#Taiwan, Seasonal #Influenza and #COVID19 #Epidemics Weekly #Update (CDC, September 15 '26): #H1N1pdm09 flu virus & #SARS-CoV-2 PQ.16.1.1 predominated

 

{Excerpts}

(...)

    The CDC pointed out that the domestic influenza epidemic is rising and in its epidemic season. 

    In the 36th week (September 6th-12th), there were 136,796 outpatient and emergency room visits for influenza-like illnesses, an increase of 16.5% compared to the previous week. 

    Additionally, last week (September 8th-14th), there were 92 new cases of severe influenza complications (79 H1N1, 5 H3N2, and 8 untyped A cases) and 21 deaths (18 H1N1, 2 H3N2, and 1 untyped A case). 

    Laboratory monitoring data shows that the influenza virus currently circulating in the community is mainly type A, with type A H1N1 accounting for 82.2%. 

    This flu season has seen a cumulative total of 1,421 severe cases (800 H1N1, 503 H3N2, 28 untyped type A, and 90 type B) and 274 deaths (149 H1N1, 104 H3N2, 9 untyped type A, and 12 type B). 

    The majority of severe cases are among those aged 65 and above (65.0%) and those with a history of chronic diseases (82.7%). 68.3% of those affected have not received the flu vaccine this season.

    According to data from the Taiwan Centers for Disease Control (CDC), the COVID-19 epidemic in Taiwan is declining, but it is still in its epidemic period. 

    In week 36 (September 6-12), there were 17,847 outpatient and emergency room visits related to COVID-19, a 13.3% decrease compared to the previous week (August 30-September 5). 

    Last week (September 8-14), there were 53 new severe cases and 18 local deaths. 

    Since October 2025, there have been a cumulative total of 675 locally transmitted cases of COVID-19 complicated by severe illness, of which 124 have died. 

    Severe cases are predominantly among those aged 65 and above (73.3%) and those with a history of chronic diseases (82.8%). 83.6% of these cases have not received the COVID-19 vaccine this season. 

    In the past four weeks, the most prevalent local variants have been NB.1.8.1 and PQ.16.1.1.

(...)

Source: 

Link: https://www.cdc.gov.tw/Bulletin/Detail/CqW5UAMFqpDkwJWfWG-WGw?typeid=9

____

Assessment of immune #response induced by ChAdOx1 nCoV-19, Sputnik V, and BNT162b2 #vaccines during #COVID19 #outbreak in #Mexican population: Gene expression of the #cytokine storm

 

Highlights

    • The molecular immune response triggered by vaccines against COVID-19 was analyzed.

    • The evaluated genes were ACE2, CD79B, TMPRSS2, CTSB, FCGR3A and MB-1.

    • These vaccines induce a protective immune response through various mechanisms.

    • Vaccines regulate the immune response through pro- and anti-inflammatory cytokines.

Abstract

Introduction

COVID-19 vaccines using different technological platforms may induce distinct molecular responses. Characterizing gene-expression patterns after vaccination and in fatal COVID-19 may identify pathways associated with vaccination and severe disease.

Objective

To compare immune-, inflammatory-, and SARS-CoV-2-entry-related gene expression after AstraZeneca, Pfizer, or Sputnik V vaccination and with unvaccinated fatal COVID-19.

Materials and methods

Eighty Mexican adults were included: AstraZeneca (n = 19), Pfizer (n = 20), Sputnik (n = 21), and unvaccinated fatal COVID-19 (n = 20). Expression of 11 genes was measured by qPCR at days 30 (D30) and 60 (D60) after vaccination.

Statistical analysis

Longitudinal differences were analyzed by two-way repeated-measures ANOVA. Comparisons with fatal COVID-19 were exploratory. Benjamini–Hochberg correction controlled false discovery rate at 5%.

Results

No differences among vaccines were detected at D30. At D60, IL-10, IL-2, and CD79A differed among selected vaccine groups. Longitudinally, FCGR3A decreased in AstraZeneca and Sputnik, ACE2 decreased in Pfizer and Sputnik, and TMPRSS2 increased in Sputnik. Fatal COVID-19 showed predominantly higher expression of several genes than vaccinated groups. Notably, IL-2 and ACE2 were consistently higher in fatal COVID-19 than in all vaccinated groups at both time points.

Discussion and conclusions

Post-vaccination transcriptional profiles were dynamic, with selected differences emerging at D60, whereas fatal COVID-19 exhibited a distinct profile characterized predominantly by higher expression of immune-, inflammatory-, and viral-entry-related genes. Consistent IL-2 and ACE2 differences highlight molecular pathways potentially associated with severe disease. The observational design, however, precludes causal attribution to vaccination.

Perspectives

Longitudinal studies with appropriate controls are needed to establish the biological significance of these transcriptional patterns.

Source: 

Link: https://doi.org/10.1016/j.meegid.2026.106025

____

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Respiratory #pandemic #risk in the #Anthropocene: A #OneHealth #framework and #GISRS+ agenda

 

Highlights

    • Respiratory pandemics are now a structural feature of the Anthropocene.

    • H5Nx and SARS-related CoVs are identified as leading pandemic candidates.

    • A geographic mismatch exists between spillover risk and surveillance.

    • A multidimensional GISRS+ agenda is proposed for proactive One Health.

Abstract

Recent epidemics and pandemics caused by respiratory viruses, alongside the animal panzootic spread of highly pathogenic avian influenza A(H5Nx), have become a structural feature of the Anthropocene, yet responses remain largely reactive. This review integrates findings from WHO's Global Influenza Surveillance and Response System (GISRS) and related surveillance data (2000–2024), epidemiological studies of influenza A virus, SARS-CoV, MERS-CoV, SARS-CoV-2, and H5Nx, and One Health literature. We examine major groups of respiratory viruses and identify mismatches between risk and surveillance by focusing on spillover potential from animal hosts, human-to-human transmission and its controllability, and Anthropocene characteristics that increase epidemic risk. The analysis indicated that SARS-related coronaviruses and influenza A viruses, particularly H5Nx, are among the leading candidates based on currently available evidence because they have large reservoirs in animal hosts and spillover to humans is highly probable. The previous presymptomatic spread of SARS-CoV-2 and recent mammalian adaptation in H5N1 clade 2.3.4.4b highlight limitations of the traditional symptom-based and pathogen-specific surveillance system. Spillover events tend to occur in tropical and subtropical regions in low- and middle-income countries, but most genomic surveillance is in high-income countries. We propose interventions that address the upstream, midstream, downstream processes of epidemics. Upstream interventions are primary prevention measures related to land use, livestock, wildlife, and urban environments; midstream interventions are GISRS+-based pathogen-agnostic genomic and metagenomic early warning systems triggered by One Health; and downstream interventions include vaccines, antivirals, non-pharmaceutical interventions, and engineering with equity-centred global governance and sustainable financing.

Source: 

Link: https://doi.org/10.1016/j.onehlt.2026.101553

____

Increased #receptor #binding and #spike #glycosylation, remodeled immune escape of surging #SARS-CoV-2 subvariant BA.3.2.2/RE.2.2/Cicada

 

Significance

SARS-CoV-2 evolved into distinct phylogenetic clades, generating a series of mutant strains. Notably, variants such as BA.1, BA.2.86, and BA.3.2 deserve special attention as they emerged abruptly at high detection frequencies during specific periods and harbored extensive mutations in the spike protein relative to contemporaneously prevalent strains, often accompanied by unique phenotypic characteristics. In this study, we primarily evaluated the structural and functional features of the BA.3.2.2 S protein, revealing its distinct traits in receptor binding, immune evasion, cross-species transmission, and glycosylation evolution. We observed constrained viral immune escape, as certain antibodies that were nonneutralizing against previously dominant subvariants exhibited neutralizing activity against recently emerged BA.3.2.2. These findings provide mechanistic insights for viral surveillance, vaccines, and therapeutics development.

Abstract

SARS-CoV-2 continues to evolve. The subvariant BA.3.2 (Cicada), a derivative of the Omicron BA.3 subtype first detected in late 2024, harbors multiple spike protein mutations, ORF7 and ORF8 deletions, and has recently evolved sublineages (BA.3.2.1 and BA.3.2.2), rendering it a critical target for epidemiological surveillance. The BA.3.2.2 sublineage, represented by RE.2.2, shows a marked upward trend in late 2025. Using surface plasmon resonance, we found that RE.2.2’s spike (S) protein receptor-binding domain (RBD) exhibits relatively high affinity for human receptor angiotensin-converting enzyme 2, with structural analysis identifying the R493Q reverse mutation as the key determinant. Pseudovirus infection and antibody neutralization assays demonstrated that RE.2.2 exhibited a distinct neutralization profile compared to contemporaneous dominant subvariants. Notably, several antibodies that previously lacked neutralizing activity (e.g., S2K146 and L4.65) to other subvariants regained neutralizing potency against RE.2.2, which was associated with key mutations including G446D. Profiling of RE.2.2 RBD binding to ACE2 orthologs across species showed no significant difference in species tropism from the representative Omicron BA.1. Importantly, RE.2.2 exhibits the newly emerged N-linked glycosylation at spike protein N529 (absent in all other subvariants), a modification potentially associated with immune evasion or spike protein conformational dynamics. In addition, we corroborated the “O-follow-N” glycosylation observation as previously reported, where O-linked glycans preferentially localize near N-glycosylation sites, implying coordinated glycan organization as an extra layer of spike regulation. These findings illuminate the evolutionary characteristics, functional changes, and the constrained virus immune escape of BA.3.2.2 (RE.2.2), providing critical insights into antibody development and variant surveillance.

Source: 

Link: https://www.pnas.org/doi/10.1073/pnas.2614163123

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#Taiwan, Seasonal #Influenza and #COVID19 Epidemics Weekly #Update (CDC, September 8 '26): H1N1pdm09 flu virus & SARS-CoV-2 PQ.16.1.1 variant are predominant

 

{Excerpts}

(...)

    The CDC pointed out that in week 35 (August 30th - September 5th), there were 115,136 outpatient and emergency room visits for influenza-like illnesses, an increase of 11.0% from the previous week, showing a recent upward trend. 

    The percentage of emergency room visits reached 11.2%, exceeding the epidemic threshold (11.0%), indicating the start of the epidemic period. 

    Additionally, last week (September 1st - September 7th), there were 105 new cases of severe influenza complications (97 H1N1, 4 H3N2, 4 untyped A cases) and 19 deaths (18 H1N1, 1 untyped A case). 

    Laboratory monitoring data shows that the influenza virus currently circulating in the community is mainly type A, with type A H1N1 accounting for 79.4% of the cases. 

    This flu season (2023-2024) has seen a cumulative total of 1,329 severe cases (717 H1N1, 498 H3N2, 24 untyped type A, and 90 type B) and 253 deaths (131 H1N1, 102 H3N2, 8 untyped type A, and 12 type B). 

    The majority of severe cases are among those aged 65 and above (65.1%) and those with a history of chronic diseases (82.8%). 68.6% of those affected have not received the flu vaccine this season.

    According to data from the Taiwan Centers for Disease Control (CDC), the COVID-19 epidemic in Taiwan is declining, but it is still in its epidemic period. 

    In week 35 (August 30 - September 5), there were 20,199 outpatient and emergency room visits related to COVID-19, a 9.7% decrease compared to the previous week (August 23 - August 29). 

    Last week (September 1 - September 7), there were 73 new severe cases and 15 deaths. 

    Since October 2025, there have been a cumulative total of 622 locally transmitted cases of COVID-19 complicated by severe illness, of which 106 have died. 

    The majority of severe cases are among those aged 65 and above (72.7%) and those with a history of chronic diseases (83.0%). 84.9% of these cases have not received the COVID-19 vaccine this season. 

    In the past four weeks, the predominant variant strain in locally transmitted cases has been PQ.16.1.1.

(...)

Source: 

Link: https://www.cdc.gov.tw/Bulletin/Detail/5gJTj70wu9L3psY5kQLUuA?typeid=9

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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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#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

 

Summary

Background

Post-acute sequelae of SARS-CoV-2 infection, more commonly known as long COVID, has emerged as a major health problem. The pathogenesis of long COVID is unknown, but among the leading hypotheses is viral persistence. We aimed to investigate whether the use of the SARS-CoV-2 antiviral nirmatrelvir–ritonavir improved long COVID symptoms.

Methods

We conducted a double-blind, placebo-controlled, randomised trial involving adults who had developed persistent symptoms (≥12 weeks) associated with three major symptom phenotypes (cognitive, autonomic, or exercise) after acute SARS-CoV-2 infection at 69 US sites. Participants were eligible if they were 18 years or older and had a previous suspected, probable, or confirmed SARS-CoV-2 infection, as defined by the Pan American Health Organization. Eligible participants were also required to have either at least two moderate symptoms from the same phenotype or one severe phenotype-associated symptom, as identified with the Cluster Targeted COVID-19 Symptom Questions. Participants were randomly allocated in a double-blind manner in a 1:1:1 ratio using permuted blocks of size 30 to receive either 15 days of active intervention followed by 10 days of placebo (300 mg nirmatrelvir–100 mg ritonavir twice daily, then 100 mg ritonavir–placebo); 25 days of active intervention (300 mg nirmatrelvir–100 mg ritonavir twice daily); or 25 days of placebo–ritonavir (100 mg ritonavir–placebo). A clinically significant change in patient-reported outcomes at day 90 comprised the primary endpoint: Patient-Reported Outcomes Measurement Information System Cognitive Function Short Form 8a, Orthostatic Hypotension Questionnaire question 1, and a modified version of the DePaul Symptom Questionnaire Post-Exertional Malaise short form. Secondary outcomes were phenotype-specific performance measures. The study was registered at ClinicalTrials.gov (NCT05595369) and is complete.

Findings

Between July 27, 2023, and Sept 6, 2024, 1207 individuals were screened. Of these, 964 were randomly allocated and 959 participants, excluding four participants who were later found ineligible and one who did not initiate treatment, were enrolled in the three phenotypes: 332 to cognitive, 334 to autonomic, and 332 to exercise. In the 959 participants in the mITT population, 643 (67%) self-reported as female, 314 (33%) were male, and two participants had a sex of unknown or undifferentiated; 750 (78%) were White; and 108 (11%) were Hispanic, Latino, or Spanish. The median age was 49 years (IQR 38–59). No statistically significant benefits were observed for any phenotype for primary endpoints. For the cognitive phenotype, adjusted differences compared to placebo were 3·2% (95% CI –10·4 to 16·8, p=0·65) for the 25-day regimen and –2·2% (–15·5 to 11·1, p=0·74) for the 15-day regimen. For the autonomic phenotype, adjusted differences were –6·4% (–18·5 to 5·7, p=0·30) for the 25-day regimen compared to placebo and –0·1% (–12·5 to 12·3, p=0·99) for the 15-day regimen compared to placebo. For exercise, adjusted differences were –7·8% (–19·5 to 3·8, p=0·19) for the 25-day regimen compared to placebo and 0·9% (–11·4 to 13·2, p=0·88) for the 15-day regimen compared to placebo. There were no differences in secondary endpoints, and no safety signals were observed; there were no deaths, and 52 serious adverse events occurred in 42 (4%) of 963 participants over the course of the study.

Interpretation

Nirmatrelvir–ritonavir for 15 days or 25 days showed no evidence of benefit in long COVID in any of the three phenotypes studied. These findings suggest additional approaches to measuring the symptom burden and treating Long COVID are needed.

Funding

National Institutes of Health.

Source: 

Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00406-8/fulltext

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