Eurosurveillance - Volume 8, Issue 4, 01 April 2003

A retrospective cohort study was conducted after 2 confirmed and 8 probable cases of VTEC 0157 occurred in a schoolgroup from Somerset following a trip to France. The strain of the 2 confirmed cases was vero-cytotoxin type 2, phage type 34. Despite its low statistical power due to small numbers, this study suggested the most likely vehicle of infection was cucumber salad (crude RR=4.3, 95%CI [0.6-29], adjusted OR=107, 95%CI indeterminate, p=0.08). The cucumbers were purchased from Belgium but it was not possible to trace them back to source. The international nature of this outbreak emphasises the importance of close collaboration between organisations in the management of outbreaks, of ensuring international standards in food safety, and of agreeing a common standard in VTEC typing across Europe.

An unexplained outbreak of skin disorder with itching papules or pustules occurred among drugs body packers in a detention clinic in the Netherlands in October-November 2002. The descriptive cohort study suggests this outbreak could be associated with an expired batch of disposable linens, with an overall attack rate of 30% in the study population (n=118). No additionnal cases have been noted since this expired batch was replaced.

In Austria, between 1990 and 2000, 924 travel related malaria cases were reported (mean = 84/year). No significant decreasing or increasing trends were observed. P. falciparum (n=517; 55.9%) accounted for the highest number of cases followed by P. vivax or ovale (n=321; 34.7%) and P. malariae (n=29; 2.2%). Most infections were contracted in highly endemic malaria regions (n=686; 74.2%) and most cases were reported from the largest counties: Vienna (n=336, 36.4%), Styria (n=156, 16.8%), and Lower Austria (n=151, 16.3%). Overall, 12 deaths occurred, most were caused by P. falciparum (n=9, 75%; case fatality rate: 1.9%). Data on chemoprophylaxis was available for 752 cases (81.4%) but only half of them (n=367, 48.8%) gave detailed information on the drug used. Data on compliance were obtained for only 45.4% of the cases, with only about 60% of patients completing the full course of prophylaxis.