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More than a third of young adults living in the US during the COVID-19 pandemic experienced anxiety and/or depression, an outcome that may be related to economic or social uncertainty. Medscape Medical News…

BackgroundInfluenza vaccination for children aged 6 months to 6 years is included in the national vaccination programme in Finland. Although all vaccines in the programme are free of charge, national coverage of influenza vaccination among children under 3 years and 3–6 years during 2020/21 was 43% and 35% respectively, with regional differences. AimTo assess factors underlying parental vaccination intention in order to increase influenza vaccine uptake among children. MethodsWe conducted a web-based survey among parents (n = 17,844) of randomly selected eligible children (aged 6 months–6 years) in February–March 2022 in five Finnish municipalities from regions of high and low coverage. Logistic regressions were used to determine associations between vaccination intention and e.g. sociodemographic factors, attitudes and knowledge. Linkage to the national vaccination register was used to confirm realisation of vaccination intention after the study. ResultsParticipation rate was 13% (n = 2,322 parents). Influenza knowledge, trust in official information, responding parent’s education level, adherence to the vaccination programme, number of children and changes in attitudes towards vaccination since COVID-19 were all associated with intention to vaccinate. Vaccination intention for children was 64%, and realised vaccination 51%. ConclusionDespite the low participation rate, both vaccinated and unvaccinated children were represented. Influenza vaccine uptake is not dependent on a single factor. Our results identified the need for open dialogue between parents and healthcare professionals, as the lack of vaccine being offered by healthcare professionals was the most reported reason for not vaccinating. …

COVID-19 appears to be heading for a holiday season increase across most of the United States. WebMD Health News…

Two doses of an mRNA COVID-19 vaccine reduced hospitalizations and emergency department visits by 40%. Medscape Medical News…

BackgroundUnderstanding the relative vaccine effectiveness (rVE) of new COVID-19 vaccine formulations against SARS-CoV-2 infection is a public health priority. A precise analysis of the rVE of monovalent and bivalent boosters given during the 2022 spring-summer and autumn-winter campaigns, respectively, in a defined population remains of interest. AimWe assessed rVE against hospitalisation for the spring-summer (fourth vs third monovalent mRNA vaccine doses) and autumn-winter (fifth BA.1/ancestral bivalent vs fourth monovalent mRNA vaccine dose) boosters. MethodsWe performed a prospective single-centre test-negative design case–control study in ≥ 75-year-old people hospitalised with COVID-19 or other acute respiratory disease. We conducted regression analyses controlling for age, sex, socioeconomic status, patient comorbidities, community SARS-CoV-2 prevalence, vaccine brand and time between baseline dose and hospitalisation. ResultsWe included 682 controls and 182 cases in the spring-summer booster analysis and 572 controls and 152 cases in the autumn-winter booster analysis. A monovalent mRNA COVID-19 vaccine as fourth dose showed 46.6% rVE (95% confidence interval (CI): 13.9–67.1) vs those not fully boosted. A bivalent mRNA COVID-19 vaccine as fifth dose had 46.7% rVE (95% CI: 18.0–65.1), compared with a fourth monovalent mRNA COVID-19 vaccine dose. ConclusionsBoth fourth monovalent and fifth BA.1/ancestral mRNA bivalent COVID-19 vaccine doses demonstrated benefit as a booster in older adults. Bivalent mRNA boosters offered similar protection against hospitalisation with Omicron infection to monovalent mRNA boosters given earlier in the year. These findings support immunisation programmes in several European countries that advised the use of BA.1/ancestral bivalent booster doses. …

This report describes the effectiveness of COVID-19 mRNA vaccines among infants and children aged 6 months-4 years.

This report presents pooled COVID-19 vaccine effectiveness (VE) estimates for the first, second and third booster doses, against hospitalisation due to COVID-19 and COVID-19 related deaths in resident populations ≥50 years of age, living in the community.

The findings demonstrate how vaccine-induced T-cell responses could potentially reduce COVID-19 severity, the authors write. Medscape Medical News…

An emerging variant of COVID-19 called BA.2.86 that caused alarm earlier this summer has landed on the CDC\'s radar again. WebMD Health News…

This Reporting Protocol describes data collection for influenza, COVID-19, and other respiratory viruses (such as RSV or new viruses of public health concern) in the EU/EEA and wider WHO European Region. Data collection is integrated for most datasets in line with the operational considerations for respiratory virus surveillance in Europe.

The first year of the COVID-19 pandemic is associated with a 50% decline in working memory and executive function among older adults, a new UK study suggests. Medscape Medical News…

IntroductionTwo large multicentre European hospital networks have estimated vaccine effectiveness (VE) against COVID-19 since 2021. AimWe aimed to measure VE against PCR-confirmed SARS-CoV-2 in hospitalised severe acute respiratory illness (SARI) patients ≥ 20 years, combining data from these networks during Alpha (March–June)- and Delta (June–December)-dominant periods, 2021. MethodsForty-six participating hospitals across 14 countries follow a similar generic protocol using the test-negative case–control design. We defined complete primary series vaccination (PSV) as two doses of a two-dose or one of a single-dose vaccine ≥ 14 days before onset. ResultsWe included 1,087 cases (538 controls) and 1,669 cases (1,442 controls) in the Alpha- and Delta-dominant periods, respectively. During the Alpha period, VE against hospitalisation with SARS-CoV2 for complete Comirnaty PSV was 85% (95% CI: 69–92) overall and 75% (95% CI: 42–90) in those aged ≥ 80 years. During the Delta period, among SARI patients ≥ 20 years with symptom onset ≥ 150 days from last PSV dose, VE for complete Comirnaty PSV was 54% (95% CI: 18–74). Among those receiving Comirnaty PSV and mRNA booster (any product) ≥ 150 days after last PSV dose, VE was 91% (95% CI: 57–98). In time-since-vaccination analysis, complete all-product PSV VE was > 90% in those with their last dose 

IntroductionThe I-MOVE-COVID-19 and VEBIS hospital networks have been measuring COVID-19 vaccine effectiveness (VE) in participating European countries since early 2021. AimWe aimed to measure VE against PCR-confirmed SARS-CoV-2 in patients ≥ 20 years hospitalised with severe acute respiratory infection (SARI) from December 2021 to July 2022 (Omicron-dominant period). MethodsIn both networks, 46 hospitals (13 countries) follow a similar test-negative case–control protocol. We defined complete primary series vaccination (PSV) and first booster dose vaccination as last dose of either vaccine received ≥ 14 days before symptom onset (stratifying first booster into received 

We followed 4,081,257 Australian adults aged ≥ 65 years between November 2022 and May 2023 for COVID-19-specific mortality, when recombinant SARS-CoV-2 Omicron lineages (predominantly XB and XBB) as well as BA.2.75 were circulating. Compared with a COVID-19 booster targeting ancestral SARS-CoV-2 given > 180 days earlier, the relative vaccine effectiveness against COVID-19 death of a bivalent (ancestral/BA.1 or ancestral/BA.4-5) booster given 8 to 90 days earlier was 66.0% (95%CI: 57.6 to 72.2%) and that of a monovalent ancestral booster given 8 to 90 days earlier was 44.7% (95%CI: 23.9 to 59.7%). …

This report describes increases in cases of congenital syphilis during the COVID-19 pandemic.

The SARS-CoV-2 BA.2.86 Omicron subvariant was first detected in wastewater in Sweden in week 31 2023, using 21 highly specific markers from the 50 investigated. We report BA.2.86’s introduction and subsequent spread to all 14 regions performing wastewater sampling, and on 70 confirmed COVID-19 cases, along with the emergence of sublineages JN.1 and JN.2. Further, we investigated two novel mutations defining the unique BA.2.86 branching in Sweden. Our integrated approach enabled variant tracking, offering evidence for well-informed public health interventions. …

We observed a rebound in consumption of antibacterials for systemic use (ATC J01) in the community sector in the European Union/European Economic Area during 2021 and 2022, after an observed decrease between 2019 and 2020. The rates in 2022 returned to pre-COVID-19-pandemic levels and were exceeded in 13 countries. Although these patterns could partly be a result of changes in disease transmission during the study period, it could also reflect a lost opportunity to strengthen and reinforce prudent antibiotic use. …

De variantopdaterede covid-19-vacciner, som er rettet mod nyere varianter af coronavirus, og som er blevet givet siden oktober i år, giver god beskyttelse mod alvorlig sygdom.

Though antivirals are critical for reducing severe COVID-19 symptoms, researchers suggested that the medication may not always be needed for milder cases. Medscape Medical News…

A 50% decline in working memory and executive function among older adults in the United Kingdom during the first year of the COVID-19 pandemic is linked to an increase in known risk factors for dementia. Medscape Medical News…

This report describes declines in influenza vaccination coverage among health care personnel working in hospitals during the COVID-19 pandemic.

This report describes the percentage of health care personnel working in hospitals and nursing homes who received a flu vaccine and the percentage who received a COVID-19 vaccine.

BackgroundThe NHS Test and Trace (NHSTT) programme was established in May 2020 in England to deliver SARS-CoV-2 testing and contact tracing in order to identify infected individuals and reduce COVID-19 spread. To further control transmission, people identified as contacts were asked to self-isolate for 10 days and test only if they became symptomatic. From March 2021, eligibility criteria for PCR testing expanded to include asymptomatic contacts of confirmed cases. AimTo analyse testing patterns of contacts before and after the change in testing guidance in England to assess the impact on PCR testing behaviour with respect to symptom status and contact type. MethodsTesting and contact tracing data were extracted from the national data systems and linked. Subsequently, descriptive statistical analysis was applied to identify trends in testing behaviour. ResultsBetween 1 January and 31 July 2021, over 5 million contacts were identified and reached by contact tracers; 42.3% took a PCR test around the time they were traced. Overall positivity rate was 44.3% and consistently higher in symptomatic (60–70%) than asymptomatic (around 20%, March–June) contacts. The proportion of tests taken by asymptomatic contacts increased over time, especially after the change in testing guidance. No link was observed between uptake of PCR tests and vaccination coverage. Fully vaccinated contacts showed lower positivity (23.8%) than those with one dose (37.2%) or unvaccinated (51.0%). ConclusionAlmost 1 million asymptomatic contacts were tested for SARS-CoV-2, identifying 214,056 positive cases, demonstrating the value of offering PCR testing to this group. …

COVID-19 has no impact on disease activity, progression, or cognitive performance in patients with multiple sclerosis. Medscape Medical News…

Among Canadians, patients aged 80 years or older are the least likely to have a history of COVID-19 infection and the most likely to be hospitalized or die following infection, data indicate. Medscape Medical News…

With the exception of venous thromboembolism and pulmonary embolism events, the antiviral drug did not reduce the incidence of post-COVID-19 conditions in a study of nearly 10,000 US veterans. Medscape Medical News…

Physicians provided tips on how to increase rates of pregnant women receiving the COVID-19 booster. Medscape Medical News…

This Reporting Protocol describes data collection for influenza, COVID-19, and other respiratory viruses (such as RSV or new viruses of public health concern) in the EU/EEA and wider WHO European Region. Data collection is integrated for most datasets in line with the operational considerations for respiratory virus surveillance in Europe.

Researchers report endoscopic features and propose diagnostic criteria for post–COVID-19 cholangiopathy — one of the most serious long-term gastrointestinal consequences of COVID-19. Medscape Medical News…

CDC detected BA.2.86 variant in a traveler within days of being reported. Timely detection provides early warning of new COVID-19 variants entering the U.S.

COVID-19 increases the risk for Guillain-Barré syndrome sixfold, while getting the Pfizer mRNA vaccine lowers risk. Medscape Medical News…

Både forekomsten af RS-virus, covid-19 og kighoste er i stigning. Sæsonen for RS-virus er nu startet, mens kighoste-forekomsten fortsætter på et epidemisk højt niveau, og forekomsten af covid-19 er støt stigende. Det viser den integrerede overvågning fra Statens Serum Institut (SSI).

Roughly half of children are noninfectious 3 days after a positive COVID-19 test, independent of vaccination status. Medscape Medical News…

This report is based on the findings from two focused After-Action reviews (AARs) in Norway and Georgia that discussed the use of evidence in the advice-making process for long-term care facilities (LTCFs) during the start of the COVID-19 Omicron wave in early 2022.

Report from the after-action review (AAR) in Norway during the emergence of the Omicron variant of concern of SARS-CoV-2.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 8-14 October 2023 and includes updates on hepatitis A, influenza A(H5N1), COVID-19, the Rugby World Cup 2023, West Nile virus, measles and diphtheria.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 8-14 October 2023 and includes updates on hepatitis A, influenza A(H5N1), COVID-19, the Rugby World Cup 2023, West Nile virus, measles and diphtheria.

BackgroundContact tracing has been a key component of COVID-19 outbreak control. Backward contact tracing (BCT) aims to trace the source that infected the index case and, thereafter, the cases infected by the source. Modelling studies have suggested BCT will substantially reduce SARS-CoV-2 transmission in addition to forward contact tracing. AimTo assess the feasibility and impact of adding BCT in practice. MethodsWe identified COVID-19 cases who were already registered in the electronic database between 19 February and 10 March 2021 for routine contact tracing at the Public Health Service (PHS) of Rotterdam-Rijnmond, the Netherlands (pop. 1.3 million). We investigated if, through a structured questionnaire by dedicated contact tracers, we could trace additional sources and cases infected by these sources. Potential sources identified by the index were approached to trace the source’s contacts. We evaluated the number of source contacts that could be additionally quarantined. ResultsOf 7,448 COVID-19 cases interviewed in the study period, 47% (n = 3,497) indicated a source that was already registered as a case in the PHS electronic database. A potential, not yet registered source was traced in 13% (n = 979). Backward contact tracing was possible in 62 of 979 cases, from whom an additional 133 potential sources were traced, and four were eligible for tracing of source contacts. Two additional contacts traced had to stay in quarantine for 1 day. No new COVID-19 cases were confirmed. ConclusionsThe addition of manual BCT to control the COVID-19 pandemic did not provide added value in our study setting. …

BackgroundUnprecedented non-pharmaceutical interventions to control the COVID-19 pandemic also had an effect on other infectious diseases. AimWe aimed to determine their impact on transmission and diagnosis of notifiable diseases other than COVID-19 in Bavaria, Germany, in 2020 and 2021. MethodsWe compared weekly cases of 15 notifiable infectious diseases recorded in Bavaria between 1 January 2016 and 31 December 2021 in time series analyses, median age and time-to-diagnosis using Wilcoxon rank sum test and hospitalisation rates using univariable logistic regression during three time periods: pre-pandemic (weeks 1 2016–9 2020), pandemic years 1 (weeks 10–52 2020) and 2 (2021). ResultsWeekly case numbers decreased in pandemic year 1 for all diseases assessed except influenza, Lyme disease and tick-borne encephalitis; markedly for norovirus gastroenteritis (IRR = 0.15; 95% CI: 0.12–0.20) and pertussis (IRR = 0.22; 95% CI: 0.18–0.26). In pandemic year 2, influenza (IRR = 0.04; 95% CI: 0.02–0.09) and pertussis (IRR = 0.11; 95% CI: 0.09–0.14) decreased markedly, but also chickenpox, dengue fever, Haemophilus influenzae invasive infection, hepatitis C, legionellosis, noro- and rotavirus gastroenteritis and salmonellosis. For enterohaemorrhagic Escherichia coli infections, median age decreased in pandemic years 1 and 2 (4 years, interquartile range (IQR): 1–32 and 3 years, IQR: 1–18 vs 11 years, IQR: 2–42); hospitalisation proportions increased in pandemic year 1 (OR = 1.60; 95% CI: 1.08–2.34). ConclusionReductions for various infectious diseases and changes in case characteristics in 2020 and 2021 indicate reduced transmission of notifiable diseases other than COVID-19 due to interventions and under-detection. …

In 2020, the world had to adapt to a pandemic caused by a then novel coronavirus. In addition to its direct impact on morbidity and mortality, the COVID-19 pandemic brought unprecedented control measures and challenges to both individuals and society. Sweden has been seen by many as an outlier in the management of the pandemic. It is therefore of special interest to document the actual management of the pandemic in Sweden during its first 2 years and how public health was affected. In the authors opinion, within the Swedish context, it has been possible to achieve a similar level of effect on mortality and morbidity through recommendations as was achieved through stringent legal measures in comparable countries. This is supported by comparisons of excess mortality that have been published. Furthermore, we see in the available data that the consequences on mental health and living habits were very limited for the majority of the population. Trust in public institutions is high in Sweden, which has been important and is part of the context that made it possible to manage a pandemic with relatively ‘soft’ measures. We acknowledge challenges in protecting certain vulnerable groups, particularly during the first and second wave. …

This report describes the Advisory Committee on Immunization Practices\' recommendation that all people aged 6 months and older get an updated COVID-19 vaccine.

The use of nirmatrelvir–ritonavir (Paxlovid) is associated with a lower risk for death or hospitalization in extremely vulnerable patients with COVID-19. Low-risk patients do not appear to benefit. Medscape Medical News…

As autumn moves to winter, the WHO/Europe, EC and ECDC are issuing a clear, urgent message: people who remain unprotected against both COVID-19 and seasonal influenza – especially the most vulnerable and at-risk – should take up any offer for vaccination to prevent or mitigate the impact of these co-circulating respiratory infections.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 1 - 7 October 2023 and includes updates on dengue, West Nile virus disease, COVID-19, chikungunya, Middle East respiratory syndrome, mpox, and mass gathering monitoring for the Rugby World Cup.

Patients with more severe COVID-19 that required hospitalization in the ICU were more likely to develop vasculitis, alopecia totalis, and several other autoimmune conditions. Medscape Medical News…

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 1 - 7 October 2023 and includes updates on dengue, West Nile virus disease, COVID-19, chikungunya, Middle East respiratory syndrome, mpox, and mass gathering monitoring for the Rugby World Cup.

International comparisons of COVID-19 incidence rates have helped gain insights into the characteristics of the disease, benchmark disease impact, shape public health measures and inform potential travel restrictions and border control measures. However, these comparisons may be biased by differences in COVID-19 surveillance systems and approaches to reporting in each country. To better understand these differences and their impact on incidence comparisons, we collected data on surveillance systems from six European countries: Belgium, England, France, Italy, Romania and Sweden. Data collected included: target testing populations, access to testing, case definitions, data entry and management and statistical approaches to incidence calculation. Average testing, incidence and contextual data were also collected. Data represented the surveillance systems as they were in mid-May 2021. Overall, important differences between surveillance systems were detected. Results showed wide variations in testing rates, access to free testing and the types of tests recorded in national databases, which may substantially limit incidence comparability. By systematically including testing information when comparing incidence rates, these comparisons may be greatly improved. New indicators incorporating testing or existing indicators such as death or hospitalisation will be important to improving international comparisons. …

This report describes COVID-19 vaccination coverage among long-term care facility residents.

This report describes COVID-19-associated hospitalizations among older adults.

This report describes the severity of respiratory syncytial virus disease among hospitalized older adults compared to hospitalizations for COVID-19 or influenza.