Annex
KEY EUROPEAN DATA ON THE FOUR DISEASES
AVIAN INFLUENZA:
1. There have been no human cases of H5N1
avian influenza in the EU though there have been intermittent
threats from outbreaks in poultry in the Europe and numbers of
people needing assessment for possible infections. There have
been human infections with other avian influenza taking place
in the EU including in the UK which are a reminder that we could
still see human cases of H5N1.
HIV/AIDS AND TUBERCULOSIS:
2. Relatively good data exists within the
European Region on the number of new diagnosis of HIV and tuberculosis
being reported each year. These data are based on cases diagnosed
by health professionals and then reported to national public health
authorities.
3. A limitation of this data is that the
number of new diagnosis being reported in a given year does not
necessarily equate with the amount of infection taking place in
that year. This is because some of the infections reported may
have occurred several years before diagnosis. Also, infections
currently taking place may remain undiagnosed—and therefore
unreported—for several years
4. People can be infected with HIV for months
or years before becoming ill. Some people infected with TB causing
bacteria may never actually develop the disease: others may not
become ill for many years. ECDC estimates that around 30% of the
people living with HIV in Europe are unaware of being infected.
Another limitation worth noting is that a few European countries
(including two in the EU) are unable to provide national data
on HIV infections.
5. In the European region of 53 countries,
86 912 newly diagnosed cases of HIV infection were reported in
2006,[6]
giving an overall rate of 111.1 per million inhabitants. Four
countries reported rates of more than 200 new HIV diagnoses per
million inhabitants: Estonia (504), Ukraine (288), Russian Federation
(275) and Portugal (205). Across Europe, the number of new diagnoses
of HIV infections has continued to increase. This could be due
to an increase in testing rates among HIV infected persons, an
increase in the number of persons becoming infected in Europe,
an increase in the number of HIV infected persons migrating to
Europe, or a combination of these factors. The level and the nature
of the epidemic and its implications for public health vary across
Europe.
6. The East of Europe[7]
has reported the largest number of new cases, with 210.8 HIV diagnoses
per million inhabitants. Although this rate is lower than the
epidemic peak observed in 2001, the number of reported new HIV
diagnoses has increased in recent years. In this region, injecting
drug use remains the main mode of transmission. Over a quarter
of the new HIV diagnoses were among young people aged 15-24 years
and 41% of the cases were reported amongst females. Further spread
into the general population through heterosexual contact is a
potential risk.
7. In the West of Europe,[8]
the rate of new diagnoses was equal to 82.5 per million inhabitants
and the nature of the epidemic reflects that of the EU, where
the majority of persons diagnosed with HIV were infected through
heterosexual contact. A substantial proportion of these however
are among persons originating from sub-Saharan Africa, the majority
of which are believed to have been infected in their country of
origin. Therefore in many countries of Western Europe sex between
men accounts for the majority of infections that take place in
the country.
8. In the Centre,[9]
the level of HIV epidemic remains low, with 9.4 new diagnoses
per million inhabitants, representing a small increase since 1999.
The most common transmission group was heterosexual contact (52%),
with a quarter attributed to men having sex with men. The number
of reported cases has increased since 1999 in both these groups,
while a decline has been observed among injecting drugs users
(16%).
9. WHO/UNAIDS estimates that, at end of
2007, 760,000 people were living with HIV in western and central
Europe and 1.6 million in eastern Europe and central Asia.
10. TB rates in the EU decreased by 2.5%
annually between 2001 and 2005.[10]
Nonetheless, a total of 91,845 tuberculosis cases were reported
in the 27 EU Member States in 2005. While the prevalence of TB
in the EU is low by international standards, rates of infection
have increased among certain vulnerable groups. These include
HIV/AIDS infected persons and people of foreign origin. In addition,
some EU countries are reporting a high rate of cases of drug resistant
TB. In the Baltic States 18% of TB cases are from drug resistant
strains (compared to 0% to 6% in other Member States).
11. Across the whole of the WHO European
Region in 2005 there were 445 000 new cases of TB reported and
66 000 TB-related deaths.
MALARIA:
12. 4,271 cases of malaria were reported
in the European Union in 2005, which equates to approximately
1.07 cases per 100,000 population.[11]
Malaria in the EU is almost always an imported disease: ie it
is linked to persons travelling to countries where malaria is
endemic. The potential for malaria to become established in Europe
is addressed in more detail in our response to Question 7.
6 EuroHIV Annual Report, Paris, November 2007. Back
7
15 countries of the former Soviet Union: Armenia, Azerbaijan,
Belarus, Estonia*, Georgia, Kazakhstan, Kyrgyzstan, Latvia*, Lithuania*,
Republic of Moldova, Russian Federation, Tajikistan, Turkmenistan,
Ukraine, Uzbekistan. Back
8
countries: Andorra, Austria*, Belgium*, Denmark*, Finland*, France*,
Germany*, Greece*, Iceland, Ireland*, Israel, Italy*, Luxembourg*,
Malta*, Monaco, Netherlands*, Norway, Portugal*, San Marino, Spain*,
Sweden*, Switzerland, United Kingdom*. Back
9
15 countries : Albania, Bosnia and Herzegovina, Bulgaria*, Croatia,
Cyprus*, Czech Republic*, Hungary*, Former Yugoslav Republic of
Macedonia, Montenegro, Poland*, Romania*, Serbia, Slovakia*, Slovenia*,
Turkey. Back
10
EuroTB Annual Report, Paris, March 2007. Back
11
Annual Epidemiological Report on Communicable Diseases in Europe,
ECDC, Stockholm, June 2007. Back
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