ABSTRACT
Протокол по проблемам воды и здоровья к Конвенции по охране и использованию трансграничных водотоков и международных озер 1992 г. направлен на защиту здоровья и благополучия людей путем связи устойчивого управления водными ресурсами с деятельностью по предотвращению, ограничению и сокращению степени распространения заболеваний, связанных с водой. Предотвращение заболеваний, связанных с водой, и сокращение их числа является одним из приоритетов программы работы в рамках Протокола на 2014-2016 гг. В результате обзора имеющихся фактических данных было обнаружено существенное занижение сведений и недооценка реального масштаба распространенности заболеваний, связанных с водой, в Общеевропейском регионе, что указывает на необходимость укрепить национальные возможности в области надзора за этими заболеваниями. К наиболее часто регистрируемым желудочно-кишечным инфекционным заболеваниям, которые могут быть связаны с водой, относятся кампилобациллярный энтерит, лямблиоз, гепатит А и шигеллез. Ограниченные опубликованные данные указывают на то, что примерно 18% расследованных вспышек заболеваний в Европейском регионе ВОЗ могут быть связаны с этим источником. Делаются определенные успехи по установке конкретных целевых показателей по предотвращению и сокращению случаев заболеваний, связанных с водой, и укреплению систем надзора и раннего предупреждения в соответствии с основными положениями Протокола.
Subject(s)
Disease Outbreaks , Environmental Health , Europe , Population Surveillance , Waterborne Diseases , Water MicrobiologyABSTRACT
The Protocol on Water and Health to the 1992 Convention on the Protection and Use of Transboundary Watercourses and International Lakes aims at protecting human health and well-being through sustainable water management and the prevention, control and reduction of water-related diseases. Prevention and reduction of water-related diseases is a priority area under the Protocol’s programme of work 2014–2016. A review of the available evidence reveals significant underreporting and underestimation of the true extent of water-related diseases in the pan-European region, indicating a need to strengthen national capacities for surveillance of these diseases. Campylobacteriosis, giardiasis, hepatitis A and shigellosis are the most commonly reported gastrointestinal infectious diseases that could be attributed to water. According to limited published data, about 18% of investigated outbreaks in the WHO European Region may be associated with this source. There has been progress in setting specific targets for prevention and reduction of water-related diseases and for strengthening surveillance and early-warning systems in accordance with the core provisions of the Protocol.
Subject(s)
Disease Outbreaks , Environmental Health , Europe , Population Surveillance , Waterborne Diseases , Water MicrobiologyABSTRACT
BACKGROUND: During the 2009-2010 pandemic in Norway, 12 513 laboratory-confirmed cases of pandemic influenza A(H1N1)pdm09, were reported to the Norwegian Surveillance System for Communicable Diseases (MSIS). 2.2 million persons (45% of the population) were vaccinated with an AS03-adjuvanted monovalent vaccine during the pandemic. Most of them were registered in the Norwegian Immunisation Registry (SYSVAK). Based on these registries, we aimed at estimating the vaccine effectiveness (VE) and describing vaccine failures during the pandemic in Norway, in order to evaluate the role of the vaccine as a preventive measure during the pandemic. METHODS: We conducted a population-based retrospective cohort study, linking MSIS and SYSVAK with pandemic influenza vaccination as exposure and laboratory-confirmed pandemic influenza as outcome. We measured VE by week and defined two thresholds for immunity; eight and 15 days after vaccination. RESULTS: The weekly VE ranged from 77% to 96% when considering 15 days or more after vaccination as the threshold of immunity and from 73% to 94% when considering eight days or more. Overall, 157 individuals contracted pandemic influenza eight or more days after vaccination (8.4/100,000 vaccinated), of these 58 had onset 15 days or more after vaccination (3.0/100,000 vaccinated). Most of the vaccine failures occurred during the first weeks of the vaccination campaign. More than 30% of the vaccine failures were found in people below 10 years of age. CONCLUSIONS: Having available health registries with data regarding cases of specific disease and vaccination makes it feasible to estimate VE in a simple and rapid way. VE was high regardless the immunity threshold chosen. We encourage public health authorities in other countries to set up such registries. It is also important to consider including information on underlying diseases in registries already existing, in order to make it feasible to conduct more complete VE estimations.
