Introduction

Denmark, Finland, Norway, and Sweden are in the northernmost part of Europe with a total population of about 20 million. The distribution of people is uneven, with the largest groups (ยป80%) living in Denmark and in the southernmost parts of Finland, Norway, and Sweden and only few inhabiting the huge areas of the very north. The populations are ethnically relatively homogenous, but for groups of immigrants of different ethnic and religious backgrounds and a small number of Lapps in the north of Finland, Norway, and Sweden.

The southern part of the region is temperate with a continental climate. There are four distinct seasons: summer is between June and August-September and winter is between December and March (3-4 months below zero). The very north is, in contrast, characterized by a sub-arctic climate without tundra but with long, dark winters of 4-6 months below zero, and short but relatively warm summers with long days and light nights. Parasites which are present in these northern parts of Europe will be discussed here (excluding arthropods), focussing on those that are the most frequent or are the most important in the view of their morbidity and mortality. Iceland, which also belongs to the Nordic countries, has a very distinct climate and geographical location. A separate chapter has therefore been dedicated to the parasites of Iceland (see Chapter 4).

The overall endemicity is very similar in Denmark, Finland, Norway, and Sweden but the surveillance systems used for detecting different pathogens vary, a fact that complicates the comparisons of their prevalence and incidence between the countries. Each of the different countries has a national agency which follows the epidemiology of infectious diseases and provides diagnostic help and advice to national health authorities (The State Serum Institute in Denmark, National Public Health Institute in Finland, National Institute of Public Health in Norway, and Swedish Institute for Infectious Disease Control in Sweden).

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