Communicable disease threats report, 9-15 March 2014, week 11

Surveillance report
Publication series: Communicable Disease Threats Report (CDTR)
Time period covered: 9-15 March 2014

​The ECDC communicable disease threats report is a weekly bulletin intended for epidemiologists and health professionals in the area of communicable disease prevention and control. Summarising information gathered by ECDC through its epidemic intelligence activities regarding communicable disease threats of concern to the European Union, it also provides updates on the global situation and changes in the epidemiology of communicable diseases with potential to affect Europe, including diseases that are the focus of eradication efforts.

Executive summary

The ECDC Communicable Disease Threats Report is a weekly bulletin intended for epidemiologists and health professionals in the area of communicable disease prevention and control. This issue covers the period 9-15 March 2014 and includes updates on:

Measles outbreak on a cruise ship in the Mediterranean Sea 
On 27 February 2014, Italy reported an outbreak of measles on board a cruise ship sailing in the north-western Mediterranean with regular port calls in Italy, Spain and France. As of 13 March 2014, 27 cases of measles (22 laboratory confirmed and 5 probable) have been reported with onset from 20 February to 1 March, with most cases among the crew. New cases among crew and passengers cannot be ruled out. Evidence suggests that the outbreak strain may be linked to the large and still ongoing measles outbreak in the Philippines.ECDC published a Rapid Risk Assessment on 6 March 2014. The Eurosurveillance journal published a preliminary report on the outbreak on 13 March 2014.

Seasonal influenza in Europe 
In week 10/2014, of the 28 EU/EEA countries reporting, only one country (Greece) reported high-intensity influenza activity, nine countries reported medium intensity and 18 countries reported low-intensity influenza activity.ECDC published its Annual Risk Assessment on seasonal influenza on 4 March 2014.

Avian influenzas A(H7N9) and A(H5N1) 
Between 7 and 13 March 2014, eight new cases of influenza A (H7N9)infection have been reported in China: six cases in Guangdong province and one case each in Jiangsu and Fujian provinces. The risk of the disease spreading to Europe in the near future is still considered low. ECDC published an updated Rapid Risk Assessment on 26 February 2014. During the past month, eight new human cases of influenza A(H5N1) infection have been reported worldwide: five in Cambodia, two in China and one in Vietnam. The influenza A(H5N1) virus, commonly known as bird flu, is fatal in about 60% of human infections. Sporadic cases continue to be reported, usually after contact with sick or dead poultry from certain Asian and African countries. No human cases have been reported from Europe.

Zika virus infection outbreak in the Pacific region 
There is an ongoing outbreak of Zika virus (ZIKAV) infection in the Pacific affecting several countries, including Easter Island, a territory administered by Chile. There is a simultaneous dengue outbreak in the region. The Zika virus (ZIKAV) outbreak has reached the Cook Islands. This is the first time that ZIKAV infection is reported in the country. As of 13 March 2014, there are 188 cases with zika-like symptoms including 19 confirmed cases. The first case was a returning traveller from Tahiti.
 
Middle East respiratory syndrome – coronavirus (MERS CoV) 
Two new cases (stated to be male) of MERS-CoVwere reported by local health authorities in Saudi Arabia. Both suffered from chronic diseases and one has died. Although there is a continued risk of cases presenting in Europe following exposure in the Middle-East, the risk of secondary transmission in the EU remains low.