Alerts in Europe
A total of 162 domestic cases of West Nile virus infection, which is transmitted by mosquitoes, have been recorded in Greece since the beginning of the year 2023. During the same period, 22 deaths of patients who developed meningitis or encephalitis due to the infection were also recorded. All patients who died were over 63 years of age. The actual number of cases is likely higher, as for every case with central nervous system symptoms there are approximately 140 cases with mild or no symptoms. Fever, headache, nausea or rash may occur in 20% of cases, but only 1% of patients develop severe disease affecting the brain.
There´s been a sharp increase in the number of reported cases of tick-borne encephalitis in Sweden this year. According to the Public Health Agency, 170 cases were confirmed in the month of August 2023 alone -- a new record. The western Västra Götaland region has already had more cases so far this year than over the whole of 2022.
As of 8 December 2022, at least five Member States in the European Region, reported an increase in cases of invasive group A streptococcus disease and in some cases also scarlet fever. An increase in related deaths has also been reported in some of these countries.
Spain reports that one in 56 healthy children under one year of age are admitted for respiratory syncytial virus, which is the main cause of bronchiolitis. There are 40% more cases than in the pre-pandemic era and Covid has changed the epidemiological cycle of viruses.
The rapid increase in the spread of COVID-19 infections in a new epidemic wave is pushing German hospitals to the limit of their capacity, following the alert today of the president of the Association of German Hospitals, Gerald Gaß.
As of 26 September 2022, 92 cases of diphtheria among migrants have been reported by seven European countries for the year 2022. Sixty-six of these cases presented with cutaneous diphtheria caused by Corynebacterium diphtheriae. Cases of respiratory diphtheria have also been reported, including one fatal case. The cases are among males, and most have been diagnosed in reception centres for migrants. Additionally, one case of cutaneous diphtheria was detected in a staff member at a reception centre in Switzerland. Most of the cases reported by EU/EEA countries and the UK in 2022, were infected by strains of C. diphtheriae for which toxin production was confirmed. For a limited number of cases, mainly in Switzerland, the toxigenicity has not been determined or reported. Diphtheria is a rare disease in the EU/EEA. An average of 52 cases were annually reported across the EU/EEA to ECDC between 2016 and 2020. Around 50% of reported cases were caused by Corynebacterium (C.) diphtheriae. Of the 128 cases caused by C. diphtheriae reported between 2016-2020, 60 were cutaneous, 25 respiratory, and one had both a cutaneous and respiratory presentation. Forty-two cases had a different clinical manifestation or missed information about the clinical manifestation. During this five-year period, 69 C. diphtheriae cases were classified as imported in eleven EU/EEA countries (an average of 14 imported C. diphtheriae cases per year), and of these, 46 presented with a cutaneous disease. It was not possible to confirm the potential migratory status of these cases as their reason for travel to the EU/EEA was not reported. The number of cases reported so far in 2022 represents an increase compared to the average number of imported cases seen in recent years. This increase could be explained by an increased volume of migrants from diphtheria-endemic countries, by an increased circulation of the pathogen in the countries of origin, or by an increased risk of transmission in specific settings such as migrant reception centres. As of 26 September 2022, ECDC is not aware of any evidence indicating outbreaks in the broader EU/EEA population resulting from the increased number of imported cases.