 SEPTICAEMIA DUE TO STAPHYLOCOCCUS AUREUS 5 A41.1 SEPTICAEMIA DUE TO OTHER SPEC. STAPHYLOCOCCUS 1 A41.5 SEPTICAEMIA DUE TO OTHER GRAM-NEGATIVE ORGANISMS 1 A41.8 OTHER SPECIFIED SEPTICAEMIA 2 A41.9 SEPTICAEMIA, UNSPECIFIED 11 A48.0 GAS GANGRENE 1 A81.0 CREUTZFELDT-JAKOB DISEASE 2 B00.4 HERPESVIRAL ENCEPHALITIS 1 B18.1 CHRONIC VIRAL HEPATITIS B 1 B18.2 CHRONIC VIRAL HEPATITIS C 1 B18.9 CRONIC VIRAL HEPATITIS, UNSPECIFIED 1 B24 AIDS 5 G00.1 PNEUMOCOCCAL MENINGITIS 1 G00.2 STEPTOCOCCAL MENINGITIS 1 G00.9 BACTERIAL MENINGITIS, UNSPECIFIED 1 J12.9 VIRAL PNEUMONIA, UNSPECIFIED 1 J13 PNEUMONIA DUE TO STREPTOCOCCUS PNEUMONIAE 1 J14 PNEUMONIA DUE TO HAEMOPHILUS INFLUENZAE 1 J15.0 PNEUMONIA DUE TO KLEBSIELLA PNEUMONIAE 1 J15.1 PNEUMONIA DUE TO PSEUDOMONAS 1 J15.2 PNEUMONIA DUE TO STAPHYLOCOCCUS 3 J15.8 OTHER BACTERIAL PNEUMONIA 1 J15.9 BACTERIAL PNEUMONIA, UNSPECIFIED 3 J18.0 BRONCHOPNEUMONIA, UNCPECIFIED 1 J18.8 OTHER PNEUMONIA, ORGANISMS UNSPECIFIED 1 J18.9 PNEUMONIA, UNSPECIFIED 31 SKUPAJ / TOTAL 92 74