PrEP can reduce new HIV infections if taken as directed. So why do PrEP failures occur? …

Flavia Riccardo, Federica Monaco, Antonino Bella, Giovanni Savini, Francesca Russo, Roberto Cagarelli, Michele Dottori, Caterina Rizzo, Giulietta Venturi, Marco Di Luca, Simonetta Pupella, Letizia Lombardini, Patrizio Pezzotti, Patrizia Parodi, Francesco Maraglino, Alessandro Nanni Costa, Giancarlo Maria Liumbruno, Giovanni Rezza and the working group

In Italy, the 2018 West Nile virus transmission season started early with a high number of cases reported. One-Health surveillance, within the Italian West Nile national preparedness and response plan, detected viral circulation 9 days before symptom-onset of the first confirmed human case; triggering timely implementation of blood and transplant safety measures. This is an example of how functional coordination allows health authorities to use early warning triggers from surveillance systems to implement preventive measures.…

David A M C van de Vijver, Ann-Kathrin Richter, Charles A B Boucher, Barbara Gunsenheimer-Bartmeyer, Christian Kollan, Brooke E Nichols, Christoph D Spinner, Jürgen Wasem, Knud Schewe and Anja Neumann

Background Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention strategy for men-who-have-sex-with-men (MSM). The high cost of PrEP has until recently been a primary barrier to its use. In 2017, generic PrEP became available, reducing the costs by 90%. Aim Our objective was to assess cost-effectiveness and costs of introducing PrEP in Germany. Methods We calibrated a deterministic mathematical model to the human immunodeficiency virus (HIV) epidemic among MSM in Germany. PrEP was targeted to 30% of high-risk MSM. It was assumed that PrEP reduces the risk of HIV infection by 85%. Costs were calculated from a healthcare payer perspective using a 40-year time horizon starting in 2018. Results PrEP can avert 21,000 infections (interquartile range (IQR): 16,000–27,000) in the short run (after 2 years scale-up and 10 years full implementation). HIV care is predicted to cost EUR 36.2 billion (IQR: 32.4–40.4 billion) over the coming 40 years. PrEP can increase costs by at most EUR 150 million within the first decade after introduction. Ten years after introduction, PrEP can become cost-saving, accumulating to savings of HIV-related costs of EUR 5.1 billion (IQR: 3.5–6.9 billion) after 40 years. In a sensitivity analysis, PrEP remained cost-saving even at a 70% price reduction of antiretroviral drug treatment and a lower effectiveness of PrEP. Conclusion Introduction of PrEP in Germany is predicted to result in substantial health benefits because of reductions in HIV infections. Short-term financial investments in providing PrEP will result in substantial cost-savings in the long term.…

Michael A. Stoto, Elena Savoia, Christopher Nelson, Rachael Piltch-Loeb, Stefano Guicciardi, Judit Takacs, Carmen Varela Santos and Massimo Ciotti

In 2017, the European Centre for Disease Prevention and Control (ECDC) developed a competency model for individuals who work in public health emergency preparedness (PHEP) in European Union (EU) countries. The model serves as the basis for developing competency-based training programmes to support professionals in PHEP efforts at the country level. The competency model describes the knowledge and skills professionals need when working in national-level PHEP, such as preparedness committee members or their equivalents. In order to develop the model, existing competency statements were reviewed, as well as case studies and reports. Fifty-three professionals from the EU and other countries provided feedback to the model by participating in a three-stage consultation process. The model includes 102 competency, 100 knowledge and 158 skill statements. In addition to specifying the appropriate content for training programmes, the proposed common competency model can help to standardise terminology and approaches to PHEP training.…

Patients are asking for Shingrix. Know the important facts about storage, preparation, and administration, and what patients should be told before they receive this vaccine. …

Barbara Bartolini, Cesare EM Gruber, Marion Koopmans, Tatjana Avšič, Sylvia Bino, Iva Christova, Roland Grunow, Roger Hewson, Gulay Korukluoglu, Cinthia Menel Lemos, Ali Mirazimi, Anna Papa, Maria Paz Sanchez-Seco, Aisha V. Sauer, Hervè Zeller, Carla Nisii, Maria Rosaria Capobianchi, Giuseppe Ippolito, Chantal B. Reusken and Antonino Di Caro

Background Crimean-Congo haemorrhagic fever virus (CCHFV) is considered an emerging infectious disease threat in the European Union. Since 2000, the incidence and geographic range of confirmed CCHF cases have markedly increased, following changes in the distribution of its main vector, Hyalomma ticks. Aims To review scientific literature and collect experts’ opinion to analyse relevant aspects of the laboratory management of human CCHF cases and any exposed contacts, as well as identify areas for advancement of international collaborative preparedness and laboratory response plans. Methods We conducted a literature review on CCHF molecular diagnostics through an online search. Further, we obtained expert opinions on the key laboratory aspects of CCHF diagnosis. Consulted experts were members of two European projects, EMERGE (Efficient response to highly dangerous and emerging pathogens at EU level) and EVD-LabNet (Emerging Viral Diseases-Expert Laboratory Network). Results Consensus was reached on relevant and controversial aspects of CCHF disease with implications for laboratory management of human CCHF cases, including biosafety, diagnostic algorithm and advice to improve lab capabilities. Knowledge on the diffusion of CCHF can be obtained by promoting syndromic approach to infectious diseases diagnosis and by including CCHFV infection in the diagnostic algorithm of severe fevers of unknown origin. Conclusion No effective vaccine and/or therapeutics are available at present so outbreak response relies on rapid identification and appropriate infection control measures. Frontline hospitals and reference laboratories have a crucial role in the response to a CCHF outbreak, which should integrate laboratory, clinical and public health responses.…

ProMED Mail

Ebola -- DR Congo- Since the beginning of vaccination on 8 Aug 2018, 69 827 people have been vaccinated, including 20 241 in Beni, 16 390 in Katwa, 7860 in Butembo, 6008 in Mabalako, 2626 in Kalunguta, 2080 in Komanda, 1911 in Goma, 1755 in Oicha, 1663 in Mandima, 1157 in Karisimbi, 877 in Vuhovi, 873 in Kayina, 842 in Kyondo, 750 in Masereka, 700 in Lubero, 599 in Mutwanga, 560 in Rutshuru, 527 in Nyankunde, 524 in Biena, 442 in Musienene, 434 in Bunia, 355 to Tchomia, 167 to Kirotshe, 125 to Nyiragongo, 114…

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Ebola -- DR Congo- Since the beginning of vaccination on 8 Aug 2018, 72 248 people have been vaccinated, including 24 435 in Beni [North Kivu], 17 527 in Katwa [North Kivu], 8099 in Butembo [North Kivu], 6008 in Mabalako [North Kivu], 2686 in Kalunguta [North Kivu], 2150 in Komanda [Ituri], 1981 in Goma [North Kivu], 1821 in Oicha [North Kivu], 1663 in Mandima [Ituri], 1157 in Karisimbi [North Kivu], 943 in Kayina [North Kivu], 877 in Vuhovi [North Kivu], 842 in Kyondo [North Kivu], 750 in Masereka [North…

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Ebola -- DR Congo- Launch of immunization of front-line providers in Lubero [North Kivu] in a preventive manner as part of the preparation of the health zone.- Since the start of vaccination on 8 Aug 2018, 39 277 people have been vaccinated, including 17 956 in Beni [total numbers of people vaccinated in North Kivu and Ituri provinces can be seen at the source URL above].Video in French: The response against Ebola in images -- Vaccination of contacts of Ebola patients--Communicated by:ProMED-mail…

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Ebola -- DR CongoVaccination- Continued wide-belt vaccination (or ring plus) in Otomaber (in Komanda Health Zone) and Aloya (in Mabalako Health Zone)- Since vaccination began on 8 Aug 2018, 43 449 people have been vaccinated, including 18 441 in Beni, 6966 in Katwa, 4792 in Mabalako, 4096 in Butembo, 2092 in Kalunguta, 1663 in Mandima, 769 in Vuhovi, 750 in Masereka, 700 in Lubero, 633 in Komanda, 599 in Mutwanga, 521 in Oicha, 434 in Bunia, 355 in Tchomia, 274 in Musienene, 241 in Kyondo, and 63 in…

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Ebola -- DR CongoHighlights----------Equateur is different from other parts of the DRC. 40 percent of its population is Twa, an African Pygmy group that lives interdependently with agricultural Bantu-speaking populations, providing them with game [that is, bushmeat. - Rapp.MM] in exchange for farm products. The Twa population is already marginalized and vulnerable, and the research effort will face many issues related to language and culture, beginning with understanding and communicating perceptions of…

ProMED Mail

Ebola -- DR Congo…

ProMED Mail

Ebola -- DR CongoAccording to the latest situation report published by the WHO, a total of 990 contacts are under surveillance in Mabalako (790), Beni (141), and Mandima (59) health zones as of [11 Aug 2018]. Of these, 129 are healthcare workers. So far, 8 healthcare workers have contracted the virus, and 1 has died.Today [15 Aug 2018] the WHO detailed the surveillance and preparedness plans underway in the DRC and Uganda, South Sudan, Rwanda, and Burundi -- the countries most likely to experience…

ProMED Mail

Ebola -- DR CongoOn Fri 17 Aug 2018, the Minister of Health, Dr. Oly Ilunga Kalenga, visited the teams deployed in Mangina (Mabalako Health Zone). In particular, he spoke with the additional surveillance teams sent in reinforcements who arrived since yesterday [Thu 16 Aug 2018] on site. With 2157 contacts already registered, they have a huge amount of work to do to follow up on these contacts, to continue the investigations and the active search for cases, as well as to prepare the ground for the vaccination…

ProMED Mail

Ebola -- DR Congo…

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Ebola -- DR Congo…

ProMED Mail

Other Animal Disease -- United StatesThe Sullivan County Animal Shelter euthanized 60 cats and kittens last week eek of 17 Sep 2018 due to feline panleukopenia, county officials said [Mon 24 Sep 2018].That bad news unfolded as the shelter was battling a separate issue in the cat room: a flea infestation among some kittens. The shelter had announced the cat room would be closed [Wed 19 Sep 2018] for deep cleaning due to the flea situation. While preparation was underway for the clean up, shelter workers were notified a kitten…

ProMED Mail

Hantavirus -- United StatesDeschutes County Health Department officials confirmed a local woman died [Wed 13 Jun 2018] from hantavirus pulmonary syndrome [HPS], a disease [virus] transmitted through rodent droppings.The woman, 67, and her husband, lived in Redmond but also maintained a home in the 3 Rivers community in Culver [Jefferson county].According to a neighbor, she had come to the Culver home before Memorial Day to prepare for a family visit."They have a loft in their barn that they use for extra…

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Ross River Virus -- AustraliaNSW [New South Wales state] Health has warned people to protect themselves against mosquitoborne diseases as the weather warms up and people move outdoors. Medical entomologist at NSW Health Pathology, Dr Cameron Webb, said the warmer weather was a time for increasing mosquito activity and it was important to prepare against diseases carried by them such as Ross River and Barmah Forest virus.There were 9 official notifications of Ross River virus in NSW Between 28 Oct-3 Nov [2018] and 11…

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Salmonella -- Worldwide/UnknownAccording to the European Food Safety Authority (EFSA), 5 European countries have reported 147 people infected with _Salmonella [enterica_ serotype] Agona, which could be linked to ready-to-eat food. In the UK, 129 people have been infected, while Finland counts 15 cases, Denmark 1, Germany 1 and Ireland 1.Experts from EFSA and the European Centre for Disease Prevention and Control (ECDC) believe that ready-to-eat products containing cucumbers and prepared in the UK may be the source of…

ProMED Mail

Foodborne Illness -- BrazilIn Para, Brazil, there has been a cluster of Chagas disease cases that officials believe may be related to the consumption of tainted acai berries. This could be because of carelessness in the conditions [during the] preparation of the product. The disease is typically contracted by consuming food or beverages contaminated by infected triatomine bugs, also known as "kissing" bugs.Illness typically develops by one week after exposure and can last for up to 60 days. Although most infected…

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Yellow Fever -- South SudanThe yellow fever outbreak in South Sudan was declared on 29 Nov 2018 in Sakure payam, Nzara county, Gbudwe state.Since the reporting of the outbreak, the Ministry of Health and partners have scaled up preparedness and response activities to mitigate and control possible spread. These activities entailed conducting follow up epidemiological; entomological; and laboratory investigations in addition to providing supportive clinical care to symptomatic cases by national rapid response…

ProMED Mail

Monkeypox, Hepatitis B, Other Human Disease, Tuberculosis, Zika virus, HIV/AIDS, Rubella, Measles, MRSA, Crimean-Congo Hemorrhagic Fever, Chagas -- NigeriaEditorials and perspectivesMonkeypox -- Enhancing public health preparedness for an emerging lethal human zoonotic epidemic threat in the wake of the smallpox post-eradication eraEskild Petersen, Ibrahim Abubakar, Chikwe Ihekweazu, David Heymann, Francine Ntoumi, Lucille Blumberg, Danny Asogun, Victor Mukonka, Swaib Abubaker Lule, Matthew Bates, Isobella Honeyborne, Sayoki Mfinanga, Peter Mwaba, Osman Dar, Francesco Vairo, Maowia Mukhtar, Richard Kock, Timothy D. McHugh, Giuseppe Ippolito,…

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-- Worldwide/UnknownPerspectivesEnhancing preparation for large nipah outbreaks beyond Bangladesh: preventing a tragedy like ebola in West AfricaInternational Journal of Infectious Diseases, Volume 72, July 2018, Pages 69-72Halsie Donaldson, Daniel Lucey A novel view on the pathogenesis of complications after intravesical BCG for bladder cancerInternational Journal of Infectious Diseases, Volume 72, July 2018, Pages 63-68Manu P. Bilsen, Krista E. van Meijgaarden, Hanna K. de Jong, Simone A.

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Foodborne Illness -- United StatesTwo more states--Iowa and Michigan--have reported _Cyclospora_ infections linked to Del Monte prepackaged vegetable trays, lifting the number of affected states to 4 and the illness total to 78, the US Centers for Disease Control and Prevention (CDC) said in a [15 Jun 2018] announcement.In a related development, Del Monte Fresh Produce on [15 Jun 2018] announced a voluntary recall of vegetable trays sold at some retailers in Illinois, Indiana, Iowa, Michigan, Minnesota, and Wisconsin. In a…

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HIV/AIDS -- Australia1. Holt M, Lea T, Mao L, et al. Community-level changes in condom use and uptake of HIV pre-exposure prophylaxis by gay and bisexual men in Melbourne and Sydney, Australia: results of repeated behavioural surveillance in 2013-17. Lancet HIV. 2018. pii: S2352-3018(18)30072-9. doi: 10.1016/S2352-3018(18)30072-9.--Communicated by:ProMED-mail[The abstract of the journal article referenced in the news report above is extracted below:Summary"Background. Pre-exposure prophylaxis…

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Malaria -- ParaguayWith free universal health services in Paraguay and a strong malaria surveillance system, malaria cases were detected early, investigated promptly, and classified correctly.Dedicated elimination strategy------------------------------After reporting its last case of malaria in 2011, Paraguay launched a 5-year plan to consolidate the gains, prevent re-establishment of transmission, and prepare for elimination certification. Activities centred on strengthening epidemiological…

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Meningitis - Neisseria -- NigeriaAs the dry season begins, we expect an increase in the number of cerebrospinal meningitis (CSM) cases in Nigeria. This is the 1st SitRep [situation report] for the 2018/2019 seasons.The National Technical Working Group for Cerebrospinal Meningitis has been improving [the] level of preparedness ahead of the 2018/2019 meningitis season. States in the meningitis belt were formally placed on alert on [8 Nov 2018].As at epi-week 50, 8 new suspected cases were reported from Katsina…

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Typhoid -- FijiA typhoid outbreak has been identified in the Naitasiri subdivision. This was confirmed by the Minister for Health, Dr. Ifereimi Waqainabete, who said there are 31 confirmed cases of typhoid and 14 suspected cases.He said the Naitasiri medical team continued to make daily visits, implementing public health awareness and public health interventions in these villages. He added that families have been educated on safe food preparation, food handling and proper hygiene practices.The…

Chantal B Reusken, Ramona Mögling, Pieter W Smit, Roland Grunow, Giuseppe Ippolito, Antonino Di Caro and Marion Koopmans

From December 2013 to March 2016, West Africa experienced the largest Ebola virus (EBOV) outbreak to date, leading to a European-wide activation of laboratory preparedness and response. At the end of the outbreak, laboratories associated with the two European preparedness networks of expert laboratories EMERGE JA and EVD-LabNet were invited to participate in an assessment of the response of European laboratories to the EBOV outbreak, to identify learning points and training needs to strengthen future outbreak responses. Response aspects assessed included diagnostics, biorisk management and quality assurance. The overall coverage of EBOV diagnostics in the European Union/European Economic Area (EU/EEA) was found to be adequate although some points for quality improvement were identified. These included the need for relevant International Organization for Standardization (ISO) accreditation, the provision of EBOV external quality assessments (EQA) in periods where there is no emergency, facilitating access to controls and knowledge, biorisk management without compromising biosafety and a rapid public health response, and the need for both sustained and contingency funding for preparedness and response activities.…