Eurosurveillance - Volume 14, Issue 26, 02 July 2009

After seven years without indigenous transmission of measles in Bulgaria, an increasing number of cases have been reported since 15 April 2009. By 19 June, the total number of notifications reached 84. To date, 64 were confirmed as measles cases and 15 cases, for whom laboratory results are pending, have been classified as probable. The present measles outbreak affects mostly the Roma population living in the north-eastern part of the country. The most affected age groups are young children below 1 year of age and children 1 to 9 years of age. An immunisation campaign was started in the affected administrative regions, targeting all persons from 13 months to 30 years of age who had not received the complete two-dose MMR vaccination.

Plague is circulating regularly in localised areas worldwide, causing sporadic cases outside Africa and remains endemic or causes limited outbreaks in some African countries. Furthermore, some notable outbreaks have been reported in Asia in the last 20 years. A limited outbreak with five cases has recently been notified by the health authorities of the Libyan Arab Jamahiriya.

We use a time dependent modification of the Kermack and McKendrick model to study the evolution of the influenza A(H1N1)v epidemic reported in the Mexico City area under the control measures used during April and May 2009. The model illustrates how the sanitary measures postponed the peak of the epidemic and decreased its intensity. It provides quantitative predictions on the effect of relaxing the sanitary measures after a period of control. We show how the sanitary measures reduced the maximal prevalence of the infected population from 10% to less than 6% of the total population. We also show how the model predicts the time of maximal prevalence and explains the effect of the control measures.

To determine appropriate influenza pandemic containment and mitigation measures, health authorities need to know the approximate case fatality ratio (CFR) for this new infection. We present four different methods for very provisionally estimating the plausible range of the CFR for symptomatic infection by this pandemic strain in developed countries. All of the methods produce substantially lower values (range 0.06% to 0.0004%) than a previously published estimate for Mexico (0.4%). As these results have many limitations, improved surveillance and serological surveys are needed in both developed and developing countries to produce more accurate estimates.

The emergence of a new influenza virus strain setting off a global epidemic can put considerable strain on the current hospital capacity. The task of estimating hospital load during an influenza pandemic event remains difficult, despite a number of tools that are publicly available for decision makers today. The estimate depends on a multitude of parameters, each with associated uncertainties. We provide a new tool, StatFlu, combining advances in static modelling using historic influenza data with a pedagogical interface designed to highlight propagation of parameter settings and uncertaintiesin the output. StatFlu provides graphs of the load on hospital wards as well as primary care units as a function of time, aiding the user in decision making. Here we present the model and software. We also demonstrate it with an example and compare the results with a similar tool.

On 30 June 2009, the European Centre for Disease Prevention and Control (ECDC) launched the guidance on chlamydia control in Europe. This guidance document aims to support the European Union Member States in developing and improving their national chlamydia control strategies.