Abstract The effectiveness of the 13-valent pneumococcal conjugate vaccine (PCV13) to prevent vaccine-serotype (VT) invasive pneumococcal disease (IPD) in children aged 2–59 months was assessed using data from 4 geographically defined areas in Canada with IPD surveillance, including immunization status. VT IPD cases and IPD controls with non-PCV13 types or PCV13-related serotypes (NVT/NR) during the years 2010–2019 were eligible. Vaccine effectiveness (VE) was estimated by the indirect cohort method, using multivariate logistic regression models. In total, 367 VT IPD cases and 564 NVT/NR IPD controls were included. VE of ≥1 dose of PCV13 against VT IPD was 70% [95% confidence interval: 49%–83%], lower against serotype 19A IPD (VE = 58%; 95%CI, 14%–80%) and against serotype 3 IPD (VE = 46%; 95%CI, −36% to 79%), but higher against all other PCV13 serotypes (VE = 90%; 95%CI, 78%–96%). Waning of protection was seen against all VT IPD, particularly for serotype 3, with a VE of 89% [54%–97%] during the first 5 months after the third dose but no protection remaining after 18 months. As serotype 3 and serotype 19A are still frequent causes of IPD in children, more effective vaccines are needed.
Abstract The Histoplasma capsulatum complex clusters cryptic species with genetic diversities linked to their geographic distribution and virulence. The American continent harbours its highest diversity, making this region the main axis for H. capsulatum spread. Species of this complex cause respiratory-systemic mycosis known as histoplasmosis. Infection occurs through the inhalation of fungal propagules that grow in sites such as caves, mines, and abandoned buildings, where environments rich in organic matter containing micronutrients present in bat and bird guano favour the development of these fungal pathogens. This research was conducted in the state of Nayarit, Mexico, where the combination of environmental factors and the constant occurrence of bats in urban and rural areas contributes to the proliferation of H. capsulatum . The presence of the fungus was detected by nested-PCR using a specific marker (Hcp100) for H. capsulatum , either in guano or in bat organ samples collected in the municipalities of Tepic, Santa María del Oro (SAMAO), and La Yesca, Nayarit. Out of 27 guano samples analysed by nested-PCR, 21 were positive for H. capsulatum , while of the 12 bats studied, only five revealed infections. The fungus was isolated from a lung sample of a nectarivorous bat ( Glossophaga mutica ) by culture. The results suggest a potential risk to exposed populations, including different specialized workers and tourists who explored bat roosts. Avoiding guano accumulation, restricting access to bat roosts, and implementing bat-exclusion strategies in homes are general recommendations to prevent fungal infections.
Abstract Social contact surveys, measuring who contacts whom, are widely used for epidemic intelligence and public health decision-making. Despite their widespread use, sample size calculations are not performed. We conducted a review of social contact surveys (2008–2025) to characterize current practice. We characterized the impact of survey size on epidemic metrics using two social contact surveys, the UK Social Contact Survey and POLYMOD (Europe), and two methods. For each dataset and approach, we generated repeated subsamples and calculated the resulting reproduction numbers, characterized their distributions, and measured uncertainty. We identified 107 unique social contact surveys from 57 studies. Sample sizes ranged from 30 to more than 10 000 participants, with a median of 1 438. One quarter of surveys contained fewer than 1 000 participants. Our analysis supports recruiting at least 1 000 participants for general-population social contact surveys used for epidemic modelling. Increasing sample size to 2 000 participants provides worthwhile gains in the precision of epidemic estimates, particularly for analyses using finer age stratification or individual-level approaches. Beyond approximately 3 000 participants, additional improvements in precision were small for the epidemic metrics analysed. This provides a practical balance between precision and participant burden.
Abstract The Moving Epidemic Method (MEM) is the ECDC/WHO-Europe-endorsed approach for establishing influenza epidemic thresholds and intensity levels, yet no positivity-based MEM analysis exists for Türkiye or any country in the WHO Western Asia transmission zone. Weekly influenza positivity rates from FluNet sentinel surveillance were analysed for ten of twelve seasons (2013/2014–2024/2025, excluding two COVID-19 pandemic seasons) using the mem R package with cross-validated optimized slope parameter, and Türkiye’s average epidemic curve and thresholds were compared with the Western Asia (excluding Türkiye) and South West Europe zones using Lin’s concordance correlation coefficient (CCC), root mean square deviation (RMSD) and complementary correlation metrics. The epidemic threshold was 10.59% positivity, with intensity thresholds at 42.56% (medium), 60.92% (high), and 71.38% (very high); cross-validated sensitivity was 0.77, specificity 0.88, and Matthews correlation coefficient 0.65. Türkiye’s average curve showed higher concordance with Western Asia (CCC=0.890; RMSD=4.22 percentage points) than South West Europe (CCC=0.672; RMSD=12.48) despite similar Pearson correlations (0.922 vs. 0.939), and the Western Asia epidemic threshold (11.50%) closely matched Türkiye’s. These first operational MEM thresholds for Türkiye and the first positivity-based thresholds for the Western Asia zone confirm alignment with the current WHO transmission zone classification and support integration into routine surveillance.
Abstract This observational descriptive study analyses the hospital burden of respiratory syncytial virus (RSV) among adults in Spain using the Minimum Basic Data Set (MBDS) from the Spanish National Hospital Data Surveillance System. Hospital admissions of adults diagnosed with non-bronchiolitis RSV infection between 2016 and 2023 were identified using ICD-10-CM codes. A total of 288,297 RSV-related hospitalizations were recorded, with a mean patient age of 76.18 years. The overall hospitalization rate was 92.43 per 100,000 inhabitants, and the mortality rate was 5.32 per 100,000. The most common severe comorbidities at admission were congestive heart failure, diabetes, and chronic obstructive pulmonary disease. Patients aged over 65 years had a significantly higher risk of in-hospital mortality (OR 1.78; 95% CI: 1.64–1.93) compared to those aged 40–64 years, increasing to 2.22 (95% CI: 2.05–2.40) in the presence of at least one severe comorbidity. Male sex was also associated with increased mortality risk (OR 1.24; 95% CI: 1.20–1.28). In conclusion, RSV represents a substantial cause of hospitalization and mortality among adults in Spain, particularly in patients over 60 years, males, and those with underlying comorbidities.
