The aim of our study was to analyse the influence of air temperature and implemented veterinary measures on salmonellosis incidence in the Czech Republic (CZ).
We conducted a descriptive analysis of ...salmonellosis as reported to the Czech national surveillance system during 1998-2017 and evaluated the influence of applied veterinary measures (started in January 2008) on salmonellosis incidence by comparing two 9-year periods (1998-2006, 2009-2017). Using a generalized additive model, we analysed association between monthly mean air temperature and log-transformed salmonellosis incidence over the entire twenty-year period.
A total of 410,533 salmonellosis cases were reported during the study period in the CZ. Annual mean incidences of salmonellosis were 313.0/100,000 inhabitants before and 99.0/100,000 inhabitants after implementation of the veterinary measures. The time course of incidence was non-linear, with a sharp decline during 2006-2010. Significant association was found between disease incidence and air temperature. On average, the data indicated that within a common temperature range every 1 °C rise in air temperature contributed to a significant 6.2% increase in salmonellosis cases.
Significant non-linear effects of annual trend, within-year seasonality, and air temperature on the incidence of salmonellosis during 1998-2017 were found. Our study also demonstrates significant direct effect of preventive veterinary measures taken in poultry in reducing incidence of human salmonellosis in the CZ. The annual mean number of salmonellosis cases in the period after introducing the veterinary measures was only 32.5% of what it had been in the previous period.
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BackgroundLeptospirosis is a zoonotic disease caused by bacteria of the genus
. Humans are infected by exposure to animal urine or urine-contaminated environments. Although disease incidence is lower ...in Europe compared with tropical regions, there have been reports of an increase in leptospirosis cases since the 2000s in some European countries.AimWe aimed to describe the epidemiology of reported cases of leptospirosis in the European Union/European Economic Area (EU/EEA) during 2010-2021 and to identify potential changes in epidemiological patterns.MethodsWe ran a descriptive analysis of leptospirosis cases reported by EU/EEA countries to the European Centre for Disease Prevention and Control with disease during 2010-2021. We also analysed trends at EU/EEA and national level.ResultsDuring 2010-2021, 23 countries reported 12,180 confirmed leptospirosis cases corresponding to a mean annual notification rate of 0.24 cases per 100,000 population. Five countries (France, Germany, the Netherlands, Portugal and Romania) accounted for 79% of all reported cases. The highest notification rate was observed in Slovenia with 0.82 cases per 100,000 population. Overall, the notification rate increased by 5.0% per year from 2010 to 2021 (95% CI: 1.2-8.8%), although trends differed across countries.ConclusionThe notification rate of leptospirosis at EU/EEA level increased during 2010-2021 despite including the first 2 years of the COVID-19 pandemic and associated changes in population behaviours. Studies at (sub)national level would help broaden the understanding of differences at country-level and specificities in terms of exposure to
, as well as biases in diagnosis and reporting.
The completeness and timeliness of the pertussis questionnaire-based enhanced surveillance system (ESS) among infants and reported pertussis data within the electronic nationwide notification system ...(NNS) in the years 2015, 2017 and 2019 were evaluated in a pilot study.
The completeness of the variables for demographic characteristics, date of symptom onset, hospitalisation and vaccination status were assessed in both systems. Timeliness of reporting in the NNS was analysed as the interval between symptom onset and a) the date of first specimen collection (diagnostic delay), and b) the date of the Regional Public Health Authority receiving notification (notification delay).
A total of 121 confirmed pertussis cases were reported to the NNS in the study years, while in the ESS a total of 104 confirmed cases were reported in infants. In both systems most cases were in the age group of one completed month of life (20% versus 23%) and males (55% versus 55%). The majority of cases were hospitalised (81% versus 85%) and unvaccinated (77% versus 78%). Within the NNS, the first dose of vaccine was reported in 13 cases, the second dose in 11, and third dose in three cases. Within the NNS, 100% completeness of following variables was found: symptom onset, week and region of reporting, age, gender and place of isolation. Median diagnostic delay was nine days. Median notification delay was 18 days.
Data completeness was high in the NNS, except for lack of vaccination data in those eligible by age. Efforts to improve the completeness of laboratory-related variables and timeliness are essential. Based on the study results, the project of improving the ESS for infants will continue with regular evaluation.
In August 2017, an increased incidence of
Bareilly was detected in the Czech Republic. An investigation was conducted with Slovakia to confirm the outbreak and identify the source. Probable outbreak ...cases were defined as cases with laboratory-confirmed
Bareilly reported in either of the national surveillance systems, and/or the Czech and Slovak National Reference Laboratory databases from July 2017. Confirmed cases had the pulsed-field gel electrophoresis (PFGE) outbreak pulsotype or up to 5 alleles difference from outbreak cluster members by core genome multilocus sequence typing (cgMLST). PFGE and whole genome sequencing were used for isolate comparison. The same trawling questionnaire was used in both countries. By the end of October 2018, 325 cases were identified. Among 88 human
Bareilly isolates analysed by PFGE, 82 (93%) shared an identical pulsotype; cgMLST of 17
Bareilly human isolates showed 1-2 allele difference. The trawling questionnaire excluded consumption of unusual or imported foods. In September 2018, an isolate closely related to the outbreak isolates was identified in a powdered egg product. A spray dryer was recognised as the contamination source and the production plant was closed. Using molecular typing methods, we detected a diffuse cross-border outbreak caused by
Bareilly.
Salmonella spp are a major cause of food-borne outbreaks in Europe. We investigated a large multi-country outbreak of Salmonella enterica serotype Enteritidis in the EU and European Economic Area ...(EEA).
A confirmed case was defined as a laboratory-confirmed infection with the outbreak strains of S Enteritidis based on whole-genome sequencing (WGS), occurring between May 1, 2015, and Oct 31, 2018. A probable case was defined as laboratory-confirmed infection with S Enteritidis with the multiple-locus variable-number tandem repeat analysis outbreak profile. Multi-country epidemiological, trace-back, trace-forward, and environmental investigations were done. We did a case-control study including confirmed and probable cases and controls randomly sampled from the population registry (frequency matched by age, sex, and postal code). Odds ratios (ORs) for exposure rates between cases and controls were calculated with unmatched univariable and multivariable logistic regression.
18 EU and EEA countries reported 838 confirmed and 371 probable cases. 509 (42%) cases were reported in 2016, after which the number of cases steadily increased. The case-control study results showed that cases more often ate in food establishments than did controls (OR 3·4 95% CI 1·6–7·3), but no specific food item was identified. Recipe-based food trace-back investigations among cases who ate in food establishments identified eggs from Poland as the vehicle of infection in October, 2016. Phylogenetic analysis identified two strains of S Enteritidis in human cases that were subsequently identified in salmonella-positive eggs and primary production premises in Poland, confirming the source of the outbreak. After control measures were implemented, the number of cases decreased, but increased again in March, 2017, and the increase continued into 2018.
This outbreak highlights the public health value of multi-country sharing of epidemiological, trace-back, and microbiological data. The re-emergence of cases suggests that outbreak strains have continued to enter the food chain, although changes in strain population dynamics and fewer cases indicate that control measures had some effect. Routine use of WGS in salmonella surveillance and outbreak response promises to identify and stop outbreaks in the future.
European Centre for Disease Prevention and Control; Directorate General for Health and Food Safety, European Commission; and National Public Health and Food Safety Institutes of the authors' countries (see Acknowledgments for full list).
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A country-wide sentinel surveillance system was initiated in Germany after implementation of routine varicella vaccination of children >11 months. Sentinel physicians report monthly the number of ...cases and of severe varicella complications (VC). Case-based questionnaires are completed for VC. We evaluated trend and clinical features of reported VC from April 2005 to March 2009. Reported VC decreased by 81%.
Surveillance of nosocomial infections (NIs) is well established in many countries but often does not include gastrointestinal infections. We sought to determine the proportion of NIs among all ...hospitalized cases for the 4 most prevalent types of gastrointestinal infections in Germany.
We analyzed all notifications of laboratory-confirmed or epidemiologically linked gastrointestinal infections due to norovirus, rotavirus, Salmonella species, and Campylobacter species reported to the Robert Koch Institute in Berlin, Germany, from 2002 through 2008. Infections were considered nosocomial if disease onset was more than 2 days after hospitalization for norovirus, rotavirus, and Salmonella infection and more than 5 days after hospitalization for Campylobacter infection.
During the study period, 710,725 norovirus, 394,500 rotavirus, 395,736 Salmonella, and 405,234 Campylobacter gastrointestinal infections were reported. Excluding cases for which nosocomial status could not be determined, we identified 39,424 (49%) of 80,650 norovirus, 11,592 (14%) of 83,451 rotavirus, 3,432 (8%) of 43,348 Salmonella, and 645 (2%) of 33,503 Campylobacter gastrointestinal infections as definite nosocomial cases. Multivariate analysis confirmed higher risk of gastrointestinal NIs for patients aged more than 70 years (relative risk RR, 7.0 95% confidence interval {CI}, 6.7-7.2; Formula: see text) and residents of western states (RR, 1.3 95% CI, 1.2-1.3; Formula: see text) and lower risk for female patients (RR, 0.9 95% CI, 0.9-0.9; Formula: see text). Yearly NI proportions remained stable except for norovirus.
The investigated gastrointestinal NIs in Germany do not show a clear trend, but they are at high level, revealing potential for public health action and improvement of hospital infection control mainly among older patients. National prevalence studies on gastrointestinal NIs would be of additional value to give more insight on how and where to improve hospital infection control.
Please cite this paper as: Hermes et al. (2011) Lack of evidence for pre‐symptomatic transmission of pandemic influenza virus A(H1N1) 2009 in an outbreak among teenagers; Germany, 2009. Influenza and ...Other Respiratory Viruses 5(6), e499–e503.
Background Observations on the role of pre‐symptomatic transmission in the spread of influenza virus are scanty. In June 2009, an outbreak of pandemic A(H1N1) 2009 infection occurred at a teenager’s party in Germany. The objective of this study was to identify risk factors for pandemic A(H1N1) 2009 infection.
Methods We performed a retrospective cohort study among party guests. A case was defined as pandemic A(H1N1) 2009 infection confirmed by rRT‐PCR who developed influenza‐like illness between 1 and 5 June 2009. Contact patterns among party guests were evaluated.
Results In eight (36%) of 27 party guests, the outcome was ascertained. A travel returnee from a country with endemic pandemic A(H1N1) 2009 who fell ill toward the end of the party was identified as the source case. Party guests with pandemic A(H1N1) 2009 infection had talked significantly longer to the source case than non‐infected persons (P‐value: 0·001). Importantly, none (0/9) of those who had left the party prior to the source case’s symptom onset became infected compared to 7 (41%) of 17 who stayed overnight (P = 0·06), and these persons all had transmission‐prone contacts to the source case.
Conclusions In this outbreak with one index case, there was no evidence to support pre‐symptomatic transmission of pandemic A(H1N1) 2009. Further evidence is required, ideally from larger studies with multiple index cases, to more accurately characterize the potential for pre‐symptomatic transmission of influenza virus.
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