Middle East respiratory syndrome coronavirus (MERS-CoV) infections in two returning travellers in the Netherlands, May 2014

Two patients, returning to the Netherlands from pilgrimage in Medina and Mecca, Kingdom of Saudi Arabia, were diagnosed with Middle East respiratory syndrome coronavirus (MERS-CoV) infection in May 2014. The source and mode of transmission have not yet been determined. Hospital-acquired infection and community-acquired infection are both possible

Middle east respiratory syndrome coronavirus (MERS-CoV) infections in two returning travellers in the Netherlands, May 2014

Two patients, returning to the Netherlands from pilgrimage in Medina and Mecca, Kingdom of Saudi Arabia, were diagnosed with Middle East respiratory syndrome coronavirus (MERS-CoV) infection in May 2014. The source and mode of transmission have not yet been determined. Hospital-acquired infection and community-acquired infection are both possible

Follow-up of contacts of middle east respiratory syndrome coronavirus–infected returning travelers, the Netherlands, 2014

Notification of 2 imported cases of infection with Middle East respiratory syndrome coronavirus in the Netherlands triggered comprehensive monitoring of contacts. Observed low rates of virus transmission and the psychological effect of contact monitoring indicate that thoughtful assessment of close contacts is prudent and must be guided by clinical and epidemiologic risk factors

Appropriate Governance Responses to Infectious Disease Threats: Developing Working Hypotheses

Infectious diseases remain a threat to public health in today's interconnected world. There is an ongoing debate on how responses to threats of infectious diseases can best be coordinated, and the field remains nascent in understanding which specific structural governance arrangement will perform best. The present paper contributes to this discussion by demonstrating that it is possible to develop working hypotheses specifying the relationship between the type of infectious disease crisis and type of response to the crisis. For type of crises and type of response mechanisms there is still a lack of research, but the hypothesis combining these two provide a perspective for a future research and action agenda. It certainly prevents us from choosing between schism or hypes when it comes to crisis response. It provides instruments to realize that no single type of response is the most effective and that not all responses are equally effective in a concrete case

Risk governance for infectious diseases : Exploring the feasibility and added value of the IRGC-framework for Dutch infectious disease control

The quality of the Dutch system for control of infectious diseases is considered to be high. However, sometimes (e.g. during the Mexican flu and HPV vaccination in 2009, during the Q-fever outbreak from 2008 to 2011) the system encounters problems in terms of perceived effectiveness and public acceptance. This raises the question: Are other governance arrangements available that could contribute to a higher effectiveness and acceptance of infectious disease control? If so, how feasible are these arrangements in the light of the high time pressure in the case of an emergent outbreak of infectious diseases? In this paper, we explore the feasibility and added value of the International Risk Governance Council (IRGC)-framework. This framework aims to improve risk governance by tailoring the risk governance approach to the specific characteristics of the risk (the IRGC distinguishes between simple, complex, uncertain and ambiguous risks). Two recent infectious disease episodes - Q-fever and Schmallenberg virus (SBV) - were analysed. The actual risk governance approach was compared with a hypothesized situation, in which the IRGC-framework would have been applied. Data were collected by means of a review of literature, policy documents, newspaper articles and interviews with risk assessors and risk managers. This exploratory study revealed that Dutch infectious disease control incorporates many elements of the IRGC-Approach, although some of these elements are used in an intuitive rather than in an explicit manner. Few elements are lacking. Incorporation of these elements (e.g. concern assessment) would have been both feasible and useful during the Q-fever epidemic (ambiguous risk), but not during the SBV outbreak (uncertain risk). We expect that primarily in cases of ambiguous infectious disease risks an explicit risk characterization and the further incorporation of concern assessment could strengthen Dutch infectious disease control. To assess whether a risk is (becoming) ambiguous remains a challenge to be operationalized