bluuebunny/crossref_metadata_2025 huggingface dataset:
The importance of school and social activities in the transmission of influenza A(H1N1)v: England, April – June 2009
Authors: Kar-Purkayastha I , Ingram C , Maguire H , Roche A
Published: October 2017

During the containment phase in the United Kingdom (April to June 2009), a cluster of influenza A(H1N1)v cases was identified prompting further investigation and public health action by the Health Protection Agency. The first confirmed case, a pupil at a school in England, was imported. During the following two weeks, 16 further cases were confirmed with epidemiological links to the first imported case. In this cluster, we found that significant transmission occurred in two classes with attack rates of 17% and 7%. In each of the two classes a case had attended school whilst symptomatic. Other settings included a party and a choir. Minimum and maximum attack rates were 14% and 25% for the party. For the choir both the minimum and the maximum attack rate was 4%. We did not find any evidence of transmission on two school bus trips despite exposure over 50 minutes to a symptomatic case and over two periods of 30 minutes to a case during the prodromal phase (i.e. within 12 hours of symptom onset). Nor was there onward transmission in another school despite exposure over several hours to two cases, both of whom attended school during the prodromal phase.
Increase in reported gonorrhoea cases in Sweden, 2001 - 2008
Authors: Velicko I , Unemo M
Published: October 2017

Gonorrhoea is on the rise in Sweden and in many other European countries. The present report describes and evaluates the gonorrhoea trends in Sweden from 2001 to 2008 when an increase of 32% was reported. Up to 86% of the cases were reported in men, with the highest proportion among heterosexually infected men (41-59% during these years). Heterosexually infected men more often acquired gonorrhoea abroad, especially in Thailand, whereas women and men who have sex with men were more likely to acquire the infection within Sweden. The recent increase in gonorrhoea cases in Sweden is most likely due to adoption of more risky sexual behaviour (e.g. an increase in the number of sexual partners and the number of new/casual sexual partners and/or low use of condoms) in the Swedish population. Further research regarding more effective identification and description of sexual transmission chains and sexual networks is needed in order to follow the spread of infection and to recognise more effective interventions to prevent the spread of gonorrhoea and also other sexually transmitted infections.
Oseltamivir susceptibility in south-western France during the 2007-8 and 2008-9 influenza epidemics and the ongoing influenza pandemic 2009
Authors: Burrel S , Roncin L , Lafon M E , Fleury H
Published: October 2017

The recent emergence of seasonal influenza A(H1N1) strains resistant to oseltamivir makes it necessary to monitoring carefully the susceptibility of human influenza viruses to neuraminidase inhibitors. We report the prevalence of the oseltamivir resistance among influenza A viruses circulating in south-western France over the past three years: seasonal influenza A(H1N1), seasonal influenza A(H3N2), and the influenza A(H1N1)v viruses associated with the ongoing 2009 pandemic. The main result of the study is the absence of oseltamivir resistance in the pandemic H1N1 strains studied so far (n=129).
Results of a vaccination campaign against human papillomavirus in the province of La Spezia, Liguria, Italy, March-December 2008
Authors: Lugarini J , Maddalo F
Published: October 2017

Sexually transmitted diseases caused by human papillomavirus (HPV) are being diagnosed more frequently than others. It is accepted that HPV infection is a necessary cause for all cases of cervical carcinoma and a large number of other anogenital and oral cancers. Two vaccines have been developed and were licensed in 2007, which can prevent infections and pre-cancerous lesions due to HPV. In Italy pre-adolescent age (12 years-old) was identified as the ideal age for vaccination against HPV. In Liguria, the first free HPV vaccination campaign was started on 8 March 2008 in 12 year-old girls. We assessed the adherence to the vaccination during the 2008 campaign as 80.6%, 79.0% and 64.1%, respectively, for the first, second and third dose of vaccine in the target population.
Pandemic H1N1 influenza surveillance in Victoria, Australia, April – September, 2009
Authors: Fielding J E , Higgins N , Gregory J E , Grant K A , Catton M G , Bergeri I , Lester R A , Kelly H A
Published: October 2017

Victoria was the first Australian state to report widespread transmission of pandemic H1N1 2009 influenza. Notifiable laboratory-confirmed influenza and a general practitioner sentinel surveillance system measuring influenza-like illness (ILI), including laboratory confirmation of influenza as the cause of ILI, were used to assess the pandemic. The pandemic influenza A(H1N1)v virus quickly became the dominant circulating strain and notification rates were highest in children and young adults. Despite a high number of notified cases, comparison of ILI rates suggested the season peaked in late June, was similar in magnitude to 2003 and 2007 and less severe than 1997. The majority of clinical presentations were mild, but one quarter of hospitalised cases required admission to intensive care. Given the low proportion of imported cases in the Victorian pandemic, the rapid increase in cases with no travel history and the low median age of cases notified during the phases of intense surveillance, we suggest there may have been silent importations of pandemic virus into Victoria before the first case was recognised. The usefulness of a general practitioner sentinel surveillance system to provide a comparable assessment of influenza and ILI activity over time was clearly demonstrated, and the need for similar hospital and mortality surveillance systems for influenza in Victoria was highlighted.
Interim report on pandemic H1N1 influenza virus infections in South Africa, April to October 2009: Epidemiology and factors associated with fatal cases
Authors: Archer B N , Cohen C , Naidoo D , Thomas J , Makunga C , Blumberg L , Venter M , Timothy G A , Puren A , McAnerney J M , Cengimbo A , Schoub B D
Published: October 2017

We provide an interim report on pandemic H1N1 influenza activity in South Africa, with a focus on the epidemiology and factors associated with deaths. Following the importation of the virus on 14 July 2009, and the epidemic peak during the week starting 3 August, the incidence in South Africa has declined. A total of 12,331 cases and 91 deaths have been laboratory-confirmed as of 12 October 2009. Age distribution and risk groups were similar to those observed elsewhere. The median age of patients who died (33.5 years) was significantly higher than that of the non-fatal cases (15.0 years, p<0.01). The most common underlying conditions among fatal cases were infection with human immunodeficiency virus (17/32 tested) and pregnancy (25/45 women of reproductive age). Active tuberculosis coinfection was present in seven of 72 fatal cases. These findings should be taken into consideration when planning vaccination strategies for 2010.
Chronic hepatitis C in Austria, 1992–2006: genotype distribution and demographic factors
Authors: Maieron A , Metz-Gercek S , Hackl F , Luger C , Ziachehabi A , Strauss R , Schöfl R , Mittermayer H
Published: October 2017

Chronic hepatitis C is a leading cause of end-stage liver disease and, with a worldwide prevalence of up to 3%, is a pandemic infectious disease. Austria, like most western European countries can be considered as a low prevalence country. This analysis aimed to assess the distribution of hepatitis C virus (HCV) genotypes in patients with chronic HCV infection in Upper Austria. Between September 1992 and December 2006, we identified 1,318 consecutive patients who tested positive for HCV RNA. Genotyping was routinely performed in 1,239 of the 1,318 patients, and in a subgroup of 617 patients data on the source of transmission were collected. Additionally we obtained data on liver histology and body mass index in a subsample of 273 of the 617 patients. Hepatitis C genotypes 1, 2, 3, 4, 6 and co-infections were found in 80.4%, 4.5%, 12.3%, 2.7%, 0.1% and 0.2% of the patients, respectively. There was a highly significant age difference in relation to gender at the time of diagnosis of chronic hepatitis C, with women being older than men (men: 45.0 years; women: 49.3 years; p<0.0001). The number of new cases of chronic hepatitis C decreased substantially over the last decade, but although risk factors for obtaining HCV are well established, we did not find a decrease in the age of first diagnosis. Besides consistent screening in defined risk groups it is important to raise awareness for risk factors for HCV acquisition and liver disease progression.
A cluster of Legionnaires' disease caused by Legionella longbeachae linked to potting compost in Scotland, 2008-2009
Authors: Pravinkumar S J , Edwards G , Lindsay D , Redmond S , Stirling J , House R , Kerr J , Anderson E , Breen D , Blatchford O , McDonald E , Brown A
Published: October 2017

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Influenza A(H1N1) outbreak in a long-term care facility for severely handicapped residents, Slovenia, March–April 2009
Authors: Socan M , Prosenc K , Tevž-Cizej N
Published: October 2017

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Seroprevalence of 2009 pandemic influenza A(H1N1) virus in Australian blood donors, October – December 2009
Authors: McVernon J , Laurie K , Nolan T , Owen R , Irving D , Capper H , Hyland C , Faddy H , Carolan L , Barr I , Kelso A
Published: October 2017

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Effectiveness of the 2010/11 seasonal trivalent influenza vaccine in Spain: preliminary results of a case–control study
Authors: Savulescu C , Jiménez-Jorge S , de Mateo S , Ledesma J , Pozo F , Casas I , Larrauri A , cycEVA Study Team Collective
Published: October 2017

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Characteristics of the enteroaggregative Shiga toxin/verotoxin-producing Escherichia coli O104:H4 strain causing the outbreak of haemolytic uraemic syndrome in Germany, May to June 2011
Authors: Scheutz F , Møller Nielsen E , Frimodt-Møller J , Boisen N , Morabito S , Tozzoli R , Nataro J P , Caprioli A
Published: October 2017

The Escherichia coli strain causing a large outbreak of haemolytic uraemic syndrome and bloody diarrhoea in Germany in May and June 2011 possesses an unusual combination of pathogenic features typical of enteroaggregative E. coli together with the capacity to produce Shiga toxin. Through rapid national and international exchange of information and strains the known occurrence in humans was quickly assessed. We describe simple diagnostic screening tools to detect the outbreak strain in clinical specimens and a novel real-time PCR for its detection in foods.
Food poisoning outbreaks linked to mussels contaminated with okadaic acid and ester dinophysistoxin-3 in France, June 2009
Authors: Hossen V , Jourdan-da Silva N , Guillois-Bécel Y , Marchal J , Krys S
Published: October 2017

In June 2009, 11 outbreaks of food poisoning occurred in France, involving 45 individuals who had consumed mussels harvested in Vilaine Bay (Northwestern France). Because the toxic dinoflagellate Dinophysis spp. had been detected in the area from mid-May, okadaic acid (OA) and dinophysistoxins were suspected to be the cause of these outbreaks, although the weekly monitoring tests by mouse bioassay had been negative. With the help of the French reporting system for food-borne disease outbreaks, the detailed data on epidemiology, mussel consumption and complete product traceback, were collected for 11 individuals involved in three reported outbreaks. The batch of mussels identified as the source of these three outbreaks contained concentrations of toxins of the okadaic acid group that were approximately eight times higher than the European regulatory limit. Moreover, based on the consumption data available for the 11 cases, a lowest observable adverse effects level (LOAEL) was deduced. The LOAEL calculated from this study, although based on a very limited number of individuals, was in the same range, i.e. approximately 50 ?g OA equivalents per person, as the LOAEL established by the European Food Safety Authority in 2006.
Surveillance status and recent data for Mycoplasma pneumoniae infections in the European Union and European Economic Area, January 2012
Authors: Lenglet A , Herrador Z , Magiorakos A P , Leitmeyer K , Coulombier D , European Working Group on Mycoplasma pneumoniae surveillance Collective
Published: October 2017

In January 2012, the European Centre for Disease Prevention and Control (ECDC) conducted an email-based survey of European Union and European Economic Area countries to describe the existing surveillance activities for Mycoplasma pneumoniae infections, recent findings and existence of clinical guidelines for the treatment of M. pneumoniae infection. Of the 20 countries that participated in the survey, seven reported increases in M. pneumoniae infections observed during the autumn and winter of 2011.
Two geographically separated food-borne outbreaks in Sweden linked by an unusual Cryptosporidium parvum subtype, October 2010
Authors: Gherasim A , Lebbad M , Insulander M , Decraene V , Kling A , Hjertqvist M , Wallensten A
Published: October 2017

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Interim estimates of influenza vaccine effectiveness in 2012/13 from Canada’s sentinel surveillance network, January 2013
Authors: Skowronski D M , Janjua N Z , De Serres G , Dickinson J A , Winter A-L , Mahmud S M , Sabaiduc S , Gubbay J B , Charest H , Petric M , Fonseca K , Van Caeseele P , Kwindt T L , Krajden M , Eshaghi A , Li Y
Published: October 2017

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Viral meningitis in Cyprus and England : summer 1996
Authors: Ramsay M E , Brown D W , Appleton H , Megson B , Polynikis A , Papantoniou L , Eleftheriou A
Published: October 2017

An outbreak of viral meningitis began in Cyprus on 5 July 1996. By 28 August a total of 316 cases had been admitted to hospital, most of whom were infants and young children; 55 (17%) were less than 1 year of age, 117 (37%) were aged 1 to 4 years, 103 (33
EWGLI: a European surveillance scheme for travel associated legionnaire’s disease
Authors: Hutchinson E. J. , Joseph C , Bartlett C L R
Published: October 2017

The European Working Group for Legionella Infections (EWGLI) was set up in 1986 and introduced the European Surveillance Scheme for Travel Associated Legionnaires’ Disease in 1987. The microbiologists working in reference laborat-ories and the epidemiolog
Editorial
Authors: Editorial Committee Collective
Published: October 2017

Over 30 years ago, AD Langmuir defined surveillance as “the ongoing systematic collection, collation and analysis of data and the prompt dissemination of the resulting information to those who need to know so that an action can result”. The countries of t
Outbreak of Salmonella enteritidis phage type 1 infection in British tourists visiting Mallorca, June 1996
Authors:   C Furtado,   S Crespi,   L Ward,   P Wall
Published: October 2017

Three British tourists became ill while on holiday in the same hotel in Alcudia, Mallorca from 11 to 25 June 1996; Salmonella enteritidisinfections were diagnosed upon their return to England. An environmental health officer informed the Gastrointestinal
Widespread dissemination of epidemic MRSA in German hospitals
Authors: Witte W , Cuny C , Braulke C , Heuck D , Klare I
Published: October 2017

Strains of Staphylococcus aureusresistant to multiple antibiotics, including those resistant to methicillin (MRSA), present a major problem in the control of hospital acquired infections. Some strains show a definite capacity for spread once introduced in
Eurosurveillance Weekly goes live
Authors: Editorial team Collective
Published: October 2017

Eurosurveillance Weekly, a weekly European bulletin on communicable diseases, and sister publication of Eurosurveillance, was launched on the world wide web in June. The Eurosurveillance Weekly homepage is updated once a week, but the frequency may be inc
Changing epidemiology of meningococcal disease in Spain, 1989-1997
Authors: Mateo S , Cano R , García C
Published: October 2017

In the 1980s, the presentation of meningococcal disease in Spain was closely linked to the predominance of serotype B. Since the early 1990s however, an increasing number of serotype C strains have been isolated from a number of localities in the west of
The European Union faces up to the threat of a pandemic: meeting at the DGV on the influenza A (H5N1) of the ad hoc group on communicable diseases Luxembourg 14 January 1998
Authors: Desenclos J C , Manigat R
Published: October 2017

The transmission of an avian influenza H5N1 virus to a child in Hong Kong in May 1997 followed by the occurrence of 17 other human cases with a high case fatality rate (6/18, 33%) suggested that an influenza pandemic could be imminent and led many Europea
Plans against influenza pandemics in Europe: history and principles
Authors: Hannoun C
Published: October 2017

Antigenic variation, New Jersey porcine influenza, Pandemic planning: Berlin 1993, Pandemics, Principles of action, H5N1 avian influenza in Hong Kong.
History of trichinellosis outbreaks linked to horse meat consumption 1975-1998
Authors: Ancelle T
Published: October 2017

Trichinellosis is a parasitic disease transmitted to humans by consumption of raw or undercooked meat from animals contaminated by worms of the Trichinella genus. In nature, the life cycle involves most carnivores, omnivores, and numerous rodents. Domesti
Upsurge of hepatitis A in the Netherlands – early 1998
Authors: Termorshuizen F , van de Laar M  J W
Published: October 2017

Far more cases of hepatitis A were identified in the Netherlands in the first five months of 1998 than in the same period of 1997 . In order to investigate the reasons for this upsurge we compared the notified cases of hepatitis A in the first five months
Outbreak of mumps associated with poor vaccine efficacy - Oporto Portugal 1996
Authors: Gonçalves G , de Araújo A , Monteiro Cardoso M. L.
Published: October 2017

Vaccination against mumps in Portugal began in 1987, with the introduction of the combined measles, mumps, and rubella vaccine (MMR) in the national vaccination programme (Programa Nacional de Vacinação: PNV) for both sexes at 15 months. In November 1990,
Emergence of multidrug resistant Salmonella thyphimurium DT 104 in the Czech Republic
Authors: Karpíšková R , Benes D , Dedicova D
Published: October 2017

The Czech Republic is a country in central Europe with a population of about 10 million inhabitants. Salmonellosis is the most commonly reported infectious intestinal disease. Until 1989 about 10 000 cases were reported each year, and similar numbers of S
The diversity of food poisoning and sources of contamination
Authors: Noah N
Published: October 2017

The three entirely different forms of food poisoning described in this issue of Eurosurveillance illustrate the extraordinary propensity of the organisms to survive and cause illness. Clostridium botulinum is an organism which produces its toxin (a toxin
A case of tuberculosis on a long distance flight: the difficulties of the investigation
Authors: Vassiloyanakopoulos A , Spala G , Mavrou E , Hadjichristodoulou C
Published: October 2017

Transmission of Mycobacterium tuberculosis from passenger to passenger aboard a long airplane flight was reported in 1996. Other cases were previously published, in particular by the Centers for Disease Control which had then suggested criteria for epidem
Pertussis immunisation in Europe – the situation in late 1999
Authors: Therre H , Baron S ,   contributors
Published: October 2017

The history of pertussis in European countries has clearly shown that immunisation decreases the morbidity associated with the disease. Inactivated whole cell pertussis vaccines (wP) have been used in some national vaccination programmes for over 30 years
MRSA in nursing homes in the Netherlands 1989 to 1998: a developing reservoir?
Authors: Goettsch W , Geubbels E , Wannet W , Hendrix M G R , Wagenvoort J H T , de Neeling A J
Published: October 2017

The prevalence of methicillin resistant Staphylococcus aureus (MRSA) in Dutch nursing homes in 1998 was higher than that found in 1989 to 1997. The increased prevalence of MRSA could lead to colonisation outside these nursing homes. A study of the prevale
Bioterrorism preparedness and response in European public health institutes
Authors: Coignard B
Published: October 2017

The terrorist attacks on 11 September 2001 and the deliberate release of anthrax in the United States had consequences for public health not only there, but also in Europe. Europe’s public health systems had to manage numerous postal materials possibly contaminated with anthrax. Our survey aimed to document the response of European public health institutes to recent bioterrorist events to identify the gaps that need to be addressed; 18 institutes from 16 countries participated in this Euroroundup. Bioterrorist threats in Europe were hoaxes only, and should be considered as a "preparedness exercise" from which three lessons can be drawn. Firstly, because of inadequate preparedness planning and funding arrangements, Europe was not ready in October 2001 to respond to bioterrorism. Secondly, although European institutes reacted quickly and adapted their priorities to a new type of threat, they need adequate and sustained support from national governments to maintain their overall capacity. Thirdly, the recent crisis demonstrated the need for increased investment in epidemiology training programmes and the establishment of a technical coordination unit for international surveillance and outbreak response in the European Union.
Influenza pandemic: preparedness planning in Germany
Authors: Fock R , Bergmann H , Bußmann H , Fell G , Finke E J , Koch U , Niedrig M , Peters M , Riedmann K , Scholz D , Wirtz A
Published: October 2017

The following conceptual framework formed the basis for a common decision made by the health ministers of Germany's 16 federal states to set up an influenza pandemic preparedness plan. The worst case scenario was used, on the basis of the data from the pandemic of 'Spanish flu', in 1918-20. The priority groups for vaccination were assessed, as well as the potentially available antiviral treatments. National policies could be highly improved by a common European view.
Current management of patients with Viral Haemorrhagic Fevers in the United Kingdom
Authors: Crowcroft N , Brown D  W , Gopal R
Published: October 2017

In the UK, suspected and confirmed cases of viral haemorrhagic fever are currently managed according to the 1996 Guidance of the Advisory Committee on Dangerous Pathogens, which describes an approach to the risk categorisation of suspected cases. It also provides guidance on patient management including transfer, laboratory investigations, infection control, and monitoring of contacts based on the risk assessment. Confirmed cases are managed in bed isolators ("Trexler units"), two of which are available in high security infectious disease units in the UK. This guidance is under review and may change. Recent experience has shown that communication and reassurance for health care workers and the public are major tasks in managing such cases.
The HIV infection in Europe: large East-West disparity
Authors: Semaille C , Alix J , Downs A M , Hamers F F
Published: October 2017

In 2001, western Europe faces an endemic situation for AIDS (22.8 cases per million population) and for HIV infection (54.9 cases per million), the most affected groups remaining injecting drug users and the homo/bisexual men. However, numbers of new HIV diagnoses are increasing among persons infected through heterosexual contact. Central Europe have been relatively spared, with AIDS incidence under 6 cases per million per year, and new HIV diagnoses between 7 and 10 cases per million. On the other hand, eastern Europe shows an epidemic increase in the number of newly diagnosed HIV infections (233 cases in 1994, around 100 000 reported cases in 2001, ie 349 cases per million population) affecting all countries.
Investigation of an unexplained skin disorder in a prison clinic in the Netherlands in 2002
Authors: Breugelmans J G , Bosman A , van der Heide A. K , Roeleveld-Kuijper E. Y.R , Bruynzeel D P
Published: October 2017

An unexplained outbreak of skin disorder with itching papules or pustules occurred among drugs body packers in a detention clinic in the Netherlands in October-November 2002. The descriptive cohort study suggests this outbreak could be associated with an expired batch of disposable linens, with an overall attack rate of 30% in the study population (n=118). No additionnal cases have been noted since this expired batch was replaced.
SARS: Retrospective cohort study among German guests of the Hotel 'M', Hong Kong
Authors: Radun D , Niedrig M , Ammon A , Stark K
Published: October 2017

Hong Kong played a pivotal role in the international spread of the Severe Acute Respiratory Syndrome (SARS): a doctor who spent the night of 21-22 February 2003 at Hotel 'M' was identified as the index case for four national and international clusters of SARS. In parallel to the international collaborative study led by WHO and United States, a retrospective study on the cohort of German persons staying at Hotel 'M' was conducted. The inclusion criteria covered a period from 21 February to 3 March 2003 to allow the detection of cases possibly due to environmental contamination. In the twenty-one German guests traced as having stayed at Hotel "M" during this period, one case of laboratory confirmed SARS was found. The case history suggests that close vicinity to the index patient may have played a role in transmission. In line with findings of environmental investigations in the hotel, environmental contamination should be considered as a possible source of infection.
The European Community Strategy Against Antimicrobial Resistance
Authors: Bronzwaer S , Lönnroth A , Haigh R
Published: October 2017

In 2001 the European Commission presented a 'Community strategy against Antimicrobial Resistance'. In previous years, the problem was addressed through an increasing number of isolated measures, but in this strategy the Commission outlined a comprehensive European Community approach across all sectors. The strategy consists of fifteen actions in four key areas: surveillance, prevention, research and product development, and international cooperation. An important part of this strategy is the 'Council Recommendation on the prudent use of antimicrobial agents in human medicine'. The Recommendation provides a detailed set of public health actions to contain antimicrobial resistance.
This paper presents the eleven points of action of the strategy that are directly related to human medicine, and discusses related European Community activities. Under the new public health programme as well as under the research programme of the European Union, antimicrobial resistance is a key priority.
Rubella in Denmark
Authors: Glismann S
Published: October 2017

An average of 20 000 rubella cases were recorded annually in Denmark until 1987. In 1989, however, only 1006 cases were reported, and the true current incidence of rubella infection in Denmark is unknown but considered to be very low and <1 per 100 000 population. The significant decrease in the inci-dence of rubella mirrors the success of vaccination of rubella seronegative women of childbearing age, which was initiated in Denmark in 1980. From 1982 and onwards the national health security scheme also refunded vaccina-tion of children and the MMR vaccine was introduced in the Danish child-hood vaccination program in 1987. The low incidence has been sustainable due to these interventions, and since 1994 congenital rubella syndrome and rubella in pregnancy have been listed as notifiable infectious diseases in Denmark. Nevertheless, in order to meet the WHO goal of control of rubella in the Region, the introduction of mandatory reporting of all laboratory diagnosed rubella cases is now being considered.
Basic Surveillance Network, a European database for surveillance data on infectious diseases
Authors: Ternhag A , Tegnell A , Lesko B , Skaerlund K , Penttinen P
Published: October 2017

The Basic Surveillance Network was started in 2000 and is one of the networks on infectious diseases funded by the European Commission. The network collects and makes readily available basic surveillance data on infectious diseases from all the 'old' (pre-2004) European Union member states. The aim is to provide easy access to descriptive data that already exist in national databases, so that it is possible to monitor and compare incidence trends for infectious diseases in the EU member states. The list of diseases covered by the network has recently been expanded from 10 initial 'pilot' diseases to over 40 diseases listed by the EU to be under surveillance. In the near future, the new member states will be invited to participate in the network. Data are case-based and comprise date of onset of disease, age and sex. Only a very short list of disease specific additional variables, such as country of infection or immunisation status, is collected. Classification of cases ( possible, probable, confirmed) is specified according to EU case definitions. The participants of the network have access to an internal web site were all the data is presented in tables and graphs. An open website is available for the public at https://www.eubsn.org./BSN/
Surveillance of invasive meningococcal disease in the Czech Republic
Authors: Kriz P
Published: October 2017

Routine notification of invasive meningococcal disease has a long tradition in the Czech Republic: mortality data are available from 1921 and morbidity data from 1943. The collection of Neisseria meningitidis strains kept in the NRL for Meningococcal Infections in Prague dates from 1970 onwards, and represents more than 3500 strains isolated from invasive disease and their contacts, from healthy carriers and from respiratory infection. Analysis of these strains showed that the Czech meningococcal population is different from that seen in western Europe. In 1993, the incidence serogroup C meningococcal disease increased and was associated with the emergence of the hypervirulent complex Neisseria meningitidis C, ST-11, ET-15/37, and caused an increase in the incidence of invasive meningococcal disease which peaked in 1995 (2.2/100 000). A vaccination strategy targeting the part of the population at highest risk of invasive meningococcal disease was adopted in the country.
Bichat clinical guidelines for bioterrorist agents
Authors: Bossi P , van Loock F , Tegnell A , Gouvras G
Published: October 2017

The deliberate release of anthrax in the United States shortly after the terrorist attacks of 11 September 2001 brought about a radical change in people’s perception of the risk of bioterrorism. These bioterrorist events, unlike others before, had a worldwide impact not only in respect of security and public health but also in other sectors. Governments and international entities with responsibilities related to maintenance of peace, security, safety and health protection reviewed urgently their political, economic, diplomatic, military and legal means to face up to such attacks and embarked upon major efforts to increase their preparedness.
Bichat guidelines for the clinical management of Q fever and bioterrorism-related Q fever
Authors: Bossi P , Tegnell A , Baka A , van Loock F , Werner A , Hendriks J , Maidhof H , Gouvras G
Published: October 2017

Q fever is a zoonotic disease caused by Coxiella burnetii. Its interest as a potential biological weapon stems from the fact that an aerosol of very few organisms could infect humans. Another route of transmission of C. burnetii could be through adding it to the food supply. Nevertheless, C. burnetii is considered to be one of the less suitable candidate agents for use in a bioterrorist attack; the incubation is long, many infections are inapparent and the mortality is low. In the case of an intentional release of C. burnetii by a terrorist, clinical presentation would be similar to naturally occurring disease. It may be asymptomatic, acute, normally accompanied by pneumonia or hepatitis, or chronic, usually manifested as endocarditis. Most cases of acute Q fever are asymptomatic and resolve spontaneously without specific treatment. Nevertheless, treatment can shorten the duration of illness and decrease the risk of complications such as endocarditis. Post-exposure prophylaxis is recommended after the exposure in the case of a bioterrorist attack.
Surveillance of tick-borne encephalitis in Europe and case definition
Authors: Günther G , Lindquist L
Published: October 2017

The study by Stefanoff et al raises two important questions concerning tick-borne encephalitis (TBE) virus infections. First, the lack of a generally accepted case definition and secondly the quality of national surveillance of TBE cases. Ideally, reported cases should be confirmed and the clinically relevant cases with central nervous system (CNS) disease should be separated from febrile cases without CNS manifestations. The surveillance of TBE in the European countries is not uniform and not always mandatory. Efforts to reach a final diagnosis, especially in less severe cases and in children, varies as well as the awareness of the disease in low endemic regions. The only relevant and stable basis for national surveillance is cases with established CNS disease, although immunity to TBE virus after less severe febrile illness is of interest on individual basis. The ratio of non-CNS disease to CNS disease is generally believed to be about three, but there are regional differences in virulence. Significantly, age related differences are basically unknown.
Avian and pandemic influenza–Five questions for 2006
Authors: Nicoll A
Published: October 2017

In January this year it was observed that 2005 was going to be the Year of the Rooster in the Chinese calendar, and that perhaps was an ill omen for bird (avian) and pandemic influenza. Certainly, influenza was the infection that then dominated the popular press in 2005, and so in a certain way this was a very ‘good’ year for influenza and those who study it. The infection has been getting the attention it deserves as a human threat.
Tribute to Andrea Infuso
Authors: Editorial team Collective
Published: October 2017

This special issue of Eurosurveillance is dedicated to the memory of Andrea Infuso, a dear and respected colleague and friend, who died suddenly on 20 September 2005 at the age of 44.
Andrea was actively involved in the preparation of this special issue on vaccination and tuberculosis. As EuroTB coordinator since 2000, his knowledge of and contacts with all European experts involved in tuberculosis surveillance in Europe were very valuable in conceiving this thematic issue. The Euroroundup published in this issue, European survey of BCG vaccination policies and surveillance in children, 2005, written by Andrea as first author, is a posthumous publication.
Tuberculosis control in Latvia: integrated DOTS and DOTS-plus programmes
Authors: Leimane V , Leimans J
Published: October 2017

From 1991 until the end of 1998, the number of patients with tuberculosis in Latvia increased 2.5 times with a simultaneous increase of drug resistant and multidrug resistant tuberculosis (MDR-TB).
Descriptive analysis of different TB programme services, activities and strategies including Directly Observed Therapy Short-course (DOTS) for tuberculosis and treatment of MDR-TB, were performed. Data from the state tuberculosis registry, drug resistance surveillance, and the national MDR-TB database were used. The state-funded national tuberculosis control programme (NTAP, Nacionâlâ Tuberkulozes Apkarodanas Programma), based on WHO recommended DOTS strategy, was introduced in Latvia in 1996. The NTAP includes TB control in prisons. Treatment of MDR-TB using second line drugs was started in 1997. Cure rates for TB patients increased from 59.5% in 1996 to 77.5% in 2003. Between 1996 and 2003, more than 200 patients began MDR-TB treatment each year, and the cure rate was between 66% and 73%. Numbers of MDR-TB patients were reduced by more than half during this period. Treatment results including MDR-TB reached the WHO target, with cure rates 85% of newly diagnosed patients. These results demonstrate that MDR-TB treatment and management using the individualised treatment approach can be effectively provided within the overall TB programme on a national scale, to successfully treat a large number of MDR-TB patients.
Rapid diagnostic methods combined with early intensified case finding, isolation and infection control measures could decrease transmission of TB and MDR-TB in hospitals and in the community. Highly important that MDR-TB management follows WHO recommendations in order to stop creating drug resistance to first and to second line drugs.
Surveillance of human listeriosis in France, 2001-2003
Authors: Goulet V , Jacquet C , Martin P , Vaillant V , Laurent E , de Valk H
Published: October 2017

Mandatory notification of listeriosis began in France in 1999. Enhanced public health surveillance, including routine molecular characterisation of Listeria monocytogenes strains, epidemiologic follow up of cases, and collection of food samples, has improved the sensitivity of outbreak detection and response.
Is there a need for a public vaccine production capacity at European level?
Authors: Lévy-Bruhl D
Published: October 2017

In this issue of Eurosurveillance, Rouaud et al report a protracted outbreak of meningococcal B invasive diseases (BMD) in the northern French department of Seine-Maritime, linked to the local expansion of a clonal strain of B:14:P1.7,16 phenotype, belonging to the ST32/ET5 clonal complex.
The emergence of LGV in Western Europe: what do we know, what can we do?
Authors: Van de Laar M JW
Published: October 2017

Lymphogranuloma venereum (LGV), a systemic sexually transmitted disease (STD) caused by a variety of the bacterium Chlamydia trachomatis, occurs rarely in the Western world [1]. However, in January 2004, public health officials in the Netherlands noted an outbreak of cases of LGV proctitis among men who have sex with men (MSM) [2]. Since then, cases have been reported from several European countries, and the United States of America and Canada. In this issue three countries report on the current status of LGV [3-5].
Investigation of a tuberculosis cluster at a job centre in Manchester, United Kingdom
Authors: Kirkpatrick A , Bell C , Petrovic M , Woodhead M , Barrett A , Duffell E , Verma A , Reynolds F
Published: October 2017

During the summer of 2005, four cases of active tuberculosis from the same occupational setting were investigated in Manchester, UK. The index case had been diagnosed in December of the previous year. At that stage the closest occupational contacts had been screened, all of whom were assessed as being free from active disease, and none had met nationally recommended criteria for chemoprophylaxis for latent tuberculosis infection (LTBI).

In June 2005, two work contacts developed progressive primary extrapulmonary (pleural) TB. Following a detailed risk assessment, the screening programme was widened to include 137 staff who worked at the job centre (employment agency) where the first four cases had been found. This screening programme was based on tuberculin Mantoux testing, CXR and gamma-interferon testing. Of these 137 contacts screened, one additional person was found to have active disease and six others were offered chemoprophylaxis for LTBI. The isolates from the index case and the first two secondary cases were indistinguishable on VNTR-MIRU (variable number tandem repeat - mycobacterial interspersed repetitive unit) typing at 15 loci. No samples were available for testing from the fourth case of active disease.

Management of this incident has benefited from the evolving fields of both genotyping and diagnostic testing for LTBI. However, further research into the epidemiological inferences made through genotyping, as well as the significance of a positive gamma-interferon test in assessing the risk of development of active disease, is still required.
Great diversity of tuberculosis treatment in Finland
Authors: Vasankari T , Kokki M , Holmström P , Liippo K , Sarna S , Ruutu P
Published: October 2017

We investigated the treatments given and the outcome in a national cohort of culture-verified pulmonary tuberculosis cases in Finland. Our aim was to find out how adequate TB treatment was, and the outcome of treatment. Medical records of all culture-verified pulmonary tuberculosis cases in 1995 - 1996 were abstracted to assess treatment and outcome, using the European recommendations for outcome monitoring.
A hotel-based outbreak of Salmonella enterica subsp. Enterica serovar Enteritidis (Salmonella Enteritidis) in the United Kingdom, 2006
Authors: Calvert N , Murphy L , Smith A , Copeland D , Knowles M
Published: October 2017

An outbreak of food-borne Salmonella Enteritidis PT4 occurred in Cumbria, in north-west England, in the summer of 2006. Fifteen people, all with positive stool samples, met the case definition; three of these were admitted to hospital, including one patient who died. Preliminary investigations suggested a link to a meal served at a local hotel. A case control study was implemented, together with microbiological and environmental investigations. Fifteen microbiologically confirmed cases and 27 unmatched controls were included in the study, controls being randomly selected from people who had eaten at the hotel on the same day. The epidemiological evidence indicated a very strong association between infection and consumption of tiramisu made with raw shell eggs, although none were available for microbiological investigation. These results are in line with other salmonellosis outbreaks that have been associated with the use of raw shell eggs in food manufacturing and production.This paper highlights the continuing need for a greater awareness by those who work in the food industry of the health risks associated with the consumption of raw shell eggs.
Community outbreak of Legionnaires’ disease in Vic-Gurb, Spain in October and November 2005
Authors: Sala M R , Arias C , Oliva J M , Pedrol A , Roura P , Domínguez A
Published: October 2017

This paper reports the investigation of a community-acquired outbreak of Legionnaires'; disease in the municipalities of Vic and Gurb (Central Region of Catalonia, Spain). There were 55 cases reported in October and November 2005. An epidemiological and environmental investigation was undertaken. Thirty-five case patients (64%) lived in Vic or Gurb, while 36% had visited or worked in Vic or Gurb during the 10 days before onset of symptoms, but no commonly frequented building could be identified. Water probes for culture were obtained from 30 cooling towers. In five cooling towers of two industrial settings in Gurb (plants A and B), Legionella pneumophila (Lp) serogroup 1 was present. Two Lp-1 strains were recovered from cooling towers in plants A and B. The Lp-1 strain from plant A showed a PGFE profile identical with those obtained from three patients. The exposure to Legionella pneumophila apparently occurred in a large area, since 43 of the 55 cases lived, visited or worked within a distance of 1,800 m from plant A, and six cases in a distance between 2,500 and 3,400 m. The inspections of cooling towers in plant A revealed inadequate disinfectant doses of biocide, non-existent maintenance records on weekends and wrong sample points for routine microbial check-ups. Weather conditions in October 2005 template temperature and high humidity (wind conditions are unappreciable) could have been favourable factors in this outbreak together with the flat terrain of Gurb and Vic area, explaining the extensive horizontal airborne dissemination of contaminated aerosols. The outbreak could have been prevented by proper and correct maintenance of the cooling tower at plant A.
Experiences with the new genetic variant of Chlamydia trachomatis in Örebro county, Sweden – proportion, characteristics and effective diagnostic solution in an emergent situation
Authors: Unemo M , Olcén P , Agné-Stadling I , Feldt A , Jurstrand M , Herrmann B , Persson K , Nilsson P , Ripa T , Fredlund H
Published: October 2017

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Is STI surveillance in England meeting the requirements of the 21st century? An evaluation of data from the South West Region
Authors: Ihekweazu C , Maxwell N , Organ S , Oliver I
Published: October 2017

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Haemorrhagic Fever with Renal Syndrome: an analysis of the outbreaks in Belgium, France, Germany, the Netherlands and Luxembourg in 2005
Authors: Heyman P , Cochez C , Ducoffre G , Mailles A , Zeller H , Abu Sin M , Koch J , van Doornum G , Koopmans M , Mossong J , Schneider F
Published: October 2017

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Gripenet: an internet-based system to monitor influenza-like illness uniformly across Europe
Authors: van Noort S P , Muehlen M , Rebelo de Andrade H , Koppeschaar C , Lima Lourenço J M , Gomes M GM
Published: October 2017

Gripenet has been monitoring the activity of influenza-like-illness (ILI) with the aid of volunteers via the internet in the Netherlands and Belgium since 2003 and in Portugal since 2005. In contrast with the traditional system of sentinel networks of mainly primary care physicians coordinated by the European Influenza Surveillance Scheme (EISS), Gripenet obtains its data directly from the population. Any resident of the three countries can participate in Gripenet by completing an application form on the appropriate websites (http://www.gripenet.pt), which contains various medical, geographic and behavioural questions. Participants report weekly on the website any symptoms they have experienced since their last visit. ILI incidence is determined on the basis of a uniform case definition.In the 2006/2007 season, 19,623 persons participated in Gripenet in the Netherlands, 7,025 in Belgium and 3,118 in Portugal. The rise, peak and decline of ILI activity occurred at similar times according to Gripenet and EISS. However, ILI attack rates in the Netherlands (6.6%), Belgium (6.1%) and Portugal (5.6%) were remarkably more similar in Gripenet than in EISS (0.8%, 3.9%, and 0.6% respectively).Monitoring ILI activity with the direct participation of volunteers provides similar incidence curves compared to the traditional system coordinated by EISS. Whereas EISS provides an established system whose data is validated by virology tests, Gripenet is a fast and flexible monitoring system whose uniformity allows for direct comparison of ILI rates between countries. A current objective of Gripenet is to engage more European countries.
General practitioners’ role in the notification of communicable diseases – study in Malta
Authors: Gauci C , Gilles H , O’Brien S , Mamo J , Calleja N
Published: October 2017

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