P-69 - MODELLING VACCINATION STRATEGIES AGAINST GONORRHOEA IN THE BRITISH POPULATIONMetelmann, Mr Soeren; Xu, Dr Feng; Oke, Dr Segun; Sun, Ms Suzy; Lenzi, Dr Luana; Decraene, Dr Valerie; Thompson, Dr Alex; Borrow, Dr Ray; Vivancos, Dr Roberto; Pellis, Dr Lorenzo; Hall, Dr Ian
doi: 10.1093/pubmed/fdag046.092pmid: N/A
BackgroundGonorrhoea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. With case numbers resurging in many countries and the emergence of drug-resistant strains it is a significant public health concern. Development of a vaccine against this infection proofed difficult for decades until observations of a meningococcal B vaccine being partially effective against gonorrhoea has given new hope. In 2023, JCVI even recommended the use of MenB vaccines for the risk group of gay, bisexual, and other men who have sex with men (GBMSM). For other population groups though, the usefulness of the vaccine remains less clear.ObjectivesOur main aim was to develop a model that can replicate and project gonococcal infections in the whole of the British population and simulate different vaccination strategies with MenB vaccines. In a second step, we then looked at the cost effectiveness of each strategy.MethodsWe use a deterministic mathematical model to describe gonococcal infections in four sexually active groups: women, heterosexual men, and GBMSM with a low and with a high number of sexual partners. For the health economic model, we perform a basic cost-benefit analysis comparing the cost of the vaccination programmes against the economic burden of disease and the quality adjusted life years lost.ResultsOur model Modelling results suggest that a vaccine that is even partially protective against gonorrhoea, delivered through an effective targeting strategy, could indeed have a significant impact on reducing the incidence of the infection. A treatment centred strategy is cost effective across all scenarios and sensitivity tested.ConclusionsWe show that vaccination at screening would be most effective in terms of disease control. The greatest benefits are observed when vaccine is targeted at GBMSM groups because of the eventual reduction in female cases.
P-53 - AUTOMATED DETECTION OF INVASIVE PNEUMOCOCCAL DISEASE CLUSTERS IN CLOSED SETTINGS: PILOT IMPLEMENTATION IN THE SOUTH WEST AND IMPLICATIONS FOR NATIONAL ROLL OUTLeaver, Ms Sarah; Khan, Dr Joshua; Wood, Dr Alasdair; Heinsbroek, Dr Ellen; Young, Dr Nicholas; Brown, Dr Claire
doi: 10.1093/pubmed/fdag046.086pmid: N/A
BackgroundInvasive pneumococcal disease (IPD) poses a substantial risk in closed settings such as care homes, where vulnerable individuals are at risk of rapid transmission and severe disease, including septicaemia, pneumonia and meningitis. Early detection of IPD clusters supports timely intervention, including infection control, chemoprophylaxis and vaccination to limit spread and reduce morbidity.ObjectivesTo describe the implementation and evaluation of a regional pilot of an automated IPD cluster detection tool in the South West of England, compare its performance with the previous manual process, and consider the implications for a national roll-out.MethodsLaboratory-confirmed IPD results reported to the UKHSA laboratory surveillance system are automatically ingested into the UKHSA Case and Incident Management System (CIMS). Previously, new IPD cases were manually reviewed to identify epidemiological links. In July 2025, the UKHSA South West team introduced an automated weekly process to identify IPD clusters in closed settings. This process uses an R script to extract laboratory-confirmed IPD reports from CIMS and identify potential clusters: two or more cases occurring at the same postcode within 14 days of the date entered. The tool was assessed for feasibility and reliability and compared with the manual method to evaluate improvements in operational efficiency, sensitivity and public health value.ResultsBetween July and December 2025, the tool detected two IPD clusters in separate care homes, leading to prompt antibiotic chemoprophylaxis and vaccination of eligible residents. Evaluation indicated that the automated tool was reliable, straightforward to use and provided meaningful time-saving benefits compared to the manual process. The once-weekly schedule of the process was highlighted as a limitation.ConclusionsThe pilot demonstrates that automated IPD cluster detection facilitates cluster identification and supports timely public health response within closed settings. Further refinement, particularly regarding frequency of the process, will support effective national roll-out and further strengthen IPD surveillance across England.
O-05 - WHEN TEST POSITIVITY MISLEADS: USE OF THE GOLDSTEIN INDEX AS A MEASURE OF RESPIRATORY PATHOGEN INTENSITY IN PRIMARY CARE IN SCOTLANDEvans, Dr Josie; McCabe, Dr Ronan; Marsh, Dr Kimberly
doi: 10.1093/pubmed/fdag046.005pmid: N/A
BackgroundSince October 2022, the nationally-representative CARI sentinel surveillance system in >100 GP practices in Scotland has used test-positivity (TP) to monitor 10 pathogens among patients presenting with acute respiratory infection (ARI). TP reflects relative pathogen prevalence among those tested but does not account for substantial variation in background ARI prevalence. The Goldstein index (GI), which combines TP with population-based ARI rates, may be a more valid measure of pathogen intensity.ObjectivesTo compare GI and TP for selected infectious respiratory pathogens in Scotland.MethodsGI, calculated as the product of CARI TP and Scotland-level ARI rates, was compared with TP for selected seasonal and non-seasonal pathogens. ARI rates are derived from GP consultation rates and are well-validated.ResultsCOVID-19 showed a distinct temporal pattern compared with typical seasonal respiratory pathogens, with activity peaking during summer months when background ARI rates were low. Consequently, high TP did not translate into high population burden. During summer COVID-19 peaks, GI values were moderate: in July 2024, TP reached 22.3% (95%CI:19.0–26.0) with a GI of 28.8/100,000, while in August 2025 TP reached 20.5% (95%CI:15.9–25.9) with a GI of 20.0/100,000.In contrast, winter-peaking respiratory pathogens exhibited lower TP but higher GI, due to higher ARI rates. Seasonal coronavirus TP peaked at 14.2% (95%CI:12.1-16.7) in February 2024, but reached GI of 34.4/100,000, substantially higher than summer COVID-19 GI. Influenza showed a similar winter pattern, with peaks in TP coinciding with high ARI rates and consequently high GI.ConclusionGI is a more meaningful measure of pathogen intensity than TP, conveying population disease burden rather than relative prevalence among those tested. For non-seasonal pathogens such as COVID-19, TP can overstate intensity during low-ARI periods and obscure meaningful seasonal differences in impact. Incorporating GI into routine surveillance supports clearer risk communication and improved public health decision-making.
PS-04 - EVALUATING RAPID COMBO LATERAL FLOW DEVICES FOR ACUTE RESPIRATORY INFECTION OUTBREAKS IN ADULT CARE HOMES IN THE SOUTH EAST: A SERVICE EVALUATIONHealy, Dr Samuel; Joshi, Dr Arun; Ferris, Dr Simon; Turner-Moss, Dr Eleanor; Hobart, Dr Carla; Fernandes, Dr Anand
doi: 10.1093/pubmed/fdag046.053pmid: N/A
BackgroundOut-of-season acute respiratory infection (ARI) outbreaks in care homes have previously relied on PCR testing to identify influenza, while in-season management has often relied on symptom criteria alone. SARS-CoV-2 and Influenza A+B Antigen Combo Rapid Tests (LFDs) may allow faster identification of respiratory pathogens and more informed outbreak management decisions.ObjectivesTo evaluate the economic benefit, feasibility and acceptability of using LFDs for ARI outbreaks in adult care homes in the South East compared with existing PCR-based processes.MethodsA pragmatic in-service cost comparison evaluated the LFD pathway against the existing PCR system, including direct cost comparisons and narrative assessment of wider health benefits. Qualitative data from surveys and focus groups involving care homes, Health Protection Teams (HPTs) and other stakeholders were analysed thematically to explore feasibility and acceptability. The survey was distributed to all care homes in the region that used LFDs when reporting an outbreak, with voluntary focus group participation from survey respondents.ResultsLFDs had higher setup costs than PCR (£33,945 vs £24,030) but were substantially cheaper per outbreak (£15.85 vs £313.71). Cost savings would be realised after approximately 33 outbreaks, with potential direct savings of up to £14,000 annually across the South East. Wider benefits not captured in the cost comparison included faster and more appropriate antiviral prescribing. Thematic analysis identified consistently positive stakeholder feedback. LFDs were viewed as a valuable outbreak management tool that improved staff confidence and reassurance. HPTs also reported reduced time spent clarifying symptoms and making antiviral decisions. Operational barriers were noted including challenges with resupply and with spreadsheet-based reporting processes.ConclusionLFDs represent a feasible, acceptable and potentially cost-saving alternative to PCR for ARI outbreak management in care homes across the South East region. Operational challenges, alongside regional differences in outbreak management and costs, should inform national implementation.
O-25 PREVENTING TRANSMISSION OF MEASLES IN GOVANHILL, GLASGOW: COMMUNITY ENGAGEMENT WORK TO PROMOTE UPTAKE OF MMR VACCINATIONBenson, MS Helen
doi: 10.1093/pubmed/fdag046.022pmid: N/A
BackgroundIn spring 2025 NHS Greater Glasgow and Clyde (GGC) managed a measles outbreak in Govanhill, Glasgow. All 5 notified cases were from the Roma community. None had travelled prior to onset, with no established epidemiological links, suggesting undetected community transmission. Govanhill is an ethnically diverse, multilingual and deprived district including Roma, Eastern European, and South Asian communities with many multigenerational households. Residents may experience barriers in accessing health campaigns and services, and the area is known to have low MMR uptake.ObjectivesTo prevent community measles transmission through MMR vaccination.MethodsOur response included provision of additional opportunities for MMR vaccination. We added a number of additional drop-in MMR clinics and increased capacity of existing clinics. We developed public messaging about measles and how to access MMR vaccination, translated into community languages including video resources sharable across social media. These included recordings in the Romani dialect spoken locally, a spoken-only language. We worked in partnership with peer educators, third sector organisations and community leaders to share these resources.ResultsMMR clinics were held in education, health and community venues, with interpreter support. Though targeted at different age groups, all clinics offered adult and child vaccination. Feedback from community leaders indicated accessible messaging in languages spoken locally was well-received, and clinic attendance was often facilitated by community organisation workers.ConclusionsDespite high overall rates, several GGC areas have lower MMR vaccination, often associated with deprivation or marginalised groups. With measles increasing in the UK and worldwide, we seek to address this by applying learning from work in Govanhill. With trust in community organisations often higher than in healthcare professionals, key learning was community engagement is as important as ensuring access to healthcare interventions. Key to this is developing appropriate, accessible messaging for local communities and partnership working with local groups.
PS-34 - EPIDEMIOLOGY OF PASTEURELLOSIS IN ENGLAND, 2017- 2025Onyeke, Mrs Claudia; Singleton, Jack; O’Hara, Gerladine; Robin, Charlotte; Pudney, Rachel; Chudasama, Dimple
doi: 10.1093/pubmed/fdag046.071pmid: N/A
BackgroundPasteurella species are zoonotic bacteria that can cause pasteurellosis in humans leading to rapidly developing soft tissue infections and severe respiratory diseases. Reports of laboratory-confirmed Pasteurella species have increased since 2017. Monitoring trends, demographic patterns and potential exposures helps understand the national burden and better inform public health strategies.ObjectivesWe aim to describe the epidemiology of pasteurellosis in England from 2017-2025.MethodsWe analysed reports of laboratory-confirmed Pasteurella species submitted to the UKHSA laboratory reporting system between 2017 and 2025. Cases were de-duplicated at patient level using a 42-day episode window. Free-text comments submitted with laboratory reports were reviewed to identify potential exposures.ResultsThere were 1007 pasteurellosis cases reported in 2025, a 49.6% increase from 673 cases in 2017. Accordingly, the overall incidence rate increased from 1.22 to 1.73 per 100,000 population. Confirmed cases accounted for 15.8% of reports in 2025 (159 cases), compared with 83 cases in 2017. Pasteurella multocida (64.3%) and P. canis (18.5%) were the most prevalent species. Incidence was higher among females (1.88 per 100,000) than males (1.51 per 100,000), with the greatest burden observed in the 45–64 age group (2.3 for females vs 2.1 for males).In 2025, free text comments were available for 187 of the 1,007 cases (18.6%). Animal bites were the primary exposure, in 48.7% of cases, with cat and dog bites accounting for 28.9% and 19.8% respectively. Bite-related exposures were documented most frequently among adults aged 15–44 years (35/187, 18.7%), and those aged 45–64 years (33/187, 17.6%).ConclusionWith incidence increasing steadily since 2017, this study improves understanding of the epidemiology of pasteurellosis. Animal bites were the most frequently reported exposure, although exposure data were limited. Improved recording of exposure information will help identify the drivers of increasing incidence and support targeted prevention efforts.
P-37 - SOCIODEMOGRAPHIC FACTORS ASSOCIATED WITH MPOX VACCINE UPTAKE AMONG GAY AND BISEXUAL MEN WHO HAVE SEX WITH MEN (GBMSM) IN SCOTLANDChua, Miss Vera; Morrison, Dr Kirsty; Hasan, Dr Taimoor; Munro, Mr James; Falconer, Miss Michelle; Cameron, Dr Claire; Gibbons, Dr Cheryl
doi: 10.1093/pubmed/fdag046.083pmid: N/A
BackgroundMpox has spread globally since 2022. Outside sub-Saharan Africa, mpox has primarily affected gay, bisexual, and other men who have sex with men (GBMSM) communities. Scotland introduced a targeted vaccination programme in June 2022 to provide protection against mpox within the high-risk GBMSM community.ObjectivesWe assessed two-dose mpox vaccine uptake among high-risk GBMSM and identified sociodemographic factors associated with vaccine uptake in Scotland.MethodsWe conducted a retrospective cross-sectional study of a cohort of high-risk eligible GBMSM. Multivariable logistic regression estimated adjusted odds ratios (aORs) for being unvaccinated and for being fully vaccinated (two doses) between July 2022 and December 2023.ResultsAmong 8,846 eligible GBMSM, 4,846 were unvaccinated. Of 4,000 who received ≥1 dose, 1,743 received one dose and 2,257 completed two doses.Higher odds of being unvaccinated were associated with age ≤24 years (reference: aged 55+ years, aOR: 3.51, 95% CI: 2.89-4.25), living in the most deprived quintile (reference: least deprived; aOR 1.46, 95% CI 1.26–1.71), eligibility via recent bacterial STI (reference: PrEP; aOR 2.98, 95% CI 2.62–3.40), and reporting sexual partners of both men and women (reference: men only; aOR 1.63, 95% CI 1.46–1.82).Lower odds of completing two doses after receiving one were associated with living in the most deprived quintile (aOR 0.58, 95% CI 0.47–0.72), eligibility via recent bacterial STI (PrEP; aOR 0.67, 95% CI 0.53–0.83), and reporting sexual partners of both men and women (aOR 0.75, 95% CI 0.63–0.88).ConclusionsSocioeconomic deprivation, younger age, eligibility pathway, and bisexual partner history were associated with non-uptake and/or partial uptake. These findings can help target interventions to improve uptake and dose completion; further work should explore reasons behind vaccine uptake decisions.
PS-08 - UKHSA FIELD SERVICES RAPID INVESTIGATION TEAM: ACTIVITY AND EARLY IMPACTOlufon, Mrs Oluwakemi; Bray, Mr Neil; Inzoungou-Massanga, Ms Carmellie; Halford, Ms Florence; Matthews, Ms Eve; Shah, Ms Anita; Awokoya, Mr Motolani; Kothandan, Mr Saravana Kumar; Kumar, Ms Deepti
doi: 10.1093/pubmed/fdag046.057pmid: N/A
BackgroundThe Field Services Rapid Investigation Team (RIT), established in 2022, is the UK Health Security Agency’s (UKHSA’s) national, multidisciplinary, deployable rapid response service. RIT adds to UKHSA’s response capability, working alongside regional Health Protection Teams and the global PHRST to respond to complex and enhanced incidents. RIT uniquely supports domestic incidents by bringing together field epidemiology, biological sampling and operational expertise.ObjectiveWe aim to share RITs capabilities, activation model, challenges, lessons learnt and achievements to date. We aim to highlight the significant contributions the RIT has made to national incident response to date.MethodsWe reviewed and summarised data on RITs biological sampling and epidemiological input for national incidents, enhanced surveillance programmes and research activities. We also reviewed RITs skill capabilities and future scope.ResultsThe team consists of a Consultant Epidemiologist, Health Protection Practitioners (HPPs), Epi-Scientists, and business support staff. Clinical staff and Epi-Scientists provide an integrated capability of data collection, rapid data analysis, report production and field biological sampling. Data collection tools are designed by the Epi-Scientists and conducted by the HPPs through online or face to face interviews. HPPs are responsible for collecting biological samples in response to an incident.Since September 2022, the team has responded to over 60 complex and enhanced incidents for UKHSA, and has deployed to 25 sites for sample collection. These incidents included numerous high-profile national investigations such as mpox, rabies, measles and most recently meningococcal B. RIT has operationalised an asymptomatic zoonotic influenza study, and are currently operationalising academic studies for Group A Streptococcal outbreaks in schools and nurseries as well a carriage study for meningococcal infection in university students.ConclusionsRIT is a high impact team which provides a flexible, evidence-driven capability that improves national readiness for “all-hazards” threats, supports rapid decision-making and strengthens UKHSA’s preparedness capabilities.
PS-40 - EMERGING AND RE-EMERGING STIS IN GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WITH MEN (GBMSM) IN ENGLANDWalsh, Miss Megan; Fountain, Holly; Sinka, Katy
doi: 10.1093/pubmed/fdag046.076pmid: N/A
BackgroundGay, bisexual, and other men who have sex with men (GBMSM) have been disproportionately affected by emerging/re-emerging STIs: lymphogranuloma venereum (LGV), syphilis, and shigella, each of which increased over time to become endemic. Real-time enhanced STI surveillance supports detection, monitoring, and control. Understanding past emergence may help guide responses to new challenges such as mpox.ObjectivesDescribe trends and epidemiology of emerging STIs among GBMSM in England to inform understanding of current and future infections and prevention options.MethodsInfectious syphilis and LGV diagnoses among GBMSM ≥15 years were extracted from GUMCAD (2010–2024). Shigella (2010–2024) and mpox (from 2022) data were obtained from SGSS. Adult males without reported travel were used as a proxy for sexually transmitted shigella; mpox data included GBMSM and adult males without recorded sexual orientation. Descriptive analyses were conducted separately as datasets could not be linked. Published surveillance data summarised trends before 2010.ResultsSyphilis re-emerged and LGV emerged in 2003, followed by sexually transmitted shigella in 2008. All increased markedly between 2010–2019: LGV: 217–1,053, +385%; syphilis: 1,610–5,877, +265%; shigella: 714–1,309, +83%, particularly following wider HIV-PrEP use from 2017. Post-COVID increases were observed for all infections, steepest for shigella (2021–2024: 642–2,317, +261%). Geographic patterns were consistent, with reports concentrating in London (2024: LGV 66%, syphilis 49%, shigella 54%, mpox 80%), and secondary contributions from the North West and South East. Age distributions were similar, with most diagnoses among 25–34-year-olds, although shigella disproportionately affected older GBMSM.ConclusionsThe overlapping epidemiology of these infections, and shared determinants of transmission and escalation highlight the need for sustained surveillance and syndemic approaches to predict and respond to current and future outbreaks, including mpox. Understanding emergence/re-emergence provides a foundation for anticipating how interventions such as doxyPEP may shift future epidemiology.
O-11 - EXAMINING THE ASSOCIATION BETWEEN SENTINEL RESPIRATORY SURVEILLANCE AND ANTIBIOTIC PRESCRIBING IN SCOTLAND: ANALYSIS OF INDIVIDUAL-LEVEL LINKED DATAMcCabe, Dr Ronan; Gadegaard, Dr Helen; Marsh, Dr Kimberly; Evans, Dr Josie
doi: 10.1093/pubmed/fdag046.011pmid: N/A
BackgroundGP practices registered to Scotland’s Community Acute Respiratory Infection (CARI) sentinel surveillance programme have reported that access to CARI’s 10 pathogen (predominantly viral) respiratory testing panel, with results available within 7-10 days, supports antimicrobial stewardship by helping ensure that patients with ARI receive the most clinically appropriate treatment.ObjectivesWe examined this association using individual-level linked data.MethodsWe identified individuals recruited to CARI in the 2024-25 season. Our comparator population included individuals with a record of an ARI consultation in digital primary care records of CARI-registered practices. We linked individual-level data on prescriptions, demographics and test results, and used binary logistic regression to compare the adjusted odds of being prescribed an antibiotic among individuals within CARI, with those with an ARI consultation but not recruited into CARI. All models were adjusted for age, sex, deprivation and time (month).ResultsThere were 22,867 individuals within CARI and 47,525 in the comparator population. The odds of prescription on the day of consultation were 52.7% lower for those within CARI [aOR=0.473, 95%CI: 0.430 to 0.516]. This association remained for prescriptions within 14-days [aOR=0.778, 95%CI: 0.721 to 0.835] and 28-days [aOR=0.673, 95%CI: 0.625 to 0.721] of consultation, excluding the day of consultation.ConclusionPeople with ARI recruited to CARI had lower odds of antibiotic prescription than those not recruited. This supports anecdotal reports that GPs use CARI recruitment to help tailor prescribing. However, the result could also be explained by unmeasured confounding or selection bias, if i) GPs are less likely to recruit to CARI when bacterial infection is suspected or ii) the comparator population of ARI GP consultations (which are known to be under-reported) are not a representative subset. Further investigation into why and how GPs recruit to CARI is warranted to understand this association.