Investigation of travel-related cases in a multinational outbreak: example of the Shiga-toxin producing E. coli outbreak in Germany, May-June 2011.

Early investigation of travel-related cases in an outbreak of an emerging infectious disease can provide useful information to epidemiologists to characterize the exposure, while they may differ in demographic profiles from cases reported in the country where the outbreak has occurred. During the spring 2011 E. coli outbreak in Germany, we proposed a methodological approach to collect a minimal set of demographic and clinical data that are relatively easy to obtain and available at an early stage of an outbreak investigation. Ninety-eight STEC O104 travel-related cases were reported in a survey by seven EU countries, Switzerland, Canada and the USA. We found a mean incubation period (n = 50) of 8·5 days, which confirmed previous estimations communicated by the Robert Koch Institute. No significant association was found between the duration of the incubation period and possible demographic and clinical factors, although the older the age, the shorter the incubation period that was observed. Such approach and observations are informative for further investigations of outbreaks of enterohaemorrhagic E. coli or other emerging infectious diseases.

Training infection control and hospital hygiene professionals in Europe, 2010: agreed core competencies among 33 European countries.

The harmonisation of training programmes for infection control and hospital hygiene (IC/HH) professionals in Europe is a requirement of the Council recommendation on patient safety. The European Centre for Disease Prevention and Control commissioned the 'Training Infection Control in Europe' project to develop a consensus on core competencies for IC/HH professionals in the European Union (EU). Core competencies were drafted on the basis of the Improving Patient Safety in Europe (IPSE) project's core curriculum (CC), evaluated by questionnaire and approved by National Representatives (NRs) for IC/HH training. NRs also re-assessed the status of IC/HH training in European countries in 2010 in comparison with the situation before the IPSE CC in 2006. The IPSE CC had been used to develop or update 28 of 51 IC/HH courses. Only 10 of 33 countries offered training and qualification for IC/HH doctors and nurses. The proposed core competencies are structured in four areas and 16 professional tasks at junior and senior level. They form a reference for standardisation of IC/HH professional competencies and support recognition of training initiatives.

Harmonizing and supporting infection control training in Europe.

Healthcare-associated infection (HCAI), patient safety, and the harmonization of related policies and programmes are the focus of increasing attention and activity in Europe. Infection control training for healthcare workers (HCWs) is a cornerstone of all patient safety and HCAI prevention and control programmes. In 2009 the European Centre for Disease Prevention and Control (ECDC) commissioned an assessment of needs for training in infection control in Europe (TRICE), which showed a substantial increase in commitment to HCAI prevention. On the other hand, it also identified obstacles to the harmonization and promotion of training in infection control and hospital hygiene (IC/HH), mostly due to differences between countries in: (i) the required qualifications of HCWs, particularly nurses; (ii) the available resources; and (iii) the sustainability of IC/HH programmes. In 2013, ECDC published core competencies for infection control and hospital hygiene professionals in the European Union and a new project was launched ['Implementation of a training strategy for infection control in the European Union' (TRICE-IS)] that aimed to: define an agreed methodology and standards for the evaluation of IC/HH courses and training programmes; develop a flexible IC/HH taxonomy; and implement an easily accessible web tool in 'Wiki' format for IC/HH professionals. This paper reviews several aspects of the TRICE and the TRICE-IS projects.