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- Volume 24, Issue 12, 21/Mar/2019
Eurosurveillance - Volume 24, Issue 12, 21 March 2019
Volume 24, Issue 12, 2019
- Editorial
- Rapid communication
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Will we reach the Sustainable Development Goals target for tuberculosis in the European Union/European Economic Area by 2030?
We assessed progress towards the Sustainable Development Goals target for tuberculosis in the European Union/European Economic Area using the latest tuberculosis (TB) surveillance and Eurostat data. Both the TB notification rate and the number of TB deaths were decreasing before 2015 and the TB notification rate further declined between 2015 and 2017. With the current average decline in notification rate and number of TB deaths however, the EU/EEA will not reach the targets by 2030.
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Influenza A(H3N2) virus exhibiting reduced susceptibility to baloxavir due to a polymerase acidic subunit I38T substitution detected from a hospitalised child without prior baloxavir treatment, Japan, January 2019
Emi Takashita , Chiharu Kawakami , Rie Ogawa , Hiroko Morita , Seiichiro Fujisaki , Masayuki Shirakura , Hideka Miura , Kazuya Nakamura , Noriko Kishida , Tomoko Kuwahara , Akira Ota , Hayato Togashi , Ayako Saito , Keiko Mitamura , Takashi Abe , Masataka Ichikawa , Masahiko Yamazaki , Shinji Watanabe and Takato OdagiriIn January 2019, two influenza A(H3N2) viruses carrying an I38T substitution in the polymerase acidic subunit (PA), which confers reduced susceptibility to baloxavir, were detected from epidemiologically unrelated hospitalised children in Japan. The viruses exhibited reduced susceptibility to baloxavir but were susceptible to neuraminidase inhibitors. Only one of the two children had been treated with baloxavir. An epidemiological analysis suggests possible transmission of the PA I38T mutant A(H3N2) virus among humans.
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- Research
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Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014
Introduction: Isoniazid (INH) is an essential drug for tuberculosis (TB) treatment. Resistance to INH may increase the likelihood of negative treatment outcome.
Aim: We aimed to determine the impact of INH mono-resistance on TB treatment outcome in the European Union/European Economic Area and to identify risk factors for unsuccessful outcome in cases with INH mono-resistant TB.
Methods: In this observational study, we retrospectively analysed TB cases that were diagnosed in 2002–14 and included in the European Surveillance System (TESSy). Multilevel logistic regression models were applied to identify risk factors and correct for clustering of cases within countries.
Results: A total of 187,370 susceptible and 7,578 INH mono-resistant TB cases from 24 countries were included in the outcome analysis. Treatment was successful in 74.0% of INH mono-resistant and 77.4% of susceptible TB cases. In the final model, treatment success was lower among INH mono-resistant cases (Odds ratio (OR): 0.7; 95% confidence interval (CI): 0.6–0.9; adjusted absolute difference in treatment success: 5.3%). Among INH mono-resistant TB cases, unsuccessful treatment outcome was associated with age above median (OR: 1.3; 95% CI: 1.2–1.5), male sex (OR: 1.3; 95% CI: 1.1–1.4), positive smear microscopy (OR: 1.3; 95% CI: 1.1–1.4), positive HIV status (OR: 3.3; 95% CI: 1.6–6.5) and a prior TB history (OR: 1.8; 95% CI: 1.5–2.2).
Conclusions: This study provides evidence for an association between INH mono-resistance and a lower likelihood of TB treatment success. Increased attention should be paid to timely detection and management of INH mono-resistant TB.
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Visual tools to assess the plausibility of algorithm-identified infectious disease clusters: an application to mumps data from the Netherlands dating from January 2009 to June 2016
IntroductionWith growing amounts of data available, identification of clusters of persons linked to each other by transmission of an infectious disease increasingly relies on automated algorithms. We propose cluster finding to be a two-step process: first, possible transmission clusters are identified using a cluster algorithm, second, the plausibility that the identified clusters represent genuine transmission clusters is evaluated.
AimTo introduce visual tools to assess automatically identified clusters.
MethodsWe developed tools to visualise: (i) clusters found in dimensions of time, geographical location and genetic data; (ii) nested sub-clusters within identified clusters; (iii) intra-cluster pairwise dissimilarities per dimension; (iv) intra-cluster correlation between dimensions. We applied our tools to notified mumps cases in the Netherlands with available disease onset date (January 2009 – June 2016), geographical information (location of residence), and pathogen sequence data (n = 112). We compared identified clusters to clusters reported by the Netherlands Early Warning Committee (NEWC).
ResultsWe identified five mumps clusters. Three clusters were considered plausible. One was questionable because, in phylogenetic analysis, genetic sequences related to it segregated in two groups. One was implausible with no smaller nested clusters, high intra-cluster dissimilarities on all dimensions, and low intra-cluster correlation between dimensions. The NEWC reports concurred with our findings: the plausible/questionable clusters corresponded to reported outbreaks; the implausible cluster did not.
ConclusionOur tools for assessing automatically identified clusters allow outbreak investigators to rapidly spot plausible transmission clusters for mumps and other human-to-human transmissible diseases. This fast information processing potentially reduces workload.
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- Surveillance
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Influenza surveillance: determining the epidemic threshold for influenza by using the Moving Epidemic Method (MEM), Montenegro, 2010/11 to 2017/18 influenza seasons
Background: In 2009, an improved influenza surveillance system was implemented and weekly reporting to the World Health Organization on influenza-like illness (ILI) began. The goals of the surveillance system are to monitor and analyse the intensity of influenza activity, to provide timely information about circulating strains and to help in establishing preventive and control measures. In addition, the system is useful for comparative analysis of influenza data from Montenegro with other countries.
Aim: We aimed to evaluate the performance and usefulness of the Moving Epidemic Method (MEM), for use in the influenza surveillance system in Montenegro.
Methods: Historical ILI data from 2010/11 to 2017/18 influenza seasons were modelled with MEM. Epidemic threshold for Montenegro 2017/18 season was calculated using incidence rates from 2010/11–2016/17 influenza seasons.
Results: Pre-epidemic ILI threshold per 100,000 population was 19.23, while the post-epidemic threshold was 17.55. Using MEM, we identified an epidemic of 10 weeks’ duration. The sensitivity of the MEM epidemic threshold in Montenegro was 89% and the warning signal specificity was 99%.
Conclusions: Our study marks the first attempt to determine the pre/post-epidemic threshold values for the epidemic period in Montenegro. The findings will allow a more detailed examination of the influenza-related epidemiological situation, timely detection of epidemic and contribute to the development of more efficient measures for disease prevention and control aimed at reducing the influenza-associated morbidity and mortality.
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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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