Eurosurveillance - Current Issue -Volume 29, Issue 48, 28/Nov/2024

We analysed trends in new HIV diagnoses and factors contributing to late diagnosis among migrants in countries in the European Union (EU)/European Economic Area (EEA) from 2014 to 2023. Of the total reported HIV diagnoses, 45.9% were in migrants, with 13.3% born in EU/EEA countries and 86.7% in non-EU/EEA countries. Late diagnosis was observed in 52.4% of migrants, particularly among non-EU/EEA migrants with heterosexual transmission, regardless of sex. Improved HIV prevention and testing strategies are essential for at-risk migrant populations.

An unprecedented upsurge in mpox, caused by clade I of the monkeypox virus (MPXV) was noted in Central Africa in 2024. The first mpox case with MPXV clade Ib outside Africa was reported in Sweden in mid-August. The case experienced a mild disease course after travelling to an affected country. No additional cases of this clade have been detected in Sweden. Strengthened public health measures and surveillance including whole genome sequencing are crucial to prevent establishment of novel MPXV clades.

In October 2024, the first imported mpox clade Ib case was confirmed in Germany in an individual in their thirties returning from Rwanda. In this report we summarise the response from the public health service in North Rhine-Westphalia related to case management, contact tracing and institutional collaborations. Our findings highlight the importance of a coordinated public health response in the management of imported mpox cases and in preventing the transmission of mpox clade Ib in Germany and beyond.

Acute myocarditis has risen among paediatric patients in Italy, with 65 clinically suspected cases reported by 12 centres in 2024, 32 linked to parvovirus B19 (B19V) infection. In 11 cases, B19V was not ruled out despite a concurrent European outbreak. Twenty-nine children required intensive care; eight fatalities occurred. While effective for both severe B19V infection and myocarditis, intravenous immunoglobulins were given in only one-third of cases. These findings highlight the need for timely diagnosis, stronger surveillance, and standardised treatment protocols.

Serratia marcescens is an opportunistic pathogen with a propensity to cause nosocomial outbreaks, particularly in neonatal intensive care units (NICUs). We present a sustained outbreak spanning over 18 months (1 January 2022–29 August 2023) in a NICU in Antwerp, Belgium, affecting 61 neonates, identified through samples taken for diagnostic purposes and by rectal screening. Ten neonates were infected: five with lower respiratory tract infection, four with conjunctivitis and one fatal case with sepsis. In a logistic regression analysis, nursing in an incubator was significantly associated with acquisition of S. marcescens (odds ratio (OR): 2.99; 95% confidence interval (CI): 1.14–8.25; p < 0.05). Whole genome sequencing-based multilocus sequence typing (wgMLST) and core genome single nucleotide polymorphism (cgSNP) analysis of isolates from clinical (n = 4), screening (n = 52) and environmental samples (n = 8), identified eight clusters and five singletons not associated with the clusters. Although outbreak measures were successful in containing further spread within the ward during sudden surges when > 4 cases per week were identified (peak events), several peaks with different clonal clusters occurred. The emergence of similar outbreaks in Belgian hospitals underscores the need of continuous surveillance and NICU-specific infection prevention and control (IPC) measures.