Microregistrar Infection Newsletter · Saturday 31 October 2026
Chickenpox put 3,037 under-18s in hospital in England in 2025, the last year before MMRV; the catch-up programme starts on 1 November.
UKHSA’s first Varicella Annual Report (published 30 Oct) describes the burden in under-18s in 2025, before varicella vaccine joined the routine schedule on 1 January 2026. There were 3,037 hospitalisations (24.9 per 100,000) and 15,099 GP consultations in the RCGP RSC sentinel network (626.0 per 100,000). Children aged 5 and under made up 71.3% (4,248) of clinical reports to health protection teams. Infants under 1 had the highest peak hospitalisation rate (5.8 vs 2.3 per 100,000 in 1–4 year olds).
Under-1s aren’t vaccinated and depend on herd protection. MMRV is given at 12 and 18 months, and from 1 November 2026 to 31 March 2028 a single catch-up MMRV dose is offered to children born 1 January 2020 to 31 August 2022 who haven’t had chickenpox or 2 doses of varicella vaccine. UKHSA says observed rates were consistent with historical means and that the data capture only a fraction of the true burden.
Check before quoting: UKHSA’s news headline says “over 3,000 infants hospitalised”, but the report and UKHSA’s own X post give 3,037 hospitalisations in under-18s. Infants had the highest rate, not most of the admissions. We read the report’s main points and GP section, not the hospital tables.
Counted from today’s digest. The Crossref sweep (online 30–31 Oct) found 13 new infection-relevant items (CID 2, JID 1, OFID 2, ARIC 3, JCM 3, JAMA 2); items already reported yesterday aren’t counted, and EID’s three early-release articles are listed separately. Links are unique content links across the issue, not counting our two website links. The five agency items are UKHSA’s varicella annual report, its Diwali vaccination call, the Td/IPV PGD (v7) and Td/IPV teenage VGD templates, and DHSC’s acceptance of JCVI advice on spring 2027 COVID-19 vaccination. MHRA’s October Safety Roundup had no infection lead item, ECDC posted no news in the window, and there was no new WHO DON.
Also today
The other headlines from today’s issue. Each card links to its source and to the full summary.
Spring 2027 COVID-19 vaccine: same cohorts as before
The government accepted JCVI advice: 75 and over, immunosuppressed people aged 6 months and over, and older adult care home residents.
New Td/IPV PGD template (v7) and teenage VGD
Revaxis PGD v7.0 is valid from 4 Dec 2026 to 4 Nov 2029, and a teenage VGD template has been added. Both need local authorisation before use.
US measles passes 4,800 cases
CDC confirmed 264 new cases in a week, bringing the 2026 total to 4,852, the 12th straight week of triple-digit rises. Pennsylvania has reported 1,426 cases.
DTR P. aeruginosa: carbapenemase producers drive clusters
Of 190 DTR-PA isolates, 20.5% carried carbapenemases (mainly VIM-2). Those were far more often in WGS clusters (OR 17.47) than carbapenemase-negative strains.
mCIM/eCIM misclassifies OXA-48-like producers
In 172 South Indian CRE, mCIM detected 98.2% of NDM producers but only 47.8% of OXA-48-like producers. eCIM also misclassified dual producers.
Kenya: no new cases for 10 days
Kenya’s MoH reports no new cases in the last 10 days, with 9 cases and 2 deaths in total (via FluTrackers). There was no new UKHSA or WHO update in the window.
Green Book vaccine Part 1 revision added
One new row dated 30 Oct now tops “Whats new?”: Greenbook vaccine part 1 revision.
What we could not confirm
UKHSA’s chickenpox headline says “infants”, but its figure (3,037) covers all under-18s, and we didn’t read the report’s hospital tables. Ebola: there’s no new WHO DON since DON622 and no UKHSA update in the window. The DRC government relay (“78 new Ebola deaths & 32 deaths for Oct 28”) is garbled as posted, so we haven’t used its figures. US measles and H5N1 items come from CIDRAP and FluTrackers. CDC HAN is still blocked, and ECDC’s CDTR archive still stops at week 42.
Microregistrar Moodle update
One new entry. We read the Microregistrar moodlecloud sheet (Index tab, “Whats new?”) directly this morning (31 Oct). Since the 30 Oct issue, one row dated 30 Oct has been added above the three 29 Oct rows we reported yesterday.
Greenbook vaccine part 1 revision
The new top row in “Whats new?”. The sheet gives only the title; we haven’t opened the Moodle page itself. Moodle ›
Histoplasma, Histoplasma interactive, Interactive module – HSV
Now the second to fourth entries; we reported them on 30 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 on the morning of 31 Oct 2026). All nine were reached, and two have something new (one of them, NICE, with nothing infection-related).
Health Protection Report (UKHSA)
No changeHPR 20(10) of 29 Oct is still the latest issue. HPR volume 20 ›
UK SMI News (RCPath)
No changeStill “There are currently no open consultations.” No new UK SMI documents are listed, and no Mail Sorter SMI forwards arrived. Consultations ›
Green Book
No changeNo chapter changes in the window. Related immunisation documents did change: the Td/IPV PGD and VGD templates (see Agencies). Green Book ›
UKHSA organisation page (GOV.UK)
NewNew varicella epidemiological reports collection and the 2025 annual report, the Diwali vaccination news story, Td/IPV PGD v7 and the teenage VGD template, and an NCSP page update (contact and data links only). The HCID country risk page hasn’t changed since 22 Oct. Varicella reports › · NCSP › · HCID risk ›
NICE published guidance
NewTA1044 (exagamglogene autotemcel for severe sickle cell disease, 5 years and over) was updated on 30 Oct. It isn’t infection-related. NICE published ›
Journal of Antimicrobial Chemotherapy
No changeNo new items in the Crossref sweep (online 30–31 Oct). JAC advance articles ›
Agencies & guidance
UKHSA published its first varicella annual report ahead of the MMRV catch-up programme, new Td/IPV PGD and VGD templates, and a pre-Diwali vaccination call. DHSC confirmed the spring 2027 COVID-19 cohorts. ECDC posted nothing new, and there was no new WHO DON. In the US, measles passed 4,800 cases.
Guidance changes
Epidemiology of varicella in England, 2025: the pre-vaccine baseline
The report combines four surveillance systems for under-18s: RCGP RSC GP consultations, clinical reports to health protection teams, absences from sentinel schools and nurseries, and hospital admissions from SUS. GP: 15,099 consultations (626.0 per 100,000); the weekly rate peaked at 21.2 per 100,000 in week 26, against a 5-year-mean peak of 28.9 in week 23. Clinical reports: 71.3% (4,248) were in children aged 5 and under. Schools: 4,117 absences in 439 sentinel settings (6,353 per 100,000). Hospital: 3,037 admissions (24.9 per 100,000); infants had the highest peak rate (5.8 vs 2.3 per 100,000 at 1–4 years). Seasonality is as expected, and rates are consistent with historical means.
For paediatric ID, virology and IPC teams: the catch-up dose runs from 1 Nov 2026 to 31 Mar 2028 for children born 1 Jan 2020 to 31 Aug 2022. Expect questions about eligibility and prior disease, and keep VZIG/antiviral post-exposure pathways for unvaccinated infants and immunocompromised children, who still rely on herd protection.
Td/IPV (Revaxis) PGD v7 and teenage Td/IPV VGD template
UKHSA has published Td/IPV (Revaxis) PGD template v7.0, valid from 4 Dec 2026 to 4 Nov 2029, together with a new Td/IPV teenage (3-in-1) VGD template. Templates need local authorisation before use.
Spring 2027 COVID-19 vaccination cohorts confirmed
In line with JCVI advice, the spring 2027 campaign will offer vaccine to adults aged 75 and over, people aged 6 months and over who are immunosuppressed, and residents of care homes for older adults. These are the same cohorts as previous spring programmes. We didn’t read the JCVI advice itself.
UKHSA / MHRA / England
Diwali call for flu, COVID-19 and RSV vaccination
UKHSA says flu, COVID-19 and RSV are all currently low, but flu usually rises during November. It urges eligible people to get vaccinated before Diwali gatherings.
MHRA Safety Roundup: no infection lead item; #MedSafetyWeek next week
The October Safety Roundup (30 Oct) leads on new antidepressant safety measures; in the part we read, there was no anti-infective item. #MedSafetyWeek runs 2–8 Nov. There were no Mail Sorter forwards and no infection emails in the window (only CQC, ONS and PHSO bulletins).
ECDC / Europe
No ECDC news in the window; CDTR archive still at week 42
ECDC’s news feed has nothing after the 29 Oct preparedness item we reported yesterday. The weekly threats archive still lists week 42 (10–16 Oct) as the latest.
Global
Kenya reports 10 days without new cases; no new official totals in the window
- Kenya (MoH, via FluTrackers): no new cases in the last 10 days, with 9 cases and 2 deaths in total. That matches the UKHSA week 43 figures we reported yesterday.
- DRC: a FluTrackers relay of a DRC government update for 28 Oct reads “78 new Ebola deaths & 32 deaths”. It probably means cases and deaths, but we couldn’t confirm this, so we’ve left the figures out. The latest verified totals are still UKHSA’s 10,060 confirmed cases and 4,887 confirmed deaths (data to 25 Oct).
- US: from 3 Nov, international travellers to the US must attest that they haven’t recently been in the DRC (CIDRAP).
- UK: no imported cases; UKHSA’s risk assessment is unchanged (low).
There’s no new WHO DON since DON622 (23 Oct), no new UKHSA outbreaks report, and CIDRAP published no new Ebola article in the window.
@FluTrackers (Kenya) › · @FluTrackers (DRC) › · UKHSA OUM week 43 ›
Barbados eliminates mother-to-child HIV transmission; Zika microcephaly burden
WHO announced that Barbados has eliminated mother-to-child transmission of HIV as a public health problem. CIDRAP reports that 60% of children with Zika-related microcephaly had been hospitalised by age 5.
WHO
No new Disease Outbreak News in the window
The latest is still DON622 (Ebola, 23 Oct).
CDC / US
4,852 US cases in 2026; elimination status likely to be lost
CDC confirmed 264 new cases in the past week, bringing the total to 4,852, the highest in 35 years. There have been 43 outbreaks, 11% of cases have been hospitalised, and 96% were unvaccinated or of unknown status. CDC counts 3 deaths, while Pennsylvania has reported 5, with a sixth under investigation. Pennsylvania had 88 new cases (1,426 total; Lancaster 493). Wisconsin’s DHS reports 392 cases in 2026 (via FluTrackers).
Figures are as reported by CIDRAP; we didn’t check them against CDC. The ICHE misdiagnosis study (6.9% missed), which CIDRAP covered again on 30 Oct, was in our 27 Oct issue.
CIDRAP › · CIDRAP (misdiagnosis) › · @FluTrackers (Wisconsin) ›
H5N1: Washington dairy herds reach 34; Colorado’s first dairy detection since 2024
USDA reported 4 more Washington dairy herds (34 in the state). Colorado reported its first dairy HPAI detection since 2024, a California layer farm of about 1.3 million birds was affected, and the US mink H5N1 total is now 12.
FluTrackers relays of USDA and state releases; not verified.
@FluTrackers (Washington) › · @FluTrackers (Colorado) › · @FluTrackers (California) ›
West Virginia Salmonella Typhimurium; polio in 4 countries; ACIP nominations
West Virginia is investigating a S. Typhimurium outbreak with 41 people ill. Four countries reported polio, and CDC is seeking nominations for its vaccine advisory board.
Taken from CIDRAP’s headline and X post; the polio countries aren’t named there.
Three new EID early-release articles; travel notices unchanged
New on 30 Oct: Leptospira exposure in urban river surfers (Germany); molecular surveillance for Oropouche, Mayaro, West Nile and St Louis encephalitis viruses (Brazil); and human Armillifer armillatus infection mimicking a strangulated umbilical hernia (France). The travel notice list is unchanged. The HAN archive was blocked again.
Leptospira › · Arboviruses › · Armillifer › · Travel notices ›
Journals
New since the 30 Oct issue (online 30–31 Oct), from a Crossref sweep of the 19 watched titles. Items we reported yesterday aren’t repeated. The Lancet titles, NEJM, AAC, JAC, JAC-AMR, Eurosurveillance and the Elsevier titles had nothing new, and 7 of JAMA’s 9 items weren’t infection-related.
Antimicrobial Resistance & Infection Control
Genotype beats phenotype: carbapenemase-producing DTR-PA drives transmission
Jasuja J, Maurer P, Carlsen L and colleagues. WGS (cgMLST) of 190 difficult-to-treat resistant P. aeruginosa isolates collected 2019–2024: 79.5% were carbapenemase-negative and 20.5% carbapenemase-producing, mainly blaVIM-2. Twelve genetic clusters involved 39 patients. Carbapenemase producers were much more often clustered (OR 17.47).
Takeaway: guidelines apply the same IPC measures to all DTR-PA, but these data support stratifying the response by carbapenemase status. Carbapenemase-negative DTR-PA rarely spread.
Antibiotic use in three Tanzanian livestock-keeping communities
Loosli K, Almadhoon H, Nthambi M and colleagues. Mixed methods (1,226 households, 708 exit surveys, 135 retail outlets): 70–80% of antibiotics came from private retailers, self-treatment was widespread, and amoxicillin was the most-used agent, followed by trimethoprim–sulfamethoxazole.
Airflow-simulation teaching in a post-anaesthesia care unit
Mellon G, Ciotti C, Astagneau P and colleagues. A quasi-experimental study of an airflow-simulation educational tool for staff (title only; no abstract available).
Journal of Clinical Microbiology
mCIM/eCIM in NDM plus OXA-48-like co-producers
Tiwary S, Suresh D, Kurian A and colleagues. 172 genotyped carbapenemase-encoding CRE from ICU perirectal swabs in South India: 65.1% NDM only, 13.4% OXA-48-like only and 21.5% both. mCIM was positive in 98.2% (NDM), 47.8% (OXA-48-like) and 94.6% (both). Among mCIM-positive isolates, eCIM was positive in 99.1%, 91% and 97.1%, so many OXA-48-like and dual producers were misclassified as MBL-only.
Takeaway: in high-prevalence settings, phenotypic mCIM/eCIM can miss OXA-48-like enzymes and mislabel dual producers. Use molecular or immunochromatographic confirmation before choosing ceftazidime-avibactam versus aztreonam-avibactam.
Commercial aztreonam–avibactam AST products perform acceptably
Pfeiffer J, Subramanya S, Kumar R and colleagues. 56 CRE tested with 4 products (Etest and Liofilchem strips; Hardy and Liofilchem discs) on 3 Mueller–Hinton agars at 2 laboratories against BMD. Essential agreement was 92.6% (bioMérieux) and 89.6% (Liofilchem), and categorical agreement 81.5–89.3%.
miLab MAL automated microscopy for Plasmodium
Monpierre L, Elaiba Y, Louboutin N and colleagues (France, 162 samples). Against LAMP and/or thick film, sensitivity was 90.4% and specificity 98.7% (κ 0.89). It failed to identify 11 P. falciparum to species level and tended to underestimate parasitaemia.
CID, OFID, JID and JAMA
Things we do for no reason: Borrelia PCR
Kufel W, Zimmer A, Mahapatra R and colleagues. In a Lyme-endemic area only 1.9% (17/885) of B. burgdorferi PCRs were positive. The authors argue that the test adds cost with little benefit and that guideline-based serology should be the default.
Adjunctive rituximab in anti-IFN-γ autoantibody immunodeficiency
Pinyopornpanish K, Laisuan W, Chaiwarit R and colleagues (Northern Thailand). A self-controlled cohort of 14 patients, all with NTM (93% rapidly growing mycobacteria). Rituximab was associated with more successful antimicrobial de-escalation (aOR 5.38, 95% CI 1.16–25.00). The study is small.
Measles contact tracing and healthcare exposures
Two correspondence pieces: Tatar D and colleagues on refining contact tracing without diluting protection for high-risk children, and Askari M, Arciuolo R, Graham K and colleagues on assessing measles exposures in healthcare facilities (no abstracts).
Vaccine safety board call; FDA HSV approval; Pennsylvania measles
In JID, Salmon D, Buttery J, Carleton B and colleagues call for an independent US National Vaccine Safety Board. JAMA news pieces cover an FDA approval of a new drug for HSV lesions (no abstract; the drug isn’t named in what we read) and whether Pennsylvania’s measles outbreak is ‘the new normal’.
On X
Saturday light check: three searches, covering agency accounts, outbreak relays and UK vaccine/AMR topics (30 Oct 08:10 GMT to the morning of 31 Oct). Each item links to the post we read.
UKHSA: a thread on the varicella report (3,037 under-18s hospitalised in 2025) and the MMRV catch-up from 1 November. @UKHSA ›
NHS North East and North Cumbria: says several areas in the region are among the best in England for MMRV uptake. @NENC_NHS ›
WHO: Barbados has eliminated mother-to-child transmission of HIV. @WHO ›
CIDRAP: US measles tops 4,800 @CIDRAP ›, and quick takes on West Virginia Salmonella, polio and ACIP nominations. @CIDRAP ›
MHRA: #MedSafetyWeek (2–8 Nov) and Yellow Card reporting. @MHRAgovuk ›
Unverified: FluTrackers relays (Kenya and DRC Ebola, US H5N1, Wisconsin measles) weren’t checked against primary sources. We found no ECDC posts in the window, and we left out vaccine-sceptic reply threads.
What we could not confirm
We want you to know exactly where today’s issue has limits, so here are the 11 gaps we couldn’t close, plus the reports that simply weren’t out yet.
| Source | Issue |
|---|---|
| Lead (varicella report) | UKHSA’s news headline says “over 3,000 infants hospitalised”, but the report gives 3,037 hospitalisations in under-18s, so the headline’s wording doesn’t match its own data. We read the main points and GP section, not the hospital or regional tables. |
| Ebola | There was no new UKHSA, WHO or CIDRAP Ebola update in the window. The DRC government relay (“78 new Ebola deaths & 32 deaths for Oct 28”) is internally inconsistent as posted, and we didn’t use its figures. The Kenya update comes via FluTrackers. |
| Journals | Crossref abstracts only. The CID measles letters, the ARIC airflow study and the JAMA HSV news piece have no abstract. The Lancet titles, NEJM, AAC, JAC and the Elsevier titles (CMI, JHI, J Infect, IJID, AJIC) returned nothing, possibly because of indexing lag. |
| US measles | Totals are as reported by CIDRAP and weren’t checked against CDC. The Wisconsin figure (392) is a FluTrackers relay of state data. CDC (3) and Pennsylvania (5) report different death counts. |
| H5N1 (US animals) | All items are FluTrackers relays of USDA and state releases; not verified. |
| CIDRAP quick takes | We used only the headline and X post. The four polio-reporting countries aren’t named there,. |
| CDC | The HAN archive was blocked again (the fetch returned a stub page). We didn’t check the 30 Oct MMWR. |
| ECDC | The CDTR archive still shows week 42 (weeks 43 and 44 are missing), and the all-items RSS returned ‘Page not found’. There was no ECDC news in the window. |
| DHSC / JCVI | We read DHSC’s announcement only, not the JCVI advice on spring 2027. |
| MHRA Safety Roundup | We read the opening of the roundup only. There may be anti-infective items further in. |
| Mail Sorter / mailbox | No Mail Sorter forwards arrived, and the only emails in the window were CQC, ONS and PHSO bulletins (not infection-related). The X guide skill wasn’t available on the box, so the X tools were used directly. |
Not out yet
- UKHSA: MMRV catch-up starts on 1 Nov; week 45 flu/COVID-19 surveillance report (data to week 44); HCAI monthly data (4 Nov); measles (12 Nov);
- ECDC: CDTR weeks 43 and 44 (overdue).
- WHO: the revised Ebola rapid risk assessment; the next DON and AFRO situation report.
- CDC: the Ebola travel attestation starts on 3 Nov; MMWR of 30 Oct not checked.
- 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 on the morning of 31 Oct)
- 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, varicella report, PGD templates and the DHSC COVID-19 announcement (content API)
- RCPath UK SMI consultations, UK SMI and Examinations pages; NICE published guidance
- Mail (microregistrar2021@gmail.com, read only): no Mail Sorter forwards or infection emails in the window
- ECDC: news feed and CDTR archive
- WHO Disease Outbreak News (API)
- CDC: travel notices (unchanged), HAN (blocked), EID early release (3 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 30–31 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 (Saturday light check): three searches