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[Infectious Diseases
News Brief]
Meningitis Vaccination: Quebec
The minister of State at Santé et Services sociaux kicked off the meningitis
vaccination campaign at the Rosemont CLSC. Along with the president of the
Association des CLSC-CHSLD du Québec, the assistant deputy minister of public
health and the chair of the immunization committee, the minister announced
that this campaign would start on September 24 and continue on an intensive
basis until the end of December. The campaign will be conducted with the cooperation
of CLSCs, public health branches of every region and the Institut national
de santé publique du Québec. By the end of 2001, approximately 1.7 million
youth between the ages of 2 months and 20 years will be vaccinated for type
C meningitis. The new conjugate vaccine (licensed just over a few months ago)
will be used; it is more effective than the vaccine that has been available
thus far. The minister said that the last major meningitis vaccination campaign
dates back to 1992-1993. It proved to be very effective since the number of
reported cases plummeted in the years that followed. However, the old vaccine
offered protection for just 5 years. According to medical experts, the new
vaccine will be effective for a much longer period, namely 15 years. Primary
or secondary school students- even college-level students-will be vaccinated
at their school. Secondary school students, who are the most vulnerable, will
be the first to be vaccinated, followed by those at the CÉGEP and primary
levels. As for pre-school children and young adults, the conditions and schedule
for their vaccination will be determined according to region. CLSCs will head
the school vaccination campaign in their own areas. In several regions, private
clinic physicians will help vaccinate very young children and young adults
who are not in school. An information campaign will be launched over the next
several days to raise the population's awareness of the importance of vaccination
and give it a general overview of the operation.
Source: Press release, Government of Quebec, September 14, 2001.
Syphilis: France
The incidence of syphilis is increasing in France in the context of a general
resurgence in sexually transmitted infections (STIs), including gonorrhoea.
After several years in which syphilis was considered a rare disease, a study
coordinated by the Institut de Veille Sanitaire (InVS) has shown a worrying
reversal in this trend. In November 2000, the STI centre at the Tarnier hospital
in Paris alerted the InVS about the unusually high number of cases of syphilis
diagnosed during the preceding 6 weeks. A study was undertaken to describe
these and other cases in detail and to determine the extent of the increase
in syphilis in France. Between January 1 and May 31, 2001, 78 syphilis cases
(of which 77 were men) were notified to the InVS by clinicians (32 of these
cases had been diagnosed in 2000 and 46 cases in the first 5 months of 2001).
Sixty-eight (87%) of the reported cases were diagnosed in Paris. The median
age of the cases was 36.4 years. Fifty-eight (75%) of the male cases were
homosexual. Overall, 21 cases (27%) had no previous history of STIs, and 41 (53%)
were coinfected with HIV. Seven patients discovered their HIV infection status
during the episode when syphilis was diagnosed. Secondary syphilis was diagnosed
in 49 cases (63%). A similar resurgence of syphilis has been observed in other
European countries, such as Belgium, Ireland, the Netherlands, and the United
Kingdom. This outbreak of syphilis in France is consistent with the increase
in other STIs and in risky sexual behaviour, especially among homosexual men.
A national network for syphilis surveillance has been established in France
as part of the response to the situation.
Source: Eurosurveillance Weekly, Issue 37, September 13, 2001.
Aseptic Viral Meningitis: Germany
Between August 11-17, 2001, the health office of Kassel, a city in the German
state of Hesse, received notifications from two hospitals in northern Hesse
of an increased number of cases of aseptic meningitis. Fifteen children and
10 adults had been admitted with symptoms including severe headache, fever,
neck stiffness, and vomiting. All were discharged after two to four days.
The health office of Kassel initiated an outbreak investigation to identify
the causative agent, describe the extent and severity of the outbreak, and
identify and exclude potential risk factors. Active case finding among resident
general practitioners and in hospitals in the city resulted in the identification
of 68 patients with aseptic viral meningitis from the Kassel and neighbouring
districts. Cerebrospinal fluid (CSF) from all 68 patients was analysed for
suspected bacterial meningitis. This diagnosis was ruled out because of an
absence of bacterial strains and an only moderately raised cell count of lymphocytes
in the CSF. The first notified patient had been admitted on July 15. On July
31, more than two patients with aseptic meningitis were admitted in one day
for the first time. The number of admissions peaked between August 4 and August
19, 2001. The youngest patient was aged 3 years, the oldest 50. Sixty per
cent (41/68) of patients were aged between 5 and 14 years. Forty patients
(59%) were male. Twenty-seven (40%) were from Kassel county district, 22 (32%)
from Kassel city, and 11 (16%) from the neighbouring Schwalm-Eder district.
Two to three patients each lived in several adjacent districts. A case-control
study is currently being conducted to identify potential risk factors. Seven
CSF specimens from two hospitals were analysed at the National Reference Centre
for Polio and Enteroviruses, where polymerase chain reaction for enteroviruses
was positive for six specimens. Echovirus 30 was cultured from four samples.
The outbreak continues.
Source: Eurosurveillance Weekly, Issue 37, September 13, 2001
The details given are for information only and may be
very provisional. Where incidents are considered of national importance and
are ongoing, the initial report will be updated as new information becomes
available.
[Infectious Diseases
News Brief]
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