scholarly journals Prevention of human rabies: a challenge for the European Union and the European Economic Area

2020 ◽  
Vol 25 (38) ◽  
Author(s):  
Céline M Gossner ◽  
Alexandra Mailles ◽  
Inma Aznar ◽  
Elina Dimina ◽  
Juan E Echevarría ◽  
...  

Rabies is enzootic in over one hundred countries worldwide. In the European Union/European Economic Area (EU/EEA), the vast majority of human rabies cases are travellers bitten by dogs in rabies-enzootic countries, mostly in Asia and Africa. Thus, EU/EEA travellers visiting rabies enzootic countries should be aware of the risk of being infected with the rabies virus when having physical contact with mammals. They should consider pre-exposure vaccination following criteria recommended by the World Health Organization and if unvaccinated, immediately seek medical attention in case of bites or scratches from mammals. As the majority of the EU/EEA countries are free from rabies in mammals, elimination of the disease (no enzootic circulation of the virus and low number of imported cases) has been achieved by 2020. However, illegal import of potentially infected animals, mainly dogs, poses a risk to public health and might threaten the elimination goal. Additionally, newly recognised bat lyssaviruses represent a potential emerging threat as the rabies vaccine may not confer protective immunity. To support preparedness activities in EU/EEA countries, guidance for the assessment and the management of the public health risk related to rabies but also other lyssaviruses, should be developed.

2016 ◽  
Vol 21 (16) ◽  
Author(s):  
Tarik Derrough ◽  
Alexandra Salekeen

Between 1973 and 2013, 12 outbreaks of paralytic poliomyelitis with a cumulative total of 660 cases were reported in the European Union, European Economic Area and candidate countries. Outbreaks lasted seven to 90 weeks (median: 24 weeks) and were identified through the diagnosis of cases of acute flaccid paralysis, for which infection with wild poliovirus was subsequently identified. In two countries, environmental surveillance was in place before the outbreaks, but did not detect any wild strain before the occurrence of clinical cases. This surveillance nonetheless provided useful information to monitor the outbreaks and their geographical spread. Outbreaks were predominantly caused by poliovirus type 1 and typically involved unvaccinated or inadequately vaccinated groups within highly immunised communities. Oral polio vaccine was primarily used to respond to the outbreaks with catch-up campaigns implemented either nationwide or in restricted geographical areas or age groups. The introduction of supplementary immunisation contained the outbreaks. In 2002, the European region of the World Health Organization was declared polio-free and it has maintained this status since. However, as long as there are non-vaccinated or under-vaccinated groups in European countries and poliomyelitis is not eradicated, countries remain continuously at risk of reintroduction and establishment of the virus. Continued efforts to reach these groups are needed in order to ensure a uniform and high vaccination coverage.


2012 ◽  
Vol 17 (48) ◽  
Author(s):  
G Likatavicius ◽  
M Van de Laar

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.


2021 ◽  
Vol 25 (2) ◽  
pp. 126-133
Author(s):  
G. Sotgiu ◽  
S. Rosales-Klintz ◽  
R. Centis ◽  
L. D'Ambrosio ◽  
R. Verduin ◽  
...  

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.


2017 ◽  
Vol 6 (2) ◽  
pp. 140-146
Author(s):  
Nikola Mandić

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.


2015 ◽  
Vol 20 (49) ◽  
Author(s):  
Basel Karo ◽  
Barbara Hauer ◽  
Vahur Hollo ◽  
Marieke J. van der Werf ◽  
Lena Fiebig ◽  
...  

Monitoring the treatment outcome (TO) of tuberculosis (TB) is essential to evaluate the effectiveness of the intervention and to identify potential barriers for TB control. The global target is to reach a treatment success rate (TSR) of at least 85%. We aimed to assess the TB TO in the European Union and European Economic Area (EU/EEA) between 2002 and 2011, and to identify factors associated with unsuccessful treatment. Only 18 countries reported information on TO for the whole observation period accounting for 250,854 new culture-confirmed pulmonary TB cases. The 85% target of TSR was not reached in any year between 2002 and 2011 and was on average 78%. The TSR for multidrug-resistant (MDR)-TB cases at 24-month follow-up was 49%. In the multivariable regression model, unsuccessful treatment was significantly associated with increasing age (odds ratio (OR) = 1.02 per a one-year increase, 95% confidence interval (CI): 1.02–1.02), MDR-TB (OR = 8.7, 95% CI: 5.09–14.97), male sex (OR = 1.40, 95% CI: 1.28–1.52), and foreign origin (OR = 1.32, 95% CI: 1.03–1.70). The data highlight that special efforts are required for patients with MDR-TB and the elderly aged ≥65 years, who have particularly low TSR. To allow for valid monitoring at EU level all countries should aim to report TO for all TB cases.


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