Eurosurveillance
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This article describes the data obtained by the Portuguese Laboratory Network, reactivated following the World Health Organization declaration of the 2009 influenza pandemic, on the diagnoses of influenza A(H1N1)pdm09 infection during the pandemic (2009/10) and post-pandemic (2010/11) influenza seasons. The laboratories analysed and reported cases of influenza-like illness (ILI) and severe acute respiratory infection (SARI) to the National Influenza Reference Laboratory, which performed more detailed antigenic and genetic characterisation of the virus isolates. In 2009/10, a total of 62,089 ILI cases, distributed in two peaks, were analysed, 25,985 of which were positive for influenza A(H1N1)pdm09. ⋯ Although the 2010/11 viruses remained antigenically similar to A/California/7/2009, increased genetic variation was observed. During the two seasons, two viruses with the neuraminidase H275Y amino acid substitution, associated with oseltamivir resistance, were detected. The Laboratory Network made an important contribution to the description of the influenza activity in the two seasons.
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Countries across Europe developed a range of database systems to register pandemic influenza A(H1N1)pdm09 cases. Anecdotal reports indicate that some systems were not as useful as expected. This was a cross-sectional, semi-structured survey of health professionals who collected and reported pandemic influenza A(H1N1)pdm09 cases in 23 countries within the 27 European Union (EU) Member States plus Norway. ⋯ We conducted the survey to identify improvements that could be made to future pandemic case registers at national and EU level. Despite many inter-country differences, 17 respondents felt that a standardised case register template incorporating a limited number of simple standard variables specified in advance and agreed between the World Health Organization and the European Centre for Disease Prevention and Control could be useful. Intra- and inter-country working groups could facilitate information exchange, clearer system objectives and improved interoperability between systems.
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We describe the Murcia regional vaccination register in Spain, which was set up in 1991, detailing its main features, advantages and limitations. We also report on some recent special actions carried out that led to an improvement in vaccination coverage against measles, rubella and mumps (MMR): by using the vaccination register, we were able to identify and vaccinate persons aged under 20 years in a measles outbreak in 2010 in the town of Jumilla who were not adequately vaccinated for their age with MMR vaccine. ⋯ We also set out our experience in the use of barcodes to identify individuals and collect vaccine data: our data show that the barcodes help to improve data quality and completeness. Finally, we identify certain challenges in search of greater standardisation for systems and encoding that is necessary to enable an easy exchange of data between different registers.
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Case Reports
Severe leptospirosis in a Dutch traveller returning from the Dominican Republic, October 2011.
In October 2011, a case of leptospirosis was identified in a Dutch traveller returning from the Dominican Republic to the Netherlands. The 51-year-old man had aspired muddy water in the Chavón river on 29 September. Twenty days later he presented with fever, nausea, vomiting, diarrhoea, arthralgia, headache, conjunctival suffusion and icterus. Leptospira serovar Icterohaemorrhagiae or Australis infection was confirmed ten days later by laboratory testing.
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We report 570 carbapenemase-producing Klebsiella pneumoniae (CPKP) clinical isolates in a 1,040-bed Greek tertiary hospital during 2004 to 2010. The first CPKP (VIM-producing) was isolated in September 2004. Despite initial containment, VIM producers have become endemic since 2006. ⋯ Resistance to colistin increased from 3.5% (4/115) in 2008 to 20.8% (25/120) in 2010, and resistance to tigecycline also increased. Following reinforcement of infection control measures, prevalence of CPKP (mainly KPC) has been reduced since mid-2009 (from 46% in 2009 to 38.3% in 2010). In view of the exhaustion of available therapies, investment in infection control resources and optimal antibiotic use is urgently required.