Eurosurveillance - Volume 15, Issue 48, 02 December 2010

In 2009, 28 European Union and European Economic Area (EU/EEA) countries reported 25,917 newly diagnosed cases of human immunodeficiency virus (HIV). Sex among men who have sex with men was the most common transmission mode (35%) followed by heterosexual contact (24%). Overall, the number of HIV cases in 2009 increased while the number of reported acquired immunodeficiency syndrome (AIDS) diagnoses continued to decline. It is of concern that a high proportion of the patients with known CD4 cells count at the time of HIV diagnosis had a CD4 cell count below 350cells/µl suggesting no timely access to treatment and care.

We report the preliminary findings of the investigation of an outbreak of foodborne Salmonella Bareilly. Between August and November 2010, there were 231 laboratory-confirmed reports of S. Bareilly in the United Kingdom. A case-control study showed that consumption of bean sprouts was significantly associated with illness. The investigation concluded that raising public awareness to ensure the correct preparation of raw bean sprouts during cooking was the principal means of preventing further cases. .

An outbreak of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae type 2 was detected in September 2009 in two hospitals in a suburb south of Paris, France. In total, 13 KPC-producing K. pneumoniae type 2 cases (four with infections and nine with digestive-tract colonisations) were identified, including a source case transferred from a Greek hospital. Of the 13 cases, seven were secondary cases associated with use of a contaminated duodenoscope used to examine the source case (attack rate: 41%) and five were secondary cases associated with patient-to-patient transmission in hospital. All isolated strains from the 13 patients: (i) exhibited resistance to all antibiotics except gentamicin and colistin, (ii) were more resistant to ertapenem (minimum inhibitory concentration (MIC) always greater than 4 mg/L) than to imipenem (MIC: 1-8 mg/L, depending on the isolate), (iii) carried the bla_KPC-2 and bla_SHV12 genes and (iv) had an indistinguishable pulsed-field gel electrophoresis (PFGE) pattern. These cases occurred in three hospitals: some were transferred to four other hospitals. Extended infection control measures implemented in the seven hospitals included: (i) limiting transfer of cases and contact patients to other wards, (ii) cohorting separately cases and contact patients, (iii) reinforcing hand hygiene and contact precautions and (iv) systematic screening of contact patients. Overall, 341 contact patients were screened. A year after the outbreak, no additional case has been identified in these seven hospitals. This outbreak emphasises the importance of rapid identification and notification of emerging highly resistant K. pneumoniae strains in order to implement reinforced control measures. .

To identify procedures employed by publicly funded clinical diagnostic laboratories in the United Kingdom (UK) for the detection of Cryptosporidium in community cases of diarrhoea, a telephone survey was conducted between August 2008 and January 2009 of all such laboratories that test stools from community-based patients. All 200 laboratories responded: 145 (72.5%) tested all stool samples for Cryptosporidium, while 55 (27.5%) applied selection criteria. There were country and regional differences in the proportion of laboratories selectively testing stools, which were significantly correlated with Cryptosporidium report rates to national surveillance (Spearman's rank correlation coefficient (r_s)=0.61, degrees of freedom (df)=11, p=0.03). Understanding of laboratory practice is fundamental to interpreting trends in surveillance data, estimating disease burden and identifying outbreaks, as well as providing important background information against which changes and effects of new public health regulations can be measured. .