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- Volume 24, Issue 19, 09/May/2019
Eurosurveillance - Volume 24, Issue 19, 09 May 2019
Volume 24, Issue 19, 2019
- Rapid communication
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Emergence of ceftazidime-avibactam-resistant Klebsiella pneumoniae during treatment, Finland, December 2018
In December 2018, a ceftazidime-avibactam (CAZ-AVI)-resistant KPC-2-producing Klebsiella pneumoniae strain was isolated in Finland. CAZ-AVI resistance was observed 34 days after CAZ-AVI treatment in a trauma patient transferred from a hospital in Greece who had been colonised with blaKPC-2-producing K. pneumoniae ST39, and later developed a bloodstream infection. The CAZ-AVI-resistant strain contained a novel 15 amino acid insertion in the KPC-2 protein causing structural changes proximal to the KPC-2 active site.
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- Research
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A cluster analysis of serious adverse event reports after human papillomavirus (HPV) vaccination in Danish girls and young women, September 2009 to August 2017
BackgroundSuspected adverse events (AE) after human papillomavirus (HPV) vaccines include postural orthostatic tachycardia syndrome (POTS), chronic fatigue syndrome (CFS), complex regional pain syndrome (CRPS) and symptoms including headache and orthostatic intolerance.
AimWe aimed to identify phenotypes of AEs after HPV vaccination, defined as patterns of AE terms (signs, symptoms, diagnoses), and to evaluate if identified phenotypes reflected previously suspected symptomatology or heightened public concerns over HPV vaccine safety since 1 January 2015.
MethodsWe conducted a retrospective observational study using latent class cluster analysis of all serious AE reports (n = 963) reported by females residing in Denmark between September 2009 and August 2017. Resulting clusters were characterised according to AE terms associated with POTS, CFS and CRPS before (September 2009–December 2014) and during (January 2015–August 2017) a time of heightened media activity regarding HPV vaccines.
ResultsFour clusters of AE reports were distinguished. The most common symptoms were fatigue, dizziness and headache but their frequency varied among clusters. The majority of reports in one cluster were submitted during a period of heightened media activity, including an anomalous spike in submissions in December 2015; a high proportion of these reports included the symptoms cognitive disorder (78%), abdominal pain (77%), dysuria (60%) and sleep disorder (60%).
ConclusionsNon-specific symptoms including headache, fatigue and dizziness feature prominently in serious AE reports from females in Denmark. Our analysis identified a cluster of reports, likely media stimulated, with a focus on symptoms of CFS and POTS.
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- Surveillance
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Piloting a surveillance system for HIV drug resistance in the European Union
Marita JW van de Laar , Arnold Bosman , Anastasia Pharris , Emmi Andersson , Lambert Assoumou , Eva Ay , Norbert Bannert , Barbara Bartmeyer , Melissa Brady , Marie-Laure Chaix , Diane Descamps , Kenny Dauwe , Jannik Fonager , Andrea Hauser , Maja Lunar , Maria Mezei , Martha Neary , Mario Poljak , Ard van Sighem , Chris Verhofstede , Andrew J Amato-Gauci and Eeva K BrobergBackgroundA steady increase in HIV drug resistance (HIVDR) has been demonstrated globally in individuals initiating first-line antiretroviral therapy (ART). To support effective use of ART and prevent spread of HIVDR, monitoring is essential.
AimWe piloted a surveillance system for transmitted HIVDR to assess the feasibility of implementation at the European level.
MethodAll 31 countries in the European Union and European Economic Area were invited to retrospectively submit data on individuals newly diagnosed with HIV in 2015 who were tested for antiviral susceptibility before ART, either as case-based or as aggregate data. We used the Stanford HIV database algorithm to translate genetic sequences into levels of drug resistance.
ResultsNine countries participated, with six reporting case-based data on 1,680 individuals and four reporting aggregated data on 1,402 cases. Sequence data were available for 1,417 cases: 14.5% of individuals (n = 244) showed resistance to at least one antiretroviral drug. In case-based surveillance, the highest levels of transmitted HIVDR were observed for non-nucleoside reverse-transcriptase inhibitors (NNRTIs) with resistance detected in 8.6% (n = 145), followed by resistance to nucleoside reverse-transcriptase inhibitors (NRTI) (5.1%; n = 85) and protease inhibitors (2.0%; n = 34).
ConclusionWe conclude that standard reporting of HIVDR data was feasible in the participating countries. Legal barriers for data sharing, consensus on definitions and standardisation of interpretation algorithms should be clarified in the process of enhancing European-wide HIV surveillance with drug resistance information.
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- Perspective
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Contact tracing following measles exposure on three international flights, Germany, 2017
When a person with contagious measles has travelled by aircraft, European guidelines recommend contact tracing of passengers and crew within 5 days of exposure for post-exposure prophylaxis (PEP), and within 12 days of exposure for informing passengers and crew, in order to prevent further transmissions. To be effective, contact tracing requires prompt diagnosis, immediate notification of public health authorities and rapid availability of passenger contact data. We report two events of contact tracing initiated in Germany after two individuals with measles travelled on three international flights. In one event, contact tracing was initiated late because laboratory confirmation of a clinically diagnosed measles case was awaited unnecessarily. Accessing passenger contact data was difficult in both events because of data protection issues with the airline which was not based in Germany. In both events, passengers were not reached in time to provide PEP, and one event resulted in at least two secondary measles cases. As all passengers were reached before the incubation period ended, tertiary cases were most probably prevented. Public health authorities and the transport sector must collaborate to resolve competing legal regulations for infection prevention and data protection, to simplify and accelerate identification of air travellers exposed to communicable diseases.
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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)
Most Read This Month
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Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR
Victor M Corman , Olfert Landt , Marco Kaiser , Richard Molenkamp , Adam Meijer , Daniel KW Chu , Tobias Bleicker , Sebastian Brünink , Julia Schneider , Marie Luisa Schmidt , Daphne GJC Mulders , Bart L Haagmans , Bas van der Veer , Sharon van den Brink , Lisa Wijsman , Gabriel Goderski , Jean-Louis Romette , Joanna Ellis , Maria Zambon , Malik Peiris , Herman Goossens , Chantal Reusken , Marion PG Koopmans and Christian Drosten
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