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Eurosurveillance
Since 1995, Eurosurveillance has provided the European public health community with an open-access platform to exchange relevant findings on communicable disease surveillance, prevention and control. A weekly, electronic, peer-reviewed publication, Eurosurveillance aims to provide timely facts and guidance for public health professionals and decision-makers in the field of infectious disease to facilitate the implementation of effective prevention and control measures. Impact factor: 9.9. More...
Latest Issue: Volume 30, Issue 21, 29 May 2025 Latest Issue RSS feed
- Rapid communication
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Coxsackievirus B4 (CV-B4) linked to four severe neonatal infections including one fatal, Northern Ireland, October 2024 to February 2025
We report four cases of severe neonatal non-polio enterovirus infection, requiring hospital admission. Infants presented to different regional hospitals across Northern Ireland from late 2024 to early 2025. Three had neonatal meningitis and one showed rapid demise, leading to sepsis, multi-organ failure and death at day 6 of life. All infants were less than 18 days old at presentation, two were considered congenital infections, with one presenting symptoms at birth. All infants had detectable enterovirus RNA, typed as coxsackievirus B4.
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- Surveillance
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Newly emerging metronidazole-resistant Clostridioides difficile PCR ribotype 955 identified in Poland, 2021 to 2023 but not in Czechia, 2012 to 2023 and Slovakia, 2015 to 2023
BackgroundOn 29 January 2024, the European Centre for Disease Prevention and Control distributed an alert about a metronidazole-resistant Clostridioides difficile outbreak of PCR ribotype (RT) 955 in England.
AimWe aimed to investigate the presence of RT955 in Czech, Slovak and Polish C. difficile isolates and evaluate different culture media for detecting its metronidazole resistance.
MethodsIsolates with binary toxin genes identified as ‘unknown’ by the WEBRIBO PCR ribotyping database up to 2023 were re-analysed after adding the RT955 profile to the database. The RT955 isolates were characterised by whole genome sequencing and tested for susceptibility to 15 antimicrobials.
ResultsWe did not find RT955 in Czech (n = 6,661, 2012–2023) and Slovak (n = 776, 2015–2023) isolates, but identified 13 RT955 cases (n = 303, 2021–2023) in three hospitals in Poland. By whole genome multilocus sequence typing, 10 isolates clustered into one clonal complex including a sequence of United Kingdom strain ERR12670107, and shared similar antimicrobial resistance genes/mutations. All 13 isolates were resistant to ciprofloxacin/moxifloxacin, erythromycin/clindamycin and ceftazidime. All isolates had a mutation in the nimB gene promoter and in NimB (Tyr130Ser and Leu155Ile). The metronidazole resistance was detected in all isolates using brain-heart-infusion agar supplemented with haemin and Chocolate agar. Results were discrepant with the European Committee on Antimicrobial Susceptibility Testing-recommended Fastidious anaerobe agar and Brucella blood agar.
ConclusionThe identification of clonally related haem-dependent metronidazole-resistant C. difficile RT955 in multiple hospitals indicates a need for prospective surveillance to estimate its prevalence in Europe.
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- Research
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Acute flaccid myelitis in Europe between 2016 and 2023: indicating the need for better registration
Jelte Helfferich , Cristina Calvo , Ekkehardt Alpeter , Cristina Andrés , Andrés Antón , Melodie Aubart , Stefania Maria Bova , Maria Cabrerizo , Karin von Eije , Stollar Fabiola , Ana Felipe , Ralitsa Iordanova , Marianne Kragh Thomsen , Per Kristian Knudsen , Freek van Loenen , Noemi Lopez , Audrey Mirand , Richard Molenkamp , Sofie Midgley , Raquel Neves , Lubomira Nikolaeva Glomb , Joakim Øverbø , Gülten Öztürk , Paula Palminha , Helle Cecilie Viekilde Pfeiffer , Birgit Prochazka , Carlos Ribeiro , Martine Rodesch , Isabelle Schuffenecker , Jay Shetty , Sandy Siegert , Silje Lae Solberg , Artur Sulik , Dilşad Türkdoğan , Olcay Ünver , Jaco Verweij , Jorgina Vila , Tytti Vuorinen , Ronny Wickström , Thea K Fischer , Heli Harvala and Kimberley S.M. BenschopBackgroundAcute flaccid myelitis (AFM) is a rare polio-like condition affecting mainly children and characterised by severe, often persistent, weakness. It is one of several causes of acute flaccid paralysis (AFP), which manifests as acute onset of limb weakness and reduced muscle tone. Some non-polio enteroviruses (EV), such as EV-D68 may cause AFM. Little is known about AFM incidence in Europe.
AimWe aimed to better understand AFM incidence, aetiology and current surveillance policies in Europe.
MethodsIn 28 countries, members of the European non-polio enterovirus network (ENPEN) and a newly established AFM network of clinicians under ENPEN received a survey asking them how AFM surveillance was performed in their countries in 2016−2023 and the numbers of AFM cases including those diagnosed with EV-D68 infection during this period.
ResultsSurveillance information was obtained for 16 countries. In eight countries, AFP surveillance initiated for poliomyelitis eradication was still ongoing, while non-polio AFM cases were only systematically reported in Norway. The survey revealed 130 AFM cases for 14 countries, with 48 (37%) EV-D68-laboratory-confirmed. Among the AFM cases, 70% (n = 91) occurred in 2016, 2018 and 2022, when EV-D68 circulation increased.
ConclusionsThis report provides some indication of AFM case numbers in Europe since 2016. However, as 15 of 16 countries with AFM monitoring information lacked structural AFM surveillance, numbers should be interpreted with caution. Knowing AFM incidence matters to determine its impact and detect future outbreaks. Thus, the newly established clinical network will develop a European AFM repository.
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- Letter
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Recent articles
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Economic impact of RSV infections in young children attending primary care: a prospective cohort study in five European countries, 2021 to 2023
Valérie DV Sankatsing , Sarah F Hak , Joanne G Wildenbeest , Roderick P Venekamp , Mauro Pistello , Caterina Rizzo , Santiago Alfayate-Miguélez , Daan Van Brusselen , Marta Carballal-Mariño , Uy Hoang , Rolf Kramer , Simon de Lusignan , Oliver Martyn , Marc Raes , Adam Meijer , on behalf of the RSV ComNet Network and Jojanneke van Summeren
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Spread of the novel vancomycin-resistant Enterococcus faecium strain ST1299/vanA from local level in Germany to cross-border level in Austria, 2018 to 2022
Anca Rath , Bärbel Kieninger , Nilufarbayim Mirzaliyeva , Guido Werner , Jennifer K Bender , Martin A Fischer , Adriana Cabal-Rosel , Werner Ruppitsch , Helena MB Seth-Smith , Adrian Egli , Milo Halabi , Anna Hörtenhuber , Yarub Salaheddin , Wolfgang Prammer , Heidrun Kerschner , Rainer Hartl , Martin Ehrenschwender , Andreas Ambrosch , Jörn Kalinowski , Levin Joe Klages , Christian Rückert-Reed , Tobias Busche , Alexander Kratzer , Aila Caplunik-Pratsch , Anja Eichner , Jürgen Fritsch and Wulf Schneider-Brachert
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From multiple measles genotype D8 introductions in 2024 to sustained B3 local transmission in and around Milan, northern Italy, January to April 2025
Clara Fappani , Maria Gori , Silvia Bianchi , Lucia Tieghi , Daniela Colzani , Sabrina Senatore , Marino Faccini , Priscilla Pasutto , Luca Imeri , Luigi Vezzosi , Gabriele Del Castillo , Simone Villa , Danilo Cereda , Silvia Gioacchini , Paola Bucci , Raoul Fioravanti , Emilio D’Ugo , Melissa Baggieri , Fabio Magurano and Antonella Amendola
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