ABSTRACT
OBJECTIVES: To describe the seroepidemiology of herpes simplex virus (HSV) types 1 and 2 in the general populations of eight European countries to better understand recent reported changes in disease epidemiology. METHODS: Belgium, Bulgaria, Czech Republic, England and Wales, Finland, Germany, Netherlands, and Slovenia conducted national cross sectional serological surveys for HSV-1 and HSV-2 between 1989 and 2000. Survey sizes ranged from 3000 to 7166 sera. External quality control was ensured through reference panel testing. RESULTS: Large intercountry and intracountry differences in HSV-1 and HSV-2 seroprevalence were observed. Age standardised HSV-1 seroprevalence ranged from 52% in Finland, to 57% in the Netherlands, 67% in Belgium, 81% in Czech Republic, and 84% in Bulgaria. Age standardised (>12 years) HSV-2 seroprevalence ranged from 24% in Bulgaria, to 14% in Germany, 13% in Finland, 11% in Belgium, 9% in Netherlands, 6% in Czech Republic, and 4% in England and Wales. In all countries, probability of seropositivity for both infections increased with age. A large proportion of teenagers and young adults remain HSV-1 susceptible particularly in northern Europe. Women were significantly more likely to be HSV-2 seropositive in six of seven (p<0.05) countries and HSV-1 seropositive in four of seven (p<0.05) countries, particularly in northern Europe. No significant evidence of a protective role of HSV-1 for HSV-2 infection was found adjusting for age and sex (p<0.05). CONCLUSIONS: There is large variation in the seroepidemiology of HSV-1 and HSV-2 across Europe. The observation that a significant proportion of adolescents are now HSV-1 susceptible may have implications for transmission and clinical presentation of HSV-1 and HSV-2.
Subject(s)
Herpes Simplex/epidemiology , Adolescent , Adult , Age Distribution , Aged , Child , Child, Preschool , Cross-Sectional Studies , Europe/epidemiology , Female , Herpesvirus 1, Human , Herpesvirus 2, Human , Humans , Infant , Male , Middle Aged , Sex DistributionABSTRACT
As a result of dramatic political and economic changes in the beginning of the 1990s, Q-fever epidemiology in Bulgaria has changed. The number of goats almost tripled; contact between goat owners (and their families) and goats, as well as goats and other animals, increased; consumption of raw goat milk and its products increased; and goats replaced cattle and sheep as the main source of human Coxiella burnetii infections. Hundreds of overt, serologically confirmed human cases of acute Q fever have occurred. Chronic forms of Q fever manifesting as endocarditis were also observed. In contrast, in Slovakia, Q fever does not pose a serious public health problem, and the chronic form of infection has not been found either in follow-ups of a Q-fever epidemic connected with goats imported from Bulgaria and other previous Q-fever outbreaks or in a serologic survey. Serologic diagnosis as well as control and prevention of Q fever are discussed.
Subject(s)
Coxiella burnetii/isolation & purification , Q Fever/epidemiology , Animals , Bulgaria/epidemiology , Cattle , Disease Outbreaks , Humans , Q Fever/prevention & control , Slovakia/epidemiologyABSTRACT
Universal vaccination against hepatitis B virus (HBV) was introduced for all newborns in Bulgaria in August 1991, after a three-year selective immunization of babies born to HBsAg-positive mothers. In 1992, a coverage level of 71.3% was achieved. Since 1989, hepatitis B morbidity among infants shows a continuing downward trend with the lowest annual incidence rate, 0.3 cases per 100,000, in 1992. This represents an 82% decrease compared to the preimmunization period. As strong epidemiological evidence exists that an early age of infection substantially increases the overall burden of chronic HBV infection, future expansion of vaccination coverage to include all children up to 6 years of age was considered an appropriate alternative to the existing policies.
