On 13 June, Germany reported a fatal case of anthrax in a 51 year old injecting drug user (IDU) in Regensburg.  A second patient in the same city was hospitalised on 18 June with fever and swelling at a heroin injection site, following injection three days previously. Anthrax has also been confirmed in this case. The patient is currently in a stable condition. Both cases of anthrax reported in Bavaria presented with the same strain type as the 2009/2010 outbreak of Bacillus anthracis in Scotland, also associated with heroin injection.

Following these reports, ECDC and EMCDDA jointly prepared a rapid risk assessment where they state that the risk of exposure for heroin users in Germany and other countries is presumably still present and therefore it is likely that additional cases among injecting drug users will be identified in the near future.

On 16 June, 2012, the Romanian Ministry of Health reported an outbreak of aseptic meningitis linked to a kindergarten in Suceava city, in the northern part of the country. A total of 62 cases of enterovirus have been identified in the city and wider district, 53 cases of which have led to aseptic meningitis. Preliminary microbiological investigations suggest that non-polio enteroviruses are the causative agent. Further information can be found in a rapid risk assessment prepared by ECDC.

A community outbreak of Legionnaires' disease was identified in Edinburgh, Scotland. As of 20 June, 44 confirmed cases and 47 suspected cases have been reported, of which 18 were hospitalised by 20 June. Two confirmed cases have died. Industrial cooling towers have been identified as a potential source of infection and the cooling systems at some facilities in the area have been subject to microbiological monitoring and chemical treatment.

As Legionnaires’ disease cannot be transmitted from human to human, the risk for the EU remains limited to people having been in the affected areas of Edinburgh. Local health authorities have implemented control measures.

Finally, ECDC and EpiNorth continue to collaborate closely on enhanced epidemic intelligence activities during this UEFA EURO 2012, in contact with the Polish and Ukrainian health authorities. So far, no public health events requesting central level response have been reported.

Read full ECDC Communicable disease threats report, 17-23 June 2012, week 25

Read more on ECDC website:

Anthrax health topic site
Legionnaires' disease health topic site