bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiological and virological assessment of influenza activity in Europe, during the 2006-2007 winter
Authors: Arkema J MS , Meijer A , Meerhoff T J , Van Der Velden J , Paget W  J , European Influenza Surveillance Scheme (EISS) Collective
Published: October 2017

Influenza surveillance in Europe is based on influenza surveillance networks that cooperate and share information through the European Influenza Surveillance Scheme (EISS). EISS collected clinical and virological data on influenza in 33 countries during the 2006-2007 winter. Influenza activity started around 1 January and first occurred in Greece, Scotland and Spain. It then moved gradually across Europe from south to north and lasted until the end of March. In 29 out of 33 countries, the consultation rates for influenza-like-illness or acute respiratory infections in the winter of 2006-2007 were similar or somewhat higher than in the 2005-2006 winter. The highest consultation rates for influenza-like-illness were generally observed among children aged 0-4 years and 5-14 years. The predominant virus strain was influenza A (97% of total detections) of the H3 subtype (93% of H-subtyped A viruses; 7% were A(H1)). The influenza A(H3) and A(H1) viruses were similar to the vaccine reference strains for the 2006-2007 season, A/Wisconsin/67/2005 (H3N2) and A/New Caledonia/20/99 (H1N1) respectively. The majority of the influenza B viruses were similar to the reference strain B/Malaysia/2506/2004, included in the 2006-2007 vaccine. In conclusion, the 2006-2007 influenza season in Europe was characterised by moderate clinical activity, a south to north spread pattern across Europe, and a dominance of influenza A(H3). Overall there was a good match between the vaccine virus strains and the reported virus strains.
EUREGIO MRSA-net Twente/Münsterland – a Dutch-German cross-border network for the prevention and control of infections caused by methicillin-resistant Staphylococcus aureus
Authors: Friedrich A W , Daniels-Haardt I , Köck R , Verhoeven F , Mellmann A , Harmsen D , van Gemert-Pijnen J E , Becker K , Hendrix M  G R
Published: October 2017

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Q fever in the Netherlands – what matters is seriousness of disease rather than quantity
Authors: Cilla G , Montes M , Pérez-Trallero E
Published: October 2017

As the number of detected cases may be closely related to the intensity of the search and the methods and criteria used in the diagnosis, we believe that exhaustive surveillance under pressure from the media could lead to over-diagnosis and unnecessary treatments which, like that of pregnant women, are not free of risk.
Surveillance of giardiasis in Northwest England 1996-2006: impact of an enzyme immunoassay test
Authors: Ellam H , Verlander N Q , Lamden K , Cheesbrough J S , Durband C A , James S
Published: October 2017

The incidence of giardiasis in Central Lancashire increased following the introduction of a sensitive enzyme immunoassay diagnostic test in November 2002. We compared the epidemiological trends for 1996-2006 in Central Lancashire with a control area which used a standard wet preparation diagnostic method throughout. Poisson regression modelling was used to investigate trends in giardiasis before and after the introduction of the test. In the control area, incidence of giardiasis was four per 100,000 in 2005. In contrast, in Central Lancashire, the rates increased in temporal association with the introduction of the enzyme immunoassay test from 10.1 per 100,000 population in 2002 to 33.6 per 100,000 in 2006. The increase in giardiasis was unexplained by local factors including travel, outbreaks or sampling trends. The increase in giardiasis occurred in all age groups except for males aged 0-14 years and was most marked in males aged 25-44 years. The relative risk for trend post-test introduction in Central Lancashire was 1.11 (95% CI, 1.01-1.23). This suggests that the increase in giardiasis following the introduction of the sensitive enzyme immunoassay test was at least in part due to improved detection. There appears to be considerable under-diagnosis of giardiasis, particularly in adults. Additional research is required to evaluate the enzyme immunoassay test more widely. The test may assist in standardisation of diagnostic methods for giardiasis and enable more accurate estimation of disease burden and transmission routes.
Two severe cases of botulism associated with industrially produced chicken enchiladas, France, August 2008
Authors: King L A , the French multidisciplinary outbreak investigation team collective
Published: October 2017

Two severe familial cases of botulism were reported to the health authorities in Brittany, north-west France, on 11 August 2008. An investigation was undertaken to identify additional cases, the vehicle of transmission, and to put in place adapted control measures.
Melamine contamination of dairy products in China – public health impact on citizens of the European Union
Authors: Coulombier D , Heppner C , Fabiansson S , Tarantola A , Cochet A , Kreidl P , Reintjes R
Published: October 2017

On 10 September 2008, ProMED issued a request for information concerning 14 cases of kidney stones in infants hospitalised in Gansu province, China, in the previous two months [1]. On 21 September, Chinese authorities reported 39,965 cases of kidney stones in infants, including three deaths related to the consumption of melamine-contaminated powdered infant formula. On that day, 12,892 of them were hospitalised, 104 with severe illness. Most of these cases (82%) affected children under two years of age.
Methicillin-resistant Staphylococcus aureus nasal carriage among healthy employees of the Hellenic Air Force
Authors: Karapsias S , Piperaki E T , Spiliopoulou I , Katsanis G , Tseleni - Kotsovili A
Published: October 2017

The prevalence of methicillin-resistant Staphylococcus aureus nasal carriage among 959 healthy employees of the Hellenic Air Force was investigated from November 2004 to October 2005. Nine participants were found to be colonised by methicillin-resistant Staphylococcus aureus (MRSA) (SCCmec type IV). Eight of the MRSA isolates were PVL-negative and belonged to ST30 by MLST, while the remaining one isolate was PVL-positive and classified as ST-80
An international outbreak of Shiga toxin-producing Escherichia coli O157 infection due to lettuce, September – October 2007
Authors: Friesema I , Sigmundsdottir G , van der Zwaluw K , Heuvelink A , Schimmer B , de Jager C , Rump B , Briem H , Hardardottir H , Atladottir A , Gudmundsdottir E , van Pelt W
Published: October 2017

Between 14 September and 20 October 2007, an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157 simultaneously occurred in the Netherlands and Iceland. A total of 50 laboratory-confirmed cases were reported with a STEC O157 infection caused by the same clone. The strain was of type O157:H-, PT8, positive for stx1, stx2, eae and e-hly, and sorbitol negative. The most probable cause of this international outbreak was contaminated lettuce, shredded and pre-packed in a Dutch food processing plant. Samples of the environment, raw produce and end products, taken at several vegetable growers and processing plants all tested negative for STEC O157. However, the only epidemiological link between the cases in the Netherlands and in Iceland was the implicated Dutch processing plant. In Europe, food products are often widely distributed posing the risk of potential spread of food borne pathogens simultaneously to several countries. This international outbreak emphasises the importance of common alert and surveillance systems in earlier detection of international outbreaks and better assessment of their spread.
Mumps outbreak on the island of Anglesey, North Wales, December 2008-January 2009
Authors: Roberts C , Porter-Jones G , Crocker J , Hart J
Published: October 2017

Twenty-three cases of clinical mumps in young people have been reported in North Wales over a five-week period since late December 2008. All cases have social links, and most of them have received two doses of mumps-containing vaccine.
Increased number of dengue cases in Swedish travellers to Thailand
Authors: Heddini A , Janzon R , Linde A
Published: October 2017

Between 2004 and 2008, around 30-60 cases of dengue fever in travellers were reported annually in Sweden. Over 75% of cases in 2005-2008 were infected when travelling to Southeast Asia, most if them in Thailand, one of the Swedes’ most popular holiday destinations. Since 2007, we have observed a 55% increase in the number of dengue fever cases reported per month, with 17 cases reported in January 2009 alone.
Early estimates of the excess mortality associated with the 2008-9 influenza season in Portugal
Authors: Nogueira P J , Nunes B , Machado A , Rodrigues E , Gómez V , Sousa L , Falcão J  M
Published: October 2017

The aim of this study was to estimate the excess mortality associated with the influenza activity registered in Portugal between week 49 of 2008 and week 5 of 2009. For this purpose available mortality data from the Portuguese Daily Mortality Monitoring (VDM) System were used. Several estimates of excess deaths associated with the recent recorded influenza activity were determined through statistical modelling (cyclic regression) for the total population and disaggregated by gender and age group. The results show that the impact of the 2008-9 influenza season was 1,961 excess deaths, with approximately 82% of these occurring in the age group of 75 years and older.
First sequence-confirmed case of infection with the new influenza A(H1N1) strain in Germany
Authors: Melzl H , Wenzel J J , Kochanowski B , Feierabend K , Kreuzpaintner B , Kreuzpaintner E , Rohrhofer A , Schreder-Meindl S , Wollner H , Salzberger B , Reischl U , Jilg W , Wolf H , Niller H H
Published: October 2017

Here, we report on the first sequence-confirmed case of infection with the new influenza A(H1N1) virus in Germany. Two direct contacts of the patient were laboratory-confirmed as cases and demonstrate a chain of direct human-to-human transmission.
A preliminary estimation of the reproduction ratio for new influenza A(H1N1) from the outbreak in Mexico, March-April 2009
Authors: Boëlle P Y , Bernillon P , Desenclos J  C
Published: October 2017

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Clinical laboratory practices for the detection of rotavirus in England and Wales: can surveillance based on routine laboratory testing data be used to evaluate the impact of vaccination?
Authors: Atchison C J , Lopman B A , Harris C J , Tam C C , Iturriza Gómara M , Gray J J
Published: October 2017

Two rotavirus vaccines have recently been licensed in Europe. Rotavirus surveillance data in many European countries are based on reports of laboratory-confirmed rotavirus infections. If surveillance data based on routine laboratory testing data are to be used to evaluate the impact of vaccination programmes, it is important to determine how the data are influenced by differences in testing practices, and how these practices are likely to affect the ability of the surveillance data to represent trends in rotavirus disease in the community. We conducted a survey of laboratory testing polices for rotavirus gastroenteritis in England and Wales in 2008. 60% (94/156) of laboratories responded to the survey. 91% of reporting laboratories offered routine testing for rotavirus all year round and 89% of laboratories offered routine rotavirus testing of all stool specimens from children under the age of five years. In 96% of laboratories, rotavirus detection was presently done either by rapid immunochromatographic tests or by enzyme-linked immunosorbent assay. Currently, rotavirus testing policies among laboratories in England and Wales are relatively homogenous. Therefore, surveillance based on laboratory testing data is likely to be representative of rotavirus disease trends in the community in the most frequently affected age groups (children under the age of five years) and could be used to help determine the impact of a rotavirus vaccine.
Shigella sonnei infections in Norway associated with sugar peas, May – June 2009
Authors: Heier B  T , Nygård K , Kapperud G , Lindstedt B A , Johannessen G S , Blekkan H
Published: October 2017

In May 2009, the Norwegian Institute of Public Health (NIPH) identified a possible outbreak of Shigella sonnei infection involving four cases. Additionally, five suspected cases in two separate households were reported. Inspectors from the Norwegian Food Safety Authority (NFSA) visited the two households and found an unopened package of sugar peas imported from Kenya in one of the households. One sample from the sugar peas was positive for Shigella sonnei by two PCR methods. Based on this result and information from patient interviews, the NFSA prohibited all sales of sugar peas imported from Kenya.
An outbreak of Shigella dysenteriae in Sweden, May–June 2009, with sugar snaps as the suspected source
Authors: Löfdahl M , Ivarsson S , Andersson S , Långmark J , Plym-Forshell L
Published: October 2017

We report an outbreak of Shigella dysenteriae type 2 infections during May- June 2009 in Sweden, involving 47 suspected cases of whom 35 were laboratory-confirmed. The epidemiological investigation based on interviews with the patients pointed at sugar snaps from Kenya as the source. Shigella was not detected in samples of sugar snaps. However, Escherichia coli was confirmed in three of four samples indicating contamination by faecal material. During April to May 2009 outbreaks with Shigella connected to sugar snaps from Kenya were reported from Norway and Denmark. In the three countries trace back of the indicated sugar snaps revealed a complex system with several involved import companies and distributers. In Sweden one wholesale company was identified and connections were seen to the Danish trace back. These three outbreaks question whether the existing international certification and quality standards that are in place to prevent products from contamination by faecal pathogens are strict enough.
Repeated prevalence studies on antibiotic use in Latvia, 2003-2007
Authors: Dimiņa E , Kūla M , Caune U , Vīgante D , Liepiņš M , Zeidaka L , Ņikitina O , Kūriņa D , Mironovska A , Dumpis U
Published: October 2017

Antibiotic resistance and nosocomial infections have recently been recognised as a growing threat in Latvian hospitals. We used a modified point prevalence study design to gain accurate information on the antibiotic prescription pattern and the prevalence of nosocomial infections in different hospital departments. A given department was observed on a given day in a given month (May) five years in a row. All antibiotic treatments, dose and route of administration were recorded, in addition to demographic data. The most commonly used antibiotic groups were first generation cephalosporins (35.6-38.9%), broad-spectrum penicillins (17.5-23.0%), fluoroquinolones (8.4-14.5%) and aminoglycosides (7.7-12.6%). Cefazolin was the most commonly used antibiotic. Antibiotics were predominantly used intravenously. The proportion of oral administration varied from 15.1% to 21.8%. A large proportion (13.3%) of the antibiotics was administered without clear reason. The crude prevalence rate of infection treated with antibiotics was 19.3%. The average prevalence of nosocomial infections was found to be 3.6%. These prevalence studies provided an opportunity to compare hospitals and outline variations and problem areas. They indicated the main problems in antibiotic prescription: large interhospital variations in the choice of an antibiotic for the most common infections, frequent antibiotic use without clear reason, and predominant intravenous administration.
Multidrug-resistant Neisseria gonorrhoeae with reduced cefotaxime susceptibility is increasingly common in men who have sex with men, Amsterdam, the Netherlands
Authors: de Vries H JC , van der Helm J J , Schim van der Loeff M F , van Dam A P
Published: October 2017

Antimicrobial resistance is an increasing problem in Neisseria gonorrhoeae (NG) treatment. Presently, third-generation parenteral cephalosporins, like ceftriaxone and cefotaxime, are the first option. Resistance to oral, but not to parenteral, third-generation cephalosporins has been reported previously. We analysed the microbial susceptibility (as minimum inhibitory concentration - MIC) of NG cultures obtained from high-risk visitors of the largest Dutch outpatient clinic for sexually transmitted infections (STI) in Amsterdam, the Netherlands. Among 1,596 visitors, we identified 102 patients with at least one NG isolate with reduced susceptibility to cefotaxime (0.125 μg/ml < MIC ≤ 0.5 μg/ml). The percentage of NG isolates with reduced susceptibility to cefotaxime rose from 4.8% in 2006 to 12.1% in 2008 (chi2 17.5, p<0.001). With multivariate logistic regression, being a man who has sex with men (MSM) was significantly associated with reduced susceptibility to cefotaxime (p<0.001). Compared to susceptible NG isolates, those with decreased susceptiblity to cefotaxime were more often resistant also to penicillin (16.5% vs. 43.3%), tetracycline (21.5% vs. 68.9%) and ciprofloxacin (44.4% vs. 90.0%, all p<0.001). The increased prevalence of NG strains with reduced susceptibility to cefotaxime among MSM may herald resistance to third-generation parenteral cephalosporins. A considerable proportion of these strains show resistance to multiple antibiotics which could limit future NG treatment options.
Economic consequences to society of pandemic H1N1 influenza 2009 –
preliminary results for Sweden
Authors: Brouwers L , Cakici B , Camitz M , Tegnell A , Boman M
Published: October 2017

Experiments using a microsimulation platform show that vaccination against pandemic H1N1 influenza is highly cost-effective. Swedish society may reduce the costs of pandemic by about SEK 2.5 billion (approximately EUR 250 million) if at least 60 per cent of the population is vaccinated, even if costs related to death cases are excluded. The cost reduction primarily results from reduced absenteeism. These results are preliminary and based on comprehensive assumptions about the infectiousness and morbidity of the pandemic, which are uncertain in the current situation.
Residual immunity in older people against the influenza A(H1N1) – recent experience in northern Spain
Authors: Pérez-Trallero E , Piñeiro L , Vicente D , Montes M , Cilla G
Published: October 2017

The 2009 pandemic influenza A(H1N1) virus has a higher incidence in children and young adults, a pattern that has also been reported in seasonal influenza caused by the influenza A(H1N1) virus. We analysed age at infection in symptomatic patients with influenza in the Basque Country (northern Spain), reported through the sentinel influenza surveillance system which monitors 2.2-2.5% of the population. Between September 1999 and August 2009, influenza A(H3N2) or seasonal influenza A(H1N1) was detected in 941 patients, and from April to August 2009, pandemic influenza A(H1N1) was detected in 112 patients. The H3/H1 seasonal influenza ratio was between 3.3 and 3.4 in the under 60 year-olds, but 9.8 in older individuals, suggesting that people born before 1950 have residual immunity against the influenza A H1N1 subtype (both seasonal and pandemic).

Introduction

In 1957, the Asian influenza pandemic was caused by influenza A(H2N2) virus, which circulated until 1968 when it was displaced by the influenza A(H3N2) virus which was responsible for the Hong Kong pandemic. Before 1957, direct descendants of the influenza A(H1N1) virus that had caused the 1918 pandemic (Spanish flu) had circulated. In 1977, an influenza A(H1N1) strain re-emerged, which, together with the dominant influenza A(H3N2) strain, has been the cause of seasonal human influenza for more than three decades [1]. Despite the prolonged co-circulation of both subtypes, few studies have analysed their ability to affect distinct age groups.

The current pandemic influenza A(H1N1) virus, influenza A(H1N1)v, which emerged in the spring of 2009, has spread throughout the world. The aim of this study was to compare the distribution in distinct age groups of infections caused by the two subtypes of seasonal influenza in the past 10 seasons and refer therelate this to recent infections due to influenza A(H1N1)v.
Preliminary analysis of the pandemic H1N1 influenza on Réunion Island (Indian Ocean): surveillance trends (July to mid-September 2009)
Authors: Thouillot F , Do C , Balleydier E , Rachou E , Staikowsky F , Morbidelli P , Jacques-Antoine Y , Bourde A , Lagrange-Xélot M , Poubeau P , Winer A , Gauzere B A , Michault A , Jaffar-Bandjee M C , Henrion G , Filleul L , D’Ortenzio E
Published: October 2017

First infections with the 2009 pandemic H1N1 influenza virus were identified on Réunion Island in July 2009. By the end of July, sustained community transmission of the virus was established. Pandemic H1N1 influenza activity peaked during week 35 (24 to 30 August), five weeks after the beginning of the epidemic and has been declining since week 36. We report preliminary epidemiological characteristics of the pandemic on Réunion Island in 2009 until week 37 ending September 13.
Progression and impact of the first winter wave of the 2009 pandemic H1N1 influenza in New South Wales, Australia
Authors: New South Wales public health network
Published: October 2017

A range of surveillance systems were used to assess the progression and impact of the first wave of pandemic H1N1 influenza in New South Wales, Australia during the southern hemisphere winter. Surveillance methods included laboratory notifications, near real-time emergency department syndromic surveillance, ambulance despatch surveillance, death certificate surveillance and purpose-built web-based data systems to capture influenza clinic and intensive care unit activity. The epidemic lasted 10 weeks. By 31 August 2009, 1,214 people with pandemic H1N1 influenza infection were hospitalised (17.2 per 100,000 population), 225 were admitted to intensive care (3.2 per 100,000), and 48 died (0.7 per 100,000). Children aged 0-4 years had the highest hospitalisation rates, while adults aged 50-54 had the highest rates of intensive care admission. During the epidemic period, overall presentations to emergency departments were 6% higher than in 2008, while presentations for influenza-like illness were 736% higher. At the peak, confirmed cases of pandemic H1N1 influenza consumed 15% of intensive care capacity. Excess mortality from influenza and pneumonia was lower than in recent influenza seasons. Health services, particularly emergency departments and intensive care units, were substantially affected by the epidemic. Mortality from influenza was comparable with previous seasons.
Pandemic influenza in a southern hemisphere setting: the experience in Peru from May to September, 2009
Authors: Gómez J , Munayco C V , Arrasco J C , Suarez L , Laguna-Torres V A , Aguilar P V , Chowell G , Kochel T J
Published: October 2017

This paper presents a description of Peru’s experience with pandemic H1N1 influenza 2009. It is based on data from four main surveillance systems: a) ongoing sentinel surveillance of influenza-like illness cases with virological surveillance of influenza and other respiratory viruses; b) sentinel surveillance of severe acute respiratory infections and associated deaths; c) surveillance of acute respiratory infections in children under the age of five years and pneumonia in all age groups; and d) case and cluster surveillance. On 9 May 2009, the first confirmed case of pandemic H1N1 influenza in Peru was diagnosed in a Peruvian citizen returning from New York with a respiratory illness. By July, community transmission of influenza had been identified and until 27 September 2009, a total of 8,381 cases were confirmed. The incidence rate per 10,000 persons was 4.4 (in the 0–9 year-olds) and 4.1 (in the 10–19 year-olds). During epidemiological weeks (EW) 26 to 37, a total of 143 fatal cases were notified (a case fatality of 1.71%, based on confirmed cases). The maximum peak in the number of cases was reached in EW 30 with 37 deaths. Currently, the impact of the pandemic in the Peruvian population has not been too severe, and fortunately, healthcare centres have not been overwhelmed. However, the future of this pandemic is uncertain and despite the fact that our country has not been seriously affected, we should be prepared for upcoming pandemic waves.
Assessing the impact of the 2009 H1N1 influenza pandemic on reporting of other threats through the Early Warning and Response System
Authors: Cox A , Guglielmetti P , Coulombier D
Published: October 2017

Since the start of 2009 H1N1 influenza pandemic, a notable surge in messages communicated through the Early Warning and Response System (EWRS) for the prevention and control of communicable diseases in the European Union has been recorded. In order to measure the impact of this increase on the reporting of other events, we compared the messages posted in the EWRS since April 2009 with those posted in the previous years (2004-2008). The analysis revealed that a ten-fold increase in messages was recorded during the pandemic period, from April to September 2009, and that the reporting of other threats dropped to a significantly low rate. These results suggest an important impact on the notification process of events in case of a situation requiring extensive mobilisation of public health resources. It emphasises the importance keeping an appropriate balancing of resources during sustained emergencies, in particular in view of a possible second wave of pandemic influenza cases, to ensure prompt detection and reporting of potential concomitant emerging threats.
First report of a North American invasive mosquito species Ochlerotatus atropalpus (Coquillett) in the Netherlands, 2009
Authors: Scholte E J , Den Hartog W , Braks M , Reusken C , Dik M , Hessels A
Published: October 2017

In late August and early September 2009, numerous larvae, pupae, and actively flying adult specimens of Ochlerotatus atropalpus were discovered in the Province of Brabant, southern Netherlands, during surveillance activities for Aedes albopictus at two trading companies that import used tires. No Ae. albopictus were found. Both companies mainly import used tires from countries in Europe, but also from North America. Oc. atropalpus is endemic to North America and has so far only been found outside of its endemic range in Europe, namely France and Italy, where it was subsequently eradicated. A preliminary modelling study shows that the weather conditions in the Netherlands are unlikely to prevent establishment of Oc. atropalpus. This species has so far only been shown to serve as a vector for virus transmission under laboratory conditions. Studies on potential human and veterinary health risks, as well as possible control strategies are currently ongoing.
The effectiveness of behavioural and psychosocial HIV/STI prevention interventions
for MSM in Europe: A systematic review
Authors: Berg R
Published: October 2017

Given the need of programme planners and policy makers for descriptions of specific interventions and quantitative estimates of intervention effects to make informed decisions concerning prevention funding and research, there is a need for a systematic review that updates the current knowledge base about HIV/STI preventive interventions targeted at men who have sex with men (MSM) in Europe. The aim was to summarise and assess the effectiveness of HIV/STI prevention interventions for MSM living in Europe, and to identify intervention characteristics associated with effectiveness as well as potential gaps in the evidence base. A systematic search for relevant literature in eight international databases and in reference lists of relevant reviews and included studies was performed. Studies were selected according to pre-specified criteria and appraised for risk of bias. We summarised results using tables and calculated effect estimates for sexual behaviour outcomes. Results from six controlled studies, involving a total of 4,111 participants at entry from four different European countries were summarised. The results showed that there was 'high' or 'unclear' risk of bias in one or more of the assessed domains in all studies. The pooled effect estimate of the four interventions for which data were available suggested that MSM who participate in HIV/STI prevention initiatives may be somewhat less likely to report unprotected anal intercourse (UAI). The evidence base was insufficient to examine characteristics of interventions most closely associated with magnitude of effect and to draw solid conclusions about unique gaps in the evaluation literature. Despite the maturity of the HIV epidemic, rigorous outcome evaluations of any form of behavioural HIV/STI intervention for MSM in Europe are scarce. The results point to possible short term effects of interventions in terms of reductions in the proportion of MSM who engage in UAI, but the paucity of controlled studies demonstrates the need for research in this area. There is an overall deficit in outcome evaluations of interventions aimed at reducing HIV/STI risk behaviour among MSM in Europe. Designing behavioural HIV/STI preventive strategies to avert new infections, and the evaluation of such prevention programmes for MSM is an important component of a comprehensive HIV/STI containment strategy across the continuum of prevention and care.
Contribution of human metapneumovirus to influenza-like infections in North Greece, 2005-2008
Authors: Gioula G , Chatzidimitriou D , Melidou A , Exindari M , Kyriazopoulou-Dalaina V
Published: October 2017

Following its detection in 2001, human metapneumovirus (hMPV) has repeatedly been reported as a respiratory pathogen, especially in children. This study was aimed at determining the proportion of hMPV infections in patients with influenza-like illness (ILI) during the three influenza seasons 2005-6, 2006-7, 2007-8 in northern Greece. We collected 380 nasopharyngeal swabs or aspirates from ILI patients during the winter seasons 2005-2008 and examined them for influenza viruses and hMPV by one-step real time RT-PCR and nested RT-PCR. Influenza viruses were detected in 151 of the 380 specimens (39.7%) and hMPV in 23 of them (6.05%). Co-infections with hMPV and influenza viruses were observed in seven cases. The majority of the ILI patients (60.5%) were 0-18 years old. However, the incidence of influenza was slightly higher in the age group of 19-60-year-olds, while the incidence of hMPV infections was higher in the age group of 0-18-year-olds. We conclude that hMPV plays an important role as a contributor in influenza-like infections, especially in children. It circulates in the community during influenza seasons and its clinical appearance can be confused with influenza symptoms. However, further research is needed to elucidate the quantitative and qualitative importance of hMPV infections.
Mass immunisation campaign in a Roma settled community created an opportunity to estimate its size and measles vaccination uptake, Poland, 2009
Authors: Stefanoff P , Orlikova H , Rogalska J , Kazanowska-Zielinska E , Slodzinski J
Published: October 2017

During a mass immunisation campaign following an outbreak of measles in a Roma community settled in the town of Pulawy, Poland, we performed an estimation of the size of this Roma population and an assessment of its vaccination uptake. We obtained a list of Roma residing in Pulawy from the local municipality and estimated using a simple capture-recapture formula that Pulawy had 377 Roma residents (43% under 20 years old), which was 27% more than the 295 registered at the municipality. During the vaccination campaign, demographic information was recorded that could be linked to information from the municipality list as well as to prior immunisation status. Among the people whose data were recorded during the vaccination campaign, 14% were not registered at the primary healthcare centres, and were therefore deprived of access to healthcare. Among 102 screened subjects under the age of 20 years, 51% were vaccinated according to schedule. Vaccine uptake for the first dose of measles-containing vaccine was 56% (54/96) and for the second dose 37% (18/49). The present study indicates the need to get a better demographic overview of Roma communities living in Poland and to understand the barriers limiting their access to healthcare and social services. Organisation of catch-up immunisations of this vulnerable population is necessary.
Ongoing mumps outbreak in a student population with high vaccination coverage, Netherlands, 2010
Authors: Whelan J , van Binnendijk R , Greenland K , Fanoy E , Khargi M , Yap K , Boot H , Veltman N , Swaan C , van der Bij A , de Melker H , Hahné S
Published: October 2017

Since December 2009, mumps incidence has increased in the Netherlands. As of 20 April 2010, 172 cases have been notified on the basis of laboratory confirmation or linkage to a laboratory-confirmed case. Of these, 112 were students, the majority of whom had been vaccinated (81%). Although outbreaks in vaccinated populations have been described before, risk factors for exposure and susceptibility, and dose-dependent vaccine effectiveness in a student population of this nature are relatively unknown.
Immunisations among school leavers: is there a place for measles-mumps-rubella vaccine?
Authors: Lashkari H P , El Bashir H
Published: October 2017

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Strategies to intervene on social determinants of infectious diseases
Authors: Semenza J C
Published: October 2017

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National outbreak of Salmonella Typhimurium (Dutch) phage-type 132 in the Netherlands, October to December 2009
Authors: Whelan J , Noel H , Friesema I , Hofhuis A , de Jager C  M , Heck M , Heuvelink A , van Pelt W
Published: October 2017

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HIV and AIDS in the European Union, 2009
Authors: Likatavicius G , Van de Laar M JW
Published: October 2017

In 2009, 28 European Union and European Economic Area (EU/EEA) countries reported 25,917 newly diagnosed cases of human immunodeficiency virus (HIV). Sex among men who have sex with men was the most common transmission mode (35%) followed by heterosexual contact (24%). Overall, the number of HIV cases in 2009 increased while the number of reported acquired immunodeficiency syndrome (AIDS) diagnoses continued to decline. It is of concern that a high proportion of the patients with known CD4 cells count at the time of HIV diagnosis had a CD4 cell count below 350cells/µl suggesting no timely access to treatment and care.
Mortality of 2009 pandemic influenza A(H1N1) in Germany
Authors: Wilking H , Buda S , von der Lippe E , Altmann D , Krause G , Eckmanns T , Haas W
Published: October 2017

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Response to the 2009 influenza A(H1N1) pandemic in Italy
Authors: Rizzo C , Rota M C , Bella A , Giannitelli S , De Santis S , Nacca G , Pompa M G , Vellucci L , Salmaso S , Declich S
Published: October 2017

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Prevalence of IgM and IgG antibodies to West Nile virus among blood donors in an affected area of north-eastern Italy, summer 2009
Authors: Pezzotti P , Piovesan C , Barzon L , Cusinato R , Cattai M , Pacenti M , Piazza A , Franchin E , Pagni S , Bressan S , Martello T , Potenza R , Scipioni C , Ammendola R , Breda A , Palù G , Russo F , Rezza G
Published: October 2017

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Emergence of carbapenemase-producing Enterobacteriaceae in France, 2004 to 2011
Authors: Vaux S , Carbonne A , Thiolet J  M , Jarlier V , Coignard B , RAISIN and Expert Laboratories Groups Collective
Published: October 2017

Emergence of carbapenemase-producing Enterobacteriaceae (CPE) is currently a major public health concern worldwide. This study showed that 53 episodes of CPE infection or colonisation have been notified by French healthcare facilities since 2004. A sharp increase in the number of notifications was observed in the last three years. Oxacillinase (OXA)-48 and Klebsiella pneumoniae carbapenemase (KPC) beta-lactamases were the most frequent enzymes reported in these episodes. The index cases in most episodes were patients with a history of hospitalisation abroad within the previous year. Around a third of the episodes (n=18) led to secondary transmission in hospitals but most of them were controlled due to reinforced measures. Reinforcement of screening and control measures at national level when there is cross-border transfer of patients, along with overall reinforcement of infection control and antimicrobial stewardship worldwide, is urgently needed to contain the spread of CPE.
Rapid emergence of carbapenemase-producing Enterobacteriaceae isolates in Belgium
Authors: Huang T- D , Bogaerts P , Berhin C , Jans B , Deplano A , Denis O , Glupczynski Y
Published: October 2017

We report on the evolution and epidemiology of carbapenem non-susceptible Enterobacteriaceae (CNSE) including carbapenemase-producing Enterobacteriaceae (CPE) in Belgium between January 2007 and April 2011. Significantly higher numbers of CNSE and of CPE were detected in 2010 and 2011 compared to the years 2007 to 2009. The majority of patients carrying CPE did not have history of travel abroad. The rapid emergence of autochthonous CPE strains in Belgium since 2010 warrants strengthened epidemiological surveillance at national level.
Mapping HIV-related behavioural surveillance among injecting drug users in Europe, 2008
Authors: Hope V , Jeannin A , Spencer B , Gervasoni J P , van de Laar M J , Dubois-Arber F , the ECDC HIV and STI Behavioural Surveillance Mapping Group collective
Published: October 2017

The systematic collection of behavioural information is an important component of second-generation HIV surveillance. The extent of behavioural surveillance among injecting drug users (IDUs) in Europe was examined using data collected through a questionnaire sent to all 31 countries of the European Union and European Free Trade Association as part of a European-wide behavioural surveillance mapping study on HIV and other sexually transmitted infections. The questionnaire was returned by 28 countries during August to September 2008: 16 reported behavioural surveillance studies (two provided no further details). A total of 12 countries used repeated surveys for behavioural surveillance and five used their Treatment Demand Indicator system (three used both approaches). The data collected focused on drug use, injecting practices, testing for HIV and hepatitis C virus and access to healthcare. Eight countries had set national indicators: three indicators were each reported by five countries: the sharing any injecting equipment, uptake of HIV testing and uptake of hepatitis C virus testing. The recall periods used varied. Seven countries reported conducting one-off behavioural surveys (in one country without a repeated survey, these resulted an informal surveillance structure). All countries used convenience sampling, with service-based recruitment being the most common approach. Four countries had used respondent-driven sampling. Three fifths of the countries responding (18/28) reported behavioural surveillance activities among IDUs; however, harmonisation of behavioural surveillance indicators is needed.
A five-year perspective on the situation of haemorrhagic fever with renal syndrome and status of the hantavirus reservoirs in Europe, 2005-2010
Authors: Heyman P , Ceianu C S , Christova I , Tordo N , Beersma M , João Alves M , Lundkvist Å , Hukic M , Papa A , Tenorio A , Zelená H , Eßbauer S , Visontai I , Golovljova I , Connell J , Nicoletti L , Van Esbroeck M , Gjeruldsen Dudman S , Aberle S W , Avšić-Županc T , Korukluoglu G , Nowakowska A , Klempa B , Ulrich R G , Bino S , Engler O , Opp M , Vaheri A
Published: October 2017

Hantavirus infections are reported from many countries in Europe and with highly variable annual case numbers. In 2010, more than 2,000 human cases were reported in Germany, and numbers above the baseline have also been registered in other European countries. Depending on the virus type human infections are characterised by mild to severe forms of haemorrhagic fever with renal syndrome. The member laboratories of the European Network for diagnostics of Imported Viral Diseases present here an overview of the progression of human cases in the period from 2005 to 2010. Further we provide an update on the available diagnostic methods and endemic regions in their countries, with an emphasis on occurring virus types and reservoirs.
Targeted screening and health education for Chagas disease tailored to at-risk migrants in Spain, 2007 to 2010
Authors: Navarro M , Perez-Ayala A , Guionnet A , Pérez-Molina J A , Navaza B , Estévez L , Norman F , Flores-Chávez M , Lopez-Velez R
Published: October 2017

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Highlights from the clinical symposium on Shiga toxin-producing Escherichia coli / haemolytic uremic syndrome, Berlin, September 2011
Authors: Jansen A
Published: October 2017

On 9 September 2011, the Estrel Convention Center in Berlin was the venue for a first clinical symposium on Shiga toxin-producing Escherichia coli / haemolytic uremic syndrome (STEC/HUS) reflecting on the large STEC outbreak in Germany earlier this year. The German Society of Nephrology (DGfN) invited internationally renowned clinical experts and microbiologists to discuss the basic science and diagnostics of STEC infections and the different options for treating an EHEC-associated HUS, including plasmapheresis, antibody therapy with Eculizumab, and extracorporeal immune adsorption.
Syndromic surveillance of epidemic-prone diseases in response to an influx of migrants from North Africa to Italy, May to October 2011
Authors: Riccardo F , Napoli C , Bella A , Rizzo C , Rota M C , Dente M G , De Santis S , Declich S
Published: October 2017

Following civil unrest in North Africa early in 2011, there was a large influx of migrants in Italy. A syndromic surveillance system was set up in April to monitor the health of this migrant population and respond rapidly to any health emergency. In the first six months, the system produced 67 alerts across all syndromes monitored and four alarms. There were no health emergencies, however, indicating that this migration flow was not associated with an increased risk of communicable disease transmission in Italy.
Nationwide outbreak of Salmonella enterica serotype 4,[5],12:i:- infection associated with consumption of dried pork sausage, France, November to December 2011
Authors: Gossner C M , van Cauteren D , Le Hello S , Weill F  X , Terrien E , Tessier S , Janin C , Brisabois A , Dusch V , Vaillant V , Jourdan-da Silva N
Published: October 2017

An outbreak of the monophasic variant of Salmonella enterica serotype 4,[5],12:i:- occurred in November and December 2011 in France. Epidemiological investigation and food investigation with the help of supermarket loyalty cards suggested dried pork sausage from one producer as the most likely source of the outbreak. Despite the absence of positive food samples, control measures including withdrawal and recall were implemented.
Epidemic of Mycoplasma pneumoniae infection in Denmark, 2010 and 2011
Authors: Uldum S  A , Bangsborg J M , Gahrn-Hansen B , Ljung R , Mølvadgaard M , Føns Petersen R , Wiid Svarrer C
Published: October 2017

Denmark experienced two waves of Mycoplasma pneumoniae infection during autumn and early winter in 2010 and 2011, respectively. Both affected the whole country. The proportion of positive results was almost the same for both, indicating that the two waves were probably of equal size. High macrolide consumption during the epidemics did not seem to affect levels of macrolide resistance in M. pneumoniae, which remain low in Demark (1% to 3%).
Præventis, the immunisation register of the Netherlands: a tool to evaluate the National Immunisation Programme
Authors: van Lier A , Oomen P , de Hoogh P , Drijfhout I , Elsinghorst B , Kemmeren J , Conyn-van Spaendonck M , de Melker H
Published: October 2017

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Use of the vaccination register to evaluate influenza vaccine coverage in seniors in the 2010/11 influenza season, Navarre, Spain
Authors: Aguilar I , Reyes M , Martínez-Baz I , Guevara M , Albéniz E , Belza M J , Castilla J
Published: October 2017

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First estimates of influenza vaccine effectiveness among severe influenza cases, France, 2011/12
Authors: Bonmarin I , Belchior E , Le Strat Y , Lévy-Bruhl D
Published: October 2017

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First report of sandfly fever virus infection imported from Malta into Switzerland, October 2011
Authors: Schultze D , Korte W , Rafeiner P , Niedrig M
Published: October 2017

We report the first documented cases of sandfly fever virus infection in travellers returning from Malta to Switzerland in autumn 2011. These cases illustrate the importance of considering sandfly-borne viral infection in the differential diagnosis of febrile patients from the Mediterranean island Malta. Raising awareness among physicians is relevant especially now at the beginning of the summer tourist season.
Investigations and actions taken during 2011 due to the first finding of Echinococcus multilocularis in Sweden
Authors: Wahlström H , Lindberg A , Lindh J , Wallensten A , Lindqvist R , Plym-Forshell L , Osterman Lind E , Ågren E O , Widgren S , Carlsson U , Christensson D , Cedersmyg M , Lindström E , Olsson G E , Hörnfeldt B , Barragan A , Davelid C , Hjertqvist M , Elvander M
Published: October 2017

Echinococcus multilocularis is a parasite that can cause alveolar echinococcosis disease. After the first positive finding of E. multilocularis in Sweden in 2011, a consulting group with representatives from relevant authorities was summoned. In this group, all relevant information was shared, strategies for information dissemination and any actions to be taken due to the finding of E. multilocularis were discussed and decided. The present paper describes the actions taken during 2011 and the results thereof, including surveillance in animals, risk assessment for humans to become infected and recommendations given to the public. Further discussion about whether the parasite was introduced, and if so, how, as well as possible future development of the infection in animals and humans in Sweden and future actions are included.
Public health response to an outbreak of Legionnaires’ disease in Edinburgh, United Kingdom, June 2012
Authors: McCormick D , Thorn S , Milne D , Evans C , Stevenson J , Llano M , Donaghy M , on behalf of the Incident Management Team Collective
Published: October 2017

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Surveillance of tularaemia in Kosovo*, 2001 to 2010
Authors: Grunow R , Kalaveshi A , Kühn A , Mulliqi-Osmani G , Ramadani N
Published: October 2017

* This designation is without prejudice to positions on status, and is in line with UNSCR 1244/99 and the ICJ Opinion on the Kosovo declaration of independence.
Japanese encephalitis virus RNA detected in Culex pipiens mosquitoes in Italy
Authors: Ravanini P , Huhtamo E , Ilaria V , Crobu M G , Nicosia A M , Servino L , Rivasi F , Allegrini S , Miglio U , Magri A , Minisini R , Vapalahti O , Boldorini R
Published: October 2017

Mosquitoes collected in northern Italy were screened for flavivirus RNA. Positive amplicons were sequenced and found most similar to insect flavivirus (ISF), Usutu virus (USUV) and surprisingly also to Japanese encephalitis virus (JEV). The sequence (167 bp), obtained from one pool of Culex pipiens, was found identical to JEV strains from bats in China. Unfortunately additional sequence data or virus isolations were not obtained in this study. Confirmation of potential introduction of JEV to Italy and other European countries is urgently needed.
New endemic West Nile virus lineage 1a in northern Italy, July 2012
Authors: Barzon L , Pacenti M , Franchin E , Lavezzo E , Martello T , Squarzon L , Toppo S , Fiorin F , Marchiori G , Russo F , Cattai M , Cusinato R , Palù G
Published: October 2017

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