Date: Mon, 7 Jan 2019 20:17:54 +0100

Vienne, Jan 7, 2019 (AFP) - Three skiers and two snowshoe hikers have died as heavy snow and avalanches hit Austria, isolating several areas of the mountainous country, authorities said Monday.

Two German skiers lost their lives in avalanches in the western region of Vorarlberg on Sunday, and a Slovenian died in the region of Salzburg, rescue services said.   The bodies of two missing snowshoe hikers were discovered Monday as snow caused chaos in parts of the country, blocking roads and shuttering schools.   Two other hikers are still missing in the country's northeast.   Up to 1.5 metres (five feet) of snow has fallen in central and north Austria since the middle of last week, with up to three metres accumulating in the mountains around Salzburg, Austria's meteorological service said.

Some 2,000 people, including tourists, were left stranded in villages in the Soelktal valley in the southeast.    Army helicopters used in avalanche control were grounded due to the bad weather.    In the Hochkar mountain range in Lower Austria, ski resorts were closed until further notice, with inhabitants and tourists requested to vacate the area.    More snow is expected this week, with up to 80 centimetres forecast from Tuesday.
Date: Tue 16 Oct 2018
Source: Food Safety News [edited]
<https://www.foodsafetynews.com/2018/10/austria-reports-hepatitis-a-cases-match-strain-in-swedish-outbreak/>

Austria has become part of a multi-country hepatitis A outbreak with 31 confirmed cases linked to frozen strawberries imported from Poland.  The outbreak of hepatitis A virus (HAV) is connected to the one recently declared over in Sweden which affected 20 people in 6 counties. Of these cases, 17 were confirmed and 3 were probable. Dates of symptom onset ranged from 30 May 2018 to 10 Jul 2018. Ages ranged from 9 to 92 years and 13 out of 20 were women.

In July and August 2018, Austria recorded 9 hepatitis A cases with the source unknown. Researchers reported in the Eurosurveillance journal that by sharing the sequence information identified in Sweden internationally, 14 cases in Austria were found linked to strawberries from the same producer.

Genotyping of the hepatitis A outbreak strain in Sweden showed of 17 of the 20 cases confirmed an identical genotype IB strain. Environmental investigations and interviews with kitchen personnel found strawberries had not been heated adequately before serving. Following the outbreak, the juice bar chain where at least 10 cases had fallen ill stopped using frozen strawberries in smoothies and changed to pasteurized frozen pellets of the fruit.

The incriminated batch of frozen strawberries was withdrawn in June 2018 but it had best before date 6 Apr 2020. In total, 1664 packages with 5 kg [11 lbs] strawberries each were removed from the Swedish market.

Almost 2 months after the initial outbreak alert in Sweden, Austria reported a case of HAV infection with a strain indistinguishable from the Swedish outbreak strain. It can take up to 6 weeks after exposure for symptoms to develop. In late August 2018, the Austrian reference laboratory for viral hepatitis reported 5 cases sharing the Swedish outbreak genotype IB strain to the Ministry of Health (MOH). The Austrian Agency for Health and Food Safety (AGES) was told to investigate the outbreak.

As of early October 2018, 36 cases of laboratory-confirmed acute hepatitis A had been reported to public health authorities in Austria since June 2018. Of those, 14 met the definition of a confirmed case and 4 were classified as non-outbreak infections based on sequence-typing data. For confirmed cases, disease onset ranged from 8 Jun to 20 Sep 2018, age range was between 5 and 70 years, with 8 males and 6 females affected. 12 patients ate strawberry ice cream during the incubation period and 9 remembered the restaurants where they ate it. For the remaining 18 cases, sequence-typing data was not yet available and patient interviews regarding food exposure during their incubation periods is ongoing, according to the researchers.

Since mid-May 2018, only one wholesaler in Austria purchased frozen strawberries from the producer in Poland, but further distribution included two wholesalers in Slovakia and one ice cream producer in Italy.

The Austrian importer of frozen strawberries from the Polish producer is expecting a supply of 22 tons at the end of 2018 and has requested evidence for a HAV-negative test result of samples. It has also asked for a guarantee from purchasers that frozen strawberries are heated before consumption.

There are several challenges with HAV outbreaks related to berries, according to the researchers. "First, the trace back can be difficult as berries are typically harvested by one producer, then packed by another food business operator whereby batches may then be mixed or split. Another point to consider during HAV outbreak investigations is the long incubation period of hepatitis A up to 6 weeks. After such a long time, it can be difficult to recall food consumption and collect food leftovers. Furthermore, the time from the onset of symptoms to a primary diagnosis and the sequence information can take several weeks," they said.

"In the current outbreak, leftovers from the suspected frozen strawberries in Sweden were sent to Livsmedelsverket and the presence of HAV could be confirmed by real-time PCR and Sanger sequencing, providing evidence for the source of infection. While being invaluable in tracing the source of infections, the molecular detection of viruses in food is challenging." Researchers also said boiling recommendations could be considered for frozen strawberries in Sweden. Such advice is already in place for frozen, imported raspberries because of the risk of norovirus.  [Byline: Joe Whitworth]
==========================
[Frozen berries have been implicated in hepatitis A transmission in the past. The exact mechanism of contamination of the berries is generally not clearly established, but hepatitis A is essentially only a human pathogen transmitted by the fecal-oral route. Transmission can be through food or water contamination or, as has been occurring in a number of large and some still ongoing outbreaks in the USA, through poor sanitation involving marginalized populations such as the homeless, with spill over into other groups. - ProMED Mod.LL]

[HealthMap/ProMED-mail maps
Austria: <http://healthmap.org/promed/p/109>
Sweden: <http://healthmap.org/promed/p/108>]
Date: Tue, 10 Jul 2018 16:14:43 +0200

Vienna, July 10, 2018 (AFP) - An American tourist brought an unexploded World War Two shell to Vienna airport in her luggage, Austrian police said on Tuesday.   The 24-year-old had found the bomb on Sunday while walking in the Dachstein mountains, according to police in Lower Austria state.

She kept the shell in her belongings as a souvenir and declared it to customs officers when she came to the airport on Monday, who immediately rang the police.   A bomb disposal unit was called and in order to safely remove the device, the baggage hall and parts of the arrivals area were closed for around 15 minutes.   There was no danger to passengers and no delays as a result, according to police.

The tourist was charged with public endangerment through negligence and given a four-figure fine.   More than 70 years after World War II and a century after World War I, unexploded bombs still regularly turn up across Austria and Germany, often during construction work.
Date: Mon 25 Jun 2018
Source: AGES (The Austrian Agency for Health and Food Safety) press release [in German, trans. submitter SZ, edited]
<https://www.ages.at/en/service/services-press/press-releases/brucellose-fall-in-oesterreich/>

On [Fri 22 Jun 2018] AGES confirmed brucellosis in a dairy herd in the Rohrbach district in Upper Austria.

Since January [2018], increased number of abortions in cows and calf deaths have occurred on the affected farm. The farm's veterinarian investigated and collected blood samples. AGES confirmed brucellosis on [Fri 22 Jun 2018].

The competent authority acted without delay and has already taken all relevant measures. The dairy farm affected is currently restricted from selling milk and moving animals.

Brucellosis is a disease caused by bacteria of the genus Brucella. The infection of humans usually takes place via foods such as raw milk. Infection of farmers or veterinarians is also possible when assisting cows during parturition or when handling aborted material. In Austria, during the last decade, between 1 and 7 imported cases per year were found in humans. In 2018, 2 cases of brucellosis have been reported in humans.

Brucellosis is a very rare disease in humans and animals in Austria. The incubation period of brucellosis is usually 1 to 2 months. Up to 90 percent of all infections are without disease symptoms; infection can only be detected by testing for specific antibodies in the patient, they are an expression of an effective immune defense.

In acute [human] brucellosis, early symptoms are fatigue, mild fever, headache and body aches. After a short, symptom-free interval, flu-like symptoms may appear, which do not stop after 7 to 10 days, as is usual with influenza.

A typical indicator of brucellosis infection are elevated evening temperature (up to 40 C [104 F]) associated with excessive sweating. The disease can be treated with antibiotics.

In Austria, the cattle population (since 1999) and the sheep and goat populations (since 2001) are officially recognized free of this pathogen. The control of this animal disease in the present case focuses on the detection, isolation and culling of the infected animals as well as on the control of animal movements in order to avoid the spread of the pathogen. The milk from the affected farm has not caused any risk to consumers, since it is consistently undergone the compulsory pasteurization.
----------------------------------------
Communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen
Germany
<http://www.cvlonghorns.de>
cvlonghorns@aol.com
=======================
[According to the media, about 50 percent of the 100 milking cows on the affected holding are infected. ('Top agrar online' dated 29 Jun 2018, in German, at <https://www.topagrar.com/news/Rind-Rindernews-Brucellose-auf-Milchviehbetrieb-in-Oesterreich-9316224.html>).

According to Austria's most recent periodic report to the OIE (Jun-Dec 2017), the last identification of Brucellosis (Brucella abortus) in Austria took place in March 2008.

Hopefully the epidemiological investigation undertaken by Austria's animal health authorities will discover soon the source of infection, and identify/test any other animal holding(s) which may have been in contact with the affected farm during recent months.

AGES is a company of the Republic of Austria, owned by the Austrian Federal Ministry of Labour, Social Affairs, Health and Consumer Protection and the Austrian Federal Ministry for Sustainability and Tourism. AGES was founded on 1st June, 2002.

Further exhaustive information on Brucellosis in animals is available in OIE's terrestrial Manual at
<http://www.oie.int/fileadmin/Home/fr/Health_standards/tahm/2.01.04_BRUCELLOSIS.pdf>.

A map of Upper Austria, Austria: <http://healthmap.org/promed/p/2787>. - ProMED Mod.AS]
Date: Tue 13 Mar 2017
From: Christian Lenard <christian@lenart.at> [edited]

A 42-year-old woman and her 87-year-old mother came to the emergency ward of our hospital suffering from diplopia and hoarseness since the previous day. 4 days earlier, both ate a pork spread, which was already expired for 1.5 months. The spread was kept in a bottled jar. It is not known whether the jar had previously been opened or not.

Two days after consumption, both women experienced a dry feeling in their throats in the morning and difficulties in swallowing by the afternoon. On the 3rd day, both reported hoarseness, leading them to consult their general physician who didn't find any clinical aberrations. Since both women suffered from diplopia the following day, they decided to visit the emergency ward. As the mother also suffered from a swollen leg, a deep vein thrombosis was ruled out. A CT scan of the head was negative in both cases. As the interval of symptoms had prolonged, we did not deliver a botulism antitoxin.

After having the patients transferred to the neurological ward, the women's symptoms worsened. On the 10th day, the mother had to be intubated due to respiratory insufficiency. She was suffering from hypercapnia [high concentration of carbon dioxide in the blood] but improved rapidly with controlled ventilation. A chest X-ray showed signs of pneumonia due to aspiration and she was treated first with amoxicillin/clavulanate and then with meropenem. Due to circulation insufficiency, catecholamines were administered. A paralytic ileus was treated with neostigmine. The patient was tracheostomized 2 weeks later, followed by successful sedation and weaning.

The patient is now conscious, awake, and breathing on her own, but still being treated in the ICU. Her daughter showed much milder symptoms, with comparatively only symptoms of dysphagia, and neither a danger of aspiration nor the need for parenteral feeding. She was discharged after 3 weeks.

In both patients, a serological test was positive for _Clostridium botulinum_ toxin. The confirmation was a result of a mouse bioassay performed by the Austrian Agency for Health and Food Safety (AGES) in Graz.

The Austrian Agency for Health and Food Safety (AGES) in Graz has been the reference centre for botulism in Austria since 2008. The statistics show 28 cases of botulism in Austria since 2000, with the majority stemming from foodborne toxin.
---------------------------------------------
Dr Christian Lenart
Department of Emergency Medicine
Krankenhaus Hietzing (Municipal Hospital Vienna-Hietzing)
Austria
christian@lenart.at
=========================
[ProMED thanks Dr Lenard for this report.  Most cases of foodborne botulism are not associated with commercially prepared food and it is not clear if the product was indeed commercially prepared. The spread was past expiration time but it is also possible that the cases occurred related to poor storage with lack of refrigeration after purchase. - ProMED Mod.LL]

[HealthMap/ProMED-mail map
Vienna, Austria: <http://healthmap.org/promed/p/4417>]
More ...