Over 400 office workers from the same unit of a manufacturing company in Stockholm County, Sweden, fell ill with gastroenteritis. A retrospective cohort study of office workers in the affected unit demonstrated that canteen visitors on one day had an increased risk of illness [risk ratio (RR) 27.1, 95% confidence interval (CI) 15.7-46.8] compared to non-visitors. A second study, investigating canteen visitors' consumption of particular food items, showed that both tomatoes from the salad buffet (RR 5.6, 95% CI 3.2-9.6) and hamburgers (RR 4.9, 95% CI 2.4-9.8) were the most likely vehicles of infection. Norovirus GI.3 (Desert Shield) was identified in stool samples from three office workers and from a food handler who prepared the tomatoes for the salad buffet and hamburger ingredients before vomiting at the workplace on 12 November. The outbreak could have been prevented if the food items prepared by the food handler some hours before vomiting had not been served.

No abstract

ObjectiveThe objective of this demonstration is to show conference attendees how one-health surveillance in medical, veterinary and environmental sectors can be improved with Electronic Integrated Disease Surveillance System (EIDSS) using CCHF as an example from Kazakhstan. IntroductionEIDSS supports collection and analysis of epidemiological, clinical and laboratory information on infectious diseases in medical, veterinary and environmental sectors. At this moment the system is deployed in Kazakhstan at 150 sites (planned 271) in the veterinary surveillance and at 8 sites (planned 23) in human surveillance. The system enforces the one-health concept and provides capacity to improve surveillance and response to infectious disease including especially dangerous like CCHF.EIDSS has been in development since 2005 and is a free-of-charge tool with plans for open-source development. The system development is based on expertise of a number of US and international experts including CDC, WRAIR, USAMRIID, et al.

Background: Kala-azar (KA) is a vector borne parasitic disease caused by protozoan parasite Leishmania donovani. The disease is endemic in eastern and central terai of Nepal. So far, KA elimination programme is running in this part of the world which aims to reduce the annual incidence less than 1 per 10,000 populations. The elimination programme only targets to detect the active cases but finding out the asymptomatic infection is not considered. It is therefore important to know the true prevalence of asymptomatic infections and to monitor their further outcome with transmission dynamics of such anthroponotically transmitted disease. In this context, this study used molecular and serological techniques to detect asymptomatic infection from high transmission foci of eastern Nepal.Methods: Altogether 299 blood samples were collected from healthy households contacts (HHC) with past KA cases and healthy past Kala-azar (HPK) cases which were successfully treated with drugs in the past. Polymerase chain reaction (PCR) and direct agglutination test (DAT) were executed on all blood samples to find out the Leishmania donovani infection.Results: In overall analysis, PCR and DAT documented the same range of Leishmania donovani infection (33.4% and 35.4 respectively) whereas very different results were encountered when results were compared according to the type of study subjects described in this study. In HHC, PCR positivity was higher than DAT positivity (34.6% and 18.2%, respectively) where as in HPK; DAT positivity rate was much higher than PCR positivity (94.1% and 29.4% respectively). Conclusion:Our study documented the high rate of Leishmania donovani infection especially in household contact group which is indeed considered as a high risk group in anthroponotic transmission of KA in this region. In addition, the presence of infection among the healthy past KA treated cases would possibly suggest the relapse or re-infection. However, due to the long half life of miltefosine drugs, which is the first line to treat KA in these regions, relapse phenomena should not be underestimated. Further follow up study are therefore definitely required to document the outcome of these large proportions of infected individuals.

Electronic reporting systems improve the quality and timeliness of the surveillance of communicable diseases. The aim of this paper is to present the process of the implementation and introduction of an electronic reporting system for the surveillance of communicable diseases in Lithuania. The project which started in 2002 was performed in collaboration between Lithuania and Sweden and was facilitated by the parallel process of adapting the surveillance system to European Union (EU) standards. The Lotus-based software, SmittAdm, was acquired from the Department of Communicable Diseases Control and Prevention of Stockholm County in Sweden and adopted for Lithuania, resulting in the Lithuanian software, ULISAS. A major advantage of this program for Lithuania was the possibility to work offline. The project was initiated in the two largest counties in Lithuania where ULISAS had been installed and put in use by January 2005. The introduction was gradual, the national level was connected to the system during late 2005, and all remaining counties were included during 2006 and 2007. The reporting system remains to be evaluated concerning timeliness and completeness of the surveillance. Further development is needed, for example the inclusion of all physicians and laboratories and an alert system for outbreaks. The introduction of this case-based, timely electronic reporting system in Lithuania allows better reporting of data to the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) compared to the former reporting system with paper-based, aggregated data.