Extraintestinal pathogenic Escherichia coli (ExPEC) causes invasive E. coli disease (IED), including bacteraemia and (uro)sepsis, resulting in a high disease burden, especially among older adults. This study describes the epidemiology of IED in England (2013–2017) by combining laboratory surveillance and clinical data. A total of 191 612 IED cases were identified. IED incidence increased annually by 4.4–8.2% across all ages and 2.8–7.6% among adults ≥60 years of age. When laboratory-confirmed urosepsis cases without a positive blood culture were included, IED incidence in 2017 reached 149.4/100 000 person-years among all adults and 368.4/100 000 person-years among adults ≥60 years of age. Laboratory-confirmed IED cases were identified through E. coli-positive blood samples (55.3%), other sterile site samples (26.3%), and urine samples (16.6%), with similar proportions observed among adults ≥60 years of age. IED-associated case fatality rates ranged between 11.8–13.2% among all adults and 13.1–14.7% among adults ≥60 years of age. This study reflects the findings of other published studies and demonstrates IED constitutes a major and growing global health concern disproportionately affecting the older adult population. The high case fatality rates observed despite available antibiotic treatments emphasize the growing urgency for effective intervention strategies. The burden of urosepsis due to E. coli is likely underestimated and requires additional investigation.

Shiga toxin-producing Escherichia coli (STEC) is a group of bacteria that causes gastrointestinal illness and occasionally causes large foodborne outbreaks. It represents a major public health concern due to its ability to cause severe illness which can sometimes be fatal. This study was undertaken as part of a rapid investigation into a national foodborne outbreak of STEC O145. On 22 May 2024, United Kingdom (UK) public health agencies and laboratories identified an increase in stool specimens submissions and patients testing positive for Shiga toxin-producing E. coli (STEC). Whole genome sequencing (WGS) identified serotype O145:H28 stx2a/eae belonging to the same five single nucleotide polymorphism (SNP) single linkage cluster as the causative agent. By 3 July 2024, 288 cases had been linked to the cluster. Most cases were adults (87%) and females (57%), 49% were hospitalized with a further 10% attending emergency care. Descriptive epidemiology and analytical studies were conducted which identified consumption of nationally distributed pre-packed sandwiches as a common food exposure. The implicated food business operators voluntarily recalled ready-to-eat sandwiches and wraps containing lettuce on 14 June 2024.

Anthrax is a bacterial zoonotic disease caused by Bacillus anthracis. We qualitatively examined facilitators and barriers to responding to a potential anthrax outbreak using the capability, opportunity, motivation behaviour model (COM-B model) in the high-risk rural district of Namisindwa, in Eastern Uganda. We chose the COM-B model because it provides a systematic approach for selecting evidence-based techniques and approaches for promoting the behavioural prompt response to anthrax outbreaks. Unpacking these facilitators and barriers enables the leaders and community members to understand existing resources and gaps so that they can leverage them for future anthrax outbreaks.

This was a qualitative cross-sectional study that was part of a bigger anthrax outbreak simulation study conducted in September 2023. We conducted 10 Key Informant interviews among key stakeholders. The interviews were audio recorded on Android-enabled phones and later transcribed verbatim. The transcripts were analyzed using a deductive thematic content approach through Nvivo 12.

The facilitators were; knowledge of respondents about anthrax disease and anthrax outbreak response, experience and presence of surveillance guidelines, availability of resources, and presence of communication channels. The identified barriers were; porous boarders that facilitate unregulated animal trade across, lack of essential personal protective equipment, and lack of funds for surveillance and response activities.

Generally, the district was partially ready for the next anthrax outbreak. The district was resourced in terms of human resources but lacked adequate funds for animal, environmental and human surveillance activities for anthrax and related response. The district technical staff had the knowledge required to respond to the anthrax outbreak but lacked adequate funds for animal, environmental and human surveillance for anthrax and related response. We think that our study findings are generalizable in similar settings and therefore call for the implementation of such periodic evaluations to help leverage the strong areas and improve other aspects. Anthrax is a growing threat in the region, and there should be proactive efforts in prevention, specifically, we recommend vaccination of livestock and further research for human vaccines.

This study presents surveillance data from 1 July 2003 to 30 June 2023 for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) notified in the Kimberley region of Western Australia (WA) and describes the region’s changing CA-MRSA epidemiology over this period. A subset of CA-MRSA notifications from 1 July 2003 to 30 June 2015 were linked to inpatient and emergency department records. Episodes of care (EOC) during which a positive CA-MRSA specimen was collected within the first 48 hours of admission and emergency presentations (EP) during which a positive CA-MRSA specimen was collected on the same day as presentation were selected and analysed further. Notification rates of CA-MRSA in the Kimberley region of WA increased from 250 cases per 100,000 populations in 2003/2004 to 3,625 cases per 100,000 in 2022/2023, peaking at 6,255 cases per 100,000 in 2016/2017. Since 2010, there has been an increase in notifications of Panton-Valentine leucocidin positive (PVL+) CA-MRSA, predominantly due to the ‘Queensland Clone’. PVL+ CA-MRSA infections disproportionately affect younger, Aboriginal people and are associated with an increasing burden on hospital services, particularly emergency departments. It is unclear from this study if PVL+ MRSA are associated with more severe skin and soft-tissue infections, and further investigation is needed.

Fast and efficient identification is critical for reducing the likelihood of weed establishment and for appropriately managing established weeds. Traditional identification tools require either knowledge of technical morphological terminology or time-consuming image matching by the user. In recent years, deep learning computer vision models have become mature enough to enable automatic identification. The major remaining bottlenecks are the availability of a sufficient number of high-quality, reliably identified training images and the user-friendly, mobile operationalization of the technology. Here, we present the first weed identification and reporting app and website for all of Australia. It includes an image classification model covering more than 400 species of weeds and some Australian native relatives, with a focus on emerging biosecurity threats and spreading weeds that can still be eradicated or contained. It links the user to additional information provided by state and territory governments, flags species that are locally reportable or notifiable, and allows the creation of observation records in a central database. State and local weed officers can create notification profiles to be alerted of relevant weed observations in their area. We discuss the background of the WeedScan project, the approach taken in design and software development, the photo library used for training the WeedScan image classifier, the model itself and its accuracy, and technical challenges and how these were overcome.

The COVID-19 pandemic impacted the transmission of many pathogens. The aim was to determine the effect of non-pharmaceutical interventions on the incidence of diseases transmitted via food. Weekly incidence rates for nine foodborne pathogens were collected from national surveillance registries. Weekly pathogen incidence during lockdown weeks of 2020 and 2021 were compared with corresponding weeks in 2015–2019. The same analyses were performed to determine the effect of self-defined expected impact levels of measures (low, intermediate and high). Eight out of 9 diseases showed a significant decrease in case number in 2020, except for listeriosis, which remained unchanged. The largest decrease was observed for rotavirus gastronteritis A (−81%), norovirus gastroenteritis (−78%), hepatitis A (−75%) and shigellosis (−72). In 2021, lower case numbers were observed for 6 out of 9 diseases compared with 2015-2019, with the largest decrease for shigellosis (−5/%) and hepatitis E (−47%). No significant change was observed for listeriosis, STEC infection and rotavirus gastroenteritis. Overall, measures with increased expected impact level did not result in a larger decrease in number of cases, except for Campylobacter, and norovirus and rotavirus gastroenteritis. Disease transmitted via food significantly decreased during the COVID-19 pandemic, with a more pronounced effect during 2020 than 2021.

Safe vaccines are critical for biosecurity protection, yet adverse events—rightly or wrongly attributed to immunization—potentially cause rapid loss of confidence, reduced vaccine uptake, and resurgence of preventable disease. Effective vaccine safety incident management is essential to provide assessment and lead appropriate actions to ensure vaccination programs are safe and mitigate unwarranted crisis escalation that could damage vaccine programs and the effective control of vaccine preventable disease outbreaks or pandemics. Incident management systems (IMS) are used globally to direct emergency management response, particularly for natural disasters of fire, flood, and storm. Public health is equally an emergency response and can therefore benefit from these command control constructs. While examples of IMS for outbreak response and mass immunization logistics exist, there is little to no information on their use in vaccine safety. We describe Australia’s vaccine safety Alert Advisory Group establishment in Victoria during the COVID-19 pandemic and onward embedding into routine practice, anticipant of new vaccines, and the next biosecurity threat.

Surveillance of SARS-CoV-2 through reported positive RT-PCR tests is biased due to non-random testing. Prevalence estimation in population-based samples corrects for this bias. Within this context, the pooled testing design offers many advantages, but several challenges remain with regards to the analysis of such data. We developed a Bayesian model aimed at estimating the prevalence of infection from repeated pooled testing data while (i) correcting for test sensitivity; (ii) propagating the uncertainty in test sensitivity; and (iii) including correlation over time and space. We validated the model in simulated scenarios, showing that the model is reliable when the sample size is at least 500, the pool size below 20, and the true prevalence below 5%. We applied the model to 1.49 million pooled tests collected in Switzerland in 2021–2022 in schools, care centres, and workplaces. We identified similar dynamics in all three settings, with prevalence peaking at 4–5% during winter 2022. We also identified differences across regions. Prevalence estimates in schools were correlated with reported cases, hospitalizations, and deaths (coefficient 0.84 to 0.90). We conclude that in many practical situations, the pooled test design is a reliable and affordable alternative for the surveillance of SARS-CoV-2 and other viruses.

International travel is thought to be a major risk factor for developing gastrointestinal (GI) illness for UK residents. Here, we present an analysis of routine laboratory and exposure surveillance data from North East (NE) England, describing the destination-specific contribution that international travel makes to the regional burden of GI infection.

Laboratory reports of common notifiable enteric infections were linked to exposure data for cases reported between 1 January 2013 and 31 December 2022. Demographic characteristics of cases were described, and rates per 100,000 visits were determined using published estimates of overseas visits from the Office for National Statistics (ONS) International Passenger Survey (IPS).

About 34.9% of cases reported international travel during their incubation period between 2013 and 2022, although travel-associated cases were significantly reduced (>80%) during the COVID-19 pandemic. Between 2013 and 2019, half of Shigella spp. and non-typhoidal Salmonella infections and a third of Giardia sp., Cryptosporidium spp., and Shiga toxin-producing Escherichia coli (STEC) infections were reported following travel. Rates of illness were highest in travellers returning from Africa and Asia (107.8 and 61.1 per 100,000 visits), with high rates also associated with tourist resorts like Turkey, Egypt, and the Dominican Republic (386.4–147.9 per 100,000 visits).

International travel is a major risk factor for the development of GI infections. High rates of illness were reported following travel to both destinations, which are typically regarded as high-risk and common tourist resorts. This work highlights the need to better understand risks while travelling to support the implementation of guidance and control measures to reduce the burden of illness in returning travellers.