An #international #outbreak of #Salmonella enterica serotype Enteritidis linked to #eggs from #Poland: a microbiological and epidemiological study (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

An international outbreak of Salmonella enterica serotype Enteritidis linked to eggs from Poland: a microbiological and epidemiological study

Roan Pijnacker, MSc  *, Timothy J Dallman, PhD *, Aloys S L Tijsma, PhD, Gillian Hawkins, MBChB, Lesley Larkin, BVSc, Saara M Kotila, MSc, Giusi Amore, PhD, Ettore Amato, PhD, Pamina M Suzuki, MSc, Sarah Denayer, PhD, Sofieke Klamer, MSc, Judit Pászti, Jacquelyn McCormick, MPH, Hassan Hartman, PhD, Gareth J Hughes, PhD, Lin C T Brandal, PhD, Derek Brown, MSc, Joël Mossong, PhD, Cecilia Jernberg, PhD, Luise Müller, MSc, Daniel Palm, PhD, Ettore Severi, MSc, Joannna Gołębiowska, DVM, Blaženka Hunjak, PhD, Slawomir Owczarek, MSc, Simon Le Hello, PhD, Patricia Garvey, PhD, Kirsten Mooijman, MSc, Ingrid H M Friesema, PhD, Coen van der Weijden, BSc, Menno van der Voort, PhD, Valentina Rizzi, PhD, Eelco Franz, PhD on behalf of theInternational Outbreak Investigation Team †

Published: May 24, 2019 / DOI: https://doi.org/10.1016/S1473-3099(19)30047-7

 

Summary

Background

Salmonella spp are a major cause of food-borne outbreaks in Europe. We investigated a large multi-country outbreak ofSalmonella enterica serotype Enteritidis in the EU and European Economic Area (EEA).

Methods

A confirmed case was defined as a laboratory-confirmed infection with the outbreak strains of S Enteritidis based on whole-genome sequencing (WGS), occurring between May 1, 2015, and Oct 31, 2018. A probable case was defined as laboratory-confirmed infection withS Enteritidis with the multiple-locus variable-number tandem repeat analysis outbreak profile. Multi-country epidemiological, trace-back, trace-forward, and environmental investigations were done. We did a case-control study including confirmed and probable cases and controls randomly sampled from the population registry (frequency matched by age, sex, and postal code). Odds ratios (ORs) for exposure rates between cases and controls were calculated with unmatched univariable and multivariable logistic regression.

Findings

18 EU and EEA countries reported 838 confirmed and 371 probable cases. 509 (42%) cases were reported in 2016, after which the number of cases steadily increased. The case-control study results showed that cases more often ate in food establishments than did controls (OR 3·4 [95% CI 1·6–7·3]), but no specific food item was identified. Recipe-based food trace-back investigations among cases who ate in food establishments identified eggs from Poland as the vehicle of infection in October, 2016. Phylogenetic analysis identified two strains of S Enteritidis in human cases that were subsequently identified in salmonella-positive eggs and primary production premises in Poland, confirming the source of the outbreak. After control measures were implemented, the number of cases decreased, but increased again in March, 2017, and the increase continued into 2018.

Interpretation

This outbreak highlights the public health value of multi-country sharing of epidemiological, trace-back, and microbiological data. The re-emergence of cases suggests that outbreak strains have continued to enter the food chain, although changes in strain population dynamics and fewer cases indicate that control measures had some effect. Routine use of WGS in salmonella surveillance and outbreak response promises to identify and stop outbreaks in the future.

Funding

European Centre for Disease Prevention and Control; Directorate General for Health and Food Safety, European Commission; and National Public Health and Food Safety Institutes of the authors’ countries (see Acknowledgments for full list).

Keywords: Food Safety; EU; European Region; Samonella spp.

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#Refugee and #migrant #health in the #European Region (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

Refugee and migrant health in the European Region

Ryoko Takahashi, Krista Kruja, Soorej Jose Puthoopparambil, Santino Severoni

Published: May 20, 2019 / DOI: https://doi.org/10.1016/S0140-6736(19)30282-X

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WHO is the respected authority in leading the production and use of core evidence for public health decision making.1 The Health Evidence Network (HEN) is an information service for public health decision makers in the WHO European Region and supports them to use the best available evidence.

(…)

We declare no competing interests.

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Article Info

Published: May 20, 2019

Identification: DOI: https://doi.org/10.1016/S0140-6736(19)30282-X

Copyright © 2019 Elsevier Ltd. All rights reserved.

Keywords: Migrants; Society; Politics; European Region; Public Health.

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#Resistance #proportions for eight priority #antibiotic – #bacterium combinations in #OECD, #EU/EEA and #G20 countries 2000 to 2030: a modelling study (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Resistance proportions for eight priority antibiotic-bacterium combinations in OECD, EU/EEA and G20 countries 2000 to 2030: a modelling study

Tiago Cravo Oliveira Hashiguchi1, Driss Ait Ouakrim1, Michael Padget1, Alessandro Cassini2, Michele Cecchini1

Affiliations: 1 Organisation for Economic Co-operation and Development (OECD), Paris, France; 2 European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden

Correspondence:  Tiago Cravo Oliveira Hashiguchi

Citation style for this article: Cravo Oliveira Hashiguchi Tiago , Ait Ouakrim Driss , Padget Michael, Cassini Alessandro, Cecchini Michele. Resistance proportions for eight priority antibiotic-bacterium combinations in OECD, EU/EEA and G20 countries 2000 to 2030: a modelling study. Euro Surveill. 2019;24(20):pii=1800445. https://doi.org/10.2807/1560-7917.ES.2019.24.20.1800445

Received: 10 Aug 2018;   Accepted: 21 Mar 2019

 

Abstract

Background

Antimicrobial resistance is widely considered an urgent global health issue due to associated mortality and disability, societal and healthcare costs.

Aim

To estimate the past, current and projected future proportion of infections resistant to treatment for eight priority antibiotic-bacterium combinations from 2000 to 2030 for 52 countries.

Methods

We collated data from a variety of sources including ResistanceMap and World Bank. Feature selection algorithms and multiple imputation were used to produce a complete historical dataset. Forecasts were derived from an ensemble of three models: exponential smoothing, linear regression and random forest. The latter two were informed by projections of antibiotic consumption, out-of-pocket medical spending, populations aged 64 years and older and under 15 years and real gross domestic product. We incorporated three types of uncertainty, producing 150 estimates for each country-antibiotic-bacterium-year.

Results

Average resistance proportions across antibiotic-bacterium combinations could grow moderately from 17% to 18% within the Organisation for Economic Co-operation and Development (OECD; growth in 64% of uncertainty sets), from 18% to 19% in the European Union/European Economic Area (EU/EEA; growth in 87% of uncertainty sets) and from 29% to 31% in Group of Twenty (G20) countries (growth in 62% of uncertainty sets) between 2015 and 2030. There is broad heterogeneity in levels and rates of change across countries and antibiotic-bacterium combinations from 2000 to 2030.

Conclusion

If current trends continue, resistance proportions are projected to marginally increase in the coming years. The estimates indicate there is significant heterogeneity in resistance proportions across countries and antibiotic-bacterium combinations.

© This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: Antibiotics; Drugs Resistance; European Region; EU.

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#Nontoxigenic Corynebacterium #diphtheriae #Infections, #Europe (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Summary, edited.]

Volume 25, Number 7—July 2019 / Letter

Nontoxigenic Corynebacterium diphtheriae Infections, Europe

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To the Editor: We read with interest the article by Dangel et al. analyzing nontoxigenic Corynebacterium diphtheriae infections in northern Germany during 2016–2017 (1). Among the cases, 2 patients originated from Poland; each experienced an invasive disease, 1 endocarditis and 1 sepsis. Poland and Germany are neighboring countries. In Poland, we also observed an accumulation of nontoxigenic C. diphtheriaeinfections during 2016–2017. In both countries, most infections were caused by isolates belonging to sequence type (ST) 8 biotype gravis, which we previously suspected of having increased pathogenic properties (2).

(…)

Keywords: Corynebacterium dipththeriae; European Region.

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Activity of # imipenem / #relebactam against #MDR #Pseudomonas aeruginosa in #Europe: SMART 2015–17 (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

Activity of imipenem/relebactam against MDR Pseudomonas aeruginosa in Europe: SMART 2015–17

Sibylle H Lob, James A Karlowsky, Katherine Young, Mary R Motyl, Stephen Hawser, Nimmi D Kothari, Melinda E Gueny, Daniel F Sahm

Journal of Antimicrobial Chemotherapy, dkz191, https://doi.org/10.1093/jac/dkz191

Published: 13 May 2019

 

Abstract

Objectives

Relebactam is a diazabicyclooctane non-β-lactam inhibitor of Ambler class A and C β-lactamases that is in clinical development in combination with imipenem/cilastatin. The current study evaluated the in vitro activity of imipenem/relebactam against 5447 isolates of Pseudomonas aeruginosasubmitted to the SMART global surveillance programme in 2015–17 by 67 clinical laboratories in 22 European countries.

Methods

MICs were determined using the CLSI broth microdilution reference method (Eleventh Edition: M07, 2018). Relebactam was tested at a fixed concentration of 4 mg/L in combination with doubling dilutions of imipenem. MICs were interpreted using EUCAST clinical breakpoints (version 8.1); imipenem breakpoints were applied to imipenem/relebactam.

Results

Rates of susceptibility to imipenem and imipenem/relebactam (MIC ≤4 mg/L) were 69.4% and 92.4%, respectively, for all isolates of P. aeruginosa. Over one-third of all isolates (34.9%, 1902/5447) were MDR; lower respiratory tract isolates (38.3%, 1327/3461) were more frequently MDR than were intraabdominal (28.5%, 355/1245) or urinary tract (29.7%, 212/714) isolates. Of all MDR isolates, 78.2% were susceptible to imipenem/relebactam, a rate that was 50–77 percentage points higher than the rate of susceptibility to imipenem or any other β-lactam tested; rates of susceptibility to imipenem/relebactam were similar for MDR isolates from lower respiratory tract (77.8% susceptible), intraabdominal (80.3%) and urinary tract (76.4%) infections. Overall, relebactam restored imipenem susceptibility to 75.2% (1254/1668) of imipenem-non-susceptible isolates of P. aeruginosa and to 69.6% (947/1361) of imipenem-non-susceptible isolates with an MDR phenotype.

Conclusions

Relebactam restored in vitro susceptibility to imipenem for most imipenem-non-susceptible and MDR clinical isolates of P. aeruginosa from European patients.

Topic: phenotype – pseudomonas aeruginosa – imipenem – lactams – respiratory system – urinary tract – infection

Issue Section: ORIGINAL RESEARCH

Keywords: Antibiotics; Drugs Resistance; Pseudomonas aeruginosa; Relebactam; Imipenem; European Region.

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The #Spanish #Influenza #Pandemic: a #lesson from #history 100 years after 1918 (J Prev Med Hyg., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Prev Med Hyg. 2019 Mar 29;60(1):E64-E67. doi: 10.15167/2421-4248/jpmh2019.60.1.1205. eCollection 2019 Mar.

The Spanish Influenza Pandemic: a lesson from history 100 years after 1918.

Martini M1,2, Gazzaniga V3, Bragazzi NL4, Barberis I4.

Author information: 1 Department of Health Sciences, Section of Medical History and Ethics, University of Genoa, Italy. 2 UNESCO CHAIR Anthropology of Health, Biosphere and Healing System, University of Genoa, Italy. 3 Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Italy. 4 Department of Health Sciences, University of Genoa, Italy.

 

Abstract

In Europe in 1918, influenza spread through Spain, France, Great Britain and Italy, causing havoc with military operations during the First World War. The influenza pandemic of 1918 killed more than 50 million people worldwide. In addition, its socioeconomic consequences were huge. “Spanish flu”, as the infection was dubbed, hit different age-groups, displaying a so-called “W-trend”, typically with two spikes in children and the elderly. However, healthy young adults were also affected. In order to avoid alarming the public, several local health authorities refused to reveal the numbers of people affected and deaths. Consequently, it was very difficult to assess the impact of the disease at the time. Although official communications issued by health authorities worldwide expressed certainty about the etiology of the infection, in laboratories it was not always possible to isolate the famous Pfeiffer’s bacillus, which was, at that time, deemed to be the cause of influenza. The first official preventive actions were implemented in August 1918; these included the obligatory notification of suspected cases and the surveillance of communities such as day-schools, boarding schools and barracks. Identifying suspected cases through surveillance, and voluntary and/or mandatory quarantine or isolation, enabled the spread of Spanish flu to be curbed. At that time, these public health measures were the only effective weapons against the disease, as no vaccines or antivirals were available. Virological and bacteriological analysis of preserved samples from infected soldiers and other young people who died during the pandemic period is a major step toward a better understanding of this pandemic and of how to prepare for future pandemics.

KEYWORDS: Flu; History of Pandemic; Mortality rate; Public Health

PMID: 31041413 PMCID: PMC6477554 DOI: 10.15167/2421-4248/jpmh2019.60.1.1205

Keywords: Pandemic Influenza; H1N1; Spanish Flu; European Region; History.

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Co-circulation of genetically distinct highly pathogenic #avian #influenza A clade 2.3.4.4 (#H5N6) viruses in wild #waterfowl and #poultry in #Europe and East #Asia, 2017-18 (Virus Evol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Virus Evol. 2019 Apr 22;5(1):vez004. doi: 10.1093/ve/vez004. eCollection 2019 Jan.

Co-circulation of genetically distinct highly pathogenic avian influenza A clade 2.3.4.4 (H5N6) viruses in wild waterfowl and poultry in Europe and East Asia, 2017-18.

Poen MJ1, Venkatesh D2, Bestebroer TM1, Vuong O1, Scheuer RD1, Oude Munnink BB1, de Meulder D1, Richard M1, Kuiken T1, Koopmans MPG1, Kelder L3, Kim YJ4, Lee YJ4, Steensels M5, Lambrecht B5, Dan A6, Pohlmann A7, Beer M7, Savic V8, Brown IH9, Fouchier RAM1, Lewis NS9,10.

Author information: 1 Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands. 2 Department of Zoology, University of Cambridge, Cambridge CB2 3EJ, UK. 3 Staatsbosbeheer, Amersfoort, the Netherlands. 4 Avian Influenza Research and Diagnostic Division, Animal and Plant Quarantine Agency, Republic of Korea. 5 Avian Virology and Immunology, Sciensano, Brussels, Belgium. 6 Veterinary Diagnostics Directorate, Budapest, Hungary. 7 Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Insel Riems, Germany. 8 Croatian Veterinary Institute, Zagreb, Croatia. 9 OIE/FAO/EURL International Reference Laboratory for Avian Influenza, Swine Influenza and Newcastle Disease, Animal and Plant Health Agency (APHA)-Weybridge, Addlestone, Surrey, UK. 10 Department of Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, UK.

 

Abstract

Highly pathogenic avian influenza (HPAI) H5 clade 2.3.4.4 viruses were first introduced into Europe in late 2014 and re-introduced in late 2016, following detections in Asia and Russia. In contrast to the 2014-15 H5N8 wave, there was substantial local virus amplification in wild birds in Europe in 2016-17 and associated wild bird mortality, with evidence for occasional gene exchange with low pathogenic avian influenza (LPAI) viruses. Since December 2017, several European countries have again reported events or outbreaks with HPAI H5N6 reassortant viruses in both wild birds and poultry, respectively. Previous phylogenetic studies have shown that the two earliest incursions of HPAI H5N8 viruses originated in Southeast Asia and subsequently spread to Europe. In contrast, this study indicates that recent HPAI H5N6 viruses evolved from the H5N8 2016-17 viruses during 2017 by reassortment of a European HPAI H5N8 virus and wild host reservoir LPAI viruses. The genetic and phenotypic differences between these outbreaks and the continuing detections of HPAI viruses in Europe are a cause of concern for both animal and human health. The current co-circulation of potentially zoonotic HPAI and LPAI virus strains in Asia warrants the determination of drivers responsible for the global spread of Asian lineage viruses and the potential threat they pose to public health.

KEYWORDS: H5N6; avian influenza; emerging diseases; highly pathogenic avian influenza; phylogeny; virology

PMID: 31024736 PMCID: PMC6476160 DOI: 10.1093/ve/vez004

Keywords: Avian Influenza; H5N6; H5N8; Reassortant Strain; Poultry; Wild Birds; European Region; Asia Region.

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