COMMUNICABLE DISEASE THREATS REPORT CDTR Week 41, 8-14 October 2017 All users This weekly bulletin provides updates on threats monitored by ECDC. NEWS ESCAIDE conference: online registration closes 27 October 2017 ESCAIDE, the European Scientific Conference on Applied Infectious Disease Epidemiology, is a three-day annual scientific conference, open to the wider communicable disease community. This year’s conference takes place 6-8 November 2017, Stockholm, Sweden. It gathers more than 500 professionals across all fields related to applied epidemiology, to share their knowledge and experience of communicable disease surveillance, prevention and control. Registered attendees to ESCAIDE are also eligible to attend the one-day training course on an Introduction to evidence-based methods and tools training course, 9 November 2017. For the full programme and to register to attend, go to: http://www.escaide.eu I. Executive summary EU Threats New! Travel-associated Legionnaires' disease - Palmanova area, Spain - 2017 Opening date: 11 October 2017 Latest update: 13 October 2017 Since 3 October 2017, 13 cases of travel-associated Legionnaires’ disease (TALD) with a travel history of visiting the Palmanova area in Majorca, Spain, have been reported to the European Legionnaires’ Disease Surveillance Network (ELDSNet). New! Influenza – Multistate (Europe) – Monitoring 2017/2018 season Opening date: 11 October 2017 Latest update: 13 October 2017 Influenza transmission in Europe shows a seasonal pattern, with peak activity during winter months. ÎUpdate of the week Update Week 2017-40 (2 to 9 October 2017) This is the first weekly report for the 2017/2018 influenza season. Low influenza activity was reported by all 36 reporting countries. Influenza viruses were detected sporadically both in sentinel and non-sentinel specimens, including hospitalised patients, with both influenza A and B type viruses detected. For week 2017-40, data from the 20 countries or regions indicated all-cause mortality at expected levels for the time of the year. 1/15 European Centre for Disease Prevention and Control (ECDC) Postal address: ECDC 171 83 Stockholm, Sweden Epidemic Intelligence duty email: [email protected] Visiting address: Tomtebodavägen 11a, Solna, Sweden Link to ECDC CDTR web page – including related PowerPoint© slides www.ecdc.europa.eu COMMUNICABLE DISEASE THREATS REPORT Week 41, 8-14 October 2017 The CDTR may contain confidential or sensitive information (i.e. EWRS) and therefore, its distribution is restricted to authorized users only. Rubella – Multistate (EU) – Monitoring European outbreaks Opening date: 7 March 2012 Rubella, caused by the rubella virus and commonly known as German measles, is usually a mild and self-limiting disease which often passes unnoticed. The main reason for immunising against rubella is the high risk of congenital malformations associated with rubella infection during pregnancy. All EU Member States recommend vaccination against rubella with at least two doses of vaccine for both boys and girls. The vaccine is given at the same intervals as the measles vaccine as part of the MMR vaccine. No new outbreaks have been detected in the EU since March 2017. ECDC reports global outbreaks of rubella in the CDTR on a monthly basis or if there is a critical event. ÎUpdate of the week No new outbreaks have been detected since March 2017. West Nile virus – Multistate (Europe) – Monitoring season 2017 Opening date: 30 May 2017 Latest update: 13 October 2017 During the West Nile virus transmission season, from June to November, ECDC monitors the occurrence of cases of West Nile fever in the EU Member States and neighbouring countries in order to inform the blood safety authorities about areas with ongoing virus transmission. In 2016, 225 human cases of West Nile fever were reported in the EU Member States and 267 cases were reported in the neighbouring countries. ÎUpdate of the week Between 5 and 12 October 2017, Romania reported six cases, Croatia reported five cases, Bulgaria and Serbia both reported one case. One of the cases reported in Croatia is in a newly affected area. All other cases were notified in areas already considered to be affected. Three deaths were reported due to West Nile fever, two by Romania and one by Croatia. In addition, 17 equine West Nile fever cases were reported through the Animal Disease Notification System (ADNS) of the European Commission. Italy reported 15 equine cases, Greece and Portugal both reported one equine case. Sources: TESSy and ADNS Chikungunya - Europe - 2017 Opening date: 15 September 2017 Latest update: 13 October 2017 Since August 2017, both France and Italy have reported autochthonous transmission of chikungunya virus, in the Var department, France and the Lazio and Calabria regions, Italy respectively. The two events involve strains of different origin and are therefore not related. ÎUpdate of the week Since the previous CDTR and as of 11 October 2017, Italy reports 13 additional chikungunya cases in Lazio region, bringing the number of cases in the region to 252. Of these cases, 197 have been reported in Anzio, 50 in Rome and five in Latina. As of 6 October 2017, according to the Ministry of Health in Italy, the Calabria region has reported 33 cases (probable and confirmed) of chikungunya in Guardavalle marina. Since the previous CDTR, France has not reported any additional chikungunya cases. Measles – Multistate (EU) – Monitoring European outbreaks Opening date: 9 February 2011 Latest update: 13 October 2017 Measles outbreaks continue to occur in a number of EU/EEA countries, with a risk of spread and sustained transmission in areas with susceptible populations. Since 15 September 2017, ECDC has been reporting EU and global outbreaks of measles in the CDTR on a monthly basis. If there are critical events, additional reports are published. ÎUpdate of the week Updates are provided for Austria, Germany, Greece, Italy and Romania. Updates outside EU/EEA countries are provided for the former Yugoslav Republic of Macedonia, Ukraine, Liberia, Nigeria, Somalia, Pakistan, Syria, Thailand, Australia, Canada and the US. 2/15 European Centre for Disease Prevention and Control (ECDC) Postal address: ECDC 171 83 Stockholm, Sweden Epidemic Intelligence duty email: [email protected] Visiting address: Tomtebodavägen 11a, Solna, Sweden Link to ECDC CDTR web page – including related PowerPoint© slides www.ecdc.europa.eu COMMUNICABLE DISEASE THREATS REPORT Week 41, 8-14 October 2017 The CDTR may contain confidential or sensitive information (i.e. EWRS) and therefore, its distribution is restricted to authorized users only. Non EU Threats Cholera – Multistate (World) – Monitoring global outbreaks Opening date: 20 April 2006 Latest update: 13 October 2017 Several countries in Africa, Asia and the Americas are reporting cholera outbreaks. The current situation in Yemen, Somalia, Ethiopia, South Sudan and the Democratic Republic of the Congo is of particular concern as cholera outbreaks are occurring during a large-scale humanitarian crisis. ÎUpdate of the week Since the beginning of 2017, the Gulf of Aden and the Horn of Africa region have been the mainly affected areas, with Yemen, Somalia, Ethiopia, South Sudan and the Democratic Republic of the Congo reporting the majority of the cases. Plague - Madagascar - 2017 Opening date: 15 September 2017 Latest update: 13 October 2017 On 14 September, media has reported five pulmonary plague deaths in Madagascar. These deaths occurred between 28 August and 11 September. Among these deaths, one occurred in the capital. The index case took a taxi from Ankazobe to Toamasina. He died on the way and he contaminated two persons in the taxi who died in Toamasina within 24 hours of infection. Two women from the same family of the two cases who died in Toamasina were contaminated. One of these women died in Antananarivo, the capital and the second died in another taxi in the south of the capital. On 11 October, WHO reported 561 cases including 415 pneumonic plague cases. A returning traveller from Madagascar to the Seychelles was confirmed for plague on 10 October in the Seychelles. ÎUpdate of the week Since the last CDTR update, with data as of 3 October, WHO reports 366 new plague cases including 326 new pulmonary cases in Madagascar. As of 11 October, WHO had reported 561 plague cases in Madagascar. Among these cases, 415 are pneumonic, 145 are bubonic and one is septicaemic. Among the 560 cases, 57 deaths are reported (CFR=10.1%). On 11 October, the Ministry of Health of the Seychelles reported one case in a returning traveller from Madagascar. The case, a 34-year-old man, returned to the Seychelles on 6 October and had onset of symptoms on 9 October. In addition, on 12 October, the authorities in the Seychelles reported a case with a positive rapid test for which the laboratory confirmation is pending. This case, in a person who is not a citizen of the Seychelles, is not linked to the first one. 3/15 European Centre for Disease Prevention and Control (ECDC) Postal address: ECDC 171 83 Stockholm, Sweden Epidemic Intelligence duty email: [email protected] Visiting address: Tomtebodavägen 11a, Solna, Sweden Link to ECDC CDTR web page – including related PowerPoint© slides www.ecdc.europa.eu COMMUNICABLE DISEASE THREATS REPORT Week 41, 8-14 October 2017 The CDTR may contain confidential or sensitive information (i.e. EWRS) and therefore, its distribution is restricted to authorized users only. II. Detailed reports New! Travel-associated Legionnaires' disease - Palmanova area, Spain - 2017 Opening date: 11 October 2017 Latest update: 13 October 2017 Epidemiological summary Since 3 October 2017, 13 cases of travel-associated Legionnaires’ disease (TALD) with a travel history of visiting the Palmanova area in Majorca, Spain, have been reported to the European Legionnaires’ Disease Surveillance Network (ELDSNet). Seven of the cases had been staying in the same hotel and three cases in a second hotel nearby. The remaining three cases had been staying in separate hotels.