Daily newsletter, 4 Nov 2026

Microregistrar Infection Newsletter
Prepared for microregistrar.com, microregistrar.moodlecloud.com and Infection Institute

Microregistrar Infection Newsletter · Wednesday 4 November 2026

Green Book pneumococcal chapter revised: Down syndrome added as a clinical risk group, and the PPV23-to-PCV20 switch written in.

On 3 Nov UKHSA republished Green Book chapter 25 (pneumococcal). The change note says it updates the history and epidemiology, dosage and schedule sections, adds Down syndrome as a specific clinical risk group, and clarifies tables 3a and 3b, including which vaccines to use. Table 2 now lists “Down syndrome: all individuals with Down syndrome”, citing a systematic review (Ditzel et al., 2025) that found a very high risk of invasive pneumococcal disease.

The chapter (dated 16 October 2026) states that in early 2026 the UK began moving from PPV23 to PCV20 for at-risk groups and for adults turning 65, and that PPV23 can no longer be ordered through the national programme. Clinical risk groups aged 2 years or over get a single 0.5 ml dose of PCV20. Adults aged 65 or over get PPV23 or PCV20, using up local PPV23 stock first. PCV20 re-immunisation every 5 years is advised in asplenia, splenic dysfunction and chronic kidney disease. The infant schedule is unchanged (PCV13 at 16 weeks plus a booster at 1 year). PCV21 is licensed from 2 years but isn’t part of the programme.

Check before quoting: this summary is taken from the GOV.UK change note and the chapter PDF. We found no accompanying JCVI statement or implementation letter, so how and when people with Down syndrome will be called is not stated. Ebola was eligible to lead today (last Ebola lead 24 Oct), but the only new figures are CIDRAP and relayed government totals.

Audience: UK/EU clinical ID, AMS, IPC and FRCPath trainees · Window: 3 Nov 2026 08:10 GMT → 4 Nov 2026 08:10 GMT (Tuesday → Wednesday morning; light X check) · Compiled: 4 Nov 2026 07:57 GMT

19
Journal items (9 new picks from CID, JAC-AMR, ICHE, ARIC, JCM, OFID and EID; 10 Journal Watch top picks)
0
New on Microregistrar Moodle (top entry still 31 Oct)
3/9
Watched pages with something new (9 of 9 checked)
83
Source links in this issue
2
New UKHSA, DHSC, MHRA, ECDC or WHO DON infection items in the window
13
Coverage gaps we could not close

Counted from today’s digest. The 2 agency items are the revised Green Book pneumococcal chapter and the new varicella epidemiology reports link in UKHSA’s chickenpox collection. UKHSA’s PFAS biomonitoring study, the HPR lead-exposure item and MHRA’s clinical trials diversity pilot aren’t infection items and aren’t counted. Journal items exclude anything that ran in an earlier issue, and links are unique content links, not counting our two website links.

Also today

The other headlines from today’s issue. Each card links to its source and to the full summary.

Measles · US

New York confirms its first measles death in 30 years

The state health department and Lewis County Public Health confirmed the death of a child. New York has 210 cases this year. CDC counts 4,852 US cases, the most in 35 years (via CIDRAP).

CIDRAP ›

Mpox · US

Clade I mpox in California: 3 of 4 cases with no travel

Stanislaus County reports 4 recent cases that are confirmed (2) or suspected (2) clade I. Three hadn’t left the county in the past year (via CIDRAP).

CIDRAP ›

Ebola · DRC

CIDRAP: 10,444 cases and 5,376 deaths

CIDRAP reports a CFR of 51.6%. The previously relayed figure was 48.8%, and the numbers don’t fully reconcile (see Agencies).

CIDRAP ›

AMS · dental

Nearly 1 in 5 dental infections treated with clindamycin

An OFID study of more than 12,000 patients found 11% treatment failure with clindamycin vs about 5% overall. Among patients given a non-penicillin, 21% had no documented penicillin allergy.

CIDRAP ›

ICHE · IPC

Daily CHG bathing: 35% fewer CLABSIs, 40% less MRSA bacteraemia

A before-after study across 21 mostly rural Appalachian hospitals (IRR 0.650 and 0.599).

Article ›

Moodle · no change

No new Moodle entries since yesterday

“Whats new?” still has the 31 Oct C. diphtheriae & C. ulcerans Interactive at the top.

Sheet ›

What we could not confirm

The lead comes from the GOV.UK change note and chapter PDF. We found no JCVI or implementation letter. CIDRAP’s Ebola CFR (51.6%) doesn’t match its own totals (5,376/10,444 = 51.5%) or yesterday’s relayed 48.8%. The US measles death counts differ between CDC (3) and Pennsylvania (5). The California clade I mpox report comes from the county via CIDRAP, and we haven’t seen a CDC statement (HAN still blocked). The H5N1 poultry detections and Israel’s suspected Ebola cases are relays. There’s still no new WHO DON, and ECDC’s CDTR archive still stops at week 42.

Microregistrar Moodle update

No new entries. We read the Microregistrar moodlecloud sheet (Index tab, “Whats new?”) directly this morning (4 Nov). The list hasn’t changed since the 3 Nov issue.

Moodle · 31 Oct 2026 · already reported

C. diphtheriae & C. ulcerans Interactive

Still the top row in “Whats new?”; we reported it on 1 Nov. Moodle ›

Moodle · 30 Oct 2026 · already reported

Greenbook vaccine part 1 revision

Second entry; reported on 31 Oct. Today’s Green Book chapter 25 revision may be worth a follow-up entry. 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 4 Nov 2026). All nine were reached. The Green Book, the UKHSA organisation page and the JAC advance list have something new.

Health Protection Report (UKHSA)

No change

No new infection content. A lead exposure (LEICSS) news item was added on 3 Nov, and the HPR 20(10) email alert (3 Nov) covers the 29 Oct issue. HPR volume 20 ›

UK SMI News (RCPath)

No change

No open consultations and no new UK SMI documents. No Mail Sorter SMI forwards. Consultations ›

RCPath Examinations

No change

No substantive text change. Examinations ›

Green Book

New

Chapter 25 (pneumococcal) revised on 3 Nov (see the lead). The collection page itself is unchanged. Chapter 25 › · Green Book ›

UKHSA organisation page (GOV.UK)

New

New on 3 Nov: the Green Book chapter 25 revision, a varicella epidemiology reports link in the chickenpox collection, and the PFAS human biomonitoring study (non-infection). The HCID country risk page hasn’t changed since 22 Oct. UKHSA › · HCID risk ›

NICE published guidance

No change

No new infection guidance. The 2 new items (HST36 setmelanotide, TA1206 tafasitamab) are non-infection. NICE published ›

Journal of Antimicrobial Chemotherapy

New

Two new items in the Crossref sweep for 3–4 Nov: INSTI resistance in Angola, and a comment on model-informed precision dosing of cefotaxime (titles only; not summarised). JAC advance articles ›

Journal of Infection

No change

No new items in the Crossref sweep. J Infect in press ›

Journal of Hospital Infection

No change

No new items in the Crossref sweep. JHI in press ›

Agencies & guidance

UKHSA revised the Green Book pneumococcal chapter and added varicella epidemiology reports. MHRA published nothing infection-related, ECDC posted no news, and there was no new WHO DON. In the US, New York confirmed a child’s measles death and California reported clade I mpox without travel.

Guidance changes

UKHSA · Green Book · chapter 25

Pneumococcal chapter revised: Down syndrome now a clinical risk group

  • What changed (GOV.UK, 3 Nov): updated history and epidemiology, and dosage and schedule sections; Down syndrome added as a specific clinical risk group; tables 3a and 3b clarified, including which vaccines to use.
  • Risk groups aged 2 years or over: a single 0.5 ml dose of PCV20. Children under 2 with asplenia, splenic dysfunction, complement disorder or severe immunocompromise should also get PCV20.
  • Adults aged 65 or over: PPV23 or PCV20, using up local PPV23 stock first. PPV23 can no longer be ordered through the national programme.
  • Re-immunisation: PCV20 every 5 years in asplenia, splenic dysfunction (including sickle cell disease) and CKD. Not recommended for other groups, and anyone already vaccinated as part of a risk group needs no dose at 65.
  • Infants: unchanged, PCV13 at 16 weeks plus a booster at 1 year.

For clinicians: check that patients with Down syndrome have been offered pneumococcal vaccination, and use PCV20 for risk-group vaccination from 2 years of age.

Based on the change note and chapter PDF (dated 16 Oct 2026). We found no JCVI statement or implementation letter.

GOV.UK › · Chapter PDF ›

UKHSA / MHRA / England

UKHSA · chickenpox

Varicella epidemiology reports linked from the chickenpox collection

On 3 Nov UKHSA added a link to new varicella epidemiology reports in the chickenpox public health management collection. This follows the annual chickenpox report in HPR 20(10) and the January 2026 introduction of the varicella (MMRV) programme.

Collection › · Varicella epidemiology 2025 ›

UKHSA · HPR · mailbox

HPR 20(10) email alert: no new content

The GovDelivery bulletin received on 3 Nov (16:23 GMT) promotes HPR 20(10) of 29 Oct: norovirus surveillance upgrade, imported cyclospora, S. Enteritidis and eggs, antiviral guidance, and annual chickenpox and TB reports. We covered these from 24 Oct. There were no Mail Sorter forwards.

HPR volume 20 ›

MHRA · #MedSafetyWeek

No MHRA safety alerts; Yellow Card reminders continue

MHRA published pilot findings on inclusion and diversity plans in clinical trials (non-infection). #MedSafetyWeek Yellow Card messaging continues until 8 Nov.

MHRA › · @MHRAgovuk ›

UKHSA · non-infection

PFAS human biomonitoring study launched

UKHSA will measure PFAS and other chemicals in blood and urine to establish UK exposure levels. Included for completeness only.

GOV.UK ›

ECDC / Europe

ECDC · CDTR

No ECDC news; CDTR archive still at week 42

The ECDC news feed has nothing after 29 Oct, and the weekly threats archive still shows week 42 as the latest.

ECDC CDTR ›

Avian influenza · UK / Europe

H5N1 in poultry: Scottish Borders and Norway (relay)

FluTrackers relayed a Scottish Government report of H5N1 confirmed at premises near Biggar, Scottish Borders, on 2 Nov. It also relayed a detection at a commercial poultry farm in Klepp, Rogaland, Norway. ESCMID’s Epi Alert notes a surge of Lyme borreliosis in Czechia.

Relays only; not checked against Scottish Government or APHA pages.

@FluTrackers (Scotland) › · @FluTrackers (Norway) › · @ESCMID ›

Global

Ebola (Bundibugyo) · DRC / Kenya / Uganda · ongoing

CIDRAP reports 10,444 cases and 5,376 deaths

  • Totals (CIDRAP Quick takes, 3 Nov): 10,444 cases and 5,376 deaths (5,372 DRC, 2 Kenya, 2 Uganda), with a CFR given as 51.6%.
  • DRC (government, via FluTrackers): 65 new cases and 23 deaths reported for 1 Nov. Treatment centres in Beni are said to be overwhelmed.
  • Kenya (MoH, via FluTrackers): no new case since 19 Oct.
  • Israel (relay): 2 travellers from the DRC are in isolation as suspected cases.
  • Response: WHO/AFRO describes community engagement surveys in Nizi guiding earlier reporting and safe burials.
  • UK: no imported cases; UKHSA’s risk assessment is unchanged (low).

Figures don’t reconcile: 5,376/10,444 = 51.5%, not 51.6%, and yesterday’s relayed DRC figure gave 48.8%. Nigeria, which ESCMID lists as affected, isn’t in CIDRAP’s death breakdown. There’s no new WHO DON since DON622 (23 Oct).

CIDRAP › · @FluTrackers (DRC) › · @FluTrackers (Kenya) › · @FluTrackers (Israel) › · @WHOAFRO ›

Avian influenza · China

Two H9N2 cases in children and older adults, mainland China

Hong Kong’s CHP reports cases in Hubei (2-year-old boy, onset 22 Sep) and Jiangxi (77-year-old woman, onset 16 Sep). There have been 22 other mainland cases in the past 6 months, and 164 confirmed cases with 2 deaths since 2015 (via CIDRAP).

CIDRAP ›

Cholera · DRC

North Kivu (Itebero): 989 suspected cases and 61 deaths in 2026 (relay)

A local report relayed by FluTrackers covers 14 health areas.

@FluTrackers ›

WHO

WHO · DON

No new Disease Outbreak News in the window

The latest is still DON622 (Ebola, 23 Oct). WHO posted for One Health Day and on seasonal influenza and COVID-19 protection.

WHO DON ›

CDC / US

Measles · New York / Pennsylvania

New York confirms its first measles death in 30 years

  • New York: the state health department and Lewis County Public Health confirmed a child’s death, the state’s first measles death in 30 years. New York has 210 cases through 31 Oct, 32 of them new.
  • Pennsylvania: 1,433 cases (74 new), 269 hospitalisations and 5 deaths.
  • National: CDC reports 4,852 cases as of 30 Oct, including 3 deaths, the most cases in 35 years.

The death counts differ (CDC 3 vs Pennsylvania’s 5 plus New York’s 1). According to CIDRAP, CDC hasn’t yet confirmed all of Pennsylvania’s deaths. Yesterday’s relayed report is now confirmed by the state.

CIDRAP › · @FluTrackers (NYSDOH statement) ›

Mpox · clade I · California

Stanislaus County: 4 clade I cases, 3 without travel

Two confirmed and two suspected clade I cases. Three hadn’t left the county in the past year, and the fourth’s travel history is under investigation. CIDRAP notes a CFR of 1–10% for clade I vs 1–4% for clade II.

For UK teams: ask about travel to California and sexual contacts there when testing for mpox, and request clade typing.

CIDRAP ›

AMS · dental infections

Nearly 1 in 5 dental infection patients get clindamycin

An OFID study of more than 12,000 patients (Trinity Health Michigan, Jan 2020 to Aug 2025): 75% received penicillins and nearly 20% clindamycin. Treatment failure was about 5% overall and 11% with clindamycin. Of the patients given non-penicillin agents, 21% had no documented penicillin allergy (via CIDRAP).

CIDRAP ›

H5N1 · dairy and poultry

Indiana’s 2nd dairy premises confirmed; Manitoba poultry (relay)

FluTrackers relays USDA confirmation of a second H5N1 dairy premises in Indiana and an avian flu detection in commercial poultry in Manitoba, Canada.

@FluTrackers (USDA) › · @FluTrackers (Manitoba) ›

CDC pages · EID · HAN

Two new EID early-release articles; travel notices unchanged

New EID articles (3 Nov) include fatal disseminated Powassan virus infection in a transplant recipient and breast dirofilariasis (see Journals). The HAN archive was blocked again, and we didn’t check MMWR.

Travel notices › · EID early release ›

Journals

New since the 3 Nov issue: our picks from a Crossref sweep of the 19 watched titles (online 3–4 Nov) and EID early release, followed by today’s full Journal Watch top 10. The Lancet titles, NEJM, IJID, AJIC, J Hosp Infect, J Infect, CMI and Eurosurveillance had nothing new in Crossref, and JAMA had no infection items. The JID pneumococcal genomic stability paper ran on 3 Nov and isn’t repeated.

IPC, AMR and diagnostics

ICHE · IPC · CHG bathing

Daily chlorhexidine bathing and bloodstream infections across a rural health system

Ratliff, Lokant, Huss and colleagues. Quasi-experimental before-after study in 21 Appalachian hospitals, with daily CHG bathing for patients with central lines or in ICU, comparing 18 months either side. CLABSIs fell by 35% (IRR 0.650; 95% CI 0.502–0.841) and MRSA bacteraemia by 40% (IRR 0.599; 0.408–0.880).

Article ›

ARIC · MRSA · genomics

22 years of MRSA surveillance in Geneva: unusual genetic features

François, Renzi, Cherkaoui and colleagues. PCR-based surveillance showed former hospital clones being replaced, and community isolates shifting towards USA300. More strains couldn’t be SCCmec-typed, and WGS found novel SCCmec elements.

Article ›

JAC-AMR · gonorrhoea · AMR

Global epidemiology of antimicrobial-resistant N. gonorrhoeae

Ho, Adamson, Klausner. Review covering phenotypic, genomic, clinical and population data: emerging azithromycin resistance and reduced susceptibility to extended-spectrum cephalosporins, and internationally spread ceftriaxone-resistant and XDR lineages. Uneven surveillance limits estimates of the global burden.

Article ›

JCM · sexual health · diagnostics

Urine flow cytometry (Sysmex UF-5000) for diagnosing urethritis in men

Toh, Modi, Ardizzone and colleagues. In 1,000 remnant male urine samples from a sexual health clinic, UF-5000 WBC counts gave an AUC of 0.86 for Gram stain-defined urethral inflammation and 0.90 for clinician-diagnosed urethritis, outperforming leukocyte esterase. Needs prospective validation.

Article ›

HIV, vaccines and parasites

CID · HIV · ART

Myths and misconceptions about modern antiretroviral therapy

Wood, Sunagawa, Moschese and colleagues. Review of outdated beliefs about ART dosing, side effects and laboratory testing in the era of second-generation INSTIs, two-drug regimens and long-acting injectables.

Article ›

OFID · HIV · herpes zoster

Herpes zoster incidence and costs in US adults with HIV

Stempniewicz, Steffens, Kim and colleagues. Insured cohort 2015–2022 (n=53,700 with HIV). Incidence was 12.0 vs 5.6 per 1,000 person-years in adults without immunocompromise (aIRR 2.05; 95% CI 1.92–2.19), with about $3,000 extra cost in the first 1–3 months.

Article ›

OFID · RSV · adults

RSV burden in adults in emerging-market countries: systematic review and meta-analysis

Kenmoe, Wahi-Singh and colleagues. 70 studies, with adjustment for under-ascertainment by specimen and test type. The abstract was truncated in Crossref, so we can’t give the pooled estimates.

Article ›

EID · arbovirus · transplant

Fatal disseminated Powassan virus infection in a transplant recipient, Pennsylvania

EID early release (3 Nov). A tick-borne flavivirus to consider in immunocompromised patients with encephalitis after tick exposure in North America. Summary based on the title.

EID ›

EID · parasites · Dirofilaria

Breast dirofilariasis: case report and systematic review, 1959–2025

EID early release (3 Nov). Relevant to breast lump differentials in travellers and residents of endemic areas, including southern Europe. Summary based on the title.

EID ›

Journal Watch top 10

Credited to Microregistrar Journal Watch (issue of 4 Nov 2026, from 32 new PubMed records for 3–4 Nov). They are ranked by Journal Watch, and the notes restate the abstracts; this isn’t clinical advice. None of the 10 ran in an earlier issue.

Journal Watch #1 · JID · RSV/hMPV · vaccines

Phase 2 trial of the IVX-A12 RSV/hMPV combination VLP vaccine in adults aged 60 or over

In 143 adults randomised to IVX-A12 or RSVPreF3, both vaccines were well tolerated and induced neutralising antibodies (solicited reactions 35.2% vs 50.0%). The authors say further study is warranted.

Article › · PubMed › · via Journal Watch

Journal Watch #2 · Lancet Infect Dis · hantavirus · IPC

Andes virus management: balancing infection control with patient safety and autonomy

US article. The PubMed record has no abstract, so we can’t summarise the content.

Article › · PubMed › · via Journal Watch

Journal Watch #3 · Diagn Microbiol Infect Dis · hantavirus · diagnostics

Diagnostic accuracy of serological, molecular and rapid tests for human hantavirus disease: meta-analysis

Across 63 studies, ELISA/EIA serology had 98.0% sensitivity and 98.8% specificity (low certainty) and was the best-supported platform. Molecular and rapid tests need prospective validation.

Article › · PubMed › · via Journal Watch

Journal Watch #4 · Lancet Microbe · mycology · preparedness

Could the next pandemic be fungal, and could we respond effectively?

Personal View (Spain). Fungi are neglected in pandemic plans despite climate-driven thermal adaptation, rising host susceptibility, no licensed vaccines and few antifungals. The authors propose an operational preparedness framework.

Article › · PubMed › · via Journal Watch

Journal Watch #5 · Lancet Microbe · S. aureus

Intracellular Staphylococcus aureus in human infections: evidence from clinical specimens

A review (Switzerland) of 33 human studies (1984–2025). The evidence strongly suggests S. aureus is present inside diverse human cell types, with gaps on viability and persistence during antibiotic exposure.

Article › · PubMed › · via Journal Watch

Journal Watch #6 · Clin Microbiol Rev · TB · CPA

Is it tuberculosis or chronic pulmonary aspergillosis?

Review (South Africa). CPA can be misdiagnosed as smear- or GeneXpert-negative TB. The authors propose an algorithm to rule CPA in or out in patients with new or previous mycobacterial disease, plus follow-up screening of high-risk patients.

Article › · PubMed › · via Journal Watch

Journal Watch #7 · Diagn Microbiol Infect Dis · molecular

NAAT for obligate intracellular and cell wall-deficient bacteria: structured narrative review

Review (Iran) covering Rickettsia, Orientia, Ehrlichia, Anaplasma, Coxiella, Chlamydia and Mycoplasma. It highlights gaps in distinguishing active infection from persistent DNA and in interpreting Ct values. Published 30 Oct.

Article › · PubMed › · via Journal Watch

Journal Watch #8 · EJCMID · C. difficile

Preventing recurrent C. difficile infection: recent advances and clinical strategies

Review (China) covering epidemiology, risk stratification, optimising antimicrobial regimens and microbiota-focused therapies. The abstract doesn’t state specific findings.

Article › · PubMed › · via Journal Watch

Journal Watch #9 · JID · Cryptosporidium · microbiome

Cryptosporidium infection and gut microbiome changes in Bangladeshi children and families

In 84 children and family members, 96.1% of infections were subclinical. In those aged 3 or over, gut microbial diversity fell during infection and recovered afterwards.

Article › · PubMed › · via Journal Watch

Journal Watch #10 · CID · CRE · treatment

Are higher-order carbapenems effective for ertapenem-resistant Enterobacterales invasive infections?

Prospective cohort (Chile) of 374 patients treated with imipenem or meropenem. Ertapenem-resistant, carbapenemase-negative isolates were associated with higher 30-day mortality than ertapenem-susceptible isolates, which the authors say challenges current guidance. An accompanying CID commentary (Satlin) is linked.

Article › · PubMed › · Commentary › · via Journal Watch

On X

Wednesday light check: we searched agency and society accounts (UKHSA, ECDC, WHO, WHO/AFRO, CDC, MHRA, CIDRAP, IDSA, ESCMID) and FluTrackers posts on Ebola, H5N1, measles, mpox, cholera and C. auris, from 3 Nov 08:10 GMT to this morning. Each item links to the post we read.

Agencies and societies

UKHSA: eligibility for a free NHS COVID-19 vaccine this winter @UKHSA ›, and the PFAS biomonitoring study @UKHSA ›

MHRA: #MedSafetyWeek Yellow Card reporting. @MHRAgovuk ›

ESCMID: Epi Alert on Bundibugyo Ebola in Kenya and Nigeria, Lyme borreliosis in Czechia and leptospirosis in Peru @ESCMID ›; the GAMRIC 2026 conference report in CMI @ESCMID ›

WHO: One Health Day @WHO ›; protection against influenza and COVID-19 @WHO ›; an Ebola clinician in Bunia @WHO ›

WHO/AFRO: Ebola community engagement in Nizi. @WHOAFRO ›

IDSA: a CID study of antibiotic fills and readmission after patient-directed discharge in drug use-associated endocarditis. @IDSAInfo ›

CIDRAP: New York measles death @CIDRAP ›; Quick takes @CIDRAP ›; dental antibiotics @CIDRAP ›; RSV hospital costs in children with underlying conditions @CIDRAP ›; a twice-yearly generic long-acting injectable for HIV prevention @CIDRAP ›

No posts from ECDC or CDC in the window.

Outbreaks

Ebola: DRC reports 65 cases and 23 deaths for 1 Nov @FluTrackers ›; Beni treatment centres overwhelmed @FluTrackers ›; Kenya reports no new case since 19 Oct @FluTrackers ›; Israel evaluating 2 suspected cases @FluTrackers ›; cross-border advice in Bangassou, CAR @FluTrackers ›

H5N1: Scottish Borders @FluTrackers ›; Norway @FluTrackers ›; Indiana dairy @FluTrackers ›; Manitoba @FluTrackers ›

Measles: NYSDOH and Lewis County joint statement. @FluTrackers ›

Cholera: Itebero, North Kivu. @FluTrackers ›

Unverified: we didn’t check FluTrackers relays against primary sources, apart from the New York measles death (confirmed via CIDRAP).

What we could not confirm

We want you to know exactly where today’s issue has limits, so here are the 13 gaps we couldn’t close, plus the reports that weren’t out yet.

SourceIssue
Lead (Green Book ch25)Based on the GOV.UK change note and the chapter PDF (dated 16 Oct). We found no JCVI statement, implementation letter or Down syndrome call-recall arrangements, and we didn’t compare the chapter line by line with the previous version.
EbolaCIDRAP’s CFR of 51.6% doesn’t match its own totals (51.5%) or yesterday’s relayed 48.8%. Nigeria is missing from CIDRAP’s death breakdown. The DRC daily figures, Kenya, Israel and Beni items are FluTrackers relays. There’s been no WHO DON since DON622.
Measles (US)CDC counts 3 deaths, but Pennsylvania (5) plus New York (1) gives 6. CDC hasn’t confirmed all of Pennsylvania’s deaths (CIDRAP). The New York figures come via CIDRAP.
Mpox clade I (California)From the county via CIDRAP. We found no CDC statement (HAN blocked), and the clade of 2 of the 4 cases is still suspected.
H5N1 / H9N2The Scottish Borders, Norway, Indiana and Manitoba detections are relays, not checked against government or APHA pages. H9N2 comes from CHP via CIDRAP.
JournalsBased on Crossref abstracts only. The OFID RSV abstract was truncated, and the EID notes are based on titles. We didn’t summarise the JAC items (INSTI resistance in Angola, cefotaxime comment), OFID PrEP/hepatitis A/HIV diagnoses items, ICHE NHSN CPT codes, ARIC prescribing barriers or AAC abacavir PK. The Elsevier and Lancet titles returned nothing in Crossref. OUP, ASM and Elsevier journal pages return 403 to automated checks (bot blocking); all DOIs were confirmed to redirect to the publisher article.
Journal WatchAll 10 were included and none ran in an earlier issue. The notes restate abstracts without rechecking, and #2 has no abstract.
X (light)Light Wednesday check only (2 searches). Relay accounts are secondary sources.
CDCThe HAN archive was blocked again (Access Denied). We didn’t check MMWR.
ECDCThe CDTR archive still shows week 42 (weeks 43 and 44 are missing). There was no ECDC news in the window.
Watched pagesA quick text check only; RCPath and NICE showed no infection content.
MoodleNo new entries. We read the sheet only, not the Moodle site itself.
Mail Sorter / mailboxThere were no Mail Sorter forwards. The only infection email was the HPR 20(10) alert, which has no new content.

Not out yet

  • UKHSA: week 45 flu/COVID-19 and norovirus reports (data to week 44) announcement ›; HCAI monthly data to October 2026 announcement ›; measles (12 Nov); next outbreaks-under-monitoring report.
  • ECDC: CDTR weeks 43 and 44 (overdue).
  • WHO: the revised Ebola rapid risk assessment; the next DON and AFRO situation report.
  • CDC: statements on clade I mpox in California and on the measles deaths.
  • MHRA: #MedSafetyWeek runs until 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 4 Nov)
  • Microregistrar moodlecloud Google Sheet (Index tab), read directly through the Sheets connector
  • UKHSA, MHRA and DHSC on GOV.UK (search API); Green Book chapter 25 (content API and PDF), HCID country risk, Health Protection Report, measles and chickenpox pages
  • RCPath UK SMI consultations, UK SMI and Examinations pages; NICE published guidance
  • Mail (microregistrar2021@gmail.com, read only): no Mail Sorter forwards; HPR 20(10) GovDelivery alert (3 Nov)
  • ECDC: news feed and CDTR archive
  • WHO Disease Outbreak News (API)
  • CDC: travel notices, HAN (blocked), EID early release (2 new)
  • CIDRAP per-topic feeds (Ebola, measles, avian flu, antimicrobial stewardship, influenza, HAI, COVID-19, pertussis, mpox, C. auris): 3 in-window items (mpox/H9N2/Ebola Quick takes, measles, dental antibiotics)
  • Journal sweep (Crossref, online 3–4 Nov): 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
  • Microregistrar Journal Watch top 10, 4 Nov 2026
  • X (Wednesday light check): searches over 3–4 Nov

Prepared for microregistrar.com, microregistrar.moodlecloud.com and Infection Institute.

AI-generated newsletterMicroregistrar Infection Newsletter · 4 November 2026, compiled this morning. This newsletter is generated by AI. It highlights actionable, high-signal items and does not replace full guideline or primary-source review. Please check the primary source before acting on any item.

Prepared using LLM, Grok

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