bluuebunny/crossref_metadata_2025 huggingface dataset:
Travel-associated Legionnaires’ disease in residents from England and Wales travelling to Corfu, Greece, August to October 2011
Authors: Maini R , Naik F , Harrison T  G , Mentasti M , Spala G , Velonakis E , Hadjichristodoulou C , de Jong B , Vatopoulos A , Phin N
Published: October 2017

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Survey of delivery of prophylactic immunoglobulins following exposure to a measles case
Authors: Bernier A , Le Goaster C , Peigue-Lafeuille H , Floret D
Published: October 2017

In France, almost 23,000 cases of measles and 10 deaths have been reported between January 2008 and August 2012. French health authorities recommend delivery of human polyvalent immunoglobulins in the event of exposure to a measles case for some categories of unvaccinated persons (children under the age of 12 months, immunocompromised persons and pregnant women), within six days after exposure and following laboratory confirmation of the contact case. We carried out a postal survey among 368 French hospital pharmacies to evaluate the number of persons affected by this measure between 1 January 2010 and 31 August 2011, to describe the characteristics of these patients and to evaluate the application of the recommendations in terms of delay between exposure and immunoglobulin delivery, and confirmation of the contact case. The response rate to the survey was 73%. In total, 400 immunoglobulin deliveries were listed, most of them for children under the age of one year, and 84% of the 250 administrations with available information occurred within six days after exposure, as recommended. However, only 48% of the 209 treated contacts with available information were laboratory-confirmed when the immunoglobulins were delivered. This survey is the first evaluation of this recommendation since its introduction in 2005 and suggests that the recommendations may need to be updated.
Novel coronavirus associated with severe respiratory disease: Case definition and public health measures
Authors: Danielsson N , on behalf of the ECDC Internal Response Team collective , Catchpole M
Published: October 2017

Two cases of rapidly progressive acute respiratory infection in adults associated with a novel coronavirus have generated an international public health response. The two infections were acquired three months apart, probably in Saudi Arabia and Qatar. An interim case definition has been elaborated and was published on the World Health Organization website on 25 September 2012.
Ensuring safety of home-produced eggs to control salmonellosis in Poland: lessons from an outbreak in September 2011
Authors: Zielicka-Hardy A , Zarowna D , Szych J , Madajczak G , Sadkowska-Todys M
Published: October 2017

Implementation of control measures in line with European Commission regulations has led to a decrease in salmonellosis in the European Union since 2004. However, control programmes do not address laying hens whose eggs are produced for personal consumption or local sale. This article reports an investigation of a salmonellosis outbreak linked to home-produced eggs following a family event held in a farm in September 2011 near Warsaw, Poland. In the outbreak, 34 people developed gastroenteritis symptoms. Results from a cohort study indicated a cake, prepared from raw home-produced eggs, as the vehicle of the outbreak. Laboratory analysis identified Salmonella enterica serotype Enteritidis (S. Enteritidis) in stool samples or rectal swabs from 18 of 24 people and in two egg samples. As no food items remained, we used phage typing to link the source of the outbreak with the isolated strains. Seven S. Enteritidis strains analysed (five from attendees and two from eggs) were phage type 21c. Our findings resulted in culling of the infected laying hens and symptomatic pigeons housed next to the hens. Salmonella poses as a public health problem in Poland: control measures should not forget home-produced eggs, as there is a risk of infection from their consumption.
Two outbreaks of diarrhoea in nurseries in Norway after farm visits, April to May 2009
Authors: Møller-Stray J , Eriksen H  M , Bruheim T , Kapperud G , Lindstedt B A , Skeie Å , Sunde M , Urdahl A M , Øygard B , Vold L
Published: October 2017

During a 2009 nationwide outbreak of sorbitol-fermenting Escherichia coli O157 in Norway, the Norwegian Institute of Public Health was notified of diarrhoea outbreaks in two nurseries. A link to the nationwide outbreak was suspected and investigated, including retrospective cohort studies. Both nurseries had recently visited farms. Faecal specimens were obtained from symptomatic children as well as from the farm animals and tested for Campylobacter, Salmonella, Yersinia, Shigella and pathogenic E. coli, and isolates were further characterised. Nursery A had 12 symptomatic children, and we found the same strain of C. jejuni in faeces from children and lambs. Nursery B had nine symptomatic children, including one child with bloody diarrhoea carrying enterohaemorrhagic E. coli (EHEC) O26. EHEC O26 with a similar multiple-locus variable number tandem repeat analysis (MLVA)-profile was found in sheep. Five children had enteropathogenic E. coli (EPEC) O76. Animals were not tested for EPEC O76. We found no significant association between illness and risk factors for either nursery. The isolated pathogens differed from the one involved in the nationwide outbreak. In each nursery outbreak, the pathogens isolated from children matched those found in farm animals, implicating animal faeces as the source. Hygiene messages are important to prevent similar outbreaks.
Malaria in Greece, 1975 to 2010
Authors: Vakali A , Patsoula E , Spanakos G , Danis K , Vassalou E , Tegos N , Economopoulou A , Baka A , Pavli A , Koutis C , Hadjichristodoulou C , Kremastinou T
Published: October 2017

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The application of geographic information systems and spatial data during Legionnaires’ disease outbreak responses
Authors: Bull M , Hall I M , Leach S , Robesyn E
Published: October 2017

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Ongoing outbreak of dengue type 1 in the Autonomous Region of Madeira, Portugal: preliminary report
Authors: Sousa C A , Clairouin M , Seixas G , Viveiros B , Novo M T , Silva A C , Escoval M T , Economopoulou A
Published: October 2017

Following the identification of two autochthonous cases of dengue type 1 on 3 October 2012, an outbreak of dengue fever has been reported in Madeira, Portugal. As of 25 November, 1,891 cases have been detected on the island where the vector Aedes aegypti had been established in some areas since 2005. This event represents the first epidemic of dengue fever in Europe since 1928 and concerted control measures have been initiated by local health authorities.
Automated extraction of typing information for bacterial pathogens from whole genome sequence data: Neisseria meningitidis as an exemplar
Authors: Jolley K A , Maiden M C
Published: October 2017

Whole genome sequence (WGS) data are increasingly used to characterise bacterial pathogens. These data provide detailed information on the genotypes and likely phenotypes of aetiological agents, enabling the relationships of samples from potential disease outbreaks to be established precisely. However, the generation of increasing quantities of sequence data does not, in itself, resolve the problems that many microbiological typing methods have addressed over the last 100 years or so; indeed, providing large volumes of unstructured data can confuse rather than resolve these issues. Here we review the nascent field of storage of WGS data for clinical application and show how curated sequence-based typing schemes on websites have generated an infrastructure that can exploit WGS for bacterial typing efficiently. We review the tools that have been implemented within the PubMLST website to extract clinically useful, strain-characterisation information that can be provided to physicians and public health professionals in a timely, concise and understandable way. These data can be used to inform medical decisions such as how to treat a patient, whether to instigate public health action, and what action might be appropriate. The information is compatible both with previous sequence-based typing data and also with data obtained in the absence of WGS, providing a flexible infrastructure for WGS-based clinical microbiology.
Nosocomial outbreak of disseminated orf infection in a burn unit, Gaziantep, Turkey, October to December 2012
Authors: Midilli K , Erkılıç A , Kuşkucu M , Analay H , Erkılıç S , Benzonana N , Yıldırım M S , Mülayim K , Acar H , Ergonul O
Published: October 2017

We report the first outbreak of nosocomial orf infection in a hospital burn unit in Gaziantep, Turkey. The outbreak lasted from October to December 2012 and involved a total of thirteen cases. It demonstrates the risk of introduction of orf virus to a burn unit, and the potential for extensive transmission among patients with compromised skin integrity. The importance of hygiene measures and infection control are highlighted and possible transmission routes of the virus discussed.
Legionnaires’ disease in Italy: results of the epidemiological surveillance from 2000 to 2011
Authors: Rota M C , Caporali M G , Bella A , Ricci M L , Napoli C
Published: October 2017

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Hantavirus infections in Finland
Authors: Vapalahti O , Vaheri A , Henttonen H
Published: October 2017

Hantaviruses cause haemorrhagic fever with renal syndrome (HFRS) and hantaviruspulmonary syndrome (HPS), and occur throughout the world. The viruses aretransmitted to humans in aerosols of rodent secretions. About 200 000 people,mainly in Eurasia, develop
Salm-Net: a network for human salmonella surveillance in Europe
Authors: Fisher I
Published: October 2017

Salm-Net aims to prevent human salmonellosis within the EU by strengthening international laboratory based human salmonella surveillance and creating an on-line European database of compatible data available to all participants. Salm-Netis funded by DG XI
Increase of syphilis in Finland related to the Russian epidemic
Authors: Hilthunen-Back E , Haikala O , Koskela P , Reunala T
Published: October 2017

In the early 1990s only 30 to 40 new serologically confirmed cases of syphilis were reported annually in Finland. Typical syphilis patients were heterosexual men who acquired the infection abroad. Since 1993, the incidence of syphilis has increased. In 19
An outbreak of cryptosporidiosis in the Netherlands
Authors: van Asperen I. A. , Mank T , Medema G. J. , Stijnen C , de Boer A S , Groot J. F. , TenHam P , Sluiters J. F. , Borgdorff M W
Published: October 2017

A hospital microbiologist in Spijkenisse, in the south west of the Netherlands - who had recently attended a parasitology course - identified cryptosporidial oocysts in stools from a patient with diarrhoea on 16 August 1995. Re-examination of 89 stool spe
Diphtheria’s European come back
Authors: Rey M , Patey O , Vincent-Ballereau F
Published: October 2017

Since children have been vaccinated routinely, diphtheria has been eliminated in most European states and the recent occurrence of a large epidemic in the Newly Independent States (NIS) of the former USSR was unexpected. The resurgence of diphtheria in th
Outbreak of Salmonella dublin infection in France, November - December 1995
Authors: Vaillant V , Haeghebaert S , Desenclos J C , Bouvet P , Grimont F , Grimont P. A. , Burnens A P
Published: October 2017

On 20 December 1995, the National Network of Public Health (Réseau National de Santé Publique - RNSP) was notified by the Salmonella and Shigella National Reference Centre (Centre National de Référence - CNR) that a greater than expected number of human i
European Concerted Action on Lyme Borreliosis (EUCALB)
Authors: O’Connell S
Published: October 2017

Continuing uncertainty about the extent of the problem posed by Lyme borreliosis, the risk of serious sequelae, and unsatisfactory laboratory techniques to investigate it have led to the collaboration of researchers from 12 European Union (EU) countries a
SRSV-1 gastroenteritis in Malta - 1995
Authors: Falzon D
Published: October 2017

Small round structured viruses (SRSV) are known to cause epidemic gastroenteritis in institutions and account for 54% of person to person outbreaks and 6% of foodborne outbreaks in England and Wales. Infection is commonly transmitted from person to person
Editorial
Authors: Editorial Committee Collective
Published: October 2017

Eurosurveillance this month presents European liaisons for the surveillance and control of communicable diseases at different stages of development. HELICS - the scheme for standardising the data collected about hospital acquired infections - has come and
Creutzfeldt-Jakob disease: results of an inquiry in the fifteen Member States of the European Union
Authors: Merkel B. C. , Peters P. W.J , Chambaud L
Published: October 2017

Creutzfeldt-Jakob Disease (CJD) was first described in 1920-1921. CJD is a rare disease with a reported incidence of 0.5 to 1 case per million people in Europe. This fatal dementia belongs to the category of Transmissible Spongiform Encephalopathies (TSE)
Scottish outbreak of Escherichia coli O157, November-December 1996
Authors: Cowden J M
Published: October 2017

On the afternoon of Friday 22 November 1996, Lanarkshire Health Board’s Public Health Department became aware of 15 cases of possible Escherichia coli O157 infection (five of which had been confirmed microbiologically) in residents of the town of Wishaw i
Outbreak of Q fever in Lohra-Rollshausen, Germany, spring 1996
Authors: Lyytikaïnen O , Ziese T , Schwartländer B , Matzdorff P , Kuhnhen C , Burger C , Krug W , Petersen L
Published: October 2017

Q fever is an acute (and sometimes chronic) febrile illness caused by the rickettsial organism Coxiella burnetii. The commonest animal reservoirs for C. burnetiiare cattle, sheep, and goats. Infected animals shed the organisms, which resist desiccation, i
Preliminary report of an international outbreak of Salmonella anatum infection linked to an infant formula milk
Authors:   International Investigation Collaborating Units
Published: October 2017

The number of isolates of Salmonella anatum from infants (aged 1 to 11 months) in England and Wales was higher than expected in November and December 1996 and early January. The Public Health Laboratory Service (PHLS) Laboratory of Enteric Pathogens (LEP)
Monitoring antimicrobial resistance in humans and animals in Europe
Authors: Editorial Committee Collective
Published: October 2017

Since publishing the editorial note on antimicrobial resistance ( Eurosurveillance 1997; 2(3): 21-2) we have received replies from Austria, Belgium, Greece, and Italy. Austria does not monitor antimicrobial resistance. The National Institute for Veterinar
Travel associated legionellosis among European tourists in Spain - a comment from the EWGLI coordinating centre
Authors: Joseph C
Published: October 2017

This interesting paper has analysed the data on cases of legionellosis associated with travel to Spain and highlighted some issues which are relevant to the European Working Group for Legionella Infections (EWGLI) surveillance system, eg the reporting of
Outbreak of legionnaire’s disease in two groups of tourists staying at camp sites in France
Authors: Infuso A , Hubert B , Dumas D , Reyrolle M , De Mateo S , Pelaz C , Hemery C , Pérez I
Published: October 2017

On 11 June 1996, three suspected cases of legionnaires’ disease in a group of 42 Dutch tourists were reported to the local public health authority by Millau hospital in south west France. The group (group 1) had been touring with caravans and staying at d
Six years surveillance of hepatitis A and B in general practice in France
Authors: Flahault A , Maison P , Farran N , Massari V
Published: October 2017

The French sentinel network is composed of general practitioners who record on an ongoing basis cases of seven infectious diseases (i.e. influenza-like illness, acute diarrhoea, chickenpox, mumps, measles, male urethritis, and acute hepatitis of probable
Cases of Neisseria meningitidis in Greece
Authors: Kremastinou J , Tzanakaki G , Vakalis N , Velonaki A
Published: October 2017

In Greece, Neisseria meningitidis appears as sporadic cases with some seasonal local outbreaks. The notification of meningococcal disease to the local health authorities and the Ministry of Health is mandatory. In 1994, the National Reference Centre for M
The WHO update on influenza A (H5N1) in Hong Kong
Authors: Lavanchy D
Published: October 2017

In May 1997 influenza A subtype H5N1 virus was isolated in the Special Administrative Region of Hong Kong from a child who died. Until then, the H5N1virus was known to infect only various species of birds, including chickens and ducks. After the first hum
Malaria imported into the United Kingdom in 1996
Authors: Bradley D J , Warhurst D C , Blaze M , Smith V , Williams J
Published: October 2017

Virtually all malaria infections seen in the United Kingdom (UK) in recent years have been contracted overseas and imported into the UK, apart from two cases in 1976 due to imported infected mosquitoes and occasional cases of congenital or of transfusion
Outbreak of trichinellosis in the Midi-Pyrénées region of France January - March 1998
Authors: Haeghebaert S , Servat M , Duchen C , Minet J- C , EAgrech A , Thièse I , Leclerc C , Vaillant V , Hemery C , Maillot E , Soulé C , Pozio E , Massip P , Magnaval J. F. , Desenclos J C
Published: October 2017

Two outbreaks of trichinellosis in the Tarn et Garonne, département, France were reported by the departmental health autorities on 2 March 1998, to the Réseau National de Santé Publique (RNSP). An epidemiological investigation began on 3 March in order to
Epidemiology of Mycoplasma pneumoniae infections in Poland : 28 years of surveillance in Warsaw 1970-1997
Authors: Rastawicki W , Kaluzewski S , Jagielski M , Gierczyski R
Published: October 2017

Mycoplasma pneumoniae is a common cause of lower respiratory tract disease in humans, particularly among older children, adolescents, and young adults. Infections are endemic in cities and epidemic increases are observed at intervals of 4 to 7 years. M. p
ESEN: a comparison of vaccination programmes – Part three : measles mumps and rubella
Authors: Lévy-Bruhl D , Pebody R , Veldhuijzen I , Valenciano M , Osborne K ,   members who provided data, on behalf of the ESEN project
Published: October 2017

Cet article est le dernier d’une série de trois articles portant sur la comparaison, dans huit pays (Danemark, Angleterre et Pays de Galles, Finlande, France, Allemagne, Italie, Suède et Pays-Bas), des programmes vaccinaux et de l’impact épidémiologique d
Botulism in the United Kingdom
Authors: Brett M
Published: October 2017

Clostridium botulinum is a spore forming bacterium that grows in the absence of oxygen and is responsible for three main epidemiological categories of disease: foodborne, infant, and wound botulism. Foodborne botulism is an intoxication caused by ingestio
An outbreak of Salmonella enteritidis food poisoning from a commercially produced cheese
Authors: Panico M. G. , Primiano F , Nappi F , Attena F
Published: October 2017

Nine suspected cases of food poisoning were reported from three hospitals to the epidemiology and prevention service (Servizio di Epidemiologia e Prevenzione - SEP) of the local health authority in Naples district (Azienda Sanitaria Locale, ASL NA 4) betw
Management of the investigation by Enter-net of international foodborne outbreaks of gastrointestinal organisms
Authors: Desenclos J C , Fisher I. S.T. , Gill N ,   in collaboration with all Enter-net participants
Published: October 2017

The free circulation of people, goods, and foods within the European Union (EU) states has increased the opportunity for international outbreaks of foodborne infections despite prevention efforts to reduce microbiological contamination of foodstuffs. The
Surveillance of salmonella: achievements and future directions
Authors: van Pelt W
Published: October 2017

This special issue of Eurosurveillance focuses on progress of the Enter-net network in the surveillance and management of outbreaks of human salmonellosis in Europe. This network has established a frequently updated international database and collaboratio
Outbreak of calicivirus gastroenteritis associated with eating frozen raspberries
Authors: Pönka A , Maunula L , von Bonsdorff C. H. , Lyytikaïnen O
Published: October 2017

Small round structured viruses (SRSVs - for example, calici-, astro-, and entero-viruses) are the commonest causes of outbreaks of non-bacterial gastroenteritis worldwide. Transmission of SRSVs by water and by various foods – including salads, bakery prod
Pork related trichinellosis: emergence of a new mode of transmission?
Authors: Desenclos J C
Published: October 2017

In this issue, Eurosurveillance publishes a report about two outbreaks of trichinellosis - of eight and 44 cases, respectively - that occurred in the German state of Northrhine-Westfalia from October to December 1998. Well conducted epidemiological invest
Outbreak of Salmonella enteritis bongori 48:z35:- in Sicily
Authors: Nastasi A , Mammina C , Salsa L
Published: October 2017

Salmonella bongori 48:z 35 :- was first isolated from a lizard in Chad in 1966 and was classified as a biochemically atypical strain of the subgenus I of Kauffmann. Successively, some additional strains with different antigenic formulas but similar bioche
From epidemiological surveillance to European integration
Authors: Tissot F
Published: October 2017

Between March and June 1999, 442 000 Kosovar refugees arrived in Albania. The national surveillance system was unprepared for this and an emergency communicable disease surveillance system was set up to detect and control potential outbreaks among the ref
Reuse of single-use sterile medical devices decreased in Danish hospitals after report discouraged it
Authors: Christensen M , Meyer M , Jepsen O B
Published: October 2017

The extent to which sterile medical devices marked ‘for single-use’ are reused was surveyed recently in 100 hospitals in Denmark, Finland, Norway, and Sweden. The same method was used in a survey of Danish hospitals two years earlier. This has enabled us
Marked decline in pertussis followed reintroduction of pertussis vaccination in Sweden
Authors: Olin P , Hallander H O
Published: October 2017

Immunisation against pertussis with an acellular pertussis vaccine for children at 3, 5, and 12 months was included in the Swedish vaccination programme in January 1996, 17 years after the withdrawal of whole cell vaccine in 1979. Within months coverage r
Methicillin resistant Staphylococcus aureus in German hospitals develop narrower patterns of antimicrobial resistance
Authors: Witte W , Braulke C , Heuck D , Cuny C
Published: October 2017

The prevalence of methicillin resistant Staphylococcus aureus (MRSA) in German hospitals has continued to increase, but the range of anti-microbials to which they are resistant has decreased. The trend cannot be attributed to changes in antibiotic consump
The socioeconomic burden of hospital acquired infection
Authors: Plowman R
Published: October 2017

Adult inpatients in common specialties who developed hospital acquired infection (HAI) remained in hospital 2.5 times longer, incurred hospital costs almost three times higher, and incurred higher general practitioner, district nurse, and hospital costs a
Improved surveillance of tuberculosis
Authors: Watson J
Published: October 2017

In 1996 a consensus statement on the surveillance of tuberculosis in Europe, recommended the collection of data on all cases of tuberculosis at the local level. The statement, backed by the International Union Against Tuberculosis and Lung Disease, the Wo
Feasibility of surveillance resistance to antituberculosis drugs :Europe, 1997
Authors: Schwoebel V , Antoine D , Veen J ,   The national coordinators for tuberculosis surveillance
Published: October 2017

Between 28% and 100% of isolates from ten countries from the EuroTB network in 1997 were reported with data on antituberculosis drug susceptibility. Drug resistance was commoner among foreign-born patients and in general among patients who had been treate
An outbreak of Norwalk like virus gastroenteritis in a nursing home in Rotterdam
Authors: Ronveaux O , Vos D , Bosman A , Brandwijk K , Vinjé J , Koopmans M , Reintjes R
Published: October 2017

Sixty-two per cent of elderly and disabled residents of a Dutch nursing home (74/120) and 32% of staff (33/102) became ill in an outbreak of Norwalk-like viral gastroenteritis. The outbreak spread from person to person was supported by temporal clustering
Airport malaria : four new cases in suburban Paris during summer 1999
Authors: Lusina D , Legros F , Estève V , Klerlein M , Giacomini T
Published: October 2017

During the summer 1999, four clustered cases of airport malaria were observed in France. The cases ’ analysis revealed that airport malaria, which is a rare disease whose diagnosis is difficult, can be observed outside occupations at risk, in people livin
Endemic presence of Salmonella enterica serotype Cerro in southern Italy
Authors: Mammina C , Cannova L , CarfiPavia S , Nastasi A
Published: October 2017

Molecular typing of salmonella strains isolated between 1997 and 1999 in southern Italy and carried out by the Southern Italy Centre for Enteric Pathogens, has shown a high frequency of Salmonella enterica serotype Cerro. This serotype is extremely rare i
European recommendations on surveillance of antituberculosis drug resistance
Authors: Schwoebel V , Lambregts C  S B , Moro M. L. , Drobniewski F , Hoffner S. E. , Raviglione M. C. , Rieder H. L. ,   the International Union Against Tuberculosis and Lung Disease (IUATLD)
Published: October 2017

Antituberculosis drug resistance, whose extent in Europe is not well documented, is a serious threat to tuberculosis control. The aim of the recent European recommendations on antituberculosis drug resistance surveillance, issued by a working group compos
Towards optimization of surveillance resistance to antituberculosis drug resistance
Authors: Raviglione M. C. , Espinal M  A
Published: October 2017

In the past decade, strengthening tuberculosis (TB) surveillance has become a public health priority in Europe. In western Europe, TB case rates slowed their previous decline, but in eastern Europe dramatic increases, often with doubling of rates, were re
Salmonella enterica serotype Oranienburg infections associated with consumption of locally produced Tyrolean cheese
Authors: Allerberger F , Kreidl P , Dierich M P , Klingsbichel E , Jenewein D , Mader C , Khaschabi D , Schönbauer M , Berghold C
Published: October 2017

Sixteen culture confirmed cases of enteric infection with Salmonella enterica serotype Oranienburg were detected between August 10 and September 29 1999 in Tyrol (Austria). Ten of them suffered bloody diarrhoea and six were asymptomatic carriers. Intervie
Bacterial resistance to antibiotics in France : a public health priority
Authors: Aubry Damon H , Carlet J , Courvalin P , Desenclos J C , Drucker J , Guillemot D , Jarlier V , Régnier B , Schlemmer B
Published: October 2017

For a few years, France has been faced to a rapid spread of anti-microbial resistance in hospitals and in general practice despite the many recommendations issued to solve this problem. In 1999, the Institut de Veille Sanitaire conducted a collective expe
Influenza vaccination coverage in elderly people, Campania (Italy), 1999
Authors: D'Argenio P , Adamo B , Coluccio R , D'Apice A , Ferrara M. A. , Giugliano F , Parrella R , Peluso F , Romeo V , Ronga C , Simonetti A , Citarella A
Published: October 2017

A study on the coverage of influenza vaccination among elderly people was carried out. Fity-six per cent of those interviewed had been vaccinated (weighted coverage 50%), compared with the target of 75%, but higher rates were reported in those older than 74 years and those with chronic diseases.
Field epidemiology training in Europe faces a bright future
Authors: Reingold Arthur  L.
Published: October 2017

It is fitting that the group of articles describing various field epidemiology training programmes published here should appear in 2001, the 50th anniversary of the Epidemic Intelligence Service (EIS) of the Centers for Disease Control and Prevention (CDC). Were he still alive today, Alex Langmuir (founder of EIS) would be delighted to see how well established and successful such training programmes have become in Europe. Similar ‘on-the-job’ training programmes intended to provide health professionals with the practical skills needed to conduct relevant and timely applied epidemiological investigations in the ‘real world’ of public health are also burgeoning in Latin America, Asia, and Africa. Some of these training programmes are being developed and offered jointly with local academic institutions, others involve formal partnerships with CDC itself, and some are stand alone efforts of local public health agencies.
The Epidemic Intelligence Service in the United States
Authors: Ostroff Stephen M.
Published: October 2017

The Epidemic Intelligence Service (EIS) - the two year applied epidemiology training programme of the United States (US) Centers for Disease Control and Prevention (CDC) - celebrates its 50th anniversary in 2001. Developed during the Korean war, only five years after CDC was established, the stimulus behind developing the EIS was a lack of trained field investigators should biological agents be intentionally used against the US population. It was, however, clear to Alexander Langmuir, the head of epidemiology at CDC and founder of the EIS, that his trainees would engage in a wide range of activities and help fill gaps in the US for epidemiologists with the skills and practical field experience to investigate and control naturally occurring outbreaks of diseases.
Seventeen years of intervention epidemiology training at Veyrier-du-Lac, 1984-2000
Authors: Malfait P , Helynck B
Published: October 2017

Early in the 1980s, those involved in public health held symposiums to assess the training of epidemiologists in France showed inadequacies in the teaching of field epidemiology. Hitherto epidemiology in France had been largely confined to research. Evolution of public health practice, with an increasing demand to base decisions on epidemiological data, made it necessary to develop a network of intervention epidemiologists trained to work with standardised methods.
Communicable disease epidemiology training in Northern Europe
Authors: Aavitsland P , Andresen S
Published: October 2017

The five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) have a long tradition of collaboration in communicable disease epidemiology and control. The state epidemiologists and the immunisation programme managers have met regularly to discuss common challenges and exchange experiences in surveillance and control of communicable diseases.

After the three Baltic countries (Estonia, Latvia and Lithuania) regained independence in 1991 and the Soviet Union dissolved, contacts were made across the old iron curtain in several areas, such as culture, education, business, military and medicine. Each of the Nordic communicable disease surveillance institutes started projects with partners in Estonia, Latvia, Lithuania or the Russian Federation. The projects were in such diverse areas as HIV surveillance and prevention (1), vaccination programmes and antibiotic resistance.

In the mid 1990s the Nordic state epidemiologists noted that there was duplication of efforts and only slow progress towards controlling communicable diseases in the region. Thus, to use the resources more efficiently and to improve the relationships with the Baltic partners, the state epidemiologists set out to co-ordinate their bilateral efforts. They felt that the Nordic network, which had worked so well, could easily be extended eastwards.
Surveillance of sexually transmitted infections in England and Wales
Authors: Hughes G , Paine T , Thomas D
Published: October 2017

Surveillance of sexually transmitted infections (STIs) in England and Wales has, in the past, relied principally on aggregated statistical data submitted by all genitourinary medicine clinics to the Communicable Disease Surveillance Centre, supplemented by various laboratory reporting systems. Although these systems provide comparatively robust surveillance data, they do not provide sufficient information on risk factors to target STI control and prevention programmes appropriately. Over recent years, substantial rises in STIs, the emergence of numerous outbreaks of STIs, and changes in gonococcal resistance patterns have necessitated the introduction of more sophisticated surveillance mechanisms. This article describes current STI surveillance systems in England and Wales, including new systems that have recently been introduced or are currently being developed to meet the need for enhanced STI surveillance data.
Recent trends in Chlamydia trachomatis in the United Kingdom and the potential for national screening
Authors: Pimenta Jeanne , Fenton K. A.
Published: October 2017

A pilot study has been carried up in the United Kingdom to assess the feasibility of a national screening programme of genital chlamydial infections. The preliminary results show a high acceptance rate (70% of the candidates) and a significant coverage of the target population (40% over a six months period). Several other studies are ongoing in order to specify the more appropriate screening processes and partner notification strategies, as well as the cost effectiveness of a national programme.
Surveillance of HIV/AIDS in Europe: update at end 2000.
Authors: Hamers F F , Alix J , Semaille C , Pilkington H , Downs A M
Published: October 2017

In the Western area of Europe, AIDS incidence decreased by 12% in 2000 compared to 1999 (22 cases per million population). In the Eastern area, the incidence of notified cases remained low, but newly diagnosed cases are still rising. In the Centre, the rates of AIDS cases and HIV infections remain low.

EuroHIV (European Centre for the Epidemiological of AIDS) coordinates the surveillance of AIDS in the WHO European Region since 1984 and of newly diagnosed HIV infection since 1999. The main findings of the latest update at end 2000 are presented here (1). To take into account the diversity of the epidemiological situation in the region, countries have been grouped into three geographic areas: the West (the 15 countries of the European Union plus Norway, Switzerland, Iceland, Israel, Malta) the East (the 15 Newly Independent States of the former Soviet Union) and the Centre (the remaining countries of the region).
The EUVAC-NET survey: national measles surveillance systems in the EU, Switzerland, Norway, and Iceland
Authors: Glismann S , Ronne T , Schmidt J- E ,   on behalf of the EUVAC-NET participants
Published: October 2017

The EUVAC-NET network undertook a questionnaire study on measles surveillance systems in EU member countries, Switzerland, Norway and Iceland. All questionnaires were completed. Surveillance systems for measles are implemented in 16 of the 18 countries. Most countries have some case based data and in all countries the shift is towards case based surveillance for measles, though there are differences between countries concerning case definitions and classifications. A two-dose MMR vaccination schedule is implemented in all the EUVAC-NET countries but methods used for estimation of vaccination coverage are diverse.
Escherichia coli O157 infections and unpasteurised milk
Authors: Allerberger F , Wagner M , Schweiger P , Rammer H- P. , Resch A , Dierich M P , Friedrich A W , Karch H
Published: October 2017

We report on two children with Escherichia coli O157 infection, one of whom developed haemolytic uraemic syndrome (HUS). Both had drunk raw cows’ or goats’ milk in the week before their illness. Molecular subtyping identified a sorbitol fermenting Escherichia coli O157:H isolate from a dairy cow. This isolate differed from Shiga toxin producing O157:H strains isolated from the 6 year old boy with HUS. This result underlines the need to search for other causes of infection, despite documented consumption of unpasteurised milk. In the second patient, human sorbitol non-fermenting O157:H isolates and animal isolates from goats were indistinguishable. The isolation of indistinguishable sorbitol non-fermenting Escherichia coli O157:H from contact animals supports the association between HUS and consumption of raw goats’ milk, and re-emphasises the importance of pasteurising milk.
Imported rocket salad partly responsible for increased incidence of hepatitis A cases in Sweden, 2000-2001
Authors: Nygård K , Andersson Y , Lindkvist P , Ancker C , Asteberg I , Dannetun E , Eitrem R , Hellström L , Insulander M , Skedebrant L , Stenqvist K , Giesecke J
Published: October 2017

An increased incidence of domestic hepatitis A without any obvious source of infection in Sweden and a small outbreak in late spring 2001 led to the undertaking of a case-control study. Consumption of imported rocket salad was clearly associated with disease (odds ratio 9.1, 95% confidence interval 1.5 to 69). The importation of vegetables from countries where hepatitis A is endemic to countries where this disease is not endemic continues to be a public health problem.
Training fellowships for intervention
Authors:   Eurosurveillance editorial team
Published: October 2017

The European Programme for Intervention Epidemiology Training started in 1995. The programme is funded by the European Commission, various European Union (EU) member states, and Norway. Subject to agreement for another round of funding, the eighth cohort of fellows is planned to start in September 2002. The programme invites applications for eight fellowships for this 24-month training programme in communicable disease field epidemiology.
The use of smallpox virus as a biological weapon: the vaccination situation in France
Authors: Lévy-Bruhl D , Guérin N
Published: October 2017

In the context of its plan to fight against bioterrorism, the Ministry of Health asked the Institut de Veille Sanitaire to evaluate the epidemic risk from a release of the small pox virus, and to make recommendations on potential vaccination strategies to be implemented. A benefit/risk assessment of various vaccination scenarios, including vaccination of the whole French population, was carried out to evaluate the severity of a terrorist action threat. This analysis concludes that at this stage, vaccination action does not seem to be justified. Even in the case of a real threat, the vaccination of frontline healthcare personnel, and in particular of contacts of cases, must be given priority.
Men having sex with men and HIV/AIDS prevention in Switzerland: 1987-2000
Authors: Dubois-Arber F , Moreau-Gruet F ,   A Jeannin
Published: October 2017

Although the latest survey on prevention behaviours of men having sex with men (MSMs) in Switzerland shows a decreasing number of HIV cases since 1992, a decrease in the protection level has also been observed. This could lead to a higher rate of HIV notifications in 2001 compared to 2000.
A new decline in preventive behaviours among homosexual men : the role of highly active antiretroviral therapy?
Authors: Laporte A
Published: October 2017

The articles published in this issue of Eurosurveillance on recent trends of preventive behaviours in homosexual men in Spain, Switzerland, and the Netherlands, all conclude that the practice of safer sex is declining. They emphasise increases in anal penetration (regardless of the nature of the relationship), non-protected anal intercourse, and ejaculation in the mouth, in particular among casual partners. The increase of diagnoses of acute sexually transmitted diseases (such as gonorrhoea and syphilis) in different European countries – illustrated in this issue by the data from the Netherlands – is the first tangible consequence of this decline.
Management of viral haemorrhagic fever in the Netherlands
Authors: Swaan C , van den Broek P- J. , Wijnands S , van Steenbergen J. E.
Published: October 2017

Two cases of Lassa fever have been reported in the Netherlands since viral haemorrhagic fevers became notifiable diseases in 1978. In 1980, an expatriate from Burkina Faso who was not seriously ill was confirmed by laboratory tests after his discharge from hospital. The second case occured in 2000: the patient died on the 11th day of admission to hospital. The problems we faced in the management of this case and the contact investigation - more than one hundred contacts - highlighted the need for national recommendations in the Netherlands.
Management of patients in Germany with suspected viral haemorrhagic fever and other potentially lethal contagious infections
Authors: Wirtz A , Niedrig M , Fock R
Published: October 2017

Patients suffering from viral haemorrhagic fevers must be handled specifically. The clinical diagnosis of these diseases in the initial stage is difficult because early symptoms are non specific. In Germany, specific diagnosis is available at two diagnostic centres with biosafety level 4 facilities. Five high security infectious disease isolation units for patient care are available in Munich, Leipzig, Hamburg, Berlin, and Frankfurt. In addition, a corresponding number of centres of competence are established to offer support and advice to the hospitals initially treating the patients and to the local public health officers. The decentralisation of these centres of competence is recommended to allow for more timely and reactive responses to VHF epidemic threats.The risk categorisation for contacts has proved to be very useful in practice.
Roles and functions of a European Union Public Health Centre for Communicable Diseases and other threats to health
Authors: Van Loock F , Gill N , Wallyn S , Nicoll A , Desenclos J C , Leinikki P
Published: October 2017

An international consensus has been reached that a European Union (EU) Technical Coordination Structure (TCS) for communicable diseases is needed to improve Europe’s future response to international communicable disease threats within and beyond its boundaries. After the American events of September 11 2001 and the deliberate releases of anthrax, the EU created a Health Security Committee, adopted a civil protection decision, and established for 18 months a team to develop responses for deliberate releases of biological and chemical agents. These two initiatives, the network’s approach and health security work, must converge into a single stream addressing health protection for the people of Europe. They could be combined into a European Centre for Communicable Diseases that is planned to become active by 2005.
Antimicrobial resistance in Italy: preliminary results from the AR-ISS project
Authors: Boccia D , Pantosti A , D'Ancona F , Giannitelli S , Monaco M. , Salmaso S ,   on behalf of the AR-ISS Workgroup
Published: October 2017

Antimicrobial resistance represents a critical problem in human medicine today, from both clinical and economic points of view. In 1999, the Council of the European Union included antibiotic resistance among the public health priorities in the Community, and a resolution entitled 'A strategy against the microbial threat' was issued (1). According to this document, the establishment or strengthening of a surveillance system for the collection of reliable and comparable data on a national and international scale is one of the main interventions needed to control and prevent antibiotic resistance. Surveillance systems should also integrate data about the use and prescription of antibiotics (2).
Clustered cases of leptospirosis in Rochefort, France, June 2001
Authors: Perra A , Servas V , Terrier G , Postic D , Baranton G , André-Fontaine G , Vaillant V , Capek I
Published: October 2017

Five clustered cases of leptospirosis were diagnosed in the area of Rochefort, France, in June 2001, among teenagers who had swum in the Genouillé canal. The symptoms included fever, headache, abdominal pain and vomiting, chills and myalgia. Three cases were confirmed by PCR and serology. The mean cumulative duration of bathing was significanthly higher in cases (23.8 hours) compared to controls (14.4 hours). No other particular risk factor was observed. The environmental investigation revealed the presence of rodents excreting of leptospires near the bathing area. For all antigens considered, the occurence of seropositive rodents was 30.8%, L. icterohaemorrhagiae being the predominant serogroup (23,1%).
Enhancing the predictive value of throat swabs in virological influenza surveillance
Authors: Leitmeyer K , Buchholz U , Kramer M. , Schweiger B
Published: October 2017

According to a national survey in Germany, the influenza virological surveillance can be improved when sentinel practitioners take throat swabs specimens only from patients who consult early after the disease onset (ie, within 48 hours), and when they use the strict clinical case definition of influenza-like illness. PCR should be used for primary detection of influenza viruses.
Real-time modelling of influenza outbreaks - a linear regression analysis
Authors: Mooney J. D. , Holmes E. , Christie P
Published: October 2017

Seasonal outbreaks of influenza exert a considerable burden on health services, and are notorious for their variability from year to year. Making use of historical data from the Scottish sentinelle surveillance since 1972, a potential candidate model has been derived based on simple linear regression. It was applied with a measure of success in the 1999–2000 winter season.
Patterns of Puumala virus infection in Finland
Authors: Rose Angie , Vapalahti O , Lyytikäinen O , Nuorti P
Published: October 2017

Puumala hantavirus infection is prevalent throughout most of Europe, and in endemic areas it may be the most common cause of acute renal failure. To evaluate trends in incidence of Puumala virus infections in Finland, we analysed national surveillance data in 12-month periods from March 1995 to February 2002. During this time, 8184 laboratory-confirmed cases were notified to the National Infectious Disease Register. Three epidemic periods were identified, for which the number of cases was more than 1400 (there were approximately 600-900 cases per non-epidemic period). The incidence of Puumala hantavirus infection varied by geographic region during the study period, and the overall number of cases may be increasing.
Tuberculosis in Austria 1995–99: geographical distribution and trends
Authors: Strauss R , Fülöp G , Pfeifer C
Published: October 2017

A descriptive analysis of routine surveillance data on tuberculosis (TB) from 1995 to 1999 was performed in Austria. The federal states of Vienna and Upper Austria showed the highest yearly incidences for all five years. In general, however, a decrease of the yearly incidence was observed for all federal states except for Carinthia (where there was a small increase of 3.2 %). In the cities of Vienna, Linz, Wels, Salzburg, Klagenfurt and St-Pölten, as well as in the regions of Eastern Tyrol, Southern Carinthia, and Southern Burgenland, the incidence was above average (>19 cases/100 000 for each). The number of cases per year and per district reported by the statutory reporting system were clearly in excess of those reported by hospitals. The comparison of the two datasets, however, showed a highly significant regional correlation of age standardised morbidity rates at district level. The findings are prone to reporting bias and might not reflect the real TB situation. The responsible health authorities should therefore consider the results as a 'working hypothesis’ in order to review the reporting behaviour at district level.