Eurosurveillance - Volume 20, Issue 16, 23 April 2015

Onchocerca lupi, a nematode parasite infecting dogs and cats with a hitherto unknown arthropod vector, is also being recognised as a parasite also responsible for human eye infections. Here we describe a case of human eye infection diagnosed molecularly by nematode 12S rDNA PCR in a German patient who had travelled to Tunisia and Turkey. The patient recovered after treatment with antibiotic and anti-inflammatory therapy.

In accordance with the goal of the World Health Organization Regional Office for Europe, the Italian national measles and rubella elimination plan aims to reduce the incidence of congenital rubella cases to?less than?one case per 100,000 live births by the end of 2015. We report national surveillance data for congenital rubella and rubella in pregnancy from 2005 to 2013. A total of 75 congenital rubella infections were reported; the national annual mean incidence was 1.5/100,000 live births, including probable and confirmed cases according to European Union case definition. Two peaks occurred in 2008 and 2012 (5.0 and 3.6/100,000 respectively). Overall, 160 rubella infections in pregnancy were reported; 69/148 women were multiparous and 38/126 had had a rubella antibody test before pregnancy. Among reported cases, there were 62 infected newborns, 31 voluntary abortions, one stillbirth and one spontaneous abortion. A total of 24 newborns were unclassified and 14 women were lost to follow-up, so underestimation is likely. To improve follow-up of cases, systematic procedures for monitoring infected mothers and children were introduced in 2013. To prevent congenital rubella, antibody screening before pregnancy and vaccination of susceptible women, including post-partum and post-abortum vaccination, should be promoted. Population coverage?of two doses of measles-mumps-rubella vaccination of ≥?95% should be maintained and knowledge of health professionals improved.

We report an outbreak of Salmonella Enteritidis phage type 14b (PT14b) in the United Kingdom (UK) between May and September 2014 where Public Health England launched an investigation to identify the source of infection and implement control measures. During the same period, outbreaks caused by a Salmonella Enteritidis strain with a specific multilocus variable-number tandem repeat analysis (MLVA) profile occurred in other European Union Member States. Isolates from a number of persons affected by the UK outbreak, who had initially been tested by MLVA also shared this particular profile. Cases were defined as any person infected with S. Enteritidis PT14b, resident in England or Wales and without history of travel outside of this geographical area during the incubation period, reported from 1 June 2014 onwards, with a MLVA profile of 2-11-9-7-4-3-2-8-9 or a single locus variant thereof. In total, 287 cases met the definition. Food traceback investigations in the UK and other affected European countries linked the outbreaks to chicken eggs from a German company. We undertook whole genome sequencing of isolates from UK and European cases, implicated UK premises, and German eggs: isolates were highly similar. Combined with food traceback information, this confirmed that the UK outbreak was also linked to a German producer. .

This perspective on hepatitis A in the European Union and European Economic Area (EU/EEA) presents epidemiological data on new cases and outbreaks and vaccination policies. Hepatitis A endemicity in the EU/EEA ranges from very low to intermediate with a decline in notification rates in recent decades. Vaccination uptake has been insufficient to compensate for the increasing number of susceptible individuals. Large outbreaks occur. Travel increases the probability of introducing the virus into susceptible populations and secondary transmission. Travel medicine services and healthcare providers should be more effective in educating travellers and travel agents regarding the risk of travel-associated hepatitis A. The European Centre for Disease Prevention and Control (ECDC) endorses the World Health Organization's recommendations on vaccination of high-risk groups in countries with low and very low endemicity and on universal vaccination in countries with intermediate endemicity. Those recommendations do not cover the use of hepatitis A vaccine to control outbreaks. ECDC together with EU/EEA countries should produce evidence-based recommendations on hepatitis A immunisation to control outbreaks. Data about risk behaviours, exposure and mortality are scarce at the EU/EEA level. EU/EEA countries should report to ECDC comprehensive epidemiological and microbiological data to identify opportunities for prevention. .

Prompt evaluation of annual influenza vaccine effectiveness (IVE) is important. IVE is estimated in Ontario using a test-negative design (TND) within a national sentinel surveillance network (SPSN). To explore alternative approaches, we applied the screening method (SM) during five seasons spanning 2007 to 2012 to passive surveillance data to determine whether routinely collected data could provide unbiased IVE estimates. Age-adjusted SM-IVE estimates, excluding 2008/09 pandemic cases and cases with missing immunisation status, were compared with TND-IVE estimates in SPSN participants, adjusted for age, comorbidity, week of illness onset and interval to specimen collection. In four seasons, including the 2009 pandemic, the SM underestimated IVE (22-39% seasonal; 72% pandemic) by 20 to 35% relative to the TND-IVE (58-63% seasonal; 93% pandemic), except for the 2010/11 season when both estimates were low (33% and 30%, respectively). Half of the cases in the routine surveillance data lacked immunisation information; imputing all to be unimmunised better aligned SM-IVE with TND-IVE, instead overestimating in four seasons by 4 to 29%. While the SM approach applied to routine data may offer the advantage of timeliness, ease and efficiency, methodological issues related to completeness of vaccine information and/or case ascertainment may constitute trade-offs in reliability. .