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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 June 9; 334(7605): 1187.
PMCID: PMC1889986

Antibiotic resistant microbes biggest threat to European health

The first epidemiological report produced by the European Centre for Disease Prevention and Control identifies six important communicable diseases that pose a threat to Europe.

The analysis is based on national data for 2005 from the 25 European Union countries at the time and from Norway, Iceland, and Liechtenstein.

Zsuzsanna Jakab, the centre's director, said that the report would “give a major input to policy makers on where they need to invest in public health,” particularly on diseases that cross borders and cannot be treated in one country alone.

Heading the list are micro-organisms that have become resistant to antibiotics, which are a rapidly growing problem in hospitals. Every year some three million people in the EU catch a healthcare associated infection. Of these about 50 000 die.

In second place comes HIV infection. In 2005 just more than 28 000 new cases were reported in the EU, bringing the total number of people with HIV in the union close to 700 000—about 30% of whom are unaware that they have the virus.

Pneumococcal infections are responsible for high death rates among young children and elderly people, and hundreds of thousands of people in the EU fall seriously ill every winter as a result of seasonal influenza. Several thousand will die, often unnecessarily, even though effective vaccines are available for people most at risk, says the report.

The fifth most dangerous threat is tuberculosis, with some 60 000 cases identified in the EU in 2005. The disease continues to rise in vulnerable groups, such as migrants and people with HIV. Cases of drug resistant tuberculosis are now appearing, particularly in the Baltic states.

Finally, the report draws attention to two further diseases—chlamydia and campylobacteriosis. Neither causes as serious illness as the first five, but the sheer number of cases—both almost 200 000 a year—is presenting a huge challenge.

The analysis points to the high financial burden for health services in treating communicable diseases. In England, from GP consultations through to hospital admissions, costs are estimated at £6bn (€9bn; $12bn) a year.

The report also notes that the way in which a large number of diseases are being detected and monitored is changing. Instead of a patient being diagnosed as having a disease by a doctor, the illness may be discovered in a laboratory, often by chance; as an unexpected finding in a medical investigation; or as part of a screening programme. The implications of this shift, according to the centre, is that the capabilities of national laboratories should be raised to the same level if an accurate epidemiological picture of the EU is to be achieved.

Ms Jakab said that the report's findings confirmed the centre's decision to place seasonal influenza, HIV infections, and tuberculosis among its top priorities. Over the next few years, it will also attach importance to making sure national data is as comparable as possible.


The Annual Epidemiological Report on Communicable Diseases in Europe is at

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