Rapid Outbreak Assessment: Update: Outbreak of hepatitis A virus infection in Italy and Ireland
Since publishing the ’Joint ECDC-EFSA rapid outbreak assessment: Outbreak of hepatitis A virus infection in residents and travellers to Italy’ in May, new information has emerged as a result of the epidemiological, microbiological and environmental investigations. Therefore, ECDC has updated its previous assessment.
The ongoing outbreak of Hepatitis A virus (HAV) infection that has affected travellers to Italy from Germany, the Netherlands and Poland, as well as local residents in Italy, may now be affecting Ireland.
Three cases of HAV have been reported in Ireland, although none of the three has any travel history to Italy. Nor have they had any contact with other HAV cases. Isolates of the virus from the three Irish cases reveal an identical sequence to that found in the Italian outbreak.
Onset of illness in the Irish cases was April 2013. Additional case finding activity is currently underway. Exposure of cases in both Italy and Ireland suggests that the same contaminated vehicle of infection has been available in at least these two countries. In Italy, mixed frozen berries have been indicated as the most likely vehicle of infection by epidemiological, microbiological and environmental investigations. In late May, an Italian distributor withdrew mixed frozen berries from the market following identification of a package contaminated with virus identical to the outbreak strain.
The most recent cases in the ongoing HAV infection outbreak have been reported by Italy. The onset of symptoms in these cases was recorded in June 2013. Due to the long shelf life of frozen berries and to the average length of approximately one month for incubation of HAV, more cases are expected to be reported.
While there is evidence pointing towards mixed frozen berries as the vehicle of infection, the specific berry type has not yet been identified. The point of contamination remains unknown at this time and as a result it is not yet possible to exclude the occurrence of associated cases in other EU Member States.
Rapid risk assessment: Zika virus disease in Var department, France
16 Oct 2019 - On 1 October 2019, a case of locally acquired Zika virus (ZIKV) disease in France (Hyères city, Var department) was laboratory confirmed. To date, and based on ECDC’s epidemiological assessment, the probability of ongoing vector-borne local transmission in Hyères (and surrounding areas) is considered very low because current evidence does not indicate the existence of a more extensive cluster of ZIKV cases.
Rapid risk assessment: Autochthonous cases of dengue in Spain and France
1 Oct 2019 - Three autochthonous cases of dengue have been reported in France and Spain. The probability of further local sustained transmission remains very low, both in Spain and in France. Environmental conditions will become progressively less suitable for transmission over the autumn season.
Carbapenem resistant Enterobacteriaceae - second update
27 Sep 2019 - Carbapenem resistance in Enterobacteriaceae such as Klebsiella pneumoniae and Escherichia coli poses a significant threat to patients and healthcare systems in all European Union/European Economic Area (EU/EEA) countries. Carbapenem-resistant Enterobacteriaceae (CRE) infections are associated with high mortality, primarily due to delays in administration of effective treatment and the limited availability of treatment options. Hypervirulent carbapenem-resistant K. pneumoniae strains have been reported presenting an additional threat with a potential for global dissemination. The spread of high risk clones and plasmids carrying carbapenemases in healthcare settings is a major cause of the spread of CRE in EU/EEA countries. Recent events of cross-border importation after patient transfer and large regional outbreaks as well as the worsening epidemiologic situation of carbapenemase-producing CRE in the EU/EEA highlight the high risk for further spread of CRE and the need for enhanced control efforts. Options for control are outlined in the respective section below.