Eurosurveillance - Volume 11, Issue 1, 01 January 2006

As in Amsterdam [1], the impetus for UK guidelines for hygienic tattooing came from an outbreak of hepatitis B caused in 1978 by a tattooist. The outbreak resulted in 30 primary and three secondary cases [2]. Guidelines for hygienic tattooing followed soon after, and were taken up, fairly enthusiastically on the whole, by the tattooists. These were expanded in 1982 to include acupuncture, ear-piercing and hair electrolysis. Laws to control the hygiene of these practitioners were introduced at the same time {Local Government Miscellaneous Provisions Act 1982 [amended 2003] and the Greater London Council [General Powers] Act 1982}. Body piercing was hardly heard of at the time: although it was undoubtedly and somewhat furtively practised, it was not as popular or as open as it is now. Guidelines for beauty therapy, hygienic hairdressing and micropigmentation followed.

Trichinellosis is a zoonotic disease caused by the ingestion of raw meat containing larvae of the nematode Trichinella. Four species of Trichinella are found in Europe : Trichinella spiralis (cosmopolitan), T. britovi (in wildlife from mountainous areas), T. nativa (in wildlife from colder and northern regions) and T. pseudospiralis (a cosmopolitan nonencapsulating species). Human trichinellosis causes high fever, facial oedema, myositis and eosinophilia. It can be a serious disease, particularly in elderly patients in whom neurological or cardiovascular complications can lead to death.

Tattooing, body piercing and permanent makeup are increasing in popularity. Here, we describe the procedures involved in these practices, their risks, the content of guidelines developed by the Municipal Health Service in Amsterdam (the Netherlands) to reduce infection risks, the legislation in the city of Amsterdam, and results of monitoring in tattoo and piercing studios.

In 2004, an outbreak of hepatitis A occurred in European tourists returning from Egypt. The reported hepatitis A attack rates varied considerably between tourists from different European countries. To determine the reason for this divergence in attack rates, a survey was undertaken with the following objectives: (a) documentation of national hepatitis A prevention policies for people travelling to Egypt and (b) documentation of hepatitis A reporting practices in these countries. A questionnaire was compiled and distributed to 13 European countries. All eight of the countries that responded had produced guidelines for the prevention of travel-associated hepatitis A. Between 2001-2003, 40% (range 4-51) of hepatitis A cases reported annually were associated with travel abroad. This occurred despite the fact that all countries recommended active vaccination with hepatitis A vaccine for people travelling to Egypt for holidays. There was no standard case definition for reporting confirmed cases in the countries that reported hepatitis A cases. As it is likely that travel-associated infections will increase as more people take overseas holidays, innovative ways to increase the number of travellers who seek and adhere to appropriate medical advice prior to travel must be explored. In addition, we recommend the use of the European Commission case definition for notification of confirmed cases of hepatitis A.

The first case of severe acute respiratory syndrome (SARS) in France was diagnosed in March 2003. We conducted a serological survey to assess whether or not asymptomatic persons who had been in contact with this patient during his infectious stage had been infected. They were interviewed and asked to provide a blood sample for SARS coronavirus immunoglobulin G antibody testing. Despite the likely high infectivity of the SARS patient, no asymptomatic SARS infection was found in any of the 37 contacts included. These findings support a SARS case definition that is essentially based on clinical and epidemiological assessment, should SARS re-emerge.

Methicillin resistant Staphylococcus Aureus (MRSA) infection is an emerging community pathogen. Community-acquired MRSA (CA-MRSA) has been associated with virulent strains producing Panton-Valentine leukocidin (PVL) and a variety of other exotoxins. In Geneva, PVL-producing CA-MRSA was first reported in 2002 and a surveillance system based on voluntary reporting was set up.

Methicillin-resistant Staphylococcus aureus has become an emerging public health problem worldwide, no longer only associated with healthcare-associated infections. With the exception of some recent reports concerning infections in cats, dogs and horses, infections with MRSA in companion animals have been infrequently reported. Here we submit findings for MRSA infections in horses in a central European university hospital.

A new EU directive relating to meat inspection for Trichinella, expected to come into force in 2006, imposes important modifications to current legislation. Nevertheless, several issues need more attention. Optimisation of methods, especially concerning sensitivity and digestibility of the meat to be inspected, along with further simplification of the legislation with regard to the number of techniques accepted, is recommended to guarantee that all member states of the EU will be given tools to perform inspection of consumer meat at the same high level. Additionally, there is a need for guidelines and protocols regarding optimal proficiency testing procedures.