Increase in ECHOvirus 6 infections associated with neurological symptoms in the Netherlands, June to August 2016

The Dutch virus-typing network VIRO-TypeNed reported an increase in ECHOvirus 6 (E-6) infections with neurological symptoms in the Netherlands between June and August 2016. Of the 31 cases detected from January through August 2016, 15 presented with neurological symptoms. Ten of 15 neurological cases were detected in the same province and the identified viruses were genetically related. This report is to alert medical and public health professionals of the circulation of E-6 associated with neurological symptoms

Norovirus outbreak in a natural playground: A One Health approach

Norovirus constitutes the most frequently identified infectious cause of disease outbreaks associated with untreated recreational water. When investigating outbreaks related to surface water, a One Health approach is insightful. Historically, there has been a focus on potential contamination of recreational water by bird droppings and a recent publication demonstrating human noroviruses in bird faeces suggested this should be investigated in future water-related norovirus outbreaks. Here, we describe a One Health approach investigating a norovirus outbreak in a natural playground. On social media, a large amount of waterfowl were reported to defecate near these playground premises leading to speculations about their potential involvement. Surface water, as well as human and bird faecal specimens, was tested for human noroviruses. Norovirus was found to be the most likely cause of the outbreak but there was no evidence for transmission via waterfowl. Cases had become known on social media prior to notification to the public health service underscoring the potential of online media as an early warning system. In view of known risk factors, advice was given for future outbreak investigations and natural playgroun

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

Use of PCR for detection of faecal HAV as a screening tool in an outbreak of hepatitis A in daycare centres.

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Risico’s op infecties door zwemmen in open water

Zwemmen in open water brengt risico’s met zich mee. De infectierisico’s zijn onderzocht bij een aantal zwemevenementen in binnenstedelijke wateren. Hieruit bleek dat deelnemers aan zwemevenementen in grachtenwater een verhoogd risico hadden op gastro-enteritis. Bepaalde omstandigheden, zoals hevige regenval voorafgaand aan het evenement, verhoogden dit risico. Naast gastro-enteritis kunnen ook andere klachten of ziektebeelden ontstaan na zwemmen in open water, zoals zwemmersjeuk en leptospirose. De meest voorkomende klachten na zwemmen in open water zijn mild en kortdurend van aard, hoewel ook een gering risico op het ontstaan van ernstige infecties bestaat. Bij georganiseerde zwemevenementen kunnen maatregelen worden genomen om de risico’s op ernstige complicaties zo klein mogelijk te houden. Het is van belang dat zwemmers geïnformeerd zijn over de risico’s. Kwetsbare groepen, zoals immuungecompromitteerden en zwangere vrouwen, kunnen worden geadviseerd niet deel te nemen. Tot slot is het belangrijk dat artsen weten wat de gevolgen kunnen zijn van zwemmen in open water

Risico’s op infecties door zwemmen in open water

Zwemmen in open water brengt risico’s met zich mee. De infectierisico’s zijn onderzocht bij een aantal zwemevenementen in binnenstedelijke wateren. Hieruit bleek dat deelnemers aan zwemevenementen in grachtenwater een verhoogd risico hadden op gastro-enteritis. Bepaalde omstandigheden, zoals hevige regenval voorafgaand aan het evenement, verhoogden dit risico. Naast gastro-enteritis kunnen ook andere klachten of ziektebeelden ontstaan na zwemmen in open water, zoals zwemmersjeuk en leptospirose. De meest voorkomende klachten na zwemmen in open water zijn mild en kortdurend van aard, hoewel ook een gering risico op het ontstaan van ernstige infecties bestaat. Bij georganiseerde zwemevenementen kunnen maatregelen worden genomen om de risico’s op ernstige complicaties zo klein mogelijk te houden. Het is van belang dat zwemmers geïnformeerd zijn over de risico’s. Kwetsbare groepen, zoals immuungecompromitteerden en zwangere vrouwen, kunnen worden geadviseerd niet deel te nemen. Tot slot is het belangrijk dat artsen weten wat de gevolgen kunnen zijn van zwemmen in open water

[Pre-exposure prophylaxis for the prevention of sexual HIV transmission; new preventative strategy using tenofovir/emtricitabine]

Item does not contain fulltextThe Netherlands has approximately 20,000 registered HIV-infected patients. The current HIV prevention policy consisting of condom use and active HIV testing does not effectively mitigate the HIV epidemic in all risk groups. In July of 2012, tenofovir/emtricitabine (TDF/FTC) was approved by the American Food and Drug Administration (FDA) for pre-exposure prophylaxis (PrEP) for long-term use in persons who exhibit frequent risky and unsafe sexual behaviour. With once-daily use and good therapy compliance, TDF/FTC has proved to be effective as PrEP, and few side effects are reported. Drawbacks in the use of TDF/FTC as PrEP are the potential risk of viral resistance and reduced condom use, the relatively high cost and the intensive counselling required. In special cases, long-term PrEP could enhance the current Dutch preventive policy. Further research is needed into the practical feasibility and protective efficacy of the ad hoc use of TDF/FTC as PrEP before a high-risk contact occurs

Mumps vaccine effectiveness in primary schools and households, the Netherlands, 2008

Item does not contain fulltextTo estimate the mumps vaccine effectiveness (VE) during a large genotype D mumps outbreak, we conducted a cross-sectional study in eight primary schools and associated households in the Netherlands. Questionnaires were used to collect information on the occurrence of mumps. Multivariate analyses were used to estimate VE. Among schoolchildren we estimated the VE against mumps. Among household contacts where the schoolchild was the index case we estimated the VE against mumps and against mumps infectiousness. In total 1175 children and 2281 household contacts participated in the study. The mumps attack rate among schoolchildren was 17%. The mumps VE in schoolchildren was 92% [95% confidence interval (CI) 83-96%] and 93% [85-97%] for one and two doses of the measles, mumps, rubella (MMR) vaccine, respectively. The adjusted mumps VE among household contacts was 67% [65-95%] and 11% [-4 to 88%] against mumps and mumps infectiousness, respectively. Our study indicates that the mumps component of the MMR vaccine offered adequate protection against mumps among schoolchildren. The relatively low VE among household contacts is of concern