ECDC warns of risk of travel-associated cholera in the Dominican Republic
The European Centre for Disease Prevention and Control (ECDC) has warned of the risk of travel-associated cholera to tourists in the Dominican Republic. The cholera epidemic in the Dominican Republic has given rise to more than 5000 cases since it began in November 2010 and the disease has become extensively distributed endemic in the country.
As the Dominican Republic is a very popular destination for tourists, imported cases are expected in the European Union. However, with appropriate precautionary measures the risk of infection and further transmission upon return to Europe remains low. Travellers should seek information on how to prevent cholera contamination prior to visiting affected areas.
VTEC O104:H4 outbreak in Germany and cluster in France: Update 29/6/11
On 24th June, France reported a cluster of cases of Haemolytic Uraemic Syndrome (HUS) and bloody diarrhoea in Bordeaux in France. As of 28th June, 15 cases have been identified, of whom eight cases have developed HUS. 11 of these cases attended an event, at which 9 reported having eaten sprouts (fenugreek, mustard and rucola). Left over seeds are currently being analysed. In three of the patients, infection with E coli O104:H4 has been confirmed
In addition, Sweden reported a confirmed case of E coli O104:H4 in southern Sweden in a person who had no history of recent travel to Germany and who did not recall having eaten sprouts prior to onset of illness.
The large outbreak of E coli O104:H4 in northern Germany has been shown to be associated with consumption of sprouts from a local producer. In this outbreak, 885 HUS cases, including 31 deaths, and 3,138 non-HUS cases, including 17 deaths have so far been reported.
Investigations are ongoing, but initial findings suggest that the consumption of sprouts is the cause of the infection in both France and Germany. Epidemiological, microbiological and trace-back investigations are currently ongoing to identify the origin of the contamination responsible for these outbreaks.
Until the investigation has been finalised, the European Centre for Disease Prevention and Control and the European Food Safety Authority strongly recommend advising consumers not to grow sprouts for their own consumption and not to eat sprouts or sprouted seeds unless they have been cooked properly. This is in line with advice from the Food Safety Authority of Ireland.
There have been no cases of E coli O104:H4 identified in Ireland. GPs and clinicians have been reminded to notify any potential cases promptly to Public Health.
The latest epidemiological updates from ECDC are available here.
Click here for further information on VTEC and HUS.
Measles outbreaks in Europe highlight importance of vaccination before travel and attending mass gathering events
The Health Protection Surveillance Centre (HPSC) is urging parents to make sure that their children are fully vaccinated against measles following a large pan national outbreak of the disease in Europe. Today ECDC stressed the importance of getting vaccinated before attending mass gathering events.
Since the start of 2011 there have been more than 10,000 cases of measles and four related deaths in 18 European countries. Many cases are due to travel of infected people between countries. As there is more travel between Europe and Ireland over the summer, there is an increased risk to Irish children and teenagers who are not fully vaccinated against measles.
There have been significant outbreaks in France, Spain and Belgium, which are popular holiday destinations for Irish families and with college students on holiday, working, visiting relatives and friends or attending summer camps or other summer activities.
Vaccination with MMR vaccine is the only way to protect against measles. In Ireland, the first MMR dose is given at 12 months of age, and the second dose at 4-5 years of age. Parents must make sure that their children and teenagers are protected against measles by ensuring they have been immunised with MMR before they visit Europe. Measles is a highly infectious and dangerous illness which spreads very easily, particularly in homes, crèches, playgroups, camps, schools and universities. Parents should speak with their GP and get the vaccine for their child if needed. The vaccine is free.
At the moment, only 90% of children in Ireland have received one dose of MMR by 24 months of age, which is below the target of 95% to prevent cases of measles and measles outbreaks.
So far, 42 cases of measles have been reported in Ireland since January 2011. Eight of these cases were in children under 12 months of age who were too young to have been vaccinated but almost half of the rest had not received any doses of MMR vaccine. One in five cases in Ireland were either related to recent European travel or to contact with infected individuals from European countries where measles outbreaks occurred.
MMR vaccine is routinely recommended for all children at 12 months and at 4-5 years of age. The vaccine is given free of charge.
Many parents and GPs have inquired about administering MMR vaccine to children less than 12 months of age who are travelling to areas where measles outbreaks are occurring in Europe.
MMR vaccine can be given be given to children as young as 6 months of age during outbreak situations (although vaccine effectiveness is usually less at this age than when given after 12 months of age).
MMR vaccine may take up to 4 weeks to be effective.
Parents who wish to lessen the risk of measles in their children between 6-12 months of age who may be exposed to measles may wish to avail of MMR vaccine. If they do so the vaccine is provided free via the HSE National Cold Chain Service but parents should pay for the vaccine administration.
This dose would not be counted as a valid dose from the point of the vaccination programme and should be repeated at 12 months of age, at least one month after the first vaccine with a further dose at 4 - 5 years of age.
Parents who wish to lessen the risk of measles in their children between 1-5 years of age who may be exposed to measles may wish to avail of a second dose of MMR vaccine. If they do so the vaccine is provided free via the HSE National Cold Chain Service but parents should pay for the vaccine administration.
This dose would usually be counted as a valid dose from the point of the vaccination programme and no further MMR vaccine is required.
Note: If a child under 18 months of age receives a second MMR vaccine within three months of the first MMR a third MMR vaccine should be given at 4-5 years of age.
For more information:
See press release issued by HSE Communications - 30/5/11
As of 15/6/2011, ECDC is reporting that in the EU/EEA, 821 HUS cases, including 24 deaths, and 2530 non-HUS VTEC cases, including 13 deaths, have been reported. Today, Germany reports two new HUS cases and 17 new non-HUS STEC cases. It also reports a new HUS death. In Luxembourg, one STEC case has recently developed HUS. This brings to 3351 the combined numbers of STEC/HUS cases. A total of 37 people have now died as a result of this outbreak. The latest reports on this outbreak from ECDC can be found here.
German Authorities are advising their citizens against consuming raw beansprouts until further notice. In addition, one of the outbreak cases has possibly contracted their illness from home grown bean sprouts, raising the possibility that beansprout seeds might have a role in this outbreak. As a result of this, German Authorities are also advising against the consumption of home grown beansprouts. Information from the German Authorities in English is available here.
VTEC in Germany: Update 10/6/11
Today the European Centre for Disease Prevention and Control is reporting that in the EU, 795 HUS cases, including 22 deaths, and 2287 non-HUS cases, including nine deaths, have been reported since the beginning of the VTEC/HUS outbreak associated with Germany. Cases have been identified in a number of countries. To date no cases have been reported from Ireland. The latest reports on this outbreak from ECDC can be found here.
Investigations in Germany indicate that illness is linked to the consumption of organic bean sprouts from one local producer. They have rescinded their warning against the consumption of tomatoes, cucumbers and lettuce. The Authorities in Germany are recommending that raw bean sprouts should not be consumed. Fuller information is available on the website of the Food Safety Authority of Ireland.
VTEC in Germany: Update 9/6/11
Today the European Centre for Disease Prevention and Control is reporting that in the EU, 757 HUS cases, including 19 deaths, and 2143 non-HUS cases, including eight deaths, have been reported since the beginning of the VTEC/HUS outbreak associated with Germany. Cases have been identified in a number of countries. To date no cases have been reported from Ireland. The latest reports on this outbreak from ECDC can be found here.
For advice for those travelling to Germany click here.
VTEC in Germany: Update 2/6/11
Cases associated with the outbreak of haemolytic uraemic syndrome (HUS) and verocytotoxigenic E. coli (VTEC) centered in Germany continue to rise. A number of countries have now reported cases to the European Centre for Disease Prevention and Control (ECDC). The latest reports on this outbreak from ECDC can be found here.
VTEC in Germany: Update 31/5/11
As of Tuesday May 31, German Authorities have identified 373 cases of Haemolytic Uraemic Syndrome (HUS) associated with an outbreak of VTEC (Verocytoxigenic Escherichia coli) VTEC O104. Six deaths in Germany are confirmed as being associated with this outbreak. The population in Germany affected in this outbreak are largely female and adult (71% are female and 88% are aged 20 years or older). Updates, in English, from German authorities are available here. Cases are being reported from a number of neighbouring countries (Sweden-15, Denmark-7, Netherlands-3, UK-2), largely among German visitors to the country in question, or in travellers to Germany. The latest Europe-wide SitRep from the European Centre of Disease Prevention and Control (ECDC) is available here. Daily updates will be posted on ECDC’s website here.
To date, there are no cases associated with this outbreak strain in Ireland.
Although salad vegetables have been shown in an initial analytical study in Germany to be associated with human disease, no definite microbiological evidence exists between illness and a particular food item. Further epidemiological and laboratory studies are ongoing, but contaminated food seems the most likely vehicle of infection. The Food Safety Authority of Ireland have issued an update in relation to this outbreak today.
Parents urged to ensure children are fully vaccinated against measles
The Health Protection Surveillance Centre (HPSC) is urging parents to make sure that their children are fully vaccinated against measles following a large pan national outbreak of the disease in Europe.
Since the start of 2011 there have been more than 10,000 cases of measles and four related deaths in 18 European countries. Many cases are due to travel of infected people between countries. As there is more travel between Europe and Ireland over the summer, there is an increased risk to Irish children and teenagers who are not fully vaccinated against measles.
There have been significant outbreaks in France, Spain and Belgium, which are popular holiday destinations for Irish families and with college students on holiday, working, visiting relatives and friends or attending summer camps or other summer activities.
Vaccination with MMR vaccine is the only way to protect against measles. In Ireland, the first MMR dose is given at 12 months of age, and the second dose at 4-5 years of age. Parents must make sure that their children and teenagers are protected against measles by ensuring they have been immunised with MMR before they visit Europe. Measles is a highly infectious and dangerous illness which spreads very easily, particularly in homes, crèches, playgroups, camps, schools and universities. Parents should speak with their GP and get the vaccine for their child if needed. The vaccine is free.
At the moment, only 90% of children in Ireland have received one dose of MMR by 24 months of age, which is below the target of 95% to prevent cases of measles and measles outbreaks.
So far, 42 cases of measles have been reported in Ireland since January 2011. Eight of these cases were in children under 12 months of age who were too young to have been vaccinated but almost half of the rest had not received any doses of MMR vaccine. One in five cases in Ireland were either related to recent European travel or to contact with infected individuals from European countries where measles outbreaks occurred.
MMR vaccine is routinely recommended for all children at 12 months and at 4-5 years of age. The vaccine is given free of charge.
Many parents and GPs have inquired about administering MMR vaccine to children less than 12 months of age who are travelling to areas where measles outbreaks are occurring in Europe.
MMR vaccine can be given be given to children as young as 6 months of age during outbreak situations (although vaccine effectiveness is usually less at this age than when given after 12 months of age).
MMR vaccine may take up to 4 weeks to be effective.
Parents who wish to lessen the risk of measles in their children between 6-12 months of age who may be exposed to measles may wish to avail of MMR vaccine. If they do so the vaccine is provided free via the HSE National Cold Chain Service but parents should pay for the vaccine administration.
This dose would not be counted as a valid dose from the point of the vaccination programme and should be repeated at 12 months of age, at least one month after the first vaccine with a further dose at 4 - 5 years of age.
Parents who wish to lessen the risk of measles in their children between 1-5 years of age who may be exposed to measles may wish to avail of a second dose of MMR vaccine. If they do so the vaccine is provided free via the HSE National Cold Chain Service but parents should pay for the vaccine administration.
This dose would usually be counted as a valid dose from the point of the vaccination programme and no further MMR vaccine is required.
Note: If a child under 18 months of age receives a second MMR vaccine within three months of the first MMR a third MMR vaccine should be given at 4-5 years of age.
For more information:
See press release issued by HSE Communications - 30/5/11
HPSC warns travellers to Germany of E coli outbreak
HPSC has learned that German authorities are investigating an extensive outbreak of Verocytotoxigenic Escherichia coli (VTEC) complicated by Haemolytic Uraemic Syndrome (HUS). The VTEC strain responsible for this outbreak is 0104, a strain not reported as having caused human disease in Ireland.
VTEC is a serious diarrhoeal illness which is transmitted by contaminated food or water or close contact with a person suffering from the illness. Its primary symptoms are diarrhoea (often bloody) and abdominal pain. Occasionally HUS (a form of kidney failure) can develop. More information on VTEC and HUS is available on the HPSC's website at http://www.hpsc.ie/hpsc/A-Z/Gastroenteric/VTEC).
More than 200 cases of HUS have been reported resulting in at least two deaths. The outbreak affects the entire country but primarily the northern part; most cases are adult and a majority are female. Ireland has not yet seen any cases associated with this outbreak. Other European countries have seen cases among travellers returning from Germany.
Early indications are that the source of the outbreak is food, most likely salad ingredients such as raw tomatoes, cucumbers and lettuce. Authorities in Germany are advising the public not to eat raw tomatoes, cucumbers and lettuce, especially in the north of the country, until further notice.
HPSC advises that anyone travelling to Germany should follow the advice regarding this outbreak from the German authorities. In addition, returning travellers with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention any recent travel history.
HPSC and the Food Safety Authority of Ireland are monitoring this evolving situation closely. Health professionals are being alerted to the situation and they are advised to urgently investigate potential VTEC cases with a travel history to Germany.
Measles outbreaks in Ireland, Europe, Africa - Measles vaccination recommended in addition to other travel vaccines
The large measles outbreak reported in Ireland earlier this year is decreasing but is not gone.
Since the beginning of 2010, 389 measles cases have been reported to the HPSC; most (52%) cases are less than 5 years of age and from the Dublin area (30%); with 22% less than 1 year of age, too young to have the vaccine usually. Most cases were preventable; of the 230 cases 12 months of age or older, for whom information on vaccination was known, 97% were either unvaccinated or had only one dose of MMR (73% unvaccinated, 24% one dose).
Measles can only be prevented with the MMR vaccine. It is very infectious, and is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions. Symptoms usually appear 8–12 days after infection and include high fever, runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards.
Complications are more common in children under the age of five, or adults over the age of 20. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia.
Reminder about need for MMR vaccination for those travelling and resident in Ireland • Measles outbreaks whether in Ireland or overseas pose a risk to non-vaccinated Irish children and adults • All children need two doses of MMR vaccine; at 12-15 months and at age 4-5 years • Older children and young adults who have not received at least two doses of MMR should contact their GP for this vaccine. • Further details on measles can be found on the HPSC website at http://www.hpsc.ie/hpsc/A-Z/VaccinePreventable/Measles/
