1887
  1. Home
  2. Eurosurveillance
  3. Volume 27, Issue 4, 27/Jan/2022
  4. Article
Surveillance Open Access
Like 0
Download

Abstract

Background

In Finland, surveillance of tularaemia relies on laboratory-confirmed case notifications to the National infectious Diseases Register (NIDR).

Aim

The aim of the study was to assess the suitability and usefulness of clinical surveillance as an addition to laboratory notification to improve tularaemia surveillance in Finland.

Methods

We retrieved NIDR tularaemia surveillance and primary healthcare data on clinically diagnosed tularaemia cases in Finland between 2013 and 2019. We compared incidences, demographic distributions and seasonal trends between the two data sources.

Results

The median annual incidence was 0.6 (range: 0.1–12.7) and 0.8 (range: 0.6–7.2) per 100,000 for NIDR notifications and primary healthcare notifications, respectively. Cases reported to NIDR were slightly older than cases reported to primary healthcare (median: 53 years vs 50 years, p = 0.04), but had similar sex distribution. Seasonal peaks differed between systems, both in magnitude and in timing. On average, primary healthcare notifications peaked 3 weeks before NIDR. However, peaks in NIDR were more pronounced, for example in 2017, monthly incidence per 100,000 of NIDR notifications peaked at 12.7 cases in September, while primary healthcare notifications peaked at 7.2 (1.8 ratio) in August.

Conclusions

Clinically diagnosed cases provide a valuable additional data source for surveillance of tularaemia in Finland. A primary healthcare-based system would allow for earlier detection of increasing incidences and thereby for early warning of outbreaks. This is crucial in order to implement targeted control and prevention measures as early as possible.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2022.27.4.2100098
2022-01-27
2024-04-25
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2022.27.4.2100098
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/27/4/eurosurv-27-4-4.html?itemId=/content/10.2807/1560-7917.ES.2022.27.4.2100098&mimeType=html&fmt=ahah

References

  1. Mörner T. The ecology of tularaemia. Rev Sci Tech. 1992;11(4):1123-30.  https://doi.org/10.20506/rst.11.4.657  PMID: 1305858 
  2. European Centre for Disease Prevention and Control (ECDC). Tularaemia factsheet. Stockholm: ECDC; 2017. Available from: https://www.ecdc.europa.eu/en/tularaemia/facts
  3. World Health Organization (WHO). WHO guidelines on tularaemia. Geneva: WHO; 2007. Available from: https://apps.who.int/iris/handle/10665/43793
  4. Dryselius R, Hjertqvist M, Mäkitalo S, Lindblom A, Lilja T, Eklöf D, et al. Large outbreak of tularaemia, central Sweden, July to September 2019. Euro Surveill. 2019;24(42):1900603.  https://doi.org/10.2807/1560-7917.ES.2019.24.42.1900603  PMID: 31640844 
  5. Rydén P, Björk R, Schäfer ML, Lundström JO, Petersén B, Lindblom A, et al. Outbreaks of tularemia in a boreal forest region depends on mosquito prevalence. J Infect Dis. 2012;205(2):297-304.  https://doi.org/10.1093/infdis/jir732  PMID: 22124130 
  6. Cross AR, Baldwin VM, Roy S, Essex-Lopresti AE, Prior JL, Harmer NJ. Zoonoses under our noses. Microbes Infect. 2019;21(1):10-9.  https://doi.org/10.1016/j.micinf.2018.06.001  PMID: 29913297 
  7. Rossow H, Ollgren J, Hytönen J, Rissanen H, Huitu O, Henttonen H, et al. Incidence and seroprevalence of tularaemia in Finland, 1995 to 2013: regional epidemics with cyclic pattern. Euro Surveill. 2015;20(33):21209.  https://doi.org/10.2807/1560-7917.ES2015.20.33.21209  PMID: 26314404 
  8. Rossow H, Ollgren J, Klemets P, Pietarinen I, Saikku J, Pekkanen E, et al. Risk factors for pneumonic and ulceroglandular tularaemia in Finland: a population-based case-control study. Epidemiol Infect. 2014;142(10):2207-16.  https://doi.org/10.1017/S0950268813002999  PMID: 24289963 
  9. Eliasson H, Lindbäck J, Nuorti JP, Arneborn M, Giesecke J, Tegnell A. The 2000 tularemia outbreak: a case-control study of risk factors in disease-endemic and emergent areas, Sweden. Emerg Infect Dis. 2002;8(9):956-60.  https://doi.org/10.3201/eid0809.020051  PMID: 12194773 
  10. Sajanti E, Virtanen M, Helve O, Kuusi M, Lyytikäinen O, Hytönen J, et al. Lyme borreliosis in Finland, 1995-2014. Emerg Infect Dis. 2017;23(8):1282-8.  https://doi.org/10.3201/eid2308.161273  PMID: 28726624 
  11. Duodecim Terveysportti. Tularemia (Jänisrutto). [Tularaemia]. Helsinki: Duodecim The Finnish Medical Society; 2018. Finnish. Available from: https://www.terveysportti.fi/apps/ltk/article/ykt00003/search/tularemia
  12. R Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2019. Available from: https://www.R-project.org
  13. Berger M, Shiau R, Weintraub JM. Review of syndromic surveillance: implications for waterborne disease detection. J Epidemiol Community Health. 2006;60(6):543-50.  https://doi.org/10.1136/jech.2005.038539  PMID: 16698988 
  14. Henning KJ. What is syndromic surveillance? MMWR Suppl. 2004;53:5-11. PMID: 15714620 
  15. Hope K, Durrheim DN, d’Espaignet ET, Dalton C. Syndromic surveillance: is it a useful tool for local outbreak detection? J Epidemiol Community Health. 2006;60(5):374-5.  https://doi.org/10.1136/jech.2005.035337  PMID: 16680907 
  16. Tsui F-C, Espino JU, Dato VM, Gesteland PH, Hutman J, Wagner MM. Technical description of RODS: a real-time public health surveillance system. J Am Med Inform Assoc. 2003;10(5):399-408.  https://doi.org/10.1197/jamia.M1345  PMID: 12807803 
  17. Jia P, Yang S. Early warning of epidemics: towards a national intelligent syndromic surveillance system (NISSS) in China. BMJ Glob Health. 2020;5(10):e002925.  https://doi.org/10.1136/bmjgh-2020-002925  PMID: 33106238 
  18. Stoto MA, Schonlau M, Mariano LT. Syndromic surveillance: an effective tool for detecting bioterrorism? Santa Monica: RAND Corporation; 2004. Available from: https://www.rand.org/pubs/research_briefs/RB9042.html
  19. Alabama Public Health (ADPH). Limitations of syndromic surveillance. Montgomery: ADPH; 2021. Available from: https://www.alabamapublichealth.gov/infectiousdiseases/syndromic-limitations.html
Is clinical primary care surveillance for tularaemia a useful addition to laboratory surveillance? An analysis of notification data for Finland, 2013 to 2019
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Charlotte+C+Hammer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hammer Charlotte C</a>, <a href="/search?value1=Timothee+Dub&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dub Timothee</a>, <a href="/search?value1=Oskari+Luomala&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Luomala Oskari</a>, <a href="/search?value1=Jussi+Sane&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sane Jussi</a></span>. Is clinical primary care surveillance for tularaemia a useful addition to laboratory surveillance? An analysis of notification data for Finland, 2013 to 2019. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(4):pii=2100098. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.4.2100098" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.4.2100098</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 22 Jan 2021;&nbsp;&nbsp; <span class="generated">Accepted</span>: 18 Jun 2021 </span> </p>
/content/10.2807/1560-7917.ES.2022.27.4.2100098
/content/10.2807/1560-7917.ES.2022.27.4.2100098
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error