May the 2nd, 2022 - Hepatitis in Zagreb has been causing quite a few issues for the best part of two months. The spread of the highly infectious Hepatitis A, a vaccine preventable liver virus caused by the Hepatitis A virus (HAV), has been taking place in multiple locations, with schools high on the list. The Hepatitis A virus is otherwise found in the stool and blood of infected individuals.

As Poslovni Dnevnik writes, There has been a sizeable outbreak of Hepatitis in Zagreb and it has been going on for around two months now. The largest number of patients at this moment in time are high school students, reports Jutarnji list.

"Since the beginning of March, we've recorded 57 cases of Hepatitis A, mostly among high school students. The causative agent is the Hepatitis A virus, which is transmitted by the feco-oral route, ie by ingesting contaminated water or food in the stool of an infected person or from hands contaminated with the stool of an infected person. The disease was reported among students from three schools in Zagreb and their household contacts.

The issue with Hepatitis in Zagreb is completely under control, and about 45 patients have already recovered. It's possible that in the end, the number of infected people will be higher because the incubation period for Hepatitis A is one month, in some cases even two months,'' said Branko Kolaric, the director of the ''Dr. Andrija Stampar'' Teaching Institute in Zagreb.

Although the schools received instructions regarding the spread of the virus that they passed on to both parents and children, Kolaric would like to appeal to everyone to maintain hand hygiene and to keep washing them regularly.

Hepatitis A or contagious jaundice is an acute contagious liver disease caused by the hepatitis A virus and is most commonly transmitted by unwashed hands, contaminated food or water, and after someone has been in close physical contact with an infected person, including through sexual activity. Incubation lasts 15-50 days, on average about a month. The affected person is contagious 14 days before the onset and seven days after the onset of symptoms.

Liver failure is a possibility if one contracts this virus

“The symptoms of acute Hepatitis A include fever, nausea, vomiting, jaundice, loss of appetite, abdominal pain, light coloured stool, and dark urine. Elevated bilirubin and transaminase levels are then confirmed by performing liver function tests. The disease is often asymptomatic or mild, especially in children under five years of age. However, the problems can really begin if the disease goes unrecognised, meaning it can progress and lead to liver failure,'' said Lorna Stemberger Maric, a pediatric infectologist from the Dr. Fran Mihaljevic Clinic for Infectious Diseases.

"Currently, we don't have any patients with Hepatitis in our department, but in the last month we've had several serious cases in high school and elementary school. Fortunately, all of our young patients have recovered so far. We've had individual cases of acute Hepatitis A in previous years, but I don't remember having such an epidemic that spread among children like this one has,'' added Lorna Stemberger Maric.

In the meantime, the principals of Zagreb's schools received instructions and handed out information leaflets to teachers, parents and students.

It was pointed out that a person can become infected if they eat food prepared by an infected person who didn't wash their hands properly or washed them in contaminated water.

One form of infection is when a person drinks contaminated water, including ice cubes. Furthermore, the consumption of raw or undercooked mussels from contaminated water, raw and uncooked and unwashed foods such as fruit, vegetables and sushi should be avoided.

Humanscan also become infected with Hepatitis A through close contact with a person who has the virus using a shared toilet and kitchen. Another way of contracting the disease is engaging in sexual intercourse with an infected person, and it is especially risky for a man to have sexual intercourse with another infected man. Another common way to contract a Hepatitis A infection is drug consumption using contaminated tools such as needles.

For more on the situation with Hepatitis in Zagreb as it unfolds, make sure to check out our news section.

January the 11th, 2022 - The new Omicron variant of the novel coronavirus has taken Europe by storm, sweeping through country after country with some richer Northern European nations such as the United Kingdom recording eye-watering infection rates despite having a very high vaccination rate. Croatian epidemiologist Branko Kolaric has spoken out about Omicron, stating that while this variant is the mildest of all so far, he doesn't believe that it will necessarily lead to herd immunity.

As Poslovni Dnevnik writes, epidemiologist Branko Kolaric of the Croatian Institute of Public Health has stated that he is far from surprised by the large number of newly infected people since Omicron began to spread.

"I can't say I'm surprised by the numbers. Many countries have a similar situation at the moment. We've had bigger and more gatherings over the last two weeks, school starts today. We have an overlap of the fourth and fifth waves. This level of spread can be slowed down, but we need adequate measures in order to ensure that,'' he told HTV.

Is omicron the mildest variant? Our hospitals are still filling up... Is the reason Croatia's poor level of vaccination?

''Yes, that's the most important reason and what causes the greatest level of concern. We have poor vaccination coverage. We also have a lot of people off on sick leave, and there will be infections spreading around in schools. There will be a lot of self-isolation to come. Omicron is the mildest variant, but when you have a lot more infected people, then the number of people in hospitals is higher. Today we have 250 people needing a respirator,'' epidemiologist Branko Kolaric explained.

Rules in schools as the kids return to the classrooms

''I was in favour of extending the school holidays for another week. In addition to the risks posed by being in school, there's also the issue of public transport. In Split there are a large number of people hospitalised, 85 percent of those people are unvaccinated, a large number are elderly… A large number of new patients infected with covid needing medical help are younger people.

The entire population is affected by the virus now. In Britain, for example, the number of hospitalised children was 40, 50, and now with Omicron there are over 100 daily hospitalisations.''

Is Omicron the beginning of the end of the pandemic? Will we reach herd immunity because of it?

''I don't think Omicron will provide herd immunity. Global vaccination is something that would reduce the likelihood of new variants even emerging,'' said epidemiologist Branko Kolaric.

Any new recommendations for this week?

Those who haven't yet been vaccinated, please, go and get vaccinated, wear your masks properly, avoid all unnecessary close contacts, whoever is able to do so, please try to work from home.

About the anti-epidemic measures...

''These are all milder measures, working from home is recommended. We don't have a significant change in the coping strategy with the pandemic on the cards. I expect a large number of infected people to be recorded over the coming days,'' epidemiologist Branko Kolaric said in conversation with HTV.

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June the 7th, 2021 - Croatian epidemiologist Branko Kolaric sat down recently to discuss the rapidly approaching tourist season and what that might mean for infection rates in Croatia when all the foreign tourists leave at the end of summer.

As Poslovni Dnevnik writes, epidemiologist Branko Kolaric commented on the current epidemiological situation for N1 this morning, and when speaking about the restrictions in care homes and nursing homes, he said that for the oldest and most unwell residents of such facilities, visitors should be allowed in for longer than fifteen minutes if the said visitor is vaccinated.

"The only thing left of the restrictive measures in care homes is if the resident hasn't yet been vaccinated, and was in the hospital, that after hospital treatment they go into self-isolation and that unvaccinated visitors can visit them for only fifteen minutes," Branko Kolaric told N1.

He said that the current vaccination rate across Croatian nursing homes is very good.

''We really do have a high turnout and currently there are a total of just twenty infected people living in nursing homes across Croatia. Of those who have fallen ill, the majority are unvaccinated people, but also some people who have been vaccinated. We know that the vaccine doesn't protect anyone at a level of 100 percent, but in the third wave, mortality was reduced by twenty times,'' explained Branko Kolaric, adding that he hoped that this pace of vaccination would continue so that we could enter autumn more calmly.

"We still have enough people interested in getting vaccinated and I hope that we will continue to have those people vaccinated in sufficient numbers," Branko Kolaric added.

''It's possible that we have variations and don't have a descent to zero as we had last summer and that is why it's still important to adhere to the anti-epidemic measures, avoid having too much contact with others, especially people who aren't yet vaccinated, and to avoid larger crowds, because in doing all that you can get infected,'' said Kolaric.

He also spoke about a possible easing of the country's epidemiological measures.

''I do think that the measures will be revised before the summer arrives and it's possible that the provision of wearing masks in areas where people have been vaccinated will be abolished. So, it all depends on how many people get vaccinated. That being said, we can't rely solely on vaccination, but we must also adhere to measures until we achieve collective immunity. Where vaccination coverage is low, at around 30-40 per cent, it remains possible that new waves of infection will occur. We need a very high percentage of vaccination,'' explained Kolaric.

Many countries are currently talking about the new wave of the coronavirus pandemic that awaits them and that the question is not whether or not it will happen, but how strong it will be. Asked if a new wave of infection awaits Croatia after the tourist season, Branko Kolaric said that on the one hand it is a matter of speculation, and that, taking into account the situation in the country's nursing homes, where there are ten times fewer infected people and twenty times fewer deaths, we can expect just that.

''That’s why we need to vaccinate people. We're never going to completely eliminate the virus, but it is important to reduce the number of deaths caused by it,'' concluded Branko Kolaric.

For all you need to know about coronavirus specific to Croatia, including travel, border and quarantine rules, as well as the locations of testing centres and vaccination points across the country, make sure to bookmark our dedicated COVID-19 section and choose your preferred language.

February the 3rd, 2021 - Croatian epidemiologist Branko Kolaric has sought to explain why Croatia has been experiencing a downward trend in terms of the coronavirus infection rate over recent weeks despite having fairly loose epidemiological measures when compared to some other countries in the EU. Slovenia, with far harsher measures, isn't experiencing Croatia's good trends.

As Poslovni Dnevnik writes, recently in Croatia, the share of those infected among those who were tested was only 5 percent, and the number of newly infected people fell below 100 for the first time since September 2020.

As for global and European trends, it's difficult to find a pattern that would show why the number of infected people is growing in some countries despite the measures, and at the same time in others with less stringent measures, such as those in Croatia, the infection rate is falling. It's true to say that Croatia is far from 50 infected people per 100,000 inhabitants, which is the limit that indicates the containment of the epidemic, but we have managed to reach 216, even though we were at more than 1200 not so long ago.

The numbers say, for example, the number of people infected with coronavirus in one day in the United States halved from early to late January from 201,420 down to 107,816 on the last day of January. The decline in the number of infected people is also being recorded, for example, in Germany with 10,620 recorded on the first Sunday in January and 8425 on the last. The numbers are similar in Austria, with 1466 and 1198, but it should be emphasised that the decline isn't drastic despite the employment of some very restrictive measures that include curfews, reports Jutarnji list.

An enigma for many...

Here in Croatia, too, the number of people infected with the novel coronavirus was halved during the month of January, so all those who think that the measures should be relaxed are in ''euphoria'' because we've had only 216 infected people per 100,000 inhabitants over the last two weeks. An additional enigma for many is Slovenia which still has 885 infected people per 100,000 inhabitants in 14 days and at the same time has very strict measures. Currently, the worst situations in the EU can be found in Portugal, Spain and France, where the number of infected people has doubled compared to the beginning of last month.

“There are several aspects that affect the numbers in this epidemic. For example, it can be the moment of the introduction of measures, the number of infected when those measures are introduced as well as the number of ''pockets'' of communities or closed subpopulations in which the epidemic persists,'' explained Croatian epidemiologist Branko Kolaric, a member of the Government Scientific Council for COVID-19.

"For example, when the epidemic is more widespread, ie when there are a lot of infected people at one time, then you don't have to wait as long to see results when you bring in measures. When the epidemic spreads as it did in our country a few months ago, resuling in 1,200 infected people per 100,000 people, then the results of the measures introduced can be seen much faster and more clearly. After six weeks of having these measures, we've significantly reduced the number of infected people in Croatia. But on the other hand, Germany has measures like ours and already had at 200 infected people in 100,000 inhabiants, and when the numbers started to rise to 300, they tightened them up even more.

In short, the measures give a more visible and faster effect when the infection rate is high. If we wanted to get down to 50 infected people per 100,000 inhabitants, we'd have to have much more rigorous measures, and the results would take more time to arrive. In that case, schools wouldn't be open, and a curfew would be likely, but the question is whether we'd eventually reach that goal,'' added Croatian epidemiologist Branko Kolaric when discussing the complexity of the implementation of epidemiological goals.

The peak of the epidemic's wave

He emphasised that, when it comes to the EU, the biggest enigma for him is neighbouring Slovenia, where the epidemiological measures have been in force for much longer than they have here in Croatia, and there are no results.

"It's difficult to understand why the number of infected is falling so slowly and why there is such a difference between Croatia and Slovenia. It's possible, for example, that there is more illegal socialising, ie that the measures aren't actually being implemented in the manner they're prescribed. In any case, in the case of the coronavirus, the natural course of the virus should probably not be neglected, so one wave passes and infects a certain circle of people and so on and so on, it does that in cycles.

In addition, there are specifics of individual countries, so this also affects the implementation of any measures. But, in any case, the fact remains that this disease is mostly transmitted by droplets, so socialising is the place where it occurs the most often and is the most possible. If there is less socialising, there's less coronavirus,'' concluded epidemiologist Branko Kolaric.

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January the 12th, 2021 - Croatian Epidemiologist Branko Kolaric has discussed the vaccination process for healthcare professionals, the elderly and the most vulnerable, and some of the rules other countries might consider bringing in for those who do not vaccinate against the novel coronavirus.

As Poslovni Dnevnik writes, the Croatian Institute of Public Health says that by the end of January and through February, a good part of the elderly, vulnerable and patients with chronic health complaints and other diseases who are in the second group are expected to be vaccinated. This will then be immediately followed by the third phase, so everyone else should be there by the time spring rolls around.

A member of the Government's Scientific Council, epidemiologist Branko Kolaric, said more about this in Dnevnik Nova TV.

As he said, Croatia is currently vaccinating people with a small number of doses. "At this rate, we should be able to vaccinate about fifty percent of the population in two years. Now the limiting factor is the number of doses we have available. We hope to register some more vaccines soon and when we get more doses, then we’ll be able to speed up the pace of vaccination. Now we’re still under one percent of people in Croatia vaccinated, but it is still at the level of the European Union,’’ said Branko Kolaric.

Regarding KOHOM's proposal to vaccinate people in large areas, he says that this is one of the possibilities when there are enough vaccines available in the country.

“Once we have a large number of doses available, this is one of the possibilities so that we can get people vaccinated faster. That will only be when we will have hundreds of thousands of doses of vaccine at our disposal,’’ Branko Kolaric explained.

Germany is now going into a stricter lockdown, and Branko Kolaric hopes that this will not happen to Croatia. "We’re on the descent of the second wave. All countries are now preparing for the third wave, which is associated with the festive period and more indoor socialising. We’ll have to see how it develops in our country. At the moment, the situation is favourable, epidemiologically speaking - we’re seeing the effects of the measures we’ve introduced,’’ said Branko Kolaric.

There have been several cases of coronavirus infection occurring even after vaccination against the disease, but Branko Kolaric explained that such people didn’t contract the disease from the vaccine.

“I’d like to just mention that when someone gets vaccinated and still gets the disease, they didn’t get the disease from the vaccine. That’s impossible, but it does mean that the person was incubating the novel coronavirus at the time of their vaccination. The vaccine teaches our body how to fight the virus and that takes some time, the first effects should take about ten days to two weeks. It’s therefore still possible to contract the virus during that first week. People who received the first dose and became ill, receive the second dose on a schedule if their isolation is over. If not, then they get it after the end of their isolation,’’ explained Branko Kolaric.

“We’re now thinking about how we can get our hands on enough doses of the vaccine. We have a great interest, people who would readily get vaccinated are calling us,’’ he added.

Restrictions for those who are not vaccinated...

But the question arises - will there be restrictions for those who don’t get vaccinated? 

“Will there be any restrictions? In my opinion, yes, I think that’s possible. Some countries and companies will introduce that. Travel companies, airlines and the like said they would ask for their passengers to be vaccinated,’’ Branko Kolaric said.

When it comes to the anti-epidemic measures, he says it is difficult to say how long they’ll need to stay in place. "We’re monitoring the number of cases and the share of positives on a daily basis. This is going to remain as it is until January the 31st and after that we’ll see what the situation will be like,’’ he said, adding that he is optimistic about Croatia’s tourist season this year despite all.

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