bluuebunny/crossref_metadata_2025 huggingface dataset:
Mumps outbreak in Jerusalem affecting mainly male adolescents
Authors: Stein-Zamir C , Shoob H , Abramson N , Tallen-Gozani E , Sokolov I , Zentner G
Published: March 2021

From mid-September 2009 to 7 December 2009, 173 cases of mumps have been reported in the Jerusalem District. Most cases (82.1%) were male adolescents (median age 14.5 years) who are students in religious boarding schools. The majority of them (74%) are appropriately vaccinated for their age; 67% had received two doses of mumps-containing vaccine. An epidemiologic connection has been reported with visitors from New York, some of whom had recently had mumps.
Microbiological and molecular investigation of an increase of human listeriosis in Belgium, 2006-2007
Authors: Yde M , Botteldoorn N , Bertrand S , Collard J M , Dierick K
Published: March 2021

In Belgium, the majority of cases of listeriosis are sporadic cases. In this study we present evidence for an episode of listeriosis: a time-linked cluster of cases that occurred in 2006 and 2007, and the identification of identical strains. The episode involved 11 patients, infected with Listeria monocytogenes of serovar 4b. The source of infection was not detected.
Rift Valley fever - a threat for Europe?
Authors: Chevalier V , Pépin M , Plée L , Lancelot R
Published: March 2021

Rift Valley fever (RVF) is a severe mosquito-borne disease affecting humans and domestic ruminants, caused by a Phlebovirus (Bunyaviridae). It is widespread in Africa and has recently spread to Yemen and Saudi Arabia. RVF epidemics are more and more frequent in Africa and the Middle East, probably in relation with climatic changes (episodes of heavy rainfall in eastern and southern Africa), as well as intensified livestock trade. The probability of introduction and large-scale spread of RVF in Europe is very low, but localised RVF outbreaks may occur in humid areas with a large population of ruminants. Should this happen, human cases would probably occur in exposed individuals: farmers, veterinarians, slaughterhouse employees etc. Surveillance and diagnostic methods are available, but control tools are limited: vector control is difficult to implement, and vaccines are only available for ruminants, with either a limited efficacy (inactivated vaccines) or a residual pathogenic effect. The best strategy to protect Europe and the rest of the world against RVF is to develop more efficient surveillance and control tools and to implement coordinated regional monitoring and control programmes.
Cases of Salmonella Urbana in Finland, the Czech Republic and Latvia, January-February 2010
Authors: Rimhanen-Finne R , Lukinmaa S , Martelius T , Rossow H , Karpíšková R , Dedicova D , Galajeva J , Bormane A , Siitonen A , Kuusi M
Published: March 2021

A cluster of 14 cases of Salmonella Urbana cases in Finland, the Czech Republic and Latvia were identified in January-February, 2010. The majority of cases (11) were male and children under 16 years of age. The investigation is currently ongoing and comparison of pulsed-field gel electrophoresis (PFGE) profiles of the isolates suggests that the cases may have a common source of infection.
Norovirus outbreaks linked to oyster consumption in the United Kingdom, Norway, France, Sweden and Denmark, 2010
Authors: Westrell T , Dusch V , Ethelberg S , Harris J , Hjertqvist M , Jourdan-da Silva N , Koller A , Lenglet A , Lisby M , Vold L
Published: March 2021

This paper reports on several simultaneous outbreaks of norovirus infection linked to the consumption of raw oysters. Since January 2010, 334 cases in 65 clusters were reported from five European countries: the United Kingdom, Norway, France, Sweden and Denmark. The article describes the available epidemiological and microbiological evidence of these outbreaks.
West Nile virus circulation in Emilia-Romagna, Italy: the integrated surveillance system 2009
Authors: Angelini P , Tamba M , Finarelli A C , Bellini R , Albieri A , Bonilauri P , Cavrini F , Dottori M , Gaibani P , Martini E , Mattivi A , Pierro A M , Rugna G , Sambri V , Squintani G , Macini P
Published: March 2021

Following a large West Nile virus (WNV) epidemic in northeastern Italy in 2008, human and animal surveillance activities were implemented in Emilia Romagna. Human surveillance was performed by serology or genome detection on blood and cerebrospinal fluid for all suspected cases suffering from acute meningoencephalitis in the regional territory. Animal surveillance consisted of passive and active surveillance of horses and active surveillance of wild birds and mosquitoes. Between 15 June and 31 October 2009, nine of 78 possible cases of West Nile neuroinvasive disease were confirmed (three fatal). From May to October, 26 cases of neurological West Nile disease were confirmed among 46 horses. The overall incidence of seroconversion among horses in 2009 was 13%. In 2009, 44 of 1,218 wild birds yielded positive PCR results for WNV infection. The planned veterinary and entomological surveillance actions detected WNV activity from the end of July 2009, about 2-3 weeks before the onset of the first human neurological case. Passive surveillance of horses seems to be an early and suitable tool for the detection of WNV activity, but it will be less sensitive in the future, because an intensive programme of horse vaccination started in June 2009.
The growing contribution of hepatitis C virus infection to liver-related mortality in Scotland
Authors: McDonald S A , Hutchinson S J , Bird S M , Robertson C , Mills P R , Graham L , Dillon J F , Goldberg D J
Published: March 2021

The large number of individuals in Scotland who became infected with the hepatitis C virus (HCV) in the 1970s and 1980s leads us to expect liver-related morbidity and mortality to increase in the coming years. We investigated the contribution of HCV to liver-related mortality in the period January 1991 to June 2006. The study population consisted of 26,861 individuals whose death record mentioned a liver-related cause (underlying or contributing). Record-linkage to the national HCV Diagnosis database supplied HCV-diagnosed status for the study population. The proportion diagnosed with HCV among people dying from a liver-related cause rose from 2.8% (1995-1997) to 4.4% (2004-June 2006); the largest increase occurred in those aged 35-44 years at death (7% to 17%). Among all deaths from a liver-related cause, an HCV-positive diagnosis was more likely in those who died in 2001 or later than those who died in 1995-1997 (2001-2003: odds ratio=1.4, 95% confidence interval: 1.1-1.7; 2004-June 2006: 1.6, 1.3-2.0), and in those who died at under 55 compared with at least 55 years of age. HCV infection represents a significant, growing, public health burden in Scotland in terms of early deaths from liver disease.
Adverse drug effects following oseltamivir mass treatment and prophylaxis in a school outbreak of 2009 pandemic influenza A(H1N1) in June 2009, Sheffield, United Kingdom
Authors: Strong M , Burrows J , Stedman E , Redgrave P
Published: March 2021

During the containment phase of the 2009 influenza A(H1N1) pandemic, mass treatment and prophylaxis with oseltamivir was used to control an outbreak of pandemic influenza in a primary school in Sheffield, United Kingdom, where ten cases of pandemic influenza had been laboratory confirmed over a three day period in June 2009. A subsequent cross-sectional survey showed that 51 of 297 (17%) pupils and 10 of 58 (17%) reported an influenza-like illness. The most common symptoms were headache, cough, fever, tiredness, sore throat and nausea. Fifty-three staff and 273 pupils took oseltamivir for treatment or prophylaxis. Of this group, 41% (113/273) of pupils and 47% (25/53) of staff reported adverse effects. Overall, 14% (37/273) of pupils and 20% (11/53) of staff did not complete the course of oseltamivir, primarily due to adverse effects. Nausea, vomiting and rash were statistically significantly associated with failing to complete the course of oseltamivir. Given the potential for side effects from oseltamivir, particularly among those without influenza who receive the drug for prophylaxis, our findings have two important implications. Firstly, the benefits of mass treatment in an outbreak setting must clearly be greater than the benefits of targeted treatment. Secondly, any large scale regional or state level system for distribution of antiviral drugs for treatment should ideally include a robust quantification of an individual’s probability of infection with influenza virus in order to avoid unnecessary treatment.
Highly divergent neurovirulent vaccine-derived polioviruses of all three serotypes are recurrently detected in Finnish sewage
Authors: Roivainen M , Blomqvist S , al-Hello H , Paananen A , Delpeyroux F , Kuusi M , Hovi T
Published: March 2021

In Finland, surveillance of potential re-emergence of poliovirus transmission is mainly based on environmental surveillance, i.e. search for infectious poliovirus in sewage samples. Since December 2008, 21 genetically highly divergent, neurovirulent vaccine-derived polioviruses (VDPV) have been isolated from sewage in Tampere, Finland. While the source of the VDPV is unknown, characteristics of the viruses resemble those of strains isolated from immunodeficient, persistently infected persons. No cases of suspected poliomyelitis have been reported in Finland since 1985.
Management of health risks associated with oysters harvested from a norovirus contaminated area, Ireland, February–March 2010
Authors: Doré B , Keaveney S , Flannery J , Rajko-Nenow P
Published: March 2021

Oysters from a harvesting area responsible for outbreaks of gastroenteritis were relaid at a clean seawater site and subsequently depurated in tanks of purified seawater at elevated temperatures. This combined treatment reduced norovirus levels to those detected prior to the outbreak. On the basis of norovirus monitoring the sale of treated oysters was permitted although the harvest area remained closed for direct sale of oysters. No reports of illness have been associated with the consumption of treated oysters.
Using tests for recent infection to estimate incidence: problems and prospects for HIV
Authors: Welte A , McWalter T A , Laeyendecker O , Hallett T B
Published: March 2021

Tests for recent infection (TRIs), such as the BED assay, provide a convenient way to estimate HIV incidence rates from cross-sectional survey data. Controversy has arisen over how the imperfect performance of a TRI should be characterised and taken into account. Recent theoretical work is providing a unified framework within which to work with a variety of TRI- and epidemic-specific assumptions in order to estimate incidence using imperfect TRIs, but suggests that larger survey sample sizes will be required than previously thought. This paper reviews the framework qualitatively and provides examples of estimator performance, identifying the characteristics required by a TRI to estimate incidence reliably that should guide the future development of TRIs.
Relapsing vivax malaria cluster in Eritrean refugees, Israel, June 2010
Authors: Kopel E , Schwartz E , Amitai Z , Volovik I
Published: March 2021

We report on a cluster of relapsing vivax malaria among Eritrean refugees residing in Israel. Since the beginning of 2010, 15 cases have been identified. Five of the six patients who had complete medical and epidemiological histories, reported Sudan as the place of primary infection during their journey to Israel, and having had the first relapse in Israel, six months later (median). Suggested place of exposure is the region of the Eritrean refugee camps in Sudan.
Meteorological and climate change themes at the 2010 International Conference on Emerging Infectious Diseases
Authors: Wilson N , Lush D , Baker M G
Published: March 2021

This report outlines selected highlights of presentations that took place at the 2010 International Conference on Emerging Infectious Diseases (ICEID) [1], held between 11 and 14 July 2010 at the Hyatt Regency Atlanta in Atlanta, Georgia, United States (US). The conference was organised by five national and international bodies and was attended by over 1,600 participants from a wide range of professional backgrounds. Abstracts for the posters and slide sessions have been published [2].
Spotlight on measles 2010: Ongoing measles outbreak in Greece, January–July 2010
Authors: Pervanidou D , Horefti E , Patrinos S , Lytras T , Triantafillou E , Mentis A , Bonovas S , Panagiotopoulos T
Published: March 2021

A measles outbreak (126 reported cases to date) has been ongoing in Greece, since January 2010, originally related to the recent outbreak in Bulgaria. Cases are mostly unvaccinated, and mainly belong to three groups: Roma population of Bulgarian nationality, Greek Roma population, and Greek non-minority population. In these population groups, 67%, 95%, and 25% of cases respectively were children aged 0-14 years. Measures were taken to raise clinical awareness, and vaccination of specific population groups was undertaken. Policies are necessary to increase routine vaccination uptake of hard-to-reach groups.
General practice out-of-hours service in Ireland provides a new source of syndromic surveillance data on influenza
Authors: Brabazon E D , Carton M W , Murray C , Hederman L , Bedford D
Published: March 2021

The use of routinely available electronic sources of healthcare data on the spread of influenza has the potential to enhance current surveillance activities. This study aimed to develop a method for identifying influenza-related records from general practitioner (GP) out-of-hours (OOH) services in Ireland. Data from one such service were interrogated for keywords relating to influenza-like illness (ILI) and a proxy measure of influenza activity in the community setting was developed. Comparison of this syndromic surveillance measure with national data on ILI consultation rates demonstrated a statistically significant temporal correlation. In five out of six influenza seasons investigated, peaks in the GP OOH influenza-related calls appeared at least one week ahead of peaks in the national ILI consultation rates. The method described in this paper has been extended to nine OOH services in Ireland (covering 70% of the Irish population) to provide weekly figures on self-reported illness for influenza in the community and its data have been incorporated into the national weekly influenza reports produced by the Health Protection Surveillance Centre. These data should provide early warnings of both seasonal and pandemic influenza in Ireland.
Ongoing outbreak of aseptic meningitis in south-eastern Latvia, June – August 2010
Authors: Perevoščikovs J , Brila A , Firstova L , Komarova T , Lucenko I , Osmjana J , Savrasova L , Singarjova I , Storozenko J , Voloscuka N , Zamjatina N
Published: March 2021

An outbreak of aseptic meningitis has been ongoing in several areas of Latgale region, in the south-eastern part of Latvia since the end of June 2010. By 9 August 2010, 114 cases had been notified. Most of the cases were registered in the city and amalgamated municipality of Daugavpils and neighbouring territories. According to current evidence, two types of enteroviruses, coxsackie A-9 virus and echovirus 30, are the causative agents of the outbreak.
Spotlight on measles 2010: Update on the ongoing measles outbreak in France, 2008-2010
Authors: Parent du Châtelet I , Antona D , Freymuth F , Muscat M , Halftermeyer-Zhou F , Maine C , Floret D , Lévy-Bruhl D
Published: March 2021

Since early 2008, France has been experiencing a measles outbreak with almost 5,000 notified cases as of 30 June 2010, including three measles-related deaths. The proportion of cases 20 years or older reached 38% during the first half of 2010. This situation is the consequence of insufficient vaccine coverage (90% at age 24 months in 2007) that led to the accumulation of susceptibles over the last years. It underlines the need for additional measures targeting susceptible children and young adults.
Characteristics of paediatric patients with 2009 pandemic influenza A(H1N1) and severe, oxygen-requiring pneumonia in the Tokyo region, 1 September–31 October 2009
Authors: Nishiyama M , Yoshida Y , Sato M , Nishioka M , Kato T , Kanai T , Ishiwata T , Wakamatsu H , Nakagawa S , Kawana A , Nonoyama S
Published: March 2021

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Spotlight on measles 2010: An ongoing outbreak of measles in an unvaccinated population in Granada, Spain, October to November 2010
Authors: López Hernández B , Laguna Sorinas J , Marín Rodríguez I , Gallardo García V , Pérez Morilla E , Mayoral Cortés J M
Published: March 2021

On 13 October 2010, the Andalusian Epidemiological Surveillance Network was notified of one case of measles. By 15 November 2010, 25 confirmed cases of measles had been reported from Granada, southern Spain, of whom 22 were unvaccinated children under the age of 15 years. This ongoing outbreak involved a subpopulation with low vaccination coverage and parents with ideological objections to vaccination. As of 7 December the number of cases has reached 59.
Spotlight on measles 2010: Increased measles transmission in Ferrara, Italy, despite high vaccination coverage, March to May 2010
Authors: Cova M , Cucchi A , Turlà G , Codecà B , Buriani O , Gabutti G
Published: March 2021

We report an increase in the incidence of measles in a population with consistently high and improving immunisation coverage in Ferrara province, northern Italy. During the first six months of 2010, 19 cases were confirmed, 10 of which were hospitalised. General practitioners, paediatricians and local healthcare authorities were alerted about the outbreak and asked to notify all suspected cases. We need to further increase immunisation coverage and to maintain and implement the monitoring system.
The second wave of 2009 pandemic influenza A(H1N1) in New Zealand, January–October 2010
Authors: Bandaranayake D , Jacobs M , Baker M , Hunt D , Wood T , Bissielo A , Macfarlane M , Lopez L , Mackereth G , Huang Q S
Published: March 2021

This paper uses data from multiple surveillance systems to describe the experience in New Zealand with the second complete wave of pandemic influenza A(H1N1)2009 in 2010. Measures such as hospitalisation rates suggest the overall impact of influenza A(H1N1)2009 in 2010 was between half and two thirds that of the first wave in 2009. There was considerable regional and sub-regional variation with a tendency for higher activity in areas that experienced low rates in 2009. Demographic characteristics of the second wave were similar to those in 2009 with highest rates seen in children under the age of five years, and in indigenous M?ori and Pacific peoples. Hospital services including intensive care units were not under as much pressure as in 2009. Immunisation appears to have contributed to the reduced impact of the pandemic in 2010, particularly for those aged 60 years and older.
Effectiveness of seasonal 2010/11 and pandemic influenza A(H1N1)2009 vaccines in preventing influenza infection in the United Kingdom: mid-season analysis 2010/11
Authors: Pebody R , Hardelid P , Fleming D M , McMenamin J , Andrews N , Robertson C , Thomas D R , Sebastianpillai P , Ellis J , Carman W , Wreghitt T , Zambon M , Watson J  M
Published: March 2021

This study provides mid-season estimates of the effectiveness of 2010/11 trivalent influenza vaccine and previous vaccination with monovalent influenza A(H1N1)2009 vaccine in preventing confirmed influenza A(H1N1)2009 infection in the United Kingdom in the 2010/11 season. The adjusted vaccine effectiveness was 34% (95% CI: -10 - 60%) if vaccinated only with monovalent vaccine in the 2009/10 season; 46% (95% CI: 7 - 69%) if vaccinated only with trivalent influenza vaccine in the 2010/11 season and 63% (95% CI: 37 - 78%) if vaccinated in both seasons.
Effectiveness of trivalent seasonal and monovalent influenza A(H1N1)2009 vaccines in population with major chronic conditions of Navarre, Spain: 2010/11 mid-season analysis
Authors: Castilla J , Moran J , Martínez-Artola V , Reina G , Martínez-Baz I , García Cenoz M , Alvarez N , Irisarri F , Arriazu M , Elía F , Salcedo E
Published: March 2021

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Malaria among patients and aid workers consulting a primary healthcare centre in Leogane, Haiti, November 2010 to February 2011 – a prospective observational study
Authors: Neuberger A , Zaulan O , Tenenboim S , Vernet S , Pex R , Held K , Urman M , Garpenfeldt K , Schwartz E
Published: March 2021

Plasmodium falciparum malaria is endemic in Haiti, but epidemiological data are scarce. A total of 61 cases of malaria were diagnosed between November 2010 and February 2011 among 130 Haitian patients with undifferentiated fever. Three additional cases were diagnosed in expatriates not taking the recommended chemoprophylaxis. No cases were diagnosed among aid workers using chemoprophylaxis. In conclusion, malaria is a significant health problem in Leogane, Haiti. Aid workers and visitors should use chemoprophylaxis according to existing guidelines.
Contamination of the cold water distribution system of health care facilities by Legionella pneumophila: Do we know the true dimension?
Authors: Arvand M , Jungkind K , Hack A
Published: March 2021

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European Risk Assessment Guidance for Infectious Diseases transmitted on Aircraft – the RAGIDA project
Authors: Leitmeyer K
Published: March 2021

In order to assist national public health authorities in the European Union to assess the risks associated with the transmission of infectious agents on board aircrafts, the European Centre for Disease Prevention and Control initiated in 2007 the RAGIDA project (Risk Assessment Guidance for Infectious Diseases transmitted on Aircraft). RAGIDA consists of two parts: the production of a systematic review and a series of disease-specific guidance documents. The systematic review covered over 3,700 peer-reviewed articles and grey literature for the following diseases: tuberculosis, influenza, severe acute respiratory syndrome (SARS), invasive meningococcal disease, measles, rubella, diphtheria, Ebola and Marburg haemorrhagic fevers, Lassa fever, smallpox and anthrax. In addition, general guidelines on risk assessment and management from international aviation boards and national and international public health agencies were systematically searched. Experts were interviewed on case-based events by standardised questionnaires. Disease-specific guidance documents on tuberculosis, SARS, meningococcal infections, measles, rubella, Ebola and Marburg haemorrhagic fevers, Lassa fever, smallpox and anthrax were the result of consultations of disease-specific expert panels. Factors that influence the risk assessment of infectious disease transmission on board aircrafts and decision making for contact tracing are outlined.
Measles resurgence in Belgium from January to mid-April 2011: a preliminary report
Authors: Sabbe M , Hue D , Hutse V , Goubau P
Published: March 2021

From 1 January to 14 April 2011, a total of 155 measles cases were notified in Belgium, whereas throughout 2010, there were only 40. Of the 103 cases with known vaccination status, 87% had not been vaccinated with measles-mumps-rubella vaccine. The resurgence of measles is the consequence of insufficient vaccine coverage in previous years. Efforts to communicate the benefits of measles vaccination to the public and to advise health professionals on control measures and outbreak management are ongoing.
Molecular detection and phylogenetic analysis of West Nile virus lineage 2 in sedentary wild birds (Eurasian magpie), Greece, 2010
Authors: Valiakos G , Touloudi A , Iacovakis C , Athanasiou L , Birtsas P , Spyrou V , Billinis C
Published: March 2021

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Yersinia enterocolitica O:9 infections associated with bagged salad mix in Norway, February to April 2011
Authors: MacDonald E , Heier B  T , Stalheim T , Cudjoe K S , Skjerdal T , Wester A , Lindstedt B A , Vold L
Published: March 2021

In March 2011, the Norwegian Institute of Public Health identified a possible outbreak involving 21 cases of Yersinia enterocolitica O:9 infection with similar MLVA-profiles. Preliminary results of epidemiological and microbiological investigations indicate bagged salad mix containing radicchio rosso (also known as Italian chicory) as a possible source. As a result of the investigation, bagged salad mixes of a specific brand were voluntarily withdrawn from the market by the producer.
Outbreak of hand, foot and mouth disease caused by Coxsackie A16 virus in a childcare centre in Croatia, February to March 2011
Authors: Ljubin-Sternak S , Slavic-Vrzic V , Vilibić-Čavlek T , Aleraj B , Gjenero-Margan I
Published: March 2021

We describe an outbreak of hand, foot and mouth disease (HFMD) in a childcare centre in a district of Zagreb county, north-west Croatia. A total of eleven cases of HFMD occurred in the childcare centre and another nine were reported from nearby areas in the district. Coxsackie A16 virus was diagnosed in 13 clinical specimens obtained from 11 symptomatic and asymptomatic children. All cases resolved without complications.
Surveillance of influenza in Finland during the 2009 pandemic, 10 May 2009 to 8 March 2010
Authors: Lyytikaïnen O , Kuusi M , Snellman M , Virtanen M J , Eskola J , Rönkkö E , Ikonen N , Julkunen I , Ziegler T , Ruutu P
Published: March 2021

The first infection caused by pandemic influenza A(H1N1)2009 virus was confirmed in Finland on 10 May 2009. The spread of the disease and its impact were monitored using several surveillance systems, such as the national infectious disease register, notifications of clusters of influenza, influenza-like or influenza-related illnesses, as well as virological, hospital, case-based and mortality surveillance. The epidemic started in early October in the north and then spread to the south about two weeks later. Based on the data from laboratory-confirmed cases, the morbidity was highest in children. The daily number of patients hospitalised with influenza A(H1N1)2009 reached a maximum of over 400 in late November. Of the 1,580 hospitalised patients (median age 32 years), 672 (43%) had at least one chronic underlying illness, 35 (2%) were pregnant, 132 (8%) were treated in intensive care units and 74 (5%) required mechanical ventilation. The median age of patients admitted to intensive care units was 48 years and 78 ( 59%) of them had at least one chronic underlying disease, none were pregnant. Altogether 44 deaths related to influenza A(H1N1)2009 were recorded (median age 56 years): 40 belonged to high-risk groups on the basis of underlying chronic diseases. Combining data from different surveillance systems gave timely information about the spread of the pandemic and contributed to identifying risk groups.
Outbreak of tularaemia in brown hares (Lepus europaeus) in France, January to March 2011
Authors: Decors A , Lesage C , Jourdain E , Giraud P , Houbron P , Vanhem P , Madani N
Published: March 2021

We report an outbreak of tularaemia in brown hares (Lepus europaeus) in France, which occurred from January to March 2011 and was characterised by a high mortality rate in the local hare population. In France, hare tularaemia is usually sporadic and does not significantly affect hare populations. The epizootic form of the outbreak reported here led us to reconsider the potential associated risks for hare populations and public health.
Potential role of asymptomatic kitchen food handlers during a food-borne outbreak of norovirus infection, Dublin, Ireland, March 2009
Authors: Nicolay N , McDermott R , Kelly M , Gorby M , Prendergast T , Tuite G , Coughlan S , McKeown P , Sayers G
Published: March 2021

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Ongoing measles outbreak in Romania, 2011
Authors: Stanescu A , Janta D , Lupulescu E , Necula G , Lazar M , Molnar G , Pistol A
Published: March 2021

Since January 2011 Romania has been experiencing a measles outbreak with 2,072 cases notified in 29 of the 42 Romanian districts. Most cases occurred in the north-western part of the country among unvaccinated children with the highest number of cases (893 cases) registered in children aged one to four years. This report underlines once more the need for additional measures targeting susceptible populations to achieve high vaccination coverage with two doses of measles-mumps-rubella vaccine.
Usutu virus – potential risk of human disease in Europe
Authors: Vázquez A , Jiménez-Clavero M A , Franco L , Donoso-Mantke O , Sambri V , Niedrig M , Zeller H , Tenorio A
Published: March 2021

Usutu virus (USUV) is an African mosquito-borne flavivirus, member of the Japanese encephalitis antigenic group. This avian virus is transmitted by arthropod vectors (mainly mosquitoes of the Culex pipiens complex). It is well known that free-living birds, including migratory species, have the potential to disperse certain pathogenic microorganisms. Usutu virus has recently been introduced to Europe and is spreading through Austria, Hungary, Italy, Spain and Switzerland, causing disease in birds and humans. Like West Nile virus, USUV may become a resident pathogen in Europe and the consequences for public health should be considered. Many different biotic and abiotic factors affect the survival of the virus in a new environment and influence the efficiency of its geographical dispersal. In this article, we consider the possibility of including USUV infections among the vector-borne diseases to be monitored in Europe.
Outbreak due to a Klebsiella pneumoniae strain harbouring KPC-2 and VIM-1 in a German university hospital, July 2010 to January 2011
Authors: Steinmann J , Kaase M , Gatermann S , Popp W , Steinmann E , Damman M , Paul A , Saner F , Buer J , Rath P M
Published: March 2021

We describe the epidemiology and characteristics of the pathogen and patients (n=7) associated with an outbreak of a carbapenem-resistant Klebsiella pneumoniae (CRKP) strain in a German university hospital from July 2010 to January 2011. Species identification and detection of carbapenem resistance were carried out using standard microbiological procedures. Carbapenemases were detected by phenotypic methods and specific polymerase chain reactions (PCRs). DNA fingerprinting profiles were performed with repetitive sequence-based PCR. Medical records of colonised or infected patients were retrospectively reviewed. Antibiotic resistance profiles, PCR-specific amplification products and genotyping demonstrated that the outbreak occurred because of the spread of a single CRKP clone harbouring both KPC-2 and VIM-1. Five of the seven patients had invasive infections with the CRKP strain; the deaths of four of them were directly related to the infection. Early implementation of infection control interventions brought about efficient containment of further cross-transmission. Rapid dissemination of carbapenemase-producing Enterobacteriaceae is a serious concern in patient care and is a problem that has emerged in western Europe.
Meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia in Tampere University Hospital: a case-control study, Finland October 2002 to January 2010
Authors: Rahikka P , Syrjänen J , Vuento R , Laine J , Huttunen R
Published: March 2021

Meticillin-resistant Staphylococcus aureus (MRSA) has emerged as a frequent pathogen in blood cultures in Pirkanmaa Hospital District (HD), Finland. To study risk factors for MRSA bacteraemia and the adequacy of empirical antimicrobial treatment, we retrospectively reviewed the hospital records of 102 patients, 51 with MRSA, and 51 with meticillin-sensitive Staphylococcus aureus (MSSA) bacteraemias respectively, who had been admitted to Tampere University Hospital in Pirkanmaa HD, from October 2002 to January 2010. For each patient with MRSA bacteraemia, one consecutively detected unmatched patient with MSSA bacteraemia was chosen as control. Patients with MRSA bacteraemias were significantly older (median age: 73 years vs 59 years, p=0.001), were more likely to have been transferred directly from another healthcare facility or were already in the hospital at the onset of bacteraemia (39/51 vs 26/51, p=0.007) and had a higher McCabe class than patients with MSSA bacteraemia (p=0.005). Patients with MRSA bacteraemia more seldom received adequate empirical antimicrobial therapy when compared to those with MSSA bacteraemia (13/51 vs 43/51, p<0.001). Of previously known MRSA carriers 10 of 29 received adequate empirical antimicrobial therapy for their condition. The percentage of MRSA bacteraemias among all S. aureus bacteraemias in Pirkanmaa HD is high compared to corresponding figures for the whole of Finland.
Preliminary report on an ongoing outbreak of hepatitis A in Estonia, 2011
Authors: Dontšenko I , Kerbo N , Pullmann J , Plank S , Võželevskaja N , Kutsar K
Published: March 2021

Since the beginning of August 2011, an outbreak of hepatitis A has been detected in Estonia. The majority of laboratory-confirmed cases (n=66) were notified between 4 August and 3 October 2011 and were linked to Viljandi county. The outbreak is still ongoing.
First Neisseria gonorrhoeae strain with resistance to cefixime causing gonorrhoea treatment failure in Austria, 2011
Authors: Unemo M , Golparian D , Stary A , Eigentler A
Published: March 2021

We describe the first cefixime-resistant Neisseria gonorrhoeae strain in Austria that caused treatment failure. It follows the first five cases in Europe of cefixime treatment failure, reported in Norway in 2010 and the United Kingdom in 2011. Effective treatment of gonorrhoea is crucial for public health control and, at present, requires substantially enhanced awareness, more frequent test-of-cure, interaction with experts after therapeutic failure, tracing and therapy of contacts, and surveillance of gonococcal antimicrobial resistance and treatment failures worldwide.
Influenza surveillance during the post-pandemic influenza 2010/11 season in Greece, 04 October 2010 to 22 May 2011
Authors: Athanasiou M , Baka A , Andreopoulou A , Spala G , Karageorgou K , Kostopoulos L , Patrinos S , Sideroglou T , Triantafyllou E , Mentis A , Malisiovas N , Lytras T , Tsiodras S , Panagiotopoulos T , Bonovas S
Published: March 2021

In this manuscript, we summarise the experience of Greece during the post-pandemic influenza season 2010/11 from 04 October 2010 to 22 May 2011. The spread of the disease and its impact were monitored using multiple surveillance systems, such as sentinel surveillance, virological surveillance and all-cause mortality surveillance. We also focus on the characteristics of laboratory-confirmed severe influenza cases who required admission to an intensive care unit (ICU) (n=368), and/or with a fatal outcome (n=180). The influenza-like illness rate reported from sentinel surveillance started rising in early January 2011 and peaked between 31 January and 6 February 2011. The total number of ICU admissions was higher in the post-pandemic influenza season than during the pandemic period causing a lot of pressure on ICUs. The overall population mortality rate due to influenza A(H1N1)2009 was higher than during the pandemic period (15.9 vs 13.2 fatal cases per million, p=0.087). Our data suggest that the severity of clinical illness in the first post-pandemic influenza season was comparable or even higher than during the pandemic.
Increase of cases of legionellosis in Latvia, 2011
Authors: Rozentale B , Bormane A , Perevoščikovs J , Lucenko I , Brila A
Published: March 2021

An increased number of legionellosis cases in 2011 has been reported in Latvia, compared to the ten previous years. A total of 30 legionellosis cases (1.35 per 100,000 inhabitants), including 19 females, have been confirmed until the end of September 2011. The majority of cases (n=23) were inhabitants of the capital city Riga. The reason for the increase in legionellosis is unclear. Twenty-six of the 30 cases are not travel-related.
Streptococcus pyogenes cluster in a care home in England April to June 2010
Authors: Milne L M , Lamagni T , Efstratiou A , Foley C , Gilman J , Lilley M , Guha S , Head F , Han T
Published: March 2021

Two fatal cases of Streptococcus pyogenes emm st22.6 bacteraemia occurred in a care home in England during April and June 2010, initiating a cluster investigation. The first case had left the home 13 days before the second case took up residence. We sought further cases and carriers. We swabbed throat and chronic skin lesions from residents and staff and examined these specimens for the presence of S. pyogenes. 61 specimens were taken from 18 of 19 residents and 39 of 39 staff. All results from swabbing were culture negative. We observed infection control practices and the environment at the care home for deficiencies. Issues were identified relating to the correct use of personal protective equipment, hand hygiene, clinical waste and laundry. Infection control practices were improved and training given. Infection control practices and the environment at a care home should be examined as part of the investigation of a S. pyogenes cluster. Screening for carriage of S. pyogenes should be done before antibiotic chemoprophylaxis is issued to care home residents and staff.
HIV infection and AIDS in the European Union and European Economic Area, 2010
Authors: Likatavicius G , van de Laar M J
Published: March 2021

In 2010, a total of 27,116 newly diagnosed HIV infections were reported by 28 countries of the European Union and European Economic Area (EU/EEA), with evidence of continuing transmission and no clear signs of decline. The predominant mode of transmission and increasing trend of HIV in the EU/EEA was due to sex between men. An increase in AIDS diagnoses in several countries and a high proportion of late presenters suggest delayed access to treatment and care.
Influenza A(H1N1)pdm09 antibodies after pandemic and trivalent seasonal influenza vaccination as well as natural infection in November 2010 in Hamburg, Germany
Authors: Cramer J P , Mac T , Hogan B , Stauga S , Eberhardt S , Wichmann O , Mertens T , Burchard G D
Published: March 2021

The 2009 influenza pandemic has introduced the new re-assorted influenza A(H1N1)pdm09 virus which recirculated during the 2010/11 influenza season. Before that season, it was possible to acquire protective immunity either by pandemic or seasonal influenza vaccination against influenza A(H1N1)pdm09 or by natural infection. To obtain data on vaccination coverage and antibody levels in a reference population and to calculate whether or not the herd immunity threshold (HIT, calculated as 33% given an R0 of 1.5) was reached at the beginning of the 2010/11 season we performed a seroprevalence study in November 2010 in Hamburg, Germany. Antibody titres were assessed applying a haemagglutination inhibition test. Vaccination coverage was very low: 14% for pandemic and 11% for seasonal 2010/11 vaccinations. Even in those with underlying risk factors, vaccination coverage was not much higher: 17% for both vaccines. Serological analysis revealed antibody titres of ≥1:10 in 135 of 352 (38%) and of ≥1:40 in 61 of 352 study participants (17%). Specific antibodies were measurable in 26% of those without history of vaccination or natural infection, indicating a high proportion of subclinical and mild influenza disease. Nevertheless, the HIT was not reached, leaving the majority of the population susceptible to influenza A(H1N1)pdm09 and its potential complications.
Screening for Coxiella burnetii infection during pregnancy: pros and cons according to the Wilson and Jungner criteria
Authors: Munster J M , Steggerda L M , Leenders A C , Aarnoudse J G , Hak E
Published: March 2021

In Europe the incidence of human Q fever has dramatically increased over the previous years. Untreated infections with Coxiella burnetii, the causal agent of Q fever, have been associated with both obstetric and maternal complications. The majority of pregnant women with a C. burnetii infection remain asymptomatic, hence screening could be of value to prevent unwanted outcomes in this high-risk group. We applied the updated Wilson and Jungner criteria to review the evidence for routine screening for C. burnetii infection during pregnancy. Since much uncertainty remains about the incidence, clinical consequences, diagnostics and treatment of C. burnetii infection during pregnancy, routine screening for C. burnetii infection during pregnancy should not be recommended. Rigorous studies to assess the effectiveness of C. burnetii screening are warranted.
A possible outbreak of hepatitis A associated with semi-dried tomatoes, England, July–November 2011
Authors: Carvalho C , Thomas H L , Balogun K , Tedder R , Pebody R , Ramsay M , Ngui S L
Published: March 2021

In October 2011, two primary cases of hepatitis A virus (HAV) infection with identical HAV genotype IB strains to those seen in other outbreaks associated with semi-dried tomatoes were reported in England. Both cases had consumed semi-dried tomatoes. Epidemiological investigations revealed two additional cases of genotype IB strains with different sequences who also reported having consumed semi-dried tomatoes. In November, five cases of HAV infection with closely related strains were identified in the Netherlands. A foodborne multiple-strain outbreak is suspected.
Microbiological and molecular characteristics of carbapenemase-producing Klebsiella pneumoniae endemic in a tertiary Greek hospital during 2004-2010
Authors: Zagorianou A , Sianou E , Iosifidis E , Dimou V , Protonotariou E , Miyakis S , Roilides E , Sofianou D
Published: March 2021

We report 570 carbapenemase-producing Klebsiella pneumoniae (CPKP) clinical isolates in a 1,040-bed Greek tertiary hospital during 2004 to 2010. The first CPKP (VIM-producing) was isolated in September 2004. Despite initial containment, VIM producers have become endemic since 2006. KPC-producing K. pneumoniae was first isolated in August 2007 from a patient who came from Israel, spread rapidly, and outcompeted VIM. Overall, 267 (47%) VIM-producing and 301 (53%) KPC-producing strains were isolated, including 141 (24.7%) from patients with bacteraemia. Two isolates carrying both VIM and KPC were isolated in two consecutive months in 2009, but not since. The prevalence of CPKP increased from 0% in 2003 to 38.3% in 2010 (p<0.0001). All genotyped KPC producers harboured blaKPC-2 and belonged to two clones, among which the hyperepidemic Greek clone, related to those from the United States and Israel, predominated. Most metallo-beta-lactamase (MBL) producers carried the blaVIM-1 gene and belonged to several clones, whereas all but one isolate with blaVIM-12 were clustered within a five-month period, arising from one clone. Resistance to non-beta-lactam antibiotics was also increased among CPKP. They were almost invariably resistant to ciprofloxacin and trimethoprim-sulfamethoxazole. Resistance to colistin increased from 3.5% (4/115) in 2008 to 20.8% (25/120) in 2010, and resistance to tigecycline also increased. Following reinforcement of infection control measures, prevalence of CPKP (mainly KPC) has been reduced since mid-2009 (from 46% in 2009 to 38.3% in 2010). In view of the exhaustion of available therapies, investment in infection control resources and optimal antibiotic use is urgently required.
Experiences from the Shiga toxin-producing Escherichia coli O104:H4 outbreak in Germany and research needs in the field, Berlin, 28–29 November 2011
Authors: STEC Workshop Reporting Group Collective
Published: March 2021

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Ongoing epidemic of Mycoplasma pneumoniae infection in Jerusalem, Israel, 2010 to 2012
Authors: Nir-Paz R , Abutbul A , Moses A E , Block C , Hidalgo-Grass C
Published: March 2021

A substantial epidemic of Mycoplasma pneumoniae infection was reported in late 2011 in some European countries. We report here an epidemic of M. pneumoniae infection that began in Jerusalem during 2010 and is still ongoing. This report complements current information on what might be a worldwide epidemic of M. pneumoniae infection that might require substantial coordinated international public health intervention.
Severe leptospirosis in a Dutch traveller returning from the Dominican Republic, October 2011
Authors: Arcilla M S , Wismans P J , van Beek-Nieuwland Y , van Genderen P J
Published: March 2021

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Excess mortality among the elderly in 12 European countries, February and March 2012
Authors: Mazick A , Gergonne B , Nielsen J , Wuillaume F , Virtanen M J , Fouillet A , Uphoff H , Sideroglou T , Paldy A , Oza A , Nunes B , Flores-Segovia V M , Junker C , McDonald S A , Green H K , Pebody R , Mølbak K
Published: March 2021

In February and March 2012, excess deaths among the elderly have been observed in 12 European countries that carry out weekly monitoring of all-cause mortality. These preliminary data indicate that the impact of influenza in Europe differs from the recent pandemic and post-pandemic seasons. The current excess mortality among the elderly may be related to the return of influenza A(H3N2) virus, potentially with added effects of a cold snap.
Influenza outbreaks in nursing homes with high vaccination coverage in Navarre, Spain, 2011/12
Authors: Castilla J , Cía F , Zubicoa J , Reina G , Martínez-Artola V , Ezpeleta C
Published: March 2021

In the 2011/12 season, three influenza outbreaks were studied in nursing homes with high vaccination coverage in Navarre, Spain. Attack rates ranged from 2.9% to 67%. Influenza A/Stockholm/18/2011(H3N2) virus strain was isolated from the three outbreaks. Vaccination should be complemented with other hygiene measures in nursing homes. Early detection of influenza outbreaks in nursing homes can aid in their control.
Ongoing mumps outbreak in Novi Sad, the autonomous province of Vojvodina, Serbia, January to April 2012
Authors: Rajčević S , Šeguljev Z , Petrovic V , Medić S , Nedelijković J , Milošević V , Turo L , Ristić M
Published: March 2021

From 16 January to 30 April 2012, a total of 119 cases of mumps were notified in Novi Sad, Serbia. Of these cases, 89 (75%), were among students. The average age of cases was 22 years-old (range 3-37). The outbreak is still ongoing in Novi Sad and is spreading to other parts of the Vojvodina province. As of 30 April, 209 cases have been notified in the province among those 119 from Novi Sad.
A large outbreak of conjunctivitis on Mayotte Island, France, February to May 2012
Authors: Lernout T , Maillard O , Boireaux S , Collet L , Filleul L
Published: March 2021

From February to May 2012, Mayotte experienced an outbreak of acute conjunctivitis with over 12,000 estimated cases, causing a significant burden on the primary healthcare system. It was most certainly caused by a coxsackievirus, as documented by isolation from a symptomatic traveller from the Comoros Islands in France. Tropical climate and poor hygiene conditions facilitate the spread of infectious diseases on Mayotte and in the region with risk of further exportation to mainland France and Europe.
Adverse events following vaccination in the French armed forces: An overview of surveillance conducted from 2002 to 2010
Authors: Mayet A , Haus-Cheymol R , Bouaiti E A , Decam C , Simon F , Mérens A , Spiegel A , Meynard J B , Deparis X , Migliani R
Published: March 2021

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