Communicable disease threats report, 23-29 March 2014, week 13

Publication series: Communicable Disease Threats Report (CDTR)
Time period covered: 23 - 29 March 2014

​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

includes updates on measles, influenza, chikungunya and ebola.

​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. This issue covers the period 23 to 28 March 2014 and includes updates on:

Measles - outbreak on a cruise ship in the Mediterranean, European monitoring

The measles outbreak on a cruise ship sailing in the north-western Mediterranean has been associated with new cases: 37 cases have been reported by Italy (36) and Austria (1) as of 27 March 2014. Twenty one cases are among crew members, seven among passengers and nine are contacts of passengers. A UK resident who was infected while visiting the Emergency Department in Sardinia alongside a previously measles patient has been reported as suspected case. More than 800 crew members have been vaccinated in response to the outbreak. The epidemiological investigations are on-going. Measles has a long incubation period of up to 21 days, and cases are contagious on average four days prior to and after the rash. Additional infections among contacts of disembarked passengers cannot be ruled out at this point.

The outbreak in the Netherlands, which affected regions with low vaccine uptake due to religious beliefs, was declared over at the end of February 2014. Several local media now report a new outbreak in The Hague region. Other EU Member States with current outbreaks include Spain, Denmark, the Czech Republic and Austria.


The influenza activity is declining across Europe with only a few countries reporting medium intensity level, wide geographical spread or an increasing trend. Of the 29 countries providing clinical data, only Estonia, Greece and Romania reported medium intensity while all other countries reported low intensity. Influenza is still circulating with a higher proportion of influenza subtype A(H3) than A(H1)pdm09. The rate for influenza-positive tested specimens is declining.

 Chikungunya in the Caribbean

During the past week, the number of new cases of chikungunya increased in most of the affected areas but at a lower rate than in the previous weeks in the French Antilles. In Martinique and Guadeloupe, new municipalities were affected. A media report (ProMED) quoting the Minister of Health reports a large suspected outbreak of chikungunya in the Dominican Republic. Specimens have been sent to CDC Atlanta for confirmation. This is the first documented outbreak of chikungunya with local transmission in the Americas.

 Ebola outbreak, Guinea

Since February 2014, an outbreak of Ebola haemorrhagic fever has been on-going in Guinea. The outbreak started in the eastern part of the country and has now reached the capital Conakry. As of 27 March 2014, 103 suspected and laboratory confirmed cases including 66 deaths (case fatality rate: 64%) have been reported from Guékédou, Macenta and Kissidougou districts in south east Guinea. Four healthcare workers are among the victims. This is the first time an Ebola outbreak is reported in Guinea.
Multidisciplinary teams have been deployed to the field to actively search and manage cases, trace and follow-up contacts, and to sensitise communities on the outbreak prevention and control. Investigations on reported cases in Liberia and Sierra Leone along the border with Guinea are on-going. So far, no confirmed cases have been reported from outside Guinea.