This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 31 August - 6 September 2024 and includes updates on mpox, West Nile virus, SARS-CoV-2 variants, influenza A(H5N1), human cases of swine influenza A(H1N1), an overview of respiratory virus epidemiology in the EU/EEA, and mass gathering monitoring for the Olympic and Paralympic Games.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 31 August - 6 September 2024 and includes updates on mpox, West Nile virus, SARS-CoV-2 variants, influenza A(H5N1), human cases of swine influenza A(H1N1), an overview of respiratory virus epidemiology in the EU/EEA, and mass gathering monitoring for the Olympic and Paralympic Games.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 31 August - 6 September 2024 and includes updates on mpox, West Nile virus, SARS-CoV-2 variants, influenza A(H5N1), human cases of swine influenza A(H1N1), an overview of respiratory virus epidemiology in the EU/EEA, and mass gathering monitoring for the Olympic and Paralympic Games.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 31 August - 6 September 2024 and includes updates on mpox, West Nile virus, SARS-CoV-2 variants, influenza A(H5N1), human cases of swine influenza A(H1N1), an overview of respiratory virus epidemiology in the EU/EEA, and mass gathering monitoring for the Olympic and Paralympic Games.

IntroductionRespiratory sentinel surveillance systems leveraging computerised medical records (CMR) use phenotyping algorithms to identify cases of interest, such as acute respiratory infection (ARI). The Oxford-Royal College of General Practitioners Research and Surveillance Centre (RSC) is the English primary care-based sentinel surveillance network. AimThis study describes and validates the RSC’s new ARI phenotyping algorithm. MethodsWe developed the phenotyping algorithm using a framework aligned with international interoperability standards. We validated our algorithm by comparing ARI events identified during the 2022/23 influenza season in England through use of both old and new algorithms. We compared clinical codes commonly used for recording ARI. ResultsThe new algorithm identified an additional 860,039 cases and excluded 52,258, resulting in a net increase of 807,781 cases (33.84%) of ARI compared to the old algorithm, with totals of 3,194,224 cases versus 2,386,443 cases. Of the 860,039 newly identified cases, the majority (63.7%) were due to identification of symptom codes suggestive of an ARI diagnosis not detected by the old algorithm. The 52,258 cases incorrectly identified by the old algorithm were due to inadvertent identification of chronic, recurrent, non-infectious and other non-ARI disease. ConclusionWe developed a new ARI phenotyping algorithm that more accurately identifies cases of ARI from the CMR. This will benefit public health by providing more accurate surveillance reports to public health authorities. This new algorithm can serve as a blueprint for other CMR-based surveillance systems wishing to develop similar phenotyping algorithms. …

This report describes the first known cluster of U.S. human influenza A(H5) cases.

This report provides new CDC recommendations for the upcoming flu season.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 17-23 August 2024 and includes updates on Mpox, dengue, West Nile virus, Legionnaires\' disease, influenza A(H5N1), poliovirus type 2 (cVDPV2), mass gathering monitoring of the Olympic and Paralympic Games in France, and poliomyelitis.

This perspective summarises and explains the long-term surveillance framework 2021–2027 for infectious diseases in the European Union/European Economic Area (EU/EEA) published in April 2023. It shows how shortcomings in the areas of public health focus, vigilance and resilience will be addressed through specific strategies in the coming years and how these strategies will lead to stronger surveillance systems for early detection and monitoring of public health threats as well as informing their effective prevention and control. A sharper public health focus is expected from a more targeted list of notifiable diseases, strictly public-health-objective-driven surveillance standards, and consequently, leaner surveillance systems. Vigilance should improve through mandatory event reporting, more automated epidemic intelligence processing and increased use of genomic surveillance. Finally, EU/EEA surveillance systems should become more resilient by modernising the underlying information technology infrastructure, expanding the influenza sentinel surveillance system to other respiratory viruses for better pandemic preparedness, and increasingly exploiting potentially more robust alternative data sources, such as electronic health records and wastewater surveillance. Continued close collaboration across EU/EEA countries will be key to ensuring the full implementation of this surveillance framework and more effective disease prevention and control. …

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 10-16 August 2024 and includes updates on Mpox, West Nile virus, mass gathering monitoring of the Olympic and Paralympic Games in France, cholera, dengue, measles, human cases of swine influenza, and Chandipura virus disease.

This report describes four cases of nontypeable Haemophilus disease that occurred at an elementary school in Detroit, Michigan.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 3-9 August 2024 and includes updates on influenza A Legionnaires’ disease, mass gathering monitoring of the Olympic and Paralympic Games in Paris 2024, West Nile virus infections, MERS-CoV and cholera. …

BackgroundA new respiratory virus surveillance platform, based on nationwide hospital laboratory data, was established in Israel during the COVID-19 pandemic. AimWe aimed to evaluate the performance of this platform with respect to the detection of influenza and respiratory syncytial virus (RSV) from week 36 in 2020 to week 15 in 2023, and how it fits with the World Health Organization (WHO) mosaic surveillance framework. MethodsData of respiratory samples from hospitalised patients sent for laboratory confirmation of influenza virus or RSV from 25 general hospital laboratories nationwide were collected. We analysed the weekly number and percentage of samples positive for influenza virus or RSV vis-à-vis SARS-CoV-2 activity and compared data from the new surveillance platform with existing surveillance platforms. Using data in the new surveillance platform, we analysed early stages of a 2021 out-of-season RSV outbreak and evaluated the capabilities of the new surveillance system with respect to objectives and domains of the WHO mosaic framework. ResultsThe new hospital-laboratory surveillance platform captured the activity of influenza virus and RSV, provided crucial data when outpatient sentinel surveillance was not operational and supported an out-of-season RSV outbreak investigation. The new surveillance platform fulfilled important objectives in all three domains of the mosaic framework and could serve for gathering additional information to fulfil more domain objectives. ConclusionThe new hospital laboratory surveillance platform provided essential data during the COVID-19 pandemic and beyond, fulfilled important domain objectives of the mosaic framework and could be adapted for the surveillance of other viruses. …

BackgroundHealthcare personnel (HCP) are at high risk for respiratory infections through occupational exposure to respiratory viruses. AimWe used data from a prospective influenza vaccine effectiveness study in HCP to quantify the incidence of acute respiratory infections (ARI) and their associated presenteeism and absenteeism. MethodsAt the start and end of each season, HCP at two Israeli hospitals provided serum to screen for antibodies to influenza virus using the haemagglutination inhibition assay. During the season, active monitoring for the development of ARI symptoms was conducted twice a week by RT-PCR testing of nasal swabs for influenza and respiratory syncytial virus (RSV). Workplace presenteeism and absenteeism were documented. We calculated incidences of influenza- and RSV-associated ARI and applied sampling weights to make estimates representative of the source population. ResultsThe median age of 2,505 participating HCP was 41 years, and 70% were female. Incidence was 9.1 per 100 person-seasons (95% CI: 5.8–14.2) for RT-PCR-confirmed influenza and 2.5 per 100 person-seasons (95% CI: 0.9–7.1) for RSV illness. Each season, 18–23% of unvaccinated and influenza-negative HCP seroconverted. The incidence of seroconversion or RT-PCR-confirmed influenza was 27.5 per 100 person-seasons (95% CI: 17.8–42.5). Work during illness occurred in 92% (95% CI: 91–93) of ARI episodes, absence from work in 38% (95% CI: 36–40). ConclusionInfluenza virus and RSV infections and associated presenteeism and absenteeism were common among HCP. Improving vaccination uptake among HCP, infection control, and encouraging sick HCP to stay home are important strategies to reduce ARI incidence and decrease the risk of in-hospital transmission. …

This Reporting Protocol describes data collection for influenza, COVID-19, and other respiratory viruses (such as RSV or new viruses of public health concern) in the EU/EEA and wider WHO European Region. Data collection is integrated for most datasets in line with the operational considerations for respiratory virus surveillance in Europe.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 20 - 26 July and includes updates on Avian influenza A(H5N6), SARS-CoV-2 variant classification, Overview of respiratory virus epidemiology in the EU/EEA, Circulating vaccine-derived poliovirus type 2 (cVDPV2), cholera, Crimean-Congo haemorrhagic fever, Oropouche virus disease, Seasonal surveillance of West Nile virus infections, Mass gathering monitoring - Olympic and Paralympic Games, Nipah virus disease.

The United Nations\' Food and Agriculture Organization on Thursday called for an urgent and unified response to an \'alarming\' rise in avian influenza in humans and animals... Reuters Health Information…

We investigated the thermostability of four European avian influenza A(H5N1) viruses in whole and semi-skimmed milk and their replication in bovine kidney and lung cells amid the current influenza A(H5N1) dairy cattle outbreak in the United States. Results showed strain-dependent differences in thermal inactivation, particularly in whole milk, and variable replication efficacy in lung cells. These findings support assessing the inactivation of European H5N1 viruses in milk and their replication in bovine cells, aiding biosafety protocols and public health measures. …

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 20 - 26 July and includes updates on Avian influenza A(H5N6), SARS-CoV-2 variant classification, Overview of respiratory virus epidemiology in the EU/EEA, Circulating vaccine-derived poliovirus type 2 (cVDPV2), cholera, Crimean-Congo haemorrhagic fever, Oropouche virus disease, Seasonal surveillance of West Nile virus infections, Mass gathering monitoring - Olympic and Paralympic Games, Nipah virus disease.

This report describes symptom monitoring and testing among exposed dairy and poultry workers in Michigan during the H5N1 outbreak.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 13-19 July 2024 and includes updates on influenza A(H5N1), Measles, Overview of respiratory virus epidemiology in the EU/EEA, ), Cholera, Seasonal surveillance of West Nile virus infections and Mass gathering monitoring.

HHS awards $176 to Moderna to develop an mRNA pandemic influenza vaccine and orders 4.8 million doses of a cell-based vaccine. Medscape Medical News…

The link between flu and myocardial infarction reinforces the value of the influenza vaccine and raises the possibility of prophylactic anticoagulation to reduce risk. Medscape Medical News…

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 6–12 July 2024 and includes updates on imported Oropouche human infections, Seasonal surveillance of West Nile virus infections, Locally acquired dengue, Yersinia enterocolitica, Cholera, Overview of respiratory virus epidemiology in the EU/EEA, Influenza A(H5N1), Mass gathering monitoring, Mpox and Middle Eastern Respiratory Syndrome (MERS).

BackgroundWastewater surveillance is an effective approach to monitor population health, as exemplified by its role throughout the COVID-19 pandemic. AimThis study explores the possibility of extending wastewater surveillance to the Paris 2024 Olympic and Paralympic Games, focusing on identifying priority pathogen targets that are relevant and feasible to monitor in wastewater for these events. MethodsA list of 60 pathogens of interest for general public health surveillance for the Games was compiled. Each pathogen was evaluated against three inclusion criteria: (A) analytical feasibility; (B) relevance, i.e. with regards to the specificities of the event and the characteristics of the pathogen; and (C) added value to inform public health decision-making. Analytical feasibility was assessed through evidence from peer-reviewed publications demonstrating the detectability of pathogens in sewage, refining the initial list to 25 pathogens. Criteria B and C were evaluated via expert opinion using the Delphi method. The panel consisting of some 30 experts proposed five additional pathogens meeting criterion A, totalling 30 pathogens assessed throughout the three-round iterative questionnaire. Pathogens failing to reach 70% group consensus threshold underwent further deliberation by a subgroup of experts. ResultsSix priority targets suitable for wastewater surveillance during the Games were successfully identified: poliovirus, influenza A virus, influenza B virus, mpox virus, SARS-CoV-2 and measles virus. ConclusionThis study introduced a model framework for identifying context-specific wastewater surveillance targets for a mass gathering. Successful implementation of a wastewater surveillance plan for Paris 2024 could incentivise similar monitoring efforts for other mass gatherings globally. …

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 29 June−5 July 2024 and includes updates on SARS-CoV-2 variant classification, swine influenza, an overview of respiratory virus epidemiology in the EU/EEA, parvovirus infection, avian influenza, West Nile virus infections, mass gatherings and botulism. …

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 29 June−5 July 2024 and includes updates on SARS-CoV-2 variant classification, swine influenza, an overview of respiratory virus epidemiology in the EU/EEA, parvovirus infection, avian influenza, West Nile virus infections, mass gatherings and botulism. …

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 22-28 June 2024 and includes updates on cholera, chikungunya and dengue, influenza, West Nile virus, and mass gathering monitoring or the UEFA European Football Championship and Hajj.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 8-14 June 2024 and includes updates on avian influenza, an overview of respiratory virus epidemiology in the EU/EEA, cholera, West Nile virus infections, measles and mass gatherings.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 25-31 May 2024 and includes updates on avian influenza, respiratory viruses, invasive meningococcal disease, mass gatherings for Hajj in Saudi Arabia, cholera, chikungunya, dengue, and poliomyelitis.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 22-28 June 2024 and includes updates on cholera, chikungunya and dengue, influenza, West Nile virus, and mass gathering monitoring or the UEFA European Football Championship and Hajj.

Highly pathogenic avian influenza (HPAI) has caused widespread mortality in both wild and domestic birds in Europe 2020–2023. In July 2023, HPAI A(H5N1) was detected on 27 fur farms in Finland. In total, infections in silver and blue foxes, American minks and raccoon dogs were confirmed by RT-PCR. The pathological findings in the animals include widespread inflammatory lesions in the lungs, brain and liver, indicating efficient systemic dissemination of the virus. Phylogenetic analysis of Finnish A(H5N1) strains from fur animals and wild birds has identified three clusters (Finland I-III), and molecular analyses revealed emergence of mutations known to facilitate viral adaptation to mammals in the PB2 and NA proteins. Findings of avian influenza in fur animals were spatially and temporally connected with mass mortalities in wild birds. The mechanisms of virus transmission within and between farms have not been conclusively identified, but several different routes relating to limited biosecurity on the farms are implicated. The outbreak was managed in close collaboration between animal and human health authorities to mitigate and monitor the impact for both animal and human health. …

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This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 15-21 June 2024, and includes updates on avian influenza, West Nile Virus infections, cholera, and mass gathering monitoring for the UEFA European Football Championship and Hajj.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 8-14 June 2024 and includes updates on avian influenza, cholera, West Nile virus infections, measles and mass gatherings.

Moderna said on Monday its combination vaccine to protect against both COVID-19 and influenza generated a stronger immune response in adults aged 50 and over when compared... Reuters Health Information…

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 1-7 June 2024 and includes updates on SARS-CoV-2 variant classification, cholera, out-of-season increase in norovirus, seasonal surveillance on West Nile virus infections, Middle East respiratory syndrome coronavirus (MERS-CoV), influenza A(H5N2), Oropouche virus disease, and an overview of respiratory virus epidemiology in the EU/EEA.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 1-7 June 2024 and includes updates on SARS-CoV-2 variant classification, cholera, out-of-season increase in norovirus, seasonal surveillance on West Nile virus infections, Middle East respiratory syndrome coronavirus (MERS-CoV), influenza A(H5N2), Oropouche virus disease, and an overview of respiratory virus epidemiology in the EU/EEA.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 25-31 May 2024 and includes updates on avian influenza, respiratory viruses, invasive meningococcal disease, mass gatherings for Hajj in Saudi Arabia, cholera, chikungunya, dengue, and poliomyelitis.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 18-25 May 2024 and includes updates on respiratory virus epidemiology in the EU/EEA, influenza, avian influenza, and cholera.

This report describes the joint investigation between CDC, U.S. Department of Agriculture, and the Food and Drug Administration after influenza A (H5N1) was detected in a U.S. farm worker.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 18-25 May 2024 and includes updates on respiratory virus epidemiology in the EU/EEA, influenza, avian influenza, and cholera.

Australia reported its first human case of avian influenza on Wednesday in a child who authorities said had been infected in India but made a full recovery, while a... Reuters Health Information…

The U.S. Centers for Disease Control on Tuesday advised states to aid in H5N1 bird flu surveillance by increasing testing of influenza A virus samples during the summer... Reuters Health Information…

The U.S. Centers for Disease Control and Prevention (CDC) on Tuesday released data on influenza A found in wastewater in a public dashboard that could assist in tracking the... Reuters Health Information…

Influenza, SARS-CoV-2 and RSV activity in EU/EEA Member States continue to decrease or remain stable at low levels. Cases, including severe infections, can still occur and it therefore remains essential to continue testing patients presenting with severe acute respiratory symptoms in order to guide treatment and inform epidemiological assessments.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 28 April - 4 May 2024 and includes updates on cholera, MERS-CoV, SARS-CoV-2, an overview of respiratory virus epidemiology in the EU/EEA, highly pathogenic avian influenza A(H5N1) in cattle and a related human case, Crimean-Congo haemorrhagic fever, and Lassa fever.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 28 April - 4 May 2024 and includes updates on cholera, MERS-CoV, SARS-CoV-2, an overview of respiratory virus epidemiology in the EU/EEA, highly pathogenic avian influenza A(H5N1) in cattle and a related human case, Crimean-Congo haemorrhagic fever, and Lassa fever.

Influenza, SARS-CoV-2 and RSV activity in EU/EEA Member States continue to decrease or remain stable at low levels. Cases, including severe infections, can still occur and it therefore remains essential to continue testing patients presenting with severe acute respiratory symptoms in order to guide treatment and inform epidemiological assessments.

A severe outbreak of influenza A(H1N1pdm09) infection in seven children (median age: 52 months) occurred between December 2023 and January 2024 in Tuscany, Italy. Clinical presentation ranged from milder encephalopathy to acute necrotizing encephalopathy (ANE) with coma and multiorgan failure; one child died. This report raises awareness for clinicians to identify and treat early acute encephalopathy caused by H1N1 influenza and serves as a reminder of severe presentations of influenza in young children and the importance of vaccination. …