Eurosurveillance - Volume 14, Issue 23, 11 June 2009

Since the first importation of influenza A(H1N1)v virus to Europe in late April of this year, surveillance data have been collected in the Member States of the European Union and European Free Trade Association. This is the first preliminary analysis of aggregated and individual data available as of 8 June 2009 at European level.

With the winter season on the southern hemisphere that starts in Réunion Island in June seasonal influenza activity usually increases shortly afterwards. The new influenza A(H1N1)v virus is rapidly spreading worldwide and may reach the island during the coming winter season. We have therefore enhanced influenza surveillance to detect the introduction of influenza A(H1N1)v, monitor its spread and impact on public health and characterise potential viral changes, particularly if seasonal influenza A(H1N1), resistant to oseltamivir, co-circulates with A(H1N1)v.

Outbreaks of pseudo-infection due to contamination of specimens have been described, often as localised incidents. From August 2006, several English hospital laboratories began to refer an unusually high number of isolates of the fungus Paecilomyces variotii from clinical specimens to the national mycology reference laboratory for microbiological testing. We describe the methods used during the outbreak investigation in order to provide infection control specialists with an overview of how such national incidents may be investigated. We surveyed the hospitals reporting the contamination problem and conducted microbiological and environmental sampling. We applied analytical epidemiology to supply chain data, comparing the supply lines of key equipment to affected and unaffected hospitals in England. The survey was useful to describe procedures and equipment in use in the hospitals reporting the problem. The microbiological aspects of the investigation helped us understand how the fungal spores were distributed in the hospital environment. In the supply chain investigation we used data that was previously only used for logistical purposes. Overall the investigation were methodologically challenging, with no existing protocol to guide the investigators. To our knowledge, this is a novel approach to the investigation of such a widespread contamination problem, affecting geographically disparate hospitals at the same time.

We describe here the results of respiratory syncytial virus (RSV) detection by reverse transcription polymerase chain reaction (RT-PCR) during two consecutive seasons, from December 2006 to February 2007 and from October 2007 to March 2008, performed in the National Laboratory of Influenza and Acute Respiratory Diseases, Bulgaria. A total number of 278 nasopharyngeal samples obtained from hospitalised children up to the age of five years were investigated for these two seasons. During the first season, the aetiological role of RSV was confirmed in 56 of 148 samples (37.8%) compared to 11 of 130 samples (8.5%) during the second season. Since the beginning of January 2008, RT-PCR for the detection of the recently identified human metapneumovirus (HMPV) has also been introduced in Bulgaria. This virus has been demonstrated as the aetiological agent in 13 out of 81 samples (16%) from children of the same age group. The use of RT-PCR allows the detection of a broader spectrum of viruses causing respiratory diseases, as well as better discrimination of the aetiological agents in clinically similar cases.