Communicable disease threats report, 17-23 November 2013, week 47

Surveillance report
Publication series: Communicable Disease Threats Report (CDTR)
Time period covered: 17-23 November 2013

​The ECDC communicable disease threats report is a weekly bulletin intended for epidemiologists and health professionals in the area of communicable disease prevention and control. Summarising information gathered by ECDC through its epidemic intelligence activities regarding communicable disease threats of concern to the European Union, it also provides updates on the global situation and changes in the epidemiology of communicable diseases with potential to affect Europe, including diseases that are the focus of eradication efforts.

Executive summary

​From 17 to 22 November 2013, ECDC monitored several ongoing public health threats within and outside the European Union.


On 16 November 2013, the Greek Centres for Disease Control and Prevention (KEELPNO) reported three autochthonous cases of Plasmodium vivax malaria in the country. Two cases were reported from the municipality of Alexandroupolis (Regional Unit Evros) and one case from Sofades (Regional Unit Karditsa).

In Greece, locally acquired cases of malaria have been occurring since 2009, with the highest number reported in 2011 when 42 autochthonous Plasmodium vivax cases were notified affecting five different Regional Units. Following implementation of public health measures, such as systematic proactive and reactive case detection, strengthening of the surveillance system and improving the diagnosis capacity of malaria, a substantial decrease of locally acquired cases was observed in 2012.Mainly persons residing and/or working in the affected areas in Greece are currently at risk for malaria infection. The risk for travellers is considered to be low since all affected areas are agricultural rather than areas attracting tourists. The use of standard mosquito biting prevention measures is recommended. As the malaria transmission season is coming to an end, the risk of infection will decrease even further.


During the first seven weeks of the current influenza season, there was no evidence of sustained influenza activity in Europe.

Middle East respiratory syndrome Coronavirus (MERS-CoV)

As of 21 November 2013, 160 laboratory-confirmed cases of MERS-CoV have been reported by local health authorities worldwide, including 69 deaths. Saudi Arabia has reported 130 symptomatic and asymptomatic cases including 55 deaths; Jordan two fatal cases; United Arab Emirates six cases, including two deaths; Qatar seven cases, including three deaths; Oman one fatal case and Kuwait two cases.  he previously reported infection of a patient in Spain has not yet been confirmed by laboratory testing and is now considered a probable case. Spain reported another probable case. Both patients have recovered in the meantime.
The continued detection of MERS-CoV cases in the Middle East indicates that there is an ongoing source of infection present in the region. The risk of secondary transmission in the EU remains low.