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Virological evaluation and clinical impact of field vaccination against lumpy skin disease in cattle
Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163
20.158
20.160
The successful establishment of regular National Vaccination Conferences and a National Vaccination Steering Committee in Germany
What do Lebanese women know about cervical cancer and human papillomavirus? A report on awareness levels in urban communities
C. Brenninkmeyer a,∗ , M.-S. Ludwig a , S. Speiser a , U. Nennstiel-Ratzel b , G. Hölscher b , R. Fischer c , C. Klinc c , W. Hierl c , F. Feil d , B. Liebl b a
Bavarian Health and Food Safety Authority, Erlangen/DE b Bavarian Health and Food Safety Authority, Oberschleißheim/DE c Bavarian State Ministry of Health and Care, Munich/DE d Ministry of Social Affairs, Health and Equal Opportunities, Lower Saxony, Hanover/DE Purpose: The German health care system has a federal structure and based on national recommendations by the Standing Committee on Vaccination, vaccination programs are implemented on the level of the federal states. Furthermore, different governmental and non-governmental structures are involved in decision making concerning the implementation and financing of vaccination programs. Consequently, close collaboration between the federal ministry of health, 16 federal states and further important stakeholders is necessary to enhance the performance of immunisation programs. Methods & Materials: Regular national vaccination conferences (NIK) have been implemented to facilitate a joint discussion of policymakers, scientists and stakeholders. Furthermore, the health minister conference enacted the implementation of a national steering committee (NaLI) presided by the host of the upcoming NIK (Lower Saxony and Bremen), to prioritise vaccination goals, agree on strategies to tackle identified challenges and guaranty continuity between successive NIKs. Results: As a result of the first two NIKs, a national vaccination plan (NIP) was compiled, including an overview of the complex structures of vaccination policy in Germany and national immunisation goals. It was published in 2012 and supplemented by a national action plan for the elimination of measles and rubella in 2015. The NaLI has been successfully established in May 2016. The federal ministry with its subordinate agencies, the federal states’ health ministries and representatives of health insurance and medical associations are founding members. NaLI is supported by the committees’ office, located at the Bavarian Health and Food Safety Authority and financed in equal parts by the federal government and the federal states. First foci NaLI agreed upon are reinforced efforts to eliminate measles and rubella in Germany, alignments for the implementation of the Preventive Health Care Act and revision of the NIP, taking the WHO European Vaccine Action Plan and changes in national legislation into account. Conclusion: In a federal political system, the implementation of immunisation strategies and therefore the achievement of vaccination goals can be challenging. Regular national vaccination conferences and the establishment of a national steering committee in addition to the existing structures have resulted in concrete goals and concerted foci which have the potential to enhance immunisation protection on national level. http://dx.doi.org/10.1016/j.ijid.2016.11.355
145
J.E. Choucair Saint Joseph University, Hotel Dieu de France, Infectious Diseases, Beirut/LB Purpose: To evaluate the knowledge of urban adult Lebanese women regarding the symptoms and risk factors of cervical cancer and the diagnostic tests and vaccination of human papillomavirus (HPV) infection. To measure in the same population the uptake of the cervical cancer-screening test (Pap smear) and the uptake of HPV vaccination, and determine the factors that may influence them. Methods & Materials: 444 Lebanese women above 18 years of age, residing in Beirut and Mount-Lebanon, with no medical background, were recruited online and in health care facilities to fill out a 32 item questionnaire about cervical cancer and HPV. Collected data was exported to and analyzed in SPSS® v. 21.0. Results: 45.7% of the women aged 18 to 25 y, residing in MountLebanon (51.8%), single (49.3%), with high education qualifications (73.9%) and currently employed (49.1%) in a field not related to health (84.9%). They did not visit a general physician (64%) or a gynecologist (64.6%) regularly. 85.6% were aware of cervical cancer; HPV infection involvement in the pathogenesis of cervical cancer was identified in 53.9% of cases. 35.6% of women were aware of HPV infection but 80.4% believed they lack information. 37.6% of participants had been screened by Pap smear for cervical cancer at least once whereas 9% did not know what a Pap smear was. Screening was significantly associated with cervical cancer awareness and regular visits to general health physicians and gynecologists. Only 11.7% of participants aged 18 to 35 were vaccinated against HPV. Vaccination uptake was significantly associated with cervical cancer awareness, religion, field of work and studies, and regular visits to gynecologists. Conclusion: Urban Lebanese women in Beirut and MountLebanon are not well informed about cervical cancer and HPV. Screening by Pap smear and HPV vaccination uptakes are nonsatisfactory. Further interventions are required to improve these numbers. http://dx.doi.org/10.1016/j.ijid.2016.11.356 20.164 Virological evaluation and clinical impact of field vaccination against lumpy skin disease in cattle P.-D. Katsoulos a,∗ , C.I. Dovas b , S.C. Chaintoutis b , Z. Polizopoulou b , O. Papadopoulos c , H. Karatzias a , C. Boscos a a
Aristotle University of Thessaloniki, Faculty of Veterinary Medicine, Clinic of Farm Animals, Thessaloniki/GR b Aristotle University of Thessaloniki, Faculty of Veterinary Medicine, Diagnostic Laboratory, Thessaloniki/GR c Aristotle University of Thessaloniki, Faculty of Veterinary Medicine, Laboratory of Microbiology and Infectious Diseases, Thessaloniki/GR Purpose: The objective was to evaluate the clinical impact of the field vaccination against lumpy skin disease (LSD) in cattle, and
146
Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163
to investigate the duration of viremia and excretion of the vaccine LSDV strain with saliva, nasal swabs and bulk-tank milk (BTM). Methods & Materials: The study was conducted in a commercial dairy cattle farm (215 animals) immunized against LSD with a Neethling strain-based commercial live vaccine for cattle (Onersterpoort Biological Products SOC Ltd). Twenty-seven animals were randomly selected for repetitive blood, saliva and nasal swab samplings. Specimens were collected for virological testing (qPCR and DNA sequencing) the day before the immunization, every two or three days until day 17 post-vaccination (p.v.) and at days 22 and 29 p.v. All vaccinated animals were being examined for signs of malaise and lesions compatible with LSD. All suspect cases were recorded and blood samples were obtained. Nodule (lump) biopsies were collected from representative cases for virus detection and identification. Milk yield was calculated, based on BTM measurements. Results: Viremia was detected between days 6-15 p.v. at 63% of the sampled animals. Saliva, nasal swabs and BTM samples were negative at all sampling points. Pronounced swelling (aseptic inflammation) was observed at injection-site at about 12% of the animals, starting at day 6 p.v., and was resolved after 2-4 days. Small-sized skin nodules were developed between days 8-18 p.v. mainly on the neck, scapula and thorax, only in adult cows, and at about 10% of the vaccinated animals. Resolution of the lesions was observable 10 days after development. The vaccine virus was also identified in aspirates obtained from the injection-site lesions, as well as in nodule biopsies. Daily milk production was reduced during the first 12 days p.v. (max. up to 16%). Conclusion: Apart from drop in milk production and injectionsite reactions, immunization against LSD resulted in the occurrence of mild and transient LSD-like signs in a considerable number of animals. In this regard, the application of diagnostic techniques for the discrimination of infected from vaccinated animals (DIVA) is of utmost importance for the field evaluation of LSD cases in vaccinated cattle herds. http://dx.doi.org/10.1016/j.ijid.2016.11.357 20.165 Major mumps outbreak in the South Bohemian Region, a question for the buster vaccination K. Kotrbova ∗ , J. Lunackova South Bohemia Ragional Hygiene Station, Ceske Budejovice/CZ Purpose: Nationwide vaccination against mumps has been carried out in the Czech Republic since 1987. In the time before vaccination, outbreaks occurred in 5-6-year intervals. Since introduction of mass vaccination major outbreaks occurred in 1995, 2006 and 2012, mostly in vaccinated population. In 2016, public health authorities notified mumps outbreaks in several regions of the Czech Republic with the highest occurrence in South Bohemia. We investigated an outbreak in South Bohemian region with the aim to understand the factors of re-emergence. Methods & Materials: The data are collected from general practitioners by the notification system EPIDAT. We analysed surveillance data by time, place and person and additional characteristics, particularly vaccination status. We compared the notification data with results in serological survey 2013. Case definitions: suspect case (11%) – compatible symptoms, probable case (57%) – compatible symptoms and epidemiological link to a confirmed case, confirmed case (32%) – compatible symptoms and laboratory confirmation.
Results: Outbreak has been detected in week 5 2016 during proms and peaked in week 12 with 158 cases. Until week 22 we notified 1415 mumps cases, 56% males, median age 18 years, range 0-75 years, 462 confirmed cases, 1% vaccinated once and 80% vaccinated twice, 19% not vaccinated or with not known status. Highest attack rate was in 15-19 years old (1893/100000), then in 10-14 years old (866/100000) and in 20-24 years old (658/100000). Most cases were vaccinated (81%). Complications were reported in 58 cases (4%), 38 orchitis, 12 meningitis, 36 of them were vaccinated. Relatively high incidence in young adults corresponds with the results of the serological surveys from 2013 when antibodies were found only in 33 percent of the age group of 15 - 19 years. Conclusion: The unusual incidence of mumps, resulting in an outbreak, was probably caused by weaning immunity after vaccination, primarily in the age group of 15 - 19 years. Our findings suggest that the third vaccine dose at the end of elementary school may increase herd immunity and prevent further outbreaks. http://dx.doi.org/10.1016/j.ijid.2016.11.358 20.166 Evaluation of an influenza vaccination campaign among pregnant women in two provinces in South Africa, 2015 S.G.P. Lengana a,∗ , M. McMorrow b , A. Tshangela c , S. Meiring d , M. Nunes e , C. Cutland f , R. Itzikowitz g , W. Isaacs g , S. Madhi h , C. Cohen i a
National Institute for Communicable Diseases, Epidemiology, Johannesburg, GAUTENG/ZA b Centers for Disease Control and Prevention, Influenza Division, Atlanta/US c National Institute for Communicable Diseases, Epidemiology, Johannesburg/ZA d National Institute for Communicable Diseases, Germs, Johannesburg/ZA e 5DST/NRF Vaccine Preventable Diseases/Respiratory and Meningeal Pathogens Research Unit, Epidemiology, Johannesburg/ZA f DST/NRF Vaccine Preventable Diseases/Respiratory and Meningeal Pathogens Research Unit, Epidemiology, Johannesburg/ZA g National Institute for Communicable Diseases, Epidemiology, Cape Town/ZA h National Institute for Communicable Diseases, Communicable Diseases, Johannesburg/ZA i National Institute for Communicable Diseases, Epidemiology and Surveillance Unit, Johannesburg/ZA Purpose: Pregnant women and infants are at increased risk of influenza-associated hospitalisation. Maternal vaccination with inactivated influenza vaccine (IIV) is safe during pregnancy and provides protection against influenza to pregnant women and their infants. A limited supply of IIV is provided in the public sector in South Africa which covers 5-10% of high risk groups, including pregnant women. We evaluated an expanded influenza vaccination campaign among pregnant women attending selected antenatal clinics in two provinces in South Africa. Methods & Materials: In collaboration with the Department of Health, we increased availability of IIV and measured vaccine coverage among women attending 40 antenatal clinics surrounding three hospitals; Chris Hani Baragwanath Hospital, Soweto; Rahima Moosa Mother and Child Hospital, Johannesburg; and Red Cross War Memorial Children’s Hospital, Cape Town. Vaxigrip® IIV3
20.158
20.160
The successful establishment of regular National Vaccination Conferences and a National Vaccination Steering Committee in Germany
What do Lebanese women know about cervical cancer and human papillomavirus? A report on awareness levels in urban communities
C. Brenninkmeyer a,∗ , M.-S. Ludwig a , S. Speiser a , U. Nennstiel-Ratzel b , G. Hölscher b , R. Fischer c , C. Klinc c , W. Hierl c , F. Feil d , B. Liebl b a
Bavarian Health and Food Safety Authority, Erlangen/DE b Bavarian Health and Food Safety Authority, Oberschleißheim/DE c Bavarian State Ministry of Health and Care, Munich/DE d Ministry of Social Affairs, Health and Equal Opportunities, Lower Saxony, Hanover/DE Purpose: The German health care system has a federal structure and based on national recommendations by the Standing Committee on Vaccination, vaccination programs are implemented on the level of the federal states. Furthermore, different governmental and non-governmental structures are involved in decision making concerning the implementation and financing of vaccination programs. Consequently, close collaboration between the federal ministry of health, 16 federal states and further important stakeholders is necessary to enhance the performance of immunisation programs. Methods & Materials: Regular national vaccination conferences (NIK) have been implemented to facilitate a joint discussion of policymakers, scientists and stakeholders. Furthermore, the health minister conference enacted the implementation of a national steering committee (NaLI) presided by the host of the upcoming NIK (Lower Saxony and Bremen), to prioritise vaccination goals, agree on strategies to tackle identified challenges and guaranty continuity between successive NIKs. Results: As a result of the first two NIKs, a national vaccination plan (NIP) was compiled, including an overview of the complex structures of vaccination policy in Germany and national immunisation goals. It was published in 2012 and supplemented by a national action plan for the elimination of measles and rubella in 2015. The NaLI has been successfully established in May 2016. The federal ministry with its subordinate agencies, the federal states’ health ministries and representatives of health insurance and medical associations are founding members. NaLI is supported by the committees’ office, located at the Bavarian Health and Food Safety Authority and financed in equal parts by the federal government and the federal states. First foci NaLI agreed upon are reinforced efforts to eliminate measles and rubella in Germany, alignments for the implementation of the Preventive Health Care Act and revision of the NIP, taking the WHO European Vaccine Action Plan and changes in national legislation into account. Conclusion: In a federal political system, the implementation of immunisation strategies and therefore the achievement of vaccination goals can be challenging. Regular national vaccination conferences and the establishment of a national steering committee in addition to the existing structures have resulted in concrete goals and concerted foci which have the potential to enhance immunisation protection on national level. http://dx.doi.org/10.1016/j.ijid.2016.11.355
145
J.E. Choucair Saint Joseph University, Hotel Dieu de France, Infectious Diseases, Beirut/LB Purpose: To evaluate the knowledge of urban adult Lebanese women regarding the symptoms and risk factors of cervical cancer and the diagnostic tests and vaccination of human papillomavirus (HPV) infection. To measure in the same population the uptake of the cervical cancer-screening test (Pap smear) and the uptake of HPV vaccination, and determine the factors that may influence them. Methods & Materials: 444 Lebanese women above 18 years of age, residing in Beirut and Mount-Lebanon, with no medical background, were recruited online and in health care facilities to fill out a 32 item questionnaire about cervical cancer and HPV. Collected data was exported to and analyzed in SPSS® v. 21.0. Results: 45.7% of the women aged 18 to 25 y, residing in MountLebanon (51.8%), single (49.3%), with high education qualifications (73.9%) and currently employed (49.1%) in a field not related to health (84.9%). They did not visit a general physician (64%) or a gynecologist (64.6%) regularly. 85.6% were aware of cervical cancer; HPV infection involvement in the pathogenesis of cervical cancer was identified in 53.9% of cases. 35.6% of women were aware of HPV infection but 80.4% believed they lack information. 37.6% of participants had been screened by Pap smear for cervical cancer at least once whereas 9% did not know what a Pap smear was. Screening was significantly associated with cervical cancer awareness and regular visits to general health physicians and gynecologists. Only 11.7% of participants aged 18 to 35 were vaccinated against HPV. Vaccination uptake was significantly associated with cervical cancer awareness, religion, field of work and studies, and regular visits to gynecologists. Conclusion: Urban Lebanese women in Beirut and MountLebanon are not well informed about cervical cancer and HPV. Screening by Pap smear and HPV vaccination uptakes are nonsatisfactory. Further interventions are required to improve these numbers. http://dx.doi.org/10.1016/j.ijid.2016.11.356 20.164 Virological evaluation and clinical impact of field vaccination against lumpy skin disease in cattle P.-D. Katsoulos a,∗ , C.I. Dovas b , S.C. Chaintoutis b , Z. Polizopoulou b , O. Papadopoulos c , H. Karatzias a , C. Boscos a a
Aristotle University of Thessaloniki, Faculty of Veterinary Medicine, Clinic of Farm Animals, Thessaloniki/GR b Aristotle University of Thessaloniki, Faculty of Veterinary Medicine, Diagnostic Laboratory, Thessaloniki/GR c Aristotle University of Thessaloniki, Faculty of Veterinary Medicine, Laboratory of Microbiology and Infectious Diseases, Thessaloniki/GR Purpose: The objective was to evaluate the clinical impact of the field vaccination against lumpy skin disease (LSD) in cattle, and
146
Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163
to investigate the duration of viremia and excretion of the vaccine LSDV strain with saliva, nasal swabs and bulk-tank milk (BTM). Methods & Materials: The study was conducted in a commercial dairy cattle farm (215 animals) immunized against LSD with a Neethling strain-based commercial live vaccine for cattle (Onersterpoort Biological Products SOC Ltd). Twenty-seven animals were randomly selected for repetitive blood, saliva and nasal swab samplings. Specimens were collected for virological testing (qPCR and DNA sequencing) the day before the immunization, every two or three days until day 17 post-vaccination (p.v.) and at days 22 and 29 p.v. All vaccinated animals were being examined for signs of malaise and lesions compatible with LSD. All suspect cases were recorded and blood samples were obtained. Nodule (lump) biopsies were collected from representative cases for virus detection and identification. Milk yield was calculated, based on BTM measurements. Results: Viremia was detected between days 6-15 p.v. at 63% of the sampled animals. Saliva, nasal swabs and BTM samples were negative at all sampling points. Pronounced swelling (aseptic inflammation) was observed at injection-site at about 12% of the animals, starting at day 6 p.v., and was resolved after 2-4 days. Small-sized skin nodules were developed between days 8-18 p.v. mainly on the neck, scapula and thorax, only in adult cows, and at about 10% of the vaccinated animals. Resolution of the lesions was observable 10 days after development. The vaccine virus was also identified in aspirates obtained from the injection-site lesions, as well as in nodule biopsies. Daily milk production was reduced during the first 12 days p.v. (max. up to 16%). Conclusion: Apart from drop in milk production and injectionsite reactions, immunization against LSD resulted in the occurrence of mild and transient LSD-like signs in a considerable number of animals. In this regard, the application of diagnostic techniques for the discrimination of infected from vaccinated animals (DIVA) is of utmost importance for the field evaluation of LSD cases in vaccinated cattle herds. http://dx.doi.org/10.1016/j.ijid.2016.11.357 20.165 Major mumps outbreak in the South Bohemian Region, a question for the buster vaccination K. Kotrbova ∗ , J. Lunackova South Bohemia Ragional Hygiene Station, Ceske Budejovice/CZ Purpose: Nationwide vaccination against mumps has been carried out in the Czech Republic since 1987. In the time before vaccination, outbreaks occurred in 5-6-year intervals. Since introduction of mass vaccination major outbreaks occurred in 1995, 2006 and 2012, mostly in vaccinated population. In 2016, public health authorities notified mumps outbreaks in several regions of the Czech Republic with the highest occurrence in South Bohemia. We investigated an outbreak in South Bohemian region with the aim to understand the factors of re-emergence. Methods & Materials: The data are collected from general practitioners by the notification system EPIDAT. We analysed surveillance data by time, place and person and additional characteristics, particularly vaccination status. We compared the notification data with results in serological survey 2013. Case definitions: suspect case (11%) – compatible symptoms, probable case (57%) – compatible symptoms and epidemiological link to a confirmed case, confirmed case (32%) – compatible symptoms and laboratory confirmation.
Results: Outbreak has been detected in week 5 2016 during proms and peaked in week 12 with 158 cases. Until week 22 we notified 1415 mumps cases, 56% males, median age 18 years, range 0-75 years, 462 confirmed cases, 1% vaccinated once and 80% vaccinated twice, 19% not vaccinated or with not known status. Highest attack rate was in 15-19 years old (1893/100000), then in 10-14 years old (866/100000) and in 20-24 years old (658/100000). Most cases were vaccinated (81%). Complications were reported in 58 cases (4%), 38 orchitis, 12 meningitis, 36 of them were vaccinated. Relatively high incidence in young adults corresponds with the results of the serological surveys from 2013 when antibodies were found only in 33 percent of the age group of 15 - 19 years. Conclusion: The unusual incidence of mumps, resulting in an outbreak, was probably caused by weaning immunity after vaccination, primarily in the age group of 15 - 19 years. Our findings suggest that the third vaccine dose at the end of elementary school may increase herd immunity and prevent further outbreaks. http://dx.doi.org/10.1016/j.ijid.2016.11.358 20.166 Evaluation of an influenza vaccination campaign among pregnant women in two provinces in South Africa, 2015 S.G.P. Lengana a,∗ , M. McMorrow b , A. Tshangela c , S. Meiring d , M. Nunes e , C. Cutland f , R. Itzikowitz g , W. Isaacs g , S. Madhi h , C. Cohen i a
National Institute for Communicable Diseases, Epidemiology, Johannesburg, GAUTENG/ZA b Centers for Disease Control and Prevention, Influenza Division, Atlanta/US c National Institute for Communicable Diseases, Epidemiology, Johannesburg/ZA d National Institute for Communicable Diseases, Germs, Johannesburg/ZA e 5DST/NRF Vaccine Preventable Diseases/Respiratory and Meningeal Pathogens Research Unit, Epidemiology, Johannesburg/ZA f DST/NRF Vaccine Preventable Diseases/Respiratory and Meningeal Pathogens Research Unit, Epidemiology, Johannesburg/ZA g National Institute for Communicable Diseases, Epidemiology, Cape Town/ZA h National Institute for Communicable Diseases, Communicable Diseases, Johannesburg/ZA i National Institute for Communicable Diseases, Epidemiology and Surveillance Unit, Johannesburg/ZA Purpose: Pregnant women and infants are at increased risk of influenza-associated hospitalisation. Maternal vaccination with inactivated influenza vaccine (IIV) is safe during pregnancy and provides protection against influenza to pregnant women and their infants. A limited supply of IIV is provided in the public sector in South Africa which covers 5-10% of high risk groups, including pregnant women. We evaluated an expanded influenza vaccination campaign among pregnant women attending selected antenatal clinics in two provinces in South Africa. Methods & Materials: In collaboration with the Department of Health, we increased availability of IIV and measured vaccine coverage among women attending 40 antenatal clinics surrounding three hospitals; Chris Hani Baragwanath Hospital, Soweto; Rahima Moosa Mother and Child Hospital, Johannesburg; and Red Cross War Memorial Children’s Hospital, Cape Town. Vaxigrip® IIV3