Eurosurveillance - Volume 13, Issue 5, 31 January 2008

In this weeks issue of Eurosurveillance, Zambon and colleagues describe the first findings of the European Union-funded European Surveillance Network for Vigilance Against Viral Resistance (VIRGIL) of some seasonal influenza viral isolates resistant to the antiviral drug oseltamivir in Europe.

Surveillance of the antiviral susceptibility of influenza viruses circulating in Europe has been established since 2004 through the European Union-funded European Surveillance Network for Vigilance against Viral Resistance (VIRGIL), in collaboration with the European Influenza Surveillance Scheme (EISS), the World Health Organization (WHO) and national influenza centres. Results from analysis of early winter (November 2007 - January 2008) A(H1N1) virus isolates has revealed that a significant proportion, approximately 14% of these European strains (see Table), are resistant to oseltamivir (Tamiflu), the most widely used anti-influenza drug, but retain sensitivity to zanamivir (Relenza) and amantadine/rimantadine. .

An outbreak of highly pathogenic avian influenza (HPAI) H5N1 in a poultry farm in Suffolk, United Kingdom, in November 2007 prompted a comprehensive public health response to stop the transmission of avian influenza to humans. A total of 176 of 178 potentially exposed (99%) received oseltamivir prophylaxis. The majority of them, 169 people (96%), received the influenza vaccine during the outbreak. Thirty people who had been given post-exposure prophylaxis were actively followed up for one week. None of them developed symptoms suggestive of influenza-like illness. Serological investigation (28-day testing) of those who reported symptoms is ongoing.

A case of falciparum malaria acquired in Goa, India, has recently been reported to the European Network on Imported Infectious Disease Surveillance (TropNetEurop, http://www.tropnet.net). The report relates to a Swedish woman in her fifties who had spent two weeks in Goa (Candolim beach) and Kerala in India without taking malaria chemoprophylaxis. In mid-December 2007, approximately two weeks after returning to Sweden, she fell ill with fever and a mild cough. Ten days after the onset of symptoms, thick and thin films were done and an infection with Plasmodium falciparum with a parasitaemia of 1.8% was diagnosed. The patient was admitted to hospital, uneventfully treated with a standard dose of mefloquine and discharged four days later.

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