RESUMO
In 2016, we reviewed preventive control measures for secondary transmission of Shiga-toxin producing Escherichia coli (STEC) in humans in European Union (EU)/European Free Trade Association (EEA) countries to inform the revision of the respective Norwegian guidelines which at that time did not accommodate for the varying pathogenic potential of STEC. We interviewed public health experts from EU/EEA institutes, using a semi-structured questionnaire. We revised the Norwegian guidelines using a risk-based approach informed by the new scientific evidence on risk factors for HUS and the survey results. All 13 (42%) participating countries tested STEC for Shiga toxin (stx) 1, stx2 and eae (encoding intimin). Five countries differentiated their control measures based on clinical and/or microbiological case characteristics, but only Denmark based their measures on routinely conducted stx subtyping. In all countries, but Norway, clearance was obtained with ⩽3 negative STEC specimens. After this review, Norway revised the STEC guidelines and recommended only follow-up of cases infected with high-virulent STEC (determined by microbiological and clinical information); clearance is obtained with three negative specimens. Implementation of the revised Norwegian guidelines will lead to a decrease of STEC cases needing follow-up and clearance, and will reduce the burden of unnecessary public health measures and the socioeconomic impact on cases. This review of guidelines could assist other countries in adapting their STEC control measures.
Assuntos
Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Transmissão de Doença Infecciosa/prevenção & controle , Infecções por Escherichia coli/prevenção & controle , Infecções por Escherichia coli/transmissão , Guias como Assunto , Escherichia coli Shiga Toxigênica/isolamento & purificação , Testes Diagnósticos de Rotina/métodos , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , União Europeia , Política de Saúde , Humanos , Noruega/epidemiologiaRESUMO
In 2017 Zagreb faced the largest outbreak of haemorrhagic fever with renal syndrome (HFRS) to date. We investigated to describe the extent of the outbreak and identify risk factors for infection. We compared laboratory-confirmed cases of Hantavirus infection in Zagreb residents with the onset of illness after 1 January 2017, with individually matched controls from the same household or neighbourhood. We calculated adjusted matched odds ratios (amOR) using conditional logistic regression. During 2017, 104 cases were reported: 11-81 years old (median 37) and 71% (73) male. Compared with 104 controls, cases were more likely to report visiting Mount Medvednica (amOR 60, 95% CI 6-597), visiting a forest (amOR 46, 95% CI 4.7-450) and observing rodents (amOR 20, 95% CI 2.6-159). Seventy per cent of cases (73/104) had visited Mount Medvednica prior to infection. Among participants who had visited Mount Medvednica, cases were more likely to have drunk water from a spring (amOR 22, 95% CI 1.9-265), observed rodents (amOR 17, 95% CI 2-144), picked flowers (amOR 15, 95% CI 1.2-182) or cycled (amOR 14, 95% CI 1.6-135). Our study indicated that recreational activity around Mount Medvednica was associated with HFRS. We recommend enhanced surveillance of the recreational areas during an outbreak.
Assuntos
Surtos de Doenças , Febre Hemorrágica com Síndrome Renal/epidemiologia , Febre Hemorrágica com Síndrome Renal/virologia , Virus Puumala , Recreação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Estudos de Casos e Controles , Criança , Croácia/epidemiologia , Feminino , Florestas , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Roedores , Adulto JovemRESUMO
In 2013-2014, the Public Health Agency of Sweden developed a web-based participatory surveillance system, HÓlsorapport, based on a random sample of individuals reporting symptoms weekly online, to estimate the community incidence of self-reported acute gastrointestinal (AGI), acute respiratory (ARI) and influenza-like (ILI) illnesses and their severity. We evaluated HÓlsorapport's acceptability, completeness, representativeness and its data correlation with other surveillance data. We calculated response proportions and Spearman correlation coefficients (r) between (i) incidence of illnesses in HÓlsorapport and (ii) proportions of specific search terms to medical-advice website and reasons for calling a medical advice hotline. Of 34 748 invitees, 3245 (9·3%) joined the cohort. Participants answered 81% (139 013) of the weekly questionnaires and 90% (16 351) of follow-up questionnaires. AGI incidence correlated with searches on winter-vomiting disease [r = 0·81, 95% confidence interval (CI) 0·69-0·89], and ARI incidence correlated with searches on cough (r = 0·77, 95% CI 0·62-0·86). ILI incidence correlated with the web query-based estimated incidence of ILI patients consulting physicians (r = 0·63, 95% CI 0·42-0·77). The high response to different questionnaires and the correlation with other syndromic surveillance systems suggest that HÓlsorapport offers a reasonable representation of AGI, ARI and ILI patterns in the community and can complement traditional and syndromic surveillance systems to estimate their burden in the community.
Assuntos
Participação da Comunidade , Monitoramento Epidemiológico , Gastroenterite/epidemiologia , Pesquisa sobre Serviços de Saúde , Infecções Respiratórias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Internet , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Suécia/epidemiologia , Adulto JovemRESUMO
In autumn 2014, enterovirus D68 (EV-D68) cases presenting with severe respiratory or neurological disease were described in countries worldwide. To describe the epidemiology and virological characteristics of EV-D68 in England, we collected clinical information on laboratory-confirmed EV-D68 cases detected in secondary care (hospitals), between September 2014 and January 2015. In primary care (general practitioners), respiratory swabs collected (September 2013-January 2015) from patients presenting with influenza-like illness were tested for EV-D68. In secondary care 55 EV-D68 cases were detected. Among those, 45 cases had clinical information available and 89% (40/45) presented with severe respiratory symptoms. Detection of EV-D68 among patients in primary care increased from 0.4% (4/1074; 95% CI 0.1-1.0) (September 2013-January 2014) to 0.8% (11/1359; 95% CI 0.4-1.5) (September 2014-January 2015). Characterization of EV-D68 strains circulating in England since 2012 and up to winter 2014/2015 indicated that those strains were genetically similar to those detected in 2014 in USA. We recommend reinforcing enterovirus surveillance through screening respiratory samples of suspected cases.
Assuntos
Enterovirus Humano D/isolamento & purificação , Infecções por Enterovirus/epidemiologia , Infecções Respiratórias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Inglaterra/epidemiologia , Infecções por Enterovirus/diagnóstico , Infecções por Enterovirus/virologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Filogenia , Prevalência , Atenção Primária à Saúde , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/virologia , Estações do Ano , Atenção Secundária à Saúde , Proteínas Virais de Fusão/genética , Adulto JovemRESUMO
Following re-emergence of malaria in Evrotas, Laconia, in 200912, a malaria-control programme was implemented in 201112 targeting migrants from malaria-endemic countries, including house-to-house active case detection, health education and distribution of mosquito protection items. In June 2013, we surveyed migrants in Evrotas to assess their malaria knowledge, attitudes and practices to guide prevention activities. We selected participants using simple random sampling and interviewed them, using structured questionnaires. We defined mosquito protection practices (MPPs) as the use of full-length clothes/topical repellent, mosquito screens, fans or air-conditioning, and insecticides. We calculated prevalence ratios (PRs) using Poisson regression and we allowed for clustering of participants in a residence. Of 654 migrants, we invited 132 and 130 participated (all men; 120 (92%) from Pakistan). Of the 130, 56 (43%) identified fever as a malaria symptom; those who were aware of this had higher level of education (PR: 3.2; 95% confidence interval (CI): 1.29.0). A total of 111 (85%) used insecticide-treated bednets and 95 (73%) used more than two MPPs. Poor housing conditions (warehouses/shacks: PR: 0.8; 95% CI: 0.60.9), were associated with use of up to two MPPs. Despite extensive interventions in Evrotas, the level of malaria awareness among migrants remained suboptimal and poor housing conditions hindered effective mosquito protection. We recommend culturally adapted health education and improvement of housing conditions to minimise the risk of new cases and re-establishment of malaria in Greece.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Mosquiteiros Tratados com Inseticida/estatística & dados numéricos , Malária/prevenção & controle , Controle de Mosquitos/métodos , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Feminino , Febre , Grécia/epidemiologia , Inquéritos Epidemiológicos , Habitação , Humanos , Entrevistas como Assunto , Malária/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Análise de Regressão , Características de Residência , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto JovemRESUMO
Saudi Arabia (SA) experienced two large invasive meningococcal disease (IMD) outbreaks during the 2000 and 2001 Hajj pilgrimages. In 2002, polysaccharide quadrivalent ACWY vaccines became mandatory for Mecca and Medina pilgrims/residents older than two years. This study aimed to analyse IMD surveillance data among citizens, residents and pilgrims in SA from 1995 to 2011, focusing on changes before and after the new vaccination policy. For all laboratory-confirmed IMD cases in the national surveillance database from 1995 to 2011, serogroup and age were retrieved. The cases' seasonal distribution as well as the case fatality ratios (CFR) were obtained. For Saudi citizens/residents and Hajj pilgrims, annual rates were calculated using mid-year population estimates. The Student's t-test was used to compare means between the pre-epidemic (1995-1999) and post-epidemic (2002-2011) periods, excluding outbreak years. From 1995 to 2011, laboratories notified 1,103 cases. Between the pre- and post-epidemic periods, mean annual IMD rates decreased from 0.20 (standard deviation (SD): 0.1) to 0.06 cases/100,000 (SD: 0.06; p=0.02), mean numbers of Hajj-related cases from 13 (SD: 9.3) to 2 cases/year (SD: 2.3; p=0.02) and the mean age from 31 (SD: 1.3) to 18 years (SD: 1.4; p<0.01). The CFR in Saudi citizens (10.4) was lower than among foreign pilgrims (28.9) and decreased from 19.3% (SD: 1.8) in the pre-epidemic to 11.4% (SD: 7.0; p=0.04) in the post-epidemic phase. The decrease of annual IMD rates, CFR and Hajj-related cases between the pre- and post- vaccine era suggests a possible positive effect of the mandatory ACWY vaccination for pilgrims/residents in Mecca and Medina. Regular surveillance with an annual data analysis is necessary to monitor trends and circulating serotypes and to implement appropriate public health measures to avoid new IMD epidemics during upcoming Hajj seasons.
Assuntos
Surtos de Doenças/prevenção & controle , Islamismo , Infecções Meningocócicas/prevenção & controle , Vacinas Meningocócicas/administração & dosagem , Neisseria meningitidis/imunologia , Viagem , Vacinação , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Política de Saúde , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Infecções Meningocócicas/epidemiologia , Infecções Meningocócicas/transmissão , Pessoa de Meia-Idade , Neisseria meningitidis/isolamento & purificação , Vigilância da População , Arábia Saudita/epidemiologia , Adulto JovemRESUMO
Malaria, which was endemic in Greece in the past, was officially eliminated in 1974. Since that time and up to 2010, a number of imported cases (ranging from 19 to 76) have been annually reported. The total number of reported laboratory-confirmed cases between 1975 and 2010 was 1,419. Plasmodium falciparum was identified in 628 (44%) of these cases, while P. vivax was found in 524 (37%). Of the total cases, 1,123 (79%) were male (ratio males vs. females: 3.78). Age was only available for 490 cases, of which 352 (72%) belonged to the 18-40 year-age group. Of the 382 malaria cases reported from 1999 to 2010 for which the region/country of acquisition was known, 210 (55%) were from Africa and 142 (37%) from Asia. The massive introduction of economic migrants, in the period from 1990 to 1991 and from 2006 onwards, mainly from countries where malaria is endemic, resulted in the appearance of introduced sporadic cases. In Peloponnese, Central and East Macedonia, Thrace and East Attica, mosquitoes of the genus Anopheles (e.g. Anopheles sacharovi, A. superpictus and A. maculipenis) that can act as plasmodia vectors are abundant and during the summer of 2011, 27 P. vivax cases were reported in Greek citizens residing in the agricultural area of Evrotas in Lakonia and without travel history. As further P. vivax malaria cases occurred in the Lakonia and East Attica areas in 2012, it is becoming urgent to strengthen surveillance and perform integrated mosquito control that will help eliminate the potential risk of malaria reintroduction and reestablishment.
Assuntos
Malária/diagnóstico , Malária/história , Plasmodium/classificação , Plasmodium/isolamento & purificação , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Antimaláricos/administração & dosagem , Criança , Pré-Escolar , Feminino , Grécia/epidemiologia , História do Século XX , História do Século XXI , Humanos , Lactente , Malária/tratamento farmacológico , Malária/epidemiologia , Masculino , Notificação de Abuso , Pessoa de Meia-Idade , Vigilância da População , Viagem , Resultado do Tratamento , Adulto JovemRESUMO
Functionalized living cells are regarded as effective tools in directed cell delivery and tissue engineering. Here we report the facile functionalization of viable isolated HeLa cells with superparamagnetic cationic nanoparticles via a single-step biocompatible process. Nanoparticles are localized on the cellular membranes and do not penetrate into the cytoplasm. The magnetically responsive cells are viable and able to colonize and grow on substrates. Magnetically facilitated microorganization of functionalized cells into viable living clusters is demonstrated. We believe that the technique described here may find a number of potential applications in cell-based therapies and in development of whole-cell biosensors.
Assuntos
Materiais Biocompatíveis/química , Compostos Férricos/química , Magnetismo , Nanopartículas/química , Técnicas Biossensoriais , Cátions/química , Membrana Celular/metabolismo , Sobrevivência Celular , Células Cultivadas , Citoplasma/metabolismo , Compostos Férricos/síntese química , Células HeLa , Humanos , Microscopia de Fluorescência , Tamanho da Partícula , Propriedades de SuperfícieRESUMO
Between 16 July and 21 August 2011, 31 cases of West Nile neuroinvasive disease were reported from four regions in Greece. Of these, 17 occurred in districts that had not been affected in 2010. The reoccurrence of human cases in two consecutive years (following the large 2010 outbreak) and the spread of the virus in new areas suggest that West Nile virus is established in Greece, and its transmission may continue to occur in the future.
Assuntos
Surtos de Doenças , Febre do Nilo Ocidental/epidemiologia , Adulto , Idoso , Animais , Culex/virologia , Feminino , Grécia/epidemiologia , Humanos , Incidência , Insetos Vetores/virologia , Masculino , Pessoa de Meia-Idade , Vigilância da População , Febre do Nilo Ocidental/sangue , Febre do Nilo Ocidental/líquido cefalorraquidiano , Febre do Nilo Ocidental/prevenção & controle , Febre do Nilo Ocidental/virologia , Vírus do Nilo Ocidental/classificação , Vírus do Nilo Ocidental/genética , Vírus do Nilo Ocidental/isolamento & purificaçãoRESUMO
Between May and September 2011, twenty cases of Plasmodium vivax infection were reported in Greek citizens without reported travel history. The vast majority of those cases were confined to a delimited agricultural area of Evrotas, Lakonia. Conditions favouring locally acquired transmission of malaria, including the presence of competent vectors and migrants from endemic countries exist in Greece, underscoring the need for the development of an integrated preparedness and response plan for malaria prevention.
Assuntos
Malária Vivax/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Grécia/epidemiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
The paper describes weekly fluctuations of all-cause mortality observed in eight European countries during the period between week 27 and 51, 2009, in comparison with three previous years. Our preliminary data show that the mortality reported during the 2009 influenza pandemic did not reach levels normally seen during seasonal influenza epidemics. However, there was a cumulative excess mortality of 77 cases (1 per 100,000 population) in 5-14-year-olds, and possibly also among 0-4-year-olds.
Assuntos
Causas de Morte/tendências , Mortalidade da Criança/tendências , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Europa (Continente)/epidemiologia , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Sistema de Registros , Adulto JovemRESUMO
OBJECTIVES: We aimed to estimate vaccine effectiveness against severe measles based on the number of vaccine doses administered and the time since last vaccination. PATIENTS AND METHODS: We included measles cases aged at least 2 years and born since 1980 who were notified in France between 2006 and mid-2019. We considered two severity levels (moderate, severe) and calculated adjusted relative risks (aRR) using multinomial logistic regression. RESULTS: We included 10,399 cases. The risk of severe measles in two-dose vaccine recipients was 71% (aRR = 0.29 [95%CI 0.12-0.72]) and 83% (aRR = 0.17 [95%CI 0.04-0.70]) lower than in unvaccinated cases, if the time since last dose was less or more than 15 years, respectively. The risk of moderate disease followed a similar pattern. CONCLUSIONS: Two-dose measles vaccination provided long-term protection against severe cases, even after vaccine failures. These findings underscore the need for compliance to the recommended measles vaccination schedule to prevent severe cases.
Assuntos
Vacina contra Sarampo , Sarampo , Pré-Escolar , França/epidemiologia , Humanos , Lactente , Modelos Logísticos , Sarampo/epidemiologia , Sarampo/prevenção & controle , VacinaçãoRESUMO
We report the findings of the first case-control study conducted in both the Republic of Ireland and Northern Ireland to determine risk factors for sporadic Campylobacter infections. A total of 197 cases and 296 case-nominated controls matched for age, were included. Based on Population Attributable Fraction (PAF), the most important risk factors were consuming chicken [adjusted matched (am) OR 6.8; 95%CI 2.1-21.9], consuming lettuce (amOR 3.3; 95%CI 1.5-7.1) and eating in takeaways (amOR=3.1; 95%CI 1.4-6.6). Contact with sheep (amOR=11; 95%CI 1.6-78), peptic ulcer (amOR=19; 95%CI 3.8-93.7), hiatus hernia (amOR=20.3; 95%CI 2.3-183.3), lower bowel problems (amOR=4.5; 95%CI 1.2-16.8) were also independently associated with infection. Mains water supply showed protective effect (amOR=0.2; 95 CI 0.1-0.9). The findings highlight the continued need for consumer food safety education and further control measures throughout the food chain on the island of Ireland.
Assuntos
Infecções por Campylobacter/epidemiologia , Adolescente , Adulto , Idoso , Campylobacter/patogenicidade , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Classe Social , Inquéritos e Questionários , Adulto JovemAssuntos
Surtos de Doenças , Vigilância da População , Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/virologia , Vírus do Nilo Ocidental/isolamento & purificação , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Ensaio de Imunoadsorção Enzimática , Feminino , Grécia/epidemiologia , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , RNA Viral , Distribuição por Sexo , Febre do Nilo Ocidental/sangue , Febre do Nilo Ocidental/líquido cefalorraquidiano , Febre do Nilo Ocidental/diagnóstico , Vírus do Nilo Ocidental/imunologia , Adulto JovemRESUMO
On 26 and 27 May, the Hellenic Centre for Disease Control and Prevention in Greece reported two confirmed cases of new influenza A(H1N1) virus infection in travellers returning from Scotland. The two cases had no apparent traceable links to an infectious source. Herein we report details of the two cases and potential public health implications.
Assuntos
Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/epidemiologia , Viagem , União Europeia , Grécia/epidemiologia , Humanos , Influenza Humana/fisiopatologia , Masculino , Escócia , Adulto JovemRESUMO
Viscoelastic properties of the rectal wall were compared with Hirschsprung's disease. The elasticity of the rectal wall after accomodation to distension was found to be significantly greater (P less than 0.001) in patients, and the time taken by the rectum to accomodate was also found to be longer (P less than 0.001). The increased elasticity correlated well with severity of the illness, but none of the parameters correlated with length of aganglionic segment. Measuring elastic properties of the rectal wall may help to assess the severity of illness in patients with Hirschsprung's disease.
Assuntos
Megacolo/fisiopatologia , Reto/fisiopatologia , Adolescente , Criança , Pré-Escolar , Elasticidade , Equipamentos e Provisões , Humanos , Lactente , Métodos , Modelos Biológicos , Pressão , ViscosidadeRESUMO
A study was undertaken in Northern Ireland (NI) prisons to (i) determine prevalence of bloodborne viruses among inmates, (ii) estimate the extent of self-reported risk behaviours. All three prisons in NI were included in the study. Outcome measures included (i) antibodies to hepatitis C (HCV), hepatitis B (HBV) core antigen, HIV, (ii) self-reported risk behaviour. Five prisoners (0.75%) tested positive for HBV, seven (1.1%) for HCV and none for HIV. Eleven per cent reported ever having injected drugs. Of these, 20% had started injecting while in prison, and 12% shared injecting equipment in prison. Two per cent had completed HBV immunisation. Injecting drugs was associated with HCV (adjusted prevalence ratio=5.2; 95% CI 0.9-16) and HBV infection (adjusted prevalence ratio=4.1; 95% CI 0.7-23). The low prevalence of bloodborne viruses within NI prisons is not consistent with findings of studies in other countries, possibly reflecting the unique sociopolitical situation in NI. In spite of knowledge of the risks of transmission of bloodborne viruses in prison, high-risk practices are occurring. Preventing risk behaviours and transmission of infection in prisons now poses a challenge for health services in the United Kingdom.
RESUMO
We report on a three-drug myeloablative regimen designed to consolidate remission and to prevent central nervous system (CNS) relapse of high-risk neuroblastoma (NB). Sixty-six NB patients received topotecan 2 mg/m2/day, x 4 days; thiotepa 300 mg/m2/day, x 3 days; and carboplatin approximately 500 mg/m2/day, x 3 days. Post-SCT treatments included radiotherapy, immunotherapy, 13-cis-retinoic acid, +/-oral etoposide. Significant nonhematologic toxicities were mucositis and skin-related in all patients, convulsions in three patients, and cardiac failure and venocclusive disease of liver in one patient each. Grade 2 hepatotoxicity led to truncating cytoreduction in two patients; both later relapsed in brain. Among 46 patients transplanted in first complete/very good partial remission (CR/VGPR), event-free survival is 54% (s.e.+/-8%) at 36 months post-SCT; notable events were three non-NB-related deaths (adenovirus on day +9, bowel necrosis at 5 months, multiorgan failure at seven months) and four relapses in brain. Of 12 patients transplanted with evidence of NB, two became long-term event-free survivors and two relapsed in the brain. Of eight patients transplanted in second or greater CR/VGPR, one became a long-term event-free survivor and seven relapsed though not in the CNS. This regimen has manageable toxicity but does not prevent CNS relapse.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias do Sistema Nervoso Central/terapia , Recidiva Local de Neoplasia/prevenção & controle , Neuroblastoma/terapia , Adolescente , Antineoplásicos/administração & dosagem , Carboplatina/administração & dosagem , Carboplatina/efeitos adversos , Neoplasias do Sistema Nervoso Central/mortalidade , Criança , Pré-Escolar , Terapia Combinada/métodos , Terapia Combinada/mortalidade , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia/mortalidade , Neuroblastoma/mortalidade , Tiotepa/administração & dosagem , Tiotepa/efeitos adversos , Topotecan/administração & dosagem , Topotecan/efeitos adversos , Falha de TratamentoRESUMO
BACKGROUND: Brucellosis is the most common bacterial zoonosis worldwide. Greece has the highest reported incidence among EU countries. However, occupational risk factors have not been well described. OBJECTIVE: To determine the incidence patterns and exposure risk factors of brucellosis in Greece. METHODS: We used national-level surveillance and occupational denominator data to estimate the incidence patterns and exposure risk factors of brucellosis in Greece, with particular emphasis on occupation. RESULTS: Between November 2003 and December 2015 a total of 2159 human brucellosis cases was reported. The mean incidence rate was 1.62 per 100 000 population per year. A large majority of cases (77.1%) reported consumption of unpasteurized milk or contact with livestock animals. Most cases occured in farmers and livestock breeders (1079 [87.7%] of 1231 cases reporting their occupation), corresponding to an annual incidence of 7.1 per 100 000. However, there were other occupations with a similar or higher risk: butchers and abattoir workers (12.7 per 100 000), laboratory personnel (3.1 per 100 000), while the highest risk was for veterinarians (53.2 per 100 000). CONCLUSION: Brucellosis incidence in specific occupational groups was much higher than in the general population. These results underline the importance of collecting information on occupation, both during the diagnostic process and in the surveillance system. Besides efforts to control brucellosis in animals, organized prevention efforts are needed within an occupational health framework, especially for the most vulnerable workers.
Assuntos
Brucelose/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Matadouros/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criação de Animais Domésticos/estatística & dados numéricos , Animais , Criança , Pré-Escolar , Feminino , Grécia/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Laboratórios/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Leite/microbiologia , Saúde Ocupacional , Pasteurização , Fatores de Risco , Medicina Veterinária/estatística & dados numéricos , Adulto JovemRESUMO
During the summer of 2010, an outbreak of West Nile virus (WNV) infections attributed to a lineage 2 WNV strain was reported among humans and horses in Central Macedonia, Northern Greece. Here, the clinical and laboratory investigation of horses that showed severe neurological signs due to WNV infection is being described. Specifically, between August and September 2010, 17 horses with neurological signs were detected. WNV infection was confirmed in all 17 clinical cases by applying laboratory testing. The duration of WNV-specific IgM antibodies in sera obtained from seven of the clinically affected horses was relatively short (10-60 days; mean 44 days). In the regional unit of Thessaloniki, (i) seroprevalence of WNV and fatality rate in horses were high (33% and 30%, respectively), and (ii) the ratio of neurological manifestations-to-infections for this virus strain was high (19%). These observations indicate that the strain responsible for the massive human epidemic of 2010 in Greece was also highly pathogenic for horses. This is the first time that WNV infection has been documented in horses with clinical manifestations in Greece. WNV infection should be included in the differential diagnosis of horses with encephalitis in Greece.