Eurosurveillance最新文献

BACKGROUNDThe Danish respiratory virus sentinel surveillance system has monitored influenza-like illness and influenza virus activity for over 30 years. During the last decade, additional virus groups were added. In 2021, the system was updated to include SARS-CoV-2, collect detailed symptomatic data, and transitioned to year-round surveillance.AIMTo explore the first two seasons of year-round respiratory virus surveillance and the first symptomatic data collected in the Danish primary care sentinel surveillance system.METHODSIn 2021/22 and 2022/23 seasons, 156 and 147 participating general practitioners, respectively, reported influenza-like illness consultation rates, collected symptomatic data and swabbed patient volunteers. Swabs were sent to Statens Serum Institut for multiplex PCR analysis, with additional characterisation using high-throughput sequencing or type-specific PCR assays for viruses such as influenza, SARS-CoV-2 and respiratory syncytial virus (RSV).RESULTSDuring the two seasons, 4,391 and 6,034 swabs, respectively, were collected and analysed. Year-round surveillance detected an unusually early wave of RSV during 2022/23. While present in nearly all weeks, SARS-CoV-2 showed waves with increased detection. Year-round surveillance also highlighted consistent patterns, such as continuous presence of entero-/rhinoviruses and endemic coronaviruses, as well as parainfluenza virus appearing after influenza virus. Symptom data showed differences by both sex and virus type, e.g. headaches were more commonly reported by women with RSV.CONCLUSIONSOur findings highlight the value of year-round respiratory virus surveillance in identifying both atypical virus activity and consistent patterns outside the winter season. Symptom data suggest the need for further research into sex-specific symptom patterns.

An outbreak of an ertapenem-resistant Klebsiella pneumoniae clone occurred in a specialist children's hospital in Liverpool, United Kingdom (UK), from April 2022 to February 2023. Carbapenem-resistant K. pneumoniae is unusual in the UK, and identification of two isolates exhibiting ertapenem resistance in the same ward in December 2022 raised concerns and triggered an outbreak investigation. Potential transmission through shared equipment was identified; a total of 11 patients were colonised and/or infected by phenotypically similar isolates. Multilocus sequence typing supported hospital transmission, and short-read whole genome sequencing (WGS) was performed on all isolates; long-read sequencing was conducted for three isolates to confidently resolve the plasmid structure. WGS confirmed a clonal outbreak and strongly supported the suspected nosocomial transmission. Detailed analysis of the resistance determinants indicated that ertapenem resistance was driven by a combination of different beta-lactamases, which would not alone convey this resistance profile, along with modifications in porin structure that suggested a synergistic interaction. These findings highlight how highly resistant strains could be mislabelled as predicted sensitive when considering genetic determinants in isolation and underscore the need to study beta-lactam resistances beyond the presence or absence of specific genes but also to consider co-occurrence.

BACKGROUNDEscherichia coli (EC) is the leading cause of bloodstream infections (BSI). The emergence of extended-spectrum beta-lactamase (ESBL) production in EC is concerning, as it may worsen infection outcomes.AIMWe aimed to assess the incidence and outcome of ESBL-EC and non-ESBL-EC BSIs in Finland in 2018-2023 and identify factors associated with death.METHODSData from national registers were used to identify EC BSIs and to determine infection origin, patient comorbidities and death within 30 days. Isolates resistant or susceptible with increased exposure to third-generation cephalosporins were defined as ESBL-producing. Trends were analysed using a binomial regression model with log link. Factors associated with 30-day case-fatality were evaluated using a multivariable logistic regression model.RESULTSIn total, 33,586 EC BSIs were identified, of which 1,916 (5.7%) were ESBL-EC BSIs. The annual incidence of ESBL-EC BSIs decreased from 7.2/100,000 to 4.9/100,000, being 3.3-fold larger for healthcare-associated than community-acquired ESBL-EC BSIs. Non-ESBL-EC BSIs showed similar but weaker trends. The 30-day case-fatality rate was 1.3-fold higher for ESBL-EC than non-ESBL-EC BSIs and 1.7-3.2-fold higher for healthcare-associated than community-acquired BSIs. Factors associated with 30-day case-fatality included age, comorbidity, male sex, and healthcare association and ESBL in patients with no or less severe comorbidities.CONCLUSIONWe observed a decline in EC BSIs in Finland in 2018-2023, especially those caused by ESBL-EC and healthcare-associated BSIs. ESBL-EC BSIs were associated with 30-day case-fatality only among patients with low comorbidity, a phenomenon requiring further investigation. Continuous surveillance of BSI pathogens, also covering BSI outcome, is essential.

BACKGROUNDGroup A Streptococcus (GAS) commonly causes mild bacterial infections but also deadly invasive disease. An upsurge in paediatric invasive GAS (iGAS) infections was observed during the last quarter of 2022 in the European Union/European Economic Area (EU/EEA) countries.AIMWe aimed to assess iGAS surveillance in the EU/EEA countries and investigate the epidemiology of iGAS infections during the 2022/23 season.METHODSWe conducted a study on GAS and iGAS surveillance to evaluate coverage and surveillance methodology across the EU/EEA countries. We collected and analysed data on paediatric iGAS cases (patients aged ≤ 16 years) occurring in September 2022-June 2023 that resulted in hospitalisation or death. Associations of severe outcome (admission to intensive care unit and/or death) with potential risk factors were estimated by logistic regression in a case-case analysis.RESULTSNineteen countries responded to the questionnaire; eleven had mandated national surveillance for iGAS before 2022. Eight countries submitted data on 1,277 paediatric iGAS cases involving hospitalisation or death: 56% were males and median age was 4 years. Sixty-three (5%) of these cases died. Severe outcome was associated with emm1 type (odds ratio (OR) = 1.73; 95% confidence interval (CI): 1.13-2.67), having a sepsis without a known anatomic source (OR = 1.73; 95% CI: 1.11-2.73) and lower respiratory tract infections (OR = 4.14; 95% CI: 2.70-6.44).CONCLUSIONSurveillance of GAS and iGAS infections varied among the participating countries. We highlight the importance of including emm typing and analysis of clinical data in iGAS surveillance and having international collaboration for effective response to future surges.

BACKGROUNDAdvanced outbreak analytics were instrumental in informing governmental decision-making during the COVID-19 pandemic. However, systematic evaluations of how modelling practices, data use and science-policy interactions evolved during this and previous emergencies remain scarce.AIMThis study assessed the evolution of modelling practices, data usage, gaps, and engagement between modellers and decision-makers to inform future global epidemic intelligence.METHODSWe conducted a two-stage semiquantitative survey among modellers in a large European epidemic intelligence consortium. Responses were analysed descriptively across early, mid- and late-pandemic phases. We used policy citations in Overton to assess policy impact.RESULTSOur sample included 66 modelling contributions from 11 institutions in four European countries. COVID-19 modelling initially prioritised understanding epidemic dynamics; evaluating non-pharmaceutical interventions and vaccination impacts later became equally important. Traditional surveillance data (e.g. case line lists) were widely available in near-real time. Conversely, real-time non-traditional data (notably social contact and behavioural surveys) and serological data were frequently reported as lacking. Gaps included poor stratification and incomplete geographical coverage. Frequent bidirectional engagement with decision-makers shaped modelling scope and recommendations. However, fewer than half of the studies shared open-access code.CONCLUSIONSWe highlight the evolving use and needs of modelling during public health crises. Persistent gaps in the availability of non-traditional data underscore the need to rethink sustainable data collection and sharing practices, including from for-profit providers. Future preparedness should focus on strengthening collaborative platforms, research consortia and modelling networks to foster data and code sharing and effective collaboration between academia, decision-makers and data providers.

A German traveller developed leg oedema with adenolymphangitis after a 3-week trip to Sri Lanka. Laboratory tests showed slight eosinophilia, positive filarial serology and motile microfilariae in day and night-time blood samples. PCR revealed 99% homology for Brugia malayi. Lymphatic filariasis has been eliminated in Sri Lanka, but zoonotic B. malayi has re-emerged. Physicians need to be alert and consider filariasis as potential differential diagnosis. Surveillance and vector control efforts should be sustained to prevent resurgence in Sri Lanka.

We report a case of a mild, self-limited rash illness in a child 18 days after measles-mumps-rubella-varicella vaccination. Initial testing with a PCR-based method failed to detect vaccine virus. Sequencing later identified a novel mutation in the probe-binding site of the vaccine assay that had arisen after vaccination and resulted in the false-negative PCR test results.

Between December 2024 and August 2025, two Italian HIV/STI clinics offered long-acting injectable cabotegravir (CAB-LA) for HIV prevention in 265 individuals, representing the first European real-world implementation. Participants were prioritised based on vulnerabilities compromising oral pre-exposure prophylaxis (PrEP), such as poor adherence, comorbidities and behavioural barriers. Adherence to injections exceeded 95%, tolerability was favourable and only 1.5% discontinued for drug-related reasons. These findings demonstrate the feasibility of CAB-LA in European clinical services and support its use in specific populations.