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- Volume 23, Issue 39, 27/Sep/2018
Eurosurveillance - Volume 23, Issue 39, 27 September 2018
Volume 23, Issue 39, 2018
- Surveillance and outbreak report
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The shift in rabies epidemiology in France: time to adjust rabies post-exposure risk assessment
The epidemiology of rabies in France and western Europe has changed during the past 22 years. In France, rabies in non-flying terrestrial mammals was declared to be eliminated in 2001, and the risk of rabies is now limited to contact with bats, rabid animals illegally imported from rabies-enzootic countries and traveller exposure in enzootic areas. We analysed the epidemiology of rabies in France from 1995 to 2016, describing and analysing data on human rabies surveillance as well as data on post-exposure prophylaxis (PEP) collected from the network of French antirabies clinics. Over the study period, seven individuals were diagnosed with rabies in France, all of whom were infected outside mainland France. PEP data analysis revealed an expected overall decrease in PEP administration for individuals exposed in mainland France, but there was still overuse of anti-rabies drugs, given the very low epidemiological risk. On the other hand, a significant increase in PEP delivered to individuals exposed abroad was evidenced. These epidemiological trends indicate that clear guidelines should be provided to support physicians’ efforts to adjust rabies risk assessment to the evolution of the epidemiological situation.
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Transmission of toxigenic Corynebacterium diphtheriae by a fully immunised resident returning from a visit to West Africa, United Kingdom, 2017
David Edwards , Dianne Kent , Caroline Lester , Colin Stewart Brown , Michael E. Murphy , Nicholas M. Brown , Olajumoke Sule , Alexandra Itani , Meera Chand , Amy Trindall , Callum Pearson , Iain Roddick , Norman K. Fry , Jorg Hoffmann , Nalini Iyanger , Laurence Kemp , Joanne White , Babak Javid , Isobel D. Ramsay , Dominik Zenner , Aliko Ahmed , Gayatri Amirthalingam , Sultan Salimee , David Litt and Mark ReacherIn early 2017, a United Kingdom (UK)-born person in their 20s presented with a skin ulcer on the foot 3 weeks after returning from Ghana. The patient had last received a diphtheria-containing vaccine in 2013, completing the recommended course. MALDI-TOF of a cutaneous swab identified Corynebacterium diphtheriae. Real-time PCR ascertained the species and presence of the diphtheria toxin gene. An Elek test confirmed toxigenicity. The isolate was macrolide sensitive and penicillin resistant. The local Public Health England (PHE) Health Protection Team obtained the patient’s clinical history and traced contacts to inform appropriate public health action. One close contact (in their early 80s with uncertain immunisation status who had not recently travelled) had a positive throat swab for toxigenic C. diphtheriae and reported a history of mild coryzal symptoms. Multilocus sequence typing revealed that strains from the index case and contact had Sequence Type 493*. Diphtheria is extremely rare in the UK due to high vaccine coverage and this is the first documented transmission in 30 years. Clinicians and laboratory staff should remain highly suspicious of lesions in overseas travellers, even when patients are fully vaccinated. Older individuals who might not have completed a full immunisation course may have higher diphtheria susceptibility.
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- Research article
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Uptake and effectiveness of influenza vaccine in those aged 65 years and older in the United Kingdom, influenza seasons 2010/11 to 2016/17
BackgroundIn 2016/17, seasonal influenza vaccine was less effective in those aged 65 years and older in the United Kingdom. We describe the uptake, influenza-associated mortality and adjusted vaccine effectiveness (aVE) in this age group over influenza seasons 2010/11–2016/17. Methods: Vaccine uptake in 2016/17 and five previous seasons were measured using a sentinel general practitioners cohort in England; the test-negative case-control design was used to estimate pooled aVE by subtype and age group against laboratory-confirmed influenza in primary care from 2010–2017. Results: Vaccine uptake was 64% in 65–69-year-olds, 74% in 70–74-year-olds and 80% in those aged 75 and older. Overall aVE was 32.5% (95% CI: 11.6 to 48.5); aVE by sub-type was 60.8% (95% CI: 33.9 to 76.7) and 50.0% (95% CI: 21.6 to 68.1) against influenza A(H1N1)pdm09 and influenza B, respectively, but only 5.6% (95% CI: - 39.2 to 35.9) against A(H3N2). Against all laboratory-confirmed influenza aVE was 45.2% (95% CI: 25.1 to 60.0) in 65–74 year olds; - 26.2% (95% CI: - 149.3 to 36.0) in 75–84 year olds and - 3.2% (95% CI: - 237.8 to 68.5) in those aged 85 years and older. Influenza-attributable mortality was highest in seasons dominated by A(H3N2). Conclusions: Vaccine uptake with non-adjuvanted, normal-dose vaccines remained high, with evidence of effectiveness against influenza A(H1N1)pdm09 and B, though poor against A(H3N2), particularly in those aged 75 years and older. Forthcoming availability of newly licensed vaccines with wider use of antivirals can potentially further improve prevention and control of influenza in this group.
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- Miscellaneous
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Volumes & issues
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Volume 29 (2024)
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Volume 28 (2023)
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Volume 27 (2022)
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Volume 26 (2021)
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Volume 25 (2020)
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Volume 24 (2019)
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Volume 23 (2018)
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Volume 22 (2017)
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Volume 21 (2016)
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Volume 20 (2015)
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Volume 19 (2014)
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Volume 18 (2013)
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Volume 17 (2012)
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Volume 16 (2011)
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Volume 15 (2010)
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Volume 14 (2009)
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Volume 13 (2008)
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Volume 12 (2007)
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Volume 11 (2006)
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Volume 10 (2005)
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Volume 9 (2004)
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Volume 8 (2003)
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Volume 7 (2002)
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Volume 6 (2001)
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Volume 5 (2000)
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Volume 4 (1999)
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Volume 3 (1998)
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Volume 2 (1997)
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Volume 1 (1996)
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Volume 0 (1995)
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