Eurosurveillance - Volume 16, Issue 13, 31 March 2011

From January to March 2011, 39 cases of tularaemia were diagnosed in three counties in central Norway: 21 cases of oropharyngeal type, 10 cases of glandular/ulceroglandular type, two of respiratory and two of typhoid type. Three cases were asymptomatic and clinical information was unavailable for one case. The mean age was 40.3 years (range 2-89 years). Thirty-four reported use of drinking water from private wells. An increased rodent (lemming) population and snow melting may have led to contamination of the wells with infected rodents or rodent excreta.

We present a summary of the main findings of the latest report of the European Food Safety Authority and European Centre for Disease Prevention and Control on zoonoses, zoonotic agents and food-borne outbreaks in the European Union (EU), based on data from 2009. Zoonoses are prevalent and widely distributed across several countries in the EU. The most important highlight of this report was the continuous decrease of human salmonellosis since 2005, probably due to effective control programmes in livestock.

Plasmodium falciparum malaria is endemic in Haiti, but epidemiological data are scarce. A total of 61 cases of malaria were diagnosed between November 2010 and February 2011 among 130 Haitian patients with undifferentiated fever. Three additional cases were diagnosed in expatriates not taking the recommended chemoprophylaxis. No cases were diagnosed among aid workers using chemoprophylaxis. In conclusion, malaria is a significant health problem in Leogane, Haiti. Aid workers and visitors should use chemoprophylaxis according to existing guidelines.

We conducted a case-control study to examine risk factors for isoniazid-monoresistant Mycobacterium tuberculosis in an ongoing outbreak in London. Cases were defined as individuals with an isoniazid-monoresistant strain diagnosed from 1995 to the third quarter of 2006 with an indistinguishable restriction fragment length polymorphism (RFLP) or mycobacterial interspersed repetitive unit (MIRU)-variable number tandem repeats (VNTR) pattern who were resident in or had epidemiological links with London. Controls were all other individuals reported with tuberculosis to the Health Protection Agency London regional epidemiology unit or the HPA London TB Register during 2000 to 2005. Of 293 cases, 153 (52%) were sputum smear-positive compared with 3,266 (18%) of controls. Cases were more likely to be young adults (aged between 15 and 34 years), born in the United Kingdom (OR: 2.4; 95% CI: 1.7-3.4) and of white (OR: 2.9; 95% CI: 1.8-4.8) or black Caribbean (OR: 12.5; 95% CI: 7.7-20.4) ethnicity, a prisoner at the time of diagnosis (OR: 20.2; 95% CI: 6.7-60.6), unemployed (OR: 4.1; 95% CI: 3.0-5.6), or a drug dealer or sex worker (OR: 187.1; 95% CI: 28.4-1,232.3). A total of 113 (39%) of cases used drugs and 54 (18%) were homeless. Completion of treatment gradually improved in cases from 55% among those diagnosed up to the end of 2002 compared with 65% by the end of 2006. Treatment completion increased from 79% to 83% in controls from 2000 to 2005. There are complex social challenges facing many cases in this outbreak that need to be addressed if medical interventions are to be successful.