Prevalence of tick-borne encephalitis virus in Ixodes ricinus ticks from three islands in north-western Norway.

Tick-borne encephalitis (TBE) is the most important viral tick-borne disease in Europe and can cause severe disease in humans. In Norway, human cases have been reported only from the southern coast. The aim of this study was to investigate the prevalence of tick-borne encephalitis virus (TBEV) in questing Ixodes ricinus ticks from the north-western part of Norway. A total of 4509 ticks were collected by flagging in May and June 2014. A subpopulation of 2220 nymphs and 162 adult ticks were analysed by real-time PCR and positive samples were confirmed by pyrosequencing. The estimated prevalence of TBEV was 3.08% among adult ticks from Sekken in Møre og Romsdal County and 0.41% among nymphs from both Hitra and Frøya in Sør-Trøndelag County. This study indicates that TBEV might be more widespread than the distribution of reported human cases suggests.

[Syphilis and blood transfusion]. / Syfilis og blodtransfusjon.

BACKGROUND: In 2007, previous syphilis infection was diagnosed in a blood donor who had given blood regularly for 15 years. This was discovered when the donor was tested for syphilis, as a new donor in another blood bank. The time of infection is unknown. An expert group, set up by The Norwegian Directorate of Health, was commissioned to evaluate the risk of syphilis transmission through blood products in Norway. MATERIAL AND METHODS: The expert group based its evaluation on the epidemiology of syphilis, risk of infection and properties of the syphilis bacterium, especially in relation to blood donation. Specific information about the actual incident, made available by the Norwegian Directorate of Health, was also evaluated. RESULTS: Of 54 blood recipients 21 were alive and 18 (86 %) were tested for syphilis, all with a negative result. For 11 deceased the hospital records were studied without discovering signs of syphilis infection. INTERPRETATION: The risk of transfusion-transmitted syphilis is low for several reasons: The prevalence of syphilis in the population is low, a compulsory interview and completion of a questionnaire before donation in Norway excludes patients who are ill or at risk of being infected; the proportion of fresh blood donations is very low and syphilis bacteria die quickly during normal storage conditions for blood. An incidental infection is symptomatic and easily treated by antibiotics. The expert group recommends to not start syphilis testing of each blood donor but to continue the present routine testing of new donors.

[Viral drug resistance]. / Resistens ved virusinfeksjoner.

BACKGROUND: More and more viral infections are treated with antiviral drugs, and resistance against these drugs is steadily increasing. Our aim is to give a general understanding of viral resistance and its clinical significance. MATERIAL AND METHODS: This article is based on review of published literature on the subject, international recommendations and our own experience as a national reference laboratory for hepatitis viruses. RESULTS AND INTERPRETATION: Development of viral resistance is an increasing problem with long-term treatment of both latent and chronic viral infections and may be one of the reasons for clinical treatment failure. Susceptibility testing is therefore an important diagnostic tool in cases of suspected failure during antiviral treatment, and is also necessary for customising of treatment to each individual patient. In Norway, susceptibility testing is offered for HIV, HBV, CMV and influenza, whereas systematic surveillance for the time being is only performed on HIV and influenza resistance. Surveillance on viral resistance is necessary in order to choose the adequate empirical therapy and to monitor the spread of resistant virus in the population. Prevalence of resistance can be limited with infection control measures and appropriate antiviral treatment, especially used in combinations of effective drugs directed at different enzymes and proteins within the virus.

[Hepatitis C--a health problem also in Norway]. / Hepatitt C--et helseproblem også i Norge.

BACKGROUND: Hepatitis C is a large global health problem; approximately 20 - 30 000 are infected in Norway. Hepatitis C-infection is often chronic and can progress into chronic liver disease, liver cirrhosis and hepatocellular carcinoma. The most important transmission route is through percutaneous exposure to infected blood. The aim of this article is to describe the clinical course, microbiological diagnostic approaches, therapy, prophylaxis and public health aspects of Hepatitis C infection. MATERIAL AND METHODS: The paper is based on results from annual health examinations (conducted since 2001) of persons who abuse drugs intravenously in Oslo, from diagnostic work in a national reference laboratory for Hepatitis C and studies of literature (retrieved from Pubmed). RESULTS AND INTERPRETATION: The prevalence of Hepatitis C varies by country and subgroup of patients. In Norway the prevalence is 0.13 % among new blood donors, 0.7 % among pregnant women, 0.55 % in the general adult population and approximately 70 % among persons who abuse drugs intravenously. Treatment with pegylated interferon and ribavirin induces sustained virological response in 80 % of patients with genotypes 2 and 3 and in 30 - 40 % of those with genotype 1.