Effectiveness of pandemic and seasonal influenza vaccine in preventing pandemic influenza A ( H 1 N 1 ) 2009

A total of 57 cases of West Nile virus infection (54 with neuroinvasive infection and three with fever) were identified in Romania between July and October 2010. The median age of the cases was 53.4 years, with the highest incidence in the age group 60–69 years. The case fatality rate was 8.8%. Cases were distributed in 19 districts in the southern, western, central and eastern parts of the country. Molecular investigation revealed lineage 2 West Nile virus, related to the Volgograd 2007 strain. for Vector-borne Diseases in the Cantacuzino Institute in Romania reported to the National Centre for Surveillance and Control of Communicable Diseases (NCSCCD) 10 positive results for West Nile virus (WNV) in samples of patients distributed in nine different Romanian districts. Six of these 10 cases were male and four were female, with a median age of 56 years (range: 32–79 years). Romania recorded the first large outbreak of West Nile neuroinvasive disease (WNND) in Europe in 1996, with 393 confirmed cases. This was also the first such outbreak in urban settings. Cases were confined to Bucharest, its rural surroundings and 14 districts in the Danube Plain [1,2]. In response to this outbreak, in 1997, the Ministry of Health set up a regional, hospital-based surveillance system and sporadic cases were recorded every year in the districts neighbouring the Danube River [3]. In 2009, the surveillance system was extended at national level, following the confirmation of two cases of West Nile fever (WNF) in humans in the central part of Romania and the detection of WNV-specific IgG antibodies among horses in many other areas of the country. Within the routine WNV surveillance activities in Romania, the following case definition is used for a suspected case with WNV infection: a person over 15 years of age who presents with fever and meningitis, encephalitis or meningoencephalitis between May and October and who reports a history of mosquito bites. Two sets of samples are collected for each suspected case: for patients with acute symptoms both cerebro-spinal fluid (CSF) and serum are taken. For patients in convalescence phase, a second serum sample is taken 14–21 days later. A probable or confirmed case of WNV infection is defined as a person who met the relevant clinical and the laboratory criteria for probable or confirmed cases described in the European Union case definition [4]. A suspected case is considered not to be a case if …