Eurosurveillance最新文献

BACKGROUNDRotavirus is a main gastroenteritis cause in children ≤ 5 years old. In 2017, when few Italian regions had rotavirus vaccination programmes, rotavirus vaccines were included in the National Plan for Preventive Vaccination (PNPV). Although all Italian regions follow the PNPV, they each decide how to implement it, contributing to rotavirus vaccination coverage differences across the country.AIMThe objective was to assess rotavirus vaccination national/regional policies in Italy and, between 2016 and 2023, vaccination coverage trends at national and regional level.METHODSScientific and grey literature was systematically reviewed for reports on Italian national/regional policies or programmes concerning rotavirus vaccination. Their key features and strategies to increase vaccination coverage were recorded. Vaccination coverage data originating from the Ministry of Health, were analysed descriptively, or with linear regression, for national and regional trends.RESULTSAmong 418 policy/programme reports identified, 25 were included. Between 2013 and 2015, Sicilia, Calabria and Puglia had already initiated universal vaccination programmes. The PNPV 2017-19 standardised regions' offer of rotavirus vaccination. Between 2016 and 2023, vaccination coverage in Italy significantly increased (p = 0.0005) from 10.5% to 70.76%, with a 140% rise in 2019-20. Regional coverage disparities existed. Throughout 2016-23, most central Italian regions had annual coverages below national values. Bolzano annual coverage was consistently < 50%, while in Veneto, coverage reached 85.10% in 2021. In 2023, five regions had > 80% coverage.CONCLUSIONSWhile rotavirus vaccination coverage improved in Italy in 2016-23, regional disparities persist. Addressing these requires overcoming logistical and societal challenges, as well as harmonised policies.

BACKGROUNDMandatory reporting of healthcare-associated infections (HCAI) in England is conducted locally by acute hospital groups and can be a large burden on healthcare staff.AIMWe aimed to determine the case ascertainment of a potential centrally-implemented, automated HCAI surveillance system in England using preexisting data feeds at the UK Health Security Agency.METHODSWe compared monthly case numbers submitted between 1 April 2016 and 31 March 2023 by acute hospital groups (locally-implemented surveillance) to routinely-collected laboratory and hospital encounter records (centrally-implemented surveillance) for all infections under mandatory surveillance in England. Since laboratories can serve multiple hospitals, we compared several methods of assigning laboratory-confirmed cases to hospital groups.RESULTSLocally-implemented vs centrally-implemented surveillance identified: meticillin-resistant Staphylococcus aureus bacteraemias 5,453 vs 5,859 (ratio 1.07), meticillin-susceptible S. aureus bacteraemias 84,680 vs 83,326 (0.98), Escherichia coli bacteraemias 281,100 vs 275,133 (0.98), Klebsiella species bacteraemias 65,877 vs 67,301 (1.02), Pseudomonas aeruginosa bacteraemias 25,862 vs 25,715 (0.99), Clostridioides difficile infections (CDI) 94,054 v 90,942 (0. 97) respectively. Assigning hospital groups by linking laboratory records to hospital encounters produced lower monthly mean absolute difference (MAD) vs locally-implemented surveillance than using laboratory records alone. MAD was 0.65 cases/month for bacteraemias, 2.99 for CDI; differences occurred in both directions. MAD decreased over time for bacteraemias but increased from April 2021 onwards for CDI.CONCLUSIONCentrally-implemented surveillance could be feasible for bacteraemias in England due to comparable case numbers with local surveillance. However, more research is needed around understanding and managing data quality of automated feeds, particularly for CDI.

BACKGROUNDOne Health (OH) is a multisectoral approach that aims to optimise health of people, animals and the environment, recognising their interconnection. Despite gaining political support in recent years, examples of successful OH implementation among governmental institutions across the European Union/European Economic Area (EU/EEA) remain limited.AIMTo identify key enablers and barriers to collaboration across human, animal and environmental health sectors, and provide a framework to support national OH operationalisation in the EU/EEA.METHODSSemi-structured interviews were conducted with 26 experts from national public health institutes in 15 EU/EEA countries, recruited through European Centre for Disease Prevention and Control networks. Transcripts were analysed through qualitative content analysis.RESULTSCollaborations between human and animal health sectors were reported, but greater integration of the environmental sector is needed to strengthen OH partnerships. Analysis of opportunities and challenges highlighted key interlinked elements that can facilitate sustainable OH implementation. Strong political leadership emerged as pivotal to drive policy coherence in nexus areas, embed collaborative activities within core funding, and facilitate cross-sectoral partnerships at the technical level.CONCLUSIONThis qualitative study provides an overview of enablers and barriers to OH collaboration at the national level. The findings constitute the basis for an empirically derived framework emphasising the cyclical relationship between political leadership and cross-sectoral technical collaboration. Incremental steps, starting with strengthening existing cross-sectoral relationships, have the potential to generate self-reinforcing progress and enhance emergency preparedness. These empirical insights provide a foundation for developing and evaluating OH policies in EU/EEA countries, complementing existing international guidelines.

Identifying and controlling food-borne disease outbreaks (FBDO) remain important public health objectives. There is plenty of guidance on how to detect potential FBDO, e.g. epidemiologically or microbiologically. Likewise, the conduct of an outbreak investigation has long been codified in steps and adapted for FBDO. However, what is less clear is when to act, mainly when to implement appropriate control measures. This is particularly challenging when the causative agent has not yet been detected in the suspected food vehicle(s). The decision on when to act is complex and depends, besides the available evidence, also on other factors, such as the dynamic of the outbreak or the disease severity. No guidance exists for this decision. Notably, an FBDO investigation provides circumstantial evidence on the culprit, and its careful assessment entails an inherently subjective element. There is a need across sectors and countries in Europe for harmonising the view on what constitutes sufficient evidence for furthering investigations and timely taking action, depending on the outbreak situation. A common understanding and possibly a harmonised legislation are the basis for streamlining discussions and decisions during FBDO, thereby preventing the delay of implementing necessary control measures.

Finland experienced three invasive pneumococcal disease (IPD) outbreaks among shipyard workers at the same shipyard, in 2019, 2023 and 2025. During the latest outbreak (30 April-6 June 2025), 13 cases were reported, with six confirmed. All five isolates from blood culture-positive cases were serotype 4 - sequence type 801. These were nearly indistinguishable from three isolates from the 2019 outbreak, nine Finnish IPD surveillance isolates and isolates of a 2019 Norwegian shipyard outbreak. We found an association with welding.

Notifications of Salmonella Strathcona infections increased in Europe in 2023 prompting a multi-country outbreak investigation. We aimed to describe the epidemiology of S. Strathcona infections in 17 European countries 2011-2024, investigate the genetic relatedness of S. Strathcona isolates and identify the vehicle. Cases were persons residing in the study area and with a laboratory-confirmed S. Strathcona infection 2011-2024. Confirmed cases had a S. Strathcona isolate clustering with the outbreak reference strain in core genome multilocus sequence typing (cgMLST) within 7 allelic differences (AD) and possible cases within 8-13 AD. Probable cases had an epidemiological link to a confirmed case and non-outbreak cases had an isolate > 13 AD from the outbreak reference strain. Since 2011, 662 S. Strathcona infections have been identified: 469 confirmed, 161 probable, 13 possible and 19 non-outbreak cases. Median age of the cases was 34 years (IQR: 19-58 years) and 306 (47.5%) were notified in 2023-2024. Most sequenced isolates (469/496; 94.5%) were highly genetically related (≤ 7 AD) over time and across countries, compatible with a common source. Epidemiological and traceback investigations identified small tomatoes from Sicily as the suspect food vehicle. Stringent control measures at the source are needed to stop the contamination and prevent future cases.

BACKGROUNDThe Danish respiratory virus sentinel surveillance system has monitored influenza-like illness and influenza virus activity for over 30 years. During the last decade, additional virus groups were added. In 2021, the system was updated to include SARS-CoV-2, collect detailed symptomatic data, and transitioned to year-round surveillance.AIMTo explore the first two seasons of year-round respiratory virus surveillance and the first symptomatic data collected in the Danish primary care sentinel surveillance system.METHODSIn 2021/22 and 2022/23 seasons, 156 and 147 participating general practitioners, respectively, reported influenza-like illness consultation rates, collected symptomatic data and swabbed patient volunteers. Swabs were sent to Statens Serum Institut for multiplex PCR analysis, with additional characterisation using high-throughput sequencing or type-specific PCR assays for viruses such as influenza, SARS-CoV-2 and respiratory syncytial virus (RSV).RESULTSDuring the two seasons, 4,391 and 6,034 swabs, respectively, were collected and analysed. Year-round surveillance detected an unusually early wave of RSV during 2022/23. While present in nearly all weeks, SARS-CoV-2 showed waves with increased detection. Year-round surveillance also highlighted consistent patterns, such as continuous presence of entero-/rhinoviruses and endemic coronaviruses, as well as parainfluenza virus appearing after influenza virus. Symptom data showed differences by both sex and virus type, e.g. headaches were more commonly reported by women with RSV.CONCLUSIONSOur findings highlight the value of year-round respiratory virus surveillance in identifying both atypical virus activity and consistent patterns outside the winter season. Symptom data suggest the need for further research into sex-specific symptom patterns.

An outbreak of an ertapenem-resistant Klebsiella pneumoniae clone occurred in a specialist children's hospital in Liverpool, United Kingdom (UK), from April 2022 to February 2023. Carbapenem-resistant K. pneumoniae is unusual in the UK, and identification of two isolates exhibiting ertapenem resistance in the same ward in December 2022 raised concerns and triggered an outbreak investigation. Potential transmission through shared equipment was identified; a total of 11 patients were colonised and/or infected by phenotypically similar isolates. Multilocus sequence typing supported hospital transmission, and short-read whole genome sequencing (WGS) was performed on all isolates; long-read sequencing was conducted for three isolates to confidently resolve the plasmid structure. WGS confirmed a clonal outbreak and strongly supported the suspected nosocomial transmission. Detailed analysis of the resistance determinants indicated that ertapenem resistance was driven by a combination of different beta-lactamases, which would not alone convey this resistance profile, along with modifications in porin structure that suggested a synergistic interaction. These findings highlight how highly resistant strains could be mislabelled as predicted sensitive when considering genetic determinants in isolation and underscore the need to study beta-lactam resistances beyond the presence or absence of specific genes but also to consider co-occurrence.

BACKGROUNDEscherichia coli (EC) is the leading cause of bloodstream infections (BSI). The emergence of extended-spectrum beta-lactamase (ESBL) production in EC is concerning, as it may worsen infection outcomes.AIMWe aimed to assess the incidence and outcome of ESBL-EC and non-ESBL-EC BSIs in Finland in 2018-2023 and identify factors associated with death.METHODSData from national registers were used to identify EC BSIs and to determine infection origin, patient comorbidities and death within 30 days. Isolates resistant or susceptible with increased exposure to third-generation cephalosporins were defined as ESBL-producing. Trends were analysed using a binomial regression model with log link. Factors associated with 30-day case-fatality were evaluated using a multivariable logistic regression model.RESULTSIn total, 33,586 EC BSIs were identified, of which 1,916 (5.7%) were ESBL-EC BSIs. The annual incidence of ESBL-EC BSIs decreased from 7.2/100,000 to 4.9/100,000, being 3.3-fold larger for healthcare-associated than community-acquired ESBL-EC BSIs. Non-ESBL-EC BSIs showed similar but weaker trends. The 30-day case-fatality rate was 1.3-fold higher for ESBL-EC than non-ESBL-EC BSIs and 1.7-3.2-fold higher for healthcare-associated than community-acquired BSIs. Factors associated with 30-day case-fatality included age, comorbidity, male sex, and healthcare association and ESBL in patients with no or less severe comorbidities.CONCLUSIONWe observed a decline in EC BSIs in Finland in 2018-2023, especially those caused by ESBL-EC and healthcare-associated BSIs. ESBL-EC BSIs were associated with 30-day case-fatality only among patients with low comorbidity, a phenomenon requiring further investigation. Continuous surveillance of BSI pathogens, also covering BSI outcome, is essential.

BACKGROUNDGroup A Streptococcus (GAS) commonly causes mild bacterial infections but also deadly invasive disease. An upsurge in paediatric invasive GAS (iGAS) infections was observed during the last quarter of 2022 in the European Union/European Economic Area (EU/EEA) countries.AIMWe aimed to assess iGAS surveillance in the EU/EEA countries and investigate the epidemiology of iGAS infections during the 2022/23 season.METHODSWe conducted a study on GAS and iGAS surveillance to evaluate coverage and surveillance methodology across the EU/EEA countries. We collected and analysed data on paediatric iGAS cases (patients aged ≤ 16 years) occurring in September 2022-June 2023 that resulted in hospitalisation or death. Associations of severe outcome (admission to intensive care unit and/or death) with potential risk factors were estimated by logistic regression in a case-case analysis.RESULTSNineteen countries responded to the questionnaire; eleven had mandated national surveillance for iGAS before 2022. Eight countries submitted data on 1,277 paediatric iGAS cases involving hospitalisation or death: 56% were males and median age was 4 years. Sixty-three (5%) of these cases died. Severe outcome was associated with emm1 type (odds ratio (OR) = 1.73; 95% confidence interval (CI): 1.13-2.67), having a sepsis without a known anatomic source (OR = 1.73; 95% CI: 1.11-2.73) and lower respiratory tract infections (OR = 4.14; 95% CI: 2.70-6.44).CONCLUSIONSurveillance of GAS and iGAS infections varied among the participating countries. We highlight the importance of including emm typing and analysis of clinical data in iGAS surveillance and having international collaboration for effective response to future surges.