http://www.eurosurveillance.org/ Eurosurveillance: peer-reviewed european information on communicable disease surveillance and control eng Copyright: http://www.eurosurveillance.org http://blogs.law.harvard.edu/tech/rss/ Eurosurveillance news RSS generator visit: http://www.eurosurveillance.org visit: http://www.eurosurveillance.org http://www.eurosurveillance.org/images/header_logo.png http://www.eurosurveillance.org/ 1 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20455 Thu, 18 Apr 2013 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20455 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20435 Thu, 21 Mar 2013 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20435 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20430 Thu, 21 Mar 2013 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20430 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20431 Thu, 21 Mar 2013 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20431 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20436 Thu, 21 Mar 2013 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20436 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20434 Thu, 21 Mar 2013 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20434 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20432 Thu, 21 Mar 2013 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20432 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20433 Thu, 21 Mar 2013 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20433 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20428 Thu, 21 Mar 2013 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20428 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20367 Thu, 17 Jan 2013 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20367 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20354 Thu, 10 Jan 2013 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20354 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20278 Thu, 20 Sep 2012 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20278 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20122 Thu, 22 Mar 2012 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20122 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20124 Thu, 22 Mar 2012 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20124 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19984 Thu, 06 Oct 2011 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19984 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19967 Thu, 15 Sep 2011 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19967 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19846 Thu, 21 Apr 2011 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19846 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19830 Thu, 31 Mar 2011 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19830 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19827 Thu, 24 Mar 2011 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19827 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19822 Thu, 24 Mar 2011 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19822 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19825 Thu, 24 Mar 2011 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19825 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19824 Thu, 24 Mar 2011 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19824 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19826 Thu, 24 Mar 2011 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19826 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19823 Thu, 24 Mar 2011 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19823 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19795 Thu, 17 Feb 2011 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19795 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19614 Thu, 15 Jul 2010 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19614 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19519 Since 2008, the European Centre for Disease Prevention and Control has been collecting data from the European Union (EU) and European Economic Area (EEA) on resistance to first- and second-line drugs against tuberculosis (TB). In 2008, the proportion of multidrug-resistant tuberculosis (MDR TB) was 6.0% of the total case load for 25 countries reporting data. Extensively drug-resistant (XDR TB) reporting has increased since 2007 and was observed in 7.3% of the MDR TB cases in 13 reporting countries. MDR TB remains a threat and XDR TB is now established within the EU/EEA borders. Thu, 18 Mar 2010 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19519 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19518 This paper describes the results of second-line drug (SLD) susceptibility tests among multidrug-resistant tuberculosis (MDR TB) cases reported in 20 European countries aiming to identify extensively drug-resistant tuberculosis (XDR TB) cases. A project on molecular surveillance of MDR TB cases was conducted by EuroTB and the National Institute for Public Health and the Environment (RIVM) from 2005 to 2007. Information on drug susceptibility testing (DST) was provided to this project and case-based data on MDR TB cases were reported on a quarterly basis by 20 countries of the World Health Organization's European Region, including 15 European Union Member States. Data included SLD susceptibility test results, enabling a retrospective description of XDR TB cases notified between 2003 and 2007 .In 18 countries DST was performed for two or more of the SLD included in the XDR TB definition. The proportion of MDR TB isolates tested for SLD varied widely between countries (range 20 to 100 percent). In the 18 countries, 149 (10%) XDR TB cases were reported among MDR TB cases with available DST results for SLD. Sixteen additional MDR TB cases were reported by the MDR TB surveillance system when compared with the number of routinely reported MDR TB cases to EuroTB in ten countries with representative data reported during three consecutive years (2003-2005). To counter the threat of XDR TB in Europe, a standardised approach to XDR TB surveillance and DST for SLD is needed, as well as increased laboratory capacity across European countries. Thu, 18 Mar 2010 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19518 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19514 An analysis of surveillance data was performed to assess treatment outcomes of patients belonging to selected calendar year cohorts. Twenty-two countries in the European Union (EU) and European Economic Area (EEA) reported treatment outcome monitoring data for culture-confirmed pulmonary tuberculosis (TB) cases reported in 2007. The overall treatment success rate was 73.8% for all culture-confirmed pulmonary cases and 79.5% for new culture-confirmed pulmonary cases. For the cohort of new culture-confirmed TB cases, only three countries achieved the target of 85% success rate. This underachievement appears to be a result of relative high defaulting and unknown outcome information. Case fatality remains high particularly among cases of national origin. This factor appears attributable to advanced age of the national cohort. Treatment outcomes for multidrug-resistant tuberculosis were reported by 15 countries, with a range of 19.8% to 100% treatment success at 24 months. The data underline the urgent need for strengthening treatment outcome monitoring in the EU and EEA in order to ensure an effective programme implementation and case management that will ultimately contribute to TB elimination. Thu, 18 Mar 2010 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19514 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19510 To quantify the risk of developing tuberculosis (TB) following school contact with a student with smear positive respiratory TB in a population with a high background rate of tuberculosis, a retrospective cohort study was conducted. This study included all students and staff (n=1,065) at an inner city secondary school in Birmingham, United Kingdom (UK). Being in the same school year as the index case resulted in a significantly higher risk of being diagnosed with active TB (odds ratio (OR) 6.11) and either active or latent TB (OR 10.52) compared to the risk for pupils in other school years. Neither lower level classroom exposure in tutoring groups nor being a staff member resulted in significantly increased risk of infection. The number of cases detected in the school was significantly higher than compared with the TB notification rate for the respective age groups in the population in the area. This study is consistent with the small body of evidence that already exists suggesting that greater levels of classroom contact with a student with smear positive active TB significantly increases the risk of contracting active and latent TB. It also suggests that staff may be at a lower risk of active TB than students. It does not appear that being in an area with high TB incidence substantially alters the epidemiology of the outbreak or risk of transmission between students in comparison to other populations. Thu, 18 Mar 2010 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19510 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19373 The evaluation of diagnostic accuracy of new in vitro diagnostic assays for tuberculosis infection has been hampered by the lack of a standard reference test. The aim of this study was to compare sensitivity and specificity of interferon gamma assays for latent tuberculosis infection by assessing the association of test results with tuberculosis occupational exposure and by using latent class analysis. We analysed data from 115 healthcare workers on whom tuberculin skin test (TST) and the following in vitro tests were performed: in-house ELISPOT for RD1 proteins, T.SPOT-TB and Quantiferon-TB Gold. Results of all tests were associated with increased occupational risk of exposure to Mycobacterium tuberculosis, but only TST was associated with Bacillus Calmette-Guérin (BCG) vaccination. Sensitivity/specificity (95% confidence intervals) estimated by a latent class model were: 99.9%/64.2% (53.0-74.1) for TST, 95.3% (61.8-99.6)/87.5% (78.0-93.2) for in-house ELISPOT, 96.7% (69.3-99.7)/85.6%(75.3-92.0) for T.SPOT-TB, and 76.3% (55.9-89.1)/93.6% (85.4-97.3) for Quantiferon. The estimated specificity of in vitro assays was higher than that of TST also among individuals who were not BCG-vaccinated. In conclusion, when used in healthcare workers, in vitro assays may provide a significant increase of specificity for tuberculosis infection compared to TST, even among non vaccinated individuals, at the cost of some sensitivity. Thu, 29 Oct 2009 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19373 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19326 Tuberculosis (TB) transmission in a non-household setting is difficult to detect, because contact with the source case is often not obvious. Here, we report on a case of a four-year-old child who got infected through sporadic non-household exposure at a coffee shop. The source case was a woman who had suffered from weight loss, productive cough and fatigue for two months before being diagnosed with TB. Screening the child's contacts revealed two active TB cases within its family. Overall 148 contacts were screened for both cases and 18 cases of latent TB infection detected. The connection between the child and the source case, who were not aware of their contact, was confirmed by molecular fingerprinting. Our case report illustrates the difficulty in detecting non-household transmission between individuals that do not have significant contact, and draws attention to the need to look for the infected adult whenever a child falls ill with TB. This report is a reminder of the importance to consider possibly neglected ways of TB transmission and highlights once again the need of early diagnosis of TB. Thu, 10 Sep 2009 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19326 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19173 Thu, 16 Apr 2009 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19173 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19150 World TB day on 24 March commemorates this event and is an opportunity for a critical appraisal of the TB situation, for raising awareness and for joining forces in order to control the disease. Thu, 19 Mar 2009 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19150 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19151 Since 1 January 2008, the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization Regional Office for Europe (WHO/Europe) jointly coordinate the tuberculosis (TB) surveillance activities in Europe. The data collected provides an opportunity for a comprehensive analysis of the TB situation. We aimed at analysing the EU and EEA/EFTA data to identify general TB trends and to provoke some discussion regarding the challenges and needs for monitoring the epidemic. Thu, 19 Mar 2009 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19151 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19149 Overall numbers of multidrug-resistant (MDR) tuberculosis (TB) rose sharply in the United Kingdom and Scotland in 2007. Risk factors associated with MDR TB in the United Kingdom have been identified but there has been no previous report on risk factors associated with MDR TB in Scotland. Enhanced Surveillance of Mycobacterial Infections (ESMI) data were used to examine demographic and clinical characteristics and treatment outcome of MDR TB cases notified in Scotland between 2000-7. There was a total of 11 culture-positive cases of MDR TB, five of which were notified in 2007. The majority of patients were female, 15-44 years old and unemployed. All were born outside the United Kingdom and most had arrived within the past year from or frequently travelled to their home countries in China, the Indian subcontinent or Africa. Except for one individual, our patients did not self report a history of previous diagnosis of TB which was previously identified as a risk factor for MDR TB in the United Kingdom. Only three patients received directly observed treatment (DOT). Only two patients had completed treatment at 12 months, partially due to the inadequate length of follow-up under the current ESMI system. Our results suggest that most patients had primary resistance due to transmission of MDR TB in high incidence countries and thus point to the importance of international efforts to control MDR TB in these countries. In Scotland, national efforts should be made to increase the number of MDR TB patients receiving DOT and to extend follow-up to improve monitoring of treatment outcome. It is important to identify high risk groups for MDR TB infection in order to deliver effective community-based disease control measures. Thu, 19 Mar 2009 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19149 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19152 In order to estimate the reliability of the officially reported national tuberculosis (TB) incidence rates we performed a retrospective review of data collected in regional and national public health framework. TB notifications for the period 2000-2003 were obtained from two major hospitals and three relevant Public Health Departments (PHDs) in the region of West Greece, and subsequently compared with the data reported to the Hellenic Centre for Diseases Control (KEELPNO). During the four-year study period a total of 161 cases of TB were reported to the PHDs in West Greece; 70% of these cases were reported to the KEELPNO. Furthermore only 72 (38.7%) out of the 186 cases of TB identified in the two hospitals were notified to the PHDs. Assuming that the degree of undernotification observed for the two hospitals is the same throughout the region, we estimated that the case detection rate was 14 cases per 100,000 persons per year, i.e. 3.7 times higher than the rate officially reported for the period 2000-2003. Male predominance (2.1, male/female ratio) and an increased incidence in the elders (older than 60 years) and adolescents (10-14 years old) were also evident. The study demonstrated a substantial underestimation of TB burden in West Greece. In the face of the massive influx of immigrants and refugees coming from regions with high TB incidence and the increase of the number of drug-resistant cases a reliable and complete notification of TB is crucial in the planning of programs and development of appropriate control policies. Thu, 19 Mar 2009 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19152 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19153 A literature review was performed to assess the effectiveness of tuberculosis (TB) contact tracing among migrants and the foreign-born population with emphasis on the European Union. Thu, 19 Mar 2009 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19153 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19069 In this report, we describe the investigation and management of an outbreak of TB associated with a mosque in Scotland, and consider the implications of large-scale TB contact tracing. The screening of casual contacts in this setting was complex and time-consuming with a low detection rate. Thu, 18 Dec 2008 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19069 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19061 The second workshop of the project "Impact of migration on HIV and TB Epidemiology in the Mediterranean Area" was intended to provide an overview on the ethical and legal issues related to health in migrant populations, contributing to the Euro-Mediterranean dialogue on the situation of migrants. Thu, 11 Dec 2008 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19061 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19004 Genotyping enables to confirm or exclude a tuberculosis (TB) cluster. Excluding the link between cases is particularly important in countries with intermediate/high incidence of TB where the emergence of several TB cases in a particular location in space or time (higher than the expected) could be explained by chance alone. Thu, 16 Oct 2008 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19004 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18940 We report on the first documented extensively drug-resistant tuberculosis (XDR-TB) case in Austria, diagnosed this year. Thu, 31 Jul 2008 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18940 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18898 The WHO has published the third edition of its guidelines "Tuberculosis and air travel: Guidelines for prevention and control". It is intended that implementing the recommendations will help to reduce the international spread of TB and decrease the risk of infection among individual travellers. Thu, 05 Jun 2008 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18898 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18896 The potential spread of tuberculosis (TB) from infectious passengers during air travel has recently received increasing attention in the media and from public health authorities. We reviewed all air travel-related tuberculosis incidents reported to the Health Protection Agency Centre for Infections between January 2007 and February 2008 in England and Wales and investigated the effectiveness of contact investigation. Thu, 05 Jun 2008 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18896 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3325 Contact tracing of air travellers exposed to cases of multi-drug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) has become an increasingly important issue. Thu, 06 Dec 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3325 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3268 On 11 July 2007, the French Minister of Health launched the National Tuberculosis Control Program and a new policy on Bacille Calmette-Guérin (BCG) vaccination. Thu, 13 Sep 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3268 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=734 This report describes the measures taken in response to a TB case in a British prison. Following diagnosis, the "stone in the pond" method was used to identify potential contacts. Sat, 01 Sep 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=734 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3242 Interferon gamma release assays (IGRA) offer an alternative to tuberculin skin testing (TST or Mantoux) for the diagnosis of tuberculosis (TB) latent infection (LTBI) or as an additional diagnostic method for active TB. Thu, 26 Jul 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3242 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3231 An increasing proportion of tuberculosis (TB) cases today are resistant to first line, and often also to second line anti-TB drugs. Drug-resistant strains of Mycobacterium tuberculosis are now responsible for over 400,000 cases of TB per year. Thu, 05 Jul 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3231 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3224 Several tuberculosis outbreaks in schools have been reported in the last decade, usually following transmission from an infectious staff member. Thu, 28 Jun 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3224 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3205 A case of extensively drug-resistant tuberculosis (XDR-TB) in a United States citizen travelling in Europe was notified to the EU Early Warning and Response System (EWRS) on 25 May by the Italian authorities. Thu, 31 May 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3205 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3194 Extensively Drug Resistant Tuberculosis (XDR-TB) is a very serious form of TB against which our treatment weapons have lost the majority of, if not all, their power Thu, 17 May 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3194 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3191 Transnational cooperation is often essential when dealing with infectious diseases, and one challenge facing European Union Member States is finding ways to collaborate with partners outside the EU. An example of one Member State doing just this is the Koch-Metschnikow-Forum (KMF). Thu, 10 May 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3191 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=713 Strains of the Beijing genotype family of Mycobacterium tuberculosis have been associated with outbreaks and multidrug resistance. We performed a retrospective thirteen-year surveillance study (1993 - 2005) on the occurrence of this strain in Elche, Spain. Tue, 01 May 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=713 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3159 Tuberculosis (TB) is a matter of concern for all countries in the World Health Organization European Region, although the epidemiological situation of the disease varies widely between countries. To mark World TB Day on 24 March 2007, the European Centre for Disease Prevention and Control (ECDC) will hold a scientific seminar at the European Parliament on 22 March (http://www.ecdc.eu.int/tbseminar) to increase awareness and share views and knowledge about the importance of TB control in Europe. Data from a newly published report from EuroTB (a collaborating centre of WHO for the surveillance of TB) on cases of the disease notified during 2005 will be presented. Thu, 22 Mar 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3159 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3160 The Stop TB Partnership for Europe was launched on 10 October 2006 at a meeting of 25 leading European organisations held in Geneva. It is a regional-level entity established under the umbrella of the Global Partnership to Stop TB and aims to accelerate progress on tuberculosis control by promoting implementation of the Global Plan to Stop TB 2006-2015 in the European region. Thu, 22 Mar 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3160 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3161 In September 2005, four notified tuberculosis (TB) cases were linked to a specific pub in a small seaside town in North Somerset, England. The pub had since closed and, following the convening of a multi-agency outbreak control team, a press release was made to raise awareness and prompt contacts to come forward for screening. During the following year, three further cases were linked to this outbreak. Thu, 22 Mar 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3161 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3162 There is an ongoing mumps outbreak in Bulgaria, with a total of 997 cases notified between 1 January and 18 March 2007. This number includes laboratory-confirmed and probable epidemiologically-linked clinical cases in line with the EU case definition and case classification that have been adopted for mumps surveillance purposes in Bulgaria since 2005. Thu, 22 Mar 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3162 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=676 We investigated the treatments given and the outcome in a national cohort of culture-verified pulmonary tuberculosis cases in Finland. Our aim was to find out how adequate TB treatment was, and the outcome of treatment. Medical records of all culture-verified pulmonary tuberculosis cases in 1995 - 1996 were abstracted to assess treatment and outcome, using the European recommendations for outcome monitoring. Mon, 01 Jan 2007 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=676 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3070 Following the urgent call for a response to the extensively drug resistant tuberculosis (XDR-TB) outbreak in Kwazulu-Natal Fri, 03 Nov 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3070 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=661 During the summer of 2005, four cases of active tuberculosis from the same occupational setting were investigated in Manchester, UK. The index case had been diagnosed in December of the previous year. At that stage the closest occupational contacts had been screened, all of whom were assessed as being free from active disease, and none had met nationally recommended criteria for chemoprophylaxis for latent tuberculosis infection (LTBI). In June 2005, two work contacts developed progressive primary extrapulmonary (pleural) TB. Following a detailed risk assessment, the screening programme was widened to include 137 staff who worked at the job centre (employment agency) where the first four cases had been found. This screening programme was based on tuberculin Mantoux testing, CXR and gamma-interferon testing. Of these 137 contacts screened, one additional person was found to have active disease and six others were offered chemoprophylaxis for LTBI. The isolates from the index case and the first two secondary cases were indistinguishable on VNTR-MIRU (variable number tandem repeat - mycobacterial interspersed repetitive unit) typing at 15 loci. No samples were available for testing from the fourth case of active disease. Management of this incident has benefited from the evolving fields of both genotyping and diagnostic testing for LTBI. However, further research into the epidemiological inferences made through genotyping, as well as the significance of a positive gamma-interferon test in assessing the risk of development of active disease, is still required. Wed, 01 Nov 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=661 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3056 An outbreak of a strain of extensive drug-resistant tuberculosis (XDR-TB) was reported recently Thu, 28 Sep 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3056 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3042 On 10 February 2004, the specialist respiratory nurse for a hospital in a city in South Wales alerted the local health authorities that Mycobacterium tuberculosis infections Thu, 07 Sep 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3042 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3016 The first reports of tuberculosis (TB) transmission linked to air travel in the early 1990s came at a time when TB Thu, 03 Aug 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3016 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2928 In 2004, 414 163 tuberculosis cases were notified by 51 of the 52 countries of the World Health Organization European Region, representing 8% of notifications to WHO worldwide in the same year. Seventy per cent of all TB cases in the region were in the 12 countries of the Former Soviet Union Thu, 23 Mar 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2928 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=603 BCG (Bacillus Calmette-Guerin) vaccine was developed from an attenuated strain of Mycobacterium bovis at the beginning of the twentieth century. Its widespread use as a vaccine against tuberculosis spread in Europe, and subsequently globally, over the next 50 years. It remains one of the most frequently administered vaccines in the world. It has also been one of the most controversial. Widely differing estimates of the effectiveness of BCG at protecting against different forms of tuberculosis in different population subgroups in different settings have been published [1]. Some countries, with a low incidence of tuberculosis, did not adopt the use of BCG vaccine at all and some others abandoned its use at a later stage. In addition, great variation developed in national programmes for the administration of BCG including the age(s) at which it should be given, whether or not its administration should be preceded by tuberculin sensitivity testing, and whether repeat vaccinations with BCG should be given. Wed, 01 Mar 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=603 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=604 In 2005, all 25 EU countries, as well as Andorra, Bulgaria, Norway, Romania and Switzerland, participated in a survey on BCG vaccination in children. BCG was recommended nationally for children under 12 months in 12 countries, in older children in five countries and in children at risk (from origin, contact or travel) in 10 countries. Seven countries did not use BCG systematically. Revaccination was practised in four countries. In countries with universal vaccination, BCG coverage was high (83.0% to 99.8%). TB cases commonly occurred in vaccinated children (at least 30%-98% in five countries using universal or high-risk approach). Disseminated infection due to BCG was rarely reported in recent years (0-1/100 000 vaccinated). There is a wide variation among BCG recommendations in Europe, and nearly half the countries surveyed were considering revisions, at a time when the European Centre for Disease Prevention and Control (ECDC) is advocating for harmonised vaccine strategies. Data on monitoring of BCG coverage in target groups is important but often lacking in Europe. Information on BCG status and eligibility should be collected routinely through TB case notification. The incidence of severe adverse effects of BCG in children should be monitored. Given lack of evidence to its efficacy, revaccination should be discontinued. Wed, 01 Mar 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=604 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=606 In 1975 the BCG vaccination policy in Sweden changed from routine vaccination of all newborn infants to selective vaccination of groups at higher risk. This report aims to evaluate the present BCG policy, with focus on the tuberculosis situation in Sweden during the period from 1989 to 2005. The population structure in Sweden has changed, with increasing numbers and proportions of people who were born outside Sweden, especially in countries with high prevalence of tuberculosis. BCG vaccination coverage fell from more than 95% before 1975 to less than 2% in 1976 to 1980, and then again increased to around 16 % (corresponding to about 88% of the risk group recommended for vaccination). The increasing proportion of foreign born tuberculosis patients among all tuberculosis cases of illness in Sweden, and the high age-specific incidence of tuberculosis in the childbearing age groups in the foreign-born population, indicate the need to continue selective vaccination of children in families originating from countries with high tuberculosis incidence. The cumulative incidence of tuberculosis in the 30 cohorts born in Sweden after 1974 and observed to the end of 2004 was estimated at 0.5 cases per 100 000 person-years. Sweden still has one of the lowest incidences of tuberculosis in the world, which means a minimal average risk of infection for the majority of children born to Swedish parents. The observed increase of tuberculosis in 2005, partly attributed to an outbreak at a day nursery, is a reminder of the serious consequences of delayed diagnosis. Intensified active case finding is the most important action to prevent childhood tuberculosis, by means of eliminating the sources of infection to prevent transmission to the child population. Early detection and treatment of infected children is necessary to prevent development of serious disseminated tuberculosis. Wed, 01 Mar 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=606 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=607 In Finland, all newborns are currently offered BCG vaccination, and the national coverage is over 98%. The annual incidence of tuberculosis is low, at 6.6/100 000 in 2004 and has been steadily declining in recent years. Finland differs from the other Nordic countries in that the majority of cases are detected in people aged 65 and over in the indigenous population, and only a smaller proportion (12%) detected in immigrants. The high incidence of TB and MDR TB in neighbouring countries has raised concern, but no increase in TB detected in Finnish-born citizens has been seen. A decision has been made to change from mass BCG vaccination to targeting risk groups. Wed, 01 Mar 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=607 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=608 We discuss tuberculosis treatment outcome monitoring and the adherence of countries in the WHO European Region to modifications introduced in 2001 to enhance inter-country comparability. Outcomes for definite pulmonary tuberculosis cases were compared for cases reported in 2001 and 2000. Reporting was considered complete if 98% or more of cases originally notified had outcome reported. In both years, maximal period of observation was 12 months from start of treatment. In 2000, countries reported outcome as 'cured', 'completed', 'died', 'failed', 'defaulted', 'transferred' and 'other, not evaluated' for cohorts of new and retreated cases. In 2001, following changes, countries were also requested to monitor cases with unknown treatment history and two outcome categories were added - 'still on treatment' and 'unknown'. Of 42 countries reporting outcomes in 2001, 74% (31) had nationwide, complete data, up from 50% (19/38) in 2000. Twelve of 21 countries that reported on observation period complied with that recommended. 'Defaulted' and 'transferred' were applied interchangeably with 'unknown'. Among new cases, 'still on treatment' was used by 15/31 countries (range: 1%-15%). 'Failed' was rarely recorded in western European countries (<1%). European tuberculosis outcome monitoring should include all definite pulmonary cases, applying the standard period of observation and revised categories, and preferably reported using individual data. Wed, 01 Mar 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=608 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=609 As in other countries with low tuberculosis incidence, tuberculosis in England and Wales tends to be concentrated in some subgroups of the population, and is mainly a problem in large cities. In 2003, almost half of all tuberculosis cases reported in England and Wales were from London, where the incidence was almost five times higher than in the rest of England and Wales. While the highest proportion of cases occur in foreign born patients, evidence from a large outbreak of drug resistant tuberculosis points to ongoing active transmission among marginalised groups including homeless people, hard drug users, and prisoners. Increasing rates of disease and levels of drug resistance, combined with a concentration of disease in hard-to-reach risk groups now present a major challenge to tuberculosis control in the city. To respond to the changing epidemiology observed in recent years, treatment and control services are being reconfigured, surveillance has been improved with the implementation of the London TB register, and the utility of mobile digital x ray screening for at risk populations such as homeless people and prisoners is being evaluated. However, tuberculosis in London is not yet under control and more needs to be done. Services must adapt to the needs of those groups now most affected. This will require continued improvements to surveillance and monitoring, combined with improved access to care, better case detection, rapid diagnosis and active social support for people undergoing treatment. Wed, 01 Mar 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=609 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=610 From 1991 until the end of 1998, the number of patients with tuberculosis in Latvia increased 2.5 times with a simultaneous increase of drug resistant and multidrug resistant tuberculosis (MDR-TB). Descriptive analysis of different TB programme services, activities and strategies including Directly Observed Therapy Short-course (DOTS) for tuberculosis and treatment of MDR-TB, were performed. Data from the state tuberculosis registry, drug resistance surveillance, and the national MDR-TB database were used. The state-funded national tuberculosis control programme (NTAP, Nacionâlâ Tuberkulozes Apkarodanas Programma), based on WHO recommended DOTS strategy, was introduced in Latvia in 1996. The NTAP includes TB control in prisons. Treatment of MDR-TB using second line drugs was started in 1997. Cure rates for TB patients increased from 59.5% in 1996 to 77.5% in 2003. Between 1996 and 2003, more than 200 patients began MDR-TB treatment each year, and the cure rate was between 66% and 73%. Numbers of MDR-TB patients were reduced by more than half during this period. Treatment results including MDR-TB reached the WHO target, with cure rates 85% of newly diagnosed patients. These results demonstrate that MDR-TB treatment and management using the individualised treatment approach can be effectively provided within the overall TB programme on a national scale, to successfully treat a large number of MDR-TB patients. Rapid diagnostic methods combined with early intensified case finding, isolation and infection control measures could decrease transmission of TB and MDR-TB in hospitals and in the community. Highly important that MDR-TB management follows WHO recommendations in order to stop creating drug resistance to first and to second line drugs. Wed, 01 Mar 2006 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=610 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2823 A female assistant at a nursery in a wealthy suburb of Stockholm was diagnosed with smear positive advanced pulmonary tuberculosis in August 2005. Thu, 27 Oct 2005 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2823 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=546 Little is known about the sensitivity of surveillance for tuberculosis after integration of formerly dedicated tuberculosis surveillance and control into the general health care system, an integration which took place in Finland in 1987. We compared routine laboratory notifications to the National Infectious Disease Register (NIDR) for Mycobacterium tuberculosis from January 1, 1995, to December 31, 1996, with data collected independently from all laboratories offering M. tuberculosis culture, and with data from patient records. 1059 culture-positive cases were found. The overall sensitivity of the NIDR was 93 % (984/1059). The positive predictive value of a culture-positive case in the NIDR to be a true culture-confirmed case was 99%. For the culture-confirmed cases in the NIDR, one or more physician notification forms had been submitted for 89%. A highly sensitive notification system for culture-positive tuberculosis can be achieved in an integrated national infectious disease surveillance system based on laboratory notification. Wed, 01 Jun 2005 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=546 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=547 The tuberculosis (TB) situation in the Russian penitentiary system has received much attention. We performed a descriptive epidemiological study of TB in two St Petersburg remand prisons (SIZOs). The medical databases of the TB divisions in these prisons were searched for all diagnosed cases of TB from 1 January 2000 to 31 December 2002. The main diagnostic method was chest x ray. The total number of reported TB cases in these two remand prisons during this three-year period was 876. Out of these, 432 were diagnosed at entry to prison, and 444 developed the disease during incarceration, with the proportion diagnosed during incarceration increasing over time. The majority of cases were aged under 30 years. TB incidence in Russian remand prisons is still very high and needs to be monitored closely. Wed, 01 Jun 2005 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=547 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2701 On 15 April 2005, a female assistant at a private school in a wealthy area of Barcelona province was diagnosed with pulmonary tuberculosis at the emergency department of a hospital. Thu, 12 May 2005 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2701 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2668 Tuberculosis (TB) is still a major global disease threat. Each year, there are over 8 million estimated cases and over 2 million deaths. In the World Health Organization European Region in 2003, 416 085 TB cases were reported. Thu, 24 Mar 2005 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2668 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2648 Between 31 January and 4 February 2005, over 21 000 people in the city of Zeist in the Netherlands were tested for latent tuberculosis infection or active tuberculosis after possible exposure via a supermarket employee. Thu, 24 Feb 2005 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2648 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2581 In 2002 in Germany, 7684 tuberculosis cases which fulfilled the reference definition were notified to the Robert Koch-Institut in Berlin. This was the first time an increase in annual reported cases had been observed since 1992 Thu, 04 Nov 2004 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2581 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2532 Results of a recently published study into the protective efficacy of the Bacille Calmette-Guérin (BCG) vaccine over time suggest that protection against tuberculosis may persist for several decades Thu, 19 Aug 2004 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2532 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2520 Approaches to screening immigrants to European countries for tuberculosis vary widely. Some countries have no specific policy, and some have comprehensive policies Thu, 05 Aug 2004 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2520 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2498 On June 2004, CDSC Wales received reports of two cases of smear and sputum culture positive pulmonary TB Thu, 01 Jul 2004 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2498 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2457 The Friedland immigration centre in Niedersachsen (Lower Saxony) is the central primary immigration centre for Aussiedler. The term Aussiedler refers to ethnic Germans who live as ethnic minorities in the former Soviet Union Thu, 29 Apr 2004 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2457 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2418 Tuberculosis (TB) remains a leading cause of illness in the world and the second most common cause of death from infectious disease Thu, 18 Mar 2004 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2418 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2419 The prevalence of multidrug resistant TB is exceptionally high in all the former countries of the Soviet Union surveyed by the World Health Organization Thu, 18 Mar 2004 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2419 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2420 The first large outbreak of multidrug resistant tuberculosis (MDR TB) in the Netherlands has been reported Thu, 18 Mar 2004 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2420 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2309 Two hundred and fifty six cases of tuberculosis were reported in Norway in 2002 Thu, 16 Oct 2003 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2309 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2197 To mark world TB day, 24 March 2003, the World Health Organization (WHO) has published the seventh annual report on global tuberculosis (TB) control. This report aims to share information from national TB control programmes, and includes data on case notifications and treatment outcomes. It also provides analysis of plans, finances and constraints on DOTS (directly observed treatment-short course) expansion for the 22 high burden countries in order to assess progress toward global targets for case detection (70%) and treatment success (85%). Thu, 03 Apr 2003 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2197 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2189 The theme of World TB day 2003 - "DOTS cured me - it will cure you too!" promotes the worldwide expansion of directly observed treatment-short course (DOTS), a multi pronged TB control strategy including the adoption of standardised patient management and the evaluation of treatment outcome of TB patients. Treatment outcome is a core surveillance indicator recommended to assess the implementation of DOTS. In recent years, DOTS has been adopted increasingly in European countries, especially in the East. The EuroTB annual report 2000 (in press, http://www.eurotb.org/) includes data on treatment outcome for TB cases notified in 1999 in 30 of the 51 countries of the World Health Organization (WHO) European Region. The WHO Global Tuberculosis Control report, available from 24 March 2003 at http://www.who.int/gtb/publications/globrep/index.html, contains current information on the DOTS situation in Europe and the rest of the world. Thu, 20 Mar 2003 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2189 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2180 Two major factors that will affect the pattern of infectious diseases in European countries over the coming decade are the intensifying HIV pandemic (1) and the substantial changes in migration from Sub-Saharan Africa (2). Although migrants and asylum seekers tend to have a better health profile than the rest of the population in their country of origin, their prevalence of current HIV infections and past Tuberculosis and hepatitis B infections will pose a challenge to the prevention and health care systems of host countries. Examination of the latest migration statistics illustrates the differential impact that can be expected between the various countries of the EU. Thu, 13 Mar 2003 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2180 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2153 According to Richard Feacham Executive Director of the Global Fund (http://www.globalfundatm.org), the global HIV/AIDS pandemic is already worse than the Black Death, which raged in the mid 14th Century and is the largest catastrophe in recorded human history. The HIV/AIDS pandemic is not expected to peak until around 2050 or 2060. Feacham noted that India is currently on the same trajectory as Africa, but lagging 15 years behind. At present, there is nothing in place to alter the situation in India and the scale of the Indian epidemic will be 'staggering'. Thu, 23 Jan 2003 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2153 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=396 A descriptive analysis of routine surveillance data on tuberculosis (TB) from 1995 to 1999 was performed in Austria. The federal states of Vienna and Upper Austria showed the highest yearly incidences for all five years. In general, however, a decrease of the yearly incidence was observed for all federal states except for Carinthia (where there was a small increase of 3.2 %). In the cities of Vienna, Linz, Wels, Salzburg, Klagenfurt and St-Pölten, as well as in the regions of Eastern Tyrol, Southern Carinthia, and Southern Burgenland, the incidence was above average (>19 cases/100 000 for each). The number of cases per year and per district reported by the statutory reporting system were clearly in excess of those reported by hospitals. The comparison of the two datasets, however, showed a highly significant regional correlation of age standardised morbidity rates at district level. The findings are prone to reporting bias and might not reflect the real TB situation. The responsible health authorities should therefore consider the results as a 'working hypothesis' in order to review the reporting behaviour at district level. Wed, 01 Jan 2003 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=396 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1948 The eighth Wolfheze Workshop, in the Netherlands from 7-12 June 2002, has concluded that tuberculosis (TB) control in Europe needs expanded directly observed treatment-short course (DOTS), linked HIV and TB control, and improved surveillance. The workshop consisted of three consecutive modules attended by a total of 92 delegates from 45 countries. The first Wolfheze workshop on tuberculosis control in Europe was held in 1990 as a policy platform for low tuberculosis incidence countries. It became a platform for TB control in all of Europe after the epidemiological changes observed in the former Soviet Union. Thu, 20 Jun 2002 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1948 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=423 With the exception of Israel, representative data from Western and Central Europe indicate consistently low levels of resistance to isoniazid (0-9,3%) or rifampicin (0-2,1%) and of multidrug resistance (0-2,1%) among new tuberculosis (TB) cases. Resistance is more frequent among previously treated cases, but comparisons of data should be done cautiously, as criteria for inclusion in TB notifications may vary across countries. In Western Europe, drug resistance is more frequent among cases of foreign origin, a group with high TB incidence. In 1999, cases of foreign origin accounted for over 90% of the MDR cases in the West, and for all MDR cases notified in Israel. The majority of foreign born cases notified originated from Africa or Asia. In the East, representative data from the Baltic States show that overall, 15% of TB cases notified in 1999 were MDR, among the highest proportion worldwide and indicating inadequacies in previous treatment programmes. In the other countries of the former Soviet Union, non-representative data show high levels of resistance which, along with data from the Baltic states and results of surveys, are very alarming. Sat, 01 Jun 2002 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=423 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2114 In Spain, the Red Nacional de Vigilancia Epidemiológica (National Epidemiological Surveillance Network) classifies both respiratory and meningeal tuberculosis as statutorily notifiable diseases (SND), to be reported on an individual basis in accordance with specific reporting protocols and case definitions (1). Thu, 11 Apr 2002 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2114 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2105 Originally devised in 1982 to celebrate the centenary of Robert Koch's discovery of the tubercle bacillus, World TB Day is now promoted each year on 24 March. It is intended to promote awareness, knowledge, and motivation for action against tuberculosis (TB) worldwide. Thu, 28 Mar 2002 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2105 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2096 Contact tracing is an important part of tuberculosis (TB) prevention and control in low incidence countries (1,2). It aims primarily to identify individuals with latent or active TB who have been in contact with patients with infectious TB so that appropriate preventive or curative treatment can be given. Thu, 14 Mar 2002 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2096 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2003 The latest issue of EpiNorth, the infectious disease bulletin of northern Europe, is now available online in English and Russian at www.epinorth.org. Articles in this issue include the following. Thu, 10 Jan 2002 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2003 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2071 Although tuberculosis (TB) did not constitute a major public health threat in Germany in 2000, Germany is not a low incidence countries, and enhanced measures to prevent TB are required, according to an article published in Germany's national surveillance bulletin (1). The number of notified cases of active TB in Germany fell for the fourth consecutive year, to 9064 in 2000 (1999: 9974; 1998: 10 440; 1997: 11 163), corresponding to an incidence of 11.0 cases per 100 000 population (1999: 12.2/100 000) (2). Wed, 05 Dec 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2071 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2061 In 2000, 548 cases of tuberculosis (TB) caused by the Mycobacterium tuberculosis complex were notified in Denmark, 199 (36%) in Danes and 349 (64%) in immigrants (1). This constitutes a slight increase on the 536 cases (31% in Danes and 69% in immigrants) in 1999. The overall incidence in 2000 was 10.3 per 100 000, 10.1/100 000 in 1999 and 10.0/100 000 in 1998. The incidence was 4.0/100 000 in Danes and 92.3/100 000 in immigrants in 2000 compared with 3.3/100 000 in Danes and 102.6/100 000 in immigrants in 1999. The ratio of male to female cases among Danes was 2.1. Thu, 22 Nov 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2061 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2051 The rapid spread of HIV-1 infection in Russia has serious implications for the control of tuberculosis (TB) epidemics in the country, according to the authors of a research letter published in the Lancet (1). Aggressive prevention measures must be taken quickly if a public health disaster is to be avoided. Since October 1999, the administrative district (oblast) of Orel in Russia has been the site of a project for TB control by directly observed treatment, short course (DOTS) (http://www.who.int/gtb/dots/), organised by the World Health Organization (WHO). Thu, 08 Nov 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2051 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2043 Despite the global increase in tuberculosis and the worrying rise in the number of cases resistant to the two principal antituberculosis drugs, isoniazid and rifampicin, the authors of a personal view in the current issue of the Lancet Infectious Diseases think that if action is taken now this tide can be turned (1). Thu, 25 Oct 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2043 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1723 Thu, 05 Jul 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1723 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1732 Thu, 21 Jun 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1732 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1752 Thu, 17 May 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1752 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1757 Thu, 10 May 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1757 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1760 Thu, 03 May 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1760 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1762 Thu, 26 Apr 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1762 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1777 Thu, 05 Apr 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1777 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1816 Thu, 25 Jan 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1816 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1820 Thu, 18 Jan 2001 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1820 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1475 Thu, 14 Dec 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1475 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1482 Thu, 30 Nov 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1482 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=34 In the past decade, strengthening tuberculosis (TB) surveillance has become a public health priority in Europe. In western Europe, TB case rates slowed their previous decline, but in eastern Europe dramatic increases, often with doubling of rates, were re Sun, 01 Oct 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=34 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=33 Antituberculosis drug resistance, whose extent in Europe is not well documented, is a serious threat to tuberculosis control. The aim of the recent European recommendations on antituberculosis drug resistance surveillance, issued by a working group compos Sun, 01 Oct 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=33 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1551 Thu, 10 Aug 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1551 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1573 Thu, 06 Jul 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1573 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1600 Thu, 25 May 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1600 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1628 Fri, 07 Apr 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1628 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1629 Fri, 07 Apr 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1629 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=35 In 1996 a consensus statement on the surveillance of tuberculosis in Europe, recommended the collection of data on all cases of tuberculosis at the local level. The statement, backed by the International Union Against Tuberculosis and Lung Disease, the Wo Sat, 01 Apr 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=35 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=36 Between 28% and 100% of isolates from ten countries from the EuroTB network in 1997 were reported with data on antituberculosis drug susceptibility. Drug resistance was commoner among foreign-born patients and in general among patients who had been treate Sat, 01 Apr 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=36 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=37 The network to monitor the spread of multidrug resistance tuberculosis (MDR-TB) in Spain based on genomic typing and set up in January 1998 benefits from the participation of about 90% of the laboratories of the national health system. Of the 94 MDR-TB pa Sat, 01 Apr 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=37 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=38 The first disaggregate data on tuberculosis in Ireland were collected in 1998. A total of 424 cases were notified (rate 11.7/100 000 population), of which 241 cases were culture positive and 122 were smear positive pulmonary cases. Only 35 cases were fore Sat, 01 Apr 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=38 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1642 Thu, 16 Mar 2000 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1642 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1310 Thu, 21 Oct 1999 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1310 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=83 Transmission of Mycobacterium tuberculosis from passenger to passenger aboard a long airplane flight was reported in 1996. Other cases were previously published, in particular by the Centers for Disease Control which had then suggested criteria for epidem Wed, 01 Sep 1999 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=83 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1366 Thu, 15 Jul 1999 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1366 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1367 Thu, 15 Jul 1999 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1367 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1464 Thu, 07 Jan 1999 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1464 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1113 Thu, 10 Dec 1998 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1113 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1117 Thu, 26 Nov 1998 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1117 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1120 Thu, 26 Nov 1998 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1120 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1129 Thu, 05 Nov 1998 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1129 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=122 The EuroTB programme for the surveillance of tuberculosis in Europe was set up in 1996 to collect, analyse, and disseminate data on tuberculosis cases notified in the World Health Organization (WHO) European Region. Following a feasibility study performed Sun, 01 Nov 1998 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=122 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1133 Thu, 29 Oct 1998 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1133 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1207 Thu, 11 Jun 1998 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1207 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1238 Thu, 26 Mar 1998 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1238 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=123 Spurred on by the reversal or slowing of the decline in tuberculosis incidence in many countries, the threat of the emergence of multidrug resistant strains of Mycobacterium tuberculosis, and possibly by the success of international AIDS surveillance, European collaborators have completed a pilot study (reported in this issue) of the feasibility of standardising tuberculosis surveillance. Although the case definitions used within countries differ, these differences are unlikely to account for the large variations in the incidence of tuberculosis between countries, ranging in 1995 from 3 per 100 000 in Malta to 102/100 000 in Romania. Equally large differences between countries were observed for the proportions of cases who had been born abroad. The establishment of surveillance for Europe as a whole is likely to strengthen national tuberculosis reporting systems and enable multidrug resistance and the relative effectiveness of control programmes to be monitored closely. When standardised case specific data are shared routinely more sophisticated analyses will be possible, which should enable prevention policies to be selected that will hasten the elimination of "the captain of all these men of death". Thu, 01 Jan 1998 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=123 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1031 Thu, 30 Oct 1997 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1031 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1069 Thu, 31 Jul 1997 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1069 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1070 Thu, 31 Jul 1997 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1070 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=199 Portugal built its first tuberculosis (TB) hospital in Funchal, Madeira, in 1862. In 1899, Queen Amelia proposed and sponsored a private foundation, with clinics, hospitals, sanatoriums and preventoria, where relatives and other contacts of TB patients we Fri, 01 Mar 1996 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=199 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=200 This paper summarises recommendations for uniform reporting on tuberculosis cases made by a working group set up in 1994 following a meeting on tuberculosis control in low prevalence countries. The meeting had been organised jointly by the World Health Or Mon, 01 Jan 1996 00:00:00 GMT http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=200