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  • Standardising surveillance of hepatitis E virus infection in the EU/EEA: a review of national practices and suggestions for the way forward
    Publication . Adlhoch, C.; Mand'áková, Z.; Ethelberg, S.; Epštein, J.; Rimhanen-Finne, R.; Figoni, J.; Baylis, S.A.; Faber, M.; Mellou, K.; Murphy, N.; O'Gorman, J.; Tosti, M.E.; Ciccaglione, A.R.; Hofhuis, A.; Zaaijer, H.; Lange, H.; de Sousa, R.; Avellón, A.; Sundqvist, L.; Said, B.; Ijaz, S.
    Background: Hepatitis E virus (HEV) infection is not notifiable at EU/EEA level, therefore surveillance relies on national policies only. Between 2005 and 2015, more than 20,000 cases were reported in EU/EEA countries. HEV testing is established in 26 countries and 19 countries sequence HEV viruses. Objective and study design: WHO's European Action plan for viral hepatitis recommends harmonised surveillance objectives and case definitions. ECDC's HEV expert group developed minimal and optimal criteria for national hepatitis E surveillance to support EU/EEA countries in enhancing their capacity and to harmonise methods. Results: The experts agreed that the primary objectives of national surveillance for HEV infections should focus on the basic epidemiology of the disease: to monitor the incidence of acute cases and chronic infections. The secondary objectives should be to describe viral phylotypes or subtypes and to identify potential clusters/outbreaks and possible routes of transmission. Seventeen of 20 countries with existing surveillance systems collect the minimal data set required to describe the epidemiology of acute cases. Eleven countries test for chronic infections. Twelve countries collect data to identify potential clusters/outbreaks and information on possible routes of transmission. Discussion: Overall, the majority of EU/EEA countries collect the suggested data and meet the outlined requirements to confirm an acute case.
    2019-09-19Journal article Restricted access Show more
  • Chlamydia trachomatis outbreak: when the virulence-associated genome backbone imports a prevalence-associated major antigen signature
    Publication . Borges, Vitor; Cordeiro, Dora; Salas, Ana Isabel; Lodhia, Zohra; Correia, Cristina; Isidro, Joana; Fernandes, Cândida; Rodrigues, Ana; Azevedo, Jacinta; Alves, João; Rôxo, João; Rocha, Miguel; Corte-Real, Rita; Vieira, Luís; Borrego, Maria José; Gomes, João Paulo
    Chlamydia trachomatis is the most prevalent sexually transmitted bacterium worldwide and the causative agent of trachoma. Its strains are classified according to their ompA genotypes, which are strongly linked to differential tissue tropism and disease outcomes [ocular disease, urogenital disease and lymphogranuloma venereum (LGV)]. While the genome-based species phylogenetic tree presents four main clades correlating with tropism/prevalence, namely ocular, LGV, urogenital T1 (more prevalent genotypes) and urogenital T2 (less prevalent genotypes), inter-clade exchange of ompA is considered a rare phenomenon probably mediating marked tropism alterations. An LGV epidemic, associated with the clonal expansion of the L2b genotype, has emerged in the last few decades, raising concerns particularly due to its atypical clinical presentation (ulcerative proctitis) and circulation among men who have sex with men (MSM).
    2019-09-19Conference object Restricted access Show more