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Background: Air travel has opened up opportunities for world transportation, but has also increased infectious disease transmission and public health risks. To control disease spread, airlines and governments are able to implement control measures in air travel. This study inventories experiences and applicability of infectious disease control measures., Methods: A literature search was performed in PubMed, including studies between 1990 and 2013. Search terms included air travel terms and intervention terms. Interventions were scored according outcome, required resources, preparation, passenger inconvenience and passenger compliance., Results: Provision of information to travelers, isolation, health monitoring, hygiene measures and vector control reportedly prevent disease spread and are well applicable. Contact tracing can be supportive in controlling disease spread but depend on disease characteristics. Exit and entry screening, quarantine and travel restrictions are unlikely to be very effective in preventing disease spread, while implementation requires extensive resources or travel implications., Conclusions: Control measures should focus on providing information towards travelers, isolation, health monitoring and hygiene measures. Appropriateness of measures depends on disease characteristics, and the required resources. As most studies analyze one type of measure in a particular situation, further research comparing the effectiveness of measures is recommended., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Rapid and wide dispersal of passengers after flights makes investigation of flight-related outbreaks challenging. An outbreak of Salmonella Heidelberg was identified in a group of Irish travellers returning from Tanzania. Additional international cases sharing the same flight were identified. Our aim was to determine the source and potential vehicles of infection. Case-finding utilized information exchange using experts' communication networks and national surveillance systems. Demographic, clinical and food history information was collected. Twenty-five additional cases were identified from Ireland, The Netherlands, Norway, USA and Canada. We conducted a case-control study which indicated a significant association between illness and consumption of milk tart (OR 10.2) and an egg dish (OR 6) served on-board the flight. No food consumed before the flight was associated with illness. Cases from countries other than Ireland provided supplementary information that facilitated the identification of likely vehicles of infection. Timely, committed international collaboration is vital in such investigations.

Between April and May 2010, several medical microbiological laboratories in the Netherlands notified a total of 90 cases of Salmonella enterica serovar Typhimurium with the same antibiogram type (resistant for ampicillin, tetracycline, and co-trimoxazol) and the same multiple locus variable number tandem repeats analysis pattern (03-16-09-NA-311) or single locus variants. Date of illness onset ranged from end of March to mid-May with a peak in the second week of April. Almost half of the cases were hospitalized. Cases completed a questionnaire about food items and other risk factors in the 7 days before illness onset. A matched case-control study was performed. Consumption of "ossenworst" (matched odds ratio 48.2 [95% confidence interval (CI): 3.9-595.9]) and filet américain (8.5 [95% CI: 1.0-73.6]) were found to be significant risk factors for illness. Eighty percent of the cases had eaten at least one or both raw meat products. The producer of the ground beef that was used to produce the "ossenworst" was identified, but no microbiological evidence was found. Consumers should be made more aware of the presence of raw meat in ready-to-eat products and of the potential risk in eating these products. Vulnerable persons such as young children, elderly, and persons with poor health should be discouraged from eating these products. Detection of this outbreak was mainly based on the antibiogram pattern that had identified possible cases 10 days before detailed typing results from the reference laboratory became available, thus facilitating early case findings.

The 25 European overseas countries and territories (OCTs) are closely associated with the European Union (EU) through the four related UE Member States: Denmark, France, the Netherlands and the United Kingdom. In 2008 and 2009, these four EU Member States, in association with the European Centre for Disease Prevention and Control (ECDC), reviewed the OCTs’ needs, with the objectives of documenting their capacity to prevent and respond to infectious diseases outbreaks, and identifying deficiencies. This Euroroundup is based on the review’s main findings, and presents an overview of the OCTs’ geography and epidemiology, briefly introduces the legal basis on which they are linked to the EU and describes the surveillance and infectious disease response systems. As a result of their diversity the OCTs have heterogeneous epidemiological profiles. A common factor, however, is that the main burden of disease is non-communicable. Nevertheless, OCTs remain vulnerable to infectious diseases outbreaks. Their capacity for surveillance, early detection and response to such outbreaks is generally limited, with laboratory capacity issues and lack of human resources. Avenues for capacity strengthening should be explored by the OCTs and the related EU Member States, in collaboration with ECDC and regional public health networks where these exist.

Background: Nursing home influenza outbreaks occur in spite of established vaccination programs, and require rapid and sensitive laboratory confirmation for timely intervention., Objectives: To evaluate diagnostic approaches for rapid confirmation of nursing home influenza outbreaks., Study Design: Influenza virus real-time PCR and Directigen Flu A+B enzyme immunoassay were performed on nasopharyngeal swabs, nasopharyngeal washes and throat swabs collected from residents with clinical suspicion of influenza during seven probable nursing home outbreaks in 2004-2005 and 2005-2006. The efficacy of specimen sampling and transport management by Public Health Service outbreak team was evaluated., Results: PCR detected influenza RNA in 80% (68/85) of specimens from 81% (38/47) residents, confirming six suspected outbreaks. Immunoassay sensitivity was highest on nasopharyngeal swabs (38%; 11/29) with a positive predictive value of 100% compared to PCR. Nasopharyngeal swabs were equally sensitive to nasopharyngeal washes by PCR. Nasopharyngeal wash sampling appeared unpractical due to common underlying disability of residents. Outbreak team support was associated with a shorter time to PCR diagnosis compared to outbreaks with no logistical support (mean, 28.2h vs. 84h; P=0.05)., Conclusions: Influenza real-time PCR on nasopharyngeal swabs, obtained by Public Health Service outbreak teams, enabled rapid and sensitive confirmation of nursing home influenza outbreaks.