Heimeriks K; Loo MAJM; Jacobi AJ(Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2011-12-19)
In the Netherlands, the number of notifications of infectious diseases contracted by people at work is low. The figure represents only one to two percent of the total number of registered infectious diseases. In 2010 the number of notifications registered was 278. This has been reported by the National Institute for Public Health and the Environment (RIVM) in an analysis of workrelated infectious diseases in 2010. The researchers share the opinion that nowhere near all work-related infectious diseases have been reported. The reason for this is partly due to underreporting of occupational diseases in the register at the Netherlands Center for Occupational Diseases (NCvB). In Osiris the link with work is not always registered because the source of contamination is often not known. Employees can come into contact with pathogens whilst they are at work and thus contract an infectious disease. The sectors of health care, education, and agriculture are occupational branches where the risk of exposure to pathogens is the greatest. The two most important Dutch registration systems for workrelated infectious diseases are Osiris and the NCvB register of occupational diseases. As commissioned by the Ministry of Social Affairs and Employment (SZW), each year the data from the Osiris and NCvB registers are analysed. SZW aims to increase the knowledge base on work-related infectious diseases and share this with employers, employees and occupational health professionals. Employers must ensure that employees are able to work in a safe and healthy work environment. Exposure to pathogens must be prevented as far as this is possible. If exposure cannot be prevented, then the appropriate measures have to be taken. In order to take good prevention measures, having good insight into which professional groups are likely to contract an infectious disease because of the work they do is pertinent. In Osiris, 189 work-related infectious diseases were reported in 2010. Whooping cough, malaria, mumps and hepatitis B constituted the highest number of notifications in Osiris. At the NCvB, 89 infectious diseases related to work were registered in 2010. These were mainly intestinal infections, skin infections and zoonoses.
van 't Klooster TM; Kemmeren JM; Vermeer-de Bondt PE; Oostvogels B; Phaff T; de Melker HE; van der Maas NAT(Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2011-12-28)
In 2010, less AEs were reported after vaccination against HPV compared with 2009. Furthermore, as in 2009, no unexpected or Serious Adverse Events were reported after vaccination against HPV that were considered causally related to the vaccination. During 2010, girls born in 1997 were vaccinated against HPV. Furthermore, girls born in 1993-1996, who were not or not fully vaccinated in 2009, were invited again. Intensified surveillance of AEs was performed. Immediate AEs on mass vaccination locations were registered. Spontaneous reports through the enhanced passive surveillance system were collected and a study on the tolerability of the vaccine was performed. Immediate AEs on locations of mass vaccination occurred in 7.7/10,000 administered doses. Presyncope or syncope was most frequently reported. The reporting rate of spontaneous reports was 5.4/10,000 administered doses overall. The reporting rates of both immediate AEs and spontaneous reports were lower compared with the 2009 campaign. No differences in reporting rates of spontaneous reports were found between the girls born in 1997 (regular NIP) and girls born in 1993-1996 (catch-up campaign). Twenty-three percent of the reports concerned a major AE, including fainting, migraine and convulsions. Of all reports, 67.4% was assessed to be causally related to the vaccination. In the study on tolerability, at least one questionnaire was returned by 2308 girls (65%). Local reactions were reported in 82.4%, mostly pain at the injection site and/or reduced use of the arm. Of all local reactions, 14.8% was classified as pronounced. In 78.7% any systemic AE was reported, in which myalgia was reported the most often. The reported proportions of local reactions and systemic AEs were lower than in the 2009 campaign. Some local reactions and systemic AEs increasing with age, and most incidences were lower after the second and third dose than after the first dose. The GP was visited by 17 girls (0.4%) within one week after the vaccination, but none visited the hospital. Results are used to inform public and professionals on the safety profile of the HPV vaccine observed in the period post introduction of mass vaccination.
David S; van der Velde MW; Bults M; Vermeer-de Bondt PE(Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2011-05-23)
During the mass vaccination campaign against Meningococcal serogroup C disease in 2002 in the Netherlands, local and/or systemic adverse events were reported in 66% of the children in the First week following vaccination. In total 2403 filled in questionnaires were analysed. Most symptoms occured within 24 hours after the vaccination. The percentage of reports of both local and systemic adverse events increased with age. Causality with the vaccination is probable in 90%-100% of the local adverse events and in 64%-90% of the systemic adverse events. The results show a good tolerability of the MenC vaccination during this campaign.
de Bruin A; van Alphen P; Janse I; van Rotterdam B(Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2011-10-25)
Q fever, caused by the bacterium C. burnetii, is a zoonosis with a worldwide distribution that affects both humans and animals. From 2007 to 2010, large community outbreaks of Q fever were observed in the Netherlands. In 2008 and 2009 source finding investigations were initiated by several Municipal Health Services, primarily on commercial dairy goat farms, to pinpoint potential sources for Q fever. In that same year, the Food and Consumer Product Safety Authority initiated a project to investigate if petting zoos were a potential source for human Q fever as well. Petting zoos showed insufficient C. burnetii DNA content for molecular typing (qPCR Cq values higher than 33) and were not considered an important source for human Q fever. However, 31 samples from eight out of 57 commercial dairy farms, involved in source finding investigations in 2009, showed a relatively high C. burnetii DNA content based on qPCR data for single copy target com1 (Cq values lower than 33). These samples were selected for molecular typing using a Multi-Locus Variable number of tandem repeat Analysis (MLVA). In this study we show that samples highly positive for C. burnetii DNA can be successfully typed using a multiplex MLVA assay. Three different MLVA types were found, based on six MLVA markers. On seven out of eight locations a single MLVA type was found. On one location a mixture of two types was observed within a number of samples. Our findings show that multiple MLVA types are present in the Netherlands, which is promising for future source finding investigations to identify potential sources. However, only a few different MLVA types have been determined in human and animal samples so far, which makes identifying transmission routes and sources of C. burnetii in the Netherlands still challenging.
Janse I; Bossers A; Roest HJ; van Rotterdam B(Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2011-11-29)
Coxiella burnetii is an intracellular bacterium which causes Q-fever. The genomes from a number of isolates obtained from the Dutch outbreak, were sequenced. These genome sequences form the basis for improved typing methods, enabling more accurate source finding and epidemiological studies. In addition, the genome sequences are highly valuable for other research, for instance of the relation between the Dutch outbreak and altered virulence properties. As a result of this project, 19 isolates from the Dutch outbreak have been cultivated. These isolates were primarily obtained from veterinary sources, but a few were acquired from human or environmental sources. The genomes of 3 isolates have been almost completely sequenced and some preliminary analyses were performed. Raw sequences from 4 additional isolates will be available soon. The bacterial isolates and genome sequences play important roles in several ongoing projects from the research partners. The experience that was acquired with harvesting and sequencing C. burnetii genomes is highly valuable for current and future research of C. burnetii and other intracellular pathogens.
Brandsema PS; Dijkstra F; van Gageldonk-Lafeber AB; Snijders BEP; Meijer A; van der Hoek W(Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2011-10-18)
Respiratory infections and community acquired pneumonia are an important reason for general practitioner consultation, hospital and intensive care unit admission, and death. This report gives the results of surveillance of a number of respiratory infectious diseases in the Netherlands for the year 2010. The year 2010 was uneventful with respect to the respiratory infectious diseases compared with 2009 when the world faced an influenza pandemic, which coincided in the Netherlands with an exceptionally large Q-fever outbreak. The end of the influenza pandemic was officially declared in 2010. The first influenza season after the pandemic was relatively mild with a peak in incidence of influenza-like illness in the first weeks of 2011. The number of notifications for acute Q-fever went down sharply in 2010. However, the Q-fever problem is not over as an increasing number of chronic Q-fever cases is expected in the coming years. Chronic Q-fever is a relatively rare but serious long-term effect of acute Q-fever infection. The increase in number of new tuberculosis cases that was observed in 2009 was not sustained in 2010. The number of cases with legionellapneumonia in 2010 was the highest ever notified in the Netherlands. There was an increase of domestic legionellapneumonia in the summer of which the causes are yet unknown but are further investigated.
van der Maas NAT; Vermeer-de Bondt PE; Hoefnagel J; van der Veen Y; van der Velde MW(Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2011-05-23)
During the mass vaccinationcampaign in 2002 in the Netherlands, targeting meningococcal serogroup C disease, many children have (nearly) fainted, mostly during or after the immunization. The highest incidence of presyncope and syncope occurred in the 6-14 year old children (21.4 per 100,000), followed by 15-18 year old children (18.9 per 100,000) and 1-5 year olds (2,2 per 100,000) respectively. In total 4470 immediate occurring adverse events were reported related more than 1.8 million administered vaccines. This 1.8 million is 63% of the total number of vaccinated children. Over 83% of the reports considered presyncope and syncope. Other reported symptoms were for instance anxiety, hyperventilation, tingling and headache. No children with symptoms of anaphylactic shock were reported.
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