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#Update: Interim #Guidance for the #Evaluation and #Management of #Infants with Possible Congenital #Zika Virus #Infection — #USA, August 2016 (CDCgov, MMWR)

  Title : #Update: Interim #Guidance for the #Evaluation and #Management of #Infants with Possible Congenital #Zika Virus #Infection — #USA...

29 Aug 2016

#USA, #Indiana: #PublicHealth #Emergency Declared in #Clark County (DoH, 8/29/2016)


Title: #USA, #Indiana: #PublicHealth #Emergency Declared in #Clark County.

Subject: Hepatitis C & HIV outbreak in Indiana.

Source: US State of Indiana Department of Health, full page: (LINK).

Code: [     ]


Public Health Emergency Declared in Clark County (8/29/2016)

Start Date: 8/29/2016 - Start Time: 12:00 AM - End Date: 8/29/2016

INDIANAPOLIS—State Health Commissioner Jerome Adams, M.D., M.P.H., today declared a public health emergency for Clark County, allowing the county health department to establish a syringe exchange program as part of a broader effort to reduce the spread of hepatitis C and HIV.

The declaration of public health emergency will run through Aug. 28, 2017.

“As the neighbor to Scott County, which has faced an unprecedented HIV outbreak tied to injection drug use, Clark County is being proactive in addressing its hepatitis C rates,” said State Health Commissioner Jerome Adams, M.D., M.P.H.

“We appreciate the work that county leaders have put into their request to operate a syringe exchange program and applaud their comprehensive approach to addressing substance use disorder in their communities.”

Senate Enrolled Act 461 made syringe exchange programs legal in Indiana for the first time, under certain circumstances. The law lays out a set of procedural and substantive requirements that local communities must meet in order for an emergency declaration to be considered by the state health commissioner. 



Keyowords: USA; Updates; Indiana; Hepatitis C; HIV.


#HK #CHP investigates local case of #dengue fever (August 29 2016)


Title: #HK #CHP investigates local case of #dengue fever.

Subject: Dengue Fever, locally vector-borne acquired case in Hong Kong.

Source: Centre for Health Protection, Hong Kong PRC SAR, full page: (LINK).

Code: [     ]


CHP investigates local case of dengue fever

The Centre for Health Protection (CHP) of the Department of Health (DH) was yesterday (August 29) investigating a local case of dengue fever (DF), and hence again urged the public to maintain strict environmental hygiene, mosquito control and personal protective measures both locally and during travel.

"Further to the first DF case suspected to be locally acquired this year reported on August 6, we are conducting extensive investigations with the Food and Environmental Hygiene Department (FEHD) to ascertain if both cases are linked with a view to controlling the possible spread," a spokesman for the CHP said.

The female patient, aged 79 with underlying illnesses, developed skin rash about two weeks ago, followed by malaise . She attended Queen Mary Hospital (QMH) and was admitted on August 25 and discharged on August 27. She has all along been in stable condition.

Testing of her blood specimen by the CHP's Public Health Laboratory Services Branch yesterday night confirmed dengue virus infection and she was then readmitted to QMH for management.

Initial enquiries revealed that the patient lives in Shelley Street, Central and often visited the Hong Kong Zoological and Botanical Gardens. She had no recent travel history.

Her home contacts have remained asymptomatic so far and have been put under medical surveillance.

"The CHP immediately commenced epidemiological investigations and promptly informed the FEHD for vector investigation and mosquito control. Investigations and health education in vicinities where the patient frequented are proceeding," the spokesman said.

Officers of the CHP will conduct site visit and field investigations by questionnaire surveys at the patient's residence for active case finding and arranging blood tests.

Persons who have been to the vicinity of Shelley Street and the Hong Kong Zoological and Botanical Gardens with DF symptoms should call the CHP's hotline (2125 2266) for laboratory investigation or referral as appropriate. The hotline will operate from 9am to 6pm between Monday and Friday to receive enquires.

To date, 81 DF cases have been confirmed in 2016, including 79 imported cases, one under investigations and this local case.

In 2015, there were 114 cases, comprising two local, 110 imported and two unclassified cases. In 2014, there were 112 cases, including three local and 109 imported cases.

"We will issue letters to doctors and hospitals to alert them to the case. We will also enhance surveillance of suspected cases in collaboration with public and private hospitals as well as private doctors. Early referral and prompt control are critical to prevent further local spread," the spokesman said.

DF is transmitted to humans through the bites of infective female Aedes mosquitoes. The public are reminded to follow anti-mosquito measures when travelling to areas where DF is endemic in order to prevent DF. When a patient suffering from DF is bitten by a vector mosquito, the mosquito is infected and it may spread the disease by biting other people. In Hong Kong, the principal vector, Aedes aegypti, has not been found in recent years but Aedes albopictus is widely present so there is a risk of secondary spread of DF from imported infections.

Dengue viruses encompass four different serotypes. The symptoms of first infection with one serotype are usually mild, but subsequent infections with other serotypes even years afterward are more likely to result in severe dengue, also known as dengue haemorrhagic fever. Severe dengue is serious and potentially fatal. Without proper treatment, the case fatality rate of severe dengue can exceed 20 per cent.

"At present, there is no locally registered dengue vaccine available in Hong Kong. Strict environmental hygiene, mosquito control and personal protective measures remain the most effective means against DF both locally and during travel," the spokesman added.

Travellers are urged to be alert to the dengue risk of travel destinations before departing and to take heed of the preventive measures below:

  • Wear loose, light-coloured, long-sleeved tops and trousers, and use DEET-containing insect repellent on exposed parts of the body and clothing;
  • Avoid using fragrant cosmetics or skin-care products and re-apply insect repellent according to instructions during outdoor activities;
  • Before the trip, arrange a travel health consultation at least six weeks in advance for any extra measures against mosquito bites;
  • During the trip, carry a portable bed net and apply permethrin (an insecticide) on it in rural endemic areas. Permethrin should not be applied to the skin; and
  • After returning from dengue endemic areas, continue to apply insect repellent for 14 days.

The incubation period of DF ranges from three to 14 days, commonly four to seven days. Anyone feeling unwell after returning from a trip should seek medical advice as soon as possible and provide travel details to their doctor.

Members of the public should also prevent the accumulation of stagnant water and maintain good environmental hygiene:

  • Change the water in vases once a week;
  • Clear the water in saucers under potted plants every week;
  • Cover water containers tightly;
  • Ensure air-conditioner drip trays are free of stagnant water;
  • Put all used cans and bottles into covered dustbins; and
  • Store food and dispose of garbage properly.

Members of the public are reminded to make reports to government departments via the hotline 1823 if mosquito problems are detected, and may visit these pages for more information:


Keywords: HK PRC SAR; Updates; Dengue fever.


#USA, #California DPH Reports #Cluster of #Shigella #Infections Among #MSMs (August 29 2016)


Title: #USA, #California DPH Reports #Cluster of #Shigella #Infections Among #MSMs.

Subject: Shigellosis, California cluster of cases.

Source: US State of California Department of Health, full page: (LINK).

Code: [     ]


CDPH Reports Cluster of Shigella Infections Among Men Who Have Sex with Men 

Date: 8/29/2016  / Number: 16-055  / Contact: Ali Bay, (916) 440-7259  / SACRAMENTO

The California Department of Public Health (CDPH), in collaboration with the Los Angeles County Department of Public Health and several Southern California local public health agencies, are investigating a cluster of Shigella infections predominantly affecting men who have sex with men (MSM).

As of Aug. 25, 2016, 14 patients infected with an uncommon strain of Shigella have been identified. All patients are adult men. Illnesses have occurred since May 2016, with five individuals requiring hospitalization.

Shigella is a type of bacteria that causes shigellosis, a diarrheal disease. Symptoms of shigellosis include diarrhea which can be bloody, fever and abdominal pain. Occasionally, the infection can spread to the bloodstream and be life-threatening. Illnesses can be especially severe in those with weakened immune systems, such as those living with HIV infection.

“It is important that men who have sex with men consult their health care provider if they have diarrhea, especially if it is bloody, to determine if they are suffering from an infection or other illness,” said Dr. Karen Smith, CDPH director and state public health officer.

“Your provider can order tests to obtain an accurate diagnosis and prescribe the appropriate antibiotic treatment if needed.”

Shigella transmission can occur through person-to-person contact, eating food contaminated by someone who has shigellosis, or swallowing contaminated recreational (e.g., lake or river) or drinking water. Transmission of Shigella among MSM is often through sex, typically through oral or anal contact.

MSM are more likely to develop shigellosis than the general adult population. Shigellosis outbreaks among MSM have been reported in California and other states, as well as internationally. There are currently strains of Shigella that are highly resistant to antibiotics that appear to be circulating among MSM in California and nationwide.

CDPH advises health care providers to be on alert for MSM presenting with symptoms consistent with shigellosis to consider it as a potential cause of diarrheal disease. Stool culture with antimicrobial susceptibility testing is important to make sure that if a patient is treated with an antibiotic, it is an appropriate one.

For people diagnosed with shigellosis, CDPH recommends the following:

  • Wash hands thoroughly with soap and water after using the bathroom.
  • Do not prepare food for others while you are sick. After you get better, wash your hands with soap and water before preparing food for others.
  • Avoid sex until two weeks after recovery. When having sex again, wash your body and hands before and after sex. Use barriers to reduce exposure during sex.
  • Avoid swimming pools and spas while ill.

To reduce the risk of shigellosis in general:

  • Wash your hands with soap and water before eating, after changing a diaper and after using the bathroom.
  • Avoid sex with a person who has diarrhea or who has recently recovered from diarrhea.
  • Use condoms and other barriers during sex.
  • Wash your genitals, anus and hands before and after sexual activity.
  • Avoid swallowing recreational (e.g., lake or river) water.

Additional information about shigellosis among MSM is at:


Keywords: USA; Updates; California; Shigellosis.


#US #CDC releases #genetic #data on #antibiotic resistant #Salmonella #infections (@CDCgov, August 29 2016)


Title: #US #CDC releases #genetic #data on #antibiotic resistant #Salmonella #infections.

Subject: Drugs Resistance, Salmonella bacteria genome sequence.

Source: US Centers for Disease Control and Prevention (CDC), full page: (LINK).

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CDC releases genetic data on antibiotic resistant Salmonella infections

For Immediate Release: Monday, August 29, 2016 / Contact: Media Relations, (404) 639-3286


For the first time, the National Antimicrobial Resistance Monitoring System (NARMS) annual report includes whole genome sequencing (WGS) data of bacteria from people with antibiotic-resistant Salmonella infections.

With WGS, health officials can rapidly detect genes that make bacteria resistant to some antibiotics which are critically important to treat infections.

WGS enables CDC to track antibiotic resistance patterns and trends more effectively. 

An interactive web tool for viewing data is also available.

The 2014 NARMS Annual Human Isolates Report provides the most recent national data on antibiotic resistance among six types of bacteria that can cause diarrhea or bloodstream infections.  These bacteria are commonly spread through food.

NARMS, established in 1996, is a collaboration of state and local public health departments, CDC, the U.S. Food and Drug Administration, and the U.S. Department of Agriculture.

NARMS helps protect public health by providing information about bacterial resistance, the ways in which resistance is spread, and how resistant infections differ from other infections.

Understanding trends in antibiotic resistance helps doctors to prescribe effective treatment and public health officials to investigate practices that could contribute to resistance.



Keywords: US CDC; USA; Updates; Antibiotics; Drugs Resistance; Salmonella.


#USA, #Texas: Reported #Zika Virus Cases – August 29, 2016 (DoH, edited)


Title: #USA, #Texas: Reported #Zika Virus Cases – August 29, 2016.

Subject: Zika Virus, US State of Texas daily epidemiological update.

Source: US State of Texas Department of Health, full page: (LINK).

Code: [     ]


Reported Zika Virus Cases – August 29, 2016

Texas has had 132 reported cases of Zika virus disease.

This count includes six pregnant women, two infants infected before birth, and one person who had sexual contact with a traveler.


Texas Zika Cases by County:

[County  - Cases]

  1. Bell  - 4
  2. Bexar  - 8
  3. Brazos – 1
  4. Collin  - 3
  5. Dallas  - 30
  6. Denton  - 4
  7. El Paso  - 2
  8. Ellis  - 1
  9. Fort Bend  - 7
  10. Frio  - 1
  11. Gray  - 1
  12. Galveston – 2
  13. Grayson  - 1
  14. Greg   - 1
  15. Hamilton  - 1
  16. Harris  - 35
  17. Jefferson  - 1
  18. Lubbock  - 1
  19. Matagorda  - 1
  20. Medina  - 1
  21. Midland  - 1
  22. Palo Pinto  - 1
  23. Randall  - 1
  24. Tarrant  - 14
  25. Travis  - 3
  26. Val Verde  - 1
  27. Walker  - 1
  28. Williamson  - 3
  29. Wise  - 1
    • Total – 130

Note: Zika case data for Texas will be updated each weekday no later than 11 a.m.


Keywords: USA; Updates; Zika Virus; Texas.


15 more cases of locally transmitted #Zika detected in #Singapore (CNA, August 29 2016)


Title: 15 more cases of locally transmitted #Zika detected in #Singapore.

Subject: Zika Virus, ongoing vector-borne transmission in Singapore.

Source: Channel News Asia, full page: (LINK).

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15 more cases of locally transmitted Zika detected in Singapore

Posted 29 Aug 2016 21:24 - Updated 29 Aug 2016 23:40

SINGAPORE: The Ministry of Health (MOH) confirmed 15 more cases of locally transmitted Zika virus infection in Singapore as of noon on Monday (Aug 29). Two cases work at the construction site at 60 Sims Drive and have recovered. 13 cases live or work in the broader Sims Drive/ Aljunied Crescent area, MOH and the National Environment Agency (NEA) said.



Keywords: Zika Virus; Singapore.


#HK CHP reminds #doctors of early #laboratory #investigation for suspected #Zika cases (August 29 2016)


Title: #HK CHP reminds #doctors of early #laboratory #investigation for suspected #Zika cases.

Subject: Zika Virus, testing guidelines for doctors in Hong Kong.

Source: Centre for Health Protection, Hong Kong PRC SAR, full page: (LINK).

Code: [     ]


CHP reminds doctors of early laboratory investigation for suspected Zika cases

The Centre for Health Protection (CHP) of the Department of Health (DH) will issue letters to doctors and hospitals today (August 29) to remind them to conduct prompt laboratory investigation in case of patients clinically suspected of Zika Virus Infection, reiterating that early identification is key to picking up any case of Zika Virus Infection.

"In view of emerging local Zika cases in Singapore and the confirmation of the first imported case in Hong Kong last week, due to a high volume of our international travel, there is a high risk of the introduction of Zika virus to Hong Kong. Both the public and the healthcare sector should be highly vigilant," a spokesman for the CHP said.

The CHP reminded doctors that, in case of patients clinically suspected of Zika Virus Infection, blood and urine tests are advised. Extra caution is warranted for those with travel history to affected areas. Early identification of any unusual clusters or linkages among patients with suspicious symptoms is key to controlling possible local transmission.

"To prevent possible local spread of Zika virus, early laboratory investigation is extremely important to identify any cases promptly to allow timely epidemiological investigations, implementation of control measures including mosquito control," the spokesman added.

The DH's Port Health Office has stepped up inspection at boundary control points (BCPs) to maintain strict environmental hygiene with effective mosquito control. Port Health Inspectors have reinforced training for contractors of BCPs, including at the airport, harbour ports and ground crossings, on port hygiene and pest control for effective vector prevention. Health promotion at BCPs has been enhanced through pamphlets and posters to alert travellers to necessary measures against Zika.

"Routine health surveillance on the body temperature of inbound travellers at all boundary control points is ongoing. Suspected cases will be referred to healthcare facilities for follow-up. However, at present, around 70 to 80 per cent of infected people are asymptomatic and most can recover fully. Therefore, we again urge those arriving from Zika-affected areas to apply insect repellent for at least 21 days upon arrival to reduce the risk of transmission," the spokesman said.

The DH has been working closely with the travel industry and stakeholders, especially agents operating tours in Zika-affected areas and personnel receiving travellers in those areas (particularly pregnant women), to regularly update them on the latest disease information and health advice.

To prevent Zika Virus Infection, in addition to general anti-mosquito measures, the DH draws the public's attention to the special notes below:


A. Travelling abroad

  • If going to areas with ongoing Zika virus transmission (affected areas), travellers, especially those with immune disorders or severe chronic illnesses, should arrange consultation with a doctor at least six weeks before the trip, and take extra preventive measures to avoid mosquito bites;
  • Those arriving from affected areas should apply insect repellent for at least 21 days upon arrival. If feeling unwell, such as having a fever, seek medical advice as soon as possible, and provide travel details to the doctor;
  • Travellers should consider not having sex during travel to affected areas, or else condoms should be used;
  • Travellers returning from affected areas should consider abstinence for at least two months upon return, or else condoms should be used. If diagnosed with Zika Virus Infection or having compatible symptoms, they should consider abstinence for at least six months upon onset, or else condoms should be used;

B. Pregnant women and those preparing for pregnancy
  • Pregnant women and those preparing for pregnancy should not travel to affected areas. Those who must travel should seek medical advice from their doctor before the trip, adopt contraception if appropriate, strictly follow steps to avoid mosquito bites during the trip, and consult and reveal their travel history to their doctor if symptoms develop after the trip;
  • Women preparing for pregnancy are advised to continue to adopt contraception for at least two months after returning from affected areas if they have no symptoms of Zika Virus Infection, or six months if one or both members of the couple are symptomatic;

C. Special notes for prevention of sexual transmission regarding adverse pregnancy outcomes
  • Pregnant women should not have sex with partners who have travelled to affected areas, or else condoms should be used;
  • Travellers returning from affected areas should:
  1. Abstain from sex with pregnant partners, or else use condoms throughout the pregnancy; and
  2. Use condoms for at least six months if female partners may get pregnant.

The public may visit the following pages for more disease information and health advice:


Keywords: Hong Kong PRC SAR; Updates; Zika Virus.


#Zika #Virus #Research #References #Library–August 29 2016 #Update, Issue No. 31


Title: #Zika #Virus #Research #References #Library–August 29 2016 #Update, Issue No. 31.

Subject: Zika Virus Infection and related complications research, weekly references library update.

Source: AMEDEO, homepage: (LINK).

Code: [  R  ]


This Week’s References:


  1. KLASE ZA, Khakhina S, Schneider AB, Callahan MV, et al.
  2. LEYSER M, de Camargo OK, Matta AP, Vasconcelos MM, et al.
  3. DIAZ-QUINONEZ JA, Lopez-Martinez I, Torres-Longoria B, Vazquez-Pichardo M, et al.
    • Autopsy and Postmortem Studies Are Concordant: Pathology of Zika Virus Infection Is Neurotropic in Fetuses and Infants With Microcephaly Following Transplacental Transmission.
  5. HUANG YS, Ayers VB, Lyons AC, Unlu I, et al.
  7. KUMAR A, Singh HN, Pareek V, Raza K, et al.
    • A Possible Mechanism of Zika Virus Associated Microcephaly: Imperative Role of Retinoic Acid Response Element (RARE) Consensus Sequence Repeats in the Viral Genome.
  8. TSETSARKIN KA, Kenney H, Chen R, Liu G, et al.
    • A Full-Length Infectious cDNA Clone of Zika Virus from the 2015 Epidemic in Brazil as a Genetic Platform for Studies of Virus-Host Interactions and Vaccine Development.
  10. ACHARYA D, Bastola P, Le L, Paul AM, et al.
  11. MINH NN, Huda Q, Asghar H, Samhouri D, et al.
  12. CHAN JF, Yip CC, Tsang JO, Tee KM, et al.
    • Differential cell line susceptibility to the emerging Zika virus: implications for disease pathogenesis, non-vector-borne human transmission and animal reservoirs.
  13. SOARES DE OLIVEIRA-SZEJNFELD P, Levine D, Melo AS, Amorim MM, et al.
  14. DI GUARDO G.
  15. LANDRY ML, Ko AI, Kramer LD, Vasilakis N, et al.
  16. BARZON L, Trevisan M, Sinigaglia A, Lavezzo E, et al.
  17. HILL CE.
  18. WYLIE BJ, Hauptman M, Woolf AD, Goldman RH, et al.
  19. MUMTAZ N, van Kampen JJ, Reusken CB, Boucher CA, et al.
  21. PANDYA K.
  23. LI H, Saucedo-Cuevas L, Regla-Nava JA, Chai G, et al.
  24. GLOWACKI EM, Lazard AJ, Wilcox GB, Mackert M, et al.
    • Identifying the public's concerns and the Centers for Disease Control and Prevention's reactions during a health crisis: An analysis of a Zika live Twitter chat.
  25. ELLINGTON SR, Devine O, Bertolli J, Martinez Quinones A, et al.
    • Estimating the Number of Pregnant Women Infected With Zika Virus and Expected Infants With Microcephaly Following the Zika Virus Outbreak in Puerto Rico, 2016.
  26. KOSTIC M.
  27. BARR KL, Anderson BD, Prakoso D, Long MT, et al.
    • MEPPitope: spatial, electrostatic and secondary structure perturbations in the post-fusion Dengue virus envelope protein highlights known epitopes and conserved residues in the Zika virus.
  30. YUN SI, Song BH, Frank JC, Julander JG, et al.
    • Complete Genome Sequences of Three Historically Important, Spatiotemporally Distinct, and Genetically Divergent Strains of Zika Virus: MR-766, P6-740, and PRVABC-59.
  31. DE SA TH, Reis-Santos B, Rodrigues LC.
  32. DOS SANTOS OLIVEIRA SJ, de Melo ES, Reinheimer DM, Gurgel RQ, et al.
  33. BOUREE P.
  34. PARRY GJ, Peacey M, Buenz EJ.
  35. NAU JY.
  36. KAPLAN CG, Covinsky MH, Heller DS.
  38. LYON J.
  39. ABBASI J.
  40. RUSSELL K, Oliver SE, Lewis L, Barfield WD, et al.
    • Update: Interim Guidance for the Evaluation and Management of Infants with Possible Congenital Zika Virus Infection - United States, August 2016.
  41. REARDON S.
  42. SPEER SD, Pierson TC.
  43. LARRIEU S, Filleul L, Reilhes O, Jaffar-Bandjee MC, et al.
  44. BARZON L, Pacenti M, Franchin E, Lavezzo E, et al.
    • Infection dynamics in a traveller with persistent shedding of Zika virus RNA in semen for six months after returning from Haiti to Italy, January 2016.
  45. SEPTFONS A, Leparc-Goffart I, Couturier E, Franke F, et al.
  46. NICASTRI E, Castilletti C, Liuzzi G, Iannetta M, et al.
    • Persistent detection of Zika virus RNA in semen for six months after symptom onset in a traveller returning from Haiti to Italy, February 2016.


Keywords: Research; Abstracts; Zika Virus; Zika References Library.


Highly pathogenic #avian #influenza #H5N2, #USA [an infected mallard #duck] (#OIE, August 29 2016)


Title: Highly pathogenic #avian #influenza #H5N2, #USA [an infected mallard #duck].

Subject: Avian Influenza, H5N2 subtype, wild birds.

Source: OIE, full page: (LINK).

Code: [     ]


Highly pathogenic avian influenza H5N2, United States of America

Information received on 26/08/2016 from Dr John Clifford, Official Delegate, Chief Trade Advisor, Animal and Plant Health Inspection Service, United States Department of Agriculture, Washington, United States of America

  • Summary
    • Report type Immediate notification
    • Date of start of the event 12/08/2016
    • Date of confirmation of the event 25/08/2016
    • Report date 26/08/2016
    • Date submitted to OIE 26/08/2016
    • Reason for notification Reoccurrence of a listed disease
    • Date of previous occurrence 24/03/2016
    • Manifestation of disease Sub-clinical infection
    • Causal agent Highly pathogenic avian influenza virus
    • Serotype H5N2
    • Nature of diagnosis Laboratory (advanced)
    • This event pertains to a defined zone within the country
  • New outbreaks
    • Summary of outbreaks
      • Total outbreaks: 1
        • Outbreak Location  - ALASKA ( Fairbanks North Star Borough, Fairbanks North Star Borough )
          • Total animals affected: Species – Susceptible  - Cases – Deaths – Destroyed – Slaughtered
            • Mallard: Anatidae (Anas platyrhynchos)  - … – **  - … – …
          • Outbreak statistics:  Species - Apparent morbidity rate - Apparent mortality rate - Apparent case fatality rate - Proportion susceptible animals lost*
            • Mallard: Anatidae (Anas platyrhynchos) – ** – ** – ** – **
            • * Removed from the susceptible population through death, destruction and/or slaughter;
            • ** Not calculated because of missing information;
  • Epidemiology
    • Source of the outbreak(s) or origin of infection
      • Contact with wild species
  • Epidemiological comments
    • The sample, from a wild mallard duck, was collected during a live bird banding program at a wildlife refuge in Alaska.
    • Genome sequencing results show that the Alaska isolate is an Eurasian/American (EA/AM) H5N2 HPAI strain.
    • The partial genome fragments that have been analyzed thus far are >99% similar to the virus isolated from a northern pintail duck in Washington State in December 2014.
    • The H5N2 outbreak viruses from 2015 were all >99% similar to the northern pintail index case (A/Northern pintail/Washington/40964/2014 H5N2).
    • Efforts to obtain sequence data for the full genome are underway.
    • This is the first detection of HPAI in a wild bird this year.
    • This detection of HPAI (EA/AM) H5N2 virus in a wild bird is NOT associated with any commercial poultry in the United States.
  • Control measures
    • Measures applied
      • Vaccination prohibited
      • No treatment of affected animals
    • Measures to be applied
      • No other measures
  • Diagnostic test results
    • Laboratory name and type - National Veterinary Services Laboratories (NVSL) ( National laboratory )
      • Tests and results: Species  - Test  - Test date – Result
        • Mallard - gene sequencing - 25/08/2016 – Positive
        • Mallard - real-time reverse transcriptase/polymerase chain reaction (RRT-PCR) - 25/08/2016 – Positive
  • Future Reporting
    • The event is continuing. Weekly follow-up reports will be submitted.


Keywords: OIE; Updates; H5N2; Avian Influenza; Wild Birds; USA; Alaska.


#EU Laboratory #Capability #Monitoring #System (#EULabCap) – #Report on 2014 #survey (@ECDC_EU, summary)


Title: #EU Laboratory #Capability #Monitoring #System (#EULabCap) – #Report on 2014 #survey.

Subject: Laboratory capabilities in the EU, report.

Source: European Centre for Disease Prevention and Control (ECDC), full PDF file: (LINK). Summary.

Code: [     ]


EU Laboratory Capability Monitoring System (EULabCap) – Report on 2014 survey of EU/EEA country capabilities and capacities


This report of the European Centre for Disease Prevention and Control (ECDC) was prepared by Katrin Leitmeyer, Joana Revez and Marc Struelens (ECDC Microbiology Coordination section).

Amanda Ozin, ECDC Microbiology Coordination section, led on the development and piloting of the survey tool in 2012–2014 and contributed to the discussion and next steps section of this report.


Contributing authors

  • National Microbiology Focal Points (NMFP) contributing to the revision of the survey, data collection/validation, results interpretation and advice on survey design and reporting format were:
    • Franz Allerberger (Austria NMFP member),
    • Petra Apfalter (Austria NMFP alternate),
    • Steven Van Gucht (Belgium NMFP member),
    • Michael Kalaï (Belgium NMFP alternate),
    • Iva Christova (Bulgaria NMFP member),
    • Stefka Krumova (Bulgaria NMFP alternate),
    • Vera Katalinić-Janković (Croatia NMFP member),
    • Blazenka Hunjak (Croatia NMFP alternate),
    • Despo Bagatzouni (Cyprus NMFP member),
    • Sophia Kyradji (Cyprus NMFP alternate),
    • Pavla Křížová (Czech Republic NMFP member),
    • Martina Havlíčková (Czech Republic NMFP alternate),
    • Thea Kølsen Fischer (Denmark NMFP member),
    • Kurt Fuursted (Denmark NMFP alternate),
    • Rita Peetso (Estonia NMFP member),
    • Külli Rae (Estonia NMFP alternate),
    • Saara Salmenlinna (Finland NMFP member),
    • Carita Savolainen-Kopra (Finland NMFP alternate),
    • Bruno Coignard (France NMFP member),
    • Sylvie Quelet (France NMFP alternate),
    • Guido Werner (Germany NMFP member),
    • Alkiviadis Vatopoulos (Greece NMFP member),
    • Ildikó Visontai (Hungary NMFP member),
    • Ágnes Dánielisz (Hungary NMFP alternate),
    • Karl Kristinsson (Iceland NMFP member),
    • Eoghan O'Neill (Ireland NMFP member),
    • Robert Cunney (Ireland NMFP alternate),
    • Giovanni Rezza (Italy NMFP member),
    • Paola Stefanelli (Italy NMFP alternate),
    • Violeta Mavcutko (Latvia NMFP member),
    • Arta Olga Balode (Latvia NMFP alternate),
    • Algirdas Griškevičius (Lithuania NMFP member),
    • Svajūnė Muralytė (Lithuania NMFP alternate),
    • Joël Mossong (Luxembourg NMFP member),
    • Matthias Opp (Luxembourg NMFP alternate),
    • Christopher Barbara (Malta NMFP member),
    • Paul Caruana (Malta NMFP alternate),
    • Nico Meessen (Netherlands NMFP member),
    • Ellen Stobberingh (Netherlands NMFP alternate),
    • Ingeborg Sundvalen Aaberge (Norway NMFP member),
    • Dominique Caugant (Norway NMFP alternate),
    • Anna Skoczyńska (Poland NMFP member),
    • Rafał Gierczyński (Poland NMFP alternate),
    • Jorge Machado (Portugal NMFP member),
    • Gabriel Ionescu (Romania NMFP member),
    • Olga Dorobat (Romania NMFP alternate),
    • Cyril Klement (Slovak Republic NMFP member),
    • Lucia Madarova (Slovak Republic NMFP alternate),
    • Metka Paragi (Slovenia NMFP member),
    • Katarina Prosenc (Slovenia NMFP alternate),
    • Julio Moreno Vazquez (Spain NMFP member),
    • José Miguel Rubio Muñoz (Spain NMFP alternate),
    • Karin Tegmark-Wisell (Sweden NMFP member),
    • Hans Gaines (Sweden NMFP alternate),
    • Maria Zambon (United Kingdom NMFP member) and
    • Nandini Shetty (United Kingdom NMFP alternate).
  • ECDC experts contributing to data collection/validation and results interpretation, in alphabetical order, were:
    • Julien Beauté,
    • Eeva Broberg,
    • Birgitta de Jong,
    • Hervé Zeller,
    • Karin Johansson,
    • Liselotte Högberg,
    • Csaba Ködmön,
    • Taina Niskanen,
    • Anastasia Pharris,
    • Gianfranco Spiteri,
    • Johanna Takkinen,
    • Ivo Van Walle,
    • Robert Whittaker and
    • Emma Wiltshire.


Suggested citation: European Centre for Disease Prevention and Control. EU Laboratory Capability Monitoring System (EULabCap) – Report on 2014 survey of EU/EEA country capabilities and capacities. Stockholm: ECDC; 2016. Stockholm, August 2016

ISBN 978-92-9193-985-5 / doi 10.2900/993419 / Catalogue number TQ-02-16-877-EN-N

© European Centre for Disease Prevention and Control, 2016 Reproduction is authorised, provided the source is acknowledged


Executive summary


The ECDC public health microbiology strategy (2012–2016) and ECDC strategic multi-annual programme (2014– 2020) aim to strengthen the capability and capacity of the EU public health microbiology system to provide the timely and reliable information that underpins infectious threat detection, assessment and surveillance at Member State and EU level for effective prevention and control of infectious diseases [1,2].

To ascertain how well this is delivered, ECDC, in close collaboration with the National Microbiology Focal Points (NMFP) and the Advisory Forum (AF), has developed and piloted a system (EULabCap) for monitoring key public health microbiology capabilities and capacity for EU surveillance and epidemic preparedness on an annual basis.

This assessment aims to help policymakers identify possible areas for action and to evaluate the impact of capacity strengthening activities and health system reforms.

The first report on the pilot 2013 survey of EU/EEA (European Economic Area) country capabilities and capacities was published in February 2016 [8].

This second report presents the indicator results achieved in 2014 and a tentative comparison with the baseline data of 2013 for 30 EU and EEA countries.



The EULabCap monitoring tool combines 60 technical indicators to assess the capability and capacity of microbiology laboratories to provide essential public health functions, as defined in EU policies and action plans, international health regulations and technical standards.

The EULabCap indicators comprise 24 structure and 36 process indicators. They are divided into 38 indicators of laboratory capability and 22 of service capacity.

About 3/4 of the indicators are based on EU policy targets or international technical standards, while the remainder assess EU surveillance and alert system contributions.

The indicators are grouped into 12 targets distributed across the following three public health microbiology system dimensions: primary diagnostic testing, national microbiology reference laboratory (NRL) services and laboratory-based surveillance and epidemic response support.

Each indicator can be scored at three levels: low, intermediate and high capability or capacity. Aggregated indices are calculated for each target and dimension as the average of component indicator scores, adjusting all index values on a scale of 0–10. A mixed method was used for data collection and scoring.

To minimise the data reporting burden for the Member States, information for 20 indicators was retrieved by ECDC from data sets accessible in The European Surveillance System (TESSy) and EU disease network reports.

For the remaining 40 indicators the NMFPs used a questionnaire to collect information from their country. The data collected for 2014 were validated by the NMFPs and the preliminary results were summarised and reported to the NMFP before being reviewed in joint consultation by the NMFPs and the AF in May 2016.

Results were reviewed for validity assessment and survey improvements and the information was used to develop actions at the national and/or EU level.

At the request of the NMFPs, another round of data validation was performed to enable minor corrections of data both for 2013 and 2014.



The country response to the survey was 100% (30/30 EU/EEA countries). Data from 2014 were provided for 95% of the indicators1 (range per country, 78–100%). The average EULabCap aggregated index for the EU/EEA was 7.3 on a scale of 1–10, as compared to the final revised EU score of 6.9 in 2013.

As in 2013, substantial inter-country variation was found with overall EULabCap indices per country ranging from 5.0 to 9.5 (in 2014) compared to 4.7 to 9.2 (in 2013).

There was also diversity of scores among targets, with common challenging areas for which many countries lacked critical capabilities and/or showed low capacity.

In 2014, the main areas of strong capability, with high scores largely meeting policy targets and standards, were the same as in 2013. These included antimicrobial drug susceptibility testing; antimicrobial drug resistance monitoring; laboratory collaboration within national and EU surveillance networks; provision and regulation of NRL microbiology services and reference diagnostic confirmation for EU notifiable diseases.

As in 2013, the main challenges were found to be in the areas of provision and regulation of clinical microbiology services; diagnostic testing guidelines and utilisation, and national reference laboratory services relating to molecular typing for surveillance and national outbreak response support.

In 2014, notable improvements, unlikely to be explained by indicator modifications, were found against the 2013 baseline data in the following technical areas: 

  • Primary diagnostics: medical test reimbursement, medical laboratory licensing, biosafety for tuberculosis diagnostics, Clostridium difficile testing guidance and utilisation, and EUCAST breakpoint use.
  • NRL services: NRL core function delivery, access to biosafety level 3 facilities, diagnostic confirmation capabilities for EU notifiable diseases and application of whole genome sequencing to national surveillance.
  • Surveillance and outbreak support: laboratory-based outbreak detection, Chlamydia trachomatis surveillance, NRL contribution to outbreak investigations and diagnostic capability for emerging pathogens.


Conclusions and next steps

The high response rate of the EU/EEA countries in the EULabCap surveys highlights the EU/EEA countries’ commitment to this new health system component monitoring and benchmarking process, thanks to the engagement of the NMFPs.

The results of this second EULabCap annual survey confirmed that the EU/EEA as a whole, with an aggregated index score of 7.3 out of 10 for 2014, as compared with 6.9 in the 2013 pilot, can rely on a public health microbiology system with strong overall capability and substantial capacity to fulfil communicable disease surveillance and response requirements. 

The main EU system strengths and weaknesses were consistent between the surveys, with specific areas of score increase suggesting that some of its public health microbiology capabilities improved.

There remains substantial inter-country variation in the EULabCap index in 2014, but with preliminary evidence of a narrowing gap.

These apparent trends will be assessed further in the surveys to come. 

The EULabCap monitoring aims to provide information for national competent bodies and policy makers at the national and EU level.

In May 2016, the results of the EULabCap 2014 report, and use of the first EULabCap reports in the Member States, were reviewed in consultation with the AF and NMFPs.

The first EULabCap reports were found useful and had been widely disseminated to national stakeholders in the majority of countries and, in over half of them, findings had been addressed for targeted capacity building action. The validity of the survey methodology and results was broadly supported by the AF and NMFPs during discussions at the May 2016 meeting.

Clarifications for a few indicators and modifications in the survey process were agreed upon to improve efficiency of data collection, quality of data and timely reporting. Evaluation of the use of the EULabCap reports for policy action by the Member States will be integrated into the monitoring system reporting cycle. Areas where further support for laboratory capacity could be provided at the EU level were also discussed.

ECDC will develop these suggestions in accordance with its Country Support Strategy [9], in close collaboration with the European Commission health programme initiatives on reference laboratory coordination and global laboratory capacity strengthening under the International Health Regulations.



Keywords: ECDC; EU; European Region; Updates, Infectious Diseases; Public Health.