Enhanced surveillance of hepatitis C in the EU, 2006 - 2012

Hepatitis C is a major public health issue across Europe, and with rapidly evolving developments in the therapeutic field, it is essential that countries have access to epidemiological information. In 2011, The European Centre for Disease Prevention and Control (ECDC) introduced enhanced surveillance of hepatitis C across EU/EEA countries collecting routine data from national notification systems using standardized case definitions. Data collected from 2006 to 2012 indicate a high burden of disease with great variation in reported cases between countries. Most cases occurred among young adult males, and although injecting drug use dominated across all cases, there were increasing numbers of acute cases reported among men who have sex with men. Geographically, the reported data were the inverse of what may be expected based on findings from recent prevalence surveys in a number of EU/EEA countries. Unexpectedly, low figures were reported through notification systems in some southern and eastern European countries where prevalence is known from surveys to be high. This discrepancy highlights the limitation of surveillance data for a disease such as hepatitis C which is largely asymptomatic until a late stage, so that notifications reflect testing practices rather than real occurrence of disease. Further improvements to the quality of the data are important to increase data utility. Improved understanding of national testing practices is necessary to allow a better interpretation of surveillance results. Additional epidemiological studies alongside routine case-based reporting in notification systems should also be considered to better estimate the true disease burden across Europe.

Enhanced surveillance of hepatitis B in the EU, 2006-2012

Robust epidemiological information on hepatitis B is important to help countries plan prevention and control programmes and evaluate public health responses to control transmission. European Centre Disease Prevention and Control (ECDC) introduced enhanced surveillance of hepatitis B at EU/EEA level in 2011 to collate routine surveillance data from national notification systems. Analysis of the data collected for the years 2006-2012 shows a high burden of hepatitis B across Europe with 110 005 cases reported over the period with the majority of these cases being chronic infections. The most commonly reported routes of transmission in acute cases included heterosexual transmission, nosocomial transmission, injecting drug use and transmission among men who have sex with men. Mother-to-child transmission was the most common route reported for chronic cases. Trends over time were difficult to analyse as national reporting practices changed, but data suggest a downward trend in acute cases, which probably reflects the impact of the widespread implementation of vaccination programmes. Notifications of chronic infection varied across countries and showed discrepancy with the expected results based on findings from recent prevalence surveys. This indicated that notifications mirror local testing practices rather than real occurrence of disease. Improving the quality of the data and considering reported notifications alongside other data sources, such as local screening practices and vaccination policies, will improve the utility of the data.

Ten years after Dublin: principal trends in HIV surveillance in the EU/EEA, 2004 to 2013

In 2004, the 31 countries of the European Union and European Economic Area (EU/EEA) adopted the Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and Central Asia. In 2013, 29,157 persons were diagnosed with HIV in 30 EU/EEA countries (adjusted rate: 6.2/100,000); new diagnoses have increased by 33% since 2004 among men who have sex with men and late diagnosis remains common. Evidence-based prevention measures and efforts towards earlier testing need to be expanded.

Surveillance of human immunodeficiency virus suggests that younger men who have sex with men are at higher risk of infection, European Union, 2003 to 2012

In 2012, newly reported human immunodeficiency virus diagnoses in the European Union /European Economic Area remained stable at around 30,000 cases. Since 2003, cases in men who have sex with men (MSM) aged 20 to 29 years-old doubled, while the proportion of late presenters in this group remained stable. Persistent declines occurred among older MSM age groups, particularly that between 30 and 39 years-old. Interventions targeting younger MSM are needed to prevent a resurgence of the epidemic in Europe.

Taking stock of the first 133 MERS coronavirus cases globally--Is the epidemic changing?

Since June 2012, 133 Middle East respiratory syndrome coronavirus (MERS-CoV) cases have been identified in nine countries. Two time periods in 2013 were compared to identify changes in the epidemiology. The case-fatality risk (CFR) is 45% and is decreasing. Men have a higher CFR (52%) and are over-represented among cases. Thirteen out of 14 known primary cases died. The sex-ratio is more balanced in the latter period. Nosocomial transmission was implied in 26% of the cases.