Eurosurveillance - Volume 13, Issue 7, 14 February 2008

After contact with a dead rabbit in Baden-Wuerttemberg in southern Germany, three members of a family were infected with tularaemia in late summer 2007. The patients were a forest worker (Patient A) in his twenties, and his parents, both in their fifties. Tularaemia is very rare in Germany. From 2002 to 2006, between one and five cases were reported annually, with the exception of 2005 with 15 reported cases [1]. In 2007, 19 cases were reported, 11 of them in Baden-Wuerttemberg [2]. In the district in which the three cases occurred, no tularaemia cases had been reported in recent years.

A preliminary analysis of sentinel surveillance data of the European Network on Imported Infectious Disease Surveillance (TropNetEurop) shows 88 cases of imported schistosomiasis for 2007 (17 cases of Schistosoma haematobium, 44 of S. mansoni, 3 of S. japonicum, and 27 unknown species, e.g. early stage, Katayama fever) [1]. Although clinical reporting data for schistosomiasis are notoriously difficult to assess due to the chronic nature of the disease and thus very long periods before diagnosis is confirmed, the analysis gives a good idea about how this infection is brought into Europe.

Mortality is an important public health indicator [1]. Mortality data is accurately recorded, readily accessible, and includes precise temporal and geographical variables. During epidemic outbreaks, excess mortality can inform on the virulence of an infection. Moreover, in the absence of outbreak prevalence data, mortality can additionally inform on the spatio-temporal progression of the disease.

Chikungunya fever is a viral disease transmitted by Aedes spp mosquitoes [1]. In recent years, several outbreaks have been reported in Kenya (2004), the Comoros Islands (2005), the island of Réunion (2005, 2006), other islands in the southwest Indian Ocean (2005) and in India (2005-2006) [2,3], during which Ae. aegypti and/or Ae. albopictus were the main vectors [1]. .

In October 2007, an outbreak of verocytotoxin-producing Escherichia coli (VTEC) O145 and E. coli O26 occurred among consumers of ice cream produced and sold in September 2007 at a farm in the province of Antwerp (Belgium). The ice cream was consumed at two birthday parties and also eaten at the farm. Five children, aged between two and 11 years, developed haemolytic uraemic syndrome (HUS), and seven other co-exposed persons contracted severe diarrhoea. In three of the five HUS cases VTEC O145 infections were laboratory confirmed, one in association with VTEC O26. Identical isolates of E. coli O145 and O26 were detected with PCR and PFGE in faecal samples of patients and in ice cream leftovers from one of the birthday parties, in faecal samples taken from calves, and in samples of soiled straw from the farm at which the ice cream was produced. Ice cream was made from pasteurised milk and most likely contaminated by one of food handlers.

Mumps is not a mandatorily notifiable disease in Austria. However, in the first week of May 2006, a sudden increase in serologically confirmed cases of mumps, confined to three public health districts of the southern Austrian province of Carinthia, was identified by the Austrian Reference laboratory for MMR. An epidemiological investigation of this cluster of mumps cases was performed. A total of 214 cases fulfilled the outbreak case definition; 143 cases were laboratory confirmed and 71 cases were epidemiologically linked and fulfilled the clinical picture of the case definition. The vaccination status was known for 169 patients. Nearly half of the cases for whom the vaccination status was known occurred in non-vaccinated persons, another 40% were vaccinated with one dose of the vaccine and 11% had received two doses. Only four mumps cases occurred in children aged 14 years or younger, indicating that the vaccination coverage and the acceptance of the recommended childhood vaccinations have strongly improved within the past 15 years. Vaccination scheme failure but not vaccine failure is primarily to blame for this mumps outbreak.