Eurosurveillance - Volume 29, Issue 9, 29 February 2024

Chickenpox, a vaccine-preventable disease caused by the varicella zoster virus, generally presents with mild symptoms but can cause complications necessitating hospitalisation. In Poland, since 2009, vaccination has been obligatory for children up to 12 years of age who are particularly vulnerable to infection and for children in their vicinity.

To examine the burden of chickenpox complications and the trends of hospitalisation arising from these complications over time in the Polish population.

Data spanning 2006–21 were sourced from the Polish Infectious Diseases Surveillance System, the Nationwide General Hospital Morbidity Study and the Statistics Poland death registry. Standardised and age-specific incidence rates, hospital discharge rates and number of deaths because of chickenpox were calculated. Moreover, the joinpoint regression model was used to analyse trends of annual hospital discharge rates.

Over the analysed timeframe, 25,804 hospitalisations and 52 deaths attributable to chickenpox complications were documented, and 1.0% of chickenpox cases required hospitalisation because of chickenpox. Age-standardised hospitalisation rates varied between 2.3 and 9.6 per 100,000 population. The analysis revealed no statistically significant trend in overall hospital discharge rates from chickenpox complications. However, a notable increase in hospitalisation rates was observed in children aged 0–4 and among inhabitants of rural areas, with annual percentage changes of 4.9% and 3.4% respectively.

Our findings suggest that the implementation of a universal chickenpox immunisation programme, supported by health education, should be considered to reduce the number of hospitalisations and nearly eliminate deaths because of chickenpox.

Epidemiology of Neisseria gonorrhoeae (NG) infection remains inadequately understood.

We aimed to characterise NG epidemiology in Europe.

We used Cochrane and PRISMA guidelines to systematically review, report, synthesise and analyse NG prevalence data from 1949 to 30 September 2021. Random-effects meta-analyses estimated pooled prevalence. Meta-regression analyses investigated associations and sources of heterogeneity.

The 844 included publications yielded 1,573 prevalence measures. Pooled prevalence of current urogenital infection was 1.0% (95% CI: 0.7–1.2%) among general populations, 3.2% (95% CI: 1.8–4.8%) among female sex workers, 4.9% (95% CI: 4.2–5.6%) among sexually transmitted infection clinic attendees and 12.1% (95% CI: 8.8–15.8%) among symptomatic men. Among men who have sex with men, pooled prevalence was 0.9% (95% CI: 0.5–1.4%), 5.6% (95% CI: 3.6–8.1%), and 3.8% (95% CI: 2.5–5.4%), respectively, for current urogenital, anorectal or oropharyngeal infection. Current urogenital, anorectal or oropharyngeal infection was 1.45-fold (95% CI: 1.19–1.77%), 2.75-fold (95% CI: 1.89–4.02%) and 2.64-fold (95% CI: 1.77–3.93%) higher among men than women. Current urogenital infection declined 0.97-fold (95% CI: 0.96–0.98%) yearly, but anorectal and oropharyngeal infection increased (1.02-fold; 95% CI: 1.01–1.04% and 1.02-fold; 95% CI: 1.00–1.04%), respectively.

Neisseria gonorrhoeae epidemiology in Europe has distinct and contrasting epidemiologies for vaginal sex transmission in heterosexual sex networks vs anal and oral sex transmission in MSM sexual networks. Increased transmission may facilitate drug-resistant strain emergence. Europe is far from achieving the World Health Organization target of 90% incidence reduction by 2030.

Vaccination adherence among healthcare workers (HCWs) is fundamental for the prevention of vaccine-preventable diseases (VPDs) in healthcare. This safeguards HCWs' well-being, prevents transmission of infections to vulnerable patients and contributes to public health.

This systematic review and meta-analysis aimed to describe interventions meant to increase HCWs’ adherence to vaccination and estimate the effectiveness of these interventions.

We searched literature in eight databases and performed manual searches in relevant journals and the reference lists of retrieved articles. The study population included any HCW with potential occupational exposure to VPDs. We included experimental and quasi-experimental studies presenting interventions aimed at increasing HCWs’ adherence to vaccination against VPDs. The post-intervention vaccination adherence rate was set as the main outcome. We included the effect of interventions in the random-effects and subgroup meta-analyses.

The systematic review considered 48 studies on influenza and Tdap vaccination from database and manual searches, and 43 were meta-analysed. A statistically significant, positive effect was seen in multi-component interventions in randomised controlled trials (relative risk (RR) = 1.37; 95% CI: 1.13–1.66) and in observational studies (RR = 1.43; 95% CI: 1.29–1.58). Vaccination adherence rate was higher in community care facilities (RR = 1.58; 95% CI: 1.49–1.68) than in hospitals (RR = 1.24; 95% CI: 0.76-2.05).

Interventions aimed at increasing HCWs’ adherence to vaccination against VPDs are effective, especially multi-component ones. Future research should determine the most effective framework of interventions for each setting, using appropriate study design for their evaluation, and should compare intervention components to understand their contribution to the effectiveness.