Eurosurveillance最新文献

BACKGROUNDCandidozyma auris has emerged globally as a major threat to public health due to its outbreak causing capacity and antifungal resistance. Outbreaks have proven difficult to control despite enhanced infection prevention measures. Thus, national surveillance is warranted.AIMWe aim to characterise the epidemiology of C. auris cases in Czechia between 2022 and 2024 to investigate whether autochthonous spread is occurring and asses antifungal resistance.METHODSHigh-resolution genotyping was performed to assess genetic relatedness between isolates. Microbroth dilution was performed on all isolates and underlying mechanisms resistance were inspected with whole genome sequencing.RESULTSEight cases from seven different hospitals were reported, mainly collected from non-sterile sites, in addition to the first documented prosthetic joint infection by C. auris. Only two patients reported travel history. Three clades were found, with the first report of Clade IV in Europe. For one patient, initial isolates were pan-susceptible but after short exposure to fluconazole became resistant with a novel mechanism.CONCLUSIONC. auris reported in Czechia in patients without travel history suggests autochthonous spread. Three clades were present, often with unknown route of introduction. Development of fluconazole resistance upon brief exposure highlights the ability of C. auris to rapidly evolve.

Older adults are at increased risk of severe chikungunya. Some countries advise against vaccinating ≥ 60 or ≥ 65-year-olds with the licenced live-attenuated vaccine (CHIKV LA, IXCHIQ), following severe adverse event (SAE) reports. A virus-like particle vaccine (CHIKV VLP, VIMKUNYA) is licensed in the United States (US), EU/EEA and the United Kingdom. Up to 31 August 2025, over 12,500 doses were administered in US and Germany; no SAEs in ≥ 65-year-olds were reported. Early post-authorisation data support its favourable safety profile in ≥ 65-year-olds.

New and emerging infections with blood-borne pathogens pose an ongoing threat to the safety of blood transfusions and transplants. Bioarchives of stored blood donor samples represent a valuable pathogen screening resource for both ensuring safety of blood transfusions and for wider public health infectious disease surveillance. Large scale testing of donors enables early detection of pathogen spread and extent of population exposure. We have implemented two complementary systems for the bioarchiving of blood donor samples in England for these purposes. The CODONET bioarchive collects samples from geographically targeted regions of potential pathogen emergence. Consenting donors provide detailed information to allow for risk assessment and, importantly, to distinguish imported from autochthonously acquired infection. Separately, the blood donor surveillance archive (BDSA) stores 100 or 200 pools of 24 randomly selected, fully anonymised donation samples from donors in England every 2 weeks, allowing large-scale continuous sampling. This enables rapid evaluation of the presence of blood-borne pathogens in donor populations and a large-scale epidemiological tool to detect pathogen emergence in real-time. Combined, these bioarchives allow for proactive assessment of donation transmission risk, and as targeted population-wide archives, contribute to public health surveillance of emerging pathogens and pandemic spread.

INTRODUCTIONChildhood vaccination coverage has declined in recent years in many countries, including the Netherlands.AIMTo understand differences in coverage between population subgroups in the Netherlands over time, we studied sociodemographic factors associated with measles-mumps-rubella (MMR) and diphtheria-tetanus-pertussis-poliomyelitis (DTaP-IPV) vaccination.METHODSWe conducted a national retrospective database study including children born between 2008 and 2020. Individual-level data linkage allowed examination of associations of sociodemographic variables with MMR and DTaP-IPV vaccination status at age 2 years. We calculated coverage for each variable, stratified by birth cohort. Multivariable Poisson regression assessed independent associations and changes in coverage over time.RESULTSMMR coverage decreased in all population subgroups (overall 95% in cohort 2008 and 89% in cohort 2020), more substantially in some. In multivariable analysis, children of non-Dutch origin, particularly Moroccan and Turkish origin, showed more pronounced declines (respectively -25% and -12% as children of Dutch origin in cohort 2020). Among children not attending daycare and children living in larger families (≥ 4 children), coverage declined faster than in those attending daycare and living in smaller families (both -12% in cohort 2020). Coverage among children of self-employed mothers and children in the lowest income households was lower than among children of mothers in employment and the highest income households (respectively -8% and -7% in cohort 2020). Trends for DTaP-IPV vaccination were nearly identical.CONCLUSIONChildhood vaccination coverage in the Netherlands declined substantially, with increasing disparities between sociodemographic groups. Vaccination efforts should be prioritised to protect public health equitably.

We report a confirmed autochthonous human case of classical rabies in Romania involving an individual in their mid-40s from Iași county, who was bitten by a free-roaming dog in February 2025. The case did not receive post-exposure prophylaxis (PEP) and died from rabies in July 2025. This event highlights critical gaps in rabies prevention, the importance of timely PEP, and the need for continued vigilance in rabies surveillance and public health communication.

Between 1 November and 12 December 2019, a Legionnaires' disease (LD) outbreak occurred in the Strasbourg metropolitan area, France. Epidemiological, environmental and genomic investigations (nested sequence-based typing and whole genome sequencing (WGS)) were undertaken to locate the outbreak source, characterise the causal Legionella strain, and understand its spread. Through a positive urinary antigen test, 28 cases (14 male; 14 female) with 70 years median age (range: 42-88 years) were diagnosed. Two died. For nine cases, typing revealed L. pneumophila serogroup 1 (Lp 1) sequence type (ST) 62 infection. Mapping where cases were during their incubation period pointed to a place south-west of Strasbourg city as the outbreak epicentre. There, in the biomass condensing boiler of a heating plant, high Lp 1 contamination levels (105-106 CFU/L) were discovered. Eight environmental Lp 1 isolates from inside the plant were ST62. Analysing WGS data from these isolates and the nine Lp 1 ST62 clinical isolates, found their sequences clustering with zero to two single nt polymorphisms. Sub-optimal maintenance and warm weather before the boiler started operating may have allowed Lp 1 proliferation within, with boiler fumes subsequently disseminating Lp 1, thereby exposing people. This outbreak highlights potential LD risks arising from innovative energy-saving heat production processes designed to reduce greenhouse gas emissions.

BACKGROUNDIn Scotland, the number of pertussis infections recorded in children in 2024 was the highest of any year in the last decade. The protective role of vaccination against severe infection and associated hospitalisations has not been assessed.AIMTo investigate the effect of vaccination and sociodemographic factors on pertussis-related hospitalisations in Scottish children aged under 18 years.METHODSIn a retrospective cohort study, laboratory-confirmed pertussis cases from January 2013 to July 2024 were extracted from the national electronic surveillance system and linked to hospitalisation data from Scottish Morbidity Records and vaccination data from the national immunisations database. The outcome was a pertussis-associated hospitalisation. Multivariable logistic regression was used to calculate odds ratios (OR) for the association between vaccination status and hospitalisation, adjusted for age, sex, ethnicity and deprivation status.RESULTSThere were 3,982 laboratory-confirmed cases of pertussis during the study period. Children fully vaccinated for age had significantly lower odds of hospitalisations than unvaccinated children (adjusted OR (aOR): 0.31; 95% CI: 0.21-0.46). Being partially vaccinated for age did not significantly reduce hospitalisations relative to unvaccinated children (aOR: 0.80; 95% CI: 0.47-1.33). In the univariable analysis, children living in the most deprived areas had significantly more hospitalisations than those in the least deprived areas (OR: 3.90; 95% CI: 2.41-6.56). This association was not significant when adjusted for the effect of vaccination (aOR: 1.47; 95% CI: 0.84-2.66).CONCLUSIONSFully vaccinated children had significantly lower odds of hospitalisation, indicative of less severe disease. This emphasises the importance of fully vaccinating children according to the childhood immunisation schedule.

BACKGROUNDContact investigation of index cases is important for tuberculosis (TB) control in low-incidence countries, yet key performance metrics have not been evaluated in Germany.AIMWe aimed to assess the yield of TB contact investigations, compliance with national guidelines and risk factors for infection among contacts.METHODSWe analysed anonymised data of TB patients and their contacts collected between 2018 and 2022 in Upper Bavaria, Germany. We assessed testing coverage, latent TB infection (LTBI), TB yield, primary prophylaxis and preventive treatment coverage. Risk factors for M. tuberculosis infection (positive tuberculin skin test (TST) / interferon-gamma release assay (IGRA) and/or TB diagnosis) among contacts were identified using multivariable logistic regression and classification tree.RESULTSOf the 2,186 contacts of 174 TB patients, 2,022 (92.5%) had a valid TST/IGRA result and/or a TB diagnosis. Of these, 308 (15.2%) had M. tuberculosis infection, including 10 (0.5%) with TB. Of 241 contacts with LTBI, 66 (28.2%) completed preventive treatment. Among 124 children < 5 years, testing coverage was 75.8%, 16.9% received an immediate chest X-ray and 72.7% primary prophylaxis. Key predictors of infection were born outside Germany (odds ratio (OR) = 2.85; 95% confidence interval (CI): 1.94-4.21) and exposure in community housing (OR = 2.65; 95% CI: 1.65-4.30; reference: exposure at work) or household/family (OR = 2.62; 95% CI: 1.74-4.00).CONCLUSIONWe observed high screening coverage of contacts and yield and risk factors comparable to other low-incidence settings. There is room for improvement regarding preventive treatment and screening of children < 5 years.