bluuebunny/crossref_metadata_2025 huggingface dataset:
Age-specific infection and death rates for human A(H5N1) avian influenza in Egypt
Authors: Dudley J P
Published: October 2017

The age-specific infection and death profiles among confirmed human cases of influenza A(H5N1) infection in Egypt differ markedly from those recorded in other countries. The case fatality rate among human H5N1 cases in Egypt is 34%, versus an average of 66% in other countries. In Egypt, children younger than 10 years comprise 48% of reported cases, nearly twice the global average of approximately 25%, and no H5N1 fatalities have been confirmed among individuals in this age group as of 23 April 2009. Females outnumber males among confirmed H5N1 cases by a factor of nearly 2:1, and 90% of reported fatalities in Egypt have been females. The evident age and sex biases in morbidity and mortality among H5N1 cases in Egypt are phenomena that warrant further investigation and analysis.
Transmission potential of the new influenza A(H1N1) virus and its age-specificity in Japan
Authors: Nishiura H , Castillo-Chavez C , Safan M , Chowell G
Published: October 2017

On 16 May 2009, Japan confirmed its first three cases of new influenza A(H1N1) virus infection without a history of overseas travel, and by 1 June, 361 cases, owing to indigenous secondary transmission, have been confirmed. Of these, 287 cases (79.5%) were teenagers (i.e. between 10 and 19 years of age). The reproduction number is estimated at 2.3 (95% confidence interval: 2.0, 2.6). The average number of secondary transmissions involving minors (those under 20 years of age) traced back to infected minors is estimated at 2.8. That is, minors can sustain transmission even in the absence of adults. Estimates of the effective reproduction number Rt moved below 1 by 17 May. Active surveillance and public health interventions, including school closures most likely have contributed to keeping Rt below one.
Application of RT-PCR for diagnosis of respiratory syncytial virus and human metapneumovirus infections in Bulgaria, 2006-7 and 2007-8
Authors: Pavlova S , Hadzhiolova T , Abadjieva P , Kotseva R
Published: October 2017

We describe here the results of respiratory syncytial virus (RSV) detection by reverse transcription polymerase chain reaction (RT-PCR) during two consecutive seasons, from December 2006 to February 2007 and from October 2007 to March 2008, performed in the National Laboratory of Influenza and Acute Respiratory Diseases, Bulgaria. A total number of 278 nasopharyngeal samples obtained from hospitalised children up to the age of five years were investigated for these two seasons. During the first season, the aetiological role of RSV was confirmed in 56 of 148 samples (37.8%) compared to 11 of 130 samples (8.5%) during the second season. Since the beginning of January 2008, RT-PCR for the detection of the recently identified human metapneumovirus (HMPV) has also been introduced in Bulgaria. This virus has been demonstrated as the aetiological agent in 13 out of 81 samples (16%) from children of the same age group. The use of RT-PCR allows the detection of a broader spectrum of viruses causing respiratory diseases, as well as better discrimination of the aetiological agents in clinically similar cases.
School closure is currently the main strategy to mitigate influenza A(H1N1)v: a modeling study
Authors: Sypsa V , Hatzakis A
Published: October 2017

Concerns about an imminent influenza pandemic have been intensified after the emergence of the new influenza A(H1N1)v strain. Mathematical modeling was employed on recent epidemiological data from Mexico in order to assess the impact of intervention strategies on the spread of influenza A(H1N1)v in the setting of the European region. When initiating the intervention of 100% school closure in a community of 2,000 people at a threshold of 1% cumulative attack rate, the total number of symptomatic cases is predicted to decrease by 89.3%, as compared to the non-intervention scenario. When this measure is coupled with treatment and home isolation of symptomatic cases as well as a 50% reduction of social contacts, a 94.8% decline in the cumulative attack rate is predicted along with a much shorter duration of influenza A(H1N1)v transmission. Active surveillance that will ensure timely treatment and home isolation of symptomatic cases in combination with school closure seem to form an efficient strategy to control the spread of influenza A(H1N1)v.
A variety of respiratory viruses found in symptomatic travellers returning from countries with ongoing spread of the new influenza A(H1N1)v virus strain
Authors: Follin P , Lindqvist A , Nyström K , Lindh M
Published: October 2017

Clinical specimens from 79 symptomatic individuals with a recent history of travel to countries with verified transmission of influenza A(H1N1)v (North America) were tested with a multiple real-time PCR targeting a broad range of agents that may cause acute respiratory infection. This analysis revealed that besides four cases of influenza A(H1N1)v, other respiratory viruses were diagnosed in almost 60% of the samples. These observations are a reminder that many different viral transmissions occur simultaneously in countries with ongoing spread of influenza A(H1N1)v. The findings demonstrate that the definition of suspected cases by clinical and epidemiological criteria has only a poor capacity for discriminating influenza A(H1N1)v from other viral infections.
Influenza A(H1N1)v virus infections in Belgium, May-June 2009
Authors: Belgian working group on influenza A(H1N1)v Collective
Published: October 2017

In response to the ongoing influenza A(H1N1)v pandemic, first detected in North America in April 2009, Belgium has set up an active surveillance system for influenza-like illness among travellers returning from affected areas. This communication describes the clinical and epidemiological features of the first 43 laboratory-confirmed cases in Belgium.
Sequence-based and monoclonal antibody typing of Legionella pneumophila isolated from patients in Portugal during 1987-2008
Authors: Chasqueira M J , Rodrigues L , Nascimento M , Marques T
Published: October 2017

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Pandemic influenza A(H1N1)v viruses currently circulating in New Zealand are sensitive to oseltamivir
Authors: Hall R J , Peacey M P , Ralston J C , Bocacao J , Ziki M , Gunn W , Quirk A , Huang Q S
Published: October 2017

New Zealand, like other southern hemisphere countries with a temperate climate, has been in the winter period with seasonal influenza activity. New Zealand has also experienced a dramatic increase in the number of cases of pandemic influenza A(H1N1)v virus. Early reports from the northern hemisphere at the beginning of the pandemic showed that the virus was sensitive to the antiviral drug oseltamivir. In this study we report that pandemic influenza A(H1N1)v viruses currently circulating in New Zealand are sensitive to oseltamivir, but seasonal influenza A(H1N1) viruses – the co-circulating predominant seasonal strain, is resistant to oseltamivir.
Epidemiological and clinical characteristics of influenza A(H1N1)v infection in children: The first 45 cases in Cyprus, June – August 2009
Authors: Koliou M , Soteriades E S , Toumasi M M , Demosthenous A , Hadjidemetriou A
Published: October 2017

Following the first imported case in a tourist in Cyprus on 2 June 2009, the influenza A(H1N1)v virus has spread on the island affecting mainly young adults and children. We describe here the first 45 cases in children. Fever, cough, rhinorrhoea and sore throat were the most common symptoms of infection. Half of the children had fever for one day or only for a few hours. Five children were hospitalised, and overall their symptoms were mild. Adherence to oseltamivir treatment was very high, with low frequency of gastrointestinal side effects such as nausea and vomiting. Camping places and summer schools played a significant role in spreading the infection among children of school age.
An analysis of a short-lived outbreak of dengue fever in Mauritius
Authors: Ramchurn S K , Moheeput K , Goorah S S
Published: October 2017

During the month of June 2009, Mauritius experienced a short-lived outbreak of dengue fever localised in its capital city Port Louis. Aedes albopictus, a secondary vector of dengue viruses, was the probable vector. We introduce a method which combines Google Earth images, stochastic cellular automata and scale free network ideas to map this outbreak. The method could complement other techniques to forecast the evolution of potential localised mosquito-borne viral outbreaks in Mauritius and in at-risk locations elsewhere for public health planning purposes.
Influenza A(H1N1)v in Germany: the first 10,000 cases
Authors: Gilsdorf A , Poggensee G , on behalf of the working group pandemic influenza A(H1N1)v collective
Published: October 2017

The analysis of the first 10,000 cases of influenza A(H1N1)v in Germany confirms findings from other sources that the virus is currently mainly causing mild diseases, affecting mostly adolescents and young adults. Overall hospitalisation rate for influenza A(H1N1)v was low (7%). Only 3% of the cases had underlying conditions and pneumonia was rare (0.4%). Both reporting and testing requirements have been adapted recently, taking into consideration the additional information available on influenza A(H1N1)v infections.
Molecular characterisation of PFGE non-typable methicillin-resistant Staphylococcus aureus in the Netherlands, 2007
Authors: Huijsdens X W , Bosch T , van Santen-Verheuvel M G , Spalburg E , Pluister G N , van Luit M , Heck M E , Haenen A , de Neeling A  J
Published: October 2017

In 2007 in the Netherlands, 30% of all human isolates of methicillin-resistant Staphylococcus aureus (MRSA) sent to the National Institute for Public Health and the Environment could not be typed by pulsed-field gel electrophoresis (non-typable (NT)-MRSA). Molecular characterisation of the NT-MRSA isolates revealed 27 different spa types and two distinct SCCmec types, type IV and V. All NT-MRSA isolates were closely related based on spa and multi-locus sequence typing and belonged to the ST398 lineage. The rapid increase of NT-MRSA (ST398) isolates over the last years shows the importance of this relatively new clonal lineage.
The 2009 pandemic H1N1 influenza and indigenous populations of the Americas and the Pacific
Authors: La Ruche G , Tarantola A , Barboza P , Vaillant L , Gueguen J , Gastellu-Etchegorry M , for the epidemic intelligence team at InVS
Published: October 2017

There are few structured data available to assess the risks associated with pandemic influenza A(H1N1)v infection according to ethnic groups. In countries of the Americas and the Pacific where these data are available, the attack rates are higher in indigenous populations, who also appear to be at approximately three to six-fold higher risk of developing severe disease and of dying. These observations may be associated with documented risk factors for severe disease and death associated with pandemic H1N1 influenza infection (especially the generally higher prevalence of diabetes, obesity, asthma, chronic obstructive pulmonary disease and pregnancy in indigenous populations). More speculative factors include those associated with the risk of infection (e.g. family size, crowding and poverty), differences in access to health services and, perhaps, genetic factors. Whatever the causes, this increased vulnerability of indigenous populations justify specific immediate actions in the control of the current pandemic including primary prevention (intensified hygiene promotion, chemoprophylaxis and vaccination) and secondary prevention (improved access to services and early treatment following symptoms onset) of severe pandemic H1N1 influenza infection.
Decrease of hypervirulent Clostridium difficile PCR ribotype 027 in the Netherlands
Authors: Hensgens M P , Goorhuis A , Notermans D  W , van Benthem B H , Kuijper E  J
Published: October 2017

After the first outbreaks of Clostridium difficile PCR ribotype 027 (North American pulsed-field type 1, restriction endonuclease analysis group BI) in the Netherlands in 2005, a national surveillance programme for C. difficile infection (CDI) was started. Furthermore, national guidelines were developed to rapidly recognise type 027 infections and prevent further spread. The mean incidence of CDI measured in 14 hospitals remained stable throughout the years: an incidence of 18 per 10,000 admissions was seen in 2007 and 2008. Between April 2005 and June 2009 a total of 2,788 samples were available for PCR ribotyping. A decrease was seen in the number and incidence of type 027 after the second half of 2006. In the first half of 2009, the percentage of type 027 isolates among all CDI decreased to 3.0%, whereas type 001 increased to 27.5%. Type 014 was present in 9.3% of the isolates and C. difficile type 078 slightly increased to 9.1%. We conclude that currently there is a significant decrease in type 027-associated CDI in the Netherlands.
Recently acquired HIV infection in men who have sex with men (MSM) in France, 2003-2008
Authors: Semaille C , Cazein F , Lot F , Pillonel J , Le Vu S , Le Strat Y , Bousquet V , Velter A , Barin F
Published: October 2017

An increase in the number of new HIV diagnoses among men who have sex with men (MSM) was observed in several countries in the early 2000s. In this article, we explore the trends among MSM in France between 2003 and 2008. To estimate the number of MSM newly diagnosed with HIV, we take into account the reporting delay, underreporting and missing data for HIV case notification. To identify recent infections (RI) (acquired an average of six months before diagnosis), we used an enzyme immunoassay for recent HIV-1 infections (EIA-RI) which has been performed routinely for new HIV diagnoses since 2003. Multivariate analysis was used to identify factors associated with RI. We estimate that between 1,900 and 2,400 MSM have been newly diagnosed with HIV every year: the proportion of MSM among all newly diagnosed with HIV cases has increased from 25.2% (95% confidence interval (CI): 23.3-27.1) in 2003 to 37.0% (95% CI: 35.2-38.7) in 2008 and was stable during the period 2006-2008. In 2008, the rate of newly diagnosed HIV cases per 10,000 MSM living in France was 72.5. The proportion of non-B subtypes of HIV-1 among cases diagnosed in MSM was 11.7% (2003-2008). The assessment of RI was performed for 4,819 MSM newly diagnosed with HIV in 2003-2008. Of these, 47.6% (95%CI = 46.2-49.0) (2,295 cases) were shown to have been recently infected. The risk of RI was greater for those of French nationality (adjusted odds ratio (aOR) =1.6 [95% CI: 1.4-1.9]), those with high economic status (aOR =1.4 [95% CI: 1.2-1.8]), those tested after a risk exposure (aOR =1.6[95% CI: 1.3-1.8]) or after presenting with clinical symptoms or abnormal biological markers (aOR =1.8 [95% CI: 1.5-2.0]), those who had tested for HIV three or more times during their life-time (aOR =4.2 [95% CI: 3.4-5.2]) and those living in the Paris area (aOR =1.2 [95% CI: 1.0-1.3]). The risk of RI decreased with age. The HIV situation among MSM living in France is a cause of concern, despite the prevention campaigns dedicated to this highly educated sub-population.
HIV/STI co-infection among men who have sex with men in Spain
Authors: Diaz A , Junquera M L , Esteban V , Martínez B , Pueyo I , Suárez J , Ureña J  M , Varela J A , Vall M , del Romero J , Sanz I , Belda J , Boronat J , Gómez P , Gual F , Colomo C , López de Munain J , Balaguer J , Landa M C , Lezaun M E , Cámara M C , Fernández E , Bru F  J , Alastrue I , Ordoñana J R , de Armas C , Azpiri M A , Gomez L , Trullén J , Diez M , on behalf of STI Study Group and EPI-VIH Group
Published: October 2017

In Spain, neither the HIV nor the STI national surveillance systems collect information on HIV/STI co-infection. However, there are two networks based on HIV/STI clinics which gather this data. We describe HIV prevalence in men who have sex with men (MSM) diagnosed with infectious syphilis and/or gonorrhoea in 15 STI clinics; and concurrent diagnoses of STI in MSM newly diagnosed with HIV in 19 HIV/STI clinics. In total, 572 MSM were diagnosed with infectious syphilis and 580 with gonorrhoea during 2005-2007. HIV prevalence among syphilis and gonorrhoea cases was 29.8% and 15.2% respectively. In the multivariate analysis, HIV/syphilis co-infection was associated with being Latin American; having a history of STI; reporting exclusively anal intercourse; and having sex with casual or several types of partners. HIV and gonorrhoea co-infection was associated with age older than 45 years; having no education or only primary education completed; and having a history of STI. In total, 1,462 HIV infections were newly diagnosed among MSM during 2003-2007. Of these, 31.0% were diagnosed with other STI at the same time. Factors associated with STI co-infection among new HIV cases in MSM were being Latin American; and having sex with casual partners or with both steady and casual partners. In Spain, a considerable proportion of MSM are co-infected with HIV and STI.
HIV risk behaviour knowledge, substance use and unprotected sex in men who have sex with men in Tallinn, Estonia
Authors: Tripathi A , Rüütel K , Parker R D
Published: October 2017

This study examines HIV risk behaviour knowledge, substance use and unprotected sex in a sample of 79 men who have sex with men (MSM) in Tallinn, Estonia. Median age of the study population was 30 years (range 18-62 years); 35 were bisexual; 56 answered correctly to at least 10 out of 13 questions about HIV risk behaviours; 23 consumed more than seven alcoholic drinks in the week before the survey; nearly half (n=34) of the participants reported some illicit drug use in the past 12 months; 40 did not use a condom regularly in the 12 months preceding the survey, and 41 did not use a condom during their last sexual intercourse. Alcohol consumption in the week before the survey was negatively associated with condom use during last intercourse (RR 0.48; 95% CI 0.41-0.56). Use of illicit drugs varied significantly by ethnicity (p-value = 0.02). Multivariable analysis showed that higher consumption of alcohol in the week before the survey could be predicted by education, age group and sexual orientation. In conclusion, socio-demographic factors such as education, age, ethnicity and sexual orientation may affect HIV risk behaviour knowledge, sexual behavior and substance use among MSM in Estonia, and need to be taken into consideration for targeted HIV prevention.
When should we intervene to control the 2009 influenza A(H1N1) pandemic?
Authors: Sato H , Nakada H , Yamaguchi R , Imoto S , Miyano S , Kami M
Published: October 2017

We simulated the early phase of the 2009 influenza A(H1N1) pandemic and assessed the effectiveness of public health interventions in Japan. We show that the detection rate of border quarantine was low and the timing of the intervention was the most important factor involved in the control of the pandemic, with the maximum reduction in daily cases obtained after interventions started on day 6 or 11. Early interventions were not always effective.
Severe hospitalised 2009 pandemic influenza A(H1N1) cases in France, 1 July-15 November 2009
Authors: Fuhrman C , Bonmarin I , Paty A C , Duport N , Chiron E , Lucas E , Bitar D , Mailles A , Herida M , Vaux S , Lévy-Bruhl D
Published: October 2017

From 1 July 2009 to 15 November 2009, 244 patients with 2009 pandemic influenza A(H1N1) were admitted to intensive care unit (ICU) and were compared with 514 cases hospitalised in medical wards in France until 2 November 2009. Detailed case-based epidemiological information and outcomes were gathered for all hospitalised cases. Infants and pregnant women are overrepresented among cases admitted to ICU with seven per cent for both groups respectively, and twenty per cent of ICU cases did not belong to a risk group. Chronic respiratory disease was the most common risk factor among cases but obesity (body mass index ≥ 30 Kg/m2), chronic cardiac disease and immunosuppression were risk factors associated with severe illness after adjustment for age and for other co-morbidities.
An outbreak of infection with Bacillus anthracis in injecting drug users in Scotland
Authors: Ramsay C N , Stirling A , Smith J , Hawkins G , Brooks T , Hood J , Penrice G , Browning L  M , Ahmed S , on behalf of the NHS GGC Collective , on behalf of the Scottish National Outbreak Control Teams Collective
Published: October 2017

An investigation is currently underway to explore and control an outbreak of Bacillus anthracis among drug users (mainly injecting) in Scotland. Contaminated heroin or a contaminated cutting agent mixed with the heroin is considered to be the most likely source and vehicle of infection. Heroin users have been advised of the risk. The risk to the general public is regarded as very low.
Spotlight on measles 2010: A measles outbreak in a Roma population in Pulawy, eastern Poland, June to August 2009
Authors: Orlikova H , Rogalska J , Kazanowska-Zielinska E , Jankowski T , Slodzinski J , Kess B , Stefanoff P
Published: October 2017

We describe a local indigenous outbreak of measles in a susceptible Roma community, which occurred in Pulawy, a town of 50,000 citizens in the Lubelskie province (eastern Poland) during summer 2009. From 22 June to 30 August 2009, 32 measles cases were reported, and additionally nine possible cases were actively identified. A mass immunisation campaign was organised to stop measles transmission in the Roma community. Active surveillance of rash-febrile illnesses allowed documentation of the impact of mass immunisation in preventing further measles spread in the Roma community, and the surrounding population of Pulawy.
Mass psychogenic illness in nationwide in-school vaccination for pandemic influenza A(H1N1) 2009, Taiwan, November 2009–January 2010
Authors: Huang W T , Hsu C C , Lee P I , Chuang J H
Published: October 2017

From 16 November 2009 to 22 January 2010, Taiwan investigated 23 clusters of mass psychogenic illness after vaccination (MPIV) in the nationwide in-school vaccination programme against the 2009 pandemic influenza A(H1N1). The median age of the 350 ill students (68% female) was 13 years. Intense media coverage of these events has driven public concerns about the safety of the pandemic influenza vaccine. In the future, countries should incorporate surveillance and communication strategies for MPIV in their pandemic preparedness plans.
Emergence of pregnancy-related listeriosis amongst ethnic minorities in England and Wales
Authors: Mook P , Grant K A , Little C L , Kafatos G , Gillespie I  A
Published: October 2017

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Monitoring influenza activity in Europe with Google Flu Trends: comparison with the findings of sentinel physician networks – results for 2009-10
Authors: Valdivia A , López-Alcalde J , Vicente M , Pichiule M , Ruiz M , Ordobas M
Published: October 2017

The number of Internet searches has recently been used by Google to estimate the influenza incidence in the United States. We examined the correlation between the Google Flu Trends tool and sentinel networks estimates in several European countries during the 2009 influenza A(H1N1) pandemic and found a good correlation between estimates and peak incidence timing, with the highest peaks in countries where Internet is most frequently used for health-related searching. Although somehow limited, Google could be a valuable tool for syndromic surveillance.
Value of syndromic surveillance in monitoring a focal waterborne outbreak due to an unusual Cryptosporidium genotype in Northamptonshire, United Kingdom, June – July 2008
Authors: Smith S , Elliot A J , Mallaghan C , Modha D , Hippisley-Cox J , Large S , Regan M , Smith G E
Published: October 2017

The United Kingdom (UK) has several national syndromic surveillance systems. The Health Protection Agency (HPA)/NHS Direct syndromic surveillance system uses pre-diagnostic syndromic data from a national telephone helpline, while the HPA/QSurveillance national surveillance system uses clinical diagnosis data extracted from general practitioner (GP)-based clinical information systems. Data from both of these systems were used to monitor a local outbreak of cryptosporidiosis that occurred following Cryptosporidium oocyst contamination of drinking water supplied from the Pitsford Reservoir in Northamptonshire, United Kingdom, in June 2008. There was a peak in the number of calls to NHS Direct concerning diarrhoea that coincided with the incident. QSurveillance data for the local areas affected by the outbreak showed a significant increase in GP consultations for diarrhoea and gastroenteritis in the week of the incident but there was no increase in consultations for vomiting. A total of 33 clinical cases of cryptosporidiosis were identified in the outbreak investigation, of which 23 were confirmed as infected with the outbreak strain. However, QSurveillance data suggest that there were an estimated 422 excess diarrhoea cases during the outbreak, an increase of about 25% over baseline weekly levels. To our knowledge, this is the first time that data from a syndromic surveillance system, the HPA/QSurveillance national surveillance system, have been able to show the extent of such a small outbreak at a local level. QSurveillance, which covers about 38% of the UK population, is currently the only GP database that is able to provide data at local health district (primary care trust) level. The Cryptosporidium contamination incident described demonstrates the potential usefulness of this information, as it is unusual for syndromic surveillance systems to be able to help monitor such a small-scale outbreak.
Spotlight on measles 2010: An ongoing measles outbreak in the district of Neamt, Romania, August –September 2010
Authors: Stanescu A , Muscat M , Romaniuc A , Pipirigeanu R , Lupulescu E , Necula G , Lazar M , Molnar G , Pistol A
Published: October 2017

We report an outbreak of measles that has been ongoing in the district of Neamt, Romania, since 22 August 2010. As of 21 September, 17 of 21 suspected cases have been laboratory-confirmed and there was one measles-related fatality.
First autochthonous malaria case due to Plasmodium vivax since eradication, Spain, October 2010
Authors: Santa-Olalla Peralta P , Vazquez-Torres M C , Latorre-Fandós E , Mairal-Claver P , Cortina-Solano P , Puy-Azón A , Adiego Sancho B , Leitmeyer K , Lucientes-Curdi J , Sierra-Moros M J
Published: October 2017

In October 2010, one case of autochthonous malaria due to Plasmodium vivax was diagnosed in Spain. The case occurred in Aragon, north-eastern Spain, where the vector Anopheles atroparvus is present. Although the source of infection could not be identified, this event highlights that sporadic autochthonous transmission of vector-borne diseases in continental Europe is possible and calls for enhanced surveillance and vector control measures.
Methicillin-resistant Staphylococcus aureus (MRSA): burden of disease and control challenges in Europe
Authors: Köck R , Becker K , Cookson B , van Gemert-Pijnen J E , Harbarth S , Kluytmans J , Mielke M , Peters G , Skov R L , Struelens M J , Tacconelli E , Navarro Torné A , Witte W , Friedrich A W
Published: October 2017

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of healthcare- and community-associated infections worldwide. Within the healthcare setting alone, MRSA infections are estimated to affect more than 150,000 patients annually in the European Union (EU), resulting in attributable extra in-hospital costs of EUR 380 million for EU healthcare systems. Pan-European surveillance data on bloodstream infections show marked variability among EU Member States in the proportion of S. aureus that are methicillin-resistant, ranging from less than 1% to more than 50%. In the past five years, the MRSA bacteraemia rates have decreased significantly in 10 EU countries with higher endemic rates of MRSA infections. In addition to healthcare-associated infections, new MRSA strains have recently emerged as community- and livestock-associated human pathogens in most EU Member States. The prevention and control of MRSA have therefore been identified as public health priorities in the EU. In this review, we describe the current burden of MRSA infections in healthcare and community settings across Europe and outline the main threats caused by recent changes in the epidemiology of MRSA. Thereby, we aim at identifying unmet needs of surveillance, prevention and control of MRSA in Europe.
A new pandemic influenza A(H1N1) genetic variant predominated in the winter 2010 influenza season in Australia, New Zealand and Singapore
Authors: Barr I G , Cui L , Komadina N , Lee R T , Lin R T , Deng Y , Caldwell N , Shaw R , Maurer-Stroh S
Published: October 2017

Pandemic H1N1 influenza virus is of global health concern and is currently the predominant influenza virus subtype circulating in the southern hemisphere 2010 winter. The virus has changed little since it emerged in 2009, however, in this report we describe several genetically distinct changes in the pandemic H1N1 influenza virus. These variants were first detected in Singapore in early 2010 and have subsequently spread through Australia and New Zealand. At this stage, these signature changes in the haemagglutinin and neuraminidase proteins have not resulted in significant antigenic changes which might make the current vaccine less effective, but such adaptive mutations should be carefully monitored as the northern hemisphere approaches its winter influenza season.
The potential for a concerted system for the rapid monitoring of excess mortality throughout Europe
Authors: Kanieff M , Rago G , Minelli G , Lamagni T , Sadicova O , Šelb J , Vantarakis A , Conti S
Published: October 2017

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Matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) mass spectrometry as a tool for rapid diagnosis of potentially toxigenic Corynebacterium species in the laboratory management of diphtheria-associated bacteria
Authors: Konrad R , Berger A , Huber I , Boschert V , Hörmansdorfer S , Busch U , Hogardt M , Schubert S , Sing A
Published: October 2017

The rapid identification of the potentially toxigenic Corynebacterium species, C. diphtheriae, C. ulcerans and C. pseudotuberculosis is essential for diagnosis and treatment of diphtheria and diphtheria-like diseases. We used matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) in comparison with classical microbiological and molecular methods on 116 Corynebacterium strains. All 90 potentially toxigenic Corynebacterium strains collected by the German National Consiliary Laboratory on Diphtheria in a period of more than ten years were correctly identified by MALDI-TOF MS. We propose an algorithm for fast and reliable diagnosis of diphtheria incorporating MALDI-TOF MS, real-time tox PCR and Elek testing.
Cohort study of a campylobacteriosis outbreak associated with chicken liver parfait, United Kingdom, June 2010
Authors: Inns T , Foster K , Gorton R
Published: October 2017

In an outbreak of 24 cases of gastroenteritis among guests at a wedding reception, 13 cases had confirmed Campylobacter infection. In a cohort study, univariate analysis revealed a strong association with consumption of chicken liver parfait: risk ratio (RR): 30.08, 95% confidence interval (CI): 4.34-208.44, p<0.001, which remained after adjustment for potential confounders in a multivariable model: RR=27.8, 95% CI=3.9-199.7, p=0.001. These analyses strongly support the hypothesis that this outbreak was caused by the consumption of chicken liver parfait.
Clinical laboratory practices for detection and reporting of Cryptosporidium in community cases of diarrhoea in the United Kingdom, 2008
Authors: Chalmers R M , Campbell B , Crouch N , Davies A P
Published: October 2017

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Control of a multi-hospital outbreak of KPC-producing Klebsiella pneumoniae type 2 in France, September to October 2009
Authors: Carbonne A , Thiolet J  M , Fournier S , Fortineau N , Kassis-Chikhani N , Boytchev I , Aggoune M , Séguier J C , Sénéchal H , Tavolacci M P , Coignard B , Astagneau P , Jarlier V
Published: October 2017

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National surveillance of pandemic influenza A(H1N1) infection-related admissions to intensive care units during the 2009–10 winter peak in Denmark: two complementary approaches
Authors: Gubbels S , Perner A , Valentiner-Branth P , Mølbak K
Published: October 2017

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Ongoing measles outbreak, Geneva, Switzerland, January to March 2011
Authors: Delaporte E , Richard J L , Wyler Lazarevic C A , Lacour O , Girard M , Ginet C , Iten A , Sudre P
Published: October 2017

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Early estimates of seasonal influenza vaccine effectiveness in Europe, 2010/11: I-MOVE, a multicentre case–control study
Authors: Kissling E , Valenciano M , I-MOVE case–control studies team Collective
Published: October 2017

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Hepatitis B prevention in Victoria, Australia – the potential to protect
Authors: Williams S , Vally H , Fielding J , Cowie B
Published: October 2017

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Clusters of infectious diseases in German nursing homes – observations from a prospective infection surveillance study, October 2008 to August 2009
Authors: Schulz M , Mielke M , Wischnewski N
Published: October 2017

A prospective infection surveillance study was carried out among residents of seven nursing homes in and around Berlin, Germany, from October 2008 to August 2009. A considerable number of infections were found to occur in clusters. Active surveillance was carried out using pre-established case definitions of infections in nursing homes (McGeer criteria). Case finding was based on routine nursing files. Infection rates were calculated per 1,000 resident days. Clusters were identified using a pre-established definition. In total 511 residents were observed during 74,626 resident days (rd), and 393 infections occurred in 243 participants, giving an overall incidence of infection of 5.3 per 1,000 rd. The most common infections were gastrointestinal infections (n=122; 1.6/1,000 rd), acute respiratory disease (n=86; 1.2/1,000 rd) and urinary tract infections (n=71; 1.0/1,000 rd). Seven clusters involving 74 infections in 57 residents were observed: three of acute respiratory disease, three of acute gastrointestinal disease and one of conjunctivitis. Attack rates varied between 11% and 61%. Clusters occurred frequently in the observed nursing homes and could be detected by infection surveillance based on routine documentation.
HIV-1 outbreak among injecting drug users in Greece, 2011: a preliminary report
Authors: Paraskevis D , Nikolopoulos G , Tsiara C , Paraskeva D , Antoniadou A , Lazanas M , Gargalianos P , Psychogiou M , Malliori M , Kremastinou J , Hatzakis A
Published: October 2017

A significant increase (more than 10-fold) in the number of newly diagnosed HIV-1 infections among injecting drug users (IDUs) was observed in Greece during the first seven months of 2011. Molecular epidemiology results revealed that a large proportion (96%) of HIV-1 sequences from IDUs sampled in 2011 fall within phylogenetic clusters suggesting high levels of transmission networking. Cases originated from diverse places outside Greece supporting the potential role of immigrant IDUs in the initiation of this outbreak.
Clinical, electrocardiographic and echocardiographic abnormalities in Latin American migrants with newly diagnosed Chagas disease 2005-2009, Barcelona, Spain
Authors: Valerio L , Roure S , Sabrià M , Balanzó X , Vallès X , Serés L
Published: October 2017

Following Latin American migration, Chagas disease has inevitably appeared in non-endemic countries in Europe and elsewhere. New policies are necessary to prevent transmission in those countries but the long, often undetected chronic period of the early stages of the disease also renders epidemiological studies important. The main objective of our study was to determine the presence of clinical, electrocardiogram (ECG) and echocardiographic abnormalities in a population of Latin American migrants infected with Trypanosoma cruzi at the moment of diagnosis. We performed a hospital-based observational study of 100 adult patients with newly diagnosed Chagas infection between January 2005 and December 2009. Thirty-seven patients were classified within the Brazilian Consensus on Chagas cardiomyopathy early cardiac stages (A or B1) and 49 presented pathological findings (stage B2) according to the Panamerican Health Organization Classification. Overall, 49 patients showed ECG and/or echocardiographic alterations. The presence of ECG and ecocardiographic alterations were significantly associated (p=0.038). The most frequent ECG and echocardiographic findings were right bundle branch block (12 cases) and impaired left ventricular wall relaxation (24 cases), respectively. In conclusion, ECG and echocardiographic alterations coherent with Chagas cardiomyopathy were found in a large proportion of newly diagnosed Latin American migrants infected with T. cruzi. In the mid-term, Chagas disease might become an important cause of chronic cadiomyopathy in our attendance area.
Tick-borne encephalitis increasing in Sweden, 2011
Authors: Lundkvist Å , Wallensten A , Vene S , Hjertqvist M
Published: October 2017

Until August, 161 cases of tick-borne encephalitis (TBE) were recorded in Sweden for 2011, leading to an incidence of 1.7 per 100,000 population. Fifty to 59 year-olds (24%) were most affected, 55% of the cases were males. An increase in TBE in Sweden has occurred in the last decade and might be explained by enlarged tick populations, more contact between TBE virus infected ticks and man, and also by growing awareness of the disease. Climatic conditions may have contributed to the increase.
Two cases of food-borne botulism in Finland caused by conserved olives, October 2011
Authors: Jalava K , Selby K , Pihlajasaari A , Kolho E , Dahlsten E , Forss N , Bäcklund T , Korkeala H , Honkanen-Buzalski T , Hulkko T , Derman Y , Järvinen A , Kotilainen H , Kultanen L , Ruutu P , Lyytikaïnen O , Lindström M
Published: October 2017

In October 2011 in Finland, two persons fell ill with symptoms compatible with botulism after having eaten conserved olives stuffed with almonds. One of these two died. Clostridium botulinum type B and its neurotoxin were detected in the implicated olives by PCR and mouse bioassay, respectively. The olives were traced back to an Italian manufacturer and withdrawn from the market. The public and other European countries were informed through media and Europe-wide notifications.
Outbreak of haemolytic uraemic syndrome due to Shiga toxin-producing Escherichia coli O104:H4 among French tourists returning from Turkey, September 2011
Authors: Jourdan-da Silva N , Watrin M , Weill F  X , King L A , Gouali M , Mailles A , van Cauteren D , Bataille M , Guettier S , Castrale C , Henry P , Mariani P , Vaillant V , de Valk H
Published: October 2017

Eight cases of diarrhoea, including two cases of haemolytic uraemic syndrome (HUS), were identified among 22 French tourists who travelled to Turkey in September 2011. A strain of Escherichia coli O104:H4 stx2-positive, eae-negative, hlyA-negative, aggR-positive, ESBL-negative was isolated from one HUS case. Molecular analyses show this strain to be genetically similar but not indistinguishable from the E. coli O104:H4 2011 outbreak strain of France and Germany. Although the source of infection was not identified, we conclude that the HUS cases had probably been infected in Turkey.
Cross-reactive antibody to swine influenza A(H3N2) subtype virus in children and adults before and after immunisation with 2010/11 trivalent inactivated influenza vaccine in Canada, August to November 2010
Authors: Skowronski D M , De Serres G , Janjua N Z , Gardy J L , Gilca V , Dionne M , Hamelin M E , Rhéaume C , Boivin G
Published: October 2017

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Outbreak of cryptosporidiosis in a child day-care centre in Gipuzkoa, Spain, October to December 2011
Authors: Artieda J , Basterrechea M , Arriola L , Yagüe M , Albisua E , Arostegui N , Astigarraga U , Botello R , Manterola J M
Published: October 2017

From October to December 2011, an outbreak of 26 cases of cryptosporidiosis occurred in a day-care centre in Gipuzkoa, Spain. The infection spread from person to person and affected 24 children under two years of age (attack rate: 38%) and two caregivers. Cryptosporidium oocysts were observed in 10 of 15 samples. During 2010, only four cases of cryptosporidium were detected in Gipuzkoa, and 27 overall in Spain.
Increased incidence of Mycoplasma pneumoniae infection in Finland, 2010–2011
Authors: Polkowska A , Harjunpää A , Toikkanen S , Lappalainen M , Vuento R , Vuorinen T , Kauppinen J , Flinck H , Lyytikäinen O
Published: October 2017

The number of cases of Mycoplasma pneumoniae infection detected by laboratory-based surveillance increased in Finland in late 2010. During 2011, the number of cases was four times higher than during the previous epidemic in 2005. The 2011 epidemic affected mostly school-age children. The increased number of cases was probably not due to changes in laboratory procedures, but public interest may have had an effect, since the number of Google queries followed closely the epidemic curve.
Estimating vaccination coverage in the absence of immunisation registers – the German experience
Authors: Siedler A , Rieck T , Reuss A , Walter D , Poggensee G , Poethko-Müller C , Reiter S
Published: October 2017

Immunisation registers are regarded as an appropriate solution to measure vaccination coverage on a population level. In Germany, a decentralised healthcare system and data protection regulations constrain such an approach. Moreover, shared responsibilities in the process of immunisation and multiple providers form the framework for public health interventions on vaccination issues. On the national level, those interventions consist mainly of conceptualising immunisation strategies, establishing vaccination programmes, and issuing recommendations. This paper provides an overview on sources and methods for collecting appropriate coverage data at national level and their public health relevance in Germany. Methods of data collection and available information on immunisations are described for three approaches: school entrance health examination, population surveys and insurance refund claim data. School entrance health examinations allow regional comparisons and estimation of trends for a specific cohort of children and for all recommended childhood vaccinations. Surveys deliver population based data on completeness and timeliness of selected vaccinations in populations defined by age or socio-demographic parameters and on knowledge and attitudes towards vaccination. Insurance refund claim data inform continuously on immunisation status (e.g. of children aged two years) or on vaccination incidence promptly after new or modified recommendations. In a complex healthcare system, the German National Public Health Institute (Robert Koch Institute, RKI) successfully compiles coverage data from different sources, which complement and validate one another. With the German approach of combining different data sources in the absence of immunisation registers, it is possible to gain solid and reliable data on the acceptance of vaccination programmes and target groups for immunisation. This approach might be of value for other countries with decentralised healthcare systems.
Immunisation registers in Canada: progress made, current situation, and challenges for the future
Authors: Laroche J A , Diniz A J
Published: October 2017

Immunisation registers have the capacity to capture data on the administration of vaccine doses at the individual level within the population and represent an important tool in assessing immunisation coverage and vaccine uptake. In 1999, the National Advisory Committee on Immunization recommended that a network of immunisation registers be established in Canada. The Canadian Immunization Registry Network (CIRN) was established to coordinate the development of standards and facilitate the sharing of knowledge and experience to develop a national network of such registers. In 2003, the National Immunization Strategy identified immunisation registers as an important component in improving national immunisation surveillance. In addition, there has been consistent public and professional interest in a national immunisation register being available and considerable progress has been made in developing technologies to facilitate the capture of immunisation-related data. More specifically, the automated identification of vaccines, through the use of barcodes on vaccines, will facilitate collection of data related to administered vaccine doses. Nevertheless, challenges remain in the implementation of immunisation registers in all Canadian provinces and territories such that Canada still does not currently have a fully functional network of immunisation registers with the capacity to be interoperable between jurisdictions and to allow for data to be captured at the national level.
Frequency of oseltamivir resistance in Sydney, during the Newcastle outbreak of community transmitted oseltamivir-resistant influenza A(H1N1)pdm09 virus, Australia, June to August 2011
Authors: Wang B , Taylor J , Ratnamohan M , McPhie K , Kesson A , Dixit R , Booy R , Hurt A C , Saksena N K , Dwyer D E
Published: October 2017

Although oseltamivir-resistant pandemic influenza A(H1N1)pdm09 is uncommon in immunocompetent individuals, a recent report from Newcastle, Australia, showed the first sustained community spread, from June to August 2011, of oseltamivir-resistant influenza A(H1N1)pdm09 virus carrying the H275Y neuraminidase (NA) mutation. To determine the frequency and the extent of this viral variant spread in the nearest major city to Newcastle, we performed a sequence-based genotypic assessment on samples from 143 oseltamivir untreated and 23 oseltamivir post-treatment individuals with influenza collected contemporaneously in Sydney, 120 km southwest of Newcastle. The detection of two of 143 (1.4%) community-derived samples containing H275Y suggests a low prevalence of oseltamivir-resistant influenza A(H1N1)pdm09 virus in the general community and no convincing evidence of spread of the NA H275Y-bearing influenza A(H1N1)pdm09 virus. In oseltamivir treated patients, oseltamivir-resistant influenza A(H1N1)pdm09 virus continue to emerge with three of 23 (13%) post-treatment samples containing the H275Y mutation. The observation of signature mutations and distinct phylogenetic relationship in full-length sequences of haemagglutinin and neuraminidase genes derived from 2011 strains against 2009 strains indicates continued genetic evolution and antigenic drift of the influenza A(H1N1)pdm09 viruses circulating in Australia.
Infectious disease surveillance for the London 2012 Olympic and Paralympic Games
Authors: Severi E , Heinsbroek E , Watson C , Catchpole M , HPA Olympics Surveillance Work Group Collective
Published: October 2017

The London 2012 Olympic and Paralympic Games will be one of the largest mass gathering events in British history. In order to minimise potential infectious disease threats related to the event, the Health Protection Agency (HPA) has set up a suite of robust and multi-source surveillance systems. These include enhancements of already established systems (notification of infectious diseases, local and regional reporting, laboratory surveillance, mortality surveillance, international surveillance, and syndromic surveillance in primary care), as well as new systems created for the Games (syndromic surveillance in emergency departments and out-of-hours/unscheduled care, undiagnosed serious infectious illness surveillance). Enhanced existing and newly established surveillance systems will continue after the Games or will be ready for future reactivation should the need arise. In addition to the direct improvements to surveillance, the strengthening of relationships with national and international stakeholders will constitute a major post-Games legacy for the HPA.