Immunisation |
Published on: 28 November2008 |
Topic Archives: 2007 | 2006 | 2005 | 2004 | 2003 | 2002 | 2001
Invasive meningococcal infections, England and Wales: laboratory reports, weeks 27-39/08
Method of diagnosis |
Cumulative*
totals to week to week |
|||||||
CSF and blood Culture |
Non- culture |
Other sites |
||||||
| 2008 | 2007 | 2008 | 2007 | 2008 | 2007 | 39/2008 | 39/2007 | |
| Group A | – |
– |
– |
– |
– |
– |
1 |
1 |
| B | 76 |
98 |
84 |
93 |
4 |
4 |
723 |
836 |
| C | 2 |
2 |
– |
5 |
1 |
– |
15 |
31 |
| W135 | – |
5 |
1 |
2 |
– |
– |
10 |
24 |
| X | – |
– |
– |
– |
– |
– |
– |
1 |
| Y | 7 |
5 |
2 |
2 |
– |
– |
26 |
31 |
| Z/29E | v |
1 |
– |
– |
– |
– |
2 |
1 |
| Ungroupable | – |
– |
– |
– |
– |
– |
1 |
2 |
| Ungrouped | – |
– |
3 |
13 |
– |
– |
35 |
51 |
| Total | 85 |
111 |
90 |
115 |
5 |
4 |
813 |
978 |
Laboratory confirmed cases of pertussis reported to the enhanced pertussis surveillance programme during April to June 2008
There were 244 laboratory confirmed cases of pertussis (culture, PCR, serology) reported to the pertussis enhanced surveillance programme in the second quarter of 2008 (table 1). This is an increase on the number of cases reported in the previous two quarters (177 in both October to December 2007 [1] and January to March 2008 [2]), consistent with seasonal increases usually observed in this quarter.
The number of cases reported this quarter represents an 83% increase on the number of cases reported during April to June in 2007 (133 cases) [1], which in turn was an increase in the number of cases in this quarter in 2006 (54 cases) [3] and 2005 (78 cases) [4]. However, culture-confirmed cases in children under one year of age have followed expected epidemiological cycles to date. The increases in laboratory confirmed cases are largely in the older age groups and subsequent to the introduction of new laboratory methods. More detailed explanations are provided in previous HPR articles [1].
Table 1. Age distribution and method of laboratory confirmation of pertussis cases in England and Wales, April to June 2008
Age group |
Culture |
PCR only |
Serology only |
Total |
| <3 months | 35 |
15 |
– |
50 |
| 3-5 months | 7 |
3 |
– |
10 |
| 6-11 months | 2 |
– |
– |
2 |
| 1-4 years | 2 |
1 |
2 |
5 |
| 5-9 years | – |
– |
7 |
7 |
| 10-14 years | – |
– |
38 |
38 |
| >15 years | 4 |
– |
128 |
132 |
| Total | 50 |
19 |
175 |
244 |
Bordetella pertussis PCR (for hospitalised cases < 1 year old) and serological investigation by estimation of anti-pertussis toxin (PT) IgG antibody levels for older children and adults are provided by the Centre for Infection's Respiratory and Systemic Infection Laboratory (RSIL). The laboratory also encourages submission of all Bordetella pertussis isolates for confirmation and national surveillance purposes. Further information is available on the HPA website at http://www.hpa.org.uk/cfi/rsil/bordetella.htm.
References
1. HPA. Laboratory confirmed cases of pertussis reported to the enhanced pertussis surveillance programme in 2007. Health Protection Report [serial online] 2007; 2(26): immunisation. Available at: http://www.hpa.org.uk/hpr/archives/2008/hpr2608.pdf
2. HPA. Laboratory confirmed cases of pertussis reported to the enhanced pertussis surveillance programme during January to March 2008. Health Protection Report [serial online] 2008; 2(34): immunisation. Available at http://www.hpa.org.uk/hpr/archives/2008/hpr3408.pdf
3. HPA. Laboratory confirmed cases of pertussis reported to the enhanced pertussis surveillance programme in 2006. Health Protection Report [serial online] 2007; 1(8): immunisation. Available at: http://www.hpa.org.uk/hpr/archives/2007/hpr0807.pdf
4. HPA. Laboratory confirmed cases of pertussis reported to the enhanced pertussis surveillance programme in 2005. Health Protection Report [serial online] 2007; 16(34): immunisation. Available at: http://www.hpa.org.uk/cdr/archives/2006/cdr3406.pdf
Laboratory confirmed cases of measles, mumps and rubella, England and Wales: July to September 2008
Data presented here is for the third quarter of 2008 (ie July to September 2008). Cases include those confirmed by oral fluid IgM antibody tests, PCR, and routine laboratory reports (table 1). Analyses are by date of onset. Regional breakdown figures relate to Government Office Regions rather than regional health authorities (pre-April 2002 definitions).
Quarterly figures for cases confirmed by oral fluid antibody detection only from 1995 and annual total numbers of confirmed cases by health region and age are available from:
http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/1191942172799?p=1191942172799
http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/1191942172913?p=1191942172913
http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/1191942172140?p=1191942172140
Table 1 Total confirmed cases of measles, mumps and rubella, and oral fluid IgM antibody tests in notified cases: weeks 27-39/2008
Cases |
Oral fluid |
Results |
||||||
Notified |
Tested |
% |
Total |
Recently |
Oral fluid IgM confirmed |
Other lab confirmed |
Total |
|
| Measles | 1347 |
1069 |
79% |
241 |
13 |
228 |
61 |
289 |
Mumps |
1688 |
1160 |
69% |
301 |
7 |
294 |
53 |
347 |
Rubella |
266 |
189 |
71 |
4 |
1 |
3 |
4 |
7 |
Measles
Two hundred and eighty-nine cases of confirmed measles with onset dates in the third quarter of 2008 were reported, compared to 427 cases in the previous quarter [1]. The overall proportion of confirmed measles amongst oral fluid samples tested is above 22.5%, a small decrease compared to the last quarter where around 25% of samples tested were confirmed.
In this quarter the number and proportion of confirmed infections in London (128; 43%) decreased in comparison to previous quarter (294; 69%). The outbreak in Blackpool mentioned in the previous quarter's report spread from school aged children and the general population to the travelling community in the area. Similar traveller outbreaks in the East Midlands, Cheshire and Merseyside Wales, and East of England were also reported [2].
Most of the cases reported this quarter (67%) were in children aged less than 15 years (28 less than one year; 67 aged 1 to 4 years; 57 aged 5 to 9 years; and 43 aged 10 to 14 years); the remaining 94 cases were aged between 15 and 53 years. Nine cases reported receiving measles-containing vaccines: three received single measles vaccine, five received one MMR vaccine, and one reported receiving two doses of MMR.
Cases were investigated from all regions except North East ( London 128, North West 43, South East 37, East of England 21, West Midlands 21, Wales 20, East Midlands 12, Yorkshire and the Humber 4 and South West 3). Although the predominant measles genotype continues to be the endemic D4 strain (MVs/Enfield.GBR/14.07), circulating in the UK since March 2007 a second D4 strain (MVs/Chester.GBR/38.08) has began to circulate. The source for this new strain has so far not been identified.
Seven cases identified recent travel as a possible risk for infection; one had been in Turkey and the other was an overseas student from Gibraltar studying in England . In addition, a family of five who returned recently from holiday in France were also diagnosed with measles.
Mumps
Three hundred and forty-seven cases of mumps with onset dates in the third quarter of 2008 were confirmed compared to 755 in the April to June quarter (1) and 422 in January to March 2008 (3). Cases continue to be confirmed predominantly in those aged between 17 and 28 years (63%), the cohort known to be at highest risk due either to not having been routinely offered MMR vaccination in childhood, or having only received one dose (table 2).
Table 2 Confirmed cases of mumps by age group and region, England and Wales: weeks 27-39/2008
Region |
Age Group |
Total |
||||||||
<1 |
1-4 |
5-9 |
10-14 |
15-19 |
20-24 |
≥25 |
NK |
|||
North East |
– |
1 |
1 |
1 |
– |
2 |
4 |
– |
9 |
|
North West |
– |
– |
6 |
8 |
4 |
11 |
14 |
– |
43 |
|
Yorkshire & Humber |
– |
– |
– |
1 |
23 |
12 |
9 |
1 |
46 |
|
East Midlands |
– |
– |
– |
1 |
– |
1 |
5 |
1 |
8 |
|
West Midlands |
– |
2 |
– |
2 |
2 |
5 |
11 |
1 |
23 |
|
East of England |
– |
1 |
– |
1 |
6 |
10 |
6 |
– |
24 |
|
London |
– |
1 |
2 |
4 |
11 |
38 |
27 |
2 |
85 |
|
South East |
– |
– |
1 |
4 |
21 |
31 |
22 |
1 |
80 |
|
South West |
1 |
1 |
– |
1 |
2 |
4 |
9 |
– |
18 |
|
Wales |
– |
– |
– |
1 |
3 |
4 |
2 |
– |
10 |
|
Not known |
– |
– |
– |
– |
– |
– |
– |
1 |
1 |
|
Total |
1 |
6 |
10 |
24 |
72 |
118 |
109 |
7 |
347 |
|
Rubella
Seven cases of rubella were confirmed in the second quarter of 2008 compared to four in the last quarter (1). Five of the seven cases were from an outbreak in children who attended an English language summer school in East Sussex; four children were from Kazakhstan and one was from Poland . Two different strains of the rubella virus were identified, neither of which is currently circulating in UK .
References
1. HPA. Laboratory confirmed cases of measles, mumps and rubella, England and Wales: April to June 2008. Health Protection Report [serial online] 2008 [cited 25 November 2008]; 2(34): Immunisation. Available at: http://www.hpa.org.uk/hpr/archives/2008/hpr3408.pdf.
2. Confirmed measles casesin England and Wales – an update to September. Health Protection Report [serial online] 2008 [cited 7 November 2008]; 2(45): news. Available at: http://www.hpa.org.uk/hpr/archives/2008/news4508.htm#msls0809.
3. HPA. Laboratory confirmed cases of measles, mumps and rubella, England and Wales: January to March 2008. Health Protection Report [serial online] 2008 [cited 25 November 2008]; 2(21): Immunisation. Available at: http://www.hpa.org.uk/hpr/archives/2008/hpr2108.pdf.