Eurosurveillance - Current Issue -Volume 30, Issue 26, 03/Jul/2025

Trichophyton indotineae is an emerging difficult to diagnose dermatophyte species associated with terbinafine resistance, which was initially described in South-Asian and Middle-Eastern countries. We report four cases of sexually transmitted dermatophytosis caused by T. indotineae in two female sex-workers, including one transgender woman, and two men who have sex with men. All four cases were acquired in Europe, highlighting the risk of pathogen spread through sexual contact outside initial endemic areas.

A general power outage affected the Iberian Peninsula on 28 April 2025. We explored all-cause mortality in Spain using the monitoring system MoMo. Starting 28 April, over 3 days, 147 excess deaths (95% CI: − 35 to 330) appeared to occur in the country, corresponding to a 4.2% increase over expected mortality. A larger significant 7.9% increase was estimated in 65–84-year-olds (94 excess deaths; 95% CI: 63 to 125). While MoMo cannot attribute such excesses to specific causes, findings highlight the usefulness of real-time surveillance systems for assessing large-scale emergencies.

In Sweden, an increase in the number of notified cases of cryptosporidiosis was observed 1 October–31 December 2019 (462 domestic cases). Although a single national outbreak was initially suspected, molecular and epidemiological analyses revealed two concurrent national outbreaks and three local outbreaks. Cryptosporidium parvum subtype IIdA22G1c and IIdA24G1 were identified as the cause of the national outbreaks and subtype IIdA20G1e and IIdA21G1 as the cause of the local outbreaks. A case-case study comparing exposures in IIdA22G1c to IIdA24G1 revealed that cases with subtype IIdA22G1c (n = 48) were associated with consumption of a fresh fruit-and-vegetable juice (adjusted odds ratio (aOR) = 17; 95% confidence interval (CI): 1.8–169; p = 0.002). In the local outbreaks with subtype IIdA20G1e and IIdA21G1, cohort studies suggested that cases were associated with consumption of salads. Several coinciding outbreaks with different C. parvum subtypes explained the increase of cryptosporidiosis, and molecular typing was crucial in guiding relevant cross-disciplinary collaboration.

In March 2024, the French genomic surveillance of enteric yersiniosis identified a cluster of lineage 2/3–9b Yersinia enterocolitica isolates, corresponding to bioserotype 2/O:9. An outbreak investigation was conducted to identify the source and implement control measures. A total of 175 confirmed cases were identified in France with sampling dates between 27 January and 23 August. Case interviews and trace-back investigations identified unpasteurised soft goat’s milk cheese from one manufacturer in France as the probable source of the outbreak. Yersinia enterocolitica belonging to the same cluster as the case isolates was isolated from 23 samples from the manufacturer and a goat farm supplying milk to the dairy. Cheeses from the manufacturer were recalled in France. A Rapid Alert System for Food and Feed (RASFF) notification was issued, allowing the identification of cheese distribution from the manufacturer to 29 countries. An Epipulse alert led to the identification of seven additional cases in Belgium, Luxembourg and Norway, illustrating the value of international warning systems. This outbreak demonstrates risks with consumption of unpasteurised cheese and emphasises the need of rigorous good hygiene practices on dairy farms and dairies, especially when milk is processed without pasteurisation.