Environmental #monitoring and spatiotemporal #trend #analysis of avian #influenza virus in #Xinjiang, 2021-2023

Abstract

Background

Avian influenza, a significant threat to public health, requires monitoring for the development of control strategies. This study aims to analyze the spatiotemporal distribution of avian influenza virus in the external environment of Xinjiang from 2021 to 2023, to enhance understanding of its transmission patterns and provide a scientific basis for public health response measures.

Methods

A total of 3913 avian-related environmental samples were collected from nine monitoring areas in Xinjiang. Sample types included poultry drinking water, meat cutting boards, cage surfaces, feces, and wastewater. Real-time RT-PCR was used to detect nucleic acid for H5, H7, and H9 subtypes. Data were statistically analyzed using Excel and SPSS, and spatial distribution was visualized through Kriging interpolation using ArcGIS.

Results

Among the collected samples, 810 tested positive, with an overall positivity rate of 20.70%. The H9 subtype was predominant, accounting for 85.43% of positive samples. Significant differences in detection rates were observed across different years, regions, sample types, and monitoring sites. Temporally, the positive rate showed an upward trend from 2021 to 2023, with higher positive rates in January and July. Geographically, Aksu, Turpan, and Ili were identified as high-risk areas. Urban and rural live poultry markets had the highest positivity rate (24.31%), and poultry drinking water, cage surfaces, and cleaning wastewater samples showed relatively high detection rates. Kriging analysis revealed several high-risk zones for virus presence.

Conclusion

This study provides crucial information for understanding the epidemiological characteristics of avian influenza virus in the external environment of Xinjiang. The H9 subtype was found to be predominant, with notable seasonal and regional variations. Live poultry markets were identified as key risk sites. These findings underscore the need for continuous surveillance and offer theoretical support for developing targeted prevention and control strategies. However, the limited scope of monitoring suggests that broader and longer-term studies are needed to better understand subtype interactions and epidemic risks.

Source: BMC Infectious Diseases, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-11155-3

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Novel Highly Pathogenic Avian #Influenza A #H5N1 Triple #Reassortant in #Argentina, 2025

Abstract

Genomic sequencing of re-emerging highly pathogenic avian influenza A(H5N1) virus detected in Argentina in February 2025 revealed novel triple-reassortant viruses containing gene segments from Eurasian H5N1 and low pathogenic viruses from South and North American lineages. These findings underscore continued evolution and diversification of clade 2.3.4.4b H5N1 in the Americas.

Source: BioRxIV, https://www.biorxiv.org/content/10.1101/2025.05.23.655175v1

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Characteristics of the first confirmed case of #human #infection with #mpox virus clade Ib in #China

Abstract

Mpox clade Ib is significant as it is associated with human cases and plays a key role in understanding the transmission and public health implications of mpox outbreaks. Here we present a case report of the first confirmed human infection of clade Ib in China, which occurred in December 2025 in Zhejiang Province. The case was a 28-year-old woman from South Africa who had sexual contact with an asymptomatic man from the Democratic Republic of the Congo. She presented with disseminated vesicular lesions on the extremities, face, buttocks, trunk, palms, and dorsum of the hands, but lesions were absent from the oral cavity, perineum, and anus. By the 18th day post-onset (DPO), only vesicles remained on the dorsum of the right foot and in the finger web spaces, with complete resolution by the 24th DPO. Among 59 consecutive samples collected, 55 tested positive for mpox virus. Oropharyngeal swabs turned negative by the 16th DPO, while skin lesion samples, urine samples, and scab specimens remained positive through the 20th DPO. Consecutive scab samples consistently exhibited high viral loads. In total, 211 contacts of the symptomatic patient were identified, and no secondary cases occurred. This study underscores the importance of multisite sampling for diagnostic sensitivity, highlights the transmission risk associated with asymptomatic sexual contact, and emphasizes the need for refined contact definitions and management strategies. Further research is needed to explore infection risks across different types of exposure.

Source: Nature Communications, https://www.nature.com/articles/s41467-025-60217-2

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Avian #Influenza in #Ireland: A Spatiotemporal, Subtype, and Host-Based Analysis (1983-2024)

Abstract

Avian influenza virus (AIV) is a significant global concern, causing widespread mortality in wild birds, domestic poultry and most recently wild and domestic mammals. This study presents a retrospective analysis of AIV detections in the Republic of Ireland. Data was sourced from official surveillance databases, peer-reviewed literature and grey literature sources. Spatio-temporal, host-specific and subtype patterns were assessed using descriptive statistics, chi-square tests, linear regression and kernel density estimations. A total of 2,888 confirmed AIV detections were recorded from 25 of Ireland's 26 counties. Wild birds accounted for 98.7% of detections, with domestic birds comprising 1.3% and two detections in foxes. H5N1 was the most prevalent subtype (96.7%) followed by H5N8 and H6N1. Spatial clustering was observed in urban areas, particularly Dublin. The highest seasonal peak occurred during summer, contrasting with traditional winter-associated patterns. Several detections occurred in migratory species outside of typical residency periods, suggesting potential climate-related shifts in migration behaviour. This study represents the first review of AIV surveillance data in Ireland to date. The findings highlight evolving patterns in virus distribution, seasonality and host dynamics, with implications for national surveillance strategies. Continued cross-species monitoring and integration of ecological data are essential to inform effective management strategies.

Source: BioRxIV, https://www.biorxiv.org/content/10.1101/2025.05.26.656175v1

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Comparative #risk #assessment of spread of highly pathogenic avian #influenza #H5 viruses in French #broiler and layer sectors.

Abstract

Since 2015, French poultry production is threatened almost every year by a reintroduction of highly pathogenic avian influenza H5 viruses. The duck sector was the most concerned by this crisis but other sectors such as broiler, layer and turkey were also affected by outbreaks. The objective of this work was to assess the risk of highly pathogenic avian influenza H5 virus transmission from one farm to another within the French broiler and layer production network. This study used the WOAH risk assessment framework. After drawing up a scenario tree of virus transmission from one farm to another, data were collected through a literature review or through experts' elicitation. Three questionnaires were developed according to the experts' field of expertise: avian influenza, broiler and layer sectors. The experts' estimates were combined using a beta distribution weighted by their confidence level. A Monte Carlo iteration process was used to combine the different probabilities of the scenario tree and to assess the transmission risk. In the broiler sector, the highest transmission probabilities were observed if the exposed farm was an indoor broiler farm and the source a broiler farm (indoor or free-range). The high transmission probability between broiler farm integrated within the same company highlighted the role of integration in this probability. The pathways which generated the highest transmission probabilities between two integrated indoor broiler farms with a good biosecurity level are person movement, transport of feed and manure management. In the layer sector, the highest transmission probabilities were observed if the source farm was a free-range farm and the exposed farm a production farm (indoor or free-range). The pathways with the highest transmission probabilities were egg transport and person movement. The sensitivity analysis showed that the exposed farm's biosecurity had a significant impact on the transmission probability. Our results provide an insight on the role of each type of farms in the virus spread within the French broiler and layer production sectors and will be useful for the implementation of control measures such as movement restriction or vaccination.

Source: BioRxIV, https://www.biorxiv.org/content/10.1101/2024.09.11.612235v3

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#HK PRC SAR, Avian #Influenza #Report - Week 21 '25 (excerpts): One New #Human #H5N1 Case in #China

{Excerpts}

Influenza A H5N1 Virus

-- Date: 23/05/2025, 

-- Location: China*, Guangxi Zhuang Autonomous Region, 

-- Sex: Female, 

-- Age: 53,  

-- Clinical Status: Recovered, 

-- Virus Subtype: H5N1.

(...)

Source: Centre for Health Protection, Hong Kong PRC SAR, https://www.chp.gov.hk/files/pdf/2025_avian_influenza_report_vol21_wk21.pdf

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Global #risk #mapping of highly pathogenic avian #influenza #H5N1 and H5Nx in the light of epidemic episodes occurring from 2020 onward

Abstract

Avian influenza (AI) is a highly contagious viral disease affecting poultry and wild water birds, posing significant global challenges due to its high mortality rates and economic impacts. Highly pathogenic avian influenza (HPAI) outbreaks, particularly those caused by H5N1 and its variants, have surged since their first occurrence in 1959. The HPAI H5N1 clade 2.3.4.4b viruses have notably expanded its geographical reach, affecting numerous countries, diverse avian species, and now wild and domestic mammals. Using an ecological niche modelling approach, this study aims to elucidate the environmental factors associated with the increased HPAI H5 cases since 2020, investigate potential shifts in ecological niches, and predict new areas suitable for local viral circulation. Focusing on H5N1 and H5Nx strains, we have developed ecological niche models for HPAI case in both wild and domestic birds while considering two distinct periods: 2015-2020 and 2020-2022. Key environmental predictors include chicken and duck population density, human density, distance to water bodies, and several land cover variables. Post-2020, we observe a notable increase in the relative importance of some of these predictors, such as intensive chicken population density and cultivated vegetation. The resulting risk maps reveal notable ecological suitability for local HPAI H5 circulation in Europe, Asia, as well as North and South America, with notable expansions of the areas at risk post-2020. The spatial distribution of HPAI H5 occurrences in wild birds appears to be primarily influenced by urban areas and open water regions. Overall, global risk maps derived from our models identify regions at risk where surveillance and control measures should be prioritised. Finally, our analyses also highlight a shift in the diversity of species affected by HPAI outbreaks, with a higher variety of avian species, particularly sea birds, being impacted post-2020. This increased diversity suggests that ecological shifts in HPAI H5 circulation may be accompanied by a broader range of susceptible species. Overall, these results further contribute to the understanding of HPAI epidemiology.

Source: BioRxIV, https://www.biorxiv.org/content/10.1101/2024.11.15.623755v2

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Home Again, Frederick McCubbin (1884)

 

Public Domain.

Source: WikiArt, https://www.wikiart.org/en/frederick-mccubbin/home-again-1884

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History of Mass Transportation: The FS D445 Diesel-Electric Locomotive

 

By Gabriele Fontana - https://www.flickr.com/photos/gabry1970/5175636373/, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=109273634

Source: Wikipedia, https://it.wikipedia.org/wiki/Locomotiva_FS_D.445

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#Coronavirus Disease Research #References (by AMEDEO, May 24 '25)

 

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#Influenza and Other Respiratory Viruses Research #References (by AMEDEO, May 24 '25)

 

Am J Med

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2. STAHLBERG M, Fischer K, Tahhan M, Zhao A, et al
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   PubMed         Abstract available
   
   
4. SANAL-HAYES NEM, Mclaughlin M, Hayes LD, Berry ECJ, et al
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   Am J Med. 2025;138:1029-1037.
   PubMed         Abstract available
   
   

   
   Ann Intern Med

5. AMAN M, Jeevananthan A, Martinez-Cruz M, Namasingh N, et al
   Endocrinology: What You May Have Missed in 2024.
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   PubMed         Abstract available
   
   
6. HAMED HKA, Nachman A, Riopel N, Schuster M, et al
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7. CORONADO GD, Petrik AF, Thompson JH, Leo MC, et al
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37. MARTIN MORENO V, Martinez Sanz MI, Gonzalez IS, Vazquez MR, et al
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38. JONGKEES MJ, Bogers S, de Vries RD, GeurtsvanKessel CH, et al
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39. PARIDANS M, Dardenne N, Gillain N, Husson E, et al
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41. VIJAYAKUMAR S, Corneau E, Erqou S, Kokkirala A, et al
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    PubMed         Abstract available
    
    
42. DORJEE K, Sadoff RC, Mansour FR, Dorjee S, et al
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    PubMed         Abstract available
    
    
43. DOGBLA L, Jaber AB, Baker JS, Boudet G, et al
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The State of the #World’s #Animal #Health 2025 (#WOAH, May 24 '25)

{Summary}

World Organisation for Animal Health (2025). – The State of the World’s Animal Health 2025. Paris, 124pp. https://doi.org/10.20506/woah.3586. Licence: CC BY-SA 3.0 IGO.

Foreword

Animal health is inextricably linked to human  health, the stability of ecosystems and the strength of economies. In a world facing increasingly complex global challenges – emerging infectious diseases, climate change, antimicrobial resistance and food insecurity – ensuring the health of animals is crucial. This first iteration of The State of the World’s Animal Health report is a landmark publication released by the World Organisation for Animal Health (WOAH) for its 92nd General Session of the World Assembly, which reflects our commitment to evidence-based decision-making and data-driven action. Drawing  on WOAH’s comprehensive information systems and the collective expertise of its Members and expert network, this report offers a clear, objective and timely analysis of the global animal health landscape, helping us understand the current situation and the path toward a healthier future. Animal diseases know no borders. Whether affecting livestock, wildlife or aquatic species, their impact can be devastating – threatening livelihoods, public health, food supply chains, international trade and biodiversity. Our ability to prevent, detect and respond to these threats depends on robust surveillance, strong Veterinary Services, and the effective implementation of science-based policies. This report serves as a valuable resource for the veterinary workforce, researchers, policy-makers, and all those invested in the health of animals and the resilience of our societies. It provides critical insights into disease trends, the situation of veterinary capacities worldwide and the effectiveness of interventions. Most importantly, it reinforces the message that proactive investment in animal health is an investment in global health security. In addition to an objective analysis of the current situation, the core focus of this inaugural report is vaccination – one key element of disease prevention and control. Vaccination, alongside other measures, has saved countless lives, prevented economic losses, and reduced the need for antimicrobial treatments, playing a fundamental role in the fight against antimicrobial resistance. From eradicating deadly diseases like rinderpest to controlling threats such as rabies, foot and mouth disease and avian influenza, vaccines remain a powerful tool at our disposal. Yet, access to vaccines remains uneven, and challenges persist in vaccine research, production, distribution and uptake. Strengthening global cooperation and ensuring equitable access to safe, effective vaccines, alongside other control measures must be a priority for all of us. Valuable insights provided by this report will serve the discussion of this year’s General Session Forum: “Veterinary vaccines and vaccination: from science to action – reflections for change”. Looking ahead, we must continue to strengthen our data collection and analysis, foster innovation in disease prevention, and reinforce global veterinary capacities. This report is not just a static reflection of where we are – it is a dynamic call to action. A call for deeper collaboration, greater investment, and a shared commitment to building a future where animal health is protected, global health is secured and sustainable development is realised, and food security is strengthened for generations to come. Because animal health is our health. It’s everyone’s health.

Dr Emmanuelle Soubeyran, Director General, World Organisation for Animal Health

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Source: World Animal Health Organization, https://www.woah.org/en/document/the-state-of-the-worlds-animal-health-2025/

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A G219A #hemagglutinin #substitution increases #pathogenicity and viral #replication of Eurasian avian-like #H1N1 swine #influenza viruses

Abstract

The Eurasian avian-like swine (EA) H1N1 virus has been widely prevalent in the Chinese swine population and has caused infections in human. However, knowledge regarding its pathogenic mechanisms remains limited. In this study, we analyzed the pathogenic determinants of two G4 genotype EA H1N1 viruses (A/Swine/Guangdong/SS12/2017 and A/Swine/Jiangxi/1110/2017) with differing pathogenicity by constructing a series of reassortant and mutant viruses. The HA-G219A mutation was found to be determinant of pathogenicity in mice. Subsequent analyses revealed that this mutation enhances viral replication in human cells, improves thermal stability, reduces HA activation pH, and alters receptor-binding properties. Furthermore, HA-G219A mutation may be an adaptive mutation that facilitates influenza virus adaptation to swine, with its prevalence increasing in the swine population. This mutation may support cross-species transmission of EA H1N1 swine influenza viruses or genetic exchange with other virus subtypes/genotypes, potentially contributing to the emergence of pandemic viruses. These findings improve our understanding of EA H1N1 pathogenicity and highlight the critical need for ongoing surveillance of influenza viruses in pigs.

Source: Veterinary Microbiology, https://www.sciencedirect.com/science/article/abs/pii/S0378113525002007?via%3Dihub

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Highly Pathogenic Avian #Influenza A(#H5N1) Caused Mass Death among Black-legged #Kittiwakes (Rissa tridactyla) in #Norway, 2023

Abstract

In 2023, highly pathogenic avian influenza (HPAI) heavily affected gulls in Europe. In July, a mass mortality event was reported in the Black-legged Kittiwake (Rissa tridactyla) breeding colony at Ekkerøy in Northern Norway. The cause was confirmed to be infection with the HPAI H5N1 clade 2.3.4.4b virus, genotype EA-2022-BB. We describe the outbreak in Kittiwakes, including pathological and virological investigations, and discuss the management and zoonotic potential. With more than 15,000 dead birds reported, we estimate that the outbreak caused a reduction in the Kittiwake population at Ekkerøy of at least 50%. Diseased birds exhibited neurological signs. Necropsy of ten birds revealed a peracute fatal systemic disease, with severe lesions in the brain and pancreas co-localizing with the presence of viral RNA and antigen. Vascular expression of α2,3-linked sialic acids and viral RNA/antigen may reflect hematogenous virus spread. Further studies should investigate the long-term impact of HPAI on Kittiwake populations.

Source: BioRxIV, https://www.biorxiv.org/content/10.1101/2025.05.23.655725v1

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#Epidemiology and Genetic Characterization of Distinct #Ebola #Sudan #Outbreaks in #Uganda

Abstract

Background. 

Sudan virus (SUDV) has caused multiple outbreaks in Uganda over the past two decades, leading to significant morbidity and mortality. The recent outbreaks in 2022 and 2025 highlight the ongoing threat posed by SUDV and the challenges in its containment. This study aims to characterize the epidemiological patterns and phylogenomic evolution of SUDV outbreaks in Uganda, identifying key factors influencing transmission and disease severity. 

Methods. 

We conducted a retrospective observational study analyzing epidemiological and genomic data from SUDV outbreaks in Uganda between 2000 and 2025. Epidemiological data were collected from official sources, including the Ugandan Ministry of Health and the World Health Organization, supplemented with reports from public health organizations. Genomic sequences of SUDV were analyzed to investigate viral evolution and identify genetic variations associated with pathogenicity and transmissibility. 

Results. 

The 2022 outbreak involved 164 confirmed cases and a case fatality rate (CFR) of 33.5%, with significant geographic variation in case distribution. The 2025 outbreak, still ongoing, was first detected in Kampala, with evidence of both nosocomial and community transmission. Phylogenomic analysis revealed the presence of two main genetic groups, representing Sudan and Uganda, respectively. The genetic variability of the Ugandan cluster is higher than that observed in Sudan, suggesting a greater expansion potential, which aligns with the current outbreak. Epidemiological findings indicate that human mobility, weaknesses in the health system, and delays in detection contribute to the amplification of the outbreak. 

Conclusions. 

Our findings underscore the importance of integrated genomic and epidemiological surveillance in understanding SUDV transmission dynamics. The recurrent emergence of SUDV highlights the need for improved outbreak preparedness, rapid response mechanisms, and international collaboration. Strengthening real-time surveillance and enhancing healthcare system resilience are critical to mitigating the impact of future outbreaks.

Source: Infectious Disease Reports, https://www.mdpi.com/2036-7449/17/3/44

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#USA, Monitoring for Avian #Influenza A(#H5) Virus In #Wastewater (CDC, May 23 '25)

{Excerpt}

Time Period: May 11, 2025 - May 17, 2025

-- H5 Detection: 18 sites (4.5%)

-- No Detection: 381 sites (95.5%)

-- No samples in last week: 59 sites

(...)

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

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#Evolution, spread and #impact of highly pathogenic #H5 avian #influenza A viruses

Abstract

Since their first detection in 1996, highly pathogenic avian influenza viruses with H5 haemagglutinin of the A/Goose/Guangdong/1/1996 (Gs/Gd) lineage have caused outbreaks in domestic and wild animals associated with mass morbidity and mortality, and economic losses as well as sporadic human infections. These viruses have spread to hosts across the European, Asian, African, and North and South American continents, and most recently Antarctica, representing a major threat to wildlife, domestic animals and humans. Owing to continuous circulation in poultry, Gs/Gd lineage viruses have diversified into numerous distinct genetic and antigenic (sub)clades, and genetic diversity has further increased by extensive reassortment with low pathogenic avian influenza viruses of wild birds. In this Review, we discuss the historical emergence of Gs/Gd lineage viruses and their evolution and geographical spread. An overview of the major determinants of host range and cross-species transmission is provided to summarize phenotypic changes that may signal increased zoonotic or pandemic risks. The recent unusual outbreaks in wild carnivorous mammals and dairy cows is discussed, as well as the changing risk to humans. Countermeasures and mitigation strategies are described from the One Health perspective for future (pre-)pandemic preparedness.

Source: Nature Reviews Microbiology, https://www.nature.com/articles/s41579-025-01189-4

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Comparative #pathogenicity of three A(#H5N1) clade 2.3.4.4b HPAI viruses in blue-winged #teal and #transmission to domestic #poultry

ABSTRACT

Long-distance migratory ducks play a critical role in the maintenance and dissemination of A(H5N1) viruses. Comparative pathogenicity studies were conducted on blue-winged teal (BWTE; Anas discors) using three distinct genotypes of A(H5N1) clade 2.3.4.4b viruses (A1, B1.3, and B4.1) isolated from wild ducks in Canada. Twenty-four hours post-intranasal infection of BWTE, contact turkeys and chickens were introduced into each of the groups to evaluate viral transmission. The levels of viral shedding in BWTE increased from 3 to 7 days post-infection (dpi) and continued at lower levels until 14 dpi. The A1 genotype virus (MALL/NS/22) was found to be the least pathogenic to BWTE compared to the reassortant genotypes, B4.1 (RBME/BC/22) and B1.3 (BWTE/MB/22). The B1.3 genotype was the most virulent to BWTE and caused 66.7% mortality compared to 12.5% mortality caused by the B4.1 genotype. The extent of transmission from infected BWTE to contact turkeys and chickens showed variations. Turkeys housed with BWTE infected with either virus died within 6 to 10 days post-contact (dpc). Conversely, the transmission and mortality among contact chickens varied. The highest mortality (3 out of 5) occurred in chickens exposed to BWTE infected with the B1.3 genotype. Whilst in the B4.1 genotype, 2 out of 6 chickens died, none of the chickens in the A1 genotype succumbed to infection. No shedding or seroconversion was noted in all surviving chickens. This research underscores variations in the pathogenic traits and transmissibility among the different genotypes of A(H5N1) clade 2.3.4.4b viruses. This finding is vital for understanding the role of migratory birds in the epidemiology of A(H5N1) and the need for continuous monitoring of these viruses.

Source: mSphere, https://journals.asm.org/doi/10.1128/msphere.00021-25

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Emergence of #Oropouche Virus in Espírito Santo State, #Brazil, 2024

Abstract

Oropouche virus (OROV), historically endemic to the Amazon, had spread to nearly all Brazil states by 2024; Espírito Santo emerged as a transmission hotspot in the Atlantic Forest biome. We characterized the epidemiologic factors driving OROV spread in nonendemic southeast Brazil, analyzing environmental and agricultural conditions contributing to viral transmission. We tested samples from 29,080 suspected arbovirus-infected patients quantitative reverse transcription PCR for OROV and dengue, chikungunya, Zika, and Mayaro viruses. During March‒June 2024, the state had 339 confirmed OROV cases, demonstrating successful local transmission. Spatial analysis revealed that most cases clustered in municipalities with tropical climates and intensive cacao, robusta coffee, coconut, and pepper cultivation. Phylogenetic analysis identified the Espírito Santo OROV strains as part of the 2022–2024 Amazon lineage. The rapid spread of OROV outside the Amazon highlights its adaptive potential and public health threat, emphasizing the need for enhanced surveillance and targeted control measures.

Source: US Centers for Disease Control and Prevention, https://wwwnc.cdc.gov/eid/article/31/6/24-1946_article

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Effect of #JYNNEOS #vaccination on #mpox clinical #progression: a case–control study

Summary

Background

The JYNNEOS modified vaccinia virus Ankara vaccine is effective in preventing clade IIb mpox disease. However, vaccine effects on mpox severity are poorly understood. We aimed to assess associations between reported clinical characteristics and vaccination status among individuals with laboratory-confirmed mpox.

Methods

We conducted a case–control study using data collected from public health surveillance interviews of people with mpox in California. Eligible participants for primary analyses were men who were cisgender and participated in telephone interviews with complete responses recorded about anatomical sites where they had lesions. We estimated JYNNEOS vaccine effectiveness against progression to disease involving disseminated lesions via the adjusted odds ratio of vaccination, comparing participants who reported lesions disseminated across multiple anatomical regions (cases) with participants who reported lesions contained to a single anatomical region (controls). We used the same case–control framework to estimate vaccine effectiveness against progression to hospitalisation and prodromal symptoms.

Findings

Men who were cisgender represented 5763 (94·3%) of 6112 people reported to have laboratory-confrimed mpox in California from May 12, 2022, to Dec 31, 2023, among whom, 4609 (79·9%) met eligibility criteria and were included in primary analyses. Of 4609 participants, 1566 (34·0%) were classified as controls and 3043 (66·0%) were classified as cases. Among 3043 cases, 114 (3·7%) received pre-exposure vaccination and 214 (7·0%) received post-exposure vaccination only. Among 1566 controls, 285 (18·2%) received pre-exposure vaccination and 146 (9·3%) received post-exposure vaccination only. For pre-exposure vaccination, vaccine effectiveness against progression was 58·8% (95% CI 50·3–65·9); for post-exposure vaccination, vaccine effectiveness against progression was 15·9% (3·3–26·8). Pre-exposure vaccine effectiveness against progression was 66·6% (56·8–74·2) among people negative for HIV and 44·8% (27·5–58·0) for those with HIV. Pre-exposure vaccination was also associated with protection against progression to severe illness necessitating hospitalisation (85·4% [95% CI 54·3–95·3]), and with reduced odds for fever, chills, and lymphadenopathy.

Interpretation

Among men who were cisgender with mpox, pre-exposure vaccination with JYNNEOS was associated with less severe illness. Awareness of an attenuated disease phenotype involving localised lesions without accompanying prodromal symptoms is needed to ensure accurate diagnosis of mpox in previously vaccinated individuals.

Source: Lancet Infectious Diseases, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(25)00180-X/fulltext?rss=yes

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