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Benoni R, Campagna I, Panunzi S, Varalta MS, Salandini G, De Mattia G, Turrina G, Moretti F, Lo Cascio G, Spiteri G, Porru S, Tardivo S, Poli A, Bovo C. Estimating COVID-19 recovery time in a cohort of Italian healthcare workers who underwent surveillance swab testing. Public Health 2021; 196:52-58. [PMID: 34144335 PMCID: PMC8133387 DOI: 10.1016/j.puhe.2021.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/26/2021] [Accepted: 05/12/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The COVID-19 pandemic is putting a huge strain on the provision and continuity of care. The length of sickness absence of the healthcare workers as a result of SARS-CoV-2 infection plays a pivotal role in hospital staff management. Therefore, the aim of this study was to explore the timing of COVID-19 recovery and viral clearance, and its predictive factors, in a large sample of healthcare workers. STUDY DESIGN This is a retrospective cohort study. METHODS The analysis was conducted on data collected during the hospital health surveillance programme for healthcare staff at the University Hospital of Verona; healthcare workers were tested for SARS-CoV-2 through RT-PCR with oronasopharyngeal swab samples. The health surveillance programme targeted healthcare workers who either had close contact with SARS-CoV-2-infected patients or were tested as part of the screening-based strategy implemented according to national and regional requirements. Recovery time was estimated from the first positive swab to two consecutive negative swabs, collected 24 h apart, using survival analysis for both right-censored and interval-censored data. Cox proportional hazard was used for multivariate analysis. RESULTS During the health surveillance programme, 6455 healthcare workers were tested for SARS-CoV-2 and 248 (3.8%, 95% confidence interval [CI]: 3.4-4.3) reported positive results; among those who tested positive, 49% were asymptomatic, with a median age of 39.8 years, which is significantly younger than symptomatic healthcare workers (48.2 years, P < 0.001). Screening tests as part of the health surveillance programme identified 31 (12.5%) of the positive cases. Median recovery time was 24 days (95% CI: 23-26) and 21.5 days (95% CI: 15.5-30.5) in right- and interval-censoring analysis, respectively, with no association with age, sex or presence of symptoms. Overall, 63% of participants required >20 days to test negative on two consecutive swabs. Hospitalised healthcare workers (4.8%) were older and had a significantly longer recovery time compared with non-hospitalised healthcare workers in both analyses (33.5 vs 24 days, P = 0.005). CONCLUSIONS Recovery from COVID-19 and viral clearance may take a long time, especially in individuals who are hospitalised. To detect asymptomatic cases, screening programmes for healthcare workers is recommended.
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Affiliation(s)
- R Benoni
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy.
| | - I Campagna
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - S Panunzi
- Department of Diagnostics and Public Health, Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy
| | - M S Varalta
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - G Salandini
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - G De Mattia
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - G Turrina
- Postgraduate School of Occupational Medicine, University of Verona, Verona, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, Verona, Italy
| | - G Lo Cascio
- Department of Pathology, Microbiology and Virology Unit, University Hospital of Verona, Verona, Italy
| | - G Spiteri
- Department of Diagnostics and Public Health, Section of Occupational Medicine, University of Verona, Verona, Italy
| | - S Porru
- Department of Diagnostics and Public Health, Section of Occupational Medicine, University of Verona, Verona, Italy; Clinical Unit of Occupational Medicine, University Hospital of Verona, Verona, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, Verona, Italy; Medical Direction, University Hospital of Verona, Verona, Italy
| | - A Poli
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, Verona, Italy
| | - C Bovo
- Medical Direction, University Hospital of Verona, Verona, Italy
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Kenyon C, Buyze J, Spiteri G, Cole MJ, Unemo M. Population-Level Antimicrobial Consumption Is Associated With Decreased Antimicrobial Susceptibility in Neisseria gonorrhoeae in 24 European Countries: An Ecological Analysis. J Infect Dis 2021; 221:1107-1116. [PMID: 30957153 DOI: 10.1093/infdis/jiz153] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/01/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES There are substantial variations between different populations in the susceptibility of Neisseria gonorrhoeae to antimicrobials, and the reasons for this are largely unexplored. We aimed to assess whether the population-level consumption of antimicrobials is a contributory factor. METHODS Using antimicrobial susceptibility data from 24 countries in the European Gonococcal Antimicrobial Surveillance Programme and antimicrobial consumption data from the IQVIA MIDAS database, we built mixed-effects linear/logistic regression models with country-level cephalosporin, fluoroquinolone, and macrolide consumption (standard doses/1000 population/year) as the explanatory variables (from 2009 to 2015) and 1-year-lagged ceftriaxone, cefixime, azithromycin, and ciprofloxacin geometric mean minimum inhibitory concentrations (MICs) as the outcome variables (from 2010 to 2016). RESULTS Positive correlations were found between the consumption of cephalosporins and the geometric mean MICs of ceftriaxone and cefixime (P < .05 for both comparisons). Fluoroquinolone consumption was positively associated with the prevalence of resistance to ciprofloxacin (P < .05). CONCLUSIONS Differences in the population-level consumption of particular antimicrobials may contribute to variations in the level of antimicrobial resistance in N. gonorrhoeae in different settings. Further interventions to reduce misuse and overuse of antimicrobials in high-consumption populations and core groups are required.
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Affiliation(s)
- Chris Kenyon
- HIV/STI Unit.,Division of Infectious Diseases and HIV Medicine, University of Cape Town, South Africa
| | - Jozefien Buyze
- Clinical Trials Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - G Spiteri
- European Centre for Disease Prevention and Control, Stockholm
| | - M J Cole
- National Infection Service, Public Health England, London, United Kingdom
| | - M Unemo
- WHO Collaborating Centre for Gonorrhea and Other Sexually Transmitted Infections, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Abstract
Surveillance of Zika virus (ZIKV) infection in the European Union/European Economic Area (EU/EEA) was implemented in 2016 in response to the large outbreak reported in the Americas in 2015 associated with an increased number of infants born with microcephaly. Between June 2015 and January 2017, 21 EU/EEA countries reported 2,133 confirmed cases of ZIKV infection, of whom 106 were pregnant women. Cases infected in the Caribbean constituted 71% of reported cases. Almost all cases (99%) were most probably infected by mosquito bite during travel outside continental Europe, while only 1% were transmitted sexually. Considering that 584 imported cases were reported between May and October 2016 among residents of areas with established presence of Aedes albopictus, the absence of autochthonous vector-borne cases suggests that Ae. albopictus is not an efficient vector for ZIKV infection.
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Affiliation(s)
- G Spiteri
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - B Sudre
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - A Septfons
- Santé publique France, Paris, France
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - J Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Abstract
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.
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Affiliation(s)
- A Pharris
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Cole MJ, Spiteri G, Chisholm SA, Hoffmann S, Ison CA, Unemo M, Van de Laar M. Emerging cephalosporin and multidrug-resistant gonorrhoea in Europe. ACTA ACUST UNITED AC 2014; 19:20955. [PMID: 25411689 DOI: 10.2807/1560-7917.es2014.19.45.20955] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Neisseria gonorrhoeae has consistently developed resistance to antimicrobials used therapeutically for gonorrhoea and few antimicrobials remain for effective empiric first-line therapy. Since 2009 the European gonococcal antimicrobial surveillance programme (Euro-GASP) has been running as a sentinel surveillance system across Member States of the European Union (EU) and European Economic Area (EEA) to monitor antimicrobial susceptibility in N. gonorrhoeae. During 2011, N. gonorrhoeae isolates were collected from 21 participating countries, and 7.6% and 0.5% of the examined gonococcal isolates had in vitro resistance to cefixime and ceftriaxone, respectively. The rate of ciprofloxacin and azithromycin resistance was 48.7% and 5.3%, respectively. Two (0.1%) isolates displayed high-level resistance to azithromycin, i.e. a minimum inhibitory concentration (MIC) ≥256 mg/L. The current report further highlights the public health need to implement the European response plan, including further strengthening of Euro-GASP, to control and manage the threat of multidrug resistant N. gonorrhoeae.
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Affiliation(s)
- M J Cole
- Public Health England, London, United Kingdom
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Ozolins D, D' Elios MM, Ripa T, Bailey R, Timms P, Spiteri G, Haar K, Unemo M. Second European multi-disciplinary conference of national strategies for Chlamydia trach. and human papillomavirus NSCP conf. in Berlin, 2013 enhanced detection, management and surveillance of sexually transmitted infections in Europe are essential! Int J Immunopathol Pharmacol 2013; 26:839-45. [PMID: 24355218 DOI: 10.1177/039463201302600401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
There is a need for updated guidance on detection, management and surveillance of sexually transmitted infections (STIs). Chlamydia, gonorrhoea and syphilisreporting needs to be mandatory in more European countries to aid collection of data. More widespread Chlamydia screening is needed in many countries as this is the only way to reduce complications. The role of Human Papillomavirus (HPV) screening in a situation where the prevalence of HPV infection has dropped significantly was also discussed in the context of the high cost of screening, the need for a relatively complex infrastructure, particularly in developing countries, and falling vaccination costs. An integrated HPV vaccination and screening policy could be the most appropriate with vaccination at 9-13 years as recommended by WHO and a single HPV screen at 35-39 years, possibly repeated thereafter every 10 years. Female and male HPV vaccination programmes could lead to near elimination of genital warts in both females and males. Surveillance of STIsshould be intensified where needed; additional or better quality data should be collected including reasons for testing, denominator data to estimate positivity rates, diagnostic methods, concurrent STIs, sexual orientation and country of acquisition; more analytical rather than descriptive epidemiology is needed.
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Affiliation(s)
| | | | - T Ripa
- County Hospital of Halland, Halmstad, Sweden
| | - R Bailey
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - P Timms
- Queensland University of Technology, Brisbane, Australia
| | - G Spiteri
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - K Haar
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - M Unemo
- Orebro University Hospital, Orebro, Sweden
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Janiec J, Haar K, Spiteri G, Likatavicius G, Van de Laar M, Amato-Gauci AJ. 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. ACTA ACUST UNITED AC 2013; 18:20644. [PMID: 24308979 DOI: 10.2807/1560-7917.es2013.18.48.20644] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
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.
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Affiliation(s)
- J Janiec
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Cole MJ, Spiteri G, Town K, Unemo M, Hoffmann S, Laar MVD, Ison C. O03.1 Risk Factors For Antimicrobial ResistantNeisseria Gonorrhoeaein Europe: Abstract O03.1 Table 1. Sex Transm Infect 2013. [DOI: 10.1136/sextrans-2013-051184.0095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Spiteri G, Haar K, Sfetcu O, Laar MVD. O03.5 Recent Increases in Gonorrhoea in Europe. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Spiteri G, Laar MVD. P3.241 Epidemiology of Sexually Transmitted Infections in Europe 1990–2011. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sfetcu O, Noori T, Spiteri G, Pharris A, Laar MVD. S13.3 The Status of HIV Prevention Among MSM: An Overview of the European Response. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Haar K, Spiteri G, Sfetcu O, Laar MVD. P3.136 Epidemic of Lymphogranuloma Venereum (LGV) in Europe. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Spiteri G, Cole M, Unemo M, Hoffmann S, Ison C, Laar MVD. O03.2 Antimicrobial Resistance of Neisseria Gonorrhoeae in the European Union: Response to the Threat of Multidrug Resistant Gonorrhoea. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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14
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Sfetcu O, Cleeve A, Likatavicius G, Spiteri G, Laar MVD. P5.008 Performance of antenatal screening for HIV and syphilis in EU/EEA, during 2006–2011: making use of surveillance data. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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15
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Affiliation(s)
- M Van de Laar
- Programme on STIs, including HIV/AIDS and blood-borne infections, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - G Spiteri
- Programme on STIs, including HIV/AIDS and blood-borne infections, European Centre for Disease Prevention and Control, Stockholm, Sweden
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Van de Laar M, Spiteri G. Increasing trends of gonorrhoea and syphilis and the threat of drug-resistant gonorrhoea in Europe. Euro Surveill 2012; 17:20225. [PMID: 22835466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
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Mazick A, Gergonne B, Wuillaume F, Danis K, Vantarakis A, Uphoff H, Spiteri G, van 't Klooster T, Junker C, Holmberg M, Molbak K. Higher all-cause mortality in children during autumn 2009 compared with the three previous years: pooled results from eight European countries. Euro Surveill 2010; 15:19480. [PMID: 20144446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
The paper describes weekly fluctuations of all-cause mortality observed in eight European countries during the period between week 27 and 51, 2009, in comparison with three previous years. Our preliminary data show that the mortality reported during the 2009 influenza pandemic did not reach levels normally seen during seasonal influenza epidemics. However, there was a cumulative excess mortality of 77 cases (1 per 100,000 population) in 5-14-year-olds, and possibly also among 0-4-year-olds.
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Affiliation(s)
- A Mazick
- Statens Serum Institut, Copenhagen, Denmark.
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Mazick A, Gergonne B, Wuillaume F, Danis K, Vantarakis A, Uphoff H, Spiteri G, van 't Klooster T, Junker C, Holmberg M, Mølbak K. Higher all-cause mortality in children during autumn 2009 compared with the three previous years: pooled results from eight European countries. Euro Surveill 2010. [DOI: 10.2807/ese.15.05.19480-en] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The paper describes weekly fluctuations of all-cause mortality observed in eight European countries during the period between week 27 and 51, 2009, in comparison with three previous years. Our preliminary data show that the mortality reported during the 2009 influenza pandemic did not reach levels normally seen during seasonal influenza epidemics. However, there was a cumulative excess mortality of 77 cases (1 per 100,000 population) in 5-14-year-olds, and possibly also among 0-4-year-olds.
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Affiliation(s)
- A Mazick
- Statens Serum Institut, Copenhagen, Denmark
| | - B Gergonne
- The National Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden
- Statens Serum Institut, Copenhagen, Denmark
| | - F Wuillaume
- Scientific Institute of Public Health, Brussels, Belgium
| | - K Danis
- Department for Surveillance and Intervention, Hellenic Centre for Disease Control and Prevention, Greece
| | - A Vantarakis
- Department of Public Health, Medical School, University of Patras, Greece
| | - H Uphoff
- Hessisches Landesprüfungs- und Untersuchungsamt im Gesundheitswesen, Dillenburg, Germany
| | - G Spiteri
- Infectious Disease Prevention and Control Unit, Department of Health Promotion and Disease Prevention, Msida, Malta
| | - T van 't Klooster
- Rijksinstituut voor Volksgezondheid en Milieu (RIVM, National Institute for Public Health and Environment), Bilthoven, Netherlands
| | - C Junker
- Federal Statistical Office, Neuchâtel, Switzerland
| | - M Holmberg
- The National Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden
| | - K Mølbak
- Statens Serum Institut, Copenhagen, Denmark
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Spiteri G, Fenech Magrin AM, Muscat M. A cluster of rubella in Malta, December 2007--January 2008. Euro Surveill 2008; 13:18840. [PMID: 18768119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- G Spiteri
- Infectious Disease Prevention and Control Unit, Department of Health Promotion and Disease Prevention, Msida, Malta
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Abstract
A cluster of rubella has been identified by the Infectious Disease Prevention and Control Unit (IDCU) of Malta in the beginning of January 2008. Two men and a woman aged between 23 and 28 years were affected. The index case had onset of illness on 23 December 2007. The second case had onset of rash on 3 January and the third case displayed symptoms on 6 January 2008. Two of the three cases were laboratory-confirmed (IgM positive), the third displayed typical symptoms and was a close contact of a laboratory-confirmed case but was IgM and IgG negative. None of the affected patients had received vaccination against rubella and there was no history of recent travel abroad. All three cases were linked through a work place. Blood samples were submitted to the World Health Organization (WHO) Regional Reference Laboratory for Measles and Rubella, Luxembourg, for further investigations. None of the cases had any complications. To date no further cases have been identified.
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Affiliation(s)
- G Spiteri
- Infectious Disease Prevention and Control Unit, Department of Health Promotion and Disease Prevention, Msida, Malta
| | - A-M Fenech Magrin
- Infectious Disease Prevention and Control Unit, Department of Health Promotion and Disease Prevention, Msida, Malta
| | - M Muscat
- EUVAC.NET hub, Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark
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Gauci C, Gilles H, O'Brien S, Mamo J, Stabile I, Ruggeri FM, Calleja N, Spiteri G. Estimating the burden and cost of infectious intestinal disease in the Maltese community. Epidemiol Infect 2007; 135:1290-8. [PMID: 17313694 PMCID: PMC2870703 DOI: 10.1017/s0950268807008084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2007] [Indexed: 11/07/2022] Open
Abstract
The aim of this study was to estimate the burden of infectious intestinal disease (IID) and cost of illness at the community level from a societal aspect. A retrospective, age-stratified cross-sectional telephone study was carried out in Malta in 2004-2005. The number of cases, resources used and cost of resources were computed. The resources involved direct costs (health-care services, stool culture tests, medicines and personal costs) and indirect costs (costs from lost employment by cases and caregivers). This study estimated 0.421 (95% CI 0.092-0.771) separate episodes of IID per person per year in Malta which corresponds to 164 471 (95% CI 35 941-301 205) episodes of IID per year or 450 (95% CI 98-825) episodes of IID each day. The largest proportion of cost is due to provision of health-care services with euro10 454 901 [Maltese liri (Lm) 4 558 970] per year; followed by euro963 295 (Lm 2 209 393) in lost productivity; euro1 286 286 (Lm 561 078) in medicines; euro152 335 (Lm 66 452) in stool culture testing and euro71 487 (Lm 31 183) in personal costs, giving a total cost of illness of over euro16 million (7 million Lm) per year. The burden and cost of IID are high enough to justify efforts to control the illness. Such estimates are important to assess the cost-effectiveness of proposed specific interventions.
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Affiliation(s)
- C Gauci
- Disease Surveillance Unit, Department of Public Health, Msida, Malta.
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Gauci C, Gilles H, O'brien S, Mamo J, Stabile I, Ruggeri FM, Gatt A, Calleja N, Spiteri G. The magnitude and distribution of infectious intestinal disease in Malta: a population-based study. Epidemiol Infect 2007; 135:1282-9. [PMID: 17224088 PMCID: PMC2870692 DOI: 10.1017/s0950268806007795] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Routine sources of information on infectious intestinal disease (IID) capture a fraction of the actual disease burden. Population studies are required to measure the burden of illness. A retrospective age-stratified cross-sectional telephone study was carried out in Malta in order to estimate the magnitude and distribution of IID at population level. A random sample of 3504 persons was interviewed by a structured questionnaire between April 2004 and December 2005. The response rate was 99.7%. From the study, the observed standardized monthly prevalence was 3.18% (95% CI 0.7-5.74) with 0.421 (95% CI 0.092-0.771) episodes of IID per person per year. The monthly prevalence was higher in the <5 years age group and in females aged 31-44 years. The mean duration of illness was 6.8 days and a median duration of 3 days. A bimodal seasonal distribution was observed with peaks in June-July and October-November.
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Affiliation(s)
- C Gauci
- Disease Surveillance Unit, Department of Public Health, Malta.
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