Eurosurveillance - Volume 16, Issue 46, 17 November 2011

Following civil unrest in North Africa early in 2011, there was a large influx of migrants in Italy. A syndromic surveillance system was set up in April to monitor the health of this migrant population and respond rapidly to any health emergency. In the first six months, the system produced 67 alerts across all syndromes monitored and four alarms. There were no health emergencies, however, indicating that this migration flow was not associated with an increased risk of communicable disease transmission in Italy.

Human T-lymphotropic virus (HTLV) infection is rare in the United Kingdom (UK) and few studies are available worldwide. Following introduction of blood donation testing in 2002, a cohort of individuals could be identified and prospectively recruited to describe progression and onset of disease. Here we describe baseline characteristics of participants, and evaluate recruitment into the UK HTLV National Register over the first six years, from July 2003 to June 2009. A multicentre cohort study recruited participants from the UK blood services (recipients and donors) and specialist HTLV clinics. Almost half of the 148 participants recruited were blood donors, nine were blood transfusion recipients, 40 contacts and 29 clinic attendees (nine asymptomatic and 20 symptomatic). Most participants were HTLV-1 positive (n=115); 11 had HTLV-2 and 22 were HTLV-negative. Baseline self-completion questionnaires were received for 83%. The most commonly reported condition was a past operation/serious illness (69%). Twenty-six participants reported four or more possible signs/symptoms of HTLV-1-associated myelopathy/tropical spastic paraparesis. Recruitment into a study of a rare, long-term infection is challenging. This cohort will enable descriptions of HTLV-associated disease progression amongst people recruited from varying sources; it is the first prospective study of its kind in Europe.

In June 2009, 11 outbreaks of food poisoning occurred in France, involving 45 individuals who had consumed mussels harvested in Vilaine Bay (Northwestern France). Because the toxic dinoflagellate Dinophysis spp. had been detected in the area from mid-May, okadaic acid (OA) and dinophysistoxins were suspected to be the cause of these outbreaks, although the weekly monitoring tests by mouse bioassay had been negative. With the help of the French reporting system for food-borne disease outbreaks, the detailed data on epidemiology, mussel consumption and complete product traceback, were collected for 11 individuals involved in three reported outbreaks. The batch of mussels identified as the source of these three outbreaks contained concentrations of toxins of the okadaic acid group that were approximately eight times higher than the European regulatory limit. Moreover, based on the consumption data available for the 11 cases, a lowest observable adverse effects level (LOAEL) was deduced. The LOAEL calculated from this study, although based on a very limited number of individuals, was in the same range, i.e. approximately 50 ?g OA equivalents per person, as the LOAEL established by the European Food Safety Authority in 2006.