#Thrombotic and #cerebrovascular events following #SARS-CoV-2 #vaccination: an umbrella #review of systematic reviews and meta-analyses

 

Abstract

Rare thrombotic and cerebrovascular events have been reported after SARS-CoV-2 vaccination, raising safety concerns. This umbrella review synthesizes evidence from 19 systematic reviews and meta-analyses examining thrombotic outcomes, including acute ischemic stroke and cerebral venous sinus thrombosis, across different vaccine platforms. Methodological quality was assessed using AMSTAR-2, and findings were synthesized by outcome and platform. Evidence consistently shows that thrombotic and cerebrovascular events following vaccination are rare. mRNA vaccines (BNT162b2, mRNA-1273) were not associated with increased risk beyond background population rates. Adenoviral vector vaccines (ChAdOx1 nCoV-19, Ad26.COV2.S) were linked to a rare syndrome of vaccine-induced immune thrombotic thrombocytopenia, most commonly presenting as cerebral venous sinus thrombosis in younger adults. Evidence for whole-virus vaccines was limited but did not indicate consistent safety concerns. Across all platforms, thrombotic risk was substantially lower than that from SARS-CoV-2 infection. Overall, vaccination benefits outweigh risks, highlighting the importance of ongoing surveillance and transparent communication.

Source: 

Link: https://www.nature.com/articles/s41541-026-01550-5

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Expedition #cruises, island hopping, and #zoonotic #risk: #governance and operational lessons from the MV #Hondius #Andes hantavirus outbreak

 

Abstract

The Andes orthohantavirus outbreak linked to the MV Hondius expedition cruise illustrates how a probable land-based zoonotic exposure can become a multinational public health event when it intersects with enclosed shipboard environments, delayed clinical recognition, remote navigation, medical evacuation, and international passenger dispersal. Although hantavirus infection is classically associated with exposure to infected rodents or contaminated environments, Andes virus is exceptional among orthohantaviruses because limited person-to-person transmission has been documented, particularly after close and prolonged contact. This Perspective uses the MV Hondius outbreak as an analytical case study to identify governance and operational gaps in expedition-era travel medicine. Existing International Health Regulations, WHO ship-event guidance, and ECDC recommendations provide essential foundations for coordination, notification, isolation, and contact tracing; however, this outbreak exposed expedition-specific gaps in safe port access, medical evacuation, onboard recognition of nonspecific febrile illness, diagnostic escalation, passenger traceability, and post-disembarkation monitoring. We therefore propose an accountability-oriented One Health preparedness model that operationalizes existing guidance through route-level risk assessment, exposure-history assessment, onboard syndromic surveillance, isolation and telemedicine triggers, reference-laboratory pathways, port-of-call agreements, auditable passenger and excursion records, and cross-border post-travel monitoring. The central lesson is not that expedition cruises, birdwatching, or ecological tourism are inherently unsafe, but that their expanding geographic reach requires binding, auditable, and expedition-specific outbreak protocols before passengers embark.

Source: 

Link: https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1892006/full

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#USA, #Wastewater Data for Avian #Influenza #H5 (CDC, July 31 '26)

 

{Excerpt}

(...)

A(H5) detections in the past week

Time Period: July 19, 2026 - July 25, 2026

    -- A(H5) Detection: 4 site(s) (0.9%)

    -- No Detection: 427 site(s) (99.1%)

    -- No samples: 81 site(s)

{Click on Image to Enlarge}

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(...)

Source: 

Link: https://www.cdc.gov/wastewater/emerging-viruses/h5.html?

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#USA, #Oregon: Avoid #contact with #bats to reduce #rabies exposure risk (Dept. of Health, July 31 '26)

 

July 30, 2026

    PORTLAND, Ore.—Oregon Health Authority (OHA) and the Oregon Department of Fish and Wildlife (ODFW) are urging people to prevent exposure to rabies while highlighting the importance of bats and other wildlife to the state’s ecosystems.

    So far, 22 bats have tested positive for rabies in 2026, according to OHA data. That means the state has matched – and is poised to surpass – its record for the number of bats that test positive for rabies in a single year. Bats have carried the rabies virus in their populations for thousands of years and are well known to carry rabies today, but generally at a very low level. Nevertheless, they account for the most human exposures to the virus more than any other species in the U.S.

    The highest number of animals testing positive for rabies since 2000 was in 2006, when 22 bats and two foxes were found to be carrying the disease. In 2023, 20 bats tested positive for the virus.

    Emilio DeBess, DVM, public health veterinarian at OHA’s Public Health Division, said the more contact someone has with bats, the higher the risk of exposure to rabies.

    “Unfortunately, when people find a dead or dying bat, they may pick it up with their hands because they want to help it, or maybe they’re just curious,” DeBess said. “When a bat or other wild animal is sick or dying with rabies, there’s an increased chance they will bite or transmit the virus in other ways.”

    Colin Gillin, DVM, ODFW state wildlife veterinarian, agrees that bats and other wildlife rarely bite people but may do so if they are sick or feel threatened. Oregon bats, in particular, eat only insects—about 1,000 insects every hour—and avoid people.

    “Bats provide important ecosystem services in Oregon, but also globally with insect control, seed dispersal, and pollination of specific plants, supporting agriculture and forest systems,” Gillin said. “And like many animals that can carry disease, bats can also prevent or suppress disease by reducing mosquitoes and other vectors that carry human and animal pathogens.”

    ° What to do if you find a bat

        § Bats are protected wildlife, which makes it illegal to harm or keep them. If you see a bat that appears to be sick:

            * Stay calm, do not touch it, and keep people and pets away.

            * When the sick or dead bat is indoors, do not release the bat. It may have exposed someone or a pet to rabies. If it is safe to do so, place a container or box over the bat.

           * When the sick or dead bat is outdoors and may have exposed someone to rabies, cover it with a box or bucket to keep it in place, if safe to do so. Finding a dead bat does not require any action unless someone was bitten or scratched before the bat died.

            * Contact your local health authority or veterinarian for your area right away to discuss potential exposures to humans or pets.

            * If there are multiple sick or dead bats observed in an area, report it to ODFW.

        § When a person or pet has been bitten or scratched by an animal that may have rabies, report this exposure immediately to your local animal regulation services or local public health authority. Seek medical care immediately from a medical provider or veterinarian.

            * Teach children to avoid all contact with bats and other wildlife.

            * Avoid bats seen in the wild, such as while hiking.

            * Make sure your dog or cats' vaccinations are up to date, whether they are indoor or outdoor pets.

            * Unvaccinated pets that come into contact with a bat may be quarantined for up to four months, or euthanized.

            * Protect your home from bats by covering vents, chimneys, and other entry points with screens.

            * If you have roosting (nesting) bats living in your attic or other areas of your house, call a wildlife control operator (WCO). ODFW is unable to respond to homeowner requests for bat removal.

(...)

Source: 

Link: https://www.oregon.gov/oha/ERD/Pages/Avoid-contact-with-bats-to-reduce-rabies-exposure-risk.aspx

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#UK, Sharp rise in #cyclospora #infections linked to #Mexico #travel (UKHSA, July 31 '26)

 

    The UK Health Security Agency (UKHSA) has published new data showing a sharp rise in cyclospora infections among travellers returning from Mexico.

    UKHSA is advising all travellers to take precautions when travelling abroad including maintaining good food and water hygiene to reduce their risk of infection.

    Cyclospora is a parasite that causes explosive diarrhoea. Contaminated food specifically herbs, salad and soft fruit are common sources of outbreaks and infections. Infection is acquired via consumption of contaminated food. Cyclospora doesn’t naturally occur in the UK and there is no risk of spread from person to person.

    Symptoms of infection can include frequent watery diarrhoea, abdominal cramping, bloating, nausea, flatulence, low-grade fever, loss of appetite and weight loss. While cyclosporiasis is usually mild and most people improve typically in a few days without any treatment, infections can be more serious or prolonged in people who are immunocompromised and antibiotics may be prescribed.

    The latest data, published today, shows that 67 cases have been reported in returning travellers in England (30 cases) Wales and (10 cases) Scotland (27 cases) between 30 April and 15 July 2026; a sharp rise this year when compared to the annual average of 93 cases recorded between 2022 and 2025.

    Travel information is available for 52 out of the 67 cases; of these, 48 reported travel to Mexico, with one also reporting travel to the USA. One further case reported travel to the USA only, and one to Kenya.

    Among those who travelled to Mexico, cases reported staying at a range of different hotels in the Riviera Maya and Cancún regions and consuming a variety of food and drink as part of all-inclusive holiday packages. Further investigations around the cases are ongoing.

    UKHSA anticipates a continued rise in travel-associated cases linked to increased summer travel to Mexico and a potential increase in cases linked to travel to the USA, where a widespread outbreak has been reported.

    Dr Philip Veal, Consultant in Travel Health at UKHSA, said:

        ''We have recently detected a rise in Cyclospora infections among travellers returning from Mexico. These infections are caused by a parasite and can affect the stomach and intestines.

        ''Travellers to Mexico and other areas where the infection is more common can reduce their risk by following good food and water hygiene measures, including drinking bottled water and eating thoroughly cooked food, even when staying in high-end all-inclusive resorts. We also advise avoiding certain foods such as fresh uncooked berries and herbs, unpeeled fruit and salad items.

        ''If you develop symptoms after returning from travel, such as watery diarrhoea, loss of appetite, weight loss, stomach cramps or pain, bloating, increased wind, nausea, fatigue or other flu-like symptoms, please seek medical attention and inform your healthcare professional of your travel history.

        ''The TravelHealthPro website has more information on the steps you can take to keep yourself and your family well.

(...)

Source: 

Link: https://www.gov.uk/government/news/sharp-rise-in-cyclospora-infections-linked-to-mexico-travel

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Seasonal #surveillance in #humans in 2026 for West Nile virus (#WNV) (ECDC, July 31 '26): 158 cases so far of which 94 from #Italy

 

{Summary}

Week 31, 2026 | Produced on 30 July 2026 at 12:00, based on data submitted up until and including 29 July 2026.

Current situation

    ° Since the beginning of the 2026 transmission season, and as at 29 July, 49 areas affected by West Nile virus (WNV) have been identified in seven countries across Europe.

    ° These areas are located in: 

        § Italy (30), 

        § Greece (eight), 

        § Romania (four), 

        § France (two), 

        § North Macedonia (two), 

        § Spain (two) and 

        § Germany (one).

    ° The seven countries have reported 158 locally acquired human cases of WNV infection: 

        § Italy has reported 94, 

        § Greece 42, 

        § North Macedonia seven, 

        § Spain seven, 

        § Romania five, 

        § France two and 

        § Germany one case.

    ° This week, 14 areas are reported as affected for the first time this season. The affected areas identified as at 29 July 2026 are listed in Table 1 and shown in Map 1 below.

(...)

{Click on Image to Enlarge}

__

{In Yellow, areas already affected since the beginning of the season.}

{In Red, areas newly affected this week.}

__

Source: 

Link: https://www.ecdc.europa.eu/en/west-nile-fever/surveillance-and-disease-data/disease-data-ecdc

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Pre-existing and Cross-Reactive #Immunity to Avian #Influenza #H5N1 in #Humans: Implications for #Pandemic #Risk and Vaccine Strategies

 

Highlights

    ° Evidence of cross-reactive antibodies to H5N1 in humans.

    ° Seasonal influenza may induce partial H5N1 cross-protection.

    ° H5N1 clade 2.3.4.4b shows expanded host range and spread.

    ° Role of viral glycoproteins in immune cross-reactivity.

    ° Implications of baseline immunity for H5N1 pandemic risk.

Abstract

Due to the continuous evolution of Influenza A viruses (IAVs), novel strains with efficient human-to-human transmission may emerge and cause future pandemics. Among these, highly pathogenic avian influenza (HPAI) H5N1 remains a major concern because of its impact on wildlife, livestock, and human health. The widespread circulation of H5N1 clade 2.3.4.4b, detected in hundreds of bird species and numerous mammals worldwide, highlights important changes in viral ecology and transmission, increasing its zoonotic and pandemic potential. This review summarizes current evidence on cross-reactive and cross-protective immunity to H5N1 in humans, focusing primarily on humoral immune responses. We examine the presence of pre-existing H5N1-reactive antibodies in individuals without known exposure and discuss how previous seasonal influenza infection or vaccination may contribute to their development. Particular attention is given to antibodies targeting conserved regions of hemagglutinin (HA), especially the stalk domain, as well as neuraminidase (NA), which may provide heterosubtypic protection. We also evaluate the ability of seasonal influenza vaccines and infections to induce cross-reactive responses against H5N1 and their potential role in partial protection or immune priming. Finally, we review current and emerging H5N1 vaccination strategies, including adjuvanted and mRNA-based platforms, and identify priorities for surveillance, population immunity assessment, and the development of broadly protective influenza vaccines.

Source: 

Link: https://www.journalofinfection.com/article/S0163-4453(26)00148-9/fulltext

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#Zoonotic neglected tropical #diseases at the animal-human interface in the Greater #Mekong Subregion: Two decades of surveillance in #Laos and #Cambodia

 

Abstract

Zoonotic neglected tropical diseases (NTDs) remain a substantial but under-recognised source of human morbidity and economic concern in the Greater Mekong Subregion, particularly in settings characterised by close human–animal interaction. This article represents a narrative synthesis of zoonotic disease research conducted in Laos and Cambodia between 2000 and 2025. The review integrates published literature with findings from long-term surveillance programmes conducted by the authors and collaborating institutions in Laos, with comparative insights from Cambodia, to examine the presence, distribution, diversity, and drivers of zoonotic pathogens at the human–animal interface. Evidence demonstrates the endemic presence of a wide range of parasitic, bacterial, and viral zoonoses, including Taenia solium, Trichinella spp., Streptococcus suis, rickettsial infections, melioidosis, hepatitis E virus, and Japanese encephalitis virus. Some of these pathogens are sustained within smallholder livestock systems, informal slaughter, farming practises, food networks, and wet market environments, where limited diagnostic capacity and fragmented surveillance obscure true disease presence. Surveillance innovations, including abattoir-based sampling, cross-sectoral serological studies, environmental surveillance approaches, and molecular diagnostic tools, have improved pathogen detection but have also highlighted persistent structural and behavioural barriers to control. Socio-cultural practices, occupational exposure, wildlife trade, and economic dependencies reinforce transmission dynamics, indicating that biomedical interventions alone are insufficient. Instead, zoonotic disease persistence reflects the interaction of livestock production systems, environmental conditions, diagnostic limitations, and entrenched human behaviours. This review emphasises the need for integrated One Health approaches that combine strengthened surveillance, improved diagnostics, behavioural interventions, and regional collaboration. Addressing zoonotic NTDs in Laos and Cambodia requires coordinated strategies that account for both biological complexity and socio-economic context to achieve sustainable disease control and improved public health outcomes.

Source: 

Link: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014584

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Assessment of Quantitative #Genetic #Distances Supports the Separation of #H17N10 and #H18N11 Subtypes of #Influenza a Virus into a Distinct Species

 

Abstract

The taxonomic status of the H17N10 and H18N11 influenza A viruses isolated from bats remains unclear due to the absence of quantitative classification criteria at this taxonomic level. A total of 3328 representative IAV genomes, encompassing all eight protein-coding segments, were analysed. Various genetic distance-based metrics were assessed at the pairwise level, including intra- and intergroup nucleotide distances, dN/dS ratios, and transition/transversion ratios, to facilitate the differentiation of the Alphainfluenzavirus genus into distinct taxa. Pairwise distances for seven of the eight segments (PB2, PB1, PA, NP, M, NA, NS) consistently differentiated the H17–H18 group from H1–H16. Across segments, intergroup nucleotide divergence was consistently above a lower bound of ~25%, with segment-specific values extending to higher levels (up to ~40% in PB2 and PA), while intragroup divergence remained substantially lower. The HA segment did not conform to this pattern, which is consistent with the hypothesis of ancient reassortment. The distribution of pairwise dN/dS values for the PB2, PB1, PA, and NP segments is evidently bimodal. Intergroup comparisons were consistently higher across all segments, whereas intragroup values remained lower. A similar lower boundary of approximately 0.12 was observed across segments, while the upper range of intergroup values varied by gene. Overall, the results support a consistent gene-specific separation pattern. Previously demonstrated absence of reassortment compatibility between bat viruses (H17–H18) and canonical influenza A (H1–H16) viruses indicates that these lineages have evolved independently over an extended period. These consistent genomic patterns provide support for the hypothesis that H17N10 and H18N11 viruses may represent a separate species within the genus Alphainfluenzavirus.

Source: 

Link: https://www.mdpi.com/1999-4915/18/8/838

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Interim #heat #mortality monitoring #report, #England: May and June 2026 (UKHSA, July 30 '26)

{Excerpt}

Published 30 July 2026

Main points

    ° During the May and June 2026 heat events:

        § there were an estimated total of 2,877 heat-associated deaths

        § an estimated 753 heat-associated deaths occurred during the May heat episode

        § an estimated 2,124 heat-associated deaths occurred during the June heat episode

        § the mortality burden is already close to the highest annual totals previously recorded by UKHSA

What you need to know about this report

    ° This interim report focuses on total heat-associated mortality estimates for the May and June 2026 heat episodes.

    ° Detailed demographic, geographic and cause-specific analyses, and comparisons with UKHSA modelled estimates, are outside the scope of this publication.

    ° Final figures of heat-associated deaths during heat episodes in 2026 will be published early in 2027.

Reason for this interim report

    The UK Health Security Agency (UKHSA) produces the annual heat mortality monitoring report. These are official statistics that provide estimates of heat-associated mortality during heat episodes in England. These estimates support understanding of the public health impacts of hot weather and inform future preparedness and response activities.

    During summer 2026, England experienced 2 notable heat events, one in May and the other in June, both of which were exceptional for different reasons. 

    The May heat event occurred unusually early in the season, with record-breaking temperatures following a period of unseasonably cool weather. 

    The June event was characterised by its intensity and formed part of a broader period of sustained hot weather across Europe. Given the public health significance of these events, and the considerable interest from policymakers, partners and the public, UKHSA has produced this interim report to provide an early assessment of heat-associated mortality. Such early assessments will only be undertaken following extraordinary periods of heat and would not normally be produced for routine heat events.

    Although this report has been produced using the same data sources, analytical methods and quality assurance processes as the annual heat mortality monitoring report, the estimates should be regarded as preliminary and operational in nature. 

    At the time of analysis, mortality data remains incomplete because of routine delays in death registration. Also, estimates for the June heat event are subject to additional uncertainty due to limited availability of non-heat period days for baseline comparison. The definitive assessment of mortality associated with these events will be published in the annual official statistics report in early 2027.

    This interim report focuses on headline estimates of heat-associated mortality. Detailed breakdowns by age, sex, geography, place of death and cause of death are not included because the analysis is based on provisional death registration data that has been adjusted for reporting delays. 

    Registration delays can vary between population groups, causes of death and geographical areas, and applying appropriate delay corrections across all breakdowns would introduce additional complexity and uncertainty into the estimates. 

    In addition, this report does not include comparisons between observed heat-associated mortality and UKHSA modelled mortality estimates. These assessments require more comprehensive analysis and are therefore reserved for the annual publication. More detailed analyses will be provided in the annual official statistics publication once more complete mortality datais available.

    The estimates presented in this report are therefore expected to differ from final numbers as additional death registrations are received and processed in the annual heat mortality monitoring report.  

(...)

Source: 

Link: https://www.gov.uk/government/publications/interim-heat-mortality-monitoring-report-england-may-and-june-2026/interim-heat-mortality-monitoring-report-england-may-and-june-2026

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#Losartan and #prednisolone for #postCOVID syndrome and cardiac inflammation: a randomized, double-blind, placebo-controlled trial

 

Abstract

Persistent cardiac symptoms are common in post-COVID syndrome, even without structural heart disease. Evidence implicates immune dysregulation, endothelial dysfunction and low-grade cardiovascular inflammation. Yet no targeted treatment exists. Myoflame-19 is a multicenter, double-blind clinical trial of 279 participants with inflammatory cardiac involvement defined by cardiovascular magnetic resonance, randomized 1:1 to losartan plus prednisolone (n = 139) or matching placebos (n = 140) for 16 weeks. The modified intention-to-treat population comprised 124 and 122 participants. The primary endpoint, change in left ventricular (LV) ejection fraction, was neutral: between-group difference 0.74 percentage points (pp), 95%CI −0.14 to 1.62, p = 0.10, unpaired t-test; supportive baseline-adjusted ANCOVA 0.99, 95%CI 0.15-1.83, p = 0.021. Among prespecified secondary endpoints, several symptom and imaging measures showed numerical differences favoring intervention, including Average Symptom Score components (modified Canadian Chest Pain Scale −4.8 pp, 95%CI −17.3 to 7.6; NYHA class −8.1 pp, −20.6 to 4.3; Long COVID symptom burden −7.7 pp, −18.9 to 3.6), native T1 and T2 values (native T1 −2.46 ms, −8.35 to 3.42; native T2 −0.31 ms, −1.16 to 0.53), and LV end-diastolic volume ( + 1.45 ml/m², −0.09 to 3.00); however, confidence intervals included the null value and these findings should be regarded as hypothesis-generating.Treatment was safe and well-tolerated. These findings indicate a neutral treatment effect on the primary endpoint. They inform targeted immunomodulation and design of future trials in post-COVID syndrome and inflammatory cardiac involvement. Trial registration: EudraCT 2022-001682-12; NCT05619653.

Source: 

Link: https://www.nature.com/articles/s41467-026-75991-w

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Estimating the #infection #fatality #ratio of zoonotic avian #influenza viruses with #pandemic potential using an evolutionary epidemiological model

 

Abstract

The risk of zoonotic avian influenza (AIV) infection to humans is challenging to estimate as many human avian influenza virus infections are undetected because infections may be asymptomatic, symptomatic but not tested, and difficult to identify through contact tracing, as human-to-human transmission is rare. We derive equations that consider the evolutionary mechanisms that give rise to pandemics and are parameterized to be consistent with records of past pandemics. We estimate that thousands of human infections with AIVs possessing pandemic potential occur worldwide in an average year. Combining these estimates with H5N1 fatality data, we estimate a historical average infection fatality ratio of 32 (95% uncertainty interval: 9.6-75) deaths per 10,000 infections. This estimate is comparable to SARS-CoV-2 during the recent pandemic and higher than seasonal human influenza. We estimate that preventing animal-to-human influenza spillovers would delay pandemic emergence by several years. Preventing human infections with AIVs is necessary given the high risk of severe outcomes to individuals and to reduce the risk of pandemics occurring in the future.

Competing Interest Statement

The authors have declared no competing interest.

Source: 

Link: https://www.medrxiv.org/content/10.64898/2026.01.21.26344526v3

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#Climatechange as an amplifier of #hantavirus #risk in South #Asia: a neglected nexus

 

Abstract

Hantavirus is seroepidemiologically established in South Asian human populations and rodent reservoirs, with anti-hantavirus antibodies confirmed in occupational risk groups in India, an independent association with chronic kidney disease demonstrated in Sri Lanka, and co-infection with leptospirosis identified in more than one-fifth of hospitalized leptospirosis patients. Despite this, the intersection of these findings with the region’s intensifying monsoon floods, rapid urbanization, and climate-driven rodent ecology remains entirely unexamined. This letter highlights the neglected climate−hantavirus nexus, identifies structural vulnerabilities that amplify transmission risk in South Asia, and calls for integrated flood-response surveillance and One Health coordination across the region.

Source: 

Link: https://academic.oup.com/trstmh/advance-article-abstract/doi/10.1093/trstmh/trag082/8746591?redirectedFrom=fulltext

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

 

A poultry farm in the Niedersachsen Region.

Source: 

Link: https://wahis.woah.org/#/in-review/7738

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#SARS-CoV-2 #Surveillance in Free-Ranging #Wildlife in New England and #Virginia, #USA, 2022–2025

 

Abstract

Since its emergence in 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected a wide range of animal species, including wildlife. Although SARS-CoV-2 infection has been widely reported in wildlife, particularly in white-tailed deer (WTD; Odocoileus virginianus) across the United States, data on viral circulation in New England wildlife remain limited. Here, we investigated active SARS-CoV-2 infection and serological evidence of previous exposure in free-ranging wildlife from New England and Virginia. We examined samples from 1646 animals representing 29 wildlife species, collected through wildlife rehabilitation centers, clinics, and hunter harvests in New England and Virginia between 2022 and 2025. SARS-CoV-2 RNA was detected in three WTD from Massachusetts and Vermont. Phylogeographic analysis showed that the Vermont WTD SARS-CoV-2 sequences were closely related to contemporaneous human SARS-CoV-2 sequences from the same region, consistent with a possible human-to-deer spillover event. Serological screening by ELISA detected SARS-CoV-2 reactive samples in nine individuals from three species, including Eastern cottontail (Sylvilagus floridanus), Eastern coyote (Canis latrans), and raccoon (Procyon lotor), providing putative evidence of prior SARS-CoV-2 exposure. However, neutralizing antibodies against the SARS-CoV-2 Omicron variant were detected in only a single Eastern cottontail. Overall, these findings indicate sporadic SARS-CoV-2 detection and limited serological evidence of prior exposure among wildlife sampled in New England and Virginia, and highlight the importance of continued surveillance to detect spillover events, monitor viral evolution, and assess the potential risks associated with wildlife reservoirs.

Source: 

Link: https://www.mdpi.com/1999-4915/18/8/832

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#Baloxavir, #favipiravir, or #oseltamivir in patients with non-severe symptomatic seasonal #influenza (AD ASTRA): a phase 2, open-label, adaptive, RCT

 

Summary

Background

The oral antiviral therapies baloxavir marboxil (hereafter baloxavir), favipiravir, and oseltamivir have not been simultaneously compared for the treatment of seasonal influenza. We aimed to determine their relative efficacies in accelerating viral clearance in patients with symptomatic influenza virus infection at low risk of progression to severe disease.

Methods

We conducted a phase 2, open-label, randomised, controlled, adaptive platform trial in patients aged 18–60 years in Thailand, Laos, Nepal, and Brazil, recruited in four hospital outpatient or primary care departments with acute influenza (≤ 4 days of symptoms) and a low risk of progression to severe disease. Patients were randomly assigned 1:1:1:1:1 using a centralised online app to receive baloxavir (single oral dose of 40 mg if bodyweight <80 kg or 80 mg if bodyweight ≥80 kg), favipiravir (oral loading dose of 1800 mg, followed by 1800 mg 12 h later, and then 800 mg twice daily for 4 days), oseltamivir (oral dose 75 mg twice daily for 5 days), no study drug, or another ongoing intervention (reported separately). Randomisation was stratified by site and used block sizes of 15. The primary endpoint was the rate of oropharyngeal influenza viral RNA clearance, estimated under a Bayesian hierarchical linear model fitted to the daily log10 oropharyngeal viral densities from day 0 to day 5. Analyses were conducted in the modified intention-to-treat population (mITT), defined as patients with PCR-confirmed influenza with more than 250 viral RNA copies per mL at randomisation. Intervention groups were assessed for superiority over the no study drug group (posterior probability >0·9 that the relative increase in viral clearance was ≥20%); if superiority was met, intervention groups were assessed for non-inferiority relative to baloxavir (posterior probability >0·9 that the relative reduction in viral clearance was ≤10%). Secondary outcomes included time to resolution of fever and time to resolution of all symptoms. The trial is registered with ClinicalTrials.gov (NCT05648448) and is ongoing.

Findings

Between Feb 22, 2023, and Dec 12, 2025, 944 patients with influenza virus infection were randomly assigned to baloxavir (n=199; mITT 163 [82%]), favipiravir (n=223; mITT 196 [88%]), oseltamivir (n=200; mITT 170 [85%]), no study drug (n=228; mITT 200 [88%]) or other interventions (n=94). 120 patients were excluded based on baseline viral density (≤250 copies per mL), and one participant withdrew before collection of quantitative PCR results on day 0. 457 (63%) patients in the mITT population were female and 272 (37%) were male. Compared with no study drug, viral clearance rates were accelerated by 86% (95% credible interval [CrI] 60–117) with baloxavir, 66% (45–94) with favipiravir, and 49% (28–74) with oseltamivir. For all interventions, the posterior probability that the relative increase in viral clearance was 20% or more was 1·0. Compared with baloxavir, oseltamivir was inferior (20% slower clearance, 95% CrI 6 to 32; posterior probability 0·93 that the relative reduction in viral clearance was <10%); non-inferiority could not be shown for favipiravir (10% slower clearance, 95% CrI –4 to 22; posterior probability 0·55 that the relative reduction in viral clearance was <10%). Median time to fever resolution was accelerated with all three antivirals compared with no study drug (absolute differences ranging from 0·5 days to 0·9 days), whereas time to resolution of all symptoms was not significantly different between groups. 31 adverse events of grade 3 or above occurred, five of which were considered severe (one in the favipiravir group, one in the oseltamivir group, and three in the no study drug group).

Interpretation

Oral baloxavir, favipiravir, and oseltamivir accelerated influenza viral clearance rates in adults with early non-severe seasonal influenza at low risk of progression to severe disease. Baloxavir had the greatest in-vivo antiviral efficacy, followed by favipiravir and oseltamivir. These antivirals shortened fever duration but showed no clear effects on time to complete symptom resolution. This pharmacometric approach can inform prioritisation of antiviral agents for further study and potential inclusion in pandemic stockpiles.

Funding

Wellcome Trust.

Source: 

Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00255-0/fulltext

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#Seroprevalence of #Influenza #H5N1 Virus in Domestic #Cats at Epicenter of Dairy #Cattle #Outbreaks, #California, #USA, 2024–2026

 

Abstract

We conducted a serologic study of domestic cats near the epicenter of the dairy cattle outbreaks of influenza A(H5N1) in California, USA. Three of the 12 cats sampled within 2 km of farms had neutralizing antibodies against H5N1 virus. Proximity to dairy farms was a statistically significant risk factor for seropositivity.

Source: 

Link: https://wwwnc.cdc.gov/eid/article/32/9/26-0785_article

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#Mutations in severe #human #H5N1 cases facilitate #evasion from human mucus and #antivirals

 

Abstract

In late 2024, two individuals in Canada and the United States were treated in intensive care for acute respiratory distress caused by infection with the avian Influenza A Virus H5N1 2.3.4.4b genotype D1.1. Viral sequence data obtained from sampling these patients indicated mixed alleles at haemagglutinin (HA) positions 190 and 226. Mutations at these positions are key determinants of HA usage of α2,6-linked sialic acids (SA), the most abundant influenza receptors in human upper respiratory tracts. Thus, these mutations raised concerns about human adaptation and pandemic potential of the H5N1 virus. In this study, we investigated the impact of the mutations at residues 190 and 226 in H5 HA. We studied the receptor binding properties, cell entry phenotypes and fitness impacts of the mutations using recombinant proteins, pseudotyped lentiviruses, and in the context of influenza viruses using reverse genetics. The mutations did not confer any detectable α2,6-linked sialic acid receptor usage either alone or in combination. Rather, viruses carrying these mutations exhibit weakened binding towards α2,3-linked sialic acid receptors. This correlated with an enhanced capacity to evade human airway mucus, and a reduced susceptibility to oseltamivir and zanamivir. This research underscores that in addition to the way HA interacts with SA as entry receptors, other factors that impact the HA/NA balance might influence the evolutionary trajectory of a zoonotic virus in the human respiratory tract. This study presents a new paradigm for the evolutionary drivers of HA, where reduced sialic acid binding can serve as an advantage for escape from host barriers and antivirals.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

Medical Research Council, https://ror.org/03x94j517, MR/Y03368X/1, MR/Y015061/1, CC2127

Biotechnology and Biological Sciences Research Council, BB/Y007298/1, APP104179, BBS/E/PI/23NB000, BBS/E/PI/23NB0003

Wellcome Trust, https://ror.org/029chgv08, CC2127, 218304/Z/19/Z

Department for Environment Food and Rural Affairs, BB/Y007298/1

The Pirbright Institute, BBS/E/PI/230002A, BBS/E/PI/230001C, BBS/E/PI/230002B

Cancer Research UK, CC2127

UK Research and Innovation, https://ror.org/001aqnf71, UKRI3602

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.07.28.740943v1

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Avian #Influenza #Report: July 19 25, '26 (Wk 30) (HK CHP, July 28 '26): Three new #human #infection with #H9N2 virus in #China

 

{Excerpt}

(...)

Avian influenza A(H9N2): 

{China}

    ° Guangdong Province: 

        § A 44-year-old man with onset on June 26, 2026. 

    ° Guangxi Zhuang Autonomous Region: 

        § A four-year-old boy with onset on June 26, 2026.  

    ° Jiangsu Province: 

        § A four-year-old boy with onset on June 22, 2026. 

(...)

Source: 

Link: https://www.chp.gov.hk/files/pdf/2026_avian_influenza_report_vol22_wk30.pdf

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HPAI #H5N1 #risk in #Australia: a model for the prediction of #poultry #outbreaks

 

Abstract

The panzootic highly pathogenic avian influenza (HPAI) H5N1 virus has now been detected on the Australian mainland, with incursions from the sub-Antarctic region posing an increasing threat to domestic wildlife and poultry populations. Our study aimed to predict the risk of HPAI H5N1 poultry outbreaks across Australia at the local government area (LGA) level using a range of influential risk factors. We first used a Maximum Entropy (MaxEnt) model to estimate the environmental suitability for HPAI H5N1 occurrence across Australia. The resulting suitability layer was then integrated with five additional predictor layers, including abundance data for two Southern Ocean wild birds, one of which has introduced HPAI H5N1 into Australia; abundance data for 28 native Australian wild birds; native bird flyways across Australia; Australian chicken density; and poultry farm density. The six layers were aggregated and averaged to generate an HPAI H5N1 risk map for poultry outbreaks across Australian LGAs. Although most incursions have occurred in Western Australia (WA) and South Australia (SA), we identified New South Wales (NSW) and Victoria (VIC) as having the highest predicted risk of HPAI H5N1 poultry outbreaks. Additional high-risk areas were identified in WA, SA, and Tasmania (TAS). In contrast, the Northern Territory (NT) and large parts of Queensland (QLD), WA, and SA were predicted to be at low risk. These findings provide a spatially explicit framework to support targeted surveillance, preparedness, and biosecurity measures aimed at mitigating the impact of future HPAI H5N1 outbreaks in Australian poultry.

Competing Interest Statement

CR MacIntyre is funded by NHMRC and Medical Research Futures Fund and is Founding Director of EPIWATCH Global Pty Ltd.

Funder Information Declared

NHMRC, CRM funded by NHMRC Investigator Grant 2016907

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.07.27.740638v1

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