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NÃ¦ste 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.
Vivian D Hope, Ross J Harris, Peter Vickerman, Lucy Platt, Justin Shute, Katelyn J Cullen, Samreen Ijaz, Sema Mandal, Fortune Ncube, Monica Desai and John V Parry
Monitoring hepatitis C virus (HCV) incidence is important for assessing intervention impact. Longitudinal studies of people who inject drugs (PWID), using repeated biological tests, are costly; alternatively, incidence can be estimated using biological markers of recent infection in cross-sectional studies.
We aimed to compare incidence estimates obtained from two different biological markers of recent infection in a cross-sectional study to inform monitoring approaches for HCV elimination strategies.
Samples from an unlinked anonymous bio-behavioural survey of PWID were tested for two recent infection markers: HCV RNA with anti-HCV negative (‘RNA’) and low-avidity anti-HCV with HCV RNA present (‘avidity’). These two markers were used separately and in combination to estimate HCV incidence.
Between 2011 and 2013, 2,816 anti-HIV-negative PWID (25% female) who had injected during the preceding year were either HCV-negative or had one of the two markers of recent infection: 57 (2.0%) had the RNA marker and 90 (3.2%) the avidity marker. The two markers had similar distributions of risk and demographic factors. Pooled estimated incidence was 12.3 per 100 person-years (pyrs) (95% credible interval: 8.8–17.0) and not significantly different to avidity-only (p = 0.865) and RNA-only (p = 0.691) estimates. However, the RNA marker is limited by its short duration before anti-HCV seroconversion and the avidity marker by uncertainty around its duration.
Both markers have utility in monitoring HCV incidence among PWID. When HCV transmission is high, one marker may provide an accurate estimate of incidence; when it is low or decreasing, a combination may be required.
PrEP can reduce new HIV infections if taken as directed. So why do PrEP failures occur?
The American Heart Association provides 'pragmatic' recommendations on cardiovascular disease prevention and management in the growing number of people living with HIV infection.
The burden from antibiotic-resistant bacterial infections in Europe has doubled since 2007 and is now similar to the combined burden of influenza, tuberculosis, and HIV, a study found.
Ndeindo Ndeikoundam Ngangro, Delphine Viriot, Nelly Fournet, Corinne Pioche, Bertille De Barbeyrac, Agathe Goubard, Nicolas Dupin, Béatrice Berçot, Sébastien Fouéré, Isabelle Alcaraz, Michel Ohayon, Nathalie Spenatto, Chantal Vernay-Vaisse, referents for the regional offices of the French national public health agency, Josiane Pillonel and Florence Lot
Diagnoses of bacterial sexually transmitted infections (STI) have been increasing in France since their resurgence in the late 1990s. This article presents recent epidemiological trends until 2016 and the patients’ characteristics. STI surveillance relies on sentinel networks: a clinician-based network RésIST (clinical, biological and behavioural data for early syphilis and gonorrhoea), the lymphogranuloma venereum (LGV) network (clinical, biological and behavioural data for rectal LGV, and the laboratory networks Rénachla and Rénago (demographic and biological data for chlamydial infections and gonorrhoea, respectively). Here we describe trends between 2014 and 2016, using data from diagnostic centres which participated regularly during the study period. The number of early syphilis, gonorrhoea and LGV diagnoses increased between 2014 and 2016, particularly in men who have sex with men. An increase in syphilis and gonorrhoea cases was also observed in heterosexuals. Nevertheless, we observed a drop in 2016 for syphilis and chlamydial infections after two decades of increases. Under-reporting and shortage of benzathine penicillin in 2016 may explain this latest evolution. Regular screening of patients and partners, followed by prompt treatment, remains essential to interrupt STI transmission in a context where human immunodeficiency virus (HIV) prevention has expanded towards biomedical prophylaxis.
Bacterial STIs increased in incidence when men who have sex with men began using HIV preexposure prophylaxis (PrEP) medications, a study found.
Emmi Andersson, Fumiyo Nakagawa, Ard van Sighem, Maria Axelsson, Andrew N Phillips, Anders Sönnerborg and Jan Albert
Sweden has a low HIV prevalence. However, among new HIV diagnoses in 2016, the proportion of late presenters and migrants was high (59% and 81%, respectively). This poses challenges in estimating the proportion of undiagnosed persons living with HIV (PLHIV).
To estimate the proportion of undiagnosed PLHIV in Sweden comparing two models with different demands on data availability and modelling expertise.
An individual-based stochastic simulation model of HIV positive populations (SSOPHIE) and the incidence method of the European Centre for Disease Prevention and Control (ECDC) HIV Modelling Tool were applied to clinical, surveillance and migration data from Sweden 1980–2016.
SSOPHIE estimated that the proportion of undiagnosed PLHIV in 2013 was 26% (n = 2,100; 90% plausibility range (PR): 900–5,000) for all PLHIV, 17% (n = 600; 90% PR: 100–2,000) for men who have sex with men (MSM), 35% in male (n = 300; 90% PR: 200–700) and 34% in female (n = 400; 90% PR: 200–800) migrants from sub-Saharan Africa (SSA). The estimates for the ECDC model in 2013 were 21% (n = 2,013; 95% confidence interval (CI): 1,831–2,189) for all PLHIV, 15% (n = 369; 95% CI: 299–434) for MSM and 21% (n = 530; 95% CI: 436–632) for migrants from SSA.
The proportion of undiagnosed PLHIV in Sweden is uncertain. SSOPHIE estimates had wide PR. The ECDC model estimates were unreliable because migration was not accounted for. Better migration data and estimation methods are required to obtain reliable estimates of proportions of undiagnosed PLHIV in similar settings.
Andreas Petersen, Susan A Cowan, Jens Nielsen, Thea K Fischer and Jannik Fonager
This study describes the prevalence of human immunodeficiency virus (HIV) drug resistance mutations among 1,815 patients in Denmark from 2004 to 2016 and characterises transmission clusters. POL sequences were analysed for subtype, drug resistance mutations and phylogenetic relationship. The prevalence of surveillance drug resistance mutations (SDRM) was 6.7%, while the prevalence of drug resistance mutations (DRM) with a clinical impact was 12.3%. We identified 197 transmission clusters with 706 patients. Patients 40 years or older were less likely to be members of a transmission cluster and patients in transmission clusters were less likely to be infected abroad. The proportion of late presenters (LP) was lower in active compared with inactive clusters. Large active clusters consisted of more men who have sex with men (MSM), had members more frequently infected in Denmark and contained a significantly lower proportion of LP and significantly fewer patients with DRM than small active clusters. Subtyping demonstrated that the Danish HIV epidemic is gradually becoming more composed of non-B subtypes/circulating recombinant forms. This study shows that active HIV-1 transmission has become increasingly MSM-dominated and that the recent increase in SDRM and DRM prevalence is not associated with more sustained transmission within identified transmission networks or clusters.
Louise Logan, Ibidun Fakoya, Alison Howarth, Gary Murphy, Anne M Johnson, Alison J Rodger, Fiona Burns and Anthony Nardone
Men who have sex with men (MSM) are at risk of HIV and are an important population to monitor and ameliorate combination prevention efforts.
To estimate HIV prevalence and identify factors associated with frequent HIV testing (≥ 2 HIV tests in the last year) and pre-exposure prophylaxis (PrEP) use among MSM in London.
For this cross-sectional study, MSM recruited from 22 social venues provided oral-fluid samples for anonymous HIV antibody (Ab) testing and completed a questionnaire. Factors associated with frequent HIV testing and PrEP use were identified through logistic regression.
Of 767 men recruited, 545 provided an eligible oral specimen. Among these, 38 MSM (7.0%) were anti-HIV positive including five (13.2%; 5/38) who reported their status as negative. Condomless anal sex within the previous 3 months was reported by 60.1% (412/685) men. Frequent HIV testing was associated with, in the past year, a reported sexually transmitted infection (adjusted odds ratio (AOR): 5.05; 95% confidence interval (CI): 2.66–9.58) or ≥ 2 casual condomless partners (AOR 2–4 partners: 3.65 (95% CI: 1.87–7.10); AOR 5–10 partners: 3.34(95% CI: 1.32–8.49). Age ≥ 35 years was related to less frequent HIV testing (AOR 35–44 years: 0.34 (95% CI: 0.16–0.72); AOR ≥ 45 years: 0.29 (95% CI: 0.12–0.69). PrEP use in the past year was reported by 6.2% (46/744) of MSM and associated with ≥ 2 casual condomless sex partners (AOR: 2.86; 95% CI: 1.17–6.98) or chemsex (AOR: 2.31; 95% CI: 1.09–4.91).
This bio-behavioural study of MSM found high rates of behaviours associated with increased risk of HIV transmission. Combination prevention, including frequent HIV testing and use of PrEP, remains crucial in London.
David A M C van de Vijver, Ann-Kathrin Richter, Charles A B Boucher, Barbara Gunsenheimer-Bartmeyer, Christian Kollan, Brooke E Nichols, Christoph D Spinner, Jürgen Wasem, Knud Schewe and Anja Neumann
Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention strategy for men-who-have-sex-with-men (MSM). The high cost of PrEP has until recently been a primary barrier to its use. In 2017, generic PrEP became available, reducing the costs by 90%.
Our objective was to assess cost-effectiveness and costs of introducing PrEP in Germany.
We calibrated a deterministic mathematical model to the human immunodeficiency virus (HIV) epidemic among MSM in Germany. PrEP was targeted to 30% of high-risk MSM. It was assumed that PrEP reduces the risk of HIV infection by 85%. Costs were calculated from a healthcare payer perspective using a 40-year time horizon starting in 2018.
PrEP can avert 21,000 infections (interquartile range (IQR): 16,000–27,000) in the short run (after 2 years scale-up and 10 years full implementation). HIV care is predicted to cost EUR 36.2 billion (IQR: 32.4–40.4 billion) over the coming 40 years. PrEP can increase costs by at most EUR 150 million within the first decade after introduction. Ten years after introduction, PrEP can become cost-saving, accumulating to savings of HIV-related costs of EUR 5.1 billion (IQR: 3.5–6.9 billion) after 40 years. In a sensitivity analysis, PrEP remained cost-saving even at a 70% price reduction of antiretroviral drug treatment and a lower effectiveness of PrEP.
Introduction of PrEP in Germany is predicted to result in substantial health benefits because of reductions in HIV infections. Short-term financial investments in providing PrEP will result in substantial cost-savings in the long term.
Christoph Niederhauser, Nadja Widmer, Magdalena Hotz, Caroline Tinguely, Stefano Fontana, Gabrielle Allemann, Mauro Borri, Laura Infanti, Amira Sarraj, Jörg Sigle, Michèle Stalder, Jutta Thierbach, Sophie Waldvogel, Tina Wiengand, Max Züger and Peter Gowland
Background and aim
Hepatitis E virus (HEV) is a virus of emerging importance to transfusion medicine. Studies from several European countries, including Switzerland, have reported high seroprevalence of hepatitis E as a consequence of endemic infections. Published HEV seroprevalence estimates within developed countries vary considerably; primarily due to improved diagnostic assays. The purpose of this study was to investigate the seroprevalence of anti-HEV IgG in Swiss blood donations. Methods: We used the highly sensitive Wantai HEV IgG EIA and assessed regional distribution patterns. We analysed age- and sex-matched archive plasma dating back 20 years from canton Bern to investigate recent changes in HEV seroprevalence levels. Results: On average, 20.4% (95% confidence intervals: 19.1–21.8) of the 3,609 blood samples collected in 2014–16 were anti-HEV IgG positive; however, distinct differences between geographical regions were observed (range: 12.8–33.6%). Seroprevalence increased with age with 30.7% of males and 34.3% of women being positive donors over > 60 years old. Differences between sexes may be attributed to dissimilarities in the average age of this group. Within the specified region of the Bern canton, overall prevalence has declined over two decades from 30.3% in 1997/98 to 27.0% in 2006 and 22.3% in 2015/6. Conclusions: HEV seroprevalence in Switzerland is high, but has declined over the last decades. The result shows that primarily endemic HEV infections occur and that current blood products may pose a risk to vulnerable transfusion recipients. Nucleic acid screening of all blood products for HEV will begin in November 2018.
Sara Croxford, Dorthe Raben, Stine F Jakobsen, Fiona Burns, Andrew Copas, Alison E Brown, Valerie C Delpech and on behalf of OptTEST by HIV in Europe
Prompt linkage to human immunodeficiency virus (HIV) care after diagnosis is crucial to ensure optimal patient outcomes. However, few countries monitor this important public health marker and different definitions have been applied, making country and study comparisons difficult. This article presents an expert-agreed, standard definition of linkage to care for a pragmatic approach to public health monitoring, appropriate to the European context. Here, linkage to care is defined as patient entry into specialist HIV care after diagnosis, measured as the time between the HIV diagnosis date and one of the following markers: either the first clinic attendance date, first CD4+ cell count or viral load date, or HIV treatment start date, depending on data availability; Linkage is considered prompt if within 3 months of diagnosis. Application of this definition by researchers and public health professionals when reporting surveillance or research data relating to linkage to care after HIV diagnosis will enable reliable comparisons across countries, better assessment of the success of health services programmes aimed at improving peoples access to HIV treatment and care and the identification of barriers limiting access to HIV care across Europe.
Pifeltro contains doravirine, a new nonnucleoside reverse transcriptase inhibitor, and Delstrigo is a fixed-dose combination of doravirine, lamivudine, and tenofovir disoproxil fumarate.
A European Medicines Agency advisory panel recommended marketing authorization for ibalizumab (Trogarzo, Theratechnologies International) for the treatment of patients with multidrug-resistant HIV-1 infection.
Dovato contains 50 mg dolutegravir and 300 mg lamivudine and would be the first once-daily, single-pill, completed 2-drug regimen for treatment of HIV in Europe.
Dovato (dolutegravir and lamivudine), a single-pill, two-drug regimen taken once daily, is noninferior to a three-drug regimen for treatment-naïve adults and children older than 12 with HIV in Europe.
Pifeltro contains doravirine, a new non-nucleoside reverse transcriptase inhibitor, and Delstrigo is a fixed-dose combination of doravirine, lamivudine, and tenofovir disoproxil fumarate.
The dolutegravir and lamivudine combination (Dovato) is the first once-daily, single-tablet, two-drug regimen for adults with treatment-naive HIV infection.
Lauren MK Mason, Erika Duffell, Irene K Veldhuijzen, Uarda Petriti, Eveline M Bunge and Lara Tavoschi
People living with HIV (PLHIV) and people in prison are population groups with a potentially high risk and/or prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection.
We conducted a systematic review in order to find prevalence and incidence estimates in these populations in the European Union/European Economic Area (EU/EEA).
Original research articles published between January 2005 and February 2017 were retrieved from PubMed and Embase in February 2017.
Fifty-two articles were included, providing 97 estimates of HBV/HCV infection prevalence or incidence. Estimates of HBV infection prevalence ranged between 2.9% and43.4% in PLHIV and 0.0% and 25.2% in people in prison. Estimates of HCV infection prevalence ranged from 2.9% to 43.4% in PLHIV and 0.0% to 25.2% in people in prison. Incidence estimates ranged between 0.0 and 2.5 cases per 100 person-years for HBV infection in PLHIV. No such data was available for people in prison. HCV infection incidence ranged between 0.3 and 0.9 cases per 100 person-years in PLHIV and between 1 and 1.2 cases per 100 person-years in people in prison. Prevalence estimates were generally higher than in the general population, especially for HCV infection and among groups with multiple risk factors.
PLHIV, people in prison and groups with multiple risk factors, have a high prevalence of HBV and HCV and may be at ongoing risk of infection. These groups should be among the populations prioritised and targeted for active case finding and prevention programmes in the EU/EEA.
On 25 April 2019, the local administration in Larkana district was alerted by media reports of a surge in human immunodeficiency virus (HIV) cases among children in Ratodero Taluka, Larkana district, Sindh province, Pakistan. A screening camp was initially established at Taluka’s main hospital. Later, screening was expanded to other health facilities including selected Rural Health Centers (RHCs) and Basic Health Units (BHUs). HIV rapid test kits that were initially used were replaced with pre-qualified WHO test kits. From 25 April through 28 June 2019, a total of 30,192 people have been screened for HIV, of which 876 were found positive. Eighty-two per cent (719/876) of these were below the age of 15 years. During the screening, several risk factors were identified, including: unsafe intravenous injections during medical procedures; unsafe child delivery practices; unsafe practices at blood banks; poorly implemented infection control programs; and improper collection, storage, segregation and disposal of hospital waste.
Alison E Brown, Rosalie Hayes, Teymur Noori, Yusef Azad, Andrew J. Amato-Gauci, Anastasia Pharris, Valerie C. Delpech and the ECDC Dublin Declaration Monitoring Network
In 2018, 52 of 55 European and Central Asian countries reported data against the UNAIDS 90–90–90 targets. Overall, 80% of people living with HIV (PLHIV) were diagnosed, of whom 64% received treatment and 86% treated were virally suppressed. Subregional outcomes varied: West (87%–91%–93%), Centre (83%–73%–75%) and East (76%–46%–78%). Overall, 43% of all PLHIV were virally suppressed; intensive efforts are needed to meet the 2020 target of 73%.
Life expectancy for US adults infected with HIV has risen dramatically since the early 1980s, but patients are still dying from HIV-related causes rather than age-related conditions.
Michael Edelstein, Nalini Iyanger, Nicola Hennessy, David Mesher, Marta Checchi, Kate Soldan, Mark McCall, Julie Nugent, Jonathan Crofts, Janice Lo, Richard Gilson, Karen Powell, Mary Ramsay and Joanne Yarwood
Background: Opportunistic human papillomavirus (HPV) vaccination for men who have sex with men (MSM) was piloted in sexual health clinics (SHC) in England between 2016 and 2018.
Aim: to evaluate the pilot’s first year (April 2016–March 2017) in terms of feasibility, acceptability, uptake, impact and equity and interpret the outcome in the context of wide HPV vaccination policy.
Methods: Attendance and uptake data from routine SHC surveillance datasets and a cross-sectional survey administered to individuals receiving the vaccine were analysed.
Results: Among 18,875 eligible MSM, 8,580 (45.5%) were recorded as having received one HPV vaccine dose, decreasing slightly with increasing age, and uptake was higher in rural than urban areas. Survey results suggested that of those receiving the first dose of HPV vaccine, 8% were new attendees and that among those, less than 11% attended just to receive the vaccine. Of those having their first HPV vaccination, 95% indicated they would like to receive the next vaccine doses at the same clinic and 85% of patients reported accessing other services when visiting SHC for the first dose of vaccine.
Conclusion: An opportunistic HPV vaccination programme for MSM can be delivered in an acceptable and, as far as can be evaluated, equitable manner, without major disruption to SHC and HIV clinics.
Basel Karo, Anke Kohlenberg, Vahur Hollo, Raquel Duarte, Lena Fiebig, Sarah Jackson, Cathriona Kearns, Csaba Ködmön, Maria Korzeniewska-Kosela , Dimitrios Papaventsis, Ivan Solovic, Dick van Soolingen and Marieke J. van der Werf
Introduction: Isoniazid (INH) is an essential drug for tuberculosis (TB) treatment. Resistance to INH may increase the likelihood of negative treatment outcome.
Aim: We aimed to determine the impact of INH mono-resistance on TB treatment outcome in the European Union/European Economic Area and to identify risk factors for unsuccessful outcome in cases with INH mono-resistant TB.
Methods: In this observational study, we retrospectively analysed TB cases that were diagnosed in 2002–14 and included in the European Surveillance System (TESSy). Multilevel logistic regression models were applied to identify risk factors and correct for clustering of cases within countries.
Results: A total of 187,370 susceptible and 7,578 INH mono-resistant TB cases from 24 countries were included in the outcome analysis. Treatment was successful in 74.0% of INH mono-resistant and 77.4% of susceptible TB cases. In the final model, treatment success was lower among INH mono-resistant cases (Odds ratio (OR): 0.7; 95% confidence interval (CI): 0.6–0.9; adjusted absolute difference in treatment success: 5.3%). Among INH mono-resistant TB cases, unsuccessful treatment outcome was associated with age above median (OR: 1.3; 95% CI: 1.2–1.5), male sex (OR: 1.3; 95% CI: 1.1–1.4), positive smear microscopy (OR: 1.3; 95% CI: 1.1–1.4), positive HIV status (OR: 3.3; 95% CI: 1.6–6.5) and a prior TB history (OR: 1.8; 95% CI: 1.5–2.2).
Conclusions: This study provides evidence for an association between INH mono-resistance and a lower likelihood of TB treatment success. Increased attention should be paid to timely detection and management of INH mono-resistant TB.
The findings represent a 'missed opportunity' to fully execute HIV screening recommendations, CDC researchers said.
The Michigan Licensing Department filed a formal complaint against Dr Roger Beyer for allegedly telling staff to re-use anorectal manometers on multiple patients.
Kristi Rüütel, Liis Lemsalu, Sirly Lätt, Jevgenia Epštein and on behalf of OptTEST by HiE
Studies of missed opportunities for earlier diagnosis of HIV have shown that patients with undiagnosed HIV often present to healthcare settings numerous times before eventually receiving their diagnosis.
The aim of the study was to assess missed opportunities for HIV testing among people newly diagnosed with HIV.
In this observational retrospective study, we collected data from the Estonian Health Board on new HIV cases in people aged 16–49 years diagnosed in 2014–15 and from the Estonian Health Insurance Fund database for treatment invoices on their contacts with healthcare services in the 2 years preceding diagnosis. Diagnoses on treatment invoices were categorised as HIV indicator conditions using ICD-10 codes.
Of 538 newly diagnosed HIV cases (62.5%; 336 men), 82% had visited healthcare services at least once during the 2 years before HIV diagnosis; the mean number of visits was 9.1. Of these, 16% had been tested for HIV and 31% had at least one ICD-10 code for an HIV indicator condition on at least one of their treatment invoices. In 390 cases of HIV indicator conditions, only 5% were tested for HIV. Of all new HIV cases aged 20–49 years from high-incidence regions (defined as priority groups in national testing guidance), 18% had been tested.
The HIV testing rate in the 2 years before an HIV diagnosis was very low, even in the presence of an HIV indicator condition. This emphasises the importance of implementing the Estonian HIV testing guidelines.
Xavier Martínez-Gómez, Adrian Curran, Magda Campins, Laia Alemany, José Ángel Rodrigo-Pendás, Natalia Borruel, Xavier Castellsagué, Cristina Díaz-de-Heredia, Fernando A Moraga-Llop, Marta del Pino and Aureli Torné
Introduction: Although human papillomavirus (HPV) routine vaccination programmes have been implemented around the world and recommendations have been expanded to include other high-risk individuals, current recommendations often differ between countries in Europe, as well as worldwide.
Aim: To find and summarise the best available evidence of HPV vaccination in high-risk patients aiding clinicians and public health workers in the day-to-day vaccine decisions relating to HPV in Spain.
Methods: We conducted a systematic review of the immunogenicity, safety and efficacy/effectiveness of HPV vaccination in high-risk populations between January 2006 and June 2016. HPV vaccination recommendations were established with levels of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.
Results: A strong recommendation about HPV vaccination was made in the following groups: HIV infected patients aged 9–26 years; men who have sex with men aged 9–26 years; women with precancerous cervical lesions; patients with congenital bone marrow failure syndrome; women who have received a solid organ transplant or hematopoietic stem cell transplantation aged 9–26 years; and patients diagnosed with recurrent respiratory papillomatosis.
Conclusions: Data concerning non-routine HPV vaccination in populations with a high risk of HPV infection and associated lesions were scarce. We have developed a document to evaluate and establish evidence-based guidelines on HPV vaccination in high-risk populations in Spain, based on best available scientific evidence.
A novel antibody monotherapy may maintain human immunodeficiency virus (HIV) suppression for up to 16 weeks, newly published data suggest.
Wan-Chin Chen, Po-Hsun Chiang, Yu-Hsin Liao, Lin-Ching Huang, Ying-Jung Hsieh, Chu-Ming Chiu, Yi-Chun Lo, Chin-Hui Yang and Jyh-Yuan Yang
The Taiwan Centers for Disease Control (CDC) were notified of increasing acute hepatitis A (AHA) in June 2015. Serum and/or stool from AHA patients and sewage samples were tested for hepatitis A virus (HAV). We defined outbreak cases as AHA patients with illness onset after June 2015 and with an HAV sequence less than 0.5% different from that of the TA-15 outbreak strain. We analysed characteristics and food exposures between outbreak and non-outbreak cases between January 2014 (start of enhanced surveillance) and February 2016. From June 2015 to September 2017, there were 1,563 AHA patients with a median age of 31 years (interquartile range (IQR): 26–38); the male-to-female ratio was 8.8 and 585 (37%) had human immunodeficiency virus (HIV) infection. TA-15 was detected in 82% (852/1,033) of AHA patients, and 14% (74/540) of sewage samples tested since July 2015. Infection with the TA-15 strain was associated with having HIV, sexually transmitted infections (STI), recent oral-anal sex and men who have sex with men (MSM). The Taiwan CDC implemented an HAV vaccine campaign starting from October 2016 where 62% (15,487/24,879) of people at risk were vaccinated against HAV. We recommend HAV vaccination for at-risk populations and continuous surveillance to monitor control measures.
Marita JW van de Laar, Arnold Bosman, Anastasia Pharris, Emmi Andersson, Lambert Assoumou, Eva Ay, Norbert Bannert, Barbara Bartmeyer, Melissa Brady, Marie-Laure Chaix, Diane Descamps, Kenny Dauwe, Jannik Fonager, Andrea Hauser, Maja Lunar, Maria Mezei, Martha Neary, Mario Poljak, Ard van Sighem, Chris Verhofstede, Andrew J Amato-Gauci and Eeva K Broberg
A steady increase in HIV drug resistance (HIVDR) has been demonstrated globally in individuals initiating first-line antiretroviral therapy (ART). To support effective use of ART and prevent spread of HIVDR, monitoring is essential.
We piloted a surveillance system for transmitted HIVDR to assess the feasibility of implementation at the European level.
All 31 countries in the European Union and European Economic Area were invited to retrospectively submit data on individuals newly diagnosed with HIV in 2015 who were tested for antiviral susceptibility before ART, either as case-based or as aggregate data. We used the Stanford HIV database algorithm to translate genetic sequences into levels of drug resistance.
Nine countries participated, with six reporting case-based data on 1,680 individuals and four reporting aggregated data on 1,402 cases. Sequence data were available for 1,417 cases: 14.5% of individuals (n = 244) showed resistance to at least one antiretroviral drug. In case-based surveillance, the highest levels of transmitted HIVDR were observed for non-nucleoside reverse-transcriptase inhibitors (NNRTIs) with resistance detected in 8.6% (n = 145), followed by resistance to nucleoside reverse-transcriptase inhibitors (NRTI) (5.1%; n = 85) and protease inhibitors (2.0%; n = 34).
We conclude that standard reporting of HIVDR data was feasible in the participating countries. Legal barriers for data sharing, consensus on definitions and standardisation of interpretation algorithms should be clarified in the process of enhancing European-wide HIV surveillance with drug resistance information.
Other Animal Disease -- PolandA deadly and disruptive bee infection has been discovered in Krakow bees, worrying local beekeepers and ecologists.American foulbrood is a bacterial disease that infects and kills young bee larvae, which can be devastating for the hive. Spores can survive in nectar and honey for as long as 40 years, making it difficult to contain the spread of the illness. Beekeepers usually burn the entire affected hive as a precaution. It is important that they not buy food from untrusted sources or move
Other Animal Disease -- IndiaEven though the drought has not affected cattle in Thirthahalli taluk [administrative district], as is the case in other drought-affected taluks of Shivamogga district, the death of 2 heads of cattle at Araga village recently has set off alarms in the district. However, a thorough investigation conducted by the Obscure Disease Research Center, Shivamogga, has revealed they [the cattle] died after consuming the toxic _Ficus tsjahela_ leaves.This is not the 1st such incident reported in the
Herpes -- United StatesWe thank ProMED-mail for the opportunity to make a few corrections to the post (archive no. http://promedmail.org/post/20181202.6176860) and add some information for your readers.Like herpesvirus in humans, elephant endotheliotropic herpesvirus (EEHV) is a lifelong infection that often does not cause serious clinical illness. There may be occasional skin lesions due to EEHV or gammaherpesviruses (more often in African elephants and only rarely in Asian elephants), but these have not been
Kyasanur Forest Disease -- IndiaThe outbreak of Kyasanur Forest disease [KFD], also known as monkey fever, in Malnad region of the district [Shivamogga] is showing no signs of abating, as 4 cases have now been reported from Tirthahalli taluk. The earlier cases were reported in Sagar taluk.With this, the total number of KFD cases in the district since December 2018 has reached 62, of which 58 cases are from Aralagodu Gram Panchayat limits in Sagar taluk. Six persons from Aralagodu died during this period.The
Kyasanur Forest Disease -- IndiaThe state government on [Tue 26 Feb 2019] told the Karnataka High Court that 8 people have died so far due to Kyasanur Forest disease (KFD) in the state. Of the 1512 suspected, 189 tested positive for the virus in Shivamogga, Uttara Kannada, and Chikkamagaluru districts. All 41 suspected cases in Udupi tested negative.A statement in this regard has been submitted to the court during the hearing of a PIL [public interest litigation] petition, filed by KP Sripal and an advocate from
Kyasanur Forest Disease -- IndiaTwo positive cases of Kyasanur Forest disease (KFD), also known as monkey fever, have been reported from Aralagodu Gram Panchayat [village council] limits in Sagar taluk [an administrative division] in the past week.Kiran S.K., Field Medical Officer of KFD, told The Hindu that the blood samples of a 40-year-old woman and a 29-year-old man from Aralagodu have tested positive for KFD. Both were admitted to McGann Hospital, a government hospital attached to Shivamogga Institute of Medical
Kyasanur Forest Disease -- IndiaDespite precautionary and surveillance measures by the Department of Health and Family Welfare in the district [Shivamogga] against Kyasanur Forest disease (KFD), also known as monkey fever, there is no sign of the outbreak subsiding in Malnad [Malenadu] region and it is extending its reach to new areas here.Chandraraju KS, a member of the Aralagodu Gram Panchayat [village council], epicentre of this season's outbreak, told The Hindu that, on an average, 4 new positive cases are reported
Kyasanur Forest Disease -- IndiaThe Department of Health and Family Welfare plans to take up a vaccination drive and step up surveillance activities to tackle Kyasanur Forest disease (KFD), also known as monkey fever, in the 2019-20 season.In 2018-19, 14 persons died in the state of monkey fever -- 12 deaths in Shivamogga district and 2 in Uttaa Kannada district. As many as 440 positive cases were reported in the state during this period, of which 341 cases were from Shivamogga district. Aralagodu Gram Panchayat in Sagar
Kyasanur Forest Disease -- IndiaAn outbreak of Kyasanur Forest disease [KFD], also known as monkey fever, has been reported in some villages of Shivamogga district, following which authorities have taken measures, including vaccination, to combat it, a health official said on Thursday [3 Jan 2019].A team of doctors and paramedics was deputed to the affected areas, and a door-to-door verification was on to identify people affected by KFD, Shivamogga District Surveillance Officer (DSO) Dr B S Shankarappa said.Allaying
MERS -- KenyaWe describe the 1st genome isolation of Middle East respiratory syndrome coronavirus (MERS-CoV) in Kenya. This fatal zoonotic pathogen was 1st described in the Kingdom of Saudi Arabia in 2012. Epidemiological and molecular evidence revealed zoonotic transmission from camels to humans and between humans. Currently, MERS-CoV is classified by the WHO as having high pandemic potential requiring greater surveillance. Previous studies of MERS-CoV in Kenya mainly focused on site-specific and archived
Monkeypox -- DR Congo[This report also has information about monkeypox cases in the Central African Republic and in Nigeria that has already been posted by ProMED-mail (see archives below). The Republic of the Congo and the Democratic Republic of the Congo reports are new. - Mod.TY]Republic of Congo:The Republic of Congo is reporting cases of monkey pox since February 2019; 2 samples from Makontipoko village in Gambona district tested in the INRB-Kinshasa turned positive for monkeypox (PCR OPX). There are 9
Typhus -- United StatesIn a follow-up to the report of an outbreak of flea-borne typhus in downtown Los Angeles [see ProMED-mail post Murine typhus - USA (04): (CA) homeless; Archive Number: http://promedmail.org/post/20181006.6075346], the Pasadena Public Health Department (PPHD) is reporting epidemic levels of typhus fever this year .In 2018, 20 Pasadena residents have been confirmed to have typhus fever, well above the expected 1-5 cases per year."Typhus fever is a disease that can cause serious
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