#WHO Rapid #Risk #Assessment - #Heatwave, WHO European Region v.1 (July 25 '26, summary): 10,650 excess deaths estimated so far

{Excerpts}

Risk statement  

    ° This rapid risk assessment aims to assess the overall public health risk posed by the 2026 heatwaves in the WHO European Region.  

    ° It considers the potential health impact, particularly among vulnerable population groups, the geographic scope and severity of the event, population vulnerabilities, available prevention and control capacities, and seasonal and environmental factors that may exacerbate heat-related morbidity and mortality.  

    ° The 2026 European heatwave is assessed as presenting a moderate public health risk across the WHO European Region, with high confidence. 

    ° Widespread and prolonged extreme temperatures across Europe, affecting large parts of Western, Central and Southern Europe, have resulted in substantial population exposure and are associated with increased heat-related morbidity and mortality, including reported excess deaths. 

    ° Several countries have recorded temperatures exceeding 40°C and activated high-level heat-health warnings and emergency response measures. 

    ° Preliminary European Mortality Monitoring network (EURO MOMO) data indicate substantial excess mortality associated with the 2026 heatwaves. 

    ° Approximately 10,650 excess deaths were estimated during 22–28 June 2026, including more than 9,000 among adults aged 65 years and older. 

    ° Across the two-week period of peak temperatures, European mortality surveillance estimates indicated more than 14,000 excess deaths, highlighting the substantial mortality impact of prolonged and extreme heat exposure.  

    ° The public health impacts of the current heatwaves are expected to vary across and within countries. 

    ° The greatest adverse health impacts are expected in severely affected countries and subnational areas, particularly in densely populated urban settings, where extreme daytime temperatures persist, night-time cooling is limited, population vulnerability is increased, and heat-health response measures are insufficient or not fully implemented. 

    ° Existing healthsystem preparedness and response capacity, including early warning, public health measures, outreach to vulnerable groups and continuity arrangements, can reduce impacts; however, healthcare facility capacity alone is insufficient to mitigate heat-related health risks. 

    ° The likelihood of significant health impacts is high wherever extreme temperatures persist, especially in the absence of comprehensive preparedness and response measures.   

    ° Extreme heat may also interact with other environmental and meteorological hazards, creating compound and cascading risks. 

    ° Heatwaves may contribute to atmospheric instability that can be followed by severe thunderstorms, intense rainfall, flash flooding, landslides and windstorms.   

    ° Heat events may coincide with drought, water stress, high ultraviolet (UV) radiation, and air pollution, including vegetation fire smoke. 

    ° These hazards can further increase morbidity and mortality, disrupt essential services, damage infrastructure, and complicate emergency response. 

    ° Recent observations across Europe, including repeated episodes of vegetation fires and severe convective storms following heat events, underscore the need for integrated multi-hazard preparedness and response. 

    ° As the event continues, heat-related morbidity, including emergency department visits and hospitalizations, and mortality are expected to increase further in affected areas, particularly among populations at increased risk. 

    ° Heatwaves may place additional pressure on healthcare delivery through increased demand for emergency and medical services, overheating of healthcare and long-term care facilities, increased energy demand, potential disruption of cooling systems, impacts on medicine and vaccine storage, and heat stress among healthcare workers. 

    ° Heat-related impacts extend beyond the health sector and may affect energy, water, transport, food systems, workplaces, schools and social services. 

    ° Power disruptions may compromise cooling, medical equipment and healthcare operations, while water stress may affect hydration, hygiene and cooling access. 

    ° Transport disruptions may limit access to healthcare, cooling centres and social support.   

    ° Despite broad population exposure across Europe, the health impacts of heatwaves are not evenly distributed and are largely determined by individual vulnerability, living conditions, occupational exposure and access to protective measures. 

    ° Populations at increased risk include: 

        § older adults, 

        § persons with underlying cardiovascular, respiratory, renal, diabetes-related or mental health conditions, 

        § infants and young children, 

        § pregnant women, 

        § migrants, refugees and displaced populations, 

        § homeless persons, 

        § informal and outdoor workers, 

        § people living in poor-quality or overcrowded housing and socially isolated individuals.  

    ° Although heatwaves are typically acute events lasting days to weeks, their direct health impacts can be immediate and severe, with short-term increases in heat-related morbidity, emergency medical calls, emergency department visits, hospital admissions and mortality. 

    ° Heat can also exacerbate chronic diseases, increase dehydration and heatstroke, worsen mental health and sleep disruption, and increase indirect risks such as drowning, occupational injuries, foodsafety problems and disruption to essential services. 

    ° Longer-term public health consequences, such as changes in the transmission dynamics of vector-borne diseases, are less likely to arise from a single heatwave event but warrant continued surveillance, particularly when extreme heat is accompanied by environmental changes, water scarcity, altered human behavior, or shifts in vector distribution and activity. 

    ° Importantly, the public health significance of heatwaves extends beyond their immediate effects, as these events are increasing in both frequency and intensity across Europe. 

    ° Consequently, repeated and more severe heatwave episodes may contribute to cumulative health risks and broader environmental and ecological changes.  

    ° Heatwaves are predictable hazards, and timely implementation of heat-health action plans can substantially reduce their impact. 

    ° Weather forecasts and early warning systems should support targeted heat-health alerts, risk communication, outreach to vulnerable groups, workers' protection measures, continuity planning for health and social care services, access to cooling spaces and drinking water, and coordination across relevant sectors. 

    ° Response planning should also consider co-occurring environmental factors, including high humidity, poor air quality, ozone, wildfire smoke, water stress, elevated night-time temperatures, and storms, which may further increase health risks and complicate public-health messaging.  

    ° The public health risk associated with the 2026 heatwaves is heterogeneous across the WHO European Region, reflecting differences in climatic conditions, population vulnerability, exposure patterns, infrastructure, and public health preparedness:  

        • The highest risk is assessed in areas where prolonged extreme heat coincides with high vulnerability and limited adaptive capacity, particularly densely populated urban areas with persistent high daytime and night-time temperatures, poor housing conditions, limited access to cooling, high levels of social vulnerability, substantial occupational heat exposure, and insufficient heat-health response mechanisms. 

        • Moderate risk is assessed in areas experiencing less intense heat where preparedness and response measures are stronger. However, northern and traditionally cooler countries may still experience significant increases in heat-related morbidity and mortality during unusually high temperatures because populations, buildings and services are generally less adapted to extreme heat. (e.g., the 2018 Scandinavian heatwave saw notable mortality despite lower absolute temperatures).  

        • In Central Asia, the risk is moderate but expected to increase as the summer progresses, as extreme heat events typically intensify later in summer season. Early warning systems and timely implementation of heat-health response measures may help mitigate the expected health impact. 

    ° Based on the current meteorological, epidemiological and public health information, the overall risk associated with the 2026 heatwave is assessed as “Moderate” in the WHO European Region, and as “Low” at the global level,  with a high level of confidence in both assessments. The rapid risk assessment will be updated as additional information becomes available. 

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{1} Confidence refers to the level of confidence in the data/information or the quality of the evidence available at the time the RRA is conducted. Poor quality information may increase the overall perceived risk due to the incertitude in the assessment.  

Source: 

Link: https://www.who.int/publications/m/item/who-rapid-risk-assessment---heatwave--who-european-region-v.1

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Seasonal #surveillance in #humans in 2026 for #WNV (West Nile Virus) (ECDC, July 24 '26): 81 confirmed cases so far of which 46 in #Italy

 

{Excerpt}

Week 30, 2026 | Produced on 23 July 2026 at 09:45, based on data submitted up until and including 22 July 2026.

Current situation

    ° Since the beginning of the 2026 transmission season, and as at 22 July, 35 areas affected by West Nile virus (WNV) have been identified in six countries across Europe.

    ° These areas are located in: 

        § Italy (20), 

        § Greece (six), 

        § Romania (four), 

        § North Macedonia (two), 

        § Spain (two) and 

        § France (one).

    ° The six countries have reported 81 locally acquired human cases of WNV infection: 

        § Italy has reported 46, 

        § Greece 21, 

        § North Macedonia five, 

        § Romania five, 

        § Spain three and 

        § France one case.

    ° This week, nine areas are reported as affected for the first time this season. The affected areas identified as at 22 July 2026 are listed in Table 1 and shown in Map 1 below.

(...)

Table 1. Areas affected by West Nile virus during the 2026 transmission season at 22 July, by country and NUTS3 or GAUL1 area

{Click on Images to Enlarge}

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Source: 

Link: https://www.ecdc.europa.eu/en/west-nile-fever/surveillance-and-disease-data/disease-data-ecdc

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#Screening and #monitoring of #travellers returning from countries affected by #Bundibugyo virus: an overview of #European approaches, July 2026

 

Abstract

The 2026 Ebola outbreak caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda has prompted European countries and the United States to revise measures for travellers, healthcare workers and humanitarian personnel returning from affected areas. We compare current procedures and protocols with those implemented during the 2013–2016 Ebola outbreak. Despite some national differences, policies have largely converged towards risk-based management, early case detection, rapid isolation, exposure-based monitoring and healthcare preparedness, rather than routine border screening.

Source: 

Link: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.28.2600578?emailalert=true#abstract_content

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Surveillance for West NileVirus Infections in Humans in Europe, Weekly Report: Week 26, 2026 (ECDC, summary)

 

{Excerpt}

Epidemiological summary

    Since the beginning of 2026, and as of 24 June, two countries in Europe reported three human cases{1} of West Nile virus (WNV) infection: Italy (two cases) and North Macedonia (one case).

    The current report in Table 1 includes the number of probable and confirmed cases of WNV infections per NUTS3 region. However, these figures are preliminary and should be interpreted with caution as they may be revised by the countries as more information becomes available. For further details on case numbers, please refer to the joint monthly report, which offers a more detailed analysis.

    Please note: The table and map in this report contain countries and areas where human West Nile virus infection cases were reported to EpiPulse Cases.

(...)

#) Country

    ° Affected area*

        § Newly affected area**

            - Number of probable cases - Number of confirmed cases - Total cases 

1) Italy

    ° Caserta

        § No

            - 0 / 1 /1 

    ° Firenze

         § No

            - 0 / 1 /1 

2) North Macedonia

    ° Vardarski

        § No

            - 0 / 1 / 1

__

{*} An ‘affected area’ or ‘risk area’ is defined as ‘a risk area with ongoing transmission of WNV to humans’. This means that at least one autochthonous human case of WNV has been reported as a result of local transmission in the area according to the agreed, standardised and disease-specific case definition. In exceptional circumstances, a probable case can be used to determine transmission, however, this should only apply in specific and agreed situations when a case cannot be confirmed within a reasonable time.

{**} Compared to the previous weekly report.

(...)

Source: 

Link: https://wnv-weekly.ecdc.europa.eu/

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Detection of #antibodies against avian #influenza in #European dairy #cattle, the #Netherlands, January 2026

 

Abstract

In December 2025, highly pathogenic avian influenza (HPAI) H5N1 clade 2.3.4.4b genotype DI.2.1 virus was detected in a cat living on a dairy cattle farm. Milk and serum samples from the dairy cattle were tested for avian influenza virus. No viral RNA was detected; however, H5N1-specific antibodies were identified in serum samples from 34 (47.2%) of 72 lactating dairy cows and 24 (63.2%) of 38 youngstock. These demonstrate expansion of the mammalian host range of HPAI H5N1 in Europe.

Source: 

Link: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.25.2600464#abstract_content

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#Spain reported a locally acquired Crimean-Congo Hemorrhagic Fever (#CCHF), according latest ECDC report (June 22 '26)

 

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Epidemiological summary

    This is the first report of the weekly seasonal surveillance reports on Crimean-Congo haemorrhagic fever (CCHF) infections in 2026.

    Since the beginning of 2026 and as of 17 June 2026, one country in Europe has reported locally acquired cases of CCHF: 

        ° Spain (one case).

    The case in Salamanca (Spain) is not unexpected as Hyalomma spp. – the main vectors of CCHF virus – are widely distributed across the region. 

    In addition, CCHF virus is known to circulate in local animal populations, and human cases have previously been reported there. 

    The timing of this case aligns with the expected seasonal pattern of CCHF in Spain, and is probably linked to increased tick activity.

(...)

Source: 

Link: https://www.ecdc.europa.eu/en/crimean-congo-haemorrhagic-fever/surveillance-and-updates/seasonal

____

Estimation of the #importation #risk of #Bundibugyo virus into the #EU/EEA in June 2026 (ECDC, summary)

 

Assessment | 15 June 2026

    In this report, we present estimates of the probability of importation of Ebola disease caused by Bundibugyo virus (BDBV), into EU/EEA countries for the period 11–25 June 2026 under different assumptions of travel volumes from the areas where most cases were reported from. 

    In addition, we estimate the volume of air travel passengers from this region that would be expected to result in one BDBV importation.

Key findings

    ° The ongoing outbreak of the Bundibugyo virus (BDBV) in the Democratic Republic of the Congo (DRC) has raised some concerns about the BDBV importation risk into the European Union/European Economic Area (EU/EEA).

    ° Based on mathematical modelling, we estimate approximately one importation per 23 000 travellers (90% Uncertainty Interval, UI: 13 000 – 54 000) from the main outbreak region (North Kivu and Ituri, DRC) to the EU/EEA.

    ° We estimate the probability of at least one BDBV importation into the EU/EEA from 11–25 June 2026 to be 0.45% (90% UI: 0.20%-0.85%), under the hypothetical assumption that 100 people travel from the outbreak region to the EU/EEA during this period. 

    ° We consider 100 travellers to be a conservative upper estimate based on available historical flight data and the closure of multiple airports in the proximity of the outbreak region. The true probability of importation is therefore likely to be lower.

    ° These estimates apply to travellers from the general population in the outbreak region. 

    ° The risk of importation associated with returning healthcare workers deployed to support the outbreak response is beyond the scope of this report.

Conclusions

    ° While sporadic BDBV importations into the EU/EEA cannot be ruled out, mathematical modelling suggests that the probability of importation from 11 to 25 June is very low. 

    ° These results apply to importation of BDBV from the general population of Ituri and North Kivu. 

    ° Humanitarian aid workers or healthcare care personnel returning from the outbreak region to the EU/EEA, who we assume would be medically evacuated from the affected areas with application of appropriate infection prevention and control measures, need to be considered separately.

    ° As one BDBV importation is expected per 24 000 travellers from the outbreak region, the vast majority of travellers will not be infected. 

    ° However, since early symptoms of BDBV infections overlap with many other conditions, a potentially large number of travellers will show similar symptoms as BDBV infections without being infected with BDBV (i.e. false positives). 

    ° Therefore, entry screening strategies based solely on symptom detection are likely to have low specificity, which will lead to unnecessary isolation, testing, and follow-up of a potentially large number of individuals per true case.

    ° The presented importation probabilities are model estimates, which are subject to several limitations and are based on currently observed trends of BDBV infections in DRC. 

    ° If there are substantial changes in the epidemiological situation, such as spread to other regions, then the results of this output need to be reassessed.

(...)

Source: 

Link: https://www.ecdc.europa.eu/en/publications-data/estimation-importation-risk-bundibugyo-virus-eueea-june-2026

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#Surveillance of West Nile Virus #WNV #infections in #human in #Europe, Weekly Report (ECDC, June 12 '26)

 

Week 24, 2026

Produced on 11 June 2026 at 08:15 based on data submitted up to 10 June 2026

Epidemiological summary

    Since the beginning of 2026, and as of 10 June, 1 country in Europe reported 1 human case of West Nile virus infection: North Macedonia.

    The current report in Table 1 includes the number of probable and confirmed cases of WNV infections per NUTS3 region. However, these figures are preliminary and should be interpreted with caution as they may be revised by the countries as more information becomes available. Consequently, no totals are provided. For further details on case numbers, please refer to the joint monthly report, which offers a more detailed analysis.

    Please note: The table and map in this report contain countries and areas where human West Nile virus infection cases were reported to EpiPulse Cases.

Introduction

    The European Centre for Disease Prevention and Control (ECDC) provides a weekly overview of human cases of West Nile virus (WNV) infection to support the competent authorities responsible for blood safety. This overview can aid decisions on the deferral or testing of blood donors who may have been exposed to the virus, in accordance with Commission Directives 2004/33/EC and 2014/110/EU.

    West Nile virus infection in humans is a notifiable disease at the EU level and cases are reported in accordance with the EU case definition. The table and map in this report show the countries and areas where human cases of WNV infection have been reported to the European surveillance portal for infectious diseases (EpiPulse Cases).

    More information on the occurrence of WNV infection among humans in Europe, as well as WNV outbreaks among equids and birds, is available in the joint monthly report produced by ECDC and the European Food Safety Authority (EFSA).

    Here we present the weekly report as of 10 June 2026.

Overview of West Nile virus cases in EU/EEA and EU-neighbouring countries

{Country - Affected Region - Probable - Confirmed - Total Cases}

    ° North Macedonia - Vardarski - 0 - 1 - 1

(...)

Source: 

Link: https://wnv-weekly.ecdc.europa.eu/

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Breeding #pig #transport drives the dispersal of #swine #influenza A virus across #Europe

 

Abstract

Pigs serve as reservoirs of former human influenza A virus (IAV) H1N1 and H3N2 lineages and act as mixing vessels for diverse strains, facilitating the emergence of novel IAVs. Understanding the spread and evolution of swine IAVs (swIAVs) is therefore crucial to assess the risk of strains with zoonotic potential emerging. This study uses a phylogeographic framework to investigate the predictors of swIAV dispersal across Europe. All publicly available swIAV genomic sequences were retrieved and subsampled for the ten largest European pig-producing countries. Discrete phylogeographic reconstructions were conducted for H1, H3, N1, N2 encoding genes and all internal gene segments. Our analyses indicate that viral dispersal predominantly occurred from north-western to southern and eastern Europe, with frequent long-distance transitions between non-adjacent countries. We also extended the discrete phylogeographical analyses with generalized linear models to test the association between viral movement and potential predictors, such as live pig trade, pork trade, pig densities, farm sizes, or the geographic distance between key pig production zones. We find that breeding pig trade is the only consistently well-supported predictor of between-country transition events, whereas pork trade and geographic distance were not supported. This highlights that farms importing breeding pigs from multiple countries could act as hotspots for reassortment of diverse swIAV strains. Strengthening external biosecurity on farms with emphasis on quarantining breeding pigs, limiting long-distance transport, and implementing a One Health surveillance system for earlier detection of emerging strains, could help curb the rapid spread and evolution of swIAV in Europe.

Competing Interest Statement

The authors have declared no competing interest.

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.06.01.729471v1

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Two #epidemics, one #genotype, different outcomes: evolutionary #changes of Avian #Influenza #H5N1, genotype EA-2024-DI

 

Abstract

Since 2020, high pathogenicity avian influenza H5Nx viruses of clade 2.3.4.4b have become enzootic in Europe, causing recurrent epidemic waves characterized by extensive reassortment events. Here, we describe the emergence of a single high-fitness genotype (EA-2024-DI) that has driven two consecutive waves, evolving into distinct sub-lineages. While its circulation is ongoing, during the 2025-2026 wave it caused an unprecedented number of cases in wild birds. Using phylodynamic analyses of a large dataset of genomic sequences, we compared the spatial diffusion and host transmission pattern of the EA-2024-DI sub-lineages across the three most recent epidemic waves (2023-2024, 2024-2025 and 2025-2026). We show that the genotype has persisted over time and has spread primarily through wild Anseriformes, but with a marked change in the transmission patterns between the different waves and a shift in the epicenter from Eastern to Central Europe, the latter having emerged as an important hub for virus diffusion throughout Europe. Our results reveal a recent increase in the frequency of viruses from wild and domestic mammals carrying mutations enhancing virus replication in mammalian hosts, highlighting the importance of proactive monitoring of this group of hosts to better understand its role in the virus ecology and evolution.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

Funded by the European Union under grant agreement (101084171) - (Kappa-Flu). Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or REA. Neither the European Union nor the granting authority can be held responsible for them

Support for this work was provided by the European Union within the framework of the activities foreseen by the European Union Reference Laboratory for Avian Influenza and Newcastle Disease under grant agreement 101201937

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.05.25.727580v1

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Rapid #Scientific #Advice on #management of #passengers In context of #Andes virus #outbreak on cruise #ship MV #Hondius (ECDC, May 9 '26, summary)

 

{Excerpt}

Key messages 

-- As of 9 May 2026, a total of eight cases of Andes virus infection, including three deaths and one critically ill patient, linked to the M/V Hondius cruise ship have been reported. 

-- ECDC has classified all people on board the ship and for the purpose of disembarkation and repatriation to be high-risk contacts. 

-- Monitoring/quarantine up to six weeks (42 days); Day 0 = 6 May 2026. 

-- High-risk contacts: 

- self-quarantine, 

- daily symptom monitoring, 

- test if symptomatic. 

-- Low-risk contacts: 

- passive monitoring; 

- isolate and test if symptoms develop. 

-- Flights: 

- trace contacts for probable/confirmed cases only (same row ±2 rows on long flights). 

-- IPC: 

- masking, 

- one to two metres distancing, 

- PPE for healthcare/cleaning 

-- Strong risk communication and misinformation management. 

-- This document provides advice for public health professionals in the EU/EEA managing individuals potentially exposed to ANDV, including on: 

- Defining contact classification criteria based on level of exposure, including close and prolonged contact with symptomatic people; 

- The identification, management and monitoring of contacts, including advice on testing;  

- Appropriate infection prevention and control (IPC) measures for managing repatriated passengers and crew, suspected and confirmed cases and their contacts in healthcare and community settings; and 

- Risk communication, community engagement and the management of misinformation. 

-- ECDC rapid scientific advice disclosure statement: 

- ECDC issues rapid scientific advice to meet an emergent or urgent public health need or to quickly reply to external requests. 

- To accommodate the accelerated timeline, the process and methods used for the development of rapid scientific advice may be modified from those of standard assessments and recommendations. Potential limitations are described. 

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Suggested citation: European Centre for Disease Prevention and Control. Rapid Scientific Advice on the management of passengers: In the context of the Andes virus outbreak on the cruise ship MV Hondius. Stockholm: ECDC; 2026. 

Source: 

Link: https://www.ecdc.europa.eu/en/publications-data/rapid-scientific-advice-management-passengers-context-andes-virus-outbreak-cruise

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ONWARD: a #OneHealth, pan - #European multidisciplinary #network advancing #surveillance, #research, clinical management and control of zoonotic #hepeviruses

 

Highlight

• HEV remains the leading cause of acute viral hepatitis in Europe

• Surveillance and diagnostics for HEV are heterogeneous across EU/EEA

• Zoonotic HEV circulates widely in pigs, wildlife and food chains

• Rat HEV expands the zoonotic spectrum and clinical burden in Europe

• ONWARD integrates One Health surveillance, research and capacity building

Abstract

Zoonotic hepeviruses, particularly hepatitis E virus (HEV, species Paslahepevirus balayani) represent a major yet underestimated public health challenge in Europe. Despite being the leading cause of acute viral hepatitis, surveillance, diagnostic practices and prevention strategies remain heterogeneous across EU/EEA countries, limiting comparability and hindering accurate burden estimates. Underdiagnosis is further compounded by extrahepatic manifestations and the growing impact of chronic HEV infection in immunocompromised patients. At the human–animal–environment interface, zoonotic HEV circulates widely in domestic pigs, wildlife and food products, while coordinated surveillance and control measures remain inconsistently implemented. The recent recognition of ratHEV (species Rocahepevirus ratti) as a cause of acute and chronic hepatitis in Europe further expands the spectrum of zoonotic hepevirus infections and underscores the need for integrated One Health approaches. To address these challenges, the One Health Zoonotic Hepevirus Network (ONWARD; COST Action CA24140) was launched in 2025 as a pan-European, multidisciplinary collaboration uniting experts across human, veterinary, food safety and environmental health sectors. ONWARD aims to harmonise diagnostic tools, strengthen clinical research, integrate multisectoral surveillance, promote capacity building and support evidence-based policy development. By fostering coordination with European stakeholders ONWARD provides a structured framework to strengthen preparedness, surveillance and response to zoonotic hepevirus threats across Europe.

Source: 

Link: https://www.sciencedirect.com/science/article/pii/S1386653226000338?dgcid=rss_sd_all

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#Potential and #challenges for sustainable #progress in human #longevity

 

Abstract

Decelerating gains in life expectancy (e0) in high-income countries have raised concerns about the future of human longevity. To enhance our understanding of these developments, we examine subnational (N = 450) mortality trends in Western Europe in the period 1992-2019. Between 1992 and 2005, gains in life expectancy were both substantial and widespread. Laggard regions experienced the fastest improvements, yielding rapid regional convergence. Between 2005 and 2019, however, gains in these regions decelerated, while remaining remarkably stable in vanguard regions, suggesting that it remains possible to continue extending longevity. The observed slowing of e0 gains is strongly associated with mortality at ages 55-74, which increased in this period across large areas of Western Europe, particularly in Germany and France. In this work, we show that monitoring mortality trends at a fine geographical level is crucial for revealing both the potential for, and challenges to, sustainable progress in human longevity.

Source: 

Link: https://www.nature.com/articles/s41467-026-68828-z

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#Ecology and #environment predict spatially stratified #risk of #H5 highly pathogenic avian #influenza clade 2.3.4.4b in wild #birds across #Europe

 

Abstract

Highly pathogenic avian influenza (HPAI) represents a threat to animal and human health, with the ongoing H5N1 outbreak within the H5 2.3.4.4b clade being one of the largest on record. However, it remains unclear what factors have contributed to its intercontinental spread. We use Bayesian additive regression trees, a machine learning method designed for probabilistic modelling of complex nonlinear phenomena, to construct species distribution models (SDMs) for HPAI clade 2.3.4.4b presence. We identify factors driving geospatial patterns of infection and project risk distributions across Europe. Our models are time-stratified to capture both seasonal changes in risk and shifts in epidemiology associated with the succession of H5N6/H5N8 by H5N1 within the clade. While previous studies aimed to model HPAI presence from physical geography, we explicitly consider wild bird ecology by including estimates of bird species richness, abundance of specific taxa, and “abundance indices” describing total abundance of birds with high-risk behavioural traits. Our projections of HPAI clade 2.3.4.4b indicate a shift in persistent, year-round risk towards cold, low-lying regions of northwest Europe associated with H5N1. Methodologically, we demonstrate that while most variation in risk can be explained by climate and physical geography, adding host ecology is a valuable refinement to SDMs of HPAI.

Source: 

Link: https://www.nature.com/articles/s41598-025-30651-9

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Unprecedented high level of highly pathogenic avian #influenza in wild #birds in #Europe during the 2025 autumn #migration

 

Abstract

Between 6 September and 14 November 2025, 1,443 highly pathogenic avian influenza (HPAI) A(H5) virus detections were reported in wild birds across 26 countries in Europe. This number was four times higher than in the same period in 2024 and the highest overall for those weeks since at least 2016. Almost all the detections (99%) were due to HPAI A(H5N1) viruses, and most of them belonged to EA-2024-DI.2.1, a new sub-lineage of the EA-2024-DI.2 genotype. These HPAI virus detections in wild birds involved increasing numbers of waterfowl species (ducks, geese and swans) that were found positive in large parts of Europe. In addition, high numbers of common cranes were affected across a wide band stretching from northeast to southwest Europe. Given the unprecedented high circulation of HPAI virus in the wild bird population compared to previous years, and the associated high environmental contamination, strict biosecurity measures and early detection of infected poultry establishments are urgently needed to prevent introductions from wild to domestic birds and further spread among poultry establishments. Prompt removal of wild bird carcasses is indicated to reduce the risk of infection for other wild and domestic birds and mammals.

Source: 

Link: https://efsa.onlinelibrary.wiley.com/doi/abs/10.2903/j.efsa.2025.9811

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#Vectors on the Move: How #Climate Change Fuels the Spread of #Arboviruses in #Europe

 

Abstract

Climate change is increasingly recognized as a major driver of emerging infectious diseases, particularly vector-borne diseases (VBDs), which are expanding in range and intensity worldwide. Europe, traditionally considered low-risk for many arboviral infections, is now experiencing autochthonous transmission of pathogens such as dengue, chikungunya, Zika virus, West Nile virus, malaria, and leishmaniasis. Rising temperatures, altered precipitation patterns, and milder winters have facilitated the establishment and spread of competent vectors, including Aedes, Anopheles, Phlebotomus, and Culex species, in previously non-endemic areas. These climatic shifts not only impact vector survival and distribution but also influence vector competence and pathogen development, ultimately increasing transmission potential. This narrative review explores the complex relationship between climate change and VBDs, with a particular focus on pediatric populations. It highlights how children may experience distinct clinical manifestations and complications, and how current data on pediatric burden remain limited for several emerging infections. Through an analysis of existing literature and reported outbreaks in Europe, this review underscores the urgent need for enhanced surveillance, integrated vector control strategies, and climate-adapted public health policies. Finally, it outlines research priorities to better anticipate and mitigate future disease emergence in the context of global warming. Understanding and addressing this evolving risk is essential to safeguard public health and to protect vulnerable populations, particularly children, in a rapidly changing climate.

Source: Microorganisms, https://www.mdpi.com/2076-2607/13/9/2034

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Incidence of #healthcare-associated #infections in long-term #care #facilities in nine #European countries: a 12-month, prospective, longitudinal cohort study

Summary

Background

The number of older people in need of long-term care is increasing, and health-care-associated infections (HAIs) are a major cause of morbidity and mortality for residents of long-term care facilities (LTCFs). This study, organised by the European Centre for Disease Prevention and Control (ECDC), provided data on the incidence of HAIs and related adverse outcomes in LTCFs in European countries, supplementing the available estimates from repeated point prevalence surveys conducted by the ECDC.

Methods

In this longitudinal, prospective cohort study, we analysed all HAIs collected in a convenience sample of residents from 65 LTCFs (including general nursing homes, residential homes, and mixed facilities) in nine EU or European Economic Area (EEA) countries (Belgium, Finland, France, Italy, Lithuania, Luxembourg, the Netherlands, Poland, and Spain) over 12 months. Eligible residents were those expected to stay in the LTCF for at least the entire study period. Data were collected with three questionnaires: an institutional questionnaire, a residents' questionnaire, and an HAI questionnaire. HAIs were defined according to standard ECDC criteria. The primary outcome was HAI incidence. Incidence measures, estimated using generalised estimating equation models to account for sample heterogeneity, were percentages of each type of HAI, numbers of HAIs per 100 LTCF residents (ratio), and numbers of HAIs per 1000 resident-days (incidence rate).

Findings

HAIs were analysed in 3029 residents of LTCFs between Jan 1–May 4, 2022, and Jan 1–May 12, 2023. The mean age of study participants was 80·9 years (SD 14·6), including 960 (31·7%) men and 2069 (68·3%) women. 3763 HAIs were recorded, with at least one HAI identified in 1717 (57%) of 3029 residents. There were 124·2 HAIs (95% CI 118·6–129·9) per 100 residents and 1·8 HAIs (0·9–3·3) per 1000 resident-days. 160 (4·3% [95% CI 3·9–5·4]) HAIs led to hospitalisation, and 154 (4·5% [2·5–4·8]) were associated with death. Respiratory tract infections (RTIs) were the most frequent type of infection (n=1080, 28·9% [95% CI 27·3–30·5]), including pneumonia (n=279, 7·3% [6·4–8·3]) and other lower RTIs (n=394, 10·7% [9·6–11·8]), followed by urinary tract infections (UTIs; n=743, 18·7% [17·2–20·3]). RTIs showed the highest incidence of mortality (n=85, 2·3% [95% CI 1·8–2·8] of all HAIs). Severe cases of COVID-19 (n=72, 1·9% [95% CI 1·5–2·4] of all HAIs) were less frequent than mild or moderate cases (n=615, 16·0% [14·9–17·1] of all HAIs).

Interpretation

This study shows the high incidence of HAIs among LTCF residents in EU or EEA countries, with more than one in two residents experiencing at least one HAI, and with RTIs and UTIs accounting for almost half of all observed HAIs.

Source: Lancet Infectious Diseases, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(25)00217-8/fulltext?rss=yes#fig1

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Multiple introductions of #equine #influenza virus into the #UK resulted in widespread #outbreaks and #lineage #replacement

Abstract

Influenza A viruses (IAVs) are prime examples of emerging viruses in humans and animals. IAV circulation in domestic animals poses a pandemic risk as it provides new opportunities for zoonotic infections. The recent emergence of H5N1 IAV in cows and subsequent spread over multiple states within the USA, together with reports of spillover infections in humans, cats and mice highlight this issue. The horse is a domestic animal in which an avian-origin IAV lineage has been circulating for >60 years. In 2018/19, a Florida Clade 1 (FC1) virus triggered one of the largest epizootics recorded in the UK, which led to the replacement of the Equine Influenza Virus (EIV) Florida Clade 2 (FC2) lineage that had been circulating in the country since 2003. We integrated geographical, epidemiological, and virus genetic data to determine the virological and ecological factors leading to this epizootic. By combining newly-sequenced EIV complete genomes derived from UK outbreaks with existing genomic and epidemiological information, we reconstructed the nationwide viral spread and analysed the global evolution of EIV. We show that there was a single EIV FC1 introduction from the USA into Europe, and multiple independent virus introductions from Europe to the UK. At the UK level, three English regions (East, West Midlands, and North-West) were the main sources of virus during the epizootic, and the number of affected premises together with the number of horses in the local area were found as key predictors of viral spread within the country. At the global level, phylogeographic analysis evidenced a source-sink model for intercontinental EIV migration, with a source population evolving in the USA and directly or indirectly seeding viral lineages into sink populations in other continents. Our results provide insight on the underlying factors that influence IAV spread in domestic animals.

Author summary

Influenza causes significant disease burden in animals, including wild birds, sea lions, pigs, horses, dogs, and more recently, cows. Outbreaks and epizootics of influenza in agricultural species are a threat to food security and the economy whereas in wild animals they could affect biodiversity and conservation efforts. Given the zoonotic nature of influenza viruses and the high levels of contact between domestic animals and humans, animal influenza is also a public health concern. Here, we combined geographical, epidemiological, and virus sequence data to determine key factors that led to one of the largest epizootics of equine influenza in the United Kingdom in decades. We show that an American equine influenza virus lineage was introduced into Europe and replaced the virus lineage that had been circulating in the United Kingdom for nearly 20 years. We also analysed a global dataset of virus genomes and propose a model of equine influenza virus intercontinental migration, in which USA is the main source of viruses to other countries. Our results provide important information concerning the basic principles of influenza virus circulation in animal populations. This is central to devise effective measures of disease control that would increase animal health while reducing zoonotic risk.

Source: PLoS Pathogens, https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1013227

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#Corynebacterium diphtheriae #Outbreak in #Migrant Populations in #Europe

Abstract

Background

A surge of cases of Corynebacterium diphtheriae infection was observed in reception centers for migrants in Europe beginning in the summer of 2022. Most of the cases were cutaneous, although some respiratory cases as well as one death were reported. A pan-European consortium was created to assess the clinical, epidemiologic, and microbiologic features of this outbreak.

Methods

We assessed cases of toxigenic C. diphtheriae infection that were reported in 10 European countries from January through November 2022. Data regarding countries of origin and transit routes were obtained from interviews with the patients. Whole-genome sequencing and antimicrobial-susceptibility testing were performed on bacterial isolates that were obtained from the patients. The phylogenetic relationships of the isolates and their antimicrobial-resistance genes were evaluated.

Results

A total of 363 toxigenic C. diphtheriae isolates were identified among 362 patients during the study period. Clinical data were available for 346 patients (95.6%): 268 (77.5%) had cutaneous diphtheria, 53 (15.3%) had respiratory diphtheria (11 [3.2%] had a pseudomembrane), and 9 (2.6%) had both respiratory and cutaneous symptoms. Four major genetic clusters were identified, which indicated the multiclonal nature of the outbreak. The ermX gene (which codes for erythromycin resistance) and the pbp2m and blaOXA-2 genes (which code for beta-lactam resistance) were detected in a subgroup of isolates. Isolates that carried ermX were resistant to erythromycin, and isolates that carried pbp2m were resistant to penicillin but were susceptible to amoxicillin. On the basis of the genomic variation within the four genetic clusters, their most recent common ancestors were estimated to have existed between 2017 and 2020.

Conclusions

The distribution of each genetic cluster of C. diphtheriae isolates across multiple countries in Europe showed repeated cross-border spread. The large number of C. diphtheriae infections among migrants is a cause for concern, particularly given that antimicrobial-resistance phenotypes threaten the efficacy of first-line treatments. (Funded by the Bavarian State Ministry of Health, Care, and Prevention and others.)

Source: The New England Journal of Medicine, https://www.nejm.org/doi/full/10.1056/NEJMoa2311981?query=TOC

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Quantifying the #zoonotic #risk profile of European #influenza A viruses in #swine from 2010 to 2020 inclusive

ABSTRACT

H1 and H3 influenza A viruses (IAVs) circulating in European pigs are markedly distinct from those circulating in other global swine populations. These viruses exhibit significant genetic diversity, further expanded by periodic interspecies transmission of IAVs from humans into pigs, followed by sustained circulation. Several zoonotic IAV infections in humans in Europe have been associated with the 1C lineage of H1 IAVs. Given the predominance of H1 detections in pigs and their zoonotic potential, we quantified antigenic evolution of H1 viruses in European pigs using ferret and pig models and assessed diversity relative to swine IAV vaccine strains. Ferret and swine antisera comparisons revealed no significant differences in antibody responses. Viruses of the 1A.3.3.2 clade exhibited reduced cross-reactivity to human seasonal vaccine strains from 2009. Viruses of the 1B.1.2.2 clade showed no cross-reactivity to the 1978 human seasonal influenza viruses nor to candidate vaccine viruses (CVVs). Clades 1C.2.1 and 1C.2.2 human variant strains had variable cross-reactivity to the tested 1C lineage CVVs, and 1C.2.4 and 1C.2.5 clade viruses exhibited rapid genetic diversification. Many viruses tested were antigenically distant from swine influenza vaccine-representative strains, highlighting the need for updated vaccine formulations. Importantly, age-stratified human serum panels revealed limited population cross-protection to tested viruses, particularly for antigenically heterogenous viruses. These findings quantify the genetic and antigenic diversity of co-circulating IAV lineages and identify specific groups of viruses that may represent a greater risk to animal and public health. These results can be used to inform future pre-pandemic preparedness efforts.

Source: Journal of Virology, https://journals.asm.org/doi/full/10.1128/jvi.00306-25?af=R

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