Eurosurveillance - Volume 14, Issue 18, 07 May 2009

The A(H5N1) influenza virus has re-emerged in 2003 in Asia, Africa, the Pacific Region as well as Europe and since then has become endemic in some countries. The virus is usually highly pathogenic and is associated with high morbidity and overall mortality rates that reach 61%.

Here, we report on the first sequence-confirmed case of infection with the new influenza A(H1N1) virus in Germany. Two direct contacts of the patient were laboratory-confirmed as cases and demonstrate a chain of direct human-to-human transmission.

The recent detection of a novel influenza A(H1N1) virus has led to the first WHO declaration of a Public Health Event of International Concern under the International Health Regulations (IHR 2005). Here we review the early epidemiological findings of confirmed cases in Mexico, the United States, Canada and EU/EFTA countries. Strengthened surveillance and continued, transparent communication across public health agencies globally will be necessary in coming months.

The age-specific infection and death profiles among confirmed human cases of influenza A(H5N1) infection in Egypt differ markedly from those recorded in other countries. The case fatality rate among human H5N1 cases in Egypt is 34%, versus an average of 66% in other countries. In Egypt, children younger than 10 years comprise 48% of reported cases, nearly twice the global average of approximately 25%, and no H5N1 fatalities have been confirmed among individuals in this age group as of 23 April 2009. Females outnumber males among confirmed H5N1 cases by a factor of nearly 2:1, and 90% of reported fatalities in Egypt have been females. The evident age and sex biases in morbidity and mortality among H5N1 cases in Egypt are phenomena that warrant further investigation and analysis.

The aim of this study was to estimate the excess mortality associated with the influenza activity registered in Portugal between week 49 of 2008 and week 5 of 2009. For this purpose available mortality data from the Portuguese Daily Mortality Monitoring (VDM) System were used. Several estimates of excess deaths associated with the recent recorded influenza activity were determined through statistical modelling (cyclic regression) for the total population and disaggregated by gender and age group. The results show that the impact of the 2008-9 influenza season was 1,961 excess deaths, with approximately 82% of these occurring in the age group of 75 years and older.

Nine hundred and forty six cases of travel-associated Legionnaires' disease were reported to the European Surveillance Scheme for Travel Associated Legionnaires' Disease (EWGLINET) with onset during 2007; 890 were confirmed and 56 were presumptive. Twenty eight cases died, giving a case fatality rate of 3.0%. 8.2% of cases were diagnosed by culture, an important increase from 5.2% in 2006. One hundred and twelve new clusters were identified; the largest involved nine cases. Sixteen of these clusters (14.3%) occurred in countries outside EWGLINET, and three involved cruise ships. Twenty nine of the new clusters (25.9%) would not have been detected without the EWGLINET scheme. A total of 151 investigations were conducted in Europe, 42 of which were conducted at re-offending sites (where additional cases had onset after a report was received to say that investigations and control measures had been satisfactorily conducted). The names of 13 accommodation sites were published on the European Working Group for Legionella Infections (EWGLI) website; 11 of these were situated in Turkey. .

Illness and death from diseases caused by unsafe food are a constant threat to public health security as well as socio-economic development throughout the world. The full extent of the burden and cost of foodborne diseases associated with pathogenic bacterial, viral and parasitic microorganisms, and food contaminated by chemicals is still unknown but is thought to be substantial. The World Health Organization (WHO) Initiative to estimate the global burden of foodborne diseases aims to fill the current data gap and respond to the increasing global interest in health information. Collaborative efforts are required to achieve the ambitious task of assessing the foodborne disease burden from all causes worldwide. Recognising the need to join forces, the WHO Initiative has assembled an alliance of stakeholders which share and support the Initiative's vision, intended objectives and outcomes. One important collaborator is the European Centre for Disease Prevention and Control (ECDC) which has embarked on a burden of disease study covering at least 18 foodborne diseases in nearly 30 countries.