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Robert Dyrdak, Emma B Hodcroft, Sandra Broddesson, Malin Grabbe, Hildur Franklin, Magnus Gisslén, Maricris E Holm, Magnus Lindh, Joanna Nederby-Öhd, Johan Ringlander, Martin Sundqvist, Richard A Neher and Jan Albert
Eurosurveillance latest updates, 11.10.2024
Tilføjet 11.10.2024
BackgroundDespite the unprecedented measures implemented globally in early 2020 to prevent the spread of SARS-CoV-2, Sweden, as many other countries, experienced a severe first wave during the COVID-19 pandemic. AimWe investigated the introduction and spread of SARS-CoV-2 into Sweden. MethodsWe analysed stored respiratory specimens (n = 1,979), sampled 7 February–2 April 2020, by PCR for SARS-CoV-2 and sequenced PCR-positive specimens. Sequences generated from newly detected cases and stored positive specimens February–June 2020 (n = 954) were combined with sequences (Sweden: n = 730; other countries: n = 129,913) retrieved from other sources for Nextstrain clade assignment and phylogenetic analyses. ResultsTwelve previously unrecognised SARS-CoV-2 cases were identified: the earliest was sampled on 3 March, 1 week before recognised community transmission. We showed an early influx of clades 20A and 20B from Italy (201/328, 61% of cases exposed abroad) and clades 19A and 20C from Austria (61/328, 19%). Clade 20C dominated the first wave (20C: 908/1,684, 54%; 20B: 438/1,684, 26%; 20A: 263/1,684, 16%), and 800 of 1,684 (48%) Swedish sequences formed a country-specific 20C cluster defined by a spike mutation (G24368T). At the regional level, the proportion of clade 20C sequences correlated with an earlier weighted mean date of COVID-19 deaths. ConclusionCommunity transmission in Sweden started when mitigation efforts still focused on preventing influx. This created a transmission advantage for clade 20C, likely introduced from ongoing cryptic spread in Austria. Therefore, pandemic preparedness should have a comprehensive approach, including capacity for large-scale diagnostics to allow early detection of travel-related cases and community transmission.
Læs mereElena Pariani, Antonio Piralla, Laura Pellegrinelli, Federica Giardina, Vincenzo Navobi Porrello, Greta Romano, Cristina Galli, Laura Sandri, Guglielmo Ferrari, Sandro Binda, Luigi Vezzosi, Gabriele Del Castillo, Sabrina Buoro, Danilo Cereda, Fausto Baldanti and Respiratory viruses pandemic preparedness group Lombardy
Eurosurveillance latest updates, 11.10.2024
Tilføjet 11.10.2024
We report a considerable increase in enterovirus D68 (EV-D68) cases since July 2024, culminating in an ongoing outbreak of acute respiratory infections in northern Italy, accounting for nearly 90% of all enterovirus infections. The outbreak was identified by community- and hospital-based surveillance systems, detecting EV-D68 in individuals with mild-to-severe respiratory infections. These strains belonged to B3 and a divergent A2 lineage. An increase in adult cases was observed. Enhanced surveillance and molecular characterisation of EV-D68 across Europe are needed.
Læs mereVita W Jongen, Daniela Bezemer, Ard van Sighem, Anders Boyd, Casper Rokx, Karin Grintjes, Aafke Cents-Bosma, Eline Op de Coul, Birgit van Benthem, Annemarie Wensing, Ferdinand WNM Wit, Marc van der Valk and on behalf of the ATHENA national observational HIV cohort
Eurosurveillance latest updates, 20.09.2024
Tilføjet 20.09.2024
BackgroundIn the Netherlands, HIV pre-exposure prophylaxis (PrEP) has been available since 2019. However, the extent of PrEP use prior to HIV diagnosis and development of PrEP-resistance-associated mutations (RAMs) is not known. AimWe assessed prior PrEP use and potential transmission of PrEP RAMs among men who have sex with men (MSM) and transgender persons (TGP) with a new HIV diagnosis in the Netherlands. MethodsData on prior PrEP use between 1 January 2018 and 31 December 2022 were available from the Dutch national ATHENA cohort. We assessed proportion of prior PrEP use, detected PrEP associated RAMs and assessed potential onward transmission of RAMs between 2010 and 2022 using a maximum likelihood tree. ResultsData on prior PrEP use were available for 583/1,552 (36.3%) individuals, with 16% (94/583) reporting prior PrEP use. In 489 individuals reporting no prior PrEP use, 51.5% did not use PrEP due to: low HIV-risk perception (29%), no access (19.1%), personal preference (13.1%), and being unaware of PrEP (19.1%). For PrEP users, 13/94 (13.8%) harboured a M184V/I mutation, of whom two also harboured a K65R mutation. In people with a recent HIV infection, detection of PrEP RAMs increased from 0.23% (2/862) before 2019 to 4.11% (9/219) from 2019. We found no evidence of onward transmission of PrEP RAMs. ConclusionThe prevalence of PrEP-associated RAMs has increased since PrEP became available in the Netherlands. More widespread access to PrEP and retaining people in PrEP programmes when still at substantial risk is crucial to preventing new HIV infections.
Læs mereMedscape Infectious Diseases, 17.09.2024
Tilføjet 17.09.2024
The UK government has ordered more than 150,000 doses of Bavarian Nordic\'s mpox vaccine to boost its preparedness against a new form of the virus currently spreading in... Reuters Health Information
Læs mereFlorian Gehre, Eric Nzeyimana, Hakim Idris Lagu, Emmanuel Achol, Julien A Nguinkal, Eric Kezakarayagwa, Théogene Ihorimbere, Néhémie Nzoyikorera, Francine Kabatesi, Marie-Noelle Uwineza, Abdi Roba, Millicent Nyakio Ndia, John Ndemi Kiiru, Gwokpan Awin Nykwec, Isaac Gatkuoth Chot Moun, Mamdouh A Aguer, James A Maror, Gregory Wani Dumo, Michael Losuba, Lul Lojok Deng, Neema Omari, Grace Ochido, Aryse Martins Melo, Peter Bernard Mtesigwa Mkama, Edna Mgimba, Monica Fredrick Francis, Lawrence A Mapunda, Alex Magesa, Nyambura Moremi, Godfrey Pimundu, Tonny Muyigi, Susan Ndidde Nabadda, Emmanuel Kabalisa, Isabelle Mukagatare, Daniel Mukadi-Bamuleka, Erick Ntambwe Kamangu, Jürgen May and Muna Affara
Eurosurveillance latest updates, 30.08.2024
Tilføjet 30.08.2024
The East African Community (EAC) is experiencing an unprecedented, emerging mpox outbreak since July 2024 in five of eight partner states. We highlight rapid regional response measures, initiated August 2024 coordinated by EAC: field deployment of six mobile laboratories in Burundi, Rwanda, Uganda, Tanzania, Kenya, South Sudan to high-risk areas, donation of one mobile laboratory to Democratic Republic of the Congo and genomic monkeypox virus (MPXV) surveillance support. These interventions aim to limit local mpox spread and support international containment.
Læs merePhillip Zucs, Julien Beauté, Daniel Palm and Gianfranco Spiteri
Eurosurveillance latest updates, 23.08.2024
Tilføjet 23.08.2024
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.
Læs mereMedscape Infectious Diseases, 22.08.2024
Tilføjet 22.08.2024
Preexposure prophylaxis prescription reversals and abandonments were lower for patients seen by primary care clinicians than by other noninfectious disease clinicians. MDedge News
Læs mereMedscape Infectious Diseases, 25.07.2024
Tilføjet 25.07.2024
Final results of the highly anticipated PURPOSE 1 trial of lenacapavir show the shots prevent new infections without many side effects. Medscape Medical News
Læs mereLouise Marron, Alberto Mateo-Urdiales, Joan O’Donnell, Eve Robinson and Lisa Domegan
Eurosurveillance latest updates, 12.07.2024
Tilføjet 12.07.2024
BackgroundAs Ireland prepared for an autumn 2023 COVID-19 vaccination booster campaign, there was concern that vaccine fatigue would affect uptake, which has been abating. AimThis study aimed to quantify the direct impact of the COVID-19 vaccination programme in Ireland on averted COVID-19-related outcomes including symptomatic presentations to primary care/community testing centres, emergency department (ED) presentations, hospitalisations, intensive care unit (ICU) admissions and deaths, in individuals aged ≥ 50 years, during Omicron dominance. MethodsWe conducted a retrospective observational COVID-19 vaccine impact study in December 2021–March 2023 in Ireland. We used national data on notified outcomes and vaccine coverage, as well as vaccine effectiveness (VE) estimates, sourced from the World Health Organization’s live systematic review of VE, to estimate the count and prevented fraction of outcomes in ≥ 50-year-olds averted by the COVID-19 vaccination programme in this age group. ResultsThe COVID-19 vaccination programme averted 48,551 symptomatic COVID-19 presentations to primary care/community testing centres (36% of cases expected in the absence of vaccination), 9,517 ED presentations (53% of expected), 102,160 hospitalisations (81% of expected), 3,303 ICU admissions (89% of expected) and 15,985 deaths (87% of expected). ConclusionsWhen Omicron predominated, the COVID-19 vaccination programme averted symptomatic and severe COVID-19 cases, including deaths due to COVID-19. In line with other international vaccine impact studies, these findings emphasise the benefits of COVID-19 vaccination for population health and the healthcare system and are relevant for informing COVID-19 booster vaccination programmes, pandemic preparedness and communicating the reason for and importance of COVID-19 vaccination in Ireland and internationally.
Læs mereMedscape Infectious Diseases, 5.07.2024
Tilføjet 5.07.2024
Patients at a high risk for HIV infection who received preexposure prophylactic injections with lenacapavir had 100% efficacy in a phase 3 clinical trial. Medscape Medical News
Læs mereMaaike C Swets, Annabel Niessen, Emilie P Buddingh, Ann CTM Vossen, Karin Ellen Veldkamp, Irene K Veldhuijzen, Mark GJ de Boer and Geert H Groeneveld
Eurosurveillance latest updates, 5.07.2024
Tilføjet 5.07.2024
BackgroundEffective pandemic preparedness requires robust severe acute respiratory infection (SARI) surveillance. However, identifying SARI patients based on symptoms is time-consuming. Using the number of reverse transcription (RT)-PCR tests or contact and droplet precaution labels as a proxy for SARI could accurately reflect the epidemiology of patients presenting with SARI. AimWe aimed to compare the number of RT-PCR tests, contact and droplet precaution labels and SARI-related International Classification of Disease (ICD)-10 codes and evaluate their use as surveillance indicators. MethodsPatients from all age groups hospitalised at Leiden University Medical Center between 1 January 2017 up to and including 30 April 2023 were eligible for inclusion. We used a clinical data collection tool to extract data from electronic medical records. For each surveillance indicator, we plotted the absolute count for each week, the incidence proportion per week and the correlation between the three surveillance indicators. ResultsWe included 117,404 hospital admissions. The three surveillance indicators generally followed a similar pattern before and during the COVID-19 pandemic. The correlation was highest between contact and droplet precaution labels and ICD-10 diagnostic codes (Pearson correlation coefficient: 0.84). There was a strong increase in the number of RT-PCR tests after the start of the COVID-19 pandemic. DiscussionAll three surveillance indicators have advantages and disadvantages. ICD-10 diagnostic codes are suitable but are subject to reporting delays. Contact and droplet precaution labels are a feasible option for automated SARI surveillance, since these reflect trends in SARI incidence and may be available real-time.
Læs mereMarieke P de Cock, Valérie O Baede, Sara R Wijburg, Sara A Burt, Robert FNA van Tiel, Kim K Wiskerke, Jens RJ van der Post, Wim HM van der Poel, Hein Sprong and Miriam Maas
Eurosurveillance latest updates, 22.06.2024
Tilføjet 22.06.2024
BackgroundTo be better prepared for emerging wildlife-borne zoonoses, we need to strengthen wildlife disease surveillance. AimThe aim of this study was to create a topical overview of zoonotic pathogens in wildlife species to identify knowledge gaps and opportunities for improvement of wildlife disease surveillance. MethodsWe created a database, which is based on a systematic literature review in Embase focused on zoonotic pathogens in 10 common urban wildlife mammals in Europe, namely brown rats, house mice, wood mice, common voles, red squirrels, European rabbits, European hedgehogs, European moles, stone martens and red foxes. In total, we retrieved 6,305 unique articles of which 882 were included. ResultsIn total, 186 zoonotic pathogen species were described, including 90 bacteria, 42 helminths, 19 protozoa, 22 viruses and 15 fungi. Most of these pathogens were only studied in one single animal species. Even considering that some pathogens are relatively species-specific, many European countries have no (accessible) data on zoonotic pathogens in these relevant animal species. We used the Netherlands as an example to show how this database can be used by other countries to identify wildlife disease surveillance gaps on a national level. Only 4% of all potential host–pathogen combinations have been studied in the Netherlands. ConclusionsThis database comprises a comprehensive overview that can guide future research on wildlife-borne zoonotic diseases both on a European and national scale. Sharing and expanding this database provides a solid starting point for future European-wide collaborations to improve wildlife disease surveillance.
Læs mereMorbidity and Mortality Weekly Report (MMWR), 16.05.2024
Tilføjet 16.05.2024
This report describes the investigation of cases in the Democratic Republic of the Congo (DRC), CDC\'s support to DRC, and U.S. public health preparedness activities to date.
Læs mereOlivia Peuchant, Cécile Laurier-Nadalié, Laura Albucher, Carla Balcon, Amandine Dolzy, Nadège Hénin, Arabella Touati, Cécile Bébéar and on behalf of the Anachla study group
Eurosurveillance latest updates, 10.05.2024
Tilføjet 10.05.2024
BackgroundIn France, lymphogranuloma venereum (LGV) testing switched from universal to selective testing in 2016. AimTo investigate changes in LGV-affected populations, we performed a nationwide survey based on temporarily reinstated universal LGV testing from 2020 to 2022. MethodsEach year, during three consecutive months, laboratories voluntarily sent anorectal Chlamydia trachomatis-positive samples from men and women to the National Reference Centre for bacterial sexually transmitted infections. We collected patients’ demographic, clinical and biological data. Genovars L of C. trachomatis were detected using real-time PCR. In LGV-positive samples, the ompA gene was sequenced. ResultsIn 2020, LGV positivity was 12.7% (146/1,147), 15.2% (138/907) in 2021 and 13.3% (151/1,137) in 2022 (p > 0.05). It occurred predominantly in men who have sex with men (MSM), with rare cases among transgender women. The proportion of HIV-negative individuals was higher than that of those living with HIV. Asymptomatic rectal LGV increased from 36.1% (44/122) in 2020 to 52.4% (66/126) in 2022 (p = 0.03). Among users of pre-exposure prophylaxis (PrEP), LGV positivity was 13.8% (49/354) in 2020, 15.6% (38/244) in 2021 and 10.9% (36/331) in 2022, and up to 50% reported no anorectal symptoms. Diversity of the LGV ompA genotypes in the Paris region increased during the survey period. An unexpectedly high number of ompA genotype L1 variant was reported in 2022. ConclusionIn rectal samples from MSM in France, LGV positivity was stable, but the proportion of asymptomatic cases increased in 2022. This underscores the need of universal LGV testing and the importance of continuous surveillance.
Læs mereDaniel Saldanha Resendes, António Tomás, Mariana Pinção Cardoso, Sebastian von Schreeb, Rita Miranda Ferrão, Paula Vasconcelos, Maria Helena Almeida, Bruno Novo Castro, Vasco Ricoca Peixoto, Renato Lourenço Silva and Margarida de Morais
Eurosurveillance latest updates, 26.04.2024
Tilføjet 26.04.2024
In January 2024, a child was diagnosed with measles in a paediatric hospital in Lisbon. Of 123 contacts, 39 (32%) were not fully immunised, presenting a risk for a potential outbreak. The public health unit initiated control measures and identified challenges during the response, such as the lack of interoperability between information systems and accessing vaccination records. The lessons learned prompted changes to national contact tracing procedures for measles, further strengthening Portugal’s preparedness.
Læs mereSebastian von Schreeb, Susanne Kriegel Pedersen, Hanne Christensen, Kristina Melbardis Jørgsensen, Lene Holm Harritshøj, Frederik Boetius Hertz, Magnus Glindvad Ahlström, Anne-Mette Lebech, Suzanne Lunding, Lars Nørregaard Nielsen, Jan Gerstoft, Gitte Kronborg and Frederik N Engsig
Eurosurveillance latest updates, 29.03.2024
Tilføjet 29.03.2024
BackgroundPre-exposure prophylaxis (PrEP) effectively prevents HIV, but its association with sexually transmitted infections (STIs) has raised concerns about risk compensation, potentially impacting the expansion of PrEP programmes. AimWe examined the relationship between PrEP and the incidence of chlamydia, gonorrhoea and syphilis. MethodsIn this prospective cohort study, we compared STI rates before and after PrEP initiation among users in the capital region of Denmark (2019–2022), calculating incidence rate ratios adjusted for age and testing frequency (aIRR). To pinpoint when increases began, we plotted weekly STI rates, adjusting the timeline to correspond with PrEP initiation. ResultsThe study included 1,326 PrEP users with a median age of 35 years. The STI incidence rate per 100,000 person-years rose from 35.3 before to 81.2 after PrEP start, with an aIRR of 1.35 (95% CI: 1.18–1.56). Notably, this increase preceded PrEP initiation by 10–20 weeks. Specific aIRR for chlamydia, gonorrhoea and syphilis were 1.23 (95% CI: 1.03–1.48), 1.24 (95% CI: 1.04–1.47) and 1.15 (95% CI: 0.76–1.72), respectively. In subanalyses for anatomical sites aIRR was 1.26 (95% CI: 1.01–1.56) for rectal chlamydia and 0.66 (95% CI: 0.45–0.96) for genital gonorrhoea. ConclusionWe found a 35% increase in STI incidence associated with PrEP use. It started before PrEP initiation, challenging the assumption that PrEP leads to risk compensation. Instead, the data suggest that individuals seek PrEP during periods of heightened sexual risk-taking. Consequently, PrEP programmes should include sexual health consultations, STI testing, treatment and prevention strategies to prevent HIV and improve sexual health.
Læs mereECDC
ECDC COVID-19 updates, 20.03.2024
Tilføjet 20.03.2024
This guidance outlines key strategic and operational considerations to inform pandemic preparedness planning round the design and implementation of public health and social measures in community settings in the EU/EEA.
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