Rapid #Risk #Assessment - #MERS-CoV, Eastern Mediterranean Region (#WHO, Feb. 3 '26, summary)

 

Risk statement  

-- The scope of this Rapid Risk Assessment is to reassess the epidemiological situation of Middle East respiratory syndrome coronavirus (MERS-CoV) following the recent exportation (in December 2025) of cases from the Arabian Peninsula to France and three healthcare-associated clusters reported by the Kingdom of Saudi Arabia (KSA) in 2024–2025. 

-- These events, together with the continued occurrence of sporadic cases in Arabian Peninsula countries, highlight the ongoing risk of international spread to non-endemic countries and reflect the persistent circulation of MERS-CoV in the Middle East.  

-- Middle East respiratory syndrome coronavirus (MERS-CoV) is a zoonotic virus transmitted to humans through direct or indirect contact with infected dromedary camels, which are the natural host of the virus. 

-- First identified in humans in 2012 in the Kingdom of Saudi Arabia (KSA) and Jordan, MERS-CoV causes a viral respiratory infection that occurs throughout the year, with cases reported sporadically and in clusters. 

-- Clinical presentation ranges from asymptomatic or mild respiratory illness to severe acute respiratory disease, pneumonia, and death. 

-- The case fatality rate among cases reported to WHO is 37%.    

-- Since MERS-CoV emergence in 2012, until 23 January 2026, under the International Health Regulations (IHR, 2005), 27 countries have reported human cases of MERS-CoV to the WHO: 

- Algeria, 

- Austria, 

- Bahrain, 

- China, 

- Egypt, 

- France, 

- Germany, 

- Greece, 

- the Islamic Republic of Iran, 

- Italy, 

- Jordan, 

- Kuwait, 

- Lebanon, 

- Malaysia, 

- the Netherlands, 

- Oman, 

- the Philippines, 

- Qatar, 

- the Republic of Korea, 

- the Kingdom of Saudi Arabia (KSA), 

- Thailand, 

- Tunisia, 

- Türkiye, 

- the United Arab Emirates (UAE), 

- the United Kingdom, 

- the United States of America, and 

- Yemen.    

-- However, of the 2635 MERS cases documented globally since 2012, 2418 (92%) were reported from the WHO Eastern Mediterranean Region (EMR). 

-- The majority (84%) of reported cases were notified by KSA (2224/2635) followed by other Arabian Peninsula countries: the UAE (94), Jordan (28), Qatar (28), Oman (26), Iran (6), Kuwait (4), Tunisia (3), Lebanon (2), Bahrain (1), Egypt (1) and Yemen (1).  

-- Exposure was commonly linked to direct or indirect contact with infected dromedary camels or transmission from infected individuals in healthcare settings or households. 

-- Most cases reported outside the Arabian Peninsula countries involved people likely infected there prior to travelling elsewhere.    

-- Following the first human infection with MERS-CoV in 2012, the Director‐General convened an Emergency Committee under the International Health Regulations (IHR 2005) in 2013 to assess whether the outbreaks of MERS constituted a Public Health Emergency of International Concern (PHEIC) and to provide guidance on the public health measures that should be taken.{i}  

-- The Committee has met on 10 occasions and, on each occasion, concluded that the outbreaks do not meet the criteria of a PHEIC.    

-- The overall risk of MERS-CoV in 2023 was assessed as moderate both at the regional and global levels.  

-- A new assessment currently confirms that this risk level remains unchanged, moderate both at the regional and global levels, taking into account the following considerations:  

- 1. Continued reports of sporadic cases in endemic countries in the Arabian Peninsula and the occasional occurrence of traveller cases and healthcare-associated transmission, including two cases reported from France in December 2025 and three clusters reported in the Kingdom of Saudi Arabia during 2024–2025. 

- 2. Since the last RRA in 2023, cases reported to WHO have not resulted in sustained onward human-tohuman transmission, as most identified close contacts tested negative and no additional household clusters have been identified. The three healthcare-related clusters remained limited, with infection only confirmed in direct contacts with the index case. 

- 3. The observed decline in reported MERS cases since 2020, in particular during the COVID-19 pandemic emergency phase, is thought to be a result of pandemic-related Infection Prevention & Control measures that also limited human-to-human transmission of MERS-CoV, as well as behavioural changes during the pandemic. Any role of potential cross-reactive immunity from SARS-CoV-2 infection and/ or vaccination remains in need of further investigation. Other hypotheses—such as reduced surveillance, viral attenuation, or decreased circulation in camel populations—are not supported by current evidence. 

- 4. Significant disparities persist globally in countries' capacities to detect and respond effectively to the disease, particularly in regions where the virus has not been previously documented. Within the EMR, six fragile, conflict-affected, and vulnerable countries are considered at greater risk.  

- 5. Global inequalities remain in the adequacy of preparedness, infection prevention and control capacities, and response measures, particularly in the context of a cross-border outbreak or a traveller case.  

- 6. MERS-CoV continues to circulate in dromedary camel populations without causing overt clinical signs, constituting a constant source of human exposure and a risk of zoonotic spillover, which may result in occasional onward human-to-human transmission. The recent detection of Clade B viruses in camels of African origin further highlights the risk of MERS-CoV spread from the Arabian Peninsula via camel movements and poses an additional risk to other regions, particularly given the documented increased replication competence and more efficient viral entry of Clade B compared with Clade C. 

- 7. Preliminary data from in vitro growth kinetics and partial sequencing indicate no major attenuation in circulating Clade B strains. 

- 8. The potential public health impact of MERS-CoV should not be underestimated given the severity of disease and its high reported case fatality rate (CFR), even though sustained global spread is currently considered unlikely.  

- 9. MERS-CoV can cause severe disease resulting in high mortality. The current CFR of 37% is based on laboratory-confirmed cases only and may therefore overestimate of the true mortality rate.  

- 10. Existing regional and global surveillance systems may fail to detect asymptomatic and mild cases of MERS, leading to underreporting.  

- 11. Limited and non-sustained human-to-human transmission has been documented, mainly in healthcare and household settings. However, due to limited research, data gaps remain in understanding transmission dynamics, including the role of environmental contaminations, asymptomatic cases and specific exposure risk in healthcare settings. Further research is needed to better understand zoonotic transmission associated with dromedary camel products and excreta.  

- 12. Due to the similarity of symptoms with other respiratory diseases that are widely circulating, like influenza or COVID-19, detection and diagnosis of MERS cases may be delayed, especially in unaffected countries, creating opportunity for local onward transmission.  

- 13. Should MERS-CoV result in a healthcare-associated outbreak in a previously unaffected country, as occurred in the Republic of Korea in May 2015, during which 186 laboratory-confirmed cases (185 in the Republic of Korea and 1 in China) and 38 deaths were reported, the public health consequences for that country could be substantial.  

- 14. The recent exportation of cases from the Arabian Peninsula to France demonstrates the ongoing risk of international spread. 

(...)

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{1} Confidence refers to the level of confidence in the data/information or the quality of the evidence available at the time the RRA is conducted. Poor quality information may increase the overall perceived risk due to the incertitude in the assessment 

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Source: 

Link: https://www.who.int/publications/m/item/who-rapid-risk-assessment-mers-cov--eastern-mediterranean-region-v.2

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Long Term Rapid #Risk #Assessment, Acute Event of Potential Public Health Concern: #COVID19, Global (#WHO, Feb. 3 '26, summary)

 

{Summary}

Overall risk statement

-- At the end of 2025, the global public health risk from COVID-19 remained moderate, following the declining deaths and hospitalizations in 2022 due to high population immunity, improved clinical management, and similar virulence and characterized by sustained stability in severity indicators—including ICU admissions and in hospital mortality—throughout the following years. 

-- Most SARS-CoV-2 variants now belong to the JN.1 Omicron sublineages, which show immune escape but do not result in increased disease severity compared to other Omicron sublineages. 

-- Nonetheless, continued surveillance gaps, reduced genomic sequencing and sharing of sequence information, and limited reporting, especially from low- and middle-income countries, undermine a more informed risk assessment at this time. 

-- SARS-CoV-2 continues to circulate widely, as indicated by sentinel surveillance under GISRS and wastewater surveillance, co-circulating with seasonal influenza and Respiratory Syncytial Virus (RSV). 

-- Post COVID-19 condition is estimated to affect around 6% of symptomatic cases, with reduced risk in vaccinated individuals. 

-- WHO has developed the Strategic Plan for Coronavirus Disease Threat Management (2025–2030) which continues to encourage integration of COVID19 into broader respiratory disease surveillance systems and recommend vaccination of populations at high-risk of severe disease. 

-- While available vaccines remain effective against severe disease and death despite continued variant evolution, global vaccine uptake among high-risk groups was very low in 2025. 

-- Overall, while the direct impact of COVID-19 has lessened since 2022, ongoing circulation and virus evolution in human populations and established animal reservoirs, low vaccine uptake, and insufficient burden and genomic surveillance data contribute to continued uncertainty, requiring constant vigilance. 

(...)

Mortality 

-- As of 28 December 2025, over seven million confirmed deaths had been reported globally to WHO. 

-- The number of weekly reported COVID-19-related deaths has been steadily declining, now consistently below 2000 since February 2024. 

-- This is a significant decrease compared to previous periods, such as the 6 000 average deaths reported per week in 2023 and the over 24 000 in 2022. 

-- Similar to case reporting, the weekly average number of countries (including areas and territories) reporting at least one death has declined from 222 in 2022 to 157 and 74 in the same periods of 2023 and 2024, respectively.   

-- In 2025 (as of 28 December), 26 424 deaths were reported from 46 countries, averaging 510 deaths across 38 countries per week. 

-- Since the beginning of 2024, global reporting of COVID-19 deaths has been predominantly driven by countries in the Region of the Americas and the European Region. 

-- It is important to note that absence of official reporting to WHO does not imply that COVID-19 related deaths are not occurring in non-reporting countries. 

-- The overall decline in reported deaths coincides with a reduction in the number of countries reporting, limiting the interpretation of global trends due to decreased geographic and income level representativeness. 

-- As a result, it is difficult to determine with certainty whether the observed decline reflects a true decrease at global level. 

-- However, data from mainly high-income countries that have maintained consistent surveillance and reporting indicate a continued downward trend in deaths, likely reflecting increased population-level immunity due to infections and vaccination. 

-- As an indicator of severity, data collected from countries reporting both hospitalizations and deaths showed a decreasing trend in number of deaths per 1000 hospitalizations in February 2021, when it was 246 deaths per 1000 hospitalizations, to under 100 deaths per 1000 hospitalizations as of the end of July 2022. 

-- Since mid-2022, this indicator has remained generally stable, with fluctuations between 30 to 100 deaths per 1000 hospitalizations. 

-- While the causes for these changes cannot be directly interpreted from data available due to their non-representative nature, they are likely due to a combination of increases in infection- and/or vaccinederived immunity, improvements in early diagnosis and clinical care, reduced strain on health systems, change in the surveillance systems and other factors. 

-- It is not possible to infer a decreased or increased intrinsic virulence of newer SARS-CoV-2 variants from these data.  

-- Nevertheless, the reported figures are an underestimate of the true death toll, which has been estimated by several groups, including WHO. (35) 

-- It is worth highlighting that most countries do not differentiate COVID-19 deaths and hospitalizations between those directly caused by SARS-CoV-2 and those testing positive for the virus incidentally. 

-- The population aged 65 years and over, and those who are not vaccinated, continue to be most at risk of severe disease and death. 

-- In 2025, 37 countries from the African Region, the Region of the Americas, the European Region and the Western Pacific Region reported deaths with age information which represents a decrease from 42 countries across the Region of the Americas, European Region and Western Pacific Region in 2024. 

-- Information on age was available for 25 039 deaths, representing 95% of the total 26 424 reported deaths in 2025. 

-- The population 65 years and over constituted 88% of all deaths during 2025. 

-- While similar to the figure reported in 2024, it nevertheless represents the highest proportion of deaths attributed to a single age group since the beginning of the pandemic. 

-- Those aged 15 to 64 years constituted 11.7% of all deaths, presenting a slight increase from 11.3% compared to 2024. 

-- These data were consistently provided by the Region of the Americas and the European Region. 

-- When compared, the proportion of deaths among those aged 15 to 64 were higher in the Region of the Americas (13%) than the European Region (5.8%). 

-- In 2025, less than 1% (n=187) of reported deaths occurred among children under 15 years of age – a consistent trend since the emergence of SARS-CoV-2.

-- However, a more detailed look reveals that 154 out of 187 (82%) deaths occurred in children under five years old, indicating that this age group remains the most vulnerable compared to older children. 

(...)

Source: 

Link: https://www.who.int/publications/m/item/covid-19-global-risk-assessment--version-9

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

 

A wild Mute Swan in Žilinský Region.

Source: 

Link: https://wahis.woah.org/#/in-review/7246

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Advancing #H5N1 #influenza #risk #assessment in #ferrets through comparative evaluation of airborne virus shedding patterns

 

Abstract

Recent A(H5N1) zoonotic cases linked to poultry and cattle in North America highlight the urgent need to assess the pandemic potential of emerging strains. Using male ferrets, we evaluate two B3.13 and two D1.1 genotype A(H5N1) viruses isolated from humans and observe fatal disease and varying capacities for direct contact transmission. To enhance pandemic risk assessment, we conduct aerosol sampling using cyclone BC251 and water condensation capture-based SPOT samplers and perform comparative analyses to include additional A(H5N1), A(H9N2), A(H7N9), and A(H1N1)pdm09 strains with known transmissibility profiles. Although none of the A(H5N1) strains transmit via the air, B3.13 viruses are detected at significantly higher levels compared to D1.1 strains. Here we show strong correlations between viral loads in nasal washes, airborne virus shedding, and transmissibility in ferrets, highlighting the value of these metrics for identifying zoonotic influenza viruses that may be adapting toward increased transmission potential.

Source: 

Link: https://www.nature.com/articles/s41467-026-68931-1

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#Potential and #challenges for sustainable #progress in human #longevity

 

Abstract

Decelerating gains in life expectancy (e0) in high-income countries have raised concerns about the future of human longevity. To enhance our understanding of these developments, we examine subnational (N = 450) mortality trends in Western Europe in the period 1992-2019. Between 1992 and 2005, gains in life expectancy were both substantial and widespread. Laggard regions experienced the fastest improvements, yielding rapid regional convergence. Between 2005 and 2019, however, gains in these regions decelerated, while remaining remarkably stable in vanguard regions, suggesting that it remains possible to continue extending longevity. The observed slowing of e0 gains is strongly associated with mortality at ages 55-74, which increased in this period across large areas of Western Europe, particularly in Germany and France. In this work, we show that monitoring mortality trends at a fine geographical level is crucial for revealing both the potential for, and challenges to, sustainable progress in human longevity.

Source: 

Link: https://www.nature.com/articles/s41467-026-68828-z

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Crowning with Thorns, Titian (c.1570 - c.1575)

 

Public Domain

Source: 

Link: https://www.wikiart.org/en/titian/crowning-with-thorns

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An intranasal adenoviral-vectored #vaccine protects against highly pathogenic avian #influenza #H5N1 in naive and antigen-experienced #animals

 

Highlights

• IN-delivered ChAd-Texas vaccine elicits mucosal antibody and T cell responses

• IN-delivered ChAd-Texas vaccine protects against H5N1 in mice and hamsters

• IN delivery of ChAd-Texas vaccine confers greater protection than IM delivery

• ChAd-Texas induces H5N1 immunity in the setting of prior influenza immunity

Summary

The emergence of highly pathogenic avian H5N1 influenza viruses in dairy cows and humans has increased the potential for another pandemic. To address this risk, we developed chimpanzee adenoviral (ChAd)-vectored H5 hemagglutinin-targeted vaccines and tested their immunogenicity and efficacy in rodents. Immunization with ChAd-Texas (clade 2.3.4.4b) vaccine in mice elicits neutralizing antibody responses and confers protection against viral infection and mortality upon challenge with a human H5N1 isolate (A/Michigan/90/2024, clade 2.3.4.4b). Intranasal delivery of the ChAd-Texas vaccine elicits mucosal antibody and T cell responses and confers greater protection than intramuscular immunization. In Syrian hamsters, a single intranasal dose of ChAd-Texas vaccine prevents weight loss and reduces airway infection after H5N1 A/Michigan/90/2024 or A/Texas/37/2024 challenge. Importantly, prior seasonal influenza vaccination does not impair antibody responses or protection after intranasal delivery of the ChAd-Texas vaccine. These results support the development of mucosally administered ChAd-Texas HA vaccines as an effective platform for HPAI H5N1 preparedness.

Source: 

Link: https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(25)00655-X?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS266637912500655X%3Fshowall%3Dtrue

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Dual roles for #influenza A protein #PAX: limiting inflammatory response and disrupting #MHC I #antigen presentation in #human respiratory epithelium

Abstract

Key to the success of influenza A virus as a pathogen are its numerous tactics of immune evasion. To suppress anti-viral cellular and organismal responses, influenza A virus encodes several immunomodulatory proteins, including the endoribonuclease PA-X. PA-X decreases inflammation and immune responses in in vivo infections by limiting host gene expression. PA-X is conserved in 99% of all influenza A viral strains, pointing to its importance as a crucial immunomodulator. However, it is not yet known how PA-X activity alters the antiviral response in the human airway or how it benefits the virus. To define how influenza A virus uses this protein to evade immune responses, we characterized the impacts of PA-X on the host response to infection in the infected and bystander cells of the airway epithelium using a 3D ex vivo model. We discovered that PA-X exerts a dual action on immune responses, dampening aspects of both the innate and adaptive immune systems. Consistent with reports in model organisms, PA-X significantly decreases secretion of multiple cytokines from airway epithelium, including IFN-λ, which likely plays a role in its ability to reduce inflammation and lung damage. In addition, we revealed that PA-X decreases and delays MHC I antigen presentation from infected cells. This reduction likely aids influenza A virus in hiding from antigen-specific T cells and allows the virus to successfully replicate prior to immune detection. This new function for PA-X highlights how influenza A virus employs active mechanisms to block immune detection, in addition to tolerating high levels of antigen mutations to escape it. Moreover, as evasion of recognition by the adaptive immune system is particularly important during infections of animals and humans with pre-existing immunity, this immunomodulatory activity may be key to the longevity of influenza A viruses and their continued circulation.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

National Institute of Allergy and Infectious Diseases, https://ror.org/043z4tv69, R01AI137358, 75N93021C00017

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.01.30.702929v1

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History of Mass Transportation: A 44-ton 1-B-1 experimental gas-turbine locomotive designed by R. Tom Sawyer and built in 1952 for testing by the U.S. Army Transportation Corps

 By Kbh3rd - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=5545061

Source: 

Link: https://en.wikipedia.org/wiki/Gas-turbine_locomotive

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Genetic diversity of alpha and #betacoronaviruses in cave and temple-roosting #bats in #Vientiane Province, #Lao PDR

 

Abstract

The emergence of MERS-CoV, SARS-CoV-1, and SARS-CoV-2 highlights the significant public health and economic threats posed by coronaviruses. In Lao PDR, SARS-CoV-2-related bat coronaviruses capable of binding to human ACE2 receptors have been found in northern regions, but little is known about coronavirus diversity in anthropized environments like temples. This study investigated coronavirus circulation, diversity, and prevalence in bats from caves and temples in Vientiane Province, Lao PDR. A total of 648 guano samples (505 Chaerephon plicatus, 100 Hipposideros spp., 43 Taphozous spp.) were collected between December 2022 and June 2023 and screened using pan-coronavirus RT-PCR approach. The overall positivity rate was 17.28%, significantly higher in caves (18.8%) than temples (4.41%) (p = 0.003). C. plicatus showed the highest positivity rate (21.38%), followed by Hipposideros spp. 4%, while Taphozous spp. were negative. Phylogenetic analysis revealed diverse coronavirus lineages within Alphacoronavirus (80.4%) and Betacoronavirus (19.6%) genera. Although none were closely related to known human pathogens, coronaviruses of Decacovirus genus related to Chinese bat viruses and Pedacovirus genus similar to porcine epidemic diarrhea virus (PEDV) were detected. Unclassified betacoronaviruses identified were also related to viruses from C. plicatus in Thailand. This study provides valuable insights into coronavirus circulation in both natural and anthropized environments. The detection of PEDV-like viruses underlines the need for continued surveillance at the human-bat interface, where activities like guano harvesting and temple visits increase contacts. Further genomic and functional studies would enhance our understanding of their evolutionary relationships and potential for further cross-species transmission.

Source: 

Link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0341737

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History of Mass Transportation: The Davenport 1597 Steam Locomotive preserved by Illawarra Light Railway Museum

 

By Hpeterswald - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=28169917

Source: 

Link: https://en.wikipedia.org/wiki/Davenport_Locomotive_Works

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Retail #Milk #Monitoring of #Influenza #H5N1 in Dairy #Cattle, #USA, 2024–2025

 

Abstract

US retail milk monitoring during April 13–May 3, 2024, identified influenza A(H5N1) viral RNA in 36% of retail milk samples, indicating widespread undetected infections in US dairy cows. After federal initiatives, reported infections more closely aligned with findings in retail milk during December 27, 2024–January 29, 2025, reflecting improved detection and control.

Source: 

Link: https://wwwnc.cdc.gov/eid/article/32/2/25-1332_article

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#Nipah virus infection - #India (#WHO D.O.N., Jan. 30 '26)

 

Situation at a glance

On 26 January 2026, the National IHR Focal Point for India notified WHO of two laboratory‑confirmed cases of Nipah virus (NiV) infection in West Bengal State. 

Both are healthcare workers at the same private hospital in Barasat (North 24 Parganas district). 

NiV infection was confirmed at the National Institute of Virology in Pune on 13 January. 

One case remains on mechanical ventilation as of 21 January, the other case experienced severe neurological illness but has since improved. 

Authorities have identified and tested over 190 contacts, who all tested negative for NiV with support from a mobile BSL‑3 laboratory deployed by the National Institute of Virology, Pune. 

No further cases have been detected to date. 

This event represents the third NiV infection outbreak reported in West Bengal (previous outbreaks reported in Siliguri in 2001 and Nadia in 2007). 

Enhanced surveillance and infection prevention and control (IPC) measures are in place while investigations into the source of exposure are ongoing. 

NiV infection is a serious but rare zoonotic disease transmitted to humans through infected animals (such as bats), or food contaminated with saliva, urine, and excreta of infected animals. 

It can also be transmitted directly from person to person through close contact with an infected person. 

There are currently no licensed medicines or vaccines for NiV infection, however early supportive care can improve survival. 

WHO assesses the risk posed by Nipah to be moderate at the sub-national level, and low at the national, the regional and global levels.

Description of the situation

On 26 January 2026, the India IHR NFP notified WHO of two confirmed NiV infection cases that occurred in West Bengal State. 

Preliminary laboratory testing suggested NiV infection, and confirmation was received from the National Institute of Virology, Pune on 13 January 2026.

The cases were confirmed through Reverse Transcription Polymerase Chain Reaction (RT-PCR) and Enzyme-Linked Immunosorbent Assay (ELISA) testing.

The first case is a female nurse and the second case is a male nurse. 

Both cases were between 20 – 30 years old, from Barasat, North 24 Parganas district. 

Both cases developed symptoms typical of severe NiV infection in late December 2025 and were admitted to hospital in early January 2026. 

As of 21 January 2026, the second case showed clinical improvement, while the first case remained under critical care.

Following the two confirmed cases, Indian health authorities identified and tested over 190 contact persons, including health and care workers and community contacts. All samples from contact persons tested negative for NiV.

The Indian National Centre for Disease Control, announced on 27 January that no further confirmed cases have been detected in West Bengal from December 2025 to date.

Epidemiology

NiV infection is a zoonotic disease transmitted to humans through infected animals (such as bats), or food contaminated with saliva, urine, and excreta of infected animals. It can also be transmitted directly from person to person through close contact with an infected person. Fruit bats or flying foxes (Pteropus species) are the natural hosts for the virus.

The incubation period ranges from 3 to 14 days. In some rare cases incubation of up to 45 days has been reported. Laboratory diagnosis of a patient with a clinical history of NiV infection can be made during the acute and convalescent phases of the disease by using a combination of tests. The main tests used are RT-PCR from bodily fluids and antibody detection via ELISA.

Human infections range from asymptomatic infection to acute respiratory infection (mild, severe), and fatal encephalitis (brain swelling).

Infected people initially develop symptoms including fever, headaches, myalgia (muscle pain), vomiting and sore throat. This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis. Some people can also experience atypical pneumonia and severe respiratory problems, including acute respiratory distress. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.

Further information about NiV infection can be found here.

The case fatality ratio (CFR) in outbreaks across Bangladesh, India, Malaysia, and Singapore range from 40% to 75%, depending on local capabilities for early detection and clinical management. There are currently no licensed medicines or vaccines specific for NiV infection. Intensive supportive care is recommended to treat severe respiratory and neurologic complications. Henipavirus nipahense (Nipah virus) is considered a priority pathogen for the acceleration of medical countermeasures (MCMs) to respond to epidemics and pandemics as part of the WHO R&D Blueprint for Epidemics. 

Public health response

Several public health measures have been implemented by local authorities, including:

-- The Government of India, in close coordination with the Government of West Bengal, initiated prompt and comprehensive public health measures in accordance with established protocols.

-- Investigations were conducted in collaboration with other sectors through a One Health coordinated approach.

-- Contact tracing has been carried out around the identified cases, with continuous follow-up.

-- Surveillance efforts have been strengthened and enhanced to ensure early case detection.

-- Health education and awareness campaigns, including community engagement and advocacy, are ongoing.

-- Clinicians have been sensitized and alerted to NiV. Infection prevention and control has been strengthened at health-care settings.

- Prompt sample collection, transportation, and testing were conducted at the reference laboratory teams.

The support provided by WHO includes:

-- Providing event communication support at national and international levels, including the submission of an official IHR notification.

-- Monitoring of the evolving outbreak situation, especially during the ongoing Nipah season, including support for assessment of epidemiological patterns, risk factors, and geographic spread.

WHO risk assessment

Nipah virus (Henipavirus nipahense) is a rare zoonotic pathogen with a high CFR (40-75%) and no licensed vaccine or treatment. 

Its reservoirs are fruit bats or flying foxes (bats in the Pteropus genus), which are distributed in the coastal regions and on several islands in the Indian ocean, India, south-east Asia and Oceania. 

The virus can be transmitted to humans from wild and domestic animals, however, as the disease can be transmitted by domesticated animals, secondary human-to-human transmissions are also possible. 

Cases of Nipah virus infection were first reported in 1998 and since then have been reported in Bangladesh, India, Malaysia, Philippines and Singapore. 

The virus is present in India, with seasonal outbreaks linked to bat activities and cultural practices such as the consumption of raw date palm sap. Seasonal outbreaks occur between December and May, coinciding with the harvesting of date palm sap.

This event represents the 13th Nipah outbreak documented in India and the third reported in West Bengal. 

Since 2001, India has reported 12 Nipah outbreaks prior to this event: 10 in the state of Kerala and two in the state of West Bengal. 

In West Bengal, previous outbreaks occurred in 2001 (Siliguri) and 2007 (Nadia district). 

Based on the current available information, WHO assesses the overall public health risk posed by NiV at the sub-national level to be moderate, taking into consideration no availability of specific drugs or vaccines for NiV infection and the difficulty of early diagnosis. 

Although sensitive and specific laboratory methods exist, the symptoms during the first phase are not specific and could potentially delay a timely diagnosis, outbreak detection and response. 

In addition, fruit bats (Pteropus spp.) are the natural reservoir of NiV, and they are present in India and repeated spillover of the virus from its reservoir to the human population has been demonstrated.

Human-to-human transmission has been documented in previous outbreaks, mostly reported in health-care settings and among family and caregivers of sick people through close contact with bodily fluids. 

Implementation of adequate infection prevention and control measures in health care facilities is critical to mitigate health care associated infection.

The yearly number of NiV infection cases reported in India has remained relatively low since 2001, except for 2001, when 66 cases were reported and 2018 when 18 cases were reported. 

Over the past 5 years, a dozen confirmed cases were reported in India, all in Kerala State. 

Strong public health measures are implemented in India to detect and control outbreaks, including established NiV surveillance, and the availability of Rapid Response Teams (RRT) at both the Central and State levels, along with the capacity to rapidly test samples.

For neighbouring countries, WHO assesses the public health risk posed by NiV at the regional level to be low. There have been no reports of cross‑border transmission, and the current outbreak remains geographically limited. 

Nevertheless, the risk of disease occurrence persists due to the shared ecological corridor of fruit bats and the history of human cases previously reported in the region. India has demonstrated strong capacity and experience in managing past NiV outbreaks.

WHO assesses the public health risk posed by NiV at the global level to be low, as there has been no confirmed spread of cases outside India.

WHO advice

In the absence of a licensed vaccine or specific therapeutic treatment for Nipah virus disease, reducing or preventing infection in people relies on raising awareness of the risk factors. 

This includes providing guidance on and reinforcing risk communication messages about the measures that people can take to reduce exposure to the Nipah virus. This is also important in the context of mass gatherings, where attendees come from different countries and may be unfamiliar with disease and its mode of transmission, as well as actions they can take to protect themselves. and case management should focus on delivering timely supportive care, supported by an effective laboratory system and adequate infection prevention and control measures in health facilities. Intensive supportive care is recommended for treatment of severe respiratory and neurologic complications. 

Public health educational messages should focus on:

-- Reducing the risk of bat-to-human transmission

- Efforts to prevent transmission should first focus on decreasing bat access to date palm sap and other fresh food products. Freshly collected date palm juice should be boiled, and fruits should be thoroughly washed and peeled before consumption. Fruits with signs of bat bites should be discarded. Areas where bats are known to roost should be avoided.

-- Reducing the risk of human-to-human transmission.

- Close unprotected physical contact with NiV-infected people should be avoided. Regular hand washing should be carried out after caring for or visiting sick people along other preventive measures.

-- People experiencing Nipah-like symptoms should be referred to a health facility, as early supportive care is key in the absence of treatment. Contact tracing and monitoring are also key to mitigate human-to-human transmission.

-- Controlling infection in health care settings

- Health and care workers caring for patients with suspected or confirmed infection, or handling specimens from them, should always implement standard precautions for infection prevention and control at all times, for all patients.

- When caring for patients with suspected or confirmed NiV, WHO advises the use of contact and droplet precautions including a well-fitting medical mask, eye protection, a fluid-resistant gown, and examination gloves. Airborne precautions should be implemented during aerosol-generating procedures, including placing the patient in an airborne-infection isolation room and the use of a fit-tested filtering facepiece respirator instead of a medical mask. Suspected or confirmed cases of NiV should be placed in a single-patient room.   For family members and caregivers visiting patients with suspected or confirmed Nipah virus, similar precautions should be applied.   

- Samples taken from people and animals with suspected NiV infection should be handled by trained staff working in suitably equipped laboratories.

Based on the currently available information, WHO does not recommend any travel and/or trade restrictions.

Further information

-- World Health Organization. Nipah virus [Fact sheet]. Geneva: WHO; 2026. Available from: https://www.who.int/news-room/fact-sheets/detail/nipah-virus

-- Ministry of Health and Family Welfare. Only Two Nipah Virus Disease Cases Reported in West Bengal Since Last December: NCDC. 196 Contacts Linked to Nipah Cases Traced and Found Asymptomatic; All Test Negative. https://www.pib.gov.in/PressReleasePage.aspx?PRID=2219219&reg=3&lang=1

-- News On AIR. West Bengal reports two suspected Nipah cases; Centre sends response team. New Delhi: Prasar Bharati; 13 January 2026. Available from: https://www.newsonair.gov.in/west-bengal-reports-two-suspected-nipah-cases-centre-sends-response-team/

-- News On AIR. Centre deploys National Joint Outbreak Response Team in West Bengal after suspected Nipah cases. New Delhi: Prasar Bharati; 12 January 2026. Available from: https://www.newsonair.gov.in/centre-deploys-national-joint-outbreak-response-team-in-west-bengal-after-suspected-nipah-cases/

-- Ministry of Health and Family Welfare (MoHFW). X (formerly Twitter). 11 Jan 2026. Available from: https://x.com/MoHFW_INDIA/status/2010751351232594216

-- World Health Organization, Regional Office for South-East Asia, Epidemiological Bulletin WHO Health Emergencies Programme, 2nd edition (2026), 28 January 2026 Reporting period: 12 to 25 Jan 2026: https://cdn.who.int/media/docs/default-source/searo/whe/wherepib/2026_02_searo_epi_bulletin.pdf

-- World Health Organization (6 August 2025). Disease Outbreak News; Nipah virus infection – India. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON577

-- https://www.who.int/news-room/fact-sheets/detail/nipah-virus

-- World Health Organization, Regional Office for South-East Asia. Regional strategy for the prevention and control of Nipah virus infection: 2023–2030. New Delhi: WHO SEARO; 2023. Available from: https://www.who.int/publications/i/item/9789290210849

-- World Health Organization. Technical brief: Enhancing readiness for a Nipah virus event in countries not reporting a Nipah virus event: interim document. Geneva: WHO; 2024 Feb. Available from: https://www.who.int/publications/i/item/9789290211273

-- Kumar SS, Maan S, Kumari M, Gupta P, Bhatia S, Maan NS. Nipah virus disease: epidemiological, clinical, diagnostic and legislative aspects of this unpredictable emerging zoonosis. Animals (Basel). 2023;13(1):159. doi:10.3390/ani13010159. Available from: https://www.mdpi.com/2076-2615/13/1/159

-- Thomas B, Chandran P, Lilabi MP, George B, Sivakumar CP, Jayadev VK, et al. Nipah virus infection in Kozhikode, Kerala, South India, in 2018: epidemiology of an outbreak of an emerging disease. Indian J Community Med. 2019;44(4):383–7. https://pubmed.ncbi.nlm.nih.gov/31802805

-- World Health Organization. Standard precautions for the prevention and control of infections: aide memoire. Geneva: WHO; 2022. Available from: https://www.who.int/publications/i/item/WHO-UHL-IHS-IPC-2022.1

-- Transmission-based precautions for the prevention and control of infections: aide memoire. Geneva: WHO; 2022. Available from: https://www.who.int/publications/i/item/WHO-UHL-IHS-IPC-2022.2

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON593

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#USA, #Wastewater Data for Avian #Influenza #H5 (#CDC, Jan. 30 '26)

 

{Excerpt}

Time Period: January 18, 2026 - January 24, 2026

-- H5 Detection: 4 site(s) (0.9%)

-- No Detection: 437 site(s) (99.1%)

-- No samples in last week: 204 site(s)

(...)

Source: 

Link: https://www.cdc.gov/nwss/rv/wwd-h5.html

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

 

A Dead swan found on lake shore in Federacija Bosna i Hercegovina.

Source: 

Link: https://wahis.woah.org/#/in-review/7244

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