ETIDIOH - NEW

Weekly epidemiological record   20 MARCH 2026, 101th YEAR, No 12, 2026, 101, 53–56 http://www.who.int/wer   Executive Summary   The WHO Expert Working Group on Surveillance of Influenza Antiviral Susceptibility (AVWG) supports the WHO GISRS by providing practical guidance for monitoring antiviral susceptibility of seasonal and emerging influenza viruses through global surveillance efforts .  The 14th WHO-AVWG meeting was held in virtual format on 10-12 June 2025 .  Update on susceptibility of seasonal influenza viruses to approved antiviral agents   From approximately May 2024 to May 2025 , five WHO Collaborating Centres (CCs) and two National Influenza Centres (NICs) reported co-circulation of influenza A(H1N1) pdm09, A(H3N2), and B/Victoria viruses.  A(H1N1)pdm09 dominated in Eastern Asia {1}. Elevated frequency of influenza neuraminidase (NA) inhibitor (NAI) reduced inhibition/ highly reduced inhibition (RI/HRI) was identified among A(H1N1)pdm09 vir...

  {Excerpt} Time Period: March 08, 2026 - March 14, 2026 -- H5 Detection :  8 site(s) ( 1.8% ) -- No Detection :  444 site(s) ( 98.2% ) -- No samples in last week :  120 site(s) (...) Source:  Link:  https://www.cdc.gov/nwss/rv/wwd-h5.html ____

  Abstract Background :  Avian Influenza (AI) is a potential pandemic threat , specifically when human-to-human transmission occurs . For outbreak management testing is essential. Current knowledge on testing behaviour is mostly derived from other infectious diseases such as COVID-19 . It is necessary to identify determinants of testing behaviour for AI in an early phase . Therefore, this interview study aims to identify a wide range of behavioural determinants of testing during a hypothetical human-to-human transmissible AI outbreak .  Methods :  Semi-structured in-depth interviews , based on the Theoretical Domains Framework, were carried out between May 2024 and February 2025. Participants were included through purposive and convenience sampling. During the interviews an animation was shown illustrating a hypothetical AI outbreak. Verbatim transcripts were thematically analysed.  Results :  We included seventeen participants (median age 44, range 20-81; ...

  Summary -- What is already known about this topic? - CDC tracks SARS-CoV-2 variants internationally using digital public health surveillance and in the United States using genomic surveillance, including wastewater and traveler-based surveillance.  - The highly divergent SARS-CoV-2 variant BA.3.2 was first detected in a respiratory sample collected on November 22, 2024, in South Africa. -- What is added by this report? - As of February 11, 2026, BA.3.2 had been reported in 23 countries.  - Detections began increasing in September 2025.  - In the United States , BA.3.2 was detected in nasal swabs from four travelers, three airplane wastewater samples, clinical samples from five patients, and 132 wastewater samples from 25 U.S. states. -- What are the implications for public health practice? - Monitoring the spread of BA.3.2 provides valuable information about the potential for this new SARS-CoV-2 lineage to evade immunity from a previous infection or vaccination. Ab...

  The Meningitis B vaccine will now be offered to everyone who has been offered preventative antibiotic treatment as part of this outbreak . -- Vaccination will now be extended to everyone who has been offered preventative antibiotic treatment as part of this outbreak. -- Preventative antibiotics – and vaccination – will also now be offered to the 6th form students ( years 12 and 13 ) in schools and colleges in Kent where confirmed or probable cases are identified. -- On a case-by-case basis, future risk assessment may also support use in other year groups or settings. -- Students can, and should, continue to attend schools and colleges as normal.  -- The NHS Kent and Medway website will be updated shortly with vaccination sites for those eligible. -- The key intervention to protect people and halt the spread remains for people to come forward for antibiotic treatment . A single course of antibiotics is highly effective in preventing the contraction and spread of this disease ...

  By USFWS Mountain-Prairie - Canada goose on Seedskadee NWR, Public Domain,  https://commons.wikimedia.org/w/index.php?curid=69188087 ___ A wild Canada Goose in Etelä-Suomen aluehallintovirasto Region. Source:  Link:  https://wahis.woah.org/#/in-review/7384 ____

  Abstract The ongoing epizootic of highly pathogenic avian influenza (HPAI) continues to cause massive deaths in wildlife . Fundamental understanding of its disease ecology in natural populations is urgently needed. This knowledge has been hindered by the difficulty of acquiring data on epidemic dynamics . Here, using data collected from a threatened population of Dalmatian pelicans (Pelecanus crispus), we recover the epidemiological and evolutionary history of one of the largest HPAI wildlife mortality events . The results show that this devastating outbreak was likely seeded by a single introduction associated with movement of the species . By estimating epidemiological features of two consecutive outbreaks in the same population, we show that panzootic H5N1 since 2022 likely exhibits higher transmissibility and longer shedding time in non-reservoir birds , compared to previous H5NX subtypes. We also evaluate effectiveness of past and future control measures : carcass removal du...

  Abstract AGILE (NCT04746183) is a Phase Ib/IIa platform, evaluating candidates to treat COVID-19 . Candidate Specific Trial 6 evaluated the safety and optimal dose of a novel intravenous formulation of favipiravir in a dose-escalating, open-label, randomized, controlled, Bayesian adaptive Phase Ib trial . Hospitalized adults with PCR-confirmed SARS-CoV-2 infection , within 14 days of symptomatic COVID-19 were randomized 2:1 in groups of 6 (n = 4 favipiravir, n = 2 standard of care) to ascending doses of intravenous favipiravir twice daily (b.i.d.) for 7 days or standard of care. Clinical data, safety evaluations, virology and pharmacokinetic samples were collected. The primary outcome was safety . Secondary outcomes included clinical, pharmacokinetic and virological endpoints . Twenty-four participants enrolled between September 10, 2022 and November 1, 2023 [10/24 female; median age 74 years (range 52–93)]. Favipiravir was well tolerated despite a high background rate of unrelat...

  ABSTRACT Respiratory viruses can infect hosts concurrently or sequentially, potentially influencing each other’s pathogenic trajectory . However, the underlying immune mechanisms governing these interactions remain poorly understood. In this study, we examined whether respiratory syncytial virus (RSV) infection modulates host susceptibility to subsequent SARS-CoV-2 infection using two murine models . We found that prior RSV infection conferred dose- and time-dependent heterologous protection against SARS-CoV-2 . Transcriptomic and immunological analyses revealed that RSV activated lung antigen-presenting cells (APCs) and SARS-CoV-2–reactive mucosal T cells by day 9 post-infection , with responses waning by 1 month . RSV also promoted expansion of pulmonary γδ T cells and upregulation of their metabolic pathways. Notably, RSV-infected TCRδ⁻/⁻ mice , which lack γδ T cells, exhibited diminished SARS-CoV-2–reactive mucosal T cell responses, elevated viral loads, and exacerbated lung ...

  The Public Health Agency (PHA) is aware of a probable case of Bacterial Meningitis in a pupil who attends a secondary school in Belfast .  All appropriate public health actions have been completed. As a precaution, PHA has worked closely with the school and has issued information to parents and guardians.  Relevant guidance has also been shared with GP Out-of-Hours services and Emergency Departments.   All individuals identified as close contacts have been risk assessed and where appropriate, have received antibiotic prophylaxis .  We urge students, staff and families to remain vigilant for the signs and symptoms of meningitis and act fast if they suspect they may have it. Symptoms of meningitis develop suddenly and can include :  - a high temperature (fever) over 37.5C (99.5F) - being sick - a headache - a blotchy rash that doesn't fade when a glass is rolled over it (this won't always develop) - a stiff neck - a dislike of bright lights - drowsines...

  Invasive meningococcal disease: advice for the NHS in England You may be aware of an evolving situation involving multiple cases of invasive meningococcal disease (IMD) reported among young people linked to the University of Kent and the Canterbury area .  More information about IMD , signs and symptoms to look out for, and approaches to clinical and public health management are provided in the accompanying Briefing Note .  The purpose of this CAS Alert is to outline priority steps that primary care and hospital clinicians should consider taking to manage suspected cases, potential contacts of cases, and to reduce the risk of infection spreading.  Note that this is a rapidly evolving situation and we will update advice as further information emerges. Epidemiology -- Between 13 and 17 March 2026, UKHSA identified 20 cases of invasive meningococcal disease in the South East .  -- Six cases have been confirmed as Neisseria meningitidis group B .  -- Most cas...

{Bântéay Méanchey, Preah Netr Preah }  On 12 March 2026, the outbreak investigation team visited a backyard chicken farm following reports of illness and mortality suspected to be caused by Avian Influenza (AI). During the visit, deaths of wild birds were also observed in the area. A total of six chicken samples were collected and submitted to NAHPRI/GDAHP for testing of Avian Influenza (H5N1). Laboratory results confirmed on 16 March 2026 that 4 out of 6 chicken samples tested positive for Avian Influenza (H5N1 ). In addition, 13 wild bird carcasses were collected and submitted for laboratory testing. On 16 March 2026, all wild bird samples were confirmed positive for Avian Influenza (H5N1). {Bântéay Méanchey, Serei Saophoan}  On 25 January 2026 , the outbreak investigation team visited a backyard chicken farm following reports of illness and mortality suspected to be caused by Avian Influenza (AI). Two chicken samples were collected and submitted to NAHPRI/GDAHP for tes...

  Abstract In this study, the phenotypic consequences of naturally occurring single nucleotide polymorphisms (SNPs) in the Middle East respiratory syndrome coronavirus (MERS-CoV) Spike protein were investigated. The impact of Spike mutations on the syncytia formation and neutralisation of contemporary MERS-CoV strains is not currently well understood. Mutations were identified by aligning 584 MERS-CoV Spike sequences from either human clinical isolates collected between 2012 and 2024 or from a clinical isolate that had been passaged in human cells . Fifteen SNPs of interest occurring in the N-terminal domain (NTD), receptor binding domain (RBD) and adjacent to the S1/S2 cleavage site were selected for further characterisation based on their location in the Spike protein, frequency and identification in previous studies. A contemporary clade B, lineage 5 wildtype Spike sequence , obtained from a human MERS-CoV clinical isolate , was used as the backbone in this study . The mutations...

  Abstract We assessed impact and durability of an infection prevention and control (IPC) bundle intervention during the Kivu/Ituri Ebolavirus outbreak (2018-2020). IPC scores increased initially, then declined 6 months post-intervention (median 19/36, 30/36, and 28/36, p<0.0001). Without sustained IPC practices , health facilities remain vulnerable to nosocomial transmission in future Ebolavirus outbreaks. Source:  Link:  https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciag192/8526630 ____

  Abstract Azithromycin is a widely used antibiotic and was frequently used to treat hospitalized patients during the COVID-19 pandemic . The impact of empiric azithromycin use on the respiratory microbiome in patients with viral respiratory infections is unclear. Here we used longitudinal metatranscriptomics on nasal swabs from a prospective multicentre cohort of 1,164 patients hospitalized for COVID-19 . We compared the upper respiratory microbiome, resistome and systemic immune response in patients treated with azithromycin (n = 366) with those who received no antibiotics (n = 474) or other antibiotics (n = 324). We found that azithromycin altered microbiome composition and increased the expression and relative proportion of macrolide/lincosamide/streptogramin (MLS) resistance genes . These changes occurred after 1 day of exposure and persisted for over a week. MLS resistance gene expression was associated with commensals and potential pathogens , while there were no differences...

  ABSTRACT H9N2 avian influenza viruses (AIVs) remain a significant economic burden on poultry production and a persistent zoonotic threat . Hemagglutinin (HA), a surface glycoprotein mediating viral entry and pathogenesis , critically depends on thermostability for its function. Our previous study indicated that recent H9N2 AIVs have experienced a reduction in hemagglutination activity and exhibit low HA thermostability ; however, the underlying molecular determinants for this instability remain poorly defined. To address this gap, we employed an in vitro-directed evolution approach to identify HA mutations that enhance thermostability. By subjecting a diverse HA mutant library to iterative heat selection at 48°C , we isolated several HA-stabilizing mutations , including L29I, N133S, N210D, G266R, D387N, A423T, and E509G, and confirmed their effect by site-directed mutagenesis. Further characterization revealed a complex interplay between HA stability, receptor binding specificity...

{Excerpts} Avian Influenza Report - VOLUME 22, NUMBER 11 - Reporting period: March 8, 2026 – March 14, 2026 (Week 11) (Published on March 17, 2026)   (...) -- Date of report :  14/03/2026 -- Country :  Cambodia -- Province / Region District / City :  Banteay Meanchey province, Preah Netr, Preah district -- Sex :  Female -- Age :  45 -- Condition at time of reporting :  Hospitalised -- Subtype of virus : H5N1   (...) Source:  Link:  https://www.chp.gov.hk/files/pdf/2026_avian_influenza_report_vol22_wk11.pdf ____

  Abstract Background   Tropical low – and middle –income countries are highly vulnerable to zoonoses and vector-borne diseases , with risks amplified by climatic events , environmental change , and limited surveillance capacity. Cambodia is particularly exposed due to its ecological diversity, seasonal flooding , and rapidly changing land use . Globally, however, field based One Health approaches remain under –implemented, limiting practical evidence on how to address these complex threats.  Methods   This protocol describes a longitudinal One Health study conducted in three villages of Battambang province, Cambodia , designed to investigate the prevalence and transmission dynamics of zoonotic and potentially zoonotic pathogens at the human –animal –environment interface . The study examines how vector density, diversity, and pathogen circulation are influenced by hydrological variation and seasonality , and assesses the sociodemographic, behavioral, and environment...