Diagnostic issues and capabilities in 48 isolation facilities in 16 European countries: data from EuroNHID surveys

Background: Highly infectious diseases (HIDs) are defined as being transmissible from person to person, causing life-threatening illnesses and presenting a serious public health hazard. The sampling, handling and transport of specimens from patients with HIDs present specific bio-safety concerns. Findings The European Network for HID project aimed to record, in a cross-sectional study, the infection control capabilities of referral centers for HIDs across Europe and assesses the level of achievement to previously published guidelines. In this paper, we report the current diagnostic capabilities and bio-safety measures applied to diagnostic procedures in these referral centers. Overall, 48 isolation facilities in 16 European countries were evaluated. Although 81% of these referral centers are located near a biosafety level 3 laboratory, 11% and 31% of them still performed their microbiological and routine diagnostic analyses, respectively, without bio-safety measures. Conclusions: The discrepancies among the referral centers surveyed between the level of practices and the European Network of Infectious Diseases (EUNID) recommendations have multiple reasons of which the interest of the individuals in charge and the investment they put in preparedness to emerging outbreaks. Despite the fact that the less prepared centers can improve by just updating their practice and policies any support to help them to achieve an acceptable level of biosecurity is welcome

Antiviral Agents for Influenza: Molecular Targets, Concerns of Resistance, and New Treatment Options

As resistance of influenza viruses to antiviral agents continues to evolve, new issues arise concerning appropriate therapy and novel therapeutic means that target influenza infections. Emergence of novel influenza mutations may lead to phenotypic as well as clinical resistance that may become a problem in serious influenza cases. Moreover, crucial public health issues emerge such as appropriate antiviral stockpiling for prepandemic and pandemic phases. The use of antiviral agents against seasonal, avian, and pandemic influenza should be an integral part of current pandemic preparedness planning and should be based on local and international surveillance data on antiviral resistance. As we tackle such resistance issues there appears to be an urgent need for developing strategies to conserve current antivirals against influenza, develop new agents or formulations that will exploit current pharmacokinetic knowledge, and study combination regimens

Crimean-Congo hemorrhagic fever in Greece: a public health perspective

In June 2008 the first non-imported fatal case of Crimean-Congo hemorrhagic fever (CCHF) was recorded in northern Greece. We present herein the public health interventions and the case definitions we developed for the epidemiological investigation. The possibility of CCHF establishing endemicity in this area is discussed. (C) 2008 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved

Crimean-Congo hemorrhagic fever in Greece: a public health perspective

SummaryIn June 2008 the first non-imported fatal case of Crimean-Congo hemorrhagic fever (CCHF) was recorded in northern Greece. We present herein the public health interventions and the case definitions we developed for the epidemiological investigation. The possibility of CCHF establishing endemicity in this area is discussed

Consecutive Serratia marcescens multiclone outbreaks in a neonatal intensive care unit

Background: This report describes 3 consecutive outbreaks caused by genetically unrelated Serratia marcescens clones that occurred in a neonatal intensive care unit (NICU) over a 35-month period. Methods: Carriage testing in neonates and health care workers and environmental investigation were performed. An unmatched case-control study was conducted to identify risk factors for S marcescens isolation. Results: During the 35-month period, there were 57 neonates with S marcescens isolation in the NICU, including 37 carriers and 20 infected neonates. The prevalence rate of S marcescens isolation was 12.3% in outbreak 1, 47.4% in outbreak 2, and 42% in outbreak 3. Nine of the 20 infected neonates died (45% case fatality rate). A total of 10 pulsed field gel electrophoresis types were introduced in the NICU in various times; 4 of these types accounted for the 9 fatal cases. During outbreak 3, a type VIII S marcescens strain, the prevalent clinical clone during this period, was detected in the milk kitchen sink drain. Multiple logistic regression revealed that the only statistically significant factor for S marcencens isolation was the administration of total parenteral nutrition. Conclusions: Total parenteral nutrition solution might constitute a possible route for the introduction of microorganisms in the NICU. Gaps in infection control should be identified and strict measures implemented to ensure patient safety. Copyright (C) 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

Post-cataract surgery endophthalmitis outbreak caused by multidrug-resistant Pseudomonas aeruginosa

In June 2010, a severe outbreak of 13 cases of post-cataract surgery endophthalmitis caused by multidrug-resistant Pseudomonas aeruginosa occurred. Pulse-field gel electrophoresis in eye isolates found 95% genetic similarity; however, extensive environmental and carriage investigation revealed no source of infection. Copyright (C) 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

Diagnostic issues and capabilities in 48 isolation facilities in 16 European countries: data from EuroNHID surveys

Abstract Background Highly infectious diseases (HIDs) are defined as being transmissible from person to person, causing life-threatening illnesses and presenting a serious public health hazard. The sampling, handling and transport of specimens from patients with HIDs present specific bio-safety concerns. Findings The European Network for HID project aimed to record, in a cross-sectional study, the infection control capabilities of referral centers for HIDs across Europe and assesses the level of achievement to previously published guidelines. In this paper, we report the current diagnostic capabilities and bio-safety measures applied to diagnostic procedures in these referral centers. Overall, 48 isolation facilities in 16 European countries were evaluated. Although 81% of these referral centers are located near a biosafety level 3 laboratory, 11% and 31% of them still performed their microbiological and routine diagnostic analyses, respectively, without bio-safety measures. Conclusions The discrepancies among the referral centers surveyed between the level of practices and the European Network of Infectious Diseases (EUNID) recommendations have multiple reasons of which the interest of the individuals in charge and the investment they put in preparedness to emerging outbreaks. Despite the fact that the less prepared centers can improve by just updating their practice and policies any support to help them to achieve an acceptable level of biosecurity is welcome.</p