#UK - High pathogenicity avian #influenza #H5N1 viruses (#poultry) (Inf. with) - Immediate notification

{England, Norfolk} Commercial indoor unit with 59562 turkeys. Increased mortality and other clinical signs were reported. Samples were taken and were tested positive for HPAI H5N1.

Source: WOAH, https://wahis.woah.org/#/in-review/6693

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

By Diliff - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=1385555

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Two wild Greylag Geese in Győr-Moson-Sopron Region.

Source: WOAH, https://wahis.woah.org/#/in-review/6687?reportId=175652&fromPage=event-dashboard-url

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Assessment of #serum #parameters caused by the #outbreak of #mycoplasma pneumoniae #pneumonia in #children after #COVID19

Abstract

Mycoplasma pneumonia pneumonia(MPP) is a common respiratory disease that often occurs in children. The purpose of this study was to explore the clinical characteristics of children with mycoplasma pneumoniae pneumonia, the first outbreak after the prevalence of COVID-19 epidemic. Meanwhile, this study also analyzed the predictive value of serum protein indicators and coagulation parameters in the MPP group, as well as the correlation between these indicators. Children with Mycoplasma pneumoniae admitted to the pediatric ward of Chengdu Fifth People’s Hospital from May 2023 to March 2024 were selected. After screening, 411 children who met the research criteria were selected as the study subjects. All of the blood samples were tested for coagulation function, procalcitonin, serum protein and glucose among MPP group and control group. All data were processed for statistical analysis using GraphPad Prism 10.2.3. Comparison of the serum proteins and coagulation function between the MPP group and control group showed that prothrobin time(PT), thrombin time (TT), fibrinogen(Fbg), activated partial thromboplastin time (APTT), international normalized ration(INR), D-Dimer(DD) were significantly higher(P < 0.05) in MPP group. Total protein, albumin, prealbumin, alkaline phosphatase, lactate dehydrogenase, adanosine deaminase, glucose, platelet, procalcitonin also were significantly higher(P < 0.05) in MPP group. A multiple logistic regression analysis showed that the children in MPP group were a statistically significant difference in comparison of TT, Fbg, total protein, albumin, glucose, platelet expression in predicting the development. Then we analyzed the area under the ROC curve and correlation of serum parameters with significant differences in MPP group children. These results indicate that the coagulation function and serum protein of MPP patients who first broke out after the COVID-19 epidemic are different from the previous clinical characteristics, which can be used as a reference for auxiliary diagnosis.

Source: Scientific Reports, https://www.nature.com/articles/s41598-025-13555-6

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Venus Anadyomene, Titian (c.1520)

 

Public Domain.

Source: WikiArt, https://www.wikiart.org/en/titian/venus-anadyomene

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Impact of #COVID19 #vaccination #coverage on global #disability burden of #GBS

Abstract

The global burden of Guillain-Barré syndrome (GBS), an immune-mediated neuropathy, remains poorly characterized during the COVID-19 pandemic. We analyzed age-standardized years lived with disability (YLD) for GBS from 1990 to 2021 using GBD 2021 data and COVID-19 vaccination coverage from Our World in Data, focusing on 2020–2021. During the pandemic, GBS YLD rates rose dramatically, with greater increases seen in low-SDI regions, females and individuals aged 15–29 years. Higher vaccination coverage was inversely associated with GBS disability burden, exhibiting a non-linear protective effect at moderate to high coverage levels. Causal mediation analysis indicated that 44.6% of this association was mediated by reductions in COVID-19 incidence, highlighting both direct and indirect neuroprotective benefits of vaccination programs. These results underscore the importance of sustaining and expanding the vaccine rollout to mitigate the secondary neurological burden associated with emerging infections.

Source: npj Vaccines, https://www.nature.com/articles/s41541-025-01239-1

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Stabilization of #H5 highly pathogenic avian #influenza #hemagglutinin improves #vaccine-elicited neutralizing #antibody responses

Abstract

Transmission of highly pathogenic avian influenza from H5 clade 2.3.4.4b has expanded in recent years to infect large populations of birds and mammals, heightening the risk of a human pandemic. Influenza viruses adapted to transmission in birds and some other animals tend to have a less stable hemagglutinin (HA) than seasonal influenza viruses, enabling membrane fusion at comparatively high pH levels. Here, we combine five mutations within H5 HA that dramatically increase its melting temperature and promote stable closure of the HA trimer. Structural analysis by cryo-electron microscopy revealed that the stabilizing mutations create several new hydrophobic interactions, while maintaining local HA structure. We found that vaccinating mice with stabilized H5 HA immunogens resulted in higher hemagglutination inhibition and neutralization titers than non-stabilized comparators. Epitope mapping of vaccine-elicited polyclonal antibody responses using negative stain electron microscopy and deep mutational scanning showed that site E on the side of the HA receptor binding domain was immunodominant across all groups; however, the stabilized immunogens shifted responses toward the receptor binding site (RBS), eliciting a higher proportion of neutralizing antibodies. These findings highlight that H5 HA-stabilizing mutations enhance the quality of antibody responses across different vaccine formats, underscoring their potential to improve pandemic preparedness vaccines targeting viruses from this widely circulating clade.

Competing Interest Statement

AD, MK, and NPK are inventors on University of Washington licensed patents related to influenza vaccines. NPK consults for AstraZeneca. JDB and BD are inventors on Fred Hutch licensed patents related to deep mutational scanning of viral proteins. JDB consults for Apriori Bio, Invivyd, GSK, Pfizer, and the Vaccine Company.

Funder Information Declared

National Institute of Allergy and Infectious Diseases, P01 AI167966, U19 AI181881, R01 AI141707, 75N93021C00015

Source: BioRxIV, https://www.biorxiv.org/content/10.1101/2025.07.30.667762v1

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History of Mass Transportation: The FS E636 Electric Locomotive

 

Di PetrS. - Opera propria, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=12034659

Source: Wikipedia, https://it.wikipedia.org/wiki/Locomotiva_FS_E.636

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#USA, #Wastewater Data for Avian #Influenza #H5 (US #CDC, August 1rst '25)

 

{Excerpt}

Time Period: July 20, 2025 - July 26, 2025

-- H5 Detection: 4 sites (1.0%)

-- No Detection: 391 sites (99.0%)

-- No samples in last week: 38 sites

(...)

Source: US Centers for Disease Control and Prevention, https://www.cdc.gov/nwss/rv/wwd-h5.html

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#Surveillance on #California dairy #farms reveals multiple #sources of #H5N1 #transmission

Abstract

Transmission routes of highly pathogenic H5N1 between cows or to humans remain unclear due to limited data from affected dairy farms. We performed extensive air, farm wastewater, and milk sampling on 14 H5N1 positive dairy farms across two different California regions. Virus was detected in the air in milking parlors and from exhaled breath of cows. Infectious H5N1 virus was detected in the air and water streams; sequence analysis revealed viral variants on a farm in these locations. Longitudinal analysis of milk from the individual quarters of cows revealed a high prevalence of subclinical H5N1 positive cows and a heterogeneous distribution of infected quarters that maintained a consistent pattern over time. Our data highlight potential modes of H5N1 transmission on dairy farms.

Competing Interest Statement

SSL and LCM receive funds from Flu Lab and NIH. ASL receives funds from Flu Lab, NIH, and CDC. ASL receives consulting fees and research support from Roche, outside of the submitted work.

Source: BioRxIV, https://www.biorxiv.org/content/10.1101/2025.07.31.666798v1

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Estimating #measles susceptibility and #transmission #patterns in #Italy: an epidemiological assessment

Summary

Background

Identifying measles transmission patterns and the most susceptible populations is crucial for anticipating and preventing outbreaks. The aim of this study was to assess the current epidemiology of measles in Italy to provide key metrics to anticipate and prevent future transmission risks.

Methods

In this epidemiological assessment study, we analysed measles epidemiological data from the National Integrated Measles and Rubella Surveillance System coordinated by the Department of Infectious Diseases of the Istituto Superiore di Sanità in Italy from Jan 1, 2013, to Dec 31, 2022. We analysed individual case records to assess the proportion of transmission that occurred in different settings; we also used pairs of measles cases to estimate the generation time and the proportion of transmission episodes between population groups defined by age and vaccination status. All suspected cases meeting the measles case definition were included in our analysis. Data, complemented with 2023 and 2024 incidence records, were used in a catalytic model to estimate the age-specific proportion of individuals susceptible to measles and the effective reproduction number (Re) in Italy in 2025 at the national level and for each Italian region.

Findings

During the study period, 14 946 measles cases (7426 females and 7520 males) were reported to the National Integrated Measles and Rubella Surveillance System. The mean generation time estimated from 795 measles infection episodes was 11·7 days (95% credible interval 11·3–12·0). 707 (88·9% [bootstrap 95% CI 86·8–91·1]) of 795 infection episodes originated in unvaccinated individuals, 265 (33·3% [30·1–36·7]) of 795 infection episodes involved individuals aged 20–39 years, and only 12 (8·5% [4·3–13·5]) of 141 transmission episodes with available information on setting were linked to school contacts. We estimated that, in 2025, 9·2% (95% prediction interval 8·9–9·3) of the Italian population remains susceptible to measles, including 11·8% (11·8–11·8) of individuals younger than 20 years. Despite marked geographical heterogeneities, immunity gaps among individuals aged 20–40 years (ie, those born in the 1980s and 1990s) were consistently observed across all regions. The average Re estimated for 2025 ranged from 1·31 to 1·78 across regions, consistent with reproduction numbers associated with national epidemics and local outbreaks between 2013 and 2019. Higher Re values were found in regions with a large fraction of susceptible adults (eg, Emilia-Romagna 1·78 [1·34–2·27]) or more than 15% susceptible individuals younger than 20 years (eg, South Tyrol 1·53 [1·11—2·02]).

Interpretation

Unvaccinated adults contribute substantially to measles transmission in Italy. Heterogeneous immunity gaps exist across regions, with some regions showing persistently low vaccine uptake in children and other regions showing a high proportion of susceptible adults. These results emphasise the need for tailored vaccination strategies, including catch-up campaigns for adults. By integrating routine surveillance data with modelling techniques, this study presents a resource-efficient approach to quantifying immunity and transmission risks, providing a scalable framework for countries aiming to refine their immunisation policies.

Funding

NextGenerationEU-MUR PNRR Extended Partnership Initiative on Emerging Infectious Diseases.

Source: Lancet Infectious Diseases, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(25)00293-2/abstract?rss=yes

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Seasonal #Influenza #Exposure Elicits Functional #Antibody and T-cell Responses to #H5 Influenza Viruses in #Humans

Abstract

Background. 

Highly pathogenic avian influenza A(H5) viruses pose a pandemic threat, with a history of zoonotic spillovers into humans that are presumed immunologically naive. Whether the general population is currently immunologically naive to circulating A(H5) influenza viruses is unknown. 

Methods. 

To evaluate the presence of cross-reactive immune responses to emerging A(H5) clade 2.3.4.4b influenza viruses in the general population, we conducted comprehensive immune profiling on cross-sectional samples from healthcare workers (n=107). Samples were collected in August and September 2024 in the scope of an ongoing prospective follow-up study: Surveillance of rEspiratory viruses iN healThcare and anImal workers in the NethErLands (SENTINEL). 

Findings. 

Low-level antibody responses directed against the A(H5) hemagglutinin (HA) head were detected in a limited number of individuals, but without hemagglutination inhibition activity. Nevertheless, we detected in most participants A(H5)-reactive antibodies with Fc-effector functions, likely directed at the conserved HA stalk. Additionally, we observed abundant neuraminidase (NA) inhibiting antibodies against avian N1s and T-cell responses against HAs and NAs from A(H5) influenza viruses. These responses correlated strongly with immune responses targeting an A(H1N1) seasonal influenza virus, indicating they were likely induced by prior exposures. 

Interpretation. 

Together, our findings suggest that partial cross-reactive immunity to A(H5) influenza viruses exists in humans, which may play an important role during future outbreaks, potentially by blunting disease severity. Characterizing such baseline immunity is crucial for accurate pandemic risk assessment and preparedness planning. 

Funding. 

Netherlands Organization for Health Research and Development (ZonMw), European Union EU4Health program DURABLE, Dutch Ministries of Agriculture, Fisheries, Food Security and Nature and Health, Welfare and Sport, National Institute of Health - National Institute of Allergies and Infectious Diseases (NIH-NIAID). The funding sources had no role in study design, data collection, analysis, interpretation of the data, or the decision to submit the paper for publication.

Competing Interest Statement

A.S. is a consultant for Alcimed, Arcturus, Darwin Health, Desna Therapeutics, EmerVax, Gilead Sciences, Guggenheim Securities, Link University, and RiverVest Venture Partners. LJI has filed for patent protection for various aspects of T cell epitope and vaccine design work. The remaining authors declare no competing interests.

Funding Statement

The study was funded by the Netherlands Organization for Health Research and Development (ZonMw, NCOH Pandemic Preparedness Research Kickstarter, grant agreement 10710022210003), European Union EU4Health program DURABLE (grant number 101102733), and the Dutch Ministries of Agriculture, Fisheries, Food Security and Nature and Health, Welfare and Sport. This project has been additionally funded with Federal funds from the National Institute of Health - National Institute of Allergies and Infectious Diseases (NIH-NIAID) contract no.75N93024C00056 and 75N93021C00014. The funding sources had no role in study design, data collection, analysis, interpretation of the data, or the decision to submit the paper for publication.

Source: MedRxIV, https://www.medrxiv.org/content/10.1101/2025.07.31.25331995v1

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A #Genome #Sequence Variant #Monitoring Program for Seasonal #Influenza #H3N2 & #RSV using #Wastewater-Based #Surveillance in #Ontario, Canada

Abstract

Seasonal respiratory viruses, such as the Influenza A virus and the respiratory syncytial virus, are responsible for over a billion infections worldwide each year resulting in a substantial burden on health care systems. Surveillance of these viruses, including their prevalence in communities and their evolution, are essential for informing public health decisions and recommending vaccine formulations and schedules. Typically, these viruses are monitored using clinical samples from patients seeking medical attention. Recently, wastewater-based surveillance (WBS) has been leveraged to understand transmission dynamics and genome evolution of SARS-CoV-2 and seasonal respiratory viruses. To further the utility of WBS we developed and implemented novel tiled-amplicon sequencing assays to identify and track Influenza A virus H3N2 and respiratory syncytial virus A circulating in Southern Ontario, Canada. We also developed virus specific deconvolution tools to estimate the abundance of mixed lineages in wastewater. These assays were able to accurately determine which lineages were circulating in wastewater with high sensitivity and specificity. If implemented in regular surveillance programs, they could be used to inform real-time public health decisions and determine potential disease surge with impact on emergency room visits and hospitalization, as well as track which emerging strains will become predominant in the future and determine which strains should be the focus of seasonal vaccines.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

Integrated Network for the Surveillance of Pathogens (INSPIRE), CBRF2-2023-00008

Ministry of the Environment, Conservation and Parks, https://ror.org/01q2d8e83, 2021-02-1-1564736554

Source: BioRxIV, https://www.biorxiv.org/content/10.1101/2025.07.29.667219v1

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Differential modulation of #Interferon and Cell Death Responses defines #Human vs Avian #Influenza A Virus Strain-Specific Virulence and guides Combination #Therapy.

Abstract

Influenza A virus (IAV) poses a significant global health risk, with highly pathogenic strains like H5N1 (CFR ~52%) causing severe disease compared to less lethal but more transmissible strains like H1N1 (CFR 0.01-0.03%). Although IAV primarily infects lung epithelial cells, causing cell death and tissue damage, the molecular basis of strain-specific pathogenesis remains poorly understood. Here we show that in cell culture, H5N1 induced more rapid and extensive cell death than H1N1. Since Interferon (IFN) signaling is key to innate immunity, we examined its role in virus-induced cell death using STAT1-knockout A549 cells and JAK/STAT pathway inhibitors like Baricitinib. Both approaches reduced cell death across various IAV strains, including H1N1, H5N1, H7N9, and H3N2. However, inhibition increased viral titers, raising concerns about its clinical use in isolation. To overcome this, we tested a combination of Oseltamivir (antiviral) and Baricitinib (anti-inflammatory). Post-infection treatment in a murine model reduced lung inflammation and improved survival. Given that both drugs are FDA-approved, this approach has strong translational potential for clinical IAV treatment.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

Wellcome Trust/DBT India Alliance, IA/I/18/1/503613

Indian Council of Medical Research, IIRPIG-2023-0000978

Source: BioRxIV, https://www.biorxiv.org/content/10.1101/2025.07.31.667854v1

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Detection of #Hemagglutinin #H5 #Influenza A Virus #RNA and Model of Potential Inputs in an Urban #California #Sewershed

Abstract

In 2024, highly pathogenic avian influenza A H5N1 caused outbreaks in wild birds, poultry, cows, and other mammals in the United States with 61 human cases also reported by the CDC. Detection of influenza A H5 RNA in wastewater has been previously reported in sewersheds in Texas and North Carolina with nearby impacted dairy herds following the emergence of H5N1 in dairy cows. Here, we conduct retrospective testing of total influenza A and H5 hemagglutinin genes in wastewater as well as present and apply new assays for detection of H1 and H3 genes across a respiratory virus season in an urban California sewershed from September 2023 to May 2024. Total influenza A, H1, and H3 were regularly detected, while H5 was first detected in March. We developed a model that uses Monte Carlo simulations and previously published parameters to estimate the numbers of infected people, poultry, wild birds, or liters of H5-contaminated milk required to result in measured H5 concentrations in wastewater. Our findings demonstrate that in this California sewershed, contaminated milk or infected poultry were the most likely sources of H5 to wastewater. We created a publicly available tool to apply the H5 input model in other sewersheds to estimate the required inputs.

This publication is licensed under CC-BY 4.0. © 2025 The Authors. Published by American Chemical Society

Source: Environmental Science & Technology, https://pubs.acs.org/doi/10.1021/acs.est.4c14792

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#Genetic characterization of the #marmot gut #virome in high-altitude #Qinghai Province and identification of novel #viruses with zoonotic potential

ABSTRACT

The high-altitude ecosystems of Qinghai Province, China, harbor unique viral communities shaped by extreme environmental conditions and host adaptations. This study presents a comprehensive genetic characterization of the marmot gut virome, revealing novel viral strains with zoonotic potential. Using viral metagenomics, we analyzed intestinal contents from 70 marmots collected from Chengduo and Maqin counties. Sequencing on the Illumina NovaSeq 6000 platform identified 19 viral genomes belonging to four major families: Adenoviridae, Astroviridae, Parvoviridae, and Picornaviridae, along with four novel circular Rep-encoding single-stranded DNA (CRESS DNA) viruses. Phylogenetic analyses demonstrated close relationships between marmot-derived strains and viruses from humans, bats, and other mammals, highlighting potential cross-species transmission risks. Notably, bat-associated adenoviruses showed closer phylogenetic proximity to human strains, while novel parvoviruses formed a distinct clade within the Dependoparvovirus genus. The discovery of a novel astrovirus with low sequence similarity to known genera underscores the need for taxonomic reclassification. Additionally, a novel picornavirus related to Sapelovirus and four divergent CRESS DNA viruses were identified, expanding our understanding of viral diversity in high-altitude rodents. These findings emphasize the role of marmots as viral reservoirs and highlight the importance of high-altitude ecosystems as hotspots for zoonotic pathogen emergence. This study provides critical insights into viral evolution, host adaptation, and zoonotic risks, advocating for integrated surveillance strategies to mitigate future spillover events.

IMPORTANCE

Viruses are the most abundant and diverse biological entities on Earth, yet their presence in wildlife from extreme environments remains poorly understood. High-altitude ecosystems, shaped by harsh conditions like intense UV radiation and low oxygen levels, create unique settings for virus evolution. This study is the first to comprehensively profile the gut virome of marmots in Qinghai Province, uncovering novel viral strains and highlighting how extreme environments drive viral diversity. Marmots, as key species in these regions, can act as bridges for virus transmission among wildlife, livestock, and humans, posing zoonotic risks. Understanding these viral communities is essential for predicting and preventing future outbreaks. Our findings emphasize the urgent need for integrated, One Health-based surveillance strategies to safeguard both public health and biodiversity in fragile high-altitude ecosystems.

Source: mSphere, https://journals.asm.org/doi/full/10.1128/msphere.00297-25?af=R

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Highly pathogenic avian #influenza: #pandemic #preparedness for a #scenario of high #lethality with no #vaccines

Abstract

Highly Pathogenic Avian Influenza (HPAI) viruses, particularly H5N1 and H7N9, have long been considered potential pandemic threats, despite the absence of sustained human-to-human transmission. However, recent outbreaks in previously unaffected regions, such as Antarctica, suggest we may be shifting from theoretical risk to a more imminent threat. These viruses are no longer limited to avian populations. Their increasing appearance in mammals, including dairy cattle and domestic animals, raises the likelihood of viral reassortment and mutations that could trigger a human pandemic. If such a scenario unfolds, the world may face a crisis marked by high transmissibility and lethality, without effective vaccines readily available. Unlike the COVID-19 pandemic, when vaccines were rapidly developed despite inequities in access, the current influenza vaccine production model, largely reliant on slow, egg-based technologies, is insufficient for a fast-moving outbreak. While newer platforms show promise, they remain in early stages and cannot yet meet global demand, which alerts to the urgent need for accelerating vaccine and drug development, especially universal vaccines, next-generation vaccine platforms designed to provide broad, long-lasting protection against a wide spectrum of HPAI virus subtypes and strains. Here we propose a paradigmatic shift toward a more integrated, digitalized One Health surveillance system that links human, animal, and environmental data, especially in high-risk spillover regions. We underscore that Artificial Intelligence can revolutionize pandemic preparedness strategies, from improving early detection to speeding up vaccine and drug development and access to medical care, but should not be considered a stand-alone solution.

Source: Frontiers in Public Health, https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1613869/full

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#Mpox - Multi-country external #situation #report no. 56 published 31 July 2025 (#WHO, edited)

 

{Excerpt}

Highlights

-- All clades of monkeypox virus (MPXV) continue to circulate in several countries. 

- When mpox outbreaks are not rapidly contained and human-to-human transmission is not interrupted, they continue to pose a risk of sustained community transmission.  

-- Since the last edition of this report, one new country, the Gambia, has reported an mpox case for the first time. 

- Genomic sequencing analysis has identified clade IIb MPXV. 

-- Furthermore, Mozambique, has reported cases of mpox due to clade Ib MPXV for the first time.  

-- Twenty-one countries in Africa have reported ongoing mpox transmission in the past six weeks. 

- Clade IIb MPXV continues to be reported in West Africa, while Central African countries report both clade Ia and clade Ib MPXV, and East African countries report clade Ib MPXV. 

-- The recent overall downward trend of confirmed cases across the continent is driven by the decline in cases in Sierra Leone and the Democratic Republic of the Congo.  

-- Uganda continues to experience community transmission of clade Ib MPXV, reporting the third-highest number of laboratory-confirmed cases in the continent. 

- Cases continue to be reported primarily among young adults of both sexes and 48% of deaths were among people living with HIV. 

- The slight increase in weekly cases that had been reported in the previous edition of this report appears to have been shortlived, with a downward trend reported in the most recent weeks. 

-- Australia, China and the United Kingdom have reported additional cases of mpox due to clade Ib MPXV since the last situation report. 

- These cases have been linked to travel, and community transmission of clade Ib MPXV continues to be reported only in countries in central and Eastern Africa. 

(...)

Source: World Health Organization, https://www.who.int/publications/m/item/multi-country-outbreak-of-mpox--external-situation-report--56---31-july-2025

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#Italy, Integrated #WNV & #USUV #Surveillance - Bulletin no. 3, July 31 2025 (IZS Teramo): 57 new human cases reported

{Excerpts}

During the epidemiological week comprised between 24 and 30 July 2025, there were fifty-seven new confirmed cases of human infection with West Nile Virus.

-- Since the start of the epidemic season, eighty-nine cases have been reported (there were thirty-two cases in the last week report), of which:

-- forty were WNND (West Nile Neuroinvasive Disease):

- 2 cases in Piedmont, 1 Lombardy, 3 Veneto, 1 Emilia-Romagna, twenty-three Latium, ten Campania);

-- two cases of asymptomatic infection were detected among blood donors (one in Veneto and one in Campania);

-- forty-six cases of West Nile Fever have been confirmed: 

- one in Lombardy, five in Veneto, thirty-five in Latium, four in Campania, one in Sardinia;

-- one asymptomatic case is from Campania;

-- Among confirmed cases, eight fatalities have been recorded: one in Piedmont, two in Latium and five in Campania. The case-fatality rate among WNND so far is at 20% (during epidemic seasons 2018 it was 20% and in 2024, 14%). 

-- The first case of the 2025 season was reported in Piedmont (a sporadic case in Novara Province). The second case was notified on July 3 in Modena Town. 

-- In the current epidemiological week, no confirmed human cases of infection with Usutu virus have been reported.

(...)

Source: National Veterinary Institute of Teramo, https://westnile.izs.it/j6_wnd/home

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A Phylogeny-Informed Mathematical #Modeling of #H5N1 #Transmission Dynamics and Effectiveness of #Control Measures

Abstract

The highly pathogenic avian influenza (HPAI) subtype H5N1 is a severe viral disease which continues to pose a significant threat to public health and a rigorous understanding of its transmission dynamics across its major pathways is essential for developing effective control strategies. Phylogenetic analysis suggests that H5N1 spillover occurs primarily between wild and domestic birds. However, increasing contact between these species and humans increases the risk of zoonotic transmission. In this work, we develop a mathematical model to examine the transmission dynamics of H5N1 and evaluate the effectiveness of proposed control measures. The model employs a compartmental framework that includes human, domestic, and wild bird populations. We then use this model to estimate the basic reproduction number for each population group and perform a sensitivity analysis to assess the contribution of the parameters to the spread of the disease. Numerical simulations are also conducted to evaluate the impact of inter-species interactions on H5N1 infection in humans and to determine the effectiveness of different control measures. The results suggest that a vaccination strategy with high vaccine efficacy, combined with a vaccination rate above 50%, significantly reduces transmission. In addition, decreasing cross-species interactions leads to a substantial reduction in disease transmission within the human population. Moreover, an optimal control analysis indicates that a combined approach involving environmental sanitation, vaccination, and targeted culling of confirmed infected poultry is an effective strategy to control the outbreak, reducing the likelihood of spillover to humans.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This work has been funded in part from the National Institute of Allergy and Infectious Diseases, a component of the NIH, Department of Health and Human Services, under contract no. 75N93021C00018 (NIAID Centers of Excellence for Influenza Research and Response, CEIRR) and Centers for Disease Control and Prevention, Department of Health and Human Services, under contract NU50CK000626.

Source: MedRxIV, https://www.medrxiv.org/content/10.1101/2025.07.29.25331913v1

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#Influenza-Associated Acute Necrotizing #Encephalopathy in #US #Children

Key Points

-- Question: What were the clinical characteristics, management approaches, and outcomes among children with influenza-associated acute necrotizing encephalopathy (ANE) in the US during the 2023-2024 and 2024-2025 influenza seasons?

-- Findings:  In this multicenter case series of 41 children from 23 US hospitals, influenza-associated ANE carried a 27% mortality rate despite multimodal therapy. Most patients (76%) had no significant medical history, despite 15 of 32 tested (47%) having genetic risk alleles potentially related to risk of ANE identified during diagnostic evaluation. The H1 2009 influenza A strain predominated (34% of cases), and only 16% had received seasonal influenza vaccination. Among survivors, 63% had moderate to severe disability at 90-day follow-up.

-- Meaning: Influenza-associated ANE represents a rare but devastating neurologic complication primarily affecting previously healthy children. The high morbidity and mortality emphasize the need for prevention, early recognition, intensive treatment, and standardized management protocols.

Abstract

Importance

Acute necrotizing encephalopathy (ANE) is a rare, but severe, neurologic condition for which epidemiologic and management data remain limited. During the 2024-2025 US influenza season, clinicians at large pediatric centers anecdotally reported an increased number of children with influenza-associated ANE, prompting this national investigation.

Objective

To understand the clinical presentation, interventions, and outcomes among US children diagnosed with influenza-associated ANE.

Design, Setting, and Participants

This study was a multicenter case series of children diagnosed with ANE with longitudinal follow-up. A call for cases was issued via academic societies, public health agencies, and by directly contacting pediatric specialists at 76 US academic centers, requesting cases between October 1, 2023, and May 30, 2025. Inclusion criteria required acute encephalopathy with radiologic evidence of acute thalamic injury and laboratory confirmation of influenza infection in individuals aged 21 years or younger.

Exposure

Influenza-associated ANE.

Main Outcomes and Measures

Presenting symptoms, vaccination history, laboratory and genetic findings, interventions, and clinical outcomes, including modified Rankin Scale score (0: no symptoms; 1-2: mild disability; 3-5: moderate to severe disability; 6: death), length of stay, and functional outcomes.

Results  

Of 58 submitted cases, 41 cases (23 females; median age, 5 years [IQR, 2-8]) from 23 US hospitals met inclusion criteria. Thirty-one cases (76%) had no significant medical history; 5 (12%) were medically complex. Clinical presentation included fever in 38 patients (93%), encephalopathy in 41 (100%), and seizures in 28 (68%). Thirty-nine patients (95%) had influenza A (14 with A/H1pdm/2009, 7 with A/H3N2, and 18 with no subtype) and 2 had influenza B. Laboratory deviations included elevated liver enzymes (78%), thrombocytopenia (63%), and elevated cerebrospinal fluid protein (63%). Among 32 patients (78%) with genetic testing, 15 (47%) had genetic risk alleles potentially related to risk of ANE including 11 (34%) with RANBP2 variants. Among 38 patients with available vaccination history, only 6 (16%) had received age-appropriate seasonal influenza vaccination. Most patients received multiple immunomodulatory treatments, including methylprednisolone (95%), intravenous immunoglobulin (66%), tocilizumab (51%), plasmapheresis (32%), anakinra (5%), and intrathecal methylprednisolone (5%). Median intensive care unit and hospital lengths of stay were 11 days (IQR, 4-19) and 22 days (IQR, 7-36), respectively. Eleven patients (27%) died a median of 3 days (IQR, 2-4) from symptom onset, primarily from cerebral herniation (91%). Among the 27 survivors with 90-day follow-up, 63% had at least moderate disability (modified Rankin Scale score ≥3).

Conclusions and Relevance

In this case series of children with influenza-associated ANE from the 2 most recent influenza seasons in the US, the condition was associated with high morbidity and mortality in this cohort of predominantly young and previously healthy children. The findings emphasize the need for prevention, early recognition, intensive treatment, and standardized management protocols.

Source: JAMA, https://jamanetwork.com/journals/jama/fullarticle/2836871?guestAccessKey=c2292d76-607e-48ca-999a-ae3cea795c8b&utm_medium=email&utm_source=postup_jn&utm_campaign=article_alert-jama&utm_content=olf-tfl_&utm_term=073025

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