ETIDIOH - NEW

  Last updated 27 October 2025 Latest update UKHSA is aware of small numbers of locally-acquired cases of clade Ib mpox in the USA , Spain, Italy , the Netherlands and Portugal which have no connection to countries with known clade Ib mpox transmission.   This suggests there is now community transmission of clade Ib mpox globally . Most of the new cases identified in Europe and the USA have been in gay, bisexual and other men who have sex with men , a population in which clade Ib mpox transmission has not previously been observed.   Mpox is usually a mild infection , and clade Ia and Ib mpox are no longer classified as a high-consequence infectious disease (HCID). However, it can be severe in some cases.  The UK has a routine mpox vaccination programme in place for eligible groups, including those who:   -- have multiple sexual partners   -- have group sex   -- visit sex-on-premises venues   Studies show that the vacc...

  Abstract Influenza antivirals play an important role in the prevention and control of influenza. We reviewed data on the effectiveness of influenza antivirals for reducing influenza transmission . We found that antiviral prophylaxis , whether given pre- or postexposure , has been shown to reduce the risk of symptomatic influenza in a variety of settings and populations . During pandemic responses, antiviral prophylaxis could play an important role, as demonstrated by the use of amantadine in the 1968–1969 influenza A(H3N2) pandemic and oseltamivir during the 2009–2010 influenza A(H1N1)pdm09 pandemic. Antiviral treatment reduces symptom severity, prevents complications, and can reduce onward transmission of infection. However, resistance, accessibility, and timing pose challenges. Future research directions include innovative therapies and combination treatments. Continued research and stewardship are crucial to optimize antiviral impact. Source: Journal of Infectious Diseases,...

  Abstract Influenza A viruses remain a global health threat, yet no universal antibody therapy exists . Clinical programs have centered on neutralizing mAbs , only to be thwarted by strain specificity and rapid viral escape . We instead engineered three non-neutralizing IgG2a mAbs that target distinct, overlapping epitopes within the conserved N terminus of the M2 ectodomain (M2e). Combined at low dose, this “triple M2e-mAb” confers robust prophylactic and therapeutic protection in mice challenged with diverse human and zoonotic IAV strains, including highly pathogenic variants. Therapeutic efficacy depends on Fc-mediated effector activity via FcγRI, FcγRIII, and FcγRIV, rather than in vitro neutralization. Serial passaging in triple M2e-mAb–treated immunocompetent and immunodeficient hosts failed to generate viral escape mutants. Our findings redefine the influenza-specific antibody therapeutic design and support Fc-optimized, non-neutralizing M2e-mAbs as a broadly effective, mut...

  Key Points -- Question:  Is regular application of azelastine nasal spray associated with reduced risk of SARS-CoV-2 infections? - Findings:  In this randomized placebo-controlled clinical trial that included 450 participants , the incidence of laboratory-confirmed SARS-CoV-2 infections was significantly lower with application of azelastine nasal spray compared with placebo treatment. -- Meaning:  The use of azelastine nasal spray may help to reduce the risk of SARS-CoV-2 infections. Abstract Importance    Limited pharmaceutical options exist for preexposure prophylaxis of COVID-19 beyond vaccination. Azelastine, an antihistamine nasal spray used for decades to treat allergic rhinitis, has in vitro antiviral activity against respiratory viruses, including SARS-CoV-2. Objective    To determine the efficacy and safety of azelastine nasal spray for prevention of SARS-CoV-2 infections in healthy adults. Design, Setting, and Participants   ...

  Summary Background Rabies is almost invariably fatal . A rabies monoclonal antibody (RmAb) was approved in India in 2016 for passive prophylaxis. This post-marketing study aimed to evaluate the long-term safety, immunogenicity, and efficacy of a post-exposure prophylaxis (PEP) regimen containing RmAb. Methods This phase 4, open-label, randomised, active-controlled study was conducted at 15 tertiary care hospitals in India . Patients aged 2 years or older with WHO category 3 rabies exposure by a suspected rabid animal were eligible if the exposure occurred less than 72 h before enrolment, or less than 24 h before enrolment for exposures to the face, neck, hand, or fingers. Participants were randomly assigned (3:1) to receive either RmAb (Rabishield; Serum Institute of India, Pune, India) plus a purified Vero cell rabies vaccine (PVRV; Rabivax-S) or equine rabies immunoglobulin (ERIG; Equirab) plus PVRV as PEP. In each treatment group, patients were further randomly assigned (1:1) ...

Abstract Background Baloxavir marboxil (baloxavir) rapidly reduces influenza virus shedding , which suggests that it may reduce transmission. Studies of treatment with neuraminidase inhibitors have not shown sufficient evidence that they prevent transmission to contacts. Methods We conducted a multicountry, phase 3b trial to assess the efficacy of single-dose baloxavir treatment to reduce influenza transmission from index patients to household contacts. Influenza-positive index patients 5 to 64 years of age were randomly assigned in a 1:1 ratio to receive baloxavir or placebo within 48 hours after symptom onset. The primary end point was transmission of influenza virus from an index patient to a household contact by day 5. The first secondary end point was transmission of influenza virus by day 5 that resulted in symptoms. Results Overall, 1457 index patients and 2681 household contacts were enrolled across the 2019–2024 influenza seasons; 726 index patients were assigned to the baloxa...

Abstract The effectiveness of antivirals in mitigating influenza outbreaks depends on both their ability to reduce the number of infections and the risk of drug resistance. We extended a previously developed mathematical model to investigate the impact of mitigation strategies , including mono or combination antiviral treatment or chemoprophylaxis and vaccination , on influenza transmission dynamics. Our findings indicate that chemoprophylaxis is more effective than treatment in reducing influenza burden, except when the resistant strain has a high transmission rate, in which case chemoprophylaxis may trigger a resistance-driven secondary infection wave. Combination therapy considerably reduces resistance emergence with similar infection numbers as mono-therapy. Vaccination coverage of at least 80% is required to prevent outbreaks; otherwise, antivirals can contribute to outbreak control provided drug resistance emergence is low. This analysis could inform public health decision-making...

Abstract Background Influenza is a pervasive respiratory infection which disproportionately burdens long-term care residents. To limit outbreaks, guidelines recommend antiviral prophylaxis, particularly oseltamivir or zanamivir , despite acknowledging the inadequate supporting evidence . Therefore, we aimed to review the literature on the efficacy of oseltamivir, zanamivir, and baloxavir prophylaxis for influenza in long-term care. Methods Medline, Embase, PubMed, and several other databases were searched from inception to August 16, 2023. For inclusion, observational studies or randomized controlled trials (RCTs) had to report influenza-like illness (ILI) or infection rates amongst adult long-term care populations receiving prophylaxis. Outcome values were meta-analyzed as intervention-specific pooled proportions (PPs) and risk ratios (RRs) when applicable. Risk of bias was assessed via the Cochrane risk of bias tool 2.0 and Joanna Briggs Institute checklist. Results In total, 14 stud...