Eurosurveillance - Volume 17, Issue 6, 09 February 2012

Community surveillance data, based on quantitative real-time polymerase chain reaction analysis, showed that one in seven children aged 5-14 years with respiratory signs tested positive for Mycoplasma pneumoniae in England and Wales from October 2011 to January 2012 - a higher proportion than that seen in previous years. Multilocus variable number tandem repeat analysis indicates that at least seven known and two novel strain types were circulating in England and Wales during this period.

Swedish laboratories reported an increase of Mycoplasma pneumoniae during the autumn 2011. Data from the laboratory in Skövde, covering 12.9% of the Swedish population, indicate an approximate increase in the number of laboratory-confirmed cases in the whole country, from around 3,500 in 2009 to 11,100 in 2011. Antibiotics are recommended only for pneumonia, not bronchitis, but compared with the autumn 2009, 42,652 more prescriptions of doxycycline and macrolides were registered in the autumn 2011.

In October 2011, two primary cases of hepatitis A virus (HAV) infection with identical HAV genotype IB strains to those seen in other outbreaks associated with semi-dried tomatoes were reported in England. Both cases had consumed semi-dried tomatoes. Epidemiological investigations revealed two additional cases of genotype IB strains with different sequences who also reported having consumed semi-dried tomatoes. In November, five cases of HAV infection with closely related strains were identified in the Netherlands. A foodborne multiple-strain outbreak is suspected.

In November 2011, a cluster of initially five cases of hepatitis A infection with closely related strains was identified in the Netherlands. England reported possibly related cases. Strains with identical sequences had been involved in previous outbreaks linked to semi-dried tomatoes. Investigation of the Dutch cluster suggested a link with ready-to-eat salads including those containing semi-dried tomatoes. Despite trace-back, a source was not identified. Vigilance is needed, and rapid sharing of data may help source-tracing.

An outbreak of salmonellosis in the summer of 2010 after a wedding party in Bavaria, Germany, was investigated, to identify vehicles and source of the outbreak and any flaws in food safety procedures. A cohort study targeting all wedding participants was carried out in addition to laboratory and environmental investigations. The overall attack rate was 59% (52/88). A group of buffet dishes containing mayonnaise was associated with the highest relative risk: 6.6 (95% CI: 1.7-25.0). Subtyping of a subset of Salmonella isolates cultured from stool samples from wedding participants and catering staff and from food samples showed the isolates to be indistinguishable (S. Enteritidis, lysotype 4/6, ribotype 3). European laws require food business operators to establish and implement food safety procedures. Investigation of the practices of the catering company revealed a lack of staff training and the absence of records of a food safety concept. Non-edible flower decorations in cold dishes were identified as a potential source of secondary contamination because their cultivation and processing are not subject to the food safety regulations minimising the risk of contamination of crops intended for human consumption. The outbreak demonstrated the importance of staff training and food safety concepts to identify and mitigate hazards to food safety.