Successful Use of Advertisement Pictures to Assist Recall in a Food-Borne Hepatitis A Outbreak in The Netherlands, 2017

This study describes an outbreak investigation of 14 hepatitis A cases in the Netherlands. The hepatitis A virus (HAV) genotype IB sequences in cases were highly similar (459/460 nt). The origin of strains could be narrowed to Bulgaria based on information from EPIS-FWD. As an association with consumption of soft fruit was suspected, a case–control study was initiated using a questionnaire and a list of pictures of soft fruit available at the supermarket chain involved. Twelve out of 13 cases consumed a specific frozen raspberry/blueberry product shown on the list (OR 46.0, 95% CI 5.0–27). In multivariable regression analysis this product was the only risk factor (aOR 26.6, 95% CI 2.0–263). Laboratory analyses could not demonstrate HAV-RNA in batches that had been on the market in the incubation period of patients. Trace back of frozen fruit showed that raspberries had been traded by a producer in Bulgaria. After withdrawal of the product from the supermarket no new cases were reported. Use of advertisement pictures of consumed food was helpful in this investigation. Suspicion of the source was strengthened by data from molecular typing and food trace back activities, underlining the importance of good (inter)national cooperation between public health and food safety organisations.     

Mitigating Natural Disasters: The Role Of Eco-Ethics

Natural disasters are complex phenomena, the causes of which lie to a large extent in human behavior that creates vulnerable communities. In order to reduce vulnerability and thereby mitigate the risk of disasters, it is important to consider underlying values, particularly with respect to how people view and interact with the natural world. Advancing an interdisciplinary, ecological paradigm, this paper argues that disaster mitigation needs to be addressed through a process that results in a greater emphasis on our interactions with and reliance upon the natural world, and the development of community resilience.     

Ultrastructure of first trimester chorionic villi with regard to the prenatal diagnosis of genodermatoses

Hopes are held out for chorion villus sampling, a technique which is gaining more and more importance for the first trimester prenatal diagnosis of chromosomal aberrations and metabolic abnormalities. A variety of inherited skin diseases can be diagnosed postnatally and prenatally (in the second trimester) by ultrastructural diagnostic markers. For evaluation of prenatal diagnosis in the first trimester, we investigated chorionic villi derived from the trophoblast layer of the early pregnancy by light microscopy and conventional electron microscopy. The ultrastructure of the cellular layers covering the villi, i.e., the inner cytotrophoblast and the outer syncytiotrophoblast, as well as that of the connective tissue of the inner extraembryonic mesoderm, are thoroughly described in relation to the ultra-structural changes in certain genodermatoses including epidermolyses and keratinization disorders. We found that chorionic villi have only a few of the characteristics differentiated in skin, and none of the structures which are relevant to the diagnosis of genodermatoses. In our view, the ultrastructural approach is not suitable for first trimester prenatal diagnosis of genodermatoses in chorionic villi.     

Seasonal variation of pollution biomarkers to assess the impact on the health status of juvenile Pacific oysters <Emphasis Type="BoldItalic">Crassostrea gigas</Emphasis> exposed in situ

Background, aim, and scope  

In this study, a suite of sublethal stress biomarkers were analyzed in juveniles of the sentinel species, the Pacific oyster Crassostrea gigas, with a view to using them as pollution monitoring tools. The aim of this work was (1) to study baseline seasonal variations of biomarkers in different body compartments of C. gigas in the reference site and, after selecting biomarkers presenting no seasonal variations, (2) to compare responses of these biomarkers between contaminated and reference sites.