Eurosurveillance最新文献

BACKGROUNDAeromonas, Campylobacter and Salmonella species can cause gastrointestinal infections in humans. Information on the performance of detection methods is relevant to assess the impact of changes on surveillance.AIMWe aimed to assess detection of Aeromonas, Campylobacter and Salmonella by culture and Seegene multiplex real-time PCR in faecal samples from patients with gastrointestinal symptoms.METHODSIn 2023, all faecal samples submitted to a clinical microbiology laboratory in Sydney, Australia, were tested for Aeromonas, Campylobacter and Salmonella species by culture and Seegene PCR, both detecting at the genus level. The results were analysed descriptively and with binomial generalised linear model, quantile regression, censored regression model and Wald tests.RESULTSOf the 90,291 samples tested, more samples were positive with PCR than with culture for Aeromonas (PCR: 2.9%; culture: 0.5%) and Campylobacter (PCR: 4.2%; culture: 3.1%), but fewer for Salmonella species (PCR: 0.7%; culture: 0.8%). Of the culture-positive samples, 19.2% were negative for Aeromonas by PCR, 3.6% for Campylobacter and 23.0% for Salmonella. Of the PCR-positive samples, 81.9% were negative for Aeromonas by culture, 25.6% for Campylobacter and 14.2% for Salmonella. Quantification cycle (Cq) values were negatively associated with patient age for Aeromonas, indicating higher bacterial loads in older patients and positively associated with age for Campylobacter, indicating lower bacterial loads in older patients (p < 0.001). Also, Cq values were negatively associated with detection by culture and faecal calprotectin levels (p < 0.001).CONCLUSIONThese findings highlight the importance of pathogen- and method-specific interpretation of PCR and culture results in diagnostic testing and surveillance.

Annual reformulation and approval of seasonal influenza vaccines necessitate yearly evaluation of their effectiveness. Regulatory agencies, including the European Medicines Agency (EMA), rely on timely, real-world evidence to inform product-specific benefit-risk assessments. We explored the feasibility of conducting annual, brand-specific influenza vaccine effectiveness studies in Denmark, Finland and Sweden, starting with the 2024/25 season. These countries maintain population-wide vaccination, clinical and laboratory registers, linkable via personal identification numbers and updated in near real-time. We discuss suitable study designs and document that cohort studies using a target trial emulation (TTE) framework are feasible in all three countries; register-based test-negative case-control design (TND) studies are currently only feasible in Denmark. Supplementary methods, including regression discontinuity and negative control outcome analyses, can address residual bias. This Nordic collaboration has proven capacity for large-scale register-based studies and its infrastructure is able to address EMA's requirements for timely, robust post-authorisation evidence to guide public health and regulatory decisions.

Genomic surveillance during an influenza surge between November and early December 2025 at a university health clinic in the United States identified A(H3N2) subclade K (J.2.4.1) viruses with shared haemagglutinin amino acid substitutions in antigenic sites and the receptor-binding domain. An epitope-based model indicated reduced vaccine protection (mean predicted protection 0.13). Phylodynamic analyses suggested multiple introductions with onward campus-to-community spread, highlighting that universities and other semi-closed settings can amplify transmission and aid early characterisation of emerging lineages.

BACKGROUNDPortugal is establishing a surveillance system for severe acute respiratory infection (SARI). Data from its existing influenza surveillance system in intensive care units (ICU), operating since 2012, has not yet been analysed.AIMWe aimed to identify individual and seasonal determinants of death from influenza in ICUs to inform ICU capacity planning, triage and SARI surveillance.METHODSWe conducted a retrospective cohort study of laboratory-confirmed influenza cases admitted to 27 ICUs between 2012 and 2024. Covariates included demographics, comorbidities, season, influenza type, seasonal and weekly influenza caseload in the ICU and weekly ICU occupancy. We calculated case fatality rates and adjusted risk ratios (aRR) for death during ICU admission using log-binomial regression. Directed acyclic graphs informed model-specific adjustments, including age, sex, influenza type and comorbidities.RESULTSOf 1,071 cases with known outcome, 262 (24%) died. Case fatality rates were higher among patients with chronic liver disease (aRR: 2.0; 95% CI: 1.5-2.6), cancer (aRR: 1.6; 95% CI: 1.1-2.1) and during a high caseload season (aRR: 1.52; 95% CI: 1.16-2.05). Case fatality rates increased with age and were highest for those aged ≥80 years (aRR: 11; 95% CI: 2.4-184), compared with 0-19-year-olds.CONCLUSIONLiver disease, cancer and older age were associated with increased fatality. Case fatality was higher in seasons with higher caseloads but showed no significant variation within seasons and did not increase during influenza peaks. These findings inform ICU triage and capacity planning for future seasons and support the implementation of broader SARI surveillance.

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 weeks 40/2025 and 04/2026. Among 10,484 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 23.5% (95% confidence interval: 11.7-33.7), indicating modest protection during this subclade K-dominated season.

Transmitted integrase inhibitor resistance in newly diagnosed HIV remains rare. We report two cases with baseline resistance to all currently available integrase inhibitors in the Netherlands in 2025. Clinical history and laboratory findings indicate possible transmitted resistance. The cases are not phylogenetically linked, representing two independent introductions of integrase inhibitor resistant HIV into the Dutch population. These observations highlight the need for strengthened surveillance and prevention efforts in Europe and globally.

BACKGROUNDThe World Health Organization aims to eliminate hepatitis B virus (HBV) by 2030 through reducing incidence and mortality. Accurate prevalence estimates are crucial to guide policies and monitor progress towards HBV elimination. However, HBV prevalence can be overestimated when relying solely on hepatitis B surface antigen (HBsAg) because of unconfirmed or false-positive results. Robust screening algorithms to improve diagnostic accuracy and minimise false positives are required.AIMWe conducted a nationwide, population-based serosurvey to estimate HBV prevalence in Belgium by using HBsAg alone or combined with hepatitis B core antibody (anti-HBc) positivity as infection criterion.METHODSWe analysed HBsAg and anti-HBc in a total of 4,955 left-over serum samples from severe acute respiratory syndrome coronavirus 2 sero-epidemiology studies in 2020. Samples were stratified per region, 10-year age band and sex. A confirmatory anti-HBc neutralisation assay was performed in discordant samples.RESULTSWe detected HBsAg in 0.75% (37/4,955) of samples, of which 62.2% (23/37) were anti-HBc-negative and showed no specific anti-HBc signal in the neutralisation assay. None of the samples from ≤ 5-year-olds (n = 87) were double-positive. Weighted analysis estimated HBsAg seroprevalence at 0.74% (95% confidence interval (CI): 0.50-1.04). However, considering double HBsAg and anti-HBc positivity, an HBV prevalence of 0.25% (95% CI: 0.13-0.42) was retained. The HBsAg/anti-HBc prevalence in ≤ 33-year-olds was lower than in older adults (0.079% vs 0.36%; p = 0.015), consistent with Belgium's vaccination policy.CONCLUSIONThis serosurvey reinforces the importance of confirmatory anti-HBc testing in HBsAg-positive samples, particularly in low-endemic countries. Incorporating anti-HBc testing improves the correctness of prevalence estimates.

BACKGROUNDChagas disease (CD), a tropical parasitic disease caused by Trypanosoma cruzi, is increasingly recognised as a public health concern among Latin American migrants living in non-endemic settings. In London, United Kingdom (UK), home to over 160,000 people from endemic countries, no formal population-level CD screening programmes exist.AIMTo investigate the seroepidemiology of CD infection in Latin American adults living in London, UK.METHODSA cross-sectional, observational study utilising questionnaires and serological (T. cruzi) screening was performed between August 2023 and January 2025. Adults born in South America, Central America or Mexico (or whose mothers were born there) were eligible to participate. Screening was offered in primary care sites and by point-of-care serological testing at community events. Outcomes were seroprevalence, screening yield, positive predictive value of screening tests and linkage to care.RESULTSIn primary care, of 2,739 eligible individuals offered screening, 276 (10.1%) accepted. At community events, 247 were screened. Of the 523 screened, 20 (3.8%) participants had positive screening tests, and CD was confirmed in 14 (2.7%), all born in Bolivia. Seroprevalence was lower in those screened in primary care (1.1%) than at community events (4.5%). The number needed to screen to detect one confirmed case (linked into care) was 37 overall, 92 in primary care and 22 at community events.CONCLUSIONSScreening for CD through primary care in the UK is highly challenging, with both low uptake and low yield amongst those tested. Targeted community-based outreach approaches result in higher screening yield and linkage to care.

During autumn 2025, drifted influenza A(H3N2) subclade K and A(H1N1)pdm09 subclade D.3.1. and D.3.1.1 viruses were detected in Finland. We assessed antibody responses against 2024/25 vaccine and 2025/26 epidemic influenza A strains among 46 Finnish healthcare workers before and after influenza vaccination with the 2024/25 vaccine; this vaccine included identical A(H1N1)pdm09 but different A(H3N2) strains compared with the 2025/26 vaccine. Neutralising antibody responses were markedly reduced against the A(H3N2) subclade K virus and titres for certain A(H1N1)pdm09 strains were reduced.