Tuesday, September 9, 2025

Heterologous two-dose #Ebola #vaccine regimen in #pregnant women in #Rwanda: a randomized controlled phase 3 trial

 


Abstract

Risk of death for both mother and fetus following Ebola virus infection is extremely high. In this study, healthy women in Rwanda aged ≥18 years were randomized to two-dose Ebola vaccination (Ad26.ZEBOV, MVA-BN-Filo) during pregnancy (group A) or postpartum (group B). Unvaccinated pregnant group B women served as control. This was a parallel, randomized, controlled, open-label, single-center trial to evaluate the safety (primary endpoint—outcomes of interest and serious adverse events (SAEs)) and immunogenicity (secondary endpoint) of the two-dose Ebola vaccination. Among 3,484 women screened, 2,013 were randomized, and 2,012 women and 1,945 infants born alive were descriptively analyzed. Adverse outcomes of interest occurred in women (5.2% in group A and 7.3% in group B) and infants (26.0% in group A and 25.6% in group B). The most common maternal outcome of interest was pathways to preterm birth (3.2% in group A and 3.4% in group B), and the most common infant outcome of interest was small for gestational age (14.3% in group A and 11.8% in group B). Maternal/fetal and neonatal/infant SAE frequencies were comparable between groups (9.8% in group A, 9.0% in group B and 21.9% in group A, 15.9% in group B, respectively). Anti-Ebola virus glycoprotein-specific binding antibody response (secondary endpoint) was sustained in ≥90% of women at 1 year postdose 1. In group A, binding antibodies were detected in cord blood (99%) and infant serum (95%) samples 14 weeks postbirth. The trial met all primary and secondary objectives. Ad26.ZEBOV, MVA-BN-Filo did not raise concerns regarding adverse maternal/fetal or neonatal/infant outcomes, had no unexpected safety issues, and induced binding antibody responses in women and offspring through passive transfer. ClinicalTrials.gov registration: NCT04556526.

Source: Nature Medicine, https://www.nature.com/articles/s41591-025-03932-z

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Shared viral burdens: Evidence of active #Usutu virus circulation and multi- #arbovirus exposure in migrant and resident #birds at wintering locations in #Nigeria

 


Abstract

Background

West Nile (WNV), Usutu (USUV), and Sindbis (SINV) virus were initially detected in the African region, and subsequently across temperate regions where they were absent. Wild birds are primary reservoirs for these arboviruses and are considered major contributors to their global spread through seasonal migration. To understand the transmission dynamics of arboviruses in wild birds and the potential of migratory birds to spread the viruses at an intercontinental scale, we investigated arboviral infections and exposures in African resident and Palearctic migratory birds at wintering locations in Nigeria. 

Methodology/Principal Findings

Oropharyngeal- and cloacal swabs, feathers and blood were collected from resident and migratory birds at two wintering locations (Amurum and Ngel-Nyaki Forest Reserves). Swabs and feathers were tested using RT-PCR for WNV, USUV and SINV, and blood with ELISA and FRNT90 or PRNT80 for antibodies. 573 birds were sampled between 2021 to 2024 across months coinciding with arrival and departure of migratory birds. USUV RNA was detected in 2.6% of feathers including a positive Icterine warbler and a garden warbler sampled prior to spring migration. None of the swabs was positive for viral RNA but neutralizing antibodies to WNV and USUV were detected in 4.5% of birds. SINV antibodies were also found in 34.1% of birds sampled across the wintering locations. 

Conclusions/Significance

Our findings showed that migratory birds can become infected with USUV, and potentially with WNV and SINV during their overwintering periods in Africa and highlighted a wider arbovirus risk in Nigeria. In addition, detections of viral RNA in feathers, but not swabs, suggest feathers may be a suitable matrix for surveillance in the absence of a reliable cold chain. The overall detections in wild birds at these locations highlight the need for further surveillance to define the epidemiology and public health risks of these arboviruses in the region.


Competing Interest Statement

The authors have declared no competing interest.

Source: BioRxIV, https://www.biorxiv.org/content/10.1101/2025.09.08.674803v1

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Monday, September 8, 2025

Continuous #evolution of #Eurasian #avian-like #H1N1 swine #influenza viruses with pdm/09-derived internal #genes enhances #pathogenicity in mice

 


ABSTRACT

Swine influenza A virus (swIAV) is an important zoonotic pathogen with the potential to cause human influenza pandemics. Swine are considered “mixing vessels” for generating novel reassortant influenza A viruses. In 2009, a swine-origin reassortant virus (2009 pandemic H1N1, pdm/09 H1N1) spilled over to humans, causing a global influenza pandemic. This virus soon spread back into swine herds and reassorted with the circulating swIAVs. We previously reported that the genotype 4 (G4) reassortant Eurasian avian-like (EA) H1N1 virus, which bore pdm/09- and triple reassortant (TR)-derived internal genes, had been predominant in swine populations of China since 2016, posing a threat to both the swine industry and public health. Here, our ongoing surveillance confirmed that G4 EA H1N1 viruses remained the predominant swIAVs in China from 2019 to 2023 and had reassorted with the co-circulating swIAVs, such as the H3N2 virus, to generate novel reassortant EA H1N2 viruses. Genetic analyses revealed that the pdm/09-derived internal genes of G4 EA H1N1 viruses originated from reassortments between pdm/09 H1N1 and EA H1N1 viruses in 2009–2010 and underwent independent and continuous evolution in the swine host, exhibiting higher evolutionary rates than those of the pdm/09 H1N1 virus circulating in humans. The accelerated evolution of internal genes enhanced the polymerase activity of G4 EA H1N1 viruses in mammalian cells, resulting in increased viral replication and pathogenicity in mice. This study provides evidence for swine in promoting the genetic evolution of influenza A virus and highlights the need for increased attention to novel reassortant viruses in swine.


IMPORTANCE

The emergence of pdm/09 H1N1 virus highlights the role of swine influenza A viruses (swIAVs) in generating novel influenza viruses with pandemic potential. Since 2009, the pdm/09 H1N1 virus has been frequently transmitted to swine and reassorted with the circulating swIAVs, generating many new reassortant viruses bearing pdm/09-derived genes globally. The G4 EA H1N1 viruses, which bore pdm/09-derived internal genes and acquired increased human infectivity, remained the predominant swIAVs in China from 2019 to 2023 and reassorted with the co-circulating swIAVs to generate novel subtype viruses. The internal genes of G4 EA H1N1 viruses originated from the human pdm/09 H1N1 viruses during 2009–2010 and exhibited higher evolutionary rates and greater genetic diversity than those in the human host. This has contributed to increased viral adaptation and pathogenicity in mammals. Therefore, sustained surveillance and immunization efforts are essential to control emerging reassortant swIAVs and protect public health.

Source: Journal of Virology, https://journals.asm.org/doi/10.1128/jvi.00430-25

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Spatial #variation of infectious virus #load in aggregated day 3 post-inoculation respiratory tract #tissues from #influenza A virus-infected #ferrets

 


ABSTRACT

The ferret model is widely used to study influenza A viruses (IAVs) isolated from multiple avian and mammalian species, as IAVs typically replicate in the respiratory tract of ferrets without the need for prior host adaptation. During standard IAV risk assessments, tissues are routinely collected from ferrets at a fixed time point post-inoculation to assess the capacity for systemic spread. Here, we describe a data set of virus titers in tissues collected from both respiratory tract and extrapulmonary sites 3 days post-inoculation from over 300 ferrets inoculated with more than 100 unique IAVs (inclusive of H1, H2, H3, H5, H7, and H9 IAV subtypes, both mammalian and zoonotic origin). All experiments were conducted by a single research group under a uniform experimental protocol, making it the largest well-controlled publicly available data set to date of discrete tissue titers reported on a per-ferret level. Analysis of these tissues revealed spatial variation in infectious virus load across different tissues, coupled with different interdependence of infectious viral titers throughout the ferret respiratory tract, dependent on the subtype and sequence identity of the IAV. Collectively, this data set enhances our understanding of the diverse heterogeneity exhibited by IAV strains that pose a threat to human health, as observed in tissues collected during the acute phase of infection in mammals, and enables subsequent in-depth analyses spanning a wide array of data science, statistical, and modeling approaches.


IMPORTANCE

The three Rs (reduction, refinement, and replacement, which govern ethical and humane use of animals in scientific research) compel investigators to consider ways to maximize value and impact of in vivo experimentation using a minimum number of animals. One way to achieve this is to aggregate and share publicly results from multiple studies for subsequent investigation. This resource report describes such a data set, reporting infectious virus titers detected in multiple tissues from influenza A virus-infected ferrets, day 3 post-inoculation, aggregated from studies conducted over multiple decades by one research group. We provide usage notes for best practices to inform analysis of these data by other investigators and report results of exploratory studies that illustrate conclusions that can be informed by analyses of this nature. Future public release of like data sets by other groups with similar historical archives may be informed by the practices and formatting described herein.

Source: mSphere, https://journals.asm.org/doi/full/10.1128/msphere.00346-25?af=R

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#H5N1 #influenza VLPs based on BEVS induce robust functional #antibodies and immune responses

 


Highlights

• The H5N1 influenza virus-like particle vaccines are prepared through baculovirus expression vector system.

In vitro assessments have confirmed that this VLP vaccine has the correct conformation and functional activity.

This VLP vaccine induces robust humoral and cellular immune responses in mice, and provides complete protection against infection with the matched strain.


Abstract

Avian influenza virus infections pose a potential pandemic threat. The currently licensed vaccines have inherent limitations, emphasizing the urgent need for improved influenza vaccines. Here, we developed a novel hemagglutinin (HA) virus-like particle (VLP) vaccine candidate through the baculovirus expression vector system (BEVS). The engineered VLPs incorporate HA from H5N1 and matrix 1 (M1) protein from H1N1. Comprehensive characterization revealed that purified HA VLPs exhibited morphological fidelity to native influenza virions while maintaining key viral biological properties. Immunization studies in murine models demonstrated the superior immunogenicity of HA VLPs through a prime-boost regimen. Compared to control groups receiving HA monomer or T4-foldon-trimerized HA formulations, VLP-immunized mice showed significantly enhanced humoral responses and robust cellular immunity. This study provides compelling evidence for advancing VLP-based vaccines as a superior alternative to conventional influenza vaccine formulations.

Source: Virology, https://www.sciencedirect.com/science/article/abs/pii/S0042682225002867?via%3Dihub

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#Dairy #Environments with #Milk Exposure are Most Likely to Have Detection of #Influenza A Virus

 


Abstract

Highly pathogenic avian influenza virus of the H5N1 subtype has been infecting U.S dairy cattle and spreading among dairy farms since March 2024. H5N1 surveillance systems for dairy farms are needed, but information on whether environmental sampling can inform these systems is lacking. To guide a surveillance framework, we determined the environmental locations on H5N1-affected dairies (n = 25) in four states (California, Colorado, Michigan, and Ohio) that harbored influenza A virus (IAV), and explored sample characteristics that may influence viral detection. A total of 623 samples from environments and sale barns were characterized for IAV and classified into six categories based on location. A total of 94 samples (15.1%) had IAV detected, the majority in the following categories: milking equipment/personal protective equipment, parlor surfaces, and wastewater/lagoons/manure. These results suggest that dairy environments most likely to harbor IAV are those with exposure to milk, although the viral load in environmental samples was typically lower than that of bulk tank milk tested on a subset of farms. Mixed effect modeling was used to explore the relationship between IAV detection, Ct value, and days into an outbreak that samples were collected or the category where samples were collected. Days into an outbreak that samples were collected was associated with IAV detection while category of collection was associated with the measured Ct value. These results may guide H5N1 surveillance efforts on dairies, and can be strengthened by studies that collect samples from farm environmental locations prior to, during, and after H5N1 outbreak periods.


Competing Interest Statement

The authors have declared no competing interest.


Funding Statement

This project was completed using Federal funds provided through the United States Department of Agriculture, Cooperative Agreement 25-9419-0731 and the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, under Contract No. 75N93021C00016. S.S.L and AJ.C are supported by discretionary funds from Emory University and gift funds to the Emory Center for Transmission of Airborne Pathogens, provided by the California Dairy Research Foundation and Flu Lab, a California-based organization founded to advance innovative approaches for the prevention and treatment of influenza.

Source: MedRxIV, https://www.medrxiv.org/content/10.1101/2025.09.03.25335023v1

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Sunday, September 7, 2025

The Adoration of the Infant Jesus, Filippo Lippi (1459)

 


Public Domain.

Source: WikiArt, https://www.wikiart.org/en/filippo-lippi/the-adoration-of-the-infant-jesus-1459

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Saturday, September 6, 2025

#Coronavirus Disease Research #References (by AMEDEO, September 6 '25)

 


    Am J Obstet Gynecol

  1. ROSSEN LM, Hoyert DL, Horon I, Branum AM, et al
    Trends in Maternal Mortality Rates by State, United States, 2018-2023.
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    PubMed         Abstract available


    Antiviral Res

  2. BI W, Zhu T, Xu Y, Chen Y, et al
    An engineered chimeric ACE2-HR2 peptide exhibits potent and broad-spectrum activity against SARS-CoV-2 variants.
    Antiviral Res. 2025;242:106265.
    PubMed         Abstract available

  3. ICHIKAWA T, Tamura T, Nao N, Suzuki H, et al
    Characterization of remdesivir resistance mutations in COVID-19 patients with various immunosuppressive diseases.
    Antiviral Res. 2025;242:106264.
    PubMed         Abstract available

  4. TASHIMA R, Kuroda T, Nobori H, Miyagawa S, et al
    Ensitrelvir suppresses prolonged olfactory abnormalities derived from SARS-CoV-2 infection in hamsters.
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    PubMed         Abstract available

  5. ZHU C, Wang Z, Pan Z, Mai X, et al
    DMBT1 promotes SARS-CoV-2 infection and its SRCR-derived peptide inhibits SARS-CoV-2 infection.
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    PubMed         Abstract available


    BMJ

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    Clin Infect Dis

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    PubMed         Abstract available

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    PubMed         Abstract available


    Int J Infect Dis

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    J Infect

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    PubMed        

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    PubMed        

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    Spatial Transcriptomics and Single Cell-RNASeq Reveals Cellular Heterogeneity of SARS-CoV-2 in Lung Tissues and Global Mutational Patterns in COVID-19 Patients.
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    PubMed         Abstract available


    J Virol

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    An RGD motif on SARS-CoV-2 Spike induces TGF-beta signaling and downregulates interferon.
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  19. JOSEPH R, Marais G, Iranzadeh I, Alisoltani A, et al
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    PubMed         Abstract available


    JAMA

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    RSV Vaccine Effectiveness Against Hospitalization Among US Adults Aged 60 Years or Older During 2 Seasons.
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    PubMed         Abstract available

  21. ANDERER S
    Breaking From CDC, ACOG Continues Recommending COVID-19 Vaccine During Pregnancy.
    JAMA. 2025 Sep 5. doi: 10.1001/jama.2025.16943.
    PubMed        


    Lancet

  22. CHANG AY, Bolongaita S, Cao B, Castro MC, et al
    Epidemiological and demographic trends and projections in global health from 1970 to 2050: a descriptive analysis from the third Lancet Commission on Investing in Health, Global Health 2050.
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    PubMed         Abstract available


    Lancet Infect Dis

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    Community-acquired respiratory virus infections in patients with haematological malignancies or undergoing haematopoietic cell transplantation: updated recommendations from the 10th European Conference on Infections in Leukaemia.
    Lancet Infect Dis. 2025 Aug 27:S1473-3099(25)00365.
    PubMed         Abstract available

  24. FOCOSI D, Maggi F
    Reassessing sotrovimab's role in COVID-19: insights and implications.
    Lancet Infect Dis. 2025 Aug 28:S1473-3099(25)00410.
    PubMed        


  25. Sotrovimab versus usual care in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.
    Lancet Infect Dis. 2025 Aug 28:S1473-3099(25)00361.
    PubMed         Abstract available

#Influenza and Other Respiratory Viruses Research #References (by AMEDEO, September 6 '25)

 


    Antimicrob Agents Chemother

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    Biochemistry

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    PubMed         Abstract available


    Cell

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    PubMed         Abstract available


    J Gen Virol

  4. POKHAREL BR, Majumdar N, Williams F, Dickerson A, et al
    SARS-CoV-2 infection of substantia nigra pars compacta induces expression of miR-330-5p at 10 days post-infection.
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    PubMed         Abstract available

  5. BILLINGTON E, Di Genova C, Warren CJ, Thomas SS, et al
    Investigating factors driving shifts in subtype dominance within H5Nx clade 2.3.4.4b high pathogenicity avian influenza viruses.
    J Gen Virol. 2025;106:002150.
    PubMed         Abstract available


    J Infect

  6. STANLEY J, Arnold D, Hamilton F
    Genetic evidence supports trialling IL-6 inhibition in influenza.
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    PubMed        


    J Virol Methods

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    PubMed         Abstract available

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    Illumina MiSeq and iSeq platforms yield comparable results for viral genomic sequencing.
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  11. KATSANOVSKAJA K, Marchesin F, Ujetz J, Ijaz S, et al
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    Lancet

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    PubMed        


    MMWR Morb Mortal Wkly Rep

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    PubMed         Abstract available


    N Engl J Med

  18. JOHANSEN ND, Modin D, Loiacono MM, Harris RC, et al
    High-Dose Influenza Vaccine Effectiveness against Hospitalization in Older Adults.
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    PubMed         Abstract available


    Pediatrics

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    PubMed         Abstract available

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    PubMed         Abstract available

  23. BODY A, Lal L, Downie P, Anazodo A, et al
    Immune Response to COVID-19 Vaccination in Children With Cancer.
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    PubMed         Abstract available


    PLoS Biol

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    Viral expansion after transfer is a primary driver of influenza A virus transmission bottlenecks.
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    PubMed         Abstract available


    PLoS Comput Biol

  25. TORRES-FLOREZ S, Flores Anato JL, He JH, Portilla VG, et al
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    PubMed         Abstract available

  26. REYNE B, Kamiya T, Djidjou-Demasse R, Alizon S, et al
    Leaky or polarised immunity: Non-Markovian modelling highlights the impact of immune memory assumptions.
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    PubMed         Abstract available


    PLoS One

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    Cancer disparities: Projection, COVID-19, and scenario-based diagnosis delay impact.
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    Deep momentum networks with market trend dynamics.
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    Who continued travelling by bus in different periods of COVID-19? A data-driven analysis from Shanghai, China.
    PLoS One. 2025;20:e0328700.
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  33. ATHA L, Ryde E, Burke L, Brady S, et al
    Investigating the use of a one-page infographic to improve recruitment and retention to the BASIL+ randomised controlled trial: A Study Within a Trial (SWAT).
    PLoS One. 2025;20:e0320821.
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  34. SEMANCIK CS, Fantin R, Butt J, Abdelnour A, et al
    SARS-CoV-2 antibody and neutralization dynamics among persons with natural- and vaccine-induced exposures.
    PLoS One. 2025;20:e0331212.
    PubMed         Abstract available

  35. RITCHWOOD TD, Burton K, Wynn M
    Before the wave: Exploring early perspectives on COVID-19 self-testing among African Americans in Eastern North Carolina.
    PLoS One. 2025;20:e0330513.
    PubMed         Abstract available

  36. EVANS LV, Bonz JW, Buck S, Gerwin JN, et al
    An adaptive simulation intervention decreases emergency physician physiologic stress while caring for patients during COVID-19: A randomized clinical trial.
    PLoS One. 2025;20:e0331488.
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  37. TAN C, Zhong J, Yang D, Huang W, et al
    Forecasting and analysing global average temperature trends based on LSTM and ARIMA models.
    PLoS One. 2025;20:e0330645.
    PubMed         Abstract available

  38. MULLER-POLYZOU R, Reuter-Oppermann M
    Radiotherapy continuity for cancer treatment: Lessons learned from natural disasters.
    PLoS One. 2025;20:e0308056.
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  39. SHANKAR R, Wang L, Hoe HS, Fong LM, et al
    Cost-effectiveness of virtual emergency care models: A protocol for a systematic review.
    PLoS One. 2025;20:e0330946.
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  40. CATES ZP, Facciuolo A, Scruten E, Kusalik A, et al
    Peptide immunoarrays for rationale development of vaccines with enhanced cross-reactivity.
    PLoS One. 2025;20:e0330741.
    PubMed         Abstract available

  41. OKYERE E, Marfoh K, Kabukeinamala D, Goundar R, et al
    Benefits and challenges: Qualitative exploration of women's experiences during the COVID-19 pandemic in Fiji.
    PLoS One. 2025;20:e0331794.
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  42. KAMADA N, Hagiya H, Kutsuna S
    Impact of COVID-19 on the awareness and interest in infectious disease specialization among Japanese medical students.
    PLoS One. 2025;20:e0329451.
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  43. NAGY A, Cernikova L, Sedlak K
    Genetic data and meteorological conditions suggesting windborne transmission of H5N1 high-pathogenicity avian influenza between commercial poultry outbreaks.
    PLoS One. 2025;20:e0319880.
    PubMed         Abstract available

  44. XIE F, Wei H
    Characteristics and dynamic evolution of inter-industry volatility spillovers in China's stock market.
    PLoS One. 2025;20:e0330599.
    PubMed         Abstract available

  45. SALAZAR-GRANIZO YE, Caparros-Gonzalez RA, Puente-Fernandez D, Hueso-Montoro C, et al
    Highly stressful global event affecting health sciences students: A longitudinal qualitative study.
    PLoS One. 2025;20:e0331694.
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  46. HAN D, Choi CG
    The spatial dynamics of urban vegetation and housing prices: Insights from pre- and post-pandemic Chicago using OLS and MGWR models.
    PLoS One. 2025;20:e0330932.
    PubMed         Abstract available


    Proc Natl Acad Sci U S A

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    HLA-B*15:01-positive severe COVID-19 patients lack CD8(+) T cell pools with highly expanded public clonotypes.
    Proc Natl Acad Sci U S A. 2025;122:e2503145122.
    PubMed         Abstract available


    Vaccine

  48. IRVING SA, Groom HC, Belongia EA, Crane B, et al
    Differences in influenza vaccination coverage by race and ethnicity across age groups in the Vaccine Safety Datalink, 2017-18 through 2022-23 influenza seasons.
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  49. ZHOU Y, Wang H, Chu L, Chen K, et al
    Influenza vaccination hesitancy and decision between parental and grandparental caregivers of preschoolers: a comparative study.
    Vaccine. 2025;64:127696.
    PubMed         Abstract available

#Genetic data and #meteorological conditions suggesting #windborne #transmission of #H5N1 high-pathogenicity avian #influenza between commercial #poultry outbreaks

 


Abstract

Understanding the transmission routes of high-pathogenicity avian influenza (HPAI) is crucial for developing effective control measures to prevent its spread. In this context, windborne transmission, the idea that the virus could travel through the air over considerable distances, is a contentious concept, and documented cases have been rare. Here, though, we provide genetic evidence supporting the feasibility of windborne transmission. During the 2023−24 HPAI season, molecular surveillance identified identical H5N1 strains among a cluster of unrelated commercial farms about 8 km apart in the Czech Republic. The episode started with the abrupt mortality of fattening ducks on one farm. This was followed by disease outbreaks at two nearby high-biosecurity chicken farms. Using genetic, epizootiological, meteorological and geographical data, we reconstructed a mosaic of events strongly suggesting wind was the most probable mechanism of infection transmission between poultry in at least two independent cases. By aligning the genetic and meteorological data with critical outbreak events, we determined the most likely time window during which the transmission occurred and inferred the sequence of infected houses at the recipient sites. Our results suggest that the contaminated plume emitted from the infected fattening duck farm was the critical medium of HPAI transmission, rather than the dust generated during depopulation. Furthermore, our results also strongly implicate the role of confined mechanically-ventilated buildings with high population densities in facilitating windborne transmission and propagating virus concentrations below the minimum infectious dose at the recipient sites. These findings underscore the importance of considering windborne spread in future outbreak mitigation strategies.

Source: PLoS One, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0319880

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History of Mass Transportation: The FS ETR 460 Electric Multiple Unit

 


By Superalbs - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=93344176

Source: Wikipedia, https://en.wikipedia.org/wiki/FS_Class_ETR_460

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Friday, September 5, 2025

#Ebola virus disease - #DRC (#WHO D.O.N., September 5 '25)

 


Situation at a glance

On 1 September 2025, WHO received an alert from the Ministry of Health of the Democratic Republic of the Congo (DRC) regarding suspected cases of Ebola virus disease (EVD) in the Bulape Health Zone, Kasai Province, DRC

The first known index case was a pregnant woman who presented at Bulape General Reference Hospital on 20 August 2025 with symptoms of high fever, bloody diarrhoea, haemorrhage and extreme weakness. She died on 25 August from multiple organ failure

On 4 September 2025, following confirmatory laboratory testing, the Ministry of Health declared an outbreak of EVD

Ebola virus disease is a serious, often fatal illness in humans. The virus is transmitted to humans through close contact with the blood or secretions of infected wildlife and then spreads through human-to-human transmission

As of 4 September 2025, 28 suspected cases, including 15 deaths (case fatality ratio (CFR): 54%), have been reported from three areas of the Bulape health zone (Bulape, Bulape Com and Dikolo) and Mweka health zone. 

Among the deaths, four are health-care workers

About 80% of the suspected cases are aged 15 years and older. Six samples were collected from five suspected cases and one probable death from Bulape health zone and arrived on 3 September at the National Public Health Laboratory (INRB) in Kinshasa for confirmation testing. All five samples tested positive for Ebola virus (EBOV) through GeneXpert and Polymerase Chain Reaction (PCR) assays on 3 September 2025. 

The Ministry of Health, with support from WHO and partners, is implementing public health response measures to contain the outbreak. WHO assesses the overall public health risk posed by the current EVD outbreak as high at the national level, moderate at the regional level and low at the global level.


Description of the situation

On 1 September 2025, WHO received an alert from the Ministry of Health of the Democratic Republic of the Congo (DRC) regarding suspected cases of EVD in the Bulape Health Zone, Kasai Province, DRC. 

The first known suspected index case was admitted to the Bulape General Reference Hospital on 20 August 2025. The patient was a pregnant woman at 34-weeks of gestation who presented with symptoms of fever, bloody diarrhoea,  haemorrhage, vomiting, asthenia, followed by multiple organ failure. She died on 25 August 2025. Two of the health-care workers that had initially been in contact with this first case also developed similar symptoms and died.

As of 4 September 2025, a total of 28 suspected cases, including 15 deaths, of which four are health-care workers (case fatality ratio (CFR): 54%) have been reported from three areas of the Bulape health zone (Bulape, Bulape Com and Dikolo) and Mweka health zone. 

About 80% of the suspected cases are aged 15 years and older. Five blood samples from five suspected cases and a  naso-pharyngeal swab from a probable death were collected from the three health areas and shipped to the National Public Health Laboratory (INRB) in Kinshasa for testing.

On 3 September 2025, the laboratory testing conducted at INRB confirmed Ebola virus (EBOV)[1] through GeneXpert and Polymerase Chain Reaction (PCR) assays.

The results obtained from whole genome sequencing suggest that the outbreak is a new zoonotic spillover event and is not directly linked to the 2007 Luebo or 2008/2009 Mweka EVD outbreaks.[2]

(...)


Epidemiology

Ebola virus disease is a severe disease caused by the Ebola virus (EBOV). The virus belongs to the species Orthoebolavirus Zairense. The virus is transmitted to humans through close contact with the blood or secretions of infected wildlife and then spreads through human-to-human transmission by direct contact with bodily fluids, organs, or contaminated surfaces and materials.

The incubation period, the time between infection with the virus and the onset of symptoms, ranges from 2 to 21 days, but typically is 7–11 days. People are not infectious during the incubation period; they become contagious with early symptoms, therefore, transmission risk begins at the onset of clinical signs and increases with disease severity.

The average case fatality ratio is 50%; case fatality ratios ranging from 25% to 90% have been reported in previous outbreaks. 

The disease is characterised by an acute onset of fever with non-specific symptoms/signs (e.g., abdominal pain, anorexia, fatigue, malaise, myalgia, sore throat) usually followed several days later by nausea, vomiting, diarrhoea, and occasionally a variable rash. 

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

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

Family members, health and care providers, and participants in burial ceremonies with direct contact with the deceased are at particular risk. 


Public health response

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

-- A crisis committee was activated at both the local and provincial levels.

-- Risk communication and active surveillance activities are ongoing.

-- All cases are isolated, and Infection Prevention and Control (IPC) measures have been implemented.

-- Patients are receiving intravenous medication.

-- Contact isolation and tracing are continuing.

-- Investigations are ongoing. 

WHO is supporting the national authorities, including through:

-- Risk assessment and investigation.

-- Providing operational, financial and technical support to the Ministry of Health to ensure swift response.

-- Provision of essential supplies (Personal Protective Equipment (PPE), medical supplies and infrastructures support)

-- The approved Ervebo vaccine is available with a stock of 2000 doses located in Kinshasa expected to be shipped shortly to the affected area, to vaccinate contacts of confirmed or suspected cases,  frontline and health workers.


WHO risk assessment

This is the 16th EVD outbreak in the DRC since 1976. The current outbreak occurs after almost three years without a confirmed EVD outbreak in the country. The last EVD outbreak in the country was declared on 15 August 2022 in Beni city, North Kivu province, with one single case reported who later died, and the MoH declared the end of the outbreak on 27 September 2022. In the Bulape district, the epicentre of the current outbreak, the last EVD outbreak was recorded in 2007.  

This outbreak is occurring in a complex epidemiological and humanitarian context. The country is facing several outbreaks, including mpox, cholera, and measles. In addition, the country is experiencing a long-term economic and political crisis. The country's resources and capacity to effectively respond to the current outbreak are therefore limited. 

The epicentre of this outbreak is in the proximity of the Tshikapa city, the capital city of the Kasai province, and the Angolan border (approximately 100 to 200 kilometres, depending on the nearest border crossing point). 

Although the affected district is a hard-to-reach rural area relatively far from the two main urban centres of Mbuji Mayi and Kananga, population movements between different parts of the province are frequent, especially between Bulape and Tshikapa.

In addition, epidemiological investigations are ongoing with transmission chains, and the source of the outbreak has not yet been identified; therefore, additional infected people cannot be ruled out.  

The date of symptom onset for the first case is not yet known, as well as the therapeutic itinerary prior to health facility consultation, which further increases the likelihood of an ongoing community transmission with further risk of spread to other health districts.

WHO assesses the overall public health risk posed by the current EVD outbreak as high at the national level, moderate at the regional level and low at the global level. 


WHO advice

Effective outbreak control relies on the application of a set of interventions, namely clinical management, IPC & Water, sanitation and hygiene (WASH), surveillance and contact tracing, good laboratory service, safe and dignified burials, community engagement, and social mobilization. 

The Ebola virus can persist in some body fluids of people who have recovered from EVD. 

In a limited number of cases, secondary transmissions resulting from exposure to the body fluids of people who have recovered from EVD have been documented. Therefore, maintaining collaborative relationships with survivor associations while monitoring survivors is a priority to mitigate any potential risks.

Early diagnosis and initiation of optimized supportive clinical care can reduce mortality from EVD. 

In addition, monoclonal antibodies active against a 3-antibody combination of atoltivimab, maftivimab and odesivimab [Inmazeb®] or a single antibody ansuvimab [Ebanga®].  

Ebola treatment centres should be designed and managed to ensure safe care is provided with appropriate biosecurity and infection prevention and control intervention, and allow optimized care, allowing direct visualization of patients in the red zone as much as possible. WHO and partners have worked to develop these innovative solutions. 

There is a need to strengthen surveillance and other response activities, including at relevant points of entry and borders, to contain the possibility of exponential spread. 

Cases, contacts and individuals in affected areas who present signs and symptoms compatible with case definitions should be considered suspects and cared for and treated in designated treatment facilities with appropriate biosecurity, infection prevention and control and be offered testing in a timely fashion and advised not to travel. 

Collaboration with neighbouring countries should be enhanced to harmonize reporting mechanisms, conduct joint investigations, and share critical data in real time. 

Surrounding countries should enhance readiness activities to enable early case detection, isolation and treatment. 

Critical infection prevention and control measures should be implemented and/or strengthened in all health care facilities, per WHO's Infection prevention and control guideline for Ebola and Marburg disease.   

Health workers caring for patients with confirmed or suspected Ebola should apply transmission-based precautions in addition to standard precautions, including appropriate use of PPE and hand hygiene according to the WHO 5 moments to avoid contact with patients’ blood and other body fluids, and with contaminated surfaces and objects. 

Waste generated in health-care facilities must be safely segregated, safely collected, transported, stored, treated and finally disposed. National guidelines should be followed on rules and regulations for safe waste disposal or WHO’s guidelines on safe waste management.

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

In accordance with the recommendations of the Strategic Advisory Group of Experts on immunization, the Ervebo vaccine is recommended during an EVD outbreak due to EBOV for ring vaccination, for contacts and potential contacts of confirmed/suspected EVD cases, as well as for frontline workers. A global stockpile has been established and is being coordinated by the International Coordination Group for vaccine procurement.

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

(...)

Source: World Health Organization, https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON580

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#Molnupiravir inhibits #Bourbon virus #infection and disease-associated #pathology in mice

 


ABSTRACT

Bourbon virus (BRBV) is an emerging tick-borne virus that can cause severe and fatal disease in humans. BRBV is vectored via the Amblyomma americanum tick, which is widely distributed throughout the central, eastern, and southern United States. Serosurveillance studies in Missouri and North Carolina identified BRBV-neutralizing antibodies in approximately 0.6% of tested individuals. To date, no specific antiviral therapy exists. As part of an initial screen, several nucleoside analogs were tested for their ability to inhibit BRBV replication in cell culture. Among the compounds assessed, molnupiravir, an antiviral drug with oral availability and broad spectrum antiviral activity against RNA viruses, showed antiviral activity against BRBV production in vitro. In vivo, pre-exposure administration of molnupiravir protected susceptible type I interferon receptor knockout (Ifnar1-/-) mice against lethal BRBV infection. The protection by molnupiravir was associated with lower virus burden in mouse tissues, improvement of T-cell (CD4+, CD8+) and B-cell (follicular) profiles in the spleen, improvement of severe thrombocytopenia, and reduced pathology in the spleen and liver of BRBV-infected mice. Finally, therapeutic administration of molnupiravir starting 24 or 48 hours after infection ameliorated weight loss, clinical signs of disease, and lethality associated with BRBV infection. Overall, our experiments suggest that molnupiravir is a potential antiviral therapy for evaluation in humans with BRBV infections.


IMPORTANCE

Bourbon virus (BRBV) is an emerging tick-borne pathogen that can cause severe and fatal illness in humans. Currently, there are no approved antiviral therapies or vaccines against this disease. In this study, we evaluated the efficacy of molnupiravir, a broad-spectrum antiviral drug that is approved in the United States for other RNA viruses, using a mouse model of lethal BRBV disease. Molnupiravir significantly inhibited virus replication, improved survival rates, and suppressed clinical signs of disease, including thrombocytopenia and liver and spleen pathology. These findings support further investigation of molnupiravir as a potential therapeutic candidate for treating BRBV infections in humans.

Source: Journal of Virology, https://journals.asm.org/doi/full/10.1128/jvi.00740-25?af=R

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#USA, #Wastewater #Data for Avian #Influenza #H5 (#CDC, September 5 '25)




{Summary}

Time Period: August 24, 2025 - August 30, 2025

-- H5 Detection3 sites (0.7%)

-- No Detection428 sites (99.3%)

-- No samples in last week31 sites




(...)

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

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#Influenza #vaccination to improve #outcomes for #patients with acute heart failure (PANDA II): a multiregional, seasonal, hospital-based, cluster-randomised, controlled trial in #China

 


Summary

Background

Influenza vaccination is widely recommended to prevent death and serious illness in vulnerable people, including those with heart failure. However, the randomised evidence to support this practice is limited and few people are vaccinated in many parts of the world. We aimed to determine whether influenza vaccination can improve the outcome of patients after an episode of acute heart failure requiring admission to hospital in China.

Methods

We undertook a pragmatic, multiregional, parallel-group, cluster (hospital)-randomised, controlled, superiority trial over three winter seasons in China. Participating hospitals were located in the counties of 12 provinces with the capability of establishing a point-of-care service to provide free influenza vaccination to a sufficient number of patients before their discharge, if allocated to the intervention group. No such service was used in hospitals allocated to usual care (control) but patients were informed of fee-for-service influenza vaccination being available at local community medical centres, as per usual standard of care. Hospitals were randomised (1:1) in each year, stratified by province and up to three times (ie, new randomisation for each season), to include eligible adult (aged ≥18 years) patients with moderate to severe heart failure (New York Heart Association class III or IV) and no contraindication to influenza vaccination. Patient enrolment was conducted over three consecutive winter seasons, from October in each year to March of the following year, between 2021 and 2024. All patients received usual standard of care and were followed up at 1, 3, 6, and 12 months after their hospital discharge by trained study personnel using a standardised protocol. The primary outcome was a composite of all-cause mortality or any hospital readmission over 12 months, excluding events that occurred within 30 days after hospital discharge at all sites and in the summer season only for sites in northern China. The effect of the intervention was assessed at an individual level in the modified intention-to-treat population (all randomly assigned patients with available information until the time of last follow-up, excluding censored events) with a two-level hierarchical logistic regression model that included study period (year) as a fixed effect, and hospital and hospital-period as random effects, with the censored events excluded. The trial is registered at the Chinese Clinical Trial Registry (ChiCTR2100053264).

Findings

Of 252 hospitals assessed for eligibility, 196 hospitals agreed to join and were randomised in three batches at the beginning of each winter season from October, 2021, but 32 hospitals subsequently withdrew before any patients were included. Overall, 7771 participants were enrolled at 164 hospitals in each winter season between Dec 3, 2021, and Feb 14, 2024, with 3570 assigned to the influenza vaccination group and 4201 to the usual care (control) group. The primary outcome occurred in 1378 (41·2%) of 3342 patients in the vaccination group and in 1843 (47·0%) of 3919 patients in the usual care group (odds ratio 0·83 [95% CI 0·72–0·97]; p=0·019). The result was consistent in the sensitivity analysis. The number of participants with a serious adverse event was significantly lower in the vaccination group (1809 [52·5%] of 3444) than the usual care group (2426 [59·0%] of 4110; odds ratio 0·82 [0·70–0·96]; p=0·013).

Interpretation

Influenza vaccination during a hospital admission in patients with acute heart failure can improve their survival and reduce likelihood of readmission to hospital over the subsequent 12 months. The integration of influenza vaccination into inpatient care could offer a widely applicable strategy for an underserved high-risk patient group, that is relevant to resource-limited and possibly resource-rich settings.

Funding

Sanofi and the Chinese Society of Cardiology.

Source: The Lancet, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01485-0/abstract?rss=yes

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Cross-reactive #human #antibody responses to #H5N1 #influenza virus #neuraminidase are shaped by immune history

 


Abstract

H5N1 highly pathogenic avian influenza viruses have spread globally and pose a risk for a human pandemic. Prior studies suggest that early life exposures to group 1 influenza viruses (H1N1 and H2N2) prime antibodies that cross-react to the hemagglutinin of H5N1, which is also a group 1 virus. Less is known about how immune history affects antibody responses against the neuraminidase (NA) of H5N1 viruses. Here, we measured NA inhibition antibodies against multiple H5N1 viruses using sera from 155 individuals born between 1927 and 2016. We found that individuals primed in childhood with H1N1 viruses were more likely to possess higher levels of antibodies that cross-react with the NA of H5N1 viruses compared to individuals primed in childhood with H2N2 or H3N2 viruses. While young children rarely possessed cross-reactive NA antibodies, we found that childhood infections with contemporary H1N1, but not H3N2, viruses can elicit them. These data suggest that immune history greatly impacts the generation of cross-reactive NA antibodies that can inhibit H5N1 viruses.


Competing Interest Statement

S.E.H. is a co-inventor on patents that describe the use of nucleoside-modified mRNA as a vaccine platform. S.E.H reports receiving consulting fees from Sanofi, Pfizer, Lumen, Novavax, and Merck. A.S.L. is now an employee of Sanofi but was affiliated with the Childrens Hospital of Pennsylvania when this work was completed. The authors declare no other competing interests.


Funding Statement

This project was funded in part with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, under contract no. 75N93021C00015 (S.E.H., S.C.) and grant number R01AI08686 (S.E.H.).

Source: MedRxIV, https://www.medrxiv.org/content/10.1101/2025.09.02.25334929v1

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