Eurosurveillance - Volume 16, Issue 27, 07 July 2011

Despite improvements in prevention, diagnosis and treatment, Lyme borreliosis (LB) is still the most common arthropod-borne disease in temperate regions of the northern hemisphere, with risk of infection associated with occupation (e.g. forestry work) and certain outdoor recreational activities (e.g. mushroom collecting). In Europe, LB is caused by infection with one or more pathogenic European genospecies of the spirochaete Borrelia burgdorferi sensu lato, mainly transmitted by the tick Ixodes ricinus. Recent surveys show that the overall prevalence of LB may be stabilising, but its geographical distribution is increasing. In addition, much remains to be discovered about the factors affecting genospecific prevalence, transmission and virulence, although avoidance of tick bite still appears to be the most efficient preventive measure. Uniform, European-wide surveillance programmes (particularly on a local scale) and standardisation of diagnostic tests and treatments are still urgently needed, especially in the light of climate change scenarios and land-use and socio-economic changes. Improved epidemiological knowledge will also aid development of more accurate risk prediction models for LB. Studies on the effects of biodiversity loss and ecosystem changes on LB emergence may identify new paradigms for the prevention and control of LB and other tick-borne diseases.

This study evaluates the ability of the Chlamydia surveillance system to provide relevant information to inform prevention and control activities in Sweden. The system was evaluated, according to the Guidelines for Evaluating Public Health Surveillance Systems from the United States Centers for Disease Prevention and Control, using surveillance data from 1997 to 2008. We interviewed staff from the Swedish Institute for Communicable Disease Control, the National Board of Health and Welfare and one county medical officer (CMO). We conducted a survey among laboratories, CMOs and a sample of clinics. Satisfaction with the system was good for 86% of CMOs, all laboratories, and 99% of clinics. The interviewed stakeholders considered the system to deliver relevant and accurate information that is useful for health policy decision making. However, the objectives for Chlamydia surveillance should be clearly defined in order to adapt the system requirements, simplify data collection and improve timeliness.

The first infection caused by pandemic influenza A(H1N1)2009 virus was confirmed in Finland on 10 May 2009. The spread of the disease and its impact were monitored using several surveillance systems, such as the national infectious disease register, notifications of clusters of influenza, influenza-like or influenza-related illnesses, as well as virological, hospital, case-based and mortality surveillance. The epidemic started in early October in the north and then spread to the south about two weeks later. Based on the data from laboratory-confirmed cases, the morbidity was highest in children. The daily number of patients hospitalised with influenza A(H1N1)2009 reached a maximum of over 400 in late November. Of the 1,580 hospitalised patients (median age 32 years), 672 (43%) had at least one chronic underlying illness, 35 (2%) were pregnant, 132 (8%) were treated in intensive care units and 74 (5%) required mechanical ventilation. The median age of patients admitted to intensive care units was 48 years and 78 ( 59%) of them had at least one chronic underlying disease, none were pregnant. Altogether 44 deaths related to influenza A(H1N1)2009 were recorded (median age 56 years): 40 belonged to high-risk groups on the basis of underlying chronic diseases. Combining data from different surveillance systems gave timely information about the spread of the pandemic and contributed to identifying risk groups.