In this edition Also - Eurosurveillance

More documents

Recommendations

Info

• closure of the particular school and day care centre for one week; • post-exposure prophylaxis for contact persons if appropriate; • control of vaccination documents in all persons of the affected institution; • access restriction to school for all persons with unclear immune status; • closure of the particular school and day care centre for one week; • after re-opening of the anthroposophic school, access restriction for pupils other than those vaccinated at least once and those with serologically documented previous infection; • offering MMR vaccination free of charge to the population younger than 15 years; • and alerting health professionals. Preliminary results of the outbreak investigation indicate the possible source case – a student from an anthroposophic school in Switzerland who visited the anthroposophic school in Salzburg city with colleagues. That student became ill with measles during their stay in Salzburg on 7 March, a week prior to the primary outbreak case in the anthroposophic school in Salzburg (13 March). Since November 2006, Switzerland is experiencing the largest measles outbreak registered in the country since notification for this disease in 1999 [1]. Conclusions Recently, ultra-orthodox Jewish communities and travelling communities have been implicated in outbreak of measles [2,3]. The outbreak described here indicates that the anthroposophic community also is an at-risk group of measles spread, because many parents in this group choose not to vaccinate their children with the MMR vaccine [4]. Anthroposophy, based on the writings of the mystic and social philosopher Rudolf Steiner (1861-1925), combines human development with an investigation of the divine spark found in all of nature. The movement has marked education (Waldorf/Steiner schools) and medicine. Anthroposophical doctors emphasise nature-based therapies that support the body’s innate healing wisdom. Antibiotics, fever-reducing agents, and vaccinations are used at one’s own discretion only [5]. F i g u r e 2 Age and sex distribution in 259 notified measles cases, Austria, March/April 2008 number of cases 50 45 40 35 30 25 20 15 10 5 0 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 >50 age groups m w Although measles has been eliminated or is under control in several EU countries, it is still a public health priority [6]. Organisers of large-scale events attended by international travellers, especially youths, should consider documentation of adequate participant vaccination [7]. In view of the current measles outbreak, Austrian and Swiss authorities advise measles vaccination before travelling to the EURO 2008 soccer games, starting on 7 June, 2008 in Austria and Switzerland. The current multi-state outbreak of measles once again highlights the need to improve the vaccination coverage in Austria, along with disease surveillance and outbreak-control capabilities [8]. Diligent case investigation of every single measles case is a prerequisite to achieve the goal of measles eradication by 2010, planned by the World Health Organization European Office [9]. References 1. Richard JL, Masserey-Spicher V, Santibaenez S, Mankertz A. measles outbreak in Switzerland – an update relevant for the European football championship (EURO 2008). Euro Surveill. 2008;13(8). Available from: http://www.eurosurveillance. org/edition/v13n08/080221_1.asp 2. Stewart-Freedman B, Kovalsky N. An ongoing outbreak of measles linked to the United Kingdom in an ultra-orthodox Jewish community in Israel. Euro Surveill. 2007;12(9):E070920.1. Available from: http://www.eurosurveillance. org/ew/2007/070920.asp#1 3. Lovoll O, Vonen L, Vevatne T, Sagvik E, Vainio K, Sandbu S, et al. An outbreak of measles among a travelling community from England in Norway: a preliminary report. Euro Surveill. 2007;12(5):E070524.1. Available from: http://www. eurosurveillance.org/ew/2007/070524.asp#1 4. Hanratty B, Holt T, Duffell E, Patterson W, Ramsay M, White JM, et al. UK measles outbreak in non-immune anthroposophic communities: the implications for the elimination of measles from Europe. Epidemiol Infect. 2000;125(2):377-83. 5. Alm JS, Swartz J, Lilja G, Scheynius A, Pershagen G. Atopy in children of families with an anthroposophic lifestyle. Lancet 1999;353(9163):1485-8. 6. Van Lier EA, Havelaar AH, Nanda A. The burden of infectious diseases in Europe: a pilot study. Euro Surveill. 2007;12(12). Available from: http://www. eurosurveillance.org/em/v12n12/1212-222.asp 7. Centers for Disesase Control and Prevention (CDC). Multistate measles outbreak associated with an international youth sproting event – Pennsylvania, Michigan, and Texas, August-September 2007. MMWR Morb Mortal Wkly Rep. 2008;57(7):169-73. 8. Schmid D, Holzmann H, Popow-Kraupp TH, Wallenko H, Allerberger F. Mumps vaccine failure or vaccination scheme failure? Clin Microbiol Infect 2007;13(11):1138-9. 9. World Health Organization. Eliminating measles and rubella and prevention congenital rubella infection, WHO European Region strategic plan 2005-2010. [cited April 15, 2008] Available from: http://www.euro.who.int/document/ E87772.pdf This article was published on 17 April 2008. Citation style for this article: Schmid D, Holzmann H, Abele S, Kasper S, König S, Meusburger S, Hrabcik H, Luckner-Hornischer A, Bechter E, DeMartin A, Stirling J, Heißenhuber A, Siedler A, Bernard H, Pfaff G, Schorr D, Ludwig MS, Zimmerman H, Løvoll Ø, Aavitsland P, Allerberger F. An ongoing multi-state outbreak of measles linked to non-immune anthroposophic communities in Austria, Germany, and Norway, March-April 2008. Euro Surveill. 2008;13(16):pii=18838. Available online: http://www. eurosurveillance.org/ViewArticle.aspx?ArticleId=18838 156 EUROSURVEILLANCE Vol. 13 · Issues 14–26 · Apr–Jun 2008 · www.eurosurveillance.org
Special issue: European Immunization Week 2008 - time for reflection Rapid communications A n o u t b r e A k o f m e A s l e s i n c l u d i n g n o s o c o m i A l t r A n s m i s s i o n in Ap u l i A, s o u t h - e A s t itA ly , JA n u A r y - m A r c h 2008 - A p r e l i m i n A r y r e p o r t G Caputi 1 , S Tafuri 2 , M Chironna 1 , D Martinelli 3 , A Sallustio 1 , A Falco 2 , C A Germinario 1 , R Prato (r.prato@unifg.it) 3 , M Quarto 1,2 1. Department of Biomedical Sciences, Section of Hygiene, University of Bari, Apulia Regional Epidemiological Observatory, Bari, Italy 2. Post-degree school in Hygiene and Preventive Medicine, University of Bari, Apulia Regional Epidemiological Observatory, Bari, Italy 3. Department of Medical Sciences, Section of Hygiene, University of Foggia, Apulia Regional Epidemiological Observatory, Foggia, Italy Between 7 January and 16 March 2008, 16 cases of measles were reported in the region of Apulia in south-eastern Italy (about four millions inhabitants). This outbreak is currently ongoing: we present here a preliminary report. A case of measles was defined as one that met the clinical case definition (clinical picture compatible with measles, i.e. a generalised rash lasting more than three days and a temperature >38.0°C, with one or more of the following symptoms: cough, coryza, Koplik’s spots, conjunctivitis [1]. A confirmed case of measles was defined either as a case that was laboratory-confirmed (by detection of IgM antibodies against measles virus or a positive PCR), or as a case that met the clinical case definition and was epidemiologically linked to a laboratoryconfirmed case [2]. F i g u r e 1 Distribution of measles cases by age group (N=16). Apulia, January–March 2008 Age group >10 6-10 1-5 38.0 °C), coryza and cough and was hospitalised on 7 January. On 10 January, the patient developed a rash. The source of infection remains unknown (the child had not travelled outside their hometown, had any contact with a measles case or any visitors from abroad in the 7 to 18 days before onset of the rash). The following seven non-cluster cases were reported between 5 February and 19 March: two 11-month-old children, a 17-month- F i g u r e 2 Reported measles cases by week of rash onset and transmission setting (N=16). Apulia, January–March 2008 Number of cases 4 3 2 1 0 community acquired secondary cases linked to nosocomial outbreak nosocomial outbreak 2 3 4 5 6 7 8 9 10 11 12 Week in 2008 EUROSURVEILLANCE Vol. 13 · Issues 14–26 · Apr–Jun 2008 · www.eurosurveillance.org 157
Page 1 and 2: EUROPEAN CENTRE FOR DISEASE PREVENT
Page 3 and 4: Special issue: World Hepatitis Day
Page 5 and 6: oth measles and mumps in certain ag
Page 7 and 8: to be done. Twenty-nine of the 53 c
Page 9 and 10: Editorial W o r l d He pat i t i s
Page 11 and 12: Editorials M o l e c u l a r t y p
Page 13 and 14: 5. Fooks A. Rabies remains a ‘neg
Page 15 and 16: Statistical analysis The antibody p
Page 17 and 18: mumps that we noticed between males
Page 19 and 20: Among the cases, 3,683 (61.8%) were
Page 21 and 22: [5] Given the periodicity of outbre
Page 23 and 24: sequences (GenBank NIH, Bethesda) p
Page 25 and 26: Special issue: European Immunizatio
Page 27: Special issue: European Immunizatio
Page 31 and 32: No. of reported rubella cases Speci
Page 33 and 34: Special issue: Molecular typing for
Page 35 and 36: From these discussions, and by test
Page 37 and 38: 15. Hæggman S, Rhod Larsen A, Vain
Page 39 and 40: Table 1 SeqNet.org participating me
Page 41 and 42: first line typing method, besides o
Page 45 and 46: criteria are combined, (iii) the or
Page 47 and 48: Retrospective surveillance data fro
Page 53 and 54: Special Issue: World Hepatitis Day
Page 55 and 56: Table Number of notifications of he
Page 57 and 58: 5. Hoffmann G, Berglund G, Elmståh
Page 59 and 60: Our epidemiological and molecular i
Page 61 and 62: The questionnaire was structured ac
Page 63 and 64: Table 2 HIV and hepatitis C testing
Page 65 and 66: to be paid regarding HCV. The repor
Page 67 and 68: Table 1 Summary of hepatitis B surv
Page 69 and 70: of the different genotypes vary bot
Page 71 and 72: Figure The incidence of reported he
Page 73 and 74: 33. Veldhuijzen IK, Smits LJ, van d
Page 75 and 76: Figure 1 The natural history of HCV
Page 77 and 78: successful engagement with and trea
Page 79 and 80:
Table 1 Definitions of HCV infectio
Page 81 and 82:
not available for surveillance purp
Page 83 and 84:
Special Issue: World Hepatitis Day
Page 85 and 86:
Surveillance and outbreak reports E
Page 87 and 88:
Distributed information about the e
Page 89 and 90:
Surveillance and outbreak reports A
Page 91 and 92:
Table 1 Survey data regarding surve
Page 93 and 94:
For the presented period of the pas
Page 95 and 96:
or individuals who acquired the inf
Page 97 and 98:
Surveillance and outbreak reports A
Page 99 and 100:
analysable fragment of 457 bp, and
Page 101 and 102:
the application of HNIG to close co
Page 103 and 104:
HCV co-infection was defined as pos
Page 105 and 106:
[18] had been observed in HIV-HBV c
Page 107 and 108:
Microbiological investigation All h
Page 109 and 110:
References 1. American Public Healt
Page 111 and 112:
Telephone calls are handled by a tw
Page 113 and 114:
At that time, the daily monitoring
Page 115 and 116:
Research articles S u r v e i l l a
Page 117 and 118:
It has been suggested that longer d
Page 119 and 120:
Virological data collection Stool s
Page 121 and 122:
Discussion Our combined epidemiolog
Page 123 and 124:
Acknowledgements We are grateful to
Page 125 and 126:
The total study sample consisted of
Page 127 and 128:
Table Multivariate model of associa
Page 129 and 130:
Euroroundups S u r v e y o f eu r o
Page 131 and 132:
event. The survey included question
Page 133 and 134:
Laboratories report anonymised case
Page 135 and 136:
8. European Union. Commission decis
Page 137 and 138:
two females aged six years and 56 y
Page 139 and 140:
Table 2 Salmonella infections with
Page 141 and 142:
17. The Community Summary Report on
Page 143 and 144:
the number of registered cases in E
Page 145 and 146:
protected vaccinees annually) [6].
Page 147 and 148:
Romania Risk of tick-borne encephal
Page 149 and 150:
34. Pavlidou V, Geroy S, Diza E, An
Page 151 and 152:
European Commission and the EU Memb
Page 153 and 154:
10. Strauss R, Muchl R, Kunze M, Hr
Page 155 and 156:
Existing monitoring efforts in Euro
Page 157 and 158:
with existing efforts in influenza
Page 159 and 160:
Obtaining a true picture of the bur
Page 161 and 162:
of being too clean, concerns about
Page 163 and 164:
single case of the disease while in
Page 165 and 166:
Rapid communications E m E rg E n c
Page 167 and 168:
Development and Food. More specific
Page 169 and 170:
Rapid communications I n c r e a s
Page 171 and 172:
immunity was high enough to prevent
Page 173 and 174:
Control measures Information about
Page 175 and 176:
• The importance of ensuring that
Page 177 and 178:
Letters A u t h o r s r e p ly : pr
Page 179 and 180:
UNITED KINGDOM England and Wales He
show all

In this edition Also - Eurosurveillance

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?