Penitent St. Mary Magdalene, Titian (1560 - c.1565)

 

Public Domain.

Source: WikiArt, https://www.wikiart.org/en/titian/penitent-st-mary-magdalene

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#Coronavirus Disease Research #References (by AMEDEO, April 12 '25)

 

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#Influenza and Other Respiratory Viruses Research #References (by AMEDEO, April 12 '25)

 

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   Epidemiol Infect

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6. WITTEVEEN-FREIDL G, Lauenborg Moller K, Voldstedlund M, Gubbels S, et al
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10. DINANT S, Castille J, Deloizy C, Bruder E, et al
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    PLoS One

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A Novel #Nobecovirus in an Epomophorus wahlbergi #Bat from #Nairobi, #Kenya

Abstract

Most human emerging infectious diseases are zoonotic, originating in animal hosts prior to spillover to humans. Prioritizing the surveillance of wildlife that overlaps with humans and human activities can increase the likelihood of detecting viruses with a high potential for human infection. Here, we obtained fecal swabs from two fruit bat species—Eidolon helvum (n = 6) and Epomophorus wahlbergi (n = 43) (family Pteropodidae)—in peridomestic habitats in Nairobi, Kenya, and used metagenome sequencing to detect microorganisms. A near-complete genome of a novel virus assigned taxonomically to the Coronaviridae family Betacoronavirus genus and Nobecovirus subclade was characterized from E. wahlbergi. Phylogenetic analysis indicates this unique Nobecovirus clade shares a common ancestor with Eidolon/Rousettus Nobecovirus subclades isolated from Madagascar, Kenya, and Cameroon. Recombination was detected across open reading frames, except the spike protein, in all BOOTSCAN analyses, indicating intra-host coinfection and genetic exchange between genome regions. Although Nobecoviruses are currently bat-specific and are not known to be zoonotic, the propensity of coronaviruses to undergo frequent recombination events and the location of the virus alongside high human and livestock densities in one of East Africa’s most rapidly developing cities justifies continued surveillance of animal viruses in high-risk urban landscapes.

Source: Viruses, https://www.mdpi.com/1999-4915/17/4/557

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#Cardiovascular post-acute #sequelae of #SARS-CoV-2 in #children and #adolescents: cohort study using electronic health records

Abstract

The risk of cardiovascular outcomes following SARS-CoV-2 infection has been reported in adults, but evidence in children and adolescents is limited. This paper assessed the risk of a multitude of cardiac signs, symptoms, and conditions 28-179 days after infection, with outcomes stratified by the presence of congenital heart defects (CHDs), using electronic health records (EHR) data from 19 children’s hospitals and health institutions from the United States within the RECOVER consortium between March 2020 and September 2023. The cohort included 297,920 SARS-CoV-2-positive individuals and 915,402 SARS-CoV-2-negative controls. Every individual had at least a six-month follow-up after cohort entry. Here we show that children and adolescents with prior SARS-CoV-2 infection are at a statistically significant increased risk of various cardiovascular outcomes, including hypertension, ventricular arrhythmias, myocarditis, heart failure, cardiomyopathy, cardiac arrest, thromboembolism, chest pain, and palpitations, compared to uninfected controls. These findings were consistent among patients with and without CHDs. Awareness of the heightened risk of cardiovascular disorders after SARS-CoV-2 infection can lead to timely referrals, diagnostic evaluations, and management to mitigate long-term cardiovascular complications in children and adolescents.

Source: Nature Communications, https://www.nature.com/articles/s41467-025-56284-0

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Invasive #meningococcal #disease - Kingdom of #Saudi Arabia (WHO D.O.N.)

{Excerpts}

Situation at a glance

On 13 March 2025, the International Health Regulations (IHR) National Focal Point (NFP) for the Kingdom of Saudi Arabia (KSA) reported 11 cases of invasive meningococcal disease (IMD) to WHO. Additionally, between 11 February and 18 March 2025, the WHO Eastern Mediterranean Regional IHR contact point received reports of six isolated cases of IMD, either through notification or bilateral communication with IHR NFPs. These cases involve individuals who had recently returned from Umrah. Meningococcal disease remains a global public health concern, particularly in the context of mass gathering events such as Hajj and Umrah. The government of Saudi Arabia regularly issues health requirements for Hajj and Umrah, including vaccination policies. As of 10 March 2025, KSA health authorities estimated that only 54% of international Umrah pilgrims had complied with the meningococcal vaccination requirements. The significant number of pilgrims traveling to KSA from countries with varying levels of meningococcal disease incidence presents a risk of international spread during these gatherings. Given the recent notification of these cases linked to Umrah, WHO strongly advises all individuals planning to attend mass gatherings such as Hajj and Umrah to receive vaccination against meningococcal disease at least 10 days prior to travel.

Description of the situation

On 13 March 2025, the NFP for KSA reported to WHO 11 confirmed cases of IMD. All cases were associated with individuals who had performed Umrah in KSA between 7 January and 12 March 2025.

Among the 11 confirmed cases, four were reported from three countries in the WHO Eastern Mediterranean Region, while the remaining cases are individuals with travel history from countries in the WHO South-East Asia Region. The median age of cases was 36 years (range 6 – 69 years) and 64% were male. The cases were diagnosed between 7 January and 2 March 2025, and none of the affected individuals had a history of vaccination against meningococcal disease. All cases received treatment in hospitals in KSA, fully recovered and were discharged. Serogrouping tests identified the causative strain as Neisseria meningitidis (N. meningitidis) serogroup W135.

In addition, between 11 February and 18 March 2025, the WHO Eastern Mediterranean Regional IHR contact point received reports—either through notifications or bilateral communication with IHR NFPs —of six isolated cases of IMD among individuals who had recently returned from Umrah. Of these, three cases were reported from the WHO Europe Region and three cases were from the WHO Eastern Mediterranean Region. The median age of cases was 19 years (range 6 – 30 years). Serogroup W135 was confirmed in two of the six cases. 

Epidemiology

Invasive meningococcal disease is a life-threatening bacterial infection caused by Neisseria meningitidis, associated with severe long-term complications and a high case fatality rate, despite prompt and appropriate treatment.

Meningococcal disease occurs worldwide, and can present as a sporadic, clustered or epidemic-prone infection with varying degrees of endemicity across regions. Outbreaks are more likely to occur in settings that facilitate transmission of infection, such as areas with low vaccination coverage, overcrowded living conditions, limited or disrupted access to healthcare services, and mass gatherings, including religious pilgrimages like Hajj and Umrah.  In the KSA, public health authorities conduct regular risk assessments and continue to identify meningococcal disease as a significant public health threat during mass gatherings. Thus, the requirement of quadrivalent meningococcal vaccination (MenACWY), which protects against serogroups A, C, W, and Y, prior to traveling to KSA for Hajj and Umrah has been maintained in the previous years.  However, vaccination compliance for Umrah was declined over the past two years.

The significant number of pilgrims arriving in KSA from countries with diverse meningococcal disease prevalence increases the risk of international spread. In 2024, 12 cases of meningococcal disease associated to Umrah and/or pilgrimage to KSA were reported from the United States of America, the United Kingdom, and France. Of these, nine patients were unvaccinated, and the vaccination status of remaining three was unknown. 

Antimicrobial susceptibility data was available for 11 of the 12 cases, and ciprofloxacin-resistant strains were identified in three cases. In 2025, to date, 17 cases associated with travel to KSA for religious pilgrimage have already been reported from multiple countries.

Public health response

-- Leadership and coordination:

- Disseminating guidelines: The government of Saudi Arabia regularly issues the health requirements for Hajj and Umrah, which are published on the Ministry of Health (MoH) website and disseminated to all countries through diplomatic channels. A key requirement is that all travelers must receive the MenACWY vaccine before departing from their home country for Umrah and Hajj.

Surveillance:

- Screening at Points of Entry: Health authorities at Saudi Arabia's points of entry conduct screenings during the Hajj and Umrah seasons by visually checking for signs and symptoms of invasive IMD among incoming travelers. They also review travelers' health documents to ensure compliance with the required health protocols.

- Conducting regular risk assessments: Public health authorities in Saudi Arabia regularly conduct risk assessments. The country has strengthened surveillance for IMD in the Umrah zone, and continuously monitors Neisseria meningitidis carriage in both Makkah and Madinah.

- Electronic surveillance system: Saudi Arabia has established a comprehensive electronic surveillance system to monitor and control IMD across all healthcare facilities. This system mandates the immediate reporting of all suspected and confirmed cases to public health authorities. Standardized case definitions are provided to ensure accurate and timely identification. Laboratory-based diagnostics, including culture, antimicrobial susceptibility testing, and PCR, are prioritized, along with the collection of detailed demographics, clinical, and epidemiological data to support response efforts. Active surveillance is particularly heightened during mass gatherings to quickly detect and respond to potential outbreaks.

-- Clinical operations:

- Case management: Healthcare facilities in Saudi Arabia are well-prepared to effectively manage cases of meningococcal disease and their close contacts. This is ensured through the provision of appropriate medical care, including timely diagnosis and prompt treatment, based on the appropriate use of antibiotics. Infection prevention and control practices are followed to minimize the risk of nosocomial (hospital-acquired) transmission.

- Post-exposure chemoprophylaxis: Chemoprophylaxis is an essential preventive measure against meningococcal disease. Antimicrobial prophylaxis is administered to close contacts of confirmed cases to prevent secondary transmission. The selection of the drug of choice should be guided by known antimicrobial resistance patterns.

- Vaccination: Targeted vaccination with a conjugate vaccine is used to prevent disease in the community. Most adults in the Umrah region had received at least one dose of the conjugate vaccine, in addition to routine meningococcal immunization for children.

- Risk communication and community engagement:

- Awareness campaigns: Saudi Arabia places strong emphasis on public education and community engagement to promote early detection, timely treatment, and prevention of meningococcal disease. Awareness campaigns are regularly conducted to inform the public on the nature of the disease, its symptoms, and the importance of early medical intervention. These campaigns also highlights the critical role of vaccination, both as part of the national immunization programme and as a mandatory requirement for Hajj and Umrah pilgrims.

WHO risk assessment

Meningococcal disease remains a public health challenge, especially for mass gathering events like Hajj and Umrah.

Umrah is a year-round pilgrimage to Mecca in KSA. The risk of meningococcal disease at mass gatherings like Hajj and Umrah is increased due to the high population influx, the person-to-person transmission through respiratory droplets, and the presence of pilgrims from diverse geographical regions and prolonged close contact—resulting from shared accommodations and participation in rituals. In 2024, it was estimated that 24 million pilgrims performed Umrah, with 50% of those being international pilgrims. Mass gatherings such as those occurring during the Umrah pilgrimage can facilitate the transmission of infectious diseases, including IMD.

Since 2001, strict preventative measures, including mandatory quadrivalent (MenACWY) meningococcal vaccination has mitigated the risk of pilgrimage-associated meningococcal outbreaks. While MenACWY vaccination is highly effective in reducing the risk of outbreaks during Hajj and preventing transmission to the home countries of pilgrims, there are challenges in ensuring the vaccination of the pilgrims in their countries of origin since the compliance with the public health advisory is voluntary. As of 10 March, it was estimated by KSA health authorities that only 54% of international Umrah pilgrims have complied with the meningococcal vaccination requirements.  As returning travelers may spread the disease to their local communities, this risk is further heightened when there is lower compliance with meningococcal vaccination among pilgrims.  

Preparedness and surveillance efforts must be maintained year-round, with particular emphasis during peak periods like Ramadan and school holidays that often see a sharp increase in pilgrim numbers. In addition, the risk of importation of meningococcal disease is increased during the epidemic season in the countries of the African meningitis belt (i.e. December through June), several of which are home to large Muslim populations. This potentially affects not only the pilgrims but also other travelers (including those traveling for non-religious purposes) and the wider community.

Another risk factor is the emergence of antibiotic resistance for N. meningitidis strains to fluoroquinolones (ciprofloxacin) and potentially third generation cephalosporins, which can complicate post-exposure prophylaxis and treatment options for individuals with IMD. The growing influx of tourists and relatively long incubation period may account for increased risk of international spread.

WHO advice

Meningococcal disease remains a key public health concern at mass gatherings such as Hajj and Umrah. Despite mandatory vaccination policies, declining compliance in recent years has increased transmission risks.

Preventive and control measures should focus on:

- Ensuring high vaccination coverage before travel.

- Enhancing timely detection, investigation and management of cases and their close contacts.

- Enhancing real-time surveillance and monitoring antimicrobial resistance trends.

- Strengthening risk communication and community engagement to improve compliance.

- Strengthening vaccination coverage and compliance for Umrah travelers

WHO strongly advises individuals attending mass gatherings such as Hajj and Umrah to receive vaccination against meningococcal disease at least 10 days prior to travel. This measure is considered the most effective strategy to prevent the disease and potential outbreaks during these events. Specifically, WHO recommends that all pilgrims receive the quadrivalent meningococcal conjugate vaccine, which covers serogroups A, C, W, and Y, prior to traveling.​

The authorities of KSA require incoming pilgrims to hold proof of vaccination with quadrivalent meningococcal conjugate vaccine ACWY. This, and other health related entry requirements, are available on the official web site of the Ministry of Health of Saudi Arabia and other governmental platforms. States Parties shall make aware immigration authorities and conveyance operators of health-related requirements implemented by the Saudi Arabia, so that the validity of heath documents carried by travelers to Saudi Arabia can be duly checked before departure and prior to arrival in Saudi Arabia.

Promotion of coordination among ministries of health, civil aviation, immigration authorities, and Hajj/Umrah tour operators to ensure harmonized implementation of vaccination and entry requirements, including pre-departure checks.

Enhancing timely case detection, investigation, and management:

Timely detection and confirmation as well as prompt, appropriate management of cases are critical control measures against meningococcal disease. Suspected cases should undergo laboratory confirmation, which requires the isolation of N. meningitidis from a normally sterile body fluid, including blood, cerebrospinal fluid, or less commonly, pleural, pericardial or synovial fluid. Confirmatory tests include culture with antimicrobial susceptibility testing as well as molecular investigations (e.g. PCR).

Antibiotic therapy, typically administered for a total duration of 5 to 7 days, is the cornerstone of treatment. Empiric therapy with intravenous ceftriaxone or cefotaxime should be initiated in suspected cases as soon as possible. Once N. meningitidis is isolated, the antibiotic regimen should be reviewed and adjusted according to AST results.

Individuals with prolonged exposure while in close proximity to an index case and as well as those directly exposed to their oral secretions are at increased risk of infection. Post-exposure antibiotic prophylaxis is therefore recommended for close contacts as a measure to prevent secondary transmission and eradicate asymptomatic nasopharyngeal carriage. Considering the rising concerns related to ciprofloxacin-resistance among  N. meningitidis isolates, the drug of choice for post-exposure prophylaxis should be selected based upon prevalent antimicrobial resistance patterns. Pre-exposure antimicrobial prophylaxis is not recommended.  

Review and update contact tracing guidance for meningococcal infections on aircraft to ensure alignment with best practices. The RAGIDA (Risk Assessment Guidelines for Infectious Diseases Transmitted on Aircraft) framework from ECDC provides valuable guidance and can serve as a reference.

Expand the digital health passport system to include comprehensive vaccination records, ensuring all required immunization data for pilgrims is current and verifiable.

Strengthening surveillance:

WHO emphasizes the importance of robust surveillance systems for meningococcal disease to effectively control and prevent outbreaks and to continue sharing information between concerned health authorities. Host countries should conduct ongoing surveillance and rely on a risk-based approach focused on the evaluation, mitigation, and communication of risk to ensure timely and appropriate public health responses.

WHO also highlights the importance of monitoring antibiotic resistance trends by systematically testing N. meningitidis isolates in order to adequately inform post-exposure prophylaxis and treatment strategies. Available information pertaining to serogroups and genomic sequencing should be timely shared with global surveillance platforms in order to track strain variations and identify potential clusters.

Risk communication and community engagement:

Awareness of requirements through policy briefs to Ministers of Health should be undertaken, emphasizing the critical role of vaccination in preventing outbreaks.

Risk communication should be undertaken to raise community awareness and boost coverage by: Engaging religious leaders (e.g., mosque imams) to advocate for vaccination within Muslim communities, including during the Friday Prayer Khutba. Other RCCE measures could include: disseminate vaccination requirements through Hajj/Umrah tour operators, mosques, embassies, and airports; work with religious leaders (e.g., imams) to promote health messaging, especially during sermons and gatherings such as Friday prayers; ensure vaccination messaging is clearly visible on official websites (e.g., Saudi MoH, embassies) and in travel documents; launching public awareness campaigns to emphasize the importance and effectiveness of vaccination in preventing meningococcal disease, utilizing social media, traditional media, and community outreach initiatives.

An information note should be provided to close contacts to raise awareness about the signs and symptoms of disease, along with contact details for reaching health authorities.  

WHO does not recommend any restriction on travel and/or trade to the Kingdom of Saudi Arabia on the basis of the information available for the current event.

(...)

Source: World Health Organization, https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON563

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#USA, Monitoring for Avian #Influenza A(#H5) Virus In #Wastewater (as of April 11 '25)

{Excerpt}

Time Period: March 30, 2025 - April 05, 2025

-- H5 Detection: 4 sites (1.1%)

-- No Detection: 372 sites (98.9%)

-- No samples in last week: 256 sites

(...)

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

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#Japan - Equine #influenza virus (Inf. with) - Immediate notification

 <Outbreaks 1-3> In early April, Livestock Hygiene Service Centres (LHSCs) in Kumamoto Prefecture received notifications from farmers with animals presenting clinical signs and collected samples. On 8 April, the LHSCs confirmed positive for Equine Influenza by RT-PCR. Genotyping is currently underway.

Source: WOAH, https://wahis.woah.org/#/in-review/6420

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Detection of #Measles in #Texas #Wastewater

Abstract

Measles outbreaks continue to pose significant public health challenges globally despite the availability of effective vaccines. In this study, we evaluated wastewater-based surveillance for detection of measles virus during an ongoing outbreak in Texas. Weekly wastewater samples collected from two Texas cities between January 2 and March 17, 2025 were analyzed using multiple RT-PCR assays targeting the nucleoprotein and matrix genes of the measles virus. Viral RNA was detected in multiple days from both cities, with City A showing positives from January 13 and City B from January 6, both predating the first confirmed case in the state on January 23. Sequencing of PCR amplicons confirmed the specificity of detection and phylogenetic analysis using global and U.S. measles genome databases further validated that the viral RNA belonged to the currently circulating genotype D8. Our findings demonstrate that wastewater surveillance can provide early evidence of measles virus circulation in communities before clinical cases are recognized and can support public health responses to these re-emerging infectious diseases.

Source: MedRxIV, https://www.medrxiv.org/content/10.1101/2025.04.08.25325475v1

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Emergence of #Influenza #H1N1pdm09 6B.1 A.5a.2a and 6B.1 A.5a.2a.1 Subclades Leading to Subtyping #Failure in a Commercial Molecular #Assay

Highlights

• Impact of genetic evolution in influenza A(H1N1)pdm09 on subtyping assay performance.

• Influenza A subtyping assays are susceptible to primer- or probe-binding mismatches.

• Subclades 6B.1 A.5a.2a.1 and 6B.1 A.5a.2a harbour mutations that caused subtyping failures in some specimens.

• Sequencing confirmed all specimens were H1N1pdm09, within recognized subclades.

Abstract

Background

During the 2023–2024 and early 2024–2025 influenza seasons, several influenza A-positive specimens in our laboratory failed subtyping for H1, H1pdm09, and H3 using the Allplex Respiratory Panel 1 (Allplex RP1) (Seegene Inc.). This study aimed to identify the cause of these subtyping failures.

Materials and Methods

Between August 2023 and December 2024, 23 nasopharyngeal specimens tested positive for influenza A but were unsubtypeable for H1, H1pdm09, and H3. Confirmatory testing by the manufacturer included target-specific PCR for the M and HA genes, followed by sequencing to determine subclades.

Results

Among the 23 unsubtypeable specimens, 22 yielded PCR products for sequencing. Of these, 21 belonged to subclade 6B.1 A.5a.2a.1 and one to 6B.1 A.5a.2a. Sequence analysis revealed mismatches in the H1pdm09 primer/probe-binding regions of Allplex RP1, explaining the subtyping failures. Despite testing negative for H1pdm09 in Allplex RP1, sequencing confirmed their classification as H1N1pdm09 subclades with HA gene mutations.

Conclusions

Subclades 6B.1 A.5a.2a.1 and 6B.1 A.5a.2a harbour mutations that contributed to subtyping failures in some specimens tested with a commercial assay. While unsubtypeable influenza A results often raise concerns about emerging strains, sequencing confirmed that all unsubtypeable specimens tested with Allplex RP1 belonged to H1N1pdm09 within recognised subclades. Thus, such subtyping failures in this assay do not necessarily indicate a novel or zoonotic virus, though genomic surveillance remains essential.

Source: Journal of Clinical Virology, https://www.sciencedirect.com/science/article/abs/pii/S1386653225000393?dgcid=rss_sd_all

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Avian #influenza A(#H5N6) virus detected during live-poultry #market #surveillance linked to a #human #infection in #Changsha, #China, from 2020 to 2023

Abstract

In November 2022, we reported a fatal case of human infection caused by a highly pathogenic avian influenza A(H5N6) virus bearing a clade 2.3.4.4b HA gene in Changsha City. We investigated the transmission route and distribution of the H5N6 virus in the largest live-poultry market (LPM), which is linked to the human infection. A total of 1357 samples from the LPM were collected for avian influenza A virus detection from 2020 to 2023. The proportion of LPM samples positive for H5 subtype avian influenza virus was 14.30% (194/1357). Sequences of H5N6 (n = 10) and H5N1 (n = 4) avian influenza viruses were obtained from the LPM samples using next-generation sequencing. The complete genome sequence of the H5N6 virus from the human infection case, A/Changsha/1/2022(EPI_ISL_16466440), was determined and analyzed. The PB1 and PB2 segments shared 99.65% and 99.23% sequence identity with A/duck/Hunan/S40199/2021(H5N6) and A/Whooper swan/Sanmenxia/H615/2020(H5N8), respectively. The other segments showed the highest sequence similarity to strain A/Guangdong/1/2021(H5N6), which was isolated in Guangzhou. L89V and I292V substitutions in the PB2 protein were predicted from the A/Changsha/1/2022 genome sequence. Phylogenetic analysis based on the HA gene showed that A/Changsha/1/2022 and other H5 subtype isolates obtained from the LPM grouped together in the 2.3.4.4b branch. Bayesian evolutionary analysis of the HA gene showed that clade 2.3.4.4b of the H5N6 virus is likely to have been prevalent in Hunan Province around October 2021. In conclusion, we confirmed that the clade 2.3.4.4b HA gene of A/Changsha/1/2022 virus recombined with those of local strains. These results demonstrate the importance of continuous surveillance of H5N6 influenza viruses.

Source: Archives of Virology, https://link.springer.com/article/10.1007/s00705-025-06280-y

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#Global #Prevalence and #Distribution of #H9 Subtype of Avian #Influenza Viruses in Wild #Birds: Literature Review with Meta-Analysis

Abstract

Background: 

As a natural accelerator of highly pathogenic avian influenza in wild birds, the H9 subtype of avian influenza poses a substantial threat to both humans and the poultry industry. A comprehensive meta-analysis is necessary to assess the current status of the global H9 outbreak. In this research, a literature review and meta-analysis are presented on the surveillance studies of the H9 subtype of avian influenza in wild birds worldwide up to 2024.

Methods: 

A comprehensive search strategy was employed, utilizing the China Science and Technology Journal Database, China National Knowledge Infrastructure, PubMed, Google Scholar, and Scientific Direct databases. The exclusion criteria for this study included duplicate studies, reviews, other host studies, as well as research with inconsistent or insufficient data. An analysis was conducted on data obtained from a total of 31 publications. The rate-conversion analyses were conducted using a random-effects model in the “meta” package of the “R” software, with the PFT method implemented.

Results: 

In the meta-analysis, the prevalence of wild bird H9 avian influenza virus (AIV) was found to be 0.02% (193 out of 365,972). Statistically significant higher prevalences of wild bird influenza A virus were observed in Norway and South Africa (0.87%, 21/2417 and 0.44%, 10/1155, respectively) in comparison with other regions. Within the Anseriformes family, the prevalence rate was much greater (0.17%, 80 out of 90,014) compared with other species. In addition, we performed subgroup analyses that included geographical variables. These assessments showed a higher prevalence of H9 in wild birds in cold regions (0.08%, 30/100,691).

Conclusion: 

In summary, our results suggest that the occurrence of H9 AIV in avian populations differs among different geographical areas and species. Therefore, it is necessary to conduct further surveillance on the prevalence of AIV in wild birds to guide the creation of strong and efficient regulatory strategies targeted at eradicating the transmission of AIV across different species.

Source: Vector-Borne and Zoonotic Diseases, https://www.liebertpub.com/doi/abs/10.1089/vbz.2024.0111

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Beyond #MERS: #Merbecovirus #receptor plasticity calls for emergence #preparedness

Abstract

Three studies recently published in Cell reveal distinct ACE2 binding interactions across the merbecoviruses, uncovering how HKU5 can use ACE2s of many non-human hosts and identifying a novel HKU5 lineage capable of using human ACE2. These findings highlight merbecovirus receptor plasticity and caution for preparedness against potential merbecovirus threats.

Source: Cell, Host & Microbe, https://www.cell.com/cell-host-microbe/abstract/S1931-3128(25)00096-4?rss=yes

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

{Kauno Region} Information about dead mute swans was received through passive surveillance. The swan was sampled and delivered to the National Reference Laboratory for HPAI detection.

Source: WOAH, https://wahis.woah.org/#/in-review/6414

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Increased #Pneumonia-Related #Emergency Department Visits, Northern #Italy

Abstract

An increase in pneumonia-related emergency department visits was observed in Lombardy, northern Italy, during June–October 2024. Viral causes appear insufficient to explain the increase, suggesting a bacterial cause. Mycoplasma pneumoniae and Bordetella pertussis emerged as possible causes when other surveillance systems were consulted, but the reasons behind this trend remain unknown.

Source: US Centers for Disease Control and Prevention, https://wwwnc.cdc.gov/eid/article/31/5/24-1790_article

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#Mexico: The Ministry of Health reports the #death of the first #human case of avian #influenza A (#H5N1)

{Automatic translation. Edited.} 

www.gob.mx/salud

The Ministry of Health reports the death of the first human case of avian influenza A (H5N1) in Mexico. 

It is reported that a three-year-old girl diagnosed with avian influenza A(H5N1) and a resident of Durango died today at 1:35 a.m. due to respiratory complications resulting from the infection. 

It is a viral disease that affects birds (wild and domestic), mammals and occasionally humans. 

Local, state, and federal health, environmental, and agricultural authorities continue prevention and control measures within the context of One Health. So far, 38 human contacts of the case have been sampled, all of which have tested negative. 

No additional human cases have been identified, and the risk of further cases is considered low. 

X:  @SSalud_mx  

Source: Ministry of Health, https://www.gob.mx/salud/prensa/secretaria-de-salud-informa-la-defuncion-del-primer-caso-humano-de-influenza-aviar-a-h5n1

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A #monoclonal anti-hemagglutinin stem #antibody modified with #zanamivir protects against both #influenza A and B viruses

Significance

Anti-influenza therapeutics remain essential for the control of influenza infections, which may require hospitalization for the most severe cases. Hemagglutinin (HA) and neuraminidase (NA), the two membrane glycoproteins of the influenza virus, play crucial roles in the viral replication cycle. While many monoclonal antibodies and small-molecule inhibitors target HA or NA, each faces limitations tied to their individual properties. We developed an antibody–drug conjugate (ADC) by covalently linking the NA inhibitor zanamivir to MEDI8852, an HA stem-specific monoclonal antibody. The MEDI8852–zanamivir conjugate targets both HA and NA and offers robust and long-lasting protection in mice against lethal infections with influenza A and B viruses. This approach represents an addition to anti-influenza therapy.

Abstract

Influenza remains a significant public health threat. Both monoclonal antibodies and small-molecule inhibitors can target the influenza surface glycoproteins hemagglutinin (HA) or neuraminidase (NA) for prevention and treatment of influenza. Here, we combine the strengths of anti-influenza antibodies and small molecules by site-specific conjugation of the NA inhibitor zanamivir to MEDI8852, an HA-specific fully human monoclonal antibody. MEDI8852 targets the conserved stem region of HA and inhibits HA-mediated fusion of the viral and host cell membranes. Elimination of virus-infected cells involves Fcγ receptor–mediated effector functions. The efficacy of MEDI8852 is limited to influenza A viruses. Zanamivir, on the other hand, binds to the active site of NA in both influenza A and B viruses to inhibit NA activity and virus release. However, because of its small size, zanamivir has a short half-life and requires repeated dosing at high concentrations. We produced a MEDI8852–zanamivir antibody–drug conjugate (ADC) that engages Fc-mediated effector functions and benefits from neonatal Fc receptor (FcRn)-mediated recycling. The MEDI8852–zanamivir conjugate extends the circulatory half-life of zanamivir, targets both influenza HA and NA, and shows enhanced antibody-dependent cellular cytotoxicity (ADCC) compared to MEDI8852 alone. The MEDI8852–zanamivir conjugate protected mice from a lethal (10 × LD50) challenge with influenza A and B viruses at a dose similar to that required for broadly neutralizing anti-NA antibodies, with the added advantage of simultaneously targeting NA (influenza A and B) and HA (influenza A).

Source: Proceedings of the National Academy of Sciences of the United States of America, https://www.pnas.org/doi/10.1073/pnas.2424889122

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Identification and characterization of a broadly neutralizing and protective #nanobody against the #HA1 domain of #H5 avian #influenza virus #hemagglutinin

ABSTRACT

The highly pathogenic avian influenza viruses (HPAIVs) of subtype H5, particularly those of the currently circulating clades 2.3.2.1 and 2.3.4.4, are largely responsible for the sporadic human infections that frequently present with a high case fatality rate. Consequently, there is an urgent necessity for the development of advanced antiviral therapeutic options against the H5 HPAIVs. Herein, the yeast two-hybrid system was employed for identifying seven nanobodies that bind the HA1 domain of hemagglutinin (HA). Among these nanobodies, Nb10 was found to exhibit high-affinity and broad-spectrum neutralization capacity against viruses of clades 2.3.2.1 and 2.3.4.4 under both in vitro and in vivo conditions. Surprisingly, Nb10 exhibited excellent efficacy against the recombinant viruses Re6/PR8, Re8/PR8, Re10/PR8, Re11/PR8, and Re14/PR8 of the subtype H5, with average half-maximal inhibitory concentrations ranging from 0.01 to 0.42 µg/mL in a microneutralization assay. Furthermore, the intratracheal administration of Nb10 resulted in remarkable prophylactic and therapeutic efficacy in mice. The findings herein reveal that the virus-neutralizing effect of Nb10 is achieved by obstructing viral entrance into host cells. Moreover, Western blot analysis and enzyme-linked immunosorbent assay revealed that Nb10 recognizes a conformational epitope located in the region spanning amino acid residues 50–271 of the protein HA1 displayed on the surface of yeast cells. The predicted structure of the binding pocket indicates that Nb10 recognizes the highly conserved receptor-binding site of HA1. Taken together, the current study offers valuable insights for the development of protective therapeutics with broad-spectrum activity and the design of broadly protective influenza vaccines.

IMPORTANCE

HPAIVs of subtype H5 have raised substantial public health concerns regarding the potential for viral adaptation and sustained human-to-human transmission. The prevention and treatment of the disease are replete with numerous challenges due to frequent antigenic alterations in the virus. Nanobodies have significant potential for clinical applications and therapies owing to their small size and robust tissue-penetrating capabilities. Herein, we describe the identification of Nb10, a broad-spectrum virus-neutralizing and protective nanobody that is effective against the currently circulating H5 HPAIVs of clades 2.3.2.1 and 2.3.4.4. The intratracheal administration of Nb10 afforded significant protection in mice infected with the H5 virus. This result provides novel insights for the rational design of antiviral pharmaceuticals. Furthermore, an analysis of the binding site of the target protein HA1 may be useful for the development of more effective vaccinations against influenza viruses of the subtype H5.

Source: Journal of Virology, https://journals.asm.org/doi/full/10.1128/jvi.02090-24?af=R

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#Israel - #Influenza A #H5N8 viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification

 A wild Booted Eagle in HaZafon Region.

Source: WOAH, https://wahis.woah.org/#/in-review/6408

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Integrating Behavioural Science and #Epidemiology to Improve Early #Detection of Zoonotic #Swine #Influenza in the #Netherlands

Abstract

Background and Objectives: 

The Netherlands faces zoonotic disease risks due to its dense human and livestock populations. The 2009 H1N1 outbreak highlighted the pandemic potential of influenza virus reassortment. Effective preparedness requires integrating behavioural and epidemiological models. Human behaviour, shaped by personal, social, and institutional factors, is critical in detecting, intervening, and treating diseases. Using the Theory of Planned Behaviour (TPB), a framework was developed integrating knowledge from the TPB to improve early detection and response, using (zoonotic) swine influenza as a case study. 

Material and Methods: 

Within the framework we defined the desired outcome: timely detection and notification of symptomatic (and hypothetical zoonotic) swine influenza to prevent its spread. Actions, such as symptom recognition and disease reporting, were linked to key drivers extracted from the TPB and disease transmission modelling. Expert elicitation estimated the likelihood of action for different farmer profiles, while disease transmission modelling assessed farm-to-farm spread probabilities. Simulations integrated these probabilities to evaluate intervention effectiveness across different scenarios. 

Results: 

The framework successfully combined behavioural science and epidemiology, offering nuanced estimates of intervention effectiveness. For early detection, 95% of farmers were estimated to notify their veterinarian within 13 days post-infection. Key factors influencing action included symptom recognition and disease spread extent. The farmer profiles influenced response likelihood, while human infections linked to outbreaks had minimal impact. Farm density and assumptions about transmission probabilities significantly affected the likelihood of spread before notification. 

Discussion and Conclusion: 

The framework provides a systematic approach for integrating social and epidemiological insights to support evidence-based policies. The work can be further enhanced by complementing expert judgement with more extensive stakeholder surveys, randomized scenario presentations, and immersive methods. This pragmatic tool aids policymakers in designing targeted interventions for zoonotic disease preparedness.

Source: BioRxIV, https://www.biorxiv.org/content/10.1101/2025.04.03.646521v1?rss=1

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