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

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

Miksi kryptosporidioositapaukset lisääntyvät Suomessa?

English summaryPeer reviewe

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

Destination specific risks of acquisition of notifiable food- and waterborne infections or sexually transmitted infections among Finnish international travellers, 1995-2015

Background: Overnight international travels made by Finns more than doubled during 1995-2015. To estimate risks and observe trends of travel-related notifiable sexually transmitted and food- and water-borne infections (STIs and FWIs) among travellers, we analysed national reports of gonorrhoea, syphilis, hepatitis A, shigellosis, campylobacteriosis and salmonellosis cases and related them to travel statistics. Method: Cases notified as travel-related to the Finnish infectious diseases register were used as numerators and overnight stays of Statistics Finland surveys as denominator. We calculated overall risks (per 100,000 travellers) and assessed trends (using regression model) in various geographic regions. Results: Of all travel-related cases during 1995-2015, 2304 were STIs and 70,929 FWIs. During 2012-2015, Asia-Oceania showed highest risk estimates for gonorrhoea (11.0; 95%CI, 9.5-13), syphilis (1.4; 0.93-2.1), salmonellosis (157; 151-164), and campylobacteriosis (135; 129-141), and Africa for hepatitis A (4.5; 2.5-7.9), and shigellosis (35; 28-43). When evaluating at country level, the highest risks of infections was found in Thailand, except for hepatitis A ranking Hungary the first. During 2000-2011, significantly decreasing trends occurred for most FWIs particularly in the European regions and for STIs in Russia-Baltics. Conclusions: Our findings can be used in targeting pre-travel advice, which should also cover those visiting Thailand or European hepatitis A risk areas.Peer reviewe