Næste uge lanceres European Testing Week for sjette gang. Der er stadig brug for at fÃ¥ sat fokus pÃ¥ at fÃ¥ flere testet for hiv og/eller hepatitis.…

Eurosurveillance editorial team

PrEP can reduce new HIV infections if taken as directed. So why do PrEP failures occur? …

The CDC recommends clinicians expedite neurology and infectious disease consultations to discuss treatment and management considerations for all possible cases. …

Is it possible to keep patients happy while practicing antimicrobial stewardship? …

Den øgede forekomst af husdyr-MRSA i danske svin skyldes tre succesfulde undertyper, der er resistente over for en række hyppigt anvendte antibiotika i svineproduktionen. Desuden har handel med svin spillet en vigtig rolle i spredningen af husdyr-MRSA mellem besætningerne. Det viser et nyt studie fra Statens Serum Institut og Danmarks Tekniske Universitet.  …

M Tandan, K Burns, H Murphy, S Hennessy, M Cormican and A Vellinga

Background The 2016 point prevalence survey (PPS) of healthcare-associated infections (HAI) and antimicrobial use (AMU) in Irish long-term care facilities (LTCF) (HALT) showed a 9.8% AMU and 4.4% HAI prevalence, based on aggregated data analysis. Aim Our aim was to identify institutional and resident risk factors of AMU and HAI. Methods HALT 2016 gathered information using institutional and resident questionnaires, for residents who met the surveillance definition of active HAI and/or AMU, limiting analysis to the aggregated institutional level. In January 2017, we requested additional data on age, sex, urinary catheter use and disorientation of current residents from HALT 2016 LTCF and matched to 2016 HALT data. Results Of 224 HALT 2016 LTCF, 80 provided additional information on 3,816 residents; prevalence of AMU was 10.6% and HAI was 4.7%. Presence of a coordinating physician (Odds ratio (OR): 0.3; 95% confidence interval (CI): 0.2–0.6), antimicrobial stewardship committee (OR: 0.2; 95%; CI: 0.1–0.6), healthcare assistants (OR: 0.9; 95% CI: 0.9–1.0), antimicrobial consumption feedback (OR: 0.3; 95% CI: 0.1–0.6) and medical care by personal general practitioner (OR: 0.6; 95% CI: 0.7–1.0) were associated with less AMU and feedback on surveillance of infection prevention and control (IPC) practices (OR: 0.6; 95% CI: 0.3–1.0) with less HAI. AMU and HAI varied significantly between LTCF. Conclusions Multilevel modelling identified significant inter-facility variation, as well as institutional factors associated with AMU and HAI. An antimicrobial stewardship committee linked with feedback on IPC and prescribing was associated with reduced AMU and HAI.…

Dora Stepan, Lea Ušaj, Marija Petek Šter, Marjetka Smolinger Galun, Hermina Smole and Bojana Beović

Residents in long-term care are at high risk of infections because of their old age and many related health problems that lead to frequent antibiotic prescribing. The aim of the study was to assess antibiotic use in Slovenian long-term care facilities (LTCFs). The point-prevalence study was conducted between April and June 2016. Online questionnaires were sent to all Slovenian LTCFs. Eighty (68.4%) of the 117 LTCFs contacted, caring for 13,032 residents (70.6% of all Slovenian LTCF residents), responded to the survey. On the day of the study, the mean antibiotic prevalence per LTCF was 2.4% (95% confidence interval: 1.94–2.66). Most (70.2%) of the residents taking antibiotics were female. Most residents were being treated for respiratory tract (42.7%) or urinary tract (33.3%) infections. Co-amoxiclav and fluoroquinolones were the most frequently prescribed antibiotics (41.0% and 22.3% respectively). Microbiological tests were performed for 5.2% of residents receiving antibiotics. Forty nine (19.8%) residents receiving antibiotics were colonised with multidrug-resistant bacteria (MDR). Antibiotic use in Slovenian LTCFs is not very high, but most prescribed antibiotics are broad-spectrum. Together with low use of microbiological testing and high prevalence of colonisation with MDR bacteria the situation is worrisome and warrants the introduction of antimicrobial stewardship interventions.…

Diamantis Plachouras, Tommi Kärki, Sonja Hansen, Susan Hopkins, Outi Lyytikäinen, Maria Luisa Moro, Jacqui Reilly, Peter Zarb, Walter Zingg, Pete Kinross, Klaus Weist, Dominique L Monnet, Carl Suetens and the Point Prevalence Survey Study Group

Antimicrobial agents used to treat infections are life-saving. Overuse may result in more frequent adverse effects and emergence of multidrug-resistant microorganisms. In 2016–17, we performed the second point-prevalence survey (PPS) of healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals. We included 1,209 hospitals and 310,755 patients in 28 of 31 European Union/European Economic Area (EU/EEA) countries. The weighted prevalence of antimicrobial use in the EU/EEA was 30.5% (95% CI: 29.2–31.9%). The most common indication for prescribing antimicrobials was treatment of a community-acquired infection, followed by treatment of HAI and surgical prophylaxis. Over half (54.2%) of antimicrobials for surgical prophylaxis were prescribed for more than 1 day. The most common infections treated by antimicrobials were respiratory tract infections and the most commonly prescribed antimicrobial agents were penicillins with beta-lactamase inhibitors. There was wide variation of patients on antimicrobials, in the selection of antimicrobial agents and in antimicrobial stewardship resources and activities across the participating countries. The results of the PPS provide detailed information on antimicrobial use in European acute care hospitals, enable comparisons between countries and hospitals, and highlight key areas for national and European action that will support efforts towards prudent use of antimicrobials.…

Enrico Ricchizzi, Katrien Latour, Tommi Kärki, Rossella Buttazzi, Béatrice Jans, Maria Luisa Moro, Olivia Aya Nakitanda, Diamantis Plachouras, Dominique L Monnet, Carl Suetens, Pete Kinross and the HALT Study Group

Antimicrobials are commonly prescribed and contribute to the development of antimicrobial resistance in long-term care facilities (LTCFs). In 2010, the European Centre for Disease Prevention and Control initiated point prevalence surveys (PPS) of healthcare-associated infections and antimicrobial use in European LTCFs, performed by external contractors as the Healthcare-Associated infections in Long-Term care facilities (HALT) projects. Here, we investigated prevalence and characteristics of antimicrobial use and antimicrobial stewardship indicators in European LTCFs in 2016–17. Twenty-four European Union/European Economic Area (EU/EEA) countries, the former Yugoslav Republic of Macedonia and Serbia participated in the third PPS in European LTCFs. Overall, 4.9% (95% confidence interval: 4.8–5.1) of LTCF residents in the EU/EEA participating countries received at least one antimicrobial. The most commonly reported Anatomical Therapeutic Chemical (ATC) groups were beta-lactam antibacterials/penicillins (J01C), other antibacterials (J01X) (e.g. glycopeptide antibacterials, polymyxins), quinolones (J01M), sulfonamides and trimethoprim (J01E), and other beta-lactams (J01D). Urinary tract infections and respiratory tract infections were the main indications for antimicrobial prescription. This PPS provides updated and detailed information on antimicrobial use in LTCFs across the EU/EEA that can be used to identify targets for future interventions, follow-up of these interventions and promote prudent use of antimicrobials in European LTCFs.…

Melinda M. Neuhauser and J. Todd Weber

The occurrence of disabling and potentially permanent side effects associated with quinolone and fluoroquinolone antibiotics has led the European Medicines Agency (EMA) to restrict or suspend their use. …

Fexinidazole is for the treatment of human African trypanosomiasis caused by Trypanosoma brucei gambiense in adults and children aged 6 years and older. …

People who inject drugs can take medication consistently enough to be cured of hepatitis C, new research shows. …

Kits to self-test for human papillomavirus (HPV) mailed to underserved women helped to identify virtually all of those with high-risk HPV oncogenic types, in a proof-of-principle study. …

Despite initial hope, fluoxetine failed to improve outcomes in children with acute flaccid myelitis and in some cases was linked to a worsening of the disorder, which can cause permanent paralysis in children. …

Sundhedsminister Ellen Trane Nørby underskriver i dag på et møde i Seattle en aftale, der skal gøre Danmark til centrum for et stort nyt internationalt forsknings- og videnscenter om antibiotikaresistens.…

Referencelaboratoriet for Antibiotikaresistens og Stafylokokker pÃ¥ Statens Serum Institut opgør hvert kvartal antallet af blodforgiftninger forÃ¥rsaget af MRSA samt dødsfald som følge af disse.…

Efter det tragiske dødsfald i England rÃ¥der SSI folk til at være opmærksomme, nÃ¥r de rejser til lande, hvor der er rabies.…

Carl Suetens, Katrien Latour, Tommi Kärki, Enrico Ricchizzi, Pete Kinross, Maria Luisa Moro, Béatrice Jans, Susan Hopkins, Sonja Hansen, Outi Lyytikäinen, Jacqui Reilly, Aleksander Deptula, Walter Zingg, Diamantis Plachouras, Dominique L Monnet, the Healthcare-Associated Infections Prevalence Study Group and Members of the Healthcare-Associated Infections Prevalence Study Group

Point prevalence surveys of healthcare-associated infections (HAI) and antimicrobial use in the European Union and European Economic Area (EU/EEA) from 2016 to 2017 included 310,755 patients from 1,209 acute care hospitals (ACH) in 28 countries and 117,138 residents from 2,221 long-term care facilities (LTCF) in 23 countries. After national validation, we estimated that 6.5% (cumulative 95% confidence interval (cCI): 5.4–7.8%) patients in ACH and 3.9% (95% cCI: 2.4–6.0%) residents in LTCF had at least one HAI (country-weighted prevalence). On any given day, 98,166 patients (95% cCI: 81,022–117,484) in ACH and 129,940 (95% cCI: 79,570–197,625) residents in LTCF had an HAI. HAI episodes per year were estimated at 8.9 million (95% cCI: 4.6–15.6 million), including 4.5 million (95% cCI: 2.6–7.6 million) in ACH and 4.4 million (95% cCI: 2.0–8.0 million) in LTCF; 3.8 million (95% cCI: 3.1–4.5 million) patients acquired an HAI each year in ACH. Antimicrobial resistance (AMR) to selected AMR markers was 31.6% in ACH and 28.0% in LTCF. Our study confirmed a high annual number of HAI in healthcare facilities in the EU/EEA and indicated that AMR in HAI in LTCF may have reached the same level as in ACH.…

ProMED Mail

Brucellosis -- United StatesWyoming state veterinarian, Dr Jim Logan, has been notified by the Wyoming State Veterinary Laboratory and the National Veterinary Services Laboratory that there is a new case of brucellosis in a cattle herd in Teton County, which is in the Wyoming brucellosis designated surveillance area (DSA). Serologic testing at both laboratories has shown reactor level results on 5 animals from one herd. Further testing, including bacterial culture, will be conducted to confirm serology results.Logan…

ProMED Mail

Ebola -- DR Congo- 2 additional probable cases have been confirmed;- 2 confirmed cases were removed (duplicates) - 16 deaths of confirmed case deaths were removed (duplicates, listing errors) News of the responseSupport-------The transit center of Beni was inaugurated this Thu 15 Nov 2018. Located opposite the office of the head of the health zone, this 16-bed transit center will isolate all suspected cases waiting for laboratory results. Only laboratory confirmed cases will be transferred to the…

ProMED Mail

Ebola -- DR Congo- An additional 7 probable cases have been validated in Kalunguta.News of the response--------------------The National Association of Ebola Winners (ANVE)- The local committee of the ANVE of Beni was installed this Thu 15 Nov 2018; 2 doctors who were cured of Ebola were elected president and vice-president of the Beni affiliation by the other members.Vaccination------------ Closure of targeted geographic vaccination in Kanihunga Village, Kalunguta Health Zone. Targeted…

ProMED Mail

Ross River Virus -- AustraliaNSW [New South Wales state] Health has warned people to protect themselves against mosquitoborne diseases as the weather warms up and people move outdoors. Medical entomologist at NSW Health Pathology, Dr Cameron Webb, said the warmer weather was a time for increasing mosquito activity and it was important to prepare against diseases carried by them such as Ross River and Barmah Forest virus.There were 9 official notifications of Ross River virus in NSW Between 28 Oct-3 Nov [2018] and 11…

ProMED Mail

West Nile Virus -- United StatesCalifornia animal health officials have confirmed another equine case of West Nile virus (WNV). So far this year [2018], there have been 11 confirmed cases of WNV in California horses."On 2 Nov 2018, a 1 year old grade mare in Sacramento County with unknown vaccination history and displaying neurologic signs was confirmed positive for West Nile virus," the California Department of Food and Agriculture (CDFA) said in a statement on its website. "The mare was euthanized due to severity of…

ProMED Mail

African Swine Fever -- UkraineRovno: event started 4 Sep 2015. 30 outbreaks (submitted) reported to date (Fri 16 Nov 2018). The event is still continuing with the last follow-up report provided on 17 Oct 2018.Total animals affected:Species / Susceptible / Cases / Deaths / Killed and disposed of / SlaughteredSwine / 728 / 63 / 62 / 666 / 0Wild boar: _Sus scrofa_ (Suidae) / - / 17 / 4 / 13 / 0--communicated by:ProMED-mail******[2] Kiev: domestic swineDate: Fri 16 Nov 2018Source: OIE, WAHIS…

ProMED Mail

Other Animal Disease -- New ZealandThe Waikato Domestic Bee Association (WDBA) is calling on all Hamilton [Waikato] beekeepers to help rid the city of the hive-destroying American foulbrood disease (AFB). An AFB infection causes death of the honey bee (_Apis mellifera_) larvae. The disease is in almost all countries where honey bees are found.The AFB bacterium produces resistant, long-lived spores and an infected beehive will usually be killed by the disease. The infection can be present in a beehive but not initially…

ProMED Mail

Plague -- IrelandAll water users along the River Shannon are being urged to take precautions after confirmation of an outbreak of crayfish plague on a stretch of the Al River. This river is one of the main tributaries to the River Shannon in Athlone [County Westmeath] and flows westerly, entering the Shannon downstream of the weir. A small number of dead freshwater crayfish were reported on the river last week [week of 5 Nov 2018]. DNA analysis by the Marine Institute has now confirmed that crayfish were…

ProMED Mail

Other Animal Disease -- PortugalInformation received on [and dated] 14 Nov 2018 from Dr Bernardo Fernando, [General Directorate of Food and Veterinary Affairs, Ministry of Agriculture, Forestry and Rural Development], Lisbon, PortugalSummaryReport type: immediate notificationDate of star of the event: 28 Oct 2018Date of confirmation of the event: 7 Nov 2018Reason for notification: listed disease in an unusual host speciesCausal agent: Myxoma virusNature of diagnosis: laboratory (advanced), necropsyThis…

ProMED Mail

Newcastle Disease -- SwedenPoultry producers have been reminded of the risks of pigeons spreading Newcastle disease (ND) following a disease outbreak in Sweden. The Swedish outbreak was reported last month [October 2018] at a large commercial farm on the western coast, which held 5000 laying hens. Presence of ND, which led to egg drop and eggs without shells but no increase in mortality, was caused by a virulent avian avulavirus type-1 (formerly Avian Paramyxovirus-1), according to PCR and gene sequencing.Sweden…

ProMED Mail

Food-related toxin -- United StatesTwo types of dry dog food have been recalled after 3 separate reports from pet owners indicated their pets were suffering from vitamin D toxicity as a result of eating the food. Natural Life Pet Products is voluntarily recalling Natural Life Chicken and Potato dry dog food in 8 states, and Nutrisca is voluntarily recalling its Chicken and Chickpea Dry Dog Food nationwide.An investigation into the matter found that a formula error led to the products containing too much vitamin D, the…

ProMED Mail

Other Human Disease -- United StatesThe number of children being stricken by a mysterious paralyzing condition continues to increase, federal officials say. At least 252 cases of acute flaccid myelitis, or AFM, have been reported to the Centers for Disease Control and Prevention (CDC) so far this year [2018] from 27 states, including 90 that have been confirmed through [Fri 9 Nov 2018], CDC reported on Tuesday [13 Nov 2018]. Most of the cases have occurred among children between the ages of 2 and 8.The illness usually starts…

ProMED Mail

Hepatitis A -- United StatesNumber of cases 1774 Demographics------------Age range 12-86 Median age 37 Male 1069 (60.3%) Hospitalizations 914 (51.5%) Deaths 5 Risk factors ------------Co-infection with hepatitis C (information available for 1384 cases) 824 (59.5%) Co-infection with hepatitis B (information available for 1384 cases) 153 (11.1%) Reports illicit drug use (information available for 1517 cases) 1135 (74.8%) Homeless 194 (10.9%) --communicated…

ProMED Mail

Measles -- UkraineOver the 1st week of November 2018, 489 people got sick with measles, according to the press service of Lviv regional Lab Center: "In Lviv region, during one week (1-7 Nov 2018), 489 cases of measles, including 373 cases with children under the age of 17 or 76% and 116 cases with the adults (23.7%) were spotted," the message said.Children aged from 5-9 made the vast majority of those infected; 78% of them were not vaccinated. 323 people were hospitalized. As we reported, since the…

ProMED Mail

Mumps -- MalaysiaAfter 14 students, aged between 10 and 12, came down with mumps, 6 classrooms at Sekolah Kebangsaan Bukit Sentosa in Rawang [Gombak district, Selangor] were ordered to be closed for 2 weeks. All 14 pupils received outpatient treatment at an area hospital and are reported to be in a stable condition, said Selangor health director Datuk Dr Khalid Ibrahim. The shuttered classes are now undergoing cleansing and disinfection measures to control the infection, he added.Dr Khalid said mumps is…

ProMED Mail

Polio -- PakistanNew wild poliovirus cases reported this week: 0Total number of wild poliovirus cases in 2018: 27Total number of wild poliovirus cases in 2017: 22New cVDPV cases reported this week: 3Total number of cVDPV cases (all types) in 2018: 85Total number of cVDPV cases (all types) in 2017: 96HeadlinesSummary of new viruses this week:- Afghanistan: 1 wild poliovirus type 1 (WPV1) positive environmental sample.- Pakistan: 4 WPV1 positive environmental samples.- Papua New Guinea: 1…

Simon Cottrell, Catherine Moore, Malorie Perry, Ember Hilvers, Chris Williams and Ananda Giri Shankar

Since 7 June 2018, an enterovirus D-68 (EV-D68) season (the third since 2015) is ongoing in Wales, with 114 confirmed cases thus far. Median age of the 220 cases since 2015 is 2.5 years (2.5 years in intensive care cases), 94% were hospitalised, 17% (n = 38) in intensive care. All had respiratory symptoms; bronchiolitis symptoms were reported in 60 cases, severe respiratory symptoms in 23 and acute flaccid myelitis in two cases.…

Statens Serum Institut, DTU Fødevareinstituttet og DTU Veterinærinstituttet inviterer til en eftermiddag om antibiotika i anledning af den internationale antibiotikauge.…

Le Nguyen Thanh Nhan, Nguyen Thi Thu Hong, Le Nguyen Truc Nhu, Lam Anh Nguyet, Nguyen Thi Han Ny, Tran Tan Thanh, Do Duong Kim Han, Hoang Minh Tu Van, C Louise Thwaites, Tran Tinh Hien, Phan Tu Qui, Pham Van Quang, Ngo Ngoc Quang Minh, H. Rogier van Doorn, Truong Huu Khanh, Nguyen Van Vinh Chau, Guy Thwaites, Nguyen Thanh Hung and Le Van Tan

Since January 2018, over 53,000 hospitalisations and six deaths due to hand, foot and mouth disease (HFMD) have occurred across Vietnam with most cases from September onward. In a large tertiary referral hospital, Ho Chi Minh City, enterovirus A71 subgenogroup C4 was predominant, while B5 was only sporadically detected. The re-emergence of C4 after causing a severe HFMD outbreak with > 200 deaths in 2011–12 among susceptible young children raises concern of another impending severe outbreak.…

DANMAP 2017 European Testing Week 23-30 November 2018 – Test.Treat.Prevent.