#Marburg virus disease– United Republic of #Tanzania

Situation at a glance

On 13 March 2025, the Ministry of Health of the United Republic of Tanzania declared the end of the Marburg virus disease (MVD) outbreak. 

This declaration came after two consecutive incubation periods (a total of 42 days) since the last person confirmed with MVD died on 28 January 2025 and was given a safe and dignified burial, in accordance with WHO recommendations. 

No new confirmed cases were reported since then. 

The outbreak was declared on 20 January 2025. As of 12 March 2025, two confirmed and eight probable cases were reported by the Ministry of Health from Biharamulo district in Kagera region. All 10 cases died (case fatality ratio 100%), including eight who died before the confirmation of the outbreak. A total of 272 contacts that were listed for monitoring completed their 21-day follow-up as of 10 February 2025. WHO, through its country office, and partners provided technical, operational and financial support to the government to contain this outbreak. The risk of re-emergence of MVD remains after the official declaration of the end of the outbreak, linked to the animal reservoir’s presence in the country. WHO encourages maintaining early case detection and care capacities in addition to sustaining the ability to quickly respond, and continued risk communication and community engagement.

Description of the situation

Since the last Disease Outbreak News on this event, published on 14 February 2025, no new confirmed cases of Marburg virus disease (MVD) have been reported in the United Republic of Tanzania.

As of 12 March 2025, 10 cases have been reported including two confirmed and eight probable cases. All cases resulted in deaths, including eight who died before the confirmation of the outbreak and were classified as probable cases, resulting in a case fatality ratio of 100%.

The first identified case, an adult female, had symptom onset on 9 December and died on 16 December 2024. The last confirmed case died on 28 January, and a safe and dignified burial was performed. No new confirmed or probable cases have been reported following this burial. All 10 cases were reported from Biharamulo district in Kagera region; the median age of cases was 30 years (range: 1 to 75 years) and the majority of cases (70%, 7) were females.

Cumulatively, 108 suspected cases were reported between 20 January and 11 March, of which 106 tested negative for MVD.

As of 12 March 2025, 281 contacts had been listed, including nine who were subsequently classified as probable and confirmed cases and 272 contacts who completed 21 days of follow-up.

On 13 March 2025, after two consecutive incubation periods (a total of 42 days) without a new confirmed case being reported after the last confirmed case died on 28 January 2025, the Ministry of Health of the United Republic of Tanzania declared the end of the MVD outbreak, as per WHO recommendations.

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Epidemiology

MVD is a highly virulent disease that can cause severe disease and is clinically similar to Ebola disease (EBOD). EBOD and MVD are caused by orthoebolaviruses and orthomarburgviruses respectively; both are members of the Filoviridae family (filovirus). People become infected after prolonged exposure to mines or caves inhabited by Rousettus fruit bat colonies, a type of fruit bat that can carry the Marburg virus.  Marburg virus then spreads between people via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids. Health workers have previously been infected while treating patients with MVD. Burial ceremonies that involve direct contact with the body of the deceased can also contribute to the transmission of Marburg virus.

The incubation period varies from two to 21 days. Illness caused by the Marburg virus begins abruptly, with a high fever, severe headache, and severe malaise. Severe watery diarrhoea, abdominal pain and cramping, nausea, and vomiting can begin on the third day. Although not all cases present with haemorrhagic signs, severe haemorrhagic manifestations may appear between five and seven days from symptom onset, and fatal cases usually have some form of bleeding, often from multiple areas of the body. In fatal cases, death occurs most often between eight and nine days after symptom onset, usually preceded by severe blood loss and shock. There is currently no approved treatment or vaccine for MVD. Some candidate vaccines and therapeutics are currently under investigation.

Eighteen outbreaks of MVD have previously been reported globally. The most recent outbreak was reported in Rwanda between September and December 2024. Additional countries that previously reported outbreaks of MVD in the African Region include Angola, the Democratic Republic of the Congo, Equatorial Guinea, Ghana, Guinea, Kenya, South Africa, and Uganda. 

Public health response

The Ministry of Health developed a national response plan to guide response activities.

A National Incident Management System was activated to coordinate the response to the event; a national task force was activated, and meetings were held weekly. At the sub-national level, regular coordination meetings were held daily in Kagera Region.

A national rapid response team was deployed to Kagera to enhance outbreak investigation and response, with technical and operational support from WHO and health partners.

WHO deployed experts to support the Ministry of Health with Emergency management and partner coordination, clinical management, health logistics, infection prevention and control, and other response activities in different pillars.

Surveillance activities were conducted with active case finding, contact tracing and mortality surveillance across affected and neighbouring areas.

The mobile laboratory deployed in Kabyaile was utilized to support the testing of suspect cases for rapid turnaround time, and samples were referred to the National Public Health Laboratory in Dar es Salaam for additional tests.  

Travellers departing from the Kagera Region were screened at key points of entry and exit, including Bukoba airport.

Health and care worker sensitization sessions on infection prevention and control were conducted across Kagera and other regions.

The Marburg Treatment Unit was upgraded with enhanced triage, patient wards, and donning and doffing areas.

Public awareness campaigns were conducted, including health education, door-to-door outreach by community health workers, and public announcements in high-risk areas.

Cross-border meetings were convened between Tanzania, Uganda, and Burundi.

WHO procured and delivered four VHF kits to Kagera region to support care for patients and infection prevention and control measures.

WHO risk assessment

With two confirmed cases and eight probable cases reported, this is the second MVD outbreak reported in the country in the last three years. Both outbreaks occurred in the same region of Kagera located at the border with Rwanda and Uganda. 

The case fatality ratio of 100% is concerning, although has been recorded in previous outbreaks, additionally 8 of the 10 cases were probable i.e. reported after their death. Late health seeking behaviour in MVD outbreaks increases the risk of further transmission.  

The source of the outbreak is still unknown, and research activities are planned. Based on the outbreak investigation and surveillance activities during the response, which included contact tracing, alert management, active case search, and mortality surveillance, no additional cases have been reported during the 42-day countdown period. However, there remains a risk of re-emergence of MVD following the declaration of the end of the outbreak, linked to a new spillover from interactions with the animal reservoir.

Based on the available information at the end of MVD outbreak in Tanzania, the risk is considered as moderate at the national level, and low at regional and global levels.

WHO advice

WHO encourages maintaining early detection and care capacities in addition to sustaining the ability to quickly respond after the outbreak ends. This is to make sure that if the disease re-emerges, health authorities can detect it immediately, prevent the disease from spreading again, and ultimately save lives.

Raising awareness of risk factors for Marburg virus infection and protective measures that individuals can take is an effective way to reduce human transmission. WHO advises the following risk reduction measures as an effective way to reduce MVD transmission in healthcare facilities and in communities:

-- Reducing the risk of bat-to-human transmission arising from prolonged exposure to mines or caves inhabited by fruit bat colonies. People visiting or working in mines or caves inhabited by fruit bat colonies should wear gloves and other appropriate protective clothing (including masks).

-- Capabilities for early detection of MVD patients should be maintained over time in settings at risk of the disease.

-- Reducing the risk of human-to-human transmission in the community arising from direct or close contact with infected patients, particularly with their body fluids. Close physical contact with MVD patients should be avoided. Patients suspected or confirmed for MVD should be isolated in a designated treatment centre for early care and to avoid transmission at home.

-- Communities affected by MVD, along with health authorities, should ensure that the population is well informed, both about the nature of the disease itself and about necessary outbreak containment measures.

-- Outbreak containment measures include safe and dignified burial of the deceased, identifying people who may have been in contact with someone infected with MVD and monitoring their health for 21 days, separating the healthy from the sick to prevent further spread and providing care to the confirmed patient. Maintaining good hygiene and a clean environment need to be observed.

-- Critical infection prevention and control measures should be implemented and/or strengthened in all health care facilities, per WHO’s Infection prevention and control guideline for Ebola and Marburg disease. Health workers caring for patients with confirmed or suspected MVD should apply transmission-based precautions in addition to: standard precautions, including appropriate use of PPE and hand hygiene according to the WHO 5 moments to avoid contact with patient’s blood and other body fluids and with contaminated surfaces and objects. Waste generated in healthcare facilities must be safely segregated, collected, transported, stored, treated and finally disposed. Follow the national guidelines, rules and regulations for safe waste disposal or follow the WHO’s guidelines on safe waste management.

-- Patient-care activities should be undertaken in a clean and hygienic environment that facilitates practices related to the prevention and control of health-care-associated infections (HAIs) as outlined in Essential environmental health standards in health care. Safe water, adequate sanitation and hygiene infrastructure and services should be provided in healthcare facilities. For details on recommendations and improvement, follow the WASH FIT implementation Package

-- WHO encourages countries to implement a comprehensive care programme to support people who have recovered from MVD (if any) with any subsequent sequelae and to enable them to access body fluid testing and to mitigate the risk of transmission through infected body fluids by adequate practices.

Based on the current risk assessment, WHO advises against any travel and trade restrictions with the United Republic of Tanzania.

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Source: World Health Organization, https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON559

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A novel reassorted #swine #H3N2 #influenza virus demonstrates an undetected #human-to-swine #spillover in Latin #America and highlights zoonotic risks

Highlights

• First isolation and molecular evidence of the subtype H3N2 in swine in Colombia.

• Swine H3N2 discovered is phylogenetically divergent from other viruses.

• Colombian H3N2 was originated from an independent human-to-swine spillover.

• Sequence-based analysis reveals this is a novel antigenic variant.

• Due to antigenic variation, Colombian H3N2 possess a relevant zoonotic risk.

Abstract

Influenza A virus (FLUAV) affects a wide range of hosts, including humans and animals, posing a threat to public health. In swine, H3N2 subtype is associated with human-to-swine spillovers of seasonal viruses. In Latin America, the molecular and antigenic characteristics of swine FLUAV H3N2, as well as its phylogenetic origin, are poorly understood. Therefore, the objective of this study was to characterize the first swine H3N2 detected in Colombia. The origin and lineage of the virus were estimated through phylogenetic and molecular clock analyses. Antigenic characterization was achieved by comparing the amino acid constitution of the HA with previously reported swine FLUAVs and seasonal vaccine strains using a sequence-based method. In addition to HA and NA, internal genes were also characterized. The results showed that the Colombian H3N2 corresponded to a novel phylogenetic and antigenic swine FLUAV variant that emerged due to an independent reverse zoonotic event, likely occurring in Colombia in the early 2000s. The immunodominant epitope in the virus was predominantly present in antigenic epitope A, which showed the highest amino acid variation. Some mutations that alter the N-Glycosylation of antigenic sites at the HA were detected. Internally, the virus exhibited pandemic configuration. This study provides the first evidence of a novel FLUAV in Colombia and describes its origin, variability, and persistence in geographically restricted populations, highlighting the need for strengthen molecular surveillance of the virus in animal populations.

Source: Virology, https://www.sciencedirect.com/science/article/abs/pii/S0042682225000959?via%3Dihub

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#Evidence of novel #reassortment in clade 2.3.4.4b avian #influenza #H5N1 viruses, #India, 2024

Highlights

• This is the first report of clade 2.3.4.4b H5N1 virus from India.

• Evidence of novel reassortment between H5N1 and low pathogenic H3N8 viruses.

• Absence of H5N1 infection among people with probable exposure.

Abstract

H5N1 viruses belonging to clade 2.3.4.4b have caused unprecedented outbreaks globally. Outbreaks of H5N1 virus were reported in poultry and wild birds from Kerala (India) in the year 2024. Samples from birds and the environment were collected. Real-time RT-PCR and virus isolation using embryonated chicken eggs were carried out. Eight out of 20 samples were positive for virus isolation. The virus showed avian type receptor specificity using sialidase assay. Full genome sequencing revealed markers associated with high pathogenicity and mammalian adaptation. All the viruses belonged to a single genotype with multiple reassortments, including internal gene segments from an avian influenza (AI) H3N8 virus reported from Kerala. Surveillance among individuals with probable exposure showed absence of human infection. This is the first report of the genetic and virological characterization of clade 2.3.4.4b H5N1 viruses from India, highlighting the need for increased AI surveillance at the human-animal and domestic-wild bird interfaces.

Source: Virology, https://www.sciencedirect.com/science/article/abs/pii/S0042682225000947?via%3Dihub

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#HPAI Virus in #Mammals: Lack of #Detection in #Cattle With Respiratory Tract Infections & Genetic Analysis of Sporadic #Spillover Infections in Wild Mammals in #Bavaria, Germany, 2022–23

ABSTRACT

Background

In 2021, the H5N1 clade 2.3.4.4b Avian Influenza Viruses (AIVs) emerged on the American continent. At the same time, a further global spread took place. Infections have been reported in avian species as well as in over 50 mammalian species in 26 countries, and often result in severe disease with notable neurological pathology. Outbreaks in dairy cattle in the United States in 2024 illustrate viral transmission at a non-traditional interface and cross-species transmission. This development raises significant global concern regarding the virus's potential for wider spread. Given that H5N1 infections in birds reached record-high levels in Germany by late 2022, it is important to investigate whether Influenza A Virus (IAV) infections were also occurring in mammals sharing habitats with wild birds.

Methods and Results

Selected wild and domestic mammal populations were monitored over a two-year period (from January 2022 to December 2023), which coincided with a major infection period in wild birds in Bavaria. Genomes of Highly Pathogenic Avian IAV H5N1 (clade 2.3.4.4b) were detected in red foxes but not in samples from ruminants such as red deer or domestic cattle. Analyses of viral whole genome sequences revealed several mutations associated with mammalian adaptation.

Conclusion

Our results indicate a high frequency of spillover events to red foxes at a time when there was a peak of H5N1 infections in wild birds in Bavaria. Phylogenetic analyses show no specifically close genetic relationship between viruses detected in mammalian predators within a geographic area. While direct fox-to-fox transmission has not yet been reported, the H5N1 clade 2.3.4.4b AIVs' ability to spread through non-traditional interfaces and to cross species barriers underlines the importance of continuous IAV surveillance in mammals and possibly including previously unknown host species.

Source: Zoonoses and Public Health, https://onlinelibrary.wiley.com/doi/10.1111/zph.13217

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Highly Pathogenic Avian #Influenza A(#H5N1) Virus #Stability in Irradiated Raw #Milk and #Wastewater and on #Surfaces, #USA

Abstract

We measured stability of infectious influenza A(H5N1) virus in irradiated raw milk and wastewater and on surfaces. We found a relatively slow decay in milk, indicating that contaminated milk and fomites pose transmission risks. Although the risk is low, our results call for caution in milk handling and disposal from infected cattle.

Source: US Centers for Disease Control and Prevention, https://wwwnc.cdc.gov/eid/article/31/4/24-1615_article

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#Tecovirimat is #safe but #ineffective as #treatment for clade II #mpox

The antiviral drug tecovirimat used without other antivirals did not reduce the time to clinical resolution of clade II mpox lesions or improve pain control among adults in an international clinical trial sponsored by the National Institutes of Health (NIH). 

The trial enrollment was stopped in late 2024 when an interim analysis showed that tecovirimat monotherapy was ineffective in the study population. Detailed results were presented at the 2025 Conference on Retroviruses and Opportunistic Infections (CROI) in San Francisco.

“This study brought us a step forward in better understanding mpox disease and potential treatment strategies,” said Jeanne Marrazzo, M.D., M.P.H., director of NIH’s National Institute of Allergy and Infectious Diseases (NIAID), which sponsored and funded the trial. “We are grateful to the study team and participants for their contributions to groundbreaking research on a disease that we still do not know enough about.”

Mpox is caused by a virus that spreads mainly through close contact. Two types of the virus have been identified, referred to as clades I and II. A clade II virus subtype caused a global mpox outbreak in 2022, and the virus continues to circulate at low levels. In 2024, a clade I outbreak in Central and East African countries was declared a public health emergency of international concern. Travel-related cases of clade I mpox have been reported in the United States, but the risk of clade I mpox to the U.S. population remains low. People with significantly compromised immune systems or certain preexisting skin conditions, children and pregnant women have an elevated risk of developing severe mpox.

The Study of Tecovirimat for Mpox (STOMP) began in September 2022 as part of the U.S. whole-of-government response to the clade II mpox outbreak. There are no mpox treatments approved in the United States. Based on animal studies, tecovirimat, also known as TPOXX, was approved by the Food and Drug Administration (FDA) to treat smallpox(link is external)—a disease caused by a virus closely related to, but typically causing disease far more serious than, the virus that causes mpox. The drug had not been studied in people with mpox until the STOMP trial and a complementary study called PALM007 in the Democratic Republic of the Congo. PALM007 reported findings in 2024 that were similar to the findings reported from STOMP.

STOMP was a randomized international efficacy study that enrolled participants who had been ill with mpox for fewer than 14 days in Argentina, Brazil, Japan, Mexico, Peru, Thailand and the United States, including Puerto Rico. Randomized study participants and trial investigators were blinded, meaning they did not know who received tecovirimat or placebo. Children, pregnant women, study participants with certain skin conditions or substantially suppressed immune systems, and participants who had severe mpox disease as defined in the study protocol were assigned to an open-label study arm, meaning they all received tecovirimat instead of being randomized. The STOMP study assessed the safety of the drug among all study participants and, in randomized arms, evaluated whether a 14-day course of tecovirimat monotherapy reduced the time to clinical resolution of visible mpox lesions and improved other outcome measures like pain, compared to a placebo.

Randomized participants reported experiencing mpox symptoms for a median of eight days before study entry and had a median of nine mpox lesions. About a third of participants reported severe pain, selecting scores of 7-10 on an 11-point scale. By day 29 following study entry, an estimated 83% of participants receiving tecovirimat had reached clinical resolution, compared to 84% who received a placebo, a non-significant difference. Among those reporting severe pain at baseline, improvements were similar between those who received tecovirimat and placebo, with average pain scores decreasing by 3.2 points for participants receiving tecovirimat and by 3.1 points among those receiving the placebo. Participants’ lesions were swabbed and tested for the presence of DNA from the virus that causes mpox throughout the study. At day eight, 48% of participants receiving tecovirimat had undetectable viral DNA compared to 37% of participants receiving the placebo. The difference between the two arms narrowed by day 15 (82% for those receiving tecovirimat versus 80% for those receiving the placebo) as mpox resolved. These differences were not statistically significant at either time point. Adverse event rates were similar between both of the randomized study arms.

A separate exploratory analysis of data collected in STOMP’s open-label arm before the study had closed aimed to determine whether any factors were associated with faster mpox lesion resolution in participants with or at elevated risk of severe mpox. Faster clinical resolution was observed in participants who were younger in age or who did not have HIV or were living with HIV but virally suppressed on antiretroviral therapy; however, no association was significant when considering the duration of symptoms before study entry. The investigators noted that STOMP open-label participants had fewer lesions, but slower clinical resolution than reported from the PALM007 trial.

“Since the start of the clade II outbreak, clinicians treating mpox have had limited evidence to guide their practice, and STOMP provided definitive answers on the lack of clinical utility of tecovirimat monotherapy for the randomized population studied” said Timothy Wilkin, M.D., M.P.H., chief of the Division of Infectious Diseases and Global Public Health at the University of California, San Diego. “Taken together, these latest results also highlight that we still have yet to isolate which factors influence mpox disease progression and clinical resolution.”

The STOMP study was conducted by the NIH-funded ACTG, a global clinical trials network focused on HIV and other infectious diseases. SIGA Technologies, Inc., based in New York, provided tecovirimat for the study. Study results also will be published in a scientific journal.

For more information about STOMP, please visit ClinicalTrials.gov using the identifier NCT05534984.

NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID website.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Source: US National Institute of Health, https://www.nih.gov/news-events/news-releases/tecovirimat-safe-ineffective-treatment-clade-ii-mpox

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#Germany - High pathogenicity avian #influenza viruses (#poultry) (Inf. with) - Immediate notification

 A turkeys-for-fattening farm in Bayern Region.

Source: WOAH, https://wahis.woah.org/#/in-review/6328

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Independent and combined #effects of long-term #air #pollution #exposure and #genetic #predisposition on #COVID19 #severity: A population-based cohort study

Significance

To date, no study has investigated the relationships between air pollutants and the progression of COVID-19, nor the potential role of genetic susceptibility on the associations. This large population-based cohort study investigates the associations between air pollutants and genetic susceptibility, both individually and in combination, with the risk of COVID-19-related outcomes. It involves 458,396 participants from UK Biobank and demonstrates that air pollutants interact with host genetic susceptibility in both multiplicative and additive manners, thereby influencing the risk of COVID-19 severity. This study with cutting-edge methods provides robust evidence for the interplay between environmental and genetic factors on COVID-19 outcomes.

Abstract

The relationships between air pollution, genetic susceptibility, and COVID-19-related outcomes, as well as the potential interplays between air pollution and genetic susceptibility, remain largely unexplored. The Cox proportional hazards model was used to assess associations between long-term exposure to air pollutants and the risk of COVID-19 outcomes (infection, hospitalization, and death) in a COVID-19-naive cohort (n = 458,396). Additionally, associations between air pollutants and the risk of COVID-19 severity (hospitalization and death) were evaluated in a COVID-19 infection cohort (n = 110,216). Furthermore, this study investigated the role of host genetic susceptibility in the relationships between exposure to air pollutants and the development of COVID-19-related outcomes. Long-term exposure to air pollutants was significantly associated with an increased risk of COVID-19-related outcomes in the COVID-19 naive cohort. Similarly, in COVID-19 infection cohort, hazard ratios (HRs) for COVID-19 hospital admission were 1.23 (1.19, 1.27) for PM2.5 and 1.22 (1.17, 1.26) for PM10, whereas HRs for COVID-19 death were 1.28 (1.18, 1.39) for PM2.5 and 1.25 (1.16, 1.36) for PM10. Notably, significant interactions were found between PM2.5/PM10 and genetic susceptibility in COVID-19 death. In COVID-19 infection cohort, participants with both high genetic risk and high air pollutants exposure had 1.86- to 1.97-fold and 1.91- to 2.14-fold higher risk of COVID-19 hospitalization and death compared to those with both low genetic risk and low air pollutants exposure. Exposure to air pollution is significantly associated with an increased burden of severe COVID-19, and air pollution–gene interactions may play a crucial role in the development of COVID-19-related outcomes.

Source: Proceedings of the National Academy of Sciences of the United States of America, https://www.pnas.org/doi/abs/10.1073/pnas.2421513122?af=R

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#Congenital #Oropouche in #Humans: Clinical Characterization of a Possible New #Teratogenic Syndrome

Abstract

Oropouche fever is caused by the Oropouche virus (OROV; Bunyaviridae, Orthobunyavirus), one of the most frequent arboviruses that infect humans in the Brazilian Amazon. This year, an OROV outbreak was identified in Brazil, and its vertical transmission was reported, which was associated with fetal death and microcephaly. We describe the clinical manifestations identified in three cases of congenital OROV infection with confirmed serology (OROV-IgM) in the mother-newborn binomial. One of the newborns died, and post-mortem molecular analysis using real-time RT-qPCR identified the OROV genome in several tissues. All three newborns were born in the Amazon region in Brazil, and the mothers reported fever, rash, headache, myalgia, and/or retro-orbital pain during pregnancy. The newborns presented with severe microcephaly secondary to brain damage and arthrogryposis, suggestive of an embryo/fetal disruptive process at birth. Brain and spinal images identified overlapping sutures, cerebral atrophy, brain cysts, thinning of the spinal cord, corpus callosum, and posterior fossa abnormalities. Fundoscopic findings included macular chorioretinal scars, focal pigment mottling, and vascular attenuation. The clinical presentation of vertical OROV infection resembled congenital Zika syndrome to some extent but presents some distinctive features on brain imaging and in several aspects of its neurological presentation. A recognizable syndrome with severe brain damage, neurological alterations, arthrogryposis, and fundoscopic abnormalities can be associated with in utero OROV infection.

Source: Viruses, https://www.mdpi.com/1999-4915/17/3/397

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#Antiviral Susceptibility of #Influenza A(#H5N1) Clade 2.3.2.1c and 2.3.4.4b Viruses from #Humans, 2023-2024

Abstract

During 2023-2024, highly pathogenic avian influenza A(H5N1) viruses from clade 2.3.2.1c caused human infections in Cambodia and from clade 2.3.4.4b caused human infections in the Americas. We assessed the susceptibility of those viruses to approved and investigational antiviral drugs. Except for 2 viruses isolated from Cambodia, all viruses were susceptible to M2 ion channel-blockers in cell culture-based assays. In the neuraminidase inhibition assay, all viruses displayed susceptibility to neuraminidase inhibitor antiviral drugs oseltamivir, zanamivir, peramivir, laninamivir, and AV5080. Oseltamivir was ≈4-fold less potent at inhibiting the neuraminidase activity of clade 2.3.4.4b than clade 2.3.2.1c viruses. All viruses were susceptible to polymerase inhibitors baloxavir and tivoxavir and to polymerase basic 2 inhibitor pimodivir with 50% effective concentrations in low nanomolar ranges. Because drug-resistant viruses can emerge spontaneously or by reassortment, close monitoring of antiviral susceptibility of H5N1 viruses collected from animals and humans by using sequence-based analysis supplemented with phenotypic testing is essential.

Source: US National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/40064473/

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Co-Circulation of 2 #Oropouche Virus #Lineages during #Outbreak, #Amazon Region of #Peru, 2023–2024

Abstract

We describe introduction of the 2022–2023 Oropouche virus lineage from Brazil, which has caused large-scale outbreaks throughout Brazil, into the Amazon Region of Peru. This lineage is co-circulating with another lineage that was circulating previously. Our findings highlight the need for continued surveillance to monitor Oropouche virus in Peru.

Source: US Centers for Disease Control and Prevention, https://wwwnc.cdc.gov/eid/article/31/4/24-1748_article

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Evaluation of #influenza #antiviral #prophylaxis for long-term care residents: a systematic review and meta-analysis

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 studies were included, comprising 12,672 residents. Individuals given oseltamivir or zanamivir experienced the fewest symptomatic, test-confirmed infections (oseltamivir PP: 0.7%, 95%CI: 0.1-4.7%, zanamivir PP: 3.0%, 95%CI: 0.9-9.4%) and ILIs (oseltamivir PP: 2.8%, 95%CI: 1.8-4.3%, zanamivir PP: 3.4%, 95%CI: 1.3-7.2%). However, no significant statistical differences were detected versus most other interventions (ILI PP range: 4.5-6.4%, infection PP range: 4.6-7.9%). Similarly, in studies directly comparing either antiviral to placebo, there were no associated benefits despite every RR being below 1 (0.51-0.75) due to expansive 95%CIs.

Conclusions

Oseltamivir or zanamivir could provide some benefit but low statistical power behind most estimates precluded definitive conclusions. Therefore, additional studies (RCTs) are needed to expand the evidence base and validate whether prophylaxis is beneficial in this setting.

Source: Clinical Infectious Diseases, https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciaf101/8064583?redirectedFrom=fulltext

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The Voyage of Life: Youth, Thomas Cole (1842)

 

Public Domain.

Source: WikiArt, https://www.wikiart.org/en/thomas-cole/the-voyage-of-life-youth-1842-1

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#Comparison of #patients presenting to #emergency departments infected with #RSV versus #influenza virus: a retrospective cohort study

Abstract

Objective

In recent years, there has been increased awareness of the impact of respiratory syncytial virus (RSV) on adult health, especially in elderly patients. Unlike influenza infection, its presentation and patient outcomes are not well studied. The aim of this study was to compare clinical outcomes in emergency department patients infected by RSV vs influenza.

Methods

This was a multicenter retrospective study in seven emergency departments (ED) in France. Patients with a laboratory-confirmed RSV or influenza infection in the ED were included between January 2017 and December 2022. The primary endpoint was in-hospital mortality truncated at day 28. Secondary endpoints included one year occurrence of thrombo-embolic event, acute coronary syndrome, and stroke.

Results

3397 patient charts were screened, and 3224 were analyzed. Of these, 551 (17%) patients had RSV-positive PCR, and 2673 (83%) had influenza-positive PCR. Patients with RSV were older (median age 73 vs.68; difference, -5.00 percentage points [CI, -4.0 to -6.0 percentage points])), and had more comorbidities (15.0% vs 22.0% difference, -6.92 percentage points [CI, -10.6 to -3.21 percentage points])), compared to those with influenza. There was no significant difference in in-hospital mortality rate at day 28: 3.82% for influenza vs. 4.72% for RSV (adjusted OR 0.93, 95%CI [0.59 to 1.46] p=0.73). There was no significant difference in the occurrence of the secondary endpoints.

Conclusions

In this large study of ED patients, although RSV patients were more fragile, no significant differences were found in in-hospital mortality or the occurrence of cardiovascular or thromboembolic events between RSV and influenza infections.

Source: Journal of Clinical Virology, https://www.sciencedirect.com/science/article/abs/pii/S1386653225000162?dgcid=rss_sd_all

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#Sudan virus #disease - #Uganda {March 8 '25}

Situation at a glance

Since the outbreak of Sudan virus disease (SVD) was declared in Uganda on 30 January 2025, and as of 5 March 2025, a total of 14 cases (including 12 confirmed cases and two probable cases) including four deaths (two confirmed and two probable) have been reported. 

On 1 March 2025, the Ministry of Health released a press statement confirming the tenth case. The patient was a child under 5 years old who presented and died in the Mulago hospital on 23 February 2025. 

As of 5 March, two additional confirmed cases and two probable deaths have been reported that are linked to this case. Both of these cases are currently admitted to treatment facilities. 

Eight confirmed cases received care at treatment centres in the capital Kampala and in Mbale and were discharged on 18 February 2025. 

As of 5 March 2025, 192 new contacts have been identified and are under follow-up in Kampala, Ntoroko and Wakiso. In the absence of licensed vaccines and therapeutics for the prevention and treatment of SVD, the risk of potential serious public health impact is high.

Description of the situation

Since the second disease outbreak news on this event published on 21 February 2025, three additional laboratory-confirmed cases and two probable deaths of SVD have been reported in Uganda. 

As of 5 March 2025, 12 confirmed and two probable cases, among these four deaths (two confirmed, two probable) have been reported with a case fatality ratio (CFR) of 29%. 

The latest confirmed cases are reported to be epidemiologically linked to the two probable cases.  

The age range of confirmed cases is 1.5 years to 55 years, with a mean age of 27 years and males accounted for 55% of the total cases. 

The cases were reported from six districts in the country which include Jinja, Kampala, Kyegegwe, Mbale, Ntoroko and Wakiso (...).

On 1 March 2025, the Ministry of Health released a press statement about the confirmation of a new case. The case was an under 5-year-old child identified at the Mulago Hospital where the patient presented with signs and symptoms meeting the suspect case definition. 

A laboratory sample was collected, and the child was confirmed with SVD on 26 February by PCR. Following investigations, two probable deaths linked to this case have been reported. This includes the child’s mother who was pregnant at the time of symptom onset on 22 January and died on 6 February. Her newborn child died on 12 February. The three deaths did not have a supervised burial. On 3 March, an 11th case was confirmed, an adult female, contact of case 10, and on 4 March, a 12th case was confirmed, an adult female, contact of the probable case (the mother of case 10). Both of these cases are currently admitted to treatment facilities.

Since the start of the outbreak, eight cases have recovered and been discharged.

(...)

As of 5 March, there are 192 new contacts listed around the new cases and 299 previously listed contacts who had completed the 21-day follow-up period.  

SVD alert levels reported from the community and the health facilities have been low and efforts are ongoing to improve this. Mortality surveillance has also been set up since the declaration of the outbreak and will continue in Jinja, Kampala, Mbale, Ntoroko and Wakiso districts.

Retrospective epidemiological and laboratory investigations are ongoing to find the source of the outbreak while active case search in and around the community and health facilities linked to the case movements have been intensified. 

Epidemiology

Sudan virus disease is a severe disease, belonging to the same family as Ebola virus disease. It is caused by Sudan virus (SUDV) and can result in high case fatality. It is typically characterized by acute onset of fever with non-specific symptoms/signs (e.g., abdominal pain, anorexia, fatigue, malaise, myalgia, sore throat) usually followed several days later by nausea, vomiting, diarrhoea, and occasionally a variable rash. Hiccups may occur. 

Severe illness may include haemorrhagic manifestations (e.g., bleeding from puncture sites, ecchymoses, petechiae, visceral effusions), encephalopathy, shock/hypotension, multi-organ failure, and spontaneous abortion in infected pregnant women. 

Individuals who recover may experience prolonged sequelae (e.g., arthralgia, neurocognitive dysfunction, uveitis sometimes followed by cataract formation), and clinical and subclinical persistent infection may occur in immune-privileged compartments (e.g., central nervous system (CNS), eyes, testes). 

Person-to-person transmission occurs by direct contact with blood, other bodily fluids, organs, or contaminated surfaces and materials with risk beginning at the onset of clinical signs and increasing with disease severity. 

Family members, healthcare providers, and participants in burial ceremonies with direct contact with the deceased are at particular risk. The incubation period ranges from 2 to 21 days, but typically is 7–11 days. 

Public health response

Health authorities are implementing public health measures, including but not limited to the following:

-- Coordination:

The Ministry of Health (MoH) has activated the coordination structures at national and subnational levels, including the Incident Management Team and dispatched Rapid Response Teams to the affected districts. Regional Emergency Operation Centers have been activated in Fort Portal, Ntoroko, Kampala, and Mbale districts.

The country developed a National Response Plan (February-April 2025). The response plan has been updated to reflect current response priorities and builds on lessons learned from previous outbreaks. It deploys the basic minimum packages of activities across the districts according to risk.

-- Surveillance and contract tracing:

MoH with support from WHO and partners, is conducting alert management including the setup of an alert desk with toll-free numbers to detect and verify alerts from all over the country that meet the case definition. Since 30 January, over 1300 signals have been reported from all over the country and 112 alerts have been verified as suspected cases.

MoH with support from partners has allocated teams to conduct detailed case investigations around all confirmed and probable cases to identify and stop the chains of transmission.

MoH has allocated teams to conduct contact listing of cases and perform daily follow-up of contacts.

Following the declaration of the outbreak, MoH, with support from WHO, has established mortality surveillance. Over 770 non-trauma deaths were tested in communities and health facilities located in the affected districts, and one tested positive (case 10).

MoH set up a hotline for notification of suspected cases.

MoH is conducting exit screening of SVD signs and symptoms among travellers at Uganda’s 13 high volume points of entry (POE) including Entebbe International Airport

-- Case Management:

MoH with support from WHO and partners has set up four designated isolation and treatment units in Jinja, Kampala, Mbale and now Fort Portal, where confirmed cases receive optimized supportive care. Plans are underway to conduct therapeutic clinical trials. 

Patients who recovered from the disease are included in the survivor care programme for support and care.

MoH has scaled up its case management strategy to ensure sufficient capacities to provide care for all suspected and confirmed cases in all hot spots

-- Laboratory:

MoH and partners have strengthened laboratory capacities and deployed a mobile laboratory to Mbale to reduce turnaround time for laboratory results.

MoH has performed a full genome sequencing on the sample of the first confirmed case and findings indicate the outbreak is most likely the result of a spillover event. Sequencing was also performed on samples of subsequent confirmed cases,

-- Infection prevention and control:

MoH has activated their IPC response coordination mechanism.

MoH has activated the IPC ring around cases, which includes cleaning and disinfection of sites where confirmed cases passed through.

In their official press statement, the MoH provided recommendations to health workers, district leaders, and the public to strengthen detection of suspected cases and implement appropriate infection, prevention and control measures.

MOH is surging and strengthening IPC activities, with the support of partners, notably to improve screening, isolation and notification at health facilities in order to better detect suspected cases.

MoH is orienting health workers on IPC measures in the context of Ebola disease outbreak response.

Risk communication and community engagement (RCCE)

An integrated community engagement approach has been adopted whereby the RCCE team facilitate access to communities for other response pillars. This helps to build trust and enhance contact tracing, case investigation, surveillance, referral to isolation units and provision of psychosocial support.

Anthropological investigation is used to identify community concerns, risk behaviours, reduce hesitancy from communities and to enhance evidence-informed decisions across pillars.

Development and dissemination of public health messages to promote protective and health seeking behaviours, community engagement to build trust and provide psychosocial support.

Research and development

-- Research priorities: The Collaborative Open Research Consortium (CORC) for the Filoviridae Family held two global consultations to deliberate and identify the research priorities for Sudan ebolavirus in general and this outbreak in particular. Over 200 scientists from around the world participated in each of the two consultations.

-- Ring vaccination trial: After the outbreak was confirmed on 30 January, researchers from the Uganda Makerere University and the Virus Research Institute (UVRI), with support from WHO, swiftly mobilised to launch the vaccination trial. The trial was initiated only four days following the outbreak, reflecting the urgency of the response while maintaining rigorous ethical and regulatory standards. The trial follows the ring vaccination model, in which primary and secondary contacts of confirmed cases receive the vaccine, to create a protective barrier and help break chains of transmission.

The development of the protocols and research priorities has been done via the MARVAC Consortium and the Collaborative Open Research Consortium (CORC) for the Filoviridae Family, European Union (EU) Health Emergency Preparedness and Response (HERA) and Canada’s International Development Research Centre (IDRC) supported the development of these crucial trial protocols during the inter-epidemic, preparedness phase

EU HERA and IDRC also provided financial support for the trial, alongside WHO. The Coalition for Epidemic Preparedness Innovations (CEPI) is also providing support with additional support from the Africa Centres for Disease Control and Prevention (Africa CDC). The vaccine itself was donated by IAVI, with additional support from the Africa CDC.

-- Therapeutics trial: While several promising candidate therapeutics are currently advancing through clinical development, no licensed treatment is yet available to effectively address potential future outbreaks of Ebola virus disease caused by the Sudan virus species. If successful, this trial could play a critical role in enhancing outbreak control measures and supporting the future regulatory approval of the candidate vaccine. Numerous developers facilitated the availability of the candidate vaccine and treatments: MappBio provided their candidate Sudan monoclonal, Gilead provided remdesivir, an antiviral.

WHO is supporting the national authorities through:

- Risk assessment and investigation.

- Providing operational, financial and technical support to the Ministry of Health to ensure swift response. A total of US$ 3.4 million was released from the Contingency Fund for Emergencies for the three levels of WHO to support the government-led response

- Supporting the national laboratory system to implement sample collection, transport and diagnostic testing.

- Providing strategic, technical and operational support to strengthen infection. prevention and control response measures and standards within health facilities and Ebola treatment units in Kampala, Mbale, Luwero districts. This includes supporting IPC ring activation activities, rapid assessments of health facilities, capacity building of health workers, mentorship and supportive supervision at designed health facilities and supporting development of key guidance, SOPs and tools.   

- Facilitating access to candidate vaccines and therapeutics and supporting the launch of the vaccine trial. Rings have been defined around all confirmed cases and their contacts have been invited to consent in the trial.  As part of this support, the "TOKEMEZA SVD" vaccine trial was launched on 3 February 2025 and the TOKOMEZA immuno (an add-on study) was launched on 1 March 2025.

- Providing technical and operation assistance for the setup of isolation centers for suspected cases and two Ebola treatment units in Kampala and Mbale.

- Mobilizing logistics to complement government supplies, including IPC supplies, drugs, resuscitation and monitoring equipment, admission packages, and mattresses.

- Deploying a team of 47 experts to Mbale, Kampala, Wakiso and Jinja districts to support across different response pillars including coordination, surveillance, laboratory, logistics, IPC, RCCE, and case management pillars.

- Supporting RCCE efforts to counter misinformation and enhance community engagement through the deployment of two anthropologists.

- Intensified and integrated risk communication and community engagement, including sensitization and training of Village Health Teams, traditional healers, religious leaders and teachers. 

- Collecting social and behavioural data and using evidence to respond to communities’ anxieties and concern, rumours, misinformation and disinformation

WHO risk assessment

Sudan virus disease (SVD) is a severe, often fatal illness affecting humans. Sudan virus (SUDV) was first identified in southern Sudan in June 1976. Since then, the virus has emerged periodically and up to now and prior to this current one, eight outbreaks caused by SUDV have been reported, five in Uganda and three in Sudan. The case fatality rates of SVD have varied from 41% to 70% in past outbreaks.

SUDV is enzootic and present in animal reservoirs in the region. Uganda reported five SVD outbreaks (one in 2000, one in 2011, two in 2012, and one in 2022).  The current outbreak is the sixth SVD outbreak in Uganda. Uganda also reported a Bundibugyo virus disease outbreak in 2007 and an Ebola virus disease outbreak exported from the Democratic Republic of the Congo in 2019. The latest SVD outbreak in Uganda was declared over on 11 January 2023. A total of 164 cases with 55 deaths were reported in nine districts.

Uganda has experience in responding to Ebola disease outbreaks including SVD. In the ongoing outbreak, cases have been reported from several districts including the capital city, Kampala, with high population movement. Cases have sought care in several health facilities, including traditional healers, and some cases have been detected at a late stage of the disease or death. The government, with support from partners is implementing several public health actions for effective control.

In the absence of licensed vaccines and therapeutics for the prevention and treatment of SVD, the risk of potential serious public health impact is high. Community deaths, care of patients in private facilities and hospitals and other community health services as well as at traditional healers with limited protection and infection prevention and control measures entail a high risk of many transmission chains. An investigation is ongoing to determine the source and the scope of the outbreak and the possibility of spread from the capital city, Kampala, to other districts. Exit screening has been set up at different points of entry to reduce the risk of potential exportation of cases to neighbouring countries.

WHO advice

Effective Ebola disease outbreak, including SVD, control relies on applying a package of interventions, including case management, surveillance and contact tracing, a strong laboratory system, implementation of infection prevention and control measures in health care and community settings, safe and dignified burials and community engagement and social mobilization.

Risk communication and community engagement is crucial to successfully controlling SVD outbreaks. This includes raising awareness of symptoms, risk factors for infection, protective measures and the importance of seeking immediate care at a health facility. Sensitive and supportive information about safe and dignified burials is also crucial. Awareness should be built through targeted campaigns and direct work with affected and proximate communities, with special attention to engage with traditional healers, clergy, ‘boda boda’ drivers and community leaders, who are important sources of information for the community. Findings from rapid qualitative assessments should continue to be implemented to collect socio-behavioural data, which can then be used to inform response pillars. Priority areas to strengthen, based on recent evidence are mortality surveillance, contact tracing and safe and dignified burials.  Misinformation and rumours should be addressed to foster trust and promote early symptom reporting.

Early initiation of intensive supportive treatment increases the chances of survival. All above-mentioned interventions need to be thoroughly implemented in affected areas to stop chains of transmission and decrease disease mortality. Cases, contacts and individuals in affected areas who present signs and symptoms compatible with case definitions should be advised not to travel and seek early care at designated facilities to improve their chances of survival and limit transmission.

WHO encourages countries to implement a comprehensive care programme to support people who recovered from Ebola disease with any subsequent sequelae and to enable them to access body fluid testing and to mitigate the risk of transmission through infected body fluids by adequate practices.

Collaboration with neighbouring countries should be enhanced to harmonize reporting mechanisms, conduct joint investigations, and share critical data in real-time. Surrounding countries should enhance readiness activities to enable early case detection, isolation and treatment.

A range of candidate vaccines and therapeutics are under different stage of development. Since 2020, WHO has convened scientific deliberations and set up an independent process to review candidate medical countermeasures (MCMs) prioritization and clinical trial designs. One candidate vaccine and two candidate therapeutics (a monoclonal antibody and an antiviral) have been recommended and are available in country and are being assessed (clinical efficacy and safety) through randomized clinical trial protocols.

Thanks to preparedness measures that the government took after the previous outbreak in 2022, and a global research collaboration led by WHO (first MARVAC now FILOVIRUS CORC), a trial of a candidate vaccine was launched just four days after the outbreak was declared. A therapeutics trial will start as soon as national authorities provide approval.

The two vaccines licensed against Ebola virus disease (from the Zaire species) will not provide cross-protection against SVD and cannot be used in this outbreak.

WHO advises against any restrictions on travel and/or trade to Uganda based on available information for the current outbreak. 

(...)

Source: World Health Organization, https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON558

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#Coronavirus Disease Research #References (by AMEDEO, March 8 '25)

 

Antiviral Res

1. PADEY B, Droillard C, Duliere V, Fouret J, et al
   Host-targeted repurposed diltiazem enhances the antiviral activity of direct acting antivirals against Influenza A virus and SARS-CoV-2.
   Antiviral Res. 2025 Mar 4:106138. doi: 10.1016/j.antiviral.2025.106138.
   PubMed         Abstract available
   
   

   
   Clin Infect Dis

2. BULLOCK A, Dalton AF, Stockwell MS, McLaren SH, et al
   Ongoing Symptoms After Acute SARS-CoV-2 or Influenza Infection in a Case-Ascertained Household Transmission Study: 7 US Sites, 2021-2023.
   Clin Infect Dis. 2025 Feb 26:ciaf026. doi: 10.1093.
   PubMed         Abstract available
   
   
3. SWARTWOOD NA, Cohen T, Marks SM, Hill AN, et al
   Effects of the COVID-19 pandemic on TB outcomes in the United States: a Bayesian analysis.
   Clin Infect Dis. 2025 Feb 27:ciaf092. doi: 10.1093.
   PubMed         Abstract available
   
   

   
   Emerg Infect Dis

4. BI K, Bandekar SR, Bouchnita A, Fox SJ, et al
   Annual Hospitalizations for COVID-19, Influenza, and Respiratory Syncytial Virus, United States, 2023-2024.
   Emerg Infect Dis. 2025;31:636-638.
   PubMed         Abstract available
   
   
5. AGUILAR-BULTET L, Gomez-Sanz E, Garcia-Martin AB, Hug MA, et al
   Extended-Spectrum beta-Lactamase-Producing Enterobacterales in Municipal Wastewater Collections, Switzerland, 2019-2023.
   Emerg Infect Dis. 2025;31:574-578.
   PubMed         Abstract available
   
   
6. LEBER AL, Embry T, Everhart K, Taveras J, et al
   Macrolide-Resistant Mycoplasma pneumoniae Infections among Children after COVID-19 Pandemic, Ohio, USA.
   Emerg Infect Dis. 2025;31:555-558.
   PubMed         Abstract available
   
   

   
   Graefes Arch Clin Exp Ophthalmol

7. KEYE P, Evers C, Glaser T, Braun P, et al
   Impact of the COVID-19 pandemic on glaucoma surgery in German hospitals.
   Graefes Arch Clin Exp Ophthalmol. 2025 Mar 7. doi: 10.1007/s00417-025-06787.
   PubMed         Abstract available
   
   

   
   Int J Infect Dis

8. CAMELO S, Dioh W, Teixeira JP, Busse LW, et al
   Modulation of the Renin-Angiotensin System against COVID-19: A path forward?
   Int J Infect Dis. 2025 Mar 4:107867. doi: 10.1016/j.ijid.2025.107867.
   PubMed         Abstract available
   
   
9. AKHTAR M, Hashmi AH, Manzoor S
   The Synergistic Tapestry: unraveling the interplay of Parvovirus B19 with other viruses.
   Int J Infect Dis. 2025 Feb 28:107865. doi: 10.1016/j.ijid.2025.107865.
   PubMed         Abstract available
   
   

   
   J Med Virol

10. HANSEN KS, Jorgensen SE, Comert C, Schiottz-Christensen B, et al
    Genetic Landscape and Mitochondrial Metabolic Dysregulation in Patients Suffering From Severe Long COVID.
    J Med Virol. 2025;97:e70275.
    PubMed         Abstract available
    
    
11. 
    Correction to "Low Neutralization of SARS-CoV-2 Omicron BA5248, XBB15 and JN1 by Homologous Booster and Breakthrough Infection".
    J Med Virol. 2025;97:e70271.
    PubMed        
    
    
12. ZONG Y, Kamoi K, Zhang J, Yang M, et al
    The Silent Epidemic: Unveiling Herpetic Uveitis in the Elderly.
    J Med Virol. 2025;97:e70286.
    PubMed         Abstract available
    
    

    
    J Travel Med

13. SHIFERAW W, Dean JA, Mills D, Lau CL, et al
    Overseas- and locally-acquired sexually transmissible infections in Australia, 2017-2023.
    J Travel Med. 2025 Mar 5:taaf022. doi: 10.1093.
    PubMed         Abstract available
    
    

    
    J Virol

14. KARL V, Hofmann M, Thimme R
    Role of antiviral CD8+ T cell immunity to SARS-CoV-2 infection and vaccination.
    J Virol. 2025 Mar 3:e0135024. doi: 10.1128/jvi.01350.
    PubMed         Abstract available
    
    
15. MA Z, Li Z, Li Y, Zhao X, et al
    Changes in the motifs in the D0 and SD2 domains of the S protein drive the evolution of virulence in enteric coronavirus porcine epidemic diarrhea virus.
    J Virol. 2025 Mar 4:e0209224. doi: 10.1128/jvi.02092.
    PubMed         Abstract available
    
    
16. HU H, Zhang Y, Zheng H, Zhao X, et al
    Thymic stromal lymphopoietin improves protective immunity of the SARS-CoV-2 subunit vaccine by inducing dendritic cell-dependent germinal center response.
    J Virol. 2025 Mar 4:e0232324. doi: 10.1128/jvi.02323.
    PubMed         Abstract available
    
    

    
    JAMA

17. STAR J, Han X, Smith RA, Schafer EJ, et al
    Cancer Screening 3 Years After the Onset of the COVID-19 Pandemic.
    JAMA. 2025 Mar 5:e250902. doi: 10.1001/jama.2025.0902.
    PubMed        
    
    

    
    Lancet Infect Dis

18. ZHANG L, Kempf A, Nehlmeier I, Chen N, et al
    Host cell entry and neutralisation sensitivity of the emerging SARS-CoV-2 variant LP.8.1.
    Lancet Infect Dis. 2025 Feb 26:S1473-3099(25)00113.
    PubMed        
    
    

    
    Life Sci

19. DUERR GD, Hamiko M, Beer J, Nattermann J, et al
    The interplay between COVID-19 and heart disease: Unravelling a complex connection.
    Life Sci. 2025 Mar 3:123524. doi: 10.1016/j.lfs.2025.123524.
    PubMed         Abstract available
    
    

    
    Nature

20. TRAN-KIEM C, Paredes MI, Perofsky AC, Frisbie LA, et al
    Fine-scale patterns of SARS-CoV-2 spread from identical pathogen sequences.
    Nature. 2025 Mar 5. doi: 10.1038/s41586-025-08637.
    PubMed         Abstract available
    
    

    
    Science

21. WEI X, Qian W, Narasimhan H, Chan T, et al
    Macrophage peroxisomes guide alveolar regeneration and limit SARS-CoV-2 tissue sequelae.
    Science. 2025;387:eadq2509.
    PubMed         Abstract available
    
    
22. SARIOL A, Perlman S
    Lung inflammation drives Long Covid.
    Science. 2025;387:1039-1040.
    PubMed         Abstract available
    
    

    
    Zhonghua Jie He He Hu Xi Za Zhi

23. ZHENG YJ, Hou JY, Zhong J, Ye XW, et al
    [A case of COVID-19-associated pulmonary aspergillosis combined with COVID-19-associated pulmonary mucormycosis].
    Zhonghua Jie He He Hu Xi Za Zhi. 2025;48:267-271.
    PubMed         Abstract available

#Influenza and Other Respiratory Viruses Research #References (by AMEDEO, March 8 '25)

 

Antiviral Res

1. PADEY B, Droillard C, Duliere V, Fouret J, et al
   Host-targeted repurposed diltiazem enhances the antiviral activity of direct acting antivirals against Influenza A virus and SARS-CoV-2.
   Antiviral Res. 2025 Mar 4:106138. doi: 10.1016/j.antiviral.2025.106138.
   PubMed         Abstract available
   
   
2. INOUE A, Ichikawa T, Wada D, Maruyama S, et al
   M49L and other drug resistance mutations emerging in individuals after administration of ensitrelvir in Japanese clinical settings.
   Antiviral Res. 2025;236:106118.
   PubMed         Abstract available
   
   
3. UEHARA T, Yotsuyanagi H, Ohmagari N, Doi Y, et al
   Ensitrelvir treatment-emergent amino acid substitutions in SARS-CoV-2 3CL(pro) detected in the SCORPIO-SR phase 3 trial.
   Antiviral Res. 2025 Jan 30:106097. doi: 10.1016/j.antiviral.2025.106097.
   PubMed         Abstract available
   
   

   
   Biochem Biophys Res Commun

4. IMBIAKHA B, Ezzatpour S, Buchholz DW, Poosala S, et al
   Novel nanobody drug conjugate as a prophylactic or therapeutic against SARS-CoV-2 infection in mice.
   Biochem Biophys Res Commun. 2025;753:151480.
   PubMed         Abstract available
   
   

   
   BMC Pediatr

5. XU YY, Dai ZZ, Zhou H, Li H, et al
   Postoperative cardiopulmonary complications in children with preoperative Omicron SARS-CoV-2 variants infection: a single-center retrospective cohort study.
   BMC Pediatr. 2025;25:162.
   PubMed         Abstract available
   
   

   
   Epidemiol Infect

6. WASIK BR, Damodaran L, Maltepes MA, Voorhees IEH, et al
   THE EVOLUTION AND EPIDEMIOLOGY OF H3N2 CANINE INFLUENZA VIRUS AFTER 20 YEARS IN DOGS.
   Epidemiol Infect. 2025 Mar 5:1-38. doi: 10.1017/S0950268825000251.
   PubMed        
   
   

   
   J Infect

7. YANG J, Zheng S, Sun J, Wu H, et al
   A human-infecting H10N5 avian influenza virus: clinical features, virus reassortment, receptor-binding affinity, and possible transmission routes.
   J Infect. 2025 Mar 4:106456. doi: 10.1016/j.jinf.2025.106456.
   PubMed         Abstract available
   
   
8. SONG Y, Gong YN, Chen KF, Smith DK, et al
   Global epidemiology, seasonality and climatic drivers of the four human parainfluenza virus types.
   J Infect. 2025 Feb 26:106451. doi: 10.1016/j.jinf.2025.106451.
   PubMed         Abstract available
   
   
9. FENG Q, Wang J, Wang X, Tian J, et al
   Clinical epidemiological characteristics of hospitalized pediatric viral community-acquired pneumonia in China.
   J Infect. 2025;90:106450.
   PubMed         Abstract available
   
   
10. MAZARAKIS N, Toh ZQ, Neal E, Bright K, et al
    The immunogenicity, reactogenicity, and safety of a bivalent mRNA or protein COVID-19 vaccine given as a fourth dose.
    J Infect. 2025 Feb 18:106447. doi: 10.1016/j.jinf.2025.106447.
    PubMed         Abstract available
    
    
11. LIANG C, Begier E, Hagel S, Ankert J, et al
    Incidence of RSV-related hospitalizations for ARIs, including CAP: Data from the German prospective ThEpiCAP study.
    J Infect. 2025;90:106440.
    PubMed         Abstract available
    
    
12. NOBLE C, McDonald E, Nicholson S, Biering-Sorensen S, et al
    Characterising the SARS-CoV-2 nucleocapsid (N) protein antibody response.
    J Infect. 2025 Feb 6:106436. doi: 10.1016/j.jinf.2025.106436.
    PubMed         Abstract available
    
    
13. QUINT JK, Dube S, Carty L, Yokota R, et al
    Immunocompromised individuals remain at risk of COVID-19: 2023 results from the observational INFORM study.
    J Infect. 2025 Jan 29:106432. doi: 10.1016/j.jinf.2025.106432.
    PubMed         Abstract available
    
    

    
    J Virol Methods

14. GASTELBONDO-PASTRANA B, Florez L, Guzman C, Torres K, et al
    Phenol-free in-house kit for RNA extraction with applicability to SARS-CoV-2 genomic sequencing studies: A contribution to biotechnological sovereignty in Colombia.
    J Virol Methods. 2025;334:115116.
    PubMed         Abstract available
    
    

    
    Lancet

15. THE LANCET
    H5N1 avian influenza: technical solutions, political challenges.
    Lancet. 2025;405:671.
    PubMed        
    
    

    
    N Engl J Med

16. WANG JJ, Warkentin TE, Schonborn L, Wheeler MB, et al
    VITT-like Monoclonal Gammopathy of Thrombotic Significance.
    N Engl J Med. 2025 Feb 12. doi: 10.1056/NEJMoa2415930.
    PubMed         Abstract available
    
    

    
    PLoS Comput Biol

17. ZHAN X, Xu Q, Zheng Y, Lu G, et al
    Reliability-enhanced data cleaning in biomedical machine learning using inductive conformal prediction.
    PLoS Comput Biol. 2025;21:e1012803.
    PubMed         Abstract available
    
    
18. CASABURI P, Dall'Amico L, Gozzi N, Kalimeri K, et al
    Resilience of mobility network to dynamic population response across COVID-19 interventions: Evidences from Chile.
    PLoS Comput Biol. 2025;21:e1012802.
    PubMed         Abstract available
    
    

    
    PLoS One

19. KLEBER M, Meunier-Beillard N, Fournel I, Ksiazek E, et al
    Barriers to and facilitators of rehabilitation according to socio-economic status, after acute respiratory distress syndrome due to COVID-19: A qualitative study in the RECOVIDS cohort.
    PLoS One. 2025;20:e0316318.
    PubMed         Abstract available
    
    
20. BURRY RD, Pike A, Maddigan J, Rauman P, et al
    New graduate nurses' experiences with and perceptions of their mental health and well-being during the COVID-19 pandemic: An interpretive description study protocol.
    PLoS One. 2025;20:e0315852.
    PubMed         Abstract available
    
    
21. RICHARD L, Carter B, Liu M, Nisenbaum R, et al
    Incidence and factors associated with SARS-CoV-2 infection and re-infection among people experiencing homelessness in Toronto, Canada: A prospective cohort study.
    PLoS One. 2025;20:e0319296.
    PubMed         Abstract available
    
    
22. MANNA RM, Rahman MH, Ara T, Usmani NG, et al
    Impact of COVID-19 on In-Patient and Out-Patient services in Bangladesh.
    PLoS One. 2025;20:e0315626.
    PubMed         Abstract available
    
    
23. VESELI B, Seifert R, Clement M, Shehu E, et al
    Trading-off health safety, civil liberties, and unemployment based on communication strategies: the social dilemma in fighting pandemics.
    PLoS One. 2025;20:e0318541.
    PubMed         Abstract available
    
    
24. KUMADOR DK, Opoku-Mensah A, Tackie-Ofosu V, Mahama S, et al
    Preterm delivery in Ghana: challenges and implications for maternal mental health trajectories.
    PLoS One. 2025;20:e0317147.
    PubMed         Abstract available
    
    
25. PUTRI ND, Laksanawati IS, Husada D, Kaswandani N, et al
    A systematic review of post COVID-19 condition in children and adolescents: Gap in evidence from low-and -middle-income countries and the impact of SARS-COV-2 variants.
    PLoS One. 2025;20:e0315815.
    PubMed         Abstract available
    
    
26. KATZ VS, Jordan AB, Ognyanova K
    Digital inequalities and U.S. undergraduate outcomes over the first two years of the COVID-19 pandemic.
    PLoS One. 2025;20:e0319000.
    PubMed         Abstract available
    
    
27. DI RISO D, Spaggiari S, Calignano G, Rigo P, et al
    Wearing face masks when no longer mandatory: An exploratory study about attitudinal and psychological health factors in a large Italian sample.
    PLoS One. 2025;20:e0314607.
    PubMed         Abstract available
    
    
28. KWAN AT, Vargo J, Kurtz C, Panditrao M, et al
    The integration of health equity into policy to reduce disparities: Lessons from California during the COVID-19 pandemic.
    PLoS One. 2025;20:e0316517.
    PubMed         Abstract available
    
    
29. AL MASOODI WTM, Radhi SW, Abdalsada HK, Niu M, et al
    Increased galanin-galanin receptor 1 signaling, inflammation, and insulin resistance are associated with affective symptoms and chronic fatigue syndrome due to long COVID.
    PLoS One. 2025;20:e0316373.
    PubMed         Abstract available
    
    
30. KENDZERSKA T, Pugliese M, Manuel D, Sadatsafavi M, et al
    Healthcare utilization trends in adults with asthma or COPD during the first year of COVID-19 pandemic in comparison to pre-pandemic: A population-based study.
    PLoS One. 2025;20:e0316553.
    PubMed         Abstract available
    
    

    
    Proc Natl Acad Sci U S A

31. MA Y, Wang J, Cui F, Tang L, et al
    Independent and combined effects of long-term air pollution exposure and genetic predisposition on COVID-19 severity: A population-based cohort study.
    Proc Natl Acad Sci U S A. 2025;122:e2421513122.
    PubMed         Abstract available
    
    
32. ZHU Y, Cong Y, Sun Y, Sheng S, et al
    Molecular patterns of matrix protein 1 (M1): A strong predictor of adaptive evolution in H9N2 avian influenza viruses.
    Proc Natl Acad Sci U S A. 2025;122:e2423983122.
    PubMed         Abstract available
    
    

    
    Vaccine

33. RAJA AI, Connor RI, Ashare A, Weiner JA, et al
    Binding and neutralising antibodies to respiratory syncytial virus and influenza A virus in serum and bronchoalveolar lavage fluid of healthy adults in the United States: A cross-sectional study.
    Vaccine. 2025;53:126936.
    PubMed         Abstract available
    
    
34. COTTER LM, Hopkins-Sheets M, Yang S, Passmore SR, et al
    Increasing confidence for pediatric COVID-19 and influenza vaccines using messages affirming parental autonomy: A randomized online experiment.
    Vaccine. 2025;53:126947.
    PubMed         Abstract available
    
    
35. NIU Y, Yan Y, Hu Y, Yang X, et al
    A novel tetravalent influenza vaccine based on one chimpanzee adenoviral vector.
    Vaccine. 2025;53:126959.
    PubMed         Abstract available
    
    
36. RIGAMONTI V, Torri V, Morris SK, Ieva F, et al
    Real-world effectiveness of influenza vaccination in preventing influenza and influenza-like illness in children.
    Vaccine. 2025;53:126946.
    PubMed         Abstract available
    
    
37. MACKENZIE LJ, Bousie JA, Newman P, Cunningham J, et al
    What three years of COVID-19 vaccine administration reveals about the incidence of shoulder injury related to vaccine administration (SIRVA).
    Vaccine. 2025;51:126892.
    PubMed         Abstract available
    
    
38. ATTI A, England A, Sung J, Foulkes S, et al
    Estimating neutralising antibody responses against emerging SARS-CoV-2 variants utilising convalescent sera before the roll-out of XBB-lineage vaccines.
    Vaccine. 2025;51:126898.
    PubMed         Abstract available
    
    
39. MEYERS E, De Rop L, Deschepper E, Duysburgh E, et al
    SARS-CoV-2 seroreversion and all-cause mortality in nursing home residents and staff post-primary course vaccination in Belgium between February and December 2021.
    Vaccine. 2025;51:126865.
    PubMed         Abstract available
    
    
40. HALL C, Lanning J, Romano CJ, Bukowinski AT, et al
    COVID-19 vaccine initiation in pregnancy and risk for adverse neonatal outcomes among United States military service members, January-December 2021.
    Vaccine. 2025;51:126894.
    PubMed         Abstract available
    
    
41. SMITH DS, Postma M, Fisman D, Mould-Quevedo J, et al
    Cost-effectiveness models assessing COVID-19 booster vaccines across eight countries: A review of methods and data inputs.
    Vaccine. 2025;51:126879.
    PubMed         Abstract available
    
    
42. OLIVIERI G, Amodio D, Manno EC, Santilli V, et al
    Shielding the immunocompromised: COVID-19 prevention strategies for patients with primary and secondary immunodeficiencies.
    Vaccine. 2025;51:126853.
    PubMed         Abstract available
    
    

    
    Virology

43. LAI SK, Lee ZQ, Tan TI, Tan BH, et al
    Evidence that the cell glycocalyx envelops respiratory syncytial virus (RSV) particles that form on the surface of RSV-infected human airway cells.
    Virology. 2025;604:110415.
    PubMed         Abstract available
    
    
44. HILLS FR, Geoghegan JL, Bostina M
    Architects of infection: A structural overview of SARS-related coronavirus spike glycoproteins.
    Virology. 2025;604:110383.
    PubMed         Abstract available
    
    
45. YAMAMOTO A, Ito H, Sakaguchi T, Higashiura A, et al
    Structural insights into nucleocapsid protein variability: Implications for PJ34 efficacy against SARS-CoV-2.
    Virology. 2025;604:110411.
    PubMed         Abstract available
    
    
46. FRAGOSO-SAAVEDRA M, Liu Q
    Towards developing multistrain PEDV vaccines: Integrating basic concepts and SARS-CoV-2 pan-sarbecovirus strategies.
    Virology. 2025;604:110412.
    PubMed         Abstract available
    
    
47. SUGRUE RJ, Tan BH
    The link between respiratory syncytial virus (RSV) morphogenesis and virus transmission: Towards a paradigm for understanding RSV transmission in the upper airway.
    Virology. 2025;604:110413.
    PubMed         Abstract available
    
    
48. SHI H, Inankur B, Yin J
    Serum starvation impacts rhinovirus spread from cell to cell.
    Virology. 2025;604:110408.
    PubMed         Abstract available
    
    
49. PATEL H, Kukol A
    Harnessing viral internal proteins to combat flu and beyond.
    Virology. 2025;604:110414.
    PubMed         Abstract available
    
    
50. SAHA A, Choudhary S, Walia P, Kumar P, et al
    Transformative approaches in SARS-CoV-2 management: Vaccines, therapeutics and future direction.
    Virology. 2025;604:110394.
    PubMed         Abstract available
    
    
51. HE M, He CQ, Ding NZ
    Human viruses: An ever-increasing list.
    Virology. 2025;604:110445.
    PubMed         Abstract available
    
    
52. PORTER SM, Hartwig AE, Quilici M, Bosco-Lauth AM, et al
    Intraspecific SARS-CoV-2 Delta variant transmission among red fox (Vulpes vulpes) and striped skunk (Mephitis mephitis).
    Virology. 2025;604:110446.
    PubMed         Abstract available

Neutralizing #Antibody #Response to #Influenza A(#H5N1) Virus in Dairy #Farm #Workers, #Michigan, #USA

Abstract

Since March 2024, highly pathogenic avian influenza A(H5N1) viruses have caused outbreaks in dairy cattle and poultry in the United States, and they continue to spill over into humans. However, data on human immune response to those viruses is limited. We report neutralizing antibody responses in 2 dairy farm worker H5N1 cases.

Source: US Centers for Disease Control and Prevention, https://wwwnc.cdc.gov/eid/article/31/4/25-0007_article

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#USA, Monitoring for Avian #Influenza A(#H5) Virus In #Wastewater {March 7 '25}

{Excerpt}

Time Period: February 23 - March 01, 2025

- H5 Detection: 8 sites (1.8%)

- No Detection: 445 sites (98.2%)

- No samples in last week: 100 sites

(...)

Source: US Centers for Disease Control and Prevention, https://www.cdc.gov/bird-flu/h5-monitoring/index.html

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