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

 

By USFWS Mountain-Prairie - Canada goose on Seedskadee NWR, Public Domain, https://commons.wikimedia.org/w/index.php?curid=69188087

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A wild Canada Goose in Etelä-Suomen aluehallintovirasto Region.

Source: 

Link: https://wahis.woah.org/#/in-review/7384

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Dynamics and #control of highly pathogenic #H5 avian #influenza in a threatened #pelican population

 

Abstract

The ongoing epizootic of highly pathogenic avian influenza (HPAI) continues to cause massive deaths in wildlife. Fundamental understanding of its disease ecology in natural populations is urgently needed. This knowledge has been hindered by the difficulty of acquiring data on epidemic dynamics. Here, using data collected from a threatened population of Dalmatian pelicans (Pelecanus crispus), we recover the epidemiological and evolutionary history of one of the largest HPAI wildlife mortality events. The results show that this devastating outbreak was likely seeded by a single introduction associated with movement of the species. By estimating epidemiological features of two consecutive outbreaks in the same population, we show that panzootic H5N1 since 2022 likely exhibits higher transmissibility and longer shedding time in non-reservoir birds, compared to previous H5NX subtypes. We also evaluate effectiveness of past and future control measures: carcass removal during the outbreak is shown to have surprisingly little impact on mitigating the mortality; and current H5 vaccines relying on capture and injection to deliver cannot establish herd immunity in a wildlife population. The results provide the first field evidence supporting the hypothesis that viral fitness difference of H5N1 to previous H5NX subtypes is the key cause of the expanded epizootic and panzootic since 2022, and on highly debated HPAI management strategies in wildlife populations.

Competing Interest Statement

The authors have declared no competing interest.

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.03.16.712014v1

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Optimal Dose and #Safety of Intravenous #Favipiravir in Hospitalized Patients With #COVID19: A Dose-Escalating, Randomized Controlled Phase Ib Study

 

Abstract

AGILE (NCT04746183) is a Phase Ib/IIa platform, evaluating candidates to treat COVID-19. Candidate Specific Trial 6 evaluated the safety and optimal dose of a novel intravenous formulation of favipiravir in a dose-escalating, open-label, randomized, controlled, Bayesian adaptive Phase Ib trial. Hospitalized adults with PCR-confirmed SARS-CoV-2 infection, within 14 days of symptomatic COVID-19 were randomized 2:1 in groups of 6 (n = 4 favipiravir, n = 2 standard of care) to ascending doses of intravenous favipiravir twice daily (b.i.d.) for 7 days or standard of care. Clinical data, safety evaluations, virology and pharmacokinetic samples were collected. The primary outcome was safety. Secondary outcomes included clinical, pharmacokinetic and virological endpoints. Twenty-four participants enrolled between September 10, 2022 and November 1, 2023 [10/24 female; median age 74 years (range 52–93)]. Favipiravir was well tolerated despite a high background rate of unrelated adverse events. No dose limiting toxicities were observed, with a model-predicted dose limiting toxicity risk of 16.8% and probability of unacceptable toxicity of 2.7% at the highest dose level. No serious adverse events were deemed related to favipiravir but an expected association with asymptomatic, transient hyperuricemia was observed. Favipiravir exposures increased disproportionally to dose with significant accumulation in plasma, but with marked variability between participants within each cohort. This novel formulation of favipiravir was safe at sustained high doses that reached pre-specified pharmacokinetic targets in a study group with frailty and complex health profiles. We consider doses up to 2,400 mg b.i.d. to be safe for further evaluation.

Study Highlights

-- WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?

- Pre-clinical studies of favipiravir describe broad spectrum antiviral activity, positioning it as a therapeutic candidate for many RNA viruses. An oral formulation of favipiravir has been widely studied as a treatment for COVID-19 in clinical trials. Pharmacokinetic modeling suggests the doses used in many of these trials may not have reached effective plasma concentrations.

-- WHAT QUESTION DID THIS STUDY ADDRESS?

- Was a novel intravenous formulation of favipiravir safe and well tolerated in patients hospitalized with COVID-19? Were pre-specified pharmacokinetic parameters met at doses modeled to be effective for the treatment of COVID-19?

-- WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?

- We demonstrate that high doses of intravenous favipiravir are safe and well tolerated in a frail and co-morbid population who are likely to be eligible for antiviral treatment but are often excluded from early phase clinical trials. We characterize the pharmacokinetic profile of intravenous favipiravir at high doses and recommend an optimal dose to be used in future Phase II studies.

-- HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE?

- There is an ongoing unmet need for antivirals to effectively treat COVID-19; however, the significance of these safety and pharmacokinetic data go beyond COVID-19. High doses of favipiravir have a use case against RNA viruses with pandemic potential including viral hemorrhagic fevers and pandemic influenza. The intravenous formulation may be particularly relevant in severely unwell patients for whom oral dosing is not possible or in whom GI absorption is affected. The pharmacokinetic characterization from this study will be used to inform doses for use against a range of significant pathogens. Early phase clinical trials of IV favipiravir in Crimean-Congo Haemorrhagic Fever are ongoing.

Source: 

Link: https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.70261

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#RSV #infection induces heterologous #protection against #SARS-CoV-2 through γδ T cell-mediated trained #immunity and activation of SARS-CoV-2–reactive mucosal T cells

 

ABSTRACT

Respiratory viruses can infect hosts concurrently or sequentially, potentially influencing each other’s pathogenic trajectory. However, the underlying immune mechanisms governing these interactions remain poorly understood. In this study, we examined whether respiratory syncytial virus (RSV) infection modulates host susceptibility to subsequent SARS-CoV-2 infection using two murine models. We found that prior RSV infection conferred dose- and time-dependent heterologous protection against SARS-CoV-2. Transcriptomic and immunological analyses revealed that RSV activated lung antigen-presenting cells (APCs) and SARS-CoV-2–reactive mucosal T cells by day 9 post-infection, with responses waning by 1 month. RSV also promoted expansion of pulmonary γδ T cells and upregulation of their metabolic pathways. Notably, RSV-infected TCRδ⁻/⁻ mice, which lack γδ T cells, exhibited diminished SARS-CoV-2–reactive mucosal T cell responses, elevated viral loads, and exacerbated lung inflammation following SARS-CoV-2 challenge compared to wild-type controls. These findings suggest that RSV infection induces γδ T cell-mediated trained immunity and primes mucosal T cell responses, thereby providing heterologous protection against SARS-CoV-2.

Source: 

Link: https://journals.asm.org/doi/full/10.1128/jvi.01658-25?af=R

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#UK, Northern Ireland: PHA #statement - #meningitis (March 18 '26)

 

The Public Health Agency (PHA) is aware of a probable case of Bacterial Meningitis in a pupil who attends a secondary school in Belfast. 

All appropriate public health actions have been completed.

As a precaution, PHA has worked closely with the school and has issued information to parents and guardians. 

Relevant guidance has also been shared with GP Out-of-Hours services and Emergency Departments.  

All individuals identified as close contacts have been risk assessed and where appropriate, have received antibiotic prophylaxis. 

We urge students, staff and families to remain vigilant for the signs and symptoms of meningitis and act fast if they suspect they may have it.

Symptoms of meningitis develop suddenly and can include: 

- a high temperature (fever) over 37.5C (99.5F)

- being sick

- a headache

- a blotchy rash that doesn't fade when a glass is rolled over it (this won't always develop)

- a stiff neck

- a dislike of bright lights

- drowsiness or unresponsiveness

- seizures (fits) 

PHA will continue to monitor the situation and provide any further advice as required. 

PHA is aware of the meningitis incident in Kent and is participating in regular UK wide meetings in relation to this. To date there is no evidence of spread beyond the South East of England.

For more information, visit: Update on meningitis incident in Kent England | HSC Public Health Agency

Further information on meningitis can be found at www.pha.site/meningitis-nidirect 

Source: 

Link: https://www.publichealth.hscni.net/news/pha-statement-meningitis

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#Outbreak of invasive #meningococcal disease, SE #England - #Alert outlines recommended courses of action to manage cases with #infection and #contacts (#UKHSA, March 18 '26)

 

Invasive meningococcal disease: advice for the NHS in England

You may be aware of an evolving situation involving multiple cases of invasive meningococcal disease (IMD) reported among young people linked to the University of Kent and the Canterbury area. 

More information about IMD, signs and symptoms to look out for, and approaches to clinical and public health management are provided in the accompanying Briefing Note. 

The purpose of this CAS Alert is to outline priority steps that primary care and hospital clinicians should consider taking to manage suspected cases, potential contacts of cases, and to reduce the risk of infection spreading. 

Note that this is a rapidly evolving situation and we will update advice as further information emerges.

Epidemiology

-- Between 13 and 17 March 2026, UKHSA identified 20 cases of invasive meningococcal disease in the South East. 

-- Six cases have been confirmed as Neisseria meningitidis group B. 

-- Most cases are students from the University of Kent, Canterbury, and sixth form students from local secondary schools. 

-- At least 10 cases attended Club Chemistry in Canterbury on 5, 6 or 7 March 2026. 

-- The illness has been severe with rapid deterioration, and 2 deaths have occurred.

Management of cases

Infection prevention and control (IPC) and personal protective equipment (PPE)

-- For patients presenting with suspected meningococcal disease, standard infection prevention and control precautions should be followed in line with the National infection prevention and control manual for England (see Appendix 11). 

-- Use appropriate PPE (including Level 2 PPE where clinically indicated) for assessment and management of suspected IMD:

- clinical staff should apply standard respiratory hygiene and infection control measures in routine clinical settings

- wear a fluid resistant surgical facemask for routine care of patients with suspected invasive meningococcal disease

- wear an FFP3 mask or Hood for aerosol-generating procedures performed on patients with suspected invasive meningococcal disease

- continue transmission-based precautions until the patient has been established on antibiotics for at least 24 hours

- no additional or enhanced IPC measures are required beyond those recommended in national guidance

Immediate case management

-- Patients with IMD may present with septicaemia and/or meningitis. 

-- Meningococcal sepsis should be considered in a rapidly deteriorating patient with sepsis even in the absence of a non-blanching rash, which is usually a late sign. 

-- Clinicians should have a high index of suspicion where a young person aged 16 to 30 attends with consistent signs or symptoms.

-- In a community setting, rapid admission to hospital is the highest priority when IMD is suspected. Conveyance to hospital should not be delayed for procurement or administration of antibiotics.

-- In acute settings, patients with sepsis should be managed according to local sepsis guidelines and immediate clinical management should focus on stabilisation (including fluid resuscitation as appropriate) and early engagement with ITU colleagues where necessary.

-- Initial treatment recommendations are as follows (full treatment regimens will be commenced during hospital admission):

- Immediate single dose of IV/IM Ceftriaxone for suspected meningococcal infections (Ceftriaxone, Drugs, BNFC, NICE):

Age/weight / Dose

- adults - dose: 2g stat

- children with body weight 50kg and over or aged 9 years and older: dose 2g stat

- children up to 50kg body weight or aged under 9 years: dose 80 to 100 mg/kg (maximum per dose 4g)

Alternatively, immediate single dose of IV/IM Benzylpenicillin sodium for suspected meningococcal infections where it is not possible to administer Ceftriaxone (Benzylpenicillin sodium, Drugs, BNF, NICE):

Age / Dose

- adults and children aged 10 years or over: dose of 1.2g

- children aged 1 to 9 years: dose of 600mg

- children aged under 1 year: dose of 300mg

Information regarding clinical samples that should be taken for suspected IMD cases and referring meningococcal-positive clinical materials (including isolates, PCR-positive clinical samples and/or DNA extracts, and lysate extracted from Biofire loading syringes) to the National Meningococcal Reference Laboratory, is included in UKHSA national guidance.

Notifying UKHSA

-- All suspected cases of invasive meningococcal disease are statutorily notifiable by registered medical practitioners to the responsible UKHSA health protection team, without waiting for laboratory confirmation.

-- Notify UKHSA by contacting your health protection team.

Management of contacts

Informing contacts

-- Remind any presenting contacts of the signs and symptoms of meningococcal disease (meningitis and septicaemia) and the importance of seeking urgent medical attention if they have symptoms (even if prophylaxis has been taken). 

-- Early detection and treatment can save lives. 

-- The UKHSA South East Health Protection Team have provided warn and inform information to all cases and close contacts and are liaising closely with all educational and other community settings to provide advice.

Providing antibiotic chemoprophylaxis

-- Close contacts of confirmed or probable cases are being identified by UKHSA and require antibiotic prophylaxis. 

-- Timely chemoprophylaxis will prevent cases of disease and will save lives. 

-- Antibiotic prophylaxis should be given as soon as possible (ideally within 24 hours) after the diagnosis of the index case, regardless of vaccination status.

-- Eligibility is defined in national UKHSA and NICE CKS guidance.

-- This includes people who had the following forms of contact during the 7 days before onset of illness in the index case:

- people who have had prolonged close contact with the case in a household-type setting

- intimate kissing or equivalent close contact

- exposure to respiratory secretions (for example, mouth-to-mouth resuscitation)

- other close contacts identified through UKHSA risk assessment

-- In response to this outbreak, a wider group of contacts have been identified as requiring antibiotic prophylaxis on a precautionary basis:

- Students who live on the Canterbury campus at the University of Kent

- Staff who live or work in affected halls of residence blocks on the Canterbury campus at the University of Kent

- Staff members working at Club Chemistry nightclub, Canterbury, and anyone who attended the nightclub as visitors on 5, 6 or 7 of March 2026.

-- Local clinics are offering chemoprophylaxis to contacts in the Canterbury area. If an eligible close contact presents to a healthcare setting (primary or secondary care) and has not already received prophylaxis through UKHSA‑coordinated clinics, this should be prescribed for them.

-- As the outbreak evolves, further groups may be identified that require antibiotic prophylaxis and will be communicated with directly.

-- Where an eligible close contact presents and has not already received prophylaxis please prescribe this as per National guidance.

The first line treatment is ciprofloxacin: 

Ciprofloxacin dosage (for one dose) [note1]

-- All to be given as a single dose:

Age / Dose

- adults and children aged 12 years and over: 500 mg stat

- children aged 5 to 11 years: 250 mg stat

- children aged 1 to 4 years: 125 mg stat

- infants under 1 year [note 2]: 30 mg/kg to a maximum 125mg stat

Note 1. Ciprofloxacin suspension contains 250 mg/5ml.

Note 2. prescribed off-label. 

-- If ciprofloxacin is not suitable, alternatives are listed in the national guidance.

-- Where demand exceeds capacity, ICBs are responsible for ensuring timely access to post‑exposure prophylaxis and vaccination in line with NHS England commissioning guidance.

Advice concerning vaccination

-- Given the severity of the outbreak, and as an additional precautionary measure, a targeted vaccination programme will begin, starting with students that are residents of the Canterbury Campus Halls of Residence at the University of Kent who will be contacted directly. 

-- Precise details of eligibility will be confirmed by UKHSA. UKHSA will continue to assess ongoing risk to other populations and the programme may be extended.

Source: 

Link: https://www.gov.uk/guidance/outbreak-of-invasive-meningococcal-disease-south-east-england

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

{Bântéay Méanchey, Preah Netr Preah} On 12 March 2026, the outbreak investigation team visited a backyard chicken farm following reports of illness and mortality suspected to be caused by Avian Influenza (AI). During the visit, deaths of wild birds were also observed in the area. A total of six chicken samples were collected and submitted to NAHPRI/GDAHP for testing of Avian Influenza (H5N1). Laboratory results confirmed on 16 March 2026 that 4 out of 6 chicken samples tested positive for Avian Influenza (H5N1). In addition, 13 wild bird carcasses were collected and submitted for laboratory testing. On 16 March 2026, all wild bird samples were confirmed positive for Avian Influenza (H5N1).

{Bântéay Méanchey, Serei Saophoan} On 25 January 2026, the outbreak investigation team visited a backyard chicken farm following reports of illness and mortality suspected to be caused by Avian Influenza (AI). Two chicken samples were collected and submitted to NAHPRI/GDAHP for testing of AI (H5N1). On 26 January 2026, laboratory results confirmed that both samples tested positive for Avian Influenza (H5N1).

Source: 

Link: https://wahis.woah.org/#/in-review/7376

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Characterisation of Naturally Occurring #MERS-CoV #Spike #Mutations and Their Impact on #Fusion and Neutralisation

 

Abstract

In this study, the phenotypic consequences of naturally occurring single nucleotide polymorphisms (SNPs) in the Middle East respiratory syndrome coronavirus (MERS-CoV) Spike protein were investigated. The impact of Spike mutations on the syncytia formation and neutralisation of contemporary MERS-CoV strains is not currently well understood. Mutations were identified by aligning 584 MERS-CoV Spike sequences from either human clinical isolates collected between 2012 and 2024 or from a clinical isolate that had been passaged in human cells. Fifteen SNPs of interest occurring in the N-terminal domain (NTD), receptor binding domain (RBD) and adjacent to the S1/S2 cleavage site were selected for further characterisation based on their location in the Spike protein, frequency and identification in previous studies. A contemporary clade B, lineage 5 wildtype Spike sequence, obtained from a human MERS-CoV clinical isolate, was used as the backbone in this study. The mutations of interest were introduced to the wildtype backbone to generate Spike variants. Spike variants were characterised via cell–cell fusion assays, and a lentiviral pseudotyping system was used to investigate the impact of these Spike mutations on neutralisation. The I529T, E536K and L745F mutations were shown to increase fusion and syncytia formation. The L411F, T424I, L506F, L745F and T746K mutations were found to increase resistance to neutralisation by pooled patient sera. This study has identified novel naturally occurring Spike mutations that resulted in phenotypic differences in the syncytia formation and neutralisation of contemporary MERS-CoV strains. Continued investigation of the phenotypic consequences of MERS-CoV Spike mutations is essential for assessing the risk to public health, especially given the pandemic potential of this virus.

Source: 

Link: https://www.mdpi.com/1999-4915/18/3/377

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Limited durability of #improvements in #infection #prevention and control practices following reactive interventions leaves #healthcare facilities vulnerable to #Ebola virus transmission

 

Abstract

We assessed impact and durability of an infection prevention and control (IPC) bundle intervention during the Kivu/Ituri Ebolavirus outbreak (2018-2020). IPC scores increased initially, then declined 6 months post-intervention (median 19/36, 30/36, and 28/36, p<0.0001). Without sustained IPC practices, health facilities remain vulnerable to nosocomial transmission in future Ebolavirus outbreaks.

Source: 

Link: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciag192/8526630

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Empiric #azithromycin alters the upper respiratory #microbiome and #resistome without anti-inflammatory benefit in #COVID19

 

Abstract

Azithromycin is a widely used antibiotic and was frequently used to treat hospitalized patients during the COVID-19 pandemic. The impact of empiric azithromycin use on the respiratory microbiome in patients with viral respiratory infections is unclear. Here we used longitudinal metatranscriptomics on nasal swabs from a prospective multicentre cohort of 1,164 patients hospitalized for COVID-19. We compared the upper respiratory microbiome, resistome and systemic immune response in patients treated with azithromycin (n = 366) with those who received no antibiotics (n = 474) or other antibiotics (n = 324). We found that azithromycin altered microbiome composition and increased the expression and relative proportion of macrolide/lincosamide/streptogramin (MLS) resistance genes. These changes occurred after 1 day of exposure and persisted for over a week. MLS resistance gene expression was associated with commensals and potential pathogens, while there were no differences in host inflammatory gene expression in blood and airways. This demonstrates that empiric azithromycin treatment impacts the upper respiratory microbiome and resistome without apparent anti-inflammatory benefit.

Source: 

Link: https://www.nature.com/articles/s41564-026-02285-8

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Identification of #thermostability-enhancing #mutations in #H9N2 avian #influenza virus hemagglutinin

 

ABSTRACT

H9N2 avian influenza viruses (AIVs) remain a significant economic burden on poultry production and a persistent zoonotic threat. Hemagglutinin (HA), a surface glycoprotein mediating viral entry and pathogenesis, critically depends on thermostability for its function. Our previous study indicated that recent H9N2 AIVs have experienced a reduction in hemagglutination activity and exhibit low HA thermostability; however, the underlying molecular determinants for this instability remain poorly defined. To address this gap, we employed an in vitro-directed evolution approach to identify HA mutations that enhance thermostability. By subjecting a diverse HA mutant library to iterative heat selection at 48°C, we isolated several HA-stabilizing mutations, including L29I, N133S, N210D, G266R, D387N, A423T, and E509G, and confirmed their effect by site-directed mutagenesis. Further characterization revealed a complex interplay between HA stability, receptor binding specificity, and acid tolerance. Our findings demonstrate that enhancing HA stability can exert pleiotropic effects on key viral properties, highlighting the importance of understanding these relationships for developing effective mitigation strategies against H9N2 AIVs.

Source: 

Link: https://journals.asm.org/doi/full/10.1128/jvi.00168-26?af=R

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#Cambodia: one new #human #infection with avian #influenza virus #H5N1 (HK CHP, March 17 '26)

{Excerpts}

Avian Influenza Report - VOLUME 22, NUMBER 11 - Reporting period: March 8, 2026 – March 14, 2026 (Week 11) (Published on March 17, 2026) 

(...)

-- Date of report: 14/03/2026

-- Country: Cambodia

-- Province / Region District / City: Banteay Meanchey province, Preah Netr, Preah district

-- Sex: Female

-- Age: 45

-- Condition at time of reporting: Hospitalised

-- Subtype of virus: H5N1 

(...)

Source: 

Link: https://www.chp.gov.hk/files/pdf/2026_avian_influenza_report_vol22_wk11.pdf

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#OneHealth Longitudinal Study #Protocol on #Zoonotic and Vector-Borne #Diseases in Battambang province, #Cambodia: An Inter-Sectoral Approach

 

Abstract

Background 

Tropical low – and middle –income countries are highly vulnerable to zoonoses and vector-borne diseases, with risks amplified by climatic events, environmental change, and limited surveillance capacity. Cambodia is particularly exposed due to its ecological diversity, seasonal flooding, and rapidly changing land use. Globally, however, field based One Health approaches remain under –implemented, limiting practical evidence on how to address these complex threats. 

Methods 

This protocol describes a longitudinal One Health study conducted in three villages of Battambang province, Cambodia, designed to investigate the prevalence and transmission dynamics of zoonotic and potentially zoonotic pathogens at the human –animal –environment interface. The study examines how vector density, diversity, and pathogen circulation are influenced by hydrological variation and seasonality, and assesses the sociodemographic, behavioral, and environmental factors shaping transmission. Integrated data will be collected through serological and molecular analyses in humans and animals, environmental sampling, and entomological surveillance, enabling cross-compartmental and spatiotemporal analyses. 

Expected Results 

The study will generate integrated, cross –sectoral data to characterize pathogen exposure patterns, identify high –risk populations and practices, and inform targeted public health, veterinary, and environmental interventions. Conclusions By sharing this protocol, the work addresses a global methodological gap in operationalizing One Health in the field and supports the development of integrated surveillance strategies in climate-sensitive, resource-limited settings.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The study received funding from the French Development Agency (AFD) through the PREACT-AFRICAM Program and from the Fondation Simone et Cino del Duca of Institut de France.

Source: 

Link: https://www.medrxiv.org/content/10.64898/2026.03.14.26347916v1

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Developing and #Benchmarking #OneHealth Genomic #Surveillance #Tools for #Influenza A Virus in #Wastewater

 

Abstract

Influenza A viruses (IAV) remain a persistent One Health threat, and whole-genome sequencing from wastewater offers a promising surveillance tool. However, IAV is at low abundance in wastewater, making it difficult to sequence. We benchmarked four targeted enrichment methods suited for whole-genome sequencing including custom and off-the-shelf amplicon and probe-based methods. Our custom HA tiled-amplicon panel was sensitive, fast, and cost-effective, making it suitable for monitoring low-abundance seasonal variants of known subtypes. However, its reliance on conserved and intact primer-binding sites limited primer design to fewer subtypes. A previously published universal amplicon method targeted all IAV subtypes, but it performed poorly in wastewater due to its reliance on intact genome segments. Probe-capture methods were resilient to RNA degradation and mismatches, potentially enabling broader surveillance and detection of emerging strains. However, probes were costly, labor-intensive, and less sensitive than tiled-amplicon. When testing compatibility of sequencing methods with upstream virus concentration and extraction methods, ultrafiltration-based virus concentration outperformed large-volume direct extraction with all four sequencing methods. This set of benchmarking comparisons and custom panels provides needed information for the translation of IAV genomic sequencing into a routine component of wastewater surveillance.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

University of California, Berkeley, L22CR4507

NIH Common Fund, 4R00GM144747-03

Source: 

Link: https://www.biorxiv.org/content/10.1101/2025.09.19.676942v2

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#UK, #England: Cases of invasive #meningococcal #disease notified in #Kent (UKHSA, March 16 '26)

 

From: UK Health Security Agency

Published: 16 March 2026

Last updated: 16 March 2026 

Update 16 March

The UK Health Security Agency (UKHSA) is continuing to investigate an outbreak of meningococcal disease in Kent with 13 cases notified since 13 March. Sadly, this includes 2 people who are known to have died.

Investigations have confirmed some of the cases visited Club Chemistry in Canterbury between 5 to 7 March prior to becoming unwell. UKHSA’s health protection team is working closely with the nightclub and partners including the University of Kent to limit the spread.

UKHSA is now advising anyone who visited Club Chemistry on 5 March, 6 March or 7 March to come forward for preventative antibiotic treatment as a precautionary measure. 

This can be collected from the following sites:

-- Senate Building at University of Kent, CT2 7NZ – open until 8pm on Monday 16 March (queue closes 7.15pm) and from 9am to 8pm on Tuesday 17 March.

-- Gate Clinic, Kent and Canterbury Hospital, Ethelbert Road, Canterbury, CT1 3NG - open until 8pm on Monday 16 March and planned to open from 8.30am to 7.30pm on Tuesday 17 March.

-- Westgate Hall, Westgate Hall Road, Canterbury, Kent, CT1 2BT. Planned to be open from 8.30am to 7.30pm on Tuesday 17 March.

-- Carey Building, Thanet Hub, Margate Northwood Rd, Westwood, Broadstairs, CT10 2WA. Planned to be open from 8.30am to 7.30 pm on Tuesday 17 March.

Advice has been issued to 16,000 staff and students at the University of Kent, where antibiotics are also being offered to those who need them.

Meningococcal disease can progress rapidly. Signs and symptoms of meningococcal meningitis and septicaemia can include:

- a fever, 

- headache, 

- rapid breathing, 

- drowsiness, 

- shivering, 

- vomiting, and 

- cold hands and feet. 

Septicaemia can also cause a characteristic rash that does not fade when pressed with a glass.

Early symptoms can often be confused with other illnesses such as a cold, flu or hangover, and students are particularly at risk of missing the early warning signs. If you or anyone you know develops any of these symptoms, seek medical help immediately by contacting a GP, calling NHS 111 or dialling 999 in an emergency. Knowing the signs and taking early treatment can be lifesaving.

Trish Mannes, UKHSA Regional Deputy Director for the South East, said:

''Our thoughts remain with the friends and family involved and we understand that many people in the university and wider community will be affected by this sad news.

''Our investigations have identified that some cases visited Club Chemistry in Canterbury and it is important that anyone who visited the club between 5 and 7 March now comes forward for preventative antibiotic treatment as a precaution, as well as those offered antibiotics at the university – these students are being contacted directly through the university.

''If you think you may have symptoms of meningitis, do not hesitate to seek medical help by contacting your GP or calling NHS 111.

Background

Meningococcal disease (meningitis and septicaemia) is an uncommon but serious disease caused by meningococcal bacteria. Very occasionally, the meningococcal bacteria can cause serious illness, (inflammation of the lining of the brain) and septicaemia (blood poisoning), which can rapidly lead to sepsis.

The onset of illness is often sudden and early diagnosis and treatment with antibiotics are vital.

Early symptoms, which may not always be present, include:

- a rash that doesn’t fade when pressed with a glass

- sudden onset of high fever

- severe and worsening headache

- stiff neck

- vomiting and diarrhoea

- joint and muscle pain

- dislike of bright lights

- very cold hands and feet

- seizures

- confusion/delirium

- extreme sleepiness/difficulty waking

Young people going on to university or college for the first time are particularly at risk of meningitis because they newly mix with so many other students, some of whom are unknowingly carrying the bacteria at the back of their nose and throat.

There are numerous strains of the meningococcal infection. The MenACWY vaccination gives good protection against MenA, MenC, MenW, and MenY. It is routinely offered to teenagers in school Years 9 and 10. However, this vaccine does not protect against all forms of meningococcal infection. Other strains such as MenB can circulate in young adults, which is why it’s important to know how to spot the symptoms of meningitis and septicaemia as early detection and treatment can save lives. 

Source: 

Link: https://www.gov.uk/government/news/cases-of-invasive-meningococcal-disease-confirmed-in-kent

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#Epidemiology of #HMPV and Other Respiratory Viral #Infections Among #Outpatients, 2016–2022

 

Abstract

Background

Most studies of human metapneumovirus (HMPV) epidemiology have been among inpatients. This study examined the epidemiology of HMPV compared with other common viruses among outpatients seeking care for an acute respiratory illness (ARI) during 5 influenza seasons (2016–2017 to 2019–2020, before the coronavirus disease 2019 pandemic, and in 2021–2022, during the pandemic).

Methods

Outpatients ≥6 months old seeking care for ARI and presenting with cough of ≤7 days’ duration provided nasal and pharyngeal swab samples, demographic data, and access to electronic medical record data. Samples were tested with reverse-transcription polymerase chain reaction assays for HMPV, influenza, parainfluenza virus (PIV) 1–4, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Student′s t and χ2 tests were used to compare HMPV cases with other ARIs.

Results

After exclusion of 68 coinfections, 7143 patients remained; 2017 had influenza, 762 had RSV, 423 had HMPV, 83 had PIV, 352 had SARS-CoV-2, and 3506 tested polymerase chain reaction negative for all of these viruses. Of all patients with ARI each influenza season, 30.2%–37.1% tested positive for influenza, 11.3%–13.6% for RSV, 4.7%–7.3% for HMPV, and 0.1%–1.9% for PIV. Compared with patients with RSV, those with HMPV less often had congestion, dyspnea, and sore throat. Compared with patients with influenza, those with HMPV were less likely to have fever but more often had congestion or dyspnea and felt worse at 7–14-day follow-up. Children recovered from HMPV faster than adults.

Conclusions

HMPV is an important cause of outpatient ARI during influenza season. Patients with HMPV had slightly different demographic characteristics and symptoms from those with other ARIs.

Source: 

Link: https://academic.oup.com/ofid/article/13/3/ofag081/8490265

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#Culicoides (Diptera: Ceratopogonidae) in Extra-Amazonian #Oropouche #Outbreak Areas of Minas Gerais, #Brazil: #Ecological Insights into Virus Transmission

 

Abstract

Oropouche fever (OF), caused by Oropouche virus (OROV), has expanded beyond its Amazonian range into Minas Gerais (MG), Brazil, raising concern about transmission in extra-Amazonian Atlantic Forest landscapes. Critical gaps persist regarding Culicoides vector communities, anthropophily, and climate-sensitive transmission risk in these newly affected regions. We conducted targeted entomological surveys outbreak-driven by human OF cases, standardized across five MG communities using CDC light traps and Protected Human Attraction (PHA) to characterize Culicoides composition. Females of Culicoides underwent RT-qPCR for OROV (n = 819) and physiological assessment (n = 312). We developed an entomological alert framework that integrates blood-fed abundance, minimum infection rate (MIR) upper confidence bounds, and environmental drivers (i.e., mean temperature, relative humidity and precipitation) via generalized additive mixed models, which explained 68% of the variability in Culicoides abundance and the alert index across communities. We collected 1171 Culicoides individuals representing five species (C. leopoldoi, C. paraensis, C. pusillus, C. foxi, and C. limai). C. leopoldoi (79.1%) and C. paraensis (20.3%) were the predominant species; notably, C. paraensis is recognized as the primary vector of OROV in the Americas. C. paraensis was documented for the first time in all five outbreak areas and dominated PHA captures (90%), suggesting anthropophily. Although no specimens tested OROV-positive (consistent with expected field infection rates of 0.01–1%), MIR upper bounds reached 132/1000 in low-sample settings and humidity and temperature strongly modulated abundance. This operational baseline and alert index transform virologically negative, sparse surveillance data into prioritized targets for intensified sampling and vector control during early, low-prevalence phases, when containment of OROV’s extra-Amazonian spread is still achievable.

Source: 

Link: https://www.mdpi.com/1999-4915/18/3/361

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#Cambodia reported one additional #human case of #infection with #H5N1 avian #influenza virus (MoH, March 16 2026)

 

{Automatic translation, edited}

Kingdom of Cambodia - Press Release

A Case of Bird Flu in a 45-year-old Woman

The Ministry of Health of the Kingdom of Cambodia would like to inform the public that there is 1 case of bird flu in a 45-year-old woman who was confirmed to be positive for the H5N1 avian influenza virus on March 14, 2026 by the National Institute of Public Health.

The patient resides in Ropai village, Chinu Meanchey commune, Preah Net Preah district, Banteay Meanchey province, and there were reports of sick and dead chickens in the village. 

On the same day, the patient was placed in isolation at the hospital and was treated with Tamiflu and received careful care from the medical team. 

Upon inquiry, it was revealed that the patient raised chickens and ducks, including some sick and dead chickens. 3 days before testing positive, she had come into contact with the dead chicken.

The National and Sub-National Health Ministry's Emergency Response Team has been collaborating with the Provincial Department of Agriculture and local authorities at all levels to actively investigate the outbreak of bird flu and respond according to technical methods and protocols, find sources of infection in both animals and humans, and search for suspected cases and contacts to prevent further transmission in the community. 

In addition, Tamiflu is being distributed to close contacts and conduct health education campaigns in the villages where the outbreak occurred. 

The Ministry of Health would like to remind all citizens to always be vigilant about bird flu because H5N1 bird flu continues to threaten the health of our citizens. 

We would also like to inform you that if you have a fever, cough, sputum, or difficulty breathing and have been in contact with sick or dead chickens in the 14 days before the onset of symptoms, do not go to crowded places or towns and seek consultation and treatment at the nearest health center or hospital immediately to avoid delaying and putting you at high risk of eventual death. 

-- How it is transmitted: 

- H5N1 bird flu is a type of flu that is usually spread from sick birds to other birds, but it can sometimes be spread from birds to humans through close contact with sick or dead birds.

- Bird flu in humans is a serious illness that requires prompt hospital treatment.

- Although it is not easily transmitted from person to person, if it mutates, it can be contagious, just like seasonal flu.

- Do not touch or eat sick or dead chickens and wear gloves and a mask or a scarf to cover your nose before handling chickens and ducks for cooking. Then blanch them in boiling water before plucking.

- Follow good hygiene practices, wash your hands frequently before handling food, especially after touching poultry or other objects that may be sources of contamination.

- Cook food thoroughly before eating, especially meat, poultry and eggs. Do not eat raw or undercooked eggs and keep raw and cooked food separate. Clean cooking utensils properly.

- If there are many sick or dead chickens at home or in the village and there are symptoms of fever, cough, sputum discharge or difficulty breathing, please immediately seek consultation and medical examination at the nearest health center or hospital to avoid delay, which puts you at high risk of sudden death. 

- Therefore, the public is requested to be aware and take care of their health in the above preventive measures. 

The Ministry of Health will continue to provide information regarding public health issues on the official social media of the Ministry of Health www.moh.gov.kh as well as the official Facebook page of the Department of Communicable Disease Control and the website www.cdcmoh.gov.kh. For more information, please contact the Ministry of Health's hotline number 115 toll-free.

Source: Ministry of Health of Cambodia, https://moh.gov.kh/en/home

Link: https://moh.gov.kh/en/notice/detail/453

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A Tale of Two Lenses: #Emergency department indoor - #air hybrid-capture #metagenomics complements #wastewater by adding a human-focused respiratory #virus perspective

 

Abstract

Background: 

Continuous, non-invasive viral surveillance is essential to monitor emerging pathogens and guide public health responses. Most environmental surveillance studies use targeted qPCR approaches, and comparisons between wastewater and indoor air surveillance remain limited. We aimed to compare the utility of emergency department indoor air and urban wastewater for tracking circulating viruses and resolving genomic information. 

Methods: 

We conducted a matched-pair study comparing 19 weekly indoor air samples from the central ventilation exhaust shaft of an emergency department and 19 24-hour composite municipal wastewater samples in Leuven, Belgium, from December 2024 to April 2025. Both sample sets were processed using probe-based hybrid-capture viral metagenomics targeting over 3000 viral species, using influenza A as a clinically relevant test case. 

Findings: 

Wastewater captured higher overall viral diversity (233 versus 106 species) and more complete genomes compared to indoor air, showing a relatively stable composition, mainly of enteric and animal-associated viruses. Indoor air demonstrated lower overall diversity but was enriched for respiratory viruses, including influenza A, coronaviruses, metapneumovirus, and respiratory syncytial virus, and more frequently achieved high genome coverage for these pathogens. Although both sample types permitted influenza A subtype characterization, influenza A genomes from wastewater were often less well covered. When coverage thresholds were met, indoor air supported targeted antiviral resistance-site screening for influenza A and RSV-A. 

Interpretation: 

Wastewater and indoor air generate distinct but complementary viromes. Wastewater acts as a diverse, population-level monitor for One-Health applications, whereas indoor air serves as a targeted, human-centric sentinel system facilitating further genomic characterization for respiratory viruses.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

Mustafa Karatas is supported by a Research Foundation Flanders (FWO) fundamental research scholarship (number: 11P7I24N). C.G., L.C., E.H., S.G. and E.A. acknowledge support from the DURABLE project. The DURABLE project has been funded by the European Union, under the EU4Health Programme (EU4H), project no. 101102733. Views and opinions expressed are however those of the authors only and do not necessarily reflect those of the European Union or the European Health and Digital Executive Agency. Neither the European Union nor the granting authority can be held responsible for them. The computing power in this work was provided by the VSC (Flemish Supercomputer Centre), financed by the FWO and the Flemish government department EWI.

Source: MedRxIV, https://www.medrxiv.org/

Link: https://www.medrxiv.org/content/10.64898/2026.03.13.26348311v1

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Middle east respiratory syndrome coronavirus (#MERS-CoV): An underestimated #betacoronavirus with #pandemic potential

 

Highlights

• MERS-CoV remains an endemic camel-associated betacoronavirus with ongoing zoonotic spillover.

• Viral evolution shows three major clades with lineage B predominance and documented recombination.

• DPP4-mediated entry, immune suppression, and T-cell apoptosis drive severe disease and high fatality.

• Diagnosis relies primarily on rRT-PCR, while treatments and vaccines remain experimental.

• Strengthened One-Health surveillance, IPC, and genomic monitoring are essential for pandemic preparedness.

Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) is a zoonotic beta coronavirus identified in 2012 that circulates in dromedary camels and occasionally infects humans. Although community spread is limited, the disease shows a high case fatality rate near 36 percent and has caused hospital outbreaks such as the 2015 South Korea event. The viral spike binds the DPP4 (CD26) receptor, enabling entry into airway epithelial and selected immune cells, while accessory proteins suppress early innate immunity. Genetic studies indicate continuing evolution with clades A, B, and C across the Arabian Peninsula and Africa. Human infection is linked to camel contact, farm exposure, or raw camel products, with secondary spread mainly in healthcare settings. Diagnosis uses rRT-PCR and serology; treatment is supportive, and vaccines and antivirals are under study. A One Health approach is vital for surveillance, early detection, and control.

Source: Diagnostic Microbiology and Infectious Disease, https://www.sciencedirect.com/journal/diagnostic-microbiology-and-infectious-disease

Link: https://doi.org/10.1016/j.diagmicrobio.2026.117367

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