Eurosurveillance - Volume 8, Issue 10, 01 October 2003

The Seventh International Meeting of the European Laboratory Working Group on Diphtheria (ELWGD) was held in Vienna, Austria in June 2002 and brought together the microbiologists and epidemiologists responsible for diphtheria in many countries throughout the world. The ELWGD was formed in 1993 in response to the epidemics of diphtheria in Russia and the Newly Independent States (NIS) of the former Soviet Union (1,2). These epidemics, and others elsewhere, highlighted the importance of strengthening and maintaining both epidemiological surveillance and reliable laboratory screening. Since December 2001, these areas have been progressed and strengthened by European Commission (EC) funding to undertake a feasibility study for diphtheria surveillance amongst European Union (EU) member states and accession countries, and to establish a definitive and official European diphtheria surveillance network called DIPNET (EC DG SANCO Agreement No. S12.324473 (2001 CVG4-012)). This was the first international meeting of the ELWGD to be organised and funded under the auspice of the DIPNET (European Diphtheria Surveillance Network).

In the spring and summer of 2002, the Nationale Referenzzentrale für Salmonellen (National Reference Centre for Salmonella - NRCS) in Austria noticed a cluster of human Salmonella enterica subsp. enterica ser. Enteritidis phage type 5 (S. Enteritidis PT5) infections in two neighbouring districts of Austria. Another small outbreak of S. Enteritidis PT5 infections that occurred in the same region in 1999 had been traced back to the flocks of a local egg producer (approximately 6 000 hens). Attention was therefore again directed at this farm. The results of voluntary bacteriological examinations from the farm and further epidemiological investigations identified the same egg producer as the source of the second outbreak. The 70 human isolates of S. Enteritidis PT5 ascertained in 2002 represented a minority of all infections. It is realistic to estimate that several hundred infections occurred in the course of the 2002 outbreak. The farmer had not vaccinated new flocks against Salmonella since August 2001. It is likely that the change in vaccination policy resulted in the reappearance of the S. Enteritidis PT5 infections. By the end of September 2002 the farmer had stopped selling untreated table eggs. In October 2002 only one isolate of S. Enteritidis PT5 was ascertained in the region.

An outbreak of scabies occurred in a ward of a local hospital in Barbastro (Huesca, Spain), between November 2002 and January 2003. The outbreak was linked to a patient infested with mites when he was admitted to the ward on 1 November 2002. The first case had onset of symptoms on 5 November and the last one on 5 January 2003. Seventeen cases were reported: 11 healthcare workers (HCWs) and six patients.The outbreak was attributed to a delay in diagnosis, and lack of individual protection measures by caregivers. The use of short-sleeved coats is an habitual risk practice in this ward. Contact with fomites, animals, infested clothes or intimate contact with people other than their usual partners were dismissed as risk factors for the infestation. The different groups of caregivers in this ward presented a similar risk of becoming infested, and the mechanism of transmission was probably person to person contact. The implementation of specific guidelines for scabies prevention and treatment, as well as an active surveillance system, were fundamental to the control of this outbreak.