scholarly journals Improving preparedness to respond to cross-border hepatitis A outbreaks in the European Union/European Economic Area: towards comparable sequencing of hepatitis A virus

2019 ◽  
Vol 24 (28) ◽  
Author(s):  
Theresa Enkirch ◽  
Ettore Severi ◽  
Harry Vennema ◽  
Lelia Thornton ◽  
Jonathan Dean ◽  
...  
Keyword(s):  
European Union ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Outbreak Detection ◽  
European Economic Area ◽  
The European Union ◽  
European Economic ◽  
Cross Border ◽  
Economic Area ◽  
Primary Diagnostics

Introduction Sequence-based typing of hepatitis A virus (HAV) is important for outbreak detection, investigation and surveillance. In 2013, sequencing was central to resolving a large European Union (EU)-wide outbreak related to frozen berries. However, as the sequenced HAV genome regions were only partly comparable between countries, results were not always conclusive. Aim The objective was to gather information on HAV surveillance and sequencing in EU/European Economic Area (EEA) countries to find ways to harmonise their procedures, for improvement of cross-border outbreak responses. Methods In 2014, the European Centre for Disease Prevention and Control (ECDC) conducted a survey on HAV surveillance practices in EU/EEA countries. The survey enquired whether a referral system for confirming primary diagnostics of hepatitis A existed as well as a central collection/storage of hepatitis A cases’ samples for typing. Questions on HAV sequencing procedures were also asked. Based on the results, an expert consultation proposed harmonised procedures for cross-border outbreak response, in particular regarding sequencing. In 2016, a follow-up survey assessed uptake of suggested methods. Results Of 31 EU/EEA countries, 23 (2014) and 27 (2016) participated. Numbers of countries with central collection and storage of HAV positive samples and of those performing sequencing increased from 12 to 15 and 12 to 14 respectively in 2016, with all countries typing an overlapping fragment of 218 nt. However, variation existed in the sequenced genomic regions and their lengths. Conclusions While HAV sequences in EU/EEA countries are comparable for surveillance, collaboration in sharing and comparing these can be further strengthened.

scholarly journals Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017

2018 ◽  
Vol 23 (33) ◽  
Author(s):  
Patricia Ndumbi ◽  
Gudrun S Freidl ◽  
Christopher J Williams ◽  
Otilia Mårdh ◽  
Carmen Varela ◽  
...  
Keyword(s):  
European Union ◽  
Sexual Behaviour ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
European Economic Area ◽  
The European Union ◽  
Case Definitions ◽  
European Economic ◽  
Economic Area ◽  
Sex With Men

Between 1 June 2016 and 31 May 2017, 17 European Union (EU) and European Economic Area countries reported 4,096 cases associated with a multi-country hepatitis A (HA) outbreak. Molecular analysis identified three co-circulating hepatitis A virus (HAV) strains of genotype IA: VRD_521_2016, V16–25801 and RIVM-HAV16–090. We categorised cases as confirmed, probable or possible, according to the EU outbreak case definitions. Confirmed cases were infected with one of the three outbreak strains. We investigated case characteristics and strain-specific risk factors for transmission. A total of 1,400 (34%) cases were confirmed; VRD_521_2016 and RIVM-HAV16–090 accounted for 92% of these. Among confirmed cases with available epidemiological data, 92% (361/393) were unvaccinated, 43% (83/195) travelled to Spain during the incubation period and 84% (565/676) identified as men who have sex with men (MSM). Results depict an HA outbreak of multiple HAV strains, within a cross-European population, that was particularly driven by transmission between non-immune MSM engaging in high-risk sexual behaviour. The most effective preventive measure to curb this outbreak is HAV vaccination of MSM, supplemented by primary prevention campaigns that target the MSM population and promote protective sexual behaviour.

Seroprevalence and susceptibility to hepatitis A in the European Union and European Economic Area: a systematic review

2017 ◽  
Vol 17 (10) ◽  
pp. e306-e319 ◽  
Author(s):  
Paloma Carrillo-Santisteve ◽  
Lara Tavoschi ◽  
Ettore Severi ◽  
Sandro Bonfigli ◽  
Michael Edelstein ◽  
...  
Keyword(s):  
Systematic Review ◽  
European Union ◽  
Hepatitis A ◽  
European Economic Area ◽  
The European Union ◽  
European Economic ◽  
Economic Area

scholarly journals DEFINITION OF NEW SPATIAL REGIONS IN SOUTH-EAST EUROPE

2020 ◽  
Vol 8 (11) ◽  
pp. 449-454
Author(s):  
Kamen Petrov ◽  
Keyword(s):  
European Union ◽  
Regional Development ◽  
European Economic Area ◽  
The European Union ◽  
East Europe ◽  
Cross Border ◽  
South East Europe ◽  
Economic Area ◽  
Definition Of ◽  
Cross Border Cooperation

The exhibition presents the problems of cross-border cooperation and opportunities for partnership. Within the European Union, conditions are created for regional development on the national territory, as well as for border and cross-border cooperation. In this direction, the article outlines the processes of building a number of Euroregions, which are designed to promote regional development. This report will clarify some of the reasons for their construction, their role and what model of cooperation is available within the European Economic Area.

scholarly journals HIV and AIDS in the European Union, 2011

2012 ◽  
Vol 17 (48) ◽  
Author(s):  
G Likatavicius ◽  
M Van de Laar
Keyword(s):  
European Union ◽  
Drug Users ◽  
Antiretroviral Treatment ◽  
Hiv And Aids ◽  
European Economic Area ◽  
The European Union ◽  
Late Presenters ◽  
European Economic ◽  
Economic Area ◽  
Sex With Men

In 2011, a total of 28,038 new HIV diagnoses were reported by European Union and European Economic Area countries. The annual rate of HIV diagnoses does not show clear signs of decrease and HIV continues to be concentrated in selected populations such as men who have sex with men and injecting drug users, and a high proportion reported as late presenters. Despite effective and available antiretroviral treatment, the number of AIDS cases increased in a few countries.

scholarly journals TB management in the European Union/European Economic Area: a multi‐centre survey

2021 ◽  
Vol 25 (2) ◽  
pp. 126-133
Author(s):  
G. Sotgiu ◽  
S. Rosales-Klintz ◽  
R. Centis ◽  
L. D'Ambrosio ◽  
R. Verduin ◽  
...  
Keyword(s):  
European Union ◽  
Infection Control ◽  
Multidrug Resistant ◽  
Control Measures ◽  
European Economic Area ◽  
The European Union ◽  
European Economic ◽  
Infection Control Measures ◽  
Treatment And Prevention ◽  
Economic Area

BACKGROUND: Essential TB care in the European Union/European Economic Area (EU/EEA) comprises 21 standards for the diagnosis, treatment and prevention of TB that constitute the European Union Standards for Tuberculosis Care (ESTC).METHODS: In 2017, we conducted an audit on TB management and infection control measures against the ESTC standards. TB reference centres in five EU/EEA countries were purposely selected to represent the heterogeneous European TB burden and examine geographic variability.RESULTS: Data from 122 patients, diagnosed between 2012 and 2015 with multidrug-resistant TB (n = 49), extensively drug‐resistant TB (XDR‐TB) (n = 11), pre‐XDR‐TB (n = 29) and drug‐susceptible TB (n = 33), showed that TB diagnosis and treatment practices were in general in agreement with the ESTC.CONCLUSION: Overall, TB management and infection control practices were in agreement with the ESTC in the selected EU/EEA reference centres. Areas for improvement include strengthening of integrated care services and further implementation of patient‐centred approaches.

scholarly journals Modified Legal Framework and Opening of the Liner Shipping Market in the Republic of Croatia to Shipping Companies from the European Economic Area

2017 ◽  
Vol 6 (2) ◽  
pp. 140-146
Author(s):  
Nikola Mandić
Keyword(s):  
European Union ◽  
Public Transport ◽  
Legal Framework ◽  
Liner Shipping ◽  
Transitional Period ◽  
European Economic Area ◽  
The European Union ◽  
European Economic ◽  
Economic Area ◽  
The Republic

Generally speaking, public transport is the transport of persons and cargo available for use to the general public, performed on the basis of a transport contract. Public transport costal liner shipping is the transport of passengers, cargo and vehicles in the internal marine waters and territorial sea ofthe Republic of Croatia performed on pre-established lines in compliance with the published terms and conditions of the sailing schedule and services pricelist. The Act on Transport in Liner Shipping and Occasional Costal Maritime Transport established the public transport system in the Republic of Croatia, ensuring regular connection of inhabited islands with the mainland and other inhabited islands, as well as between coastal towns, with an appropriate number of daily two-way connections, to improve the conditions of island life and stimulate their development. Prior to the accession of the Republic of Croatia to the European Union, the maritime liner shipping market in the Republic of Croatia was reserved primarily for Croatian shipping companies. Now, following the expiry of the transitional period negotiated in pre-accession negotiations with the European Union and the expiry of previously concluded concession contracts, the market is opening up to shipping companies from the European Economic Area. Hence, over the last couple of years, the Republic of Croatia was required to modify its legal framework regulating this subject matter. This paper presents novelties in the legal framework introduced in 2016 and 2017, which directly affect the opening of the maritime liner shipping market in the Republic of Croatia to shipping companies from the European Economic Area, with the critical analysis of the new solutions.

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