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EPI-NEWS NATIONAL SURVEILLANCE of COMMUNICABLE DISEASES Editor: Peter Henrik Andersen Dept EPI-NEWS NATIONAL SURVEILLANCE OF COMMUNICABLE DISEASES Editor: Peter Henrik Andersen Dept. of Epidemiology Tel.: +45 3268 3268 • Fax: +45 3268 3874 Statens Serum Institut • 5 Artillerivej • DK 2300 Copenhagen S www.ssi.dk • [email protected] • ISSN: 1396-4798 REVISION OF VACCINATION RECCOMENDATIONS FOR TRAVELS ABROAD No. 21/22, 2006 Since 1985, Statens Serum Institut has asplenia/no splenic function or known extended period of time (group 4). published an annual overview detail- complement defect. Furthermore, it is Vaccination of other groups may be ing vaccination recommendations for recommended to health care workers considered, for instance vaccination travellers going abroad. To ensure who will be stationed in densely of health care workers who will have continued and full national consensus populated refugee camps where the close contact with the local population on the Danish recommendations, SSI risk of a meningitis epidemic is non- for an extended period of time (group set up a working group of represen- neglible. Besides, vaccination is 4), if necessary preceded by a Man- tatives from a range of scientific recommended for the following toux test. Vaccination should be ad- societies in the spring of 2005. groups of travellers: ministered intradermally and should The working group’s participants - Pilgrims travelling to Mecca (ACY- be given 6-8 weeks before departure. include Mads Buhl and Eskild W135 vaccination is required) Petersen, Danish Society of Travel - Travellers (apart from group 1) Hepatitis A Medicine, Søren Thybo, Danish entering the African meningitis belt Vaccination is recommended to all (Sahel). The risk peaks during the dry travellers (including group 1) to areas Infectious Diseases Society, Jørgen season from December to July. with a moderate or high hepatitis A Kurtzhals, Danish Society for Clinical Normally, AC vaccine is given. On incidence, see www.ssi.dk/rejser (in Microbiology, Niels Erik Møller, specific knowledge of W135, ACY- Danish). This also applies to ordinary Danish College of General Prac- W135 vaccine is given; see tourist travels to Turkey. titioners, Lasse Vestergaard, Danish www.ssi.dk/rejser (in Danish). Gammaglobulin currently has a limit- Society of Tropical Medicine and - Travellers (apart from group 1) to ed field of application for pregnant International Health, Kjeld Gade, areas with current non-B meningitis women and e.g. elderly people who Danish Paediatric Society, and Peter epidemics. The vaccination type are only planning to travel once. Henrik Andersen, SSI. depends on the detected serogroup. The revised country-specific recom- - Travellers spending more than 6 Hepatitis B mendations will be published in a months in or travelling frequently Recommendations remain unchanged future edition of EPI-NEWS. Travel- (group 4) to areas where non-B (groups 3 and 4). For further inform- lers are still divided into four groups. meningitis epidemics have been ation on global prevalence, see The following considerations are of observed within the past 2 years, i.e. www.ssi.dk/rejser (in Danish). particular importance: predominantly in Africa, excluding Hepatitis B vaccination can often be Sahel, and Asia. combined with hepatitis A General considerations vaccination. In accordance with the guidelines of Influenza the National Board of Health, the Influenza is a risk factor when visiting Japanese encephalitis vaccinee should remain in the surgery the Southern Hemisphere during the Vaccination is normally only recom- 10-15 min. after the vaccination. summer (i.e. their winter) and when mended for stays exceeding 1 month travelling to the tropics throughout in rural areas within the JE transmis- Diphtheria and tetanus the year. Travellers belonging to a sion zone, see www.ssi.dk/rejser (in All travellers should be protected risk group who normally receive Danish). In the overview table, all against diphtheria and tetanus from influenza vaccination should also be capital Js have therefore been the outset. These two vaccinations are protected by vaccination during changed to lower case js. therefore not included in the over- travels. If the traveller received vac- Data from the Danish Medicines view. Following primary vaccination cination during the preceding Danish Agency on reported adverse effects with three doses, EPI-NEWS 7/04, winter, he or she will be protected for following JE vaccination during the revaccination should take place after a period of 6 months from the time of period 1999-2004 show that the pre- 5 years and subsequently every 10 the vaccination, provided the influen- viously reported allergic reactions, years. za antigens circulating at the destin- EPI-NEWS 3/97, have almost dis- ation concord with the composition of appeared. Consequently, there is no Typhoid fever the vaccine. Otherwise, vaccination basis for maintaining the previous Vaccination is recommended to all for the Southern Hemisphere should recommendation that the second immigrants planning to visit family or be offered to such travellers. vaccination be given no later than 10 friends in non-industrialised countries For 2006, the vaccine composition for days before departure. where sanitary and hygienic con- the Southern Hemisphere is different ditions are generally poor, regardless from the vaccine used in Denmark Yellow fever of the duration of the stay (group 4). during the winter 2005-2006. SSI In the future, lower case g will be used Furthermore, vaccination is recom- keeps a limited stock of influenza in the overview table to mark countries mended to all travellers who plan to vaccine for the Southern Hemisphere. in which yellow fewer is present, but stay in said areas for a longer period Travellers who are not normally only in part of the country, e.g. Brazil. of time. Other travellers (groups 1-3) offered influenza vaccination may Please refer to www.ssi.dk/rejser (in are generally not recommended for chose to be vaccinated during the Danish) for a map detailing yellow typhoid vaccination. Danish influenza season to reduce fewer transmission areas. Vaccination As the infection risk is greatest on the their risk of becoming infected with must be given no later than 10 days Indian subcontinent, vaccination is influenza when travelling. before departure. recommended to all travellers visiting India, Sri Lanka, Bangladesh, Nepal, Tuberculosis TBE/Central European encephalitis Bhutan, Pakistan or Afghanistan for BCG vaccination is recommended to Recommendations remain unchanged. more than two weeks, i.e. groups (2), immigrant children visiting their fami- For further information on prevalence, 3 and 4. lies in areas with a high TB incidence see www.ssi.dk/rejser (in Danish). Meningococcal disease and to all children and adolescents (The working group mentioned in the Vaccination is recommended to those who are expected to have close con- text) at special risk, i.e. persons with tact with the local population for an 31 May 2006 Individually notifiable diseases Selected laboratory diagnosed infections Number of notifications received in the Department of Number of specimens, isolates, and/or notifications Epidemiology, SSI (2006 figures are preliminary) received in SSI laboratories Week 21 Cum. Cum. Week 21 Cum. Cum. Table 1 Table 2 2006 2006 1) 2005 1) 2006 2006 2) 2005 2) AIDS 2 17 30 Bordetella pertussis Anthrax 0 0 0 (all ages) 3 103 266 Botulism 0 0 0 Gonococci 3 176 180 Cholera 0 0 0 of these, females 0 33 25 Creutzfeldt-Jakob 1 7 2 of these, males 3 143 155 Diphtheria 0 0 0 Listeria monocytogenes 0 11 12 Foodborne diseases 9 142 130 Mycoplasma pneumoniae of these, infected abroad 3 36 31 Resp. specimens 3) 4 219 571 Gonorrhoea 12 186 230 Serum specimens 4) 6 197 474 Haemorrhagic fever 0 0 0 Streptococci 5) Hepatitis A 2 7 36 Group A streptococci 1 82 67 of these, infected abroad 0 1 9 Group B streptococci 1 39 24 Hepatitis B (acute) 0 10 21 Group C streptococci 0 9 8 Hepatitis B (chronic) 3 178 56 Group G streptococci 3 53 58 Hepatitis C (acute) 0 5 1 S. pneumoniae 23 549 636 Hepatitis C (chronic) 5 278 132 Week 19 Cum. Cum. Table 3 HIV 4 83 130 2006 2006 2) 2005 2) Legionella pneumonia 1 30 32 Pathogenic int. bacteria 6) of these, infected abroad 0 5 6 Campylobacter 22 572 764 Leprosy 0 0 0 S. Enteritidis 3 109 129 Leptospirosis 0 4 9 S. Typhimurium 4 96 121 Measles 0 20 1 Other zoon. salmonella 8 160 176 Meningococcal disease 0 29 47 Yersinia enterocolitica 2 52 85 of these, group B 0 15 27 Verocytotoxin- of these, group C 0 3 9 producing E. coli 3 45 49 of these, unspec. + other 0 11 11 Enteropathogenic E. coli 3 71 81 Mumps 0 8 4 Enterotoxigenic E. coli 2 70 88 Neuroborreliosis 0 16 17 2) Cumulative number 2006 and in corresponding period 2005 Ornithosis 1 7 9 3) Resp. specimens with positive PCR Pertussis (children < 2 years) 0 24 80 4) Serum specimens with pos. complement fixation test Plague 0 0 0 5) Isolated in blood or spinal fluid Polio 0 0 0 6) See also www.germ.dk Purulent meningitis Haemophilus influenzae 0 1 0 Sentinel surveillance of the influenza activity Listeria monocytogenes 0 4 1 Weekly percentage of consultations, 2004/2005/2006 Streptococcus pneumoniae 0 32 66 8 Other aethiology 0 1 6 2004 2005 2006 Unknown aethiology 0 7 10 6 Under registration 5 30 - % 4 Rabies 0 0 0 2 Rubella (congenital) 0 0 0 Rubella (during pregnancy) 0 0 0 0 Shigellosis 0 22 37 27 32 37 42 47 52 4 9 14 19 24 29 34 39 44 49 2 7 12 17 22 25 of these, infected abroad 0 20 34 Week no. Syphilis 0 28 47 Sentinel Basal curve Alert threshold Tetanus 0 0 2 Sentinel: Influenza consultations Tuberculosis 8 157 171 (as percentage of total consultations) Typhoid/paratyphoid fever 0 13 11 of these, infected abroad 0 13 10 Basal curve: Expected frequency of consultations Typhus exanthematicus 0 0 0 under non-epidemic conditions VTEC/HUS 1 45 65 Alert threshold: Possible incipient epidemic of these, infected abroad 0 10 26 1) Cumulative number 2006 and in corresponding period 2005 31 May 2006 .
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