Table of Contents PLENARY SESSIONS SPEAKER ABSTRACTS 5 A. Ageing and infectious diseases 6 B. H1N1 pandemic: Will vaccines solve the problem, and how will we know? 7 C. What has genotyping to offer epidemiologists 9 D. New methods for analyzing outbreaks 10 PARALLEL SESSIONS ABSTRACTS 13 01. Influenza 1 14 02. Outbreaks 1 16 03. Health care associated infections 1 19 04. Surveillance 1 21 05. Vaccine preventable diseases 1 24 06. HIV 26 07. Influenza 2 28 08. Food-and water-borne diseases 30 09. Surveillance 2 33 10. International Health 35 11. Vaccine preventable diseases 2 38 12. Health care associated infections 2 40 13. Environmental Epidemiology 43 14. Tuberculosis 45 15. Sexually Transmitted Infections 47 16. Influenza 3 49 17. Outbreaks 2 51 18. New methods in public health 54 19. Surveillance 3 56 20. Zoonozes 58 21. Antimicrobial resistance 61 LATE BREAKERS SESSION ABSTRACTS 65 POSTERS ABSTRACTS 69 A1. Antimicrobial resistance 70 A2. Food- and water-borne diseases 73 A3. Health care associated infections 79 A4. HIV - STI 84 A5. Influenza 87 A6. International health 93 A7. Molecular epidemiology 97 B1. Public health methodology and new approaches 99 B2. Epidemic intelligence activities 103 B3. Outbreaks 105 B4. Surveillance 110 B5. Tuberculosis 118 B6. Vaccine preventable diseases 121 B7. Vector borne diseases 129 B8. Zoonoses 131 INDEX By subject 136 By author 140 Abstract Book - ESCAIDE 2009 - 3 Plenary Session Speaker Abstracts Abstract Book - ESCAIDE 2009 - 5 Plenary Session Speaker Abstracts Reference: Plenary Session A Reference: Plenary Session A Ageing and infectious diseases Ageing and infectious diseases The times of our lives: The impact of current demographic a history of longevity change on the dynamics and control Professor Christopher Dye of childhood infectious diseases Office of HIV/AIDS, Tuberculosis, Malaria & Neglected Tropical Diseases , (measles as an example) World Health Organization, CH 1211 Geneva 27, Switzerland Professor Piero Manfredi (1), S. Merler (2), M. Ajelli (2), JR Williams (3), M. Iannelli (4) ABSTRACT 1. Dipartimento di Statistica & Matematica Applicata all'Economia, Università di Pisa, Italy 2. Predictive models for Biomedicine and Environment, Fondazione Bruno Kessler, Trento, Italy The massive increase in life expectancy that took place in 3. Department of Infectious Disease Epidemiology, Imperial College London. the industrialized world between 1800 and 1950 is among 4. Dipartimento di Matematica, Università di Trento, Italy the most remarkable facts in human biology. No one living in 18th century Europe could have foreseen the amazing plasticity of human life spans, or the potential for such rapid ABSTRACT change. I shall begin this talk by considering why life span doubled in Britain and other industrializing countries after During the last 30 years European populations have 1800. I shall investigate the underlying population processes, experienced a variety of changes, e.g. the generalised spread and identify the key interventions that changed mortality of low fertility, the "postponement" of life events, and the rates attributable due to infectious diseases. Longevity in increasing role of international immigration. In this talk we low- and middle-income countries did not improve until discuss the impact of demographic change on the dynamics well in the 20th century, showing some similarities, but also and control of childhood infectious disease (CID) from a some important differences, from earlier events in Europe. modelling perspective. We first clarify the circumstances Having reviewed the history and geography, I shall discuss under which demographic change might actually have an the interplay between aging, fertility, demographic change impact on CID dynamics. Then we review those, among and the global distribution of infectious diseases today. current demographic changes, which we believe to be mostly The growth in life expectancy must eventually stop, but it important for the dynamics and control of CID, i.e. fertility is debatable whether centenarians will become the norm or decline and immigration, and their impact on population and remain exceptional during the 21st century. household distributions. Next, we investigate the relation between population change and social contact patterns by a model of infection where contacts occur in three distinct arenas, i.e. the school (or work), the household, and "other" population contacts. We assume that school contacts are essentially unaffected by demographic change, owing to the common EU policy to keep fixed the average class size, so that most demographic change will be reflected in changes in household and other population contacts. We illustrate, under a variety of equilibrium or transient conditions, the effects of fertility decline on the corresponding contact matrices. By adding available estimates of arena-specific transmission rates we are able to compute basic reproduction numbers and therefore to figure out a relationship between degrees of fertility change and disease control conditions. Overall we suggest that for highly transmissible disease the impact of demographic change on transmission may be smaller than predicted in the literature (Manfredi-Williams 2005, Gao-Hethcote 2006), but a better understanding of transmission per arenas is certainly a need. Abstract Book - ESCAIDE 2009 - 6 Plenary Session Speaker Abstracts Reference: Plenary Session B Reference: Plenary Session B H1N1 pandemic: Will vaccines solve the problem, H1N1 pandemic: Will vaccines solve the problem, and how will we know? and how will we know? Overview of the current situation Assessing the effectiveness regarding H1N1 with particular of H1N1 vaccine in Europe emphasis on vaccine strategies Dr Alan Moren and prioritization I-MOVE Professor Angus Nicoll ECDC ABSTRACT To be published during session. ABSTRACT To be published during session. Abstract Book - ESCAIDE 2009 - 7 Plenary Session Speaker Abstracts Reference: Plenary Session B Reference: Plenary Session B H1N1 pandemic: Will vaccines solve the problem, H1N1 pandemic: Will vaccines solve the problem, and how will we know? and how will we know? Modelling the potential benefits H1N1 Vaccine uptake: of vaccine use Challenges for risk communication Mr Tommi Asikainen Professor Karl Ekdahl ECDC ECDC ABSTRACT ABSTRACT To be published during session. To be published during session. Abstract Book - ESCAIDE 2009 - 8 Plenary Session Speaker Abstracts Reference: Plenary Session C Reference: Plenary Session C What has genotyping to offer epidemiologists What has genotyping to offer epidemiologists Integrating strain typing Next generation molecular and epidemiology in international epidemiology of RNA viruses networks: focus on diphtheria and invasive group A streptococcal Dr Oliver Pybus infections University of Oxford, United Kingdom Dr Androulla Efstratiou ABSTRACT Health Protection Agency Centre for Infections, London, United Kingdom Molecular epidemiology is changing rapidly, due to the increasing abundance of pathogen genome sequences, acceleration in computer processing power, and the ABSTRACT development of sophisticated inference methods based on phylogenetics and population genetics. As a result, the range Two distinct bacterial diseases, namely diphtheria and of epidemiological questions that can be answered using invasive group A streptococcal infections (iGAS) will be genetic data has grown enormously. This is especially true for described to illustrate the relevance and importance RNA viruses, which evolve so quickly that their evolutionary of epidemiological strain typing amongst international and ecological dynamics occur on similar timescales and networks. Both diseases have the potential to cause are therefore coupled. I will illustrate the range of empirical significant morbidity and mortality on a global scale. questions open to current and next-generation methods of The main typing method for diphtheria is ribotyping, which evolutionary analysis, with reference to the hepatitis C virus has proved to be invaluable for the molecular epidemiology of and other human RNA viruses. I will also consider whether the 1990s epidemic in Europe; the largest outbreak since the the explosion in sequence data is outpacing our ability to advent of mass immunization. Cases are still being reported develop methods that fully exploit its potential. and the epidemic strain 'Sankt Petersburg' continues to circulate in the European Region. The situation is still being closely monitored by the international diphtheria networks DIPNET (European Diphtheria Surveillance Network) and the WHO/ELWGD (European Laboratory Working Group on Diphtheria). iGAS infections re-emerged globally in the 1980s and high incidence still persists. The 'global typing scheme' is based upon the emm gene which encodes the organism's key virulence factor the M protein, more than 200 emm types are currently described. GAS epidemiology varies with time in the long term and the short term where temporal variation of emm predominance is encountered, hence global diversity. An official network does not exist but in 2002, the European Commission funded research on iGAS infections (strep- EURO), with participation from 12 EU Members states. This 'adhoc' network investigated the epidemiology of these infections for the first time on a Pan-European scale and contributed significantly to epidemiology, raised awareness and provided data for future vaccine formulations and public health guidelines. There are many unanswered questions