WHO Surveillance Programme for Control of Foodborne Infections and Intoxications in Europe 8th Report Country Reports: Armenia ARMENIA

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1 WHO Surveillance Programme for Control of Foodborne Infections and Intoxications in Europe Country Reports: Armenia BfR ARMENIA PROVISIONAL DATA Population 1999: Population 2000: Area: km2 1. General Information Armenia (country abbreviation: AM) is administratively divided into 11 districts - ten marzes and one city with the status of marz - Yerevan, the capital of Armenia. The country has developed a State Hygienic and Epidemiological Service (SHES) responsible for the prevention and control of communicable diseases including surveillance of foodborne and waterborne infections, intoxications and poisonings. SHES is regulated in the framework of the law entitled Ensuring sanitary-epidemiological safety of the population of RA. The main objectives of the SHES, among others, are implementation of preventive measures, disease control and evaluation. The statutes of the Service and principles of its activities are regulated by the Government resolutions N518 and N107 dated and respectively. At the basic (first) level there are 51 territorial centres of HEC. The centres of HEC in the marzes act as coordinating institutions and form the link between the top (national level) and basic levels of the state SHES. Each HEC center has a microbiological laboratory for the examination of specimens obtained from patients, contacts, and food handlers as well as specimens of food and water. Some of the territorial HEC also have chemical laboratories. At the national level, the responsible agency is the Ministry of Health, with its department of Hygienic and Epidemiological Surveillance and Republican Centre of Hygienic and Epidemiological Control (RCHEC). The Ministry of Health is the policy making agency.

2 RCHEC operates as a research, training and supervisory centre for the work of the centres of marzes, cities and territorial communities, Hygienic and Epidemiological Control (CHEC) and for collection and analysis of epidemiological data at the national level. RCHEC undertakes some specific, higher-level laboratory activities. Epidemiological information from all 51 centres of HEC is collected centrally and published monthly and annually in MOH summaries. All infectious diseases are notifiable in Armenia. Laboratory confirmation is needed for the registration of cases of some diseases, including cholera, dysentery, salmonellosis, and others. Some reference laboratories are able to diagnose and type strains obtained from other laboratories. Each medical worker (doctor or nurse) who diagnoses or suspects a case of a notifiable infectious disease is obliged to inform the territorial centre HEC by means of a completed standard reporting form. In urgent or unusual cases, the Ministry of Health can be informed directly, and faster communication methods can be used. Every case of notifiable disease is epidemiologically investigated by an epidemiologist from the territorial centre HEC. Outbreaks of foodborne infections and intoxications are always registered and epidemiologically investigated whenever there are (two) three or more people involved. Even a single case of botulism or other bacterial foodborne intoxications is epidemiologically investigated and registered as an outbreak. Outbreaks of foodborne diseases are more carefully investigated than sporadic cases, and more effort is made to identify causative agents and other attributes connected with the outbreaks Foodborne Disease Surveillance and the Reporting System This report focuses on the food- and waterborne diseases registered during the years for which epidemiological data are available. According to officially reported data, morbidity due to foodborne diseases during the period under consideration was low. Obviously, these data do not reflect the real situation of foodborne infections and intoxications in the country, inasmuch as they are based only on those incidents which come to the attention of public health authorities. The course of some diseases is normally rather mild; therefore, people do not seek advice or treatment through primary health care services, hospitals or other medical facilities

3 Figure AM 1 Foodborne Disease Surveillance and Reporting System ARMENIA Ministry of Health Head State Sanitary Doctor of RA Department of Hygienic and Antiepidemic Control of MOH CDC Center of disease control and prevention (National level) Regional State Centres for Hygienic and Anti-epidemic Epidemiological Surveillance (II level) 1. Epidemiological investigation 2. Taking samples 3. Laboratory investigation 4. Information to CDC to Regional Centre for Hygienic and Anti-epidemic Control Local Centres for Hygienic and Anti-epidemic Control (I level) 1. Epidemiological investigation 2. Taking samples 3. Laboratory investigation 4. Information to CDC to Regional Centre for Hygienic and Antiepidemic Control Immediate reporting by telephone by and in writing (notification reporting form) Medical Doctors of local medical institutions - 3 -

4 2. Notified cases of foodborne diseases Table AM 1 Notified cases of foodborne diseases ARMENIA Disease Salmonellosis Staphylococcosis 8 11 Botulism Campylobacteriosis N/A N/A Shigellosis E.coli enteritis N/A N/A Listeriosis N/A N/A Cholera N/A N/A Brucellosis Other bacterial foodborne N/A N/A infections and intoxications Hepatitis A Other virus enteritis N/A N/A Echinococcosis Trichinellosis N/A N/A Giardiasis N/A N/A Amoebiasis N/A N/A Infectious Enteritis of unknown origin Mushroom poisoning Others N/A N/A N/A not avaible Table AM 2 Salmonella cases and morbidity ARMENIA Year Number of Salmonella cases Morbidity (number of cases people )

5 3. Epidemiologically investigated incidents Table AM 3 Salmonella cases by serotypes ARMENIA Serotype S. Enteritidis n.a. S. Typhimurium S. Newport n.a. n.a. S. Arizona S. Truly B S. Moscow n.a. 1 Table AM 4 Data of foodborne outbreaks ARMENIA 1999 Year Causative Agent No. of cases in outbreaks Incriminate d Food Place of consumption Outbreak 1 Unknown 4910 Water Household Outbreak 2 Abd. Typhus 11 Water Household Outbreak 3 Abd. typhus 7 Water Household Outbreak 4 Abd. typhus 6 Water Household Outbreak 5 Bac. dysentery 98 Water Household Outbreak 6 Dysentery 80 Water Household Outbreak 7 Hepatitis A 54 Water Household Outbreak 8 Hepatitis A 16 Water Household Outbreak 9 Dysentery 21 Water Household Outbreak 10 Dysentery 27 Water Household Outbreak 11 Dysentery 89 Water Household Contributing factors - 5 -

6 Table AM 5 Data of foodborne outbreaks ARMENIA 2000 Year 2000 Causative No. of cases Incriminated Place of Contributing Agent in outbreaks food consumption factors Outbreak 1 Unknown 41 Water Household Outbreak 2 Unknown 18 Water Household Outbreak 3 Hepatitis A 87 Water Household Outbreak 4 Unknown 157 Water Household 4. Additional information For further reference on national and international data on foodborne diseases, please visit the web page -