Eurosurveillance - Volume 13, Issue 45, 06 November 2008

To date, 276 clinical diagnosed cases of measles have been notified in Gibraltar. The outbreak, which has been ongoing since August 2008 and affected almost 1% of the local population, unmasked errors in vaccination uptake assumptions and highlighted the need for improved data recording and research on disease transmission rates in small crowded populations.

Italy has been classified as rabies-free since 1997. In October 2008, two foxes have been diagnosed with rabies in the Province of Udine, north-east Italy. One case of human exposure caused by a bite from one of the foxes has occurred and was properly treated.

Between 2003 and 2007, a yearly average of six cases of West Nile virus neuroinvasive infection were diagnosed in Hungary. In 2008, 14 cases have been confirmed by the end of October. In contrast with previous years the infection has now appeared also in the north-western part of the country which is endemic for tick-borne encephalitis.

Ciguatera is a toxic poisoning due to ingestion of fish and is rarely reported in France. Little is known about this imported tropical disease. We present a case observed in Paris in a traveller returning from the Dominican Republic.

Following the fatal invasive meningococcal disease in a Swiss student who had been visiting Berlin, several public health institutions on local, regional and national level cooperated to ensure that the appropriate measures such as contact tracing and post exposure prophylaxis were taken to prevent further cases. The incidence highlighted the importance of early disease notification and showed that if an infectious disease requiring public health action occurs in an international context, it is vital that relevant information is communicated to all levels of the public health systems of the countries involved.

In October 2007 an increase in laboratory-confirmed cryptosporidiosis cases in Staffordshire, England prompted an outbreak investigation. Case ascertainment included interviewing suspected cases and contacts and obtaining faecal specimens from those with diarrhoea for laboratory identification. Over a three-month period we identified 57 cases of cryptosporidiosis (39 confirmed) distributed across 36 households. The majority of cases (69%) were younger than 20 years. The most plausible exposure was multiple swimming episodes (56% of cases) in 13 local public swimming pools. One large swimming pool was most frequently visited by swimmers and considered a significant contributor to transmission because of substandard filtration and maintenance systems. Control measures focused on inspecting and improving operating standards at swimming pools, hygiene information to swimmers, and early detection and exclusion of cases. The rapid case investigation described in this paper provided adequate information for the early detection and control of a typical seasonal swimming pool related cryptosporidiosis outbreak. Ensuring adequate filtration standards at public swimming pools particularly before the high use periods of late summer and autumn remains a priority.

The objective of this study was to estimate the lifetime age-specific cumulative incidence of self-reported genital warts diagnosis in Slovenia and to explore the association with demographic characteristics and self-reported sexual behaviour. Data were collected in the period from November 1999 to February 2001 from a national probability sample of the general population aged 18-49 years through a combination of face-to-face interviews at the respondents' homes and anonymous self-completed questionnaires. In total, 849 men and 903 women were interviewed (response: 63.3% men, 70.9% women). Among sexually experienced respondents with available information (752 men and 842 women), previous diagnosis of genital warts was reported by 0.3% of men (95% confidence interval (CI): 0.0%-1.3%) and 0.4% of women (95% CI: 0.1%-1.1%), and in the age group of 40-49 year-olds by 0.5% of men (95% CI:0.0-3.2) and 0.7% of women (95% CI: 0.2%-2.9%). In comparison to women with fewer than 10 lifetime male partners, those who reported to have had at least 10 male partners were more likely to have a previous diagnosis of genital warts (adjusted odds ratio: 7.2 (95% CI: 1.1%-47.8%). The lifetime cumulative incidence of self-reported genital warts diagnosis among Slovenians was relatively low in comparison to other published estimates from probability sample surveys in the general population in European countries. Our findings will inform the Slovenian vaccination policy against human papillomaviruses (HPV) and contribute to a better understanding of the differences between European countries regarding the burden of genital warts.

Investigating and reporting of foodborne outbreaks became mandatory with Directive 2003/99/EC. In 2006 and 2007 the Community reporting system for foodborne outbreaks was further developed in an interdisciplinary approach, which is described in this paper. This involved experts on investigating and reporting foodborne outbreaks as well as experts on communicable diseases in addition to the European Food Safety Authority (EFSA) Task Force for Zoonoses Data Collection, the European Centre for Disease Prevention and Control (ECDC) Advisory Forum and representatives of ECDC, the World Health Organization (WHO), the World Organization for Animal Health (OIE) and the European Commission. European Union Member States participated in a survey regarding their national reporting systems and the needs for information on foodborne outbreaks at the Community level. The acceptability, the functionality and the data quality of the current reporting system were evaluated. The results were used to propose new variables on which data should be reported. Pick-lists were developed to facilitate reporting and better integration of the Community system with Member States' reporting systems. The new system is expected to yield better quality data on foodborne outbreaks relevant for risk assessment and risk management while reducing the work load for Member States.