Foodborne disease outbreaks in Australia 2001-2009

BACKGROUND: Analysis of surveillance data from foodborne disease outbreaks can help identify high-risk aetiological agents, food vehicles and settings. This information may help prevent future illness by informing the development of public health policy

Staat van infectieziekten in Nederland, 2013

In dit rapport wordt gelinked naar een bijlage: appendix150205001.De uitbraak van mazelen in 2013 was de meest in het oog springende infectieziekte van dat jaar. Dit blijkt uit de Staat van Infectieziekten in Nederland 2013, die inzicht geeft in ontwikkelingen van infectieziekten bij de Nederlandse bevolking. Daarnaast worden de ontwikkelingen in het buitenland beschreven die voor Nederland relevant zijn. Met deze jaarlijkse uitgave informeert het RIVM beleidsmakers van het ministerie van Volksgezondheid, Welzijn en Sport (VWS). Elk jaar komt in de Staat van Infectieziekten een thema aan bod; dit jaar is dat de hoeveelheid jaren in goede gezondheid die verloren gaan (ziektelast) door infectieziekten. Sommige infectieziekten, zoals maag-darminfecties, komen erg vaak voor maar veroorzaken over het algemeen geen ernstige klachten. Andere daarentegen, bijvoorbeeld tetanus, komen slechts zelden voor maar veroorzaken relatief veel sterfgevallen. Een gezondheidsmaat die deze aspecten van ziekten combineert is de Disability Adjusted Life Year (DALY). Voor 32 infectieziekten is de ziektelast in Nederland tussen 2007 en 2011 geschat. De gemiddelde jaarlijkse ziektelast voor de totale Nederlandse bevolking was het hoogst voor ernstige pneumokokkenziekte (9444 DALY's per jaar) en griep (8670 DALY's per jaar), die respectievelijk 16 en 15 procent van de totale ziektelast van alle 32 infectieziekten vertegenwoordigen. Na polio en difterie (0 gevallen in de onderzochte periode), werd de laagste ziektelast geschat voor rodehond op 0,14 DALY's per jaar. De ziektelast voor deze ziekten is zo laag dankzij het Rijksvaccinatieprogramma. De ziektelast per individu varieerde van 0,2 DALY's per honderd infecties voor giardiasis (diarree die wordt veroorzaakt door een parasiet), tot 5081 en 3581 DALY's per honderd infecties voor respectievelijk hondsdolheid en een variant van de ziekte van Creutzfeldt-Jakob. Voor alle ziektelaststudies geldt dat de resultaten afhankelijk zijn van de modelparameters en aannames, en van de beschikbaarheid van accurate gegevens over de mate waarin de ziekten voorkomen. Toch kunnen deze schattingen informatief zijn voor beleidsmakers binnen de gezondheidszorg om prioriteiten te kunnen aanbrengen in preventieve en andere maatregelen.The measles outbreak in 2013 was the most striking infectious disease of that year. This is demonstrated in the State of Infectious Diseases in the Netherlands 2013, which provides insight into infectious disease trends in the Dutch population. Developments in other countries that are relevant for the Netherlands are also described. This annual RIVM publication informs policy-makers from the Ministry of Health, Welfare and Sport (VWS). Every year the State of Infectious Diseases in the Netherlands publishes reports on a particular theme. This year's topic concerns the estimation of disease burden: how many years of health life are lost due to infectious diseases? Some infectious diseases, such as gastrointestinal infections, occur frequently in the population, but do not generally give rise to serious complaints. In contrast, other diseases, for example tetanus, occur rarely but may lead to a high risk of death. A summary measure of population health that combines the morbidity and premature mortality attributable to a disease in a single quantity is the Disability Adjusted Life Year (DALY). For 32 infectious diseases, we estimated the disease burden in the Netherlands between 2007 and2011. The highest average annual burden for the total Netherlands population was estimated for invasive pneumococcal disease (9444 DALYs per year) and influenza (8670 DALYs per year), which represent 16 and 15 percent, respectively, of the total burden of all 32 diseases considered. After poliomyelitis and diphtheria (no cases in the period investigated), the lowest burden was estimated for rubella, at 0.14 DALYs per year. The extremely low burden for these diseases is due to the National Immunization Programme. The disease burden per individual varied from 0.2 DALYs per 100 infections for giardiasis (diarrhea that is caused by a parasite), to 5081 and 3581 DALYs per 100 infections for rabies and variant Creutzfeldt-Jakob disease, respectively. As with all burden of disease studies, results depend on disease model parameters and assumptions and on the availability of accurate data on the incidence of infection. Nevertheless, estimates of disease burden can be informative for public health policy-makers regarding the prioritization of preventive and other measures.Ministerie van VW

The impact of healthcare costs in the last year of life and in all life years gained on the cost-effectiveness of cancer screening

It is under debate whether healthcare costs related to death and in life years gained (LysG) due to life saving interventions should be included in economic evaluations. We estimated the impact of including these costs on cost-effectiveness of cancer screening. We obtained health insurance, home care, nursing homes, and mortality data for 2.1 million inhabitants in the Netherlands in 1998–1999. Costs related to death were approximated by the healthcare costs in the last year of life (LastYL), by cause and age of death. Costs in LYsG were estimated by calculating the healthcare costs in any life year. We calculated the change in cost-effectiveness ratios (CERs) if unrelated healthcare costs in the LastYL or in LYsG would be included. Costs in the LastYL were on average 33% higher for persons dying from cancer than from any cause. Including costs in LysG increased the CER by €4040 in women, and by €4100 in men. Of these, €660 in women, and €890 in men, were costs in the LastYL. Including unrelated healthcare costs in the LastYL or in LYsG will change the comparative cost-effectiveness of healthcare programmes. The CERs of cancer screening programmes will clearly increase, with approximately €4000. However, because of the favourable CER's, including unrelated healthcare costs will in general have limited policy implications

Staat van infectieziekten in Nederland 2012

De uitbraken van kinkhoest en Salmonella Thompson in 2012 waren de meest in het oog springende infectieziekten van dat jaar. Dit blijkt uit de Staat van Infectieziekten in Nederland 2012, die inzicht geeft in ontwikkelingen van infectieziekten bij de Nederlandse bevolking. Daarnaast worden ook de ontwikkelingen in het buitenland beschreven die voor Nederland relevant zijn. Met deze jaarlijkse uitgave informeert het RIVM beleidsmakers van het ministerie van Volksgezondheid, Welzijn en Sport (VWS). Elk jaar komt er een thema aan bod; dit keer de ontwikkelingen in vaccins en vaccinatieprogramma's en de relevantie daarvan voor de Nederlandse volksgezondheid. De meeste vaccinaties worden gegeven vanuit nationale vaccinatieprogramma's, zoals het Rijksvaccinatieprogramma (ongeveer 2 miljoen prikken per jaar) en het Nationale Griep Preventieprogramma (ongeveer 3,5 miljoen prikken per jaar). Daarnaast wordt gevaccineerd bij onder andere reizigers, medische risicogroepen zoals mensen zonder milt en werknemers die een verhoogd risico hebben om een infectieziekte tijdens het werk op te lopen, zoals personeel in de zorg en in laboratoria. Per vaccinatieprogramma is in kaart gebracht in welke mate de ziekten voorkomen, wat het percentage gevaccineerden is en het aantal gegeven vaccins. Het percentage gevaccineerden bij reizigers, medische risicogroepen en werknemers is onbekend. Veranderingen in de maatschappij zorgen ervoor dat bepaalde groeperingen kritisch staan ten opzichte van vaccinaties. In het jaaroverzicht staat ook beschreven welke groepen afzien van vaccinatie, zoals orthodoxgereformeerden (circa 250.000 mensen) en antroposofen. Ook wordt de motivatie en houding van ouders besproken om hun kind wel of niet te laten vaccineren. Daarnaast komt de toename van het aantal ouderen en chronisch zieken aan bod. Hun gevoeligheid voor infecties maakt hen een belangrijke groep om (nieuwe) vaccinaties te overwegen.In 2012, outbreaks of pertussis and Salmonella Thompson were the most important events concerning infectious diseases in the Netherlands. These outbreaks are described in the State of Infectious Diseases in the Netherlands in 2012. The purpose of this annual report is to provide insight into developments and trends of infectious diseases in the Dutch population. In addition, developments in other countries that are relevant for the Netherlands, are described. The annual report is compiled for policymakers at the Ministry of Health, Welfare and Sport (VWS). Each year, one particular topic is highlighted. This time the focus is on developments in vaccines and vaccination programmes and their relevance for the Dutch public health. Many vaccines are given through countrywide vaccination programmes, such as the National Immunization Programme (approximately 2 million vaccinations each year) and the National Influenza Prevention Programme (approximately 3,5 million vaccination each year). In addition, vaccinations are given to travellers, medical risk groups, such as people without a spleen, and employees who have an increased risk for an infectious disease through their vocation, such as health care and laboratory personnel. The epidemiology, the mortality and morbidity, and vaccine coverage are described per vaccination programme. Vaccine coverage in travellers, employees and medical risk groups is largely unknown. Changes in society ensure that certain groups are critical to vaccinations. In this report we describe groups who refuse vaccination, such as members of Reformed Congregations and people with an anthroposophical lifestyle. Also, the attitude and motivation of parents to have their child vaccinated or not is discussed. Finally, we describe the increase in the number of elderly and chronically ill people. Their susceptibility to infections makes them an important group to consider (new) vaccinations.Ministerie van VW

Ziekenhuisuitbraken en resistente micro-organismen

OBJECTIVE: To determine the number and duration of nosocomial outbreaks caused by highly resistant microorganisms (HRMO) posing a potential threat to public health, in order to undertake a risk assessment. DESIGN: Descriptive study. METHOD: Data on nosocomial outbreaks were collected from April 2012 to June 2014. The following characteristics were recorded at the start and end of each outbreak: type of microorganism, reason for reporting, phase of outbreak, number of patients colonised and infected, and infection prevention measures implemented. RESULTS: 47 medical institutions reported 87 outbreaks (mean: 3 outbreaks per month). 20 outbreaks were reported in 2012 (2.2/month), 39 in 2013 (3.3/month), and 28 in the first six months of 2014 (4.7/month). Outbreaks of vancomycin-resistant enterococci (n = 26), methicillin-resistant Staphylococcus aureus (MRSA; n = 23) and resistant or highly resistant Enterobacteriaceae (n = 17) were reported most frequently. 65 outbreaks (75%) were controlled within two months of reporting. CONCLUSION: Transparent reporting of HRMO outbreaks is important for correct public perceptions of the safety of hospitals and nursing homes in the Netherlands. Reports to the Hospital-acquired Infection and Antimicrobial Resistance Monitoring Group show that HRMO outbreaks are an almost daily occurrence in Dutch hospitals. However, most outbreaks are quickly controlled without posing a threat to public health