Browsing by Subject "Outbreak"

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  • Smura, Teemu; Blomqvist, Soile; Kolehmainen, Pekka; Schuffenecker, Isabelle; Lina, Bruno; Boettcher, Sindy; Diedrich, Sabine; Love, Arthur; Brytting, Mia; Hauzenberger, Elenor; Dudman, Susanne; Ivanova, Olga; Lukasev, Alexander; Fischer, Thea Kolsen; Midgley, Sofie; Susi, Petri; Savolainen-Kopra, Carita; Lappalainen, Maija; Jääskeläinen, Anne J. (2020)
    Picornaviruses (family Picornaviridae) are small, nonenveloped, positive-sense, single-stranded RNA viruses. The members of this family are currently classified into 47 genera and 110 species. Of picornaviruses, entero-and parechoviruses are associated with aseptic meningitis. They are transmitted via fecal-oral and respiratory routes, and occasionally, these viruses may cause a brief viremia and gain access to central nervous system (CNS). During the diagnostic screening of entero-and parechovirus types in Finland in year 2013-14, we detected a cluster of echovirus 4 (E4) infections in young adults and adolescents. As E4 is infrequently detected in Finland, we contacted several Northern and Central European laboratories that conduct routine surveillance for enteroviruses and, for those who have had E4 cases, we send a query for E4 sequences and data. Here we report CNS infections caused by E4 in Finland, Sweden, Norway, Denmark, Iceland and Germany in 2013 and 2014, and show that the E4 detected in these countries form a single lineage. In contrast, E4 strains circulating in these countries preceding the year 2013, and those circulating elsewhere in Europe during 2013-2014, formed several independent clusters.
  • Helanterä, I.; Janes, R.; Anttila, V-J (2018)
    Background: Influenza A(H1N1) causes serious complications in immunocompromised patients. The efficacy of seasonal vaccination in these patients has been questioned. Aim: To describe two outbreaks of influenza A(H1N1) in immunocompromised patients. Methods: Two outbreaks of influenza A(H1N1) occurred in our institution: on the kidney transplant ward in 2014 including patients early after kidney or simultaneous pancreas-kidney transplantation, and on the oncology ward in 2016 including patients receiving chemotherapy for malignant tumours. Factors leading to these outbreaks and the clinical efficacy of seasonal influenza vaccination were analysed. Findings: Altogether 86 patients were exposed to influenza A(H1N1) during the outbreaks, among whom the seasonal influenza vaccination status was unknown in 10. Only three out of 38 vaccinated patients were infected with influenza A(H1N1), compared with 20 out of 38 unvaccinated patients (P = 0.02). The death of one out of 38 vaccinated patients was associated with influenza, compared with seven out of 38 unvaccinated patients (P = 0.06). Shared factors behind the two outbreaks included outdated facilities not designed for the treatment of immunosuppressed patients. Vaccination coverage among patients was low, between 40% and 70% despite vaccination being offered to all patients free of charge. Vaccination coverage of healthcare workers on the transplant ward was low (46%), but, despite high coverage on the oncology ward (92%), the outbreak occurred. Conclusion: Seasonal influenza vaccination was clinically effective with both a reduced risk of influenza infection and a trend towards reduced mortality in these immunocompromised patients. Several possible causes were identified behind these two outbreaks, requiring continuous awareness in healthcare professionals to prevent further outbreaks. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
  • Turunen, T.; Kontunen, K.; Sugulle, K.; Hieta, P.; Snellman, O.; Hussein, I.; Dub, T.; Melin, M.; Haveri, A.; Ekström, N.; Ikonen, N.; Helve, O.; Sane, J. (2021)
    Background shared accommodation may increase the risk of SARS-CoV-2 transmission. In April 2020, an increasing number of asylum seekers at a reception centre in Espoo, Finland presented with COVID-19 despite earlier implementation of preventive measures. We decided to screen the entire population of the centre for SARS-CoV-2. Methods we offered nasopharyngeal swab collection and SARS-CoV-2 real-time polymerase chain reaction (RT-PCR) analysis to the centre's clients. Symptoms were recorded at the time of diagnostic sample collection using electronic forms and followed up for two weeks through phone interviews and a review of medical records. Findings 260 clients were screened. Of them, 96 (37%) were found positive for SARS-CoV-2 and isolated. The high attack rate prompted the local public health authority to set the other clients in quarantine for 14 days to prevent further spread. Of the positive cases, 61 (64%) reported having had symptoms at the time of the screening or one week prior. Of the 35 initially asymptomatic individuals, 12 developed symptoms during follow-up, while 23 (or 18% of all screened SARS-CoV-2 positive clients) remained asymptomatic. No widespread transmission of COVID-19 was detected after the quarantine was lifted. Interpretation in this large COVID-19 outbreak, voluntary mass screening provided valuable information about its extent and helped guide the public health response. Comprehensive quarantine and isolation measures were likely instrumental in containing the outbreak. Funding Finnish Institution for Health and Welfare, Finnish Immigration Agency, City of Espoo
  • Friman, Mari Johanna; Eklund, Marjut Hannele; Pitkälä, Anna Helena; Rajala-Schultz, Päivi Johanna; Rantala, Merja Hilma Johanna (2019)
    Background Infection with Serratia spp. have been associated with mastitis outbreaks in dairy cattle herds. Environmental contamination or a point source, like a teat dip product, have often been observed to be potential sources of such outbreaks. We describe two Serratia marcescens associated mastitis outbreaks associated with a contaminated teat dip containing a tertiary alkyl amine, n,n-bis (3-aminopropyl) dodecylamine in two dairy cattle farms in Finland. S. marcescens strains isolated from milk and environmental samples were identified by the MALDI-TOF method. Results Six specimens (n = 19) on Herd 1 and all specimens (n = 9) on Herd 2 were positive for S. marcescens. Positive specimens were from mastitis milk and teat dip liquid and equipment. Bacteria were not isolated from the unopened teat dip canister. The same clone of S. marcescens was isolated from milk samples and teat dip samples within the farms. Pulsed field gel electrophoresis results to the S. marcescens isolates from these two different herds were tested with unweighted pair-group method using arithmetic average clustering analysis. The isolates were not same clone in both herds, because similarity in that test was only 75% when cut-off value to similarity is 85%. Conclusions Our investigation showed that the post milking teat dip and/or temporary containers were contaminated with S. marcescens and these were most likely the sources for new mastitis cases. The negative result from the unopened teat dip canister and positive results from refillable containers demonstrated that the product itself was not contaminated with S. marcescens at the production unit, but became contaminated at the farm level.
  • Friman, Mari J; Eklund, Marjut H; Pitkälä, Anna H; Rajala-Schultz, Päivi J; Rantala, Merja H J (BioMed Central, 2019)
    Abstract Background Infection with Serratia spp. have been associated with mastitis outbreaks in dairy cattle herds. Environmental contamination or a point source, like a teat dip product, have often been observed to be potential sources of such outbreaks. We describe two Serratia marcescens associated mastitis outbreaks associated with a contaminated teat dip containing a tertiary alkyl amine, n,n-bis (3-aminopropyl) dodecylamine in two dairy cattle farms in Finland. S. marcescens strains isolated from milk and environmental samples were identified by the MALDI-TOF method. Results Six specimens (n = 19) on Herd 1 and all specimens (n = 9) on Herd 2 were positive for S. marcescens. Positive specimens were from mastitis milk and teat dip liquid and equipment. Bacteria were not isolated from the unopened teat dip canister. The same clone of S. marcescens was isolated from milk samples and teat dip samples within the farms. Pulsed field gel electrophoresis results to the S. marcescens isolates from these two different herds were tested with unweighted pair-group method using arithmetic average clustering analysis. The isolates were not same clone in both herds, because similarity in that test was only 75% when cut-off value to similarity is 85%. Conclusions Our investigation showed that the post milking teat dip and/or temporary containers were contaminated with S. marcescens and these were most likely the sources for new mastitis cases. The negative result from the unopened teat dip canister and positive results from refillable containers demonstrated that the product itself was not contaminated with S. marcescens at the production unit, but became contaminated at the farm level.
  • Haimi-Hakala, Minna; Hälli, Outi; Laurila, Tapio; Raunio-Saarnisto, Mirja; Nokireki, Tiina; Laine, Taina; Nykäsenoja, Suvi; Pelkola, Kirsti; Segales, Joaquim; Sibila, Marina; Oliviero, Claudio; Peltoniemi, Olli; Pelkonen, Sinikka; Heinonen, Mari Leena (2017)
    Background: The objective of our study was to clinically and etiologically investigate acute outbreaks of respiratory disease in Finland. Our study also aimed to evaluate the clinical use of various methods in diagnosing respiratory infections under field conditions and to describe the antimicrobial resistance profile of the main bacterial pathogen(s) found during the study. Methods: A total of 20 case herds having finishing pigs showing acute respiratory symptoms and eight control herds showing no clinical signs suggesting of respiratory problems were enrolled in the study. Researchers visited each herd twice, examining and bleeding 20 pigs per herd. In addition, nasal swab samples were taken from 20 pigs and three pigs per case herd were necropsied during the first visit. Serology was used to detect Actinobacillus pleuropneumoniae (APP), swine influenza virus (SIV), porcine reproductive and respiratory syndrome virus (PRRSV), porcine respiratory coronavirus (PRCV) and Mycoplasma hyopneumoniae antibodies. Polymerase chain reaction (PCR) was used to investigate the presence of porcine circovirus type 2 (PCV2) in serumand SIV in the nasal and lung samples. Pathology and bacteriology, including antimicrobial resistance determination, were performed on lung samples obtained from the field necropsies. Results: According to the pathology and bacteriology of the lung samples, APP and Ascaris suum were the main causes of respiratory outbreaks in 14 and three herds respectively, while the clinical signs in three other herds had a miscellaneous etiology. SIV, APP and PCV2 caused concurrent infections in certain herds but they were detected serologically or with PCR also in control herds, suggesting possible subclinical infections. APP was isolated from 16 (80%) case herds. Marked resistance was observed against tetracycline for APP, some resistance was detected against trimethoprim/sulfamethoxazole, ampicillin and penicillin, and no resistance against florfenicol, enrofloxacin, tulathromycin or tiamulin was found. Serology, even from paired serum samples, gave inconclusive results for acute APP infection diagnosis. Conclusions: APP was the most common cause for acute respiratory outbreaks in our study. SIV, A. suum, PCV2 and certain opportunistic bacteria were also detected during the outbreaks; however, viral pathogens appeared less important than bacteria. Necropsies supplemented with microbiology were the most efficient diagnostic methods in characterizing the studied outbreaks.
  • Haimi-Hakala, Minna; Hälli, Outi; Laurila, Tapio; Raunio-Saarnisto, Mirja; Nokireki, Tiina; Laine, Taina; Nykäsenoja, Suvi; Pelkola, Kirsti; Segales, Joaquim; Sibila, Marina; Oliviero, Claudio; Peltoniemi, Olli; Pelkonen, Sinikka; Heinonen, Mari (BioMed Central, 2017)
    Abstract Background The objective of our study was to clinically and etiologically investigate acute outbreaks of respiratory disease in Finland. Our study also aimed to evaluate the clinical use of various methods in diagnosing respiratory infections under field conditions and to describe the antimicrobial resistance profile of the main bacterial pathogen(s) found during the study. Methods A total of 20 case herds having finishing pigs showing acute respiratory symptoms and eight control herds showing no clinical signs suggesting of respiratory problems were enrolled in the study. Researchers visited each herd twice, examining and bleeding 20 pigs per herd. In addition, nasal swab samples were taken from 20 pigs and three pigs per case herd were necropsied during the first visit. Serology was used to detect Actinobacillus pleuropneumoniae (APP), swine influenza virus (SIV), porcine reproductive and respiratory syndrome virus (PRRSV), porcine respiratory coronavirus (PRCV) and Mycoplasma hyopneumoniae antibodies. Polymerase chain reaction (PCR) was used to investigate the presence of porcine circovirus type 2 (PCV2) in serum and SIV in the nasal and lung samples. Pathology and bacteriology, including antimicrobial resistance determination, were performed on lung samples obtained from the field necropsies. Results According to the pathology and bacteriology of the lung samples, APP and Ascaris suum were the main causes of respiratory outbreaks in 14 and three herds respectively, while the clinical signs in three other herds had a miscellaneous etiology. SIV, APP and PCV2 caused concurrent infections in certain herds but they were detected serologically or with PCR also in control herds, suggesting possible subclinical infections. APP was isolated from 16 (80%) case herds. Marked resistance was observed against tetracycline for APP, some resistance was detected against trimethoprim/sulfamethoxazole, ampicillin and penicillin, and no resistance against florfenicol, enrofloxacin, tulathromycin or tiamulin was found. Serology, even from paired serum samples, gave inconclusive results for acute APP infection diagnosis. Conclusions APP was the most common cause for acute respiratory outbreaks in our study. SIV, A. suum, PCV2 and certain opportunistic bacteria were also detected during the outbreaks; however, viral pathogens appeared less important than bacteria. Necropsies supplemented with microbiology were the most efficient diagnostic methods in characterizing the studied outbreaks.
  • Blomvall, Laura; Pelkola, Kirsti; Lienemann, Taru; Lehtoniemi, Suvi; Pohjola, Leena; Fredriksson-Ahomaa, Maria (2022)
    A Yersinia pseudotuberculosis outbreak was diagnosed in a male turkey flock in Finland. Y. pseudotuberculosis is a quite rare zoonotic bacterium, which typically causes enteritis in humans and sudden death in animals. In this study, osteomyelitis was diagnosed in small, lame, 11-to 12-wk-old male turkeys. Lameness and slower growth among the turkeys was observed on the farm. During pathological examination, multiple lesions were found in the metaphyseal and physeal areas of the femurs, tibiotarsi, and tarsometatarsi, with multifocal to coalescing mixed heterophilic/granulomatous necrotizing osteomyelitis. Y. pseudotuberculosis was isolated from the femoral and tibiotarsal bones or from the joints of six lame turkeys sent for necropsy. The isolation required homogenizing of lesion tissue in phosphate-mannitol-peptone broth, which was cultured directly -and, if needed, after cold enrichment - on selective cefsulodin-irgasan-novobiocin agar. Whole-genome sequencing was used for identification and typing. All isolates belonged to bio/serotype 1/O:1a and sequence type ST42 (Achtman scheme), which is commonly reported in both human and animal Y. pseudotuberculosis infections in Europe. The isolates from all six turkeys showed only one to two allele differences in the core genome comparison, indicating a common source of infection. All asymptomatic turkeys were slaughtered at the age of 17 weeks. Whole and partial carcass condemnation rates at the slaughterhouse were high, but no macroscopic changes in the skeletal system were found, showing that food chain information is essential. This study confirms earlier findings that Y. pseudotuberculosis can cause osteomyelitis in fattening turkeys, leading to lameness. Food chain information is essential for slaughterhouse operations, to protect the workers and emphasize good working hygiene during slaughter.
  • Strona, Giovanni; Castellano, Claudio; Fattorini, Simone; Ponti, Luigi; Gutierrez, Andrew Paul; Beck, Pieter S.A. (2020)
    Outbreaks of a plant disease in a landscape can be meaningfully modelled using networks with nodes representing individual crop-fields, and edges representing potential infection pathways between them. Their spatial structure, which resembles that of a regular lattice, makes such networks fairly robust against epidemics. Yet, it is well-known how the addition of a few shortcuts can turn robust regular lattices into vulnerable ‘small world’ networks. Although the relevance of this phenomenon has been shown theoretically for networks with nodes corresponding to individual host plants, its real-world implications at a larger scale (i.e. in networks with nodes representing crop fields or other plantations) remain elusive. Focusing on realistic spatial networks connecting olive orchards in Andalusia (Southern Spain), the world’s leading olive producer, we show how even very small probabilities of long distance dispersal of infectious vectors result in a small-world effect that dramatically exacerbates a hypothetical outbreak of a disease targeting olive trees (loosely modelled on known epidemiological information on the bacterium Xylella fastidiosa, an important emerging threat for European agriculture). More specifically, we found that the probability of long distance vector dispersal has a disproportionately larger effect on epidemic dynamics compared to pathogen’s intrinsic infectivity, increasing total infected area by up to one order of magnitude (in the absence of quarantine). Furthermore, even a very small probability of long distance dispersal increased the effort needed to halt a hypothetical outbreak through quarantine by about 50% in respect to scenarios modelling local/short distance pathogen’s dispersal only. This highlights how identifying (and disrupting) long distance dispersal processes may be more efficacious to contain a plant disease epidemic than surveillance and intervention concentrated on local scale transmission processes.
  • Kontturi, Miia; Kujala, Minna; Junni, Reijo; Malinen, Erja; Seuna, Eija; Pelkonen, Sinikka; Soveri, Timo; Simojoki, Heli (2017)
    Background: Severe outbreaks of interdigital phlegmon (IP) associated with a high morbidity and major economic losses have occurred in Finland in the past decade. A survey was performed to indicate the current occurrence of infectious hoof diseases and to identify herd level risk factors predisposing to an outbreak of IP. Results: Responses to a questionnaire revealed that an outbreak of IP defined as morbidity >= 5% within the 1st month of the outbreak, had occurred in 18.0% of the respondent study farms. Risk factors for an outbreak included animal transport between herds, i.e. either animal purchase or contract heifer rearing, enlargement or renovation of the barn, and if the fields of the farm had been organically cultivated. Having any kind of mechanical ventilation in comparison to natural ventilation seemed to lower the risk of IP. Additionally, the farms that had experienced an outbreak of IP often had other infectious hoof diseases. However, it was unclear which disease appeared first. Conclusions: More attention is needed before and during enlargement or renovation of the barn and substantial planning is crucial for every part of the enlargement process in dairy farms.
  • Kontturi, Miia; Kujala, Minna; Junni, Reijo; Malinen, Erja; Seuna, Eija; Pelkonen, Sinikka; Soveri, Timo; Simojoki, Heli (BioMed Central, 2017)
    Abstract Background Severe outbreaks of interdigital phlegmon (IP) associated with a high morbidity and major economic losses have occurred in Finland in the past decade. A survey was performed to indicate the current occurrence of infectious hoof diseases and to identify herd level risk factors predisposing to an outbreak of IP. Results Responses to a questionnaire revealed that an outbreak of IP defined as morbidity ≥5% within the 1st month of the outbreak, had occurred in 18.0% of the respondent study farms. Risk factors for an outbreak included animal transport between herds, i.e. either animal purchase or contract heifer rearing, enlargement or renovation of the barn, and if the fields of the farm had been organically cultivated. Having any kind of mechanical ventilation in comparison to natural ventilation seemed to lower the risk of IP. Additionally, the farms that had experienced an outbreak of IP often had other infectious hoof diseases. However, it was unclear which disease appeared first. Conclusions More attention is needed before and during enlargement or renovation of the barn and substantial planning is crucial for every part of the enlargement process in dairy farms.