[Mumps outbreak in the Plzen Region in 2011]. / Epidemie príusnic v Plzenském kraji v roce 2011.

AIM: The mumps outbreak in the Plzen Region in 2011 was analysed retrospectively using the epidemiological, clinical, and laboratory data. Vaccine efficacy analysis was also conducted in various population groups. MATERIAL AND METHODS: The routine procedure and standard form were used by the epidemiologists to collect data on the age, sex, place of residence, presence in collectivities, date of disease onset, type of complications and date of their onset, hospital admission, vaccination, and results of laboratory analyses. Based on the records of general practitioners for children and adolescents, data on the vaccination of children born in the previous three years have been provided to the epidemic control departments every year by 30 June since 1989. To estimate the vaccination coverage rate, the numbers of single-dose or two-dose recipients are related to the number of children registered in a given year. The first year of vaccine recipients were children born in 1986 who were aged 25 in 2011. The data collected on the population of the Plzen Region were used for the primary analyses. To estimate the efficacy of the mumps vaccine, age and vaccine coverage cohort analysis was performed using the screening method. To analyse categories, the chi-square test with Yates correction was applied at a significance level of p = 0.05 % (EPIINFO version 6.04d). RESULTS: In 2011, 721 mumps cases were reported in the Plzen Region (incidence: 126.1 cases per 100 000 population). The average patient age was 19.4 years, with a median of 18 years (age range 1-77 years). Four hundred and seventeen (57.8%) patients were males. Biological specimens from 375 (52.0%) patients were investigated serologically in the virology laboratory and mumps were laboratory confirmed in 316 (43.8%) of them - in 222 patients, one blood specimen was analysed. The most afflicted area was the Klatovy district with the incidence of 449.3/100 000 population. The most affected age group were 15-19 year-olds with the incidence of 1008.2/100 000 population. Forty-two (5.8%) patients were diagnosed with complications and 68 (9.4%) patients were admitted to the hospital. No statistically significant difference was found in the incidence of complications between the vaccinated and non-vaccinated patients. The assessment of hospitalisation risk showed a statistically significant difference between the vaccinated and non-vaccinated persons in both the whole study cohort and subcohort of patients who received the mumps vaccine within the childhood immunization schedule (p = 0.000 and p = 0.004, respectively). The average age of the vaccinated patients was 16.1 years (median of 17) and that of the non-vaccinated patients was, 29.3 years (median of 27). At the six to ten-month interval, as laid down by the legislation, the second dose of the vaccine was only given to 83.6 % of the patients. The screening method showed a high efficacy of the vaccine in the age group 20-25 years (97.6% in two-dose recipients), declining to 29.6% in the most affected age group of 15-19 years. CONCLUSIONS: Mumps outbreak may has been a result of the accumulation of high numbers of susceptible individuals in the population. The most affected area was the Klatovy district where the last epidemic outbreak occurred 23 years ago. To make the favourable epidemiological situation with occasional local outbreaks continue, the high two-dose vaccine coverage rate needs to be maintained.

Cluster of three cases of invasive meningococcal disease in a preschool facility in West Bohemia, the Czech Republic.

From 1993 to 2009, there was only one cluster of invasive meningococcal disease (IMD) reported in a community of children in the Czech Republic. This exceptional cluster that occurred in a preschool facility is the focus of this report. In response to the announcement of the disease, anti-epidemic precautions were put in place. Neisseria meningitidis isolates were delivered from local laboratories to the National Reference Laboratory for Meningococcal Infections in Prague. Phenotyping was performed there along with multilocus sequence typing. Related factors and microbiological results were analyzed retrospectively. In October 2009, three girls contracted IMD within a period of 1 week in a 42-member group in a preschool facility attached to the elementary school in Starý Plzenec-Sedlec. In relation to three cases of the disease, another 66 people were registered of which 58 underwent a microbiological examination. N. meningitidis was detected in a total of five (8.6 %) people. The National Reference Laboratory for Meningococcal Infections defined the type of the strain to be C: P1.18-1,34-2,38: F1-7: ST-467 (cc269) and penA27. Tests showed the precise identity of all strains obtained from the three sick children and of two strains contracted through contact with the preschool facility. Despite the complete recovery of all patients with no permanent damage, the need for rapid cooperation between clinical sites, diagnostic laboratories, and epidemiologists was confirmed.

[Long-term experience with testing family and sexual contacts of HBsAg positive persons]. / Dlouhodobé zkusenosti s vysetrováním rodinných a sexuálních kontaktu HBsAg+ osob.

UNLABELLED: The study objectives were to identify HBsAg positive persons and to offer free vaccination against the infection to their family and sexual contacts found negative in screening for viral hepatitis B (VHB) postinfection markers. MATERIAL AND METHODS: Any person testing HBsAg positive in the Plzen region was registered in cooperation with laboratories. The collected data included reason for testing, clinical diagnosis and ethnicity. Contacts were screened for postinfection markers and vaccinated. RESULTS: Between 1997 and 2004, 939 HBsAg positive persons were registered by laboratories in the Plzen region. Their mean age was 42.2 (0-90) years. As many as 63.4 % of the infected persons appeared to be "healthy" carriers. Nevertheless, a significant upward trend in HBsAg positivity was recorded among immigrants (mainly those from Vietnam). Altogether 18.2 % of 829 family and sexual contacts tested positive for VHB postinfection markers (HBsAg, anti-HBc). The highest percentages of infected contacts were detected among siblings and parents of HBsAg positive persons (36.5 % and 27.3 %, respectively). Free vaccination has been requested by 82.2 % of susceptible contacts. CONCLUSION: Systematic vaccination of family and sexual contacts of HBsAg positive persons can contribute to more rapid VHB elimination in the Czech Republic. Currently, special attention in detecting infected persons is to be paid to immigrants from Asia.

[A water-borne epidemic of tularemia in Chlumcany]. / Vodní epidemie tularémie v Chlumcanech.

During an epidemic of tularaemia in Chlumcany in December 2000 48 people, 36 adults, 12 children fell ill. In the patients the oroglandular form predominated which was diagnosed 46 times. None of the patients died. The vehicle of the infection was inadequately treated water which was used by the patients for the preparation of soda water and for washing. Using the polymerase chain reaction francisellae were detected in two water samples.

[3-years' study of family contacts of HBsAg+ individuals]. / Tríleté zkusenosti s vysetrováním rodinných kontaktu HBsAg+ osob.

BACKGROUND: About 50,000 HbsAg carriers exist in Czech Republic. The most endangered group is the family members and sex partners. On the basis of positive HbsAg laboratory findings we decided to offer laboratory examination of post-infectious hepatic markers and to sero-negative also the vaccination against viral hepatitis B. METHODS AND RESULTS: The group of HbsAg carriers included 453 persons (253 males and 200 females), average age 42.3 years, within the range of 0 to 89 years. When samples were taken, 55.4% of examined persons were classified as "Healthy carrier". To offer of free examination and vaccination 410 family contacts responded. Postinfectious markers (HbsAg, antiHbsAg) were identified in 19.0% of examined persons, 78.3% of sensitive ones were vaccinated. When financial costs were evaluated, it is possible to conclude that examination and vaccination of contacts of HbsAg positive persons in the whole Czech Republic using the same method and similar collaboration may require 58.5 millions Kc. When laboratory tests were omitted, the costs may be reduced to 59.4%. CONCLUSIONS: On the basis of presented data authors deduce that the legislation of Czech Republic should be quickly changed to include the precept of free vaccination of family contacts of HbsAg positive persons. In accordance with it, rational method of depistage of those persons and information transfer should be developed. Considering long-term consequences of the viral B hepatitis, unreplaceable role in the prevention and diagnostics of the infection have general practitioners.

[Incidence of tick-borne encephalitis in the West Bohemia Region 1960-1999--evaluation of vaccination]. / Výskyt klíst'ové encefalitidy v Západoceském kraji v letech 1960-1999--zhodnocení vakcinace.

In 1960-1999 in the West Bohemian region 1216 cases of tick-borne encephalitis were recorded, four were fatal. Since 1992 there was a marked increase in the number of these infections--in 1992-1999 the relative morbidity was 6.7 per 100,000 population per year, the highest specific morbidity shifted to the age group of 55-64 years. In the whole region changes occurred as to the probable transmission of infection. By the end of 1999 in western Bohemia the hygiene service immunized, by at least three doses against tick-borne encephalitis 23,225 subjects, i.e. 2.7% of the population. The negligible vaccination rate did not have so far an impact on the epidemiological characteristics of the infection. In view of the more frequent and clinically more severe affection in elderly subjects it is important to raise the vaccination rate in particular in more advanced age groups.

[Incidence of Lyme borreliosis in the West Bohemian Region (1988-1992)]. / Výskyt lymské boreliózy v Západoceském kraji (1988-1992).

During 1988-1992 the hygiene service of the West Bohemian region received 1,954 notifications of Lyme borreliosis (LB), incl. 48.5% confirmed by serological examination. Among the affected systems the skin, joints and the nervous system predominated. The most frequently reported vector were ticks which alone accounted for 57.8%. Contrastly to tick-borne encephalitis, the disease was detected in all districts of the region and in all age groups. The highest morbidity was recorded in women in the age bracket of 45-64 years.