#COVID19 #vaccination induces cross-neutralisation of #sarbecoviruses related to #SARS-CoV-2

 

Abstract

The combined threats of future sarbecovirus zoonosis and continually emerging SARS-CoV-2 VOCs highlight the need to assess the breadth of existing SARS-CoV-2 vaccine-mediated protection. Here, we investigate a cohort of older individuals who received four COVID-19 vaccine doses, for potential cross-neutralisation against lentiviral particles bearing spikes from either Omicron VOCs or other sarbecoviruses. Despite recent fourth bivalent mRNA vaccine doses (encoding SARS-CoV-2 Wu-1 and Omicron spikes), neutralisation of Omicron lineage VOCs was reduced compared to Wu-1, consistent with an imprinted immune response. Similarly, particles bearing either SARS-CoV-1 or a SARS-CoV-1-related bat sarbecovirus spike were neutralised less efficiently than Wu-1. Unexpectedly, however, we observed that particles with spikes from two animal SARS-CoV-2-related viruses, BANAL-20-52 from bats and a pangolin CoV, were significantly more sensitive to serum neutralising antibodies than SARS-CoV-2 Wu-1 itself. These surprising findings suggest that vaccine-mediated adaptive immunity may provide efficient cross-neutralisation and potential protection against certain animal sarbecoviruses.

Source: npj Vaccines, https://www.nature.com/npjvaccines/

Link: https://www.nature.com/articles/s41541-026-01469-x

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#Ebola #laboratory #preparedness at #frontline hospitals: can we or can’t we?

 

ABSTRACT

Frontline hospitals are required to care for patients with suspected viral hemorrhagic fever (VHF), yet guidance on laboratory preparedness remains fragmented and incomplete. We conducted a multidisciplinary risk assessment of our institutional capacity to perform routine diagnostic testing for VHF persons under investigation (PUI), focusing on the feasibility of using automated core laboratory instruments. Our assessment revealed substantial gaps between CDC guidance (which permits core lab testing) and the practical ability to implement it safely. Public health mandates for VHF preparedness have not been accompanied by granular guidance on biosafety, laboratory infrastructure, or regulatory clarity necessary for implementation. Community hospitals, which would benefit most from safely using their existing automated core laboratory instruments, lack the infrastructure, staffing expertise, and clear guidance to do so, while well-resourced tertiary centers are often best positioned to develop dedicated point-of-care testing (POCT)-based workflows. Federal and state authorities must provide explicit, validated examples of acceptable mitigation strategies for testing using core lab instrumentation and reconcile conflicting recommendations across guidance documents. Without such authoritative clarity, frontline hospitals cannot confidently meet their mandated VHF preparedness obligations.

Source: Journal of Clinical Microbiology, https://journals.asm.org/journal/jcm

Link: https://journals.asm.org/doi/10.1128/jcm.00903-26

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Past #lessons for the 2026 #Bundibugyo virus #outbreak: #filovirus infection #prevention in #conflict-affected settings

 

Summary

In May 2026, the World Health Organization declared a Public Health Emergency of International Concern after Bundibugyo virus disease re-emerged in Ituri Province, Democratic Republic of the Congo, with cross-border transmission to Uganda. The suspected index case was a healthcare worker, and at least four healthcare workers had died before the outbreak was confirmed. The outbreak is unfolding in a region characterised by armed conflict, mass displacement, fragile governance and disrupted clinical infrastructure — a setting in which the high-containment infection prevention measures developed for filovirus disease in well-resourced facilities are difficult to implement reliably. In this narrative, evidence-informed review we propose an achievable infection prevention bundle for filovirus outbreaks in conflict-affected settings, framing personal protective equipment, training, supervised doffing, supply chains, staffing, environmental controls and facility organisation as interdependent components of a single coherent system rather than as alternatives. We summarise outbreak situation reports, operational documentation and simulation evidence; identify operational failure modes in austere conditions; and propose an eight-element bundle prioritised by implementation urgency. The bundle is anchored in WHO core IPC programme guidance. Most of the available evidence base is filovirus-general or Zaire ebolavirus-derived; extrapolation to Bundibugyo virus is reasonable but limited, and the bundle should be understood as a framework for decision-making rather than as a validated intervention package.

Source: Journal of Hospital Infection, https://www.journalofhospitalinfection.com/

Link: https://www.journalofhospitalinfection.com/article/S0195-6701(26)00266-5/abstract

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#Ebola at 50 — #Lessons for #Outbreak Response and #Preparedness

 

(...)

Key Lessons from Ebola’s History for Outbreak Response and Preparedness.

1. Discovery is a continuum. 
• Ebola virus was identified by means of an interdependent process involving African clinical recognition, patient care, field investigation, epidemiology, specimen collection, and international laboratory science.
2. Recognition matters. 
• A complete historical account should acknowledge the contributions of African clinicians, scientists, health workers, and communities alongside international collaborators.
3. Partnerships are essential to outbreak response. 
• Effective outbreak response depends on coordination among frontline health workers, communities, ministries of health, research institutions, and national and international partners.
4. Frontline responders are central contributors. 
• Clinicians, nurses, laboratory personnel, community health workers, burial teams, and other responders play indispensable roles in outbreak detection, control, and knowledge generation.
5. Community trust is a preparedness asset. 
• Trust, meaningful community engagement, respectful care, and transparent communication are fundamental determinants of outbreak-control success.
6. Equity must be built before emergencies. 
• Shared leadership, equitable authorship, sample and data governance, benefit sharing, and sustained support for local and regional institutions are essential for effective and sustainable outbreak science.
7. Outbreak response and preparedness must extend beyond Zaire ebolavirus. 
• The Bundibugyo outbreak highlights the need for diagnostics, vaccines, therapeutics, and clinical trial readiness across pathogenic ebolaviruses.
8. Sustained investment between outbreaks is essential. 
• Long-term investment in workforce development, laboratories, surveillance systems, clinical research platforms, regulatory capacity, and manufacturing strengthens preparedness.

(...)

Source: 

Link: https://www.nejm.org/doi/full/10.1056/NEJMp2607819?query=TOC

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#Andes Virus on a Cruise #Ship, what it Tells us About the #Global #Pandemic #Preparedness Agenda

 

Summary

The outbreak of hantavirus disease caused by Andes virus aboard a cruise ship is a reminder of the challenges posed by emerging diseases in the modern era. While Andes virus-associated disease can be particularly severe, it is unlikely to spread extensively beyond the current number of cases or emerge as a large epidemic, especially if public health measures are followed. Nonetheless, the outbreak exemplifies the complexity of international outbreak response with differences in national preparedness frameworks and the rapid spread of mis-/disinformation. We discuss this outbreak in the context of global epidemic and pandemic preparedness and emphasize the importance of sustained, inclusive global collaborative One Health approaches to preparedness and response. We stress the urgent need for global coordination, discuss specific challenges, and provide recommendations for further strengthening of global preparedness.

Source: 

Link: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(26)00167-5/fulltext

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Maintenance of #Hokkaido virus, a genotype of #Orthohantavirus puumalaense, in the #rodent host Myodes rufocanus bedfordiae under natural conditions

 

ABSTRACT

A variety of orthohantaviruses (family Hantaviridae) have preferred natural host species, with transmission among hosts generally thought to occur through direct physical contact and inhalation of virus-contaminated excreta, although the infection to the other species occasionally occurs. Despite extensive experimental studies, the mechanisms of orthohantavirus maintenance and transmission under natural conditions remain unclear. In this study, field surveys were conducted in a forest in Tobetsu, Hokkaido, Japan, between 2022 and 2025 to capture gray red-backed voles (Myodes rufocanus bedfordiae), the natural host of Hokkaido virus (HOKV), a genotype of Orthohantavirus puumalaense. Among 199 captured rodents, 23 were positive for HOKV infection. Five individuals were positive for viral RNA but negative for anti-HOKV IgG antibodies on ELISA and IFA and exhibited low neutralizing antibody titers and low IgG avidity indexes (≤26%), suggesting acute infection. In contrast, 18 individuals were positive for viral RNA and showed high antibody titers on ELISA, IFA, and neutralization tests, as well as high IgG avidities (≥64%); these individuals were considered persistently infected. High levels of viral RNA and antigens were consistently detected in the lungs, kidneys, and spleen during both potential acute and persistent phases of HOKV infection by quantitative PCR and immunohistochemistry. Infectious HOKV was also recovered from oral swabs (8/8), urine (3/6), and feces (4/6) of individual rodents captured in 2024. These findings showed that HOKV can persist at high viral loads in host organs and be excreted throughout the course of infection, contributing to the long-term maintenance of orthohantavirus in natural host populations.

Source: Journal of Virology, https://journals.asm.org/journal/jvi

Link: https://journals.asm.org/doi/10.1128/jvi.00321-26

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#Sudan virus disease in #humans

 

Summary

In 2025, Uganda had Africa’s ninth outbreak of disease caused by Sudan virus (SUDV), a filovirus similar to Ebola virus (EBOV) that causes severe febrile disease in humans. In this Review, we summarise the evidence on the epidemiology, natural history, and immunology of Sudan virus disease (SVD) from outbreaks since 1976. Following an incubation period averaging about 1 week, SVD typically presents with an influenza-like illness followed by a severe diarrhoeal disease, often accompanied by cardiorespiratory symptoms and dehydration. Clinical findings can include kidney and liver injury, acute inflammation, and coagulopathy. Severe cases can progress rapidly to shock, multiorgan failure, and death. The pooled case-fatality rate until 2022 was 49% (95% CI 39–58), although a lower case-fatality rate of 29% was recorded during the 2025 outbreak. The virus is detectable in blood from symptom onset, peaking during acute illness. Transmission occurs mainly through close contact with acutely symptomatic individuals and their body fluids, driving household and nosocomial spread. Early T-cell responses and SUDV-specific antibodies might be important for survival, and suppressed immunity and uncontrolled inflammation might predict fatal outcomes. Survivors present durable humoral and cellular immunity for up to 15 years after infection. Although outbreaks to date offer valuable insights into SVD, substantial evidence gaps and limitations exist. Future outbreak preparedness should include prospective planning for high-quality research that can be rapidly implemented to address key evidence gaps. Strengthening these data, together with advancing the development and evaluation of vaccines and therapeutics, will be essential for timely and effective outbreak response.

Source: The Lancet Global Health, https://www.thelancet.com/journals/langlo/home

Link: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00072-0/fulltext

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#Sialic acid-anchored #haemagglutinin stalk neutralizing #antibody M-SiaB enhances #protection against highly pathogenic #influenza #H5N1/Texas/2024

 

Abstract

The recently emerged cattle H5N1/Texas/2024 strain highlights the need for effective prophylactic and therapeutic drug interventions, yet most existing neutralizing antibodies (NAbs) have limited efficacy against genetically divergent pathogenic influenza viruses. Here we engineer a sialic acid-anchored tandem M-SiaB by fusing a hemagglutinin (HA) stalk-specific monoclonal NAb with a sialic acid-receptor-binding domain (SiaB). M-SiaB shows 4- to 20-fold greater neutralizing potency against diverse authentic influenza viruses compared to the parental NAb and suppresses multiple stages of the viral life cycle, including viral attachment, entry and release. Importantly, intranasal M-SiaB confers markedly enhanced protection against nasal challenges with the pathogenic H1N1/PR8 and H5N1/Texas/2024 strains. Notably, a single dose of M‑SiaB maintains survival after a highly lethal H5N1/Texas/2024 challenge for up to 21 days. These findings demonstrate that simultaneously targeting HA stalk and sialic acid-receptor is a promising strategy to enhance the potency and breadth of NAbs against genetically divergent pathogenic influenza viruses.

Source: Nature Communications, https://www.nature.com/ncomms/

Link: https://www.nature.com/articles/s41467-026-74633-5

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#Genomic and structural #evidence of #SARS-CoV-2 and #MERS-CoV in migratory #birds

 

Significance

Coronaviruses are regarded as highly important pathogens of birds and mammals. Herein, we obtained three almost full-length severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes and one partial Middle East respiratory syndrome coronavirus (MERS-CoV) genome in the feces of migratory birds based on meta-transcriptome and PCR amplification. We determined the affinities and the complex structures between receptor-binding domain (RBD) of the SARS-CoV-2 viral spike protein and angiotensin-converting enzyme 2 (ACE2) protein of two migratory birds, Tundra and Black swans. Moreover, pseudotyped SARS-CoV-2 variants can enter into HeLa cells expressing ACE2 proteins of these birds. Altogether, our results expand our understanding of migratory birds as potential carrier of both SARS-CoV-2 and MERS-CoV.

Abstract

Migratory birds are the natural reservoir of influenza A virus (IAV), but their role as a carrier of SARS-CoV-2 remains unclear. Here, we report the identification of three almost full-length viral genome sequences of SARS-CoV-2 variants of concern (VOCs) in Tundra swans. These sequences are named hCoV-19/Tundra swan/Jiangxi/IMCAS_M1/2021 (IMCAS_M1), hCoV-19/Tundra swan/Jiangxi /IMCAS_M2/2021 (IMCAS_M2), and hCoV-19/Tundra swan/Jiangxi/IMCAS_M3/2021 (IMCAS_M3). IMCAS_M1 and IMCAS_M3 have the same mutations as the Beta VOC (K417N, E484K, and N501Y) in the receptor-binding domain (RBD) of the viral spike (S) protein, whereas IMCAS_M2 shares the same mutations as the Gamma VOC (K417T, E484K, and N501Y) in the RBD with all three showing their distinct mutations in the genomes. Virus receptor angiotensin-converting enzyme 2 (ACE2) proteins from both Tundra swan (tsACE2) and Black swan (bsACE2) can bind to the RBDs of all three viruses and the Alpha VOC, but not to RBD of the prototype (PT) virus. The polar contacts and hydrophobic interactions revealed by cryo-electron microscopy (cryo-EM) structures of the RBD–ACE2 complex, play key roles in virus–receptor engagement. Furthermore, HeLa cells expressing bsACE2 and tsACE2 proteins could be transduced by pseudotyped SARS-CoV-2 variants (Alpha, Beta, and Gamma) but not PT SARS-CoV-2. In addition, we obtained one partial genome of MERS-CoV named Bar-headed goose/Tibet/IMCAS_M4/2022 (IMCAS_M4) with 20,180 bp (~70.0% coverage). Our findings highlight the importance of migratory birds as potential carrier of both SARS-CoV-2 and MERS-CoV, thereby posing potential threat to public health.

Source: Proceedings of the National Academy of Sciences of the United States of America, https://www.pnas.org/

Link: https://www.pnas.org/doi/10.1073/pnas.2400023123

____

#Andes Virus #Exposure and #Nosocomial #Transmission Events to #Healthcare Personnel: A Systematic Review

 

Abstract

Background

Andes virus (ANDV) is a high-consequence infectious disease with substantial mortality. On May 2, 2026, the World Health Organization reported a multinational ANDV outbreak, raising questions regarding risk of transmission to healthcare personnel (HCP).

Methods

We performed a systematic review per PRISMA guidelines (PROSPERO:CRD420261283806) for studies describing healthcare-associated ANDV exposure or transmission events to HCP.

Results

Eight studies reporting on 7 events were included, describing a total of 17 healthcare-associated cases. Overall, 207 individuals were exposed, including 118 HCP, resulting in 8 infections and 4 deaths among HCP. Studies describing HCP infections reported none or inadequate personal protective equipment (PPE) use.

Conclusions

Transmission of ANDV to HCP has been reported in the setting of delayed implementation of transmission-based precautions or breaches in infection control practice. Limitations in published exposure events highlight the need for standardized reporting of exposure events and outcomes as well as infection prevention measures implemented.

Source: Clinical Infectious Diseases Journal, https://academic.oup.com/cid

Link: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciag394/8721691

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{#Canada} #Fatal #rabies in a #child (CMAJ)

 

{Summary}

Key points

    ° Rabies is a neurotropic infection that is rare in Canada and almost always fatal once symptoms develop.

    ° Rabies postexposure prophylaxis is highly effective in preventing infection in exposed humans if administered promptly and before onset of rabies symptoms.

    ° Any direct human contact with a bat is an indication for rabies postexposure prophylaxis and should be discussed with the regional public health authority.

    ° No established efficacious therapies are available for treatment of rabies once symptom onset has occurred.

An immunocompetent 11-year-old boy presented with odynophagia and emesis to an urban hospital emergency department in Ontario, Canada. Seven days before presentation, he had developed progressive right-sided facial paresthesia and numbness, followed by anorexia and right-sided facial swelling. Four days after symptom onset, he had been prescribed oral valacyclovir (1 g, 3 times daily) at a local urgent care clinic for presumed Bell palsy secondary to herpes simplex virus; however, he was unable to tolerate this because of odynophagia. He had no history of allergies, sick contacts, tick bites, or recent travel outside the country.

(...)

Source: Canadian Medical Association Journal, https://www.cmaj.ca/

Link: https://www.cmaj.ca/content/198/25/E969

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#Bundibugyo virus disease: #transmission dynamics, infectiousness and viral #persistence

 

Abstract

BVD is a severe filoviral haemorrhagic fever caused by the Bundibugyo virus (BDBV), for which outbreak-related evidence remains limited compared with that available for Zaire ebolavirus. This perspective summarizes current evidence on transmission dynamics, presymptomatic infectiousness, post-recovery viral persistence and the duration of infectiousness, distinguishing BDBV-specific data from evidence extrapolated from other ortho-Ebolaviruses.

Available epidemiological data from the 2007–2008 outbreak in Uganda indicate that BDBV transmission occurs primarily through direct contact with the blood or body fluids of symptomatic or deceased individuals, with the handling of corpses representing a significant risk factor (adjusted odds ratio 3.83; 95% confidence interval 1.78–8.23).

The average incubation period is 6.3 days, and prolonged chains of transmission were documented in household and healthcare settings. No documented evidence of pre-symptomatic transmission in humans is currently available, although experimental animal data suggest biological plausibility.

No BDBV-specific data are available regarding viral persistence and duration of infectiousness. Consequently, current recommendations rely largely on evidence derived from other orthoebolaviruses. Viral RNA may persist after recovery in immunoprivileged sites, particularly in semen, with rare but documented episodes of delayed transmission. The ongoing outbreak highlights the need for BDBV-specific studies to strengthen the evidence base underpinning public health recommendations.

Source: 

Link: https://www.ijidonline.com/article/S1201-9712(26)00574-6/fulltext

____

#Genetic and biological characterization of a #reassortant #H3N2 swine #influenza virus isolated in #China with internal genes from the 2009 pandemic #H1N1

 

Abstract

Swine influenza virus (SIV) not only causes significant losses to the pig industry but also poses a potential threat to human health due to its ability for cross-species transmission and zoonotic characteristics. In this study, 600 nasal swab samples were collected from pigs in Shandong Province and tested for SIV using RT-qPCR. One sample tested positive, and the virus was successfully isolated in 10-day-old specific-pathogen-free (SPF) embryonated chicken eggs. Subtype-specific RT-PCR and sequencing identified the isolate as H3N2, designated A/swine/Shandong/116/2022 (H3N2). Whole-genome sequencing and similarity analysis showed that PB2, PB1, PA, NP, and M genes were most similar to H1N1 viruses (97.71–99.67%), while HA, NA, and NS genes were closest to H3N2 viruses (96.06–97.85%), suggesting this isolate is a reassortant between H1N1 and H3N2 viruses. Phylogenetic analysis indicated that PB2, PB1, PA, NP, and M genes belong to the 2009 pandemic H1N1 (pdm/09 H1N1) lineage, HA and NA genes belong to the human-like H3N2 (HL H3N2) lineage, and the NS gene belongs to the triple-reassortant (TR) H1N2 lineage. Key amino acid analysis showed a monobasic HA cleavage site (PEKQTR/G), consistent with low pathogenicity, and residues 190V, 226I, and 228S, which may affect receptor binding. PB2 residues 271A, 590S, and 591R may influence viral replication and host adaptation. Compared with the human influenza vaccine strain A/Darwin/9/2021 (H3N2), several amino acid changes were found in HA antigenic sites A, B, C, and E, suggesting possible antigenic drift. In addition, clear differences were found in N-linked glycosylation sites between the isolate and vaccine strain, including loss of several glycosylation sites and the appearance of a new site at position 499, which may change virus antigenicity and immune recognition. Functional studies demonstrated that the isolate efficiently infected MDCK cells and replicated in the respiratory tissues of BALB/c mice, causing mild to moderate lung lesions without mortality or significant weight loss. In summary, the isolated is a multi-source reassortant virus with low pathogenicity, providing valuable insights into the genetic characteristics and epidemiology of H3N2 SIV circulating in pigs in China.

Source: 

Link: https://link.springer.com/article/10.1186/s12866-026-05324-w

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#Pixavir Marboxil: First Approval

 

Abstract

Pixavir marboxil (Yilikang®; 壹立康®) is an oral cap-snatching endonuclease inhibitor being developed by TaiGen Biotechnology for the treatment of influenza virus infections. Pixavir marboxil recently received approval in China for the treatment of uncomplicated influenza A and B in previously healthy adults and adolescents aged ≥ 12 years. This article summarizes the milestones in the development of pixavir marboxil leading to this first approval for uncomplicated influenza A and B infections.

Source: 

Link: https://link.springer.com/article/10.1007/s40265-026-02320-2

____

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Detection of #H5N1-Related #PB1 Sequences in a Low Pathogenic #H11N2 Virus from South #American Migratory #Shorebirds

 

Abstract

Highly pathogenic avian influenza (HPAI) A(H5N1) viruses of clade 2.3.4.4b have recently spread across the Americas, prompting intensified surveillance efforts in Brazil aimed at early detection in wild birds. As part of these efforts, we identified a low pathogenic avian influenza A(H11N2) virus in a white-rumped sandpiper (Calidris fuscicollis) sampled at Lagoa do Peixe National Park (PNLP) in southern Brazil. Whole-genome sequencing revealed that seven of the eight gene segments shared high nucleotide similarity (approximately 98.8%) with viruses previously detected in shorebirds from Delaware Bay, North America. In contrast, the PB1 segment showed high nucleotide similarity (approximately 99%) to the PB1 lineage associated with clade 2.3.4.4b A(H5N1) genotype B3.2 viruses circulating in the Americas. Phylogenetic, nucleotide identity, and molecular clock analyses indicated that this lineage shares a recent common ancestor with North American LPAI viruses and was subsequently detected in distinct viral genetic backgrounds. Although no HPAI virus was identified in this study, the presence of a PB1 segment related to H5N1-associated lineages suggests that genetic components linked to these viruses were circulating among low pathogenic avian influenza viruses in South America. These findings highlight the importance of continued surveillance in migratory bird populations to improve understanding of avian influenza virus diversity and support epidemiological monitoring.

Source: 

Link: https://www.mdpi.com/1999-4915/18/7/710

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The #NK Cell #Landscape in the Natural History of #Hantavirus Cardiopulmonary Syndrome in a Chilean Cohort

 

Abstract

Hantavirus cardiopulmonary syndrome (HCPS) caused by Andes Orthohantavirus (ANDV) carries case-fatality rates up to 40%; however, the innate immune determinants of disease severity remain poorly defined. Natural killer (NK) cells are central mediators of early antiviral immunity, but their landscape during the earliest phase of ANDV infection has not been characterized. Using multiparameter flow cytometry and unsupervised UMAP-based clustering in PBMCs from 13 HCPS patients stratified by severity and nine healthy donors, we show that severe HCPS is characterized by a coordinated disruption of the CD56dim NK cell compartment, encompassing reduced subset frequencies, specific reduction in the terminally differentiated NKG2C+CD57+ adaptive-like pool, and intrinsic impairment of IFN-γ production and degranulation, deficits that were absent in mild patients and persisted in part beyond clinical recovery. Furthermore, CD56dimCD16+ NK cell frequencies correlated negatively with viral load across all acute patients, independent of clinical severity. These findings establish severe HCPS not merely as a state of NK cell depletion, but as one of selective functional impairment of the most cytotoxically competent NK cell population during the critical early acute phase of ANDV infection.

Source: 

Link: https://www.mdpi.com/1999-4915/18/7/712

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Systemic #atopy and upper - #airway disease define susceptibility to incident #asthma after #COVID19 in #Korea

 

Abstract

Incident asthma is an important respiratory sequela after COVID-19, but it is unclear which allergic phenotypes amplify risk. Using a linked nationwide Korean database of 3,987,182 individuals with confirmed severe acute respiratory syndrome coronavirus 2 infection, we compare claims-based incident asthma in those with pre-existing systemic atopy and/or upper-airway disease (allergic rhinitis, chronic rhinosinusitis, atopic dermatitis or food allergy) versus those without after 1:1 propensity score matching. During follow-up to 31 December 2022, participants with pre-existing disease have higher asthma incidence than matched controls (3.55 vs 2.13 per 1,000 person-years), with a hazard ratio of 1.66 (95% confidence interval 1.58–1.75). Asthma risk is elevated for each condition and increases with greater disease burden. These findings show that pre-existing allergic and upper-airway phenotypes stratify post-COVID incident asthma risk on a national scale, supporting targeted surveillance in high-risk subgroups.

Source: 

Link: https://www.nature.com/articles/s41467-026-74860-w

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Effectiveness of #baloxavir marboxil in nonhuman #primates infected with highly pathogenic avian #influenza #H7N9 virus

 

Summary

Background

Highly pathogenic avian influenza (HPAI) A(H7N9) virus poses a potential public health threat, underscoring the need for effective antiviral options for outbreak preparedness. Baloxavir marboxil (BXM) is a cap-dependent endonuclease inhibitor approved for seasonal influenza, but its in vivo efficacy against HPAI A(H7N9) virus has not been fully evaluated.

Methods

We evaluated the efficacy of BXM in cynomolgus macaques infected with a reverse genetics-generated HPAI A(H7N9) virus. Animals received either low- or high-dose BXM, single-dose oseltamivir, or vehicle at 4 or 48 h post-infection (hpi). BXM administration was designed to mimic human pharmacokinetics. Viral titres, body temperature, body weight, lung pathology, and treatment-emergent viral substitutions were analysed.

Findings

Early treatment (4 hpi) with BXM significantly reduced viral titres in nasal and tracheal swabs, lessened weight loss, and decreased pulmonary inflammation and alveolar damage compared to untreated or oseltamivir-treated animals. Virus pathogenicity was relatively mild; no animals died. Delayed treatment (48 hpi) showed limited benefit. The PA-I38T (83.8%) and PA-E23G (78.6%) substitutions associated with BXM resistance were detected in one animal, and a PA-K34R (85.4%) substitution was detected in another animal. These substitutions reduce BXM susceptibility and were detected at low titres.

Interpretation

Although the dosing regimen used in this study involved repeat dosing to achieve the plasma drug concentrations after a single dose in humans, these findings highlight the importance of early antiviral intervention and support BXM use as a potential countermeasure against HPAI A(H7N9) virus infection, as resistance-associated substitutions remained limited in the macaque model. BXM may be a valuable therapeutic option for HPAI A(H7N9) virus infections.

Funding

Supported by the Japan Agency for Medical Research and Development (JP20wm0125002, JP223fa627001) and Shionogi & Co., Ltd.

Source: 

Link: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(26)00233-1/fulltext

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