Weekly releases (1997–2007) - Volume 6, Issue 49, 05 December 2002

The biggest change in the epidemiology of Salmonella enterica serotype Enteritidis in England and Wales since the emergence of S. Enteritidis phage type (PT) 4 in the 1980s has occurred during the autumn of 2002 (1,2). Since the beginning of September 2002, 19 outbreaks of S. Enteritidis have been reported to the Public Health Laboratory Service Communicable Disease Surveillance Centre in England (PHLS CDSC), compared with five during the same period in 2001. Almost 1000 people have been affected in these outbreaks, and there have been 10 deaths (all in people with underlying illnesses, and including one late death). Cases in three continuing outbreaks, affecting over 400 people, are distributed nationally. These are outbreaks of S. Enteritidis PT 14b (345 cases), S. Enteritidis PT 56 (31 cases) and S. Enteritidis PT 6d (resistant to ampicillin (Ampr)) (35 cases).

The HIV/AIDS Surveillance in Europe mid-year report 2002 published by the European centre for the epidemiological monitoring of AIDS (EuroHIV, http://www.eurohiv.org) clearly illustrates that the HIV/AIDS epidemic affecting the World Health Organization European region consists of a multitude of diverse epidemics differing in time, place, person, and severity (1).

On 2 December 2002, the Department of Health in England published guidelines for responding to a deliberate release of smallpox (1, 2). The guidelines, which are for discussion over the next month, describe vaccination strategies prior to and in the event of an outbreak, procedures for diagnosis and management of the initial cases, and other essential outbreak preparedness and control measures.

Respiratory syncytial virus (RSV) is currently circulating in Ireland, England, France, the Netherlands, and the Czech Republic. In Ireland and the Netherlands, RSV detections are higher than usual while in England and France, RSV activity is normal for the time of the year (1).

The geographical distribution of measles in Italy during the epidemic that occurred in 2002 (1) closely reflected the vaccination coverage distribution at provincial and regional level. Over recent years there had been an accumulation of susceptible children and adolescents. Estimates of the full impact of the 2002 epidemic are awaited although by July in one region there had been 13 cases of encephalitis and three deaths (1). To eliminate measles in Italy, it will be necessary to vaccinate more than 95% of children with two doses of vaccine and reduce older susceptibles with supplementary “catch-up” vaccination programmes. Also, as elimination gets closer, surveillance and the capacity to investigate epidemics must be improved.