Eurosurveillance最新文献

In October-November 2025, eight autochthonous cases of monkeypox (MPXV) clade Ib virus infection were reported in the Netherlands. All cases were men who have sex with men aged 25-65; none required hospital admission or antiviral treatment. Phylogenetic analysis combined with contact tracing suggest multiple introductions or cryptic circulation with onwards transmission within the community. Highly related international sequences were identified dating back to August 2025, indicating sustained global community transmission of clade Ib outside the African continent.

BACKGROUNDWest Nile virus (WNV) and Usutu virus (USUV) outbreaks in Europe pose growing public health concerns. In Austria, human WNV and USUV infections occur nearly every year since 2009 with notable case number variations.AIMWe analysed annual incidences and spatiotemporal distributions of human WNV and USUV infections in Austria in 2009-2024.METHODSAnnual incidence rates of laboratory-confirmed WNV and USUV cases recorded through the national surveillance were calculated, stratified by age, sex, clinical presentation, exposure place and virus sequence.RESULTSDuring 2009-2024, recorded case numbers were highest in 2024, with 37 WNV (19 male/18 female; median age: 62 years, range: 18-88) and 27 USUV infections (18 male/9 female; median age: 59 years, range: 20-69). Nineteen WNV cases developed West Nile neuroinvasive disease, while no USUV cases had neurological disease. Thirty-four of the WNV cases and all USUV cases were locally acquired. In northern Burgenland, an eastern Austrian region with an avian hotspot and only sporadic cases previously reported, WNV and USUV incidences respectively rose from averages of 0.6 and 1.0 per 100,000 in previous years to 6.6 and 4.2 per 100,000 in 2024. All 25 sequences analysed in 2024 from locally acquired WNV cases were of lineage 2. Among 15 USUV sequences, 14 belonged to the Europe-2 and one to the Africa-3 clade.CONCLUSIONHuman WNV and USUV infection increases in a previously low-incidence region underscore their increasing public health impact in Austria. Strengthening surveillance and response measures is essential for early detection, guiding prevention efforts, and ensuring blood donor safety.

BACKGROUNDDual penicillin- and ciprofloxacin-resistant Neisseria meningitidis causing invasive meningococcal disease (IMD) have recently emerged in association with sequence type (ST) 3587, harbouring ROB-1 β-lactamase (bla _ROB-1) and a mutated DNA gyrase (gyrA). These strains pose a threat to current antimicrobial treatment and prophylaxis.AIMWe aimed to characterise the first dual-resistant N. meningitidis ST-3587 isolates harbouring bla _ROB-1 and a mutated gyrA identified in Spain.METHODSThree N. meningitidis isolates encoding bla _ROB-1 were identified in 2024. They were characterised by whole genome sequencing to determine capsular genogroups, ST and genetic antimicrobial resistance markers. Dated phylogenetic analysis was performed alongside global ST-3587 strains.RESULTSThe three bla _ROB-1-encoding isolates belonged to ST-3587, genogroup Y, harboured a T91I mutation in gyrA and showed resistance to penicillin and ciprofloxacin. These isolates were obtained from urethral, oropharyngeal and blood samples, each from a different patient. According to the dated phylogenetic analysis of ST-3587 and the presence of bla _ROB-1, two clades were defined: clade I and clade II. Within clade II, subclade II.I was identified, comprising isolates which, in addition to bla _ROB-1, carried the T91I mutation in gyrA. This subclade included the three Spanish isolates, which exhibited close genetic relatedness.CONCLUSIONThis study documents the emergence of N. meningitidis ST-3587 with dual resistance in Europe, including a documented urogenital infection by this lineage. Continued surveillance of antimicrobial resistance in N. meningitidis, including non-invasive cases, is crucial for timely public health responses and effective IMD prevention strategies.

In November 2023, the UK Health Security Agency was notified of PCR-confirmed group B (MenB) invasive meningococcal disease (IMD) in a 3-year-old child (Case A), followed by probable IMD in a 2-year-old (Case B, culture and PCR tests negative) attending the same nursery. An incident management team (IMT) was convened. Both children were fully vaccinated with the MenB vaccine 4CMenB (Bexsero, GSK Biologicals). All 39 children attending the nursery and nine staff received ciprofloxacin chemoprophylaxis preceded by pharyngeal swabbing. Pharyngeal swabbing yielded two MenB isolates matching Case A. Antibiotic sensitivity testing and assessment of 4CMenB vaccine coverage using the meningococcal antigen typing system (MATS) revealed the strain was not covered by the 4CMenB vaccine. Although the alternative MenB vaccine, MenB-fHbp (Trumenba, Pfizer), is only licensed from 10 years and has never been given to children previously immunised with 4CMenB, the IMT considered the benefits of outbreak control outweighed potential risks. Two doses were given 4 weeks apart to 38 children (one family declined) and all staff; there were no serious adverse events. Our findings highlight the utility of swabbing to identify outbreak strains and provide first evidence for safe use of the MenB-fHbp vaccine in children previously vaccinated with 4CMenB.

Background: Baloxavir marboxil, a cap-dependent endonuclease inhibitor, was approved in Japan in February 2018 for treatment of influenza A and B infections, making Japan the first country to introduce its clinical use.

Aim: We aimed to assess baloxavir susceptibility among seasonal influenza viruses in Japan during the first seven seasons of clinical use, from 2017/18 to 2023/24.

Methods: We conducted nationwide surveillance on 3,671 influenza viruses using phenotypic and genotypic assays to evaluate baloxavir susceptibility and identify amino acid substitutions in the polymerase acidic (PA) protein associated with reduced susceptibility.

Results: Overall, 1.7% of tested viruses exhibited reduced susceptibility to baloxavir. Influenza A(H3N2) viruses showed the highest frequency (3.6%), followed by influenza A(H1N1)pdm09 (0.9%); no influenza B viruses exhibited reduced susceptibility. Key PA substitutions included E23K, Y24C, I38M/N/S/T/V and E199G/K. Viruses with reduced susceptibility were detected in both treated and untreated individuals. Reduced susceptibility was most frequent during the 2018/19 (4.6%) and 2022/23 (3.2%) seasons, both dominated by A(H3N2) viruses. Notably, the 2018/19 season coincided with peak baloxavir supply to medical institutions, while subsequent seasons with lower antiviral use showed a lower proportion of reduced-susceptibility viruses.

Conclusion: Our findings suggest a possible association between the extent of baloxavir use and the emergence of resistance and highlight how circulating subtypes shape seasonal susceptibility profiles. Although reduced susceptibility to baloxavir remains relatively rare, emergence of transmissible virus variants emphasises the need for continued phenotypic and genotypic surveillance to guide treatment strategies, support public health preparedness, and prevent the spread of resistant viruses.

During the early 2025/26 influenza season, influenza A(H3N2) subclade K rapidly predominated in Beijing, China. Using a test-negative design, we estimated influenza vaccine effectiveness (VE) among influenza-like illness outpatients tested between September and December 2025. Among 9,579 participants, sequencing of 316 randomly selected A(H3N2)-positive samples showed 84.8% were subclade K, and antigenic analysis of 65 viruses indicated antigenic divergence. Despite this, adjusted VE against laboratory-confirmed influenza was 41.3% (95% CI: 29.2 to 51.3), indicating moderate protection during this subclade K-dominated season.

BACKGROUNDRespiratory syncytial virus (RSV) is a leading cause of morbidity and mortality in young children and older adults. A long-acting anti-RSV monoclonal antibody (nirsevimab) and bivalent pre-fusion F-protein pregnancy vaccine became available to prevent RSV in young children in 2024; two RSV vaccines for adults ≥ 60 years were also available.AIMTo report 2024 RSV epidemiology in Australia, identify risk factors for severe outcomes, and use and effectiveness of RSV immunisation products.METHODSNational sentinel hospital-based RSV surveillance was established in 2024, recruiting hospitalised laboratory-confirmed RSV cases and test-negative controls from 22 sites in a national hospital network (FluCAN-PAEDS).RESULTSBetween April and December 2024, 3,998 subjects (3,415 children; 582 adults) were hospitalised with RSV. Most cases were infants < 12 months (n = 1,534; 38.4%); 1,661 (41.5%) had underlying medical conditions. Children < 6 months, First Nations children, those born preterm or with underlying medical conditions (cardiac, neurological, genetic and metabolic disease/disorders, immunosuppression) were at greatest risk of severe outcomes. Severe outcomes were more frequent in adults with malignancy, respiratory or cardiac disease. Nirsevimab effectiveness against hospitalisation in infants < 12 months in the two Australian jurisdictions with population-wide immunisation programmes was 83.1% (95% CI: 67.4-91.3). RSV vaccine use (pregnancy; adults ≥ 60 years) was limited, precluding effectiveness assessments.CONCLUSIONNational surveillance enabled timely 2024 data collection with the capability to evaluate effectiveness of immunisation products preventing RSV. Nirsevimab demonstrated comparable effectiveness to that in the northern hemisphere, informing Australia's 2025 strategy. Evaluation to assess the impact of more widespread uptake of RSV prevention products continues.

The recast Urban Wastewater Treatment Directive (UWWTD) calls for monitoring antimicrobial resistance (AMR) in wastewater of large European agglomerations (≥ 100,000 person equivalents). Guidance on scope and methods is currently in development. Two European Joint Actions share a goal to harmonise procedures and indicators: the European Union (EU)-Wastewater Integrated Surveillance for Public Health (EU-WISH), aiming to strengthen wastewater-based surveillance (WBS) for public health and the EU-Joint Action Antimicrobial Resistance and Healthcare Associated Infections (EU-JAMRAI) 2, providing among others, approaches for environmental surveillance of AMR. An EU-WISH survey in 2024, mapping WBS AMR-related activities across Europe, revealed that of 27 countries surveyed, 11 had an operative AMR WBS system and mainly employed WBS to determine AMR trends, primarily through culture-based analyses, in-depth characterisation of specific bacteria, and quantitative PCR for specific resistance genes. Occasionally metagenomics was used. We argue that prioritising AMR WBS targets should consider the intended objectives of surveillance, which could include uncovering AMR trends and emerging AMR determinants in humans, the assessment of antimicrobial/AMR environmental release, and wastewater treatment efficiency. Targets should be assessed for their public health relevance and the usefulness of complementary information they provide, while integrating measurability, resource efficiency, and expertise from different One Health domains.