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Medscape Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
Rates of hospitalisation, rehospitalisation, and complications are higher among people with diabetes. Medscape UK
Læs mereMedscape Infectious Diseases, 1.03.2024
Tilføjet 1.03.2024
Herpes simplex virus (HSV) is associated with an increased risk for dementia but cytomegalovirus (CMV) is not, new observational data suggested. Medscape Medical News
Læs mereSophie Landré, Florence Ader, Olivier Epaulard, Pierre Tattevin, Jean Paul Stahl, Alexandra Mailles and on behalf of the Steering committee and Investigators
Eurosurveillance latest updates, 9.02.2024
Tilføjet 9.02.2024
BackgroundData on infectious encephalitis in immunodeficient (ID) individuals are scarce. This population may present with atypical clinical symptoms, be infected by uncommon pathogens and develop poor outcomes. AimWe aimed to describe the epidemiology of infectious encephalitis among HIV-negative ID patients. MethodsPatients from the ENCEIF (Etude Nationale de Cohorte des Encéphalites Infectieuses en France) prospective cohort meeting criteria for infectious encephalitis between January 2016 and December 2019 were included. We compared clinical presentation, magnetic resonance imaging (MRI) results, biological results, infection causes and outcome of ID patients with immunocompetent (IC) patients using Pearson’s chi-squared test and Student’s t-test. We carried out logistic regression to assess the role of immunodeficiency as risk factor for poor outcome. ResultsID patients (n = 58) were older (mean 72 vs 59 years), had higher prevalence of diabetes (26% vs 12%), pre-existing neurological disorders (12% vs 5%) and higher case-fatality rate (23.6% vs 5.6%) compared to IC patients (n = 436). Varicella zoster virus was the primary cause of encephalitis in ID patients (this aetiology was more frequent in ID (25.9%) than in IC patients (11.5%)), with herpes simplex virus second (22.4% in ID patients vs 27.3% in IC patients). Immunodeficiency was an independent risk factor for death or major sequelae (odds ratio: 3.41, 95%CI: 1.70–6.85). ConclusionsVaricella zoster virus is the most frequent cause of infectious encephalitis in ID patients. Immunodeficiency is a major risk factor for poor outcome. ID encephalitis patients should benefit from stringent investigation of cause and early empiric treatment.
Læs mereStefano Orru', Sibylle Bierbaum, Alexander Enk, Hartmut Hengel, Marcus Hoffelner, Daniela Huzly, Brigitte Keller-Stanislawski, Vera Mahler, Maja Mockenhaupt and Doris Oberle
Eurosurveillance latest updates, 15.12.2023
Tilføjet 15.12.2023
BackgroundShortly after the launch of a novel adjuvanted recombinant zoster vaccine (RZV), Shingrix, cases of suspected herpes zoster (HZ) or zoster-like skin reactions following immunisation were reported. AimWe aimed to investigate if these skin manifestations after administration of RZV could be HZ. MethodsBetween April and October 2020, general practitioners (GP) reporting a suspected case of HZ or zoster-like skin manifestation after RZV vaccination to the Paul-Ehrlich-Institut, the German national competent authority, were invited to participate in the study. The GP took a sample of the skin manifestation, photographed it and collected patient information on RZV vaccination and the suspected adverse event. We analysed all samples by PCR for varicella-zoster virus (VZV) and herpes-simplex virus (HSV) and genotyped VZV-positive samples. In addition, cases were independently assessed by two dermatologists. ResultsEighty eligible cases were enrolled and 72 could be included in the analysis. Of the 72 cases, 45 were female, 33 were 60–69 years old, 32 had skin symptoms in the thoracic and 27 in the cervical dermatomes. Twenty-seven samples tested PCR positive for VZV (all genotyped as wild-type, WT), three for HSV-1 and five for HSV-2. ConclusionIt may be difficult to distinguish HZ, without a PCR result, from other zoster-like manifestations. In this study, VZV-PCR positive dermatomal eruptions occurring in the first weeks after immunisation with RZV were due to WT VZV, which is not unexpected as HZ is a common disease against which the vaccine is unlikely to provide full protection at this time.
Læs mereFabiana Gámbaro, Ana Belén Pérez, Matthieu Prot, Eduardo Agüera, Artem Baidaliuk, María Paz Sánchez-Seco, Luis Martínez-Martínez, Ana Vázquez, María Dolores Fernandez-Garcia and Etienne Simon-Loriere
Eurosurveillance latest updates, 10.11.2023
Tilføjet 10.11.2023
BackgroundVarious pathogens, including bacteria, fungi, parasites, and viruses can lead to meningitis. Among viruses causing meningitis, Toscana virus (TOSV), a phlebovirus, is transmitted through sandfly bites. TOSV infection may be suspected if patients with enterovirus- and herpesvirus-negative aseptic (non-bacterial) meningitis recall recent insect bites. Other epidemiological factors (season, rural area) may be considered. The broad range of possible meningitis aetiologies poses considerable diagnosis challenges. Untargeted metagenomic next-generation sequencing (mNGS) can potentially identify pathogens, which are not considered or detected in routine diagnostic panels. AimIn this retrospective, single-centre observational study, we investigated mNGS usefulness to understand the cause of meningitis when conventional approaches fail. MethodsCerebrospinal fluid (CSF) samples from patients hospitalised in southern Spain in 2015–2019 with aseptic meningitis and no aetiology found by conventional testing, were subjected to mNGS. Patients’ demographic characteristics had been recorded and physicians had asked them about recent insect bites. Obtained viral genome sequences were phylogenetically analysed. ResultsAmong 23 idiopathic cases, TOSV was identified in eight (all male; median age: 39 years, range: 15–78 years). Five cases lived in an urban setting, three occurred in autumn and only one recalled insect bites. Phylogenetic analysis of TOSV segment sequences supported one intra-genotype reassortment event. ConclusionsOur study highlights the usefulness of mNGS for identifying viral pathogens directly in CSF. In southern Spain, TOSV should be considered regardless of recalling of insect bites or other epidemiological criteria. Detection of a disease-associated reassortant TOSV emphasises the importance of monitoring the spread and evolution of phleboviruses in Mediterranean countries.
Læs mereDomenico Martinelli, Filippo Quattrone, Francesca Fortunato, Elisa Di Maggio, Antonietta Filia, Maria Cristina Rota, Pier Luigi Lopalco and Rosa Prato
Eurosurveillance latest updates, 27.10.2023
Tilføjet 27.10.2023
In Europe, National Immunisation Technical Advisory Groups (NITAGs) were established in most countries to promote evidence-informed decision-making in introducing new or improved vaccines or changing recommendations for existing ones. Still, the role, activities and outcomes of NITAGs have not been optimally implemented across Europe. Within the European Joint Action on Vaccination (EU-JAV), we conducted a survey to collect information on decision-making process including the main criteria for the introduction of new vaccines or changes to recommendations on their use. Between December 2021 and January 2022, 13 of the 28 European countries invited participated in an online survey. The criteria ranked as most relevant were disease burden and availability of financial resources. Only one country specified that the NITAG recommendations were binding for the government or the health authority. Vaccinations more often reported for introduction or recommendation changes were those against herpes zoster, influenza, human papillomavirus infection, pneumococcal and meningococcal disease. The planned changes will mainly address children and adolescents (2–18 years) and adults (≥ 45–65 years). Our findings show potential overlaps in the activities of NITAGs between countries; and therefore, collaboration between NITAGs may lead to optimisation of the workload and better use of resources.
Læs mereMedscape Infectious Diseases, 10.06.2023
Tilføjet 10.06.2023
"The take-home finding is that herpes zoster incidence is high among people with MS overall." MDedge News
Læs mereProMED, 15.05.2023
Tilføjet 15.05.2023
Equine Herpes Virus -- United StatesAn 18-year-old warmblood gelding in Riverside County, California, has been euthanized after developing equine herpesvirus myeloencephalopathy (EHM) secondary to EHV-1 infection. The gelding developed clinical signs on 27 Mar 2023 including progressive hind-end ataxia, inability to rise and recumbency. EHM was confirmed on 4 Apr 2023.The index horse had no recent show or travel history within the past 30 days. There is no apparent link between this case and the previously confirmed active
Læs mereProMED, 6.03.2023
Tilføjet 6.03.2023
Equine Herpes Virus -- SpainNine horses are receiving 'close monitoring' in hospital in Valencia, 8 of which are showing neurological signs of equine herpesvirus (EHV-1).H&H reported that the organisers of the Mediterranean Equestrian Tour in Oliva Nova, Spain, had cancelled the 2nd part of the showjumping tour (7-26 Feb [2023]) as 4 horses on-site had tested positive for EHV-1. Ten horses, 6 of whom were showing signs of illness, were put in isolation on 21 Feb [2023]. Swabs were taken, 4 of which were positive, 4
Læs mereEurosurveillance latest updates, 23.02.2023
Tilføjet 24.02.2023
BackgroundHerpes zoster (HZ) affects 1 in 3 persons in their lifetime, and the risk of HZ increases with increasing age and the presence of immunocompromising conditions. In Spain, vaccination guidelines were recently updated to include the recommendation of the new recombinant zoster vaccine (RZV) for certain risk groups.AimTo describe the epidemiology of HZ-related hospitalisations in Spain in order to prioritise vaccination recommendations and define a baseline to monitor the effectiveness of vaccination policies.MethodsRetrospective study using the National Health System’s Hospital Discharge Records Database, including all HZ-related hospitalisations from 1998 to 2018.ResultsThe 65,401 HZ-related hospitalisations, corresponded to an annual mean hospitalisation rate of 6.75 per 100,000 population. There was an increasing trend of HZ hospitalisations over the study period. This rate was higher in males and older age groups, particularly over 65 years. Comorbidities with higher risk of readmission were leukaemia/lymphoma (RR 2.4; 95% CI: 2.3–2.6) and solid malignant neoplasm (RR 2.2; 95% CI: 2.1–2.4). Comorbidities associated with higher risk of mortality were leukaemia/lymphoma (RR 2.9; 95% CI: 2.7–3.2), solid malignant neoplasm (RR 2.9; 95% CI: 2.7–3.1) and HIV infection (RR 2.2; 95% CI: 1.8–2.7).ConclusionOf all patients hospitalised with HZ, those with greater risk of mortality or readmission belonged to the groups prioritised by the current vaccination recommendations of the Spanish Ministry of Health. Our study provided relevant information on clinical aspects of HZ and established the base for future assessments of vaccination policies.
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