Eurosurveillance最新文献

Using real-life data from Spain between October 2023 and March 2024, the number needed to immunise (NNI) with nirsevimab and the cost to prevent one RSV hospitalisation were estimated at 90 infants (95% CI: 77-108) and 19,700 EUR for catch-up immunisation, and 41 infants (95% CI: 35-50) and 9,000 EUR for at-birth immunisation. By month of birth, NNI and cost were lowest in infants born shortly before the RSV epidemic peak, with impact decreasing gradually for earlier or later births.

BackgroundSince 2009, European guidelines recommend individuals with hepatitis B virus (HBV) and HIV be tested for hepatitis D virus (HDV).AimTo analyse HDV testing in individuals with HBV/HIV during routine practice in the Netherlands.MethodsWe assessed data from the ATHENA cohort of people with HIV who were ever HBV surface antigen-positive, aged ≥ 18 years and attended one of 24 HIV treatment centres in the Netherlands during 2000-22. Using longitudinal analysis, we estimated the percentage of individuals ever tested for HDV (antibody or RNA test) over time. In cross-sectional analysis, determinants for ever being tested by end of follow-up were assessed using relative risk regression.ResultsWe identified 1,715 individuals with HBV/HIV; 1,460 (85.1%) and 255 (14.9%) were male and female at birth, respectively (median age: 52 years; IQR: 42-59). Only 249 (14.5%) had an HDV test. The percentage tested increased from 5.0% (95% CI: 3.4-7.3) in 2000 to 17.0% (95% CI: 14.9-19.3) in 2022. In 2022, 16.2% (95% CI: 13.7-19.1) of men who have sex with men, 25.0% (95% CI: 9.7-50.9) of persons who inject(ed) drugs and 18.1% (95% CI: 14.6-22.3) of heterosexual/others were tested. In multivariable analysis, ever having an HDV test was associated with detectable HBV DNA viral load (p < 0.001), ever presenting with elevated alanine aminotransferase (ALT) levels (p = 0.023), advanced fibrosis/cirrhosis (p = 0.001) and being overweight/obese (p = 0.043).ConclusionsHDV testing coverage in the Netherlands is low for individuals with HBV/HIV. Although testing was more common in those with advanced liver disease, a considerable proportion at risk of HDV still need testing.

We report a national outbreak of Serratia marcescens complex type 755 (ct755) in Norway, with 74 cases identified between June 2021 and February 2023. Careful reviews of patient journals and interviews were performed, involving 33 hospitals throughout Norway. All available clinical isolates of S. marcescens collected between January 2021 and February 2023 (n = 455, including cases) from all involved hospitals were whole genome sequenced. Cases displayed a pattern of opportunistic infections, as usually observed with S. marcescens. No epidemiological links, common exposures or common risk factors were identified. The investigation pointed to an outbreak source present in the community. We suspect a nationally distributed product, possibly a food product, as the source. Phylogenetic analysis revealed a highly diverse bacterial population containing multiple distinct clusters. The outbreak cluster ct755 stands out as the largest and least diverse clone of a continuum, however a second cluster (ct281) also triggered a separate outbreak investigation. This report highlights challenges in the investigation of outbreaks caused by opportunistic pathogens and suggests that the presence of identical strains of S. marcescens in clinical samples is more common than previously recognised.

BackgroundRespiratory syncytial virus (RSV) causes substantial morbidity in infants < 1 year. In October 2023, Spain recommended the monoclonal antibody nirsevimab to all children born since 1 April 2023, at birth or as catch-up if born before October 2023.AimWe estimated nirsevimab effectiveness in preventing RSV hospitalisations during the 2023/24 season.MethodsWe conducted a nationwide population-based matched case-control study. Cases were children hospitalised for lower respiratory tract infection who were RSV PCR-positive. For each case, we selected four population density controls born in the same province and date (±2 days). We defined at-birth immunisation as receiving nirsevimab during the first 2 weeks of life, and catch-up immunisation within 30 days from campaign onset. Causal intention-to-treat (ITT) and per-protocol (PP) effectiveness was estimated using inverse-probability-of-immunisation weighted conditional logistic regression.ResultsWe included 406 cases and 1,623 controls in catch-up and 546 cases and 2,182 controls in at-birth immunisation studies. Effectiveness in preventing RSV hospitalisations for catch-up immunisation was 71% (95% confidence interval (CI): 65-76) by ITT and 80% (95% CI: 75-84) PP. Effectiveness for at-birth immunisation was 78% (95% CI: 73-82) by ITT and 83% (95% CI: 79-87) PP. Effectiveness was similar for ICU admission, need of mechanical ventilation, and RSV viral subgroups A and B. Children born pre-term or with birthweight < 2,500 g showed lower PP effectiveness of 60-70%.ConclusionsPopulation-level nirsevimab immunoprophylaxis in children in their first RSV season was very effective in preventing RSV hospitalisations, ICU admission and mechanical ventilation, with reduced but still high effectiveness for pre-term and low-birthweight children.

Influenza circulates at high levels in Europe since November 2024. Using a test-negative study based on data from French community laboratories between October 2024 and February 2025, we estimated vaccine effectiveness (VE) against PCR-detected influenza infection (44,420/15,052; positive/negative individuals). For all age groups, the overall VE was 42% (95% CI: 37-46%), with 26% (95% CI: 18-34%) against influenza A and 75% (95% CI: 66-82%) against influenza B. Among individuals ≥ 65-year-olds VE was 22% (95% CI: 13-30%) and among 0-64-year-olds, 60% (95% CI: 56-65%).

BackgroundTick-borne encephalitis virus (TBEV) is a flavivirus spread by ticks and can cause tick-borne encephalitis (TBE) in humans. Previously, TBE has been reported in returning travellers in the United Kingdom (UK), but in 2019 and 2020, two probable cases of TBE acquired in the UK were identified.AimThe aim of this study was to investigate TBE cases in the UK between 2015 and 2023, describing the incidence, place and mode of acquisition and diagnostic process.MethodsA retrospective review of possible, probable and confirmed cases of TBE diagnosed by the Rare and Imported Pathogens Laboratory (RIPL) between January 2015 and December 2023 was performed. For cases identified in 2022 and 2023, clinical data were collected for enhanced surveillance using structured case record forms. Laboratory diagnosis is reviewed and described.ResultsWe identified 21 cases: three possible, seven probable and 11 confirmed cases. Of these, 12 were between January 2022 and December 2023: three possible, three probable and six confirmed cases. Two confirmed TBE cases had definite or highly probable acquisition in the UK, in June and August 2022, respectively. One of the possible cases had definite UK acquisition. Cases typically have a biphasic presentation, with encephalitis in the second phase.ConclusionClinicians should be aware of the possibility of TBE when the cause for encephalitis is not identified, even in the absence of travel to previously identified endemic regions.

We report an adenovirus outbreak with unusually severe clinical presentation, particularly in military conscripts and their close contacts. During 1 February-30 June 2024, 129 patients with adenovirus infection were hospitalised, 30 were admitted to ICU, 10 required ECMO treatment and six died. Cases consisted of 75 conscripts (58.1%) and 54 civilians (41.9%). Most samples were type 7 (97/108; 89.8%); all 24 sequenced samples were subtype 7d. During 1 August-30 November 2024, 274 additional hospitalised cases were identified from registries.

We estimated early influenza vaccine effectiveness (VE) for the 2024/25 season in outpatients, in Beijing using a test-negative design. A(H1N1)pdm09 dominated (99.3%), all sequenced strains (n = 38) clustered in clade 6B.1A.5a.2a, and 37 of 38 antigenically similar to the vaccine strain. VE against any influenza virus infection was 48.5% (95% CI: 34.8-59.5) and 48.7% (95% CI: 35.1-59.7) against A(H1N1)pdm09. Vaccination in the current or previous season against any influenza showed a VE of 52.5% to 54.9%, compared to no vaccination in both seasons.

The 2024/25 influenza season in Europe is currently characterised by co-circulation of influenza A(H1N1)pdm09, A(H3N2) and B/Victoria viruses, with influenza A(H1N1)pdm09 predominating. Interim vaccine effectiveness (VE) estimates from eight European studies (17 countries) indicate an all-age influenza A VE of 32-53% in primary care and 33-56% in hospital settings, with some signals of lower VE by subtype and higher VE against influenza B (≥ 58% across settings). Where feasible, influenza vaccination should be encouraged and other prevention measures strengthened.

BackgroundThe global dissemination of ceftriaxone-resistant Neisseria gonorrhoeae FC428-like strains poses a public health concern. To assess and follow their spread, establishing effective antimicrobial resistance (AMR) surveillance systems is essential.AimThis study aimed to track ceftriaxone-resistant FC428-like strains in parts of China, using a molecular screening tool.MethodsSamples were collected from Sichuan, Zhejiang, Shanghai, and Guangdong provinces between 2019 and 2021. We employed a rapid molecular tool - the high-resolution melting analysis-based FC428 (HRM-FC428) assay, to screen for FC428-like strains. All FC428-like strains detected were further characterised by genotyping and PCR-sequencing.ResultsOf 1,042 tested samples, 44 harboured the penA-60.001 allele linked to ceftriaxone resistance, revealing a 4.2% prevalence of FC428-like strains. The HRM-FC428 assay additionally uncovered six strains with mosaic penA-195.001 or penA-232.001 alleles, both bearing the A311V mutation, a ceftriaxone resistance marker. During the study, the prevalence of FC428-like strains among overall samples appeared to increase, with rates of 2.8% (11/395) in 2019, 4.2% (16/378) in 2020, and 6.3% (17/269) in 2021. Some strains' sequence types (ST)s were identified across provinces (e.g. ST1903, ST1600) and most strains (24/44) were ST1903, an ST also reported in other regions/countries, suggesting local evolution and global transmission.ConclusionOur work underscores the value of culture-independent antimicrobial resistance monitoring and validates the use of molecular diagnostic tools, like the HRM-FC428 assay for this purpose. This study offers insights into the complex landscape of ceftriaxone-resistant N. gonorrhoeae, emphasising the importance of continued surveillance and global collaboration to mitigate this growing public health threat.