No 28-33 - 2012

Welcome to the new EPI-NEWS layout
HPV vaccination of females born 1985-1992
Malaria and West Nile virus in Greece
Eurosurveillance impact factor 6.15
Nordic Vaccine Meeting 5-7 September

Welcome to the new EPI-NEWS layout

As from this week, EPI-NEWS will be sent directly to all e-mail subscribers in the single-column layout also used at the SSI web page. Full-size figures and tables will be presented as an integrated part of the newsletter's text. Similarly, at the webpage, figures and tables will be presented as part of the text. EPI-NEWS can be printed directly from the news mail, and a single-column PDF version is available for download/printing from the webpage as the previous three-column layout has been abandoned. 

Presenting the current occurrence of notifiable diseases and selected laboratory-confirmed infections, page two will, as previously, be available via a link from the news mail or directly from

The scope of the EPI-NEWS contents remains unchanged and we will stride to maintain its brief and concise form, but the length of the text may vary somewhat from one week to the next.

We hope that the new layout will be well received by the nearly 9,000 EPI-NEWS subscribers (Danish version) and by occasional readers.

(P.H. Andersen, Editor of EPI-NEWS, Department of Infectious Disease Epidemiology)

HPV vaccination of females born 1985-1992

On 27 August, a temporary, free HPV vaccination offer comes into force covering females from the 1985-1992 birth cohorts, EPI-NEWS 26/12. The offer is available until the end of 2013, and it is the result of the Danish 2012 state budget negotiations. Procurement of the vaccines was put out to tender and the Gardasil® vaccine won. This vaccine is also given to 12-year-old girls under the Danish Childhood Vaccination Programme and protects against cervical cancer as well as genital warts (condyloma), EPI-NEWS 35/08. Young females who have had their sexual debut may also benefit from the vaccination either because they have not yet been infected with HPV (human papilloma virus), or because they have not been infected with all the HPV types covered by the vaccine.

It is believed that the vaccine protects against 70 percent of cervical cancer cases in females who are not infected at the time of the HPV vaccination. The vaccine consequently does not protect against all cervical cancer cases and it is therefore essential that young females continue their participation in the screening programme from they turn 23 years old, even though they have been vaccinated.

The vaccination programme

The vaccinations may be given by any physician who in pursuance of the Danish Act on Authorization of Health Staff and Health Professional Activity is entitled to act independently as a physician. Inter-regional settlement shall be made electronically and via the settlement systems recommended by the regions. A vaccination series comprises three doses of Gardasil® 0.5 ml administered at day 0 and after two and six months. The minimum interval separating the 1st and the 2nd vaccination is a month, and the 2nd and the 3rd vaccinations should be given at a minimum interval of three months.

If possible, all three vaccinations should be administered within a year, and if one vaccination is delayed, the next should be given as soon as possible. The vaccination series should never be reinitiated.

In case of pregnancy, the recommendation is to postpone Gardasil® vaccination until after the pregnancy. Gardasil® can be given during the breastfeeding period.

For further information on HPV vaccination, please see "Questions & answers" at and the webpage of the Danish Health and Medicines Authority (, where you will also find the Act in question.

Service codes

The following administrative service codes (Danish: ydelseskoder) have been created for this age group:

1. HPV vaccination = 8334
2. HPV vaccination = 8335
3. HPV vaccination = 8336

It is essential that the correct codes are used for all vaccinations. The codes form the basis for assessment of vaccination coverage and facilitate monitoring of the long-term effects of vaccination on the occurrence of HPV-related conditions.
(P. Valentiner-Branth, L.K. Knudsen, P.H. Andersen, Department of Infectious Disease Epidemiology)

Malaria and West Nile virus in Greece

Since the beginning of June, the Greek authorities have reported a total of six cases of vivax malaria in the Greek regions of Marathon and Lakonia. The first case fell ill around 7 June 2012 and the latest case was reported on 7 August. All cases occurred in Greek inhabitants who had not travelled abroad in the past five years. The local authorities have implemented a series of malaria control measures and information campaigns and have initiated mosquito control measures. Travellers to the affected areas should use effective mosquito bite protection. In 2011 Greece also saw outbreaks of vivax malaria, EPI-NEWS 48/11.

Vivax malaria is normally not life-threatening, but may present many months after infection as the parasite may remain dormant (hyponozoit) when residing in the liver. Malaria symptoms may present very much like influenza, including fever, headache and musculoskeletal pain.

With regard to West Nile virus (WFV), a total of 40 cases have currently been reported in 2012, the majority in the Attica region; but cases have also been observed in Thessaloniki, Samos, Imathia, Evia, Xanthi and Ahaia. The first patient was admitted to hospital on 29 June 2012. Two patients have died. Blood transfusion was the cause of infection in an immunosuppressed patient, in relation to whom both the donation and the transfusion had been made before the first case of WNV was reported.

No vaccine is available to counter infection with WNV. Mosquito bite protection is the primary prevention against infection. Living quarters may be sprayed with an insecticide.

In humans, WNV is often asymptomatic (80%) or presents as mild febrile illness. However, particularly among the elderly and immunosuppressed individuals, the infection may cause meningitis and/or encephalitis and such cases can be fatal.

2011 saw more than 100 laboratory-confirmed WNV cases in Greece, and outbreaks were also observed in 2010, EPI-NEWS 34/10.
You may follow the development of the current outbreak (in Danish) under "Rejser og smitsomme sygdomme" at (A.H. Christiansen, Department of Infectious Disease Epidemiology)

Eurosurveillance impact factor 6.15

Eurosurveillance, a peer-reviewed journal focussing on epidemiology, monitoring, prevention and control of infectious diseases, EPI-NEWS 2/12, was awarded its first impact factor, a significant 6.15, in 2011. This places the Journal sixth among the 70 journals in the infectious diseases category. An impact factor of 6.15 means that articles published in Eurosurveillance in 2009 and 2010 were, on average, cited more than six times in 2011.

As from March 2007, Eurosurveillance has been published by the Scockholm-based European Centre for Disease Prevention and Control (ECDC). Eurosurveillance is open access and free for readers as well as contributors. All articles are indexed to the PubMed/MEDLINE, Scopus, Embase and EBSCO databases. The Journal has approx. 11,700 electronic subscribers. In 2011, 95 peer-reviewed rapid communications and 94 peer-reviewed articles were published in Eurosurveillance by authors from 40 countries.(Department of Infectious Disease Epidemiology)

Nordic Vaccine Meeting 5-7 September

This year, the Statens Serum Institut hosts the Nordic Vaccine Meeting which is held 5-7 September at Eigtveds Pakhus, Copenhagen. The meeting is potentially of interest to any health professional working with vaccination, e.g. GPs and paediatricians.

(Department of Infectious Disease Epidemiology)

15 August 2012