Pan-continental #spillover #risk: integrated spatiotemporal, transmissibility and #surveillance analysis of avian #influenza #H5N1 in #Africa

 

Abstract

Background: 

The HPAI H5N1 panzootic represents a critical threat to human health in Africa, where traditional poultry systems and dense human-animal interfaces facilitate frequent zoonotic spillover. While sporadic human cases raise pandemic concerns, continent-wide integration of spatial dynamics, transmissibility indicators, and surveillance performance has been lacking. This study quantifies avian influenza transmission over two decades across Africa, identifies geographical hotspots, and evaluates the responsiveness of current surveillance systems.

Methods: 

We analysed 8,037 avian influenza outbreak events and 369 laboratory-confirmed human cases, predominantly caused by HPAI H5N1 (2004–2025), using harmonised data from FAO (EMPRES-i+), WHO, and WOAH. A Bayesian Besag-York-Mollié (BYM) spatiotemporal model estimated residual transmission risks and Incidence Rate Ratios (IRR) by subtype. The basic reproduction number (R₀) was derived via an exponential growth model applied to human outbreak phases across infectious durations of 7–30 days. Surveillance responsiveness was assessed by quantifying notification delays between clinical observation and official reporting.

Results: 

Risk of infection in animals: HPAI H5N1 was the dominant strain, representing 87.8% of animal cases, with Egypt acting as the primary epidemiological epicentre (66% of total records). The spatiotemporal model revealed that H5N1 is associated with a significantly higher risk of animal infection (IRR = 8.37; 95% CI: 6.65–10.53). Although 71% of outbreaks were reported within 5 days of detection, significant delays (≥15 days) occurred in 12% of cases, with notable regional disparities. Risk of infection in human: H5N1 was associated with a 67-fold increase in the incidence of human cases compared to other subtypes (IRR = 66.78; 95% CI: 25.29–176.37). Sensitivity analyses yielded R0 estimates ranging from 1.05 (95% CI: 0.91–1.31) to 1.23 (95% CI: 0.60–2.33), indicating localised epidemic potential.

Conclusion: 

Our findings highlight a persistent and geographically heterogeneous H5N1 reservoir in Africa with high zoonotic affinity. Although sustained human-to-human transmission remains limited, the identification of dual poultry-human hotspots and localised R0 peaks underscores the urgent need for geographically targeted One Health interventions. Strengthening real-time reporting systems and improving biosecurity in high-risk poultry value chains are critical to mitigating future pandemic threats on the continent.

Source: 

Link: https://www.frontiersin.org/journals/epidemiology/articles/10.3389/fepid.2026.1813211/full

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#Camel #Prion Disease, Tataouine, #Tunisia, 2019–2021

 

Abstract

We report 6 cases of camel prion disease in dromedaries in Tunisia, confirming widespread occurrence in North Africa. Affected animals showed neurologic signs and scrape prion protein accumulation in brain and lymphoid tissues. These findings highlight the importance of active surveillance and investigation of the epidemiology, transmission, and public health implications.

Source: 

Link: https://wwwnc.cdc.gov/eid/article/32/8/25-1474_article

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Identification of #Contacts With High Rates of Missed and #Asymptomatic Infection Following an #Outbreak of #Ebola Virus Disease: A Seroepidemiological Study in Likati Health Zone, #DRC

 

Abstract

Background

Ebola virus disease (EVD) is often regarded as severe and highly fatal, but growing evidence suggests that subclinical or minimally symptomatic infections occur and frequently go undetected. During the 2017 outbreak in Likati Health Zone, only 8 cases were confirmed despite many reported exposures. We evaluated the extent of asymptomatic or unrecognized Ebola virus infection and associated factors among contacts of reported cases.

Methods

In November 2017, we conducted a cross-sectional community-based serosurvey among contacts originally identified through Ministry of Health records and newly identified through additional post-outbreak investigations. Participants provided blood samples and completed questionnaires on demographics, exposures, and symptoms within 4 weeks of symptom onset of the EVD case with whom contact was reported. Sera were tested for anti-EBOV nucleoprotein IgG by ELISA. Seropositive individuals were classified as asymptomatic (no symptoms) or unrecognized (≥1 symptom). Secondary attack rate (SAR) was estimated, and logistic regression assessed associations with sociodemographic factors, exposure level, and symptoms.

Results

Among 180 participants (79 originally identified; 101 newly identified), 33 (18.3%) were seropositive. Of these, 19 (58%) reported symptoms, and 14 (42%) were asymptomatic. Any EVD-related symptom was associated with higher odds of seropositivity (OR 2.48, P = .021), though no specific symptom was significant. Asymptomatic individuals had higher antibody titers than symptomatic seropositive contacts (P = .009). The overall SAR was 19.1% (95% CI: 15.9–23.0). High exposure level strongly predicted seropositivity (OR 11.2, 95% CI: 3.8–33.3).

Conclusions

Asymptomatic infections occurred, including among contacts missed during the response, highlighting the need for exposure-based serologic assessments in EVD investigations and raising questions about immune responses and the true disease burden in outbreak-affected settings.

Source: 

Link: https://academic.oup.com/ofid/article/13/7/ofag397/8725922

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#Spain, Ministry of Health is strengthening #prevention, #preparedness and response to #animal-borne #influenza with a national plan (Min. Health, July 16 '26)

 

    Madrid, July 16, 2026.- The Public Health Commission has approved the State Plan against infections by influenza viruses of zoonotic origin: Prevention, Surveillance and Control, which establishes a common framework for prevention, surveillance, early detection and response to influenza viruses that circulate in animals and can be transmitted to people.

    The Plan adopts the "One Health" approach and establishes a joint response across the fields of human health, animal health, and the environment. Its objective is to improve coordination among the different sectors at the national, regional, and local levels, and to ensure that epidemiological, microbiological, and environmental information is integrated, up-to-date, and readily available to facilitate the early implementation of control measures.

    The document has been coordinated by the Center for Coordination of Health Alerts and Emergencies (CCAES) of the Ministry of Health and prepared jointly with the Ministries of Agriculture, Fisheries and Food and for Ecological Transition and the Demographic Challenge, the Carlos III Health Institute, the Spanish Agency for Food Safety and Nutrition and other units involved in the prevention and management of these risks.

    Zoonotic influenza viruses circulate among animals. Transmission to humans remains infrequent and is usually linked to direct contact with infected animals, their secretions, or contaminated environments. However, their ability to mutate and exchange genetic material necessitates continuous surveillance, especially given the increased detection of these viruses in various mammal species.

    The Plan organizes the actions into four scenarios , which allow the measures to be progressively adapted to the epidemiological situation of each territory.

    Scenario 0 corresponds to a situation with no detected infections in animals or people and focuses on ordinary actions of prevention, surveillance, training and maintenance of diagnostic capabilities.

    Scenario 1 is activated upon detection of outbreaks in wild or captive animals. It distinguishes between isolated outbreaks in birds, multiple outbreaks distributed across a territory, and detections in wild mammals.

    Scenario 2 considers outbreaks in domestic animals and also differentiates between isolated outbreaks in birds, multiple outbreaks, and detections in domestic mammals.

    Finally, scenario 3 applies when a human infection is identified. In this case, a distinction is made between cases with known exposure to animals or contaminated environments, those where no risk exposure is identified, and cases associated with contact with another infected person, which would imply possible limited human-to-human transmission.

    The scenarios are not mutually exclusive and may be applied simultaneously in the same territory. Each autonomous community will conduct its own risk assessment to determine the necessary measures in each affected province, community, or geographical area.

    The Plan envisions the creation of a Permanent State Committee for Coordination and Monitoring , chaired and technically coordinated by the CCAES, responsible for reviewing preparedness and response measures, promoting common protocols, conducting joint risk assessments, and evaluating the Plan's effectiveness. Furthermore, it recommends that the autonomous communities establish equivalent bodies to coordinate actions related to public health, animal health, the environment, food safety, and occupational health.

    This body will include representatives from the competent departments in public health, animal health, biodiversity, food safety, occupational health, medicines and health products and epidemiological and microbiological surveillance, as well as from the autonomous communities, the Spanish Federation of Municipalities and Provinces and experts.

    Human health measures focus especially on people who, due to their professional activity, may come into contact with infected animals, their secretions or contaminated materials, such as livestock farm personnel, veterinary professionals, environmental agents or zoo workers.

    Companies must assess the risk, provide the necessary protective equipment, and ensure health monitoring. Occupational risk prevention services will identify and monitor exposed personnel in the event of outbreaks in animals and, where appropriate, may recommend PCR tests, preventive antiviral treatment, or vaccination against zoonotic viruses.

    The Plan also maintains the recommendation for seasonal flu vaccination for those who work in direct contact with animals, with the aim of reducing the risk of coinfection by human and animal flu viruses.

    In the animal sector , the Plan strengthens surveillance of wild and domestic birds and mammals, as well as genomic analysis of viruses to detect changes that could increase their transmissibility. In the event of outbreaks on farms, biosecurity measures, movement controls, confinement, and, where appropriate, vaccination will be implemented.

    In parks and urban or peri-urban areas, protocols will be established to safely remove sick or dead animals, clean and disinfect affected areas, and inform the public. It is recommended not to touch or handle them and to report their presence to the appropriate authorities.

    The Plan incorporates risk communication and community participation as one of its five main components. To this end, an inter-institutional communication group will be established, websites with updated information will be created, and campaigns will be developed targeting both the general public and the professional sectors with the greatest exposure.

    Media and social media will also be monitored to detect and respond to rumors, false content, or unverified information. In higher-risk scenarios, an official spokesperson will be appointed, information will be updated daily, and, when necessary, a citizen hotline will be activated.

    The Permanent State Committee will develop the indicators that will allow the evaluation of preparedness and response, as well as compliance with the Plan in its various components and at the state and regional levels.

    In the last year, more than 150 outbreaks of avian influenza have been detected in Spain, mostly in wild birds, although outbreaks have also been recorded in poultry, leading to the culling of thousands of animals. Despite the increased circulation of the virus among birds, Spain has not registered any human cases of avian influenza to date. Regarding swine influenza, three human cases of infection have been identified in Spain since 2009.

    The new Plan will strengthen prevention, early detection and coordinated response to any changes in the epidemiological situation.

Source: 

Link: https://www.sanidad.gob.es/gabinete/notasPrensa.do?id=6965

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#Screening and #monitoring of #travellers returning from countries affected by #Bundibugyo virus: an overview of #European approaches, July 2026

 

Abstract

The 2026 Ebola outbreak caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda has prompted European countries and the United States to revise measures for travellers, healthcare workers and humanitarian personnel returning from affected areas. We compare current procedures and protocols with those implemented during the 2013–2016 Ebola outbreak. Despite some national differences, policies have largely converged towards risk-based management, early case detection, rapid isolation, exposure-based monitoring and healthcare preparedness, rather than routine border screening.

Source: 

Link: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.28.2600578?emailalert=true#abstract_content

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#NewZealand - #Influenza A #H5N1 viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification

 

Di Antoine Lamielle, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=128547540

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    ° This is the first detection of highly pathogenic avian influenza H5N1 clade 2.3.4.4b virus in New Zealand. 

    ° The detection is in a single subantarctic skua (Stercorarius antarcticus) found on Petone Beach, Lower Hutt. 

    ° The bird was found weak and emaciated and no neurological or respiratory clinical signs were observed. 

    ° Subantarctic skua are an ocean-going species. 

    ° Genomic sequencing indicates that the virus is closely related to H5N1 HPAI clade 2.3.4.4b viruses recently detected in Western Australia. 

    ° An epidemiological investigation is underway, and general surveillance is continuing. At this time, there is no evidence of further spread. 

    ° Vaccination of specific populations of threatened avian species is being initiated.

    ° A single ocean-going subantarctic skua (Stercorarius antarcticus), also known as brown skua.

Source: 

Link: https://wahis.woah.org/#/in-review/7709

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Occupationally Exposed and General #Population #Antibody #Profiles to #Influenza A Viruses Circulating in #Swine as Indication of Zoonotic #Risk

 

Abstract

Persons with occupational exposure to swine might be at disproportionate risk for zoonotic swine influenza A virus. To evaluate human antibody responses, we tested serum or plasma from swine veterinarian, farm employee, and general population cohorts by hemagglutination inhibition assays against representative swine and human seasonal influenza vaccine strains. We analyzed hemagglutination inhibition data by antigenic cartography to assess strain relationships and reproduction number modeling to evaluate pandemic potential using age-stratified immunity profiles. Occupationally exposed groups had lower human seasonal vaccine uptake (45.5% vs. 70%) and lower odds of seropositivity to several H1 and H3 strains from swine than did general population cohorts. One swine strain exhibited significant antigenic drift (3.62 antigenic units) from its nearest vaccine strain. Multiple strains required lower reproduction number thresholds for pandemic spread (1.09–1.35) than recorded pandemic strains (1.46–1.80), demonstrating that population immunity gaps heighten zoonotic risk to circulating swine H1 and H3 strains.

Source: 

Link: https://wwwnc.cdc.gov/eid/article/32/8/25-1995_article

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First nationwide full- #genome characterisation of #human-derived #Andes virus in #Chile: a retrospective genomic #epidemiology study

Summary

Background

Andes virus (ANDV) is the only hantavirus known to transmit between humans and causes hantavirus cardiopulmonary syndrome in Chile and Argentina. In Chile, ANDV genomic diversity remains incompletely characterised. This study aimed to characterise the genetic diversity, geographical structure, and molecular signatures of ANDV using human clinical samples collected over a 13-year period (2011–24).

Methods

We conducted a retrospective genomic epidemiology study of ANDV infections in Chile. Clinical samples from patients with confirmed ANDV, collected between March 9, 2011, and June 27, 2024, were analysed and sequenced. Clinical and epidemiological data were obtained from diagnostic laboratories and surveillance programmes. Consensus sequences for the S, M, and L segments were generated, and genetic clustering and divergence were assessed using phylogenetic inference and variant calling.

Findings

We analysed clinical samples from 58 infected individuals and identified two major genomic variants of ANDV with distinct geographical distributions, defined by regionally structured patterns of nucleotide and amino acid substitutions across the S, M, and L segments: ANDV Chi-North (central Chile) and ANDV-South (southern Chile). No consistent clustering by clinical severity was observed, and no recurrent non-synonymous substitutions were uniquely associated with severe disease. Substitutions previously associated with person-to-person transmission in outbreaks in Argentina were not consistently observed in Chilean sequences, including in four person-to-person transmission cases. Although some substitutions described in ANDV-like viruses were present in the Chi-North lineage, this lineage remained phylogenetically distinct and geographically restricted to central Chile.

Interpretation

To our knowledge, this study provides the first nationwide genomic characterisation of human-derived ANDV in Chile. The identification of geographically structured variants indicates that ANDV diversity in Chile is driven by regional diversification rather than clinical outcome. The absence of consistent amino acid signatures associated with disease severity or person-to-person transmission suggests that these phenotypes are unlikely to be explained by viral genetic variation alone. These findings refine current understanding of ANDV evolution and highlight the need for continued integrated genomic surveillance in endemic regions.

Funding

Agencia Nacional de Investigación y Desarrollo de Chile and National Institutes of Health.

Source: 

Link: https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(26)00109-6/fulltext

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#Bundibugyo #ebolavirus from the 2026 Ebola #outbreak in #Uganda and #DRC: a new #variant

 

{Excerpt}

(...)

In conclusion, we show that the BDBV variant identified in Uganda from a travel-related case linked to the ongoing outbreak in Ituri represents a new clade of BDBV. These findings underscore the diversity of the BDBV ecosystem and the urgent need for antiviral and vaccine countermeasures to reduce fatalities and for public health measures to limit the spread of the virus. Global efforts are immediately needed in this region. Continued genomic surveillance is required for in-depth monitoring to track emerging BDBV variants and adjust and employ BDBV countermeasures in a timely manner.

Source: 

Link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01079-2/fulltext

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#Andes Virus — A #Clinical #Review

 

Summary

Andes virus (ANDV) is the sole orthohantavirus with documented human-to-human transmission. We summarize the epidemiology and clinical features of ANDV infection and review best practices in clinical management, as based on published expert consensus guidelines, field experience, and clinical trials. We also evaluate currently available and investigational treatments (including the use of antiviral agents), assess emerging monoclonal antibody therapies, and outline prospects for vaccine development. Finally, we discuss important infection prevention and control measures.

Source: 

Link: https://www.nejm.org/doi/full/10.1056/NEJMra2606651?query=TOC

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Detection of Highly Pathogenic Avian #Influenza #H5N1 Clade 2.3.4.4b Genotype #D1.2 Virus in #Swine after Experimental Inoculation

 

Abstract

Highly pathogenic avian influenza H5NX clade 2.3.4.4b viruses continue to circulate globally. Reintroduction of Eurasian lineage viruses into North America and reassortment with endemic low pathogenicity strains have resulted in new genotypes, including D1.2. To assess pathogenicity and cellular tropism, we intranasally inoculated genotype D1.2 virus into pigs. We isolated virus from nasal secretions from most inoculated animals for multiple days. At 5 days postinoculation, PCR and immunohistochemistry detected virus in musculoskeletal, respiratory, digestive, lymphatic, and nervous systems and isolates from meat juice. At 35 days postinoculation, we detected viral antigen and low levels of RNA in the brain of an animal with lesions consistent with a viral etiology and found viral antigen in the ethmoid of 2 animals. Consistent detection in nasal swab specimens, combined with subclinical respiratory infection, systemic distribution, and protracted detection of clade 2.3.4.4b virus in swine, suggest identifying infection in commercial swine without overt respiratory signs could be difficult.

Source: 

Link: https://wwwnc.cdc.gov/eid/article/32/8/25-1765_article

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#Honduras - #Influenza A viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification

 

    ° As a result of the strengthened epidemiological surveillance of avian influenza implemented by the National Agri-Food Health and Safety Services (SENASA), a report was received regarding an unusual increase in mortality among backyard birds in a community, associated with contact with wild birds. 

    ° In response, national protocols for addressing suspected cases of high pathogenicity avian influenza (HPAI) were immediately activated, including the conduct of an epidemiological investigation, sample collection, and the implementation of containment measures established in the National Contingency Plan. 

    ° Analyses conducted by the official laboratory confirmed the presence of the high pathogenicity avian influenza virus, prompting the implementation of the corresponding sanitary measures. 

    ° These included the culling of affected birds and susceptible birds (stamping out) on adjacent properties within the risk zone; the safe disposal of products and materials considered to pose a risk; as well as the cleaning and disinfection of the facilities and all potentially contaminated items, with the aim of reducing the risk of the virus spreading. 

    ° Additionally, SENASA has established an outbreak zone, a perifocal zone, and a surveillance zone around the confirmed outbreak, where intensified epidemiological surveillance, sampling of susceptible birds, epidemiological investigations, restriction of bird movement, and risk communication efforts targeting producers and the general public are being carried out; furthermore, the Ministry of Health has been notified to ensure a joint response to the event. 

    ° These activities aim to promptly detect any associated events and verify the effectiveness of the control measures implemented. 

    ° SENASA will continue epidemiological monitoring of the event until the activities established in the National Contingency Plan are completed and the absence of viral circulation in the affected area is demonstrated. 

    ° It will also keep producers, authorities, and the general public informed through periodic updates to the relevant reports.

    ° The affected population consisted of backyard birds, comprising susceptible domestic species raised in family-based production systems. 

    ° These birds were of various age groups and were in frequent contact with the outdoor environment, a condition that facilitates interaction with wild birds and increases the risk of exposure to the high pathogenicity avian influenza virus.

Source: 

Link: https://wahis.woah.org/#/in-review/7710

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#Peru - High pathogenicity avian #influenza #H5N1 viruses (Inf. with) (#poultry) - Immediate notification

 

    ° The National Agricultural Health Service (SENASA) within its epidemiological surveillance responds to reports of suspected animal diseases. 

    ° It has identified an outbreak of highly pathogenic avian influenza in poultry (fighting birds) exhibiting respiratory and neurological signs. 

    ° Real-time PCR confirmed the presence of the H5N1 avian influenza virus, prompting the immediate implementation of quarantine measures and an epidemiological investigation. 

    ° All birds were culled, and the affected premises were cleaned and disinfected; in addition, surveillance around the outbreak was conducted to detect possible cases.

    ° A premises raising fighting cocks and backyard poultry of various ages

Source: 

Link: https://wahis.woah.org/#/in-review/7700

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A systematic #review of #Nipah virus disease epidemiological #parameters, #outbreaks, and mathematical #models

 

Summary

Our systematic review, based on PRISMA guidelines (PROSPERO CRD42023393345), characterised the epidemiology, outbreaks, and mathematical models of Nipah virus, an important public health threat in south and southeast Asia. We searched PubMed and Web of Science from database inception to March 14, 2025, and extracted 243 parameters, 89 risk factors, 39 models, and 23 distinct outbreaks from 119 papers. IgG seroprevalence estimates in the general population ranged from 0% to 12·5%. Nipah virus causes severe disease, with pooled case–fatality ratio estimates ranging widely from 9·1% (95% CI 0·2–41·3) in Singapore to 81·9% (95% CI 71·9–88·9) in Bangladesh. The infection timeline and clinical course of Nipah virus remain poorly characterised; we estimated a median incubation period of 8·77 days (165, 95% CI 7·53–10·02) from eight estimates in seven articles with sufficient information. Transmission parameter estimates were scarce, and all but one of five central estimates of the basic reproduction number were less than one. Nipah virus mathematical models (39) were rarely fitted to data (eight). All extracted information is accessible via our R package, epireview.

Source: 

Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00239-2/abstract?rss=yes

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About #birdflu and the #risk to #NewZealand {First case of #H5N1 detected in a wild seabird} (Min. Agriculture, July 15 '26)

 

SITUATION UPDATE: 15 July 2026

    A single ocean-going sea bird has tested positive for H5 bird flu in New Zealand.

    The bird was found on Petone Beach in Wellington and reported to our exotic pest and disease hotline. 

    Subsequent testing confirmed H5 bird flu (H5N1 avian influenza clade 2.3.4.4b).

    This is the first detection of H5 bird flu in New Zealand. It hasn't been found in any other birds and there are no detections in poultry.

    The risk to human health remains low.

    New Zealand is well prepared to respond and will react quickly to protect poultry production, and to reduce impacts on wildlife and communities.

        ° Be alert and use good habits to limit the impact of bird flu.

        ° Keep your distance. Stay away from sick or dead wildlife. Keep pets away too.

        ° Keep clean. Wash your hands and clean your gear after being outdoors.

        ° Know when to report. If you see 3 or more sick or dead wildlife, report them to the exotic pest and disease hotline on 0800 809 966.

Source: 

Link: https://www.mpi.govt.nz/biosecurity/pest-and-disease-threats-to-new-zealand/animal-disease-threats-to-new-zealand/high-pathogenicity-avian-influenza/about-avian-influenza-and-the-risk-to-nz

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#Neurological Manifestations of #Hantavirus Infection - A Review

 

Abstract

Importance  

Hantaviruses have caused several recent human disease outbreaks. They carry a high mortality rate, and some species can spread from person to person although they are typically spread from rodents to humans. Neurological complications have been documented but are poorly understood.

Observations

Broadly, 2 types of syndromes have been associated with hantaviruses. The pulmonary syndrome carries a high mortality rate and can result in pulmonary and cardiac failure. Neurological involvement is typically secondary to hypoxic and ischemic injury or metabolic dysfunction. Another manifestation of the infection that is associated with some species of the virus is termed hemorrhagic fever with renal syndrome. Some patients may develop a meningoencephalitis or pituitary apoplexy resulting in sudden visual loss and pituitary dysfunction. Rarely, seizures, myelitis, and peripheral neuropathy may occur. Although there are no specific antiviral drugs approved for treatment of hantavirus, there are several that showed efficacy in preclinical trials. Management is supportive care and treatment of symptoms.

Conclusions and Relevance  

Neurological manifestations of hantavirus infection are uncommon but can be severe. Prospective studies and experimental models are needed to better characterize these manifestations, understand pathophysiology, identify therapeutic targets, and develop guidelines for management.

Source: 

Link: https://jamanetwork.com/journals/jamaneurology/fullarticle/2851731

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#USA, #Michigan DHHS updates #recommendations for #cyclosporiasis prevention (July 14 '26)

 

    LANSING, Mich. – The Michigan Department of Health and Human Services (MDHHS) continues to investigate an outbreak of cyclosporiasis with 2,640 cases reported as of Monday, July 13. 

    While the investigation is ongoing, current results point to lettuce or salad greens as a potential source for this outbreak, although other food items cannot be completely ruled out. 

    No specific type of produce, grower or supplier has been identified as the source. 

    “Although we do not have a definite product identified as the source of the outbreak, we want to let Michiganders know what we have learned so far so they can take steps to protect their families,” said Dr. Natasha Bagdasarian, chief medical executive. 

    “Early information has shown lettuce as a common product that regularly comes up during the investigation. We will continue to provide updates as we learn more.” 

    Cyclospora is a parasite that infects the intestines and causes watery diarrhea, nausea, and stomach cramps. It is often contracted by eating or drinking something contaminated with the parasite. Typically, Michigan only records 40 to 50 cases of cyclosporiasis annually.  

    MDHHS continues to work closely with local health departments to conduct in-depth interviews of individuals testing positive for cyclosporiasis, as well as with other state and federal partners to conduct traceback investigations. More than 1,000 interviews have than have been completed to date. 

    Given the extent of the outbreak, the incubation period of up to two weeks for symptoms to develop after exposure and complex food distribution networks across the state and country, it will take some time for agencies to complete their investigation.   

    Recreational water exposure, such as swimming in lakes, is not a recognized risk factor for cyclosporiasis and there is currently no evidence linking recreational water activities to this outbreak. While people should always avoid swallowing recreational water, foodborne exposure – particularly exposure to contaminated produce – remains the primary focus of this outbreak investigation. 

    MDHHS recommends the following safe practices for all individuals serving, preparing, or consuming lettuce and salad greens in impacted counties, this includes restaurants and commercial kitchens. Because this is an active and evolving situation, these recommendations may change as more information becomes available. 

Focus on lettuce and salad greens 

    Given early information and the historical link between cyclospora and pre-packaged salad greens, MDHHS recommends adopting the following lettuce-specific safety measures: 

    ° Purchase whole heads: 

        - Buy whole heads of lettuce rather than pre-washed, bagged lettuce or pre-mixed salad kits. 

    ° Discard outer layers: 

        - Before preparation, throw away the outer two to three layers of leaves. 

    ° Wash inner leaves: 

        - Thoroughly wash the remaining inner leaves under clean running water. 

    ° Prioritize cooking: 

        - For any greens that can be cooked, cooking to a temperature of at least 158 F (70 C) is the safest option, as the parasite is resistant to routine chemical disinfection and washing alone cannot guarantee its removal. 

Previous outbreaks 

    The following foods have been specifically linked to previous cyclospora outbreaks in the United States and Canada: 

    ° Bagged salad mixes and kits.  

    ° Fresh cilantro (coriander leaves). 

    ° Fresh basil. 

    ° Raspberries. 

    ° Snow peas. 

    ° Green onions (scallions). 

General rules to reduce risk 

    ° Cook when possible. Heating food to 158 F (70 C) or higher kills cyclospora. 

    ° Peel produce. Peeling is highly effective for food items with removable skin as the parasite sits on the outer surface. 

    ° Wash all fresh produce. Wash under clean running water, even if you plan to peel it. “Pre-washed” does not guarantee safety and rewashing bagged lettuce is unlikely to remove cyclospora. While washing alone may not fully eliminate cyclospora, it enhances protection when combined with cooking or peeling. 

    These recommendations are particularly important for people who have a higher risk of dehydration or weakened immune systems such as patients on chemotherapy, organ transplant recipients, infants and young children and elderly people. 

If you do become ill  

    People experiencing frequent, watery diarrhea are encouraged to contact their health care provider and specifically request testing for cyclospora as routine stool tests may miss the parasite. Cyclosporiasis is treated with antibiotics along with rest and drinking plenty of fluids to maintain hydration. 

(...)

Source: 

Link: https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2026/07/13/cyclo-3

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#Bundibugyo Virus Disease #Outbreak in #DRC, #Uganda & #France - #Situation Report 09, Data as of 12 July 2026 (WHO AFRO, edited): 1963 cases & 719 deaths in DRC

 

Key Figures at a Glance (Democratic Republic of the Congo) 

{Click on Image to Enlarge}

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Summary

{Click on Image to Enlarge}

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Event description

    ° The Bundibugyo virus disease outbreak in the Democratic Republic of the Congo intensified during the past week, with epidemiological indicators suggesting sustained and increasing transmission. 

    ° The outbreak was characterized by a rising incidence of reported cases, increasing mortality and continued geographic expansion into additional provinces and health zones, indicating ongoing propagation across affected areas. 

    ° Outside the Democratic Republic of the Congo, the epidemiological situation remained unchanged, with no new cases reported in Uganda or France and no evidence of secondary transmission. 

    ° Nevertheless, continued geographic expansion and increasing transmission intensity within the Democratic Republic of the Congo elevate the likelihood of cross-border spread and reinforce the need for sustained regional surveillance, preparedness and response measures. 

Democratic Republic of the Congo

    ° Since the last update of 5 July 2026 (Situation Report #8), the epidemiological situation in the Democratic Republic of the Congo has further deteriorated with sustained transmission and continued geographic expansion. 

    ° An additional 339 confirmed cases and 198 confirmed deaths have been reported, representing increases of 20.9% and 38.0% in cumulative confirmed cases and deaths, respectively. 

    ° The crude case fatality ratio (CFR) among confirmed cases increased from 32.1% to 36.6%, likely reflecting delayed case detection, late presentation for care, and the persistently high proportion of deaths occurring in the community, rather than increased disease severity. 

    ° Geographic spread also continued during the reporting period, with the outbreak expanding from three to five affected provinces following the confirmation of cases in Haut-Uélé and Tshopo provinces. 

    ° The number of affected health zones increased from 36 to 42, with Wamba (Haut-Uélé Province), Ariwara and Boga (Ituri Province), and Lubunga, Makiso-Kisangani, and Mangobo (Tshopo Province) reporting their first confirmed cases.  

    ° Daily reported confirmed cases have continued to increase over the course of the outbreak, although substantial day-to-day variability is observed. 

    ° A log-linear model fitted to the daily incidence data estimates an average daily growth rate of 2.3% (95% CI 2.0% - 2.5%), indicating that the outbreak continues to expand and transmission remains above the threshold required for sustained epidemic expansion.  

Figure 1. Epidemic curve showing daily confirmed case incidence and estimated epidemic growth, Democratic Republic of the Congo, 11 May–12 July 2026 

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    ° Despite this continued geographic expansion, recent transmission remains concentrated in a subset of affected areas. 

    

    ° Of the 42 affected health zones, 33 have reported at least one confirmed case within the past 21 days. 

    ° During this period, 869 confirmed cases and 441 confirmed deaths were reported. 

    ° Ituri Province continues to bear the overwhelming burden of the outbreak, accounting for 775 cases (89.2%) and 382 deaths (86.6%), while the remaining four affected provinces together reported 94 cases (10.8%) and 59 deaths (13.4%). 

    ° In contrast, nine previously affected health zones have now surpassed 21 consecutive days without reporting a confirmed case, suggesting an absence of recent transmission while enhanced surveillance remains in place. 

    ° These include Miti-Murhesa (53 days) in South Kivu Province; Aru (38 days), Aungba (23 days), and Gety (52 days) in Ituri Province; and Goma (48 days), Kalunguta (49 days), Mabalako (29 days), Oicha (26 days), and Vuhovi (31 days) in North Kivu Province. 

    ° The highest levels of recent transmission were recorded in Bunia (207 cases), Rwampara (159), Mongbwalu (92), and Nizi (80) in Ituri Province, reaffirming the Bunia–Rwampara–Mongbwalu transmission corridor while highlighting Nizi as an increasingly important hotspot. 

    ° Transmission also intensified in Mangala (36 cases) and Nia-Nia (33), the latter serving as the epidemiological source of the newly affected provinces of Haut-Uélé and Tshopo. 

    ° In North Kivu Province, Katwa (39 cases) remained the principal hotspot, followed by Butembo (16) and Beni (10). 

    ° Collectively, these health zones accounted for 77.3% of all confirmed cases reported during the past 21 days. 

    ° A similar pattern was observed for mortality. Bunia reported the highest number of confirmed deaths (108), followed by Mongbwalu (71), Rwampara (52), Nizi (30), Katwa (28), Mangala (23), Nyankunde (14), Lita (13), Nia-Nia (11), Beni (8), and Butembo (7). 

    

    ° Together, these health zones accounted for 365 (82.8%) of the 441 confirmed deaths reported during the same period. 

    ° The confirmation of cases in Haut-Uélé and Tshopo provinces marks a significant geographic expansion of the outbreak beyond its original focus in Ituri and North Kivu. 

    ° Although relatively few cases have been reported in these newly affected provinces, the detection of cases in three health zones in Tshopo, including Makiso-Kisangani in the provincial capital, raises concern because of its large urban population and its role as a major transport hub connecting northeastern DRC with other parts of the country. 

    ° Epidemiological investigations indicate that the cases in Tshopo and Haut-Uélé are linked to transmission originating in Nia-Nia Health Zone in Ituri, suggesting geographic extension of an existing transmission chain rather than the emergence of independent outbreak foci. 

    ° The recent confirmation of the first case in Ariwara Health Zone represents a further northward expansion of the outbreak towards the borders with South Sudan and Uganda, increasing the potential for cross-border spread through frequent population movement and trade.  

    ° The expanding geographic footprint of the outbreak has also continued to pose risks beyond affected communities. 

    ° During the reporting period, a United States humanitarian worker infected with Bundibugyo virus disease while working in the Democratic Republic of the Congo was medically evacuated to a specialized high-level isolation unit at Frankfurt University Hospital, Germany. 

    ° The patient, a logistics staff member with a humanitarian organization supporting the Ebola response in Bunia, Ituri Province, was reported to be in stable condition following early diagnosis and treatment. 

    ° The case highlights the continued occupational risk faced by frontline humanitarian personnel responding to the outbreak. 

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    ° Since the beginning of the outbreak, the Democratic Republic of the Congo has reported 1963 confirmed cases, including 719 confirmed deaths (CFR 36.6%). 

    ° Ituri Province remains the epicentre of the outbreak, accounting for 90.3% (1,772) of all confirmed cases and 84.6% (608) of all reported deaths nationwide. 

    ° The most affected health zones continue to be Bunia (503 cases, 156 deaths), Rwampara (384 cases, 89 deaths), Mongbwalu (329 cases, 171 deaths), Nizi (110 cases, 36 deaths), Nyankunde (97 cases, 23 deaths), Mangala (50 cases, 29 deaths), and Lita (45 cases, 19 deaths), all located in Ituri Province, together with Katwa (71 cases, 47 deaths), Butembo (44 cases, 20 deaths), and Beni (30 cases, 20 deaths) in North Kivu Province. Collectively, these health zones account for approximately 84.7% of all confirmed cases and 84.8% of all confirmed deaths reported nationally. 

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    ° Close contacts, including 7,830 (79.4%) successfully seen during the reporting period. In North Kivu, 2,152 of 2,377 contacts (90.5%) were successfully followed up, while all contacts in South Kivu had completed the required 21-day monitoring period. 

    

    ° Contact follow-up data for the newly affected provinces of Haut-Uélé and Tshopo were not reported. 

    ° The overall follow-up rate remains below the operational target for effective contact tracing. 

    ° The marked disparity between provinces is of particular concern. While North Kivu achieved a follow-up rate exceeding 90%, Ituri, the epicentre of the outbreak and home to more than 80% of contacts under follow-up, reached only 79.4%. This leaves a substantial number of contacts in the highest transmission setting unreached each day, increasing the risk of undetected infections and sustained community transmission. 

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Uganda

    ° No new confirmed case has been reported in Uganda since the previous update. The most recent confirmed case, reported on 21 June 2026, was identified in a truck driver travelling along the Democratic Republic of the CongoUganda international route. 

    ° Since then, no additional imported or locally acquired cases have been detected and there is no evidence of ongoing transmission.  

    ° As of 12 July 2026, the outbreak remained limited to 21 cases (20 confirmed and one probable), including three deaths (two confirmed and one probable). 

    ° Seventeen patients have recovered and been discharged from care, leaving one confirmed patient currently admitted to a treatment facility. 

    ° Since the onset of the outbreak, 836 contacts were identified. All contacts have successfully completed the required 21-day follow-up period with 6 secondary cases detected, indicating that known transmission chains have been effectively contained. 

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France

    ° No additional Bundibugyo virus disease (BVD) cases have been reported in France since the previous update. No secondary transmission has been identified among the five flight contacts who were placed under precautionary quarantine following exposure to the imported case reported on 24 June 2026.

    ° Their formal release from follow-up had not been officially announced at the time of reporting. 

Risk Assessment 

    ° The overall public health risk in the Democratic Republic of the Congo remains very high, driven by sustained transmission, increasing mortality, and continued geographic expansion from three to five affected provinces. 

    ° Although transmission remains concentrated in Ituri Province, the emergence of new affected health zones in HautUélé and Tshopo highlights the continued potential for spread to previously unaffected areas. 

    ° The increasing crude CFR and the high proportion of community deaths continue to indicate delays in case detection, isolation, and access to clinical care. 

    ° Contact tracing remains below the operational target, particularly in Ituri Province, where follow-up performance is substantially lower than in North Kivu despite accounting for the majority of ongoing transmission. 

    ° Uganda remains at high risk of re-introduction because of the ongoing outbreak in the neighbouring Democratic Republic of the Congo despite reporting no new cases during the reporting period. 

    ° The absence of secondary transmission following the imported case in France demonstrates the effectiveness of rapid public health measures but also underscores the continued risk of international spread through travel. 

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Source: 

Link: https://www.afro.who.int/countries/democratic-republic-of-congo/publication/ebola-bundibugyo-virus-disease-outbreak-2

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