This issue includes confirmation of H5N1 in swine in Oregon, a serosurvey showing more widespread H5N1 in farm workers, a fatal Lassa Fever case in Iowa, the WHO’s new list of top endemic pathogens for which vaccines are needed, and what another Trump administration could mean for the CDC and global health security.
FEATURED
Bird Flu Found in Pigs in U.S. for the First Time, Raising Concerns About Potential Risks to Humans
State health officials in Oregon announced on Oct. 30 the first confirmed incidence of H5N1 bird flu virus identified in a pig in the United States. A second pig was later confirmed to be positive. The pigs were two of five on a backyard farm in Crook County in south-central Oregon that was experiencing an H5N1 outbreak in poultry. Pigs can become coinfected with bird and human viruses, allowing genes to swap to form a new, more dangerous virus that can more easily infect humans. This phenomenon, called reassortment, is what gave rise to the 2009 H1N1 pandemic. STAT, Washington Post, CIDRAP, USDA APHIS
CDC Calls for Expanded Testing for Bird Flu After Blood Tests Reveal More Farmworker Infections
Federal health officials on today called for more testing of employees on farms with bird flu after a new study showed that some dairy workers had signs of infection, even when they didn’t report feeling sick. The new guidance comes after blood tests for 115 farmworkers in Michigan and Colorado showed that eight workers — or 7% — had antibodies that indicated previous infection. The CDC study provides the largest window to date into how the bird virus first detected in March in dairy cows may be spreading to people. AP, CIDRAP, STAT
Iowa Reports Fatal Lassa Fever Case in a Traveler
On 28 October, health officials in Iowa reported the death of a middle-aged eastern Iowa resident from Lassa fever, a rare viral hemorrhagic fever that can be transmitted among humans through infected body fluids. The individual had recently traveled to West Africa, where they are thought to have contracted the virus. Initial testing was conducted at the Nebraska Public Health Laboratory, and confirmation testing is under way at the CDC. CDC, CIDRAP, STAT
WHO Study Lists Top Endemic Pathogens for Which New Vaccines are Urgently Needed
A new study published in eBioMedicine names 17 pathogens that regularly cause diseases in communities as top priorities for new vaccine development. The WHO study is the first global effort to systematically prioritize endemic pathogens based on criteria that included regional disease burden, antimicrobial resistance risk and socioeconomic impact. World Health Organizations
What Trump Winning the Election Could Mean for the CDC
Republican House appropriators want to slash the public health agency’s budget by about 20 percent and eliminate two dozen programs they consider “duplicative and controversial,” including initiatives to study the public health impact of climate change. “He’ll go down the path that he started, which is to fully politicize the C.D.C.,” said Lawrence Gostin, the director of the W.H.O. Collaborating Center on Global Health Law, referring to a second Trump administration. A diminished role for the National Institutes of Health seems likely, as well. Washington Post, New York Times
Russia Expands Labs at Sergiev Posad-6
The construction of new labs at the site is being closely watched by U.S. intelligence agencies and bioweapons experts amid worries about Moscow’s intentions as the Ukraine conflict grinds through its third year. The Russian site has a notorious Cold War past: It had once been a major research center for biological weapons, with a history of experiments with the viruses that cause smallpox, Ebola and hemorrhagic fevers. While expanding and improving containment labs and capacity to deal with health threats following a global pandemic mirrors similar efforts in other nations, Russia’s lack of transparency on select agent work, rhetoric on “US-supported bioweapons labs in Ukraine”, and recent violations of humanitarian norms regarding chemical weapons use underpin Western concerns. Washington Post
POLICY + GOVERNMENT
The Pandemic Agreement Fractures in the Latest Negotiations
WHO Member States are back together at the twelfth meeting of the Intergovernmental Negotiation Body (INB) (Nov. 4-15) to make progress on a pandemic agreement. The draft text currently reflects that WHO member states still have not reached consensus on many provisions of the Pandemic Agreement, including on the definitions of important terms and concepts. Most of the commitments on which negotiators have reached common ground are not transformative. On issues many countries have considered critical, such as pathogen access and benefit sharing, member states reached a stalemate again and proposed having the parties to the treaty negotiate solutions at a later date. With efforts to make this a make-or-break moment for important and contentious priorities, negotiators will be evaluating their progress on Friday (Nov. 8) to reach a decision on Monday as to whether a World Health Assembly could be called in December to finalize the agreement. Think Global Health, Pandemic Action Network
Global Health Policy Under Another Trump Administration
President-Elect Trump will likely pull U.S. diplomats out of any Pandemic Agreement negotiations and may quit the WHO altogether, as he moved to do when he was president in 2020. The U.S. provides about a quarter of the WHO’s core annual budget and often gives more. The U.S. is also the principal funder — to the tune of millions of dollars — of other U.N. agencies and global campaigns to combat disease, such as the World Bank-hosted Pandemic Fund; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and Gavi: The Vaccine Alliance. Trump, especially if paired with a Republican Congress, will seek to hold flat or reduce those levels, public health advocates expect. Politico
North American Preparedness for Animal and Human Pandemics Initiative
North American Plan for Animal and Pandemic Influenza (NAPAPI) is a long-standing trilateral collaboration framework among Canada, Mexico, and the United States first launched in 2007 to prepare for human and avian influenza viruses with pandemic potential. This framework supports a renewed opportunity for complementary trilateral collaboration and supports a vision for North America’s joint ability to prevent and mitigate, prepare for, respond to, and recover from pandemics and events that pose a threat to its health security. Government of Canada
U.K. Budget Preserves Science
Despite fears that science funding would face a £1 billion shortfall in the new U.K. government’s first national budget, the Labour government announced last week it would uphold pledges by its predecessor, allocating £20.4 billion for R&D over the next year. In 2020, the Conservative government promised to increase R&D funding from £13 billion to £22 billion by this year, a figure later reduced to £20 billion. Science
MEDICAL COUNTERMEASURES
Ebola Vaccine Dashboard
The WHO International Coordinating Group (ICG) on Vaccine Provision manages the global stockpile of Ebola vaccine doses. The stockpile, which is the first of its kind for Ebola vaccines, allows the WHO, countries and other partners to contain future Ebola outbreaks by ensuring equitable and timely access to vaccines for populations most at risk during outbreaks. The Ebola Vaccine Dashboard encompasses the past 4 years of vaccine distribution, and details preventive vaccination campaigns in the DRC in 2024 to utilize doses with a short shelf-life, as well as for research purposes (DRC and Rwanda). World Health Organization
A Monoclonal Antibody Shows Strong Protection Against Ricin Poisoning
Although a vaccine for preventing ricin poisoning (RiVax™) is in clinical development, there are currently no commercially available prophylaxis or treatments for ricin intoxication. These findings offer promising results for the clinical development of a therapeutic candidate against ricin intoxication and may also pave the way for novel vaccination strategies against ricin or other toxins. Toxins
Antibodies Targeting the Crimean-Congo Hemorrhagic Fever Virus Nucleoprotein
Further research on a self-replicating, alphavirus-based RNA vaccine that expresses the CCHFV nucleoprotein and is protective against lethal CCHFV disease in mice. The research expands our understanding of the antiviral function of TRIM21 against enveloped viruses and suggests that humoral immunity against the CCHFV NP, rather than just a diagnostic marker of infection, may be a key protective host response. The protective efficacy of passive transfer of immune sera demonstrates that anti-NP antibodies may be viable therapeutics for CCHFV. Nature Communications
BioFactura Receives $7.8 Million for its Smallpox Biodefense Therapeutic
BARDA exercised contract options totaling $7.8 million as part of BioFactura’s prime contract valued at up to $78 million for the advanced development of a Smallpox Biodefense Therapeutic. This monoclonal antibody cocktail has the potential to augment current medical countermeasures and guard against potential resistance. BioHealth Innovation
Investigations of Thiosemicarbazides as Botulinum Toxin Active-Site Inhibitors
The etiology behind BoNT/A is its action as a zinc-dependent protease, which can cause extended paralysis through the cleavage of SNARE proteins. Thiosemicarbazones, known zinc chelators, provide a privileged scaffold that can be leveraged for the development of BoNT/A LC inhibitors. ACS Infectious Diseases
Africa CDC Launches Trial of Smallpox Drug for Mpox
The Africa Centres for Disease Control and Prevention (CDC) announced the launch of a trial of the antiviral smallpox drug brincidofovir for the treatment of mpox. The trial will be conducted in the Democratic Republic of the Congo in partnership with Emergent BioSolutions. CIDRAP
Testing the Efficacy of Carbapenem and Cephalosporin Treatments for Anthrax
Findings in a rabbit model support the CDC recommendation of using a combination of doxycycline and meropenem for systemic patients with or without indications of CNS infection. Cefazolin was found to be a decent choice for PEP or early-stage systemic disease but the authors recommend considering using this antibiotic only if all other options are not available. Pathogens
BIOSECURITY + BIOPREPAREDNESS
Reducing Potential Dual-Use Risks in Synthetic Biology Laboratory Research: A Dynamic Model of Analysis
Analysis reveals a significant impact of the safety atmosphere (including frequency of refresher safety training) on both error rate and safety awareness within the laboratory, while effective storage of hazardous chemicals outstandingly enhances infrastructure safety. In addition, different attitudes toward risk highlight the necessity for specific management protocols. Humanities and Social Sciences Communications
Robust Biosecurity Measures Should Be Standardized at Scientific Cloud Labs
Currently, there is a lack of data regarding cloud lab operations, their workflows, or their number and types of customers. In addition, there are no standardized approaches for customer screening that are public and shared between different cloud lab organizations. Synthesis screening can provide effective mitigation against potential misuse, however, it should be treated as one tool in a broader arsenal. The security concerns raised by cloud labs go beyond just the end products, and include equipment, how research becomes centralized, and natural language inputs. More direct guidance specifically designed for cloud labs, and autonomous science in general, is warranted. RAND
Charles River Shipments of Research Monkeys to Canada Spark a Probe
A charter company working for Charles River Laboratories, one of the largest U.S. clinical research organizations, was recently fined by Canadian authorities for improperly shipping long-tailed macaques into the country, and the flights have now prompted a probe by officials who oversee an international treaty governing endangered species. STAT
IV Solution Production Resuming in North Carolina
Baxter has restarted manufacturing some of their IV solutions at North Cove, North Carolina facility following Hurricane Helene. The site was significantly impacted by the rain and storm surge from the hurricane. Specifically, Baxter has restarted the highest-throughput IV solutions manufacturing line. At its peak operation (prior to the hurricane), this line represented approximately 25% of the site’s total production and approximately 50% of the site’s production of one-liter IV solutions, the most commonly used size by hospitals and clinics. Assessment and repair of equipment with phased testing continues to progress across all other production lines. HHS, Baxter
Exercise on Functionality of National Public Health Emergency Operations Centers in the African Region
To test the functionality of public health emergency operations centers (PHEOCs) in WHO African Region member states, a regional functional exercise simulating an Ebola virus disease outbreak was conducted. Health Security
Bioterrorism Disaster Preparedness Among EMS in Saudi Arabia
EMS workers were found to have moderate disaster knowledge, skills, and preparedness levels. The study findings revealed a significant positive correlation between disaster preparedness levels and age, years of experience, education level, and the facility worked in. EMS workers surveyed generally reported a high level of involvement in regular disaster drills and a strong interest in further disaster education opportunities. Disaster Medicine and Public Health Preparedness
The Importance of a Culture-Centered Approach to Risk and Crisis Communication for Laboratory Research on Zoonotic Diseases
Continuing laboratory research into zoonotic diseases is necessary for public health preparedness. However, the COVID-19 pandemic has elevated existing concerns about the risks BSL-4 research facilities can pose to the surrounding community. This study places such concerns in the context of previous research regarding the construction of biosafety labs, as well as policy discussions related to other scientific controversies like gain of function research. Disaster Medicine and Public Health Preparedness
Preparing Acute Care Facilities Infrastructure for High-Consequence Infectious Diseases
Patients with suspected or confirmed high-consequence infectious diseases (HCIDs) may present for care at any acute care facility. This paper presents consensus statements on factors such as patient room space, doors and windows, air handling, and waste management. Health Security
Pandemic Lessons From Hong Kong
As one of the few metropolises that were at the forefront of both the severe acute respiratory syndrome (SARS) and coronavirus diseases 2019 (COVID-19), two of the most devastating global infectious disease outbreaks in recent decades, Hong Kong has a relatively rich reservoir of hard-earned hands-on experience and know-how in fighting pandemics. Disaster Medicine and Public Health Preparedness
SELECT AGENTS + PRIORITY PATHOGENS
As of today, Rwanda has recorded 66 illnesses and 15 deaths from Marburg, with 51 recovered cases. There are no active cases identified currently. CDC is working with international partners to obtain the latest case counts and will update this page every Monday, Wednesday, and Friday. The Rwanda Ministry of Health maintains a webpage with case counts for this outbreak. Rwanda Biomedical Centre
An ‘Unprecedented’ Good News Story About a Deadly Viral Outbreak
No new cases of Marburg virus disease have been reported in Rwanda since 30 October 2024. “We are at a case fatality rate of 22.7% — probably among the lowest ever recorded [for a Marburg outbreak],” said Dr. Yvan Butera, the Rwandan Minister of State for Health. Two of the Marburg patients, who experienced multiple organ failure and were put on life support, have now been extubated and have recovered from the virus. “We believe this is the first time patients with Marburg virus have been extubated in Africa,” says Tedros Adhanom Ghebreyesus, director general of the World Health Organization. “These patients would have died in previous outbreaks.” NPR
Ebola and Marburg Information for Researchers
NIAID is conducting and supporting research to find new and improved ways to diagnose, treat, and prevent Ebola and Marburg infections. Through the Resources for Researchers hub , the Ebola and Marburg scientific community can learn about NIAID funding opportunities, programs, and networks to further research and encourage collaboration. This section also provides information on resources provided by NIAID to advance product development. National Institute of Allergy and Infectious Diseases
Intracranial Inoculation Rapidly Induces Nipah Virus Encephalitis in Syrian Hamsters
This study supports development of an animal model to allow the efficacy testing of potential antivirals when administered once virus may have already reached the CNS. PLOS Neglected Tropical Diseases
MPOX
Cost of Mpox Shot Deters Americans at Risk, Critics Say
A particularly deadly form of mpox, formerly called monkeypox, has led to more than 48,000 cases and more than 1,100 deaths in Africa this year. The Biden administration has donated one million doses of the vaccine to affected countries. But in the United States, mpox vaccines are out of reach for many people. In the 2022 outbreak that reached this country, doses of the mpox vaccine, Jynneos, were made available for free from the federal stockpile. That arrangement ended this April, when the vaccine became available commercially. But insurance companies do not yet cover the vaccine or, if they do, reimburse only a tiny fraction of the cost. And some people at high risk of mpox, including those with H.I.V., are less likely to have any form of insurance at all. New York Times
UK Reports Two Further Cases of Clade Ib Mpox
Two additional cases of clade Ib mpox have been detected in household contacts of the first UK case, bringing the total number of confirmed cases to three, health officials have reported. Officials said the risk to the UK population remained low and that contacts of all three cases were being followed up and being offered testing and vaccination. The BMJ
Mpox Vaccine Acceptance, Democratic Republic of the Congo
Given the ongoing mpox clade Ia and clade Ib outbreaks in the DRC and identification of cases in adjacent countries in Central Africa, introduction of a vaccine is increasingly needed. However, a paucity of information has been available regarding mpox knowledge and vaccine acceptance across DRC. This study observed greater interest in mpox vaccine deployment among respondents from rural than urban locations. That finding could be explained by the historic mpox burden in DRC, where mpox cases primarily were among children in rural regions. Emerging Infectious Diseases
AVIAN INFLUENZA
Antiviral Susceptibility of Swine-Origin Influenza A Viruses Isolated from Humans
The continuing pandemic threat posed by animal-origin influenza A viruses necessitates closely monitoring their antiviral susceptibilities. Since 2013, a total of 167 human infections with swine-origin (variant) influenza A viruses of A(H1N1)v, A(H1N2)v, and A(H3N2)v subtypes have been reported in the United States. In the United States, 3 NAIs (oseltamivir, zanamivir, and peramivir) are approved, and laninamivir is additionally approved in Japan only. The emergence and global spread of oseltamivir-resistant seasonal H1N1 virus in 2008–2010 and reports of community spread of oseltamivir-resistant A(H1N1)pdm09 viruses demonstrate that broad circulation of antiviral resistant influenza virus is an ongoing public health concern. Emerging Infectious Diseases
USDA Announces Plan for Bulk Milk Sampling
California and Colorado—two of the hardest hit states—had instituted mandatory bulk milk tank testing to get a better grip on the extent of spread in dairy cows. USDA APHIS announced a tiered strategy to collect milk samples to better assess where H5N1 is present proactively support effective biosecurity measures and to help state minimize the risk to farm workers. It noted that bulk milk testing helped stamp out brucellosis in US dairy herds and that Colorado’s use of the testing helped the state stem its surge over summer months. CIDRAP
Influenza A(H5N1) Virus Resilience in Milk after Thermal Inactivation
The effects of pasteurization-like temperatures on influenza viruses in retail and unpasteurized milk revealed virus resilience under certain conditions. Although pasteurization contributes to viral inactivation, influenza A virus, regardless of strain, displayed remarkable stability in pasteurized milk. Emerging Infectious Diseases
Detection of H1N1 Influenza Virus in the Bile of a Severe Influenza Mouse Model
Viremic spread is suspected and detection of viral RNA in blood has been frequently reported. However, recovery of replication-competent influenza virus from blood has rarely been demonstrated. Only a few clinical cases and animal studies with highly pathogenic avian influenza have reported successful recovery of live virus from blood stream. This study indicates that influenza virus viremia is present in severe influenza, and that the liver is a target organ for influenza viral sepsis. Influenza and Other Respiratory Diseases
Highly Pathogenic Avian Influenza (HPAI) H5 Virus Exposure in Domestic Cats and Rural Stray Cats
This study analyzed serum samples, throat and lung samples from domestic and stray cats in the Netherlands to investigate exposure to influenza viruses and associated factors. Of the 701 stray cats sampled, 83 had been exposed to HPAI virus, whereas only four of the 871 domestic cats. Exposure was more common in older cats and cats living in nature reserves. Some stray cats had been exposed to both avian and human influenza viruses. In contrast, 40 domestic cats were exposed to human influenza viruses. Exposure was more common in older cats and cats living in nature reserves. Some stray cats had been exposed to both avian and human influenza viruses. In contrast, 40 domestic cats were exposed to human influenza viruses. Eurosurveillance
Information for Employers Providing Personal Protective Equipment to Reduce Exposure to Novel Influenza A
This guidance outlines CDC’s recommendations for preventing exposures to highly pathogenic avian influenza (HPAI) A(H5N1) viruses, infection prevention and control measures including the use of PPE, testing, antiviral treatment, patient investigations, monitoring of exposed persons (including persons exposed to sick or dead wild and domesticated animals and livestock with suspected or confirmed infection, and antiviral chemoprophylaxis of exposed persons. Centers for Disease Control and Prevention
CHEMICAL + RADIOLOGICAL THREATS
CounterACT Translational Exploratory and Developmental Research Projects
This funding supports discovery of novel treatment strategies that address serious morbidity and mortality after acute exposure to chemical warfare agents, toxic industrial chemicals, pesticides, and ultra-potent synthetic (UPS) opioids. Supported activities include preliminary efficacy or early preclinical development studies towards discovery and validation of novel molecular entities or biologics, or repurposing existing products, as candidate medical countermeasures for chemical threats. NIH Grants
CounterACT Basic Research on Chemical Threats that Affect the Nervous System
This funding opportunity supports basic research to inform toxicology of chemical warfare agents and select toxic industrial chemicals and materials that have primary or secondary effects on the nervous system. Research is expected to generate results that further improve understanding of mechanisms of toxicity of these agents and potential new targets for development of medial countermeasures that are effective in civilian mass exposure situations. NIH Grants
Preparedness and Response Strategies for CBRN Incidents in the Middle East and North Africa
This study aimed to develop a region-specific assessment tool, operational response guidelines for managing CBRN incidents in the MENA region, and simulation tabletop exercises for training pre- and in-hospital health-care professionals. Disaster Medicine and Public Health Preparedness
SURVEILLANCE + DETECTION
Health Departments Struggle to Track Human Cases of Bird Flu, Emails Reveal
Hundreds of emails from state and local health departments, obtained in records requests from KFF Health News, reveal that despite health officials’ arduous efforts to track human infections, surveillance is marred by delays, inconsistencies, and blind spots. Several documents reflect a breakdown in communication with a subset of farm owners who don’t want themselves or their employees monitored for signs of bird flu. Other emails hint that cases on dairy farms were missed. And an exchange between health officials in Michigan suggested that people connected to dairy farms had spread the bird flu virus to pet cats. But there hadn’t been enough testing to really know. MedPage Today
Health Systems Will Likely Struggle to Differentiate Human Bird Flu Cases From Flu-Like Illnesses
In the weeks and months to come, when dairy farmworkers or others culling infected poultry flocks develop influenza-like symptoms, what ails them could be a common cold, Covid-19, regular influenza, or a bird flu virus. Trying to do this surveillance at any point in the year is devilishly tough. Doing it in flu season will be next-level hard, experts warn. While wastewater surveillance contributes to the picture, if it turns up H5N1 virus in a community’s sewage system, it cannot say if the virus came from a person, a cow, or discarded contaminated milk. STAT
Logistics for Rapid Isolation of Viruses From Humans
The implementation of this protocol for rapid isolation of a virus, alongside the availability of logistic capacity with strong knowledge of biosafety and a readily available cohort of participants who had possibly been exposed to the new variant, facilitated the rapid and successful isolation of the Omicron subvariant BA.5 in Sweden. Health Security
Evaluation of an ECL Assay for the Rapid Detection of Ricin Toxin
The results show that the ricin assay exhibits good sensitivity and specificity with a limit of detection of 1.2 ng/mL. However, the dynamic range of the assay for the quantitation of ricin was limited. A hook effect was observed at higher ricin concentrations, which can lead to potential false negative results. A modification of the assay protocol that incorporates extra wash steps can decrease the hook effect and the potential for false negative results. Health Security
A Strategic Framework of SARS-CoV-2 Genomic Surveillance in Bangladesh
This study outlines a strategic framework of genomic surveillance to track the evolution of the virus in Bangladesh between June 2021 and December 2022 through the National SARS-CoV-2 Variant Surveillance (NSVS) program involving collaboration across 4 major institutes and 13 hospitals nationwide. Influenza and Other Respiratory Diseases
Development of Smallpox Antibody Testing and Surveillance Following Smallpox Vaccination in the Republic of Korea
This study aimed to develop an ELISA test using less lethal Vaccinia virus antibodies against the bioterrorism pathogen variola virus in humans and assess the effectiveness of this method in evaluating the efficacy of smallpox vaccines and antibody therapies, monitoring outbreaks, and determining population-level antibody titers. Vaccines
Wastewater Surveillance for Poliovirus in Selected Jurisdictions, United States
During 2022–2023, a total of 7 US jurisdictions (5 states and 2 cities) participated in prospective or retrospective testing of wastewater for poliovirus after a paralytic polio case was identified in New York state. The value of routine wastewater surveillance for poliovirus apart from an outbreak is unclear. However, these results highlight the ongoing risk for poliovirus importations into the United States and the need to identify undervaccinated communities and increase vaccination coverage to prevent paralytic polio. Emerging Infectious Diseases
Novel Strategy to Reduce Diagnostic Errors in RT-PCR Using Probe-Based Techniques
Results demonstrated that both real-time PCR without an RT step and real-time RT-PCR (with RT) exhibited comparable detection sensitivity levels, indicating that the RT step in real-time PCR did not significantly affect detection sensitivity, even when cpDNA was used as a template. Therefore, plasmid DNA is a valuable tool for use as a PCR-positive control for both DNA- and RNA-type pathogen gene detection. Scientific Reports
ENVIRONMENTAL FLUX
Dengue Fever is Rare in L.A. That Could Start to Change Because of Climate Change
This autumn, Los Angeles County public health officials reported 8 cases of locally acquired dengue fever. It’s a small but significant signal that the region is becoming increasingly hospitable to the disease and the mosquitoes that carry it. Last year was the first time such locally spread cases were ever seen in the region. NPR
Florida Reports 16 Deaths From Rare Flesh-Eating Bacteria After Hurricanes
The back-to-back hurricanes Helene and Milton hurricanes have helped reach another terrible milestone: there have now been more reported cases of the flesh-eating bacteria in Florida this year than in the last 16. There have been 80 cases so far in 2024, according to data from the Florida Department of Health, surpassing the 74 cases in 2022 when Hurricane Ian smashed the state. More than half of those cases were reported just since mid-September. Of those, 16 people have died, compared to 17 in 2022. Vibrio vulnificus multiplies rapidly in the blood, presenting often with some GI symptoms, a fever, and perhaps some limb pain. The rapidity of the infectious onslaught in the face of what appears to be mild symptoms can result in delayed treatment. The Guardian, ABC News, American Council on Science and Health, Herald-Tribune
Polar Bears’ Exposure to Pathogens is Increasing as Their Environment Changes
As the Arctic warms, polar bears now face a greater risk of contracting several pathogens than bears three decades ago. In the new study, researchers examined blood samples from polar bears in the Chukchi Sea in 1987-1994 and then three decades later, 2008-2017, looking for antibodies to six pathogens. Five of these pathogens had become more common in the later samples: the parasites that cause toxoplasmosis and neosporosis, the bacteria that cause rabbit fever and brucellosis, and the canine distemper virus. The increases in the prevalence of these pathogens represent some of the most rapid changes in exposure ever reported among polar bears. PLOS One, The Microbiologist
INFECTIOUS DISEASES
Scientists Provide Evidence of Mom-to-Baby Oropouche Virus Spread in Brazil
The case resulted in the stillbirth of the baby, after the 40-year-old mother reported fever, chills, generalized muscle aches, and severe headache at 30 weeks’ gestation. The virus, spread by biting midge and some types of mosquitoes, has caused outbreaks this year in regions of Brazil that previously had not had cases. CIDRAP, NEJM, The Lancet Infectious Diseases
Tuberculosis Returns as Top Infectious Disease Killer, WHO Says
Tuberculosis replaced COVID-19 to become the top cause for infectious disease-related deaths in 2023, according to a World Health Organization report published on Tuesday, highlighting the challenges in the global effort in eradicating the disease. Reuters
Outbreak Investigation of E. coli O157:H7: Onions
FDA continues working with CDC, USDA FSIS, state partners, and involved firms to investigate an outbreak of E. coli O157:H7 infections linked to onions. Epidemiologic and traceback data show that slivered onions served at affected McDonald’s locations are the likely source of this outbreak. As of October 30, 90 people from 13 states have been infected with the outbreak strain of E. coli O157:H7. Illnesses started on dates ranging from Sept 27, 2024 to October 16, 2024. Of 83 people with information available, 27 have been hospitalized, and 2 people developed HUS, a serious condition that can cause kidney failure. One death has been reported from an older adult in Colorado. Symptoms begin anywhere from a few days after consuming contaminated food or up to nine days later. McDonald’s stores in CO, KS, and WY, and portions of IA, ID, MO, MT, NE, NM, NV, OK, and UT have temporarily stopped using slivered onions. FDA
Influenza Vaccine Effectiveness Against Illness and Asymptomatic Infection in 2022–2023
Vaccination reduced incidence of symptomatic but not asymptomatic influenza virus infection, suggesting that influenza vaccination attenuates progression from infection to illness. Clinical Infectious Diseases
Malaria Is Surging in Ethiopia, Reversing a Decade of Progress Against the Disease
Malaria infection rates are soaring in Ethiopia, where a combination of armed conflict, climate change and mosquitoes’ growing resistance to drugs and insecticides has accelerated the spread of a disease the country once thought it was bringing under control. More than 6.1 million malaria cases, and 1,038 deaths, have been recorded in the country this year through the end of September. New York Times
ANTIMICROBIAL RESISTANCE CRISIS
Can Improved Tests Speed Up Treatment for Antibacterial Resistant Infections?
Currently, antimicrobial resistance results in approximately 1.3 million deaths worldwide, including 35,000 in the United States each year. A new clinical trial sponsored by NIAID is currently evaluating whether the use of a rapid test of antibiotic susceptibility for bacteria growing in blood cultures improves clinical outcomes for patients with sepsis in settings that have high rates of antibiotic-resistant bacterial infections. The trial will ultimately enroll roughly 900 hospitalized participants at seven locations around the world. The Fast Antibiotic Susceptibility Testing for Gram-Negative Bacteremia Trial (FAST) will test whether use of the bioMérieux’s VITEK REVEAL AST System, a direct-from-positive-blood-culture fast phenotypic susceptibility test already available for clinical use in the EU. NIAID Now Blog
Combating Antibiotic-Resistant Bacteria Interdisciplinary Research Units
This funding opportunity supports basic and clinical research focused on discovery to early development to inform new approaches to prevent, diagnose, and treat antibiotic-resistant bacterial infections. Projects range from studies of microbial physiology and antigenic structure to collaborative trials of experimental drugs and vaccines, mechanisms of resistance to antibiotics as well as research dealing with epidemiological observations in hospitalized patients or community populations. NIH Grants
COVID-19 PANDEMIC
Aerosolized Ad5-NCoV COVID-19 Vaccine in a Non-Inferiority Randomized Controlled Trial
Participants were randomized 1:1 to receive either one dose of inhaled Recombinant COVID-19 Vaccine (Ad5-nCoV-IH) or intramuscular tozinameran (BNT-IM). The study assessed safety, vaccine efficacy (VE) and immunogenicity against SARS-CoV-2 variants. Ad5-nCoV-IH showed lower immunogenicity than BNT-IM. Adverse drug reactions (ADRs) were less frequent with Ad5-nCoV-IH compared to BNT-IM. Both vaccines had comparable efficacy against COVID-19 variants. NPJ Vaccines
Live Imaging of Airway Epithelium Reveals Mucociliary Clearance Modulates SARS-CoV-2 Spread
SARS-CoV-2 initiates infection in the conducting airways, where mucociliary clearance inhibits pathogen penetration. However, it is unclear how mucociliary clearance impacts SARS-CoV-2 spread after infection is established. To investigate viral spread at this site, researchers performed live imaging of SARS-CoV-2 infected differentiated primary human bronchial epithelium cultures for up to 12 days. Nature Communications
Performance of Rapid Antigen Tests to Detect SARS-CoV-2 Variant Diversity and Correlation with Viral Culture Positivity
This study evaluated the performance of two commercially available antigen-based rapid diagnostic tests (Ag-RDTs) and a research Ag-RDT to detect multiple SARS-CoV-2 variants, and determine whether Ag-RDT results correlated with culture positivity. Results suggest that various Ag-RDTs may have differing levels of correlation with viral culture positivity and, therefore, vary in their ability to detect infectiousness. mBio
Emerging Insights Into COVID Household Transmission
Finding from a study presented at this year’s IDWeek annual meeting focused on leveraging g indicated that although the most common source of infection was the index case, there were multiple sources of infection in over half of individual households. “Before the widespread availability of viral genome sequence data, chronologically clustered cases in households were often presumed to be all secondary to intra-household transmission. Now that genetic data are being integrated into a number of epidemiologic studies, there have been a number of observations of the simultaneous circulation of multiple viral lineages in households within a short time.” MedPage Today
Delineating the Functional Activity of Antibodies with Cross-Reactivity to Sarbecoviruses
The recurring spillover of pathogenic coronaviruses and demonstrated capacity of sarbecoviruses, such SARS-CoV-2, to rapidly evolve in humans underscores the need to better understand immune responses to this virus family. This study identified antibodies targeting conserved regions across SARS-CoV-2 variants and sarbecoviruses that may serve as therapeutics for pandemic preparedness as well as blueprints for the design of immunogens capable of eliciting cross-neutralizing responses. PLOS Pathogens
Studies Show Long-COVID Symptoms Distinct from Other Respiratory Infections, Common in Marines
Two new studies offer fresh insights into long COVID, with the first noting a greater neurological, cognitive, and fatigue impact compared with long-term symptoms after similar respiratory diseases, and the second demonstrating that a fourth of young Marines who contracted COVID-19 went on to develop long COVID. CIDRAP
HISTORICAL REFLECTIONS
That 800-Year-Old Corpse in the Well? Early Biological Warfare.
Archaeologists in Norway have confirmed that an ancient set of human remains known as the Well Man were intended to make the locals unwell. New York Times
An Emergency Doc’s Experience Contracting Ebola
Interview with Craig Spencer, MD, MPH, of Brown University, about the 10-year anniversary of his treatment for Ebola at Bellevue Hospital in New York City after contracting the disease in Guinea while volunteering for Doctors Without Borders. “From the first patients you saw, the first time you put in an IV on someone — something that I do all the time, I’ve done thousands and thousands of times — but it was almost as if I was doing it the first time in West Africa, in Guinea, because I was in a really hot suit and it was a really hot day and I was already dehydrated and I was wearing two pairs of gloves, and I was scared, scared, scared. Knowing that if I missed, if something happened, if I poked myself, had a needle stick injury, I would die. It’s not that I would be infected. It’s not that I would get sick. It’s that I would die.” MedPage Today
SPECIAL INTEREST
Audio Interview: The Marburg Virus Outbreak in Rwanda
In this audio interview conducted on October 30, 2024, NEJM editors are joined by the Minister of Health of Rwanda to discuss both actions taken to halt the spread of Marburg disease and the use of experimental vaccines and therapies. New England Journal of Medicine
FDA Clinical Investigator Training Course (CITC) 2024
The primary goal of this clinical investigator training course (Dec 10-12) is to provide participants with the essential knowledge and skills to conduct clinical trials effectively, ethically, and in accordance with regulatory standards. The course aims to prepare clinical investigators to conduct high-quality research that contributes to scientific knowledge and improves patient care. FDA
Women at the Front Line of the Marburg Virus Disease Response in Rwanda
“We are female health-care workers standing on the front line of the Marburg virus disease outbreak in Rwanda. We worked in the emergency, intensive care, and Marburg virus disease isolation and treatment units… We observed a disturbing trend—while many male colleagues showed gradual deterioration in their physical health, our female colleagues seemed stable before suddenly decompensating.” The Lancet Global Health
ECDC Offers Revamped Learning Portal
The new Learning Portal replaces the previous ECDC Virtual Academy (EVA).
It provides courses for professionals working in infectious diseases and public health areas such as epidemiology, microbiology, bioinformatics, prevention, preparedness and response. Learners can complete or browse a training course and select relevant content. Trainers can reuse or adapt the materials to develop their own training courses. All training courses and materials are free of charge. European Centre for Disease Prevention and Control.
2024 FDA Broad Agency Announcement Day
2024 FDA BAA Day will provide an opportunity to learn more about the application process and FDA’s priorities for regulatory research in FY2025. View the BAA, register in advance for the virtual event, and preview speaker bios and the meeting agenda. FDA
IN MEMORIAM
Diane Edmund Griffin, Renowned Infectious Disease Virologist, Dies at 84
NAS vice president Diane Griffin died unexpectedly on October 28 at age 84 in Baltimore, where she was a University Distinguished Service Professor, Gilman Scholar, and chair emeritus of the W. Harry Feinstone Department of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health. Diane’s research focused on virology, including discoveries related to mortality from and immunity to infection by the virus responsible for measles. She also led ground-breaking work on the role of the mosquito in malaria. JHU, National Academies of Science
Richard A. Cash, Who Saved Millions with Cholera Research, Dies at 83
Richard A. Cash, who as a young public-health researcher in South Asia in the late 1960s showed that a simple cocktail of salt, sugar and clean water could check the ravages of cholera and other diarrhea-inducing diseases, an innovation that has saved an estimated 50 million lives, died on Oct. 22 at his home in Cambridge, Mass. He was 83. New York Times
ALSO READING
Pandemic exercises: Lessons for a new era in pandemic preparedness. Health Security
Improving the last mile delivery of vaccines through an informed push model: Experiences, opportunities and costs based on an implementation study in a rural district in Uganda. PLOS Global Public Health
Safety, efficacy and immunogenicity of aerosolized Ad5-NCoV COVID-19 vaccine. NPJ Vaccines
The posttranslational modification tightrope of flavivirus replication. PLOS Pathogens
Global Model WHO youth delegates urge swift action on pandemic prevention, preparedness and response. WHO
Will South Africa become first country to accept controversial form of human genome editing? Nature