Detection and characterization of #antiviral #resistant viruses during the #influenza season of 2024–25

 

ABSTRACT

During the high severity season of 2024–25, CDC with public health partners sequenced and analyzed genomes of >10,000 influenza viruses for antiviral resistance markers. Available sequence-flagged and representative viruses were tested with antivirals using in vitro assays. In the US, three oseltamivir-resistant A(H3N2) viruses had treatment-emergent neuraminidase (NA) mutations, either E119V or R292K. Oseltamivir-resistant A(H1N1)pdm09 viruses with NA-H275Y were detected in 15 states, albeit at a low frequency (0.53%). They belonged to several phylogenetic groups, with hemagglutinin (HA) subclade D.3.1 combined with either NA subclade D.1 or D.2 being most common. Based on shared sequence data, nearly all H275Y viruses from Australia, Canada, and Chile also belonged to these HA and NA subclades. Conversely, most H275Y viruses (68/81) from China belonged to HA subclade C.1.9 and NA subclade D and shared the permissive mutation R257K. Influenza polymerase acidic (PA) mutations conferring 4- to 92-fold decreased baloxavir susceptibility were detected in nine influenza A viruses. Viruses with PA-I38T showed mild attenuation of replicative fitness in three cell lines. Based on available data, NA-H275Y and PA-I38T viruses were collected from patients with no exposure to antivirals. Baseline susceptibility to all US-approved influenza antivirals remained largely unchanged compared to previous seasons. All swine-origin viruses detected in the US had adamantane resistance-conferring marker, M2-S31N, but remained susceptible to other approved antivirals. Monitoring antiviral susceptibility has substantially improved with increased sequencing capacities and bioinformatic support at public health laboratories. Information gained through influenza surveillance has been used to guide recommendations on antiviral use.

Source: 

Link: https://journals.asm.org/doi/10.1128/spectrum.01514-26

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#Andes #Hantavirus: an imported case, a French-Argentine national on #tourist trip to #France, has been detected in the territory (Min. Health, August 6 '26)

 

Health authorities have been informed of a case of hantavirus in the country. The Andes strain was confirmed by the National Reference Center (CNR) this Thursday, August 6. The patient, who is isolating with his family in Spain, is a tourist who transited through France during the second half of July. The patient, who was initially only mildly symptomatic, is no longer exhibiting any symptoms. All necessary management measures are being implemented to care for the patient and trace his travel history.

    Today at 3 p.m., a group of scientific experts, in conjunction with the Directorate General of Health and Public Health France, is meeting to determine the appropriate course of action and management measures to be implemented regarding this imported case. Coordination at the European level is also being established.

    The health authorities are fully mobilized and will communicate regularly on the evolution of the situation.

    ° What is hantavirus and Andes hantavirus?

        § Hantaviruses are viruses transmitted by infected rodents, primarily through the inhalation of dust contaminated by their urine or feces. It is a rare but serious disease that can be fatal. In humans, some hantaviruses cause two types of illness:

            * Hemorrhagic fever with renal syndrome (especially in Europe and Asia);

            * Cardiopulmonary syndrome (especially in America, more serious).

        § There are 140 types of hantavirus, present on all continents, including the Andes virus.

    

    The Andes virus, found in South America, is distinguished by its rare ability to transmit from person to person through close and prolonged contact. 

    After an incubation period of one to six weeks, the infection typically begins with flu-like symptoms including fever, body aches, and fatigue. 

    Severe cases can progress to kidney damage or severe respiratory distress.

    At this stage, we are not dealing with a virus that is circulating widely in the population.

Source: 

Link: https://sante.gouv.fr/actualites-presse/presse/communiques-de-presse/article/hantavirus-andes-un-cas-importe-franco-argentin-en-voyage-touristique-en-france

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#COVID19, Global #Risk #Assessment - Version 10 (WHO, August 6 '26, summary)

{Summary} 

Overall risk statement

    As of 30 July 2026, the global public health risk from COVID-19 remains moderate following an assessment of data and information reported between 1 January and 30 July 2026. 

    While the direct public health impact of COVID-19 has declined compared with the early phases of the pandemic (the COVID-19 Public Health Emergency of International Concern - PHEIC, was lifted on 5 May 2023), the SARS-CoV-2 virus continues to circulate globally, maintaining its capacity to cause severe disease and fatalities, particularly among high-risk populations, including older and immunocompromised adults and people living with comorbidities. 

    As of 28 June 2026, over 779 million confirmed cases and over seven million confirmed deaths have been reported globally to WHO since the event was confirmed to WHO in 2020, while seroprevalence estimates suggest that there are orders of magnitude more infections and reinfections that remain unreported. 

    Uncertainties persist regarding the long-term consequences for the health of individuals suffering repeated infections and/or affected by post-COVID-19 condition (PCC). 

    Global estimates indicate that 6% of people with symptomatic COVID-19 infection develop PCC, with reduced risk in vaccinated individuals. 

    Of these, approximately 15% have persistent symptoms even at 12 months.

    Continued global circulation and ongoing virus evolution and diversification, including in established animal reservoirs, warrant constant monitoring and vigilance. 

    While available vaccines remain effective against severe disease and death despite continued COVID-19 variants evolution, the global vaccine uptake was very low in 2025, even by those at high risk of developing severe disease. 

    This further enables virus circulation and genetic evolution and increases health risks for vulnerable individuals. 

    Decreased reporting, reduced genomic sequencing (and sharing of sequence information) have led to gaps in surveillance, especially from low- and middle-income countries, which affects the representativeness and completeness of available data. 

    Consequently, the ability to accurately assess the public health risk from COVID-19 remains constrained, resulting in a low level of confidence in the current assessment.

    As indicated by sentinel surveillance through WHO’s Global Influenza Surveillance and Response System (GISRS) and wastewater surveillance, SARS-CoV-2 circulation continues at a low level globally, with test positivity remaining below 5% since December 2025. 

    The virus is co-circulating with seasonal influenza and Respiratory Syncytial Virus (RSV). 

    The previously observed decline in deaths and hospitalizations continued throughout this assessment period and can be explained by high population immunity, improved clinical management, and unchanged virulence of circulating variants. 

    Most currently circulating SARS-CoV-2 variants belong to the JN.1 Omicron sublineages, which show immune escape but do not result in increased disease severity compared to other Omicron sublineages, reflected by the stability of severity indicators.

    In December 2025, WHO published the Strategic Plan for Coronavirus Disease Threat Management (2025–2030) which recommends continued integration of COVID-19 into broader respiratory disease surveillance systems. 

    In March 2026, WHO provided updated recommendations for routine COVID-19 vaccination with a continued focus on targeting populations at high risk of severe disease. WHO also regularly updates recommendations for vaccine composition, with the latest published in May 2026.

(...)

Source: 

Link: https://www.who.int/publications/m/item/covid-19-global-risk-assessment--version-10

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#Ebola Bundibugyo Virus Disease Outbreak, #DRC & #Uganda - Situation #Report 12, Data as of 02 August 2026 (WHO, edited): 3802 cases & 1707 deaths in DRC

 

{Excerpt}

{Click on Image to Enlarge}

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Event description  

    The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo continues to expand rapidly, with sustained transmission, persistently high mortality, and ongoing geographic spread. 

    It is now the largest BVD outbreak ever recorded and the second largest Ebola disease outbreak in history after the 2013 – 2016 West Africa epidemic. 

    Since its detection only a few months ago, the epidemic has grown at an exceptional rate, highlighting its intensity and the challenges facing response efforts. 

    Although no new international spread has been detected, continued transmission indicates that the outbreak remains in an expansion phase and continues to pose a high risk of regional and international spread. 

Democratic Republic of the Congo 

    Since the last update of 26 July 2026 (Weekly External Situation Report #11), the Democratic Republic of the Congo has reported an additional 540 confirmed cases and 270 confirmed deaths, representing increases of 16.6% and 18.8%, respectively, in cumulative confirmed cases and deaths. 

    Although the absolute numbers of newly reported cases and deaths remain substantial, the proportional increases are markedly lower than those reported during the previous reporting period, reflecting the absence of the large retrospective data reconciliation that contributed to last week's increase. 

    Nevertheless, the reporting of more than 500 additional confirmed cases and more than 250 confirmed deaths within a single week indicates that transmission remains intense and that the outbreak continues to expand. 

    The crude case fatality ratio (CFR) increased from 44.1% to 44.9%, reflecting persistently high mortality despite ongoing response efforts. 

    During the reporting period, the cumulative number of affected health zones increased from 48 to 51, with Kabondo and Wanie-Rukula in Tshopo Province and Lubero in North Kivu Province becoming the latest affected health zones, further demonstrating the continued geographic expansion of the outbreak. 

Figure 1.  Weekly trend of confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo by epidemiological week of notification, epidemiological weeks 18 – 31, 2026 

{Click on Image to Enlarge}

___

    During the last 21 days, transmission remained highly concentrated geographically, with an additional 1,867 confirmed cases and 953 confirmed deaths reported nationally. 

    Approximately 87.9% (n=1,641) of recently reported confirmed cases and 84.8% (n=808) of deaths occurred in Ituri Province, with the Bunia–Rwampara–MongbwaluNizi corridor continuing to represent the principal transmission focus. 

    North Kivu, Haut-Uélé, and Tshopo together accounted for 223 cases (11.9%) and 144 deaths (15.1%), while South Kivu reported no new confirmed cases. 

    However, an imported confirmed death from Tshopo Province generated new contacts requiring follow-up in South Kivu. 

    Of the 51 affected health zones, 42 reported at least one confirmed case during the preceding 21 days, whereas nine health zones (Gety, Kambala, Lubunga, Mangobo, Mabalako, Makiso-Kisangani, Miti-Murhesa, Rungu, and Vuhovi) have not reported a confirmed case for more than three weeks, suggesting that transmission may have been interrupted in these areas, provided surveillance remains sufficiently sensitive to detect any ongoing transmission. 

    The largest increases in confirmed cases over the previous 21 days were recorded in Bunia (312 cases), Nizi (285), Rwampara (216), Mongbwalu (207), Katwa (104), Lita (84), Nia-Nia (66), Mangala (63), Fataki (31), and Butembo (29). 

    Together, these ten health zones accounted for approximately 84% of all additional confirmed cases reported nationally during the period. 

    Bunia, Nizi, Mongbwalu, and Rwampara remained the principal transmission corridor, accounting for nearly 55% of all newly reported confirmed cases. 

    Continued increases in Lita, Nia-Nia, Mangala, and Fataki indicate sustained transmission within the Ituri epicentre, while ongoing transmission in Katwa and Butembo confirms persistent transmission in North Kivu. 

    Continued increases in Isiro and Wamba further indicate that the outbreak is becoming increasingly established in Haut-Uélé Province.  

    Mortality remained concentrated within the same transmission corridor driving the epidemic. 

    More than half (55.4%) of all confirmed deaths continue to occur outside designated treatment facilities, indicating that many patients are still being detected only late in illness or after death. 

    Delayed case detection and delayed access to specialised treatment therefore remain major contributors to mortality. 

    Recent analyses indicate a median interval of eight days from symptom onset to death, with almost half of deaths occurring within the first week of illness, emphasizing the narrow window available for life-saving clinical intervention.  

(...)

    Children younger than five years continue to experience disproportionately high mortality. 

    Although they account for fewer than one in ten confirmed cases nationally, they represent approximately 17% of all confirmed deaths, experience the highest case fatality ratios of any age group, and have the shortest interval between symptom onset and death. 

    Conversely, adults aged 20 – 59 years continue to account for most transmission, representing nearly two-thirds of confirmed cases. These findings suggest that outbreak control should continue to prioritise interrupting transmission among working-age adults while simultaneously strengthening rapid identification and referral of young children to reduce mortality. 

(...)

    Surveillance performance remains suboptimal. As of 2 August 2026, 18,276 contacts were under follow-up nationally, of whom 14,466 (79.2%) were successfully seen during the previous 24 hours, remaining well below the operational target of 95%. 

    Contact tracing capacity continues to lag behind the growing number of contacts to follow, particularly in Ituri and North Kivu, while persistently low follow-up rates and intermittent reporting in Haut-Uélé and Tshopo limit interpretation of recent trends.  

(...)

    Since the beginning of the outbreak, the Democratic Republic of the Congo has reported 3,802 confirmed cases, including 1,707 confirmed deaths, corresponding to a crude CFR of 44.9%. 

    The outbreak now affects 51 health zones across five provinces. Ituri Province remains the epicentre, accounting for 3,317 confirmed cases (87.2%) and 1,382 confirmed deaths (81.0%) nationwide. 

    The most affected health zones remain Bunia (914 cases, 270 deaths), Rwampara (655 cases, 263 deaths), Mongbwalu (552 cases, 263 deaths), Nizi (402 cases, 194 deaths), Lita (141 cases, 84 deaths), and Nyankunde (115 cases, 34 deaths) in Ituri Province, together with Katwa (186 cases, 122 deaths) and Butembo (87 cases, 69 deaths) in North Kivu Province. Collectively, these health zones account for the overwhelming majority of confirmed cases and deaths reported nationwide. 

(...)

Uganda and France  

    No new cases have been reported in Uganda or France since the previous update. 

    In Uganda, the last confirmed patient was discharged on 16 July 2026, and 17 days have passed without a new confirmed case. 

    All identified contacts have completed the required 21-day follow-up, and no contacts remain under active monitoring. 

    In France, the imported confirmed BVD case reported on 24 June 2026 recovered and was discharged on 4 July 2026 after two consecutive negative PCR test results. 

    No secondary transmission was identified, and all five flight contacts completed their 21-day follow-up without developing symptoms. 

    As of 2 August 2026, 29 days have passed since the patient's discharge without any additional confirmed BVD cases being reported from France. 

    Despite the absence of new cases, Uganda remains at high risk of reintroduction because of the ongoing outbreak in the neighbouring Democratic Republic of the Congo. 

Risk Assessment 

    The overall public health risk in the Democratic Republic of the Congo remains very high. The outbreak continues to expand, with sustained transmission, persistently high mortality, and continued spread to newly affected health zones. 

    Transmission remains concentrated within the Bunia–Rwampara–Mongbwalu–Nizi corridor, while ongoing spread in Haut-Uélé and Tshopo indicates progressive geographic expansion beyond the original epicentre. 

    The risk of further national and international spread remains high because transmission continues along major internal and cross-border mobility corridors linking the outbreak to Uganda, South Sudan, and other neighbouring countries. 

    Although Uganda and France have reported no additional cases since their previous imported events, sustained transmission in eastern Democratic Republic of the Congo continues to pose a significant risk of crossborder spread. Continued cross-border surveillance, rapid information sharing, and preparedness remain essential to ensure early detection and rapid containment of any imported cases. 

(...)

Situation interpretation 

    The BVD outbreak in the Democratic Republic of the Congo remains in an expansion phase despite an increasingly robust response. 

    Persistently high mortality, frequent community deaths, delayed case detection, and suboptimal contact tracing continue to sustain transmission, while weak infection prevention and control in health facilities contributes to ongoing healthcare-associated transmission. 

    Although response capacity has expanded substantially, including laboratory services, case management, logistics, and regional preparedness, further progress will depend on rapidly improving early case detection, achieving high-quality contact tracing, strengthening infection prevention and control, reducing community deaths through earlier access to treatment, and maintaining coordinated crossborder preparedness to prevent regional and international spread. 

Source: 

Link: https://www.afro.who.int/countries/uganda/publication/ebola-bundibugyo-virus-disease-outbreak-democratic-republic-congo-5

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An imported case of #Bundibugyo virus #infection, #France, June 2026

 

Abstract

In June 2026, an intensive care physician deployed in the Democratic Republic of the Congo and previously vaccinated against Ebola virus developed fatigue, nausea and headaches while returning to France. Bundibugyo virus was identified with RT-PCR. The patient was treated with remdesivir and recovered fully. Contact tracing identified five low-risk contacts and no secondary cases. Stringent infection prevention and control measures and multidisciplinary collaboration are important when managing suspected or confirmed Ebola disease cases, even with low viral loads.

Source: 

Link: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.31.2600627?emailalert=true#abstract_content

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Transient #Andes #orthohantavirus #RNA #detection in an asymptomatic #healthcare worker following indirect exposure during hospital care of an imported case, the #Netherlands, 2026

 

Abstract

Following an outbreak of Andes hantavirus (ANDV) infections on a cruise ship in May 2026, a healthcare worker not directly involved in caring for an imported ANDV case in the Netherlands had a single low-positive ANDV PCR result. The healthcare worker remained asymptomatic, showed no seroconversion, and all subsequent samples tested negative. We describe a retrospective investigation, including detailed reconstruction of potential transmission routes. Our finding may indicate that asymptomatic ANDV infections with low-level viraemia can occur after indirect exposure.

Source: 

Link: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.31.2600580?emailalert=true#abstract_content

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A cohort study of persons exposed to highly pathogenic avian #influenza #H5N1 at premises with infected #animals, #England, 2023 to 2025

 

Abstract

BACKGROUND

The ongoing panzootic of highly pathogenic avian influenza A(H5N1) presents a risk to human health both from infections resulting from exposure to infected birds or mammals, and from potential mutations enabling human-to-human transmission of a virus to which there is little or no population immunity.

AIM

This cohort study was designed with the aim of informing assessments of the risk of avian influenza to human health and the public health management of influenza A(H5N1) exposures.

METHODS

We recruited 428 individuals at 34 highly pathogenic avian influenza A(H5N1) outbreak sites between April 2023 to March 2025, throughout England. Through nasopharyngeal samples and questionnaires, we investigated risk factors including exposure periods and usage of personal protective equipment (PPE), and characteristics of influenza A(H5N1) infection.

RESULTS

The median participant age was 37 years (interquartile range: 28–51 years), 296 (69%) were male. Most participants (85%) reported full PPE use when exposed, and 82 (19%) were vaccinated against seasonal influenza. Six persons tested PCR-positive for influenza A(H5N1), of whom three (< 1%) met the case definition for infection (two confirmed, one unclear) attributable to exposure periods. No severe illness was reported; no secondary cases were identified. None of the six cases with positive detections were vaccinated against seasonal influenza; two of them reported not wearing full PPE when exposed.

CONCLUSION

We recommend continued conscientious PPE use and the resumption of enhanced surveillance following detection of an increased risk of animal-human transmission, with a One Health focus, to mitigate pandemic risk of influenza A(H5N1).

Source: 

Link: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.31.2500906?emailalert=true#abstract_content

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

 

{Click on Image to Enlarge}

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By Bengt Nyman from Vaxholm, Sweden - Mergus merganser merganser 2078, CC BY 2.0, https://commons.wikimedia.org/w/index.php?curid=49877622

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In accordance with the WOAH Terrestrial Animal Health Code, Article 10.4.1, point 4, this outbreak does not change the disease status of Sweden as wild birds or birds kept in a single household do not fall within the WOAH definition of poultry.

A Common Merganser was found dead. It was sent to the Swedish Veterinary Agency for laboratory analysis as part of the national surveillance program for avian influenza.

Source: 

Link: https://wahis.woah.org/#/in-review/7750

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Heterologous prime-boost #vaccination against #H5 avian #influenza: Safety and immunogenicity of a MF59-adjuvanted, cell-culture derived #H5N6 vaccine

 

ABSTRACT

With increasing H5 avian influenza cases reported globally and the potential for pandemic emergence, induction of cross-reactive antibody responses may represent an important attribute of an effective vaccine. This phase 2 extension study evaluated immunogenicity and safety of MF59-adjuvanted, cell culture-derived H5N6 vaccine (aH5N6c) in adults primed with MF59-adjuvanted, cell culture-derived H5N1 vaccine (aH5N1c) and in unprimed adults. Adults previously primed with two doses of aH5N1c in the parent study V89_18 were randomized to receive two aH5N6c doses (Group 1) or one aH5N6c and one placebo (Group 2) 3 weeks apart. Unprimed adults received two aH5N6c doses (Group 3). Immunogenicity was assessed by hemagglutination inhibition (HI) and microneutralization (MN) assays against the priming (H5N1) and booster (H5N6) strains on Days 1, 8, 22, 43, and 202. Among 258 exposed participants, primed subjects (Groups 1 and 2) showed higher HI geometric mean titers against both strains than unprimed (Group 3) subjects, with MN responses similarly enhanced. Heterologous H5N1 responses were robust in primed subjects (Day 43 HI GMTs: 333–343; seroconversion rates >89%) but minimal in unprimed subjects, with responses persisting to Day 202. Solicited adverse events were mild or moderate, comparable between groups, and consistent with other MF59-adjuvanted pandemic vaccines; no vaccine-related serious adverse events occurred. Heterologous H5N6 booster vaccination in H5N1-primed adults elicited strong cross-reactive immunity against the priming strain, demonstrating long-lasting immune memory for at least 6 y and supporting heterologous prime-boost strategies for pandemic preparedness against emerging H5 outbreaks.

Source: 

Link: https://www.tandfonline.com/doi/full/10.1080/21645515.2026.2712791

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Accelerating #biomass loss from #forest disturbances across #Europe

 

Abstract

Forest disturbances are rising globally due to climate change and land-use pressures, weakening the terrestrial carbon sink. However, declines in aboveground biomass from tree cover loss remain poorly quantified, limiting our understanding of the role of disturbances in global carbon dynamics. Here we present a spatially explicit estimate of aboveground biomass losses from natural disturbances and harvest across Europe’s 216 million hectares of forests, using satellite remote sensing. From 1985 to 2023, gross aboveground biomass losses totalled 6.5 ± 0.8 Pg. Of these, 18% were caused by high-severity natural disturbances, whereas stand-replacing harvests accounted for 82%. From 2018 onward, aboveground biomass losses increased by 46% reaching annual values unprecedented in the preceding four decades. This acceleration coincided with high natural disturbance activity in biomass-rich temperate forests. After 2018, the sensitivity of aboveground biomass loss to disturbance area increased substantially, suggesting that even small increases in natural disturbances can result in large losses. As climate-driven natural disturbances intensify, we thus expect sustained aboveground biomass losses across Europe, despite policies to enhance the forest carbon sink until 2030.

Source: 

Link: https://www.nature.com/articles/s41561-026-02032-y

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Virus #reactivation in acute and long #COVID19

 

Abstract

Chronic viral infections are ubiquitous in humans, with individuals carrying multiple viruses that can reactivate during physiological stress, including severe illness1. Notably, SARS-CoV-2 infection has been shown to reactivate chronic viruses such as Epstein–Barr virus and cytomegalovirus, yet the full extent, temporal dynamics and immunological impact of viral reactivation in COVID-19 remain incompletely understood. Here, leveraging multi-omic longitudinal data from 1,154 hospitalized patients with COVID-19 from the Immunophenotyping Assessment in a COVID-19 Cohort (IMPACC) study, we reveal significant reactivation of Herpesviridae and Anelloviridae during acute COVID-19, with distinct temporal dynamics for different viruses, and demonstrate that reactivation correlates with disease severity, host immune effects and clinical outcomes. Although our results do not establish causation between virus reactivation and clinical outcomes, we highlight the prevalence of chronic viral reactivation during acute COVID-19 and long COVID. Our findings challenge the prevailing view that chronic viral reactivation is primarily a consequence of immunosuppression, demonstrating that reactivations occur frequently in immunocompetent individuals during severe illness and in association with increased systemic inflammation. Additionally, we demonstrate persistence of viral reactivation in convalescence, and report an association of Anelloviridae with long COVID. This study provides immune, transcriptomic and metabolomic signatures of viral reactivation that could inform future strategies to prognosticate and treat acute COVID-19 and long COVID.

Source: 

Link: https://www.nature.com/articles/s41586-026-10740-z

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

 

A wild Canada Goose in the Etelä-Suomen aluehallintovirasto Region.

Source: 

Link: https://wahis.woah.org/#/in-review/7748

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The relationship between #plasma #favipiravir concentrations and #clinical #outcomes in #COVID19

 

Abstract

Background

Favipiravir has shown efficacy against SARS-CoV-2 in patients <60 years old, but data linking plasma concentrations to clinical outcomes are limited. This study investigated whether favipiravir plasma concentrations influence clinical efficacy and outcomes in patients hospitalised with COVID-19. The main research question was, How can antiviral dosing strategies be optimised to improve pandemic preparedness and treatment efficacy?

Methods

Adult participants were drawn from the PIONEER trial, in which patients received oral favipiravir (1800 mg twice daily for 1 day, then 800 mg twice daily for 9 days) plus standard care. This analysis included patients with confirmed COVID-19 and ≥75% study adherence. Samples were collected between days 5 and 10 post-treatment initiation. The primary outcome was time to clinical improvement. Secondary outcomes included achievement of clinical improvement and mortality risk.

Results

Out of 140 patients (50% male; mean±sd age 59.5±14.8 years), target plasma concentrations were reached in 29 (21%). Mean time to improvement was 7.7±5.9 days in target achievers versus 9.1±7.2 days in non-achievers (p=0.26). The target was more often achieved in female (34%) than male (7%) participants (p=0.0002). Plasma concentration inversely correlated with body mass index (r= –0.4, p<0.0001), and with lower body mass index in achievers (26.0±5.1 kg·m−2 versus 30.5±6.9 kg·m−2, p=0.003). Alkaline phosphatase and alanine aminotransferase levels were also lower in achievers (p=0.004 and p=0.02, respectively).

Conclusion

Most patients did not reach target favipiravir levels. Concentrations were influenced by sex, body mass index and liver function, confirming the need for pharmacokinetically guided dosing and therapeutic monitoring to optimise antiviral efficacy in future pandemic responses.

Shareable abstract @ERSpublications

Plasma favipiravir concentrations vary with sex, BMI and liver function. Concentrations in most patients fail to reach therapeutic levels, highlighting the need for personalised, pharmacokinetically guided dosing to optimise antiviral efficacy in future pandemics. https://bit.ly/4a6PvEa

Source: 

Link: https://publications.ersnet.org/content/erjor/12/4/01560-2025

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Avian #Influenza #Report: July 26 – August 1, '26 (Wk 31) (HK CHP, August 4, 2026): Four New #Human #Infection with #H9N2 virus in #China

 

{Excerpt}

(...)

Avian influenza A(H9N2): 

    ° Gansu Province: 

        § A three-year-old girl with onset on July 11, 2026. 

    ° Jiangsu Province: 

        § A 12-year-old boy with onset on July 6, 2026. 

    ° Jiangxi Province: 

        § A 72-year-old woman with onset on July 5, 2026. 

    ° Yunnan Province: 

        § A 58-year-old woman with onset on July 13, 2026. 

(...)

Source: 

Link: https://www.chp.gov.hk/files/pdf/2026_avian_influenza_report_vol22_wk31.pdf

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Congolese #hospital #staff cohort admitted with infectious symptoms in the setting of the #Bundibugyo virus #outbreak, April and May 2026, Bunia, #DRC

 

{Excerpt}

On May 15, 2026, DR Congo announced an outbreak of Ebola disease caused by a new variant of Bundibugyo virus in Ituri Province.1 The outbreak's epicentre was Mongbwalu, a gold mining town located 80 km from Bunia, Ituri's capital. In the 2 weeks before this announcement, Centre Medical Evangelique's Centre Hospitalier de Bunia (CME-Bunia), had received 11 patients from Mongbwalu, 63% of whom eventually died. Most had fever, diarrhoea, and vomiting, and several developed bleeding. Subsequent chart review has shown similar cases arriving as early as April 2.

(...)

Source: 

Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00420-2/fulltext?rss=yes

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A One-Shot Multivalent Live-Attenuated Candidate #Influenza #Vaccine against Divergent #Zoonotic #H5N1 Clades

 

Abstract

The continued emergence of genetically diverse high pathogenicity avian influenza (HPAI) H5N1 viruses with zoonotic potential highlights the urgent need for developing vaccines capable of providing broad protection against multiple circulating clades. Here, we developed a one-shot, multivalent, live-attenuated influenza vaccine (LAIV) based on the temperature-sensitive (ts), cold-adapted (ca), and attenuated (att) influenza A/Ann Arbor/6/1960 master donor virus (MDV) that incorporates the hemagglutinin (HA) and neuraminidase (NA) glycoproteins from representative clades 2.3.4.4b (A/Louisiana/12/2024), 2.3.2.1a (A/Victoria/149/2024), and 2.3.2.1e (A/Cambodia/2302009/2023) H5N1 viruses. A single intranasal (IN) immunization of C57BL/6 mice with the multivalent LAIV elicited robust humoral immune responses, with immune sera exhibiting broad cross-reactivity against antigens from all three H5N1 clades included in the vaccine. Following homologous viral challenge, vaccinated C57BL/6 mice were completely protected from disease, demonstrating the immunogenicity and protective efficacy of the multivalent LAIV. By simultaneously targeting antigenically distinct H5N1 lineages with pandemic potential, this strategy expands antigenic coverage within a single LAIV to confirm pan-H5N1 protection. Together, these findings support the development and implementation of this multivalent LAIV as a broadly protective pan-H5N1 LAIV for pandemic preparedness.

Competing Interest Statement

The A.G.-S. laboratory has received research support from Avimex, Dynavax, Pharmamar, and Accurius, outside of the reported work within the last three years. A.G.-S. has consulting agreements for the following companies involving cash and/or stock within the last three years: Castlevax, Amovir, Vivaldi Biosciences, Contrafect, Avimex, Pagoda, Accurius, Applied Biological Laboratories, Pharmamar, CureLab Oncology, CureLab Veterinary, Virofend, Prosetta and A.A.C.T., outside of the reported work. A.G.-S. has been an invited speaker in meeting events within the last three years organized by Seqirus, Novavax and Hipra. A.G.-S. is inventor on patents and patent applications on the use of antivirals and vaccines for the treatment and prevention of virus infections and cancer, owned by the Icahn School of Medicine at Mount Sinai, New York, outside of the reported work. The Icahn School of Medicine at Mount Sinai has licensed some of these inventions to Medimmune, Avimex, Leinco Technologies, Castlevax, Virofend, Kerafast, Cell Signaling, EMD Millipore, Genentech, Paratus and Nura Bio, and as a result receives financial compensation. Subject to Mount Sinai receiving such financial consideration, AG-S will receive a portion of that consideration pursuant to the terms of the Mount Sinai Intellectual Property Policy. All other authors declare no commercial or financial conflict of interest.

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.08.02.742385v1

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#WHO TAG-VE #Risk #Evaluation for #SARS-CoV-2 #Variant Under Monitoring: PQ.16.1.1 (WHO, Accesed on August 4 '26)

Executive Summary 

    PQ.16.1.1, an NB.1.8.1-descendent SARS-CoV-2 lineage, has been designated a variant under monitoring (VUM) with increasing proportions globally, driven largely by detections in the Western Pacific Region, particularly Singapore. 

    Considering the available evidence, the additional public health risk posed by PQ.16.1.1 is evaluated as low at the global level. 

    Its mutation profile may confer additional immune escape, although direct phenotypic evidence is currently limited. 

    Available surveillance does not indicate increased clinical severity compared with other circulating variants, and existing vaccines are expected to continue providing protection against severe disease. 

Initial Risk Evaluation of PQ.16.1.1, 27 July 2026 

    PQ.16.1.1 is a descendant of the Omicron JN.1-derived lineage NB.1.8.1, with the earliest available sequence collected on 25 March 2026. 

    Compared with NB.1.8.1, PQ.16.1.1 has the additional Spike substitutions D253G, N417T, D420N and I478T, together with Nucleocapsid T135I and ORF8 G8E [1]. 

    PQ.16.1.1 is one of seven VUMs tracked by the WHO and was designated as a VUM on 27 July 2026. 

    The parent lineage NB.1.8.1 has demonstrated robust soluble human ACE2 engagement and pseudovirus infectivity, with only marginal additional immune evasion compared with LP.8.1 [2,3]. 

    Preliminary PQ.16.1.1-specific data indicate that its receptor-binding domain binds human ACE2 with significantly lower affinity than that of NB.1.8.1 (KD: 16.5 nM versus 8.22 nM). 

    Consistent with this, soluble human ACE2 showed reduced neutralization of PQ.16.1.1 pseudoviruses compared to NB.1.8.1 (IC50: 0.22 µg/mL versus 0.17 µg/mL). 

    Neutralizing antibody titres against PQ.16.1.1 and NB.1.8.1 were broadly similar in plasma from individuals with prior Omicron exposure. 

    In plasma from Wuhan-Hu-1-primed individuals, titres against PQ.16.1.1 were modestly lower than those against NB.1.8.1. 

    PQ.16.1.1 also showed substantially reduced susceptibility to class 1 RBD-targeting monoclonal antibodies. 

    These preliminary findings suggest that the growth of PQ.16.1.1 is unlikely to be explained by enhanced ACE2 receptor binding alone and may instead be partly related to escape from specific antibody classes [4]. 

    As of 8 July 2026, 457 PQ.16.1.1 sequences with collection dates through epidemiological week (EW) 25 had been submitted to GISAID from eight countries [1]. 

    Of these, 438 (95.8%) were from the Western Pacific Region (WPR), including 388 (84.9% of the global total) from Singapore. 

    The remaining sequences were reported from Hong Kong SAR (34), Australia (10), the United States of America (10), Canada (8), the Republic of Korea (5), France (1) and Taiwan, China (1). 

    No PQ.16.1.1 have been reported from the African (AFR) and Eastern Mediterranean (EMR) Regions. 

    Globally, the proportion of PQ.16.1.1 among available sequences increased from 2.7% in EW 18 to 29.6% in EW 25, Table 1. 

    Over the same period, its proportion increased from 5.4% to 39.3% in WPR. In the Region of the Americas, PQ.16.1.1 represented 6.4% of available sequences in EW 25, although this estimate was based on only three of 47 sequences. 

    Singapore reported an increase from 12.6% in EW 18 to 55.1% in EW 25. In Hong Kong SAR, the proportion increased from 20.0% to 66.7%, with fluctuations, but the EW 25 estimate was based on four of six sequences submitted that week. In Singapore, sentinel SARS-CoV-2 test positivity increased rapidly from 6.5% in EW 16 to a peak of 19.8% in EW 19. Test positivity remained elevated through EW 22 before declining through EW 25. 

    The timing and magnitude of the increase were consistent with the seasonal pattern observed in 2024 and 2025. 

    Compared with 2025, however, the period of elevated test positivity was shorter, with a more rapid decline following the peak. 

    No case or death data were reported to WHO during the reporting period [5]. 

(...)

    WHO and its Technical Advisory Group on Virus Evolution (TAG-VE) continue to recommend that Member States prioritize specific actions to address the remaining uncertainties concerning PQ.16.1.1: 

        • Confirm the preliminary neutralization findings using live-virus and pseudovirus assays with contemporary human sera representative of affected populations and varied vaccination and infection histories. 

        • Undertake comparative studies of cell entry, replication, fusogenicity and Spike processing in the complete PQ.16.1.1 genetic background. 

        • Conduct comparative evaluations of hospitalization, intensive-care admission and death, controlling for age, prior immunity, comorbidities and time since vaccination or infection. 

        • Assess the performance of antigen-based and molecular diagnostic assays and determine phenotypic susceptibility to available direct-acting antivirals. 

    WHO and its Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC) continue to assess the impact of SARS-CoV-2 evolution on the performance of COVID-19 vaccines. 

    In its May 2026 recommendation, WHO TAG-CO-VAC advised the use of monovalent LP.8.1 as a COVID-19 vaccine antigen, while noting that other antigens, including XFG or NB.1.8.1, could also be used if they demonstrate broad and robust neutralizing-antibody responses or effectiveness against circulating variants. 

    Vaccination should not be delayed in anticipation of access to vaccines containing an updated antigen, and populations at highest risk of severe disease remain the priority [6]. 

    No PQ.16.1.1-specific vaccine-effectiveness estimates are currently available. 

    The risk evaluation below follows the published WHO framework for risk evaluation of SARS-CoV-2 variants [7] and is based on evidence available as of 21 July 2026. 

    This risk evaluation should be revised as additional epidemiological, phenotypic and clinical evidence becomes available. 

(...)

References  

{1} Khare, S.; Gurry, C.; Freitas, L.; Schultz, M.B.; Bach, G.; Diallo, A.; Akite, N.; Ho, J.; Lee, R.T.C.; Yeo, W.; et al. GISAID’s Role in Pandemic Response. China CDC Wkly. 2021, 3, 1049–1051, doi:10.46234/ccdcw2021.255. 

{2} Guo, C.; Yu, Y.; Liu, J.; Jian, F.; Yang, S.; Song, W.; Yu, L.; Shao, F.; Cao, Y. Antigenic and Virological Characteris cs of SARS-CoV-2 Variants BA.3.2, XFG, and NB.1.8.1. Lancet Infect. Dis. 2025, doi:10.1016/S1473-3099(25)00308-1. 

{3} WHO World Health Organiza on Technical Advisory Group on COVID-19 Vaccine Composition: Statement on the Antigenic Compositon of COVID-19 Vaccines 15 May 2025. 

{4} He, P.; Song, Y.; Guo, C.; Yu, L.; Yu, Y.; Jian, F.; Shao, F.; Cao, Y. Antibody Evasion and Receptor Binding of SARS-CoV-2 Variants PQ.16.1.1 and RK.1. 2026, doi:10.64898/2026.07.21.739818. 

{5} World Health Organiza on WHO COVID-19 Dashboard 2026. 

{6} WHO World Health Organiza on Technical Advisory Group on COVID-19 Vaccine Composition: Statement on the Antigen Composition of COVID-19 Vaccines 16 May 2026. 

{7} World Health Organiza on SARS-CoV-2 Variant Risk Evaluation, 30 August 2023; World Health Organization: Geneva, 2023; 

{8} Planas, D.; Staropoli, I.; Michel, V.; Lemoine, F.; Dona , F.; Prot, M.;Porrot, F.; Guivel-Benhassine, F.; Jeyarajah, B.; Brisebarre, A.; et al. Distinct Evolution of SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 Lineages Combining Increased Fitness and An body Evasion. Nat. Commun. 2024, 15, 2254, doi:10.1038/s41467-02446490-7. 6  

Source: 

Link: https://cdn.who.int/media/docs/default-source/documents/epp/tracking-sars-cov-2/21072026_pq1611_ire.pdf?sfvrsn=5d73f0b_4#:~:text=Considering%20the%20available%20evidence%2C%20the,profile%20may%20confer%20additional%20immune

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#Taiwan, Citizens Urged to Get Vaccinated against #COVID19 as epidemic intensified (CDC, Aug. 4 '26): PQ.16.1.1 dominant variant

 

    The Centers for Disease Control (CDC) stated today (August 4th) that the domestic COVID-19 epidemic continues to rise and is in its epidemic period. 

    The CDC urges the public not to let their guard down and to take good self-protection measures, including frequent handwashing; wearing masks when entering and exiting medical care facilities, taking public transportation, and going to crowded indoor places; if experiencing fever or respiratory symptoms, it is recommended to stay home as much as possible and avoid unnecessary outings, remembering to wear a mask when going out; those who have not yet been vaccinated should get vaccinated as soon as possible; and those with other risk factors for severe illness should seek medical attention immediately if they experience suspected symptoms, so that doctors can diagnose and treat them early and prescribe antiviral drugs, reducing the risk of severe complications or death after infection.

    According to CDC monitoring data, the domestic COVID-19 epidemic is rising. In the 30th week (July 26th - August 1st), there were 18,990 outpatient and emergency room visits for COVID-19, an increase of 74.8% compared to the previous week (July 19th - July 25th); last week (July 28th - August 3rd), there were 62 new local severe cases and 3 local deaths. 

    Since October 2025, there have been a total of 265 local cases of COVID-19 complicated by severe illness, of which 28 have died. 

    The majority of severe cases are among those aged 65 and above (74.0%) and those with a history of chronic diseases (85.3%). 

    89.1% of these cases have not been vaccinated this season. 

    In the past four weeks, the predominant variant strain in local cases is PQ.16.1.1. 

    The global positivity rate is trending upward, with the US and Europe showing a slight increase from their lows, while Southeast Asia and the Western Pacific are at a plateau. 

    The epidemic continues to rise in China, the US, and the UK; the epidemic is declining weekly in Hong Kong, Japan, and Thailand. 

    Recently, the predominant global variant strains are NB.1.8.1, XFG, and JN.1.

    The Centers for Disease Control (CDC) points out that as of August 2, 2026, approximately 1.772 million COVID-19 vaccinations have been administered this season, with vaccination rates among those aged 65 and above at 21.12% for the first dose and 0.78% for the second dose. 

    Taiwan has approximately 165,000 doses of COVID-19 vaccine in stock. 80,550 doses were allocated to various counties and cities for vaccination on July 30th, and an additional 45,000 doses are expected to be distributed on August 6th based on demand. 

    Those wishing to be vaccinated are reminded that the expanded vaccination program has been extended to September 28th; please take advantage of this period to get vaccinated. 

    If you experience COVID-19 related symptoms such as sore throat, cough, nasal congestion, runny nose, fever, fatigue, headache, and muscle aches, you can first use a home rapid test kit for self-testing and then seek medical attention as soon as possible, or go directly to a clinic for a medical rapid test. 

    On holidays, you can also visit the Sunday and National Holiday Emergency Care Center (UCC) for evaluation, rapid testing, and antiviral medication. 

    The Centers for Disease Control (CDC) reminds the public that frequent travel during the summer holidays increases the risk of virus transmission and urges everyone not to be complacent and to strictly implement personal protective measures such as frequent handwashing, wearing masks, and vaccination. 

    For information regarding COVID-19 vaccination sites, contracted hospitals for publicly funded oral antiviral drugs, and the latest epidemic prevention policies, please visit the "COVID-19 Prevention Zone" on the Taiwan Centers for Disease Control and Prevention's website (https://www.cdc.gov.tw) or call the toll-free epidemic prevention hotline 1922 (or 0800-001922). 

    Information regarding home-use rapid COVID-19 test kits can be found on the Food and Drug Administration's "Home-use Novel Coronavirus Test Kit Supply Information Zone" (https://reurl.cc/XxWbbM), or purchased from nearby pharmacies, convenience stores, or other retail outlets.

Source: 

Link: https://www.cdc.gov.tw/Bulletin/Detail/lFK7neXKyk54GdPYg_hNDg?typeid=9

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Structural and functional characterization of a conserved cryptic #epitope on #SARS-CoV-2 #spike S2 subunit

 

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has undergone extensive evolution since its emergence in 2019, underscoring the continuous need for vaccines and therapeutics effective against multiple variants of concern (VOCs). The S2 subunit of the viral spike (S) glycoprotein is highly conserved among sarbecoviruses, making it an attractive target for broadly protective countermeasures. To elucidate the S2 antigenic landscape, we employed yeast surface display to isolate S2-targeted antibodies from COVID-19 convalescent donors. Biophysical characterization revealed that these S2 apex-directed antibodies preferentially bind to open spike conformations and a stabilized S2 construct but not to the closed, trimeric prefusion spike. Cryo-electron microscopy structures defined a cryptic epitope encompassing the upper helix and fusion peptide proximal region on S2. This epitope is conserved among sarbecoviruses but remains largely occluded in the closed prefusion conformation of the spikes. As a result, the antibodies exhibited weak neutralization activity against SARS-CoV-2 pseudoviruses, failed to neutralize authentic viruses, and did not provide protection in a lethal mouse challenge model using a mouse-adapted SARS-CoV-2 strain. These findings highlight a non-neutralizing epitope on S2 capable of eliciting antibodies during SARS-CoV-2 infection in humans and provide valuable reagents for probing S2 conformational dynamics and optimizing S2-based vaccine antigens.

Source: 

Link: https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1014391

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