Eurosurveillance - Volume 13, Issue 28, 10 July 2008

Denmark is currently experiencing an unusually large outbreak of gastrointestinal illness caused by Salmonella Typhimurium, phage type U292. The outbreak was discovered in early April by molecular typing (MLVA typing) of S. Typhimurium isolates at the Statens Serum Institut (SSI); the first patients reported onset on illness in February, but the number of reported cases has been particularly high in May and June (Figure 1). There are currently (as of 7 July) 366 confirmed cases, effectively making this the largest outbreak of salmonella infections in Denmark since 1993 [1].

Hamaguchi et al. recently reported on the on the occurrence of enterovirus type 71 (EV71) subgenogroup C4 in Japan [1]. According to the authors, this strain may have emerged in mainland China and in Taiwan. EV71 subgenogroup C4 has recently gained public health interest following reports of an ongoing outbreak in China and Vietnam in 2008: In June 2008, more than 176,000 cases of hand, foot and mouth disease (HFMD) were reported in China alone, and at least 24 deaths have been attributed to EV71 [2,3]. In the largest and most severe EV71-associated HFMD outbreak in Taiwan in 1998, 405 children had severe neurological complications and/or pulmonary oedema; 78 children died [4].

Controlling sexually transmitted Chlamydia trachomatis in Europe is important because it is one of the most common notifiable infections in many European and other industrialised countries. Prevalence is highest in young sexually active adults, with infection rates of 2-6% estimated in population-based studies among under 30 year-olds in the Netherlands [1], Denmark [2], and the United Kingdom (UK) [3]. Untreated genital chlamydia infections can cause tubal infertility, ectopic pregnancy, and chronic pelvic pain in women and epididymo-orchitis in men [4]. During pregnancy, chlamydia infections are associated with adverse outcomes and neonatal infections [4]. HIV infection is also transmitted more easily in the presence of co-infection with Chlamydia [4].

Hantavirus infections are widely distributed in Europe with the exception of the far north and the Mediterranean regions. The underlying causes of varying epidemiological patterns differ among regions: in western and central Europe epidemics of haemorrhagic fever with renal syndrome (HFRS) caused by hantavirus infections follow mast years with increased seed production by oak and beech trees followed by increased rodent reproduction. In the northern regions, hantavirus infections and HFRS epidemics occur in three to four year cycles and are thought to be driven by prey - predator interactions. Hantavirus infections and HFRS seem to be on the increase in Europe, partly because of better diagnostics, partly perhaps due to environmental changes. Unfortunately, hantavirus infections are still heavily under-diagnosed in many European countries. Here we report the results of a survey conducted in 2007 amongst the member laboratories of the European Network for diagnostics of Imported Viral Diseases (ENIVD).

The EpiNorth website (http://www.epinorth.org) has recently been updated with 2007 data.

On 30 May 2008, a Memorandum of Understanding was signed between Eurosurveillance and EpiNorth Journal to strengthen the existing good collaboration between the editorial teams of the two journals.