Eurosurveillance - Volume 14, Issue 28, 16 July 2009

In response to the ongoing influenza A(H1N1)v pandemic, first detected in North America in April 2009, Belgium has set up an active surveillance system for influenza-like illness among travellers returning from affected areas. This communication describes the clinical and epidemiological features of the first 43 laboratory-confirmed cases in Belgium.

We report an outbreak of Shigella dysenteriae type 2 infections during May- June 2009 in Sweden, involving 47 suspected cases of whom 35 were laboratory-confirmed. The epidemiological investigation based on interviews with the patients pointed at sugar snaps from Kenya as the source. Shigella was not detected in samples of sugar snaps. However, Escherichia coli was confirmed in three of four samples indicating contamination by faecal material. During April to May 2009 outbreaks with Shigella connected to sugar snaps from Kenya were reported from Norway and Denmark. In the three countries trace back of the indicated sugar snaps revealed a complex system with several involved import companies and distributers. In Sweden one wholesale company was identified and connections were seen to the Danish trace back. These three outbreaks question whether the existing international certification and quality standards that are in place to prevent products from contamination by faecal pathogens are strict enough.

We report the first foodborne outbreak caused by Cryptosporidium parvum in Finland. The outbreak occurred among personnel of the Public Works Department in Helsinki, who had eaten in the same canteen. 72 persons fell ill with diarrhoea, none was hospitalised. Four faecal samples obtained from 12 ill persons were positive for Cryptosporidium by an antigen identification assay and microscopy. The vehicle of infection could not be identified with certainty but a salad mixture was suspected.

The monoclonal antibodies and the sequence-based typing (SBT) are two methodologies widely used to characterise Legionella pneumophila strains serogroup 1 (sg1). In this study, we analysed the clinical strains received in two Portuguese laboratories since 1987, including the strains isolated in Portugal during the four years of the surveillance scheme for Legionnaires' disease implemented in 2004. In total, 63 clinical isolates of L. pneumophila sg1 were differentiated by SBT into 19 different sequence types. Ten of them were new in the SBT database of the European Working Group for Legionella Infections (EWGLI). As a result of the combination of the two methodologies, these strains were discriminated into 25 different profiles. This study enabled, for the first time in Portugal, not only to characterise the L. pneumophila sg1 clinical isolates, but also to create a database of Portuguese profiles for use in epidemiological surveillance efforts. .