EARLY 2016/17 #VACCINE #EFFECTIVENESS #ESTIMATES AGAINST INFLUENZA A(#H3N2): I-MOVE STUDIES … (@eurosurveillanc, abstract)

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

Eurosurveillance, Volume 22, Issue 7, 16 February 2017 / Rapid communication

EARLY 2016/17 VACCINE EFFECTIVENESS ESTIMATES AGAINST INFLUENZA A(H3N2): I-MOVE MULTICENTRE CASE CONTROL STUDIES AT PRIMARY CARE AND HOSPITAL LEVELS IN EUROPE

E Kissling 1 2 , M Rondy 1 2 , I-MOVE/I-MOVE+ study team 3

Author affiliations: 1. EpiConcept, Paris, France; 2. Both authors have contributed equally to the study and manuscript writing; 3. The members of I-MOVE/I-MOVE+ study team are listed at the end of the article

Correspondence: Esther Kissling (e.kissling@epiconcept.fr)

Citation style for this article: Kissling E, Rondy M, I-MOVE/I-MOVE+ study team. Early 2016/17 vaccine effectiveness estimates against influenza A(H3N2): I-MOVE multicentre case control studies at primary care and hospital levels in Europe. Euro Surveill. 2017;22(7):pii=30464. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2017.22.7.30464

Received:09 February 2017; Accepted:16 February 2017

 

Abstract

We measured early 2016/17 season influenza vaccine effectiveness (IVE) against influenza A(H3N2) in Europe using multicentre case control studies at primary care and hospital levels. IVE at primary care level was 44.1%, 46.9% and 23.4% among 0–14, 15–64 and ≥ 65 year-olds, and 25.7% in the influenza vaccination target group. At hospital level, IVE was 2.5%, 7.9% and 2.4% among ≥ 65, 65–79 and ≥ 80 year-olds. As in previous seasons, we observed suboptimal IVE against influenza A(H3N2).

Keywords: Seasonal Influenza; H3N2; Vaccines, European Region.

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EXPERIMENTAL #TRANSMISSION OF #ZIKA VIRUS BY #MOSQUITOES FROM CENTRAL #EUROPE (@eurosurveillanc, abstract)

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

Eurosurveillance, Volume 22, Issue 2, 12 January 2017 / Rapid communication

EXPERIMENTAL TRANSMISSION OF ZIKA VIRUS BY MOSQUITOES FROM CENTRAL EUROPE

A Heitmann 1 2 , S Jansen 1 2 3 , R Lühken 1 , M Leggewie 1 3 , M Badusche 1 , B Pluskota 4 , N Becker 4 5 , O Vapalahti 6 , J Schmidt-Chanasit 1 3 , E Tannich 1 3

Author affiliations: 1. Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; 2. These authors contributed equally to this work; 3. German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Germany; 4. Institute for Dipterology (IfD), Speyer, Germany; 5. University of Heidelberg, Heidelberg, Germany; 6. University of Helsinki and Helsinki University Hospital, Helsinki, Finland

Correspondence: Renke Lühken (renkeluhken@gmail.com)

Citation style for this article: Heitmann A, Jansen S, Lühken R, Leggewie M, Badusche M, Pluskota B, Becker N, Vapalahti O, Schmidt-Chanasit J, Tannich E. Experimental transmission of Zika virus by mosquitoes from central Europe . Euro Surveill. 2017;22(2):pii=30437. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2017.22.2.30437

Received:15 November 2016; Accepted:10 January 2017

 

Abstract

Mosquitoes collected in Germany in 2016, including Culex pipiens pipiens biotype pipiens, Culex torrentium and Aedes albopictus, as well as Culex pipiens pipiens biotype molestus (in colony since 2011) were experimentally infected with Zika virus (ZIKV) at 18 °C or 27 °C. None of the Culex taxa showed vector competence for ZIKV. In contrast, Aedes albopictus were susceptible for ZIKV but only at 27 °C, with transmission rates similar to an Aedes aegypti laboratory colony tested in parallel.

Keywords: Aedes Albopictus; Culex spp.; European Region; Zika Virus.

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Occurrence of #carbapenemase-producing #Klebsiella pneumoniae and #Escherichia coli in the #EuSCAPE: a prospective, multinational study (Lancet Infect Dis., abstract)

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

Articles

Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study

Prof Hajo Grundmann, MD, Corinna Glasner, PhD*, Barbara Albiger, PhD, David M Aanensen, PhD, Chris T Tomlinson, PhD, Prof Arjana Tambić Andrasević, MD, Prof Rafael Cantón, MD, Prof Yehuda Carmeli, MD, Prof Alexander W Friedrich, MD, Christian G Giske, MD, Prof Youri Glupczynski, MD, Prof Marek Gniadkowski, PhD, Prof David M Livermore, PhD, Prof Patrice Nordmann, PhD, Laurent Poirel, PhD, Prof Gian M Rossolini, MD, Prof Harald Seifert, MD, Prof Alkiviadis Vatopoulos, MD, Prof Timothy Walsh, PhD, Prof Neil Woodford, PhD, Dominique L Monnet, PhD the European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group†

* These authors contributed equally

†A list of the EuSCAPE Working Group can be found at the end of the manuscript and in the appendix

Published: 17 November 2016 / Article has an altmetric score of 1 / DOI: http://dx.doi.org/10.1016/S1473-3099(16)30257-2

© 2016 Elsevier Ltd. All rights reserved.

 

Summary

Background

Gaps in the diagnostic capacity and heterogeneity of national surveillance and reporting standards in Europe make it difficult to contain carbapenemase-producing Enterobacteriaceae. We report the development of a consistent sampling framework and the results of the first structured survey on the occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in European hospitals.

Methods

National expert laboratories recruited hospitals with diagnostic capacities, who collected the first ten carbapenem non-susceptible clinical isolates of K pneumoniae or E coli and ten susceptible same-species comparator isolates and pertinent patient and hospital information. Isolates and data were relayed back to national expert laboratories, which made laboratory-substantiated information available for central analysis.

Findings

Between Nov 1, 2013, and April 30, 2014, 455 sentinel hospitals in 36 countries submitted 2703 clinical isolates (2301 [85%] K pneumoniae and 402 (15%) E coli). 850 (37%) of 2301 K pneumoniae samples and 77 (19%) of 402 E coli samples were carbapenemase (KPC, NDM, OXA-48-like, or VIM) producers. The ratio of K pneumoniae to E coli was 11:1. 1·3 patients per 10 000 hospital admissions had positive clinical specimens. Prevalence differed greatly, with the highest rates in Mediterranean and Balkan countries. Carbapenemase-producing K pneumoniae isolates showed high resistance to last-line antibiotics.

Interpretation

This initiative shows an encouraging commitment by all participants, and suggests that challenges in the establishment of a continent-wide enhanced sentinel surveillance for carbapenemase-producing Enterobacteriaeceae can be overcome. Strengthening infection control efforts in hospitals is crucial for controlling spread through local and national health care networks.

Funding

European Centre for Disease Prevention and Control.

Keywords: Antibiotics; Drugs Resistance; Carbapenem; Enterobacteriaceae; K. Pneumoniae; E. Coli; European Region.

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#MRSA #infections among #patients in the #emergency #department: a European multicentre study (J Antimicrob Chemother., abstract)

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

MRSA infections among patients in the emergency department: a European multicentre study

C. Bouchiat1,*, S. Curtis2, I. Spiliopoulou3, M. Bes1, C. Cocuzza4, I. Codita5, C. Dupieux1, N. Giormezis3, A. Kearns2, F. Laurent1, S. Molinos6,7, R. Musumeci4, C. Prat6,7, M. Saadatian-Elahi8, E. Tacconelli9, A. Tristan1, B. Schulte10 and F. Vandenesch1 on behalf of the ESCMID Study Group on Staphylococci and Staphylococcal Infections (ESGS)

Author Affiliations: 1National Reference Center for Staphylococci, 59 Bd Louis Pinel, 69677 Bron cedex, Lyon, France; 2Staphylococcus Reference Service, Public Health England, 61 Colindale Avenue London NW9 5EQ, UK; 3National Reference Laboratory for Staphylococci, University of Patras, University Campus, Rion 26504, Patras, Greece; 4Laboratory of Clinical Microbiology and Virology, University of Milano-Bicocca, Via Cadore 48, Monza, Italy; 5Cantacuzino National Institute of Research, Splaiul Independentei 103, RO-050096 Bucharest, Romania; 6Servei de Microbiologia Hospital Universitari Germans Trias i Pujol, Badalona, Spain; 7CIBER Enfermedades Respiratorias. Carretera del Canyet s/n. 08916 Badalona, Spain; 8Epidemiology unit, Hospices Civils de Lyon, Place d’Arsonval, 69008 Lyon, France; 9Division of Infectious Diseases, Department of Internal Medicine 1, University Hospital Tuebingen, Geissweg 3, 72076 Tuebingen, Germany; 10Institut für Mikrobiologie und Infektionsmedizin, University Hospital Tuebingen, Auf der Morgenstelle 28, 72076 Tuebingen, Germany

*Corresponding author. CNR des Staphylocoques—Centre de Biologie Est, 59 Boulevard Louis Pinel, 69677 Bron cedex, France. Tel: +33-4-27-85-52-57; Fax: +33-4-72-35-73-35; E-mail: coralie.bouchiat@chu-lyon.fr

Received July 26, 2016. Revision requested August 26, 2016. Revision received September 9, 2016. Accepted September 13, 2016.

 

Abstract

Background

MRSA is a therapeutic concern worldwide, and a major agent of community-acquired skin and soft tissue infections (CA-SSTIs). While the US epidemiology of MRSA in CA-SSTIs is well described and reports the high prevalence of the USA300 clone, data on the European situation are lacking.

Objectives

To determine the prevalence and clonal characteristics of MRSA in CA-SSTIs in seven European emergency departments.

Patients and methods

From April to June 2015, patients presenting to the tertiary hospital emergency department with a Staphylococcus aureus CA-SSTI were prospectively enrolled. S. aureus isolates were characterized by antimicrobial susceptibility testing, detection of Panton–Valentine leucocidin encoding genes and spa-typing, MLST and/or DNA microarray.

Results

Two-hundred and five cases of S. aureus-associated CA-SSTIs were included, comprising folliculitis, furuncles, abscesses, paronychia, impetigo, carbuncles and cellulitis. Of the 205 cases, we report an MRSA prevalence rate of 15.1%, with a north (0%) to south (29%) increasing gradient. Fifty-one isolates were Panton–Valentine leucocidin-positive (24.9%), whether MSSA or MRSA, with a heterogeneous distribution between countries. Clonal distribution of MSSA and MRSA showed high diversity, with no predominant circulating clone and no archetypical USA300 CA-MRSA clone.

Conclusions

This original prospective multicentre study highlights stark differences in European MRSA epidemiology compared with the USA, and that the USA300 CA-MRSA clone is not predominant among community-infected patients in Europe.

© The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Keywords: Staphylococcus Aureus; MRSA; Antibiotics; Drugs Resistance; European Region.

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Improving #influenza #virological #surveillance in #Europe: strain-based reporting of #antigenic and genetic characterisation data, 11 European countries, influenza season 2013/14 (@eurosurveillanc, abstract)

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

Eurosurveillance, Volume 21, Issue 41, 13 October 2016  / Surveillance and outbreak report

Improving influenza virological surveillance in Europe: strain-based reporting of antigenic and genetic characterisation data, 11 European countries, influenza season 2013/14

E Broberg 1 , O Hungnes 2 , B Schweiger 3 , K Prosenc 4 , R Daniels 5 , R Guiomar 6 , N Ikonen 7 , A Kossyvakis 8 , F Pozo 9 , S Puzelli 10 , I Thomas 11 , A Waters 12 , Å Wiman 13 , A Meijer 14

Author affiliations: 1. European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; 2. Norwegian Institute of Public Health, Oslo, Norway; 3. National Influenza Reference Centre, Robert Koch-Institute, Berlin, Germany; 4. Laboratory for Public Health Virology, National Laboratory for Health, Environment and Food Slovenia, Ljubljana, Slovenia; 5. Crick Worldwide Influenza Centre, The Francis Crick Institute, Mill Hill Laboratory, London, United Kingdom; 6. National Influenza Reference Laboratory, National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal; 7. Viral Infections Unit, National Institute for Health and Welfare (THL), Helsinki, Finland; 8. National Influenza Reference Laboratory of Southern Greece, Hellenic Pasteur Institute, Athens, Greece; 9. Respiratory Viruses and Influenza Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain; 10. National Influenza Centre, Instituto Superiore di Sanità, Rome, Italy; 11. National Influenza Reference Centre, Scientific Institute of Public Health, Brussels, Belgium; 12. National Virus Reference Laboratory, University College Dublin, Dublin, Ireland; 13. Public Health Agency of Sweden, Solna, Sweden; 14. National Institute of Public Health and the Environment, Bilthoven, the Netherlands

Correspondence: Eeva Broberg (eeva.broberg@ecdc.europa.eu)

Citation style for this article: Broberg E, Hungnes O, Schweiger B, Prosenc K, Daniels R, Guiomar R, Ikonen N, Kossyvakis A, Pozo F, Puzelli S, Thomas I, Waters A, Wiman Å, Meijer A. Improving influenza virological surveillance in Europe: strain-based reporting of antigenic and genetic characterisation data, 11 European countries, influenza season 2013/14. Euro Surveill. 2016;21(41):pii=30370. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.41.30370

Received:25 February 2016; Accepted:25 April 2016

 

Abstract

Influenza antigenic and genetic characterisation data are crucial for influenza vaccine composition decision making. Previously, aggregate data were reported to the European Centre for Disease Prevention and Control by European Union/European Economic Area (EU/EEA) countries. A system for collecting case-specific influenza antigenic and genetic characterisation data was established for the 2013/14 influenza season. In a pilot study, 11 EU/EEA countries reported through the new mechanism. We demonstrated feasibility of reporting strain-based antigenic and genetic data and ca 10% of influenza virus-positive specimens were selected for further characterisation. Proportions of characterised virus (sub)types were similar to influenza virus circulation levels. The main genetic clades were represented by A/StPetersburg/27/2011(H1N1)pdm09 and A/Texas/50/2012(H3N2). A(H1N1)pdm09 viruses were more prevalent in age groups (by years) < 1 (65%; p = 0.0111), 20–39 (50%; p = 0.0046) and 40–64 (55%; p = 0.00001) while A(H3N2) viruses were most prevalent in those ≥ 65 years (34%; p = 0.0012). Hospitalised patients in the age groups 6–19 years (67%; p = 0.0494) and ≥ 65 years (52%; p = 0.0005) were more frequently infected by A/Texas/50/2012 A(H3N2)-like viruses compared with hospitalised cases in other age groups. Strain-based reporting enabled deeper understanding of influenza virus circulation among hospitalised patients and substantially improved the reporting of virus characterisation data. Therefore, strain-based reporting of readily available data is recommended to all reporting countries within the EU/EEA.

Keywords: European Region; Seasonal Influenza; H1N1pdm09; H3N2.

——

#Characterization of a Novel #Chimeric #Swine Enteric #Coronavirus from Diseased #Pigs in Central Eastern #Europe in 2016 (Transbound Emerg Dis., abstract)

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

Transbound Emerg Dis. 2016 Sep 12. doi: 10.1111/tbed.12579. [Epub ahead of print]

Characterization of a Novel Chimeric Swine Enteric Coronavirus from Diseased Pigs in Central Eastern Europe in 2016.

Belsham GJ1, Rasmussen TB1, Normann P1, Vaclavek P2, Strandbygaard B1, Bøtner A3.

Author information: 1DTU National Veterinary Institute, Technical University of Denmark, Lindholm, Kalvehave, Denmark. 2Department of Virology, State Veterinary Institute Jihlava, Jihlava, Czech Republic. 3DTU National Veterinary Institute, Technical University of Denmark, Lindholm, Kalvehave, Denmark. aneb@vet.dtu.dk.

 

Abstract

During a severe outbreak of diarrhoea and vomiting in a pig herd in Central Eastern Europe, faecal samples were tested positive for porcine epidemic diarrhoea virus (PEDV) and negative for transmissible gastroenteritis virus (TGEV) using a commercial RT-qPCR assay that can detect both of these coronaviruses. However, further analyses, using other TGEV- and PEDV-specific RT-qPCR assays, provided results inconsistent with infection by either of these viruses. Sequencing of an amplicon (ca. 1.6 kb), generated by an RT-PCR specific for the PEDV S-gene, indicated a very close similarity (ca. 99% identity) to recently described chimeric viruses termed swine enteric coronaviruses (SeCoVs). These viruses (with an RNA genome of ca. 28 kb) were first identified in Italy in samples from 2009 but have not been detected there since 2012. A closely related virus was detected in archived samples in Germany from 2012, but has not been detected subsequently. Building on the initial sequence data, further amplicons were generated and over 9 kb of sequence corresponding to the 3′-terminus of the new SeCoV genome was determined. Sequence comparisons showed that the three known SeCoVs are ≥98% identical across this region and contain the S-gene and 3a sequences from PEDV within a backbone of TGEV, but the viruses are clearly distinct from each other. It is demonstrated, for the first time, that pigs from within the SeCoV-infected herd seroconverted against PEDV but tested negative in a TGEV-specific ELISA that detects antibodies against the S protein. These results indicate that SeCoV is continuing to circulate in Europe and suggest it can cause a disease that is very similar to PED. Specific detection of the chimeric SeCoVs either requires development of a new diagnostic RT-qPCR assay or the combined use of assays targeting the PEDV S-gene and another part of the TGEV genome.

© 2016 Blackwell Verlag GmbH.

KEYWORDS: porcine epidemic diarrhoea virus; recombination; transmissible gastroenteritis virus

PMID: 27619563 DOI: 10.1111/tbed.12579

[PubMed – as supplied by publisher]

Keywords: Research; Abstracts; Swine Enteric Coronavirus; European Region; Pigs.

——

#Prevalence of #microcephaly in #Europe: population based study (BMJ, abstract)

[Source: British Medical Journal, full page: (LINK). Abstract, edited.]

Research

Prevalence of microcephaly in Europe: population based study

BMJ 2016; 354 / doi: http://dx.doi.org/10.1136/bmj.i4721 / (Published 13 September 2016) / Cite this as: BMJ 2016;354:i4721

Joan K Morris, professor of medical statistics1, Judith Rankin, professor of maternal and perinatal epidemiology2, Ester Garne, consultant paediatrician3, Maria Loane, reader in public health4, Ruth Greenlees, EUROCAT database manager4, Marie-Claude Addor, clinical geneticist5, Larraitz Arriola, epidemiologist6, Ingeborg Barisic, professor of paediatrics and medical genetics7, Jorieke E H Bergman, clinical geneticist8, Melinda Csaky-Szunyogh, head of department9, Carlos Dias, coordinator and invited assistant professor10, Elizabeth S Draper, professor of perinatal and paediatric epidemiology11, Miriam Gatt, consultant in public health medicine12, Babak Khoshnood, medical epidemiologist13, Kari Klungsoyr, professor14, Jennifer J Kurinczuk, director15, Catherine Lynch, specialist in public health medicine16, Robert McDonnell, consultant in public health medicine17, Vera Nelen, director18, Amanda J Neville, senior research fellow19, Mary T O’Mahony, specialist in public health medicine20, Anna Pierini, researcher21, Hanitra Randrianaivo, scientific director22, Anke Rissmann, head of department23, David Tucker, CARIS manager24, Christine Verellen-Dumoulin, professor25, Hermien E K de Walle, senior epidemiologist8, Diana Wellesley, consultant and honorary senior lecturer in clinical genetics26, Awi Wiesel, head of epidemiology27, Helen Dolk, professor of epidemiology and health services research4

Author affiliations: 1Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK; 2Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK; 3Paediatric Department, Hospital Lillebaelt, Kolding, Denmark; 4University of Ulster, Newtownabbey, Co Antrim, Northern Ireland, UK; 5Division of Medical Genetics, Lausanne, Switzerland; 6Public Health Division of Gipuzkoa, Instituto BIO-Donostia, Basque Government, CIBER Epidemiologia y Salud Publica – CIBERESP, Spain; 7Children’s Hospital Zagreb, Medical School University of Zagreb, Zagreb, Croatia; 8University of Groningen, University Medical Centre Groningen, Department of Genetics, Groningen, Netherlands; 9National Public Health and Medical Officer Service, Hungarian Congenital Abnormality Registry, Budapest, Hungary; 10Centro de Estudos e registo de A C, Lisbon, Portugal; 11University of Leicester, Leicester, UK; 12Department of Health Information and Research, Guardamangia, Malta
13INSERM, Paris, France; 14Department of Global Public Health and Primary Care, University of Bergen, and Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen, Norway; 15National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK; 16Health Service Executive, Kilkenny, Republic of Ireland; 17Health Service Executive, Dublin, Republic of Ireland; 18Provincial Institute for Hygiene, Antwerp, Belgium; 19IMER Registry, Centre for Clinical and Epidemiological Research, University of Ferrara and Azienda Ospedaliero- Universitaria di Ferrara, Ferrara, Italy; 20Health Service Executive, Cork, Republic of Ireland; 21CNR Institute of Clinical Physiology, Pisa, Italy; 22Registre des Malformations Congenitales de la Reunion, Saint-Pierre, Reunion; 23Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Magdeburg, Germany; 24Public Health Wales, Swansea, UK; 25Institut de Pathologie at de Genetique, Charleroi, Belgium; 26University of Southampton and Wessex Clinical Genetics Service, Southampton, UK; 27Birth Registry Mainz Model, University Medical Centre of Johannes Gutenberg University, Mainz, Germany

Correspondence to: J Morris j.k.morris@qmul.ac.uk

Accepted 30 August 2016

 

Abstract

Objectives 

To provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe, and evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Congenital Anomalies).

Design 

Questionnaire and population based observational study.

Setting 

24 EUROCAT registries covering 570 000 births annually in 15 countries.

Participants 

Cases of microcephaly not associated with a genetic condition among live births, fetal deaths from 20 weeks’ gestation, and terminations of pregnancy for fetal anomaly at any gestation.

Main outcome measures 

Prevalence of microcephaly (1 Jan 2003-31 Dec 2012) analysed with random effects Poisson regression models to account for heterogeneity across registries.

Results 

16 registries responded to the questionnaire, of which 44% (7/16) used the EUROCAT definition of microcephaly (a reduction in the size of the brain with a skull circumference more than 3 SD below the mean for sex, age, and ethnic origin), 19% (3/16) used a 2 SD cut off, 31% (5/16) were reliant on the criteria used by individual clinicians, and one changed criteria between 2003 and 2012. Prevalence of microcephaly in Europe was 1.53 (95% confidence interval 1.16 to 1.96) per 10 000 births, with registries varying from 0.4 (0.2 to 0.7) to 4.3 (3.6 to 5.0) per 10 000 (χ2=338, df=23, I2=93%). Registries with a 3 SD cut off reported a prevalence of 1.74 per 10 000 (0.86 to 2.93) compared with those with the less stringent 2 SD cut off of 1.21 per 10 000 (0.21 to 2.93). The prevalence of microcephaly would need to increase in one year by over 35% in Europe or by over 300% in a single registry to reach statistical significance (P<0.01).

Conclusions 

EUROCAT could detect increases in the prevalence of microcephaly from the Zika virus of a similar magnitude to those observed in Brazil. Because of the rarity of microcephaly and discrepant diagnostic criteria, however, the smaller increases expected in Europe would probably not be detected. Clear diagnostic criteria for microcephaly must be adopted across Europe.

Keywords: Research; Abstracts; Microcephaly; European Region.

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