Eurosurveillance - Volume 18, Issue 27, 04 July 2013

Since January 2013, an unusual increase in hepatitis A cases has been detected in northern Italy. A total number of 352 cases were reported to the integrated surveillance system between January and the end of May 2013 and this represents a 70% increase compared to the same period of the previous year. The outbreak is ongoing and the public health authorities are continuing their investigations to establish the transmission vehicle and to control the outbreak.

The Nordic countries faced a food-borne outbreak of hepatitis A that started in October 2012 and was ongoing with 103 reported cases as of 27 June 2013. A case-control study in Denmark, Finland, Norway and Sweden, combined with trace-back investigations, has identified frozen strawberries as the likely cause of the outbreak. The origin of the berries is still being investigated. .

We report the first detection of Seoul hantavirus (SEOV) in a pet rat in Sweden. SEOV-specific antibodies were detected in the pet rat blood by focus reduction neutralising test (FRNT), and SEOV RNA in lung tissue was confirmed by reverse transcription-nested polymerase chain reaction (RT-PCR) followed by sequencing. The discovery follows the recent reports of SEOV infected pet rats, as well as associated human cases of severe haemorrhagic fever with renal syndrome (HFRS), in England and Wales.

We describe trends of Salmonella enterica serovars isolated from humans in Italy from January 1980 to December 2011. A total of 229,279 Salmonella isolates were reported during this period. Serovars Enteritidis, Typhimurium, Infantis, Derby, 4,[5],12,:i:-, and Napoli accounted for 135,783 (59%) of these isolates. Temporal trends from 2000 to 2011 varied by serovar: Enteritidis and Infantis decreased significantly (with a mean of -3.0% and -2.8% isolates per year, respectively, p<0.001); Typhimurium remained stable; while 4,[5],12:i:-, Derby and Napoli increased significantly (+66.4%, p<0.001; +8.1%, p<0.001; and +28.2%, p<0.05, respectively). Since 2000, Enteritidis fell consistently below Typhimurium, which is the most reported serovar in Italy in contrast to the international situation where Enteritidis still ranks at the top despite its significant decrease. Most serovars showed a marked seasonality, increasing over the summer months and peaking in August/September. Typhimurium, 4,[5],12:i:-, and Napoli were most likely to be isolated from children, whereas Enteritidis, Derby, and Infantis from adults. We conclude that the applied control measures are not equally efficient against the considered Salmonella serovars and that sources of infection other than those of Enteritidis (laying hens and eggs) have become increasingly important. Further investigations on the emerging serovars and on the causes related to their emergence are needed to define and implement newly tailored control measures.

We conducted a cross-sectional study in 10 primary care centres in Catalonia, to determine applicability, acceptability and effectiveness of partner notification cards used by patients diagnosed of a sexually transmitted infection (STI) and to characterise these and their sexual partners. Statutorily notifiable STIs included Chlamydia infection, gonorrhoea, syphilis, human immunodeficiency virus (HIV) infection or other STIs as deemed necessary by the treating physician. Between June 2010 and June 2011, 219 index cases were enrolled, of whom 130 were men (59.4%), 71 of them men who have sex with men (54.6%). Chlamydia infection (41.1%), gonorrhoea (17.8%) and syphilis (16.0%) were the STIs most frequently diagnosed. HIV infection accounted for 4% of cases. A total of 687 sexual partners were reported, and 300 of these were traceable through the notification card (45.7%). Those who did not report traceable contacts were older (mean age: 34 years versus 31 years, p=0.03). The main reason for not distributing the card was anonymous sexual intercourse (38%). Patient referral notification cards can reach a high percentage of sexual partners at risk. However, only few notified sexual partners attended participating health centres. Internet-based partner notification may be considered in order to reach those partners not otherwise traceable.