An imported case of vaccine-derived poliovirus type 2, Spain in the context of the ongoing polio Public Health Emergency of International Concern, September 2021.

The monthly retrospective search for unreported acute flaccid paralysis (AFP) cases conducted as a complementary component of the Spanish AFP surveillance system identified a case of AFP in a child admitted in Spain from Senegal during August 2021. Vaccine-derived poliovirus 2 was identified in the stool in September 2021. We present public health implications and response undertaken within the framework of the National Action Plan for Polio Eradication and the Public Health Emergency of International Concern.

Review of hepatitis C screening programs for immigrants in Spain from endemic countries.

BACKGROUND: hepatitis C virus (HCV) screening strategies in European countries do not usually include the migrant population from endemic countries as a target group for screening. The aim of this study is to describe and to evaluate HCV screening strategies for the migrant population residing in Spain and to compare the differences at a regional level. METHODS: on-line research on every Health Public Department's website of each autonomous community was carried out during 2017 and 2019. RESULTS: Aragon, Cantabria, Catalunya, Canary Islands and Madrid have HCV screening programmes and include migrants from high-endemic countries as a high-risk group that should be targeted in the screening programme. The Valencian Community and the Basque Country have an HCV programme although migrants for high endemic countries are not included as a high-risk group. Finally, the other autonomic communities have no specific programme for HCV in place. Few of them have a screening control system and/or evaluation. CONCLUSION: there is heterogeneity on the different HCV autonomic programs concerning the risk groups that should be targeted. A homogenization of such criteria would be recommended. HCV screening in migrant populations from endemic countries should be extended to the rest of autonomic communities. More measures for control and evaluation should be implemented in autonomic strategies with specific indicators for migrant populations.

Rare Recombinant GI.5[P4] Norovirus That Caused a Large Foodborne Outbreak of Gastroenteritis in a Hotel in Spain in 2021.

Noroviruses are among the most important causes of acute gastroenteritis (AGE). In summer 2021, a large outbreak of norovirus infections affecting 163 patients, including 15 norovirus-confirmed food handlers, occurred in a hotel in Murcia in southeast Spain. A rare GI.5[P4] norovirus strain was identified as the cause of the outbreak. The epidemiological investigation determined that norovirus transmission might have been initiated through an infected food handler. The food safety inspection found that some symptomatic food handlers continued working during illness. Molecular investigation with whole-genome and ORF1 sequencing provided enhanced genetic discrimination over ORF2 sequencing alone and enabled differentiation of the GI.5[P4] strains into separate subclusters, suggesting different chains of transmission. These recombinant viruses have been identified circulating globally over the last 5 years, warranting further global surveillance. IMPORTANCE Due to the large genetic diversity of noroviruses, it is important to enhance the discriminatory power of typing techniques to differentiate strains when investigating outbreaks and elucidating transmission chains. This study highlights the importance of (i) using whole-genome sequencing to ensure genetic differentiation of GI noroviruses to track chains of transmission during outbreak investigations and (ii) the adherence of symptomatic food handlers to work exclusion rules and strict hand hygiene practices. To our knowledge, this study provides the first full-length genome sequences of GI.5[P4] strains apart from the prototype strain.