No 13 - 2015

Individually notified diseases 2014

This annual report comprises individually notifiable diseases with onset in 2014. Figures may subsequently be adjusted due to late notification or new information received. To facilitate comparison with the previous period, the following are included: 2013 totals, the mean annual average for the entire five-year period 2009-2013, and the minimum-maximum annual averages for the same period.

There have been no reported cases of anthrax, diphtheria, haemorrhagic fever, plague, polio, rabies or rubella.

Read more in this annual report 2014 (pdf)

World TB Day

Every day, a person in Denmark develops tuberculosis

24 March was World TB Day and there are plenty of good reasons why we should continue focusing on the condition - also in Europe.
The WHO estimates that a total of 360,000 persons in the WHO’s European Region developed tuberculosis in 2013. Data published by The European Centre for Disease Prevention and Control (ECDC) and the WHO show this. The figure constitutes an approx. 6% decrease compared with the previous year.

In Denmark, tuberculosis is a rare condition in the majority of the population, but it is not a rare disease among the socially marginalised part of the population where the tuberculosis prevalence is high, particularly among Danish and Greenlandic men.

Currently, 300-400 persons are notified and treated annually for tuberculosis in Denmark, EPI-NEWS 3/15 and www.ssi.dk/data. About half come from areas in the world where tuberculosis is highly prevalent, but transmission of the disease between different nationalities is limited. A total of 13% of Danish-born and 5% of foreign-born tuberculosis patients die during treatment, many due to non-TB-related conditions, EPI-NEWS 27-33/13.

Multi-drug-resistant tuberculosis

In the overwhelming majority of cases, tuberculosis can be managed effectively with antibiotics. But resistance to antibiotics may also develop among tuberculosis patients. Some types of tuberculosis are resistant to more treatment types - i.e. they are multi-drug-resistant, MDR-TB. MDR-TB is also a problem in Europe. According to the ECDC and the WHO, Europe is the area in the world that is most heavily affected by MDR-TB. Only 50% of all MDR-TB patients are detected and only half of those detected are cured.

In recent years, Denmark has seen an average of 2 cases of multi-drug-resistant tuberculosis annually; and in the past two years, the first 2 cases of extremely drug-resistant tuberculosis (XDR-TB) have been detected in Denmark. XDR-TB is practically impossible to treat and requires several years of costly and complicated treatment that is associated with significant adverse effects. Early detection of tuberculosis is therefore important to limit transmission of the infection and therefore also the spreading of multi- and extremely drug-resistant tuberculosis bacteria.

Tuberculosis control

According to the WHO, the capacity to detect and treat patients affected by drug-resistant forms of TB has been improved in the European countries, but there are differences between the challenges facing the individual countries and the progress they have achieved.

Currently, the number of cases decreases by 6% annually. If this trend continues, it is assessed that Europe will not become tuberculosis-free until sometime in the next century. This is not in line with the WHO objective to eliminate TB in Europe by 2035 at the latest.

In Denmark, access to diagnostics and treatment with effective drugs is free, but it can be challenging to reach all patient groups, particularly among the socially marginalised. Persistent efforts are needed if Denmark should be among the countries in which tuberculosis is eliminated in just 20 years.

When facing a new case of tuberculosis, it is necessary always to try to identify the source of infection and to establish if there are any other cases. Additionally, active outreach work among the socially exposed groups is decisive to tracing new tuberculosis cases and limiting the spreading of the infection.
(T. Lillebæk, National TB and Mycobacteria Reference Laboratory, P.H. Andersen, Department of Infectious Disease Epidemiology)

Link to previous issues of EPI-NEWS

25 March 2015