VOL.11 Issues 7-9 Jul-Sept 2006 EUROPEAN COMMUNICABLE DISEASE JOURNAL Lymphogranuloma venereum emerging in Europe Editorial • Is there a need for a public vaccine production capacity at European level? Euroroundup • Pneumococcal disease surveillance in Europe Surveillance report • Antibiotic resistance in the southeastern Mediterranean: ARMed FUNDED BY DG HEALTH AND CONSUMER PROTECTION OF THE COMMISSION OF THE EUROPEAN COMMUNITIES "Neither the European Commission nor any person acting on the behalf of the Commission is responsible for the use which might be made of the information in this journal. The opinions expressed by authors contributing to Eurosurveillance do not necessarily reflect the opinions of the European Commission, the European Centre for Disease Prevention and Control (ECDC), the Institut de veille sanitaire (InVS), the Health Protection Agency (HPA) or the institutions with which the authors are affiliated" Eurosurveillance VOL.11 Issues 7-9 Jul-Sept 2006 Peer-reviewed European information on communicable disease surveillance and control Articles published in Eurosurveillance are indexed by Medline/Index Medicus C ONTENTS E DITORIALS 146 • The emergence of LGV in Western Europe: what do we know, what can we do? 146 Marita JW Van de Laar • Is there a need for a public vaccine production capacity at European level? 148 Daniel Lévy-Bruhl Editorial offices France O RIGINAL ARTICLES 150 Institut de Veille Sanitaire (InVS) 12, rue du Val d’Osne 94415 Saint-Maurice, France Topic: Lymphogranuloma venereum Tel + 33 (0) 1 41 79 68 33 Fax + 33 (0) 1 55 12 53 35 • A slow epidemic of LGV in the Netherlands UK in 2004 and 2005 150 Health Protection Agency MJW van de Laar, FDH Koedijk, HM Gotz, HJC de Vries Centre for Infections 61 Colindale Avenue • Lymphogranuloma venereum emerging in men London NW9 5EQ, UK who have sex with men in Germany 152 Tel + 44 (0) 20 8327 7417 Fax + 44 (0) 20 8200 7868 V Bremer, T Meyer, U Marcus, O Hamouda • Rectal lymphogranuloma venereum surveillance RESPONSIBLE EDITOR in France 2004-2005 155 Gilles Brücker (InVS, France) M Herida, B de Barbeyrac, P Sednaoui, C Scieux, N Lemarchand, G Kreplak, M Clerc, J Timsit, V Goulet, MANAGING EDITORS JC Desenclos, C Semaille Hélène Therre (InVS, France) [email protected] • HIV incidence increasing in MSM in Germany: Elizabeth Hoile (HPA CfI, UK) factors influencing infection dynamics 157 [email protected] U Marcus, L Voss, C Kollan, O Hamouda PROJECT LEADERS Philippe Bossi (InVS, France) Surveillance reports 161 Noel Gill (HPA CfI, UK)) • Diagnosis of non-viral sexually transmitted infections in Lithuania and international ASSISTANT EDITORS recommendations 161 Anneli Goldschmidt (InVS, France) A Vagoras, R Butylkina, V Juseviciute, A Hallén, [email protected] M Unemo, M Domeika Farida Mihoub (InVS, France) [email protected] • Antibiotic resistance in the southeastern Candice Pettifer (ECDC, Sweden) Mediterranean – preliminary results [email protected] from the ARMed project 164 MA Borg, E Scicluna, M de Kraker , ASSOCIATE EDITORS N van de Sande-Bruinsma , E Tiemersma, D Gür, Noel Gill (HPA CfI, UK) S Ben Redjeb, O Rasslan, Z Elnassar, M Benbachir, Stefania Salmaso (Istituto Superiore di Sanità, D Pieridou Bagatzouni, K Rahal, Z Daoud, H Grundmann, Italy) J Monen Henriette de Valk (InVS, France) Norman Noah (London School of Hygiene • Healthcare associated infections in university and Tropical Medicine, UK) hospitals in Latvia, Lithuania and Sweden: Richard Pebody (HPA CfI, UK) a simple protocol for quality assessment 167 Kate Soldan (HPA CfI, UK) J Struwe, U Dumpis, J Gulbinovic, Å Lagergren, Karl Ekdahl (ECDC, Sweden) U Bergman EDITORIAL ADVISORS (see back cover) www.eurosurveillance.org © Eurosurveillance, 2006 Eurosurveillance VOL.11 Issues 7-9 Jul-Sept 2006 Euroroundup 171 S HORT REPORTS 190 • Pneumococcal disease surveillance in Europe 171 • Outbreak of invasive meningococcal disease RG Pebody, W Hellenbrand, F D’Ancona, P Ruutu , among soldiers in Skwierzyna, Poland, March 2006 190 on behalf of the European Union funded Pnc-EURO M Grecki, M Bienias contributing group • Twenty years of active paediatric surveillance in the UK and Republic of Ireland 191 Outbreak reports 178 RM Lynn, R Pebody, R Knowles • Prolonged outbreak of B meningococcal disease • Case of Lassa fever imported into Germany in the Seine-Maritime department, France, from Sierra Leone 192 January 2003 to June 2005 178 Unit for Surveillance and Communication, P Rouaud, A Perrocheau, MK Taha, C Sesboué, A Forgues, Unit for Preparedness and Response, Editorial team I Parent du Châtelet, D Lévy-Bruhl • Unexpected increase in case fatality of invasive group B • Shiga toxin-producing Escherichia coli (STEC) O157 streptococcal infections in infants in Norway, outbreak, The Netherlands, September – October 2005 182 January-July 2006 192 Y Doorduyn, CM de Jager, WK van der Zwaluw, IHM Friesema, A Hajdu, H Blystad, EA Høiby, E Klouman, AE Heuvelink, E de Boer, WJB Wannet, YTHP van Duynhoven B Schimmer, K Nygård • Epidemic conjunctivitis in Germany, 2004 185 • Wound infections due to Vibrio cholerae in Sweden A Schrauder, D Altmann, G Laude, H Claus, K Wegner, after swimming in the Baltic Sea, summer 2006 193 R Köhler, H Habicht-Thomas, G Krause Y Andersson, K Ekdahl • Diversity of needle exchange provision in the UK: O UTBREAK DISPATCHES 188 findings from a national survey 193 • Outbreak of Salmonella Kedougou in Norway S Huntington, V Hope, S Hutchinson, D Goldberg, F Ncube associated with salami, April-June 2006 188 • Vibrio vulnificus wound infections after contact KE Emberland, K Nygård, BT Heier, P Aavitsland, J Lassen, with the Baltic Sea, Germany 194 TL Stavnes, B Gondrosen C Frank, M Littmann, K Alpers, J Hallauer • Botulism associated with vacuum-packed smoked • Outbreak of Salmonella Enteritidis infections whitefish in Finland, June-July 2006 189 in people attending a village event in Latvia 195 M Lindström, M Vuorela, K Hinderink, H Korkeala, J Patrina, I Antonenko, J Perevošcikovs E Dahlsten, M Raahenmaa, M Kuusi • Removal of ticks: a review of the literature 196 DW Pitches • Outbreak of extended spectrum beta-lactamase producing E. coli in a nursing home in Ireland, May 2006 198 H Pelly, D Morris, E O’Connell, B Hanahoe, C Chambers, K Biernacka, S Gray, M Cormican O THER ONLINE- ONLY CONTENT 200 N ATIONAL BULLETINS The Eurosurveillance print edition is a compilation of weekly and monthly electronic releases published on the Eurosurveillance website. Only a representative selection of Eurosurveillance’s weekly release articles from each three month period are printed here, and the full listing of all Eurosurveillance articles can be found in the Archives section of the website. E DITORIAL E MERGENCE OF LGV IN WESTERN EUROPE: WHAT DO WE KNOW, WHAT CAN WE DO? Marita JW van de Laar European Centre for Diseases prevention and Control (ECDC), Sweden Seconded National Expert from the Centre for Infectious Disease Control, National Institute of Public Health and the Environment, the Netherlands Lymphogranuloma venereum (LGV), a systemic sexually An unusual clinical picture for LGV? transmitted disease (STD) caused by a variety of the bacterium The classical picture of LGV usually involves adenopathy and is Chlamydia trachomatis, rarely occurs in the Western world [1]. characterized by buboes [23]. This current epidemic, however, is However, in January 2004, public health officials in the Netherlands mainly characterized by cases presenting with severe proctitis. LGV noted an outbreak of LGV proctitis cases among men who have sex proctitis in MSM is well recognised [24]. In the early 80’s, serovar with men (MSM) [2]. Since then, cases have been reported from L2 was found to be associated with more severe forms of proctitis several European countries, the United States of America and than non-LGV strains [24-27]. Serovar L1/L2 was also identified in Canada. In this issue three countries report on the current status 68 cases of LGV among 101 rectal samples of symptomatic men of LGV [3-5]. in San Francisco [28] and L1 in proctitis cases in Seattle [29]. An epidemic of LGV among heterosexuals, recently described by Initial reports and current status Bauwens et al, was linked to crack cocaine use and HIV infection, The first 13 cases among MSM were diagnosed between April suggesting that LGV is not just a tropical disease but that it also and November 2003 and reported to the local health authorities has the potential to interact with HIV as was observed before with in Rotterdam in December 2003 [2,6]. Most of the men were HIV herpes [30]. Recognition of the current epidemic of proctitis LGV positive, and the majority had reported unprotected anal intercourse was hampered by poor clinical awareness, poor public health in the past year. Only one patient, with onset of illness in April intervention and atypical clinical presentation [31]. Clinicians in 2003, had symptoms usually associated with the classical picture of industrialised countries would not be expected to consider LGV LGV (i.e., buboes and a painful genital ulcer). All other patients had as a likely cause for gastrointestinal illness [32-34]. The clinical gastrointestinal symptoms, (e.g., bloody proctitis with a purulent presentation of LGV was therefore easily missed as evidenced by or mucous anal discharge and constipation) [6]. The majority of the retrospective case reports from the Netherlands [5,35,36], LGV patients had participated in casual sex gatherings during the France [4] , England [37], and Switzerland [38]. LGV proctitis may 6–12 months period before onset of symptoms. be far more common among MSM than previously LGV patients also reported having numerous Active case-finding thought. Before 2003, however, it was unusual to sex contacts in cities in Europe and the United perform additional testing if chlamydial proctitis States. An alerting report was sent to the EWRS and contact tracing should was diagnosed [39,40].