Eurosurveillance - Volume 13, Issue 25, 19 June 2008

Brucellosis is a zoonosis resulting in reproductive failure in wild and domestic animals and febrile disease and occasionally severe infections of the central nervous system and endocarditis in humans. In animals and humans alike, it is found worldwide, including southeastern Europe, the Mediterranean basin (Portugal, Spain, southern France, Italy, Greece, Turkey, northern Africa), parts of Mexico, Central and Latin America, Asia, and Africa [1]. Human brucellosis represents a professional hazard, being acquired via ingestion, inhalation in laboratories or abattoirs, conjunctiva and skin trauma contamination with infected animal tissues and products [1,2]. Symptoms can appear as acute or insidious onset, after five to 60 days and last for days, months and occasionally as long as a year. Relapses can also occur. Treatment is effective with antibiotics. Untreated brucellosis can lead to death (case-fatality ratio around 2%), usually by heart complications.

Lymphogranuloma venereum (LGV) is a systemic sexually transmitted infection (STI) caused by Chlamydia trachomatis (L serovars L1, L2 or L3). Since 2003, several outbreaks of rectal LGV affecting men who have sex with men (MSM) have occurred in western Europe [1]. The first case in Spain was confirmed in Barcelona in 2005 [2], but no further cases have been detected in this city since until September 2007. We briefly summarise the characteristics of the LGV cases diagnosed at the outpatient STI clinic in Barcelona between September 2007 and April 2008.

A new syndromic surveillance system has been developed in Bordeaux City, South West France, using a general practitioners' house calls network. Routinely collected, sociodemographic data, patients' complaints and medical diagnoses made at the end of the visit were monitored using syndrome groups such as influenza syndromes, bronchiolitis, gastrointestinal, respiratory syndromes and others, based on International Classification of Primary Care (ICPC)-2 codes. A process control chart was implemented in order to distinguish signals of interest from 'background noise'. In 2005 and 2006, a total of 303,936 visits were recorded. Seasonal epidemics of influenza-like illness, bronchiolitis or gastrointestinal were identified. The automated and real time nature of the system also allowed the early detection of unusual events such as an acute increase in the number of heat syndromes during the heat-wave that occurred in France in July 2006. This new system complements existing surveillance programs by assessing a large part of episodes of illness that do not require hospital admissions or the identification of an etiologic agent. Attributes and advantages of the system, such as timeliness and diagnostic specificity, demonstrated its utility and validity in term of syndromic surveillance purposes, and its extension at the national level is in process. .

The Swedish Strategic Programme against Antibiotic Resistance (Strama) and the Swedish Institute for Infectious Disease Control (SMI) have just published "SWEDRES/2007", the seventh report on Swedish antimicrobial utilisation and resistance in human medicine.