Photodynamic Therapy: Esophagus

Photodynamic therapy (PDT) is a minimally invasive, organ-preserving therapeutic modality, involving three separate components - light, oxygen and a photosensitizing drug. The principles of PDT are described, and the indications for its use are reviewed. Although a widespread clinical application for PDT has not yet emerged, PDT may establish itself as an endoscopic procedure with few or no side effects in the treatment of Barrett’s esophagus (high-grade dysplasia and early carcinoma) and, in selected cases, for the treatment of early squamous cell carcinoma

Active animal health surveillance in European Union Member States: gaps and opportunities

Animal health surveillance enables the detection and control of animal diseases including zoonoses. Under the EU-FP7 project RISKSUR, a survey was conducted in 11 EU Member States and Switzerland to describe active surveillance components in 2011 managed by the public or private sector and identify gaps and opportunities. Information was collected about hazard, target population, geographical focus, legal obligation, management, surveillance design, risk-based sampling, and multi-hazard surveillance. Two countries were excluded due to incompleteness of data. Most of the 664 components targeted cattle (26·7%), pigs (17·5%) or poultry (16·0%). The most common surveillance objectives were demonstrating freedom from disease (43·8%) and case detection (26·8%). Over half of components applied risk-based sampling (57·1%), but mainly focused on a single population stratum (targeted risk-based) rather than differentiating between risk levels of different strata (stratified risk-based). About a third of components were multi-hazard (37·3%). Both risk-based sampling and multi-hazard surveillance were used more frequently in privately funded components. The study identified several gaps (e.g. lack of systematic documentation, inconsistent application of terminology) and opportunities (e.g. stratified risk-based sampling). The greater flexibility provided by the new EU Animal Health Law means that systematic evaluation of surveillance alternatives will be required to optimize cost-effectiveness

Quality and Safety Aspects of Infant Nutrition

Quality and safety aspects of infant nutrition are of key importance for child health, but oftentimes they do not get much attention by health care professionals whose interest tends to focus on functional benefits of early nutrition. Unbalanced diets and harmful food components induce particularly high risks for untoward effects in infants because of their rapid growth, high nutrient needs, and their typical dependence on only one or few foods during the first months of life. The concepts, standards and practices that relate to infant food quality and safety were discussed at a scientific workshop organized by the Child Health Foundation and the Early Nutrition Academy jointly with the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, and a summary is provided here. The participants reviewed past and current issues on quality and safety, the role of different stakeholders, and recommendations to avert future issues. It was concluded that a high level of quality and safety is currently achieved, but this is no reason for complacency. The food industry carries the primary responsibility for the safety and suitability of their products, including the quality of composition, raw materials and production processes. Introduction of new or modified products should be preceded by a thorough science based review of suitability and safety by an independent authority. Food safety events should be managed on an international basis. Global collaboration of food producers, food-safety authorities, paediatricians and scientists is needed to efficiently exchange information and to best protect public health. Copyright (C) 2012 S. Karger AG, Base

The immunology and genetics of resistance of sheep to Teladorsagia circumcincta

Teladorsagia circumcincta is one of the most economically important gastrointestinal nematode parasites of sheep in cool temperate regions, to which sheep show genetically-varying resistance to infection. This is a very common parasite and viable sheep production requires the extensive use of anthelmintic drugs. However, the emergence of drug-resistant parasites has stimulated the search for alternative control strategies to curb production losses. Lambs become infected soon after weaning and begin to control parasite burden within 8-10 weeks of continual infection. This control is an acquired characteristic mediated by the development of parasite-specific antibodies. This paper describes the immunology associated with resistance and susceptibility, focussing on differential T cell activation that regulates the production of specific effector mechanisms. It continues by summarizing the methods used to identify genes that could be exploited as molecular markers of selection for resistance. In particular it focusses on the link between understanding the molecular immunology of infection and the identification of candidate genes for selection

Reply to Mikoláš's comment on "Opinion Paper: Forest management and biodiversity" by Schulze et al. (2014)

No abstract available

Systematic review on the non-vectorial transmission of Tick-borne encephalitis virus (TBEv)

Tick-borne encephalitis (TBE) is an infection caused by the Tick-borne encephalitis virus (TBEv) and it is common in Europe. The virus is predominantly transmitted by ticks, but other non-vectorial modes of transmission are possible. This systematic review synthesises the epidemiological impact of non-vectorial modes of TBEv transmission in Europe. 41 studies were included comprising of 1308 TBE cases. Alimentary (36 studies), handling infected material (3 studies), blood-borne (1 study), solid organ transplant (1 study) were identified as potential routes of TBEv transmission; however, no evidence of vertical transmission from mother to offspring was reported (2 studies). Consumption of unpasteurised milk/milk products was the most common vehicle of transmission and significantly increased the risk of TBE by three-fold (pooled RR 3.05, 95% CI 1.53 to 6.11; 4 studies). This review also confirms handling infected material, blood-borne and solid organ transplant as potential routes of TBEv transmission. It is important to tracing back to find the vehicle of the viral infection and to promote vaccination as it remains a mainstay for the prevention of TBE

Multidisciplinary investigation of a multicountry outbreak of salmonella stanley infections associated with Turkey meat in the European Union, August 2011 to January 2013

Between August 2011 and January 2013, an outbreak of Salmonella enterica serovar Stanley (S. Stanley) infections affected 10 European Union (EU) countries, with a total of 710 cases recorded. Following an urgent inquiry in the Epidemic Intelligence Information System for food- and waterborne diseases (EPIS-FWD) on 29 June 2012, an international investigation was initiated including EU and national agencies for public health, veterinary health and food safety. Two of three local outbreak investigations undertaken by affected countries in 2012 identified turkey meat as a vehicle of infection. Furthermore, routine EU monitoring of animal sources showed that over 95% (n=298) of the 311 S. Stanley isolates reported from animal sampling in 2011 originated from the turkey food production chain. In 2004–10, none had this origin. Pulsed-field gel electrophoresis (PFGE) profile analysis of outbreak isolates and historical S. Stanley human isolates revealed that the outbreak isolates had a novel PFGE profile that emerged in Europe in 2011. An indistinguishable PFGE profile was identified in 346 of 464 human, food, feed, environmental and animal isolates from 16 EU countries: 102 of 112 non-human isolates tested were from the turkey production chain. On the basis of epidemiological and microbiological evidence, turkey meat was considered the primary source of human infection, following contamination early in the animal production chain

From data to action: a machine learning model to support tick-borne encephalitis surveillance and prevention in Europe

Background Tick borne encephalitis (TBE) is a severe zoonotic neurological infection caused by the TBE virus (member of the Flaviriridae family) and it is one of the most important tick-borne viral diseases in Europe and Asia. The infection is mostly acquired after a tick bite, but alimentary infection is also possible. Despite the availability of a vaccine, TBE incidence is increasing with the appearance of new foci of virus circulation in new endemic areas. The increase in TBE cases across Europe - from 2412 in 2012 to 3514 in 2022, has highlighted the need for predictive tools capable to identify areas where human TBE infections are likely to occur. In response, this study presents a novel spatio-temporal modelling framework that provides annual predictions of the occurrence of human TBE infections across Europe, at both regional and municipal levels. Methods We used data on confirmed and probable TBE cases provided by the European Surveillance System (TESSy, ECDC) to infer the distribution of TBE human cases at the regional (NUTS3) level during the period 2017-2022. We trained the model on data from countries with sufficient reporting, i.e., that provided the location of infection at the NUTS-3 level for at least 75% of cases notified during the selected period. To account for the natural hazard of viral circulation, we included variables related to temperature (derived from satellite images acquired by the Moderate Resolution Imaging Spectroradiometer (MODIS) and supplied by NASA with a resolution of 5.6 km), precipitation (derived from the ECMWF ERA5-Land dataset at 30 arc seconds resolution), land cover (extracted from the 2018 Corine Land Cover (CLC) data inventory (class “3.1”) with a resolution of 0.25x0.25 km) and ticks’ hosts presence (originally produced using random forest and boosted regression trees approaches). We also used indexes based on recorded intensities of human outdoor activity in forests (based on the OpenStreetMap database) and population density (obtained from WorldPop) as proxies of human exposure to tick bites. We identified the yearly probability of TBE occurrence using a spatio-temporal boosted regression tree modeling framework. Results Our results highlight a statistically significant rising trend in the probability of human TBE infections not only in north-western, but also in south-western European countries. Areas with the highest probability of human TBE infections are primarily located in central-eastern Europe, the Baltic states, and along the coastline of Nordic countries up to the Bothnian Bay. Such areas are characterised by the presence of key tick host species, forested areas, intense human recreational activity in forests, steep drops in late summer temperatures and high precipitation amounts during the driest months. The model showed good predictive performance, with a mean AUC of 0.85, sensitivity of 0.82, and specificity of 0.80 at the regional level, and a mean AUC of 0.82, sensitivity of 0.80, and specificity of 0.69 at the municipal level. Discussion With ongoing climate and land use changes, the burden of human TBE infections on European public health is likely to increase, as trends are already indicating. This underscores the need for predictive models that can help prioritize intervention efforts. Hence, the development of a modeling framework that predicts the probability of human TBE infections at the finest administrative scale based on easily accessible covariates, represents a step forward towards comprehensive TBE risk estimation in Europ