#Measles - #Bangladesh (WHO, D.O.N., April 23 '26)

 

Situation at a glance

On 4 April 2026, the National International Health Regulations (IHR) Focal Point for Bangladesh notified WHO of a nationwide increase in measles cases, geographically affecting 58 out of 64 districts across all eight divisions in Bangladesh. 

A total of 19 161 suspected measles cases and 2897 laboratory-confirmed measles cases have been reported between 15 March and 14 April 2026, including 166 measles related deaths (CFR 0.9%). 

The majority (79%) of the reported cases are children aged under 5 years. 

A targeted measles-rubella (MR) vaccination campaign started on 5 April, and various outbreak response measures are ongoing including strengthening nationwide surveillance and epidemiological analysis to enhance case detection and reporting. 

Based on currently available information, WHO assesses the risk at the national level as high due to ongoing transmission across multiple divisions, the large number of susceptible children, documented immunity gaps, and the occurrence of suspected measles-related deaths.

Description of the situation

On 4 April 2026, the National IHR Focal Point of Bangladesh notified WHO of a significant increase in measles cases, driven by sustained domestic transmission. 

Since January 2026, Bangladesh has experienced a marked increase in measles cases. 

Geographically, cases have been reported across all eight divisions, in 58 out of 64 districts (91% of districts), indicating widespread transmission nationally.  

Since 15 March 2026 and as of 14 April, a total of 19 161 suspected measles cases and 2973 laboratory-confirmed measles cases have been reported. 

Moreover, 166 suspected measles-related deaths (CFR 0.9%) and 30 confirmed measles-related deaths (CFR= 1.1%) have been recorded. 

A total of 12 318 hospital admissions and 9772 hospital discharges have also been reported. 

The highest cumulative burden of suspected measles cases since 15 March 2026 has been reported in Dhaka (8263 cases), Rajshahi (3747 cases), Chattogram (2514 cases), and Khulna (1568 cases). 

In Dhaka, cases are concentrated in densely populated informal settlements, including Demra, Jatrabari, Kamrangirchar, Korail, Mirpur, and Tejgaon industrial and slum clusters.  (HEOC, DGHS, 15 April 2026).

Children aged under 5 years account for the majority of reported cases (79%), including children aged under 2 years (66%) and infants aged under 9 months (33%). 

A total of 166 suspected deaths have been reported (CFR 1%), mainly among unvaccinated children aged under 2 years.

Epidemiology

Measles is a highly contagious acute viral disease which affects individuals of all ages and remains one of the leading causes of death among young children globally. The mode of transmission is airborne or via droplets from the nose, mouth, or throat of infected persons.

Initial symptoms, which usually appear 10-14 days (range 7-23 days) after infection, include high fever, usually accompanied by a runny nose, bloodshot eyes, cough and tiny white spots inside the mouth. The rash usually appears 10-14 days after exposure and spreads from the head to the trunk to the lower extremities. A person is infectious from four days before up to four days after the appearance of the rash. There is no specific antiviral treatment for measles, and most people recover within 2-3 weeks.

Measles is usually a mild or moderately severe disease. However, measles can lead to complications such as pneumonia, diarrhoea, secondary ear infection, inflammation of the brain (encephalitis), blindness, and death. Postinfectious encephalitis can occur in about one in every 1000 reported cases. About two or three deaths may occur for every 1000 reported cases.

Vaccination with measles containing vaccine is safe and effective, providing protection against measles and its complications for all eligible populations. WHO recommends two doses of Measles Containing Vaccine (MCV) to be provided through the routine immunization schedule. Strong routine immunization systems are therefore critical foundations for achieving and sustaining high levels of population immunity to vaccine preventable diseases such as measles.

WHO further recommends the conduct of Supplementary Immunization Activities (SIAs) or mass immunization campaigns as an effective strategy for delivering vaccination to children who may have been missed by routine services. In protecting vulnerable populations against measles, mass vaccination campaigns can rapidly improve population immunity by reducing the number of susceptible individuals in the population.

Public health response

A nationwide measles-rubella (MR) vaccination campaign was approved by the National Immunization Technical Advisory Group (NITAG) on 30 March 2026, targeting children aged 6–59 months (with expanded coverage for 6–8 months), and started on 5 April in 30 upazilas (sub-districts) of 18 priority districts. A nationwide campaign commenced on 20 April. 

Vitamin A campaign was held throughout the country on 15 March 2025.  During this outbreak response, Vitamin A supplementation is provided to all suspected and confirmed measles cases as an essential component of standard treatment and case management. 

District Rapid Response Teams (RRTs) have been activated, and vaccine procurement fast-tracked by the Ministry of Health. Other outbreak response actions include strengthening routine immunization to prevent further spread of the outbreak, enhancing hospital preparedness, ensuring availability of vitamin A, strengthening isolation capacity, and reinforcing infection prevention and control measures. 

Strengthening nationwide surveillance and epidemiological analysis, is also ongoing including measures to improve case detection and reporting. Trainings are being conducted at health facilities to improve case detection and reporting, and weekly situation reports produced to support evidence-based decision-making. 

National and divisional guidelines have been issued to guide response activities, including vaccination, clinical management, infection prevention and control, patient care pathways, and procurement. 

WHO risk assessment

Measles is a highly contagious viral disease that affects susceptible individuals of all ages and remains one of the leading causes of death among young children globally. Measles can cause serious illness in at-risk groups, including children under 5 years of age, those who are malnourished especially those with vitamin A deficiency and people with weakened immune systems. Measles complications include hearing loss, diarrhoea, pneumonia and blindness. Severe complications of measles include encephalitis, brain damage, and death. 

The current outbreak in Bangladesh is occurring in the context of suboptimal population immunity. A substantial proportion of cases occurred among children who were either unvaccinated or had received only one dose of measles-containing vaccine. In addition, some children were infected before reaching the age of eligibility for vaccination at 9 months. Most cases (91%) occurred among children aged 1 to 14 years, indicating substantial immunity gaps in this age group. 

Before this outbreak, Bangladesh had made substantial progress towards measles elimination. Reported coverage with the first dose of measles-containing vaccine increased considerably between 2000 (89% - WUENIC) and 2016 (118% - WUENIC), while coverage with the second dose also improved between its nationwide introduction in 2012 (22% - WUENIC) and 2024 (121% - WUENIC). During the same period, confirmed measles incidence declined sharply. However, recent declines in MR1 and MR2 coverage due to nationwide stockout of MR vaccine between 2024-2025, combined with routine immunization gaps and the absence of regular nationwide supplementary measles-rubella campaigns since 2020, have increased the number of susceptible children and contributed to the current outbreak. 

The risk at the national level is assessed as high due to ongoing transmission across multiple divisions, the large number of susceptible children, documented immunity gaps, and the occurrence of suspected measles-related deaths. The concentration of cases among unvaccinated and under-vaccinated children including infants too young to be vaccinated, raises concern for continued uninterrupted transmission and severe disease outcomes. 

Overall, the outbreak suggests a reversal from Bangladesh’s previous progress towards measles elimination and highlights increasing vulnerability to sustained transmission. Continued spread is likely unless urgent measures are implemented to strengthen surveillance, rapidly detect and respond to cases, and close immunity gaps through high-quality vaccination activities. 

There are considerable risks of cross-border spread, facilitated by cross-border population movement, with major urban centres such as Dhaka, Chattogram, Sylhet, and Cox’s Bazar being important international travel and transit hubs increasing the likelihood of national and international spread, particularly among unvaccinated or inadequately vaccinated travelers. 

Measles is endemic across the South-East Asia region. The risk is assessed as high at regional level.

Bangladesh shares extensive land borders with India and Myanmar, and population mobility across these borders may facilitate continued transmission. In Myanmar there is a considerable number of unvaccinated/zero dose children. With ongoing conflict and humanitarian crisis, surveillance and response capacities are limited. India, despite achieving high vaccination coverage, has reported a rise in case count over the past six months. Cities with high incidence such as Jashore and Chapainawabganj (an identified hotspot) share busy land crossings with India, thereby increasing the risk of introduction across the border. Despite Bangladesh’s progress towards measles elimination the current outbreak highlights the vulnerability of the population and underscores the fragility of immunization gains.

The risk at the global level is assessed as moderate due to high levels of population mobility, combined with ongoing widespread measles transmission and immunity gaps.

WHO advice

WHO recommends maintaining sustained homogeneous coverage of at least 95% with the first and second doses of the MCV vaccine in all municipalities and strengthening integrated epidemiological surveillance of measles and rubella to achieve timely detection of all suspected cases in public, private, and social security healthcare facilities.  

WHO recommends strengthening epidemiological surveillance in high-traffic border areas to rapidly detect and respond to highly suspected measles cases. Providing a rapid response to imported measles cases to avoid the re-establishment of endemic transmission through the activation of rapid response teams trained for this purpose and by implementing national rapid response protocols when there are imported cases. Once a rapid response team has been activated, continued coordination between the national, sub-national, and local levels must be ensured, with permanent and fluid communication channels between all levels. During outbreaks, it is recommended to establish adequate hospital case management to avoid nosocomial transmission, with appropriate referral of patients to isolation rooms (for any level of care) and avoiding contact with other patients in waiting rooms and/or other hospital rooms.  

WHO recommends vaccination of at-risk populations (without proof of vaccination or immunity against measles and rubella), such as healthcare workers, persons working in tourism and transportation (hotels, airports, border crossings, mass transportation, and others), and international travelers. Implementing a plan to immunize migrant populations in high-traffic border areas, prioritizing those considered at-risk, including both migrants and residents, in these municipalities increases vaccination coverage to increase population immunity.  

In all settings, consideration should be given to providing susceptible contacts with post-exposure prophylaxis (PEP), including a dose of MCV or normal human immunoglobulin (NHIG) (if available) for those at risk and in whom the vaccine is contraindicated. In well-resourced settings, MCV should be provided to susceptible contacts within 3 days. For contacts for whom vaccination is contraindicated or is not possible within 3 days post-exposure, consideration can be given to providing NHIG up to 6 days post-exposure. Infants, pregnant women, and the immunocompromised should be prioritized.  

WHO recommends maintaining a stock of the MR and/or measles, mumps, rubella (MMR) vaccine, and syringes/supplies for control actions of imported cases. Facilitating access to vaccination services according to the national scheme to those from other countries or people from the same country who perform temporary activities in countries with ongoing outbreaks; displaced populations; indigenous populations, or other vulnerable populations.  

WHO does not recommend any restriction on travel and trade based on the information available on the current outbreak.  

Further information

-- World Health Organization. Measles [Internet]. Geneva: World Health Organization; [cited 2026 Apr 6]. Available from: https://www.who.int/health-topics/measles 

-- World Health Organization. Measles fact sheet [Internet]. Geneva: World Health Organization; 2025 Nov 28 [cited 2026 Apr 6]. Available from: https://www.who.int/news-room/fact-sheets/detail/measles  

-- World Health Organization. Immunization dashboard [Internet]. Geneva: World Health Organization; [cited 2026 Apr 6]. Available from: https://immunizationdata.who.int/  

-- World Health Organization. Measles outbreak guide [Internet]. Geneva: World Health Organization; 2022 Aug 31 [cited 2026 Apr 6]. Available from: https://www.who.int/publications/i/item/9789240052079  

-- Directorate General of Health Services (Bangladesh). Press releases [Internet]. Dhaka; [cited 2026 Apr 6]. Available from: https://dghs.gov.bd/pages/press-releases/  

-- Measles vaccines: WHO position paper – April 2017; https://www.who.int/publications/i/item/who-wer9217-205-227

-- Measles: Vaccine Preventable Diseases Surveillance Standards; https://www.who.int/publications/m/item/vaccine-preventable-diseases-surveillance-standards-measles

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Citable reference: World Health Organization (23 April 2026). Disease Outbreak News: Measles in Bangladesh. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON598

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON598

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

 

Backyard poultry in Kiev Region.

Source: 

Link: https://wahis.woah.org/#/in-review/7495

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Longitudinal #serum #proteomics analyses reveal #biomarkers for porcine #influenza and #coronavirus infections

 

Abstract

Respiratory virus infections affect both humans and livestock, causing considerable mortality and morbidity. While respiratory pathogens such as swine influenza A virus (pH1N1) and porcine respiratory coronavirus (PRCV) often present with overlapping clinical symptoms, their pathological trajectories and outcomes differ. Given the propensity for pathogen spillover and the use of pigs as a physiologically relevant large-animal translational model, we aimed to characterise host serum protein signatures that detect and differentiate pH1N1 from PRCV, enabling improved disease monitoring and control. Using high-resolution mass spectrometry-based proteomics, we identified 162 serum proteins that were significantly dysregulated across 3 infection timepoints (1, 5, and 12 days post-infection (DPI)), with signatures correlating with viral shedding and lung pathology as early as 1 DPI. Notably, multiplexed targeted analysis of a subset of proteins in an independent cohort from a different breed and geographic location demonstrated detection, femtomole-level targeted quantitation, and validation of SRGN as a diagnostic marker for pH1N1 and PRCV (AUC=0.85). Further, SOD1 was validated as an early marker for PRCV, increasing as early as 1 DPI (AUC= 0.9). Finally, a multi-peptide signature composed of SRGN, SOD1, and RAN demonstrated reasonable predictive power for pH1N1 (AUC=0.75) and PRCV (AUC=0.65) at 1 DPI. Our data validate the proteomic screening, provide insights into the role of early protein markers in distinguishing respiratory viral infections, and pave the way for the development of point-of-care diagnostics and targeted prevention strategies, enhancing preparedness against emerging zoonotic threats.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

UKRI Biotechnology and Biological Sciences Research Council (BBSRC), BB/X019780/1, BBS/E/PI/230002A, BBS/E/PI/230002B, BBS/E/PI/230002C, BS/E/PI/23NB0004

University of Surrey, https://ror.org/00ks66431

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.04.21.719833v1

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Heterologous Sequential #mRNA #Vaccination of Indian Rhesus #Macaques Elicits Broad Binding and Neutralizing #Antibody Responses Against Diverse #Henipaviruses

 

Abstract

Henipaviruses (HNVs), including Nipah virus (NiV) and Hendra virus (HeV), are highly pathogenic and often lethal zoonotic viruses with broad species tropism and no approved human vaccines. The emergence of genetically divergent HNVs—including Ghana virus (GhV), Langya virus (LayV), and Mojiang virus (MojV)—emphasizes the need for broadly protective countermeasures. Here, we evaluated the antibody (Ab) responses to sequential mRNA vaccines encoding the membrane-bound attachment glycoprotein (gG) from NiV, GhV, and/or LayV in a pilot study with Indian rhesus macaques. Serum binding Ab responses were quantified by ELISA against five soluble gG antigens (NiV, HeV, GhV, LayV, MojV). Functional activity was assessed by neutralization assays using NiV, HeV, and GhV pseudoviruses, and by receptor-blocking ELISA. Sequential vaccination induced high-titer IgG binding against all five HNV gGs with increasing breadth after each dose. Pan-genus regimens elicited moderate neutralizing Ab titers against NiV, HeV, and GhV, whereas the NiV-only regimen elicited potent but narrow neutralization against NiV and HeV. Conversely, the GhV-LayV-GhV regimen elicited strong binding to GhV, LayV, and MojV gG and robust neutralization of GhV pseudovirus, but limited cross-reactivity to NiV and HeV. In this pilot study, we demonstrated that mRNA vaccination can elicit broadly reactive binding and neutralizing Ab responses across phylogenetically distant HNVs. Additionally, we show GhV pseudovirus neutralization for the first time. Collectively, these data provide a foundation for the development of next-generation pan-genus HNV vaccines capable of mitigating future HNV outbreaks.

Source: 

Link: https://www.mdpi.com/1999-4915/18/5/487

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#Nosocomial #outbreak of #Lassa fever in Conakry, #Guinea, 2022

 

Abstract

Background

Lassa fever (LF) is endemic in Guinea, with high seroprevalence in the forest region. However, clinical cases have been only anecdotally reported. In August 2022, a nosocomial outbreak occurred at a private clinic in the capital Conakry, an area previously considered low risk.

Methods

Suspected cases were confirmed by real-time RT-PCR within 24 hours. Viremia was monitored during hospitalization, and whole-genome sequencing was performed in-country within 13 days of outbreak detection. Outbreak investigation involved rodent testing in the home village of the suspected primary case.

Results

Six cases were laboratory-confirmed, five of which were healthcare workers of the clinic. The case fatality rate was 16.7%. Viral RNA remained detectable in blood of survivors for a median of 26 days (IQR 24-41) post disease onset. Epidemiological investigations identified a suspected primary case, who had died of a febrile disease compatible with Lassa fever, had contact with all secondary cases, and had a travel history from Kissidougou area. Three near-complete and one partial Lassa virus genomes were recovered from the secondary cases, which phylogenetically clustered with genomes from central Guinea. Consistent with a common transmission source, the four genomes were almost identical. Rodent testing revealed a new reservoir area in eastern-central Guinea.

Discussion

This outbreak highlights the vulnerability of healthcare settings in low-prevalence areas of West Africa to nosocomial Lassa virus transmission due to human mobility. Facilitated by capacity building programs for viral hemorrhagic fevers, rapid diagnosis, genomic analysis, and ecological assessment enabled an efficient outbreak response and control.

Source: 

Link: https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiag229/8661158

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#Cambodia reported fourth #human #infection with #H5N1 #influenza virus this year (ANTARA, Apr. 23 '26)

 

{Excerpt}

PHNOM PENH (ANTARA) - A 66-year-old woman from Svay Rieng province, southeastern Cambodia, has been confirmed positive for H5N1 bird flu, becoming the fourth case in 2026, the Ministry of Health said in a statement on Wednesday.

The victim, who lives in Trapaing Thkov village in Romduol district, was confirmed positive for the virus by the Cambodian National Institute of Public Health on Tuesday (April 21).

The patient is currently being quarantined at a hospital under intensive care by a team of doctors, the statement said.

(...)

Source: 

Link: https://m.antaranews.com/amp/berita/5537212/kamboja-konfirmasi-kasus-keempat-flu-burung-pada-manusia

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Oral #Nirmatrelvir – Ritonavir for #Covid19 in Higher-Risk #Outpatients

 

Abstract

Background

Nirmatrelvir–ritonavir has been shown to reduce progression to severe illness from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in unvaccinated high-risk outpatients. The effectiveness of nirmatrelvir–ritonavir in persons who have been vaccinated, infected naturally, or both is unclear.

Methods

In two open-label platform trials (PANORAMIC in the United Kingdom and CanTreatCOVID in Canada), we enrolled higher-risk adults (≥50 years of age or ≥18 years of age with coexisting conditions) in the community who tested positive for SARS-CoV-2 and had been unwell for 5 days or less. The participants were randomly assigned to receive usual care plus nirmatrelvir (300 mg)–ritonavir (100 mg) twice a day for 5 days or to receive usual care alone. The primary outcome was hospitalization or death from any cause within 28 days after randomization.

Results

From December 8, 2021, to September 30, 2024, a total of 3516 participants in the PANORAMIC trial and 716 participants in the CanTreatCOVID trial underwent randomization. In the PANORAMIC trial, 14 of 1698 participants (0.8%) in the nirmatrelvir–ritonavir group and 11 of 1673 participants (0.7%) in the usual-care group were hospitalized or died (adjusted odds ratio, 1.18; 95% Bayesian credible interval, 0.55 to 2.62; probability of superiority, 0.334). In the CanTreatCOVID trial, 2 of 343 participants (0.6%) in the nirmatrelvir–ritonavir group and 4 of 324 participants (1.2%) in the usual-care group were hospitalized or died (adjusted odds ratio, 0.48; 95% Bayesian credible interval, 0.08 to 2.23; probability of superiority, 0.830). In a substudy involving 634 participants, viral load was reduced by the end of treatment with nirmatrelvir–ritonavir. Serious adverse events with nirmatrelvir–ritonavir were reported in 9 participants in the PANORAMIC trial and in 4 participants in the CanTreatCOVID trial.

Conclusions

In two open-label trials, nirmatrelvir–ritonavir did not reduce the incidence of hospitalization or death among vaccinated higher-risk participants with SARS-CoV-2 infection. (Funded by the National Institute for Health and Care Research, and others; PANORAMIC ISRCTN number, 2021-005748-31; CanTreatCOVID ClinicalTrials.gov number, NCT05614349.)

Source: 

Link: https://www.nejm.org/doi/full/10.1056/NEJMoa2502457?query=TOC

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The ‘Spanish’ #influenza #pandemic: new #evidence for influenza #outbreaks in #England and #France prior to 1918

 

Abstract

The Spanish influenza pandemic of 1918 caused well over fifty million deaths. The epicentre undoubtedly was China, where gene mixing of different virus strains occurred amongst aquatic, migrant birds. But where and when did the virus first infect (or spill over to) a human being? We take, as our starting point, a paper demonstrating that an infection causing the same symptoms as the influenza virus was widespread in New York during the winter of 1917–1918. The authors of that paper went on to suggest that the virus had probably reached North America from Europe, in the context of troop movement during World War I. Our own researches have focussed on this point. We show that outbreaks of serious respiratory disease, local in nature but causing unusual patterns of mortality, were indeed reported by scientists and doctors in army hospitals in England and in France, well before the first wave of the pandemic had arrived. We use the records of these hospitals, now held in the National Archives, to trace the progress of this disease amongst the individuals who fell ill. We examine contemporary reactions to this minor epidemic – an epidemic, we suggest, which acted as a herald wave of the pandemic yet to come. The latter part of our paper addresses the second question, as to how troop movement across the North Atlantic, once the United States had entered into war, may well have enabled the virus to spread from Europe to North America.

Source: 

Link: https://www.cambridge.org/core/journals/medical-history/article/spanish-influenza-pandemic-new-evidence-for-influenza-outbreaks-in-england-and-france-prior-to-1918/8BC01CCE54683ED7A4DD1DFF0C3AE7EA

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Heart-nosed #bat #alphacoronaviruses use #human CEACAM6 to enter #cells

 

Abstract

Identifying viruses with zoonotic potential on the basis of their ability to enter human cells is a critical component of pandemic prediction, prevention and preparedness. Here using a computational approach that retains maximum phylogenetic diversity, we selected an optimal subset of alphacoronavirus spike proteins to screen against broad coronavirus receptor libraries. Most of the selected spike proteins did not use any of the established coronavirus receptors. However, the pseudotyped spike protein of Cardioderma cor (heart-nosed bat) coronavirus KY43 (CcCoV-KY43) could enter human cells. Using a recombinant CcCoV receptor-binding domain (RBD) and a human receptor screening platform, we identified direct interactions with the human CEACAM proteins CEACAM3, CEACAM5 and CEACAM6. Overexpression of human CEACAM6—a protein widely expressed in the human lung—conferred permissivity to otherwise refractory human cells. A crystal structure showed that the RBD binds the amino-terminal IgV-like domain of human CEACAM6. Immune surveillance studies using sera of individuals from the Taveta region of Kenya, where CcCoV-KY43 was identified, did not show significant evidence of recent spillover. Wider characterization of alphacoronaviruses related to CcCoV-KY43 showed that human CEACAM6 is used by two other CcCoVs collected in Kenya. Moreover, there was more restricted nonhuman CEACAM6 tropism for viruses isolated from Rhinolophus bats from Russia and China. Thus, alphacoronaviruses that use CEACAM6 are probably geographically widespread, and viruses from East Africa show potential for transmission to humans.

Source: 

Link: https://www.nature.com/articles/s41586-026-10394-x

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Decade-long #warming accelerates #antibiotic #resistance in #grassland soils

 

Abstract

Soils are critical reservoirs of antibiotic-resistance genes (ARGs), which are strongly shaped by microbial interactions and environmental conditions and are therefore highly sensitive to disturbance. Although climate warming is recognized as one of the most significant disturbances to microbial communities and their functions, its impacts on soil resistomes remain poorly understood. Here we investigated the effects of decade-long experimental warming on ARGs in grassland soils using integrated experimental and computational approaches. Our results revealed that ARG abundance substantially increased (23.9%) under warming—particularly glycopeptide- and rifamycin-resistance genes. Warming specifically enriched Actinomycetota hosts, including various potential plant pathogens, and enhanced ARG mobility. Large-scale unprecedented isolates-based phenotypic analyses also validated that warming increased bacterial resistance to multiple antibiotics. Further mechanistic analyses revealed that warming increased ARG abundance primarily through co-selection of resistance genes physically linked to adaptive traits (for example, thermal tolerance and nitrogen assimilation) and positive selection for thermal tolerance genes, which could be further amplified via horizontal gene transfer. Together, these findings convincingly demonstrate that climate warming substantially accelerates soil antibiotic resistance at genomic, ecological and evolutionary levels, with broad implications for public health and environmental sustainability in a warming world.

Source: 

Link: https://www.nature.com/articles/s41586-026-10413-x

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#Ensitrelvir for the #treatment of hospitalized adults with #COVID19: an international phase 3 randomized placebo-controlled trial

 

Abstract

Background

Antivirals remain an important treatment strategy for persons who experience severe and life-threatening COVID-19. Ensitrelvir is an oral 3CL protease inhibitor with potent antiviral activity.

Methods

We conducted an international randomized, placebo-controlled trial of ensitrelvir with standard of care (SOC) among adults hospitalized for COVID-19. The primary outcome was clinical recovery assessed by the Days to Recovery Scale through Day 60 (DRS-60), analyzed using a Van Elteren test.

Results

From 2023 to 2025, 589 participants received blinded study treatment (293 ensitrelvir and 296 placebo). Median age was 69 years, 49% were female, 68% were White, and SOC commonly included corticosteroids (61% and 54%) and remdesivir (62% and 60%) in ensitrelvir and placebo groups, respectively. Median DRS-60 category was 6 (IQR: 3-15) in the ensitrelvir and 5.5 (IQR: 3-12) in the placebo group (p=0.19), and the OR was 0.82 (95% CI: 0.62-1.09) for a better DRS-60 category with ensitrelvir. Ensitrelvir participants had lower detectable viral antigen in plasma at Day 5 (13.4% vs 25.1%; p<0.001). There was no difference in secondary clinical outcomes or pre-specified safety outcomes, though the mortality rate was 6.1% vs 4.4% and the frequency of hemorrhagic events was 3.4% vs 0.3% among ensitrelvir and placebo groups, respectively.

Conclusions

Ensitrelvir treatment did not improve clinical recovery in addition to SOC for adults hospitalized for COVID-19. The lower illness severity in the Omicron era compared to earlier periods in the COVID-19 pandemic, and high use of remdesivir and corticosteroids, may have contributed to the lack of clinical benefit.

Source: 

Link: https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciag272/8660678?redirectedFrom=fulltext

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Next-Generation #Sequencing #Strategies During the 2024–2025 Avian #Influenza #H5N1 #Emergency Response in the #US

 

Abstract

The first influenza A(H5N1) human case associated with the A(H5N1) dairy cattle outbreak in the United States was identified in April 2024. The U.S. CDC response to this outbreak was activated days later and remained active until July 2025. During this time, 70 human cases of influenza A(H5N1) were detected with a range of epidemiological links to sources of exposure. Next-generation sequencing (NGS) of human samples was an effectual mechanism for tracking and analyzing the outbreak evolution throughout the response. Due to the specimens’ importance and their variable physical quality, an assortment of laboratory methods was utilized including influenza segment-specific amplification, enrichment capture, short-read, and long-read sequencing. Combining these methods allowed for high-quality genomic data production with rapid turnaround times—typically 2 days from sample receipt to public database submission. By leveraging replicate sequencing, enrichment capture, and sequencing of diagnostic amplicons, valuable genomic data could be produced directly from human clinical specimens that would have normally been considered too weak for routine virologic surveillance sequencing. The resulting assemblies were characterized and analyzed by CDC and shared with local and state public health authorities to facilitate case investigations and risk assessment. These data were further used for phylogenetic analyses of viruses from human cases to investigate likely animal-to-human transmission events and identify clusters within the outbreak that might indicate trends in the types of exposures. Through the adaptable laboratory workflow and the rapid release of viral genomic data, the public health risk mitigation strategies could be evaluated and adjusted in real time.

Source: 

Link: https://www.mdpi.com/1999-4915/18/4/482

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Dual-route #H5N1 #vaccination induces systemic and mucosal #immunity in murine and bovine #models

 

Abstract

Highly pathogenic H5N1 avian influenza (clade 2.3.4.4b) has spread widely among dairy cattle herds since early 2024, causing major economic losses. This zoonotic event emphasizes the urgent need for H5 vaccines eliciting strong, durable, cross-reactive immune responses in cows. To address this, we immunized mice and cattle with a centralized consensus H5 vaccine, localizing near the central node of the human H5 phylogenetic tree. The vaccine was delivered using serotype-switched adenoviral vectors in a prime–boost regimen, combined with intramuscular and intranasal coadministration to target systemic and mucosal immunity and elicit strong humoral and cellular immune responses. This approach strategically integrates multiple innovative features: centralized consensus immunogens, mucosal targeting, and vector serotype switching aimed at maximizing immune protection against H5N1 viruses. Our results show that vaccination elicits strong humoral and cellular immunity in both mice and calves. In challenge experiments, vaccinated mice were fully protected against lethal infection with divergent H5N1 strains, including A/bovine/Ohio/B24OSU-439/2024. Vaccine-induced immunity was consistent across species, supporting the translatability of the mouse model findings to cattle. Overall, our findings represent a promising approach for immunizing key livestock, including cattle, against highly pathogenic avian influenza H5N1, mitigating agricultural losses, and reducing the risk of zoonotic transmission.

Source: 

Link: https://www.nature.com/articles/s41541-026-01460-6

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Avian #Influenza #Report - Reporting period: April 12 - 18 '26 (Wk 16) (HK CHP, April 21 '26): 3 new #human cases of #H9N2 virus in #China

 

{Excerpt}

(...)

Avian influenza A(H9N2): 

-- Guangdong Province: 

1) A five-year-old boy with onset on February 23, 2026.

-- Jiangxi Province: 

2) A two-year-old boy with onset on March 20, 2026. 

-- Yunnan Province:

3) A two-year-old girl with onset on March 3, 2026. 

(...)

Source: 

Link: https://www.chp.gov.hk/files/pdf/2026_avian_influenza_report_vol22_wk16.pdf

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Timing of #Remdesivir Initiation and Clinical #Outcomes in Hospitalized Patients with #COVID19 Who Are at High Risk of Disease Progression in #Japan: A Health Insurance Claims Database Study

 

Abstract

Early initiation of remdesivir (RDV) is recommended to improve COVID-19 outcomes, but real-world studies describing patterns of RDV use and related outcomes among Japanese COVID-19 patients at high-risk of severe outcomes or death are limited. This claims-based cohort study included 60,165 high-risk patients hospitalized with COVID-19 between October 2021 and June 2023 using the DeSC Healthcare claims database. Patients were categorized into early-RDV (within 2 days of hospital admission), late-RDV (between day 3 and day 7), and no-RDV groups based on RDV initiation timing. Descriptive analyses were performed according to RDV groups. Of the study patients, ≥85% were very elderly (≥75 years). Approximately 39% of patients received early RDV, 2% received late RDV, and 59% received no RDV. By day 28, the proportion of alive discharge for early-, late-, and no-RDV groups was 74.9%, 63.1%, and 71.8%, respectively. The mortality for early-, late-, and no-RDV groups was 7.7%, 8.8%, and 8.4%, respectively. Future hypothesis-driven studies with an appropriate adjustment for confounders are needed to formally evaluate the impact of RDV initiation timing on clinical outcomes in this high-risk, predominantly late-elderly population in Japan.

Source: 

Link: https://www.mdpi.com/1999-4915/18/4/479

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Emergence of D1.1 #reassortant #H5N1 avian #influenza viruses in North #America

 

Abstract

Since 2021, highly pathogenic avian influenza viruses (HPAIVs) belonging to H5N1 clade 2.3.4.4b have circulated widely in North American wild birds and repeatedly spilled over into mammals. In 2025, the first H5N1-associated deaths in humans were recorded in the Western hemisphere, raising questions about how the ongoing evolution of the virus in wild birds impacts spillover risk. Here, our analysis of 21,471 H5N1 genomes identified an evolutionary shift in mid-2024, driven by interhemispheric migration from Asia and reassortment with new antigens. The genotypes that dominated the early years of North America's H5N1 epizootic traced their ancestry back to Europe, but Asia was the source of new "D1.1" genotype viruses that (a) spread faster, (b) have higher reassortment potential, (c) a broader host range, (d) repeatedly spill over to bovines, and (e) cause severe disease in humans, including non-farm workers.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

Research Foundation - Flanders, https://ror.org/03qtxy027, G098321N, G0E1420N

European Union Horizon 2023 RIA project LEAPS, 101094685

DURABLE EU4Health project 02/2023-01/2027, 101102733

Fonds National de la Recherche Scientifique, F.4515.22

European Union Horizon 2020 project MOOD, 874850

Centers of Excellence for Influenza Research and Response, National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH), Department of Health and Human Services, 75N93021C00014

Source: 

Link: https://www.biorxiv.org/content/10.64898/2025.12.19.695329v2

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#Outdoor roaming of owned #cats elevates #risk of zoonotic #pathogen #exposure: A global synthesis

 

Abstract

Domestic animals play a central role in pathogen transmission at the human–wildlife interface. Domestic cats, in particular, are uniquely consequential in disease spillover dynamics due to their global distribution, large, human-subsidized free-roaming populations, and high contact rate with humans, domestic animals, and wildlife. However, the extent to which human ownership and management mitigate this spillover risk remains a key knowledge gap. To address this gap, we conducted a global systematic review and quantitative synthesis of the prevalence and diversity of zoonotic pathogens in indoor-only, outdoor-owned (roaming unsupervised), and unowned (feral or stray) cats. Our dataset comprised 174,064 individuals from 88 countries, representing 124 pathogen species, 97 of which are zoonotic. Using generalized linear models within a Bayesian framework and rarefaction analyses, we show that ownership provides limited protection against zoonoses when owned cats have unsupervised outdoor access. Outdoor-owned cats were 3–5 times more likely to carry zoonotic pathogens than indoor-only cats, and, notably, had infection odds statistically equivalent to those of feral cats, despite receiving presumed veterinary care and feeding. Feral cats carried the highest pathogen diversity, however, outdoor-owned cats still harbour 1.5 times the helminth richness of indoor cats, highlighting their potential as effective bridges for pathogen spillover. With approximately 62% of owned cats roaming freely worldwide, and rates exceeding 90% in some regions, these findings reveal a major yet overlooked route of zoonotic risk. Public health and One Health frameworks have traditionally focused on feral cats; however, our results highlight the need to explicitly incorporate owned outdoor cats into zoonotic disease prevention strategies by restricting unsupervised roaming and promoting responsible ownership practices. Without such integration, current frameworks risk overlooking a pervasive and preventable pathway for pathogen transmission at the human–wildlife–domestic animal interface.

Source: 

Link: https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1014160

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#Surveillance and #control efficacy of the Bergerac, #France, 2025 #chikungunya #outbreak

 

Abstract

The spread of the highly invasive mosquito, Aedes albopictus, across Europe, combined with climate change and human travel and trade, has led to new epidemic threats from mosquito-borne viruses, most significantly dengue and chikungunya, which are increasing in frequency and magnitude. In 2025, mainland France has seen a record number of autochthonous cases and outbreaks of chikungunya, spread across multiple locations, primarily introduced by travellers from the French Overseas Territory of La Réunion which is experiencing severe chikungunya outbreaks. Here, we describe one of the largest French outbreaks and subsequent control measures in the city of Bergerac, Dordogne, which resulted in 102 cases as of 5th November 2025. We apply a climate-driven mathematical model for Ae. albopictus and chikungunya virus transmission to the Bergerac 2025 outbreaks, comparing outputs to case data. The model suggests that the initial control measures in the first four weeks after the discovery of the outbreak, limited in their intervention radius and intensity, had little effect on reducing the number of cases, given the high incidence and the wide geographic extent of viral circulation. However, subsequent more widespread and intense control efforts, combined with likely increased public awareness, substantially reduced case numbers. These findings underscore the need to tailor control measures to intensity and scale of viral circulation combined with effective preventive and proactive arbovirus surveillance. Adulticides combined with public awareness campaigns can be effective for public health protection and are an important part of mitigating against the risk of Aedes-borne arboviruses and the ongoing outbreaks in mainland France.

Source: 

Link: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014184

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Uncomplicated #malaria as a #risk factor for #COVID19 duration and severity in western #Kenya and #Burkina Faso (MALCOV): a prospective cohort study

 

Summary

Background

The relationship between malaria and COVID-19 varies across different clinical scenarios; historical malaria exposure might protect against severe COVID-19, whereas co-infection in hospitalised patients with severe disease might increase mortality. Interactions between non-severe malaria and COVID-19 remain poorly understood. We conducted a cohort study among COVID-19 patients of all ages in western Kenya and Burkina Faso to assess the effects of acute, uncomplicated Plasmodium falciparum malaria co-infection on COVID-19 outcomes in ambulatory patients.

Methods

Participants with laboratory-confirmed SARS-CoV-2 infection (positive rapid antigen test or reverse transcription quantitative real-time PCR [RT-qPCR]) were tested for malaria by rapid antigen tests with confirmatory microscopy. Patients with COVID-19 and malaria co-infection received artemether–lumefantrine or pyronaridine–artesunate. COVID-19 symptom course was assessed daily using FLU-PRO Plus (a validated patient-reported outcome instrument) until day 14. Viral load was measured by RT-qPCR on days 0, 3, 7, 14, and 28. The primary endpoint was time to symptom resolution on the FLU-PRO Plus. Analyses were adjusted for country, age, disease severity, and viral load.

Findings

Between Jan 8, 2021 and Jan 24, 2022, we screened 5161 participants and recruited 756 with COVID-19. 742 participants with valid malaria tests were enrolled, of which 151 (20%) had malaria co-infection and the remaining 591 (80%) did not have malaria. Patients with malaria were younger (49 [32%] aged <15 years) than those without malaria (35 [6%]; p<0·0001). Time to symptom resolution was similar between those with malaria (median 9 days [IQR 5–13]) and those without (10 days [IQR 6–13]; adjusted hazard ratio [aHR] 1·14 [95% CI 0·91–1·42]; p=0·26). Three (2%) patients with malaria and nine (2%) without malaria were hospitalised; two (1%) with malaria and three (1%) without malaria died, four from acute respiratory distress syndrome and one (in the no malaria group) from perforated peptic ulcer complicated by anaemia. Participants with malaria more frequently reported moderate-to-severe symptoms at enrolment (68% vs 60%; p=0·074), but overall symptom duration was similar (adjusted incidence rate ratio 0·95 [95% CI 0·86–1·05]; p=0·31). Previous malaria exposure significantly modified outcomes, with patients with malaria co-infection and previous exposure having faster symptom clearance than those without previous exposure (pinteraction=0·042). SARS-CoV-2 clearance was slower in the malaria group by day 7 (aHR 0·69 [95% CI 0·51–0·94]; p=0·017) but was similar between groups by day 28 (adjusted risk ratio 0·99 [95% CI 0·79–1·24]; p=0·95).

Interpretation

This study shows that acute uncomplicated malaria co-infection does not adversely affect COVID-19 progression when appropriately treated. Moreover, serological evidence confirms that previous lifelong malaria exposure might provide some protection, with exposed individuals having faster symptom resolution.

Funding

Gates Foundation.

Translation

For the French translation of the abstract see Supplementary Materials section.

Source: 

Link: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(25)00541-8/fulltext

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A natural five-amino-acid insert at the S2’ #cleavage site of #MERS-CoV #spike enhances viral membrane fusion

 

Highlights

• A novel 5-aa insert, TSGVF, is present at the S2’ cleavage site of the spike protein of MERS-CoV from dromedary camels.

• Pseudovirus-based entry assays showed that the TSGVF insert increases viral entry efficiency in different human cells.

• Pseudovirus with TSGVF insert at the S2’ cleavage site showed strong resistance to TMPRSS2 inhibitor.

• The natural occurrence of TSGVF insert at the spike S2’ cleavage site enhances viral membrane fusion and syncytia formation.

Source: 

Link: https://www.sciencedirect.com/science/article/pii/S1995820X26000611?via%3Dihub

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