Epidemiology of laboratory-confirmed influenza among kidney transplant recipients compared to the general population-A nationwide cohort study

Seasonal influenza causes morbidity and mortality after organ transplantation. We quantified the detection of laboratory-confirmed influenza among kidney transplant recipients compared to the general population in a nationwide cohort. All laboratory-confirmed cases of influenza and hospitalizations due to influenza among all kidney transplant recipients in our country between 1995 and 2017 were captured with database linkage from statutory national registries. Data from the general population of Finland, population 5.5 million, were used for comparisons. Annual incidences of influenza and hospitalizations due to influenza, and standardized incidence ratios (SIR) were calculated. Altogether 3904 kidney transplant recipients with a total follow-up of 37 175 patient-years were included. Incidence of laboratory-confirmed influenza was 9.0 per 1000 patient years in 2003-2019, and 18.0 per 1000 patient years during 2015-2019. The risk of laboratory-confirmed influenza was significantly higher among kidney transplant recipients compared to the general population (SIR 5.1, 95% CI 4.5-5.7). SIR for hospitalization due to influenza was 4.4 (95% CI 3.4-4.7). Mortality of the hospitalized patients was 9%, and 5% of the patients with laboratory-confirmed influenza. Detection of laboratory-confirmed influenza is increased fivefold and risk of hospitalization due to influenza more than fourfold among kidney transplant recipients compared to the general population.Peer reviewe

Elintarvike- ja talous­ve­si­vä­lit­teiset epidemiat

•Elin­tar­vike- ja talous­ve­si­vä­lit­teiset epi­demiat saat­tavat ai­heuttaa tu­hansien ih­misten sairas­tu­misen Suo­messa vuo­sittain. •Jos tie­tyllä alueella tiet­tynä ai­kana ha­vaitaan taval­lista enemmän saman­kal­taisia tauti­ta­pauksia, elin­tar­vike- ja talous­ve­si­vä­lit­tei­sissä epi­de­mioissa yleensä suolis­toin­fek­tioita, ky­se voi ol­la epi­de­miasta. •Sel­vi­tystyö on tär­keää käyn­nistää he­ti, kun epäily epi­de­miasta syn­tyy. Epi­de­mia­sel­vi­tyksen tu­lee ol­la su­juvaa yhteis­työtä eri vira­no­maisten vä­lillä. •Epäil­lystä elin­tar­vike- tai talous­ve­si­vä­lit­tei­sestä epi­de­miasta tu­lee il­moittaa kun­nan elin­tar­vi­ke­val­von­nasta vastaa­valle vira­no­mai­selle. •Ter­veyden ja hyvin­voinnin lai­toksen verkko­si­vuille on koot­tu oh­jeita elin­tar­vike- ja talous­ve­si­vä­lit­teisten epi­de­mioiden selvit­tä­mistä var­ten.Ohjeet elintarvike- ja vesivälitteisten epidemioiden selvittämiseen THL:n verkkopalvelussa</a

Severe Outbreak of Sorbitol-Fermenting Escherichia coli O157 via Unpasteurized Milk and Farm Visits, Finland 2012

Shiga toxin-producing, sorbitol-fermenting Escherichia coli O157 (SF O157) has emerged as a cause of severe human illness. Despite frequent human findings, its transmission routes and reservoirs remain largely unknown. Foodborne transmission and reservoir in cattle have been suspected, but with limited supporting evidence. This study describes the outbreak of SF O157 that occurred in Finland in 2012. The outbreak originated from a recreational farm selling unpasteurized milk, as revealed by epidemiologic and microbiological investigations, and involved six hospitalized children and two asymptomatic adults with culture-confirmed infection. An identical strain of SF O157 was isolated from patients, cattle and the farm environment, and epidemiologic analysis suggested unpasteurized milk as the vehicle of transmission. This study reports the first milkborne outbreak of SF O157, provides supporting evidence of cattle as a reservoir and highlights the health risks related to the consumption of unpasteurized milk

Tuberculosis in Kidney Transplant Recipients : A Nationwide Cohort in a Low Tuberculosis Incidence Country

Background. World Health Organization recommends tuberculosis (TB) preventive treatment for risk groups such as patients preparing for organ transplantation. Pretransplant screening or treatment of latent TB infection has not been routine practice in Finland. Methods. In this nationwide registry study, we assessed the risk of TB among kidney transplant recipients compared to the general population. TB cases were identified by data linkage of the national infectious disease and the national transplant registries between 1995 and 2019. Standardized incidence ratios were calculated with adjustment for age, sex, and annual TB dynamics. Results. A total of 4101 kidney transplants in 3900 recipients with a follow-up of 37 652 patient-years were included. Eighteen TB cases were detected. Patients diagnosed with TB were older (median age 64 y, interquartile range 56-66) at transplantation than those without TB (median 51 y, interquartile range 41-60, P < 0.001). The standardized incidence ratio of TB was 6.9 among kidney transplant recipients compared to general population during the whole study period 1995-2019 but decreased from 12.5 in 1995-2007 to 3.2 in 2008-2019. The standardized incidence ratio was 44.2 during the first year after transplantation. Significant differences in 5-y graft losses were not detected between TB patients and those without TB. Conclusions. The standardized incidence ratio of TB in kidney transplant recipients has decreased over the years, but these patients remain at risk of TB, especially during the first posttransplant year. Cost-benefit analysis is required to address feasibility of latent TB infection screening among transplant candidates in countries with low incidence of TB.Peer reviewe

Miksi kryptosporidioositapaukset lisääntyvät Suomessa?

English summaryPeer reviewe