CZECH REPUBLIC Population 1999: Population 2000: Area: km 2

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1 WHO Surveillance Programme for Control Foodborne Infections and Intoxications in Europe Country Reports: Czech Republic BfR CZECH REPUBLIC Population 1999: Population 2000: Area: km 2 1. General information 1.1 Organizational structure Under the Ministry Health the Czech Republic (country abbreviation: CZ), public health services at all levels (central governmental, regions and districts) are centralized. The Public Health Service is responsible for the collection and processing notifiable disease data. The National Institute Public Health in Prague carries the main responsibility for this activity and coordinates the reporting system notifiable diseases at the national level. Regional Institutes Hygiene and Epidemiology Control and District Institutes Hygiene and Epidemiology form a link between the top and basic levels Public Health Service. Data on the occurrence notifiable diseases is reported by the District Public Health Service to the Regional Public Health Service, which in turn forwards the information to the National Institute Public Health. Food inspection falls mainly under the responsibility the Veterinary Service the Ministry Agriculture and Food the Czech Republic, which cooperates closely with medical epidemiology and hygiene authorities.

2 Figure CZ 1 Structure and information flow the Public Health Service CZECH REPUBLIC MINISTRY OF HEALTH National Institute Public Health, Prague Regional Institute Hygiene and Epidemiologie 8 Regional Institutes Regional Institute Hygiene and Epidemiology District Institute Hygiene and Epidemiology District Institute Hygiene and Epidemilogy 85 District Institutes First contact reports to District Institute 1.2 Collection and processing data Data collection and processing is carried out with the EPIDAT program (based on the EPI- INFO system). EPIDAT was created by the Regional Public Health Service Central Bohemia to ensure the notification, registration and analysis morbidity due to infectious diseases. It extends the previous Information System Transmissible Diseases the Computer Technique Department the Regional Public Health Institute in Ostrava that had been in use between 1982 and Since 1993, EPIDAT has been used nation-wide by all public health services and currently is part the National Health Information System and forms the basis local, regional and national surveillance infectious diseases. Throughout the years, the program has been adapted to users needs and available equipment. EPIDAT is a health information system based on notification by attending physicians and those within the public health service. Inasmuch as it comprises personal data on patients and individuals at risk, it is governed by legislation on the protection personal data in health information systems. The system consists several interdependent sections allowing data entry at District level and data coding and transmission to the Regional level and to the National Institute Public Health, where major analyses for different periods are conducted. Data is entered continuously, data export is performed at one-week intervals, transmissions are executed by , and outputs are prepared weekly. The input and output files are referred to the National Institute Public Health, where access rights are dealt with. The transmitted data are encoded. 1.3 Coding and Definitions The obligatory notification communicable diseases, including foodborne infections and intoxications, is performed according to international recommendations and the ICD-10 coding system. At least two cases connected in any way or by any factor in place or time are - 2 -

3 considered an outbreak. Cases without any connection are considered sporadic. Cases in families (close collectives) are classified as family. 1.4 Information output A "Weekly Communicable Diseases Monitor" is released regularly. The "Monitor" is provided to all participating institutes hygiene and epidemiology and to the Ministry Health. It is available in printed or computerized form. A monthly and yearly analysis is regularly produced and provided to human and veterinary health authorities. 2. Statutory notification More than cases foodborne diseases were notified in 1999 and 2000 under the mandatory notification system. The most frequently notified disease was salmonellosis, comprising 74% all notified cases in 1999 and 63% cases in 2000, followed by campylobacteriosis, comprising 16% and 27% all cases for the years in question (Table CZ 1). An overview the number foodborne diseases notified between 1993 and 2000 is shown in Figure CZ 2. Table CZ 1 Notified cases foodborne diseases ICD- 10 Disease Incidence rate Incidence rate notified cases notified cases A00 Cholera A02 Salmonellosis A03 Shigellosis A04.4 E.coli enteritis A04.5 Campylobacteriosis A05 Other bacterial foodborne infections and intoxications A05.0 Staphylococcosis A05.1 Botulism A06 Amoebiasis A07.1 Giardiasis A08 Other viral enteritis A09 Infectious Enteritis unknown origin A23 Brucellosis A32 Listeriosis B15 Hepatitis A B67 Echinococcosis B75 Trichinellosis Total

4 Figure CZ Notified Cases Foodborne Diseases CZECH REPUBLIC salmonellosis cases Year Shigellosis Hepatitis A Inf.enteritis unknown origin Other viral enteritis Giardiasis Amoebiasis Other bact. foodb. infect. Botulism E. coli * Salmonellosis * = : EHEC cases; : E.coli cases Salmonellosis Table CZ 2 Notified salmonellosis cases by serotype Serotype cases cases S.Enteritidis S.Typhimurium S.Infantis S.Virchow S.Hadar S.Saintpaul S.Agona S.Montevideo S.Derby S.Newport S.Heidelberg 13 7 S.Oranienburg 3 13 S.Paratyphi B var.java 12 4 S.Kentucky 10 5 Other serotypes Total

5 A total and Salmonella isolates were serotyped in 1999 and 2000 respectively. In both years, S. Enteritidis was the most frequently identified serotype (96% cases). S. Typhimurium was isolated in 2% the cases (Table CZ 2). An overview the serotypes isolated between 1993 and 2000 is shown in Figure CZ 3. Figure CZ Notified Salmonellosis Cases by Serotype CZECH REPUBLIC Year S. enteritidis cases S. Typhimurium S. Infantis S. Agona S. Tennessee S. Enteritidis 3. Epidemiologically investigated incidents Details were reported from investigations 121 foodborne disease involving 2775 cases in 1999 and 132 involving 5019 cases in The number persons ill, hospitalised, and dead, categorized by causative agent, is shown in Table CZ 3. The distribution foodborne disease cases according to age group is shown in Table CZ 4. Table CZ 3 Morbidity and mortality figures foodborne disease by causative agent Causative Agent persons ill persons hospitalized persons dead Campylobacter sp. n.k. n.k. n.k. n.k. n.k. n.k. Campylobacter jejuni n.k. n.k. n.k. n.k. n.k. n.k. S. Enteritidis S. Infantis S. Typhimurium Unknown Total n.k. = not known - 5 -

6 Table CZ 4 Age distribution cases foodborne diseases persons ill aged persons ill aged persons ill aged persons ill aged persons hospitalised aged persons hospitalised aged persons hospitalised aged persons hospitalised aged persons dead aged persons dead aged persons dead aged persons dead aged Causative agents The number and the number cases in by causative agent is shown in Table CZ 5. The most frequently identified agent was S. Enteritidis, followed by S. Typhimurium. The causative agent was identified both microbiologically and epidemiologically. Table CZ 5 Foodborne disease by causative agent Causative Agent in in Campylobacter sp Campylobacter jejuni S. Enteritidis S. Infantis S. Typhimurium Unknown Total

7 3.2 Incriminated food The number and the number cases in by incriminated food is shown in Table CZ 6. Eggs and sweets were the most frequently identified food items involved in foodborne disease in both 1999 and Thirty-three percent the cases in 1999 and 21% the cases in 2000 were linked to the consumption eggs, whereas sweets accounted for 26% the cases reported in 1999, and potato salad was responsible for 18% the cases investigated in Table CZ 6 Foodborne disease by incriminated food Incriminated food in No. Of cases in Beef Chicken Curd pie Delicacies Dumplings Dumplings, beef Eggs Eggs, cheese Eggs, chicken Eggs, pork Eggs, potato salad Eggs, smoked meat Eggs, sweets Ice cream Mayonnaise Meat Meat products Milk products Minced meat Pastry Pork Potato salad Poultry Sauce Smoked meat Sweets Vegetable products Unknown Total

8 3.3 Place consumption The number and the number cases in by place consumption is shown in Table CZ 7. In 1999, the place most frequently linked to foodborne disease investigated was the private home, followed by schools and canteens. In 2000, only 17% the investigated occurred in the private home, whereas 20% were linked to canteens and schools. While 24% the cases foodborne diseases were linked to the private home in 1999, 34% the foodborne disease cases reported in 2000 were linked to schools and 18% to canteens. Table CZ 7 Foodborne disease by place consumption Place consumption in in Buffet Camping Canteen Community Educational establishment Home for elderly people Hotel Kindergarten Medical care facility Nursery Prison Private home Recreation establishment Restaurant Retail store School Social care home Other Unknown Total

9 4. Additional information Detailed information on foodborne disease reported between 1992 and 2002 can be found in the Monthly Report Infectious Diseases in Czech Republic, "Zpravy Cem", ISSN A summary can be found on the web page Additional information can be found on the web page the Centre Epidemiology and Microbiology (National Institute Public Health) at For further reference on national and international data on foodborne diseases, please visit the web page -