Meningitis was among three strong clinical risk factors identified in a nationwide, population-based study. Medscape Medical News…

A new test appears to be better than current options for diagnosing pathogens that cause meningitis, encephalitis, and other neurologic infections. Medscape Medical News…

Elizabethkingia anophelis is a multidrug-resistant pathogen causing high mortality and morbidity in adults with comorbidities and neonates. We report a Dutch case of E. anophelis meningitis in a neonate, clonally related to samples taken from an automated infant milk dispenser located at the family’s residence. We inform about the emergence of E. anophelis and suggest molecular surveillance in hospitals and other health settings. This is the first case connecting an automated formula dispenser to an invasive infection in a neonate. …

Clinicians are evaluating optimal timing for vaccination now that the first pentavalent vaccine against all five major serogroups of meningococcal disease is available. Medscape Medical News…

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. …

BackgroundRodent-borne viruses such as orthohantaviruses and arenaviruses cause considerable disease burden with regional and temporal differences in incidence and clinical awareness. Therefore, it is important to regularly evaluate laboratory diagnostic capabilities, e.g. by external quality assessments (EQA). AimWe wished to evaluate the performance and diagnostic capability of European expert laboratories to detect orthohantaviruses and lymphocytic choriomeningitis virus (LCMV) and human antibody response towards orthohantaviruses. MethodsWe conducted an EQA in 2021; molecular panels consisted of 12 samples, including different orthohantaviruses (Seoul, Dobrava-Belgrade (DOBV), Puumala (PUUV) and Hantaan orthohantavirus), LCMV and negative controls. Serological panels consisted of six human serum samples reactive to PUUV, DOBV or negative to orthohantaviruses. The EQA was sent to 25 laboratories in 20 countries. ResultsThe accuracy of molecular detection of orthohantaviruses varied (50‒67%, average 62%) among 16 participating laboratories, while LCMV samples were successfully detected in all 11 participating laboratories (91-100%, average 96%). The accuracy of serological diagnosis of acute and past orthohantavirus infections was on average 95% among 20 participating laboratories and 82% in 19 laboratories, respectively. A variety of methods was used, with predominance of in-house assays for molecular tests, and commercial assays for serological ones. ConclusionSerology, the most common tool to diagnose acute orthohantavirus infections, had a high accuracy in this EQA. The molecular detection of orthohantaviruses needs improvement while LCMV detection (performed in fewer laboratories) had 95% accuracy. Further EQAs are recommended to be performed periodically to monitor improvements and challenges in the diagnostics of rodent–borne diseases. …

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 23-29 July 2023 and includes updates on cholera, MERS-CoV, Chikungunya, dengue, COVID-19, West Nile virus, avian influenza, echovirus, botulism, and bacterial meningitis.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 23-29 July 2023 and includes updates on cholera, MERS-CoV, Chikungunya, dengue, COVID-19, West Nile virus, avian influenza, echovirus, botulism, and bacterial meningitis.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 25 June - 1 July 2023. It includes updates on avian influenza, COVID-19, West Nile virus, poliomyelitis, cholera, fungal meningitis, Oz virus, and information on mass gatherings (the Hajj).

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 25 June - 1 July 2023. It includes updates on avian influenza, COVID-19, West Nile virus, poliomyelitis, cholera, fungal meningitis, Oz virus, and information on mass gatherings (the Hajj).

BackgroundPneumococcal conjugated vaccine (PCV)7 and PCV13 programmes started in Israel from July 2009 and November 2010 respectively, with a 2+1 schedule (one dose at 2 months old, one at 4 months old, and a booster dose at 12 months old). Thereafter, invasive pneumococcal disease (IPD) rates substantially declined in children. Uptake of all three doses in  90%. For still incompletely vaccinated infants (≤ 12 months old), how well the PCV 2+1 programme shields from IPD is not fully resolved. AimTo assess the adequacy of protection conferred by the 2+1 schedule PCV vaccination programme, particularly among incompletely-vaccinated infants. MethodsThis was a population-based, prospective, nationwide active IPD surveillance study in Israel, 2004–2019, in children

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 28 May - 3 June 2023 and includes updates on COVID-19, West Nile virus, Legionnaires\' disease, avian influenza, Marburg virus disease, cholera, and fungal meningitis.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 28 May - 3 June 2023 and includes updates on COVID-19, West Nile virus, Legionnaires\' disease, avian influenza, Marburg virus disease, cholera, and fungal meningitis.

Meningitis -- United StatesAuthorities in the U.S. and Mexico have asked the World Health Organization to declare a public health emergency of international concern over a deadly fungal outbreak, a Centers for Disease Control and Prevention official said Friday [26 May 2023]. The request comes after recruiters lured hundreds of patients from multiple countries and 24 U.S. states to 2 facilities in Mexico for cosmetic operations that may have exposed them to the fungus. The CDC is currently monitoring the condition…

Leptospirosis -- United StatesA cluster of brain infections in Oklahoma may have been caused by bacteria from rat urine contaminating the state\'s lakes, an expert suggests. Several people have fallen ill after swimming in rivers and lakes near Bartlesville city, in the east of the state, officials say. They are believed to be suffering from meningitis, or an inflammation of the lining of the brain or spinal cord caused by an infection.Testing has already ruled out the brain-eating amoeba _Naegleria fowleri_, which can…

Meningitis -- United StatesHistory appears to be repeating itself. Authorities in Mexico and the United States believe a contaminated anesthetic drug is behind a meningitis outbreak at 2 private clinics in Matamoros, Mexico, located close to the country\'s border with the United States. Both clinics, which specialize in cosmetic surgery, were closed on 13 May 2023.Mexico\'s Ministry of Health has reported 23 cases: 9 involving American patients and a further 14 infections among Mexican patients. One death has been…

Meningitis -- CDC is collaborating with the Mexican Ministry of Health and U.S. state and local health departments to respond to an outbreak of suspected fungal meningitis among patients who had surgical procedures under epidural anesthesia in Matamoros, Tamaulipas, Mexico. Officials have identified two clinics associated with the outbreak, River Side Surgical Center and Clinica K-3. These clinics were closed on [13 May 2023].The Mexican Ministry of Health sent CDC a list of 221 U.S. patients who might…