Hepatitis of unknown aetiology in children - epidemiological overview of cases reported in Europe, 1 January to 16 June 2022.

Following the report of an excess in paediatric cases of severe acute hepatitis of unknown aetiology by the United Kingdom (UK) on 5 April 2022, 427 cases were reported from 20 countries in the World Health Organization European Region to the European Surveillance System TESSy from 1 January 2022 to 16 June 2022. Here, we analysed demographic, epidemiological, clinical and microbiological data available in TESSy. Of the reported cases, 77.3% were 5 years or younger and 53.5% had a positive test for adenovirus, 10.4% had a positive RT-PCR for SARS-CoV-2 and 10.3% were coinfected with both pathogens. Cases with adenovirus infections were significantly more likely to be admitted to intensive care or high-dependency units (OR = 2.11; 95% CI: 1.18-3.74) and transplanted (OR = 3.36; 95% CI: 1.19-9.55) than cases with a negative test result for adenovirus, but this was no longer observed when looking at this association separately between the UK and other countries. Aetiological studies are needed to ascertain if adenovirus plays a role in this possible emergence of hepatitis cases in children and, if confirmed, the mechanisms that could be involved.

Outbreak of Salmonella Newport linked to imported frozen cooked crayfish in dill brine, Sweden, July to November 2019.

In autumn 2019, the Public Health Agency of Sweden identified a cluster of Salmonella Newport cases by whole genome sequencing (WGS). Cases' distribution in place and time indicated a nation-wide ongoing outbreak. An investigation was initiated to identify the source and prevent further cases. We conducted a case-case study based on notified salmonellosis cases and a Salmonella trawling questionnaire, comparing 20 outbreak cases and 139 control cases. Food exposures were compared by adjusted odds ratios (aOR) with 95% confidence interval (CI) using logistic regression. Implicated foods were sampled. Outbreak cases were more likely to have consumed crayfish (aOR = 26; 95% CI: 6.3-105). One specific brand of imported frozen, pre-cooked whole crayfish in dill brine was identified as the source. Salmonella Newport was later detected in different batches from retail and in one sample from border control. Isolates from food samples clustered with the human outbreak strain by WGS. Although the retailer made a complete recall, two more cases were identified long afterwards. This investigation demonstrated the successful use of a case-case study and targeted microbiological testing to identify the source. The immediate action taken by the retailer was important to confirm the source and stop the outbreak.

A Case-Series Report on The Use of a Salicylic Acid Bandage as a Non-Antibiotic Treatment for Early Detected, Non-Complicated Interdigital Phlegmon in Dairy Cows.

Interdigital phlegmon (IP) is an important cause of lameness in cattle. The aim of this study was to evaluate the treatment effect of a salicylic acid bandage in the interdigital space in dairy cows with early detected IP. Dairy cows (n = 109) with IP diagnosed and treated by the farmer were included in the study. On day 0, the rectal temperature, general condition, coronary circumference, and lameness score were recorded. The cow was immobilized in a trimming chute and the interdigital space was cleaned and inspected. For treatment, 1⁻2 tablespoons of 100% salicylic acid powder were applied into the interdigital space followed by bandaging of the hoof. On days 1⁻2 and days 3⁻5, the rectal temperature, the general condition, and the lameness score were recorded. On days 3⁻5, the cow was restrained, the bandage was taken off, and the coronary circumference was recorded again. Treatment of IP with salicylic acid gave a satisfactory treatment result. Within three⁻five days, treated cows responded with reduced lameness, lower body temperature, decreased coronary swelling, and an improved general condition compared to the day when the treatment started. Salicylic acid therefore proved to be an alternative in the treatment of early-detected non-complicated IP.