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Infectieziekten,   Risico of Fictie? Science café Zeist, 10 maart 2011 Roel A. Coutinho 5 maart 2011 Center for Infectious Disease Control  National Institute for Public Health and the Environment Bilthoven Academic Medical Center University of Amsterdam
5 maart 2011
5 maart 2011
5 maart 2011
5 maart 2011 1975 1925 1950 1900 1999 Bron CBS 2001
5 maart 2011
5 maart 2011
5 maart 2011
HIV transmission routes ,[object Object],[object Object],[object Object],[object Object],[object Object],5 maart 2011
5 maart 2011
5 maart 2011
5 maart 2011
Factors in the emergence of infectious diseases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],5 maart 2011
5 maart 2011
5 maart 2011
5 maart 2011
5 maart 2011 PB2 PB1 PA HA NP NA MA NS A/California/4/2009 Vermoedelijke samenstelling van het H1N1 Mexicaanse griep virus Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team*, New England Journal of Medicine, 2009 Nieuwe griep virus is ontstaan door mengen van genen PB2,PA: PB1: ~ 1998 ~ 1968 ~ 1998 HA, NP, NS: ~ 1918 NA, MA: ~ 1979 Classical swine Eurasian swine Triple reassortant
Leeftijdsverdeling van patiënten met ziekenhuisopname wegens laboratorium bevestigde of waarschijnlijke Nieuwe Influenza A (H1N1) t/m 10 maart  2010  ( n=2201*) 5 maart 2011 Bron: Osiris / Pandora / CIb * Er  ontbreken 46 ziekenhuisopnames in de  grafiek door onvolledige informatie.
Aantal sterfgevallen met laboratorium bevestigde Nieuwe Influenza A (H1N1) per week t/m 10 maart  2010 ( n=56*) 5 maart 2011 Bron: Osiris / Pandora / CIb * Van 2 sterfgevallen zijn nog niet alle gegevens bekend waardoor deze niet in de grafiek worden getoond.
5 maart 2011
5 maart 2011
5 maart 2011
5 maart 2011
5 maart 2011
5 maart 2011
Risk of new vectors 5 maart 2011 Aedes albopictus (vector for flaviviruses, SE-Asia) Since nineties in Southern Europe 2005 imports through “lucky-bamboo” in Holland Can it survive, settle in Holland?
5 maart 2011 Map 2 – Areas for possible establishment of  Aedes albopictus  in Europe based on 5 climate scenarios.
5 maart 2011 Day 7 :  :  KAD informs surrounding area (mostly companies) and starts with removal potential breeding sites. One  albopictus  female  is found close to company site (in BG sentinel trap) and one  Ae. aegypti  female (on human), also close to the  company. Two French experts arrive, treatment starts late evening at company site in Heijningen with adulticiding  (aqua-K-othrine). VROM inspection is present.
5 maart 2011 Methicillin-resistant  Staphylococcus aureus  in Pig Farming Andreas Voss,*†         Frans Loeffen,* Judith Bakker,* Corne Klaassen,† and Mireille Wulf* *Radboud University Medical Centre, Nijmegen, the Netherlands; and †Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands We conducted a study among a group of 26 regional pig farmers to determine the methicillin-resistant  Staphylococcus aureus  prevalence rate and found it was >760 times greater than the rate of patients admitted to Dutch hospitals. While  spa -type t108 is apparently a more widespread clone among pig farmers and their environment, we did find other  spa -types. Emerg Infect Dis. 2005 Dec;11(12):1965-6
5 maart 2011 MRSA isolaties 2009
The proportion of ESBL positive BLOOD isolates per year 3.9% 5.7% 4.6% 6.3% 5.7% 9.1% = E. coli = K. pneumoniae 2008 2009 2010 Increase :   E. coli   46%   K.  pneumoniae   60%
5 maart 2011
Antibiotic Usage in Animals in NL 5 maart 2011
Retrospective GP-study  results 5 maart 2011 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],38,6 191,3 0 20 40 60 80 100 120 140 160 1993 1997 2001 2005 2009 Consults erythema  / 100.000 inhabitants 0 100 200 300 400 500 600 Consults tick bites / 100.000 inhabitants Erythema consults Tick bite consults 133,9 563,5 103,8 446,3 74,3 371,9
5 maart 2011
[object Object],[object Object],[object Object],5 maart 2011 Transmissiedag, 18 maart 2008, Q-koorts, blijft het een vraagteken? Bron: GD, Deventer
5 maart 2011
Q fever notifications by week of onset of illness 5 maart 2011
5 maart 2011
Mumps genotype analysis (SH gene, 316bp) ,[object Object],[object Object],5 maart 2011 G 5 UK 2004/2005 > 56,000 cases NL 2004/2005, hundreds USA 2006 > 6000 cases Canada 2007, hundreds Moldova 2008, >20,000 cases Macedonia 2009, ... NL 2010 - Utrecht, Delft, Leiden (hundreds of vaccinated students) D MVS UK99-102x13 MVS UK99-190 WLZ1-CNA95(F) MuVi/Tiel.NLD/50.04(bv201 ) Tay-UK50s(N) L-Zagreb vaccine(M) Leningrad 3 vaccine(M) Urb-Jap67(B) Odate-1(I) Fukuoda49-JPN00(L) UNK02-19(O) Glouc1-UK96(G) UK01-22 UK02-304 Mum NewJersey US 2006 MuVs/DenHaag.NLD/39.04(170) Mum Iowa US 2006 MuVs/Boxtel.NLD/19.05(546) Be1-UK88 DS267701DAT(H) Bf-UK75(C) Ed2-UK88(E) Mumps virus strain UK02-361(K) ZgA/Cro69 Ge9-Gem77 DS267701DAT(D) ES06-AHx1 Islip1-UK97(D) Po26s/Portugal/96 Po17s/Portugal/96 sp9 SPN 2000 Kent1-3/UK97 Lon1/UK96 MuVs/Werkendam.NLD07/45.07(869u) MuVs/Werkendam.NLD/45.07(865s) MuVs/Nieuwaal.NLD/40.07(810s) MuVs/GGDDordrecht.NLD/37.07(835s) MuVs/Werkendam.NLD/45.07(859s) JL-US63 (Jeryl Lynn) vaccine strain (A) MP94H-JNP94(J) 0.01
5 maart 2011
5 maart 2011 Summary of evidence for an environmental route of resistance development A single dominant resistance mechanism: TR/L98H A TR is a common resistance mechanism in plant pathogenic molds TR/L98H  A. fumigatus  in azole-naïve patients TR/L98H  A. fumigatus  was found in cultivated soil
5 maart 2011 VWS / ZonMw Universiteit ziekenhuis WIP SWAB GGD Nederland BZK / LNV  beroepsvereniging onderzoek preventie bestrijding Beleid  VGZ Centrum GGD MML huisarts specialist KNCV-TB WHO SOA AIDS VWA ECDC

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Science café zeist, maart 2011.ppt ingepakt

  • 1. Infectieziekten, Risico of Fictie? Science café Zeist, 10 maart 2011 Roel A. Coutinho 5 maart 2011 Center for Infectious Disease Control National Institute for Public Health and the Environment Bilthoven Academic Medical Center University of Amsterdam
  • 5. 5 maart 2011 1975 1925 1950 1900 1999 Bron CBS 2001
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  • 17. 5 maart 2011 PB2 PB1 PA HA NP NA MA NS A/California/4/2009 Vermoedelijke samenstelling van het H1N1 Mexicaanse griep virus Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team*, New England Journal of Medicine, 2009 Nieuwe griep virus is ontstaan door mengen van genen PB2,PA: PB1: ~ 1998 ~ 1968 ~ 1998 HA, NP, NS: ~ 1918 NA, MA: ~ 1979 Classical swine Eurasian swine Triple reassortant
  • 18. Leeftijdsverdeling van patiënten met ziekenhuisopname wegens laboratorium bevestigde of waarschijnlijke Nieuwe Influenza A (H1N1) t/m 10 maart 2010 ( n=2201*) 5 maart 2011 Bron: Osiris / Pandora / CIb * Er ontbreken 46 ziekenhuisopnames in de grafiek door onvolledige informatie.
  • 19. Aantal sterfgevallen met laboratorium bevestigde Nieuwe Influenza A (H1N1) per week t/m 10 maart 2010 ( n=56*) 5 maart 2011 Bron: Osiris / Pandora / CIb * Van 2 sterfgevallen zijn nog niet alle gegevens bekend waardoor deze niet in de grafiek worden getoond.
  • 26. Risk of new vectors 5 maart 2011 Aedes albopictus (vector for flaviviruses, SE-Asia) Since nineties in Southern Europe 2005 imports through “lucky-bamboo” in Holland Can it survive, settle in Holland?
  • 27. 5 maart 2011 Map 2 – Areas for possible establishment of Aedes albopictus in Europe based on 5 climate scenarios.
  • 28. 5 maart 2011 Day 7 : : KAD informs surrounding area (mostly companies) and starts with removal potential breeding sites. One albopictus female is found close to company site (in BG sentinel trap) and one Ae. aegypti female (on human), also close to the company. Two French experts arrive, treatment starts late evening at company site in Heijningen with adulticiding (aqua-K-othrine). VROM inspection is present.
  • 29. 5 maart 2011 Methicillin-resistant Staphylococcus aureus in Pig Farming Andreas Voss,*†     Frans Loeffen,* Judith Bakker,* Corne Klaassen,† and Mireille Wulf* *Radboud University Medical Centre, Nijmegen, the Netherlands; and †Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands We conducted a study among a group of 26 regional pig farmers to determine the methicillin-resistant Staphylococcus aureus prevalence rate and found it was >760 times greater than the rate of patients admitted to Dutch hospitals. While spa -type t108 is apparently a more widespread clone among pig farmers and their environment, we did find other spa -types. Emerg Infect Dis. 2005 Dec;11(12):1965-6
  • 30. 5 maart 2011 MRSA isolaties 2009
  • 31. The proportion of ESBL positive BLOOD isolates per year 3.9% 5.7% 4.6% 6.3% 5.7% 9.1% = E. coli = K. pneumoniae 2008 2009 2010 Increase : E. coli 46% K. pneumoniae 60%
  • 33. Antibiotic Usage in Animals in NL 5 maart 2011
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  • 38. Q fever notifications by week of onset of illness 5 maart 2011
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  • 42. 5 maart 2011 Summary of evidence for an environmental route of resistance development A single dominant resistance mechanism: TR/L98H A TR is a common resistance mechanism in plant pathogenic molds TR/L98H A. fumigatus in azole-naïve patients TR/L98H A. fumigatus was found in cultivated soil
  • 43. 5 maart 2011 VWS / ZonMw Universiteit ziekenhuis WIP SWAB GGD Nederland BZK / LNV beroepsvereniging onderzoek preventie bestrijding Beleid VGZ Centrum GGD MML huisarts specialist KNCV-TB WHO SOA AIDS VWA ECDC