Infectious disease figures for 2010 show decline in many common infections
The HSE Health Protection Surveillance Centre has published its annual report on the incidence of notifiable diseases in Ireland during 2010.
The main findings are as follows:
Healthcare associated infections:
MRSA bloodstream infections fell 14% in 2010 with 305 cases notified compared with 355 cases in 2009. MRSA rates in Ireland are now at their lowest rates since surveillance began in 1999.
Cases of Clostridium difficile-associated disease fell by 11% in 2010 with 1,696 cases notified compared with 1,897 cases in 2009.
Overall outpatient antibiotics consumed in 2010 fell by 2% in 2010 compared with 2009. However, hospital antimicrobial consumption rose by 4% for the same period. A recently launched HSE initiative on reducing unnecessary antibiotic usage aims to improve these figures next year.
Gastroenteric diseases:
Cryptosporidiosis cases fell by 34% in 2010 with 294 cases notified compared with 445 cases in 2009.
Verotoxigenic E. coli cases fell by 17% in 2010 with 199 cases notified compared with 241 cases in 2009. There is a marked urban / rural divide indicating that contact with farm animals and the use of private water supplies are potential sources of this infection.
Campylobacter cases fell by 1% in 2010 with 1,661 cases notified compared with 1,807 cases in 2009. Campylobacter is the most common bacterial cause of gastroenteritis in Ireland.
Respiratory diseases:
Provisional data for 2010 shows an 11% decline in TB cases with 427 cases provisionally notified compared with 479 cases in 2009.
Bloodborne and sexually transmitted infections:
HIV cases fell by 21% in 2010 with 331 cases notified compared with 395 cases in 2009. The highest proportion of new HIV diagnosis in 2010 were among men who have sex with men (MSM), with 40.5% of newly diagnosed HIV cases occurring in this category. This trend has been observed in many European countries to such an extent that ECDC now recommends that interventions to control HIV among MSM should be the cornerstone of HIV prevention strategies in Europe.
Hepatitis C cases remained largely the same in 2010 with 1,239 cases notified compared with 1,241 cases in 2009.
Sexually transmitted infections (STI) fell by 4.1% in 2009 with 10,834 cases notified compared with 11,294 cases in 2008. The 2009 data is the latest available information for STIs.
Vaccine preventable diseases
Invasive pneumococcal disease cases fell by 10% in 2010 with 391 cases notified compared with 432 cases in 2009. Invasive pneumococcal disease continues to decline following the introduction of the conjugate pneumococcal vaccine in 2008. During 2010 the incidence of all types of invasive pneumococcal disease fell by 25% compared with 2008 when the vaccine was first introduced. Sadly, in 2010, one death occurred from pneumococcal meningitis in a young child who was unvaccinated.
Measles cases increased by 149% in 2010, with 403 cases notified compared with 162 cases in 2009. 108 of these cases were hospitalised in 2010. Forty separate measles outbreaks were reported during the year. Cases predominantly occurred in the traveller and Roma communities and amongst those who choose not to have their children vaccinated against vaccine preventable diseases. Other European countries also saw measles outbreaks during 2010.
Mumps cases fell by 53% in 2010 with 293 cases reported were notified compared with 620 cases in 2009. Complications of this disease in 2010 included orchitis, deafness, pancreatitis, encephalitis and appendicitis.
Commenting on the publication of the report, HPSC director, Dr Darina O'Flanagan, said that the decline in many notifiable diseases was very welcome and was due to strong public health surveillance and hard work in the battle against infectious disease.
For example, the decline in healthcare associated infections will have been supported by a national hand hygiene observation audit tool and standard operating procedures for use in acute hospitals.
This was developed and piloted by HPSC, in conjunction with the Infection Prevention Society, in 2010 and was rolled out in 2011 with a programme of hospital hand hygiene auditor training. On a related issue, overall consumption of antibiotics in Ireland remains mid-to-high in comparison with other European countries but a recently launched HSE initiative on reducing unnecessary antibiotic usage should improve our ranking in Europe.
Vaccination remains an important and very effective way of combating many diseases. This is illustrated by the success of the conjugate pneumococcal vaccine which has led to a 25% reduction in all types of invasive pneumococcal disease in the two year period since its introduction. A catch-up MMR vaccination campaign is needed to control and eliminate the continued transmission of measles, mumps and rubella in Ireland as we saw a worrying number of measles outbreaks in Ireland and Europe during 2010.
At risk groups urged to get flu jab as first cases of winter influenza identified
The HSE–Health Protection Surveillance Centre (HPSC) has urged people in at risk groups to get vaccinated against influenza following the identification of the first cases of Influenza A virus this winter.
The National Virus Reference Laboratory (NVRL) has identified two cases which were detected by a network of 60 sentinel general practices who report weekly on the number of patients with influenza-like illness. The network was established by the Health Protection Surveillance Centre, in partnership with the Irish College of General Practitioners and the NVRL in 2000.
Commenting on the cases HPSC Director, Dr Darina O’Flanagan, said that while influenza activity in Ireland is low at present, people in at risk groups need to get vaccinated.
"The vaccine is available free of charge from GPs for all people in at risk groups, and from pharmacists for everyone aged 65 and over. An administration charge may apply to people who don't hold medical cards or GP visit cards.
"Those at risk include:
Everyone aged 65 years and over
Anyone over six months of age with a long term illness requiring regular medical follow-up such as chronic lung disease, chronic heart disease or diabetes
Pregnant women
Those with lower immunity due to disease or treatment
Children or teenagers on long-term aspirin therapy
Residents of nursing homes and other long stay facilities
Healthcare workers and carers
"The 2010/2011 influenza season peaked in early January 2011 and over 2,000 cases of influenza were confirmed by the NVRL.
"Based on advice from the World Health Organization (WHO), this year's seasonal influenza vaccine protects against three common influenza virus strains - the H1N1 (swine flu) strain which is still circulating, influenza A (H3) and influenza B.
"People who were vaccinated last year still need to get their flu jab this year as immunity from the vaccine lasts twelve months and wanes over time.
"Flu is different from the common cold. Flu usually develops quickly over a matter of hours and symptoms include a high temperature, sore muscles, dry cough, headache and sore throat. The common cold tends to come on gradually and symptoms usually include a runny nose and a normal temperature. Anyone in the at-risk categories who develops influenza symptoms should contact their GP."
Antibiotics are a precious resource. They are very useful drugs and save lives. However using antibiotics when they are not needed is a waste of time and money and hinders the fight against infections in the future. Using antibiotics needlessly allows bugs that cause infections to build up resistance against antibiotics and renders them useless over time. Very few new types of antibiotic are being developed, which means that we must make sure that the ones we have remain effective against infections for the sake of future generations.
A Post Graduate Course on Health Protection is commencing on January 12th 2012 in University College Cork.
Further information can be found here
Botulism in Scotland linked to contaminated jar of Loyd Grossman Korma sauce
Two cases of botulism have occurred in children in Scotland, linked to a contaminated jar of Loyd Grossman Korma sauce. The FSAI has identified that an implicated batch of this product was distributed to Tesco in Ireland, and are advising the public who have purchased this specific product not to eat it. See here for more details from the FSAI.
The symptoms of botulism include blurred vision, difficulty swallowing, headaches and muscle weakness. The HSE Health Protection Surveillance Centre advises anyone who has these symptoms to seek urgent medical attention. The symptoms of botulism are caused by a toxin produced by a bacterium called Clostridium botulinum which attacks the nervous system. There is an antitoxin available, which is very effective in treating botulism if treated early.
Draft guidelines on the management of viral haemorrhagic fever in Ireland now available for consultation
Draft guidelines “The management of viral haemorrhagic fever in Ireland” are now available for consultation. These guidelines have been prepared by the Viral Haemorrhagic Fevers Subcommittee of the HPSC Scientific Advisory Committee of the Health Protection Surveillance Centre. All comments and suggestions are welcomed. They will be reviewed by the subcommittee and taken into consideration when preparing the final document. To facilitate the process, please use the template consultation response form.
The draft document and consultation response form are available here
Early clinical & public health management of bacterial meningitis guidelines now available for consultation
The draft "Guidelines for the early clinical and public health management of bacterial meningitis (including meningococcal disease)" are now available for consultation. These guidelines have been prepared by the Bacterial Meningitis Subcommittee of the Scientific Advisory Committee of the Health Protection Surveillance Centre. The subcommittee would very much appreciate feedback on every aspect of the document (content, structure, wording etc.).
The draft guidance and consultation proforma sheet are available here.
Managing Public Health Risks Associated with Fish Pedicures
HPSC has issued guidance on managing public health risks associated with fish pedicures. Further information is available here.
Multi-Drug Resistant Organism (MDRO) guidelines now out for consultation
Draft guidelines for the control and prevention of multi-drug resistant organisms (excluding MRSA) in the healthcare setting are now available for consultation. The deadline for return of completed comments is November 7th 2011.
The guidelines and the consultation comment template are available here.
New guidance from ECDC & EMCDDA on prevention and control of infectious diseases among people who inject drugs
Joint guidance on Prevention and control of infectious diseases among people who inject drugs has been developed by the European Centre for Disease Prevention and Control (ECDC) and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) with the support of a technical advisory group composed of policy makers, service providers, civil society representatives and preventative health experts from throughout the EU/EEA.
This evidence-based guidance is designed to inform the development, monitoring and evaluation of national strategies and programmes in countries in Europe in order to reduce and prevent infections among people who inject drugs. The guidance identifies seven key interventions which, in synergistic combination, have been shown by evidence and experience to be effective in the prevention and control of infectious diseases that affect people who inject drugs.
Consultation on "Your Health is Your Wealth" - public health policy framework for a healthier Ireland 2012-2020
The Department of Health is developing a public health policy, which aims to improve the health of the population and reduce health inequalities by addressing the causes of preventable illnesses.
Your views are being sought on the development of this policy and you can input by answering questions which can be accessed via the Consultation Questionnaire
The aim is to develop a policy for a healthier population for all ages and all sectors in society. This policy will cover the period 2012 to 2020.
Ireland needs a national policy on public health because:
Poor diet, a lack of physical activity, tobacco smoking and excessive alcohol consumption contribute significantly to most chronic diseases such as diabetes, heart disease and many cancers which are forecast to double over a 20 year period.
Improvements in life expectancy gained in recent decades are significantly threatened by rising rates of obesity.
People in lower socio-economic groups have poorer health experience and reduced life expectancy than those who are wealthier.
Our population is ageing and this demographic profile change presents considerable challenges.
Major public health threats such as avian flu, swine flu and drug resistant viruses/illness (eg hospital bugs like MRSA) are increasing and demonstrate the health protection challenges faced in a globalised world.
Since many factors influence health, such as sanitation, access to health care, lifestyle choices, educational attainment, level of income and the environment it is essential that the health service, government, local government, the voluntary sector, communities and individuals work together to ensure the Irish population experiences the best of health.
Public health includes health protection, health promotion, environmental health, health surveillance, health intelligence and tackling health inequalities.
You can respond to the consultation process by email or letter. The closing date for responses is Friday 30 September 2011.
Parents urged to vaccinate children with MMR as cases of measles rise
Parents are strongly advised to ensure their children have 2 doses of MMR Vaccine, as cases of measles begin to rise in Ireland. Outbreaks have been reported in Dublin and cases linked to the Dublin outbreaks are being reported in other parts of the country. The MMR vaccine is the only protection from measles available. Measles can be a very serious and sometimes fatal illness.
There has been a rapid increase in numbers of measles cases recently, most of them centred in North Dublin City. Measles is a serious illness, and MMR vaccine is the only protection against it. In the year 2000, a serious outbreak in Dublin saw cases rise as high as 1600, and claimed the lives of 3 young children. Measles is a highly infectious and dangerous illness which spreads very easily, particularly in homes, crèches, playgroups, camps, schools and universities.
Provisional data (08/09/2011) shows that the outbreak is spreading, with 191 cases of measles reported in Ireland since the start of 2011; over 86% of cases are in Dublin (mainly, but not exclusively, in the north Dublin area); 75% of cases have not been vaccinated with any MMR doses; 10% of cases have been hospitalised; no deaths have been reported.
The increase in cases among non-vaccinated children and young adults is a major cause for concern. Measles is a serious, but preventable, disease. Of the more than 26,000 cases across Europe, some have resulted in some severe outcomes, with six deaths, 14 neurological complications and 444 cases of severe pneumonia.
MMR Vaccine is the only protection against measles – parents are urged to make sure their children are fully protected by having the complete course of 2 MMR vaccinations. In Ireland, the first MMR dose is given routinely at 12 months of age, and the second dose at 4-5 years of age. 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.
The HPSC urges all parents, country-wide, to seek MMR vaccination for their child if they have missed it.
What should parents do?
If you have a preschool or primary school child who never had an MMR shot – please go to your GP now for MMR vaccination.
If you have a primary school aged child who missed out on the MMR booster - please go to your GP now for MMR vaccination.
If you or an infant between 6 and 12 months is a contact of a measles case – please go to your GP for MMR vaccination.
If you’re not sure whether your child has had the full course of 2 doses – go to your GP for MMR vaccination
Symptoms of Measles:
High fever
Cough
Runny nose
Red eyes
Red rash that starts on the head and moves down the body
Measles can cause chest infections, fits, ear infections, swelling of the brain and brain damage.
If you think you or your child has measles, before you see your GP, call your doctor to arrange an appointment to minimise risk of transmission to others (either a house visit or a clinic visit at end of day).
Two clusters of botulism, affecting a total of eight people, in southern and northern France have been associated with eating tapenade, a food product based on ground olives.
French authorities have recalled additional artisan products due to this outbreak. Products from the implicated producer are sold under three brand names: Terre de Mistral, Le Secret D'Anais and Les Delices de Marie Claire and were available for online purchase from the following two websites: www.chocolatprovence.com and http://www.epicerie-terroirprovence.com. A full list of products produced by the implicated producer is available on the Food Safety Authority of Ireland website.
Botulism is caused by a botulinum toxin, which is a poison produced by the bacterium Clostridium botulinum. The bacterium is commonly found in the soil in the form of spores. Botulism produces a neurological condition affecting the nerves of the body. Symptoms often begin with blurred vision and difficulty in swallowing and speaking, but sometimes diarrhoea and vomiting can occur. The disease can lead to problems with vision, and paralysis. Most cases make a recovery, but the recovery period can be many months. The disease can be fatal in 5-10% of cases. Botulism is a notifiable disease in Ireland.
More information on botulism is available on the HPSC website here.
Botulism Outbreak in France
Two clusters of botulism, affecting a total of eight people, in southern and northern France have been associated with eating tapenade, a food product based on ground olives.
All cases had consumed tapenade produced in the Vaucluse district of southern France under the brand name "Les Délices de Marie-Claire", batch number 112005. This product is distributed in four districts in southern France (i.e. Bouches-du-Rhône, Drome, Var and Vaucluse), and was available in food delicatessen stores since 31 May 2011 with a best before date of 16 December 2012. French authorities have issued a national recall of all products produced by the implicated producer, and have informed the public health authorities of all European Member States.
Tourists who may have purchased this product while staying in France, are advised not to consume it.
Botulism is caused by a botulinum toxin, which is a poison produced by the bacterium Clostridium botulinum. The bacterium is commonly found in the soil in the form of spores. Botulism produces a neurological condition affecting the nerves of the body. Symptoms often begin with blurred vision and difficulty in swallowing and speaking, but sometimes diarrhoea and vomiting can occur. The disease can lead to problems with vision, and paralysis. Most cases make a recovery, but the recovery period can be many months. The disease can be fatal in 5-10% of cases. Botulism is a notifiable disease in Ireland.
More information on botulism is available on the HPSC website here.
More information (in French) about this event is available on the French official websites:
Survey of Dental Antibiotic Use in Ireland Underway
All dentists in Ireland are being invited to take part in an anonymous survey to determine antibiotic use in dental practices. Currently there is very little data on antibiotic use in dental practice in Ireland, and a lack of national dental antibiotic prescribing guidelines. To address these gaps, a survey of dental antibiotic prescribing in Ireland is being carried out by the SARI (Strategy for the Control of Antimicrobial Resistance in Ireland) Sub-Committee on Antibiotic Use in Dentistry. The survey will provide valuable information on the use of antibiotics in dentistry in Ireland, and will help to identify what infections will need to be included in national dental prescribing guidelines.
Parents warned to vaccinate children with MMR as cases of measles rise
Parents are strongly advised to ensure their children have 2 doses of MMR Vaccine, as cases of measles begin to rise in Ireland. Outbreaks have been reported across Europe and in New Zealand. The MMR vaccine is the only protection available from measles, which can be a very serious and sometimes fatal illness.
There has been a rapid increase in numbers of measles cases recently, most of them centred in North Dublin City. Measles is a serious illness, and MMR vaccine is the only protection against it. In the year 2000, a serious outbreak in Dublin saw cases rise as high as 1600, and claimed the lives of 3 young children. Measles is a highly infectious and dangerous illness which spreads very easily, particularly in homes, crèches, playgroups, camps, schools and universities.
There have been 135 cases of measles in Ireland since the start of 2011, with over 70% arising in North Dublin City. Of the more than 26,000 cases across Europe, some have resulted in some severe outcomes, with six deaths, 14 neurological complications and 444 cases of severe pneumonia.
MMR Vaccine is the only protection against measles – parents are urged to make sure their children are fully protected by having the complete course of 2 MMR vaccinations. In Ireland, the first MMR dose is given at 12 months of age, and the second dose at 4-5 years of age. 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.
The HSE is contacting GPs in the North Inner City of Dublin area, informing them of the rising numbers of cases and giving specific advice on vaccination measures, and is also arranging for special MMR vaccination clinics to be delivered in primary schools in the North Dublin area, when schools return in September.
What should parents do?
If you have a preschool or primary school child who never had an MMR shot – please go to your GP now for MMR vaccination.
If you have a primary school aged child who missed out on the MMR booster - please go to your GP now for MMR vaccination.
If you or an infant between 6 and 12 months is a contact of a measles case – please go to your GP for MMR vaccination.
If you’re not sure whether your child has had the full course of 2 doses – go to your GP for MMR vaccination
Symptoms of Measles:
High fever
Cough
Runny nose
Red eyes
Red rash that starts on the head and moves down the body
Measles can cause chest infections, fits, ear infections, swelling of the brain and brain damage.
The MMR vaccine is free.
More information on measles is available here and from the HSE National Immunisation Office at www.immunisation.ie.
Parents urged to ensure children are vaccinated before travel as Europe sees increase in measles cases
Parents continue to be urged to ensure 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 26,000 cases of measles in Europe. More than half of the reported cases occurred in France where six deaths, 15 neurological complications and 615 cases with severe pneumonia have been reported, according to the latest European Measles Monthly Monitoring Report issued by the European Centre for Disease Prevention and Control (ECDC).
One death has occurred in Germany and large outbreaks are also being reported from Romania, Switzerland, Spain, Belgium, Denmark, UK and Italy.
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. Additionally, the World Youth Day in Madrid in August will bring a large gathering of youth from all over the Europe together.
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.
As of 10th August, provisional data reported to the HPSC indicates that 118 cases of measles have been reported in Ireland since January 2011. Eighty one percent, or 96 cases of measles, have occurred in residents in the HSE East and 15 cases were under 12 months of age and were too young to have been vaccinated. Fifty-four percent of cases occurred in individuals who were eligible for vaccination but had not received any dose of MMR vaccine while 23 cases received one dose of MMR. Two doses of MMR will protect 99% of those receiving the vaccine. Thirteen individuals with measles have been hospitalised for between 2 and 14 days.
At least ten Irish measles cases were infected while travelling overseas in Europe or had direct links to imported cases.
Parents urged to ensure children are vaccinated before travel as Europe sees increase in measles cases
The HSE National Immunisation Office today (Wednesday) urged 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 21,000 cases of measles in Europe. More than half of the reported cases occurred in France where six deaths, 14 neurological complications and 444 cases with severe pneumonia have been reported, according to the head of the HSE National Immunisation Office, Dr Brenda Corcoran.
"One death occurred in Germany and large outbreaks are also being reported from Romania, Switzerland, Spain, Belgium, Denmark, UK and Italy.
"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. Additionally, the World Youth Day in Madrid will bring a large gathering of youth from all over the Europe together.
"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, 110 cases of measles have been reported in Ireland since January 2011. Seventy nine percent, or 87 cases of measles, have occurred in residents in the HSE East and 14 cases were under 12 months of age and were too young to have been vaccinated. Nearly 50% of cases occurred in individuals who were eligible for vaccination but had not received any dose of MMR vaccine while 22 cases received one dose of MMR. Two doses of MMR will protect 99% of those receiving the vaccine. Twelve individuals with measles have been hospitalised for between 2 and 14 days.
"At least eight of our measles cases were infected while travelling overseas in Europe, transmission from these cases then occurred in Ireland," added Dr Corcoran.
World Hepatitis Day is an annual event that each year provides international focus for patient groups and people living with hepatitis B and C. It is an opportunity around which interested groups can raise awareness and influence real change in disease prevention and access to testing and treatment.
The World Hepatitis Alliance first launched World Hepatitis Day in 2008, and since then thousands of events have taken place around the world, generating massive public and media interest. The Alliance has also received support from governments worldwide, high-profile Non-Governmental Organisations (NGOs) and supranational bodies, such as Médecins Sans Frontières.
Following the World Health Assembly in May 2010, it was agreed that World Hepatitis Day would be recognised annually on 28 July.
Further information on Hepatitis B and C in Ireland is available here:
This week Eurosurveillance published a rapid communications article on the first isolation and outbreak of OXA-48-type CRE in an Irish hospital. Five OXA-48-producing Klebsiella pneumoniae were detected in a tertiary referral hospital in Ireland between March and June 2011. None of the cases had received healthcare at a facility outside of Ireland in the previous 12 months. This is the first report of OXA-48-type CRE in Ireland and the occurrence of this outbreak is described as dramatically changing the epidemiology of CRE in Ireland.
Screening for CRE carriage is currently indicated for patients with history of admission to the following healthcare facilities for more than 48 hours in the past 12 months:
Republic of Ireland
HSE-Mid-West Hospitals (Mid-Western Regional Hospital, St John’s Hospital, Ennis General Hospital, Nenagh General Hospital)
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.
IMB reports on EMA statement on use of the Pandemrix vaccine
The Irish Medicines Board (IMB) has reported on the European Medicines Agency’s statement on the use of the Pandemrix vaccine and the onset of narcolepsy. Investigation into cases occurring in Ireland is on-going.
Measles outbreaks in Europe continue to escalate - July 2011
As measles continues to spread in Europe and in Ireland parents are urged to ensure children and teenagers are fully immunised against measles with the MMR vaccine.
Since the start of 2011 more than 21 000 cases were reported in EU and EEA/EFTA countries. Most cases are either un- or incompletely immunised individuals.
In France there is a huge ongoing outbreak which accounts for more than half of the reported cases in 2011. Six deaths, 14 neurological complications and 444 cases with severe pneumonia have been reported. Large outbreaks are also being reported from Romania, Switzerland, Spain, Belgium, Denmark, UK and Italy.
Mass gathering events such as the upcoming World Youth Day in Madrid in August 2011 poses a risk to susceptible participants who may be exposed to measles while there and bring it home with them, spreading the disease to others.
Two doses of MMR vaccine are routinely recommended for children;
The first dose at 12 months of age and the second at 4-5 years.
Unvaccinated older children, teenagers and young adults should get it to protect against measles.
VTEC O104:H4 outbreak in Germany and cluster in France: Update 6/7/2011
The VTEC O104 outbreak on the continent continues, but the rate at which new cases are being reported has fallen markedly. As of 5/7/2011, a total of 897 HUS cases, including 33 deaths, and 3314 non-HUS cases, including 17 deaths, have been reported. A number of countries have been affected; distribution of the cases is available on the website of the European Centre for Disease Prevention and Control. The last reported date of illness onset among all cases was 29 June 2011. No cases associated with this outbreak have been identified in Ireland.
The latest cases outside Germany appeared in the Bordeaux region of France; all were associated with attendance at a single event. The strain of VTEC responsible for the French cases is indistinguishable from that that led to the German outbreak. This suggests that these two events are related to a common source.
Click here for further information on VTEC and HUS.
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.
Safe Patient Care:Healthcare-associated Infection Prevention & Control for All: A Foundation Course 2011
Date of Course: Monday 5th to Thursday 8th September 2011
Venue: Houston Lecture Theatre, RCSI, St Stephen’s Green, Dublin 2
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
Revised draft guidelines for control and prevention of CJD in Irish healthcare settings
Revised draft guidelines for control and prevention of CJD in Irish healthcare settings are available for consultation here
VTEC in Germany: Update 15/6/11
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.
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
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.
HIV & AIDS in Ireland, 2010
During 2010, the number of new HIV diagnoses in Ireland declined by 16.2%. However, the data suggest that HIV transmission in Ireland has not declined significantly. The HPSC annual HIV case-based surveillance report for 2010 outlines the key statistics and epidemiology of disease transmission among key risk groups. The HIV & AIDS in Ireland, 2010 report may be found here
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.
Resources for HALT 2011
The HSE- Health Protection Surveillance Centre is conducting a prevalence study of healthcare-associated infection and antibiotic use in Irish long term care facilities in May 2011.
This study will use the same protocol as that used in the called Healthcare associated Infection in European Long term Care Facilities (HALT project) 2010. As in 2010, this study will be a point prevalence survey. This means that on one day in May (selected by the long term care facility - LTCF), all patients on antibiotics will be reviewed, and by using specific definitions the type of infection (e.g. respiratory, urinary) will be selected.
Updated antibiotic guidelines for primary care are now available
Guidelines for management of common infections in primary/community care settings have been produced by the SARI Community Antimicrobial Stewardship Committee. The guidelines have been finalised, following a consultation process, and are free to download and distribute. The guidelines will be revised and updated on a regular basis.
The updated antibiotic guidelines for primary care may be found here
National Zoonoses Committee of Ireland: National Zoonoses Conference June 2011
The National Zoonoses Conference will take place on 8th-9th June 2011 in UCD. The conference will be of interest to a range of professional groups including medical and veterinary public health professionals, environmental health officers, microbiologists, researchers, surveillance scientists, epidemiologists, food industry stakeholders, risk managers and local authority engineers, in addition to Government Departments and National Agencies (related to Health, Agriculture, Food, the Environment, Sea Fisheries) and those linked to the broader Food Industry.
For further information on the conference programme and registration click here.
People who take part in outdoor pursuits must protect against Lyme disease
The HSE Health Protection Surveillance Centre urges people who take part in outdoor pursuits to protect themselves against Lyme disease, which is spread by tick bites. Lyme disease can, in a minority of cases, cause severe debilitating heart and nervous system disease.
As people are more likely to engage in out door pursuits in the summer months, ramblers, campers, mountain bikers, and others who work and walk in forested or grassy areas must be vigilant against tick bites.
Ticks are tiny insect like creatures that feed on the blood of mammals and birds and will also feed on humans. Ticks are more numerous and more active in the summer months and protecting against tick bites protects against Lyme disease.
Tick bites can be prevented by:
Wearing long trousers, long sleeved shirt and shoes
Using an insect repellent
Checking skin, hair and warm skin folds (especially the neck and scalp of children) for ticks, after a day out
Removing any ticks and consulting with a GP if symptoms develop
Only a minority of ticks carry infection. If a tick is removed within a few hours, the risk of infection is low. The entire tick, including any mouthparts which might break off, should be removed with a tweezers by gripping it close to the skin. The skin where the tick was found should then be washed with soap and water and the area checked over the next few weeks for swelling or redness. Anyone who develops a rash or other symptoms should visit their GP and explain that they have been bitten by a tick.
Although the true incidence of Lyme disease is not known it is likely that there are at least 50-100 cases in Ireland every year.
Further important information to protect against Lyme disease is available on the HPSC website here.
Measles in Ireland and Europe: Challenges to elimination
Measles outbreaks are widespread in Europe at the moment. Although the large measles outbreak that occurred in Ireland last year has abated, HPSC is aware that measles is still circulating in the community, with four individuals diagnosed with laboratory confirmed measles this year so far and others under investigation. Both children and adults have been affected with measles.
The risk of getting measles is also present in other countries of Europe. Large measles outbreaks are occurring in France, Belgium, Switzerland, Denmark, Germany, the Netherlands, Norway, Serbia, Switzerland and the former Yugoslav Republic of Macedonia. Turkey recently reported an outbreak in Istanbul, in addition to cases linked to a large outbreak in Bulgaria in 2010. In addition, small outbreaks have occurred in the Russian Federation (in Krasnoyarsk and Tomsk), linked to Uzbekistan.
Updated information on the measles situation in Europe is available here
Remember:
Measles is highly infectious. Individuals without immunity to measles can be infected with measles without even knowing that they were in contact with somebody who was infectious (e.g. in a public area)
Measles can be prevented by vaccination with the MMR vaccine
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, or are unsure if they were vaccinated should contact their GP for this vaccine
Further details on measles can be found on the HPSC website
European Immunisation Week takes place on 23-30 April 2011
Immunisation is the best and most effective way, to prevent disease
650,000 people in the WHO European region are not fully immunised
Are you?
Are your children?
Click here for more information on European Immunization Week information on WHO website
Click here for links to National Immunisation Office
Click here for the latest update on immunisation statistics in Ireland in 2010
Next steps towards eliminating measles and rubella in Europe
In September 2010, WHO European Region set a new target date for eliminating measles and rubella by 2015. At a WHO/Europe consultation in December 2010, national immunisation experts agreed on the steps that will be taken to document and verify the elimination of measles and rubella, and the prevention of congenital rubella syndrome (due to infection early in pregnancy) from the Region. The participants approved a framework for the verification process that takes account of countries' experiences.
Framework for the verification process in Europe Documenting and verifying the elimination of measles and rubella and prevention of congenital rubella syndrome in the WHO European Region require several standard, interrelated components, including:
detailed information on measles and rubella epidemiology;
virologic surveillance, supported by molecular epidemiology;
an analysis of the vaccinated population;
high-quality surveillance; and
a sustainable national immunisation programme.
Establishment of national committees National committees for verification of measles and rubella elimination will be established to compile and submit this information annually to a regional commission. The national committees will continue to provide data for at least three years after the regional commission has reported the interruption of endemic measles and rubella transmission. Only then can regional elimination be declared.
World Health Day 2011 - No action today, no cure tomorrow
World Health Day is celebrated every year on April 7th to mark the founding of the World Health Organization (WHO).
Each year, WHO choses a key health issue, to promote good health and well-being.
The issue of antimicrobial resistance has been selected to mark World Health Day in 2011.
Antimicrobials are medicines used to treat infections. Antimicrobial resistance is not a new problem but is becoming more dangerous as fewer new antimicrobials are being discovered and as microorganisms (bacteria, viruses, fungi and parasites) develop new ways of becoming resistant to available medicine.
Antimicrobial resistance is facilitated by the inappropriate use of antimicrobials. For example, taking antibiotics for viral infections such as colds or flu, when they are not effective against these ailments or not completing the prescribed course of antimicrobial treatment for an infection.
Urgent and consolidated efforts are needed to avoid returning to the era before antimicrobials were available, when patients often died from common infections.
On April 7th 2011, WHO will call on everyone, including:
• Policy makers and planners • The public and patients • Healthcare professionals and prescribers • Pharmacists • The pharmaceutical industry
to think, act and to take responsibility for combating resistance to antimicrobials.
The campaign slogan is “No action today, no cure tomorrow”.
World TB Day, falling on March 24th each year, aims to increase public awareness about tuberculosis (TB) and to support worldwide TB control efforts. March 24th commemorates the day in 1882 when Dr. Robert Koch announced that he had discovered the TB bacillus which was the cause of tuberculosis. At the time of Koch's announcement in Berlin, TB was raging through Europe and the Americas, causing the death of one out of every seven people and his discovery opened the way towards diagnosing and curing TB.
The Stop TB partnership theme for World TB Day 2011 is: “On the move against Tuberculosis: Transforming the fight towards elimination” (http://www.stoptb.org/events/world_tb_day/2011/). The aim of this campaign is to promote innovation in TB research and care and is inspired by the ambitious new objectives and targets of the Global Plan to Stop TB 2011-2015: Transforming the Fight-Towards Elimination of Tuberculosis, which was launched by the Stop TB Partnership in October 2010. This new plan, for the first time, identifies all the research gaps that need to be filled to bring rapid TB tests, faster treatment regimens and a fully effective vaccine to market. It also shows public health programmes how to drive universal access to TB care, including how to modernise diagnostic laboratories and adopt revolutionary TB tests that have recently become available. Each new advance in the diagnosis, treatment and prevention of TB should be a step towards TB elimination
To mark World TB Day, the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization Regional Office for Europe are highlighting the need to address childhood TB as an important component towards TB elimination. In Europe, almost 40,000 TB cases in children were notified in the past decade with more than 3,300 reported cases. ECDC has dedicated a theme website on childhood TB. On March 18th, ECDC in collaboration with the Stop TB Partnership hosted an international meeting on childhood TB in Stockholm. The meeting sought to identify possible strategies to improve the diagnosis, treatment and prevention of childhood TB.
Ireland In 2008, (the latest validated figures) there were 468 cases of TB reported in Ireland, a notification rate of 11.0 cases per 100,000 population. This is a slight decrease in TB cases notified compared to 2007 when 480 cases were notified and the notification rate was 11.3 per 100,000. In 2009, 472 cases of TB have been provisionally reported giving a notification rate of 11.1 per 100,000.
The age-specific incidence rate for children aged 0-14 years in 2008 was 1.7 per 100,000. TB cases in this age group (0-14 year old) accounted for 3.2% of all notified TB cases in 2008. Between 2004 and 2007 the age-specific incidence rate for children aged 0-14 years ranged between 1.2 per 100,000 in 2004 to 4.7 per 100,000 in 2007. In Europe, overall TB rates in this age group dropped from 5.5 per 100,000 in 2000 to 4.2 per 100,000 in 2009.
In 2008, the notification rate for TB in the indigenous population was 7.4 per 100,000 while the rate in foreign-born persons was 33.3 per 100,000. The number of TB cases reported in Ireland has declined since the 1990s with 604 cases reported in 1992, a rate of 17.1 per 100,000. The decline has been even more considerable since the early 1950s when 7,000 cases of TB were notified annually.
The Health Protection Surveillance Centre (HPSC) has warned parents that reptiles are not appropriate pets for children under the age of five. This comes after the identification of a case of infant botulism following exposure to a turtle or turtle feed combined with the fact that a significant proportion of cases of salmonella are associated with contact with reptiles.
Dr Paul McKeown, Specialist in Public Health Medicine, of HPSC said, "Recently, there has been one case of botulism, a small baby, associated with pet turtles. On top of that, in 2008, a year when we had 449 cases of salmonellosis, fifteen of these cases had recent contact with reptiles. Very worryingly, nine of these fifteen cases were in children under one year of age. This tells us that these diseases are appearing too commonly in households that have pet reptiles and too commonly in infants and babies."
Small children are not the only group at increased risk of illness from reptiles; pregnant women, elderly or frail adults or immunosuppressed people (e.g. people with cancer, HIV/AIDS, and people with a CD4 count less than 200 should avoid all contact with reptiles.
"Given these risks", said Dr McKeown, "reptiles should not be kept as pets in a house where there are children under the age of five."
He went on to say, "For most people keeping reptiles does not pose a significant health risk, as long as proper hygiene steps are taken. These include proper handling of reptiles and disposal of waste and water, frequent handwashing following contact with reptiles and keeping your reptiles in their tank."
"Enjoy your pet reptiles but keep children under five away from them entirely and take the proper hygiene steps to make sure they don’t make any of your family ill," said Dr McKeown.
Further information on reptiles and the risk of infectious disease is available here.
Revised hand hygiene observational audit tool available for consultation
The hand hygiene observational audit tool has been revised and is now available here for consultation. Comments on or before Monday 21st March 2011.
EPIET cohort 17 Selection
In 2011 ECDC will have funding for up to 18 EPIET fellows. The details of the format of employment have been published on the ECDC website:
Deadline for applications is February 06, 2011 CET 24:00.
Conference on Preventing Infection Associated with Intravascular Catheters: March 2011
The HPSC and the Infection Prevention Society (IPS) are organising a conference on preventing infection associated with intravenous catheters on March 2nd in the Grand Hotel, Malahaide, Dublin. The conference is aimed at front line healthcare workers who insert and manage intravascular catheters. Attendance at the day is free, however pre registration is a requirement. Click here for further information.
