RIVM Publications Repository
Each year the Dutch National Institute for Public Health and the Environment (RIVM) produces numerous reports and publications on all aspects of public health, nutrition and food, health care, disaster management, nature and the environment.
In addition, RIVM employees publish scientific articles in national and international journals.
Elk jaar brengt het Rijksinstituut voor Volksgezondheid en Milieu (RIVM) talloze rapporten en adviezen uit over volksgezondheid en gezondheidszorg, voeding, natuur en milieu en rampenbestrijding.
Daarnaast publiceren RIVM-medewerkers wetenschappelijke artikelen in (inter-)nationale tijdschriften.
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Publication Human infections with Eurasian avian-like swine influenza virus detected by coincidence via routine respiratory surveillance systems, the Netherlands, 2020 to 2023(2025-05)BackgroundZoonotic influenza, including infections with avian and swine influenza A viruses (swIAV), is a notifiable disease in the Netherlands. Human cases infected with swIAV have previously been rarely detected in the Netherlands.AimWe aimed to describe detection and characterisation of Eurasian avian-like swIAV infections in humans in the Netherlands 2020-2023.MethodsThe Dutch National Influenza Center coordinates different activities to monitor respiratory infections and circulating human influenza viruses. This monitoring includes sentinel surveillance in general practitioner practices, community participatory surveillance and characterisation of influenza viruses received from diagnostic laboratories. A subset of the specimens positive for influenza A virus from the monitoring activities are sent for further characterisation. We characterised swIAV from human patients using whole genome sequencing, tested the viruses for antiviral susceptibility and in haemagglutination inhibition assays for antigenic characterisation and compared them with previous detections from humans and pigs.ResultsAvian-like swine influenza virus was detected in three persons presenting with mild respiratory symptoms, and all recovered fully. Only one patient had close contact with pigs shortly before the start of symptoms. Sequence analyses of the viruses showed clustering with swAIV from pigs in a recently initiated surveillance system on pig farms.ConclusionsThese human cases show that swIAV viruses with zoonotic potential are enzootic in the Netherlands. Finding them by coincidence suggests human infections might occur more frequently than noticed.Publication How to improve support for people with (complex) multiple-problems through social prescribing in a vulnerable neighborhood; professionals', experts-by-experience' and clients' perspectives(2025-05-15)Comparative analysis of literature on social prescribing implementation suggests that strategies for implementing social prescribing for people with (complex) multiple-problems may differ significantly from those for people with mild-psychosocial issues. Similar findings have been observed in the Netherlands, where a SP program has been developed in 2018. This study examines the perspectives of health and care professionals, experts-by-experience, and clients regarding the design and implementation of social prescribing in vulnerable neighborhoods in order to better support people with (complex) multiple-problems.Publication What is the current evidence base for measles vaccination earlier than 9 months of age?: Report from an informal technical consultation of the World Health Organization(2025-05-14)Measles is one of the most contagious vaccine preventable diseases, causing severe complications and deaths globally. While vaccination with a measles-containing vaccine (MCV) has prevented millions of measles deaths, recent trends, especially from low- and middle-income countries, are discouraging. Measles cases have increased since 2021 as MCV coverage has decreased; and an estimated 107,500 measles deaths, mostly in children under-five years, occurred in 2023. Thus, a renewed focus on proven and innovative strategies to control measles is needed. The World Health Organization (WHO) recommends a first MCV dose administered at 9-15 months of age (routine MCV1), however MCV1 below 9 months of age (early MCV1) may increase vaccination coverage because uptake of all vaccines tends to be higher the younger the child, and this might protect vulnerable infants earlier in life. However, due to concerns about possible reduced vaccine performance, early MCV1 is not routinely recommended by WHO. WHO hosted an informal technical consultation on December 6-7, 2023, in Geneva, Switzerland to evaluate recent evidence on early MCV1 and identify evidence gaps for policy making. The recent evidence suggests a robust humoral immune response shortly after early MCV1 at 5-8 months of age. Immune blunting of a routine second MCV dose (e.g., MCV2) after early MCV1 was not demonstrated in the presented data. However, 3-7 years after MCV1, children receiving early MCV1 had lower measles antibodies than children receiving routine MCV1, suggesting faster waning of immunity. The totality of evidence on immune blunting remains inconsistent. Meeting participants thought more data are needed before revisiting WHO's current recommendation for a potential revision. Evidence gaps include: understanding measles disease burden and severity in infants; early MCV1 effectiveness and duration; vaccine-induced cellular immunogenicity; whether measles in infants is acquired from other infants or older children or adults; and blunting of routine MCV2. Addressing evidence gaps through targeted studies and measles outbreak investigations, as well as evaluations of country-level introductions of early MCV1 are warranted. Ensuring high MCV1 and MCV2 coverage remains the priority in measles control.Publication An observational study protocol on wastewater measurements and diaper culture to estimate antimicrobial resistance in long-term care facilities for people with intellectual disabilities: The GIRAF-MIC study protocol(2025-05-15)Antimicrobial resistance (AMR) has become one of the leading global health threats. It is critical to understand the burden of AMR, particularly among vulnerable populations such as people with intellectual disabilities residing in long-term care facilities (ID-LTCFs). Traditional study methods to estimate the burden of AMR in these settings, such as rectal swabs to measure the prevalence of MDRO carriage, are considered burdensome for this population. This underscores the importance of a non-invasive method to assess the burden of AMR among people living in ID-LTCFs. This publication describes a study protocol for an alternative approach to estimate AMR, specifically Extended Spectrum Beta-Lactamase (ESBL) and carbapenemase-producing Enterobacterales (CPE), in ID-LTCFs in the Netherlands, through wastewater measurements combined with analysis of stool collected from diaper material. The protocol provides detailed information about the study design and methodologies proposed for a pilot study.Publication Age-related decline in IgM responses associate with reduced opsonophagocytic activity following PCV13 vaccination(2025-05-14)Pneumococcal vaccination is crucial in preventing Streptococcus pneumoniae infections in older adults. However, vaccine responses often diminish with age. This study investigates serotype-specific IgM and IgG responses in relation to opsonophagocytic activity (OPA) following thirteen-valent pneumococcal conjugate (PCV13) vaccination in younger (26-49 y; n = 44), middle-aged (50-64 y; n = 71), and older adults (65-98 y; n = 141). Both OPA and IgM responses declined with age, while IgG responses remained relatively stable. In younger adults, post-PCV13 OPA correlated moderate-to-strong with IgM for 8/13 serotypes and with IgG for only 4/13 serotypes. In contrast, middle-aged and older adults showed strong correlations between OPA and both IgM (10/13 serotypes) and IgG (12/13 serotypes). Overall, post-PCV13 OPA was predominantly associated with IgM levels. These observations suggest that declines in IgM, rather than IgG responses, explain reduced PCV13-induced opsonophagocytic activity in aging adults and may inform future vaccination strategies to enhance protection of older adults against pneumococcal disease.
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