Microregistrar Infection Newsletter · Thursday 29 October 2026
UKHSA publishes a single, consolidated IPC guidance resource for adult social care in England, bringing together the 2022 ASC and 2013 care homes guidance.
UKHSA, commissioned by DHSC, published Infection prevention and control (IPC) in adult social care (ASC) on 28 Oct. It applies to all ASC settings, including care homes, supported living, day services and domiciliary care, and updates and consolidates ‘Infection prevention and control in adult social care settings’ (2022) and ‘Care homes: infection prevention and control’ (2013), bringing everything into one place with a new structure.
The resource is split into separate parts covering standard and transmission-based precautions, fundamentals of care, vaccination for staff and residents, managing outbreaks, an A–Z of infections of concern, TB, suspected infectious diarrhoea and/or vomiting, IPC for clinical interventions, staff health and sickness, and AMR. It names community IPC teams, local authority public health, ICBs, UKHSA health protection teams and CQC as secondary audiences, and it adapts the advice for care in people’s own homes.
Check before quoting: we read the collection page and the background section in full; the other parts were not reviewed line by line, so we don’t summarise specific changes to isolation periods or outbreak thresholds. The guidance covers England only.
Counted from today’s digest. The Crossref sweep (online 28–29 Oct) found 15 infection-relevant items (JID 5, AAC 4, JAC 3, JAMA 2, OFID 1); JAMA’s other six items weren’t infection-related, and the one ICHE item was already reported yesterday. Links are unique content links across the issue, not counting our two website links. The five agency items are UKHSA’s adult social care IPC guidance, the Green Book meningococcal chapter update, the consolidated avian influenza human exposure guidance and week 43 NOIDs causative agents, plus ECDC’s newborn RSV immunisation assessment.
Also today
The other headlines from today’s issue. Each card links to its source and to the full summary.
Meningococcal chapter 22 updated for anticoagulated patients
The administration section now includes more on people on anticoagulation therapy or with bleeding disorders (28 Oct).
Avian flu human exposure guidance consolidated
Two older documents for HPTs and initial clinical management were withdrawn as superseded by the exposure and sporadic spillover case guidance.
Universal newborn RSV immunisation could prevent 61% of early infant admissions
ECDC modelling: 90% nirsevimab-type coverage at birth averts 61% of RSV hospitalisations in the first two months; maternal vaccination 52%.
DRC nears 5,000 deaths; US to bar recent DRC travellers
CIDRAP: 10,141 confirmed cases and 4,928 deaths. Genomics link the Kenya and Nigeria cases to the DRC lineage. The US attestation rule starts 3 Nov.
Most US travel-associated enteric fever not ciprofloxacin-susceptible
CDC data (JAMA Netw Open, via CIDRAP): 78.4% of Typhi and 94.2% of Paratyphi isolates non-susceptible; 5.5% of Typhi ceftriaxone-resistant.
MUCOPS: serial plasma Mucorales PCR screening in high-risk haematology
200 patients, 2,400 tests; 5 mucormycosis cases (2.5%), 3 detected by plasma PCR. NPV 99.9%.
2026 UKHSA flu guideline added to Microregistrar Moodle
“2026 UKHSA Flu guideline”, dated 28 Oct, is the new top row in “Whats new?”.
What we could not confirm
We read only the overview and background of the adult social care IPC guidance, and only the change note for the Green Book meningococcal chapter (not the PDF). Ebola totals (10,141 cases, 4,928 deaths) are CIDRAP; there’s still no new WHO DON since DON622. The enteric fever, rotavirus and RSV study figures are via CIDRAP. Avian flu, screwworm, Bangladesh measles and dengue figures are FluTrackers relays. CDC HAN is still blocked, ECDC’s week 43 CDTR is still missing, and Elsevier journals returned nothing from Crossref.
Microregistrar Moodle update
One new entry. We read the Microregistrar moodlecloud sheet (Index tab, “Whats new?”) directly at about 07:50 GMT. Since the 28 Oct issue, one more row dated 28 Oct has been added above the BBV entry we reported yesterday.
2026 UKHSA Flu guideline
The new top row in “Whats new?”. The sheet gives only the title; we haven’t opened the Moodle page itself. Moodle ›
BBV risk in dialysis unit – test and management
Now the next entry down; we reported it on 28 Oct. Sheet ›
The full list is in the Microregistrar moodlecloud sheet ›
Watched pages
We check nine pages every morning for anything new, compared with what we saw last time (checked 29 Oct 2026 ~07:50 GMT). All nine were reached, and three have something new.
Health Protection Report (UKHSA)
No changeNo new HPR issue; the collection pages still show their May/June 2026 update dates. HPR ›
UK SMI News (RCPath)
No changeStill “There are currently no open consultations.” B 6 (whooping cough) remains listed as a closed draft, and no new UK SMI documents are listed. Consultations ›
RCPath Examinations
No changeNo change since yesterday; autumn 2026 FRCPath, Certificate and Diploma applications remain closed. Examinations ›
Green Book
NewChapter 22 (meningococcal) updated on 28 Oct: more information in the administration section for people on anticoagulation therapy or with bleeding disorders. The collection page itself wasn’t re-dated. Chapter 22 ›
UKHSA organisation page (GOV.UK)
NewNew IPC in adult social care guidance, consolidated avian influenza human exposure guidance (and a tidied avian influenza collection), and week 43 NOIDs causative agents data (all 28 Oct). ASC IPC › · Avian flu collection › · NOIDs ›
NICE published guidance
No changeNothing published since the 27 Oct technology appraisals (TA1203, TA1204), neither infection-related. NICE published ›
Journal of Antimicrobial Chemotherapy
NewThree items (online 28 Oct): lenacapavir resistance in heavily treated people with HIV (PRESTIGIO), natural capsid inhibitor resistance in Guangxi, and MPT64-based rapid TB susceptibility testing. Lenacapavir › · Capsid DRMs › · MPT64 DST ›
Agencies & guidance
UKHSA published adult social care IPC guidance, updated the Green Book meningococcal chapter and consolidated its avian flu exposure guidance. ECDC modelled newborn RSV immunisation. WHO DON had nothing new. In the US, CDC announced an Ebola travel attestation rule.
Guidance changes
Infection prevention and control (IPC) in adult social care (ASC)
A multi-part resource for all ASC settings in England: background and responsibilities; why IPC matters; standard infection control precautions; transmission-based precautions; fundamentals of care; vaccination for care workers and people receiving care; managing outbreaks; infections of concern (A–Z); TB; suspected infectious diarrhoea and/or vomiting; IPC for clinical interventions; staff health and sickness; and resources for managers, with a glossary and indexes. It updates and consolidates the 2022 ASC guidance and the 2013 care homes guidance. Key messages include staying off work if unwell with an infection that may spread to others, keeping IPC person-centred, and balancing safety with dignity and wellbeing.
For community IPC teams, HPTs and ICBs: update training materials, outbreak checklists and links to the 2013 or 2022 documents, and point providers to the single new resource.
Avian influenza: managing human exposures and sporadic cases
UKHSA withdrew “Managing the human health risk of avian influenza in poultry and wild birds: guidance for health protection teams” and “Investigation and initial clinical management of possible human cases of avian influenza with potential to cause severe human disease”. Both are superseded by the guidance for people exposed to infected birds or other animals and by “Managing sporadic avian influenza human spillover cases and their contacts in England”. Out-of-date risk assessments were also removed from the avian influenza collection. HCID country-specific risk page: no change since 22 Oct.
For ID and microbiology on call: check local avian flu pathways link to the current documents, not the withdrawn ones.
UKHSA / MHRA / England
Meningococcal chapter: anticoagulation and bleeding disorders
Chapter 22 updated on 28 Oct with additional administration information for those on anticoagulation therapy or with bleeding disorders. The UKHSA stakeholder cascade (28 Oct) also reports first interim MenB coverage for the one-off MenB programme in England: 26.6% (212,549 of 799,840) to 20 Sept, with the offer ending on 31 Dec. The cascade notes that Ixchiq’s UK authorisation was withdrawn last week, leaving Vimkunya (12 years and over) as the only UK chikungunya vaccine.
Salmonella egg recall, Ebola returning workers and NOIDs
From the 28 Oct cascade: an FSA Food Alert for Action recalls eggs from one Ukrainian supplier after UKHSA sampling found Salmonella Enteritidis linked by WGS to 36 cases in England in 2026 (not the current outbreak strains). The Ebola Returning Workers Scheme now lists Kenya and Nigeria (updated last Friday). The Keep Antibiotics Working campaign is in phase 3. Week 43 NOIDs causative agent data were added on 28 Oct. MHRA published field safety notices (19–23 Oct); none were infection-specific in the listing.
ECDC / Europe
Newborn RSV immunisation could halve infant RSV admissions
A multi-model ECDC assessment: with 90% of newborns given a long-acting monoclonal antibody at birth, 61% of RSV hospitalisations in the first two months of life could be prevented. Universal maternal vaccination would prevent 52%. ECDC says universal newborn immunisation can cut the risk of RSV-related hospitalisation by more than half.
France chikungunya; Geneva Ebola patient
French authorities reported 205 autochthonous chikungunya and 8 dengue cases in the week to 26 Oct. Geneva described its care of the imported Ebola patient. ECDC’s week 43 CDTR is still not on the archive (latest week 42).
Secondary (FluTrackers relays); not checked against Santé publique France.
@FluTrackers (France) › · @FluTrackers (Geneva) › · ECDC CDTR ›
Global
DRC approaches 5,000 deaths; genomics tie Kenya and Nigeria to the DRC lineage
- DRC (CIDRAP, 28 Oct): 10,141 confirmed cases and 4,928 deaths, up from the 10,060 cases we reported yesterday (+81). WHO officials say 50–80 new cases a day across eight provinces, with 80% outside known transmission chains. Media report another doctor has died in Beni and a health centre in Kisangani was ransacked after a suspected case was transferred.
- Genomics: the Kenya and Nigeria index cases share the DRC lineage, with no markers of the May–June Uganda cases. Both patients were at Entebbe airport on 3 Oct. How the Nigerian patient was infected is still unknown.
- Kenya / Nigeria: nine cases and two deaths in Kenya; no further cases in Nigeria. Africa CDC’s Jean Kaseya warned the outbreak could spread to the UK and other European countries.
- US: from 3 Nov to 18 Dec, passengers flying to the US must attest they haven’t been in the DRC in the previous 21 days. Those who have, including people only transiting the DRC, won’t be allowed to board.
There’s been no new WHO DON since DON622 (23 Oct). The 10,141 figure is described by CIDRAP as confirmed cases, whereas yesterday’s 10,060 was total cases; the definitions may differ. The Beni and Kisangani items are media reports relayed by FluTrackers.
CIDRAP › · @FluTrackers (Beni) › · @FluTrackers (Kisangani) ›
Fluoroquinolones shouldn’t be used empirically for travel-associated enteric fever
CDC (JAMA Network Open, via CIDRAP): 2,342 US cases from 2016 to 2020, with 81.9% linked to travel (mainly India, Pakistan and Bangladesh). Of 1,635 isolates tested by NARMS, 78.4% of Typhi and 94.2% of Paratyphi were not susceptible to ciprofloxacin. 5.5% of Typhi were ceftriaxone-resistant, mostly from travel to Pakistan.
Relevance to the UK: the same travel corridors apply here. Use travel history (especially Pakistan, where XDR Typhi is a risk) and susceptibility results to choose treatment.
Bangladesh measles deaths 1,242; dengue in Chad and Senegal
Bangladesh reports two more child deaths (1,242 total), with 1,322 new suspected and 90 confirmed measles cases in 24 hours (up from the 1,240 deaths we reported yesterday). Chad recorded 1,075 dengue cases and 4 deaths from 9 to 21 Oct; Senegal has about 70 confirmed cases.
Press and government reports relayed by FluTrackers; not verified.
@FluTrackers (Bangladesh) › · @FluTrackers (Chad) › · @FluTrackers (Senegal) ›
WHO
No new Disease Outbreak News in the window
The latest is still DON622 (Ebola, 23 Oct). WHO epidemiological figures in the window came through CIDRAP.
Operational field ethics for epidemic responses
A JAMA Viewpoint by Tonen-Wolyec and colleagues argues for integrating field ethicists into outbreak responses to address community resistance to public health measures. It’s relevant as violence against Ebola facilities continues in the DRC.
CDC / US
H5N1 rises in US poultry; screwworm reaches Arizona
USDA APHIS (via CIDRAP): 29 H5N1 flock confirmations in 30 days (11 commercial, 18 backyard) and 1.32 million birds affected, including a 934,600-bird layer farm in Illinois. FluTrackers relays USDA’s first New World screwworm case in Arizona and five more infected animals, bringing the US total to 71 (66 yesterday + 5 = 71).
Rotavirus policy modelling; maternal RSV vaccine vs nirsevimab
CIDRAP reports that moving US rotavirus vaccination to shared clinical decision-making could add more than $100 million in costs by age 2. In a separate study, it reports maternal RSV vaccination and monoclonal antibody were equally effective in protecting infants. We read only CIDRAP’s posts, not the articles.
No new EID items; US measles spread continues
EID early release had nothing new since 27 Oct, and the CDC travel notice list is unchanged. The HAN archive was blocked again, and MMWR is due later today (US time). FluTrackers relays new county-level measles cases in Wisconsin, Indiana and Georgia.
“The flu deaths we’ve learned to ignore”
A CIDRAP op-ed (published 07:12 GMT on 28 Oct, just before the window) argues that seasonal flu deaths have become normalised. Michael Osterholm’s Halloween Q&A names his top three public health threats.
Journals
New since the 28 Oct issue (online 28–29 Oct), from a Crossref sweep of the 19 watched titles. We summarise the most relevant 11 of 15 infection items; the rest are AAC correspondence and a JID editorial without an abstract. CID, JCM, the Lancet titles, NEJM and the Elsevier titles had nothing new.
Open Forum Infectious Diseases
MUCOPS: blood Mucorales PCR screening in high-risk haematology patients
Vanbiervliet Y, Aerts R, Boon E and colleagues. A prospective multicentre Belgian study of adults on AML/MDS induction or first allogeneic HCT, screened twice weekly with plasma MucorGenius PCR for three months, with results fed into routine care. 200 patients had 2,400 tests; 12 (6.0%) had a positive screen. Five mucormycosis cases (2.5%): three detected by plasma PCR and two by BAL PCR only. Reported sensitivity 83.3%, specificity 99.6%, PPV 52.6% and NPV 99.9%.
The figures don’t fit a simple per-patient count (3 of 5 cases detected = 60%; 3 of 12 positives = 25%), so the diagnostic metrics are probably per-episode or per-sample. The abstract is truncated, so check the paper.
Takeaway: plasma Mucorales PCR has a high NPV for screening, but a negative plasma result doesn’t exclude disease if BAL is indicated.
Journal of Antimicrobial Chemotherapy
Lenacapavir in heavily treatment-experienced people: PRESTIGIO registry
Santoro M, Spalletta D, Spagnuolo V and colleagues. Nine people with MDR HIV received lenacapavir for a median of 19.8 months; 8 of 9 were suppressed or became suppressed. One poorly adherent patient developed Q67K plus K70H, giving a 2,081-fold reduction in susceptibility.
Natural capsid inhibitor resistance in ART-naive people, Guangxi
Pan P, Mo C, Chen R and colleagues. Near-full-length NGS of 495 sequences: 4.44% carried CAI-associated mutations (Q67H 0.80%, T107A 2.22%, T107S 1.81%), with no cross-resistance to other classes.
MPT64 secretion for rapid phenotypic TB susceptibility testing
Murase Y and colleagues. Proof of concept in 130 M. tuberculosis strains: resistance-detection sensitivity was 100% for rifampicin, 98% for isoniazid and 90% for moxifloxacin, with no false resistance. Linezolid and bedaquiline were exploratory.
Journal of Infectious Diseases
Dengvaxia suppressed by pre-existing DENV4 immunity
Adams C, Hein L, White L and colleagues. A Philippines cohort found vaccine suppression in 61% of children with monotypic DENV4 immunity. This supports DENV4 replication dominance in Dengvaxia.
Childhood obesity and dengue antibody quality
Mercado-Hernandez R and colleagues. In 85 Nicaraguan children, obesity was linked to more binding antibodies (FC 1.89) but not more neutralising antibodies, with lower neutralising efficiency (FC 0.67).
Transplantation and the HIV latent reservoir
Howard J, Smith M, Balagopal A. A review: 13 reported cases of acquired cure, all after allo-HSCT, and lessons from kidney and liver transplantation in people with HIV.
Donepezil and metformin and COVID-19 mortality in dementia
Li B and colleagues (N3C). 30-day mortality was 10.3% vs 13.2% with donepezil 5 mg compared with matched controls. This is retrospective and hypothesis-generating only.
AAC and JAMA
Ulonivirine with a combined oral contraceptive
Robinson M and colleagues. A phase 1 study in 20 women: once-weekly ulonivirine modestly lowered levonorgestrel and ethinylestradiol exposure (AUC GMR 0.88 and 0.85).
Acute rhinosinusitis in adults
Fan J, Alexander J. A JAMA Clinical Guidelines Synopsis of the 2025 AAO-HNSF update on diagnosing and managing acute rhinosinusitis, which is relevant to antibiotic stewardship in primary care.
On X
Thursday light check: three searches, covering agency accounts, outbreak and AMR accounts, and UK/EU AMR, measles and IPC topics (28 Oct 08:10 to 29 Oct ~07:50 GMT). Each item links to the post we read.
Ebola: CIDRAP on the DRC approaching 5,000 deaths and the US travel rule. @CIDRAP ›
AMR and stewardship: CIDRAP on enteric fever and ciprofloxacin, @CIDRAP › a stewardship account sharing the MUCOPS trial, @ABsteward › and a linezolid vs tedizolid bone and joint cohort. @ABsteward › The same account posted C. auris resistance figures from the CDC report (96% fluconazole, 16% amphotericin B, 1% echinocandins), which we haven’t verified. @ABsteward › A BSAC parliamentary fellow reflected on UK AMR policy work. @iyioladunjoye_ ›
Avian flu: CIDRAP on rising US poultry outbreaks. @CIDRAP ›
Conferences: ESCMID Global 2027 registration is open (Stockholm, 9–13 April 2027). @ESCMID ›
Unverified: the C. auris resistance percentages, screwworm and avian flu counts, and the South Asia and African death tolls weren’t checked against primary sources. UK measles posts in the window were political argument, not data, so we didn’t include them. We found no UKHSA or ECDC posts in the window.
What we could not confirm
We want you to know exactly where today’s issue has limits, so here are the 8 gaps we couldn’t close, plus the reports that simply weren’t out yet.
| Source | Issue |
|---|---|
| Lead (ASC IPC guidance) | We read the collection page and the background section; the other parts weren’t reviewed in detail, so we don’t report specific changes from the 2022 and 2013 guidance. |
| Green Book / avian flu | For meningococcal chapter 22 we read only the GOV.UK change note, not the PDF. For avian flu we read the change notes, not the full current documents. |
| Ebola | The 10,141 and 4,928 figures are CIDRAP, which calls them confirmed cases; yesterday’s 10,060 was total cases, so the definitions may differ. There’s no new WHO DON or situation report. The Beni doctor death and Kisangani incident are media reports via FluTrackers. |
| Journals | Crossref abstracts only; MUCOPS was truncated and its diagnostic metrics don’t match a per-patient count. Elsevier titles (CMI, JHI, J Infect, IJID, AJIC) returned nothing, probably because of indexing lag. The enteric fever (JAMA Netw Open), rotavirus and RSV studies were read through CIDRAP only. |
| Zoonoses / outbreaks | H5N1, screwworm, France chikungunya, Bangladesh measles and Chad/Senegal dengue figures are FluTrackers relays and weren’t verified. |
| CDC / ECDC | The CDC HAN archive returned Access Denied. ECDC’s week 43 CDTR is still not on the archive (latest week 42), and ECDC’s all-items RSS was malformed. MMWR isn’t out yet. |
| Mail Sorter / mailbox | No Mail Sorter forwards arrived. The only infection email in the window was the UKHSA stakeholder cascade (28 Oct), filed under UKHSA and Green Book above. Some of its items (Ixchiq withdrawal, Returning Workers Scheme, FSA egg alert) predate the window and are included as important. |
| UKHSA flu / COVID-19 | This week’s flu and COVID-19 surveillance report isn’t out until this afternoon. The cascade gives only week 42 (12–18 Oct): flu still low, with the early rise slowing. |
Not out yet
- UKHSA: flu/COVID-19 surveillance (Thursday 29 Oct, afternoon); HCAI monthly data (4 Nov); measles (12 Nov); ICU bloodstream infection annual report (26 Nov). Cold-health alerting starts on 1 Nov.
- ECDC: CDTR week 43 (overdue) and week 44 (Friday 30 Oct).
- WHO: the revised Ebola rapid risk assessment; the next DON and AFRO situation report.
- CDC: MMWR (Thursday 29 Oct); the Ebola travel attestation starts on 3 Nov.
- AMR: ESCMID AMR Action Subcommittee applications close on 31 Oct; Faculty of Public Health AMR leadership webinar on 23 Nov.
- MHRA: #MedSafetyWeek runs 2–8 Nov.
Sources
What we checked for this issue. Every link in the issue was retrieved and checked during this run.
- Watched pages (9 of 9 checked, 29 Oct ~07:50 GMT)
- Microregistrar moodlecloud Google Sheet (Index tab), read directly through the Sheets connector
- UKHSA, MHRA and DHSC on GOV.UK (search API); Green Book, HCID country risk, Health Protection Report, measles, avian influenza, ASC IPC and NOIDs (content API)
- RCPath UK SMI consultations, UK SMI and Examinations pages; NICE published guidance
- Mail (microregistrar2021@gmail.com, read only): the UKHSA stakeholder cascade of 28 Oct; no Mail Sorter forwards in the window
- ECDC: news feed and CDTR archive
- WHO Disease Outbreak News (API)
- CDC: travel notices (unchanged), HAN (blocked), EID early release (nothing new)
- CIDRAP per-topic feeds (Ebola, measles, avian flu, antimicrobial stewardship, influenza, HAI, COVID-19, pertussis, mpox, C. auris); in-window articles only
- Journal sweep (Crossref, online 28–29 Oct): Lancet Infect Dis, Lancet Microbe, NEJM, JAMA, CID, JID, OFID, IJID, ICHE, AJIC, JAC, JAC-AMR, J Hosp Infect, J Infect, CMI, ARIC, AAC, JCM, Eurosurveillance; EID checked separately
- X (Thursday light check): three searches