Epidemiological and microbiological investigation of a large increase in vibriosis, northern Europe, 2018

Abstract

Background Vibriosis cases in Northern European countries and countries bordering the Baltic Sea increased during heatwaves in 2014 and 2018. Aim We describe the epidemiology of vibriosis and the genetic diversity of Vibrio spp. isolates from Norway, Sweden, Denmark, Finland, Poland and Estonia in 2018, a year with an exceptionally warm summer. Methods In a retrospective study, we analysed demographics, geographical distribution, seasonality, causative species and severity of non-travel-related vibriosis cases in 2018. Data sources included surveillance systems, national laboratory notification databases and/or nationwide surveys to public health microbiology laboratories. Moreover, we performed whole genome sequencing and multilocus sequence typing of available isolates from 2014 to 2018 to map their genetic diversity. Results In 2018, we identified 445 non-travel-related vibriosis cases in the study countries, considerably more than the median of 126 cases between 2014 and 2017 (range: 87–272). The main reported mode of transmission was exposure to seawater. We observed a species-specific geographical disparity of vibriosis cases across the Nordic-Baltic region. Severe vibriosis was associated with infections caused by Vibrio vulnificus (adjOR: 17.2; 95% CI: 3.3–90.5) or Vibrio parahaemolyticus (adjOR: 2.1; 95% CI: 1.0–4.5), age ≥ 65 years (65–79 years: adjOR: 3.9; 95% CI: 1.7–8.7; ≥ 80 years: adjOR: 15.5; 95% CI: 4.4–54.3) or acquiring infections during summer (adjOR: 5.1; 95% CI: 2.4–10.9). Although phylogenetic analysis revealed diversity between Vibrio spp. isolates, two V. vulnificus clusters were identified. Conclusion Shared sentinel surveillance for vibriosis during summer may be valuable to monitor this emerging public health issue.

Correlation of High Seawater Temperature with Vibrio and Shewanella Infections, Denmark, 2010–2018

“…In the unusually warm summer of 1994 in Denmark, several V. vulnificus and S. algae infections were seen among patients who reported bathing in seawater ( 5 , 6 ). Furthermore, during 2014–2018, more than 1,055 cases of vibriosis were reported in northern Europe countries, including Denmark ( 7 ).…”

“…infections increased beginning in week 23, reaching a peak in the warmest months (July and August), followed by a tail of decreasing number in subsequent months (Appendix 1 Figure , panel A). A recent study on 2018 data alone reported that most human vibriosis cases reported in the Nordic region were likely linked to exposure to the warm seawater that year (7). We found that infections were more prevalent in men and boys 10-19 years of age and in elderly We found a marked geographic distribution in results obtained from 2018, when most cases were in persons who lived near coastal areas with brackish waters characterized by low saline levels (<30 parts per thousand; Figure 2) (13).…”

Global disease burden and trends of leukemia attributable to occupational risk from 1990 to 2019: An observational trend study

“…In terms of the countries and regions' distribution of these two kinds of leukemia, in Mexico and Latin America, the age-standardized DALYs and death rates were the highest, possibly because of the most common of these two types of leukemia in young adults and regional economic development. Thus, accurate surveillance data were important for developing a prevention-and-control program and providing valuable countermeasures to estimate the impact of those programs ( 44 , 45 ). Elderly people were found to have disproportionately high DALYs and death rates in total leukemia attributable to occupational risk-related deaths, which might be due to age factors.…”

First Steps towards a near Real-Time Modelling System of Vibrio vulnificus in the Baltic Sea

“…Vibriosis outbreaks in Northern Europe are often attributed to V. alginolyticus , V. cholerae ( non-O1/non-O139 ), V. parahaemolyticus , and V. vulnificus [ 11 , 12 , 13 ]. The number of incidents is generally low.…”

“…The number of incidents is generally low. However, infections with the species V. vulnificus are often severe (>90% of all cases) and have high mortality rates [ 9 , 12 , 13 ]. Therefore, vibriosis, particularly vibriosis linked to V. vulnificus , is a public health concern [ 13 ].…”