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Epi-News 3/10 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 No. 3, 2010 INCREASE IN THE NUMBER OF Figure 1. Notified cases of listeriosis per 105 per year, 2000-2009 LISTERIA CASES IN 2009 Incidence After remaining stable at 30-40 for a period of years, the number of noti- 2,0 fied listeriosis cases has increased 1,8 every year as from 2003, barring 2008, Figure 1. In 2009, a total of 97 1,6 cases were notified, i.e. 2-3 times the 1,4 previous level. 1,2 Listeriosis is a food-borne disease caused by infection with Listeria 1,0 monocytogenes. The bacterium oc- 0,8 curs in many types of raw and proc- 0,6 essed foods including vegetables, smoked foods, meat and diary pro- 0,4 ducts. The bacteria reproduce at 0,2 fridge temperature, but perish when 0,0 heated. 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Listeriosis is typically seen in con- junction with sepsis with or without meningitis, while localised infections are rare. departments have forwarded the iso- children adopted from Ethiopia. The The condition primarily affects per- lated strains soon after bacteria 2009 increase shows that this issue sons above 60 years and immunode- growth, and it has therefore been remains relevant. When assessing ficient individuals. Risk factors in- possible to obtain timely typing re- the state of health of adopted Ethio- clude, among others: Cancer, hae- sults. This has been a great advan- pian children upon arrival to Den- matological conditions, diabetes, al- tage in connection with the confir- mark, salmonella infection should coholism, organ transplants and mation/dismissal of outbreak suspi- therefore be considered and physi- AIDS. cion and also in the process of delim- cians should include the possibility Furthermore, pregnant women are at iting the patients forming part of the of multi-resistance. (R. Hendriksen, risk, and L. monocytogenes infection outbreak. DTU Food, K. Mølbak, S. Ethelberg, may cause abortion/still birth or A number of other European coun- Department of Epidemiology) cases of congenital sepsis/meningi- tries have experienced increases in tis. Frequently, these infants are se- the number of patients with listerio- SUPPLY SITUATION FOR JAPA- riously ill at birth, but have a good sis. NESE ENCEPHALITIS VACCINE prognosis when receiving adequate (M. Kemp. Department for Microbi- Unfortunately, we have experienced therapy. ological Monitoring & Research, production and supply problems for L. monocytogenes is susceptible to S. Ethelberg, Department of Epide- the Ixiaro® vaccine against Japanese cephalosporins, but responds to am- miology) encephalitis (JE) since the end of picillin. For a more detailed descrip- December 2009, and the JE vaccine tion of listeriosis, please see EPI- SALMONELLA CONCORD has therefore not been available for NEWS 34/98 and 42-43/06. AMONG ADOPTED ETHIOPIAN all January orders. The next delivery In Denmark listeriosis cases are noti- CHILDREN of Ixiaro® is expected by the begin- fiable via the laboratory notification In Denmark, Salmonella Concord is ning of February, at which point all system and strains of L. monocyto- normally a very rare salmonella sero- orders will be delivered. genes which have been isolated from type. It has been isolated 0 - 2 times (B. Neale, Sales and Business Devel- patients are forwarded to Statens Se- annually during the latest 10-year- opment) rum Institut. To identify any out- period. In 2009 the infection was ob- breaks, methods of serology and mo- served in eight cases. All patients COUNSELLING OF THE GENERAL lecular biology, including PFGE were adopted children from Ethiopia, PUBLIC (pulsed field gel electrophoresis), is seven of whom were infants. The sal- The SSI continuously receives a used for typing. monella isolates were all ESBL- number of enquiries from private producing and multiresistant with citizens stating that their GP has re- Commentary resistance to ampicillin, cefotaxime, ferred them for counselling about The reason for the increased number ceftiofur, chloramphenicol, gen- travel vaccination or the like. SSI of listeria cases observed in 2009 is tamicine, streptomycine, sulfameth- does not usually advise private citi- unknown. A preliminary revision of oxazole, tetracycline and zens. The counselling should take patient data has not identified pre- trimethoprim and had reduced sensi- place via the person’s own GP or disposing factors not already known. tivity to ciprofloxacin. They were other healthcare staff who, in case of Apart from a single outbreak, EPI- sensitive to apramycin and amoxicil- doubt or for more detailed questions, NEWS 36/09, in which eight persons lin+clavulanate. may contact the Institute. Further, on were diagnosed with listeriosis after the SSI website www.ssi.dk, answers ingesting pre-cooked food from a ca- Commentary to many questions may be found. tering company, no outbreaks were International studies have previously (Department of Epidemiology) detected in 2009. shown that multiresistant Salmonella In 2009, the clinical microbiology Concord commonly occurs among 27 January 2010 Individually notifiable diseases Number of notifications received in the Department of Epidemiology, SSI (2009 figures are preliminary) Week 2 Cum. Cum. Week 53 Cum. Cum. Table 1 Table 3 2010 2010 1) 2009 1) 2009 2009 2) 2008 2) AIDS 1 1 1 MRSA 17 807No. 3, -2010 Cholera 0 0 0 Pathogenic int. bacteria 6) Creutzfeldt-Jakob 0 2 0 Campylobacter 9 3288 3441 Food-borne diseases 2 6 18 S. Enteritidis 2 601 637 of these, infected abroad 1 2 0 S. Typhimurium 4 777 1992 Gonorrhoea 8 21 27 Other zoon. salmonella 7 750 1015 Hepatitis A 1 2 0 Yersinia enterocolitica 0 225 330 of these, infected abroad 0 0 0 Verocytotoxin-prod. E.coli 4 172 158 Hepatitis B (acute) 0 1 0 Enteropathogenic E. coli 3 223 215 Hepatitis B (chronic) 1 3 0 Enterotoxigenic E. coli 2 343 417 Hepatitis C (acute) 0 0 0 Hepatitis C (chronic) 9 13 0 Tables 2 & 3, comments HIV 4 7 21 Legionella pneumonia 4 7 4 2) Cumulative no. 2010 and corresponding period 2009 of these, infected abroad 0 1 0 3) Respiratory specimens with positive PCR Leptospirosis 0 0 0 4) Serum specimens with pos. complement fixation test Measles 0 0 3 5) Isolated in blood or spinal fluid Meningococcal disease 2 5 6 6) See also www.germ.dk of these, group B 0 0 3 of these, group C 1 1 0 of these, unspec. + other 0 0 0 Norovirus 2008-2009 Mumps 1 1 0 Examined samples and percent positive, Dec 08 - Dec 09 Neuroborreliosis 1 1 0 Ornithosis 0 0 0 Samples examined Pertussis (children < 2 years) 3 3 5 No. of samples % pos Purulent meningitis % positive Haemophilus influenzae 0 0 1 1600 600 Listeria monocytogenes 0 0 0 1400 Streptococcus pneumoniae 3 3 7 500 Other aethiology0001200 400 Unknown aethiology0001000 Under registration 0 0 1 800 300 Rubella (during pregnancy) 0 0 0 600 Rubella (congenital) 0 0 0 200 Shigellosis 3 4 7 400 100 of these, infected abroad 2 3 7 200 Syphilis 5 13 8 0 0 Tetanus 0 0 0 Dec Feb April Juni Aug Okt Dec Tuberculosis 7 11 21 Typhoid/paratyphoid fever 0 0 0 of these, infected abroad 0 0 0 Samples from clinical microbiology departments at VTEC/HUS 4 7 3 Odense University Hospital, Copenhagen University of these, infected abroad 1 1 0 Hospital, and the Department of Virology, SSI Table 1, comments Sentinel surveillance of the influenza activity In 2010, none of the following have been reported: Weekly percentage of consultations, 2008/2009/2010 Anthrax, botulism, cholera, diphtheria, haemorrhagic ffever, leprosy, plague, polio, rabies, typhus 8 exanthematicus 2008 2009 2010 1) Cumulative no. 2010 and corresponding period 2009 6 Selected laboratory diagnosed infections % 4 Number of specimens, isolates, and/or notifications received at Statens Serum Institut 2 Week 2 Cum. Cum. Table 2 2010 2010 2) 2009 2) 0 Bordetella pertussis 27333945515 11172329354147536 12182428344046 (all ages) 2 3 5 Gonococci 18 33 9 Week no. of these, females 4 7 1 of these, males 14 26 8 Basal curve Alert threshold Sentinel Listeria monocytogenes 2 3 2 Mycoplasma pneumoniae Sentinel: Influenza consultations Resp. specimens 3) 365 (as percentage of total consultations) Serum specimens 4) 12 17 3 Streptococci 5) Basal curve: Expected frequency of consultations Group A streptococci 4 11 15 under non-epidemic conditions Group B streptococci 0 2 3 Group C streptococci 1 3 1 Alert threshold: Possible incipient epidemic Group G streptococci 2 17 5 S. pneumoniae 21 100 97 X 20 January 2010 .
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