Luxembourg

Activity Report: Luxembourg
8th EURL-AR Workshop, 7 April 2014
Joël Mossong PhD
Laboratoire National de Santé
Luxembourg
A very small country in Europe
Sandwiched between Belgium,
France & Germany
Sandwiched between Belgium,
France & Germany
Area 2500 km2
Population of 530000 inhabitants
1/10th size of
Denmark
Cross-border Commuters increase
population to 700000 during daytime
Luxembourg is a Grand-Duchy
Wealth largely dependent on
banking industry, although …
Pass Frank Zappa country test
Pass Frank Zappa country test
National airline
Pass Frank Zappa country test
National airline
National beer(s)
Pass Frank Zappa country test
National airline
National beer(s)
National football team
National football team won
3-2 against Northern Ireland in
Sept. 2013!
Laboratoire National de Santé
(LNS)
• Founded in 1897
• ~ 200 full-time equivalents
• Medical routine activities
– Human diagnostic lab for microbiology, blood chemistry
and haematology
– Pathology, cervical cancer screening & cancer registry
– Prenatal testing
– Legal medicine, autopsies
• Environmental, food and forensic lab
– Processed foods, GMO, toxicology
Laboratoire National de Santé
(LNS)
New law in 2012
New building since
2013
Microbiology lab landscape
LNS
SEMI
Veterinary
services
Raw foods
Human
clinical
Processed
foods
Agriculture
Animal feed
Animal
Pathology
Microbiology lab landscape
LNS
SEMI
Veterinary
services
Raw foods
Human
clinical
Processed
foods
Agriculture
Animal feed
Animal
Pathology
Surveillance & epidemiology of
infectious diseases
• Main mission
– laboratory-based surveillance of infectious diseases
• 3 major areas of interests:
– Food-borne infections: Salmonella, Campylobacter, VTEC,
Yersinia & Shigella, Listeria
– Nosocomial infections: MRSA, CPE, C. diff
– Vaccine-preventable respiratory infections : influenza
• Methodological focus
– Molecular typing (PFGE, MLVA, MLST, Sanger & Miseq)
– Establishing sources and reservoirs by comparing human
and veterinary/food/environmental strains
Human Salmonella & Campylobacter in Luxembourg
160
Campylobacter
140
Salmonella
Incidence per 100 000
120
100
80
60
40
20
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Year
R-type ASSuT
DT193
Environmental Campylobacter research project HypoCamp
HypoCamp in numbers
Risk factor survey Case control study
22 isolates
ANSES
330 isolates
ISP
1246
526
911
Molecular typing
veterinary lab.
2140 isolates
19 260
alleles
Sequencing 9 genes
hospitals,clinical lab.
year 1 => 687 isolates
year 2 => 610 isolates
53 sites
920 isolates
collected
1297 isolates
Water cycle
Distribution of human cases – Top 20 genotypes
Campylobacter jejuni
Genotype
Human
Gyrase
2011
2012
T86I
19-8-7
2274-9-705
48-5-7
50-1-6
572-3-60
572-3-61
257-32-1
12
12
17
16
12
19
3
16
15
09
10
13
5
18
+
+
21-8-7
21-1-48
464-8-1472
267-1-73
257-10-1
44-8-11
257-9-1
990-9-257
990-10-257
6
13
3
8
5
4
11
11
8
14
6
16
7
9
10
1
1
2
+
51-6-11
354-8-58
42-4-71
3720-26-55
7
3
6
8
5
9
5
2
354-8-97
4
5
+
+
+
Poultry
S22G
+
Bovine
Mammal
2011
2012
2011
2012
2011
2012
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Milking cow & stream
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Cow and donkey
●
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+
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●
●
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+
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●
+
+
+
+
+
Comment
Surface water
+
+
+
●
+
●
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Milking cow & stream
●
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Sewage
Turkey
Sewage
●
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Dog cat bpvine
+
+
●
dinde
Huge diversity: 677 genotypes for 1300 human strains
Top 20 genotypes account for 30% of cases
Acknowledgments
• Catherine Ragimbeau & F. Djabi