Microregistrar Infection Newsletter · Wednesday 21 October 2026
Nigeria confirms an imported Bundibugyo Ebola case in Abuja; Kenya reaches nine cases; MHRA withdraws the IXCHIQ chikungunya vaccine.
Nigeria’s Federal Ministry of Health confirmed one case of Ebola disease in the Federal Capital Territory on 20 Oct: a woman who arrived on an international flight from Uganda and was cared for in a private hospital for several days before diagnosis. She is isolated, and 44 close contacts, including healthcare workers, patients and caregivers, are being traced. Kenya reported a ninth case in its single family cluster. In the UK, the MHRA has withdrawn the IXCHIQ chikungunya vaccine: stop using it and update travel-clinic materials. UKHSA’s HCID country-specific risk list was last updated on 15 Oct and doesn’t yet mention Nigeria: take a full travel and transit history for VHF risk assessment.
Check before quoting: Nigeria’s onset and admission dates and the travel route (eastern DRC, transit through Uganda) are press-reported, as are Kenya’s ninth-case details. There’s no WHO Disease Outbreak News for either country yet, and the DRC SitRep 158 figures come from a summary site.
Counted from today’s digest. The seven journal items are from ICHE, OFID, JAMA, ARIC (two) and AAC (a letter and reply); the UK SMI B 6 draft is under Guidance. Links are unique content links across the issue, not counting our two website links. Gaps are the items in the Coverage gaps list; reports that simply haven’t been published yet are listed separately.
Also today
The other headlines from today’s issue. Each one links through to the full summary. UK flu/COVID-19, measles and Salmonella figures are unchanged; week 43 flu/COVID is due on 22 Oct at 14:00.
Nigeria: first imported case, Abuja
Confirmed on 20 Oct in a woman who arrived from Uganda; 44 close contacts; IPC support for the treating private hospital.
Official statement; dates press-reported.
DRC: 9,637 cases, 4,646 deaths
+85 cases and +44 deaths on 19 Oct; 7-day average 70.4 cases/day; 1,029 in treatment centres. ECDC now confirms the totals to 18 Oct (9,552 / 4,602).
Taken from the ebola-tracker.org SitRep summary, not WHO or ECDC.
Kenya: 9 cases, 1 death
A ninth case in the index family cluster, already in quarantine; 134 of 135 contacts traced.
Press-reported.
IXCHIQ chikungunya vaccine withdrawn
Benefit–risk no longer favourable (CHM advice). Do not prescribe, supply or administer; dispose of stock.
B 6 whooping cough draft open to 26 Oct
NAAT preferred; PT IgG serology ≥2 weeks after onset; oral fluid testing for ages 2–16.
0.8% virological failure on long-acting CAB+RPV
3,349 adults (Spain); 71.4% of failures within 12 months of switching.
What we could not confirm
Nigeria’s timeline and travel route and Kenya’s ninth case are press-reported, with no WHO Disease Outbreak News yet. The DRC figures come from a SitRep summary site. Moodle, RCPath exams, NICE, CDC HAN and CDC measles weren’t checked this morning, and several journal items were title-only.
Microregistrar Moodle update
Not checked today: Moodle Keeper couldn’t be asked during this run, so new entries are listed as a coverage gap.
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 21 Oct 2026 ~09:10 BST; 7 of 9 checked). After our relevance filter, two pages have something new: an open UK SMI consultation on whooping cough and an SFTS guidance update on GOV.UK.
Health Protection Report (UKHSA)
No changeNo new reports in the UKHSA GOV.UK feed.
UK SMI News (RCPath)
NewOpen consultation: UK SMI B 6, Investigation of whooping cough (12–26 Oct 2026); see Guidance changes. The SMI news page returned 404; the consultations page loaded. Consultations ›
RCPath Examinations
Not checkedNot reached this morning (see Gaps).
Green Book
No changeNo Green Book chapter in the UKHSA GOV.UK feed since 19 Oct (checked indirectly).
UKHSA organisation page (GOV.UK)
NewSFTS guidance updated (testing information clarified); RSV older-adult leaflet translations and accessible formats added; HIV South East data spotlight. The many norovirus/rotavirus and flu/COVID-19 “statistics announcement” entries are scheduling only.
NICE published guidance
Not checkedNot checked directly (see Gaps).
Journal of Antimicrobial Chemotherapy
No changeNo new items.
Journal of Infection
No changeNo new items.
Journal of Hospital Infection
No changeNo new items.
Agencies & guidance
Nigeria’s first imported Ebola case, Kenya’s ninth case, DRC SitRep 158 and the MHRA’s withdrawal of IXCHIQ are today’s main developments. UK surveillance and WHO DON are unchanged since yesterday.
Guidance changes
Comments requested on UK SMI B 6: Investigation of whooping cough
Open 12–26 Oct 2026; replaces B 6i9 (May 2018). NAAT is preferred, best within 2–3 weeks of cough onset; IS481/IS1001 alone can’t identify the species, so extra targets are needed. Culture is still valid and is needed for AMR surveillance and typing. PT IgG serology is most useful ≥2 weeks after onset, but recent vaccination or infection can confound it for up to 12 months. Oral fluid PT IgG testing is available for ages 2–16 via local HPTs.
- How to respond: through the RCPath survey form linked from the consultation page; queries to standards@ukhsa.gov.uk.
- Still open: the UKAP consultation on healthcare workers living with HIV who perform exposure-prone procedures (closes 8 Nov 2026).
- Still current: MHRA DSI/2026/014 on echinocandins with CRRT.
UKHSA / MHRA / England
IXCHIQ chikungunya vaccine: UK marketing authorisation withdrawn
After CHM advice, the MHRA has concluded that IXCHIQ’s benefit–risk balance is no longer favourable.
Action: do not prescribe, supply or administer it; dispose of stock under local policy; update materials and systems that list UK vaccine options; advise travellers on alternatives (other chikungunya vaccines, avoiding mosquito bites, current travel advice). Previous recipients need no action but should seek advice if they suspect an adverse reaction; report via Yellow Card.
Nigeria not yet updated for Ebola
The page was last updated on 15 Oct (Kenya, Thailand).
Action: until it’s updated, assess VHF risk using the official Nigeria and Kenya statements and the full travel and transit history, including healthcare exposure.
Severe fever with thrombocytopaenia syndrome: testing information clarified
A tick-borne bunyavirus (Haemaphysalis longicornis), endemic in China, Japan and South Korea; documented person-to-person transmission is rare. Reported CFR ranges from 5.2% (China) to 32.6% (South Korea).
RSV older-adult leaflet: translations and accessible formats
Resources only; no change to eligibility.
Week 42 still the latest
Hospital lab positivity: flu 6.0%, COVID-19 8.8%, RSV 1.0%. Week 43 is due 22 Oct 2026 at 14:00.
England: 1,030 cases
Lab-confirmed, 1 Jan–12 Oct 2026.
S. Enteritidis t5.9411: 439 cases
Data to week 41; no week 42 release yet.
Still week 41
Week ending 11 Oct; no newer release.
No new infection-relevant device alert
The 19 Oct field safety notice round-ups were routine. A medical devices consultation outcome (CE-mark recognition) posted on 21 Oct isn’t infection-specific.
ECDC
DRC 9,552 / 4,602 (data to 18 Oct); Kenya 8 cases as of 20 Oct
- This confirms the SitRep 157 figures we reported yesterday from a secondary source: +97 cases / +41 deaths (Nord-Kivu 48, Ituri 42, Haut-Uélé 7); 937 hospitalised in isolation; 2,550 recovered; contact follow-up 76.9%.
- Ituri is the most affected province (6,960 cases, 3,217 deaths); 66 of 178 health zones in 8 provinces are affected.
- Kenya: 8 cases including 1 death, listed before Kenya announced its ninth. Nigeria wasn’t yet mentioned.
No new Communicable Disease Threats Report (week 43 expected around 23 Oct) and no new Eurosurveillance issue (expected 22 Oct).
Global — Ebola (Bundibugyo)
Nigeria: first imported case confirmed, Abuja (FCT), 20 Oct
- From the ministry statement: a woman who recently arrived on a flight from Uganda was cared for in a private hospital for several days before diagnosis and is now isolated.
- 44 close contacts identified (healthcare workers, patients, caregivers, travel contacts); the hospital is getting IPC support; facilities nationwide are told to keep a high index of suspicion.
- Press-reported: onset 7 Oct, admitted 11 Oct (Al Jazeera/Reuters). Uganda’s ministry says she had travelled to eastern DRC, transited Uganda without symptoms, and that Uganda has no confirmed active cases.
Check before quoting: WHO AFRO has posted on the case (title seen, content not retrieved). There’s no WHO Disease Outbreak News yet.
DRC: 9,637 confirmed, 4,646 deaths (data to 19 Oct, published 20 Oct)
- +85 cases / +44 deaths (Ituri 43, Nord-Kivu 33, Haut-Uélé 6, Tshopo 2, Nord-Ubangi 1). Hotspot zones: Beni 13, Bunia 10, Mandima 10. CFR 48.2%.
- Recovered 2,574; 1,029 in Ebola treatment centres. 7-day average 70.4 cases/day (68.4 the week before). Still 66 zones in 8 provinces.
- The sums check out: 9,552 + 85 = 9,637 and 4,602 + 44 = 4,646.
Check before quoting: these figures come from the ebola-tracker.org SitRep summary, not WHO or ECDC.
Kenya: 9 confirmed cases, 1 death
- A 24-year-old close family member of the index case tested positive on 19 Oct after falling ill in quarantine.
- Eight patients are stable; 134 of 135 contacts (99.3%) are traced and quarantined. There’s a dedicated lab at the Kenyatta National Hospital Infectious Disease Unit.
- Contacts quarantined since 6 Oct can be released from 25 Oct.
Press-reported: from the ministry statement as reported by the media.
WHO
No Disease Outbreak News on Nigeria or Kenya
The latest is still MERS-CoV, Saudi Arabia (15 Oct); the last Ebola DON was on 8 Oct.
CDC / US
No Nigeria notice at compile time
Ebola notices: Level 4 Ituri/Nord-Kivu, Level 3 Haut-Uélé/Tshopo, the existing Level 2 notices and the Kenya Level 1 notice (19 Oct).
HAN not checked this morning
The last known HAN is CDCHAN-00533 (rabies PEP, 10 Sep).
Still the 15 Oct issue
The next weekly issue is expected around 22 Oct.
4,410 US cases (as of 15 Oct)
Carried over from yesterday; the next update is due Thursday.
African swine fever virus in spray-dried porcine plasma, South Korea, 2026
Title only; a veterinary/feed-safety signal. The Shamonda virus article was covered yesterday.
Journals
New since the 20 Oct issue (online 20–21 Oct), from a Crossref sweep. No new items in this window for Lancet Infect Dis, Lancet Microbe, JID, IJID, AJIC, JAC, JAC-AMR, J Hosp Infect, J Infect, CMI or JCM, and no new Eurosurveillance issue. Non-infection NEJM/JAMA items aren’t listed, and the CID extrapulmonary TB paper was covered yesterday.
Infection Control & Hospital Epidemiology
Whole-genome sequencing in a late-onset GBS outbreak in a NICU (Toronto, 57 beds)
WGS (SNVPhyl) found three separate clusters. Three of 4 late-onset isolates matched a day-1 early-onset case (0 SNVs, serotype Ia); one was 1 SNV from a later conjunctivitis case (serotype V); a February pair traced to the mother’s antepartum isolate (serotype IV). Weekly point-prevalence surveys found 5 unrelated carriers. Audits found gaps in hand and environmental hygiene.
Takeaway: WGS separates true transmission from coincident cases; screening surveys help.
Open Forum Infectious Diseases
Long-acting cabotegravir + rilpivirine in real-world care: RELATIVITY cohort (Spain)
3,349 adults switched from suppressive oral ART; median follow-up 25.1 months. Suppression 95.5% (96.6% of those evaluable); 89.0% still on CAB+RPV LA. Virological failure 28 (0.8%), 71.4% of them within 12 months; emergent INSTI/NNRTI resistance in 19 of 28. Injection adherence ≥90% in 99.3%.
Takeaway: failure is rare but concentrated early; check resistance testing when it happens.
JAMA
Initial HIV therapy for adults and treatment-associated weight gain
Title only; no abstract retrieved.
Antimicrobial Resistance & Infection Control
Automated systems for detecting hand-hygiene compliance (systematic review and meta-analysis)
Title only.
Swiss healthcare workers’ knowledge, attitudes and behaviour on antibiotics and AMR (cross-sectional)
Title only.
Antimicrobial Agents and Chemotherapy
On X
A minimal weekday check. No individual posts are linked.
Nigeria / Kenya Ebola dominated, with no new information beyond the official sources in the Agencies tab. Posts also covered El Salvador reportedly barring travellers from Kenya and several other African countries.
AMR: a US start-up reports the first patient treated with AI-designed bacteriophages for resistant E. coli under compassionate use; outcomes weren’t disclosed.
Waterborne: 408 gastrointestinal illness cases in Tshwane Region 7 (South Africa), 7–18 Oct, linked to unchlorinated water; norovirus, Campylobacter and Shigella reported, cholera excluded.
UK: the Covid Inquiry care-home report (20 Oct); no breaking UKHSA/NHS outbreak signal.
Unverified: the El Salvador travel restriction, the phage case and the Tshwane figures come from X summaries and press, with no primary agency source.
What we could not confirm
We want you to know exactly where today’s issue has limits, so here are the 7 gaps we couldn’t close, plus the reports that simply weren’t out yet.
| Source | Issue |
|---|---|
| Nigeria | The ministry statement is official, but the onset and admission dates and the travel route are press-reported. WHO AFRO content not retrieved; no WHO DON yet. |
| Kenya | The ninth case comes from the ministry statement as reported in the media; ECDC still listed 8 as of 20 Oct. |
| DRC | SitRep 158 figures come from ebola-tracker.org, not WHO or ECDC. |
| Moodle | Moodle Keeper couldn’t be asked during this run; no Moodle update. |
| UK pages | RCPath SMI news page returned 404 (consultations page used instead). RCPath exams and NICE weren’t checked; the Green Book was checked only through the UKHSA feed. |
| CDC | HAN and measles pages not checked this morning. |
| Journals | Crossref sweep only, and indexing can lag. JAMA, ARIC and AAC items are title-only. |
Not out yet
- UKHSA: week 43 flu/COVID-19 (due 22 Oct 14:00), week 42 Salmonella and outbreaks under monitoring; HCID page update for Nigeria.
- ECDC: CDTR week 43 (~23 Oct); Eurosurveillance (22 Oct).
- WHO: Disease Outbreak News on Nigeria/Kenya.
- CDC: next MMWR (~22 Oct); measles update Thursday.
Sources
Today’s digest doesn’t include a sources checklist, so we can’t show ticked and open checks this time. These are the sources it draws on, as described in the issue.
- Watched pages (7 of 9 checked, 21 Oct ~09:10 BST)
- Microregistrar Moodle sheet (not checked today)
- UKHSA GOV.UK: organisation feed, HCID country-specific risk list, SFTS, RSV leaflet, flu/COVID-19, measles, Salmonella, outbreaks under monitoring, UKAP consultation
- MHRA: Drug Safety Update (IXCHIQ) and drug and device alerts
- RCPath UK SMI consultations page and B 6 draft (also forwarded by Mail Sorter on 19 Oct)
- ECDC: Ebola page (20 Oct 15:00), news feed, CDTR, Eurosurveillance
- Nigeria: FMoH statement, WHO AFRO, Reuters via CNBC Africa, Al Jazeera
- Kenya: Citizen Digital, AP
- DRC: SitRep 158 summary (ebola-tracker.org)
- WHO Disease Outbreak News
- CDC: travel notices, MMWR, EID ahead of print
- Journal sweep (Crossref, online 20–21 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
- X: a minimal weekday search