#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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#BUNDIBUGYO VIRUS DISEASE #OUTBREAK, #DRC, #Uganda, #France - Situation #Report 11, as of 26 July 2026 (WHO, summary): 3262 cases & 1437 deaths in DRC

 

{Excerpts}

(...)

{Click on Image to Enlarge}

___

Event description  

    ° The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo continued to intensify during the reporting period, with sustained transmission, increasing mortality, and ongoing geographic expansion within the country. 

    ° The cumulative number of reported cases has exceeded the two previously documented Bundibugyo virus disease outbreaks, making this the largest outbreak caused by the Bundibugyo virus to date. 

    ° Although no new cases have been reported outside the Democratic Republic of the Congo, persistent transmission in areas connected by major national and cross-border mobility corridors continues to sustain a high risk of regional spread. 

    ° These epidemiological trends underscore the need for strengthened surveillance, cross-border collaboration, and preparedness to rapidly detect and contain any international spread. 

(...)

Situation interpretation 

    ° The BVD outbreak in the Democratic Republic of the Congo continues to intensify despite the ongoing scale-up of response operations. 

    ° The sustained increase in transmission and mortality indicates that the outbreak remains uncontrolled. 

    ° Although transmission remains concentrated within a number of interconnected health zones, its continued expansion into adjacent areas suggests that current interventions have not yet been sufficient to reduce transmission intensity or halt the geographic spread of the outbreak. 

    ° The persistently high proportion of community deaths, suboptimal contact follow-up, and critically weak IPC capacity indicate that many transmission chains continue to be detected too late to prevent onward spread. 

    ° Although no international spread has been reported during the current reporting period, sustained transmission along major domestic and cross-border mobility corridors continues to pose a substantial risk of regional spread. 

    ° Strengthening early case detection, community engagement, IPC, and coordinated cross-border preparedness remains critical to interrupt transmission and reduce the risk of further national and international spread. 

Source: 

Link: https://www.afro.who.int/countries/democratic-republic-of-congo/publication/ebola-bundibugyo-virus-disease-outbreak-3

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#H5N1 #influenza binding and cell entry via #human class II #MHC, and blocking by cross-reactive #antibodies

 

Abstract

Highly pathogenic avian influenza H5N1 clade 2.3.4.4b viruses are currently responsible for a multi-species outbreak affecting wild birds, poultry, numerous mammalian species, and humans. Influenza A viruses typically initiate infection through binding to sialic acid, although select bat and human influenza viruses can also exploit class II major histocompatibility complex (MHC–II) molecules for cell entry. Here we show that emerging H5N1 clade 2.3.4.4b viruses, but not historical H5 lineages, bind human MHC–II HLA-DR and mediate sialic acid-independent cell entry. Hemagglutinin binding to primary human immune cells varies with MHC–II expression and is further shaped by HLA–DR allelic variation, identifying host genetic determinants that may influence susceptibility to infection. Mammalian-adaptive substitutions within the hemagglutinin sialic acid receptor-binding domain reduce MHC–II binding, suggesting this interaction is remodeled during clade 2.3.4.4b H5 adaptation to a human host. Lastly, cross-reactive monoclonal antibodies isolated from clade 2.3.4.4b H5–naive humans can block the hemagglutinin–MHC–II interaction. These findings identify a previously unrecognized receptor pathway in contemporary H5N1 viruses and reveal that both human genetic variation and pre-existing humoral immunity can modulate this interaction, with implications for host range, cellular tropism, spillover risk, and therapeutic intervention.

Competing Interest Statement

S.D.B. has consulted for Regeneron, Sanofi, Novartis, Genentech, Pfizer, Visterra, and Otsuka on topics unrelated to the research presented here; owns stock in AbCellera Biologics; and is a scientific cofounder of Immunera, Inc.; S.E.H reports receiving consulting fees from Sanofi, Pfizer, Lumen, Novavax, and Merck.

Funder Information Declared

NIH/NIAID CEIRR contract, 75N93021C00015

NIH, 1U54CA260517

HIPC, U19AI057266

P01 grant, 5P01AI153559

David Crown Foundation endowment

Early Postdoc Mobility Fellowship Stipend from the Swiss

National Institutes of Health NRSA T32, T32OD011121

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.07.22.739677v1

____

#Taiwan, As the #COVID19 #epidemic escalates, public is urged to get vaccinated as soon as possible (CDC, July 28 '26): 117% rise in cases compared last week

 

    The Centers for Disease Control (CDC) stated today (28th) that the domestic COVID-19 epidemic continues to rise and has entered the epidemic period. 

    In addition, it coincides with the summer vacation travel peak season, which increases the risk of disease transmission. 

    The CDC calls on the public to take precautions such as washing hands frequently, wearing masks, and getting vaccinated. 

    When entering and leaving medical care institutions, in crowded places where it is not possible to maintain an appropriate distance or in poorly ventilated places, or when in close contact with the elderly or people with weakened immune systems, it is recommended to wear masks. 

    If you have a fever or respiratory symptoms, it is recommended to stay at home as much as possible and avoid unnecessary outings. 

    People with severe risk factors should seek medical attention as soon as possible if they have suspected symptoms so that doctors can diagnose and treat them early and prescribe antiviral drugs to reduce the risk of complications or death after infection.

    According to data from the Taiwan Centers for Disease Control (CDC), the COVID-19 epidemic in Taiwan is on the rise. 

    In the 29th week (July 19-25), there were 10,605 outpatient and emergency room visits related to COVID-19, a 117.4% increase compared to the previous week (July 12-18). 

    Last week (July 21-27), there were 42 new locally transmitted severe cases and 2 new locally transmitted deaths. 

    Since October 2025, there have been a cumulative total of 203 locally transmitted cases of COVID-19 complicated by severe illness, with 25 deaths. 

    The majority of severe cases are among those aged 65 and above (73.4%) and those with a history of chronic diseases (83.7%). 

    90.6% of these cases have not received the COVID-19 vaccine this season. 

    In the past four weeks, the most prevalent local variant strain has been NB.1.8.1. 

    Clinical manifestations are mainly upper respiratory symptoms, including sore throat, cough, nasal congestion, runny nose, fever, fatigue, headache, and muscle aches. 

    The global positivity rate has recently risen, with all regions except Southeast Asia and Africa showing an upward trend; neighboring countries/regions such as China, Hong Kong, Japan, and the United States are also experiencing an increase in cases. 

    Currently, the predominant circulating variant globally is NB.1.8.1 (58.76%), followed by XFG (19.07%) and JN.1 (15.46%).

    The Taiwan Centers for Disease Control (CDC) indicated that as of July 26, 2026, approximately 1.742 million COVID-19 vaccinations have been administered this season, with vaccination rates for those aged 65 and above at 21.01% for the first dose and 0.56% for the second dose. 

    Data shows that severe cases in Taiwan are still predominantly among those aged 65 and above and those with a history of chronic diseases, and over 90% of these individuals have not received the COVID-19 vaccine this season. 

    Considering the escalating COVID-19 situation in Taiwan and the recent upward trend in the global positivity rate, the government has extended the expanded government-funded COVID-19 vaccination program until September 28, 2026. 

    Domestic COVID-19 vaccine stocks are sufficient, with 437,000 doses remaining (including approximately 435,000 doses of Moderna vaccine and approximately 2,000 doses of Novavax vaccine). 

    The Novavax vaccine expires on July 31st of this year. Those who have not yet received this season's COVID-19 vaccine are urged to get vaccinated as soon as possible. Furthermore, three high-risk groups—those aged 65 and above, indigenous people aged 55 and above, and those with compromised immune systems—are advised to receive their second dose as soon as possible if they have already received one dose and the interval is 6 months (180 days) to further enhance their protection and effectively reduce the risk of severe illness or death.

    The Centers for Disease Control (CDC) stated that in response to the recent surge in COVID-19 cases, it has comprehensively reviewed and consolidated domestic medical supplies. There are still 168,000 doses of the publicly funded oral antiviral drug Paxlovid and 17,000 doses of Xocova. There are also 153,000 doses of injectable Remdesivir in stock. 

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

    In addition, approximately 630,000 home rapid COVID-19 test kits are available to meet the public's needs. Information can be found on the Food and Drug Administration's "Home COVID-19 Test Kit Supply Information Zone" (https://reurl.cc/XxWbbM), or by visiting pharmacies, convenience stores, or other sales channels.

Source: 

Link: https://www.cdc.gov.tw/Bulletin/Detail/HqTIUKC58EK9fO9AVWU3Cg?typeid=9

____

#BUNDIBUGYO VIRUS DISEASE #OUTBREAK: #DRC, #Uganda, #France - Situation Report No. 10, as of 19 July '26 (WHO, edited): 2423 cases & 967 deaths in DRC

 

(...)

{Click on Image to Enlarge}

___

Event description  

    ° Transmission of Bundibugyo virus disease (BVD) remained intense in the Democratic Republic of the Congo during the reporting week, with continued detection of new confirmed cases and deaths across multiple affected areas, alongside further expansion of the outbreak's geographic footprint. 

    ° The epidemiological situation outside the Democratic Republic of the Congo remained stable, with no new cases or evidence of secondary transmission reported in Uganda or France. 

    ° However, the persistence and geographic expansion of transmission within the Democratic Republic of the Congo continue to increase the risk of cross-border spread, highlighting the need for sustained regional surveillance, preparedness, and response efforts. 

Democratic Republic of the Congo 

    ° Since the last update of 12 July 2026 (Situation Report #9), the epidemiological situation in the Democratic Republic of the Congo has continued to deteriorate, with sustained transmission and ongoing geographic expansion. 

    ° An additional 460 confirmed cases and 248 confirmed deaths have been reported, representing increases of 23.4% and 34.5% in cumulative confirmed cases and confirmed deaths, respectively. 

    ° The crude case fatality ratio (CFR) among confirmed cases increased from 36.6% to 39.9%, likely reflecting delayed case detection, late presentation for care, and the persistently high proportion of deaths occurring outside designated treatment facilities, rather than increased disease severity. 

    ° During the reporting period, the outbreak expanded to five additional health zones across Haut-Uélé and Ituri provinces, increasing the total number of affected health zones from 42 to 47. 

    ° The newly affected health zones were Pawa, Boma Mangbetu, and Isiro in Haut-Uélé Province, and Mahagi and Adja in Ituri Province. 

Figure 1.  Weekly trend of confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo by epidemiological week of report, epidemiological weeks 18 – 29, 2026 

{Click on Image to Enlarge}

___

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

    ° Of the 47 affected health zones, 40 have reported at least one confirmed case during the past 21 days. 

    ° During this period, 1,090 confirmed cases and 568 confirmed deaths were reported. 

    ° Ituri Province continues to bear the overwhelming burden of the outbreak, accounting for 946 cases (86.8%) and 476 deaths (83.8%), while the remaining four affected provinces together accounted for 144 cases (13.2%) and 92 deaths (16.2%). 

    ° In contrast, seven affected health zones have now gone more than 21 consecutive days without reporting a confirmed case, suggesting an absence of recent transmission, provided that surveillance remains sufficiently sensitive to detect ongoing transmission. 

    ° These health zones include Miti-Murhesa (60 days) in South Kivu Province; Aungba (30 days) and Gety (59 days) in Ituri Province; and Goma (55 days), Kalunguta (56 days), Mabalako (36 days), and Vuhovi (38 days) in North Kivu Province. 

    ° Recent transmission remained highly concentrated in a limited number of health zones. 

    ° The largest increases over the 21-day period were recorded in Bunia (281 cases), Nizi (173), Rwampara (155), Mongbwalu (105), Katwa (59), Lita (49), Nia-Nia (40), Mangala (37), and Bambu and Butembo (24 each). Together, these ten health zones accounted for approximately 86.9% of all additional confirmed cases reported during the period. 

    ° Bunia, Rwampara, Mongbwalu, and Nizi remained the principal transmission corridor. 

    ° The rapid increase in cases in Nizi, a health zone hosting several internally displaced persons (IDP) camps, together with the emergence of cases in Adja Health Zone, indicates continued westward and northward expansion of transmission within Ituri Province. 

    ° Mortality was similarly concentrated. The largest increases in confirmed deaths over the same 21-day period were reported in Bunia (129 deaths), Nizi (84), Mongbwalu (80), Rwampara (73), Katwa (45), Mangala (26), Lita (18), Butembo (16), Nyankunde (13), and Beni (11). 

    ° Collectively, these ten health zones accounted for approximately 87.0% of all additional confirmed deaths reported during the period. 

(...)

    ° Overall, the distribution of confirmed deaths remained heavily skewed towards deaths occurring outside designated treatment centres, highlighting persistent delays in case detection, referral, and access to treatment. 

    ° Between 24 June and 19 July 2026, 673 confirmed deaths were reported, of which 400 (59.4%) occurred outside designated treatment centres and 273 (40.6%) occurred within designated treatment centres. 

    ° During the most recent reporting week (13 – 19 July 2026), mortality remained high, with community deaths (defined as deaths occurring outside designated treatment centres) accounting for 65.4% of all reported deaths, compared with 34.6% occurring within designated treatment centres. 

    ° This persistent predominance of community deaths suggests that delays in case detection, referral, and timely access to treatment continue to contribute substantially to mortality and underscore the need to strengthen community surveillance, rapid referral, and early access to care. 

    ° Since the beginning of the outbreak, the Democratic Republic of the Congo has reported 2,423 confirmed cases, including 967 confirmed deaths, corresponding to a crude case fatality ratio (CFR) of 39.9%. 

    ° Ituri Province remains the epicentre, accounting for 2,160 confirmed cases (89.1%) and 811 confirmed deaths (83.9%) reported nationally. 

    ° The most affected health zones continue to be Bunia (639 cases, 211 deaths), Rwampara (450 cases, 133 deaths), Mongbwalu (363 cases, 203 deaths), Nizi (214 cases, 93 deaths), Nyankunde (99 cases, 28 deaths), Lita (78 cases, 27 deaths), and Mangala (61 cases, 38 deaths) in Ituri Province, together with Katwa (104 cases, 72 deaths), Butembo (58 cases, 30 deaths), and Beni (37 cases, 25 deaths) in North Kivu Province. 

    ° Collectively, these ten health zones account for approximately 86.8% of all confirmed cases (2,103 of 2,423) and 88.9% of all confirmed deaths (860 of 967) reported nationally, demonstrating that, despite continued geographic expansion, the burden of the outbreak remains highly concentrated. 

(...)

    ° As of 19 July 2026, a total of 10,519 contacts were under follow-up in the Democratic Republic of the Congo, of whom 8,531 (81.1%) were successfully seen within the previous 24 hours. 

    ° Ituri Province accounted for the majority of contacts under follow-up, with 7,537 contacts, including 6,123 (81.3%) successfully seen during the reporting period. 

    ° In North Kivu Province, 1,801 of 2,149 contacts (83.8%) were successfully followed up, while Haut-Uélé Province, one of the newly affected provinces, reported 607 contacts, of whom only 317 (52.3%) were seen within the previous 24 hours. 

    ° South Kivu Province had no contacts under active follow-up, reflecting the absence of recent transmission requiring contact monitoring, whereas contact follow-up data for Tshopo Province were not reported.  

    ° The overall contact follow-up rate remains below the operational target for effective contact tracing. Although follow-up performance in Ituri Province improved slightly compared with previous weeks, more than 1,400 contacts were not reached during the reporting period. The markedly low follow-up rate in Haut-Uélé Province is of particular concern given the recent geographic expansion of the outbreak. These gaps increase the risk of undetected infections, missed chains of transmission, and sustained community transmission in both established and newly affected areas. 

(...)

Uganda  

    ° No new confirmed cases have been reported in Uganda since the previous update. 

    ° The most recent confirmed case, reported on 21 June 2026, was identified in a truck driver travelling along the Democratic Republic of the Congo Uganda international route. 

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

    ° As of 19 July 2026, the outbreak remains limited to 21 cases (20 confirmed and one probable), including three deaths (two confirmed and one probable). 

    ° All 18 recovered patients have now been discharged from care, with the last confirmed patient discharged on 16 July 2026. 

    ° Since the beginning of the outbreak, 836 contacts have been identified, all of whom successfully completed the required 21-day follow-up period, during which six secondary cases were detected. 

    ° No contacts are currently under follow-up, reflecting the absence of active transmission chains.  

    ° Following the discharge of the last confirmed patient on 16 July 2026, Uganda entered the 42-day countdown required to declare the end of the outbreak. As of 19 July 2026, the country was on Day 5 of the countdown. 

    ° Nevertheless, Uganda remains at high risk of reintroduction due to the ongoing outbreak in the neighbouring Democratic Republic of the Congo. 

    ° Continued population movement across the shared border underscores the importance of maintaining cross-border coordination, surveillance, rapid case detection, and response readiness until transmission has been interrupted in both countries. 

Figure 5.  Weekly trends of confirmed cases of Bundibugyo virus disease in Uganda by epidemiological week of report, epidemiological weeks 18 – 29, 2026 

{Click on Image to Enlarge}

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France 

    ° No additional Bundibugyo virus disease (BVD) cases have been reported in France since the previous update. 

    ° No secondary transmission has been identified among the five flight contacts who were placed under precautionary quarantine following exposure to the imported case reported on 24 June 2026. 

    ° All five flight contacts successfully completed the 21-day monitoring period. 

Risk Assessment 

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

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

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

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

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

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

(...)

Situation interpretation 

    ° The BVD outbreak in the Democratic Republic of the Congo continues to intensify despite the ongoing scale-up of response operations. 

    ° Although transmission remains highly concentrated in a limited number of health zones in Ituri Province, continued geographic expansion into Haut-Uélé and Tshopo provinces indicates that new transmission foci continue to emerge. 

    ° Persistently high mortality, driven by the large proportion of deaths occurring outside designated treatment centres, together with a rising CFR, indicates that many patients are still being detected and referred too late to benefit from optimal clinical care. 

    ° While surveillance, laboratory, case management, and operational capacities continue to expand, important gaps remain in contact tracing, infection prevention and control, and community engagement, particularly in newly affected areas. 

    ° Strengthening early case detection, improving contact follow-up, expanding timely access to clinical care, reinforcing infection prevention and control measures in healthcare settings, and sustaining community trust and cross-border preparedness will be critical to interrupt transmission and reduce mortality 

Source: 

Link: https://www.afro.who.int/countries/uganda/publication/ebola-bundibugyo-virus-disease-outbreak-democratic-republic-congo-4

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History of Mass Transportation: The BDŽ class 75 006-7 Diesel Locomotive at Belitsa station (Bulgaria)

 {Click on Image to Enlarge}

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By Reneman - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=32904861

Source: 

Link: https://en.wikipedia.org/wiki/BD%C5%BD_class_75#/media/File:Diesellokomotive_der_Rhodopenbahn_BDZ_Henschel_75006-7_in_Beliza_IMG_5990.jpg

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By the townwall, Caspar David Friedrich (1800)

 

{Click on Image to Enlarge}

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Public Domain.

Source: 

Link: https://www.wikiart.org/en/caspar-david-friedrich/by-the-townwall

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The #Environmental Polycyclic Aromatic Hydrocarbon (PAH) #Benzopyrene (BP) Alters #SARS-CoV-2 #Pathogenesis in a Mouse #Model of Disease

 

Abstract

Since emerging in late 2019, SARS-CoV-2 has caused over 7 million deaths globally and remains a public health concern. Understanding SARS-CoV-2 pathogenesis is vital, especially as factors like environmental exposures are still poorly understood. Polycyclic aromatic hydrocarbons (PAHs), like benzo[a]pyrene (BP), found in pollutants like cigarette smoke, diesel exhaust, and charcoal-broiled steaks, are known to injure the lungs. We aimed to evaluate if BP exacerbates SARS-CoV-2 pathogenesis in a mouse model of disease. One day following intranasal administration of BP (20 mg/kg) or vehicle control, we infected male and female K18-hACE2 mice with ancestral SARS-CoV-2 and assessed lung viral load, weight change, clinical scores, immune cell recruitment, and survival in the presence and absence of BP exposure. We found that BP-exposed mice had decreased survival compared to mock-exposed mice. Additionally, BP did not alter innate or adaptive immune cell populations in the lungs of SARS-CoV-2-infected mice. These findings suggest that PAH exposure exacerbates severe COVID-19 outcomes by unknown mechanisms, highlighting the need to further explore environmental impacts on SARS-CoV-2 infection.

Source: 

Link: https://www.mdpi.com/1999-4915/18/8/823

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