List Of Notifiable Diseases Research Articles

Focus, vigilance, resilience: towards stronger infectious disease surveillance, threat detection and response in the EU/EEA.

This perspective summarises and explains the long-term surveillance framework 2021-2027 for infectious diseases in the European Union/European Economic Area (EU/EEA) published in April 2023. It shows how shortcomings in the areas of public health focus, vigilance and resilience will be addressed through specific strategies in the coming years and how these strategies will lead to stronger surveillance systems for early detection and monitoring of public health threats as well as informing their effective prevention and control. A sharper public health focus is expected from a more targeted list of notifiable diseases, strictly public-health-objective-driven surveillance standards, and consequently, leaner surveillance systems. Vigilance should improve through mandatory event reporting, more automated epidemic intelligence processing and increased use of genomic surveillance. Finally, EU/EEA surveillance systems should become more resilient by modernising the underlying information technology infrastructure, expanding the influenza sentinel surveillance system to other respiratory viruses for better pandemic preparedness, and increasingly exploiting potentially more robust alternative data sources, such as electronic health records and wastewater surveillance. Continued close collaboration across EU/EEA countries will be key to ensuring the full implementation of this surveillance framework and more effective disease prevention and control.

Evaluation of medical professionals’ knowledge about Q fever

Aims: evaluate the medical professionals’ knowledge about Q fever, seeking integrative contributions to public health that may favor the formulation of policies and the development of strategies based on a One Health approach. Methods: this is a cross-sectional and quantitative study with data collection through a structured questionnaire applied face-to-face to physicians from various clinical specialties working at the three levels of health care in Brazil. The questionnaire consisted of 25 questions, seven of which were specific to assessing knowledge about Q fever. Univariate and multivariate logistic regression analyses were conducted to assess whether the variables medical specialty, level of health care in which they work, age range and gender were associated with a correct answer to at least one specific question about Q fever. Results: among the 254 physicians included, 236 (92.9%) were unaware of Q fever. Only three (16.6%) of the 18 who correctly answered at least one specific question about the disease had a score of more than 50%. The highest rates of correct answers for at least one question (p < 0.0001) occurred among the medical specialties most related to clinical signs and symptoms or the differential diagnosis of Q fever and among males. It is highlighted that 85.8% of physicians consider Q fever a neglected and underreported disease in Brazil. Additionally, all physicians responded that they were not aware of the One Health approach. Conclusions: the almost total lack of knowledge among medical professionals regarding Q fever reinforces the need for greater disclosure for this zoonosis with a One Health approach in Medical Schools, in Residency Programs and for physicians in general. In addition, the inclusion of Q fever in the national list of notifiable diseases becomes relevant, allowing a better understanding of its epidemiological situation in Brazil. Finally, effective public health actions must be carried out to avoid underdiagnosis and the development of severe cases of the disease. Methods: this is a cross-sectional and quantitative study with data collection through a structured questionnaire applied face-to-face to physicians from various clinical specialties working at the three levels of health care in Brazil. The questionnaire consisted of 25 questions, seven of which were specific to assessing knowledge about Q fever. Univariate and multivariate logistic regression analyses were conducted to assess whether the variables medical specialty, level of health care in which they work, age range and gender were associated with a correct answer to at least one specific question about Q fever. Results: among the 254 physicians included, 236 (92.9%) were unaware of Q fever. Only three (16.6%) of the 18 who correctly answered at least one specific question about the disease had a score of more than 50%. The highest rates of correct answers for at least one question (p < 0.0001) occurred among the medical specialties most related to clinical signs and symptoms or the differential diagnosis of Q fever and among males. It is highlighted that 85.8% of physicians consider Q fever a neglected and underreported disease in Brazil. Additionally, all physicians responded that they were not aware of the One Health approach. Conclusions: the almost total lack of knowledge among medical professionals regarding Q fever reinforces the need for greater disclosure for this zoonosis with a One Health approach in Medical Schools, in Residency Programs and for physicians in general. In addition, the inclusion of Q fever in the national list of notifiable diseases becomes relevant, allowing a better understanding of its epidemiological situation in Brazil. Finally, effective public health actions must be carried out to avoid underdiagnosis and the development of severe cases of the disease.

Chapter 12a: TBE-epidemiology by country – an overview

TBE is a flavivirus infection of the central nervous system (CNS), transmitted by ticks and in some instances by ingestion of unpasteurized milk. It is diagnosed in the forested belts of Northern Eurasia ranging from the UK, eastern France, The Netherlands and Norway down to Italy through central and Eastern Europe, Russia, Kazakhstan, and China to Japan. About 10,000 cases of TBE are reported annually, likely a significant underestimate as serological testing is more sporadic than complete and, in some countries, (like Japan) not even available. The European Centre for Disease Prevention and Control (ECDC) have put TBE on their list of notifiable diseases. Their case definition requires clinical symptoms of CNS infection plus virological or serological confirmation of the infection, usually by detection of specific immunoglobulins IgG and IgM. Vaccination against TBE is on the World Health Organization’s List of Essential Medicines. the safest and most effective medicines needed in a health system. Surveillance of TBE and the TBEV is incomplete. Reported incidences do not reflect actual risk since this fluctuates annually as a result of changes in exposure, vaccine uptake, intensity of case finding and reporting, climate factors, reservoir animals and ticks – just to mention the most relevant factors. For largely unknown reasons (including human behavior, improved diagnostics, or climate change) TBEV appears to be spreading north, east, west, even south and to higher altitudes to areas that were previously believed to be free of the virus.

Chapter 12a: Epidemiology by country – an overview

TBE is a flavivirus infection of the central nervous system (CNS), transmitted by ticks and in some rare instances by ingestion of unpasteurized milk. It is diagnosed in the forested belts of Northern Eurasia ranging from the UK, eastern France, The Netherlands and Norway down to Italy through central and Eastern Europe, Russia, Kazakhstan, and China to Japan. About 10,000 cases of TBE are reported annually, likely a significant underestimate as serological testing is more sporadic than complete and in some countries and, in some countries, (like Japan) not even available. The European Centre for Disease Prevention and Control (ECDC) have put TBE on their list of notifiable diseases. Their case definition requires clinical symptoms of CNS infection plus virological or serological confirmation of the infection, usually by detection of specific immunoglobulins IgG and IgM. Vaccination against TBE is on the World Health Organization's List of Essential Medicines. the safest and most effective medicines needed in a health system. Surveillance of TBE and the TBEV is incomplete. Reported incidences do not reflect actual risk since this fluctuates annually as a result of changes in exposure, vaccine uptake, intensity of case finding and reporting, climate factors, reservoir animals and ticks - just to mention the most relevant factors. For largely unknown reasons (including human behavior, improved diagnostics, or climate change) TBEV appears to be spreading north, east, west, even south and to higher altitudes to areas that were previously believed to be free of the virus.

Epidemiology and risk factors of contagious caprine pleuropneumonia in the Republic of Chad

Contagious caprine pleuropneumonia is a bacterial infection of goats. It is caused by a bacterium belonging to the Mycoplasmataceae family and the Mycoplasma genus. Causative agent of the disease is Mycplasma capricolum subspecies capripneumoniae (Mccp). This disease causes significant economic losses in Asia and Africa. Because of the very high morbidity and mortality and its socio-economic impact, contagious caprine pleuropneumonia is on the OIE list of notifiable diseases. This disease affects mainly goats and occasionally sheep, but also wild ruminants. Contagious caprine pleuropneumonia is characterized by cough, dyspnoea and very high mortality and morbidity, fibrinous pleuropneumonia, unilateral lung hepatization and accumulation of pleural fluid in the thoracic cavity. Animals are infected by inhalation of dropes expelled by sick animals. Direct contact is essential for infection to occur. The porosity of borders shared with other countries and the lack of financial resources allocated to the national animal disease surveillance system make it difficult to control cross-border livestock movements. This exposes the national herd to various infectious diseases, including contagious caprine pleuropneumonia. Cross-border movements linked to the international trade in animals, to transhumance, as well as to insecurity due to existing hotbeds of tension in African countries, lead to massive movements of herders and animals in search of pastures and water. All of this constitutes risk factors for the introduction and spread of viral and bacterial infections in the countries. The objective of this manuscript is to summarize the epidemiology and risk factors of contagious caprine pleuropneumonia in Chad based on bibliographical data.

An analysis of primary healthcare in terms of service management standards in Khyber Pakhtunkhwa, Pakistan

This study investigates the implementation of the service management quality standards set by the Khyber Pakhtunkhwa (KP) government at primary health care facilities (PHCFs) in district Kohistan. Primary data through a questionnaire was collected from 42 functional PHCFs of district Kohistan. A total of 142 responses were recorded which includes 42 responses from the incharge of PHCFs and 100 from the patients who attended PHCFs facilities. Simple descriptive statistics were used to analyze this collected data. Most of the service management standards were not met in rural health centers (RHCs) However, the state of affairs at Civil Dispensary (CDs) and Basic Health Unit (BHUs) was terrifying. This study identifies the weak areas which require quality enhancement. This study suggests quality improvement in Primary Care Management Committee, A list of notifiable diseases, Essential Equipment, Rubbish Pit, waiting area, SOPs and Guidelines, and Duty roaster, Copy of Job Description, Guidelines for Risks, and Hazards and Patient’s Feedback Mechanism and Complaint Box. This study suggests that the KP government must defy trouble areas identified by the current study to improve health facilities in PHCFs.This will also reduce the patient's pressure in tertiary health facilities.

Foodborne botulism survey in Northern Italy from 2013 to 2020: Emerging risk or stable situation?

Italy has one of the highest incidence rates of foodborne botulism in Europe. It is a neuro-paralytic disease caused by ingesting ready-formed botulinum neurotoxins (BoNTs) produced by some spore-forming clostridia. Due to its severity and epidemic potential, foodborne botulism is included in the list of notifiable diseases, and botulism cases are managed based on collaboration among public health authorities providing food inspections, formal analysis, and supporting hospitals in rapid diagnosis. This study aimed to conduct a survey for investigating BoNT-producing clostridia occurrences in foods from Northern Italy between 2013 and 2020. In total, 2187 food samples were provided by food business operators for their own control protocols, and the presence of BoNT-producing clostridia was investigated using multiplex real-time PCR. Sixteen food samples (0.73%, 95% CI 0.45–1.19) were found positive for the presence of BoNT-producing clostridia, including dairy products, fruit, vegetables, sauces, bakery products, gastronomic preparations, meat products, and spices and flavourings, with the target genes bont/A and bont/B being the only targets found in this survey. Collaboration with local hospitals was carried out through analysis of biological samples in suspected foodborne botulism cases using a mouse bioassay for identifying the toxin involved. When available, food residues related to the suspected cases were also analysed. Among 52 patients with suspected symptoms of foodborne botulism, 18 patients were confirmed to be positive, showing the presence of BoNT/A, BoNT/B, and BoNT/E. In five cases, food residues were identified, mostly as homemade products. Our study highlights that foodborne botulism continues to be a public health concern in both industrial processing and homemade products, stressing the importance of consumer education to avoid hazardous botulism outbreaks. • Clostridia producing botulinum toxins were studied in foods from Northern Italy. • Toxins were detected also in biological samples and in a related food vehicle. • Foodborne botulism concerns mainly home-made preparations both meat and vegetables.

Chapter 12a: Epidemiology by country – an overview

TBE is a flavivirus infection of the central nervous system (CNS), transmitted by ticks and in some instances by ingestion of unpasteurized milk. It is diagnosed in the forested belts of Northern Eurasia ranging from the UK, eastern France, The Netherlands and Norway down to Italy through central and Eastern Europe, Russia, Kazakhstan, and China to Japan. About 10,000 cases of TBE are reported annually, likely a significant underestimate as serological testing is more sporadic than complete and, in some countries, (like Japan) not even available. The European Centers for Disease Prevention and Control (ECDC) have put TBE on their list of notifiable diseases. Their case definition requires clinical symptoms of CNS infection plus virological or serological confirmation of the infection, usually by detection of specific immunoglobulins IgG and IgM. Vaccination against TBE is on the World Health Organization’s List of Essential Medicines. the safest and most effective medicines needed in a health system. Surveillance of TBE and the TBEV is incomplete. Reported incidences do not reflect actual risk since this fluctuates annually as a result of changes in exposure, vaccine uptake, intensity of case finding and reporting, climate factors, reservoir animals and ticks – just to mention the most relevant factors. For largely unknown reasons (including human behavior, improved diagnostics, or climate change) TBEV appears to be spreading north, east, west, even south and to higher altitudes to areas that were previously believed to be free of the virus.

Response to reviews of Containing Contagion by Sara E. Davies

It was always known that implementing the IHR was going to be a long and difficult journey for many countries in the region, one pursued alongside other equally important health goals such as universal health care and vaccination coverage The COVID-19 pandemic has clearly demonstrated the cost of failing to incorporate a human rights framework as one of the essential core capacity requirements for meeting the IHR The Asia Pacific Strategy for Emerging Infectious Diseases (APSED) was developed to assist the two regional offices member states come to grips with the capacities required under the revised IHR I found that though there were profound differences between them, overall, ASEAN states had responded positively to the concept of shared infectious disease surveillance and the reporting of infectious disease outbreaks, both endemic and emerging diseases, to neighbouring states [Extracted from the article] Copyright of Singapore Journal of Tropical Geography is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Notifiable diseases interoperable framework toward improving Iran public health surveillance system: Lessons learned from COVID-19 pandemic.

BACKGROUND:Direct transmission of notifiable disease information in a real-time and reliable way to public health decision-makers is imperative for early identification of epidemiological trends as well as proper response to potential pandemic like ongoing coronavirus disease 2019 crisis. Thus, this research aimed to develop of semantic-sharing and collaborative-modeling to meet the information exchange requirements of Iran's notifiable diseases surveillance system.MATERIALS AND METHODS:First, the Iran's Notifiable diseases Minimum Data Set (INMDS) was determined according to a literature review coupled with agreements of experts. Then the INMDS was mapped to international terminologies and classification systems, and the Health Level seven-Clinical Document Architecture (HL7-CDA) standard was leveraged to define the exchangeable and machine-readable data formats.RESULTS:A core dataset consisting of 15 classes and 96 data fields was defined. Data elements and response values were mapped to Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) reference terminology. Then HL7-CDA standard for interoperable data exchange were defined.CONCLUSION:The notifiable disease surveillance requires an integrative participation of multidisciplinary team. In this field, data interoperability is more essential due to the heterogeneous nature of health information systems. Developing of INMDS based on HL7-CDA along with SNOMED-CT codes offers an inclusive and interoperable dataset that can help make notifiable diseases data more comparable and reportable across studies and organizations. The proposed data model will be further modifications in the future according probable changes in Iran's notifiable diseases list.

Outbreak investigation and a case control study of Dengue fever at Rawalpindi, Pakistan during July to September 2019

Background: Dengue is one of the most prevalent vector born disease and has been a major public health threat since 2005 in Pakistan. It has been added in list of notifiable diseases since 2007 in Pakistan. It is caused by any of its four virus species so a person can be infected with a dengue virus as many as four times in his or her life. A dengue mosquito takes 8 to 10 days from an egg to an adult. The objective was to confirm the outbreak, identify possible risk factors and to formulate recommendations for immediate control and future prevention. Methods and materials: Study design A descriptive study followed by case control study. Methodology Active case finding through house to house search was conducted by surveying 540 houses from 29th August till 5th September 2019. A spot Map was made. Tool to collect information was a semi structured Questionnaire. A Case was defined as any person having high grade fever for more than 2 and less than10 days along with any two of the following signs and symptoms:headache,retro-orbital pain, myalgia, arthralgia, epistaxis, hematemesis, melena, hemoptysis, vomiting or abdominal pain residing in Gulbahar Scheme, during 7th August to 5th September 2019. Results: During active case search 104 confirmed cases of dengue fever were identified, effecting all age groups from 3 to 78 years. Most effected age group was 31 to 40 years, 30.76%. Most effected gender was male 62.5%.Age Specific attack rates were calculated. Risk factor analysis revealed most probable causes of spread was presence of water bodies in the area (OR 0.196%), water storage in houses (OR 1.00%), exposure to other cases (OR 0.44%), and under construction houses. Conclusion: Major causes of this outbreak include extensive rains this year leading to pooling of rain water at uneven areas and construction sites. Many under construction houses and vacant plots serving as garbage dump and water pools. Non Availability of proper water drainage system in the area. Uncovered water storage in houses and open water tanks on roofs. Not much protective measures and routine IRS.

Animal Coronaviruses in the Light of COVID-19.

Coronaviruses are extremely susceptible to genetic changes due to the characteristic features of the genome structure, life cycle and environmental pressure. Their remarkable variability means that they can infect many different species of animals and cause different disease symptoms. Moreover, in some situations, coronaviruses might be transmitted across species. Although they are commonly found in farm, companion and wild animals, causing clinical and sometimes serious signs resulting in significant economic losses, not all of them have been classified by the World Organization for Animal Health (OIE) as hazardous and included on the list of notifiable diseases. Currently, only three diseases caused by coronaviruses are on the OIE list of notifiable terrestrial and aquatic animal diseases. However, none of these three entails any administrative measures. The emergence of the SARS-CoV-2 infections that have caused the COVID-19 pandemic in humans has proved that the occurrence and variability of coronaviruses is highly underestimated in the animal reservoir and reminded us of the critical importance of the One Health approach. Therefore, domestic and wild animals should be intensively monitored, both to broaden our knowledge of the viruses circulating among them and to understand the mechanisms of the emergence of viruses of relevance to animal and human health.

Chapter 12a: Epidemiology by country - An overview

TBE is a flavivirus infection of the central nervous system (CNS), transmitted by ticks and in some instances by ingestion of unpasteurized milk. It is diagnosed in the forested belts of Northern Eurasia ranging from the UK, eastern France, The Netherlands and Norway down to Italy through central and Eastern Europe, Russia, Kazakhstan, and China to Japan. About 10,000 cases of TBE are reported annually, likely a significant underestimate as serological testing is more sporadic than complete and, in some countries, (like Japan) not even available. The European Centers for Disease Prevention and Control (ECDC) have put TBE on their list of notifiable diseases. Their case definition requires clinical symptoms of CNS infection plus virological or serological confirmation of the infection, usually by detection of specific immunoglobulins IgG and IgM. Vaccination against TBE is on the World Health Organization’s List of Essential Medicines. the safest and most effective medicines needed in a health system. Surveillance of TBE and the TBEV is incomplete. Reported incidences do not reflect actual risk since this fluctuates annually as a result of changes in exposure, vaccine uptake, intensity of case finding and reporting, climate factors, reservoir animals and ticks – just to mention the most relevant factors. For largely unknown reasons (including human behavior, improved diagnostics, or climate change) TBEV appears to be spreading north, east, west, even south and to higher altitudes to areas that were previously believed to be free of the virus.

Legislation and policy analysis on management of listeriosis epidemic disaster in South Africa.

During the 2017-2018 listeriosis outbreak in South Africa (SA), the total number of cases reached 1,060. In this study, the disaster management response to the 2017-2018 South Africa listeriosis outbreak is analyzed. The hazard was in part the contamination of a brand of a ready-to-eat (RTE) "polony" with a strain of Listeria monocytogenes ST6. The initial phase of the 2017-2018 listeriosis outbreak was characterized by a rapid increase in the number of detected human cases. The listeriosis outbreak was officially proclaimed in December 2017, resulting in listeriosis being added to the list of notifiable diseases in SA. The delay between onset and proclamation was a result of the difficulty in identifica-tion of the actual number of cases of listeriosis in the country. The response to the disaster included the coordination of the National Department of Health, the National Institute of Communicable Diseases (NICD), businesses/producers of the contaminated brand of RTE products, and the public. Some of these activities led to the removal of the contami-nated products from the retail sector in March 2018, resulting in a decrease in the number of cases found in SA. In re-sponse to the outbreak, the National Department of Health formed a multisector incidence response team and imple-mented the Emergency Response Plan. Impacts of future listeriosis outbreaks could be mitigated by the adoption of international listeriosis guidelines such as the WHO/FAO and FDA. Practical steps in this context should include setting a limit of L. monocytogenes in RTE products. WHO/FAO and FDA listeriosis policies which are described "zero toler-ance" where a limit of < 100 L. monocytogenes cells/g at the moment of consumption is acceptable can be adopted. Additional resources must be provided for research into infectious doses and the various routes of human exposure.

African Swine Fever Virus - The Possible Role of Flies and Other Insects in Virus Transmission.

African swine fever (ASF) is an acute viral haemorrhagic disease of pigs and wild boars. It presents a serious threat to pig production worldwide, and since 2007, ASF outbreaks have been recorded in the Caucasus, Eastern Europe, and the Baltic States. In 2014, the disease was detected in Poland. ASF is on the list of notifiable diseases of the World Organisation for Animal Health (OIE). Due to the lack of an available vaccine and treatment, the countermeasures against the disease consist in early detection of the virus in the pig population and control of its spread through the elimination of herds affected by disease outbreaks. Knowledge of the potential vectors of the virus and its persistence in the environment is crucial to prevent further disease spread and to understand the new epidemiology for how it compares to the previous experience in Spain gathered in the 1970s and 1980s.

Genetic mapping of Koi herpesvirus resistance (KHVR) in Mirror carp (Cyprinus carpio) revealed genes and molecular mechanisms of disease resistance

Koi herpesvirus is a double-stranded DNA virus that causes fatal disease and mortality in koi and common carp (Cyprinus carpio) of all ages. Koi herpesvirus disease has been added to the list of notifiable diseases of the World Organisation for Animal Health. The genetic basis of fish resistance to Koi herpesvirus remains little understood, and thus, it cannot be used in genetic breeding programs to produce high-resistance carp strains. Dissection of the molecular mechanism of resistance could help prevent or reduce losses due to Koi herpesvirus disease. Common carp is a widely distributed species cultured all around the world. Its allotetraploidy and high economic and environmental value have attracted a great deal of interest in its genetics and genomics. Here, we use both QTL mapping and GWAS in Mirror carp subjected to Koi herpesvirus infection to detect potential loci and genes related to resistance to this virus. Many immune-related genes were identified around the significant QTLs or SNPs, including tnfa, hif1a, galectin-8, rootletin, and palladin. GO and KEGG analyses were performed based on the union of the candidates. Of particular interest were the Herpes simplex infection pathway and mTOR signaling pathway, which play potential roles in the immune response. Using publicly available transcriptome data from Koi herpesvirus infected carp, the expression patterns of candidate genes were obtained, and the results indicated potential roles of homoeolog functional divergence in immune response in the allotetraploid common carp. Overall, our study of the genetic architecture of carp Koi herpesvirus resistance provides many valuable candidate genes, which could be considered in the marker-assisted selection of common carp strains with high resistance to Koi herpesvirus.

Bluetongue Virus in France: An Illustration of the European and Mediterranean Context since the 2000s.

Bluetongue (BT) is a non-contagious animal disease transmitted by midges of the Culicoides genus. The etiological agent is the BT virus (BTV) that induces a variety of clinical signs in wild or domestic ruminants. BT is included in the notifiable diseases list of the World Organization for Animal Health (OIE) due to its health impact on domestic ruminants. A total of 27 BTV serotypes have been described and additional serotypes have recently been identified. Since the 2000s, the distribution of BTV has changed in Europe and in the Mediterranean Basin, with continuous BTV incursions involving various BTV serotypes and strains. These BTV strains, depending on their origin, have emerged and spread through various routes in the Mediterranean Basin and/or in Europe. Consequently, control measures have been put in place in France to eradicate the virus or circumscribe its spread. These measures mainly consist of assessing virus movements and the vaccination of domestic ruminants. Many vaccination campaigns were first carried out in Europe using attenuated vaccines and, in a second period, using exclusively inactivated vaccines. This review focuses on the history of the various BTV strain incursions in France since the 2000s, describing strain characteristics, their origins, and the different routes of spread in Europe and/or in the Mediterranean Basin. The control measures implemented to address this disease are also discussed. Finally, we explain the circumstances leading to the change in the BTV status of France from BTV-free in 2000 to an enzootic status since 2018.

Potential role of Emergency Medical System call centres in epidemiological surveillance of seasonal influenza.

Seasonal influenza causes high morbidity worldwide and high mortality in developing countries. As a result, the development of systems for seasonal influenza surveillance has been of great interest. The aim of this study is to explore the potential role of an Emergency Medical System (EMS) call centre to complement traditional surveillance systems of seasonal influenza. Retrospective observational study in which data on influenza from the system of Notifiable Diseases List (Spanish acronym EDO) and Sentinel Physicians Network (Spanish acronym RMC) were compared with information on calls made to the Principality of Asturias EMS call centre that covers all the region population (1,027,659 inhabitants) based on a set of specific criteria to determine differences and explore this emergency call system as a complementary epidemiological surveillance system. Cases registered by different systems have been compared to the same 68 weeks period, from week 45 of 2011 to week 8 of 2013. RMC reported a total of 2,354 cases of influenza, EDO 43,071 cases and EMS call centre 4,360 "case calls" out of 180,720 total emergency calls. Case series of EDO and EMS call centre have shown a positive correlation (R = 0.42, p = 0.003). Case series from EMS call centre and RMC were correlated (R = 0.38, p = 0.007). Case series from EDO and RMC have shown a strong positive correlation (R = 0.91, p < 0.001). Correlation analysis of the cases reported by the three systems have shown a significant positive correlation between them (p < 0.001). The spike of EMS calls related to the studied influenza syndrome occurs one week in advance compared to traditional epidemiological surveillance systems. EMS call centre data on influenza could be potentially used as a complementary surveillance system to the traditional epidemiological surveillance systems for influenza.

Urgent action on antimicrobial resistance

Urgent action on antimicrobial resistance

Infectious bursal disease virus tissue tropism and pathogenesis of the infection in chickens by application of in situ PCR, immunoperoxase and HE staining

Infectious bursal disease is one of an OIE list of notifiable diseases. Chicken is the only host that manifests clinical signs and its pathogenicity is correlated with the distribution of antigens in organs. This study was conducted to determine disease pathogenesis and virus tissue tropism by in situ PCR, immunoperoxidase staining (IPS), and HE staining. Twenty four chickens were infected with very virulent Infectious Bursal Disease Virus (vvIBDV). Fifteen chickens were kept as a control group. Infected chickens were sacrificed at hrs 2, 4, 6, 12, days 1, 2, 4, and 6 post-inoculation (pi). While, control chickens were euthanized on days 0, 1, 2, 4, and 6 pi. Different tissues were collected, fixed in 10% buffered formalin, and processed. At hr 2 pi, virus was detected in intestinal, junction of the proventriculus and gizzard, cecal tonsil, liver, kidney, and bursa of Fabricius. At hr 4 pi, virus reached spleen, and at hr 6 pi, it entered thymus. At hr 12 pi, virus concentration increased in positive tissues. The latest invaded tissue was muscle on day 1 pi. Secondary viraemia occurred during 12–24 h pi. In situ PCR was the most sensitive technique to highlight obscure points of infection in this study.