Eurosurveillance - Volume 18, Issue 18, 02 May 2013

Greece has been rabies-free since 1987 with no human cases since 1970. During 2012 to 2013, rabies has re-emerged in wild and domestic animals in northern Greece. By end March 2013, rabies was diagnosed in 17 animals including 14 red foxes, two shepherd dogs and one cat; 104 subsequent human exposures required post-exposure prophylaxis according to the World Health Organization criteria. Human exposures occurred within 50 km radius of a confirmed rabies case in a wild or domestic animal, and most frequently stray dogs were involved.

From 24 April to 31 July 2011, nine cases of listeriosis were registered in the cantons of Aargau, Basel-Land and Zurich, Switzerland. In six of the cases, infection with Listeria monocytogenes was laboratory confirmed, while three remained suspected cases. The suspected cases were family members of confirmed cases with identical or similar symptoms. All confirmed cases were infected with a L. monocytogenes strain belonging to serovar 1/2a: all had an indistinguishable pulsotype by pulsed-field gel electrophoresis (PFGE). The same strain was detected in samples of cooked ham that were on sale from a particular retailer. Two samples of ham tested contained 470 and 4,800 colony-forming units (CFU) L. monocytogenes per gram respectively. Data of shopper cards from two confirmed cases could be evaluated: both cases had purchased the contaminated ham. The outbreak initiated a product recall and alert actions at national and European level, through the Rapid Alert System for Food and Feed (RASFF). Following the RASFF alert, the company producing the contaminated ham was inspected by the responsible authorities. Their investigations showed that the ham was not contaminated in the production plant, but in the premises of a company to which slicing and packing was outsourced.

Two gendarmes who participated in canyoning activities on 27 June 2011 on the Caribbean island of Martinique were diagnosed with leptospirosis using quantitative real-time polymerase chain reaction (qPCR), 9 and 12 days after the event. Among the 45 participants who were contacted, 41 returned a completed questionnaire, of whom eight met the outbreak case definition. The eight cases sought medical attention and were given antibiotics within the first week after fever onset. No severe manifestations of leptospirosis were reported. In seven of the eight cases, the infection was confirmed by qPCR. Three pathogenic Leptospira species, including L. kmetyi, were identified in four of the cases. None of the evaluated risk factors were statistically associated with having developed leptospirosis. Rapid diagnostic assays, such as qPCR, are particularly appropriate in this setting - sporting events with prolonged fresh-water exposure - for early diagnosis and to help formulate public health recommendations. Participants in such events should be made specifically aware of the risk of leptospirosis, particularly during periods of heavy rainfall and flooding. .

Following a bloodstream infection in June 2011 with Ralstonia mannitolilytica in a premature infant treated with a humidifying respiratory therapy device, an investigation was initiated at the Hadassah Medical Centres in Jerusalem. The device delivers a warmed and humidified mixture of air and oxygen to patients by nasal cannula. The investigation revealed colonisation with R. mannitolilytica of two of 15 patients and contamination of components of five of six devices deployed in the premature units of the Hadassah hospitals. Ten isolates from the investigation were highly related and indistinguishable from isolates described in an outbreak in 2005 in the United States (US). Measures successful in containing the US outbreak were not included in user instructions provided to our hospitals by the distributor of the device.