Weekly releases (1997–2007) - Volume 6, Issue 41, 10 October 2002

Preliminary findings based on clinical reports and serological tests have confirmed an ongoing outbreak of Yellow Fever (YF) in Touba (Mbaké Department, Senegal, West Africa, 160 km east of Dakar). Twelve individuals with symptoms consistent with YF tested positive for specific IgM and IgG. The first suspected case was reported on 8 September 2002 in the inner city. Specific actions have been taken by the Senegalese Ministry of Health, in collaboration with the World Health Organization and the Pasteur Institute in Dakar. These include vector control, a mass vaccination campaign of the population of Touba and surrounding area, and strengthening YF surveillance. The estimated population of Touba is 800 000 inhabitants.

A sixth case of legionnaires’ disease reported in a 64 year old British man, has been associated with a cluster of cases of legionnaires’ disease linked to a Belgian hotel (1). The man stayed at the hotel in Belgium for one night in the ten days before onset of illness. The six cases include three men, one of whom has died, and three women, aged between 63 and 84 years. They became ill between 7 and 28 September 2002. All six cases have been confirmed as L. pneumophila serogroup 1; one by culture of the organism and five by urinary antigen detection. The sixth case was travelling with the same coach tour as one of the previously reported cases. Public health authorities in Great Britain are investigating three further possible cases.

One hundred and thirty four confirmed cases of Salmonella Enteritidis PT 14b (not known to be linked with foreign travel) have been reported to the Public Health Laboratory Service Communicable Disease Surveillance Centre in England (PHLS CDSC) by the PHLS Laboratory of Enteric Pathogens (LEP) since 26 September 2002 (1,2). The earliest onset is 3 September 2002 and the latest onset date reported so far is 1 October 2002 (figure). Eight people are known to have been admitted to hospital.

A workshop will be held at the European Parliament in Brussels, on 6 November 2002, on the need and possible function of a European Centre for Communicable Disease. The workshop is organised by Professor Antonios Trakatellis, rapporteur for the European Parliament on the programme of Community action in the field of public health (2003-08), in cooperation with the European Vaccine Manufacturers (EVM), a specialised group within the European Federation of Pharmaceutical Industry Associations (EFPIA).

In many countries pertussis is well controlled due to an effective vaccination programme. Nevertheless, the disease has not been eliminated, and cases still occur in the most vulnerable group of young infants. It is considered that these cases are most likely to have been infected by older household contacts, such as siblings or parents. Erythromycin chemoprophylaxis has been advocated to prevent secondary cases but the evidence for its use is weak.

Sexually transmitted infections (STI) are an occupational risk for people who sell sex, but most are very keen to keep themselves and their partners safe. Many people believe that sex workers have a high risk of and play an important role in transmission of STIs. Research in Europe over the past two decades has been important in countering this belief (1-3). Studies consistently show a high rate of condom use in commercial sex, and relatively low risks of HIV and other STI for women sex workers (2,3). A survey of 945 women sex workers in nine European cities in 1990-1 found an overall HIV-1 prevalence of 5.3%, associated with sharing injecting equipment, coming from a high prevalence area, and use of incompatible lubricants during sex. Women who did not inject drugs had a prevalence of 1.5% (1). Two cohort studies in Europe have shown a relatively low incidence of HIV infection (0.2 and 0.9 cases per 100 person years respectively in the United Kingdom and Spain) (2,4). Higher risks have been found in more stigmatised sex workers, including men who sell sex, transgenders, and injecting drug users (5,6).

The European Antimicrobial Resistance Surveillance System (EARSS) annual report 2001 has recently been published and widely distributed among all EARSS participants, public health institutes, ministries of health and other collaborating projects and organisations in Europe and beyond (1). From EARSS data it can be concluded that proportions of antimicrobial resistance vary markedly between European countries (figures 1 and 2). This is most likely to be as a result of differences in hospital infection control activities and the antibiotic prescribing practices. However, many other variables exist, some of which can interact with those mentioned above.