RESUMO
Sweden reports large and variable numbers of human tularemia cases, but the high-risk regions are anecdotally defined and factors explaining annual variations are poorly understood. Here, high-risk regions were identified by spatial cluster analysis on disease surveillance data for 1984-2012. Negative binomial regression with five previously validated predictors (including predicted mosquito abundance and predictors based on local weather data) was used to model the annual number of tularemia cases within the high-risk regions. Seven high-risk regions were identified with annual incidences of 3·8-44 cases/100 000 inhabitants, accounting for 56·4% of the tularemia cases but only 9·3% of Sweden's population. For all high-risk regions, most cases occurred between July and September. The regression models explained the annual variation of tularemia cases within most high-risk regions and discriminated between years with and without outbreaks. In conclusion, tularemia in Sweden is concentrated in a few high-risk regions and shows high annual and seasonal variations. We present reproducible methods for identifying tularemia high-risk regions and modelling tularemia cases within these regions. The results may help health authorities to target populations at risk and lay the foundation for developing an early warning system for outbreaks.
Assuntos
Surtos de Doenças , Modelos Estatísticos , Topografia Médica , Tularemia/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Análise por Conglomerados , Feminino , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Medição de Risco , Estações do Ano , Análise Espacial , Suécia/epidemiologia , Fatores de Tempo , Adulto JovemRESUMO
From 24 December to 24 July 2015, 174 cases were reported in a nationwide salmonellosis outbreak in Sweden: 108 cases were connected to a single restaurant. A spice mix, containing dried vegetables from the restaurant tested positive for the outbreak strain. Additional spice mixes with similar content from different suppliers also tested positive. The outbreak investigation suggests there could be a risk of contaminated products being also on the market in other countries.
Assuntos
Surtos de Doenças , Vigilância da População , Restaurantes , Intoxicação Alimentar por Salmonella/epidemiologia , Fagos de Salmonella/classificação , Salmonella enteritidis/isolamento & purificação , Especiarias/microbiologia , Verduras/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Tipagem de Bacteriófagos , Criança , Pré-Escolar , Feminino , Manipulação de Alimentos , Microbiologia de Alimentos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Intoxicação Alimentar por Salmonella/microbiologia , Intoxicação Alimentar por Salmonella/prevenção & controle , Suécia/epidemiologia , Adulto JovemRESUMO
Free-living wild birds worldwide act as reservoir for Chlamydia psittaci, but the risk of transmission to humans through contact with wild birds has not been widely documented. From 12 January to April 9 2013, a total of 25 cases of psittacosis were detected in southern Sweden, about a threefold increase compared with the mean of the previous 10 years. A matched case-control study investigating both domestic and wild bird exposure showed that cases were more likely than controls to have cleaned wild bird feeders or been exposed to wild bird droppings in other ways (OR: 10.1; 95% CI: 2.1-47.9). We recommend precautionary measures such as wetting bird feeders before cleaning them, to reduce the risk of transmission of C. psittaci when in contact with bird droppings. Furthermore, C. psittaci should be considered for inclusion in laboratory diagnostic routines when analysing samples from patients with atypical pneumonia, since our findings suggest that psittacosis is underdiagnosed.
Assuntos
Doenças das Aves/epidemiologia , Doenças das Aves/transmissão , Chlamydophila psittaci/isolamento & purificação , Psitacose , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Animais Domésticos/microbiologia , Animais Selvagens/microbiologia , Aves , Estudos de Casos e Controles , Chlamydophila psittaci/patogenicidade , Análise por Conglomerados , DNA Bacteriano/análise , Reservatórios de Doenças/microbiologia , Reservatórios de Doenças/veterinária , Fezes/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psitacose/epidemiologia , Psitacose/transmissão , Psitacose/veterinária , Fatores de Risco , Suécia , ZoonosesRESUMO
The number of sporadic cases of Cryptosporidium identified in the Stockholm county area increased above the expected limit during October 2010. Additionally, two food-borne outbreaks of cryptosporidiosis occurred in two other Swedish cities: Umeå (4 October) and Örebro (9 October). The outbreak investigations did not reveal any responsible food item, however fresh herbs were suspected. Thirty stool samples, originating from all three events, tested positive for Cryptosporidium oocysts. Polymerase chain reaction (PCR) and subsequent restriction fragment length polymorphism (RFLP) revealed that 27 individuals were infected with C. parvum, two with C. hominis, and one with C. felis. Using sequence analysis of the GP60 glycoprotein gene, a polymorphic marker with high intra-species diversity, we identified the same C. parvum subtype IIdA24G1 in samples from both the Umeå outbreak and the Stockholm area cases, thus indicating a possible outbreak in the Stockholm area and establishing a link between these two events. C. parvum IIdA24G1 has not previously been described in connection with a food-borne outbreak. For the outbreak in Örebro, another subtype was identified: C. parvum IIdA20G1e. These findings demonstrate that subtyping C. parvum isolates using GP60 gene amplification can be used to link cases in an outbreak investigation and we recommend its use in future similar events.
Assuntos
Criptosporidiose/epidemiologia , Cryptosporidium parvum/genética , Surtos de Doenças , Doenças Transmitidas por Alimentos/epidemiologia , Glicoproteínas/genética , Criptosporidiose/diagnóstico , Criptosporidiose/parasitologia , Cryptosporidium parvum/classificação , Cryptosporidium parvum/isolamento & purificação , DNA de Protozoário/genética , Fezes/parasitologia , Feminino , Parasitologia de Alimentos , Marcadores Genéticos , Variação Genética , Humanos , Masculino , Oocistos , Reação em Cadeia da Polimerase/métodos , Polimorfismo de Fragmento de Restrição , Fatores de Risco , Análise de Sequência de DNA , Inquéritos e Questionários , Suécia/epidemiologiaRESUMO
Echinococcus multilocularis is a parasite that can cause alveolar echinococcosis disease. After the first positive finding of E. multilocularis in Sweden in 2011, a consulting group with representatives from relevant authorities was summoned. In this group, all relevant information was shared, strategies for information dissemination and any actions to be taken due to the finding of E. multilocularis were discussed and decided. The present paper describes the actions taken during 2011 and the results thereof, including surveillance in animals, risk assessment for humans to become infected and recommendations given to the public. Further discussion about whether the parasite was introduced, and if so, how, as well as possible future development of the infection in animals and humans in Sweden and future actions are included.
Assuntos
Equinococose/veterinária , Echinococcus multilocularis/isolamento & purificação , Raposas/parasitologia , Animais , Equinococose/diagnóstico , Equinococose/epidemiologia , Equinococose/transmissão , Helmintíase Animal/epidemiologia , Humanos , Prevalência , Medição de Risco , Vigilância de Evento Sentinela/veterinária , Suécia/epidemiologiaRESUMO
This paper reports on several simultaneous outbreaks of norovirus infection linked to the consumption of raw oysters. Since January 2010, 334 cases in 65 clusters were reported from five European countries: the United Kingdom, Norway, France, Sweden and Denmark. The article describes the available epidemiological and microbiological evidence of these outbreaks.
Assuntos
Infecções por Caliciviridae/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Contaminação de Alimentos/estatística & dados numéricos , Doenças Transmitidas por Alimentos/epidemiologia , Gastroenterite/epidemiologia , Norovirus/isolamento & purificação , Ostreidae/microbiologia , Animais , Infecções por Caliciviridae/microbiologia , Europa (Continente)/epidemiologia , Doenças Transmitidas por Alimentos/microbiologia , Gastroenterite/microbiologia , Humanos , Incidência , Vigilância da População , Medição de Risco/métodos , Fatores de RiscoRESUMO
In November-December 2008, Norway and Denmark independently identified outbreaks of Salmonella Typhimurium infections characterised in the multiple-locus variable number of tandem repeats analysis (MLVA) by a distinct profile. Outbreak investigations were initiated independently in the two countries. In Denmark, a total of 37 cases were identified, and multiple findings of the outbreak strain in pork and pigs within the same supply chain led to the identification of pork in various forms as the source. In Norway, ten cases were identified, and the outbreak investigation quickly indicated meat bought in Sweden as the probable source and the Swedish authorities were alerted. Investigations in Sweden identified four human cases and two isolates from minced meat with the distinct profile. Subsequent trace-back of the meat showed that it most likely originated from Denmark. Through international alert from Norway on 19 December, it became clear that the Danish and Norwegian outbreak strains were identical and, later on, that the source of the outbreaks in all three countries could be traced back to Danish pork. MLVA was instrumental in linking the outbreaks in the different countries and tracing the source. This outbreak illustrates that good international communication channels, early alerting mechanisms, inter-sectoral collaboration between public health and food safety authorities and harmonised molecular typing tools are important for effective identification and management of cross-border outbreaks. Differences in legal requirements for food safety in neighbouring countries may be a challenge in terms of communication with consumers in areas where cross-border shopping is common.
Assuntos
Surtos de Doenças/estatística & dados numéricos , Contaminação de Alimentos/estatística & dados numéricos , Carne/microbiologia , Vigilância da População , Intoxicação Alimentar por Salmonella/epidemiologia , Salmonella typhimurium/isolamento & purificação , Dinamarca/epidemiologia , Humanos , Incidência , Noruega/epidemiologia , Medição de Risco/métodos , Fatores de Risco , Intoxicação Alimentar por Salmonella/microbiologia , Suécia/epidemiologiaRESUMO
Tularaemia, is a zoonotic disease caused by the bacterium Francisella tularensis. This disease has been reported in Sweden since 1931 and its wide distribution in the country poses a challenge for understanding the transmission, ecology and epidemiology of the disease. In Sweden, the disease is usually transmitted by mosquitoes, but in this study we could show that consumption of well water was epidemiologically linked to the outbreak, by isolating F. tularensis from the water. In this article, we describe an outbreak of tularaemia in the region of Västra Götaland in the southwest of Sweden in spring of 2013.
Assuntos
Surtos de Doenças , Francisella tularensis/isolamento & purificação , Tularemia/epidemiologia , Tularemia/microbiologia , Microbiologia da Água , Poços de Água , Animais , Humanos , Suécia/epidemiologiaRESUMO
Previous outbreaks of Salmonella Enteritidis in Canada and the United States have been associated with the consumption of almonds. From December 2005 to August 2006 a cluster of 15 cases of Salmonella Enteritidis NST 3+ was reported in Sweden. A case-control study was performed to identify the source of transmission. Three controls per case were randomly selected, matched on sex, age and place of residence. Cases and controls were interviewed by telephone and data were analysed with a conditional logistic model. The results showed that eating almonds was a risk factor for infection with Salmonella Enteritidis NST3+ (unmatched odds ratio 45.0, 95% confidence interval: 4.8-421.8). No Salmonella was isolated from almonds tested in the study. In conclusion, almonds could be the source of the outbreak and should be considered when investigating outbreaks as well as sporadic cases of Salmonella Enteritidis.
Assuntos
Surtos de Doenças/estatística & dados numéricos , Contaminação de Alimentos/estatística & dados numéricos , Gastroenterite/epidemiologia , Vigilância da População , Prunus/microbiologia , Intoxicação Alimentar por Salmonella/epidemiologia , Salmonella enteritidis/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Análise por Conglomerados , Feminino , Gastroenterite/microbiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Medição de Risco/métodos , Fatores de Risco , Intoxicação Alimentar por Salmonella/microbiologia , Suécia/epidemiologiaAssuntos
Encefalite Transmitida por Carrapatos/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Vírus da Encefalite Transmitidos por Carrapatos/isolamento & purificação , Feminino , Flavivirus/isolamento & purificação , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Suécia/epidemiologia , Vacinação , Adulto JovemAssuntos
Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Frutas/intoxicação , Gastroenterite/epidemiologia , Gastroenterite/virologia , Norovirus/isolamento & purificação , Adulto , Criança , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/epidemiologia , Humanos , Suécia/epidemiologiaRESUMO
A large outbreak of enterohaemorrhagic Escherichia coli (EHEC) infections occurred in southern Sweden during autumn 2002. A matched case-control study was performed and indicated an association between consumption of fermented sausage and EHEC infection (odds ratio 5.4, P<0.002). Pulsed-field gel electrophoresis analysis identified a strain of E. coli O157:H7 in clinical faecal isolates, which was identical to a strain isolated from sausage samples obtained from households of infected individuals. A combination of microbiological and epidemiological results established a link between sausage consumption and the outbreak in 30 out of a total of 39 investigated cases. Contaminated beef was suspected to be the source of infection. Delayed start of fermentation, lack of heat-treatment and a short curing period in cold temperature were identified as the main factors enabling EHEC survival. EHEC can survive throughout the entire production process of fermented sausage if curing conditions are inadequate.