#EBV and #MS #risk in the #Finnish #Maternity #Cohort (Ann Neurol., abstract)

[Source: Annals of Neurology, full page: (LINK). Abstract, edited.]

Epstein‐Barr virus and multiple sclerosis risk in the Finnish Maternity Cohort

Kassandra L. Munger ScD,  Kira Hongell MD,  Marianna Cortese MD, PhD,  Julia Åivo MD, Merja Soilu‐Hänninen MD, PhD,  Heljä‐Marja Surcel PhD,  Alberto Ascherio MD, DrPH

First published: 21 June 2019 / DOI:  https://doi.org/10.1002/ana.25532

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/ana.25532.




To determine whether maternal Epstein‐Barr virus (EBV) IgG antibody levels are associated with risk of multiple sclerosis (MS) in the offspring.


We conducted a prospective nested case‐control study in the Finnish Maternity Cohort (FMC) with serum samples from over 800,000 women collected during pregnancy since 1983. Cases of MS among offspring born between 1983 and 1991 were identified via hospital and prescription registries; 176 cases were matched to up to 3 controls (n=326) on region and dates of birth, sample collection, and mother’s birth. We used conditional logistic regression to estimate relative risks (RR) and adjusted models for sex of the child, gestational age at sample collection, and maternal serum 25‐hydroxyvitamin D and cotinine levels. Similar analyses were conducted among 1,049 women with MS and 1,867 matched controls in the FMC.


Maternal viral capsid antigen IgG levels during pregnancy were associated with an increased MS risk among offspring (RRtop vs. bottom quintile=2.44, 95%CI: 1.20‐5.00, p trend=0.004); no associations were found between maternal EBNA‐1, EA‐D, or cytomegalovirus IgG levels and offspring MS risk. Among women in the FMC, those in the highest versus lowest quintile of EBNA‐1 IgG levels had a 3‐fold higher risk of MS (RR=3.21, 95%CI: 2.37‐4.35, p trend <1.11e‐16). These associations were not confounded or modified by 25‐hydroxyvitamin D.


Offspring of mothers with high VCA IgG during pregnancy appear to have an increased risk of MS. The increase in MS risk among women with elevated pre‐diagnostic EBNA‐1 IgG levels is consistent with previous results.

This article is protected by copyright. All rights reserved.

Keywords: EBV; Multiple Sclerosis; Pregnancy; Finland; Neurology.



Emergence of #ceftazidime – #avibactam- #resistant #Klebsiella pneumoniae during #treatment, #Finland, December 2018 (Euro Surveill., abstract)

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

Emergence of ceftazidime-avibactam-resistant Klebsiella pneumoniae during treatment, Finland, December 2018

Kati Räisänen 1, Irma Koivula 2, Heikki Ilmavirta 3, Santeri Puranen 4, Teemu Kallonen 1,5, Outi Lyytikäinen 1, Jari Jalava 1

Affiliations: 1 Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland; 2 Kuopio University Hospital, Unit of Infections and Hospital hygiene, Kuopio University Hospital, Kuopio, Finland; 3 Eastern Finland laboratory Centre, Kuopio, Finland; 4 Aalto University, Department of Computer Science, Espoo, Finland; 5 Department of Biostatistics, University of Oslo, Oslo, Norway

Correspondence:  Kati Räisänen

Citation style for this article: Räisänen Kati, Koivula Irma, Ilmavirta Heikki, Puranen Santeri, Kallonen Teemu, Lyytikäinen Outi, Jalava Jari. Emergence of ceftazidime-avibactam-resistant Klebsiella pneumoniae during treatment, Finland, December 2018. Euro Surveill. 2019;24(19):pii=1900256. https://doi.org/10.2807/1560-7917.ES.2019.24.19.1900256

Received: 24 Apr 2019;   Accepted: 07 May 2019



In December 2018, a ceftazidime-avibactam (CAZ-AVI)-resistant KPC-2-producing Klebsiella pneumoniae strain was isolated in Finland. CAZ-AVI resistance was observed 34 days after CAZ-AVI treatment in a trauma patient transferred from a hospital in Greece who had been colonised with blaKPC-2-producing K. pneumoniae ST39, and later developed a bloodstream infection. The CAZ-AVI-resistant strain contained a novel 15 amino acid insertion in the KPC-2 protein causing structural changes proximal to the KPC-2 active site.

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

Keywords: Antibiotics; Drugs Resistance; Ceftazidime; Avibactam; Klebsiella pneumoniae; Greece; Finland.


#Travellers as #sentinels of #chikungunya #epidemics: a #family #cluster among Finnish travellers to Koh Lanta, #Thailand, January 2019 (Euro Surveill., abstract)

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

Travellers as sentinels of chikungunya epidemics: a family cluster among Finnish travellers to Koh Lanta, Thailand, January 2019

Anu Kantele 1

Affiliations: 1 Inflammation Center, Department of Infectious Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

Correspondence:  Anu Kantele

Citation style for this article: Kantele Anu. Travellers as sentinels of chikungunya epidemics: a family cluster among Finnish travellers to Koh Lanta, Thailand, January 2019. Euro Surveill. 2019;24(11):pii=1900162. https://doi.org/10.2807/1560-7917.ES.2019.24.11.1900162

Received: 04 Mar 2019;   Accepted: 14 Mar 2019



In January 2019, five of 11 travellers to Koh Lanta, Thailand, contracted chikungunya, symptoms starting 4 days after presumed transmission. Four cases were hospitalised, one child treated in intensive care; 6 weeks after disease onset, all three adults have persistent arthralgias/arthritis, incapacitating for two. Together with a recent report of eight chikungunya cases among travellers to various destinations in Thailand, the high attack rate in our cluster points to an ongoing outbreak in the country.

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

Keywords: Chikungunya fever; Finland; Thailand.


Long-Term #Antibody Response to Human #Papillomavirus #Vaccines: up to 12 Years Follow-Up in the #Finnish Maternity Cohort (J Infect Dis., abstract)

[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

Long-Term Antibody Response to Human Papillomavirus Vaccines: up to 12 Years Follow-Up in the Finnish Maternity Cohort

Hanna Artemchuk, Tiina Eriksson, Mario Poljak, Heljä-Marja Surcel, Joakim Dillner, Matti Lehtinen, Helena Faust

The Journal of Infectious Diseases, jiy545, https://doi.org/10.1093/infdis/jiy545

Published: 18 September 2018




Most cervical cancers are caused by vaccine-preventable infections with human papillomaviruses (HPV). HPV prophylactic vaccines Gardasil™ and Cervarix™ have been widely used for >10 years and are reported to induce high antibody levels. A head-to-head comparison of the antibody responses induced by the two vaccines has been performed only up to 5 years.


Virtually all 3,300 16- to 17-year-old Finnish females, who got one of the two HPV vaccines in phase III licensure trials, consented to registry-based long-term follow-up. Linkage with the Finnish Maternity Cohort found that they donated >2,500 serum samples up to 12 years later. Sera of 337 (38.6%) Gardasil™ and 730 (30.3%) Cervarix™ vaccine recipients were retrieved and HPV type-specific antibody levels were determined using in-house multiplexed heparin-HPV Pseudovirion Luminex assay.


HPV16 and HPV18 antibody levels remained stable and above natural infection-related antibody levels for up to 12 years for most vaccine recipients. The median antibody levels were higher among Cervarix™ recipients 7 to 12 years post vaccination (p<0.0001).


The stability of vaccine-induced antibody levels is in accordance with the high long-term protection reported previously. The differences in antibody levels induced by the two vaccines imply that continued follow-up to identify possible breakthrough cases and estimation of the minimal protective levels of serum antibodies is a research priority.

Human papillomavirus (HPV), HPV vaccine, long-term follow-up, comparison, antibodies, serology, Gardasil™, Cervarix™, Finnish Maternity Cohort (FMC)

Issue Section: Major Article

© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: HPV; Cancer; Vaccines; Finland.


#Yersinia spp. in Wild #Rodents and #Shrews in #Finland (Vector Borne Zoo Dis., abstract)

[Source: Vector Borne and Zoonotic Diseases, full page: (LINK). Abstract, edited.]

Vector-Borne and Zoonotic Diseases

Yersinia spp. in Wild Rodents and Shrews in Finland

To cite this article: Joutsen Suvi, Laukkanen-Ninios Riikka, Henttonen Heikki, Niemimaa Jukka, Voutilainen Liina, Kallio Eva R., Helle Heikki, Korkeala Hannu, and Fredriksson-Ahomaa Maria. Vector-Borne and Zoonotic Diseases. March 2017, ahead of print. doi:10.1089/vbz.2016.2025.

Online Ahead of Print: March 23, 2017

Author information: Suvi Joutsen,1 Riikka Laukkanen-Ninios,1 Heikki Henttonen,2 Jukka Niemimaa,2 Liina Voutilainen,2,3 Eva R. Kallio,4 Heikki Helle,4 Hannu Korkeala,1 and Maria Fredriksson-Ahomaa1

1Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland. 2Natural Resources Institute Finland, Vantaa, Finland. 3Department of Virology, University of Helsinki, Helsinki, Finland. 4Department of Biological and Environmental Science, University of Jyväskylä, Jyväskylä, Finland.

Address correspondence to: Suvi Joutsen, Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, Helsinki FI-00014, Finland, E-mail: suvi.joutsen@helsinki.fi



Yersinia enterocolitica and Yersinia pseudotuberculosis are important zoonotic bacteria causing human enteric yersiniosis commonly reported in Europe. All Y. pseudotuberculosis strains are considered pathogenic, while Y. enterocolitica include both pathogenic and nonpathogenic strains which can be divided into six biotypes (1A, 1B, and 2–5) and about 30 serotypes. The most common types causing yersiniosis in Europe are Y. enterocolitica bioserotypes 4/O:3 and 2/O:9. Strains belonging to biotype 1A are considered as nonpathogenic because they are missing important virulence genes like the attachment-invasion-locus (ail) gene in the chromosome and the virulence plasmid. The role of wild small mammals as a reservoir of enteropathogenic Yersinia spp. is still obscure. In this study, the presence of Yersinia spp. was examined from 1840 wild small mammals, including voles, mice, and shrews, trapped in Finland during a 7-year period. We isolated seven Yersinia species. Y. enterocolitica was the most common species, isolated from 8% of the animals; while most of these isolates represented nonpathogenic biotype 1A, human pathogenic bioserotype 2/O:9 was also isolated from a field vole. Y. pseudotuberculosis of bioserotype 1/O:2 was isolated from two shrews. The ail gene, which is typically only found in the isolates of biotypes 1B and 2–5 associated with yersiniosis, was frequently (23%) detected in the nonpathogenic isolates of biotype 1A and sporadically (6%) in Yersinia kristensenii isolates. Our results suggest that wild small mammals, especially voles, may serve as carriers for ail-positive Y. enterocolitica 1A and Y. kristensenii. We also demonstrate that voles and shrews sporadically excrete pYV-positive Y. enterocolitica 2/O:9 and Y. pseudotuberculosis 1/O:2, respectively, in their feces and, thus, can serve as a contamination source for vegetables by contaminating the soil.

Keywords: Yersinia spp.; Wildlife; Finland.


Mid-season real-time #estimates of seasonal #influenza #vaccine #effectiveness in persons 65+ in … #Sweden, & #Finland, Jan. ’17 (@eurosurveillanc, abstract)

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

Eurosurveillance, Volume 22, Issue 8, 23 February 2017  / Research article

Mid-season real-time estimates of seasonal influenza vaccine effectiveness in persons 65 years and older in register-based surveillance, Stockholm County, Sweden, and Finland, January 2017

M Hergens 1 2 , U Baum 2 3 , M Brytting 4 , N Ikonen 5 , A Haveri 5 , Å Wiman 4 , H Nohynek 2 6 , Å Örtqvist 1 2

Author affiliations: 1. Department of Communicable Disease Control and Prevention, Stockholm County Council, and Karolinska Institutet, Department of Medicine Karolinska Solna, Unit of Infectious Diseases, Stockholm, Sweden; 2. These authors contributed equally to this work; 3. Impact Assessment Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland; 4. Unit for laboratory surveillance of viral pathogens and vaccine preventable diseases, Department of Microbiology, The Public Health Agency of Sweden, Solna, Sweden; 5. Viral Infections Unit, Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland; 6. Vaccination Programme Unit, Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland

Correspondence: Åke Örtqvist (ake.ortqvist@sll.se)

Citation style for this article: Hergens M, Baum U, Brytting M, Ikonen N, Haveri A, Wiman Å, Nohynek H, Örtqvist Å. Mid-season real-time estimates of seasonal influenza vaccine effectiveness in persons 65 years and older in register-based surveillance, Stockholm County, Sweden, and Finland, January 2017. Euro Surveill. 2017;22(8):pii=30469. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2017.22.8.30469

Received:08 February 2017; Accepted:20 February 2017



Systems for register-based monitoring of vaccine effectiveness (VE) against laboratory-confirmed influenza (LCI) in real time were set up in Stockholm County, Sweden, and Finland, before start of the 2016/17 influenza season, using population-based cohort studies. Both in Stockholm and Finland, an early epidemic of influenza A(H3N2) peaked in week 52, 2016. Already during weeks 48 to 50, analyses of influenza VE in persons 65 years and above showed moderately good estimates of around 50%, then rapidly declined by week 2, 2017 to 28% and 32% in Stockholm and Finland, respectively. The sensitivity analyses, where time since vaccination was taken into account, could not demonstrate a clear decline, neither by calendar week nor by time since vaccination. Most (68%) of the samples collected from vaccinated patients belonged to the 3C.2a1 subclade with the additional amino acid substitution T135K in haemagglutinin (64%) or to subclade 3C.2a with the additional haemagglutinin substitutions T131K and R142K (36%). The proportion of samples containing these alterations increased during the studied period. These substitutions may be responsible for viral antigenic change and part of the observed VE drop. Another possible cause is poor vaccine immunogenicity in older persons. Improved influenza vaccines are needed, especially for the elderly.

Keywords: Seasonal Influenza; H3N2; Vaccines; Sweden; Finland.



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

Eurosurveillance, Volume 21, Issue 38, 22 September 2016 / Surveillance and outbreak report


H Nohynek 1 , U Baum 2 , R Syrjänen 2 , N Ikonen 3 , J Sundman 2 , J Jokinen 2

Author affiliations: 1. Vaccine Programme Unit, Department of Health Protection, National Institute for Health and Welfare, Finland; 2. Impact Assessment Unit, Department of Health Protection, National Institute for Health and Welfare, Finland; 3. Viral Infections Unit, Department of Infectious Diseases, National Institute for Health and Welfare, Finland.

Correspondence: Hanna Nohynek (hanna.nohynek@thl.fi)

Citation style for this article: Nohynek H, Baum U, Syrjänen R, Ikonen N, Sundman J, Jokinen J. Effectiveness of the live attenuated and the inactivated influenza vaccine in two-year-olds – a nationwide cohort study Finland, influenza season 2015/16. Euro Surveill. 2016;21(38):pii=30346. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.38.30346

Received:19 July 2016; Accepted:03 September 2016



Although widely recommended, influenza vaccination of children is part of the national vaccination programme only in few countries. In addition to Canada and the United States (US), in Europe Finland and the United Kingdom have introduced live attenuated influenza vaccine (LAIV) for healthy children in their programmes. On 22 June 2016, the US Advisory Committee on Immunizations Practices, voted against further use of LAIV due to no observed vaccine effectiveness (VE) over three consecutive influenza seasons (2013/14 to 2015/16). We summarise the results of a nationwide, register-based cohort study (N=55,258 of whom 8,086 received LAIV and 4,297 TIV); all outcome (laboratory-confirmed influenza), exposure (vaccination) and confounding variable data were retrieved from four computerised national health registers, which were linked via a unique personal identity code assigned to all permanent Finnish residents regardless of nationality. Our study provides evidence of moderate effectiveness against any laboratory-confirmed influenza of the quadrivalent LAIV vaccine (VE: 51%; 95% confidence interval (CI): 28–66%) as well as the inactivated trivalent vaccine (VE: 61%; 95% CI: 31–78%) among two-year-olds during the influenza season 2015/16 in Finland. Based on these data, Finland will continue using LAIV for young children in its National Immunisation Programme this coming influenza season.

Keywords: Research; Abstracts; Finland; Seasonal Influenza; Vaccines.