BCG vaccine

Tetanus in Serbia, 2015-2025: Epidemiological Overview and Lessons from Two Pediatric Cases.

Kovacevic Gordana G, Stijovic Vesna V, Kovacevic Branko B, Parezanovic Miro M et al.

Tetanus is a vaccine-preventable disease that has become rare in countries with sustained immunization programs. However, unvaccinated children remain at risk of severe disease. We provide an epidemiological overview of tetanus in Serbia and describe two cases of generalized tetanus in children. We retrospectively reviewed tetanus surveillance data and immunization coverage reports in Serbia for 2015-2025. Tetanus cases were recorded under ICD-10 code A35. We analyzed demographics, incidence, outcomes, case-fatality, and tetanus-containing vaccine coverage. Two pediatric cases were reviewed for clinical presentation, diagnostic challenges, management, and outcomes. Fourteen tetanus cases were reported during 2015-2025 (annual incidence, 0-0.06 per 100,000 population), including two children. Most cases occurred among women aged >60 years; the overall case-fatality proportion was 42.9%. Primary vaccination coverage ranged from 90.8% to 95.1%, while recommended revaccination coverage remained below the 95% target. Both pediatric patients had received only BCG and hepatitis B vaccination at birth with no subsequent routine immunization due to parental neglect or refusal. The 18-month-old boy presented with fever, otorrhea, and recurrent episodes of generalized stiffening and was initially evaluated for meningoencephalitis. The emergence of trismus, opisthotonus, and neck muscle rigidity led to the diagnosis of tetanus. The 6-year-old boy presented with odynophagia and involuntary tongue biting, followed by progressive trismus and limb spasms. Tetanus was suspected based on the clinical findings and absent immunization. He developed respiratory failure and autonomic instability. Both patients recovered following tetanus immunoglobulin, antimicrobial therapy, and supportive care. Although tetanus remains rare in Serbia and predominantly affects older adults, unvaccinated children remain at risk of severe disease. Atypical presentations may delay diagnosis, emphasizing the importance of early recognition and timely treatment. Maintaining high vaccination coverage and ensuring catch-up immunization remain essential for prevention.

Patient Journey and Treatment Patterns of Non-Muscle-Invasive Bladder Cancer in Mexico.

Scavuzzo Anna A, Castillejos-Molina Ricardo Alonso RA, Bravo-Castro Iván I, Jiménez-Ríos Miguel A MA et al.

Non-muscle-invasive bladder cancer (NMIBC) accounts for most newly diagnosed bladder tumors, yet little is known about how it is managed in Mexico, particularly during prolonged Bacillus Calmette-Guérin (BCG) shortages. This retrospective, multicenter observational study characterized the clinical and histopathological profile, the diagnostic and treatment timelines, and the adherence to guideline-recommended care of patients with NMIBC treated at three tertiary referral hospitals in Mexico City. The records of 221 adults diagnosed between January 2010 and December 2020 were reviewed, and the risk of recurrence or progression was classified according to the European Association of Urology 2019 classification. The median age was 68 years (interquartile range [IQR] 59-75) and the male-to-female ratio was 3:1. Hematuria was the most frequent presenting symptom (83.3%). Three-quarters of patients had T1 tumors, 6.3% had concomitant carcinoma in situ, 84.6% had high-grade tumors, and 92.8% were at high risk of recurrence or progression. The median interval from symptom onset to histopathologic diagnosis was 167 days (IQR 81-329) and varied between centers. After diagnosis, the median time to second-look resection was 67 days (IQR 33.5-112) and to the first BCG instillation 92.5 days (IQR 41.8-165.5). Adjuvant intravesical therapy was administered to 66% of patients, most often BCG, although fewer than half of the BCG-treated patients (45%) completed induction, and 40% of the patients eligible for a second-look transurethral resection did not undergo it. Thirty percent of patients had no documented post-treatment surveillance. These real-world data provide a baseline description of NMIBC care in Mexican tertiary centers and identify specific, measurable gaps that may inform standardization and quality-improvement efforts in resource-constrained settings.

First mRNA Cancer Vaccine Succeeds in Phase III Trial.

Adding the mRNA-based individualized neoantigen vaccine intismeran autogene to the PD-1 inhibitor pembrolizumab following surgery for melanoma reduced the risk of disease recurrence or death by 42%, according to the results of the phase III INTerpath-0001 trial. The data were presented at the ESMO Congress 2026, held October 23-27, in Madrid, Spain.

Innovative vaccine strategies for sustainable control and eradication of peste des petits ruminants virus.

Bello Muhammad Bashir MB, Hameed Sodiq A SA, Abdullahi Adama Musa AM, Lawal Nafi'u N et al.