Hospital infection control – 200 years after the birth of Ignaz Semmelweiss.
Editorial: Preventing sepsis in healthcare
We have now published several papers of our special issue on the screening and prevention of communicable diseases in newly arrived migrants in Europe.
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Special edition on HIV PrEP: options for affordable PrEP in national prevention programmes in Europe, economic evaluation among MSM in England, and more …
Special edition: HIV PrEP
Eurosurveillance
Since 1995, Eurosurveillance has provided the European public health community with an open-access platform to exchange relevant findings on communicable disease surveillance, prevention and control. A weekly, electronic, peer-reviewed publication, Eurosurveillance aims to provide timely facts and guidance for public health professionals and decision-makers in the field of infectious diseases to facilitate the implementation of effective prevention and control measures. Impact factor: 7.2. More...
- Research article
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Resurgence risk for measles, mumps and rubella in France in 2018 and 2020
More LessBackgroundLarge measles and mumps outbreaks recently occurred throughout Europe and the United States. Aim: Our aim was to estimate and map the risk of resurgence for measles, mumps and rubella in France. Methods: We used a multi-cohort model combining seroprevalence information, vaccine coverage and social contact data. Results: The overall outbreak risk for France in 2018 was highest for mumps, remained significant for measles despite a recent measles outbreak and was low for rubella. Outbreak risks were heterogeneous between departments, as the effective reproduction numbers for 2018 ranged from 1.08 to 3.66. The seroprevalence, and therefore the risk of measles and rubella infection, differed significantly between males and females. There was a lower seroprevalence, and therefore a higher risk, for males. Infants of less than 1 year would be seriously affected in a future outbreak of measles, mumps or rubella, but the highest overall caseload contribution would come from teenagers and young adults (10–25 years old). Conclusions: The high risk for teenagers and young adults is of concern in view of their vulnerability to more severe measles, mumps and rubella disease and complications.
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Reducing demand for antibiotic prescriptions: evidence from an online survey of the general public on the interaction between preferences, beliefs and information, United Kingdom, 2015
More LessBackground: Antimicrobial resistance (AMR), a major public health threat, is strongly associated with human antibiotic consumption. Influenza-like illnesses (ILI) account for substantial inappropriate antibiotic use; patient understanding and expectations probably play an important role. Aim: This study aimed to investigate what drives patient expectations of antibiotics for ILI and particularly whether AMR awareness, risk preferences (attitudes to taking risks with health) or time preferences (the extent to which people prioritise good health today over good health in the future) play a role. Methods: In 2015, a representative online panel survey of 2,064 adults in the United Kingdom was asked about antibiotic use and effectiveness for ILI. Explanatory variables in multivariable regression included AMR awareness, risk and time preferences and covariates. Results: The tendency not to prioritise immediate gain over later reward was independently strongly associated with greater awareness that antibiotics are inappropriate for ILI. Independently, believing antibiotics were effective for ILI and low AMR awareness significantly predicted reported antibiotic use. However, 272 (39%) of those with low AMR awareness said that the AMR information we provided would lead them to ask a doctor for antibiotics more often, significantly more than would do so less often, and in contrast to those with high AMR awareness (p < 0.0001). Conclusion: Information campaigns to reduce AMR may risk a paradoxical consequence of actually increasing public demand for antibiotics. Public antibiotic stewardship campaigns should be tested on a small scale before wider adoption.
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The potential value of crowdsourced surveillance systems in supplementing sentinel influenza networks: the case of France
More LessIntroductionParticipatory surveillance systems provide rich crowdsourced data, profiling individuals and their health status at a given time. We explored the usefulness of data from GrippeNet.fr, a participatory surveillance system, to estimate influenza-related illness incidence in France. Methods: GrippeNet.fr is an online cohort since 2012 averaging ca. 5,000 weekly participants reporting signs/symptoms suggestive of influenza. GrippeNet.fr has flexible criteria to define influenza-related illness. Different case definitions based on reported signs/symptoms and inclusions of criteria accounting for individuals’ reporting and participation were used to produce influenza-related illness incidence estimates, which were compared to those from sentinel networks. We focused on the 2012/13 and 2013/14 seasons when two sentinel networks, monitoring influenza-like-illness (ILI) and acute respiratory infections (ARI) existed in France. Results: GrippeNet.fr incidence estimates agreed well with official temporal trends, with a higher accuracy for ARI than ILI. The influenza epidemic peak was often anticipated by one week, despite irregular participation of individuals. The European Centre for Disease Prevention and Control ILI definition, commonly used by participatory surveillance in Europe, performed better in tracking ARI than ILI when applied to GrippeNet.fr data. Conclusion: Evaluation of the epidemic intensity from crowdsourced data requires epidemic and intensity threshold estimations from several consecutive seasons. The study provides a standardised analytical framework for crowdsourced surveillance showing high sensitivity in detecting influenza-related changes in the population. It contributes to improve the comparability of epidemics across seasons and with sentinel systems. In France, GrippeNet.fr may supplement the ILI sentinel network after ARI surveillance discontinuation in 2014.
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- Surveillance and outbreak report
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Uptake and impact of vaccinating primary school-age children against influenza: experiences of a live attenuated influenza vaccine programme, England, 2015/16
More LessThe 2015/16 influenza season was the third season of the introduction of an intra-nasally administered live attenuated influenza vaccine (LAIV) for children in England. All children aged 2‒6 years were offered LAIV, and in addition, a series of geographically discrete areas piloted vaccinating school-age children 7‒11 years old. Influenza A(H1N1)pdm09 was the dominant circulating strain during 2015/16 followed by influenza B. We measured influenza vaccine uptake and the overall and indirect effect of vaccinating children of primary school -age, by comparing cumulative disease incidence in targeted and non-targeted age groups in vaccine pilot and non-pilot areas in England. Uptake of 57.9% (range: 43.6–72.0) was achieved in the five pilot areas for children aged 5‒11 years. In pilot areas, cumulative emergency department respiratory attendances, influenza-confirmed hospitalisations and intensive care unit admissions were consistently lower, albeit mostly non-significantly, in targeted and non-targeted age groups compared with non-pilot areas. Effect sizes were less for adults and more severe endpoints. Vaccination of healthy primary school-age children with LAIV at moderately high levels continues to be associated with population-level reductions in influenza-related respiratory illness. Further work to evaluate the population-level impact of the programme is required.
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