Campylobacter is among the most important agents of enteritis in developed countries. We have described the potential environmental determinants of the seasonal pattern of infection with campylobacter in Europe, Canada, Australia and New Zealand. Specifically, we investigated the role of climate variability on laboratory-confirmed cases of campylobacter infection from 15 populations. Regression analysis was used to quantify the associations between timing of seasonal peaks in infection in space and time. The short-term association between weekly weather and cases was also investigated using Poisson regression adapted for time series data. All countries in our study showed a distinct seasonality in campylobacter transmission, with many, but not all, populations showing a peak in spring. Countries with milder winters have peaks of infection earlier in the year. The timing of the peak of infection is weakly associated with high temperatures 3 months previously. Weekly variation in campylobacter infection in one region of the UK appeared to be little affected by short-term changes in weather patterns. The geographical variation in the timing of the seasonal peak suggests that climate may be a contributing factor to campylobacter transmission. The main driver of seasonality of campylobacter remains elusive and underscores the need to identify the major serotypes and routes of transmission for this disease.

Currently the surveillance of infectious disease in the European Union (EU) is supported by the Basic Surveillance Network (BSN) and other disease specific surveillance networks (DSNs). Each network has its own website. The objective of the current study was to describe the information presented with public access on each website from the perspective of its usefulness for the surveillance of an EU member state. The BSN and the DSNs cited in Decision 2003/542/CE were included. Each website was reviewed and assessed on the inclusion of characteristics from three broad categories: 1) general information, 2) procedures for data collection and 3) data presentation. Ten surveillance network websites were reviewed during the week of 5 December 2005. At least 80% of the 10 networks included a list of participating countries, the contact addresses for the coordinator of the network and the participating country gatekeepers and the network's objectives. Only one network specified the source and coverage of the data of each country on its website, and seven presented the disease case definition. Raw data were shown on eight websites and only two networks included presentation of elaborated data for the whole of the EU. Four networks included no reports on their websites. The periodicity of presentation for both raw data and elaborated data varied greatly between networks. The publicly available information on the 10 network websites studied was not homogeneous. We recommend that all networks present a basic set of characteristics on their websites, including case definitions, procedures used for data collection and periodic reports covering elaborated data for the entire EU.

By 27 October 2005, 32 cases of gastroenteritis due to Salmonella Goldcoast had been detected in tourists

On 3 September 2002, the Spanish national centre of epidemiology (Centro Nacional de Epidemiología - CNE) was alerted to a high number of gastroenteritis cases in Spanish tourists who had travelled to a hotel in Punta Cana on different days during august 2002. Entamoeba hystolitica cysts have been visualised by microscopy in the stools of several patients that sought medical attention in the Dominican Republic. The CNE informed the health authorities in the Dominican Republic and conducted in conjunction an epidemiological investigation. A descriptive study of the 76 initial cases estimated a mean illness duration of 5.1+2.9 days and a exposure period of 3.6+2.2 days. Following a retrospective cohort study, the attack rate was found to be 32.4%. Consequently, 216 (95% CI=114.75-317.25) spanish tourists had probably developed the illness. Stool samples were collected in Spain from untreated patients who still felt unwell. None of the samples were positive for E.hystolitica. On 10 September, a hygiene inspection was undertaken at the hotel. Samples of the ice and meals served at the buffet that day, yielded coliform bacteria. Consumption of water from the resort water system was the only risk factor associated with the symptoms (RR= 3.55; 95% CI =1.13-10.99). To avoid similar outbreaks occurring again at the hotel, it is essential to regularly monitor the water quality and to improve food handling hygiene standards. Basic food hygiene training for food handlers should be mandatory. An international guideline for the management foodborne and waterborne outbreaks among tourists in holiday resorts should be drawn up, involving all competent authorities of both destination and tourist origin countries.