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Microregistrar Infection Newsletter · Friday 16 October 2026

UKHSA week 42: flu and COVID-19 stable, but COVID admissions rise and RSV starts to climb.

UKHSA’s week 42 report (15 Oct, data to 11 Oct) has flu stable at baseline, with hospital lab positivity 6.0% (from 6.2%). COVID-19 is stable at low levels (8.8%, from 9.0%), but COVID admissions rose to 2.46/100,000 (from 2.13). RSV is rising but still at baseline (1.0%, from 0.4%). England’s monthly measles update is also out: 1,030 cases this year, and activity has stabilised.

Read the week 42 summary ›

Audience: UK/EU clinical ID, AMS and IPC · Window: ~15 Oct 2026 08:15 BST → 16 Oct 2026 ~08:20 BST (Thursday → Friday morning) · Compiled: 16 Oct 2026 ~08:25 BST

8

New journal items, from 6 journals

0

New on Microregistrar Moodle

3/9

Watched pages with something new

36

Source links in this issue

2.46

COVID-19 admissions per 100,000 (from 2.13)

4

Coverage gaps we could not close

Counted from today’s digest. New journal items are the ones on the Journals tab (2 NEJM, 2 CID, 1 Eurosurveillance, 1 Lancet Infect Dis, 1 JAC, 1 J Infect). The new EID early releases are on the Agencies tab under CDC and aren’t counted. Links are unique content links across the issue, not counting our two website links. Gaps come from the Coverage gaps list. Today’s digest has no sources checklist, so there’s no checks card.

Also today

The other headlines from today’s issue. Each one links through to the full summary.

UKHSA · measles

England: 1,030 measles cases

1 Jan–12 Oct 2026, +27 since 17 Sep. Only 19 cases had onset in the last 4 weeks, so activity has stabilised after the May peak. London is still 50%.

Read more ›

UKHSA · HCID guidance

HCID country risk: Kenya updated

Use the updated list (15 Oct) when assessing VHF risk in returning travellers.

Read more ›

Ebola · CDC figures

DRC: 9,212 confirmed, 4,441 deaths

CDC’s page (as of 15 Oct), up from 9,144 / 4,410 in SitRep 151. Kenya is still on 2 confirmed cases and 1 death, and UKHSA rates the UK risk as low.

Not yet confirmed: we couldn’t retrieve the DRC bulletin behind CDC’s figure, and ECDC is still on data to 12 Oct.

Read more ›

UKHSA · Salmonella

Egg-linked S. Enteritidis: 439 cases

The t5.9411 cluster is up 11 in a week (84 in the past 4 weeks). 27% of cases with data were admitted to hospital, and there has been one death.

Read more ›

NEJM · HIV

IMPALA: long-acting CAB+RPV non-inferior

In African adults with adherence problems, long-acting cabotegravir plus rilpivirine was non-inferior to oral dolutegravir, but virological failure was 1.9% vs 0%.

Read more ›

CDC · MMWR

DTaP 96.2% effective against pertussis

In children with ≥3 doses during Alaska’s 2024 outbreak. There’s no new HAN.

Read more ›

What we could not confirm

The DRC’s latest Ebola figures (9,212 / 4,441) come from CDC, and we couldn’t retrieve the DRC bulletin behind them. ECDC’s week 42 threats report isn’t out yet. Several CDC and journal pages refused our access, so some details come from PubMed or search summaries.

See all 4 coverage gaps ›

Microregistrar Moodle update

No new Moodle updates since 14 Oct 2026. The latest entry is still the REMAP-CAP trial review.

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 16 Oct 2026 ~08:09 BST; all 9 were reachable). Three have something new: the UKHSA organisation page, JAC and the Journal of Infection. The other six were quiet, including RCPath exams.

Health Protection Report (UKHSA)

No change

No new reports (still volume 20 issue 9, 24 Sep).

UK SMI News (RCPath)

No change

No new items.

RCPath Examinations

No change

No new exam news.

Green Book

No change

No new or updated chapters.

UKHSA organisation page (GOV.UK)

NEW

• 15 Oct — National flu and COVID-19 surveillance report, week 42. See Agencies. Report ›
• 15 Oct — Measles epidemiology: latest monthly figures. Measles 2026 ›
• 15 Oct — Outbreaks under monitoring, week 41: Bundibugyo virus disease (BVD) update and CCHF in Senegal. Week 41 ›
• 15 Oct — HCID country-specific risk: Kenya entry updated (relevant for returning-traveller VHF risk assessment). HCID country risk ›
• 15 Oct — Norovirus/rotavirus week 42 and Salmonella Enteritidis week 41 releases.

We left out routine bulletins, corrections and minor page refreshes.

NICE published guidance

No change

No new infection or antimicrobial items.

Journal of Antimicrobial Chemotherapy

NEW

15 Oct: Genomic evidence of clonal and IncX3 plasmid-mediated dissemination of blaNDM-7 in the Klebsiella pneumoniae complex (Yangzhou, China). Summarised in the Journals tab. Article ›

Journal of Infection

NEW

15 Oct: AMR trends and lineage distribution in invasive pneumococcal disease before and after PCV13, South Africa. Summarised in the Journals tab. Article ›

The CrAg LFA conversion paper re-listed on ScienceDirect was already reported on 13–15 Oct.

Journal of Hospital Infection

No change

Nothing new beyond the 14 Oct papers we’ve already covered.

Agencies & guidance

The week 42 respiratory report and the monthly measles update both came out yesterday. UKHSA has also updated Kenya’s entry on the HCID country risk list.

Guidance changes

UKHSA · HCID country risk · updated

Kenya entry updated (15 Oct)

Use it in returning-traveller VHF risk assessment. Still open: the UKAP consultation on healthcare workers living with HIV who perform exposure-prone procedures (closes 8 Nov 2026). No new UK SMI, Green Book, NICE infection/AMR or EUCAST changes; EUCAST breakpoints remain v16.1.

HCID country-specific risk › · UKAP consultation ›

UKHSA / England

UKHSA · flu/COVID-19/RSV · week 42 · new

Week 42 report (data to week 41, 5–11 Oct)

• Flu: hospital lab positivity 6.0% (6.2% the week before), stable, at baseline. ILI GP consultations rose to 6.3/100,000 (from 5.6); flu admissions stable at 1.88/100,000.
• COVID-19: hospital PCR positivity 8.8% (9.0%); GP swab positivity fell to 6.6% (from 10.2%). Admissions rose to 2.46/100,000 (from 2.13); ICU/HDU unchanged at 0.06/100,000.
• RSV: rising but still at baseline; lab positivity 1.0% (from 0.4%); admissions 0.23/100,000 (from 0.13).

Week 42 report ›

UKHSA · measles · new

England: 1,030 cases, 1 Jan–12 Oct 2026

+27 since 17 Sep (last month’s figure was 1,003). 61% are children aged 10 and under. London 50% (520), West Midlands 16% (162), North West 11% (111); Enfield 111, Birmingham 82, Hertfordshire 64. 19 cases had onset in the 4 weeks since 14 Sep (11 of 19 in London). UKHSA says activity peaked in May and has declined and stabilised since. Next update 12 Nov.

Measles 2026 › · Dashboard ›

UKHSA · Salmonella · weekly

Egg-linked S. Enteritidis clusters (data to 13 Oct)

t5.9411: 439 cases (+11 in a week; 84 in the past 4 weeks; sample dates to 30 Sep). The highest rate is in the North East (2.31/100,000). 74 of 272 (27.2%) were admitted to hospital, and there has been 1 death. t0.24068: 194 cases, no change. ECDC lists a multi-country outbreak (the UK has 61% of 341 confirmed cases).

Week 41 release ›

UKHSA · norovirus/rotavirus

Week 42: within expected levels

Norovirus lab reports in weeks 40–41 were 18.6% below the 5-season average, and hospital outbreaks reported to HNORS (the hospital norovirus outbreak reporting system) were 25.4% below. GII.4[P16] is the commonest genotype (24.6%). Rotavirus is 19.7% above average but still within expected levels.

Week 42 report ›

UKHSA · outbreaks under monitoring · week 41

BVD and CCHF update

BVD data to 14 Oct: DRC 9,066 / 4,381 (to 11 Oct), +463 cases since the last report; Ituri is easing while North Kivu and Haut-Uélé persist, and Dakwa is the newest health zone. Kenya: 2 cases, 1 death; 128 contacts listed, 113 traced, 108 quarantined, and 5 contacts abroad notified under the IHR (International Health Regulations). UK risk low; no UK imported cases. Also one new CCHF case in Dakar, Senegal (8 in 2026).

Week 41 ›

MHRA · HPR · unchanged

No new alerts or issues

No new infection-relevant MHRA alert. DSI/2026/014 (echinocandins with PAN-membrane CRRT filters) is unchanged since 13 Oct. No new HPR or Vaccine Update.

MHRA alerts ›

ECDC

ECDC · Ebola

Updated 15 Oct 13:30, still data to 12 Oct

9,144 confirmed / 4,410 deaths; 899 in isolation; 2,418 recovered; contact follow-up 77.6%. ECDC rates the import risk to the EU/EEA as very low. The CDTR is still week 41 (9 Oct); week 42 is expected today.

ECDC Ebola ›

Eurosurveillance · issue 41

Vol 31 Issue 41 (15 Oct)

XDR Shigella in the Netherlands (see Journals) and HPV vaccine perceptions in Germany.

Issue 41 ›

Global — Ebola (Bundibugyo)

Ebola · DRC · CDC figures

DRC: 9,212 confirmed, 4,441 deaths (CDC, as of 15 Oct)

The latest published INSP bulletin is still SitRep 151 (data to 12 Oct: 9,144 / 4,410). CDC’s figure implies about +68 cases and +31 deaths. CDC also lists Kenya 2/1, Uganda 20 confirmed (outbreak over) and France 1 (recovered). US entry restrictions for travellers from the DRC continue.

Not yet confirmed: we couldn’t retrieve the DRC bulletin behind CDC’s figure, and ECDC hasn’t published it.

CDC Ebola › · ebola-tracker SitRep archive ›

Kenya · updated 15 Oct

Still 2 confirmed cases, 1 death

The second case (a 39-year-old relative, onset 13 Oct while in quarantine) was confirmed by both the national virology lab and KEMRI-CDC. Of 128 contacts, 113 have been traced and 108 are quarantined; 15 are still being traced, and 5 contacts abroad have been notified under the IHR. People in contact with the second case after onset, including health workers, are being assessed. A suspected case in Wajir tested negative. Africa CDC’s reconstruction suggests the index case was unwell from 15 Sep and passed several missed detection points in the DRC and at airports.

Kenya News Agency › · Al Jazeera › · BBC ›

WHO

Watch · Irkutsk · unchanged

No new Disease Outbreak News

Nothing since DON620 (Irkutsk, 10 Oct).

Still not confirmed: the cause remains undetermined.

WHO DON ›

CDC / US

CDC · MMWR · Vol 75 No 40 · new

DTaP effectiveness in Alaska’s pertussis outbreak (May–Nov 2024)

84 cases and 229 matched controls aged 6 months to 6 years. VE (vaccine effectiveness) was 96.2% with ≥3 primary doses and 85.3% with partial vaccination; unvaccinated children had 26.1 times the odds of pertussis. Useful when counselling on pertussis catch-up. Also: Notes from the Field on dengue in the US Virgin Islands (Jan 2024–Jun 2025, title only), and the Cladophialophora bantiana report (covered 15 Oct) is now in the weekly issue. No new HAN; the latest infection HAN is still rabies PEP (CDCHAN-00533, 10 Sep).

MMWR › · MMWR 2026 index ›

CDC · EID · early release

New EID articles (15 Oct)

• Breakthrough TMP-SMX-resistant disseminated nocardiosis in a kidney transplant recipient (India): pulmonary and cerebral disease alongside invasive aspergillosis while on co-trimoxazole prophylaxis. Resistant to co-trimoxazole and ciprofloxacin; cured with imipenem/meropenem plus linezolid, then minocycline. Supports susceptibility testing and brain imaging in all pulmonary nocardiosis. EID ›
• Community pneumonic plague cluster, Fenoarivobe, Madagascar (2022): 21 cases, CFR (case fatality rate) 57%, spread within households and at funerals. The index case was first treated as malaria, and specific treatment began only in week 4. EID ›
• Telling avian from seasonal flu in wastewater by digital PCR (EU JRC): a clade 2.3.4.4b-specific HA assay detected H5N1 RNA even against a high seasonal flu background (spiked samples only). EID ›
• Also (titles only): dengue transmission dynamics in Ceará, Brazil, 2010–2025; systemic Spiroplasma turonicum knee arthritis, France.

CDC · outbreak investigation

Endotoxin reactions after compounded injectable glutathione

On 15 Oct CDC re-flagged its multistate investigation into products made from a dietary-supplement-grade ingredient. More than 25 people in at least 4 states became ill with sepsis-like illness, and at least 3 were hospitalised (CDC page last updated 15 Sep).

CDC investigation ›

CDC · measles · unchanged

4,080 US cases (as of 8 Oct)

42 outbreaks, 2 deaths. The Thursday 15 Oct refresh wasn’t visible yet.

CDC measles ›

CDC · travel notices · unchanged

Travel notices

Level 4 for Ituri and Nord-Kivu; Level 3 for Haut-Uélé and Tshopo; Level 2 for the rest of the DRC and Uganda.

CDC travel notice ›

Journals

Eight new items from six journals, including the IMPALA trial in NEJM and two antimicrobial-stewardship papers in CID. Our watched JAC and Journal of Infection pages each have one new paper.

NEJM — new

NEJM · HIV · phase 3b

IMPALA: long-acting cabotegravir + rilpivirine vs oral dolutegravir in African adults with adherence challenges

Kenya, South Africa and Uganda; n=537. Viral load under 50 copies/mL at week 48 in 91.0% vs 89.2%, so non-inferior. However, confirmed virological failure occurred in 1.9% vs 0%, and there was no baseline resistance testing.

Takeaway: promising for patients who struggle with adherence, but the resistance risk needs monitoring.

DOI: https://doi.org/10.1056/NEJMoa2518753

NEJM · dengue · letter

Once-weekly mosnodenvir as dengue prophylaxis in a human infection model

Title-level only.

DOI: https://doi.org/10.1056/NEJMc2516395

Clinical Infectious Diseases — new

CID · AMS · VRE

Linezolid restriction and VRE outcomes

Difference-in-differences study of 521,493 admissions at 2 US centres. Restriction cut linezolid use by 27% and linezolid resistance by 41%. Overall mortality didn’t change, but mortality in VRE-screen-positive patients rose by 4.7 percentage points, more so with bacteraemia or sepsis.

Takeaway: restriction policies should include a fast track for septic VRE-colonised patients.

DOI: https://doi.org/10.1093/cid/ciag656

CID · AMS · resistance

Prior antibiotic exposure causally linked to same-class resistance

1.17 million culture episodes in 3 US health systems, analysed with double machine learning. Prior fluoroquinolone exposure raised non-susceptibility by about 9–13 percentage points. Empirical fluoroquinolones for BSI (bloodstream infection) were inactive in 50–71% of episodes after prior exposure, against 27–37% without. The effect was strongest within 30 days.

Takeaway: ask about antibiotics in the last 3 months before choosing empirical therapy.

DOI: https://doi.org/10.1093/cid/ciag549

Eurosurveillance and Lancet Infect Dis — new

Eurosurveillance · Shigella

Shigellosis in the Netherlands, 2018–2024 (3,020 cases)

XDR (extensively drug-resistant) isolates rose from 1/58 in 2018 to 22% in 2023. XDR strains were linked to MSM (men who have sex with men) contact and to genomic clusters, and much transmission was domestic.

Takeaway: this matches UK XDR S. sonnei/flexneri trends; take a sexual history and send stool culture for susceptibility testing.

DOI: https://doi.org/10.2807/1560-7917.ES.2026.31.41.2600075

Lancet Infect Dis · Ebola · letter

Cross-neutralisation of Ebola and Bundibugyo virus after natural infection or Ervebo vaccination

A CDC letter that follows yesterday’s T-cell cross-reactivity data.

Title-level only; abstract not available.

DOI: https://doi.org/10.1016/S1473-3099(26)00544-X

JAC and Journal of Infection — new on our watched pages

JAC · NDM-7 · watched

NDM-7 on IncX3 plasmids across clinical, hospital-environment and wastewater K. pneumoniae complex isolates

7 NDM-7 isolates from 1,049 clinical, hospital-surface and wastewater samples. The ~46 kb IncX3 plasmids were highly transferable and stable, and six ST196 K. quasipneumoniae isolates from different sources differed by only 0–7 core SNPs.

Takeaway: a carbapenemase plasmid moving between hospital, environment and wastewater.

Article ›

J Infect · pneumococcus · watched

Pneumococcal AMR after PCV13, South Africa

In children under 5, penicillin-MDR invasive pneumococcal disease fell from 5.5 to 0.4 per 100,000 (−93%), but residual 19A/19F and non-vaccine serotypes still carry resistance.

Article ›

On X

Two searches of agency accounts and UK/EU outbreak keywords (from 15 Oct).

@UKHSA, 15 Oct: #UKHSAVirusWatch thread with the week 42 figures (flu 6.0%, COVID 8.8%, RSV 1.0%), matching the GOV.UK report. Post ›

@CDCgov, 15 Oct: warning against injectable glutathione made with a dietary-supplement-grade ingredient (multistate outbreak investigation). Post ›

No other credible breaking UK/EU signals; the keyword search turned up mostly unverified commentary.

What we could not confirm

We want you to know exactly where today’s issue has limits, so here are the 4 gaps we couldn’t close and what went wrong.

Source	Issue
DRC bulletins	We couldn’t retrieve INSP SitRep 152 or later, so we’ve used and flagged CDC’s figure as of 15 Oct.
ECDC	The week 42 CDTR isn’t published yet (due today).
CDC	MMWR article pages refused our access, so the details came from search summaries of the MMWR page. We couldn’t open the HAN archive directly. The US measles page still showed the 9 Oct update.
Journals	The Lancet Infect Dis Online First listing refused our access, so we found Lancet items via PubMed; the Ebola cross-neutralisation letter has no abstract. JAC and Journal of Infection article pages blocked us, so their abstracts came from PubMed.

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 (9 pages, all reachable, checked 16 Oct ~08:09 BST)
• Microregistrar Moodle sheet (no new items)
• UKHSA GOV.UK: week 42 flu/COVID-19 report, measles monthly figures, Salmonella and norovirus/rotavirus releases, Outbreaks under monitoring, HCID country risk
• MHRA drug and device alerts
• ECDC: Ebola page, CDTR, Eurosurveillance
• CDC: Ebola, MMWR, EID early release, HAN, measles, travel notices, outbreak investigations
• WHO Disease Outbreak News; ebola-tracker SitRep archive; Kenya News Agency, Al Jazeera and BBC
• Journal sweep (PubMed where pages were blocked) plus watched journal feeds
• X: two searches of agency accounts and outbreak keywords

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