Sigrid Heuberger

Österreichische Agentur für Gesundheit und Ernährungssicherheit | AGES · National reference Centre for Meningococci, Pneumococci and Haemophilus influenzae

Invasive meningococcal disease surveillance in Europe combines isolate characterisation and epidemiological data to support public health intervention. A representative European Meningococcal Strain Collection (EMSC) of IMD isolates was obtained, and whole genome sequenced to characterise 799 EMSC isolates from the epidemiological year July 2011-Ju...

In 2007, a European survey identified variation in country policies on public health management of invasive meningococcal disease (IMD). In 2009–10, the European Centre for Disease Prevention and Control (ECDC) published evidence-based guidance on IMD. We therefore surveyed again European countries to describe policies for managing IMD cases and co...

The evidence underpinning public health policy is often of low quality, leading to inconsistencies in recommended interventions. One example is the divergence in national policies across Europe for managing contacts of invasive meningococcal disease. Aiming to develop consistent guidance at the European level, a group of experts reviewed the litera...

New vaccines targeting meningococci expressing serogroup B polysaccharide have been developed with some being licenced in Europe. Coverage will depend on the distribution of disease-associated genotypes and this may vary by age. It is well established that a small number of hyperinvasive lineages account for most disease and they are associated wit...

Neisseria meningitidis is a leading cause of meningitis and sepsis worldwide. Thus, monitoring the epidemiology of invasive meningococcal disease (IMD) is an important public health measure. The National Reference Centre for Meningococci at the Austrian Agency for Health and Food Safety is operating the laboratory-based surveillance database. IMD i...

We performed a systematic literature review to assess the effectiveness of chemoprophylaxis for contacts of sporadic cases of invasive meningococcal disease (IMD) in educational settings. No studies directly compared IMD risk in contacts with/without chemoprophylaxis. However, compared to the background incidence, an elevated IMD risk was identifie...

Invasive Meningokokkeninfektionen (invasive meningococcal disease = IMD) manifestieren sich meist als bakterielle Meningitis mit oder ohne begleitende Septikämie. Bei etwa jeder fünften IMD fehlen allerdings meningeale Zeichen, und gerade diese isoliert septischen Formen können einen rasch progredienten, häufig therapierefraktären Verlauf nehmen, d...

Invasive disease caused by the encapsulated bacteria Neisseria meningitidis, Haemophilus influenzae and Streptococcus pneumoniae remains an important cause of morbidity and mortality worldwide, despite the introduction of successful conjugate polysaccharide vaccines that target disease-associated strains. In addition, resistance, or more accurately...

Identification of clinical isolates of Neisseria meningitidis that are resistant to rifampin is important to avoid prophylaxis failure in contacts of patients, but it is hindered by the absence of a breakpoint for resistance, despite many efforts toward standardization. We examined a large number (n = 392) of clinical meningococcal isolates, spanni...

In this era of new pneumococcal conjugate vaccines (PCV), we described and compared surveillance of invasive pneumococcal disease (IPD) and PCV policies in 30 European countries to provide guidance for Europe-wide surveillance. We confirmed the heterogeneity of surveillance systems and case definitions across countries but identified elements commo...

We previously reported an outbreak of listeriosis in Austria and Germany due to consumption of ‘Quargel’ cheese. It comprised 14 cases (including five fatalities) infected by a serotype 1/2a Listeria monocytogenes (clone 1), with onset of illness from June 2009 to January 2010. A second strain of L. monocytogenes serotype 1/2a (clone 2) spread by t...

We previously reported an outbreak of listeriosis in Austria and Germany due to consumption of Quargel cheese. It comprised 14 cases (including five fatalities) infected by a serotype 1/2a Listeria monocytogenes (clone 1), with onset of illness from June 2009 to January 2010. A second strain of L. monocytogenes serotype 1/2a (clone 2) spread by thi...

Prevalence of Clostridium difficile was examined in Austrian ground meat samples and bactofugates, following an evaluation of enrichment broths. Bactofugation is a centrifugation procedure used at sensitive dairies to lower the concentration of spores in raw milk before heat treatment. Among the five enrichment broths tested, C. difficile moxalacta...

An international collaboration was established in 1996 to monitor the impact of routine Haemophilus influenzae type b (Hib) vaccination on invasive H. influenzae disease; 14 countries routinely serotype all clinical isolates. Of the 10,081 invasive H. influenzae infections reported during 1996-2006, 4,466 (44%, incidence 0.28 infections/100,000 pop...

We report an outbreak of listeriosis in Austria and Germany due to the consumption of ‘Quargel’ cheese produced by an Austrian manufacturer. At the time of writing this report, the outbreak was known to account for 14 outbreak cases in 2009, including four cases with lethal outcome. On 23 January 2010, the cheese product was voluntarily withdrawn f...

The purpose of this document is to provide evidence-based guidance for good practice in public health management of sporadic cases of meningococcal disease and their contacts. It has the additional aim of assisting countries across Europe in making decisions about appropriate measures to control and prevent meningococcal disease at national and sub...

In 2007, a European survey was conducted to compare national policies on public health management of cases of meningococcal disease and their contacts. The results revealed differences in definitions of close contacts and prophylactic regimens between countries. These differences can be attributed to a lack of evidence on optimal prevention and tre...

In 2007, a European survey was conducted to compare national policies on public health management of cases of meningococcal disease and their contacts. An electronic questionnaire was sent to 27 national public health institutes; 22 countries responded (response rate 81%). The results of the survey revealed differences in definitions of close conta...

Clinical isolates of Neisseria meningitidis with reduced susceptibility to penicillin G (intermediate isolates, PenI) harbor alterations in the penA gene encoding the penicillin binding protein 2 (PBP2). A 402-bp DNA fragment in the 3′ half of penA was sequenced from a collection of 1,670 meningococcal clinical isolates from 22 countries that spann...

An outbreak of acute gastroenteritis occurred in September 2006 in a boarding school in eastern Austria. Of 113 cases, 101 were hospitalised. In order to identify the outbreak source, a retrospective cohort study on the group at risk was performed, including 222 pupils and 30 staff members. Food exposure in the canteen of the school was identified...

Between 1999 and 2004, the European Union Invasive Bacterial Infections Surveillance Network (EU-IBIS) received c. 50,000 reports of meningococcal disease from 27 participating countries. Analysis has demonstrated a major decline in the incidence of invasive disease in those countries that have introduced routine vaccination against serogroup C inf...

National policies for chemoprophylaxis after single cases of meningococcal disease in day-care or nursery settings vary across Europe. We carried out a multi-national retrospective study to compare the effectiveness of different policies. Countries were divided into those recommending chemoprophylaxis only to close contacts (policy A, close) and th...

To review the evidence for effectiveness of treatment with antibiotics before admission in reducing case fatality from meningococcal disease. Systematic review. Cochrane register of trials and systematic reviews, database of abstracts of reviews of effectiveness, health technology assessment, and national research register in England and Wales, Med...

Aim of the study: The notified incidence of meningococcal disease in European countries varies from <1 case per 100,000 inhabitants to approximately 7 cases per 100,000. Assessing the true burden of disease is important for setting priorities in health services and for estimating the benefit of interventions such as vaccination. Completeness and t...

Meningococcal disease surveillance in most countries is based upon a combination of statutory notification systems and laboratory reporting, both of which are recognised to underestimate the true burden of disease. The incidence of meningococcal disease varies throughout Europe, and although there are many reasons for this, it is important to quant...

Neisseria meningitidis is the most common cause of meningitis and causes epidemic outbreaks. One trait of N. meningitidis, which is associated with most of the currently recognized virulence determinants, is the presence of phase-variable genes that are suspected to enhance its ability to cause an invasive disease. To detect the immune responses to...

Twenty clinical samples (18 cerebrospinal fluid samples and 2 articular fluid samples) were sent to 11 meningococcus reference centers located in 11 different countries. Ten of these laboratories are participating in the EU-MenNet program (a European Union-funded program) and are members of the European Monitoring Group on Meningococci. The remaini...

To summarise the evidence for the role of antibiotics in preventing further cases of meningococcal disease through chemoprophylaxis given to the index patient, household contacts, and children in day care settings after a single case. Systematic review. Studies were identified by searching Embase (1983-2003), Medline (1965-2003), and CAB Health (19...

Previous studies have shown that there is considerable variation in the methods and media used to determine the susceptibility of Neisseria meningitidis to antimicrobial agents in different countries. In this study, national and regional reference laboratories used a standardized methodology to determine the MICs of antibiotics used in the manageme...