TY - JOUR T1 - COVID-19 Clusters in Belgian Nursing Homes: Impact of Facility Characteristics and Vaccination on Cluster Occurrence, Duration and Severity JF - Viruses Y1 - 2023 A1 - Sara Dequeker A1 - Milena Callies A1 - Lucy Catteau A1 - Laura Int Panis A1 - Esma Islamaj A1 - Sofieke Klamer A1 - Katrien Latour A1 - Marijke Pauwels A1 - Catharina Vernemmen A1 - Romain Mahieu A1 - Hanna Masson A1 - Muhammet Savsin A1 - Etienne Clercq A1 - Mireille Thomas A1 - Boudewijn Catry A1 - Eline Vandael KW - clusters KW - infection prevention KW - long-term care facilities KW - SARS-CoV-2 KW - Vaccination AB -

COVID-19 severely affected nursing home residents from March 2020 onwards in Belgium. This study aimed to model the impact of vaccination and facility characteristics on cluster occurrence, duration and severity in this setting. Possible clusters were identified between June 2020 and January 2022, based on the Belgian COVID-19 surveillance in nursing homes. Median attack rates (AR) among residents and staff, case hospitalization rates (CHR) and case fatality rates (CFR) were calculated. A negative binomial model was used to identify the association between nursing home characteristics and the number of cases, hospital admissions and deaths and the duration of the cluster. A total of 2,239 clusters were detected in more than 80% of nursing homes. Most of these (62%) occurred before the start of COVID-19 vaccination (end of December 2020). After vaccination, the number of clusters, the AR among residents and staff, the CHR and the CFR dropped. Previous cluster(s) and vaccination decreased the number of cases, hospital admissions and deaths among residents. Previous cluster experience and having started vaccination were protective factors. We recommend continued implementation of targeted interventions such as vaccination, large-scale screening and immediate implementation of additional infection prevention and control measures.

VL - 15 CP - 1 M3 - 10.3390/v15010232 ER - TY - JOUR T1 - Clinical Severity of SARS-CoV-2 Omicron Variant Compared with Delta among Hospitalized COVID-19 Patients in Belgium during Autumn and Winter Season 2021-2022. JF - Viruses Y1 - 2022 A1 - Nina Van Goethem A1 - Pui Yan Jenny Chung A1 - Marjan Meurisse A1 - Mathil Vandromme A1 - Laurane De Mot A1 - Ruben Brondeel A1 - Veerle Stouten A1 - Sofieke Klamer A1 - Lize Cuypers A1 - Toon Braeye A1 - Lucy Catteau A1 - Louis Nevejan A1 - Joris Van Loenhout A1 - Koen Blot KW - ADOLESCENT KW - Belgium KW - Cohort Studies KW - COVID-19 KW - Humans KW - Retrospective Studies KW - SARS-CoV-2 KW - Seasons AB -

This retrospective multi-center matched cohort study assessed the risk for severe COVID-19 (combination of severity indicators), intensive care unit (ICU) admission, and in-hospital mortality in hospitalized patients when infected with the Omicron variant compared to when infected with the Delta variant. The study is based on a causal framework using individually-linked data from national COVID-19 registries. The study population consisted of 954 COVID-19 patients (of which, 445 were infected with Omicron) above 18 years old admitted to a Belgian hospital during the autumn and winter season 2021-2022, and with available viral genomic data. Patients were matched based on the hospital, whereas other possible confounders (demographics, comorbidities, vaccination status, socio-economic status, and ICU occupancy) were adjusted for by using a multivariable logistic regression analysis. The estimated standardized risk for severe COVID-19 and ICU admission in hospitalized patients was significantly lower (RR = 0.63; 95% CI (0.30; 0.97) and RR = 0.56; 95% CI (0.14; 0.99), respectively) when infected with the Omicron variant, whereas in-hospital mortality was not significantly different according to the SARS-CoV-2 variant (RR = 0.78, 95% CI (0.28-1.29)). This study demonstrates the added value of integrated genomic and clinical surveillance to recognize the multifactorial nature of COVID-19 pathogenesis.

VL - 14 CP - 6 M3 - 10.3390/v14061297 ER - TY - JOUR T1 - COVID-19 contact tracing in Belgium: main indicators and performance, January - September 2021. JF - Arch Public Health Y1 - 2022 A1 - Kristiaan Proesmans A1 - Sharon Hancart A1 - Toon Braeye A1 - Sofieke Klamer A1 - Robesyn, Emmanuel A1 - Achille Djiena A1 - Frances De Leeuw A1 - Romain Mahieu A1 - Alex Dreuw A1 - Hammami, Naïma A1 - Wildemeersch, Dirk A1 - Laura Cornelissen A1 - Dieter Van Cauteren AB -

BACKGROUND: Contact tracing is one of the main public health tools in the control of coronavirus disease 2019 (COVID-19). A centralized contact tracing system was developed in Belgium in 2020. We aim to evaluate the performance and describe the results, between January 01, 2021, and September 30, 2021. The characteristics of COVID-19 cases and the impact of COVID-19 vaccination on testing and tracing are also described.

METHODS: We combined laboratory diagnostic test data (molecular and antigen test), vaccination data, and contact tracing data. A descriptive analysis was done to evaluate the performance of contact tracing and describe insights into the epidemiology of COVID-19 by contact tracing.

RESULTS: Between January and September 2021, 555.181 COVID-19 cases were reported to the central contact center and 91% were contacted. The average delay between symptom onset and contact tracing initiation was around 5 days, of which 4 days corresponded to pre-testing delay. High-Risk Contacts (HRC) were reported by 49% of the contacted index cases. The mean number of reported HRC was 2.7. In total, 666.869 HRC were reported of which 91% were successfully contacted and 89% of these were tested at least once following the interview. The estimated average secondary attack rate (SAR) among the contacts of the COVID-19 cases who reported at least one contact, was 27% and was significantly higher among household HRC. The proportion of COVID-19 cases who were previously identified as HRC within the central system was 24%.

CONCLUSIONS: The contact-tracing system contacted more than 90% of the reported COVID-19 cases and their HRC. This proportion remained stable between January 1 2021 and September 30 2021 despite an increase in cases in March-April 2021. We report high SAR, indicating that through contact tracing a large number of infections were prospectively detected. The system can be further improved by (1) reducing the delay between onset of illness and medical consultation (2) having more exhaustive reporting of HRC by the COVID-19 case.

VL - 80 CP - 1 M3 - 10.1186/s13690-022-00875-6 ER - TY - JOUR T1 - Evaluating methodological approaches to assess the severity of infection with SARS-CoV-2 variants: scoping review and applications on Belgian COVID-19 data. JF - BMC Infect Dis Y1 - 2022 A1 - Marjan Meurisse A1 - Herman Van Oyen A1 - Koen Blot A1 - Lucy Catteau A1 - Ben Serrien A1 - Sofieke Klamer A1 - Emilie Cauët A1 - Robert, Annie A1 - Nina Van Goethem KW - Belgium KW - COVID-19 KW - Humans KW - intensive care units KW - SARS-CoV-2 AB -

BACKGROUND: Differences in the genetic material of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants may result in altered virulence characteristics. Assessing the disease severity caused by newly emerging variants is essential to estimate their impact on public health. However, causally inferring the intrinsic severity of infection with variants using observational data is a challenging process on which guidance is still limited. We describe potential limitations and biases that researchers are confronted with and evaluate different methodological approaches to study the severity of infection with SARS-CoV-2 variants.

METHODS: We reviewed the literature to identify limitations and potential biases in methods used to study the severity of infection with a particular variant. The impact of different methodological choices is illustrated by using real-world data of Belgian hospitalized COVID-19 patients.

RESULTS: We observed different ways of defining coronavirus disease 2019 (COVID-19) disease severity (e.g., admission to the hospital or intensive care unit versus the occurrence of severe complications or death) and exposure to a variant (e.g., linkage of the sequencing or genotyping result with the patient data through a unique identifier versus categorization of patients based on time periods). Different potential selection biases (e.g., overcontrol bias, endogenous selection bias, sample truncation bias) and factors fluctuating over time (e.g., medical expertise and therapeutic strategies, vaccination coverage and natural immunity, pressure on the healthcare system, affected population groups) according to the successive waves of COVID-19, dominated by different variants, were identified. Using data of Belgian hospitalized COVID-19 patients, we were able to document (i) the robustness of the analyses when using different variant exposure ascertainment methods, (ii) indications of the presence of selection bias and (iii) how important confounding variables are fluctuating over time.

CONCLUSIONS: When estimating the unbiased marginal effect of SARS-CoV-2 variants on the severity of infection, different strategies can be used and different assumptions can be made, potentially leading to different conclusions. We propose four best practices to identify and reduce potential bias introduced by the study design, the data analysis approach, and the features of the underlying surveillance strategies and data infrastructure.

VL - 22 CP - 1 M3 - 10.1186/s12879-022-07777-6 ER - TY - JOUR T1 - SARS-CoV-2 Surveillance in Belgian Wastewaters JF - Viruses Y1 - 2022 A1 - Raphael Janssens A1 - Sven Hanoteaux A1 - Hadrien Maloux A1 - Sofieke Klamer A1 - Valeska Laisnez A1 - Bavo Verhaegen A1 - Catherine Linard A1 - Lies Lahousse A1 - Peter Delputte A1 - Matthieu Terwagne A1 - Jonathan Marescaux A1 - Rosalie Pype A1 - Christian Didy A1 - Katelijne Dierick A1 - Koenraad Van Hoorde A1 - Marie Lesenfants KW - alerting indicator KW - Correlation KW - public health authority KW - SARS-CoV-2 KW - Surveillance KW - viral load per capita KW - viral to faecal ratio KW - wastewater-based epidemiology AB -

Wastewater-based surveillance was conducted by the national public health authority to monitor SARS-CoV-2 circulation in the Belgian population. Over 5 million inhabitants representing 45% of the Belgian population were monitored throughout 42 wastewater treatment plants for 15 months comprising three major virus waves. During the entire period, a high correlation was observed between the daily new COVID-19 cases and the SARS-CoV-2 concentration in wastewater corrected for rain impact and covered population size. Three alerting indicators were included in the weekly epidemiological assessment: High Circulation, Fast Increase, and Increasing Trend. These indicators were computed on normalized concentrations per individual treatment plant to allow for a comparison with a reference period as well as between analyses performed by distinct laboratories. When the indicators were not corrected for rain impact, rainy events caused an underestimation of the indicators. Despite this negative impact, the indicators permitted us to effectively monitor the evolution of the fourth virus wave and were considered complementary and valuable information to conventional epidemiological indicators in the weekly wastewater reports communicated to the National Risk Assessment Group.

VL - 14 CP - 9 M3 - 10.3390/v14091950 ER - TY - JOUR T1 - Viral clade is associated with severity of symptomatic genotype 3 Hepatitis E virus infections in Belgium, 2010-2018. JF - Journal of Hepatology Y1 - 2022 A1 - Michael Peeters A1 - Julie Schenk A1 - Thomas De Somer A1 - Tania Roskams A1 - Tatjana Locus A1 - Sofieke Klamer A1 - Lorenzo Subissi A1 - Vanessa Suin A1 - Jean Delwaide A1 - Peter Stärkel A1 - Stéphane De Maeght A1 - Philippe Willems A1 - Colle, Isabelle A1 - Marc Van Hoof A1 - Van Acker, Jos A1 - Christophe Van Steenkiste A1 - Christophe Moreno A1 - Filip Janssens A1 - Marijke Reynders A1 - Matthias Steverlynck A1 - Wim Verlinden A1 - Luc Lasser A1 - Chantal de Galocsy A1 - Geerts, Anja A1 - Jeroen Maus A1 - Marie Gallant A1 - Steven Van Outryve A1 - Astrid Marot A1 - Hendrik Reynaert A1 - Jochen Decaestecker A1 - Bottieau, Emmanuel A1 - Jonas Schreiber A1 - Jean-Pierre Mulkay A1 - Sébastien de Goeij A1 - Mikhaël Salame A1 - Diederik Dooremont A1 - Sergio Negrín Dastis A1 - Juul Boes A1 - Jochen Nijs A1 - Jan Beyls A1 - Hens, Niel A1 - Frederik Nevens A1 - Steven Van Gucht A1 - Thomas Vanwolleghem VL - 78 CP - 1 M3 - 10.1016/j.jhep.2022.08.033 ER - TY - JOUR T1 - Asymptomatic SARS-CoV-2 infection in Belgian long-term care facilities. JF - Lancet Infect Dis Y1 - 2021 A1 - Ana Hoxha A1 - Chloé Wyndham-Thomas A1 - Sofieke Klamer A1 - Dominique Dubourg A1 - Melissa Vermeulen A1 - Hammami, Naïma A1 - Laura Cornelissen KW - Adult KW - Aged KW - Aged, 80 and over KW - Asymptomatic Infections KW - Belgium KW - COVID-19 KW - cross-sectional studies KW - Female KW - Health Facilities KW - Humans KW - long-term care KW - Male KW - middle aged KW - SARS-CoV-2 VL - 21 CP - 4 M3 - 10.1016/S1473-3099(20)30560-0 ER - TY - JOUR T1 - Conceptual causal framework to assess the effect of SARS-CoV-2 variants on COVID-19 disease severity among hospitalized patients JF - Archives of Public Health Y1 - 2021 A1 - Nina Van Goethem A1 - Ben Serrien A1 - Mathil Vandromme A1 - Chloé Wyndham-Thomas A1 - Lucy Catteau A1 - Ruben Brondeel A1 - Sofieke Klamer A1 - Marjan Meurisse A1 - Lize Cuypers A1 - Emmanuel André A1 - Koen Blot A1 - Herman Van Oyen AB -

BACKGROUND: SARS-CoV-2 strains evolve continuously and accumulate mutations in their genomes over the course of the pandemic. The severity of a SARS-CoV-2 infection could partly depend on these viral genetic characteristics. Here, we present a general conceptual framework that allows to study the effect of SARS-CoV-2 variants on COVID-19 disease severity among hospitalized patients.

METHODS: A causal model is defined and visualized using a Directed Acyclic Graph (DAG), in which assumptions on the relationship between (confounding) variables are made explicit. Various DAGs are presented to explore specific study design options and the risk for selection bias. Next, the data infrastructure specific to the COVID-19 surveillance in Belgium is described, along with its strengths and weaknesses for the study of clinical impact of variants.

DISCUSSION: A well-established framework that provides a complete view on COVID-19 disease severity among hospitalized patients by combining information from different sources on host factors, viral factors, and healthcare-related factors, will enable to assess the clinical impact of emerging SARS-CoV-2 variants and answer questions that will be raised in the future. The framework shows the complexity related to causal research, the corresponding data requirements, and it underlines important limitations, such as unmeasured confounders or selection bias, inherent to repurposing existing routine COVID-19 data registries.

TRIAL REGISTRATION: Each individual research project within the current conceptual framework will be prospectively registered in Open Science Framework (OSF identifier: https://doi.org/10.17605/OSF.IO/UEF29 ). OSF project created on 18 May 2021.

VL - 79 CP - 1 M3 - 10.1186/s13690-021-00709-x ER - TY - JOUR T1 - Confirmed COVID-19 Cases per Economic Activity during Autumn Wave in Belgium. JF - Int J Environ Res Public Health Y1 - 2021 A1 - Johan Verbeeck A1 - Godelieve Vandersmissen A1 - Jannes Peeters A1 - Sofieke Klamer A1 - Sharon Hancart A1 - Tinne Lernout A1 - Mathias Dewatripont A1 - Godderis, Lode A1 - Molenberghs, Geert KW - Belgium KW - Communicable Disease Control KW - COVID-19 KW - Humans KW - Occupations KW - SARS-CoV-2 AB -

Some occupational sectors, such as human health and care, food service, cultural and sport activities, have been associated with a higher risk of SARS-CoV-2 infection than other sectors. To curb the spread of SARS-CoV-2, it is preferable to apply targeted non-pharmaceutical interventions on selected economic sectors, rather than a full lockdown. However, the effect of these general and sector-specific interventions on the virus circulation has only been sparsely studied. We assess the COVID-19 incidence under different levels of non-pharmaceutical interventions per economic activity during the autumn 2020 wave in Belgium. The 14-day incidence of confirmed COVID-19 cases per the Statistical Classification of Economic Activities in the European Community (NACE-BEL) sector is modelled by a longitudinal Gaussian-Gaussian two-stage approach. This is based on exhaustive data on all employees in all sectors. In the presence of sanitary protocols and minimal non-pharmaceutical interventions, many sectors with close contact with others show considerably higher COVID-19 14-day incidences than other sectors. The effect of stricter non-pharmaceutical interventions in the general population and non-essential sectors is seen in the timing of the peak incidence and the width and height of the post-peak incidence. In most sectors incidences returned to higher levels after the peak than before and this decrease took longer for the health and care sector. Sanitary protocols for close proximity occupations may be sufficient during periods of low-level virus circulation, but progressively less with increasing circulation. Stricter general and sector-specific non-pharmaceutical interventions adequately decrease COVID-19 incidences, even in close proximity in essential sectors under solely sanitary protocols.

VL - 18 CP - 23 M3 - 10.3390/ijerph182312489 ER - TY - JOUR T1 - One year of laboratory-based COVID-19 surveillance system in Belgium: main indicators and performance of the laboratories (March 2020-21). JF - Arch Public Health Y1 - 2021 A1 - Marjan Meurisse A1 - Adrien Lajot A1 - Yves Dupont A1 - Marie Lesenfants A1 - Sofieke Klamer A1 - Javiera Rebolledo A1 - Tinne Lernout A1 - Mathias Leroy A1 - Arnaud Capron A1 - Johan Van Bussel A1 - Sophie Quoilin A1 - Emmanuel André A1 - Kaat Kehoe A1 - Luc Waumans A1 - Van Acker, Jos A1 - Vandenberg, Olivier A1 - Van den Wijngaert, Sigi A1 - Ann Verdonck A1 - Lize Cuypers A1 - Dieter Van Cauteren KW - Belgium; COVID-19; Laboratory-based surveillance; SARS-CoV-2 AB -

BACKGROUND: With the spread of coronavirus disease 2019 (COVID-19), an existing national laboratory-based surveillance system was adapted to daily monitor the epidemiological situation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the Belgium by following the number of confirmed SARS-CoV-2 infections, the number of performed tests and the positivity ratio. We present these main indicators of the surveillance over a one-year period as well as the impact of the performance of the laboratories, regarding speed of processing the samples and reporting results, for surveillance.

METHODS: We describe the evolution of test capacity, testing strategy and the data collection methods during the first year of the epidemic in Belgium.

RESULTS: Between the 1 of March 2020 and the 28 of February 2021, 9,487,470 tests and 773,078 COVID-19 laboratory confirmed cases were reported. Two epidemic waves occurred, with a peak in April and October 2020. The capacity and performance of the laboratories improved continuously during 2020 resulting in a high level performance. Since the end of November 2020 90 to 95% of the test results are reported at the latest the day after sampling was performed.

CONCLUSIONS: Thanks to the effort of all laboratories a performant exhaustive national laboratory-based surveillance system to monitor the epidemiological situation of SARS-CoV-2 was set up in Belgium in 2020. On top of expanding the number of laboratories performing diagnostics and significantly increasing the test capacity in Belgium, turnaround times between sampling and testing as well as reporting were optimized over the first year of this pandemic.

VL - 79 CP - 1 M3 - 10.1186/s13690-021-00704-2 ER - TY - JOUR T1 - Prevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studies. JF - BMC Infect Dis Y1 - 2021 A1 - Nathalie Fischer A1 - Ilse Peeters A1 - Sofieke Klamer A1 - Marion Montourcy A1 - Vicky Cuylaerts A1 - Dominique Van Beckhoven A1 - Irith De Baetselier A1 - Johan Van der Heyden A1 - Wim Vanden Berghe KW - ADOLESCENT KW - Adult KW - Belgium KW - Chlamydia Infections KW - Chlamydia trachomatis KW - cross-sectional studies KW - Female KW - Genitalia KW - Humans KW - Male KW - middle aged KW - prevalence KW - Risk Factors KW - Sexual Behavior KW - STI KW - Young adult AB -

BACKGROUND: Chlamydia trachomatis (chlamydia) is the most diagnosed sexually transmitted infection in Belgium. Screening programs focus on young women, due to the implications of chronic asymptomatic infections for reproductive health. Thereby, the frequency of infections in men and older adults is underestimated. This study aimed to estimate the point-prevalence of chlamydia in the broader Belgian population, to inform evidence-based prevention and control strategies.

METHODS: We conducted two cross-sectional prevalence studies of chlamydia infection in the population of Belgium aged 16-59 years, 2018-2020. In the CT1 study 12,000 representative individuals were randomly selected from the national register and invited by letter to collect a urine sample at home. The CT2 study used urine samples collected through the Belgian Health Examination Survey. Molecular detection of chlamydia DNA was performed using Xpert or Abbott Real-Time CT/NG assays. Weighted estimated prevalence and 95% confidence interval (CI) was calculated per gender and age groups of 16/18-29, 30-44 and 45-59 years, relative to the general Belgian population. Data collected on sociodemographic variables and sexual behavior were used to identify potential risk factors for chlamydia infection through calculation of the odds ratio (OR).

RESULTS: The population-wide weighted estimated prevalence was 1.54% (95% CI 0.78-3) in CT1 and 1.76% (95% CI 0.63-4) in CT2. We observed no statistically significant difference between men and women or age groups. Civil relationship status (OR = 14.1 (95% CI 1.78-112), p < 0.01), sexual intercourse with a casual partner (OR = 6.31 (95% CI 1.66-24.1), p < 0.01) and > 3 sexual partners in the last 12 months (OR = 4.53 (95% CI 1.10-18.6), p = 0.02) were associated with higher relative risk for chlamydia infection.

CONCLUSION: Nationwide prevalence studies are relevant to assess the distribution of chlamydia and inform public health actions. The overall low prevalence and heterogeneous distribution of chlamydia in the general Belgian population needs to be considered for future strategies and potential harm of testing and treating asymptomatic individuals need to be taken into account. Effective case management should include appropriate treatment of symptomatic patients and partner notification, and prevention strategies should encourage behaviors such as condom use.

VL - 21 CP - 1 M3 - 10.1186/s12879-021-06646-y ER - TY - JOUR T1 - Prioritisation for future surveillance, prevention and control of 98 communicable diseases in Belgium: a 2018 multi-criteria decision analysis study JF - BMC Public Health Y1 - 2021 A1 - Sofieke Klamer A1 - Nina Van Goethem A1 - Daniel Thomas A1 - Els Duysburgh A1 - Toon Braeye A1 - Sophie Quoilin VL - 21 CP - 1 M3 - 10.1186/s12889-020-09566-9 ER - TY - JOUR T1 - Prioritisation for future surveillance, prevention and control of 98 communicable diseases in Belgium: a 2018 multi-criteria decision analysis study JF - BMC Public Health Y1 - 2021 A1 - Sofieke Klamer A1 - Nina Van Goethem A1 - Daniel Thomas A1 - Els Duysburgh A1 - Toon Braeye A1 - Sophie Quoilin VL - 21 CP - 1 M3 - 10.1186/s12889-020-09566-9 ER - TY - RPRT T1 - SARS-CoV-2 chez les enfants et les adolescents de 0 à 17 ans en Belgique, pendant l'année scolaire 2020-2021. Y1 - 2021 A1 - Kristiaan Proesmans A1 - Bram Bloemen A1 - Florence De Bock A1 - Els Duysburgh A1 - Laura Cornelissen A1 - Sofieke Klamer AB -

L'année scolaire 2020-2021 a été marquée par la COVID-19 pour les écoles et élèves. Les mesures prises pour limiter la propagation du virus SARS-CoV-2 ont eu un impact énorme sur la société en général et sur les enfants et les jeunes en particulier. Les données de ce rapport confirment que les infections par le SARS-CoV-2 chez les enfants et les adolescents provoquent généralement un tableau clinique bénin. De nombreux enfants et adolescents étaient asymptomatiques au moment du test positif. Les décès dus au COVID-19 chez les enfants et les adolescents étaient très rares. Des hospitalisations ont été observées, mais beaucoup moins fréquentes que dans la population plus âgée, et elles étaient principalement de courte durée et avec une évolution clinique favorable. L'augmentation du nombre de cas asymptomatiques détectés en janvier 2021, ainsi que dans les mois suivants, correspondait souvent au nombre de tests effectués. En outre, l'incidence chez les enfants et les adolescents a suivi une tendance et une évolution similaires à celles observée dans la population adulte, ce qui indique un échange du virus intergénérationnel. L'étude relative à la séroprévalence (la présence d'anticorps contre SARS-CoV-2) a montré qu’environ deux fois plus d'enfants et d'adolescents ayant été le virus SARS-CoV-2 que le nombre d'enfants et d'adolescents ayant été enregistré comme des cas confirmés de COVID-19. Cela est également observé pour la population générale. Cela suggère que la circulation du virus n'était pas plus importante chez les enfants et les adolescents et dans les écoles que dans d'autres populations et environnements. Après une année scolaire à laquelle les écoles sont restées ouvertes autant que possible, ce constat est rassurant. Il existe très peu de données sur la santé mentale des enfants et des adolescents pendant cette pandémie, mais il semblerait que la pandémie de COVID-19 (et ses mesures) ait mis à rude épreuve le bien-être d'une proportion importante des enfants et des adolescents.

Les données de ce rapport montrent que le nombre de cas confirmés et la séroprévalence chez les enfants et les adolescents diffèrent peu de ceux observé dans la population adulte, mais la COVID-19 chez les enfants et les adolescents est beaucoup moins susceptible de provoquer des maladies graves et des décès.

RECOMMANDATIONS 

ER - TY - RPRT T1 - SARS-CoV-2 infecties bij kinderen en jongeren van 0 tot en met 17 jaar in België, schooljaar 2020-2021 Y1 - 2021 A1 - Kristiaan Proesmans A1 - Bram Bloemen A1 - Sharon Hancart A1 - Florence De Bock A1 - Els Duysburgh A1 - Laura Cornelissen A1 - Sofieke Klamer AB -

Het schooljaar 2020-2021 stond voor scholen en leerlingen in het teken van COVID-19. Maatregelen om de verspreiding van het SARS-CoV-2 virus te beperken hebben een enorme impact gehad op de samenleving in het algemeen en op kinderen en jongeren in het bijzonder. De gegevens in dit rapport bevestigen dat SARS-CoV-2 infecties bij kinderen en jongeren over het algemeen een mild klinisch beeld veroorzaken. Heel wat kinderen en jongeren waren asymptomatisch op het moment van de positieve test. Sterfgevallen omwille van COVID-19 bij kinderen en jongeren waren heel zeldzaam. Hospitalisaties werden wel gezien, maar veel minder frequent dan bij de oudere bevolking en ze waren vooral van korte duur en met goede uitkomst. Een stijging van het aantal asymptomatisch gedetecteerde gevallen liep in januari 2021 en ook gedurende latere maanden vaak gelijk op met het aantal uitgevoerde testen. Daarnaast volgde de incidentie in kinderen en jeugd een zelfde trend en evolutie als de incidentie in de volwassen populatie, wat erop duidt dat er virus-uitwisseling was tussen de generaties. De seroprevalentiestudie (studie naar de aanwezigheid van antistoffen tegen SARS-CoV-2) liet zien dat ongeveer dubbel zoveel kinderen en jongeren een SARS-CoV-2 infectie hebben doorgemaakt dan het aantal dat geregistreerd werd als COVID-19 bevestigd geval. We zien hetzelfde bij de algemene bevolking. Dit wijst erop dat er niet meer viruscirculatie was onder kinderen en jongeren en op scholen dan in andere bevolkingsgroepen en omgevingen. Na een schooljaar waarin scholen zoveel mogelijk open bleven, is dit een geruststellende vaststelling. Er zijn erg weinig gegevens over de mentale gezondheid van de kinderen en jongeren tijdens deze pandemie, maar het lijkt erop dat de COVID-19 pandemie (en de maatregelen) het welbevinden van een aanzienlijk deel van de kinderen en jongeren in belangrijke mate onder druk gezet heeft.
Kortom, gegevens in dit rapport tonen aan dat het aantal bevestigde gevallen en de seroprevalentie bij kinderen en jongeren weinig verschillen van de volwassen bevolking, maar dat COVID-19 bij kinderen en jongeren véél minder vaak leidt tot ernstige ziekte en overlijdens.

AANBEVELINGEN 

ER - TY - RPRT T1 - COVID-19-infectie bij kinderen in België. Resultaten van labo-surveillance, schoolgegevens en ziekenhuis surveillance 15/03-28/06/2020 Y1 - 2020 A1 - Laura Cornelissen A1 - Amber Litzroth A1 - Marion Montourcy A1 - Maarten De Rouck A1 - Chloé Wyndham-Thomas A1 - Sofieke Klamer A1 - Dominique Van Beckhoven AB -

Kinderen zijn niet zomaar “kleine volwassenen”, ze vormen een aparte groep die zowel lichamelijk als qua sociale omstandigheden verschilt van de volwassen bevolking en die bijzondere aandacht verdient. Dit rapport gaat dieper in op deze specifieke groep en brengt gegevens uit verschillende Belgische COVID-19-gerelateerde databronnen samen. Het totaal aantal bevestigde gevallen van COVID-19 bij kinderen ligt laag. Dit wordt vaak toegeschreven aan het feit dat kinderen minder getest werden. De laboratoriumgegevens tonen aan dat dat maar ten dele klopt. Kinderen werden inderdaad minder vaak getest: ze vormen 20% van de Belgische bevolking, maar slechts 10% van het totaal aantal testen. Maar ook als kinderen wel getest worden, is de test minder vaak positief dan bij volwassenen (gemiddeld 1,8% tegenover 6,3%). Het aantal testen bij kinderen lag vooral laag in het begin van de epidemie, toen testen voorbehouden werden voor ernstige gevallen. Na de wijzigingen in de teststrategie op 4 mei (elk mogelijk geval kan getest worden) en op 11 juni (alle nauwe contacten van een bevestigd geval moeten ook getest worden), zien we het aantal testen bij kinderen sterk stijgen. Tijdens het grootste deel van de periode die in dit rapport beschreven wordt, was afstandsonderwijs de regel, zeker voor de leerlingen van de middelbare scholen. In totaal werden 378 gevallen op school gemeld, waarvan 270 bij leerlingen en 108 bij personeelsleden. De meldingen op school leidden ertoe dat meer dan 4 715 personen (waarvan 243 volwassenen) preventief in quarantaine werden geplaatst. Het hoge aantal personen in quarantaine staat in contrast met het beperkt aantal secundaire gevallen dat gerapporteerd werd: 11 personeelsleden (4,7% van de personeelsleden in quarantaine) en 36 leerlingen (0,8% van de 4 472 leerlingen in quarantaine) werden vermoedelijk besmet na contact op school. De meerderheid van de kinderen die positief testten voor SARS-CoV-2 moest niet in het ziekenhuis worden opgenomen. Hoewel ze 3% uitmaken van het aantal personen met een bevestigde infectie, maakten ze maar 1,6% uit van het totaal aantal gehospitaliseerde patiënten met COVID-19. Het overgrote deel (81%) van de ziekenhuisopnames bij kinderen verliep bovendien zonder ernstige complicaties (zoals longontsteking, bacteriële surinfectie of schimmelinfectie, opname op intensieve zorgen en acuut respiratoir stresssyndroom). De verblijfsduur van kinderen in het ziekenhuis was dan ook meestal kort (mediaan = 3 dagen) en lag beduidend lager dan die voor alle patiënten in de hospitaalsurveillance (mediaan = 8 dagen). De allerjongsten, met name kinderen jonger dan 3 maanden, vertegenwoordigen een groot deel van deze hospitalisaties bij kinderen. Dit wordt vermoedelijk verklaard door het feit dat koorts bij deze jonge kinderen een alarmsignaal is dat snel tot het uitvoeren van een diagnostische test leidt (wat de kans op een bevestiging van de diagnose verhoogt) en het feit dat een positieve test in deze leeftijdsgroep meer bezorgdheid opwekt (en dus sneller zal leiden tot opname in het ziekenhuis). Ondanks de vaststelling dat jongere kinderen vaker gehospitaliseerd worden, lijken het, op basis van onze gegevens, net de oudere leeftijdsgroepen (1 jaar of ouder vergeleken met jonger dan 1 jaar) te zijn die meer risico lopen op een ernstiger ziekteverloop. Mogelijk worden deze gegevens vertekend door het gegeven dat, zoals hierboven besproken, jonge kinderen sneller getest en gehospitaliseerd worden.

ER - TY - RPRT T1 - Epidemiologische surveillance van hepatitis B - 2018 Y1 - 2020 A1 - Sofieke Klamer A1 - Chloé Wyndham-Thomas A1 - Vanessa Suin KW - Hepatitis B KW - Surveillance AB -

 In 2018 hebben de peillaboratoria 2116 nieuwe gevallen van actieve infectie met het hepatitis B virus (HBV) gemeld, een iets hoger aantal dan tijdens de twee jaren voordien (2017, n=1650 2016, n=1662). Acute HBV-infecties komen het vaakst voor in de leeftijdsgroep 25-44 jaar: 53% van de nieuwe diagnoses geregistreerd door het netwerk van peillaboratoria waren in deze leeftijdsgroep. Onder de geregistreerde nieuwe HBV-infecties, is er een daling waargenomen van het aandeel gevallen jonger dan 25 jaar (de leeftijdsgroep die profiteerde van gratis vaccinatie, die in 1999 is gestart voor zuigelingen en jonge adolescenten). Dit zou een weerspiegeling kunnen zijn van het bestaande vaccinatiebeleid.

Het is aanbevolen om een register op te stellen van de patiënten die besmet zijn met HBV om de impact van het vaccinatieprogramma en het effect van de nieuwe behandelingen te volgen. Om virale hepatitis op termijn te elimineren als majeur volksgezondheidsprobleem, heeft de Wereldgezondheidsorganisatie (WGO) de volgende doelstellingen bepaald: daling met 90% van het aantal nieuwe diagnoses en met 65% van het aantal sterfgevallen als gevolg van virale hepatitis tegen 2030 (vergeleken met 2015).

PB - Sciensano CY - Brussel ER - TY - RPRT T1 - Infection COVID-19 chez les enfants en Belgique. Résultats de la surveillance laboratoire, données scolaires et surveillance clinique des patients hospitalisés, 18/03-28/06/2020 Y1 - 2020 A1 - Laura Cornelissen A1 - Amber Litzroth A1 - Marion Montourcy A1 - Maarten De Rouck A1 - Chloé Wyndham-Thomas A1 - Sofieke Klamer A1 - Dominique Van Beckhoven AB -

Les enfants ne sont pas des “petits adultes” ; ils constituent un groupe distinct, différent de la population adulte tant physiquement que dans ses caractéristiques sociales, et qui mérite une attention particulière. Le présent rapport se focalise sur ce group spécifique et réunit des données provenant de plusieurs sources de données belges. Le nombre total de cas confirmés de COVID-19 chez les enfants est faible. Ceci a souvent été attribué au fait que les enfants sont moins testés, mais les données de laboratoires montrent que ce n’est que partiellement correct. Les enfants ont effectivement été moins testés : ils constituent 20 % de la population belge mais seulement 10 % du nombre total de tests réalisés. Mais même lorsque les enfants sont testés, le test est moins souvent positif que chez les adultes (1,8 % en moyenne contre 6,3 %). Le nombre de tests chez les enfants a été particulièrement faible au début de l’épidémie, lorsque les tests étaient réservés aux cas sévères. Après les changements apportés à la stratégie de testing le 4 mai (tous les cas possibles pouvant être testés) et le 11 juin (tous les contacts étroits d’un cas confirmé devant également être testés), nous avons observé une forte augmentation du nombre de tests réalisés chez les enfants. Pendant la majeure partie de la période décrite dans ce rapport, l’enseignement à distance était la règle, certainement pour les élèves des écoles secondaires. Au total, 378 cas ont été signalés en milieu scolaire, dont 270 élèves et 108 membres du personnel. Ces cas signalés dans les écoles ont eu pour conséquence la mise en quarantaine préventive de 4715 personnes (dont 243 adultes). Le nombre élevé de personnes en quarantaine est en contraste avec le nombre limité de cas secondaires rapportés : 11 membres du personnel (4,7 % des membres du personnel en quarantaine) et 36 élèves (0,8 % des 4 472 élèves en quarantaine) ont probablement été contaminés dans le cadre scolaire. La majorité des enfants testés positifs au SARS-CoV-2 n’ont pas dû être hospitalisés. Même s’ils constituaient 3 % du nombre de personnes ayant une infection confirmée, ils ne représentaient que 1,6 % du nombre total de patients hospitalisés pour le COVID-19. En outre, la grande partie (81 %) des hospitalisations chez les enfants se sont déroulées sans complications graves (telles que pneumonie, surinfection bactérienne ou fongique, hospitalisation en soins intensifs et syndrome de détresse respiratoire aiguë). La durée du séjour des enfants à l’hôpital était par conséquent généralement courte (médiane = 3 jours) et significativement moins longue que celle de l’ensemble des patients faisant partie de la surveillance hospitalière (médiane = 8 jours). Les plus jeunes enfants, à savoir les enfants de moins de 3 mois, représentent une grande partie de ces hospitalisations pédiatriques. Cela s’explique probablement par le fait que la fièvre chez ces jeunes enfants est un signal d’alarme menant rapidement à la réalisation d’un test diagnostique (ce qui augmente les chances de confirmation du diagnostic) et par le fait qu’un test positif dans cette tranche d’âge engendre une plus grande inquiétude (et entraînera donc une hospitalisation plus rapide). Malgré le fait que les jeunes enfants sont hospitalisés plus souvent, il semble, sur la base de nos données, que ce sont au contraire les groupes d’âge plus élevés (un an ou plus, comparé aux moins d’un an) qui sont à plus haut risque de présenter une évolution clinique sévère. Il est néanmoins possible que ces données soient biaisés par le fait que, comme expliqué plus haut, les jeunes enfants sont plus rapidement testés et hospitalisés.

ER - TY - RPRT T1 - infections liées aux aliments et à l'eau, synthèse épidémiologique, data 2017-2018 Y1 - 2020 A1 - Stéphanie Jacquinet A1 - Dieter Van Cauteren A1 - Sofieke Klamer A1 - Javiera Rebolledo ER - TY - RPRT T1 - Surveillance épidémiologique de l’hépatite B - 2018 Y1 - 2020 A1 - Sofieke Klamer A1 - Chloé Wyndham-Thomas A1 - Vanessa Suin KW - epidemiology KW - Hepatitis B KW - Surveillance AB -

En 2018, les laboratoires vigies ont rapporté 2116 nouveaux cas d’infection active par le virus de l’hépatite B (VHB), un nombre un peu plus élevé qu’au cours des deux années précédentes (2017, n=1650 2016, n=1662). Le VHB survient le plus souvent dans le groupe d’âge des 25-44 ans: 53 % des nouveaux diagnostics enregistrés se situaient dans cette tranche d’âge. Une diminution de la proportion des nouvelles infections par le VHB chez les moins de 25 ans (groupe d'âge ayant bénéficié de la gratuité de la vaccination, initiée en 1999 pour les nourrissons et les jeunes adolescents) est observée. Ceci pourrait être un reflet de la politique vaccinale en place.

Il est recommandé d’établir un registre des patients infectés par le VHB afin de suivre l’impact du programme de vaccination ainsi que l’effet des nouveaux traitements. Afin d’éliminer les hépatites virales comme problème de santé publique majeur, l’Organisation mondiale de la Santé (OMS) a défini comme objectifs la réduction de 90 % du nombre de nouveaux cas et la réduction de 65 % le nombre de décès dus à l’hépatite virale d’ici 2030 (par rapport à 2015).

PB - Sciensano CY - Bruxelles ER - TY - RPRT T1 - Voedsel-en watergerelateerde infectieziekten, epidemiologische verslag, data 2017-2018 Y1 - 2020 A1 - Stéphanie Jacquinet A1 - Dieter Van Cauteren A1 - Sofieke Klamer A1 - Javiera Rebolledo ER - TY - RPRT T1 - Epidémiologie des maladies infectieuses à prévention vaccinale. Synthèse annuelle 2018 Y1 - 2019 A1 - Chloé Wyndham-Thomas A1 - Toon Braeye A1 - Laura Cornelissen A1 - Tine Grammens A1 - Stéphanie Jacquinet A1 - Sofieke Klamer A1 - Adrien Lajot A1 - Marie Lesenfants A1 - Amber Litzroth KW - rapport annuel PB - Sciensano CY - Brussels ER - TY - RPRT T1 - Epidemiologie van infectieziekten die voorkomen kunnen worden door vaccinatie. Samenvattend jaarverslag 2018 Y1 - 2019 A1 - Chloé Wyndham-Thomas A1 - Toon Braeye A1 - Laura Cornelissen A1 - Tine Grammens A1 - Stéphanie Jacquinet A1 - Sofieke Klamer A1 - Adrien Lajot A1 - Marie Lesenfants A1 - Amber Litzroth PB - Sciensano CY - Brussels ER - TY - JOUR T1 - Epidemiology and genotype 3 subtype dynamics of hepatitis E virus in Belgium, 2010 to 2017. JF - Euro Surveill Y1 - 2019 A1 - Vanessa Suin A1 - Sofieke Klamer A1 - Veronik Hutse A1 - Wautier, Magali A1 - Marjorie Meurisse A1 - Mona Abady A1 - Lamoral, Sophie A1 - Vera Verburgh A1 - Isabelle Thomas A1 - Bernard Brochier A1 - Lorenzo Subissi A1 - Steven Van Gucht KW - hepatitis E; HEV; surveillance; epidemiology; genotype; Belgium AB -

BackgroundHepatitis E virus (HEV) is an emerging public health concern in high-income countries and can cause acute and chronic hepatitis. Reported numbers of indigenously acquired HEV infection have increased in the past decade in many European countries. Since 2010, the National Reference Centre (NRC) for Hepatitis Viruses has been testing samples of suspected hepatitis E cases in Belgium.AimIn this surveillance report, we present the epidemiological trends of symptomatic HEV infections in Belgium, from the distribution by age, sex and geography to the molecular characterisation of the viral strains.MethodSerum samples of suspected cases sent to the NRC between 2010 and 2017 were analysed for the presence of HEV-specific IgM and RNA. Virus was sequenced for genotyping and phylogenetic analysis in all samples containing sufficient viral RNA.ResultsThe NRC reported an increase in the number of samples from suspected cases (from 309 to 2,663 per year) and in the number of laboratory-confirmed hepatitis E cases (from 25 to 117 per year). Among 217 sequenced samples, 92.6% were genotype 3 (HEV-3), followed by 6.5% of genotype 1 and 0.9% of genotype 4. HEV-3 subtype viruses were mainly 3f, 3c and 3e. HEV-3f was the most common subtype until 2015, while HEV-3c became the most common subtype in 2016 and 2017.ConclusionThe increasing trend of HEV diagnoses in Belgium may be largely explained by increased awareness and testing.

VL - 24 CP - 10 M3 - 10.2807/1560-7917.ES.2019.24.10.1800141 ER - TY - JOUR T1 - The health and economic impact of acute gastroenteritis in Belgium, 2010-2014 JF - Epidemiol Infect Y1 - 2019 A1 - Theofilos Papadopoulos A1 - Sofieke Klamer A1 - Stéphanie Jacquinet A1 - Boudewijn Catry A1 - Amber Litzroth A1 - Laure Mortgat A1 - Pavlos Mamouris A1 - Javiera Rebolledo A1 - Bert Vaes A1 - Dieter Van Cauteren A1 - Johan Van der Heyden A1 - Philippe Beutels A1 - Brecht Devleesschauwer KW - burden of disease KW - cost-of-illness KW - Disability-Adjusted Life Years KW - Gastroenteritis AB -

Acute gastroenteritis (AGE) remains a common condition in both low- and high-income countries. In Belgium, however, there is currently a lack of information on the societal health and economic impact of AGE. We conducted a retrospective study using mortality and cause-of-death data, hospital data, primary care data, health interview survey data and other published data. We estimated the burden of illness during a 5-year period (2010-2014) in Belgium in terms of deaths, patients admitted to hospitals, patients consulting their general practitioner (GP) and cases occurring in the community. We further quantified the health impact in terms of disability-adjusted life years (DALYs) and the economic impact in terms of cost-of-illness estimates. We estimated 343 deaths, 27 707 hospitalised patients, 464 222 GP consultations and 10 058 741 episodes occurring in the community (0.91 cases/person) on average per year. AGE was associated with 11 855 DALYs per year (107 DALY per 100 000 persons). The economic burden was estimated to represent direct costs of €112 million, indirect costs of €927 million (90% of the total costs) and an average total cost of €103 per case and €94 per person. AGE results in a substantial health and economic impact in Belgium, justifying continued mitigation efforts.

VL - 147 M3 - 10.1017/S095026881900044X ER - TY - JOUR T1 - An international outbreak of Salmonella enterica serotype Enteritidis linked to eggs from Poland: a microbiological and epidemiological study JF - The Lancet Infectious Diseases Y1 - 2019 A1 - Roan Pijnacker A1 - Timothy J Dallman A1 - Aloys S L Tijsma A1 - Gillian Hawkins A1 - Lesley Larkin A1 - Kotila, Saara M A1 - Giusi Amore A1 - Ettore Amato A1 - Pamina M Suzuki A1 - Sarah Denayer A1 - Sofieke Klamer A1 - Jacquelyn McCormick A1 - Hassan Hartman A1 - Gareth J Hughes A1 - Lin C T Brandal A1 - Derek Brown A1 - Mossong, Joel A1 - Cecilia Jernberg A1 - Luise Müller A1 - Daniel Palm A1 - Ettore Severi A1 - Joanna Gołębiowska A1 - Hunjak, Blaženka A1 - Slawomir Owczarek A1 - Le Hello, Simon A1 - Patricia Garvey A1 - Kirsten Mooijman A1 - Ingrid H M Friesema A1 - Coen van der Weijden A1 - Menno van der Voort A1 - Valentina Rizzi A1 - Eelco Franz A1 - Sophie Bertrand A1 - Martine Brennan A1 - Lynda Browning A1 - Bruce, Ryan A1 - Vera Cantaert A1 - Marie Chattaway A1 - John Coia A1 - Sarah Couper A1 - Tjaša Žohar Čretnik A1 - Ondřej Daniel A1 - Anna Maria Dionisi A1 - Laetitia Fabre A1 - Ife Fitz-James A1 - Karolina Florek A1 - Martina Florianová A1 - Eithne Fox A1 - Tatjana Frelih A1 - Eva Grilc A1 - Vera Katalinic Jankovic A1 - Nathalie Jourdan A1 - Renata Karpíšková A1 - Hans van den Kerkhof A1 - Sjoerd Kuiling A1 - Sanja Kurečić Filipović A1 - Valeska Laisnez A1 - Heidi Lange A1 - Niall deLappes A1 - Judith Leblanc A1 - Ida Luzzi A1 - Georgia Mandilara A1 - Henry Mather A1 - Wesley Mattheus A1 - Mellou, Kassiani A1 - Deborah Morgan A1 - Judit Pászti A1 - de Pinna, Elizabeth A1 - Ragimbeau, Catherine A1 - Margrethe Hovda Røed A1 - Saara Salmenlinna A1 - Robert Smith A1 - Alison Smith-Palmer A1 - Michaela Špačková A1 - Torpdahl, Mia A1 - Marija Trkov A1 - Linda Trönnberg A1 - Tzani, Myrsini A1 - Lara Utsi A1 - Dariusz Wasyl A1 - Pierre Weicherding KW - International KW - outbreak KW - Salmonella AB -

Salmonella spp are a major cause of food-borne outbreaks in Europe. We investigated a large multi-country outbreak of Salmonella enterica serotype Enteritidis in the EU and European Economic Area (EEA).

VL - 19 CP - 7 M3 - 10.1016/S1473-3099(19)30047-7 ER - TY - JOUR T1 - Subtype-specific differences in the risk of hospitalisation among patients infected with hepatitis E virus genotype 3 in Belgium, 2010-2018. JF - Epidemiol Infect Y1 - 2019 A1 - Lorenzo Subissi A1 - Michael Peeters A1 - Lamoral, Sophie A1 - Sofieke Klamer A1 - Vanessa Suin A1 - Steven Van Gucht KW - hepatitits E AB -

Some European countries recently reported an increase in hepatitis E virus genotype 3 (HEV-3) of the subtype 3c. No link between HEV-3 subtypes and severity is established to date. Here, we report that patients infected with HEV-3c were at lower risk of hospitalisation, compared to those infected with HEV-3f, the other main subtype circulating in Belgium.

VL - 147 M3 - 10.1017/S0950268819001122 ER - TY - JOUR T1 - 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. JF - Euro Surveill Y1 - 2018 A1 - Patricia Ndumbi A1 - Gudrun S Freidl A1 - Christopher J Williams A1 - Otilia Mårdh A1 - Carmen Varela A1 - Ana Avellón A1 - Ingrid Friesema A1 - Vennema, Harry A1 - Kazim Beebeejaun A1 - Siew Lin Ngui A1 - Michael Edelstein A1 - Alison Smith-Palmer A1 - Niamh Murphy A1 - Jonathan Dean A1 - Mirko Faber A1 - Jürgen Wenzel A1 - Mia Kontio A1 - Luise Müller A1 - Sofie Elisabeth Midgley A1 - Lena Sundqvist A1 - Ederth, Josefine Lundberg A1 - Anne-Marie Roque-Afonso A1 - Elisabeth Couturier A1 - Sofieke Klamer A1 - Javiera Rebolledo A1 - Vanessa Suin A1 - Stephan W Aberle A1 - Schmid, Daniela A1 - Rita De Sousa A1 - Augusto, Gonçalo Figueiredo A1 - Valeria Alfonsi A1 - Martina Del Manso A1 - Anna Rita Ciccaglione A1 - Mellou, Kassiani A1 - Christos Hadjichristodoulou A1 - Alastair Donachie A1 - Maria-Louise Borg A1 - Maja Sočan A1 - Poljak, Mario A1 - Ettore Severi KW - ADOLESCENT KW - Adult KW - Aged KW - Aged, 80 and over KW - Child KW - Child, Preschool KW - Disease Outbreaks KW - Europe KW - European Union KW - Genotype KW - Hepatitis A KW - hepatitis A virus KW - Homosexuality, Male KW - Hospitalization KW - Humans KW - Infant KW - Infant, Newborn KW - Male KW - middle aged KW - Risk Factors KW - Sexual Behavior KW - Spain KW - Young adult AB -

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.

VL - 23 CP - 33 M3 - 10.2807/1560-7917.ES.2018.23.33.1700641 ER - TY - RPRT T1 - Maladies infectieuses liées à l'eau et aux aliments: données 2015-2016 Y1 - 2018 A1 - Stéphanie Jacquinet A1 - Sofieke Klamer A1 - Javiera Rebolledo ER - TY - RPRT T1 - Voedsel-en watergerelateerde infectieziekten, epidemiologische verslag, data 2015-2016 Y1 - 2018 A1 - Stéphanie Jacquinet A1 - Sofieke Klamer A1 - Javiera Rebolledo ER - TY - RPRT T1 - Maladies infectieuses liées à la consommation des aliments et de l’eau 2015-2016 Y1 - 2016 A1 - Stéphanie Jacquinet A1 - Sofieke Klamer A1 - Javiera Rebolledo KW - Maladies infectieuse AB -

Rapport thématique.

Surveillance épidémiologique en Belgique, 2015 et 2016

PB - Sciensano CY - Brussels ER - TY - RPRT T1 - Voedsel- en watergerelateerde infectieziekten 2015-2016 Y1 - 2016 A1 - Stéphanie Jacquinet A1 - Sofieke Klamer A1 - Javiera Rebolledo KW - Infectieziekten AB -

Thematisch rapport

Epidemiologische surveillance in België, 2015 en 2016

PB - Sciensano CY - Brussels ER -