Eurosurveillance - Volume 13, Issue 20, 15 May 2008

The Latvian Public Health Agency (PHA) is currently investigating an outbreak of at least 44 hepatitis A cases (as of 8 May) associated with a restaurant X in Riga, Latvia. Seven of the infected people were employees of the restaurant; 37 were customers, mostly employees from the nearby office buildings who had lunch at this restaurant.

On 4 February 2008, the Andalusian Epidemiological Surveillance Network (SVEA) was notified of two epidemiologically linked cases of measles. By 18 April 2008, a total of 142 suspected cases of measles had been reported from Algeciras, a town in the south of Spain, with a population of approximately 110 000 inhabitants. Of the 142 reports, 57 cases were confirmed, 61 are still under investigation, and in 24 cases measles was ruled out by laboratory investigation.

In Austria, Clostridium difficile is the leading cause of community-acquired bacterial diarrheal illness and the most frequently identified cause of hospital-acquired diarrhea [1]. It is the causative agent of pseudomembranous colitis. A new emerging hypervirulent strain of C. difficile - PCR ribotype 027 - causes more severe disease and is associated with a higher case-fatality-ratio than other types [2]. This increased virulence is associated with two deletions in a toxin regulator gene resulting in hyperproduction of toxins A and B. The incidence of C. difficile-associated disease (CDAD) due to type 027 is increasing in the United States, Canada, Asia and Europe [2,3,4,5,6]. In Austria, C. difficile type 027 has so far only been discovered once, in a British tourist with pseudomembranous colitis in 2006 [7]. In April 2008, C. difficile PCR ribotype 027 was found in two cases of C. difficile-associated disease affecting Austrian citizens treated in hospitals in Vienna and Graz, Austria. .

Currently, the monitoring of influenza vaccination uptake is mainly a national issue. As influenza infection easily crosses international borders, it is in the interest of all countries to have a high vaccine uptake in people who may be vulnerable when influenza spreads. A Europe-wide monitoring system can provide insight into the strengths and weaknesses of uptake rates in countries and, once sufficient levels are achieved, can safeguard the continuation of the achieved levels. This paper aims to address the following issues: a) How is influenza vaccination uptake monitored in Europe? b) What methods to monitor vaccination uptake are available and what are their limitations? c) What steps should be taken to implement a European-wide influenza vaccination uptake monitoring system? Based on existing literature and experiences in monitoring influenza vaccination uptake, an approach to set up a European-wide monitoring system is proposed. The following issues were identified as relevant for influenza vaccination uptake monitoring: a) Agreement on the population groups in which vaccination uptake should be monitored; b) The frequency of data collection; c) The importance of sharing experiences regarding existing influenza vaccination campaigns in order to learn from each other, and develop 'best practices'; d) The need to publish uptake data in close relation with influenza surveillance data and other European efforts on dissemination of vaccination knowledge. To stimulate the discussion on implementing a pan-European influenza uptake monitoring scheme the following recommendations were suggested : a) Develop a common set of variables; b) Build on experience from individual countries; c) Create a coordinating body; d) Create or identify a platform to publish the data; e) Start small and expand rapidly. .

The European Food Safety Authority (EFSA) has published a survey on Salmonella levels detected on commercial turkey farms across the European Union.