Eurosurveillance最新文献

A Burkholderia stabilis (ST480) outbreak associated with skin cleansing wipes has comprised 59 confirmed cases in the United Kingdom 2018-2026. Cases included patients with co-morbidities and clinically relevant infections. There was one associated death. Burkholderia stabilis was recovered from non-sterile alcohol-free cleansing wipes which did not have the relevant medicines authorisation. Products were suspended from sale though not recalled, and the outbreak continued following public health intervention. We highlight risks of potential relevance to other countries.

BACKGROUNDIn tuberculosis (TB) surveillance, genomics is mainly used to identify TB patient clusters; growing clusters are commonly attributed to ongoing transmission events.AIMThis study's objective was to explore other factors, in addition to ongoing transmission, contributing to cluster expansion.METHODSThe study population included all 1,886 culture-positive TB cases diagnosed within the whole Almería province population, Spain, between January 2003 and June 2024. Cases' Mycobacterium tuberculosis strains were whole genome sequenced enabling detection of clusters (with pairwise distance between strains < 12 single nucleotide polymorphisms (SNPs)). Evolutionary analyses positioned cases within genomic networks based on SNP distribution. This allowed, together with clinical and epidemiological data, to infer why new cases (diagnosed 3.5 years prior) entered clusters.RESULTSCases' mean age was 37.3 years (standard deviation: 16.4); 71.7% (1,352/1,886) were male and 65.2% (1,230/1,886) migrants from 50 countries, with mostly Moroccan (21.6%; 407/1,886), Romanian (10%; 188/1,886), Senegalese (8.3%; 156/1,886) and Malian (5.2%; 98/1,886) nationalities. We detected 106 clusters, comprising 537 cases in total. The 106 new cases occurred within 53 clusters, including 31 growing clusters (identified pre-2021) and 22 recent clusters (that arose in 2021 and after). Ongoing transmission was responsible for cluster expansion in around one-third of growing clusters (9/31), versus two-thirds (15/22) of recent clusters. Genomic network assessments found that newly clustered cases not due to ongoing transmission, were likely driven by reactivation of past exposures, prolonged diagnostic delays or subclinical periods, or a combination of these factors.CONCLUSIONUnderstanding cluster dynamics guides case-specific management and supports TB control.

BACKGROUNDFew studies have quantified mortality caused by healthcare-associated infections (HAIs) of all types.AIMThis work's objective was to estimate the overall impact of HAIs on mortality in Spain.METHODSSpain performs annually a point prevalence survey of HAIs and antimicrobial use in hospitalised patients. In 2022 and 2023, prospective follow-ups of patients to evaluate their status 30 days after the survey (still admitted, discharged, deceased) were additionally conducted. This information allowed assessing the effect of HAIs on mortality, by logistic regression. We calculated the attributable fraction among the exposed (patients with HAIs) and the population attributable fraction (among all hospitalised patients). Finally, we estimated the annual number of deaths attributable to HAIs.RESULTSOf 107,781 inpatients included in the study, 56,323 (52.26%) were males and 51,458 (47.7%) females. Most patients (n = 59,790; 55.47%) were ≥ 65 years old. The HAI prevalence was 7.8% (n = 8,375). Crude mortality rate was 5.7% (5,715/99,406) among patients without HAIs and 11.0% (918/8,375) among those with HAIs. The adjusted odds ratio (AOR) for inpatient mortality associated with HAIs was 1.70 (95%CI: 1.56-1.86). The attributable fraction of deaths due to HAIs among inpatients who died with a HAI was 41.2% and 3.2% among all inpatient deaths. The estimated annual number of inpatient deaths attributable to HAIs in Spain was 6,774.CONCLUSIONIn Spain, HAIs highly impact mortality. The number of deaths attributable to HAIs is over three times that caused by road traffic accidents. Addressing this requires immediate strengthening of infection prevention programmes across healthcare settings and their thorough implementation.

BACKGROUNDPregnant women and their newborns are at increased risk of severe outcomes from influenza and COVID-19 infections; maternal vaccination is recommended. However, no routine surveillance of maternal vaccine coverage exists in Norway.AIMTo provide insights into vaccination coverage and timing during pregnancy.METHODSThis population-based registry study included women who gave birth in Norway during 1 October 2023-30 September 2024. Data on influenza and COVID-19 vaccinations administered during 1 October 2023-10 May 2024 were obtained from the national immunisation registry and linked to birth data from the Medical Birth Registry Norway. Cumulative coverage included vaccines administered during pregnancy, with sub-analyses focusing on second and third trimester vaccinations, month of delivery and maternal age.RESULTSOverall influenza vaccination coverage was 29.9% (15,915/53,161), with 22.3% (11,856/53,161) vaccinated in the second or third trimester. Coverage increased from 16.4% (7,287/44,454) in October to 26.4% (12,982/49,170) in November and plateaued thereafter. Coverage peaked among women delivering in February (50.8%; 2,159/4,248) and declined afterwards. COVID-19 vaccination coverage was 12.1% (6,423/53,161) with 10.1% (5,349/53,161) in the second or third trimester, following a similar pattern to influenza. Overall, 11.4% received both vaccines. The lowest uptake (< 19%) was among women aged 25 years or younger.CONCLUSIONCoverage of maternal influenza and COVID-19 vaccinations for 2023/24 remained low, with missed opportunities to reach pregnant women beyond November 2023. Overall, the coverage was lowest among women aged 25 years or younger. Strengthened efforts are needed to increase vaccination coverage among pregnant women and reduce gaps in protection.

In interim 2025/26 analyses, the Canadian Sentinel Practitioner Surveillance Network estimates influenza vaccine reduced the risk of medically-attended acute respiratory illness due to predominant influenza A(H3N2) viruses, including antigenically distinct subclade K, by about 40% relative to unvaccinated individuals. Vaccine effectiveness was about 30% against A(H1N1)pdm09, with insufficient case numbers for interim influenza B estimation. Meaningful protection against subclade K, despite substantial vaccine mismatch, is interpreted in the context of immuno-epidemiological considerations, including potential viral glycosylation, imprinting, and pre-immunity effects.

The 2025/26 season was marked by co-circulation of influenza A subtypes, with the first detection of A(H3N2) subclade K in September 2025. In August 2025 in Portugal, 14.8% (95% CI: 12.2-17.8) of 886 persons tested had cross-protective antibodies against this subclade. The overall seroprevalence against circulating A(H1N1)pdm09 strains was 28.1% (95% CI: 24.4-32.0). These data highlight the presence of previous cross-reactive antibodies and the possible advantage of vaccination in the extent of detectable antibodies against influenza viruses.

BACKGROUNDPublic Health Intelligence (PHI) aims to detect health threats early for a timely and effective response. The PHI team at the Robert Koch Institute (RKI) uses the Epidemic Intelligence from Open Sources (EIOS) system in combination with other sources for detecting signals of international public health threats relevant to Germany. However, while EIOS is increasingly used for PHI worldwide, it is rarely evaluated.AIMWe designed and conducted an attribute-based evaluation to assess EIOS's performance for international PHI in 2023 and to identify areas for improvement.METHODSWe adapted surveillance system attributes and designed attribute-specific data collection methods. We conducted a mixed-method evaluation combining prospective and retrospective operational data collection with feedback from PHI officers.RESULTSDuring 2 weeks in July 2023, the PHI team reported 20 signals: 16 detected using EIOS and four from other sources. Increasing the number of EIOS sources increased timeliness and sensitivity slightly but caused a 35-fold increase in articles to screen (35,546 vs 1,138). The team found EIOS flexible and simple for signal detection but identified challenges in simplicity of signal documenting and reporting and in completeness of EIOS sources screened by the team.CONCLUSIONThe current use of EIOS proved sensitive and timely. However, PHI must balance sensitivity, timeliness and resource requirements. To maintain this balance, we strongly recommend regular evaluations of the use of EIOS for PHI. Our evaluation offers practical guidance for other PHI teams. We recommend integrating EIOS with an event management system to facilitate signal documentation and reporting.

In February 2022, we observed an increase in the number of paediatric patients with haemolytic uraemic syndrome (HUS) associated with Shiga toxin-producing Escherichia coli (STEC) in France. We interviewed cases or caretakers about food exposures, identified purchases on supermarket loyalty cards, conducted a case-control study, tested food samples and characterised isolates. We identified 59 cases of STEC O26:H11 or O103:H2 infections nationwide from 18 January to 5 April 2022. Fifty cases presented with HUS and two died. Data from supermarket loyalty cards identified frequent purchase of Brand A Type B frozen pizzas. A case-control study confirmed a strong association between the consumption of Brand A pizzas and illness (OR = 116.0; 95% confidence interval (CI): 26.8-501.9). Manufacturing of Brand A Type B pizzas did not include pre-baking of the dough. Isolates from pizza dough and flour samples were indistinguishable from the clinical outbreak strains. On 18 March, the manufacturer recalled the Type B pizzas. While flour is a known STEC vehicle, this outbreak is highly unusual, as cooking of frozen pizzas should eliminate STEC. Further research aiming to understand the origins and persistence of contamination should contribute to improving food safety practices.