In Belgie werd tussen 1 januari en 15 mei 2011 melding gemaakt van minstens 231 gevallen van mazelen, terwijl er in het jaar 2010 slechts sprake was van 40 gevallen. Van de 142 gevallen waarvan de vaccinatiestatus gekend was, waren 119 (84%) gevallen niet gevaccineerd. Deze toename in 2011 kan verklaard worden door het nog altijd bestaan van subgroepen met een lage vaccinatiegraad en door de onvoldoende hoge vaccinatiegraad met het mazelen-bof-rubellavaccin in het verleden, waardoor een accumulatie van vatbare personen mogelijk werd. In meerdere Europese landen worden gelijkaardige uitbraken vastgesteld in 2010 en 2011. Naar aanleiding van de Europese vaccinatieweek van 23-30 april 2011 ondernam de Vlaamse Gemeenschap verscheidene sensibilisatieacties. Vanuit het Comite voor de Eliminatie van Mazelen en Rubella gebeurde er een actieve communicatie naar de ziekenhuizen en naar het algemene publiek.
SummaryA Belgian airline pilot had paraplegic poliomyelitis in 1986, after infection in Dakar (Senegal) with wild-type poliovirus 1 which was isolated from his stools 6 weeks after onset. Serology available from day 25 showed the concomitant rise of type 2, but no longer of type 1 antibodies.Exercise to fight off early symptoms probably aggravated severity; residual sequelae are serious. The patient had probably never been vaccinated. The case stresses the need for (re) vaccination of travellers to endemic areas. For this purpose, there is now a choice between live oral and killed injectable polio vaccines.
Transmitted drug resistance (TDR) influencing nonnucleoside reverse transcriptase inhibitor (NNRTI) activity is increasing among new HIV-1 patients in several countries. As we recently observed an increase of K103N prevalence among new diagnoses in Belgium, we mined the Belgian national sequence database for homologous sequences. The earliest reverse transcriptase (RT) sequences available for drug-naive patients as well as sequences related to treatment failure were included. Fifty-five sequences were aligned and subjected to phylogenetic analysis, revealing the presence of a cluster of 29 virus sequences. All except one of those sequences were from antiretroviral (ARV)-naive patients at the time of sampling, and 22 had the K103N mutation. Epidemiological data of clustered patients were collected through the Institute of Public Health. Seventy-two percent of the clustered patients were infected through homosexual or bisexual contacts while the others reported heterosexual contacts only. All patients reside and were infected in Belgium. Sixteen were diagnosed between January 2011 and June 2012; 14 were aged between 18 and 29 years at the time of diagnosis. Nearly 60% of the clustered patients live close to the city of Namur, where HIV incidence substantially increased in the past 2 years. The identification of this transmission network advocates for local prevention reinforcement and underscores the need for continuous TDR monitoring. The spread of NNRTI TDR could affect ARV initiation schemes and prophylaxis strategies.
This survey showed low rates of HBV chronic infection in HIV-infected and uninfected children living in a RLS of KZN province. The vertical and horizontal transmissions before 5 years of age decreased in both cohorts since the introduction of the HBV vaccine. Due to their weaker immune system, HIV-infected children had lower anti-HBs rates than the HIV-uninfected patients. Without establishing regular monitoring of their immunity and adaptation of the vaccine schedule, prevalence of HBV could stay high in SA despite optimal vaccination coverage in HIV-infected patients. 1.World Health Organization, 2014. HIV/AIDS (Accessed January 2016). http://www.who.int/hiv/en/ 2.Phung BC, Sogni P, Launay O. 2014 Hepatitis B and human immunodeficiency virus co-infection. World J Gastroenterol. 14;20(46):17360-7. 3.Healy SA, Gupta S, Melvin AJ. 2013. HIV/HBV coinfection in children and antiviral therapy. Expert Rev Anti Infect Ther. 11(3):251-63. 4.Amponsah-Dacosta E, Lebelo RL, Rakgole JN, Burnett RJ, Selabe SG, Mphahlele MJ. 2014. Evidence for a change in the epidemiology of hepatitis B virus infection after nearly two decades of universal hepatitis B vaccination in South Africa. J Med Virol. 86(6):918-24. 5.Simani OE, Leroux-Roels G, Francois G, Burnett RJ, Meheus A, Mphahlele MJ. 2009. Reduced detection and levels of protective antibodies to hepatitis B vaccine in under 2-year-old HIV positive South African children at a paediatric outpatient clinic. Vaccine. 1;27(1):146-51.
Un groupe a recu une dose unique de minocycline (100 mg) et l'autre groupe une dose identique de doxycycline. Aucune difference n'a ete observee entre les 2 groupes du point de vue reaction febrile et hypotensive. L'efficacite therapeutique a egalement ete identique dans les 2 groupes avec negativation de la goutte epaisse au bout de 24 heures
