1
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Beauté J, Innocenti F, Aristodimou A, Špačková M, Eves C, Kerbo N, Rimhanen-Finne R, Picardeau M, Faber M, Dougas G, Halldórsdóttir AM, Jackson S, Leitēna V, Vergison A, Borg ML, Pijnacker R, Sadkowska-Todys M, Martins JV, Rusu LC, Grilc E, Estévez-Reboredo RM, Niskanen T, Westrell T. Epidemiology of reported cases of leptospirosis in the EU/EEA, 2010 to 2021. Euro Surveill 2024; 29:2300266. [PMID: 38362624 PMCID: PMC10986659 DOI: 10.2807/1560-7917.es.2024.29.7.2300266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/09/2023] [Indexed: 02/17/2024] Open
Abstract
BackgroundLeptospirosis is a zoonotic disease caused by bacteria of the genus Leptospira. 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 Leptospira, as well as biases in diagnosis and reporting.
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Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Francesco Innocenti
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Epidemiology Unit, Regional Health Agency of Tuscany, Florence, Italy
| | | | - Michaela Špačková
- Centre for Epidemiology and Microbiology, Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | - Caroline Eves
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Natalia Kerbo
- Department of Communicable Diseases Epidemiology, Health Board, Tallinn, Estonia
| | - Ruska Rimhanen-Finne
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mathieu Picardeau
- Institut Pasteur, Unité Biologie des spirochètes, Centre National de Référence de la Leptospirose, Paris, France
| | - Mirko Faber
- Department of Infectious Disease Epidemiology, Robert Koch-Institute (RKI), Berlin, Germany
| | - Georgios Dougas
- Directorate of Epidemiological Surveillance and Intervention for Infectious Diseases, National Public Health Organization, Athens, Greece
| | | | - Sarah Jackson
- Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Maria Louise Borg
- Infectious Disease Prevention and Control Unit, Health Promotion and Disease Prevention Directorate, Pieta, Malta
| | - Roan Pijnacker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - João Vieira Martins
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | - Lavinia Cipriana Rusu
- National Centre for Surveillance and Control if Communicable Diseases, National Institute of Public Health, Bucharest, Romania
| | - Eva Grilc
- National Institute of Public Health, Ljubljana, Slovenia
| | | | - Taina Niskanen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Therese Westrell
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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2
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Van Heuverswyn J, Hallmaier-Wacker LK, Beauté J, Gomes Dias J, Haussig JM, Busch K, Kerlik J, Markowicz M, Mäkelä H, Nygren TM, Orlíková H, Socan M, Zbrzeźniak J, Žygutiene M, Gossner CM. Spatiotemporal spread of tick-borne encephalitis in the EU/EEA, 2012 to 2020. Euro Surveill 2023; 28:2200543. [PMID: 36927718 PMCID: PMC10021474 DOI: 10.2807/1560-7917.es.2023.28.11.2200543] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
BackgroundTick-borne encephalitis (TBE) is a vaccine-preventable disease involving the central nervous system. TBE became a notifiable disease on the EU/EEA level in 2012.AimWe aimed to provide an updated epidemiological assessment of TBE in the EU/EEA, focusing on spatiotemporal changes.MethodsWe performed a descriptive analysis of case characteristics, time and location using data of human TBE cases reported by EU/EEA countries to the European Centre for Disease Prevention and Control with disease onset in 2012-2020. We analysed data at EU/EEA, national, and subnational levels and calculated notification rates using Eurostat population data. Regression models were used for temporal analysis.ResultsFrom 2012 to 2020, 19 countries reported 29,974 TBE cases, of which 24,629 (98.6%) were autochthonous. Czechia, Germany and Lithuania reported 52.9% of all cases. The highest notification rates were recorded in Lithuania, Latvia, and Estonia (16.2, 9.5 and 7.5 cases/100,000 population, respectively). Fifty regions from 10 countries, had a notification rate ≥ 5/100,000. There was an increasing trend in number of cases during the study period with an estimated 0.053 additional TBE cases every week. In 2020, 11.5% more TBE cases were reported than predicted based on data from 2016 to 2019. A geographical spread of cases was observed, particularly in regions situated north-west of known endemic regions.ConclusionA close monitoring of ongoing changes to the TBE epidemiological situation in Europe can support the timely adaption of vaccination recommendations. Further analyses to identify populations and geographical areas where vaccination programmes can be of benefit are needed.
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Affiliation(s)
| | | | - Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Joana Gomes Dias
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Joana M Haussig
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Jana Kerlik
- Regional Authority of Public Health in Banská Bystrica, Banská Bystrica, Slovakia
| | | | - Henna Mäkelä
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Hana Orlíková
- National Institute of Public Health, Prague, Czechia
| | - Maja Socan
- National Institute of Public Health, Ljubljana, Slovenia
| | - Jakub Zbrzeźniak
- National Institute of Public Health - NIH - National Research Institute, Warsaw, Poland
| | - Milda Žygutiene
- National Public Health Center under the Ministry of Health, Vilnius, Lithuania
| | - Céline M Gossner
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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3
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Beauté J, Kramarz P. Public health surveillance in countries hosting displaced people from Ukraine. Euro Surveill 2022; 27:2200430. [PMID: 35656833 PMCID: PMC9164672 DOI: 10.2807/1560-7917.es.2022.27.22.2200430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Piotr Kramarz
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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4
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Suk JE, Pharris A, Beauté J, Colzani E, Needham H, Kinsman J, Niehus R, Grah R, Omokanye A, Plachouras D, Baka A, Prasse B, Sandmann F, Severi E, Alm E, Wiltshire E, Ciancio B. Public health considerations for transitioning beyond the acute phase of the COVID-19 pandemic in the EU/EEA. Euro Surveill 2022; 27. [PMID: 35485272 PMCID: PMC9052765 DOI: 10.2807/1560-7917.es.2022.27.17.2200155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Many countries, including some within the EU/EEA, are in the process of transitioning from the acute pandemic phase. During this transition, it is crucial that countries’ strategies and activities remain guided by clear COVID-19 control objectives, which increasingly will focus on preventing and managing severe outcomes. Therefore, attention must be given to the groups that are particularly vulnerable to severe outcomes of SARS-CoV-2 infection, including individuals in congregate and healthcare settings. In this phase of pandemic management, a strong focus must remain on transitioning testing approaches and systems for targeted surveillance of COVID-19, capitalising on and strengthening existing systems for respiratory virus surveillance. Furthermore, it will be crucial to focus on lessons learned from the pandemic to enhance preparedness and to enact robust systems for the preparedness, detection, rapid investigation and assessment of new and emerging SARS-CoV-2 variants. Filling existing knowledge gaps, including behavioural insights, can help guide the response to future resurgences of SARS-CoV-2 and/or the emergence of other pandemics. Finally, ‘vaccine agility’ will be needed to respond to changes in people’s behaviours, changes in the virus, and changes in population immunity, all the while addressing issues of global health equity.
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Affiliation(s)
- Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Anastasia Pharris
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Edoardo Colzani
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Howard Needham
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - John Kinsman
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Rene Niehus
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Rok Grah
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Ajibola Omokanye
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Agoritsa Baka
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Bastian Prasse
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Frank Sandmann
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Ettore Severi
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Erik Alm
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Emma Wiltshire
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Bruno Ciancio
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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5
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Marrone G, Nicolay N, Bundle N, Karki T, Spiteri G, Suija H, Kärblane KG, Mossong J, Vergison A, Avdicova M, Mecochova A, Cullen G, O'Lorcain P, Celentano LP, Derrough T, Beauté J. Risk reduction of severe outcomes in vaccinated COVID-19 cases: an analysis of surveillance data from Estonia, Ireland, Luxembourg and Slovakia, January to November 2021. Euro Surveill 2022; 27. [PMID: 35177166 PMCID: PMC8855507 DOI: 10.2807/1560-7917.es.2022.27.7.2200060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Despite high COVID-19 vaccine coverage in the EU/EEA, there are increasing reports of SARS-CoV-2 infections and hospitalisations in vaccinated individuals. Using surveillance data from Estonia, Ireland, Luxembourg and Slovakia (January-November 2021), we estimated risk reduction of severe outcomes in vaccinated cases. Increasing age remains the most important driver of severity, and vaccination significantly reduces risk in all ages for hospitalisation (adjusted relative risk (aRR): 0.32; 95% confidence interval (CI): 0.26-0.39) and death (aRR: 0.20; 95% CI: 0.13-0.29).
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Affiliation(s)
- Gaetano Marrone
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Nick Bundle
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Tommi Karki
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Gianfranco Spiteri
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | | | | | | | | | - Maria Avdicova
- Regional Public Health Authority, Banska Bystrica, Slovakia
| | | | | | | | | | - Tarik Derrough
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
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6
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Nicolay N, Innocenti F, Beauté J, Učakar V, Grgič Vitek M, Poukka E, Hannila-Handelberg T, Gauci C, Melillo T, Georgakopoulou T, Jarkovsky J, Slezak P, Delgado-Sanz C, Olmedo-Lucerón C, Suija H, Liausediene R, O'Lorcain P, Murphy N, Peralta-Santos A, Casaca P, Gregoriou I, Bundle N, Spiteri G, Ravasi G. Initial assessment of the COVID-19 vaccination's impact on case numbers, hospitalisations and deaths in people aged 80 years and older, 15 EU/EEA countries, December 2020 to May 2021. Euro Surveill 2021; 26:2101030. [PMID: 34857068 PMCID: PMC8641072 DOI: 10.2807/1560-7917.es.2021.26.48.2101030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/02/2021] [Indexed: 11/20/2022] Open
Abstract
Prioritisation of elderly people in COVID-19 vaccination campaigns aimed at reducing severe outcomes in this group. Using EU/EEA surveillance and vaccination uptake, we estimated the risk ratio of case, hospitalisation and death notifications in people 80 years and older compared with 25-59-year-olds. Highest impact was observed for full vaccination uptake 80% or higher with reductions in notification rates of cases up to 65% (IRR: 0.35; 95% CI: 0.13-0.99), hospitalisations up to 78% (IRR: 0.22; 95% CI: 0.13-0.37) and deaths up to 84% (IRR: 0.16; 95% CI: 0.13-0.20).
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Affiliation(s)
- Nathalie Nicolay
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Francesco Innocenti
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
- Epidemiology Unit, Regional Health Agency of Tuscany, Florence, Italy
| | - Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | | | | | - Eero Poukka
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Charmaine Gauci
- Health Promotion and Disease Prevention Directorate, Msida, Malta
| | - Tanya Melillo
- Health Promotion and Disease Prevention Directorate, Msida, Malta
| | - Theano Georgakopoulou
- Department of Epidemiological Surveillance and Intervention of the National Public Health Organization (NPHO), Athens, Greece
| | - Jiri Jarkovsky
- Data analysis department, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
| | - Pavel Slezak
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | | | | | - Heleene Suija
- Department of Communicable Diseases, Health Board, Tallin, Estonia
| | | | | | - Niamh Murphy
- Health Protection Surveillance Centre, Dublin, Ireland
| | - André Peralta-Santos
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | - Pedro Casaca
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | | | - Nick Bundle
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Gianfranco Spiteri
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Giovanni Ravasi
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
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7
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Ferland L, Carvalho C, Dias JG, Lamb F, Adlhoch C, Suetens C, Beauté J, Kinross P, Plachouras D, Hannila-Handelberg T, Fabiani M, Riccardo F, van Gageldonk-Lafeber R, Teirlinck AC, Mossong J, Vergison A, Melillo J, Melillo T, Mook P, Pebody R, Coutinho Rehse AP, Monnet DL. Risk of hospitalization and risk of death for health care workers with COVID-19 in nine European countries, January 2020-January 2021. J Hosp Infect 2021; 119:170-174. [PMID: 34752802 PMCID: PMC8665668 DOI: 10.1016/j.jhin.2021.10.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 11/26/2022]
Abstract
This article presents and compares coronavirus disease 2019 attack rates for infection, hospitalization, intensive care unit (ICU) admission and death in healthcare workers (HCWs) and non-HCWs in nine European countries from 31st January 2020 to 13th January 2021. Adjusted attack rate ratios in HCWs (compared with non-HCWs) were 3.0 [95% confidence interval (CI) 2.2–4.0] for infection, 1.8 (95% CI 1.2–2.7) for hospitalization, 1.9 (95% CI 1.1–3.2) for ICU admission and 0.9 (95% CI 0.4–2.0) for death. Among hospitalized cases, the case-fatality ratio was 1.8% in HCWs and 8.2% in non-HCWs. Differences may be due to better/earlier access to treatment, differential underascertainment and the healthy worker effect.
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Affiliation(s)
- Lisa Ferland
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Carlos Carvalho
- European Centre for Disease Prevention and Control, Solna, Sweden.
| | - Joana Gomes Dias
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Favelle Lamb
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Carl Suetens
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Julien Beauté
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Pete Kinross
- European Centre for Disease Prevention and Control, Solna, Sweden
| | | | | | | | | | | | - Anne C Teirlinck
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | | | | | | | - Piers Mook
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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8
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Beauté J, Adlhoch C, Bundle N, Melidou A, Spiteri G. Testing indicators to monitor the COVID-19 pandemic. The Lancet Infectious Diseases 2021; 21:1344-1345. [PMID: 34450053 PMCID: PMC8384351 DOI: 10.1016/s1473-3099(21)00461-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control, Solna 169 73, Sweden.
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control, Solna 169 73, Sweden
| | - Nick Bundle
- European Centre for Disease Prevention and Control, Solna 169 73, Sweden
| | - Angeliki Melidou
- European Centre for Disease Prevention and Control, Solna 169 73, Sweden
| | - Gianfranco Spiteri
- European Centre for Disease Prevention and Control, Solna 169 73, Sweden
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9
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Abstract
Healthcare-associated Legionnaires’ disease (HCA LD) can cause nosocomial outbreaks with high death rates. We compared community-acquired LD cases with HCA LD cases in Europe during 2008−2017 using data from The European Surveillance System. A total of 29 countries reported 40,411 community-acquired and 4,315 HCA LD cases. Of the HCA LD cases, 2,937 (68.1%) were hospital-acquired and 1,378 (31.9%) were linked to other healthcare facilities. The odds of having HCA LD were higher for women, children and persons <20 years of age, and persons >60 years of age. Out of the cases caused by Legionella pneumophila with a known serotype, community-acquired LD was more likely to be caused by L. pneumophila serogroup 1 (92.3%) than was HCA LD (85.1%). HCA LD patients were more likely to die. HCA LD is associated with specific patient demographics, causative strains, and outcomes. Healthcare facilities should consider these characteristics when designing HCA LD prevention strategies.
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10
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Abstract
To tailor a surveillance system to its objectives and to evaluate its fitness for purpose, an accurate description of its structural elements is essential. Existing recommendations for setting up a system seldom offer a comprehensive list of all surveillance elements to be considered. Moreover, there is sometimes confusion in the way terms describing these elements are interpreted. The objective of this paper is to propose a comprehensive set of surveillance system descriptors that can delineate the important elements and clarify the meaning of the terms used. We identified 20 descriptors that we classified in five categories: (i) surveillance scheme; (ii) population and cases; (iii) supplementary data; (iv) information flow; and (v) period of time. We tried to make the definitions of these descriptors as clear and simple as possible to avoid confusion or misinterpretation of the terms used. The relative importance of each element may vary depending on the objectives of the surveillance scheme. Surveillance descriptors should be reviewed periodically to document changes and to assess if the system continues to be fit for purpose. Together with the minimum requirements for variables and the planned outputs for disseminating the data, the surveillance descriptors can be used to define surveillance standards.
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Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Takis Panagiotopoulos
- Department of Public Health Policies, School of Public Health, University of West Attica, Athens, Greece
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11
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Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Gianfranco Spiteri
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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12
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Johnson HC, Gossner CM, Colzani E, Kinsman J, Alexakis L, Beauté J, Würz A, Tsolova S, Bundle N, Ekdahl K. Potential scenarios for the progression of a COVID-19 epidemic in the European Union and the European Economic Area, March 2020. Euro Surveill 2020; 25:2000202. [PMID: 32156332 PMCID: PMC7068161 DOI: 10.2807/1560-7917.es.2020.25.9.2000202] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/04/2020] [Indexed: 11/20/2022] Open
Abstract
Two months after the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the possibility of established and widespread community transmission in the European Union and European Economic Area (EU/EEA) is becoming more likely. We provide scenarios for use in preparedness for a possible widespread epidemic. The EU/EEA is moving towards the 'limited sustained transmission' phase. We propose actions to prepare for potential mitigation phases and coordinate efforts to protect the health of citizens.
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Affiliation(s)
- Helen C Johnson
- European Centre for Disease Prevention and Control, Solna, Sweden
- These authors contributed equally
| | - Céline M Gossner
- European Centre for Disease Prevention and Control, Solna, Sweden
- These authors contributed equally
| | - Edoardo Colzani
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - John Kinsman
- European Centre for Disease Prevention and Control, Solna, Sweden
| | | | - Julien Beauté
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Andrea Würz
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Svetla Tsolova
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Nick Bundle
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Karl Ekdahl
- European Centre for Disease Prevention and Control, Solna, Sweden
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13
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Spiteri G, Fielding J, Diercke M, Campese C, Enouf V, Gaymard A, Bella A, Sognamiglio P, Sierra Moros MJ, Riutort AN, Demina YV, Mahieu R, Broas M, Bengnér M, Buda S, Schilling J, Filleul L, Lepoutre A, Saura C, Mailles A, Levy-Bruhl D, Coignard B, Bernard-Stoecklin S, Behillil S, van der Werf S, Valette M, Lina B, Riccardo F, Nicastri E, Casas I, Larrauri A, Salom Castell M, Pozo F, Maksyutov RA, Martin C, Van Ranst M, Bossuyt N, Siira L, Sane J, Tegmark-Wisell K, Palmérus M, Broberg EK, Beauté J, Jorgensen P, Bundle N, Pereyaslov D, Adlhoch C, Pukkila J, Pebody R, Olsen S, Ciancio BC. First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020. Euro Surveill 2020; 25:2000178. [PMID: 32156327 PMCID: PMC7068164 DOI: 10.2807/1560-7917.es.2020.25.9.2000178] [Citation(s) in RCA: 354] [Impact Index Per Article: 88.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/05/2020] [Indexed: 12/14/2022] Open
Abstract
In the WHO European Region, COVID-19 surveillance was implemented 27 January 2020. We detail the first European cases. As at 21 February, nine European countries reported 47 cases. Among 38 cases studied, 21 were linked to two clusters in Germany and France, 14 were infected in China. Median case age was 42 years; 25 were male. Late detection of the clusters' index cases delayed isolation of further local cases. As at 5 March, there were 4,250 cases.
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Affiliation(s)
| | - James Fielding
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | | | - Christine Campese
- Santé Publique France - Direction des maladies infectieuses, Saint-Maurice, France
| | - Vincent Enouf
- Centre national de référence Virus des infections respiratoires, dont la grippe, Institut Pasteur, Paris, France
| | - Alexandre Gaymard
- Centre national de référence Virus des infections respiratoires, dont la grippe, Hospices civils de Lyon, Lyon, France
| | | | - Paola Sognamiglio
- Istituto Nazionale Malattie Infettive Lazzaro Spallanzani, Rome, Italy
| | - Maria José Sierra Moros
- Coordination Centre for Health Alerts and Emergencies. Spanish Ministry of Health, Madrid, Spain
| | | | - Yulia V Demina
- Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor), Moscow, Russia
| | - Romain Mahieu
- Department of Infectious Disease Prevention and Control, Common Community Commission, Brussels-Capital Region, Brussels, Belgium
| | - Markku Broas
- Chief Physician, Infection control unit, Lapland Hospital District, Rovaniemi, Finland
| | - Malin Bengnér
- County Medical Officer, Jönköping Region, Jönköping, Sweden
| | | | | | - Laurent Filleul
- Santé publique France - Direction des régions, Cellule régionale Nouvelle Aquitaine, Bordeaux, France
| | - Agnès Lepoutre
- Santé publique France - Direction des régions, Cellule régionale Ile-de-France, Paris, France
| | - Christine Saura
- Santé publique France - Direction des régions, Cellule régionale Auvergne-Rhône-Alpes, Lyon, France
| | - Alexandra Mailles
- Santé Publique France - Direction des maladies infectieuses, Saint-Maurice, France
| | - Daniel Levy-Bruhl
- Santé Publique France - Direction des maladies infectieuses, Saint-Maurice, France
| | - Bruno Coignard
- Santé Publique France - Direction des maladies infectieuses, Saint-Maurice, France
| | | | - Sylvie Behillil
- Centre national de référence Virus des infections respiratoires, dont la grippe, Institut Pasteur, Paris, France
| | - Sylvie van der Werf
- Centre national de référence Virus des infections respiratoires, dont la grippe, Institut Pasteur, Paris, France
| | - Martine Valette
- Centre national de référence Virus des infections respiratoires, dont la grippe, Hospices civils de Lyon, Lyon, France
| | - Bruno Lina
- Centre national de référence Virus des infections respiratoires, dont la grippe, Hospices civils de Lyon, Lyon, France
| | | | - Emanuele Nicastri
- Istituto Nazionale Malattie Infettive Lazzaro Spallanzani, Rome, Italy
| | - Inmaculada Casas
- National Centre for Microbiology, WHO-National Influenza Centre, Institute of Health Carlos III. Madrid, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Institute of Health Carlos III. Madrid, Spain
| | | | - Francisco Pozo
- National Centre for Microbiology, WHO-National Influenza Centre, Institute of Health Carlos III. Madrid, Spain
| | - Rinat A Maksyutov
- State Research Center of Virology and Biotechnology "Vector", Rospotrebnadzor, Moscow, Russia
| | | | - Marc Van Ranst
- Laboratory of Clinical Virology, Department of Microbiology and Immunology, Rega Institute, KU Leuven - University of Leuven, Leuven, Belgium
| | - Nathalie Bossuyt
- Epidemiology of infectious diseases, Sciensano, Brussels, Belgium
| | - Lotta Siira
- Expert Microbiology Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Jussi Sane
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | | | | | - Eeva K Broberg
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Julien Beauté
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Pernille Jorgensen
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Nick Bundle
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Dmitriy Pereyaslov
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Jukka Pukkila
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Sonja Olsen
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
- These authors have contributed equally to the manuscript
| | - Bruno Christian Ciancio
- European Centre for Disease Prevention and Control, Stockholm, Sweden
- These authors have contributed equally to the manuscript
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Beauté J, Westrell T, Schmid D, Müller L, Epstein J, Kontio M, Couturier E, Faber M, Mellou K, Borg ML, Friesema I, Vold L, Severi E. Travel-associated hepatitis A in Europe, 2009 to 2015. ACTA ACUST UNITED AC 2019; 23. [PMID: 29871720 PMCID: PMC6152172 DOI: 10.2807/1560-7917.es.2018.23.22.1700583] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Travel to countries with high or intermediate hepatitis A virus (HAV) endemicity is a risk factor for infection in residents of countries with low HAV endemicity. Aim: The objective of this study was to estimate the risk for hepatitis A among European travellers using surveillance and travel denominator data. Methods: We retrieved hepatitis A surveillance data from 13 European Union (EU)/ European Economic Area (EEA) countries with comprehensive surveillance systems and travel denominator data from the Statistical Office of the European Union. A travel-associated case of hepatitis A was defined as any case reported as imported. Results: From 2009 to 2015, the 13 countries reported 18,839 confirmed cases of hepatitis A, of which 5,233 (27.8%) were travel-associated. Of these, 39.8% were among children younger than 15 years. The overall risk associated with travel abroad decreased over the period at an annual rate of 3.7% (95% confidence interval (CI): 0.7–2.7) from 0.70 cases per million nights in 2009 to 0.51 in 2015. The highest risk was observed in travellers to Africa (2.11 cases per million nights). Cases more likely to be reported as travel-associated were male and of younger age (< 25 years). Conclusion: Travel is still a major risk factor for HAV infection in the EU/EEA, although the risk of infection may have slightly decreased in recent years. Children younger than 15 years accounted for a large proportion of cases and should be prioritised for vaccination.
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Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Therese Westrell
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Daniela Schmid
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | | | - Mia Kontio
- National Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Kassiani Mellou
- Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | | | - Ingrid Friesema
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Line Vold
- Norwegian Institute of Public Health, Oslo, Norway
| | - Ettore Severi
- Karolinska Institutet, Stockholm, Sweden.,European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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15
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Beauté J, Sandin S, de Jong B, Hallström LP, Robesyn E, Giesecke J, Sparén P, On Behalf Of The European Legionnaires' Disease Surveillance Network. Factors associated with Legionnaires' disease recurrence in hotel and holiday rental accommodation sites. ACTA ACUST UNITED AC 2019; 24. [PMID: 31115313 PMCID: PMC6530253 DOI: 10.2807/1560-7917.es.2019.24.20.1800295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BackgroundThe detection of a cluster of travel-associated Legionnaires' disease (TALD) cases in any European Union/European Economic Area (EU/EEA) country prompts action at the accommodation, follow-up by health authorities and reporting of measures taken. Some accommodations incur further cases despite presumed implementation of adequate control measures.AimTo identify factors associated with the occurrence of a further TALD case after the implementation of control measures.MethodsWe conducted a retrospective cohort study of hotel and holiday rental accommodations in the EU/EEA associated with two or more TALD cases with onset dates less than 2 years apart (a 'cluster') and notification between 1 June 2011-31 December 2016. We fitted Cox regression models to estimate the association between accommodation characteristics and the occurrence of a further case, defined as any case with onset date after the report on measures taken.ResultsOf the 357 accommodations in the analysis, 90 (25%) were associated with at least one further case after the report on measures taken (12.4/100 accommodation-years). Accommodations associated with two or more cases before the cluster notification were more likely to be associated with a further case, compared with those not previously associated with any case (adjusted hazard ratio 1.85; 95% confidence interval: 1.14-3.02). Neither the detection of Legionella in the water system nor the type of disinfection were found to be associated with the risk of a further case.ConclusionAccommodation size and previous TALD cases were predictive of further Legionnaires' disease cases after implementation of control measures.
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Affiliation(s)
- Julien Beauté
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Sven Sandin
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, United States.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, United States.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta de Jong
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Emmanuel Robesyn
- Department of Public Health Sciences, Karolinska Institutet, Sweden.,European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Johan Giesecke
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Pär Sparén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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16
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Abstract
Since 2012, tick-borne encephalitis (TBE) is a notifiable in the European Union. The European Centre for Disease Prevention and Control annually collects data from 28 countries plus Iceland and Norway, based on the EU case definition. Between 2012 and 2016, 23 countries reported 12,500 TBE cases (Ireland and Spain reported none), of which 11,623 (93.0%) were confirmed cases and 878 (7.0%) probable cases. Two countries (Czech Republic and Lithuania) accounted for 38.6% of all reported cases, although their combined population represented only 2.7% of the population under surveillance. The annual notification rate fluctuated between 0.41 cases per 100,000 population in 2015 and 0.65 in 2013 with no significant trend over the period. Lithuania, Latvia and Estonia had the highest notification rates with 15.6, 9.5 and 8.7 cases per 100,000 population, respectively. At the subnational level, six regions had mean annual notification rates above 15 cases per 100,000 population, of which five were in the Baltic countries. Approximately 95% of cases were hospitalised and the overall case fatality ratio was 0.5%. Of the 11,663 cases reported with information on importation status, 156 (1.3%) were reported as imported. Less than 2% of cases had received two or more doses of TBE vaccine.
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Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Gianfranco Spiteri
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Eva Warns-Petit
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden (affiliation when the work was performed),Direction Départementale de la Cohésion Sociale et de la Protection des Populations d’Ille-et-Vilaine, Rennes, France (current affiliation)
| | - Hervé Zeller
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden (affiliation when the work was performed)
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17
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Abstract
Under the coordination of the European Centre for Disease Prevention and Control (ECDC), the European Legionnaires’ disease Surveillance Network (ELDSNet) conducts surveillance of Legionnaires’ disease (LD) in Europe. Between 2011 and 2015, 29 countries reported 30,532 LD cases to ECDC (28,188 (92.3%) confirmed and 2,344 (7.7%) probable). Four countries (France, Germany, Italy and Spain) accounted for 70.3% of all reported cases, although their combined populations represented only 49.9% of the study population. The age-standardised rate of all cases increased from 0.97 cases/100,000 population in 2011 to 1.30 cases/100,000 population in 2015, corresponding to an annual average increase of 0.09 cases/100,000 population (95%CI 0.02–0.14; p = 0.02). Demographics and infection setting remained unchanged with ca 70% of cases being community-acquired and 80% occurring in people aged 50 years and older. Clinical outcome was known for 23,164 cases, of whom 2,161 (9.3%) died. The overall case fatality ratio decreased steadily from 10.5% in 2011 to 8.1% in 2015, probably reflecting improved reporting completeness. Five countries (Austria, Czech Republic, Germany, Italy, and Norway) had increasing age-standardised LD notification rates over the 2011−15 period, but there was no increase in notification rates in countries where the 2011 rate was below 0.5/100,000 population.
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Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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- The members of the network are listed at the end of the article
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18
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Beauté J, Cowan S, Hiltunen-Back E, Kløvstad H, Velicko I, Spiteri G. Travel-associated gonorrhoea in four Nordic countries, 2008 to 2013. ACTA ACUST UNITED AC 2017; 22:30537. [PMID: 28537548 PMCID: PMC5479976 DOI: 10.2807/1560-7917.es.2017.22.20.30537] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 09/23/2016] [Indexed: 11/23/2022]
Abstract
Travel may be associated with a higher risk of gonorrhoea and infection by antibiotic-resistant strains. The objective of this study was to estimate the risk for gonorrhoea among travellers from four Nordic European countries using surveillance data and to identify at-risk travellers to help target interventions. We retrieved gonorrhoea surveillance data from Denmark, Finland, Norway and Sweden and tourism denominator data from the Statistical Office of the European Union. A travel-associated case of gonorrhoea was defined as one for which the reported country of infection differed from the reporting country. During 2008−2013, the four countries reported 3,224 travel-associated gonorrhoea cases, of which 53% were among individuals below 35 years of age. The overall risk associated with travel abroad was 2.4 cases per million nights abroad. The highest risk was observed with travel to Asia (9.4). Cases more likely to be reported as travel-associated were: males, heterosexuals of both sexes, people older than 65 years, and foreign-born individuals. More effective interventions targeting young adults and other at-risk groups are needed. The use of travel-planning websites and social media should be explored further.
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Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Susan Cowan
- Statens Serum Institut (SSI), Copenhagen, Denmark
| | | | - Hilde Kløvstad
- Norwegian Institute of Public Health (FHI), Oslo, Norway
| | - Inga Velicko
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Gianfranco Spiteri
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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19
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Abstract
Surveillance of Zika virus (ZIKV) infection in the European Union/European Economic Area (EU/EEA) was implemented in 2016 in response to the large outbreak reported in the Americas in 2015 associated with an increased number of infants born with microcephaly. Between June 2015 and January 2017, 21 EU/EEA countries reported 2,133 confirmed cases of ZIKV infection, of whom 106 were pregnant women. Cases infected in the Caribbean constituted 71% of reported cases. Almost all cases (99%) were most probably infected by mosquito bite during travel outside continental Europe, while only 1% were transmitted sexually. Considering that 584 imported cases were reported between May and October 2016 among residents of areas with established presence of Aedes albopictus, the absence of autochthonous vector-borne cases suggests that Ae. albopictus is not an efficient vector for ZIKV infection.
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Affiliation(s)
- G Spiteri
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - B Sudre
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - A Septfons
- Santé publique France, Paris, France
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - J Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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20
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Hollo V, Beauté J, Ködmön C, van der Werf MJ. Tuberculosis notification rate decreases faster in residents of native origin than in residents of foreign origin in the EU/EEA, 2010 to 2015. ACTA ACUST UNITED AC 2017; 22:30486. [PMID: 28367798 PMCID: PMC5388127 DOI: 10.2807/1560-7917.es.2017.22.12.30486] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 03/16/2017] [Indexed: 11/20/2022]
Abstract
To estimate trends in tuberculosis (TB) notification rates by geographical origin, we retrieved surveillance data from 2010 to 2015 for 29 European Union and European Economic Area countries. The TB notification rate decreased at an annual rate of 5.3%. The decrease in notification rate was higher in native residents (7.0%) than in those of foreign origin (3.7%). Targeted screening and facilitated access to care and treatment could help prevent and control TB in migrants.
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Affiliation(s)
- V Hollo
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - J Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - C Ködmön
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - M J van der Werf
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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21
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Vega T, Lozano JE, Meerhoff T, Snacken R, Beauté J, Jorgensen P, Ortiz de Lejarazu R, Domegan L, Mossong J, Nielsen J, Born R, Larrauri A, Brown C. Influenza surveillance in Europe: comparing intensity levels calculated using the moving epidemic method. Influenza Other Respir Viruses 2016; 9:234-46. [PMID: 26031655 PMCID: PMC4548993 DOI: 10.1111/irv.12330] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2015] [Indexed: 11/29/2022] Open
Abstract
Objectives Although influenza-like illnesses (ILI) and acute respiratory illnesses (ARI) surveillance are well established in Europe, the comparability of intensity among countries and seasons remains an unresolved challenge. The objective is to compare the intensity of ILI and ARI in some European countries. Design and setting Weekly ILI and ARI incidence rates and proportion of primary care consultations were modeled in 28 countries for the 1996/1997–2013/2014 seasons using the moving epidemic method (MEM). We calculated the epidemic threshold and three intensity thresholds, which delimit five intensity levels: baseline, low, medium, high, and very high. The intensity of 2013/2014 season is described and compared by country. Results The lowest ILI epidemic thresholds appeared in Sweden and Estonia (below 10 cases per 100 000) and the highest in Belgium, Denmark, Hungary, Poland, Serbia, and Slovakia (above 100 per 100 000). The 2009/2010 season was the most intense, with 35% of the countries showing high or very high intensity levels. The European epidemic period in season 2013/2014 started in January 2014 in Spain, Poland, and Greece. The intensity was between low and medium and only Greece reached the high intensity level, in weeks 7 to 9/2014. Some countries remained at the baseline level throughout the entire surveillance period. Conclusions Epidemic and intensity thresholds varied by country. Influenza-like illnesses and ARI levels normalized by MEM in 2013/2014 showed that the intensity of the season in Europe was between low and medium in most of the countries. Comparing intensity among seasons or countries is essential for understanding patterns in seasonal epidemics. An automated standardized model for comparison should be implemented at national and international levels.
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Affiliation(s)
- Tomás Vega
- Public Health Directorate, Castilla y León Regional Health Ministry, Valladolid, Spain
| | - José E Lozano
- Public Health Directorate, Castilla y León Regional Health Ministry, Valladolid, Spain
| | - Tamara Meerhoff
- The Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - René Snacken
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Julien Beauté
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Pernille Jorgensen
- Division of Health Security, Infectious Diseases and the Environment, WHO Regional Office for Europe, Copenhagen, Denmark
| | | | - Lisa Domegan
- Health Protection Surveillance Centre, Dublin, Ireland
| | - Joël Mossong
- Laboratoire National de Santé, Luxembourg, Luxembourg
| | | | - Rita Born
- Division of Communicable Diseases, Federal Office of Public Health, Directorates of Public Health, Bern, Switzerland
| | - Amparo Larrauri
- CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Caroline Brown
- Division of Health Security, Infectious Diseases and the Environment, WHO Regional Office for Europe, Copenhagen, Denmark
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22
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Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), 17183 Stockholm, Sweden.
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23
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Broberg E, Snacken R, Adlhoch C, Beauté J, Galinska M, Pereyaslov D, Brown C, Penttinen P. Start of the 2014/15 influenza season in Europe: drifted influenza A(H3N2) viruses circulate as dominant subtype. ACTA ACUST UNITED AC 2015; 20. [PMID: 25655052 DOI: 10.2807/1560-7917.es2015.20.4.21023] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The influenza season 2014/15 started in Europe in week 50 2014 with influenza A(H3N2) viruses predominating. The majority of the A(H3N2) viruses characterised antigenically and/or genetically differ from the northern hemisphere vaccine component which may result in reduced vaccine effectiveness for the season. We therefore anticipate that this season may be more severe than the 2013/14 season. Treating influenza with antivirals in addition to prevention with vaccination will be important.
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Affiliation(s)
- E Broberg
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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24
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Suk JE, Van Cangh T, Beauté J, Bartels C, Tsolova S, Pharris A, Ciotti M, Semenza JC. The interconnected and cross-border nature of risks posed by infectious diseases. Glob Health Action 2014; 7:25287. [PMID: 25308818 PMCID: PMC4195207 DOI: 10.3402/gha.v7.25287] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/16/2014] [Accepted: 09/16/2014] [Indexed: 01/01/2023] Open
Abstract
Infectious diseases can constitute public health emergencies of international concern when a pathogen arises, acquires new characteristics, or is deliberately released, leading to the potential for loss of human lives as well as societal disruption. A wide range of risk drivers are now known to lead to and/or exacerbate the emergence and spread of infectious disease, including global trade and travel, the overuse of antibiotics, intensive agriculture, climate change, high population densities, and inadequate infrastructures, such as water treatment facilities. Where multiple risk drivers interact, the potential impact of a disease outbreak is amplified. The varying temporal and geographic frequency with which infectious disease events occur adds yet another layer of complexity to the issue. Mitigating the emergence and spread of infectious disease necessitates mapping and prioritising the interdependencies between public health and other sectors. Conversely, during an international public health emergency, significant disruption occurs not only to healthcare systems but also to a potentially wide range of sectors, including trade, tourism, energy, civil protection, transport, agriculture, and so on. At the same time, dealing with a disease outbreak may require a range of critical sectors for support. There is a need to move beyond narrow models of risk to better account for the interdependencies between health and other sectors so as to be able to better mitigate and respond to the risks posed by emerging infectious disease.
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Affiliation(s)
- Jonathan E Suk
- European Centre for Disease Prevention and Control, Stockholm, Sweden; Global Public Health Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK;
| | - Thomas Van Cangh
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Julien Beauté
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Cornelius Bartels
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Svetla Tsolova
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Anastasia Pharris
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Massimo Ciotti
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Jan C Semenza
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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25
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Beauté J, Pharris A, Suk J, Semenza J. Impact of the economic crisis on infectious disease surveillance in Europe. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku165.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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26
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27
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Magnani A, Brosselin P, Beauté J, de Vergnes N, Mouy R, Debré M, Suarez F, Hermine O, Lortholary O, Blanche S, Fischer A, Mahlaoui N. Inflammatory manifestations in a single-center cohort of patients with chronic granulomatous disease. J Allergy Clin Immunol 2014; 134:655-662.e8. [PMID: 24985400 DOI: 10.1016/j.jaci.2014.04.014] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 04/04/2014] [Accepted: 04/17/2014] [Indexed: 01/12/2023]
Abstract
BACKGROUND Chronic granulomatous disease (CGD) is a rare phagocytic disorder that results in not only infections but also potentially severe inflammatory manifestations that can be difficult to diagnose and treat. OBJECTIVE To describe inflammatory manifestations in a single-center cohort of patients with CGD. METHODS Medical records of patients treated at Necker-Enfants Malades Hospital (Paris, France) between 1968 and 2009 and registered at the French National Reference Center for Primary Immunodeficiencies (CEREDIH) were retrospectively reviewed. RESULTS In a study population of 98 patients, a total of 221 inflammatory episodes were recorded in 68 individuals (69.4%). The incidence rate of inflammatory episodes was 0.15 per person-year (0.18 in patients with X-linked [XL] CGD and 0.08 in patients with autosomal-recessive [AR] CGD). The most commonly affected organs were the gastrointestinal tract (in 88.2% of the patients), lungs (26.4%), the urogenital tract (17.6%), and eyes (8.8%). Inflammation at other sites (the skin, central nervous system, and tympanum) and autoimmune manifestations (lupus, arthritis, etc) were recorded in 19.1% and 10.3% of the patients, respectively. Granuloma was found in 50% of the 44 histological analyses reviewed. The risk of inflammatory episodes was 2-fold higher in patients with XL-CGD than in patients with AR-CGD (relative risk, 2.22; 95% CI, 1.43-3.46). CONCLUSIONS Patients with XL-CGD have a higher risk of developing inflammatory episodes than do patients with AR-CGD. Although the most commonly affected organ is the gastrointestinal tract, other sites can be involved, making the management of patients with CGD a complex, multidisciplinary task.
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Affiliation(s)
- Alessandra Magnani
- Assistance Publique-Hôpitaux de Paris, Service d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Assistance Publique-Hôpitaux de Paris, Centre de Référence des Déficits Immunitaires Héréditaires (CEREDIH), Hôpital Universitaire Necker-Enfants Malades, Paris, France; University Paris Descartes, Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - Pauline Brosselin
- Assistance Publique-Hôpitaux de Paris, Centre de Référence des Déficits Immunitaires Héréditaires (CEREDIH), Hôpital Universitaire Necker-Enfants Malades, Paris, France; University Paris Descartes, Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - Julien Beauté
- Assistance Publique-Hôpitaux de Paris, Centre de Référence des Déficits Immunitaires Héréditaires (CEREDIH), Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Nathalie de Vergnes
- Assistance Publique-Hôpitaux de Paris, Centre de Référence des Déficits Immunitaires Héréditaires (CEREDIH), Hôpital Universitaire Necker-Enfants Malades, Paris, France; University Paris Descartes, Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - Richard Mouy
- Assistance Publique-Hôpitaux de Paris, Service d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Marianne Debré
- Assistance Publique-Hôpitaux de Paris, Service d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Felipe Suarez
- Assistance Publique-Hôpitaux de Paris, Centre de Référence des Déficits Immunitaires Héréditaires (CEREDIH), Hôpital Universitaire Necker-Enfants Malades, Paris, France; University Paris Descartes, Sorbonne Paris Cité, Institut Imagine, Paris, France; Assistance Publique-Hôpitaux de Paris, Service d'Hématologie Adultes, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Olivier Hermine
- Assistance Publique-Hôpitaux de Paris, Centre de Référence des Déficits Immunitaires Héréditaires (CEREDIH), Hôpital Universitaire Necker-Enfants Malades, Paris, France; University Paris Descartes, Sorbonne Paris Cité, Institut Imagine, Paris, France; Assistance Publique-Hôpitaux de Paris, Service d'Hématologie Adultes, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Olivier Lortholary
- Assistance Publique-Hôpitaux de Paris, Centre de Référence des Déficits Immunitaires Héréditaires (CEREDIH), Hôpital Universitaire Necker-Enfants Malades, Paris, France; University Paris Descartes, Sorbonne Paris Cité, Institut Imagine, Paris, France; Assistance Publique-Hôpitaux de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Stéphane Blanche
- Assistance Publique-Hôpitaux de Paris, Service d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Assistance Publique-Hôpitaux de Paris, Centre de Référence des Déficits Immunitaires Héréditaires (CEREDIH), Hôpital Universitaire Necker-Enfants Malades, Paris, France; University Paris Descartes, Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - Alain Fischer
- Assistance Publique-Hôpitaux de Paris, Service d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Assistance Publique-Hôpitaux de Paris, Centre de Référence des Déficits Immunitaires Héréditaires (CEREDIH), Hôpital Universitaire Necker-Enfants Malades, Paris, France; University Paris Descartes, Sorbonne Paris Cité, Institut Imagine, Paris, France; Collège de France, France
| | - Nizar Mahlaoui
- Assistance Publique-Hôpitaux de Paris, Service d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Assistance Publique-Hôpitaux de Paris, Centre de Référence des Déficits Immunitaires Héréditaires (CEREDIH), Hôpital Universitaire Necker-Enfants Malades, Paris, France; University Paris Descartes, Sorbonne Paris Cité, Institut Imagine, Paris, France; Laboratoire de Génétique Humaine des Maladies Infectieuses, Hopital Universitaire Necker-Enfants Malades, Inserm U1163, Paris, France.
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Adlhoch C, Broberg E, Beauté J, Snacken R, Bancroft E, Zucs P, Penttinen P. Influenza season 2013/14 has started in Europe with influenza A(H1)pdm09 virus being the most prevalent subtype. ACTA ACUST UNITED AC 2014; 19. [PMID: 24507465 DOI: 10.2807/1560-7917.es2014.19.4.20686] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The 2013/14 influenza season has started in Europe. Four countries have reported medium intensity influenza activity, with children under 15 years being the most affected age group. A growing number of countries see increasing rates of influenza-like illness or acute respiratory infection and increasing proportions of specimens positive for influenza A(H1)pdm09 virus. In previous seasons, this subtype was associated with higher reported numbers of severe and fatal cases. Clinicians should offer influenza vaccination to unvaccinated persons belonging to risk groups.
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Affiliation(s)
- C Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Abstract
Legionnaires' disease is underreported in Europe; notification rates differ substantially among countries. Approximately 20% of reported cases are travel-associated. To assess the risk for travel-associated Legionnaires' disease (TALD) associated with travel patterns in European countries, we retrieved TALD surveillance data for 2009 from the European Surveillance System, and tourism denominator data from the Statistical Office of the European Union. Risk (number cases reported/number nights spent) was calculated by travel country. In 2009, the network reported 607 cases among European travelers, possibly associated with 825 accommodation sites in European Union countries. The overall risk associated with travel abroad was 0.3 cases/million nights. We observed an increasing trend in risk from northwestern to southeastern Europe; Greece had the highest risk (1.7). Our findings underscore the need for countries with high TALD risks to improve prevention and control of legionellosis; and for countries with high TALD risks, but low notification rates of Legionnaires' disease to improve diagnostics and reporting.
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Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control, Stockholm, Sweden.
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Beauté J, Broberg E, Plata F, Bonmarin I, O Donnell J, Delgado C, Boddington N, Snacken R. Overrepresentation of influenza A(H1N1)pdm09 virus among severe influenza cases in the 2011/12 season in four European countries. Euro Surveill 2012; 17:20105. [PMID: 22401564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
In France, Ireland, Spain and the United Kingdom, the influenza season 2011/12 started in the final weeks of 2011 and has been dominated by influenza A(H3) viruses with minimal circulation of influenza A(H1N1) pdm09 and B viruses. A relatively greater proportion, however, of influenza A(H1N1)pdm09 viruses were reported in hospitalised laboratory-confirmed influenza cases in four countries. Compared to the season 2010/11, the proportion of subtype A(H3) among hospitalised cases has increased, associated with a larger proportion of cases in the youngest and oldest age groups.
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Affiliation(s)
- J Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
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Blumental S, Mouy R, Mahlaoui N, Bougnoux ME, Debré M, Beauté J, Lortholary O, Blanche S, Fischer A. Invasive mold infections in chronic granulomatous disease: a 25-year retrospective survey. Clin Infect Dis 2012; 53:e159-69. [PMID: 22080130 DOI: 10.1093/cid/cir731] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Invasive fungal infection (IFI) represents a life-threatening condition for patients with chronic granulomatous disease (CGD) and causes one-third of deaths in this population. This study offers a descriptive review of invasive mold infection (mIFI) in children with CGD over an extended period of time. METHODS In a cohort of patients with CGD registered in the French National database for Primary Immunodeficiency, we performed a retrospective review of proven mIFI episodes (European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group 2008 criteria) occurring from 1984 through 2009. RESULTS Twenty-nine proven mIFIs were identified in 24 patients. Thirteen (54%) of 24 children were receiving itraconazole prophylaxis. Seven episodes were caused by Aspergillus fumigatus, 10 by Aspergillus nidulans, 2 by Aspergillus species, and 6 by other opportunistic molds (4 patients only had positive pathological examination findings). First proven mIFI occurred later in the group that received itraconazole than in the group without (median time to mIFI, 10 vs 4 years; P < .01), with a higher proportion of infections due to A. nidulans and other opportunistic molds (P < .05). Course of IFI was complex, with the median duration of therapy and hospitalization reaching 446 and 153 days, respectively. Combined antifungal therapy was commonly used. Four patients received geno-identical hematopoietic stem cell transplantation as salvage therapy. Global cure rate among the cohort reached 75%, but sequelae were frequent. Prognosis has improved over time (43% mortality during 1985-1990 vs 6% thereafter; P = .06). Mortality tended to be lower in the group that recieved itraconazole prophylaxis but at the cost of a longer duration of therapy among cured patients. CONCLUSIONS Management of mIFI remains challenging in patients with CGD, but significant improvements have been made over the past decade.
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Affiliation(s)
- Sophie Blumental
- Immunology and Haematology Unit, Hôpital Necker Enfants Malades, Paris, France.
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Beauté J, Broberg E, Plata F, Bonmarin I, O’Donnell J, Delgado C, Boddington N, Snacken R. Overrepresentation of influenza A(H1N1)pdm09 virus among severe influenza cases in the 2011/12 season in four European countries. Euro Surveill 2012. [DOI: 10.2807/ese.17.09.20105-en] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In France, Ireland, Spain and the United Kingdom, the influenza season 2011/12 started in the final weeks of 2011 and has been dominated by influenza A(H3) viruses with minimal circulation of influenza A(H1N1)pdm09 and B viruses. A relatively greater proportion, however, of influenza A(H1N1)pdm09 viruses were reported in hospitalised laboratory-confirmed influenza cases in four countries. Compared to the season 2010/11, the proportion of subtype A(H3) among hospitalised cases has increased, associated with a larger proportion of cases in the youngest and oldest age groups.
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Affiliation(s)
- J Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - E Broberg
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - F Plata
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - I Bonmarin
- Institut de Veille Sanitaire (InVS), Saint-Maurice, France
| | - J O’Donnell
- Health Protection Surveillance Centre, Dublin, Ireland
| | - C Delgado
- Centro Nacional de Epidemiología (National Centre of Epidemiology), Instituto de Salud Carlos III, Madrid, Spain
| | - N Boddington
- Respiratory Diseases Department, Health Protection Agency, London, United Kingdom
| | - R Snacken
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Rammaert B, Goyet S, Beauté J, Hem S, Te V, Try PL, Mayaud C, Borand L, Buchy P, Guillard B, Vong S. Klebsiella pneumoniae related community-acquired acute lower respiratory infections in Cambodia: clinical characteristics and treatment. BMC Infect Dis 2012; 12:3. [PMID: 22233322 PMCID: PMC3282637 DOI: 10.1186/1471-2334-12-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Accepted: 01/10/2012] [Indexed: 11/12/2022] Open
Abstract
Background In many Asian countries, Klebsiella pneumoniae (KP) is the second pathogen responsible for community-acquired pneumonia. Yet, very little is known about KP etiology in ALRI in Cambodia, a country that has one of the weakest medical infrastructures in the region. We present here the first clinico-radiological description of KP community-acquired ALRI in hospitalized Cambodian patients. Methods Through ALRI surveillance in two provincial hospitals, KP was isolated from sputum and blood cultures, and identified by API20E gallery from patients ≥ 5 years-old with fever and respiratory symptoms onset ≤14 days. Antibiotics susceptibility testing was provided systematically to clinicians when bacteria were isolated. We collected patients' clinical, radiological and microbiological data and their outcome 3 months after discharge. We also compared KP-related with other bacteria-related ALRI to determine risk factors for KP infection. Results From April 2007 to December 2009, 2315 ALRI patients ≥ 5 years-old were enrolled including 587 whose bacterial etiology could be assigned. Of these, 47 (8.0%) had KP infection; their median age was 55 years and 68.1% were females. Reported prior medication was high (42.5%). Patients' chest radiographs showed pneumonia (61.3% including 39% that were necrotizing), preexisting parenchyma lesions (29.5%) and pleural effusions alone (4.5%) and normal parenchyma (4.5%). Five patients had severe conditions on admission and one patient died during hospitalization. Of the 39 patients that were hospital discharged, 14 died including 12 within 1 month after discharge. Only 13 patients (28%) received an appropriate antibiotherapy. Extended-spectrum beta-lactamases (ESBL) - producing strains were found in 8 (17.0%) patients. Female gender (Odds ratio (OR) 2.1; p = 0.04) and diabetes mellitus (OR 3.1; p = 0.03) were independent risk factors for KP-related ALRI. Conclusions KP ALRI in Cambodia has high fatality rate, are more frequently found in women, and should be considered in diabetic patients. The extremely high frequency of ESBL-producing strains in the study is alarming in the context of uncontrolled antibiotic consumption and in absence of microbiology capacity in most public-sector hospitals.
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Affiliation(s)
- Blandine Rammaert
- Institut Pasteur in Cambodia, Réseau International des Instituts Pasteur, Phnom Penh, Cambodia.
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Micol R, Kayal S, Mahlaoui N, Beauté J, Brosselin P, Dudoit Y, Obenga G, Barlogis V, Aladjidi N, Kebaili K, Thomas C, Dulieu F, Monpoux F, Nové-Josserand R, Pellier I, Lambotte O, Salmon A, Masseau A, Galanaud P, Oksenhendler E, Tabone MD, Teira P, Coignard-Biehler H, Lanternier F, Join-Lambert O, Mouillot G, Theodorou I, Lecron JC, Alyanakian MA, Picard C, Blanche S, Hermine O, Suarez F, Debré M, Lecuit M, Lortholary O, Durandy A, Fischer A. Protective effect of IgM against colonization of the respiratory tract by nontypeable Haemophilus influenzae in patients with hypogammaglobulinemia. J Allergy Clin Immunol 2011; 129:770-7. [PMID: 22153772 DOI: 10.1016/j.jaci.2011.09.047] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 09/01/2011] [Accepted: 09/26/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Primary immunoglobulin deficiencies lead to recurrent bacterial infections of the respiratory tract and bronchiectasis, even with adequate immunoglobulin replacement therapy. It is not known whether patients able to secrete IgM (eg, those with hyper-IgM [HIgM] syndrome) are as susceptible to these infections as patients who lack IgM production (eg, those with panhypogammaglobulinemia [PHG]). OBJECTIVE This study is aimed at identifying specific microbiological and clinical (infections) characteristics that distinguish immunoglobulin-substituted patients with PHG from patients with HIgM syndrome. METHODS A cohort of patients with HIgM syndrome (n = 25) and a cohort of patients with PHG (n = 86) were monitored prospectively for 2 years while receiving similar polyvalent immunoglobulin replacement therapies. Regular bacterial analyses of nasal swabs and sputum were performed, and clinical events were recorded. In parallel, serum and saliva IgM antibody concentrations were measured. RESULTS When compared with patients with PHG, patients with HIgM syndrome were found to have a significantly lower risk of nontypeable Haemophilus influenzae carriage in particular (relative risk, 0.39; 95% CI, 0.21-0.63). Moreover, patients with HIgM syndrome (including those unable to generate somatic hypermutations of immunoglobulin genes) displayed anti-nontypeable H influenzae IgM antibodies in their serum and saliva. Also, patients with HIgM syndrome had a lower incidence of acute respiratory tract infections. CONCLUSIONS IgM antibodies appear to be microbiologically and clinically protective and might thus attenuate the infectious consequences of a lack of production of other immunoglobulin isotypes in patients with HIgM syndrome. Polyvalent IgG replacement therapy might not fully compensate for IgM deficiency. It might thus be worth adapting long-term antimicrobial prophylactic regimens according to the underlying B-cell immunodeficiency phenotype.
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Affiliation(s)
- Romain Micol
- CEREDIH Network (French National Reference Center for Primary Immunodeficiencies), Hôpital Necker-Enfants Malades, AP-HP, Paris, France
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Vong S, Huy R, Ong S, Teurlai M, Ly S, Beauté J, Duong V, Buchy P. Epidemiology and burden of dengue in Cambodia. BMC Proc 2011. [DOI: 10.1186/1753-6561-5-s1-p49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Rammaert B, Goyet S, Beauté J, Hem S, Te V, Try PL, Mayaud C, Borand L, Buchy P, Guillard B, Vong S. Klebsiella pneumoniae related community-acquired acute lower respiratory infections in CAMBODIA: clinical characteristics and treatment. BMC Proc 2011. [DOI: 10.1186/1753-6561-5-s1-p72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Rammaert B, Beauté J, Borand L, Hem S, Buchy P, Goyet S, Overtoom R, Angebault C, Te V, Try PL, Mayaud C, Vong S, Guillard B. Pulmonary melioidosis in CAMBODIA: a prospective study. BMC Proc 2011. [DOI: 10.1186/1753-6561-5-s1-p73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Micol R, Ben Slama L, Suarez F, Le Mignot L, Beauté J, Mahlaoui N, Dubois d’Enghien C, Laugé A, Hall J, Couturier J, Vallée L, Delobel B, Rivier F, Nguyen K, Billette de Villemeur T, Stephan JL, Bordigoni P, Bertrand Y, Aladjidi N, Pedespan JM, Thomas C, Pellier I, Koenig M, Hermine O, Picard C, Moshous D, Neven B, Lanternier F, Blanche S, Tardieu M, Debré M, Fischer A, Stoppa-Lyonnet D. Morbidity and mortality from ataxia-telangiectasia are associated with ATM genotype. J Allergy Clin Immunol 2011; 128:382-9.e1. [DOI: 10.1016/j.jaci.2011.03.052] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 02/05/2011] [Accepted: 03/08/2011] [Indexed: 12/21/2022]
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Rammaert B, Beauté J, Borand L, Hem S, Buchy P, Goyet S, Overtoom R, Angebault C, Te V, Try PL, Mayaud C, Vong S, Guillard B. Pulmonary melioidosis in Cambodia: a prospective study. BMC Infect Dis 2011; 11:126. [PMID: 21569563 PMCID: PMC3117704 DOI: 10.1186/1471-2334-11-126] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 05/14/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Melioidosis is a disease caused by Burkholderia pseudomallei and considered endemic in South-East Asia but remains poorly documented in Cambodia. We report the first series of hospitalized pulmonary melioidosis cases identified in Cambodia describing clinical characteristics and outcomes. METHODS We characterized cases of acute lower respiratory infections (ALRI) that were identified through surveillance in two provincial hospitals. Severity was defined by systolic blood pressure, cardiac frequency, respiratory rate, oxygen saturation and body temperature. B. pseudomallei was detected in sputum or blood cultures and confirmed by API20NE gallery. We followed up these cases between 6 months and 2 years after hospital discharge to assess the cost-of-illness and long-term outcome. RESULTS During April 2007 - January 2010, 39 ALRI cases had melioidosis, of which three aged ≤2 years; the median age was 46 years and 56.4% were males. A close contact with soil and water was identified in 30 patients (76.9%). Pneumonia was the main radiological feature (82.3%). Eleven patients were severe cases. Twenty-four (61.5%) patients died including 13 who died within 61 days after discharge. Of the deceased, 23 did not receive any antibiotics effective against B. pseudomallei. Effective drugs that were available did not include ceftazidime. Mean total illness-related costs was of US$65 (range $25-$5000). Almost two-thirds (61.5%) incurred debt and 28.2% sold land or other belongings to pay illness-related costs. CONCLUSIONS The observed high fatality rate is likely explained by the lack or limited access to efficient antibiotics and under-recognition of the disease among clinicians, which led to inappropriate therapy.
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Arnott A, Vong S, Sek M, Naughtin M, Beauté J, Rith S, Guillard B, Deubel V, Buchy P. Genetic variability of human metapneumovirus amongst an all ages population in Cambodia between 2007 and 2009. Infect Genet Evol 2011; 15:43-52. [PMID: 21292032 PMCID: PMC7106057 DOI: 10.1016/j.meegid.2011.01.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 01/20/2011] [Accepted: 01/21/2011] [Indexed: 12/29/2022]
Abstract
First identified in 2001, human metapneumovirus (HMPV) is a novel pathogen and causative agent of acute respiratory tract infection. Re-infection with HMPV is common, and currently there is no available vaccine against HMPV infection. Two genotypes of HMPV have been identified, A and B, both of which can be divided further into at least two distinct sub-genotypes. Here we report the results of the first study to investigate the genetic variability of HMPV strains circulating within Cambodia. The overall incidence of HMPV infection amongst an all-ages population of patients hospitalised with ALRI in Cambodia during 3 consecutive years, between 2007 and 2009, was 1.7%. The incidence of HMPV infection was highest amongst children less than 5 years of age, with pneumonia or bronchopneumonia the most frequent clinical diagnoses across all age groups. The incidence of HMPV infection varied annually. As anticipated, genetic diversity was low amongst the conserved F gene sequences but very high amongst G gene sequences, some strains sharing as little as 56.3% and 34.2% homology at the nucleotide and amino acid levels, respectively. Simultaneous co-circulation of strains belonging to the HMPV sub-genotypes B1, B2 and lineage A2b, amongst patients recruited at 2 geographically distinct provincial hospitals, was detected. Sub-genotype B2 strains were responsible for the majority of the infections detected, and a significant (p = 0.013) association between infection with lineage A2b strains and disease severity was observed.
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Affiliation(s)
- Alicia Arnott
- Institut Pasteur in Cambodia, Réseau International des Instituts Pasteur, 5 Monivong blvd, PO Box 983, Phnom Penh, Cambodia
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42
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Rammaert B, Beauté J, Borand L, Hem S, Buchy P, Goyet S, Overtoom R, Angebault C, Te V, Try PL, Mayaud C, Vong S, Guillard B. Pulmonary melioidosis in CAMBODIA: a prospective study. BMC Proc 2011; 5. [PMCID: PMC3019502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Blandine Rammaert
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Julien Beauté
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Laurence Borand
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Sopheak Hem
- Biomedical Laboratory, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Philippe Buchy
- Virology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Sophie Goyet
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | | | - Cécile Angebault
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Vantha Te
- Pediatric Department, Donkeo Provincial Hospital, Takeo, Cambodia
| | - Patrich Lorn Try
- Pediatric Department, Provincial Hospital, Kampong Cham, Cambodia
| | - Charles Mayaud
- Pneumology and Intensive Care Unit, Hôpital Tenon, Paris, France
| | - Sirenda Vong
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Bertrand Guillard
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
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Vong S, Huy R, Ong S, Teurlai M, Ly S, Beauté J, Duong V, Buchy P. Epidemiology and burden of dengue in Cambodia. BMC Proc 2011. [PMCID: PMC3019475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Sirenda Vong
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Rekol Huy
- National Center for Malariology, National Dengue Surveillance Program, Phnom Penh, Cambodia
| | - Sivuth Ong
- Virology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Magali Teurlai
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Sowath Ly
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Julien Beauté
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Veasna Duong
- Virology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Philippe Buchy
- Virology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
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Rammaert B, Goyet S, Beauté J, Hem S, Te V, Try PL, Mayaud C, Borand L, Buchy P, Guillard B, Vong S. Klebsiella pneumoniae related community-acquired acute lower respiratory infections in CAMBODIA: clinical characteristics and treatment. BMC Proc 2011. [PMCID: PMC3019501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Blandine Rammaert
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Sophie Goyet
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Julien Beauté
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Sopheak Hem
- Biomedical Laboratory, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Vantha Te
- Pediatric Department, Donkeo Provincial Hospital, Takeo, Cambodia
| | - Patrich Lorn Try
- Pediatric Department, Provincial Hospital, Kampong Cham, Cambodia
| | - Charles Mayaud
- Pneumology and Intensive Care Unit, Hôpital Tenon, Paris, France
| | - Laurence Borand
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Philippe Buchy
- Virology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Bertrand Guillard
- Biomedical Laboratory, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Sirenda Vong
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
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Abstract
Background Dengue is endemic in Cambodia (pop. estimates 14.4 million), a country with poor health and economic indicators. Disease burden estimates help decision makers in setting priorities. Using recent estimates of dengue incidence in Cambodia, we estimated the cost of dengue and its burden using disability adjusted life years (DALYs). Methods Recent population-based cohort data were used to calculate direct and productive costs, and DALYs. Health seeking behaviors were taken into account in cost estimates. Specific age group incidence estimates were used in DALYs calculation. Results The mean cost per dengue case varied from US$36 - $75 over 2006-2008 respectively, resulting in an overall annual cost from US$3,327,284 in 2008 to US$14,429,513 during a large epidemic in 2007. Patients sustain the highest share of costs by paying an average of 78% of total costs and 63% of direct medical costs. DALY rates per 100,000 individuals ranged from 24.3 to 100.6 in 2007-2008 with 80% on average due to premature mortality. Conclusion Our analysis confirmed the high societal and individual family burden of dengue. Total costs represented between 0.03 and 0.17% of Gross Domestic Product. Health seeking behavior has a major impact on costs. The more accurate estimate used in this study will better allow decision makers to account for dengue costs particularly among the poor when balancing the benefits of introducing a potentially effective dengue vaccine.
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Affiliation(s)
- Julien Beauté
- Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Bd Monivong 5, BP 983 Phnom Penh, Cambodia.
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Beauté J, Levy P, Millet V, Debré M, Dudoit Y, Le Mignot L, Tajahmady A, Thomas C, Suarez F, Pellier I, Hermine O, Aladjidi N, Mahlaoui N, Fischer A. Economic evaluation of immunoglobulin replacement in patients with primary antibody deficiencies. Clin Exp Immunol 2009; 160:240-5. [PMID: 20041884 DOI: 10.1111/j.1365-2249.2009.04079.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Lifelong immunoglobulin replacement is the standard, expensive therapy for severe primary antibody deficiencies. This treatment can be administrated either by intravenous immunoglobulin (IVIG) or subcutaneous infusions (SCIG) and delivered at home or in an out-patient setting. This study aims to determine whether SCIG is cost-effective compared with IVIG from a French social insurance perspective. Because both methods of administration provide similar efficacies, a cost-minimization analysis was performed. First, costs were calculated through a simulation testing different hypothesis on costs drivers. Secondly, costs were estimated on the basis of field data collected by a questionnaire completed by a population of patients suffering from agammaglobulinaemia and hyper-immunoglobulin (Ig)M syndrome. Patients' satisfaction was also documented. Results of the simulation showed that direct medical costs ranged from 19 484 euro for home-based IVIG to 25 583 euro for hospital-based IVIG, with home-based SCIG in between at 24 952 euro per year. Estimations made from field data were found to be different, with significantly higher costs for IVIG. This result was explained mainly by a higher immunoglobulin mean dose prescribed for IVIG. While the theoretical model showed very little difference between SCIG and hospital-based IVIG costs, SCIG appears to be 25% less expensive with field data because of lower doses used in SCIG patients. The reality of the dose difference between both routes of administration needs to be confirmed by further and more specific studies.
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Affiliation(s)
- J Beauté
- Centre de Référence Déficits Immunitaires Héréditaires, Hôpital Necker-Enfants Malades, AP-HP, Paris, France.
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Gathmann B, Grimbacher B, Beauté J, Dudoit Y, Mahlaoui N, Fischer A, Knerr V, Kindle G. The European internet-based patient and research database for primary immunodeficiencies: results 2006-2008. Clin Exp Immunol 2009; 157 Suppl 1:3-11. [PMID: 19630863 DOI: 10.1111/j.1365-2249.2009.03954.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Primary immunodeficiencies (PID) are rare diseases; therefore transnational studies are essential to maximize the scientific outcome and to improve diagnosis and therapy. In order to estimate the prevalence of PID in Europe as well as to establish and evaluate harmonized guidelines for the diagnosis and treatment of PID, the European Society for Immunodeficiencies (ESID) has developed an internet-based database for clinical and research data on patients with PID. This database is a platform for epidemiological analyses as well as the development of new diagnostic and therapeutic strategies and the identification of novel disease-associated genes. Within 4 years, 7430 patients from 39 countries have been documented in the ESID database. Common variable immunodeficiency (CVID) represents the most common entity, with 1540 patients or 20.7% of all entries, followed by isolated immunoglobulin (Ig)G subclass deficiency (546 patients, 7.4%). Evaluations show that the average life expectancy for PID patients varies from 1 to 49 years (median), depending on the type of PID. The prevalence and incidence of PID remains a key question to be answered. As the registration progress is far from finished we can only calculate minimum values for PID, with e.g. France currently showing a minimum prevalence of 3.72 patients per 100,000 inhabitants. The most frequently documented permanent treatment is immunoglobulin replacement; 2819 patients (42% of all patients alive) currently receive this form of treatment.
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Affiliation(s)
- B Gathmann
- Department of Rheumatology and Clinical Immunology, University Medical Center Freiburg, Freiburg, Germany
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48
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Abstract
OBJECTIVE Sciatica is thought to have a good clinical outcome, but in fact, its natural history is not well known. STUDY DESIGN AND SETTING We studied a prospective cohort of 3,164 workers from the French national electricity and gas company. In this cohort, 622 subjects suffered from sciatica in 1991. The predictive factors of the persistence or recurrence of sciatica after 2 years were identified by multivariate analysis (logistic regression). RESULTS Of the 622 subjects with sciatica in 1991, 55% still reported its symptoms in 1993 and 53% in 1995. Of those who had recovered from sciatica in 1993, 61% still had low back pain and 27% of them long-lasting low back pain in 1993. The factors predictive of the persistence or recurrence of sciatica in 1993, identified by multivariate analysis, were: driving at least 2 hr/day, carrying heavy loads at work, a high level of psychosomatic problems, and sciatica symptoms the year before study inclusion. CONCLUSION Recovery from sciatica is less frequent than expected. Attention should be given to occupational and personal factors associated with persistence or recurrence of sciatica.
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Affiliation(s)
- Florence Tubach
- INSERM U88, Hôpital National de Saint Maurice, 94415 Saint-Maurice Cedex, France.
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