Candida in the Respiratory Tract Potentially Triggers Galactomannan Positivity in Nonhematological Patients.

BAL fluid samples from critically ill patients shared a rate of 29% false-positive galactomannan results. We aimed to determine whether Candida species abundance in BAL fluid causes galactomannan (GM) positivity. A total of 89 Candida culture-positive BAL fluid samples from patients without suspicion of invasive aspergillosis (IA) were analyzed. GM results were correlated with Candida species abundance, Candida species quantity, and patient data. Candida species quantities of ≥104/ml and Candida glabrata abundance were significantly associated with positive GM results. The added diagnostic value of GM in BAL fluid for diagnosing IA in critically ill patients is limited.

Assessment of public health issues of migrants at the Greek-Turkish border, April 2011.

A joint mission to assess the public health situation of migrants in Greek detention centres was undertaken in April 2011 by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) Regional Office for Europe. The assessment visit follows the increased migration to the Evros prefecture, Eastern Macedonia and Thrace region, at the Greek-Turkish border where large numbers of migrants are entering Greece via the Evros River, a natural border. Migrants are housed in local detention centres. The main problem in detention centres are the substandard hygiene conditions, especially overcrowding and lack of personal hygiene facilities, lack of basic supplies and lack of access to fresh air and physical exercise. As the migration route via the Evros region is increasingly used since 2009, and due to the unstable political situation in North Africa and the Middle East, an increased influx of migrants was to be expected with the falling water levels of the Evros River in summer, resulting in further deterioration of the already critical situation in the Thrace region's detention centres.

Protection against poliomyelitis in Europe.

The reappearance of circulating wild poliovirus type 1 (WPV 1) in Tajikistan is the first outbreak from imported wild poliovirus since the World Health Organization (WHO) European Region was declared polio-free in 2002. The risk of poliomyelitis importation to the European Union and European Economic Area countries has probably not increased, but the current outbreak is a reminder that high vaccination coverage, monitoring of protective immunity and maintaining surveillance are important to sustain the present polio-free situation.

Initial surveillance of 2009 influenza A(H1N1) pandemic in the European Union and European Economic Area, April-September 2009.

European Union (EU) and European Economic Area (EEA) countries reported surveillance data on 2009 pandemic influenza A(H1N1) cases to the European Centre for Disease Prevention and Control (ECDC) through the Early Warning and Response System (EWRS) during the early phase of the 2009 pandemic. We describe the main epidemiological findings and their implications in respect to the second wave of the 2009 influenza pandemic. Two reporting systems were in place (aggregate and case-based) from June to September 2009 to monitor the evolution of the pandemic. The notification rate was assessed through aggregate reports. Individual data were analysed retrospectively to describe the population affected. The reporting peak of the first wave of the 2009 pandemic influenza was reached in the first week of August. Transmission was travel-related in the early stage and community transmission within EU/EEA countries was reported from June 2009. Seventy eight per cent of affected individuals were less than 30 years old. The proportions of cases with complications and underlying conditions were 3% and 7%, respectively. The most frequent underlying medical conditions were chronic lung (37%) and cardio-vascular diseases (15%). Complication and hospitalisation were both associated with underlying conditions regardless of age. The information from the first wave of the pandemic produced a basis to determine risk groups and vaccination strategies before the start of the winter wave. Public health recommendations should be guided by early capture of profiles of affected populations through monitoring of infectious diseases.

Childhood vaccination schedules in Europe vary widely. Is this a problem?

Childhood vaccination programmes in Europe are basically very safe and effective. On the other hand there are very large differences between countries in the way they are organised. In this paper we analyse the immunisation schedules used in 29 European countries to highlight similarities and differences. One of the most evident differences is the total number of doses administered under 18 years of age, which ranges between 4 and 7 if we consider DT-containing vaccines. Any change in vaccination schedules is associated with costs. Thus, this process is worthy only if it can lead in the long run to an overall improvement in the national vaccination programmes. National sovereignty in the area of vaccination programmes prevails; therefore any step forward will be feasible only if consensus in Europe is reached.

Cross-sectional point prevalence survey to study the environmental contamination of nosocomial pathogens in intensive care units under real-life conditions.

BACKGROUND: In intensive care units (ICUs), inanimate surfaces and equipment may be contaminated by nosocomial pathogens, including multi-drug-resistant micro-organisms. AIMS: To assess the degree of environmental contamination close to and distant from patients, and contamination of healthcare workers' (HCWs) hands with nosocomial pathogens under real-life conditions and to investigate potential transmission events. METHODS: Over the course of three weeks, agar contact samples were taken close to and distant from patient areas and from HCWs' hands in eight ICUs of a tertiary care hospital in Innsbruck, Austria. Each ICU was visited once without announcement. Species identification and antimicrobial susceptibility testing were performed according to standard methods, and corresponding strains from patient, environment and hand samples were genotyped using pulsed-field gel electrophoresis. FINDINGS: Among 523 samples, HCWs' hands were most frequently contaminated with potentially pathogenic bacteria (15.2%), followed by areas close to patients (10.9%) and areas distant from patients (9.1%). Gram-positive bacteria were identified most often (67.8%), with Enterococcus spp. being the most prevalent species (70% vancomycin sensitive and 30% vancomycin resistant) followed by Staphylococcus aureus, of which 64% were classified as meticillin-resistant Staphylococcus aureus. Molecular typing documented identical strains among patient, environment and hand isolates. CONCLUSION: This study found widespread contamination of the ICU environment with clinically relevant pathogens, including multi-drug-resistant micro-organisms, despite cleaning and disinfection. The bioburden might not be restricted to areas close to patients. The role of extended environmental disinfection of areas distant from patients in order to improve infection prevention needs further discussion.

Utilization and impact of European immunization week to increase measles, mumps, rubella vaccine uptake in Austria in 2016.

This paper describes engagement in European Immunization Week (EIW) in Tyrol, Austria in April 2016 and an assessment of its possible impact on demand for measles, mumps, rubella vaccination (MMR). It further describes the output of a knowledge, attitudes and practice (KAP) survey conducted during EIW, showing that 93% (188/202) of respondents were in favor of vaccination in general and 90% (192/214) perceived MMR vaccination to be important. MMR vaccination was perceived as important by more participants than other vaccinations. The number of MMR doses administered by public health services in the province of Tyrol during EIW was greater than in the previous week, and EIW activities thus potentially resulted in increased MMR vaccine uptake in Tyrol during the observed period. The annual EIW campaign provides important opportunities to address vaccine hesitancy by raising awareness about immunization, to identify barriers to immunization and test possible solutions.

Cluster of measles cases in the Roma/Sinti population, Italy, June-September 2006.

Three clusters of measles cases occurred between June and September 2006, in the Roma/Sinti populations in three different Italian regions: the Bolzano-South Tyrol in northern Italy; Lazio in central Italy; and the island of Sardinia in the southwest.

Investigation of an outbreak of amoebiasis in Georgia.

Entamoeba histolytica, a protozoan parasite, occurs worldwide and 12% of the world's population are estimated to be infected. The prevalence of infection varies between 1% in industrialised countries to between 50% and 80% in tropical countries, where tra

Salmonella enterica serotype Oranienburg infections associated with consumption of locally produced Tyrolean cheese.

Sixteen culture confirmed cases of enteric infection with Salmonella enterica serotype Oranienburg were detected between August 10 and September 29 1999 in Tyrol (Austria). Ten of them suffered bloody diarrhoea and six were asymptomatic carriers. Intervie

[Screening of South Tyrolean school children after exposure to a tuberculosis case]. / Screening-Studie unter Südtiroler Schülern nach Tuberkuloseexposition.

BACKGROUND: During a language course in Ireland 422 schoolchildren aged 15-17 years and 44 accompanying persons from the autonomous Province of Bolzano--South Tyrol in Italy were repeatedly exposed to a Mycobacterium tuberculosis complex culture-positive, but smear-negative Irish teacher for more than 10 lessons. METHODS: Immediate action included contact tracing of exposed persons, administration of a standardised questionnaire, intradermal PPD (5IU) testing and thorax X-ray of persons with an induration of > or = 5 mm in the PPD test. The questionnaire included information on demographic factors, symptoms, vaccination status, underlying diseases, regular medical treatment and past infection in the last three months. A control group of children with similar age and BCG vaccination status was enrolled in the same schools to estimate the effect of exposure and the influence of previous BCG vaccination and ambient non-tuberculous mycobacteria. RESULTS: Exposure in Ireland was not associated with an elevated prevalence of positivity in the PPD test in the exposed group, but having intra-familiar contact with tuberculosis cases (OR = 3.3; 95 % confidence interval: 1.35-8.07) or being from school A (OR = 2.3; 95 % confidence interval: 1.19-4.32) was associated with an induration > or = 5 mm in the multivariate analysis. CONCLUSIONS: Contact tracing is an important public health action after exposure to an infectious tuberculosis case, nevertheless, in this case it may have resulted in overtreatment of exposed persons. BCG vaccination may have a long-term effect on PPD skin testing.

Potential susceptible individuals to poliomyelitis in Austria.

This report presents the results of a vaccine coverage survey that was performed in the Tyrol (Austria) in 1997. The major finding is that pockets of children susceptible to poliomyelitis currently exist in the area, because of delayed immunisation. The cause for the delay is the practice of interrupting oral poliomyelitis vaccine (OPV) administration during summer months.

Long-term predominance of a rare meningococcal phenotype in a small geographical area.

Reported here is a predominant clone of Neisseria meningitidis B:14:P1.13 that persisted over a 6-year period in the northernmost province of Italy, where it was responsible for a higher incidence of meningococcal disease compared to the rest of the country. Genetic relatedness of isolates was confirmed by multilocus sequence typing, pulsed-field gel electrophoresis and PorA variable region typing. All strains examined belonged to the ST44 complex/lineage III. Risk factors for infection were evaluated through a case-control study conducted with 21 cases and 63 age- and sex-matched controls. Risk factors for infection in the seven patients younger than 13 years were (i) residence in a rural area, (ii) exposure to passive smoke, and (iii) living in a home with rooms rented to tourists (all odds ratios infinite). The only risk factor for the older patients was previous influenza-like illness (odds ratio, 41.9; 95% confidence interval, 1.6-1068.9). Guidelines for the early treatment of patients and public information campaigns were successfully implemented to reduce disease transmission and the case fatality rate in the region.

Domestic pets as risk factors for alveolar hydatid disease in Austria.

To identify the risk of pet ownership (i.e., cats and dogs) for alveolar echinococcosis caused by Echinococcus multilocularis, the habits and activities of 21 patients (histologic confirmation or positive serology with corresponding evidence on an ultrasonogram, radiograph, or computed tomography scan) in Austria during the period 1967-1997 were compared with the habits and activities of 84 controls matched by sex, age, and residence. Cat ownership (odds ratio (OR) = 6.47, 95% confidence interval (CI) 1.54-27.29) and hunting (OR = 7.83, 95% CI 1.16-52.77) were independent risk factors associated with alveolar hydatid disease. The study is not in agreement with the hypothesis that eating mushrooms or certain wild berries which grow near the ground are the main risk factors for acquiring this disease. No other behavior patterns or activities studied were identified as risk factors.