The Gardens of the Villa Medici in Rome, Diego Velazquez (1630)

 

{Click on Image to Enlarge}

___

Public Domain.

Source: 

Link: https://www.wikiart.org/en/diego-velazquez/the-gardens-of-the-villa-medici-in-rome-1630

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Challenges in managing ruptured #ectopic #pregnancy complicated by hemorrhagic #shock in an #Ebola treatment unit in #DRC: first reported case

 

Abstract

Background: 

Ectopic pregnancy (EP) is an obstetric emergency; early diagnosis is critical for maternal survival. In resource-limited settings, such as Ebola treatment units (ETU), delayed diagnosis or management of EP often leads to rupture and life-threatening hemorrhagic shock.

Case presentation: 

We report the case of a pregnant woman in her 30s who was admitted to the ETU with suspected Ebola virus disease in the Democratic Republic of Congo (DRC). Her clinical presentation included fever and abdominal pain, which began 4 days before her admission. Thirteen months earlier, she had recovered from an Ebola infection. At admission, she presented with 8 weeks of amenorrhea and discrete pelvic pain. On vaginal examination, we noted a slightly enlarged uterus and palpated a small left adnexal mass. Laboratory exams confirmed malaria and pregnancy. Her EVD test was negative. Due to the absence of an ultrasound machine in the ETU, pelvic ultrasound was impossible. Supportive treatment was initiated. Nineteen hours after admission, the patient developed an acute surgical abdomen, with progressive left-sided pelvic pain, abdominal distension, and diffuse tenderness. A ruptured ectopic pregnancy was suspected and confirmed by diagnostic abdominal puncture, which revealed hemoperitoneum. She developed hemorrhagic shock. However, the ETU lacked an operating room, surgical equipment, and anesthetic drugs. Transfer to another ETU was not feasible due to the absence of a surgical-capable facility, while transfer to a community facility required at least a second negative EVD test 48 h after the first. We used an unused building that was part of the neighboring health center to perform an explorative laparotomy, which revealed an EP in the left tube with ampullary dislocation and active bleeding. We performed a left salpingectomy and homeostatic sutures. The real-time polymerase chain reaction (RT-PCR) tests for EVD performed at 48 and 72 h were negative. She had a normal postoperative course and was discharged from ETU to the community on the 14th day after surgery.

Conclusion: 

Ruptured ectopic pregnancy (REP) remains a life-threatening obstetric emergency that may occur in ETUs, where resources and treatment conditions are limited. To protect maternal health, ETUs should ensure not only proper care for Ebola infection but also adequate capacity for the timely diagnosis and management of obstetric complications.

Source: 

Link: https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1848720/full

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#Safety, humoral and cellular immune responses to a pre-pandemic adjuvanted #influenza #H5N8 #vaccine

 

Abstract

Highly pathogenic avian influenza (HPAI) A(H5) viruses can be transmitted from infected birds to various mammalian species, including humans. Avian influenza viruses (AIVs), members of the Orthomyxoviridae family, possess segmented RNA genomes prone to reassortment, favoring the emergence of novel genetic traits that may alter transmissibility, pathogenicity, and antigenicity. Although no sustained human-to-human transmission has been reported, the potential adaptation of these viruses poses a significant pandemic threat. This study aimed to evaluate the non-clinical safety, toxicity, and humoral immune responses induced by an adjuvanted H5 influenza vaccine in rats and rabbits, to support future clinical safety trials in humans. Male and female Wistar rats and New Zealand rabbits were observed for 14, 28, and 90 days after receiving two intramuscular doses of the H5N8 vaccine (15 μg HA/dose) formulated with the IB160 oil-in-water emulsion adjuvant. No systemic comorbidities, central nervous system alterations, or relevant clinical signs were observed. Hematological parameters remained within normal ranges, with total and differential leukocyte counts showing only minor fluctuations (<1% of total leukocytes). Mild biochemical variations in urea and hepatic transaminase levels were not correlated with histopathological alterations. The vaccine elicited a robust humoral response soon after immunization, with all groups reaching protective HAI-antibody titers. Although antibody levels declined over time, particularly in males, they remained significantly above baseline, indicating durable immunological memory. Furthermore, the vaccine induced a specific cellular immune response, confirmed by IL-2 and TNF production by antigen-specific T lymphocytes in splenic cell cultures after the booster dose. In conclusion, the H5N8 vaccine with the IB160 adjuvant was well tolerated locally and systemically, without compromising vital organ function. The safety and immunogenicity findings are consistent with expectations for adjuvanted influenza vaccines, demonstrating strong and durable humoral and cellular immune responses.

Source: 

Link: https://www.sciencedirect.com/science/article/abs/pii/S0264410X26008583?via%3Dihub

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History of Mass Transportation: Henschel & Sohn NG Mallet E214 Steam Locomotive with Vouga Historical Train from Aveiro to Macinhata do Vouga, Portugal

 {Click on Image to Enlarge}

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By Nelso Silva from Porto, Portugal - CP E214, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=99684021

Source: 

Link: https://en.wikipedia.org/wiki/Comboios_de_Portugal#/media/File:CP_E214_(50923344792).jpg

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#Coronavirus Disease Research #References (AMEDEO, Sept. 5 '26)

 

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   PubMed         Abstract available
   
   
3. GODWIN P, Shvachko V, Oppelt T, Wang CY, et al
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8. MEZA-FUENTES G, Delgado I, Vial PA, Godoy-Faundez A, et al
   Temporal trends in critical care burden and outcomes of Andes virus-associated hantavirus cardiopulmonary syndrome: a national Chilean cohort.
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10. WALKER JL, Ribeiro S, Litt D, Patel T, et al
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12. HU L, Tian R, Gao L, Xu N, et al
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13. DARNLEY JA, Waller SJ, French RK, Parata R, et al
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    JAMA

14. LIPSON RA, Senerth E, Watson MA, Saini H, et al
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15. SENERTH E, Sheikholeslamian SM, Sivakumaran K, Watson MA, et al
    Influenza Vaccine Effectiveness and Safety for the 2026-2027 Respiratory Season.
    JAMA. 2026 Sep 2. doi: 10.1001/jama.2026.18126.
    PubMed         Abstract available
    
    
16. ROTEN L, Maurhofer J, Krisai P, Breitenstein A, et al
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    PubMed         Abstract available
    
    

    
    Lancet Infect Dis

17. BADEN LR, Shah NS, Liu STH, Cohen J, et al
    Nirmatrelvir-ritonavir targeting viral persistence in post-COVID-19 condition (long COVID) in the USA (RECOVER-VITAL): a randomised, double-blind, placebo-controlled, phase 2 trial.
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    PubMed         Abstract available
    
    

    
    Nature

18. MAKIN S
    When do infections lead to long COVID? Scientists close in on triggers and treatments for post-viral syndromes.
    Nature. 2026;657:26-28.
    PubMed 

#Influenza and Other Respiratory Viruses Research #References (AMEDEO, Sept. 5 '26)

 

Antimicrob Agents Chemother

1. DE ANGELIS M, Gori Savellini G, Piselli E, Anichini G, et al
   Redox-sensitive factors as targets of thiol compounds to hinder SARS-CoV-2 replication and inflammatory response.
   Antimicrob Agents Chemother. 2026;70:e0051826.
   PubMed         Abstract available
   
   
2. JEENA N, Khan IA
   Targeting SARS-CoV-2 programmed -1 ribosomal frameshifting: structural dynamics and RNA-directed antiviral strategies.
   Antimicrob Agents Chemother. 2026;70:e0068726.
   PubMed         Abstract available
   
   
3. AVILA-PONCE DE LEON U, Esmaeili S, Owens K, Schiffer JT, et al
   Plasma concentrations of nirmatrelvir and molnupiravir required for inhibition of SARS-CoV-2 replication differ between rhesus macaques and humans.
   Antimicrob Agents Chemother. 2026 Aug 5:e0030726. doi: 10.1128/aac.00307.
   PubMed         Abstract available
   
   

   
   Antiviral Res

4. PU F, Guo Y, Pan X, Liu X, et al
   Dual-targeting engineered binding proteins block SARS-CoV-2 infection and complement activation.
   Antiviral Res. 2026;254:106515.
   PubMed         Abstract available
   
   
5. YURGELONIS I, Rai DK, Lee JT, Li Z, et al
   Antiviral activity of nirmatrelvir against contemporary SARS-CoV-2 variants.
   Antiviral Res. 2026;254:106517.
   PubMed         Abstract available
   
   

   
   Epidemiol Infect

6. NAQVI OH, Wendelboe AM, Beasley WH, Tyungu DL, et al
   Epidemiological characteristics of paediatric COVID-19 and influenza co-infections in the United States, 2020-2024 - CORRIGENDUM.
   Epidemiol Infect. 2026;154:e111.
   PubMed        
   
   

   
   J Infect Dis

7. ZHAO B, Zhang G, Wu J, Zhang W, et al
   Characterization of bronchiolitis and vaccine-induced enhanced respiratory disease in Syrian hamsters caused by respiratory syncytial virus infection.
   J Infect Dis. 2026 Mar 4:jiag136. doi: 10.1093.
   PubMed         Abstract available
   
   

   
   J Virol

8. BHAVSAR D, Civljak A, Bonnettaz B, Arunkumar GA, et al
   Broadly reactive antibodies against influenza B virus hemagglutinin neutralize and protect through distinct structural mechanisms.
   J Virol. 2026 Sep 4:e0080226. doi: 10.1128/jvi.00802.
   PubMed         Abstract available
   
   
9. LIU D, Zhang Y, Zhang M, Guo R, et al
   A neuraminidase-targeting nanobody as a therapeutic candidate against influenza A and B viruses.
   J Virol. 2026 Aug 31:e0087426. doi: 10.1128/jvi.00874.
   PubMed         Abstract available
   
   

   
   JAMA

10. SENERTH E, Sheikholeslamian SM, Sivakumaran K, Watson MA, et al
    Influenza Vaccine Effectiveness and Safety for the 2026-2027 Respiratory Season.
    JAMA. 2026 Sep 2. doi: 10.1001/jama.2026.18126.
    PubMed         Abstract available
    
    

    
    Pediatrics

11. CHAN OW, Cheng YT, Liu YH, Chou IJ, et al
    Anakinra in Severe RSV-Associated Autoinflammatory Encephalopathy With Delayed ADEM-Like Changes.
    Pediatrics. 2026;158:e2026076364.
    PubMed         Abstract available
    
    
12. PAYNE AB, Battan-Wraith S, Reese SE, Hathaway CA, et al
    Effectiveness of RSV Prevention Strategies in US Infants: 2024-2025.
    Pediatrics. 2026 Aug 4:e2026076089. doi: 10.1542/peds.2026-076089.
    PubMed         Abstract available
    
    
13. MIN J, Tam V, Jacoby SF, McDonald CC, et al
    Community Firearm Violence, Youth Depression, and Suicide Risk in Philadelphia: 2017-2024.
    Pediatrics. 2026;158:e2025075438.
    PubMed         Abstract available
    
    

    
    PLoS Comput Biol

14. FREEDMAN AS, Nielsen BF, Saad-Roy CM, Grenfell BT, et al
    Economic factors promoting vaccine nationalism in the face of viral evolution.
    PLoS Comput Biol. 2026;22:e1014466.
    PubMed         Abstract available
    
    

    
    PLoS Med

15. ELIAS KM, Mitchell A, Stadler E, Schlub TE, et al
    Neutralising antibodies and protection from progression to severe COVID-19: A meta-analysis.
    PLoS Med. 2026;23:e1005230.
    PubMed         Abstract available
    
    

    
    PLoS One

16. ADAMCZYK G, Jablonski A, Nowakowski PT, Ptaszek RT, et al
    Theodicy perspective as an effect of the interpenetration of mental and religious issues during the COVID-19 pandemic in Poland.
    PLoS One. 2026;21:e0355379.
    PubMed         Abstract available
    
    
17. JUNGMANN SM, Garbe Huedo SF, Jacobs KAS, Pothorn NK, et al
    Mental load in women and mothers: Causes of distress, personality traits, and psychopathology.
    PLoS One. 2026;21:e0356255.
    PubMed         Abstract available
    
    
18. MOUNADI N, Nour H, El Kouali M, Samadi A, et al
    Repositioning antiviral phytoconstituents as broad-spectrum inhibitors of influenza A neuraminidase and human metapneumovirus fusion protein.
    PLoS One. 2026;21:e0348517.
    PubMed         Abstract available
    
    
19. HAWKES BA, Hollister J, Porter C, Lyski ZL, et al
    Age-specific humoral immune response to SARS-CoV-2: A comparative analysis of antibody levels in children and adults after vaccination with primary series or infection.
    PLoS One. 2026;21:e0356178.
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20. AVSAR FN, Kilicaslan N, Sahutoglu T
    Comparative associations of Anakinra and Tocilizumab initiation with in-hospital mortality in severe COVID-19: A single-center sequential cohort study.
    PLoS One. 2026;21:e0357671.
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21. SEEGERT N, Gaulin M, Chaiyakunapruk N, Navarro-Sanchez F, et al
    The impact of state- versus county-level mask mandates on economic activity during the COVID-19 pandemic.
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22. HARDY MJ, Williams CK, Ladman BS, Pitesky ME, et al
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23. KOPP J, Spies Rodriguez DC, Kunzi L, Puhan MA, et al
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    PLoS One. 2026;21:e0357465.
    PubMed         Abstract available
    
    

    
    Proc Natl Acad Sci U S A

24. KARADAKIC R, Keating NL, Barnett ML
    Interpreting vaccine-associated survival differences in immune checkpoint inhibitor therapy.
    Proc Natl Acad Sci U S A. 2026;123:e2621501123.
    PubMed         Abstract available
    
    

    
    Vaccine

25. MOHAMMED H, Andraweera P, Marshall HS
    A cohort study to assess the safety and coverage of COVID-19, influenza, and pertussis vaccine in Australian pregnant women.
    Vaccine. 2026;91:129081.
    PubMed         Abstract available
    
    
26. SHEN AK, Tupps C, Bino S, Chipoya M, et al
    Investments in seasonal influenza vaccination programs pack a punch for pandemic preparedness.
    Vaccine. 2026;92:129098.
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27. TRAN S, McClymont E, Blitz S, Barrett J, et al
    Self-reported reactogenicity after COVID-19 vaccination with and without influenza vaccine coadministration during pregnancy in Canada.
    Vaccine. 2026;92:129122.
    PubMed         Abstract available
    
    
28. MARIA DA, Martins IM, Porto GPM, Villas-Boas IM, et al
    Safety, humoral and cellular immune responses to a pre-pandemic adjuvanted influenza A (H5N8) vaccine.
    Vaccine. 2026;92:129049.
    PubMed         Abstract available
    
    
29. ZHENG Y, Qiao B, Gao Z, Zhang X, et al
    Development of a subunit vaccine candidate (RBD-HA trimer) provides dual protection against multi-subtype avian influenza viruses and QX-type infectious bronchitis virus.
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30. KORNUTA CA, Zhou G, Kane KP, Vliagoftis H, et al
    Mucosal adjuvant activity of a PAR-2-activating peptide enhances lymph node immune cell recruitment and promotes immune cell activation in a prime-boost influenza vaccination model.
    Vaccine. 2026;92:129110.
    PubMed         Abstract available
    
    

    
    Virology

31. BROGAARD L, Laybourn HA, Kristensen C, Welner S, et al
    Site-specific microRNA responses in lungs of pigs depend on the host-adaptation of H1N1 influenza A virus.
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    PubMed         Abstract available
    
    
32. SEKINE W, Kamiki H, Ishida H, Matsugo H, et al
    HA1-T138A and HA1-Q226L substitutions in H3N2 canine influenza virus contribute to binding to human-type alpha2,6-linked sialic acid receptors.
    Virology. 2026;625:111071.
    PubMed         Abstract available
    
    
33. OLDENSAND F, Rafati N, Van Hoef V, Lundkvist A, et al
    Single-cell transcriptomic landscape of avian influenza H9N2 virus infection in human and chicken cells.
    Virology. 2026;625:111070.
    PubMed         Abstract available
    

#Phylogenetic analysis of the 2025 #Ebola #outbreak in the #DRC

 

Abstract

On 4 September 2025, the Ministry of Public Health, Hygiene and Social Welfare officially declared the 16th Ebola disease outbreak in the Democratic Republic of the Congo (DRC). This outbreak ended on 1 December 2025 and occurred in Bulape Health Zone, Kasaï Province, an area with limited access to appropriate healthcare facilities and resources. Here, we describe the probable index patient and molecular investigations of samples obtained from six suspected patients from the initial outbreak phase. We identified Orthoebolavirus zairense (EBOV) in five samples from different patients. In addition, we performed whole-genome sequencing and generated four complete EBOV genomes. These genomes form a well-supported phylogenetic cluster with genomes from the 1976 Yambuku/Mayinga outbreak. This study suggests a likely new zoonotic spillover event from an as-yet unidentified natural reservoir. While the close relationship to 1976 EBOV Yambuku/Mayinga genomes is striking, this poses additional challenges on the comprehension of the animal reservoir species.

Source: 

Link: https://www.nature.com/articles/s41467-026-77542-9

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#USA, #Wastewater Data for Avian #Influenza #H5 (CDC, Sept. 4 '26)

 

{Excerpts}

(...)

A(H5) detections in the past week

Time Period: August 23, 2026 - August 29, 2026

    -- A(H5) Detection: 3 site(s) (0.7%)

    -- No Detection: 439 site(s) (99.3%)

    -- No samples: 74 site(s)

{Click on Image to Enlarge}

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(...)

Source: 

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

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Sex differences in #vaccine-induced #neuraminidase cross-recognition impact #H5N1 #dissemination to the lower respiratory tract in mice

 

Abstract

H5N1 vaccines have been poorly immunogenic in humans, creating a challenge for vaccine development. Seasonal influenza vaccines offer some cross-protection against H5N1, but there has been no consideration of whether protection differs between the sexes. We investigated sex differences in antibody responses following receipt of either beta-propiolactone inactivated whole virus H1N1 or H5N1 (LAIV backbone) vaccines in C57BL/6 mice. Using systems serology assays, vaccination induced strong homologous and heterologous antibody responses, with females generating greater IgG titers than males against whole virus H1N1 and H5N1, which was primarily mediated by greater IgG responses to neuraminidase (NA) than hemagglutinin (HA) protein. Cross-reactive H5N1 IgG titers were greater among H1N1-vaccinated females, and primarily mediated by greater N1-specific IgG titers. IgG2b and IgG2c were the primary antibody isotypes generated in response to these vaccines, with females having greater IgG2b titers and enhanced binding to FcγRIV for avian and human NA than males following either homologous or heterologous vaccination. Antibody-dependent complement deposition was measured as an FcR-mediated non-neutralizing response against HA and NA and was more robust among H1N1 and H5N1 vaccinated females than their male counterparts in response to homologous HA only. Vaccinated females tended to have greater neutralizing antibody titers than males against the homologous vaccine strain, with limited cross-neutralizing antibodies detected in either sexes. Neuraminidase inhibition titers were greater in vaccinated females than males against the heterologous virus following H1N1 vaccination and against both the vaccine and heterologous viruses following H5N1 vaccination. When H1N1 and H5N1 vaccinated mice were challenged with a lethal dose of A/Texas/37/2024 H5N1, all H5N1 vaccinated mice were protected, regardless of sex. Among H1N1 vaccinated mice, while both sexes were protected against disease, H1N1 vaccinated females restricted virus to the upper respiratory tract and had lower pulmonary virus titers than males at 3 days post challenge. These findings highlight that sex differences in vaccine-induced NA-specific antibody responses are associated with differential respiratory dissemination of H5N1 and that sex should be considered in studies of vaccine-induced cross-reactive influenza immunity.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

NIH/NIAID Johns Hopkins Center of Excellence for Influenza Research and Response, 75N93021C00045

Richard Eliasberg Family Foundation

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.05.26.728011v3

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Seasonal #surveillance in #humans in 2026 for #WNV (ECDC, Sept. 4 '26), Weekly Update: 1,086 cases so far, of which 516 in #Italy

{Excerpt, Summary}

(...)

Week 36, 2026 | Published on 04 September 2026, based on data submitted up  until and including 3 September 2026.

Current situation

    ° Since the beginning of the 2026 transmission season, and as at 3 September, 144 areas affected by West Nile virus (WNV) have been identified in 15 countries across Europe.

    ° These areas are located in: 

        

        § Italy (62), 

        § Greece (19), 

        § Romania (17), 

        § France (13), 

        § Serbia (seven), 

        § the Netherlands (five), 

        § Croatia (four), 

        § Spain (four), 

        § Hungary (three), 

        § North Macedonia (three), 

        § Germany (two), 

        § Albania (one), 

        § Austria (one), 

        § Cyprus (one) and 

        § Kosovo* (one).

    ° This week, 20 areas are reported as affected for the first time this season. (...)

    ° The 15 countries have reported 1 086 locally acquired human cases of WNV infection: 

    

        § Italy (516 cases), 

        § Greece (284 cases, of which 11 with unknown place of infection), 

        § Spain (88 cases), 

        § Romania (56 cases), 

        § North Macedonia (55 cases), 

        § France (36 cases), 

        § Serbia (18 cases), 

        § the Netherlands (nine cases), 

        § Croatia (seven cases), 

        § Cyprus (six cases), 

        § Austria (four cases), 

        § Hungary (three cases), 

        § Germany (two cases), 

        § Albania (one case) and 

        § Kosovo* (one case)

(...)

Source: 

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

____

Lessons Learned During 2024‒25 Highly Pathogenic Avian #Influenza #H5N1 Virus #Outbreak Response in #USA: Experience of State and Local Public Health Departments

 

Abstract

Objectives. 

To describe challenges and lessons learned during state and local health department responses to the 2024‒2025 highly pathogenic avian influenza A(H5N1) outbreaks.

Methods. 

We conducted semistructured interviews from August to November 2025 with Department of Health and Agriculture staff from states with confirmed or probable A(H5N1) human cases. We conducted 15 total interviews with 37 participants from 10 US states. Interview transcripts were inductively and deductively coded to identify generalizable lessons that might improve future outbreak response efforts.

Results. 

Key themes included difficulty accessing farms and reaching at-risk populations; lack of sufficient guidelines for proactively responding to zoonotic outbreaks that could have human health implications; the importance of maintaining preparedness planning, capacity, and infrastructure; and uncertainty around future capacity to respond to outbreaks because of resource constraints and changes in federal leadership.

Conclusions. 

Although this study focused on responses to A(H5N1) outbreaks, the findings are indicative of the nation’s overall readiness for biological threats. Prioritization of capacity building for infectious disease outbreaks, including robust health department funding to support continued disease surveillance, is critical to prevent more widespread transmission. 

(Am J Public Health. Published online ahead of print September 3, 2026:e1–e7. https://doi.org/10.2105/AJPH.2026.308656)

Source: 

Link: https://ajph.aphapublications.org/doi/10.2105/AJPH.2026.308656

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#Italy, #WNV & #Usutu Virus Weekly #Surveillance #Report No. 6 (ISS, Sept. 4 '26): 521 human cases so far this season, 26 fatal

 

{Excerpt, Summary}

(...)

    ° Since the beginning of the epidemic season and as of September 2 '26, 521 human cases of confirmed infection with West Nile Virus were reported. They were 432 in the last week report. 

        § Of these, 269 were WNND (West Nile Neuroinvasive Disease), of which 4 were imported: 1 from Maldives, 1 France, 1 Belgium and 1 Greece; 

        § 70 cases were detected among blood donors; 

        § 179 cases were of West Nile Fever (1 case imported from Burkina Faso), 

        § 2 cases were of unspecified nature; 

        § 1 case was asymptomatic. 

    ° The number of affected provinces has risen to 75 in 19 Regions.

    ° Among confirmed cases, 26 fatalities have been recorded. The Case-Fatality Rate is now at 9.4% (during 2025, it was 14.6%).

    ° So far this season, 10 human cases of infection with Usutu virus have been confirmed (6 in Lombardy, 1 Emilia-Romagna, 1 Marche, 1 Latium, 1 Piedmont).

(...)

Source: 

Link: https://www.epicentro.iss.it/westnile/bollettino/Bollettino_WND_2026_6.pdf

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Experimental #reproduction numbers disentangle #vaccine effects on susceptibility and infectiousness during #H5N1 #transmission in #geese

 

Abstract

Vaccination against high pathogenicity avian influenza virus (HPAIV) is increasingly used to protect poultry, but vaccine performance is commonly inferred from clinical protection and virus shedding rather than measured transmission. We asked whether reproduction numbers from controlled transmission experiments can quantify how vaccination changes susceptibility and infectiousness. Domestic geese were prime-boost vaccinated with an H5 clade 2.3.4.4b RNA-replicon vaccine and challenged with homologous HPAIV H5N1. Replicated seeder-sentinel groups represented transmission among unvaccinated animals, to vaccinated contacts, and from vaccinated breakthrough-infected animals. Vaccinated directly challenged geese remained clinically protected although all became RT-qPCR-positive. Estimated reproduction numbers were R0=4.7 (95% CI, 2.8-8.0) among unvaccinated geese, Rs=2.6 (1.6-4.5) for transmission to vaccinated contacts, Ri=3.7 (2.0-6.8) for transmission from vaccinated infected geese, and Rvacc=2.0 (0.8-4.9) for a fully vaccinated population. Vaccination reduced transmission but did not reduce the point estimate for Rvacc below one under these intensive exposure conditions. Vaccinated infected geese also shed substantially less viral RNA, whereas the estimated reduction in infectiousness was more modest, indicating that RNA shedding alone may not reliably predict transmission reduction. Experimental reproduction numbers therefore provide a direct population-level complement to conventional vaccine endpoints and separate effects on susceptibility from effects on onward transmission.

Competing Interest Statement

Christophe Cazaban is an employee of CEVA Santé Animale, which provided the experimental vaccine used in this study. The remaining authors declare no competing interests.

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.09.02.748824v1

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

 

Backyard captive birds in Los Lagos Region.

Source: 

Link: https://wahis.woah.org/#/in-review/7802

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Immunogenicity and #safety of seasonal #influenza #vaccine co-administered with other vaccines: a systematic review and meta-analysis

 

Abstract

Seasonal influenza remains a leading cause of global morbidity and mortality, highlighting the need for vaccination strategies that improve coverage and streamline vaccine delivery. In this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials for randomised controlled trials (RCTs), cohort, case-control, and cross-sectional studies, evaluating immunogenicity and safety of same-day co-administration of influenza vaccines with COVID-19 or other vaccines, compared with non-concomitant administration. Comparators included sequential administration, single vaccine administration or placebo-controlled delayed vaccination. Risk of bias was evaluated using the Cochrane Risk-of-Bias tool for Randomized Trials and Risk of Bias In Non-randomized Studies of Interventions; certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development and Evaluation. Immunogenicity was assessed using geometric mean fold rise (GMFR) in antibody titres and seroprotection rate. Safety was assessed by adverse event (AE) incidence. 52 eligible studies were included. Influenza immunogenicity was comparable between the co-administration and non-concomitant comparator group across all strains (H1N1 GMFR ratio of means (ROM): 1.02 [95% CI: 0.95–1.10]; H3N2, 1.05 [95% CI: 0.97–1.13]; B strain, 1.01 [95% CI: 0.97–1.05]). Pooled risk ratio (RR) for seroprotection was 1.00 for all three strains with 95% CIs ranging from 0.99–1.01. GMFR for COVID-19 vaccines was modestly reduced under co-administration (ROM 0.84 [95% CI: 0.74–0.95]; p = 0.006). Serious AEs were more frequent in the co-administration group compared to the non-concomitant group (RR 1.41 [95% CI: 1.07–1.86]; p = 0.014; absolute risk difference: 1.56 percentage points). Overall, co-administration preserves influenza immunogenicity but modestly reduces COVID-19 vaccine GMFR. Although safety findings warrant cautious interpretation, the low absolute risk difference supports its feasibility as a strategy to streamline vaccination schedules and improve uptake.

Source: 

Link: https://www.nature.com/articles/s41541-026-01548-z

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#Ring and #community #vaccination for #Bundibugyo virus #outbreak response: a stochastic network modelling study

 

Summary

Background

Vaccination with rVSV-ZEBOV is highly effective against Ebola virus, but protection against Bundibugyo virus (BDBV) is unproven. We evaluated the relative population impact and dose efficiency of a partially cross-protective hypothetical vaccine under operationally realistic constraints during a BDBV outbreak.

Methods

We developed a stochastic transmission model on a clustered household–community contact network with empirically realistic local structure, calibrated to 2026 DR Congo BDBV outbreak data. Time-varying effective reproduction numbers were estimated using a Bayesian renewal model. We evaluated case detection, isolation, contact tracing, reactive ring vaccination (Ring 1: direct contacts of the index case; Ring 2: contacts of contacts), and community vaccination (20–80% coverage). Base-case vaccine effectiveness was 45% and included post-exposure protection against disease and mortality. Primary outcomes were mortality and incidence reductions, total doses, and dose efficiency (doses per death averted) over 90 days, evaluated in a probabilistic sensitivity analysis with 10 000 matched stochastic replicates per strategy.

Findings

Compared with base operations alone (30% detection, 30% tracing), enhanced operations alone (70% detection, 80% tracing) reduced expected mortality by 81·6% (95% uncertainty interval 73·1–87·7). Reactive Ring 2 vaccination under base operations reduced mortality by 24·6% (18·0–29·6), requiring 35·1 doses per death averted. Added to enhanced operations, Ring 2 vaccination reduced mortality by 83·6% overall (76·4–89·0), an incremental benefit of 10·5% (6·2–15·6) beyond enhanced operations alone. Community vaccination at 20%, 40%, 60%, and 80% coverage reduced mortality by 44·7% (34·8–52·5), 67·4% (56·2–74·3), 79·8% (70·4–85·3), and 86·6% (79·2–90·4), respectively, requiring 53·8–111·4 doses per death averted.

Interpretation

Strengthened case finding, contact tracing, and isolation averted most deaths even without vaccination. Once these operations were strong, reactive ring vaccination added a modest further benefit, whereas rapid community vaccination produced the largest reductions in simulated scenarios but required substantially more doses. A partially protective BDBV vaccine's population-level value will depend principally on rapid, broad delivery.

Funding

Canadian Institutes of Health Research.

Translation

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

Source: 

Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00464-0/fulltext

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#WHO emergency #guidance on use of licensed #Ebola {Zaire} #vaccine during #Bundibugyo virus disease #outbreaks - Interim guidance 31 August 2026 (Summary)

 

Context

    Ervebo® is currently the only licensed Ebola vaccine available. Ervebo®  (rVSV-EBOV-GP) is a live, recombinant vesicular stomatitis virus (rVSV)-based vaccine licensed that was prequalified by the World Health Organization (WHO) in 2019 for the prevention of Ebola virus disease caused by Ebola virus (EBOV, species Orthoebolavirus zairense, previously known as Zaire ebolavirus) in individuals aged one year or older. It is not licensed for use against Bundibugyo virus (BDBV) and therefore the use of Ervebo® against BDBV constitutes off-label use{1} BDBV and EBOV cause Ebola disease that is  clinically similar but are genetically and antigenically distinct virus species. Their  glycoproteins share approximately only 60–65% amino acid sequence  identity, a distinction that is particularly relevant for vaccination because currently  available Ebola vaccines, including Ervebo®, target the viral  glycoprotein.

    Consequently, although Ervebo® is highly effective against EBOV, the  extent to which Ervebo®-induced immunity provides clinically meaningful  protection against BDBV remains unknown. (1)

    On 19 August 2026 (2), the Strategic Advisory Group of Experts on Immunization (SAGE) reviewed and deliberated on the additional evidence that  had become available following the publication of the WHO emergency guidance  on the use of licensed Ebola virus vaccine during Bundibugyo virus disease  outbreaks, 28 May 2026. (3)

    The BDBV outbreak in the Democratic Republic of the Congo has spread  substantially, with continued transmission and high mortality, creating an urgent  need to strengthen outbreak response and reduce preventable deaths. (4) The  severity of the disease and evolving epidemiological situation increases the  imperative to consider all potentially beneficial interventions, while at the same  time carefully weighing the unknown efficacy of Ervebo® against BDBV, and resultant risks.

    A ring vaccination randomized controlled trial (henceforth referred to as  ring RCT) of Ervebo® and BDBV-specific vaccine candidates is planned to be  conducted in the Democratic Republic of the Congo as a matter of urgency. (5) If  well designed and rigorously implemented, the trial would provide the critical  evidence currently lacking on the efficacy of Ervebo® against BDBV.

Assessment of additional evidence on Ervebo® performance against BDBV since May 2026

    Findings from an increased, albeit still limited, number of studies  conducted to date in nonhuman primates and ferrets suggest some  protection by Ervebo® against BDBV-related mortality, while showing little or no  protection against viraemia and clinical disease (...).

    In the absence of an established correlate or surrogate of  protection  against BDBV, the extent to which findings from animal challenge  models (disease and laboratory-based immunological studies) can predict  protection in humans remains unknown. 

    Available human immunogenicity data regarding potential cross-protection  conferred by Ervebo® against BDBV showed that Ervebo® induces cross-reactive BDBV glycoproteinbinding antibodies which are at levels  approximately 5-fold lower than against EBOV, and that cross-neutralization of  BDBV pseudoviruses with neutralizing titres are approximately 3.5–4-fold lower  than against EBOV (...).

    No Ervebo® vaccine efficacy data against BDBV in humans have been  generated yet. 

    There are a small number of anecdotal reports of previously vaccinated  health care workers who subsequently developed BDBV disease and survived.  However, no conclusions regarding vaccine efficacy or effectiveness can be drawn  from these observations because of the very small sample size, the absence of an  appropriate comparator group, the potential for substantial bias, non-systematic  data collection, and the resulting considerable statistical uncertainty.

    Overall, the limited data and anecdotal reports are suggestive of some  protection against BDBV-related mortality and are consistent in trending towards  some as yet unquantified benefit.

    In conclusion, the available data remain insufficient to determine whether Ervebo® provides any clinically meaningful protection against  BDBV in humans or to reliably estimate the magnitude of such protection,  including protection against infection, disease, severe disease or death.

Benefit–risk considerations regarding off-label use of Ervebo® in the context of unknown efficacy against BDBV

    There is currently clinical equipoise regarding the efficacy of Ervebo®  against    BDBV. 

    Vaccine efficacy in humans remains to be established and could range  from high efficacy, with substantial clinical and public health benefit, through  moderate or partial efficacy, to limited or negligible efficacy, with little or no  meaningful protection. The lower limit of the range of potential effects may even  include harm. The potential ratio of benefits and risks of broader use therefore  differ considerably depending on where within this range the true efficacy ultimately lies.

    If efficacy is high or clinically meaningful, broader use while the ring RCT  is underway could potentially reduce severe disease and deaths and, if the vaccine  also protects against infection and transmission, contribute to outbreak  control. In a context where other medical countermeasures remain limited, earlier  access could provide populations at high risk with a vaccine that has a  well-characterized safety profile, while BDBV-specific vaccines remain under  evaluation and are not yet available for use. Use within appropriately designed  research frameworks could also generate complementary real-world effectiveness  data. In addition, vaccinated individuals would be expected to benefit from  protection against Ebola virus disease should they subsequently be exposed during a future EBOV outbreak.

    Conversely, if efficacy is low, negligible or absent, the balance of benefits  and risks would be substantially less favourable. Considerable financial, logistic  and human resources would be diverted to an intervention providing little or no  clinical or public health benefit. These resources could otherwise support  outbreak-control measures of established effectiveness, including surveillance,  contact tracing, timely testing and case detection, isolation, infection prevention  and control, and safe and dignified burials. These resources could also have been better invested in the development of BDBV-specific vaccines.

    A scenario in which Ervebo® provides meaningful protection against  severe disease or death, but limited or no protection against infection, viraemia or  onward transmission, would require careful consideration. Protection against  severe disease or death would constitute an important individual and public health  benefit, even in the absence of substantial effects on infection or  transmission. However, vaccination could then reduce morbidity and mortality without necessarily interrupting transmission. If this efficacy profile is  not clearly understood and communicated, vaccination could lead to false  reassurance among vaccinated individuals, communities and responders,  potentially reducing adherence to established outbreak-control measures. Such  behavioural changes could offset some of the benefits of vaccination and, if  infection and onward transmission are not sufficiently reduced, could contribute to continued transmission and potentially prolong or exacerbate the outbreak.

    If efficacy proves limited or negligible, substantial numbers of  breakthrough cases or deaths could also undermine public trust in the outbreak  response and confidence in Ebola vaccines, vaccination programmes generally,  and the health sector more broadly. Once broader vaccination has commenced, a  subsequent decision to restrict or discontinue Ervebo® use, if the evidence shows  limited efficacy, could itself create important communication and trust challenges.

    There are also important evidence-generation trade-offs. The use of  Ervebo® outside rigorous research protocols could interfere with the feasibility,  recruitment, implementation and scientific integrity of studies, particularly the ring  RCT, designed to establish vaccine efficacy for Ervebo® and BDBV-specific  vaccine candidates (which are expected to have the potential for better  performance against BDBV). This could delay the generation of the robust evidence needed to guide policy. Observational Ervebo® effectiveness  studies could provide useful complementary information but are inherently more  susceptible to bias and confounding than RCTs and may therefore be more difficult  to interpret or insufficiently robust to resolve the central question of  efficacy. Vaccine effectiveness (VE) studies of vaccines with modest efficacy are  particularly prone to these limitations. Hence the value of any observational study  depends partly on the extent to which its design can ensure that uptake of the  intervention is as close to random as possible and that outcome data are collected  systematically from all participants allowing comparable analysis, thereby reducing selection and information biases. Conversely, if the ring RCT  demonstrates clinically meaningful efficacy of Ervebo® and/or BDBV-specific  vaccine candidates, such a trial would provide a strong basis for rapidly updating  policy and expanding vaccine(s) use to benefit the wider population.

    Extensive reliance on Ervebo® could potentially affect community willingness to participate in future studies or receive BDBV-specific vaccines,  which become especially important if the efficacy of Ervebo® against BDBV is insufficient.

    Finally, widespread deployment would have implications for global vaccine security. Largescale use of available Ervebo® doses against BDBV could  temporarily deplete the International Coordinating Group on Vaccine  Provision stockpile and potentially compromise timely access to vaccine for  response to a future outbreak caused by EBOV, against which Ervebo® has demonstrated efficacy and is licensed.

    Taken together, the uncertainties described above reinforce the importance of obtaining robust efficacy data as rapidly as possible while  carefully weighing the potential benefit of any broader use against its potential negative consequences.

(...)

{1} Use of a vaccine for an unapproved indication (not described in the approved  labelling) or in an unapproved age group, dosage, or route of administration. 

(...)

© World Health Organization 2026. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence.

Suggested citation. WHO emergency guidance on the use of licensed Ebola vaccine during Bundibugyo virus disease outbreaks, 31 August 2026. Geneva:  World Health Organization; 2026. https://doi.org/10.2471/B09884

Source: 

Link: https://doi.org/10.2471/B09884

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