Early #Introduction of #SARS #Coronavirus 2 into #Europe (Emerg Infect Dis., abstract)

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

Volume 26, Number 7—July 2020 / Dispatch

Early Introduction of Severe Acute Respiratory Syndrome Coronavirus 2 into Europe

Sonja J. Olsen  , Meng-Yu Chen, Yu-Lun Liu, Mark Witschi, Alexis Ardoin, Clémentine Calba, Pauline Mathieu, Virginie Masserey, Francesco Maraglino, Stefano Marro, Pasi Penttinen, Emmanuel Robesyn, Jukka Pukkila, and the European COVID-19 Work Group

Author affiliations: World Health Organization Regional Office for Europe, Copenhagen, Denmark (S.J. Olsen, J. Pukkila); Taiwanese Centers for Disease Control, Taipei, China (M.-Y. Chen, Y.-L. Liu); Swiss Federal Office of Public Health, Bern, Switzerland (M. Witschi, V. Masserey); Agence Régionale de Santé Ile-de-France, Paris, France (A. Ardoin); Santé Publique France, Paris (C. Calba); Direction Générale de la Santé, Paris (P. Mathieu); Ministry of Health, Rome, Italy (F. Maraglino, S. Marro); European Centre for Disease Prevention and Control, Stockholm, Sweden (P. Penttinen, E. Robesyn)



Early infections with severe acute respiratory syndrome coronavirus 2 in Europe were detected in travelers from Wuhan, China, in January 2020. In 1 tour group, 5 of 30 members were ill; 3 cases were laboratory confirmed. In addition, a healthcare worker was infected. This event documents early importation and subsequent spread of the virus in Europe.

Keywords: SARS-CoV-2; COVID-19; European Region.


First cases of #coronavirus disease 2019 (#COVID19) in the #WHO #European Region, 24 January to 21 February 2020 (Euro Surveill., abstract)

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

First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020

Gianfranco Spiteri1, James Fielding2, Michaela Diercke3, Christine Campese4, Vincent Enouf5, Alexandre Gaymard6, Antonino Bella7, Paola Sognamiglio8, Maria José Sierra Moros9, Antonio Nicolau Riutort10, Yulia V. Demina11, Romain Mahieu12, Markku Broas13, Malin Bengnér14, Silke Buda3, Julia Schilling3, Laurent Filleul15, Agnès Lepoutre16, Christine Saura17, Alexandra Mailles4, Daniel Levy-Bruhl4, Bruno Coignard4, Sibylle Bernard-Stoecklin4, Sylvie Behillil5, Sylvie van der Werf5, Martine Valette6, Bruno Lina6, Flavia Riccardo7, Emanuele Nicastri8, Inmaculada Casas18, Amparo Larrauri19, Magdalena Salom Castell20, Francisco Pozo18, Rinat A. Maksyutov21, Charlotte Martin22, Marc Van Ranst23, Nathalie Bossuyt24, Lotta Siira25, Jussi Sane26, Karin Tegmark-Wisell27, Maria Palmérus28, Eeva K. Broberg1, Julien Beauté1, Pernille Jorgensen2, Nick Bundle1, Dmitriy Pereyaslov2, Cornelia Adlhoch1, Jukka Pukkila2, Richard Pebody2, Sonja Olsen2,29, Bruno Christian Ciancio1,29

Affiliations: 1 European Centre for Disease Prevention and Control, Stockholm, Sweden; 2 World Health Organisation Regional Office for Europe, Copenhagen, Denmark; 3 Robert Koch Institute, Berlin, Germany; 4 Santé Publique France – Direction des maladies infectieuses, Saint-Maurice, France; 5 Centre national de référence Virus des infections respiratoires, dont la grippe, Institut Pasteur, Paris, France; 6 Centre national de référence Virus des infections respiratoires, dont la grippe, Hospices civils de Lyon, Lyon, France; 7 Istituto Superiore di Sanita, Rome, Italy; 8 Istituto Nazionale Malattie Infettive Lazzaro Spallanzani, Rome, Italy; 9 Coordination Centre for Health Alerts and Emergencies. Spanish Ministry of Health, Madrid, Spain; 10 Servicio de Epidemiología, Dirección General de Salut Pública, Islas Baleares, Spain; 11 Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor), Moscow, Russia; 12 Department of Infectious Disease Prevention and Control, Common Community Commission, Brussels-Capital Region, Brussels, Belgium; 13 Chief Physician, Infection control unit, Lapland Hospital District, Rovaniemi, Finland; 14 County Medical Officer, Jönköping Region, Jönköping, Sweden; 15 Santé publique France – Direction des régions, Cellule régionale Nouvelle Aquitaine, Bordeaux, France; 16 Santé publique France – Direction des régions, Cellule régionale Ile-de-France, Paris, France; 17 Santé publique France – Direction des régions, Cellule régionale Auvergne-Rhône-Alpes, Lyon, France; 18 National Centre for Microbiology, WHO-National Influenza Centre, Institute of Health Carlos III. Madrid, Spain; 19 National Centre of Epidemiology, CIBERESP, Institute of Health Carlos III. Madrid, Spain; 20 Dirección General de Salut Pública, Islas Baleares, Spain; 21 State Research Center of Virology and Biotechnology “Vector”, Rospotrebnadzor, Moscow, Russia; 22 St. Pierre Hospital, Brussels, Belgium; 23 Laboratory of Clinical Virology, Department of Microbiology and Immunology, Rega Institute, KU Leuven – University of Leuven, Leuven, Belgium; 24 Epidemiology of infectious diseases, Sciensano, Brussels, Belgium; 25 Expert Microbiology Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland; 26 Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland; 27 Public Health Agency of Sweden, Solna, Sweden; 28 Jönköping Region, Jönköping, Sweden; 29 These authors have contributed equally to the manuscript

Correspondence:  Gianfranco Spiteri

Citation style for this article: Spiteri Gianfranco, Fielding James, Diercke Michaela, Campese Christine, Enouf Vincent, Gaymard Alexandre, Bella Antonino, Sognamiglio Paola, Sierra Moros Maria José, Riutort Antonio Nicolau, Demina Yulia V., Mahieu Romain, Broas Markku, Bengnér Malin, Buda Silke, Schilling Julia, Filleul Laurent, Lepoutre Agnès, Saura Christine, Mailles Alexandra, Levy-Bruhl Daniel, Coignard Bruno, Bernard-Stoecklin Sibylle, Behillil Sylvie, van der Werf Sylvie, Valette Martine, Lina Bruno, Riccardo Flavia, Nicastri Emanuele, Casas Inmaculada, Larrauri Amparo, Salom Castell Magdalena, Pozo Francisco, Maksyutov Rinat A., Martin Charlotte, Van Ranst Marc, Bossuyt Nathalie, Siira Lotta, Sane Jussi, Tegmark-Wisell Karin, Palmérus Maria, Broberg Eeva K., Beauté Julien, Jorgensen Pernille, Bundle Nick, Pereyaslov Dmitriy, Adlhoch Cornelia, Pukkila Jukka, Pebody Richard, Olsen Sonja, Ciancio Bruno Christian. First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020. Euro Surveill. 2020;25(9):pii=2000178. https://doi.org/10.2807/1560-7917.ES.2020.25.9.2000178

Received: 24 Feb 2020;   Accepted: 05 Mar 2020



A cluster of pneumonia of unknown origin was identified in Wuhan, China, in December 2019 [1]. On 12 January 2020, Chinese authorities shared the sequence of a novel coronavirus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolated from some clustered cases [2]. Since then, the disease caused by SARS-CoV-2 has been named coronavirus disease 2019 (COVID-19). As at 21 February 2020, the virus had spread rapidly mostly within China but also to 28 other countries, including in the World Health Organization (WHO) European Region [3-5]. Here we describe the epidemiology of the first cases of COVID-19 in this region, excluding cases reported in the United Kingdom (UK), as at 21 February 2020. The study includes a comparison between cases detected among travellers from China and cases whose infection was acquired due to subsequent local transmission.

Keywords: European Region; COVID-19; SARS-CoV-2.


#Laboratory #readiness and #response for novel #coronavirus (2019-nCoV) in expert laboratories in 30 #EU/EEA countries, January 2020 (Euro Surveill., abstract)

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

Laboratory readiness and response for novel coronavirus (2019-nCoV) in expert laboratories in 30 EU/EEA countries, January 2020

Chantal B.E.M. Reusken1,2, Eeva K. Broberg3, Bart Haagmans2, Adam Meijer1, Victor M. Corman4,5, Anna Papa6, Remi Charrel7, Christian Drosten4,5, Marion Koopmans2, Katrin Leitmeyer3, on behalf of EVD-LabNet and ERLI-Net8

Affiliations: 1 Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; 2 Viroscience department, Erasmus MC, Rotterdam, the Netherlands; 3 European Centre for Disease Prevention and Control, Solna, Sweden; 4 Charité – Universitätsmedizin Berlin Institute of Virology, Berlin, Germany; 5 German Centre for Infection Research (DZIF), Berlin, Germany; 6 Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece; 7 Unité des Virus Emergents (Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France; 8 The participating members of EVD-LabNet and ERLI-Net are acknowledged at the end of the article

Correspondence:  Chantal Reusken

Citation style for this article: Reusken Chantal B.E.M., Broberg Eeva K., Haagmans Bart, Meijer Adam, Corman Victor M., Papa Anna, Charrel Remi, Drosten Christian, Koopmans Marion, Leitmeyer Katrin, on behalf of EVD-LabNet and ERLI-Net. Laboratory readiness and response for novel coronavirus (2019-nCoV) in expert laboratories in 30 EU/EEA countries, January 2020. Euro Surveill. 2020;25(6):pii=2000082. https://doi.org/10.2807/1560-7917.ES.2020.25.6.2000082

Received: 03 Feb 2020;   Accepted: 11 Feb 2020



Timely detection of novel coronavirus (2019-nCoV) infection cases is crucial to interrupt the spread of this virus. We assessed the required expertise and capacity for molecular detection of 2019-nCoV in specialised laboratories in 30 European Union/European Economic Area (EU/EEA) countries. Thirty-eight laboratories in 24 EU/EEA countries had diagnostic tests available by 29 January 2020. A coverage of all EU/EEA countries was expected by mid-February. Availability of primers/probes, positive controls and personnel were main implementation barriers.

Keywords: SARS-CoV-2; COVID19; Diagnostic tests.


Novel #coronavirus (2019-nCoV) early-stage #importation #risk to #Europe, January 2020 (Euro Surveill., abstract)

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

Novel coronavirus (2019-nCoV) early-stage importation risk to Europe, January 2020

Giulia Pullano1, Francesco Pinotti1, Eugenio Valdano2, Pierre-Yves Boëlle1, Chiara Poletto1, Vittoria Colizza1

Affiliations: 1 INSERM, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique, IPLESP, Paris, France; 2 Center for Biomedical Modeling, The Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, United States

Correspondence:  Vittoria Colizza

Citation style for this article: Pullano Giulia, Pinotti Francesco, Valdano Eugenio, Boëlle Pierre-Yves, Poletto Chiara, Colizza Vittoria. Novel coronavirus (2019-nCoV) early-stage importation risk to Europe, January 2020. Euro Surveill. 2020;25(4):pii=2000057. https://doi.org/10.2807/1560-7917.ES.2020.25.4.2000057

Received: 23 Jan 2020;   Accepted: 30 Jan 2020



As at 27 January 2020, 42 novel coronavirus (2019-nCoV) cases were confirmed outside China. We estimate the risk of case importation to Europe from affected areas in China via air travel. We consider travel restrictions in place, three reported cases in France, one in Germany. Estimated risk in Europe remains high. The United Kingdom, Germany and France are at highest risk. Importation from Beijing and Shanghai would lead to higher and widespread risk for Europe.

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

Keywords: 2019-nCoV; European Region.


The #Justinianic #Plague: An inconsequential #pandemic? (Proc Natl Acad Sci USA, abstract)

[Source: Proceedings of the National Academy of Sciences of the United States of America, full page: (LINK). Abstract, edited.]

The Justinianic Plague: An inconsequential pandemic?

Lee Mordechai, Merle Eisenberg, Timothy P. Newfield, Adam Izdebski, Janet E. Kay, and Hendrik Poinar

PNAS first published December 2, 2019 / DOI: https://doi.org/10.1073/pnas.1903797116

Edited by Noel Lenski, Yale University, New Haven, CT, and accepted by Editorial Board Member Elsa M. Redmond October 7, 2019 (received for review March 4, 2019)



The Justinianic Plague (circa 541 to 750 CE) has recently featured prominently in scholarly and popular discussions. Current consensus accepts that it resulted in the deaths of between a quarter and half of the population of the Mediterranean, playing a key role in the fall of the Roman Empire. Our contribution argues that earlier estimates are founded on a small subset of textual evidence and are not supported by many other independent types of evidence (e.g., papyri, coins, inscriptions, and pollen archaeology). We therefore conclude that earlier analyses of the mortality and social effects of the plague are exaggerated, and that the nontextual evidence suggests plague did not play a significant role in the transformation of the Mediterranean world or Europe.



Existing mortality estimates assert that the Justinianic Plague (circa 541 to 750 CE) caused tens of millions of deaths throughout the Mediterranean world and Europe, helping to end antiquity and start the Middle Ages. In this article, we argue that this paradigm does not fit the evidence. We examine a series of independent quantitative and qualitative datasets that are directly or indirectly linked to demographic and economic trends during this two-century period: Written sources, legislation, coinage, papyri, inscriptions, pollen, ancient DNA, and mortuary archaeology. Individually or together, they fail to support the maximalist paradigm: None has a clear independent link to plague outbreaks and none supports maximalist reconstructions of late antique plague. Instead of large-scale, disruptive mortality, when contextualized and examined together, the datasets suggest continuity across the plague period. Although demographic, economic, and political changes continued between the 6th and 8th centuries, the evidence does not support the now commonplace claim that the Justinianic Plague was a primary causal factor of them.

Justinianic Plague – first plague pandemic – Late Antiquity – plague – Yersinia pestis

Keywords: European Region; Plague; History; Society.


#Drug #resistant #tuberculosis in eastern #Europe and central #Asia: a time-series analysis of routine surveillance data (Lancet Infect Dis., abstract)

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

Drug-resistant tuberculosis in eastern Europe and central Asia: a time-series analysis of routine surveillance data

Andrei Dadu, MD, Arax Hovhannesyan, MD, Sevim Ahmedov, MD, Marieke J van der Werf, PhD, Masoud Dara, MD

Published: November 26, 2019 / DOI: https://doi.org/10.1016/S1473-3099(19)30568-7




Among all WHO regions, the WHO European Region has the highest proportion of drug-resistant tuberculosis among new and retreated cases. The 18 high-priority countries in eastern Europe and central Asia account for 85% of the tuberculosis incidence and more than 90% of drug-resistant tuberculosis cases emerging in the region. We aimed to analyse time-series trends in notification rates of drug-resistant tuberculosis among new tuberculosis cases in the 18 high-priority countries in the WHO European Region.


We used country data stored in WHO’s global tuberculosis database. For each country, we calculated annual notification rates per 100 000 population of new tuberculosis cases and of drug-resistant tuberculosis among new cases reported from Jan 1, 2000, to Dec 31, 2017. We computed annual percentage changes of notification rates and identified time-points of significant change in trends using the joinpoint regression method.


All 17 countries with data (no data available from Turkmenistan) showed a significant decline in new tuberculosis notification rates in the most recent years since the last joinpoint if one was identified. Notification rates of drug-resistant tuberculosis showed diverse trends, with substantial year-to-year variation. In the most recent years, notification rates of drug-resistant tuberculosis among new tuberculosis cases were decreasing in two countries (Estonia and Latvia), increasing in eight countries (Azerbaijan, Kyrgyzstan, Moldova [Republic of Moldova], Romania, Russia [Russian Federation], Tajikistan, Ukraine, and Uzbekistan), and stable in seven countries (Armenia, Belarus, Bulgaria, Georgia, Kazakhstan, Lithuania, and Turkey).


Our findings suggest that countries in the WHO European Region are more successful in controlling drug-susceptible tuberculosis than drug-resistant forms, and as a result, the proportion of drug-resistant strains among newly notified patients with tuberculosis is increasing in many settings. Two countries showed that it is possible to decrease incidence of both drug-susceptible and drug-resistant tuberculosis. If no additional efforts are made in prevention and care of patients with drug-resistant tuberculosis, further decline of the tuberculosis burden will be halted. Further studies are needed to investigate the success stories and document the most effective interventions to reach the target to end tuberculosis by 2030.


United States Agency for International Development.

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


#Zika virus #threshold determines #transmission by #European #Aedes albopictus #mosquitoes (Emerg Microbes Infect., abstract)

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

Emerg Microbes Infect. 2019;8(1):1668-1678. doi: 10.1080/22221751.2019.1689797.

Zika virus threshold determines transmission by European Aedes albopictus mosquitoes.

Vazeille M1, Madec Y2, Mousson L1, Bellone R1, Barré-Cardi H3, Sousa CA4, Jiolle D5, Yébakima A6, de Lamballerie X7, Failloux AB1.

Author information: 1 Institut Pasteur, Department of Virology, Arboviruses and Insect Vectors, Paris, France. 2 Institut Pasteur, Department of Infection and Epidemiology, Emerging Diseases Epidemiology, France. 3 Office de l’Environnement de la Corse, Observatoire Conservatoire des Insectes de Corse, Corte, France. 4 Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal. 5 UMR MIVEGEC (IRD 224-CNRS 5290-UM), Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle, Institut de Recherche pour le Développement (IRD), Montpellier, France. 6 VECCOTRA, Rivière salée, Martinique. 7 Unité des Virus Emergents (UVE), Aix Marseille Université, IHU Méditerranée Infection, Marseille, France.



Since its emergence in Yap Island in 2007, Zika virus (ZIKV) has affected all continents except Europe. Despite the hundreds of cases imported to European countries from ZIKV-infested regions, no local cases have been reported in localities where the ZIKV-competent mosquito Aedes albopictus is well established. Here we analysed the vector competence of European Aedes (aegypti and albopictus) mosquitoes to different genotypes of ZIKV. We demonstrate that Ae. albopictus from France was less susceptible to the Asian ZIKV than to the African ZIKV. Critically we show that effective crossing of anatomical barriers (midgut and salivary glands) after an infectious blood meal depends on a viral load threshold to trigger: (i) viral dissemination from the midgut to infect mosquito internal organs and (ii) viral transmission from the saliva to infect a vertebrate host. A viral load in body ≥4800 viral copies triggered dissemination and ≥12,000 viral copies set out transmission. Only 27.3% and 18.2% of Ae. albopictus Montpellier mosquitoes meet respectively these two criteria. Collectively, these compelling results stress the poor ability of Ae. albopictus to sustain a local transmission of ZIKV in Europe and provide a promising tool to evaluate the risk of ZIKV transmission in future outbreaks.

KEYWORDS: Aedes albopictus; Europe; Zika; arbovirus; epidemic potential

PMID: 31735122 DOI: 10.1080/22221751.2019.1689797

Keywords: Zika Virus; Mosquitoes; Aedes albopictus; European Region.