Emerging Infectious Diseases最新文献

The current recommendation for treating Lassa fever with ribavirin is supported only by weak evidence. Given the persistent effects in areas with endemic transmission and epidemic potential, there is an urgent need to reassess ribavirin and investigate other potential therapeutic candidates; however, a robust clinical trial method adapted to Lassa fever epidemiology has not yet been established. We propose an adaptive phase II/III multicenter randomized controlled platform trial that uses a superiority framework with an equal allocation ratio and accounts for challenges selecting the primary end point and estimating the target sample size by using an interim analysis.

Epidemic surveillance using traditional approaches is dependent on case ascertainment and is delayed. Open-source intelligence (OSINT)–based syndromic surveillance can overcome limitations of delayed surveillance and poor case ascertainment, providing early warnings to guide outbreak response. It can identify outbreaks of unknown cause for which no other global surveillance exists. Using the artificial intelligence–based OSINT early warning system EPIWATCH, we describe the global epidemiology of 310 outbreaks of unknown cause that occurred December 31, 2019–January 1, 2023. The outbreaks were associated with 75,968 reported human cases and 4,235 deaths. We identified where OSINT signaled outbreaks earlier than official sources and before diagnoses were made. We identified possible signals of known disease outbreaks with poor case ascertainment. A cause was subsequently reported for only 14% of outbreaks analyzed; the percentage was substantially lower in lower/upper-middle–income economies than high-income economies, highlighting the utility of OSINT-based syndromic surveillance for early warnings, particularly in resource-poor settings.

Arboviruses represent a major cause of illness in Africa and have the potential to trigger widespread epidemics. We present data on arbovirus epidemics in Africa in 2023 and demonstrate the need for global public health authorities to intensify efforts in the surveillance and control of arbovirus diseases. Data were collected from the World Health Organization Weekly Bulletin on Outbreaks and Other Emergencies, Africa Centers for Disease Control and Prevention Weekly Event Based Surveillance Report, and other online sources. In 2023, a total of 7 arboviruses were responsible for 29 outbreaks across 25 countries in Africa, 22 of which occurred in West Africa; the outbreaks resulted in 19,569 confirmed cases and 820 deaths. Arbovirus epidemics in Africa pose a threat not only to public health within the continent but also globally, underscoring the urgent need for substantial investment in arbovirus surveillance, research, and preparedness capacities in Africa to prevent and respond to health crises effectively.

Given recent outbreaks of Oropouche virus in Latin America and >100 confirmed travel-associated cases in the United States, we evaluated the competence of US vectors, including Aedes albopictus, Culex quinquefasciatus, Culex pipiens, and Anopheles quadrimaculatus mosquitoes. Results with historic and recent isolates suggest transmission potential for those species is low.

We isolated Venezuelan equine encephalitis virus (VEEV) subtype IE phylogenetically related to Gulf Coast strains in a spider monkey (Ateles geoffroyi) released from a rescue center in Guatemala. Serologic testing of 118 monkeys indicated no additional VEEV infections. Infection of a primate warrants intensified surveillance of VEEV transmission cycles in North America.

We describe chronic wasting disease (CWD) prion detection in raw and cooked meat from a CWD-positive elk. We found limited zoonotic potential in CWD prions from those meat products. Nonetheless, risk for transmission to humans is still unclear, and monitoring of circulating and emerging CWD prion strains for zoonotic potential is warranted.

We describe detection of SAT2 topotype XIV foot-and-mouth disease viruses in western Asia during 2022–2023. Sequences show the viruses originated in eastern Africa and were introduced into western Asia on >1 occasion. The rapid spread in naive animals highlights risks for onward transmission and potential endemicity in Asia.

In October 2023, a partially engorged female Ixodes tick was removed from a dog in Bozeman, Montana, USA, that had recently spent time in eastern Montana. The tick was identified as I. scapularis according to morphologic characteristics and genomic sequencing, suggesting an expanded geographic distribution requiring continued public health surveillance.

Melioidosis is caused by the environmental pathogen Burkholderia pseudomallei. Among 1,331 patients with melioidosis during 1989–2023 in the Darwin Prospective Melioidosis Study in Australia, we identified 6 locally acquired cases caused by B. pseudomallei sequence type 46. Because of global transmission and expansion of endemicity, clinicians should increase awareness of melioidosis.