Pub Date : 2026-01-12DOI: 10.1016/s1473-3099(25)00742-x
Josefina L Razzini MD, Iago Giné-Vázquez PhD, Jing Jin PhD, María-Isolina Santiago-Pérez BS, Olaia Pérez-Martínez MD, María-Teresa Otero-Barrós MD, Nuria Suárez-Gaiche MD, Rolf Kramer PhD, Leticia Platero-Alonso PhD, Rosa-María Álvarez-Gil MD, Olga-María Ces-Ozores RPH, Victoria Nartallo-Penas PhD, Susana Mirás-Carballal RPH, Marta Piñeiro-Sotelo RPH, Juan-Manuel González-Pérez BS, Carmen Rodríguez-Tenreiro-Sánchez PhD, Ángela Manzanares-Casteleiro MD, Ana Dacosta-Urbieta, Cintia Álvarez-Smith MD, Irene Rivero-Calle MD, Prof Antonio Salas PhD, Carmen Durán-Parrondo PhD, Narmeen Mallah PhD, Prof Federico Martinón-Torres PhD
Real-world evidence on nirsevimab impact beyond the first season when given under universal immunisation programmes is emerging. We aimed to assess the medium-term impact of universal infant respiratory syncytial virus (RSV) prophylaxis with nirsevimab across inpatient and outpatient settings during two consecutive RSV seasons.
{"title":"Impact of universal nirsevimab prophylaxis in infants on hospital and primary care outcomes across two respiratory syncytial virus seasons in Galicia, Spain (NIRSE-GAL): a population-based prospective observational study","authors":"Josefina L Razzini MD, Iago Giné-Vázquez PhD, Jing Jin PhD, María-Isolina Santiago-Pérez BS, Olaia Pérez-Martínez MD, María-Teresa Otero-Barrós MD, Nuria Suárez-Gaiche MD, Rolf Kramer PhD, Leticia Platero-Alonso PhD, Rosa-María Álvarez-Gil MD, Olga-María Ces-Ozores RPH, Victoria Nartallo-Penas PhD, Susana Mirás-Carballal RPH, Marta Piñeiro-Sotelo RPH, Juan-Manuel González-Pérez BS, Carmen Rodríguez-Tenreiro-Sánchez PhD, Ángela Manzanares-Casteleiro MD, Ana Dacosta-Urbieta, Cintia Álvarez-Smith MD, Irene Rivero-Calle MD, Prof Antonio Salas PhD, Carmen Durán-Parrondo PhD, Narmeen Mallah PhD, Prof Federico Martinón-Torres PhD","doi":"10.1016/s1473-3099(25)00742-x","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00742-x","url":null,"abstract":"Real-world evidence on nirsevimab impact beyond the first season when given under universal immunisation programmes is emerging. We aimed to assess the medium-term impact of universal infant respiratory syncytial virus (RSV) prophylaxis with nirsevimab across inpatient and outpatient settings during two consecutive RSV seasons.","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"34 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145956961","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 : 2026-01-12DOI: 10.1016/s1473-3099(25)00772-8
Yu Kaku, Mizuka Fujiwara, Keiya Uriu, Maximilian Stanley Yo, Shusuke Kawakubo, Jumpei Ito, Naoya Itoh, Yoshifumi Uwamino, Fumitake Saito, Hironori Satoh, The Genotype to Phenotype Japan (G2P-Japan) Consortium, Kei Sato
{"title":"Humoral immunity after LP.8.1 monovalent vaccines against a broad range of SARS-CoV-2 variants including XEC, LP.8.1, NB.1.8.1, XFG, and BA.3.2","authors":"Yu Kaku, Mizuka Fujiwara, Keiya Uriu, Maximilian Stanley Yo, Shusuke Kawakubo, Jumpei Ito, Naoya Itoh, Yoshifumi Uwamino, Fumitake Saito, Hironori Satoh, The Genotype to Phenotype Japan (G2P-Japan) Consortium, Kei Sato","doi":"10.1016/s1473-3099(25)00772-8","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00772-8","url":null,"abstract":"","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"39 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145956960","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 : 2026-01-12DOI: 10.1016/s1473-3099(25)00777-7
Corinne Levy, Robert Cohen
{"title":"Nirsevimab over two RSV seasons: do the findings align with expectations?","authors":"Corinne Levy, Robert Cohen","doi":"10.1016/s1473-3099(25)00777-7","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00777-7","url":null,"abstract":"","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"182 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145956963","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 : 2026-01-09DOI: 10.1016/s1473-3099(26)00007-1
Marco De Ambrogi
{"title":"Highlights from ASTMH 2025","authors":"Marco De Ambrogi","doi":"10.1016/s1473-3099(26)00007-1","DOIUrl":"https://doi.org/10.1016/s1473-3099(26)00007-1","url":null,"abstract":"","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"4 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145956962","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 : 2026-01-08DOI: 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":"https://doi.org/10.1016/S1473-3099(25)00776-5","url":null,"abstract":"","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":31.0,"publicationDate":"2026-01-08","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 : 2026-01-08DOI: 10.1016/s1473-3099(25)00775-3
Sara Carazo, Danuta M Skowronski, Manale Ouakki, Gaston De Serres
No Abstract
没有抽象的
{"title":"Methodological considerations in the attribution of long COVID to first or second infection","authors":"Sara Carazo, Danuta M Skowronski, Manale Ouakki, Gaston De Serres","doi":"10.1016/s1473-3099(25)00775-3","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00775-3","url":null,"abstract":"No Abstract","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"8 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947514","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 : 2026-01-08DOI: 10.1016/s1473-3099(25)00684-x
Richard James Allan, Ramona Scherrer, Sara Estecha-Querol, David Weetman, Laura Paris, Umar Ba'abba Goni, Fatima Idris Abdulhamid, Blaise Nfornuh Alenwi, Sajjad Ahmad, Chad L Cross, Garba Mohammed Ashir, Mala Waziri, Godwin Ntadom, Louisa Alexandra Messenger
<h3>Background</h3>In 2025, the UN estimated that 305 million people would need humanitarian aid, and by 2030, two-thirds of the poorest populations will reside in areas of fragility, conflict, and violence. When individuals are forcibly displaced into malaria endemic areas, the risk of severe disease and mortality can be high. Novel vector control tools suited to the emergency context, for which conventional interventions suffer from biological and operational limitations, are urgently needed to interrupt vector-borne disease transmission among the world's most vulnerable. This study aimed to evaluate the effectiveness of spatial repellent emanators against malaria during a protracted humanitarian crisis.<h3>Methods</h3>We conducted a 6-month, two-arm pragmatic, open-label, controlled trial in 24 camps for people who are internally displaced in Maiduguri, Nigeria. Children aged 6–10 years were enrolled into a monthly cohort to estimate the primary trial epidemiological outcome of intervention impact on malaria infection incidence. The study team allocated 12 camps, which were spatially clustered, to receive the intervention and 12 other camps were allocated to the control group and received no intervention. Spatial repellent emanators, designed to remain efficacious for trial duration, were installed by the study team, or the householder under supervision, at the label coverage, in 50 eligible households per camp allocated to the intervention group. Monthly entomological monitoring measured changes in vector density (primary entomological outcome) and blood feeding (secondary entomological outcome). Intervention acceptability and feasibility was assessed using focus group discussions (tertiary trial outcomes). Patients were analysed according to treatment received and analyses were conducted using all non-missing observations, allowing for inclusion of participants with partial follow-up. This trial was 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>NCT06179732</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>) and is completed.<h3>Findings</h3>Between June 20 and July 3, 2023, 1655 participants were recruited, and 842 participants were assigned to the intervention group, and 813 patients were assigned to the control group. 770 patients were male and 885 were female. Post-intervention, after adjusting for baseline malaria prevalence, spatial repellent emanators significantly reduced malaria infection incidence over 6 months of follow-up (incidence rate ratio 0·713, 95% CI 0·584–0·869; p=0·001; n=1655). The estimated protective efficacy of spatial repellent emanators
{"title":"The effectiveness of long-lasting spatial repellent emanators against malaria in humanitarian crisis settings in northern Nigeria: a two-arm pragmatic, open-label, controlled trial","authors":"Richard James Allan, Ramona Scherrer, Sara Estecha-Querol, David Weetman, Laura Paris, Umar Ba'abba Goni, Fatima Idris Abdulhamid, Blaise Nfornuh Alenwi, Sajjad Ahmad, Chad L Cross, Garba Mohammed Ashir, Mala Waziri, Godwin Ntadom, Louisa Alexandra Messenger","doi":"10.1016/s1473-3099(25)00684-x","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00684-x","url":null,"abstract":"<h3>Background</h3>In 2025, the UN estimated that 305 million people would need humanitarian aid, and by 2030, two-thirds of the poorest populations will reside in areas of fragility, conflict, and violence. When individuals are forcibly displaced into malaria endemic areas, the risk of severe disease and mortality can be high. Novel vector control tools suited to the emergency context, for which conventional interventions suffer from biological and operational limitations, are urgently needed to interrupt vector-borne disease transmission among the world's most vulnerable. This study aimed to evaluate the effectiveness of spatial repellent emanators against malaria during a protracted humanitarian crisis.<h3>Methods</h3>We conducted a 6-month, two-arm pragmatic, open-label, controlled trial in 24 camps for people who are internally displaced in Maiduguri, Nigeria. Children aged 6–10 years were enrolled into a monthly cohort to estimate the primary trial epidemiological outcome of intervention impact on malaria infection incidence. The study team allocated 12 camps, which were spatially clustered, to receive the intervention and 12 other camps were allocated to the control group and received no intervention. Spatial repellent emanators, designed to remain efficacious for trial duration, were installed by the study team, or the householder under supervision, at the label coverage, in 50 eligible households per camp allocated to the intervention group. Monthly entomological monitoring measured changes in vector density (primary entomological outcome) and blood feeding (secondary entomological outcome). Intervention acceptability and feasibility was assessed using focus group discussions (tertiary trial outcomes). Patients were analysed according to treatment received and analyses were conducted using all non-missing observations, allowing for inclusion of participants with partial follow-up. This trial was 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>NCT06179732</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>) and is completed.<h3>Findings</h3>Between June 20 and July 3, 2023, 1655 participants were recruited, and 842 participants were assigned to the intervention group, and 813 patients were assigned to the control group. 770 patients were male and 885 were female. Post-intervention, after adjusting for baseline malaria prevalence, spatial repellent emanators significantly reduced malaria infection incidence over 6 months of follow-up (incidence rate ratio 0·713, 95% CI 0·584–0·869; p=0·001; n=1655). The estimated protective efficacy of spatial repellent emanators","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"28 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947521","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 : 2026-01-07DOI: 10.1016/S1473-3099(25)00682-6
Deborah R Leitner, Stephen R Walsh, Masataka Suzuki, Michaël Desjardins, Alisse Hannaford, Amy C Sherman, Hannah Levine, Lena Carr, Elliot Hammerness, Akina Osaki, Emily Sullivan, Bryan Wang, George I Balazs, Jun Bai Park Chang, Damien M Slater, Nirajan Puri, Carole J Kuehl, Wilbur H Chen, Jason B Harris, Steven Piantadosi, Lindsey R Baden, Matthew K Waldor
<p><strong>Background: </strong>Killed whole-cell oral cholera vaccines can be used to prevent cholera but require multiple doses and have limited efficacy in young children. PanChol is a single-dose, live-attenuated, oral cholera vaccine derived from a current seventh pandemic Vibrio cholerae O1 strain. It co-expresses Inaba and Ogawa antigens, over-expresses the non-toxic cholera toxin B subunit, and is designed to minimise reactogenicity and be incapable of toxigenic reversion. We aimed to assess safety and immunogenicity of PanChol in a first-in-human trial.</p><p><strong>Methods: </strong>This phase 1a trial was conducted at the Brigham and Women's Hospital (Boston, MA, USA) and involved an open-label fixed dose-escalation module, followed by a randomised, double-blind, placebo-controlled dose-expansion module. Eligible participants were healthy adults aged 18-55 years without a previous V cholerae infection or cholera vaccination or a history of gastrointestinal disorders. In the open-label dose-escalation phase, eligible participants were enrolled into one of five cohorts receiving one dose of oral 10<sup>6</sup>-10<sup>10</sup> colony-forming units (CFU) of PanChol. A dose de-escalation (10<sup>4</sup> CFU and 10<sup>5</sup> CFU) module was added after protocol amendment. In the subsequent randomised, double-blind module, participants were randomly assigned (7:7:4) to one of two dosing groups of one oral dose of PanChol (2 × 10<sup>7</sup> CFU or 2 × 10<sup>8</sup> CFU) or one oral dose of placebo (matching diluent). The list of assignments was generated from a custom program written by the statistician using blocked random assignments with a hidden block size (two blocks of 18). The co-primary outcomes were safety, including solicited, unsolicited, and serious adverse events following a single-dose of PanChol, and seroconversion (four-fold rise in titre over baseline) of vibriocidal titres to both Inaba and Ogawa V cholerae at 14 days post-vaccination (day 15). Safety was assessed in all participants who received the study product, and immunogenicity was assessed in all vaccine recipients who had samples available past day 7. Stool shedding of PanChol organisms was assessed as a secondary outcome in all participants. This trial is registered with ClinicalTrials.gov, NCT05657782, and is ongoing.</p><p><strong>Findings: </strong>Between Dec 13, 2022, and Feb 7, 2025, 57 healthy adults were enrolled, including 15 in the dose-escalation module (three in each group), six in the dose de-escalation module (three in each group), and 36 in the dose-expansion module (14 assigned to 10<sup>7</sup> CFU PanChol, 14 to 10<sup>8</sup> CFU PanChol, and eight to placebo); all participants received the allocated intervention. 27 (47%) of 57 participants were male, 30 (53%) were female, and the median age was 30·6 years (IQR 25·1-45·1); the majority were White (35 [61%]) and not Hispanic or Latino (51 [89%]). 34 (69%) of 49 PanChol recipients reported at l
{"title":"Safety and immunogenicity of PanChol, a single-dose live-attenuated oral cholera vaccine: results from a phase 1a, double-blind, randomised, placebo-controlled trial.","authors":"Deborah R Leitner, Stephen R Walsh, Masataka Suzuki, Michaël Desjardins, Alisse Hannaford, Amy C Sherman, Hannah Levine, Lena Carr, Elliot Hammerness, Akina Osaki, Emily Sullivan, Bryan Wang, George I Balazs, Jun Bai Park Chang, Damien M Slater, Nirajan Puri, Carole J Kuehl, Wilbur H Chen, Jason B Harris, Steven Piantadosi, Lindsey R Baden, Matthew K Waldor","doi":"10.1016/S1473-3099(25)00682-6","DOIUrl":"https://doi.org/10.1016/S1473-3099(25)00682-6","url":null,"abstract":"<p><strong>Background: </strong>Killed whole-cell oral cholera vaccines can be used to prevent cholera but require multiple doses and have limited efficacy in young children. PanChol is a single-dose, live-attenuated, oral cholera vaccine derived from a current seventh pandemic Vibrio cholerae O1 strain. It co-expresses Inaba and Ogawa antigens, over-expresses the non-toxic cholera toxin B subunit, and is designed to minimise reactogenicity and be incapable of toxigenic reversion. We aimed to assess safety and immunogenicity of PanChol in a first-in-human trial.</p><p><strong>Methods: </strong>This phase 1a trial was conducted at the Brigham and Women's Hospital (Boston, MA, USA) and involved an open-label fixed dose-escalation module, followed by a randomised, double-blind, placebo-controlled dose-expansion module. Eligible participants were healthy adults aged 18-55 years without a previous V cholerae infection or cholera vaccination or a history of gastrointestinal disorders. In the open-label dose-escalation phase, eligible participants were enrolled into one of five cohorts receiving one dose of oral 10<sup>6</sup>-10<sup>10</sup> colony-forming units (CFU) of PanChol. A dose de-escalation (10<sup>4</sup> CFU and 10<sup>5</sup> CFU) module was added after protocol amendment. In the subsequent randomised, double-blind module, participants were randomly assigned (7:7:4) to one of two dosing groups of one oral dose of PanChol (2 × 10<sup>7</sup> CFU or 2 × 10<sup>8</sup> CFU) or one oral dose of placebo (matching diluent). The list of assignments was generated from a custom program written by the statistician using blocked random assignments with a hidden block size (two blocks of 18). The co-primary outcomes were safety, including solicited, unsolicited, and serious adverse events following a single-dose of PanChol, and seroconversion (four-fold rise in titre over baseline) of vibriocidal titres to both Inaba and Ogawa V cholerae at 14 days post-vaccination (day 15). Safety was assessed in all participants who received the study product, and immunogenicity was assessed in all vaccine recipients who had samples available past day 7. Stool shedding of PanChol organisms was assessed as a secondary outcome in all participants. This trial is registered with ClinicalTrials.gov, NCT05657782, and is ongoing.</p><p><strong>Findings: </strong>Between Dec 13, 2022, and Feb 7, 2025, 57 healthy adults were enrolled, including 15 in the dose-escalation module (three in each group), six in the dose de-escalation module (three in each group), and 36 in the dose-expansion module (14 assigned to 10<sup>7</sup> CFU PanChol, 14 to 10<sup>8</sup> CFU PanChol, and eight to placebo); all participants received the allocated intervention. 27 (47%) of 57 participants were male, 30 (53%) were female, and the median age was 30·6 years (IQR 25·1-45·1); the majority were White (35 [61%]) and not Hispanic or Latino (51 [89%]). 34 (69%) of 49 PanChol recipients reported at l","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":31.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949339","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 : 2026-01-07DOI: 10.1016/S1473-3099(25)00725-X
David A Wohl, Carwolo Pewu, Chanhwa Lee, Emmanuel Kerkula, Martha Gayflowu, Nukal Doetein, Katie R Mollan, Taylor J Krajewski, Becky Straub, Alfred Flomo, Amara Fofana, Stanley Kerkula, Thomas Sumo, Alexander Sampson, Samuel Vouh, Fred Flomo, McKenzie A Colt, Thomas Remont, Eleanor Rose Watts, Marta Zizek, Catherine Nimely, Minnie Ricks, Jefferson Sibley, William A Fischer
<p><strong>Background: </strong>Lassa virus (LASV) is a persistent threat to public health in west Africa and beyond. LASV is endemic in west Africa and each year it is responsible for an estimated 2·7 million infections, 23 700 hospitalisations, and 5000 deaths. With over 32 reported cases of Lassa fever imported into non-endemic countries-one-third of which were fatal-the importance of enhanced detection and management of Lassa fever extends beyond west Africa.</p><p><strong>Methods: </strong>The prevalence, pathogenesis, and persistence (PREPARE) study was a prospective cohort study among patients admitted to two hospitals in a hyperendemic area of Liberia. Any patients aged 5 years or older with a febrile illness were eligible to enrol and be tested for Lassa fever. The study aimed to measure the prevalence of LASV infection and assess the signs and symptoms, LASV viral replication kinetics, and LASV-specific IgM and IgG responses longitudinally among adults and children with laboratory-confirmed Lassa fever.</p><p><strong>Findings: </strong>From July 10, 2018, to Aug 12, 2024, a total of 435 participants were enrolled, including 362 admitted with a febrile illness and 73 who were directly admitted with clinical suspicion for Lassa fever. Lassa fever was diagnosed by plasma LASV RT-PCR in 41 (11%) of 362 febrile participants and 47 (64%) of 73 participants directly admitted with suspected Lassa fever, resulting in a total of 88 cases of confirmed Lassa fever. At entry, anorexia (71 [81%] of 88 vs 178 [51%] of 347), severe fatigue or weakness (63 [72%] vs 178 [51%]), and nausea or vomiting (39 [44%] vs 95 [27%]) were more likely to be reported by participants with Lassa fever than by participants who tested LASV RNA negative. Among the participants with Lassa fever, 11 (13%) of 88 died after admission. Mental status changes, seizures, acute kidney failure, hyperkalaemia, and metabolic acidosis were more frequent in patients with Lassa fever who died than in patients who survived. Median cycle threshold values at study entry for glycoprotein complex gene (GPC) or polymerase gene (L) were lower in those who died (GPC cycle threshold 22·4 [IQR 20·0-27·9]; L cycle threshold 21·7 [19·0-27·7]) than in those who survived (GPC cycle threshold 31·5 [28·0-33·9]; L cycle threshold 32·3 [28·0-33·9]). Among the 70 participants with Lassa fever who consented to longitudinal follow-up through their hospitalisation, seven died and these participants tended to have lower cycle threshold values and lower IgM and IgG LASV responses compared with survivors.</p><p><strong>Interpretation: </strong>In a region of Liberia where it is endemic, Lassa fever is a prevalent cause of morbidity and mortality. Several symptoms were more likely in those with Lassa fever but overlap with those caused by other common infectious diseases. Compared with survivors, those who died during hospitalisation for Lassa fever tended to have evidence of organ dysfunction along with higher
{"title":"Lassa fever symptomatology, viral dynamics, and host immune response (PREPARE): a prospective, observational cohort study in Liberia.","authors":"David A Wohl, Carwolo Pewu, Chanhwa Lee, Emmanuel Kerkula, Martha Gayflowu, Nukal Doetein, Katie R Mollan, Taylor J Krajewski, Becky Straub, Alfred Flomo, Amara Fofana, Stanley Kerkula, Thomas Sumo, Alexander Sampson, Samuel Vouh, Fred Flomo, McKenzie A Colt, Thomas Remont, Eleanor Rose Watts, Marta Zizek, Catherine Nimely, Minnie Ricks, Jefferson Sibley, William A Fischer","doi":"10.1016/S1473-3099(25)00725-X","DOIUrl":"https://doi.org/10.1016/S1473-3099(25)00725-X","url":null,"abstract":"<p><strong>Background: </strong>Lassa virus (LASV) is a persistent threat to public health in west Africa and beyond. LASV is endemic in west Africa and each year it is responsible for an estimated 2·7 million infections, 23 700 hospitalisations, and 5000 deaths. With over 32 reported cases of Lassa fever imported into non-endemic countries-one-third of which were fatal-the importance of enhanced detection and management of Lassa fever extends beyond west Africa.</p><p><strong>Methods: </strong>The prevalence, pathogenesis, and persistence (PREPARE) study was a prospective cohort study among patients admitted to two hospitals in a hyperendemic area of Liberia. Any patients aged 5 years or older with a febrile illness were eligible to enrol and be tested for Lassa fever. The study aimed to measure the prevalence of LASV infection and assess the signs and symptoms, LASV viral replication kinetics, and LASV-specific IgM and IgG responses longitudinally among adults and children with laboratory-confirmed Lassa fever.</p><p><strong>Findings: </strong>From July 10, 2018, to Aug 12, 2024, a total of 435 participants were enrolled, including 362 admitted with a febrile illness and 73 who were directly admitted with clinical suspicion for Lassa fever. Lassa fever was diagnosed by plasma LASV RT-PCR in 41 (11%) of 362 febrile participants and 47 (64%) of 73 participants directly admitted with suspected Lassa fever, resulting in a total of 88 cases of confirmed Lassa fever. At entry, anorexia (71 [81%] of 88 vs 178 [51%] of 347), severe fatigue or weakness (63 [72%] vs 178 [51%]), and nausea or vomiting (39 [44%] vs 95 [27%]) were more likely to be reported by participants with Lassa fever than by participants who tested LASV RNA negative. Among the participants with Lassa fever, 11 (13%) of 88 died after admission. Mental status changes, seizures, acute kidney failure, hyperkalaemia, and metabolic acidosis were more frequent in patients with Lassa fever who died than in patients who survived. Median cycle threshold values at study entry for glycoprotein complex gene (GPC) or polymerase gene (L) were lower in those who died (GPC cycle threshold 22·4 [IQR 20·0-27·9]; L cycle threshold 21·7 [19·0-27·7]) than in those who survived (GPC cycle threshold 31·5 [28·0-33·9]; L cycle threshold 32·3 [28·0-33·9]). Among the 70 participants with Lassa fever who consented to longitudinal follow-up through their hospitalisation, seven died and these participants tended to have lower cycle threshold values and lower IgM and IgG LASV responses compared with survivors.</p><p><strong>Interpretation: </strong>In a region of Liberia where it is endemic, Lassa fever is a prevalent cause of morbidity and mortality. Several symptoms were more likely in those with Lassa fever but overlap with those caused by other common infectious diseases. Compared with survivors, those who died during hospitalisation for Lassa fever tended to have evidence of organ dysfunction along with higher ","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":31.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949403","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}