Eurosurveillance最新文献

This case report details the public health response to a multibacillary leprosy case in Ireland. The case presented with hypopigmented skin lesions and neurological symptoms. Challenges included delayed recognition in the clinical setting, contact tracing within a congregate setting and lack of specific Irish guidelines. Comprehensive contact tracing, chemoprophylaxis and follow-up care were implemented, guided by international protocols. This case underscores the need for tailored guidelines and stigma mitigation strategies for this neglected tropical disease in non-endemic regions.

BackgroundThe potential impact of urban structure, as population density and proximity to essential facilities, on spatial variability of infectious disease cases remains underexplored.AimTo analyse the spatial variation of COVID-19 case intensity in relation to population density and distance from urban facilities (as potential contagion hubs), by comparing Alpha and Omicron wave data representing periods of both enacted and lifted non-pharmaceutical interventions (NPIs) in Málaga.MethodsUsing spatial point pattern analysis, we examined COVID-19 cases in relation to population density, distance from hospitals, health centres, schools, markets, shopping malls, sports centres and nursing homes by non-parametric estimation of relative intensity dependence on these covariates. For statistical significance and effect size, we performed Berman Z1 tests and Areas Under Curves (AUC) for Receiver Operating Characteristic (ROC) curves.ResultsAfter accounting for population density, relative intensity of COVID-19 remained consistent in relation to distance from urban facilities across waves. Although non-parametric estimations of the relative intensity of cases showed fluctuations with distance from facilities, Berman's Z1 tests were significant for health centres only (p < 0.032) when compared with complete spatial randomness. The AUC of ROC curves for population density was above 0.75 and ca 0.6 for all urban facilities.ConclusionResults reflect the difficulty in assessing facilities' effect in propagating infectious disease, particularly in compact cities. Lack of evidence directly linking higher case intensity to proximity to urban facilities shows the need to clarify the role of urban structure and planning in shaping the spatial distribution of epidemics within cities.

In 2024, circulating vaccine-derived poliovirus type 2 (cVDPV2) was detected in wastewater samples in Finland, Germany, Poland, Spain and the United Kingdom (UK). All strains were genetically linked, but sequence analysis showed high genetic diversity among the strains identified within individual wastewater sites and countries and an unexpected high genetic proximity among isolates from different countries. Taken together these results, with sequential samples having tested positive in various sites, a broader geographic distribution beyond positive sampling sites must be considered.

BackgroundThe first Corona Monitoring Nationwide (RKI-SOEP) study (October 2020-February 2021) found a low pre-vaccine SARS-CoV-2 antibody seroprevalence (2.1%) in the German adult population (≥ 18 years).AimThe objective of this second RKI-SOEP (RKI-SOEP-2) study in November 2021-March 2022 was to estimate the prevalence of SARS-CoV-2-specific anti-spike and/or anti-nucleocapsid (anti-N) IgG antibodies (combined seroprevalence), past infection based on infection-induced seroprevalence (anti-N), and basic immunisation (at least two antigen contacts through vaccination or infection) in individuals aged ≥ 14 years. We also aimed to estimate under-reporting of infections.MethodsDried blood-spot specimens from a population-based sample embedded in a dynamic cohort, the Socio-Economic Panel (SOEP), were serologically analysed. Resulting serological data and self-reports via a questionnaire from the same individuals were used to estimate prevalences.ResultsCombined seroprevalence was 90.7% (95% CI: 89.7%-91.6%) without correction and 94.6% (95% CI: 93.6%-95.7%) with correction for sensitivity/specificity and antibody waning. While one in nine individuals had been infected (11.3%; 95% CI: 9.1%-13.5%), nine in 10 had a basic immunisation (90%; 95% CI: 88.9-90.9%), primarily due to vaccination. Population-weighted estimates differed by age, region, and socioeconomic deprivation. The under-reporting factor was estimated as 1.55 (95% CI: 1.3-1.8).ConclusionsWhen the SARS-CoV-2-Omicron wave was beginning, most people had been vaccinated, infected, or both. Large-scale vaccination, but not a high infection rate, was able to fill the immunity gap, especially in ≥ 65 year-olds who are known to be at higher risk of severe COVID-19. Our data point towards the need for targeted socioeconomically, demographically and regionally stratified mitigation strategies, including measures to enhance vaccine uptake.

BackgroundThe COVID-19 pandemic resulted in increased mortality directly and indirectly associated with COVID-19.AimTo assess the impact of the COVID-19 pandemic on all-cause and disease-specific mortality and explore potential health inequalities associated with area-level deprivation in Wales.MethodsTwo population-based cohort studies were derived from multi-sourced, linked demographic, administrative and electronic health record data from 2016 to 2019 (n = 3,113,319) and 2020 to 2022 (n = 3,571,471). Data were analysed using generalised linear models adjusting for age, sex, area-level deprivation and time at risk.ResultsCOVID-19 deaths peaked in January 2021 (54.9/100,000 person-months, 95% confidence interval (CI): 52.4-57.5). The pandemic indirectly affected deaths, with higher than expected maximum relative mortality rates (RR) related to cancer (RR: 1.24, 95% CI: 1.13-1.36), infectious diseases (excluding respiratory infections) (RR: 2.09, 95% CI: 1.27- 3.43), circulatory system (RR: 1.41, 95% CI: 1.28-1.56), trauma (RR: 2.04, 95% CI: 1.57- 2.65), digestive system (RR: 1.54, 95% CI: 1.25-1.91), nervous system (RR: 1.63; 95% CI: 1.34-2.00) and mental and behavioural disorders (RR: 1.85, 95% CI: 1.58-2.16). Mortality associated with respiratory diseases (unrelated to COVID-19) were lower than expected (minimum RR: 0.52, 95% CI: 0.45-0.60). All-cause mortality was lower in least deprived communities compared with most deprived (RR: 0.61, 95% CI: 0.60-0.62), and the magnitude of this effect increased during the pandemic.ConclusionsAll-cause and disease-specific mortality directly and indirectly associated with COVID-19 increased during the COVID-19 pandemic. Socioeconomic disparities were exacerbated during this time.

IntroductionNuvaxovid became available in Australia from February 2022, a year after the first COVID-19 vaccines. This protein-based vaccine was an alternative for people who had had an adverse event to and/or were hesitant to receive an mRNA or adenovirus-based COVID-19 vaccine. Although safety from clinical trials was reassuring, small trial populations, low administration rates and limited post-licensure intelligence meant potential rare adverse events were underinformed.AimWe aimed to describe Nuvaxovid's safety profile in a real-world setting.MethodsWe conducted a retrospective observational analysis of adverse events following immunisation (AEFI) spontaneously reported to SAFEVAC, the integrated vaccine safety surveillance system in Victoria and Western Australia. Reports from 14 February 2022 to 30 June 2023 were analysed by vaccinee demographics, reported reactions and COVID-19 vaccine dose, and compared as reporting rates (RR) per 100,000 doses administered.ResultsWe received 356 AEFI reports, following 102,946 Nuvaxovid doses administered. Rates were higher after dose 1 than dose 2 (rate ratio: 1.5, p = 0.0008), primary series than booster (rate ratio: 2.4, p < 0.0001), and in females vs males (rate ratio: 1.4, p = 0.004). Clinically confirmed serious AEFI included 94 cases of chest pain (RR = 91.3), two myocarditis (RR = 1.9) and 20 pericarditis (RR = 19.4). Guillain-Barré syndrome or thrombosis with thrombocytopaenia syndromes were not reported, nor deaths attributable to vaccination.ConclusionSAFEVAC's collaborative data model enabled pooling of clinically reviewed data across jurisdictions, increasing the safety profile evidence for Nuvaxovid and improving the odds for identification and description of rare events. This analysis affirmed the safety profile of Nuvaxovid.

Shiga toxin-producing Escherichia coli (STEC) is a zoonotic pathogen associated with illness ranging from mild diarrhoea to haemolytic uremic syndrome (HUS) or even death. Cross-sectoral data sharing provides an opportunity to gain insight in reservoirs and sources of human infections and starting points for pro-active measures. Nevertheless, phylogenetic clustering of STEC strains from animals, food and human cases is low in the Dutch surveillance system. This is partly due to the substantial contribution of international travel and person-to-person spread in the STEC epidemiology. Furthermore, some STEC strains causing disease in humans may have a human reservoir. Although the main reservoirs and sources are included in the Dutch monitoring programmes, some animals and food products may be under-recognised as potential sources of human infections. More effort in investigating the role of other reservoirs beyond the well-known can provide a better understanding on STEC ecology in general, improving surveillance and source attribution, and ultimately provide better guidance for monitoring and source finding. This also implies having good diagnostics in place and isolates available for typing. Therefore, on the human side of the surveillance, the decision has been made to start isolating STEC at national level.

BackgroundDuring the 2023/24 influenza season in the European Union/European Economic Area (EU/EEA), influenza viruses A(H1N1)pdm09, A(H3N2) and B/Victoria viruses were co-circulating.AimWe aimed to describe the circulating influenza viruses by (sub)type, genetic clade, antigenic group and antiviral susceptibility in that season in the EU/EEA.MethodsWe collected surveillance data from EU/EEA countries through weekly submissions to The European Surveillance System (TESSy). Data were submitted in strain-based format for weeks 40/2023 to 9/2024.ResultsTwenty-nine EU/EEA countries reported 154,718 influenza virus detections (primary care sentinel and non-sentinel combined), of which 97% (150,692) were type A and 3% (4,026) were type B. Of the subtyped influenza A viruses, 30,463 (75%) were influenza A(H1)pdm09 and 10,174 (25%) were influenza A(H3). For 809 (20%) of the type B viruses, the lineage was determined; all were B/Victoria/2/87 lineage, and none were B/Yamagata/16/88 lineage. Genetic diversification of seasonal influenza viruses continued, and clade 5a.2a of A(H1N1)pdm09, 2a.3a.1 of A(H3N2) and V1A.3a.2 of B/Victoria-lineage viruses dominated. Of the A(H3N2) 2a.3a.1 viruses, 23% were antigenically distinct from the 2023/24 vaccine virus.ConclusionThe 2023/24 influenza season was characterised by co-circulation of different influenza (sub)types, antigenically similar to the components recommended for the 2023/24 northern hemisphere vaccine, A/Victoria/4897/2022 (egg-based) and A/Wisconsin/67/2022 (cell culture- or recombinant-based). However, genetic diversification of the viruses continued. The World Health Organization's vaccine recommendations for the northern hemisphere 2024/25 season were updated to include a new A(H3N2) component, while maintaining the current A(H1N1)pdm09 and B/Victoria components.

An outbreak of influenza A(H1N1)pdm09 viruses exhibiting cross-resistance to oseltamivir and peramivir occurred in Yokohama, Japan, in September 2024. Among 24 students in a class, 11 were diagnosed with influenza or influenza-like illness, and viruses harbouring the NA H275Y and HA Q210H substitutions were isolated from four. Deep sequencing analysis confirmed the clonal spread of these mutants. Antigenic analysis revealed differences from the vaccine strain. Continued monitoring is crucial to assess the potential for further spread of these mutant viruses.