Pub Date : 2026-03-10DOI: 10.1016/s1473-3099(26)00057-5
Eva Guichard, Sylvain Juchet, Ijeoma Chukwudumebi Etafo, Béatrice Serra, Delphine Gabillard, Chukwuyem Abejegah, Abiodun Tolani Abidoye, Bimpe Oyegunle, Benjamin Séri, Alexandre Duvignaud, Jackson Katembo Vihundira, Denis Malvy, Marion Bérerd-Camara, Nelson Akinola Adedosu, Ayeni Olufunke Gbenga, Liasu Adeagbo Ahmed, Oladele Oluwafemi Ayodeji, Marie Jaspard
Background
Lassa fever is one of the most important viral haemorrhagic fevers, yet post-discharge sequelae remain inadequately characterised. Previous studies have been limited by small sample sizes and unsystematic assessments. We aimed to describe post-discharge sequelae in Lassa fever survivors and explore the effect of disease severity on sequelae patterns.
Methods
LASCOPE was a prospective study of patients with PCR-confirmed Lassa fever hospitalised at Federal Medical Centre Owo, Owo, Nigeria, between April 23, 2018, and Feb 17, 2023. All patients who provided informed consent were included, with no age restriction. Severe disease was defined as the presence of at least one of the following during the acute phase: National Early Warning Score version 2 score of 7 or higher, Kidney Disease Improving Global Outcomes stage 2 or higher, or Lassa virus PCR Ct value of less than 25. At hospital discharge, follow-up of survivors was planned for day 60 after admission, or before that, based on medical need. A systematic symptom assessment was done at each visit. The main outcome was clinical remission, defined as complete absence of symptoms. Other outcomes were post-discharge death, symptom incidence, and prevalence of symptoms over time. Subgroup analyses were performed by age group (children aged <18 years or adults aged ≥18 years) and disease severity (severe or not severe).
Findings
Of 882 survivors (median age 32 years [IQR 22–46], 459 [52%] female and 423 [48%] male), post-discharge data were available for 807 (91%), with a total of 2603 person-months of follow-up. For three of 807 survivors with post-discharge information, only the vital status was collected. 736 (91%) of 807 reached clinical remission, with a median time to clinical remission of 19 days (95% CI 16–23) post discharge. The most frequently reported symptoms were asthenia (158 [20%] of 804), headache (148 [18%]), and post-exertional malaise (123 [15%]). Hearing symptoms were reported by only 17 (2%) of 804 survivors, which was substantially lower than previous studies. Disease severity did not affect time to remission. Six (1%) survivors died after hospital discharge.
Interpretation
Patient-reported symptoms suggest good recovery with few hearing or neurosensory disorders in most survivors of Lassa fever. Future research would benefit from extended follow-up periods and standardised diagnostic assessments, including objective audiometry, to further characterise the full spectrum of post-Lassa fever complications.
Funding
Institut National de la Santé et de la Recherche Médicale, University of Oxford, EU, UK Department for International Development, Wellcome Trust, French Ministry of Foreign Affairs, Agence Nationale de Recherches sur le SIDA et les Hépatites Virales, and French National Research Institute for Sustainable Development.
背景：拉沙热是最重要的病毒性出血热之一，但出院后的后遗症仍然没有充分的特征。以前的研究受到样本量小和评估不系统的限制。我们的目的是描述拉沙热幸存者出院后的后遗症，并探讨疾病严重程度对后遗症模式的影响。方法slascope是一项前瞻性研究，研究对象为2018年4月23日至2023年2月17日在尼日利亚奥沃联邦医疗中心奥沃住院的pcr确诊拉沙热患者。所有提供知情同意的患者均被纳入，没有年龄限制。严重疾病被定义为在急性期至少存在以下一种：国家早期预警评分版本2评分为7或更高，肾脏疾病改善全球结局阶段2或更高，或拉沙病毒PCR Ct值小于25。出院时，根据医疗需要，计划在入院后第60天或在此之前对幸存者进行随访。每次就诊时进行系统的症状评估。主要结果是临床缓解，定义为症状完全消失。其他结局是出院后死亡、症状发生率和症状随时间的流行。按年龄组（18岁儿童或≥18岁成人）和疾病严重程度（严重或不严重）进行亚组分析。在882例幸存者中（中位年龄32岁[IQR 22-46]，女性459例[52%]，男性423例[48%]），807例（91%）获得出院后资料，随访时间共计2603人月。807名幸存者中有3名出院后的信息，只有重要状态被收集。807例患者中有736例（91%）达到临床缓解，出院后达到临床缓解的中位时间为19天（95% CI 16-23）。最常报告的症状是虚弱（804例中158例[20%]）、头痛（148例[18%]）和运动后不适（123例[15%]）。804名幸存者中只有17人（2%）报告了听力症状，这大大低于以前的研究。疾病严重程度不影响缓解时间。6名（1%）幸存者在出院后死亡。患者报告的症状表明，大多数拉沙热幸存者恢复良好，几乎没有听力或神经感觉障碍。未来的研究将受益于延长随访期和标准化诊断评估，包括客观听力学，以进一步描述拉沙热后并发症的全部特征。资助单位：英国牛津大学、欧盟、英国国际发展部、威康信托基金会、法国外交部、法国国家农业和农业发展研究所、法国国家可持续发展研究所。
{"title":"Post-discharge sequelae of Lassa fever survivors in Nigeria: an analysis of the LASCOPE prospective cohort","authors":"Eva Guichard, Sylvain Juchet, Ijeoma Chukwudumebi Etafo, Béatrice Serra, Delphine Gabillard, Chukwuyem Abejegah, Abiodun Tolani Abidoye, Bimpe Oyegunle, Benjamin Séri, Alexandre Duvignaud, Jackson Katembo Vihundira, Denis Malvy, Marion Bérerd-Camara, Nelson Akinola Adedosu, Ayeni Olufunke Gbenga, Liasu Adeagbo Ahmed, Oladele Oluwafemi Ayodeji, Marie Jaspard","doi":"10.1016/s1473-3099(26)00057-5","DOIUrl":"https://doi.org/10.1016/s1473-3099(26)00057-5","url":null,"abstract":"<h3>Background</h3>Lassa fever is one of the most important viral haemorrhagic fevers, yet post-discharge sequelae remain inadequately characterised. Previous studies have been limited by small sample sizes and unsystematic assessments. We aimed to describe post-discharge sequelae in Lassa fever survivors and explore the effect of disease severity on sequelae patterns.<h3>Methods</h3>LASCOPE was a prospective study of patients with PCR-confirmed Lassa fever hospitalised at Federal Medical Centre Owo, Owo, Nigeria, between April 23, 2018, and Feb 17, 2023. All patients who provided informed consent were included, with no age restriction. Severe disease was defined as the presence of at least one of the following during the acute phase: National Early Warning Score version 2 score of 7 or higher, Kidney Disease Improving Global Outcomes stage 2 or higher, or Lassa virus PCR Ct value of less than 25. At hospital discharge, follow-up of survivors was planned for day 60 after admission, or before that, based on medical need. A systematic symptom assessment was done at each visit. The main outcome was clinical remission, defined as complete absence of symptoms. Other outcomes were post-discharge death, symptom incidence, and prevalence of symptoms over time. Subgroup analyses were performed by age group (children aged <18 years or adults aged ≥18 years) and disease severity (severe or not severe).<h3>Findings</h3>Of 882 survivors (median age 32 years [IQR 22–46], 459 [52%] female and 423 [48%] male), post-discharge data were available for 807 (91%), with a total of 2603 person-months of follow-up. For three of 807 survivors with post-discharge information, only the vital status was collected. 736 (91%) of 807 reached clinical remission, with a median time to clinical remission of 19 days (95% CI 16–23) post discharge. The most frequently reported symptoms were asthenia (158 [20%] of 804), headache (148 [18%]), and post-exertional malaise (123 [15%]). Hearing symptoms were reported by only 17 (2%) of 804 survivors, which was substantially lower than previous studies. Disease severity did not affect time to remission. Six (1%) survivors died after hospital discharge.<h3>Interpretation</h3>Patient-reported symptoms suggest good recovery with few hearing or neurosensory disorders in most survivors of Lassa fever. Future research would benefit from extended follow-up periods and standardised diagnostic assessments, including objective audiometry, to further characterise the full spectrum of post-Lassa fever complications.<h3>Funding</h3>Institut National de la Santé et de la Recherche Médicale, University of Oxford, EU, UK Department for International Development, Wellcome Trust, French Ministry of Foreign Affairs, Agence Nationale de Recherches sur le SIDA et les Hépatites Virales, and French National Research Institute for Sustainable Development.","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"45 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147384121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-09DOI: 10.1016/s1473-3099(26)00001-0
Lalita Priyamvada PhD, Faisal S Minhaj PharmD, Toutou Likafi MScN, Elisabeth Pukuta MSc, Elisabeth Muyamuna BSc, William C Carson BSc, Margaret Moriarty BSc, Sergio Rodriguez PhD, Taina Joseph MPH, Joelle Kabamba MD, Gaston Kokola BSc, Robert Shongo Lushima MD, Jean-Jacques Muyembe-Tamfum MD, Christine M Hughes MPH, Brett W Petersen MD, Yon Yu PharmD, Agam Rao MD, Andrea M McCollum PhD, Prof Didine K Kaba MD, Beatrice U Nguete MD, Panayampalli S Satheshkumar PhD, Michael B Townsend PhD
The expanding mpox outbreak in Africa and travel-associated cases in other continents have increased efforts to vaccinate populations at high risk. This study aimed to assess serological immune responses 5 years after individuals received a primary vaccination (two-dose series) with the smallpox and mpox vaccine modified vaccinia Ankara-Bavarian Nordic (MVA-BN), as well as to evaluate the safety and immunogenicity of a third dose (booster). To date, there are no data for immunological memory or third-dose-induced immunity for MVA-BN at these long-term timescales.
{"title":"Immunogenicity and safety of MVA-BN vaccine administered 5 years after a two-dose primary series in DR Congo: a prospective cohort study","authors":"Lalita Priyamvada PhD, Faisal S Minhaj PharmD, Toutou Likafi MScN, Elisabeth Pukuta MSc, Elisabeth Muyamuna BSc, William C Carson BSc, Margaret Moriarty BSc, Sergio Rodriguez PhD, Taina Joseph MPH, Joelle Kabamba MD, Gaston Kokola BSc, Robert Shongo Lushima MD, Jean-Jacques Muyembe-Tamfum MD, Christine M Hughes MPH, Brett W Petersen MD, Yon Yu PharmD, Agam Rao MD, Andrea M McCollum PhD, Prof Didine K Kaba MD, Beatrice U Nguete MD, Panayampalli S Satheshkumar PhD, Michael B Townsend PhD","doi":"10.1016/s1473-3099(26)00001-0","DOIUrl":"https://doi.org/10.1016/s1473-3099(26)00001-0","url":null,"abstract":"The expanding mpox outbreak in Africa and travel-associated cases in other continents have increased efforts to vaccinate populations at high risk. This study aimed to assess serological immune responses 5 years after individuals received a primary vaccination (two-dose series) with the smallpox and mpox vaccine modified vaccinia Ankara-Bavarian Nordic (MVA-BN), as well as to evaluate the safety and immunogenicity of a third dose (booster). To date, there are no data for immunological memory or third-dose-induced immunity for MVA-BN at these long-term timescales.","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"15 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147392879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-09DOI: 10.1016/s1473-3099(26)00051-4
Luis Flores Girón MSc, Gustavo Sganzerla Martinez PhD, Baganda Ntahuma Daniel MD, Alfred Kesheni Bisimwa MD, Nkonzi Pacific MD, Georges Assumani Martin BVSc, Jean Christian Amini Kabwana BSc, Anuj Kumar PhD, Ali Toloue Ostadgavahi MSc, Mansi Dutt MSc, Kawaya Lusante Bénite BSc, Mangura Hamuli Damien BSc, Prof Christian Gortázar PhD, Bahaa Abu-Raya PhD, Alyson A Kelvin PhD, Kaleme Kiswele Prince PhD, Prof David J Kelvin PhD
Mpox is a public health concern in eastern DR Congo. It continues to cause substantial numbers of hospital admissions, with changing demographics including children and adolescents, requiring comprehensive clinical and epidemiological investigation. In this study, we aim to describe the clinical characteristics of hospitalised participants infected with monkeypox virus (MPXV) subclade Ib/2023sh in the Kabare Territory in South Kivu, DR Congo.
{"title":"Case presentation of patients hospitalised with mpox (subclade Ib/2023sh) including children, adolescents, and adults in South Kivu, Democratic Republic of the Congo: an observational cohort study","authors":"Luis Flores Girón MSc, Gustavo Sganzerla Martinez PhD, Baganda Ntahuma Daniel MD, Alfred Kesheni Bisimwa MD, Nkonzi Pacific MD, Georges Assumani Martin BVSc, Jean Christian Amini Kabwana BSc, Anuj Kumar PhD, Ali Toloue Ostadgavahi MSc, Mansi Dutt MSc, Kawaya Lusante Bénite BSc, Mangura Hamuli Damien BSc, Prof Christian Gortázar PhD, Bahaa Abu-Raya PhD, Alyson A Kelvin PhD, Kaleme Kiswele Prince PhD, Prof David J Kelvin PhD","doi":"10.1016/s1473-3099(26)00051-4","DOIUrl":"https://doi.org/10.1016/s1473-3099(26)00051-4","url":null,"abstract":"Mpox is a public health concern in eastern DR Congo. It continues to cause substantial numbers of hospital admissions, with changing demographics including children and adolescents, requiring comprehensive clinical and epidemiological investigation. In this study, we aim to describe the clinical characteristics of hospitalised participants infected with monkeypox virus (MPXV) subclade Ib/2023sh in the Kabare Territory in South Kivu, DR Congo.","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"17 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147392877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-09DOI: 10.1016/s1473-3099(26)00006-x
Jenny Clarke, Herve Semukunzi, Sian E Faustini, Jennifer L J Heaney, Hin Fai Kwok, Jean Marie Vianney Uwimana, Karishma Gokani, Gilbert Rukundo, Jean Pierre Musabyimana, Prosper Ingabire, Leopold Bitunguhari, Jean de Dieu Harelimana, Alex G Richter, Claude M Muvunyi, Christopher A Green
<h3>Background</h3>Validated serological assays for mpox are scarce, particularly in outbreak regions where they are most urgently needed. We aimed to conduct an in-country validation of a serum-based mpox IgG ELISA during an outbreak of clade Ib mpox in Rwanda, and report immunological observations after infection and vaccination and on background seropositivity.<h3>Methods</h3>This observational, cross-sectional, clinical validation study of an mpox-specific IgG ELISA was conducted at the Rwanda National Reference Laboratory, within the Rwanda Biomedical Centre, Kigali, Rwanda. Adults (aged ≥18 years) were recruited into one of three groups of equal size: those who had previously had a microbiologically confirmed mpox infection (the infection cohort), those who had previously received an mpox vaccination (the vaccination cohort), and individuals with no history of mpox infection or vaccination (the unexposed cohort). Venous blood and dried blood spot (DBS) samples were collected from the participants. The IgG assay, containing four immunodominant mpox antigens, was developed into plate-based ELISA kits and used to analyse the serum and DBS samples, and an IgG ratio was obtained from the optical density readout. The performance of the assay was assessed by analysis of the receiver operating characteristic curve, intra-assay and interassay precision, and linearity, and the agreement between serum and DBS concentrations was tested with Spearman's correlation and Bland–Altman analysis.<h3>Findings</h3>Between Aug 1 and Aug 12, 2025, 194 individuals were invited to participate in the study, of whom 150 were enrolled, 50 in each of the three cohorts. Median IgG ratios were 3·24 (IQR 1·33–8·01) in the infection cohort, 1·77 (0·90–2·86) in the vaccination cohort, and 0·68 (0·39–1·16) in the unexposed cohort. IgG ratios in the infection and vaccination cohorts overlapped, but were both significantly higher than in the unexposed cohort (p<0·0001 for the infection cohort; p=0·0002 for the vaccination cohort). Intra-assay (coefficient of variation ≤13%) and interassay (≤10%) precision was high, and ratios were linear across dilutions. DBS and serum measurements were strongly correlated (<em>R</em><sup>2</sup>=0·84), but DBS measurements showed a small underestimation. In the vaccination cohort, IgG ratios were higher in female participants (median 2·70 [IQR 0·83–3·77], n=21) than in male participants (1·35 [0·90–2·42], n=29; p=0·0030).<h3>Interpretation</h3>We show that an mpox ELISA can be implemented within a national reference laboratory in a resource-limited setting as part of outbreak-response measures. The assay is suitable for population-level surveys and can analyse both DBS and serum samples. These findings provide a platform for larger population studies and further work to explore immune correlates of protection in mpox.<h3>Funding</h3>United Nations Environment Programme and the UK Department for Environment, Food and Rural Affairs; East Afr
{"title":"A combined ELISA for infection-induced and vaccine-induced mpox antibodies during the clade Ib outbreak in Rwanda: an observational, cross-sectional, clinical validation study","authors":"Jenny Clarke, Herve Semukunzi, Sian E Faustini, Jennifer L J Heaney, Hin Fai Kwok, Jean Marie Vianney Uwimana, Karishma Gokani, Gilbert Rukundo, Jean Pierre Musabyimana, Prosper Ingabire, Leopold Bitunguhari, Jean de Dieu Harelimana, Alex G Richter, Claude M Muvunyi, Christopher A Green","doi":"10.1016/s1473-3099(26)00006-x","DOIUrl":"https://doi.org/10.1016/s1473-3099(26)00006-x","url":null,"abstract":"<h3>Background</h3>Validated serological assays for mpox are scarce, particularly in outbreak regions where they are most urgently needed. We aimed to conduct an in-country validation of a serum-based mpox IgG ELISA during an outbreak of clade Ib mpox in Rwanda, and report immunological observations after infection and vaccination and on background seropositivity.<h3>Methods</h3>This observational, cross-sectional, clinical validation study of an mpox-specific IgG ELISA was conducted at the Rwanda National Reference Laboratory, within the Rwanda Biomedical Centre, Kigali, Rwanda. Adults (aged ≥18 years) were recruited into one of three groups of equal size: those who had previously had a microbiologically confirmed mpox infection (the infection cohort), those who had previously received an mpox vaccination (the vaccination cohort), and individuals with no history of mpox infection or vaccination (the unexposed cohort). Venous blood and dried blood spot (DBS) samples were collected from the participants. The IgG assay, containing four immunodominant mpox antigens, was developed into plate-based ELISA kits and used to analyse the serum and DBS samples, and an IgG ratio was obtained from the optical density readout. The performance of the assay was assessed by analysis of the receiver operating characteristic curve, intra-assay and interassay precision, and linearity, and the agreement between serum and DBS concentrations was tested with Spearman's correlation and Bland–Altman analysis.<h3>Findings</h3>Between Aug 1 and Aug 12, 2025, 194 individuals were invited to participate in the study, of whom 150 were enrolled, 50 in each of the three cohorts. Median IgG ratios were 3·24 (IQR 1·33–8·01) in the infection cohort, 1·77 (0·90–2·86) in the vaccination cohort, and 0·68 (0·39–1·16) in the unexposed cohort. IgG ratios in the infection and vaccination cohorts overlapped, but were both significantly higher than in the unexposed cohort (p<0·0001 for the infection cohort; p=0·0002 for the vaccination cohort). Intra-assay (coefficient of variation ≤13%) and interassay (≤10%) precision was high, and ratios were linear across dilutions. DBS and serum measurements were strongly correlated (<em>R</em><sup>2</sup>=0·84), but DBS measurements showed a small underestimation. In the vaccination cohort, IgG ratios were higher in female participants (median 2·70 [IQR 0·83–3·77], n=21) than in male participants (1·35 [0·90–2·42], n=29; p=0·0030).<h3>Interpretation</h3>We show that an mpox ELISA can be implemented within a national reference laboratory in a resource-limited setting as part of outbreak-response measures. The assay is suitable for population-level surveys and can analyse both DBS and serum samples. These findings provide a platform for larger population studies and further work to explore immune correlates of protection in mpox.<h3>Funding</h3>United Nations Environment Programme and the UK Department for Environment, Food and Rural Affairs; East Afr","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"6 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147384142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-09DOI: 10.1016/s1473-3099(26)00121-0
Yap Boum, Mosoka Fallah, Michel Muteba, Henry Kyobe Bosa, Kyeng Mercy, John Misaki Wayengera, Bruce Kirenga, John Otshudiema, Placide Mbala, Marie-Roseline Belizaire, Ngashi Ngongo, Jean Kaseya
{"title":"From emergency to integration: research as the bridge in mpox control","authors":"Yap Boum, Mosoka Fallah, Michel Muteba, Henry Kyobe Bosa, Kyeng Mercy, John Misaki Wayengera, Bruce Kirenga, John Otshudiema, Placide Mbala, Marie-Roseline Belizaire, Ngashi Ngongo, Jean Kaseya","doi":"10.1016/s1473-3099(26)00121-0","DOIUrl":"https://doi.org/10.1016/s1473-3099(26)00121-0","url":null,"abstract":"","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147392878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-09DOI: 10.1016/s1473-3099(25)00779-0
Faisal S Minhaj, Anna Mandra, Béatrice U Nguete, Toutou Likafi, Gaston Kokola, Stephanie Tran, Jordan L Kennedy, Benjamin Monroe, Christine M Hughes, Taina Joseph, Marissa K Person, Michael B Townsend, Panayampalli S Satheshkumar, Joelle Kabamba, Mary G Reynolds, Agam K Rao, Dorah Kasongo, Patricia A Yu, Yon Yu, Robert Shongo Lushima, Andrea M McCollum
<h3>Background</h3>Modified vaccinia Ankara-Bavarian Nordic (MVA-BN) is a third-generation, replication-deficient, smallpox and mpox vaccine that is prepared in liquid and lyophilised formulations. DR Congo reports the highest number of mpox cases annually. Safety data on MVA-BN are available from high-income countries, but comprehensive safety evaluations of MVA-BN are limited in the African continent.<h3>Methods</h3>From Feb 23 to Aug 29, 2017, and from Aug 15 to Sept 17, 2019, 1600 adult (aged 18 years and older) health-care personnel (eg, physicians, nurses, and technicians) at risk for mpox in the Tshuapa province and in Kinshasa were enrolled in an investigational prospective cohort study to evaluate safety of the two-dose MVA-BN vaccine series. Participants were excluded if they were pregnant, acutely ill, involved in another research study or had vaccine administration in the past 28 days, or had conditions that could have put the participant at an unacceptable risk. 1000 (62·5%) participants were administered the liquid formulation and 600 (37·5%) participants were administered the reconstituted lyophilised formulation. Vaccine doses were given on study days 0 and 28 and participants followed up at specified timepoints for up to 2 years for serological monitoring (14, 28, 42, 180, 365, 545, and 730 days). Participants were evaluated for immediate vaccine reactions, given adverse event diaries to document specific adverse events for 7 days following vaccine administration, and asked about potential adverse events at later timepoints up to the 2-year mark. The primary outcome was to assess the safety of MVA-BN for up to 2 years across formulations in a population at increased risk of mpox. This study is registered with <span><span>ClinicalTrials.gov</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span> (<span><span>NCT02977715</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>).<h3>Findings</h3>There was no significant difference in the risk of an adverse event between the liquid formulation (488 [49·0%] of 995 participants) and lyophilised formulation (315 [53·7%] of 586 participants; adjusted risk ratio [aRR] 1·08 [95% CI 0·98–1·19]) within 7 days after vaccination. Within 7 days of vaccine administration, participants had similar proportions of local injection-site reactions between the liquid (356 [35·7%] of 995 participants) and lyophilised (213 [36·3%] of 586 participants) formulations, but those who received the lyophilised formulation had a higher risk for systemic symptoms than those who received the liquid formulation (aRR 1·20 [95% CI 1·05–1·37]). 18 serious adverse events, including 17 deaths and one stillbirth, oc
{"title":"Safety of MVA-BN vaccine in health-care personnel in DR Congo: a prospective cohort study","authors":"Faisal S Minhaj, Anna Mandra, Béatrice U Nguete, Toutou Likafi, Gaston Kokola, Stephanie Tran, Jordan L Kennedy, Benjamin Monroe, Christine M Hughes, Taina Joseph, Marissa K Person, Michael B Townsend, Panayampalli S Satheshkumar, Joelle Kabamba, Mary G Reynolds, Agam K Rao, Dorah Kasongo, Patricia A Yu, Yon Yu, Robert Shongo Lushima, Andrea M McCollum","doi":"10.1016/s1473-3099(25)00779-0","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00779-0","url":null,"abstract":"<h3>Background</h3>Modified vaccinia Ankara-Bavarian Nordic (MVA-BN) is a third-generation, replication-deficient, smallpox and mpox vaccine that is prepared in liquid and lyophilised formulations. DR Congo reports the highest number of mpox cases annually. Safety data on MVA-BN are available from high-income countries, but comprehensive safety evaluations of MVA-BN are limited in the African continent.<h3>Methods</h3>From Feb 23 to Aug 29, 2017, and from Aug 15 to Sept 17, 2019, 1600 adult (aged 18 years and older) health-care personnel (eg, physicians, nurses, and technicians) at risk for mpox in the Tshuapa province and in Kinshasa were enrolled in an investigational prospective cohort study to evaluate safety of the two-dose MVA-BN vaccine series. Participants were excluded if they were pregnant, acutely ill, involved in another research study or had vaccine administration in the past 28 days, or had conditions that could have put the participant at an unacceptable risk. 1000 (62·5%) participants were administered the liquid formulation and 600 (37·5%) participants were administered the reconstituted lyophilised formulation. Vaccine doses were given on study days 0 and 28 and participants followed up at specified timepoints for up to 2 years for serological monitoring (14, 28, 42, 180, 365, 545, and 730 days). Participants were evaluated for immediate vaccine reactions, given adverse event diaries to document specific adverse events for 7 days following vaccine administration, and asked about potential adverse events at later timepoints up to the 2-year mark. The primary outcome was to assess the safety of MVA-BN for up to 2 years across formulations in a population at increased risk of mpox. This study is registered with <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span> (<span><span>NCT02977715</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>).<h3>Findings</h3>There was no significant difference in the risk of an adverse event between the liquid formulation (488 [49·0%] of 995 participants) and lyophilised formulation (315 [53·7%] of 586 participants; adjusted risk ratio [aRR] 1·08 [95% CI 0·98–1·19]) within 7 days after vaccination. Within 7 days of vaccine administration, participants had similar proportions of local injection-site reactions between the liquid (356 [35·7%] of 995 participants) and lyophilised (213 [36·3%] of 586 participants) formulations, but those who received the lyophilised formulation had a higher risk for systemic symptoms than those who received the liquid formulation (aRR 1·20 [95% CI 1·05–1·37]). 18 serious adverse events, including 17 deaths and one stillbirth, oc","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"71 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147384095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-02DOI: 10.1016/s1473-3099(26)00120-9
{"title":"Correction to Lancet Infect Dis 2026; published online Jan 28. https://doi.org/10.1016/S1473-3099(25)00747-9","authors":"","doi":"10.1016/s1473-3099(26)00120-9","DOIUrl":"https://doi.org/10.1016/s1473-3099(26)00120-9","url":null,"abstract":"","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"31 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147360569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-08DOI: 10.1016/S1473-3099(25)00776-5
Bingyu Zhang, Qiong Wu, Ravi Jhaveri, Christopher B Forrest, Yong Chen
{"title":"Methodological considerations in the attribution of long COVID to first or second infection - Authors' reply.","authors":"Bingyu Zhang, Qiong Wu, Ravi Jhaveri, Christopher B Forrest, Yong Chen","doi":"10.1016/S1473-3099(25)00776-5","DOIUrl":"10.1016/S1473-3099(25)00776-5","url":null,"abstract":"","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":" ","pages":"e141"},"PeriodicalIF":31.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01DOI: 10.1016/S1473-3099(26)00009-5
David L Paterson, Abdullah T Aslan, Patrick N A Harris
{"title":"Precision diagnostics for MBLs: the true game changer in treating antimicrobial resistance - Authors' reply.","authors":"David L Paterson, Abdullah T Aslan, Patrick N A Harris","doi":"10.1016/S1473-3099(26)00009-5","DOIUrl":"https://doi.org/10.1016/S1473-3099(26)00009-5","url":null,"abstract":"","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"26 3","pages":"e145"},"PeriodicalIF":31.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01DOI: 10.1016/S1473-3099(26)00008-3
Brenda A Warecki, María F Mojica, Alejandro J Vila, Robert A Bonomo
{"title":"Precision diagnostics for MBLs: the true game changer in treating antimicrobial resistance.","authors":"Brenda A Warecki, María F Mojica, Alejandro J Vila, Robert A Bonomo","doi":"10.1016/S1473-3099(26)00008-3","DOIUrl":"https://doi.org/10.1016/S1473-3099(26)00008-3","url":null,"abstract":"","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"26 3","pages":"e144"},"PeriodicalIF":31.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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