High number of hospitalisations and non-classical presentations: lessons learned from a measles outbreak in 2017, Belgium.

We describe and analyse an outbreak of measles that affected Belgium early 2017. In total, 289 cases were reported, mostly (53%) in people 15 years or older. For 133 (46%) vaccination status was unknown and a further 117 (41%) were not vaccinated.

A comparison of exclusive breastfeeding in Belgian maternity facilities with and without Baby-friendly Hospital status.

A retrospective cross-sectional study was carried out in Wallonia (the southern region of Belgium) in which a 20-question breastfeeding (BF) module was included in an immunization survey. The purpose of this paper is to compare exclusive breastfeeding (EBF) prevalences and BF practices for mothers giving birth in Baby-friendly Hospital Initiative (BFHI) and non-BFHI maternity facilities. A total of 557 mothers responded to BF questions when their child was 18-24 months old; 26.

[Determinants of breastfeeding in the Brussels Region].

Purpose: The objectives of this paper is to study the prevalence of breastfeeding in Brussels, to assess whether the targets of the Maternal and Child Health program (MCH) were met (prevalence's of breastfeeding of 85 and 75% of exclusive breastfeeding) and finally to identify factors associated with exclusive breastfeeding at the birth.

Materials And Method: The cross-sectional survey is representative of children 18 to 24 months living in Brussels. Data on breastfeeding are anamnestic and retrospective.

Breastfeeding duration: a survival analysis-data from a regional immunization survey.

Objective: To report the duration of and factors associated with exclusive and any breastfeeding among the French-speaking community of Belgium (Wallonia).

Material And Methods: A two-stage cluster sample was drawn from the population of children aged 18-24 months living in the area in 2012. Anamnestic data on breastfeeding and sociodemographic information were collected from 525 mothers.

Vaccination coverage for infants: cross-sectional studies in two regions of Belgium.

Methods And Objectives: To estimate infant vaccination coverage in the French-speaking region of Belgium (Wallonia) and in the Brussels-Capital Region, two cross-sectional studies were performed in 2012. A face-to-face questionnaire was administered by trained investigators. The objective was to evaluate infant vaccination coverage retrospectively in 18- to 24-month-old children.

[Breastfeeding in the French-speaking community of Belgium (2009)].

Purpose: The objectives of this paper were to study the prevalence of breastfeeding in the French-speaking community of Belgium, to assess whether the targets of the Maternal and Child Health program (MCH) were met (prevalence of breastfeeding of 85, 70, 50, and 25% at the maternity hospital and at 3, 6, and 12 months of age, respectively), and to identify factors associated with breastfeeding at the maternity hospital and at 6 months of age.

Materials And Methods: A sample (two-stage cluster sampling) was drawn from the population of children aged 18-24 months living in the area. A face-to-face questionnaire was administered by trained investigators.

The Reasons for Early Weaning, Perceived Insufficient Breast Milk, and Maternal Dissatisfaction: Comparative Studies in Two Belgian Regions.

Objective and Method. To report on the weaning reasons at the maternity ward, at 3, 6, and 12 months and to report the socioeconomic characteristics of mothers not satisfied with breastfeeding duration as well as of those who have weaned their child because of perceived insufficient milk (PIM). Two cross-sectional studies were performed in 2012.

Occupational exposure to cobalt is not associated with incipient signs of dilated cardiomyopathy in a Belgian refinery.

Background: Excessive absorption of cobalt has been associated with cases of dilated cardiomyopathy in the past, but it is unclear whether occupationally exposed populations are at risk.

Objective: To assess the possible relationship between occupational exposure to cobalt and incipient signs of dilated cardiomyopathy.

Methods: A cross-sectional survey was conducted in a cobalt production facility in Belgium constituting one of the largest occupational populations worldwide (n=256 male workers).

Occupational exposure to indium: what does biomonitoring tell us?

Background: The industrial uses of indium, a rare metal with no known physiological role in humans, have increased dramatically over the past 15 years. The results of animal toxicity studies showing pulmonary and systemic effects as well as some reports in workers have created a growing concern about the possible occurrence of toxic effects in exposed workers. Validated biomarkers to assess exposure to indium are not available.

Impact of conjugate 7-valent vaccination in Belgium: addressing methodological challenges.

In Belgium, the 7-valent pneumococcal conjugate vaccine (PCV7) was introduced into the national schedule in 2007. The early impact of PCV7 vaccination on paediatric invasive disease was estimated by comparing pre- and post-vaccination incidence from national surveillance. In children <2 year-olds, vaccine-serotype incidence declined by 96% but non-vaccine-types increased 2-3-fold.

[Vaccination: cost-effectiveness ratio].

Vaccination is often recognized as having an excellent cost-effectiveness ratio. Economic assessments are more and more important regarding the steadily increasing costs of vaccines. However, vaccine-specific features have to be taken in account and there is scope for improving quality of available economic evaluations of vaccination programmes.

[Vaccine prevention of Rotavirus infection].

Two new life attenuated vaccines have been granted this year a marketing authorization by European and American regulatory agencies. One, Rotarix, is a monovalent vaccine derived from a human strain and takes advantage of the cross-reactivity between human Rotavirus strains. The other, RotaTeq, is a pentavalent human-bovine reassortant.

Recommendations for the use of the 23-valent polysaccharide pneumococcal vaccine in adults: a Belgian consensus report.

A multidisciplinary expert panel, appointed by the High Council for Public Health, evaluated the scientific evidence on which the recommendations for the appropriate use of the pneumococcal vaccine was based and reviewed the studies that became available since previous reports. The conclusions of the working group, presented in this manuscript, resulted in an update of the Belgian recommendations for pneumococcal vaccination.

[Pertussis vaccine in adolescents and adults].

Despite high immunisation rates in infancy, Bordetella pertussis is still circulating in industrialised countries, causing severe infections in infants too young to be vaccinated, as well as an important number of long lasting cough episodes in older children, adolescents and young adults. The limited duration of the protection resulting from vaccination in the 2 first years of life is probably responsible for the insufficient control of the disease. The development of acellular pertussis vaccines has allowed immunisation of school age children, and an adult formulation is now available.

[Pneumococcal conjugate vaccine in children].

Streptococcus pneumoniae is one of the major causes of severe invasive infections in young children. As purified polysaccharide are not immunogenic in infants, vaccines containing the bacterial polysaccharide conjugated to a carrier protein have been developed according to the model that has proved to be effective for Haemophilus influenzae b and group C meningococcus. A conjugate vaccine containing the 7 serotypes responsible for about 90% of the invasive infections occuring in children in the United States has been shown to have a 97% protective efficacy against infections caused by vaccine serotypes.

[Hexavalent combined vaccination].

Since January 2004, hexavalent combined vaccines are available in Belgium. They protect children simultaneously against 6 diseases (poliomyelitis, diphtheria, tetanus, pertussis, invasive infections with Haemophilus influenzae type b and hepatitis B) and reduce the number of needed injections. Acellular pertussis vaccine is the corner-stone of the combination.

Lung function changes in workers exposed to cobalt compounds: a 13-year follow-up.

The objective of the study was to examine the influence of cobalt exposure on lung function changes in workers from a cobalt-producing plant in a health monitoring program implemented between 1988 and 2001. A total of 122 male workers with at least 4 (median = 6) lung function tests (FEV(1) and FVC) during the follow-up period were assessed longitudinally. Cobalt exposure significantly decreased over the follow-up period, as reflected by the measurements in air and urine.

[Conjugate vaccines].

Conjugate vaccines extend the vaccinal prevention for children to more diseases. Conjugating the capsular polysaccharide to a carrier protein transforms a T-independent antigen in a T-dependent, allowing protection of the children (before 2 years of age) against Haemophilus influenzae type b, meningococcal C and pneumococcal infections. This article reviews the 3 conjugate vaccines and their results with focus on some questions: antigens interference in the immunological response, serological subrogate for protection, herd immunity and replacement of circulating serotypes.

[Conjugate vaccines].

Conjugate vaccines extend the vaccinal prevention for children to more diseases. Conjugating the capsular polysaccharide to a carrier protein transforms a T-independent antigen in a T-dependent, allowing protection of the children (before 2 years of age) against Haemophilus influenzae type b, meningococcal C and pneumococcal infections. This article reviews the 3 conjugate vaccines and their results with focus on some questions: antigens interference in the immunological response, serological subrogate for protection, herd immunity and replacement of circulating serotypes.

[Conjugated vaccines].

Conjugate vaccines extend the vaccinal prevention for children to more diseases. Conjugating the capsular polysaccharide to a carrier protein transforms a T-independent antigen in a T-dependent, allowing protection of the children (before 2 years of age) against Haemophilus influenzae type b, meningococcal C and pneumococcal infections. This article reviews the 3 conjugate vaccines and their results with focus on some questions: antigens interference in the immunological response, serological subrogate for protection, herd immunity and replacement of circulating serotypes.

Analysis of factors influencing vaccine uptake: perspectives from Belgium.

Methods And Objectives: To estimate the infant vaccination coverage in Belgium, a random cluster sample according to the expanded program on immunization (EPI) cluster sampling technique was performed in 1999 in the Flemish (Flanders) and French (Wallonia) speaking community of Belgium. The objective was to document the infant vaccination coverage retrospectively in 18-24-month-old children. In addition, the study offered the opportunity to assess some factors influencing vaccine uptake in infants.

Oral poliomyelitis vaccine: time to change?

For 3 decades, vaccination against poliomyelitis has rested mainly on the use of the oral attenuated vaccine (OPV). In countries where wild type poliomyelitis has been successfully controlled by OPV, the rare cases of poliomyelitis that can still be identified occur in vaccinees or their contacts and are caused by vaccine related strains. Over years, data indicating that the inactivated vaccine (IPV) also has the potential to control poliomyelitis and that there are no known risks associated with the use of this vaccine have accumulated.

Epidemiological survey of workers exposed to inorganic germanium compounds.

Objectives: To assess occupational exposure to inorganic germanium (Ge) in workers from a producing plant, and to assess the health of these workers, with a special focus on respiratory, kidney, and liver functions.

Methods: Cross sectional study of 75 workers exposed to Ge and 79 matched referents. Exposure was characterised by measuring air and urine concentrations of the element during a typical working week, and health was assessed by a questionnaire, clinical examination, lung function testing, chest radiography, and clinical chemistry in serum and urine, including high and low molecular weight urinary proteins.

Safety and immunogenicity of an Haemophilus influenzae type b-tetanus toxoid conjugate (PRP-T) and diphtheria-tetanus-pertussis (DTP) combination vaccine administered in a dual-chamber syringe to infants in Belgium and Chile.

To document any unexpected differences in the immune response between study populations and to evaluate immunogenicity and safety of a simplified presentation (dual-chamber syringe) of an Haemophilus influenzae type b-tetanus toxoid conjugate (PRP-T) and diphtheria-tetanus-pertussis (DTP) combination vaccine, a multicentre, randomized, comparative study was conducted in Belgium and Chile. A total of 537 healthy infants, 270 in Chile and 267 in Belgium, received PRP-T and DTP vaccines combined in a dual-chamber syringe (D-Ch group, DTP/PRP-T, reconstituted by pressing the plunger of the syringe immediately before injection, n = 239) or combined in a single-chamber syringe (C-In group, DTP@PRP-T, reconstituted immediately before injection, n = 61) or in separate injections (S-In group, DTP + PRP-T, simultaneously injected at separate sites, n = 237) at 3, 4, and 5 months of age. Serum samples were collected before vaccination and at 6 months of age.

Acute and subacute inhalation toxicity of germanium dioxide in rats.

Two acute (4 hr) and one subacute (4 wk) inhalation toxicity studies on germanium dioxide (purity > or = 99%, mean particle size 1.7-2.6 microns) were conducted in young adult Wistar rats.