Eurosurveillance - Volume 30, Issue 2, 16 January 2025

Toscana virus (TOSV) is transmitted to humans through bites of infected sand flies. Neuroinvasive TOSV infections are leading causes of meningitis/encephalitis in southern Europe and notifiable in Italy since 2016. In 2022–23, Italy experienced extreme climate anomalies and a concomitant increase in mosquito and tick-borne disease transmission.

To identify the spatiotemporal distribution and risk groups of neuroinvasive TOSV infections in Italy in 2022–23 vs 2016–21.

We retrospectively described all autochthonous, laboratory-confirmed neuroinvasive TOSV cases notified to the national surveillance system in 2016–23 using frequencies, proportions, incidences and incidence risk ratios (IRRs) with 95% CIs, stratified by year, sex, age, region/autonomous province (AP) of infection/exposure and infection/exposure municipality by urbanisation level.

In 2022–23, 276 cases were notified (average annual incidence: 2.34/1,000,000 population) vs 331 cases in 2016–21 (0.92/1,000,000), with increased incidence extending into September. In 2022–23, infections were acquired in 12/21 regions/APs, predominantly in Emilia Romagna (57.6%; 159/276) as in 2016–21, including four regions/APs with no local infections in 2016–21. Similar to 2016–21, during 2022–23 residence in rural municipalities (vs urban), male sex, working age (19–67 years) and age > 67 years (vs ≤ 18 years) were identified as risk factors with IRRs of 2.89 (95% CI: 2.01–4.17), 2.17 (95% CI: 1.66–2.84), 5.31 (95% CI: 2.81–10.0) and 5.06 (95% CI: 2.59–9.86), respectively.

Italy experienced a nearly 2.6-fold increase in neuroinvasive TOSV incidence in 2022–23 vs 2016–21. Raising public awareness on risk factors and personal protection measures may enhance prevention efforts.

Human parainfluenza viruses (HPIV) commonly cause upper respiratory tract infections, with potential for severe lower respiratory complications. Understanding seasonal increases informs strategies to prevent HPIV spreading.

We examined the impact of COVID-19 on HPIV epidemiological and clinical patterns in Scotland using non-sentinel and sentinel surveillance data.

Information on HPIV swab positivity (January 2017–October 2023) and demographic data was obtained from the Electronic Communication of Surveillance in Scotland (ECOSS) non-sentinel surveillance sources (laboratory-based data from hospital and community) and the Community Acute Respiratory Infection (CARI) sentinel surveillance programme (enhanced surveillance and symptom data).

In 2020 during early COVID-19 waves, HPIV detection decreased aligning with lockdowns and preventive measures. In summer 2021, HPIV positivity increased, with HPIV-3 possibly reverting to pre-pandemic seasonality, but HPIV-1 not yet re-establishing alternate-year peaks. Most positive results from non-sentinel sources came from hospital tests. Sentinel surveillance (CARI) complemented non-sentinel data, offering community-level insights. There was no significant difference in CARI swab positivity by sex in any age group. Consistent with historical trends, children under five years exhibited highest test positivity: 9.3% (95% CI: 7.6–11.2) in females and 8.5% (95% CI 7.0–10.2) in males.

The COVID-19 pandemic impacted HPIV detection in Scotland. The decline during the pandemic peak and subsequent partial resurgence underscores the complex interplay between viral epidemiology and public health measures. Combining diverse surveillance systems provides a comprehensive understanding of HPIV dynamics. Insights into age-specific and symptom-associated patterns contribute to understanding HPIV epidemiology and refining public health strategies.