Alertas epidemiológicas

Alertas hasta 8 de diciembre de 2017

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Listeria monocytogenes IVb, ST6 - Multistate (Europe) - 2017 Opening date: 30 November 2017 . A multi-country outbreak involving 26 Listeria monocytogenes cases including four fatal cases in five Member States (Austria, Denmark, Finland, Sweden and the United Kingdom) is currently ongoing. Human isolates belonging to the same genomic cluster were reported since 2015.

Influenza transmission in Europe Influenza activity across Europe remained at low levels. For week 2017-48, 8.8% of the sentinel specimens tested positive for influenza viruses, which is higher than the previous week (7%). Data from 16 countries or regions reporting to the EuroMOMO project indicated that all-cause excess mortality was within normal range for this time of year. Additional information on global influenza activity is available from WHO’s biweekly global updates

Rubella, caused by the rubella virus and commonly known as German measles, is usually a mild and self-limiting disease which often passes unnoticed. The main reason for immunising against rubella is the high risk of congenital malformations associated with rubella infection during pregnancy. All EU Member States recommend vaccination against rubella with at least two doses of vaccine for both boys and girls. The vaccine is given at the same intervals as the measles vaccine as part of the MMR vaccine. No new outbreaks have been detected in the EU since March 2017. ECDC reports global outbreaks of rubella in the CDTR on a monthly basis or if there is a critical event.

Measles. Measles outbreaks continue to occur in a number of EU/EEA countries with a risk of spread and sustained transmission in areas with susceptible populations. Since 15 September 2017, ECDC has been reporting EU and global outbreaks of measles in the CDTR on a monthly basis unless new developments are taking place. Measles – Multistate (EU) – Monitoring European outbreaks Opening date: 9 February 2011 Latest update: 8 December 2017 ÎUpdate of the week There is a decreasing trend of measles cases in Italy and Romania. Greece continues reporting a substantial number of cases, particularly in the south of the country. Updates are provided for Austria, Germany, Greece, Ireland, Italy, Romania, Spain and the UK. Updates outside EU/EEA countries are provided for Kosovo*, Serbia and Ukraine.

Poliomyelitis. Global public health efforts are ongoing to eradicate polio by immunising every child until transmission of the virus has completely stopped and the world becomes polio-free. Polio was declared a public health emergency of international concern (PHEIC) by the World Health Organization (WHO) on 5 May 2014 due to concerns regarding the increased circulation and international spread of wild poliovirus during 2014. On 14 November 2017, WHO agreed that the spread of poliovirus remains a public health event of international concern and extended the temporary recommendations for an additional three months. The last locally-acquired wild polio cases within the current EU borders were reported from Bulgaria in 2001. In June 2002, the WHO European Region was officially declared polio-free.

ÎUpdate of the week On 14 November 2017 the fifteenth IHR emergency committee regarding the international spread of poliovirus unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC), and recommended the extension of revised Temporary Recommendations for further three months. Based on the current situation regarding WPV1 and cVDPV, and reports by Afghanistan, the Democratic Republic of Congo, Nigeria, Pakistan, and the Syrian Arab Republic, the Director-General accepted the Committee’s assessment and on 20 November 2017 determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV. Since the last CDTR on 3 November 2017 and as of 5 December 2017, Afghanistan has reported three cases of wild poliovirus type 1 (WPV1). Syria has reported 17 cases of type 2 circulating vaccine-derived poliovirus (cVDPV2). An advance notification was received of one new wild poliovirus type 1 (WPV1) case in Sindh province, Pakistan. The case will be officially reflected in next week’s global data reporting. In 2017, as of 5 December, 16 wild poliovirus cases have been reported, 11 cases from Afghanistan and five cases from Pakistan. In addition, 80 circulating cVDPV2 cases have been reported in 2017, ten from the Democratic Republic of Congo, and 70 from Syria

Plague - Madagascar – 2017, An outbreak of plague in Madagascar began in August 2017 and has expanded rapidly. More than half of the cases reported were due to pneumonic plague. The number of cases and deaths exceeds those in previous outbreaks and the majority of the cases have been recorded in the capital of Antananarivo and the port of Toamasina, the largest cities in Madagascar. Since the peak in the first two weeks of October 2017, a decreasing trend has been observed.

Update of the week According to WHO, since 1 August and as of 26 November 2017, 2 417 confirmed, probable and suspected cases of plague, including 209 deaths (case fatality rate 8.7%) have been reported from 57 of 114 districts in the country. This is an increase by 33 cases and two deaths since the previous CDTR published on 1 December. Of the 2 417 cases, 1 854 (77%) were clinically classified as pulmonary plague, 355 (15%) were bubonic plague, one was septicaemic, and 207 were not classified. Among the cases, 81 are healthcare workers. To date, no cases outside of Madagascar related to this outbreak have been detected. The number of reported cases has been declining over the past month, suggesting that the control measures implemented have been effective.

Influenza A(H7N9) – China – Monitoring human cases. In March 2013, a novel avian influenza A(H7N9) virus was detected in patients in China. Since then, cases continue to be reported from China. No autochthonous cases have been reported outside China. Most cases are isolated, and sporadic zoonotic transmission from poultry to humans is the most likely explanation for the outbreak. Influenza A(H7N9) – China – Monitoring human cases Opening date: 31 March 2013 Latest update: 8 December 2017 ÎUpdate of the week On 2 December 2017, the first case of the sixth season of influenza A(H7N9) was reported. A 64-year-old man, from Yunnan province, China, reported contact with dead poultry prior to the onset of symptoms on 21 November.

Middle East respiratory syndrome coronavirus (MERS-CoV) – Multistate. Since the disease was first identified in Saudi Arabia in September 2012, approximately 2 000 MERS-CoV cases have been detected in over 20 countries. In Europe, eight countries have reported confirmed cases, all with direct or indirect connection with the Middle East. The majority of MERS-CoV cases continue to be reported from the Middle East. The source of the virus remains unknown, but the pattern of transmission and virological studies point towards dromedary camels in the Middle East as being a reservoir from which humans sporadically become infected through zoonotic transmission. Human-to-human transmission is amplified among household contacts and in healthcare settings. Middle East respiratory syndrome coronavirus (MERS-CoV) – Multistate Opening date: 24 September 2012 Latest update: 8 December 2017 ÎUpdate of the week Between 31 October and 5 December, Saudi Arabia reported 17 MERS-CoV cases. Of the 17 cases, 13 were male and four were female. Sixteen are primary cases of which six reported direct or indirect camel contact. One case is a household contact. On 1 November, WHO reported one case in Oman. The case, a 27-year-old male living in Sharqiyah Region, reported contact with dromedaries prior to symptom onset on 21 October 2017. Prior to this case, the most recent case of MERS-CoV from Oman was reported on 30 August 2017. This is the tenth case reported by Oman since 2013.

Yellow fever - Nigeria – 2017. Nigeria has reported its first yellow fever outbreak since 2002. Yellow fever is a mosquito-borne viral infection occurring in some of the tropical areas of Africa and South America. The last major outbreaks notified in Africa were in Angola and the Democratic Republic of the Congo in 2016. Yellow fever - Nigeria - 2017 Opening date: 14 November 2017 Latest update: 8 December 2017 ÎUpdate of the week Since 12 September 2017 and as of 21 November 2017, Nigeria has reported 276 cases, including 45 deaths. This is an increase by 97 cases and 14 deaths since the previous update on 7 November.