Background: Protection of refugees, migrants, and asylum seekers living in open hosting camps (HCs) and reception and identification centers (RICs) has been a priority since the beginning of the COVID-19 pandemic. We present the epidemiological data of COVID-19 infection in HCs/RICs in Greece from February 2020 to May 2021, before the initiation of the onsite vaccinations.Methods: Case confirmation was performed by rapid antigenic test and/or RT-PCR. Data were retrieved from the National COVID-19 registry. The notification rate by type of accommodation facility, by sex and ethnicity and the mean age of cases, were calculated for HCs, RICs and general population. Data on clinical manifestations, and disease severity (admissions to intensive care unit (ICU) / case fatality rate) were analysed.Results: Of the 397,497 recorded domestic COVID-19 infection cases, 2,609 (0.7%) regarded HCs/RICs; of them 1,566 (60%) were identified in 27 HCs and 1,043 (40%) in six RICs. The notification rate was 542 and 380 cases per 10,000 population in HCs/RICs and the general population, respectively (p-value<0.001).Up to February 2021 the occurrence of cases in HCs/RICs did not follow the occurrence of cases in the general population. After March 2021 the course of the outbreak in HCs/RICs and the general population was similar.The median age of cases in HCs/RICs and the general population was 27 (range:0-81) and 44 (range:0-106), respectively (p<0.001). Twenty-four different ethnicities were reported among migrant cases; 51% were from Afghanistan, 13% from Syria, 6% from Kongo and 5% from Somalia.Overall, 48% and 80% of cases, respectively in HCs/RICs and the general population were symptomatic (p<0.001). Five (0.2%) cases in HCs/RICs were admitted to the ICU compared to 10,426 cases (3.0%) in the general population (p-value <0.001). Case fatality rate was 3% in the general population and 0.08% in HCs/RICs (p-value <0.001).Conclusion: Recorded COVID-19 infections were less severe in migrants living at HCs/RICs than the general population, however, the number of identified cases was high and measures for the prevention of transmission should be strengthened.
Background Variant Creutzfeldt–Jakob disease (vCJD), is a form of CJD associated with consumption of tissues from cattle infected with bovine spongiform encephalopathy. Confirmation requires cerebral histopathologic examination, ascertaining spongiform change and extensive prion protein deposition with florid plaques. In Greece, the disease has been included in the Mandatory Notification System since 2004 however no reference laboratory has been available since 2009 due to low global occurrence. In 2014, the surveillance system was strengthened to also include possible and probable cases based on the non-confirmatory diagnostic criteria of the EU case definition. Hereby we present the results of the surveillance for 2014–2018. Methods A new reporting form for CJD was introduced at the national level, including fields aligned with EU case definition criteria for vCJD (preconditions, clinical, diagnostic, and epidemiological). The non-confirmatory diagnostic criteria for the classification of probable and possible vCJD cases were based on examinations routinely available at hospitals, namely EEG and cerebral MRI. Reported CJD cases were assessed according to the fulfillment of required combinations of EU criteria for possible, probable, and confirmed vCJD cases. Results From 2014 to 2018, 37 CJD cases were reported, with a median age of 67 years (IQR: 58–73) concerning mostly females (71.3%, 95% CI: 56.7–85.9%). Among the reported cases, 6 (16.2%) fulfilled only the preconditions, 8 (21.6%) fulfilled the preconditions and the clinical criteria, 21 (56.8%) had a compatible EEG, and 7 (18.9%) had a compatible MRI brain scan. Confirmatory examination was not performed to any of the CJD cases; however, no case was classified as possible or probable vCJD based on the EU case definition. Conclusion Notification of CJD patients from 2014 to 2018 in Greece, yielded no vCJD cases. The possible re-emergence of vCJD renders continuous surveillance of the disease imperative. Current EU case definition can support the surveillance of vCJD, by screening CJD patients for possible and probable vCJD cases with the utilization of conventional diagnostic examinations, available in most hospitals. Disclosures All authors: No reported disclosures.
BackgroundRabies re-emerged in Greek fauna in October 2012, 25 years after the last report in animals. Hellenic Center for Disease Control & Prevention developed a semi-active surveillance system to monitor the medical management of potentially exposed persons to rabies. This study aims to providing insight on the biologicals administered and the epidemiological characteristics of the cases where post-exposure prophylaxis was initiated after contact with animals.MethodsData received from November 2012 to December 2017 on demographics, exposure event, animal species involved, category of exposure (COE) according to WHO, vaccination history, the veterinary evaluation of the animal and the type of treatment administered, were analyzed with Epidata Analysis V.2.2.2.180.ResultsA total of 1,616 cases (63.2% males) received rabies post-exposure prophylaxis. In 94.7% of cases cleansing of the wound before visiting a medical practitioner took place during the first 3 hours after the exposure whereas 75.1% of victims presented at a healthcare setting during the first 24 hours; COE III cases had shorter time interval (P < 0.01), before arrival at a hospital (mdn = 1.3 hours) compared with COE II (mdn = 3.6 hours) or COE I (mdn = 88.2 hours) (Figure 1); 55.1% were initiated on a vaccine series, 43.1% received both vaccine and immunoglobulin and 1.7% immunoglobulin alone. Exposure to stray dogs represented 67.3% of all incidents (Table 1).Table 1: Post-Exposure Prophylaxis (PEP) by Animal Involved, Greece, 2012–2017SpeciesStatusPEP%DogOwnerless1,08767.3With owner25215.6Unknown201.2CatOwnerless1207.4Companion171.1Unknown10.1Fox483.0Bat332.0Other domestic species60.4Other wildlife species181.1Unidentified140.9Total1,616100No human case was recorded.ConclusionThe vast majority of the reported treatments involved stray dogs as Greek legislation permits free roaming of ownerless companion animals in urban settings. Bat was the fourth most frequently reported species in our treatment series. Surveillance of post-exposure prophylaxis represents a valuable tool for outlining the epidemiological profile of treated cases and for planning of effective policies for the management of rabies.Disclosures All authors: No reported disclosures.
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