Transnational exchange of surveillance data reveals previously unrecognized TBEV microfocus.

Tick-borne encephalitis (TBE) is a tick-borne infection with an increasing presence in many European countries. It is caused by the TBE virus (TBEV), a flavivirus transmitted by the Ixodes ricinus tick in northern Europe. In Denmark, the virus exists endemically on the island of Bornholm. However, a large proportion of Danish cases are also imported from Sweden, where the incidence of TBE has steadily been increasing during the last few decades. With the prospect of expanding risk areas due to climate change, TBE surveillance data exchange between countries could facilitate the identification of new TBEV microfoci and thereby aid healthcare workers in the issuing of vaccination recommendations. We present data from a collaborative effort between Denmark and Sweden on the surveillance of TBEV that resulted in the uncovering of a previously unrecognized possible TBEV microfocus in central Sweden.

Hepatitis A vaccine for immunosuppressed patients with rheumatoid arthritis: a prospective, open-label, multi-centre study.

BACKGROUND: Hepatitis A vaccine is the most frequently used travel vaccine, yet data are scarce about its ability to induce protection in patients with concurrent immunosuppressive treatment. We assessed the immunogenicity of this vaccine in rheumatoid arthritis (RA) patients treated with tumour necrosis factor-inhibitors (TNFi) and/or methotrexate (MTX). METHODS: Hepatitis A vaccine was administered to non-immune RA patients at 0 and 6 months. Hepatitis A virus (HAV) antibodies were assessed at 0, 1, 6, 7, 12, and 24 months with a quantitative Chemiluminescent Microparticle Immuno Assay (CMIA) for HAV-IgG. Samples from month 1, 6, and 7 were, in addition, analysed with a microparticle EIA (MEIA) for anti-HAV IgM + IgG. RESULTS: The final study population consisted of 53 patients treated with TNFi (n = 15), TNFi + MTX (n = 21) or MTX (n = 17). One and six months after the first dose, 10% and 33% of the patients had attained seroprotection. One and six months after the second dose 83% and 72% were seroprotected. At month 24, 86% of the vaccinees showed protective levels. CONCLUSIONS: Two doses of hepatitis A vaccine at a 6-month interval provided protection for most immunosuppressed RA patients. A single dose does not seem to afford sufficient protection to this group of patients.