Eurosurveillance - Volume 20, Issue 19, 14 May 2015

In fish spas, clients may submerge their hands, feet or whole body in basins with Garra rufa fish, for dead skin removal. Skin infections may result from using these spas, transmitted from fish to clients, through either fish or water, or from client to client. The microbiological water quality was determined in 24 fish spas in 16 companies in the Netherlands through analysis of a single water sample per fish spa. Water samples were tested for the presence of Aeromonas spp., Vibrio spp., Pseudomonas aeruginosa, nontuberculous mycobacteria, and faecal indicator bacteria by using standard culture methods. The majority of the examined fish spas contained Aeromonas spp. (n?=?24), P. aeruginosa (n?=?18), Vibrio spp. (n?=?16) including V. cholerae non-O1/O139 and V. vulnificus, and several rapid growing Mycobacterium spp. (n?=?23) including M. fortuitum, M. conceptionense, M. abscessus and M. chelonae. Faecal contamination of the fish spa water was low. Based on the detected concentrations of Aeromonas spp., Vibrio spp., and P. aeruginosa, the detected Mycobacterium spp., and the health implications of these bacteria, the health risk from using fish spas is considered limited for healthy people with an intact skin and no underlying disease.

In 2011, a nationwide outbreak of tularaemia occurred in Norway with 180 recorded cases. It was associated with the largest peak in lemming density seen in 40 years. Francisella tularensis was isolated from 18 patients. To study the geographical distribution of F. tularensis genotypes in Norway and correlate genotype with epidemiology and clinical presentation, we performed whole genome sequencing of patient isolates. All 18 genomes from the outbreak carried genetic signatures of F. tularensis subsp. holarctica and were assigned to genetic clades using canonical single nucleotide polymorphisms. Ten isolates were assigned to major genetic clade B.6 (subclade B.7), seven to clade B.12, and one to clade B.4. The B.6 subclade B.7 was most common in southern and central Norway, while clade B.12 was evenly distributed between the southern, central and northern parts of the country. There was no association between genotype and clinical presentation of tularaemia, time of year or specimen type. We found extensive sequence similarity with F. tularensis subsp. holarctica genomes from high-endemic tularaemia areas in Sweden. Finding nearly identical genomes across large geographical distances in Norway and Sweden imply a life cycle of the bacterium without replication between the outbreaks and raise new questions about long-range migration mechanisms.

The number of international tourist arrivals reached 1,000 million in 2012. Assessment of travellers' health problems has relied on proportionate morbidity data. Given the lack of data on number of visitors to each region, incidences have been impossible to calculate. This study, largest yet reporting travellers' health problems, is the first to present incidence of illness and injury. Data on Finnish travellers with health problems abroad during 2010 to 2012 were retrieved from the database of an assistance organisation, SOS International, covering 95% of those requiring aid abroad. The numbers were compared with those of Finnish travellers in the database of the Official Statistics of Finland. The SOS International database included 50,710 cases: infections constituted the most common health problem (60%), followed by injuries (14%), diseases of skin (5%), musculoskeletal system and connective tissue (5%), digestive tract (3%), and vascular system (2%). Gastroenteritis (23%) and respiratory infections (21%) proved the most frequent diagnoses. Overall incidence of illness or injury was high in Africa (97.9/100,000 travel days; 95% Bayesian credible interval (BCI): 53.1-145.5), southern Europe plus the eastern Mediterranean (92.3; 95% BCI: 75.4-110.1) and Asia (65.0; 95% BCI: 41.5-87.9). The data show significant differences between geographical regions, indicating the main risks and thus providing destination-specific tools for travellers' healthcare. .

The apparent seroprevalence of hepatitis E Virus (HEV) varies greatly among developed countries depending on the geographical area and the sensitivity of immunoassays. We used a validated assay to determine the prevalence of HEV IgG and IgM antibodies among 3,353 blood donors living in southern France, who gave blood during the two first weeks of October 2011 and participated in the study. Demographic and epidemiological information was collected using a specific questionnaire. We also screened 591 samples for HEV RNA. Overall IgG seroprevalence was 39.1% and varied from 20% to 71.3% depending on the geographical area (p?

Difficulties by France to identify and properly estimate the impact and consequences of the intensive 2003 heatwave, and the identification of a need for an interoperable real time medical surveillance system in the French military deployed forces, has prompted France to establish two syndromic surveillance systems. These systems, a civil syndromic surveillance system 'Surveillance sanitaire des urgences et des décès' (SurSaUD) [1] and a military syndromic surveillance system, 'Le Système d'Alerte et de Surveillance en Temps Réel' (ASTER) [2] were set up in 2004. The aim of these systems is to reinforce the early warning capacity of public health events. Syndromic surveillance, defined as the (near) real time collection, analysis, interpretation and dissemination of health-related data aims at detecting, monitoring and evaluating unexpected, emerging or expected public health threats and contributes to the monitoring and assessment of the impact of these [3]. .