Eurosurveillance - Volume 15, Issue 23, 10 June 2010

We report a fatal case of overwhelming pneumococcal infection in an asplenic young adult not vaccinated against Streptococcus pneumoniae (S. pneumoniae). Post-mortem microbiological investigations revealed the presence of S. pneumoniae in blood samples and lungs. Serotyping by molecular methods identified the presence of a 6C serotype not comprised in the current 23-valent pneumococcal vaccine, highlighting that a risk of fatal infections may persist even in vaccinated splenectomised individuals.

The Eyjafjallajökull volcano in Iceland erupted on 14 April 2010 emitting a volcanic ash plume that spread across the United Kingdom and mainland Europe. The Health Protection Agency and Health Protection Scotland used existing syndromic surveillance systems to monitor community health during the incident: there were no particularly unusual increases in any of the monitored conditions. This incident has again demonstrated the use of syndromic surveillance systems for monitoring community health in real time. .

Multidrug-resistant (MDR) Salmonella Concord has been associated with adoptees from Ethiopia. In 2009, Denmark saw an increase in MDR S. Concord infections: all eight cases reported in 2009 were among Ethiopian adoptees. The upsurge was linked to an increased number of infants adopted from Ethiopia. Data from other European countries suggests that they may face a similar problem.

Mumps is a mandatorily notifiable disease in the former Yugoslav Republic of Macedonia. Routine vaccination with one dose of measles-mumps-rubella (MMR) vaccine at the age of 13 months started in 1983 and a two-dose vaccination schedule, with the second dose at the age of seven years, was implemented in 1997. The previous mumps outbreak in the country was reported in 1996, with 4,321 registered cases. In October 2007, an increase in mumps notifications was observed. Between January 2008 and June 2009, the Institute of Public Health received 16,352 notifications of mumps cases through the routine surveillance system. Young people aged 15-19 years (n=7,876, 48.2%) were most affected; more males (61.2%, n=10,013) were reported than females. Of the cases whose vaccination status was checked (n=14,178, 86.7%), 19.5% had not been vaccinated, 37% had been vaccinated with one MMR dose, 34.4% had received two doses, 0.6% had been vaccinated during catch-up vaccination (with MMR vaccine for people aged 15-26 years) and for 8.5% there were no records of vaccination. For 13.3% (n=2,174) of reported cases, their vaccination status was not checked. In February 2009, biological specimens (serum, saliva and urine) from 20 cases aged 15-19 years were sent to the National Institute for Public Health and the Environment (RIVM) in the Netherlands for genotyping. Of the 20, nine had been vaccinated with two doses of MMR vaccine, five with one dose, one had not been vaccinated and five had no records of vaccination). Mumps viral RNA was detected in samples from 17 patients: the sequence of the amplified small hydrophobic gene from all 17 showed that the mumps virus was genotype G5. .