Eurosurveillance - Volume 13, Issue 4, 24 January 2008

Secondary cases of meningococcal disease among healthcare workers are rare and avoidable. In this report, we describe a secondary infection in a healthcare worker who did not have significant contact with respiratory secretions of the index case.

Increased influenza activity was reported in 13 European countries in week 2 of 2008: Austria, Bulgaria, France, Hungary, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Slovenia, Spain, Switzerland and the UK. Based on historical trends, influenza activity is expected to increase in more countries in the coming weeks and to move gradually eastwards and northwards in Europe [1]. Influenza activity is mainly associated with type A influenza virus, subtype H1, which usually causes only mild- to medium-intensity influenza epidemics.

Two prophylactic human papillomavirus (HPV) vaccines have been licensed in Europe: the quadrivalent vaccine, Gardasil® (Sanofi Pasteur MSD) and the bivalent vaccine, Cervarix® (GlaxoSmithKline Biologicals) [1,2]. Both vaccines are made from virus-like particles and are non-infectious [3]. Both vaccines protect against the high-risk HPV types 16 and 18, which cause an estimated 73% of cervical cancer cases in Europe. Gardasil also protects against HPV 6 and 11, which cause most cases of genital warts. Both vaccines have a good safety profile. They have been shown to prevent more than 90% of precancerous lesions associated with types 16 or 18 among HPV naïve women in clinical trials [4]. .

For the last four years Greece has faced a large number of infections, mainly in the intensive care units (ICU), due to carbapenem-resistant, VIM-1-producing Klebsiella pneumoniae. The proportion of imipenem-resistant K. pneumoniae has increased from less than 1% in 2001, to 20% in isolates from hospital wards and to 50% in isolates from ICUs in 2006. Likewise, in 2002, these strains were identified in only three hospitals, whereas now they are isolated in at least 25 of the 40 hospitals participating in the Greek Surveillance System. This situation seems to be due to the spread of the blaVIM-1 cassette among the rapidly evolving multiresistant plasmids and multiresistant or even panresistant strains of mainly K. pneumoniae and also other enterobacterial species. However, the exact biological basis of this phenomenon and the risk factors that facilitate it are not yet fully understood. Moreover, the fact that most strains display minimum inhibitory concentration (MIC) values below or near the Clinical Laboratory Standard Institute (CLSI) resistance breakpoint create diagnostic and therapeutic problems, and possibly obstruct the assessment of the real incidence of these strains.

It has been estimated that 30 percent of people living with HIV in the European Union (EU) are unaware of their infection [1]. As undiagnosed patients cannot benefit from early treatment and may unknowingly transmit HIV to others, this situation poses a major challenge in the fight against the HIV/AIDS epidemic.