Eurosurveillance最新文献

BackgroundToscana virus (TOSV) is transmitted to humans through bites of infected sand flies. Neuroinvasive TOSV infections are leading causes of meningitis/encephalitis in southern Europe and notifiable in Italy since 2016. In 2022-23, Italy experienced extreme climate anomalies and a concomitant increase in mosquito and tick-borne disease transmission.AimTo identify the spatiotemporal distribution and risk groups of neuroinvasive TOSV infections in Italy in 2022-23 vs 2016-21.MethodsWe retrospectively described all autochthonous, laboratory-confirmed neuroinvasive TOSV cases notified to the national surveillance system in 2016-23 using frequencies, proportions, incidences and incidence risk ratios (IRRs) with 95% CIs, stratified by year, sex, age, region/autonomous province (AP) of infection/exposure and infection/exposure municipality by urbanisation level.ResultsIn 2022-23, 276 cases were notified (average annual incidence: 2.34/1,000,000 population) vs 331 cases in 2016-21 (0.92/1,000,000), with increased incidence extending into September. In 2022-23, infections were acquired in 12/21 regions/APs, predominantly in Emilia Romagna (57.6%; 159/276) as in 2016-21, including four regions/APs with no local infections in 2016-21. Similar to 2016-21, during 2022-23 residence in rural municipalities (vs urban), male sex, working age (19-67 years) and age > 67 years (vs ≤ 18 years) were identified as risk factors with IRRs of 2.89 (95% CI: 2.01-4.17), 2.17 (95% CI: 1.66-2.84), 5.31 (95% CI: 2.81-10.0) and 5.06 (95% CI: 2.59-9.86), respectively.ConclusionItaly experienced a nearly 2.6-fold increase in neuroinvasive TOSV incidence in 2022-23 vs 2016-21. Raising public awareness on risk factors and personal protection measures may enhance prevention efforts.

BackgroundClostridioides difficile infection (CDI) is a severe infection that needs to be monitored. This infection predominantly occurs in hospitalised patients after antimicrobial treatment, with high mortality in elderly patients.AimWe aimed at estimating the incidence of CDI in Italian hospitals over 4 months in 2022.MethodsWe estimated incidences of hospital-acquired CDI (HA-CDI), community or unknown CDI (CA/UA-CDI), recurrent CDI and overall CDI in 25 Italian hospitals, characterised C. difficile isolates using PCR ribotyping, analysed them for toxin genes and susceptibility to antimicrobials.ResultsClostridioides difficile was detected in 9.7% (655/6,722) of samples from 550 patients, 18 patients died of CDI. The mean overall CDI incidence was 5.0 cases per 10,000 patient days (range: 0.7-11.9). For HA-CDI, mean incidence was 3.7 (range: 0.7-9.2), for CA/UA-CDI 0.8 (range: 0.0-3.2) and for recurrent CDI 0.5 (range: 0.0-3.4). Most patients were female (n = 295; 53.6%), aged ≥ 65 years (n = 422; 76.7%) and previously hospitalised (n = 275; 50.0%). Of the 270 culturable isolates, 267 (98.9%) had toxin A and B genes and 51 (18.9%) the binary toxin genes. Of the 55 PCR ribotypes (RTs) identified, RT 018 (n = 56; 20.7%) and RT 607 (n = 23; 8.5%) were the most common, RT 607 in the northern (p < 0.0001) and RT 018 in the central (p < 0.0001) regions of Italy. Most isolates (n = 158; 58.5%) were antimicrobial-resistant and 119 (44.1%) were multidrug-resistant (MDR).ConclusionHighly virulent and MDR C. difficile types are circulating in Italian hospitals which highlights the need of robust surveillance and stringent prevention and control measures.

In 2021, a large outbreak of hantavirus disease (HAVID) in Croatia with 334 notified cases coincided with a COVID-19 wave and included patients from areas previously not considered endemic, challenging HAVID recognition and patient management. We analysed clinical and epidemiological data on all 254 patients with HAVID treated in the Clinical Hospital Center Rijeka (CHC Rijeka) between February and November 2021. Most patients (n = 246; 96.9%) had antibodies against Puumala virus, 212 (83.5%) were residents of endemic areas for HAVID, 93 (36.6%) reported occupational exposure and 86 (33.9%) had observed rodents or rodent excreta. Thirty-seven (14.6%) patients were not notified to the public health authorities. Most patients (n = 177; 69.7%) were male. The median age of the patients was 43 years (range: 17-79 years) in males and 54 years (range: 14-77 years) in females. More severe courses of disease were observed in males aged < 45 years than in older males and females of any age (OR = 2.27; 95% CI: 1.21-4.24; p < 0.005). Measures to prevent exposure, early detection and notification of cases and close collaboration between primary and secondary healthcare teams with public health personnel are essential to improve surveillance and prevent hantavirus outbreaks.

We isolated three genotypes of highly pathogenic avian influenza virus (HPAIV) clade 2.3.4.4b from wild birds infected with H5N1 (n = 12) and H5N8 (n = 1) in Hong Kong SAR 2021-2024. Viruses from two spoonbills from late 2022 were genetically related to a virus from a human in China. Four tested viruses exhibited variable virulence in mice but were susceptible to approved antivirals. No neutralising antibody was detected in 63 age-stratified human sera, suggesting potential risk should the virus adapt to humans.

BackgroundEarly detection and characterisation of SARS-CoV-2 variants have been and continue to be essential for assessing their public health impact. In August 2023, Santé publique France implemented enhanced surveillance for BA.2.86 and sub-lineage JN.1 because of their genetic divergence from other variants and increased prevalence.AimTo detail how combining epidemiological and laboratory data sources, targeted investigations and modelling enabled comprehensive characterisation of sub-lineage JN.1.MethodsData were collected from epidemiological investigations using a standardised questionnaire and from routine and novel (RELAB network) surveillance systems. JN.1 cases were compared with cases infected with previously circulating variants, such as EG.5, BA.4/BA.5 and other BA.2.86 sub-lineages. The growth rate and doubling time of JN.1 were estimated.ResultsJN.1 was first detected in September 2023 in the Île-de-France region, France, and spread widely across the country. By late November, doubling time was estimated to be 8.6 to 26.4 days depending on the region. For all data sources, cases infected by JN.1 showed similar demographics, rates of hospitalisation and RT-PCR cycle threshold values compared with those infected by previous variants. JN.1 cases also had older median age (54 years; 40-71 vs 47 years; 30-59), more frequent reports of feverish feeling and less frequent cough or nausea compared with BA.4/BA.5 cases. JN.1 cases had significantly higher frequency of anosmia compared with other BA.2.86 cases.ConclusionCombining different data sources played a key role in detecting emerging variant JN.1, for which no evidence of increased public health impact was found despite its genetic divergence.

In October and December 2024, circulating vaccine-derived poliovirus type 2 (cVDPV2) was detected from two wastewater samples in Poland during routine environmental surveillance. The first isolate was characterised and matched previous cVDPV2 isolates detected in Spain in September, as well as in Germany, Finland, and the United Kingdom in November and December 2024. In response to the event, active surveillance for acute flaccid paralysis (AFP) has been strengthened, and the frequency of environmental sample collection has been increased.

In 2022-23, several European countries reported paediatric acute liver failure (ALF) with enterovirus infection. In August-November 2024, three neonatal cases of ALF with echovirus 11 (E11) were reported in Tokyo, Japan. All neonates developed irreversible multiple-organ failure and died. The E11 strain belonged to the new lineage 1, which was the same as strains isolated from neonatal ALF cases in Europe in 2022-23.

BackgroundHuman parainfluenza viruses (HPIV) commonly cause upper respiratory tract infections, with potential for severe lower respiratory complications. Understanding seasonal increases informs strategies to prevent HPIV spreading.AimWe examined the impact of COVID-19 on HPIV epidemiological and clinical patterns in Scotland using non-sentinel and sentinel surveillance data.MethodsInformation on HPIV swab positivity (January 2017-October 2023) and demographic data was obtained from the Electronic Communication of Surveillance in Scotland (ECOSS) non-sentinel surveillance sources (laboratory-based data from hospital and community) and the Community Acute Respiratory Infection (CARI) sentinel surveillance programme (enhanced surveillance and symptom data).ResultsIn 2020 during early COVID-19 waves, HPIV detection decreased aligning with lockdowns and preventive measures. In summer 2021, HPIV positivity increased, with HPIV-3 possibly reverting to pre-pandemic seasonality, but HPIV-1 not yet re-establishing alternate-year peaks. Most positive results from non-sentinel sources came from hospital tests. Sentinel surveillance (CARI) complemented non-sentinel data, offering community-level insights. There was no significant difference in CARI swab positivity by sex in any age group. Consistent with historical trends, children under five years exhibited highest test positivity: 9.3% (95% CI: 7.6-11.2) in females and 8.5% (95% CI 7.0-10.2) in males.ConclusionThe COVID-19 pandemic impacted HPIV detection in Scotland. The decline during the pandemic peak and subsequent partial resurgence underscores the complex interplay between viral epidemiology and public health measures. Combining diverse surveillance systems provides a comprehensive understanding of HPIV dynamics. Insights into age-specific and symptom-associated patterns contribute to understanding HPIV epidemiology and refining public health strategies.