Journal of Travel Medicine

International wildlife trade represents one of the major drivers of biodiversity exploitation worldwide. However, the true taxonomic diversity embedded within commercial wildlife products often remains unknown because processing removes diagnostic morphological characteristics, preventing reliable species identification. Consequently, biodiversity assessments based solely on product labels may substantially underestimate the diversity of species involved in trade networks. To investigate hidden biodiversity within wildlife trade products, we applied DNA barcoding based on the mitochondrial cytochrome c oxidase subunit I (COI) gene to 77 products commercialized as fish swim bladders and seized at Guarulhos International Airport, Brazil. Molecular analyses successfully identified all samples and revealed the presence of four species: Plagioscion auratus (n = 38), Cynoscion acoupa (n = 7), Melanosuchus niger (n = 17), and Caiman crocodilus (n = 15). Fish species accounted for 71.4% of all samples, whereas crocodilians represented 28.6%, demonstrating that products marketed under a single commercial category may conceal substantial taxonomic diversity. Notably, the occurrence of two Amazonian crocodilian species within a trade chain traditionally associated with fish products reveals a previously undocumented component of the international wildlife trade. Our findings demonstrate that DNA barcoding is an effective tool for uncovering hidden biodiversity within processed wildlife products and provide evidence that wildlife trade networks may involve a broader spectrum of species than suggested by commercial labels. These results highlight the importance of molecular surveillance for biodiversity monitoring, wildlife trade regulation, and conservation planning.

Japanese encephalitis virus (JEV) is a leading cause of viral encephalitis in humans in Asia. Prior to 2021, only sporadic outbreaks had been detected in Australia's tropical northern extremes. However, during 2021-23, JEV infection was identified in 45 people and in more than 85 piggeries, together with many detections in feral pigs, mosquitoes, and other livestock across Australia, including in the temperate far south. Here we estimated the spatial extent of virus transmission during the outbreak (the realised niche) and the area environmentally suitable for transmission (the potential niche). We collated a national dataset of JEV surveillance and detection in humans, mosquitoes, domestic pigs, feral pigs, and sentinel chickens from 2021-23. We combined these data with (1) previously published predictions of habitat suitability for vertebrate host and vector species, and (2) estimated densities of humans, domestic pigs, and feral pigs, in a multipart assessment of spatial risk. Our model projected broad potential environmental suitability over much of northern and eastern Australia during the outbreak period, but floodplain wetland areas in the north and the inland east of Australia had both the highest estimated environmental suitability for transmission, and the strongest evidence for virus circulation.

Low pathogenic avian influenza A(H7N7) virus detected in a poultry worker in Taiwan, 2026 was related to viruses circulating in Asian wild birds and possessed PB2 E627K, a mammalian adaptation marker. Enhanced surveillance for H7 viruses in poultry and rapid characterization of human cases are essential to assess pandemic potential.

There is currently no clinical data for the effectiveness of the only licensed Ebola virus disease vaccine (Ervebo) against Bundibugyo virus disease. A number of studies have shown immune cross-reactivity with Bundibugyo virus after Ervebo vaccination. However, antibody recognition of Bundibugyo is around 2.8-fold lower than recognition of Ebola virus. Here, we aimed to infer how a 2.8-fold drop in immune recognition may affect Ervebo protection against Bundibugyo virus disease based on analysis of data on Ervebo immunogenicity and protection from Ebola virus disease. This work has three main components. Firstly, we analysed the timing of vaccine protection in the Ervebo pivotal ring vaccination clinical trial. Secondly, we performed a systematic review and meta-analysis of antibody responses to Ebola virus after Ervebo vaccination over time. Thirdly, we combined these data with previously reported data on the cross-reactivity to Bundibugyo virus to infer protection of Ervebo against Bundibugyo virus disease. We find that the clinical trial data for Ervebo supports vaccine protection beginning earlier than 10 days after vaccination. Secondly, binding antibody levels against Ebola virus on day 28 post vaccination (peak responses) were on average 12.9-fold (95% confidence interval, CI: 6.4 - 26.0) higher than on day 7, 6.3-fold (95% CI: 3.7 -10.8) higher than on day 10, and 2.5-fold (95% CI: 1.4 - 4.4) higher than on day 14 (neutralising antibodies showed similar results). Finally, we consider the scenarios where antibody levels to Ebola virus at day 7 or 10 are putative protective thresholds against Ebola virus disease, and we assume these thresholds also apply for Bundibugyo virus disease. Then, with a 2.8-fold reduction of responses to Bundibugyo compared to Ebola virus, we predict antibody responses to Bundibugyo virus after Ervebo vaccination are likely above these putative protective thresholds.

Since 2020, highly pathogenic avian influenza (HPAI) A(H5Nx) clade 2.3.4.4b viruses have spread globally, causing extensive outbreaks in domestic and wild birds. Increased circulation has resulted in frequent spillover to mammals, and occasional mammal-to-mammal transmission. Although human infections remain rare, the zoonotic potential of these viruses continues to be a public health concern. We investigated six cases of HPAI in red foxes (Vulpes vulpes) in Norway during 2022-2024 and identified infections with H5N1 and H5N5 viruses. Pathological and virological investigations demonstrated systemic infection, with prominent lesions in the brain and/or lungs. Phylogenetic analyses showed high similarity between viruses detected in foxes and those concurrently circulating in wild birds. The mammalian adaptation marker PB2:E627K was identified in one H5N1 virus and as a minority variant in a second H5N1 virus.

Traditional veterinary pathology investigations on wild animals generally conclude a primary cause of death based on a combination of observed clinical signs, gross and microscopic lesions, microbial culture and PCR. However, these methods may fail to capture the broader microbial community of the host. We employed metatranscriptomic sequencing to characterise the potential pathobiome of necropsied marine turtles, comparing these findings with corresponding veterinary pathology reports. Tissue samples were collected from 76 individuals spanning three species of marine turtles -- the green turtle (Chelonia mydas), the hawksbill turtle (Eretmochelys imbricata), and the loggerhead turtle (Caretta caretta) -- across the coastline of New South Wales, Australia. Reported causes of mortality ranged from infectious disease to trauma. We identified a diverse range of parasites within the genera Neospirochis, Hapalotrema, Paraorgymatobothrium, Eimeria and Callitetrarhynchus, and bacteria including the genera Aeromonas, Clostridium, and Vibrio. Novel viruses of the families Astroviridae, Caliciviridae, Hepaciviridae, Hepeviridae, Nyamivirdae, Orthomyxoviridae, Picobirnaviridae and Rhabdoviridae were also identified. In cases where infectious disease was noted in the pathology report, we frequently observed high pathogen read counts consistent with the listed primary diagnoses. However, we also detected a range of incidental infections involving eukaryotic parasites, bacteria, and viruses. The diversity of infectious agents detected in marine turtles suggests that the observed disease outcomes are unlikely to be driven by a single causative agent, but rather by complex interactions between host health, the pathobiome, and environmental stressors. We discuss the potential implications for turtle health and conservation.

Objectives To evaluate the impact of COVID-19 vaccination on the prevention of long COVID (LC) in the Omicron era through an updated systematic review and meta-analysis. Methods We performed an update of our previously published systematic review and meta-analysis of vaccination and LC risk (searches between 1 January 2022 and 1 March 2024). Databases (Embase, MEDLINE, PubMed, Europe PMC, LILACS, Cochrane COVID-19 Study Register) were searched for studies published between 1 March 2024 and 13 July 2026. Observational studies assessing the impact of vaccination on the risk of LC four or more weeks after SARS-CoV-2 infection were included. Vaccines were restricted to those centrally authorised in the European Union. Random-effects meta-analyses, restricted to adults, were performed to calculate pooled odds ratios (OR) of LC in three comparisons: vaccinated (any dose) versus unvaccinated; booster vaccination versus unvaccinated; and booster vaccination versus primary course vaccination only. Results Nineteen new studies were identified, of which ten were included in the updated meta-analyses alongside eight studies from the original review. The pooled OR of LC in vaccinated adults (any dose) versus unvaccinated was 0.75 (95% confidence interval [CI] 0.67-0.84; 13 studies). ORs were also lower for booster vaccination versus unvaccinated (0.73; 95% CI 0.65-0.82; 6 studies), and booster vaccination versus primary course vaccination (0.63; 95% CI 0.53-0.75; 6 studies). Significant associations between vaccination and lower LC odds were observed in subgroup analyses of mRNA-only vaccination and LC outcomes three or more months after infection. Conclusions This updated review and meta-analysis reinforces our previous finding that vaccination may reduce the burden of LC in the Omicron era, with booster doses potentially providing additional protection. Although evidence in high-risk groups now prioritised for vaccination in most countries remains limited, these findings clearly demonstrate the benefits of vaccination and support current seasonal vaccination strategies.

In 2024, Chicago experienced a measles virus outbreak. Air samples collected as part of routine respiratory virus surveillance from three hospitals that received measles patients were retrospectively analyzed. Measles virus was detected in air samples from one emergency department across five weeks when measles patients were present and another when no known cases were present. Two of three viral sequences derived from air samples were identical to measles patients. The source of one diverging sequence could not be identified and may represent a case not identified by traditional surveillance methods. Air sampling may supplement measles investigation, surveillance and response.

To reduce health risks for human space exploration, it is important to model the effects of deep-space radiation on biological systems. The budding yeast Saccharomyces cerevisiae is a common model organism in space radiobiology, but little is known about how radiation damage to individual cells translates into the population-level effects that experiments measure. The Agent-Based Model for Microbial Populations Exposed to Radiation (AMMPER) is a spatially explicit agent-based model that simulates the effects of ionizing radiation on S. cerevisiae cells and produces population-level results. Its goal is to improve experiment design and data interpretation. AMMPER-1 demonstrated that agent-based simulations can qualitatively reproduce the effects of proton radiation on the growth rate of wild-type and DNA-repair mutant yeast. Here, we present AMMPER-2, which addresses limitations of the first model and expands its capabilities. AMMPER-2 incorporates the dynamics of the redox dye alamarBlue, a data type commonly generated in spaceflight microbiology experiments, and models the fate of reactive oxygen species in more detail. It also adds an improved graphical interface and runs faster. AMMPER-2 remains easy to execute in Python on a standard personal laptop, providing space biologists a tool to explore experimental conditions, generate hypotheses, and interpret data from microbial space radiation experiments.

Despite the use of technological countermeasures, studies show that the sensory conflict, and thus symptoms of motion sickness such as nausea, cannot be completely prevented while traveling as a car passenger. Accordingly, reliable prediction of motion sickness will represent a possible solution for intelligent vehicles to avoid the abortion of the drive, e.g., through adapted driving strategies or route planning. In previous works, the authors were able to demonstrate an application-oriented parameter set for the popular 6DOF-SVC model to estimate motion sickness incidence (MSI) in passengers with a lowered gaze on a non-driving-related task. In the current study, these parameters were validated and further optimized using five previous conducted motion sickness driving experiments. For the first time, it is also shown that the expected natural MSI fluctuations based on the driving dynamic profile, due to route characteristics or driving style, as well as the variation in experimental determined MSI is approximately 10%. Moreover, findings indicate that the participants appear to have an individual MSI threshold that correlates with their susceptibility to motion sickness, however, this threshold fluctuates too strongly across experiments to be suitable for practical application. As a result, the model can successfully estimate motion sickness risk across the test tracks, however, inaccuracies in the predicted MSI trajectories remain.

In England and Wales, Usutu virus (USUV) was detected in 2020 and is now established. West Nile virus (WNV) has so far only been detected in a single location, in two Aedes vexans mosquito pools sampled during 2023 surveillance. Given the growing threat to the UK from Culex-borne viruses there is a need to undertake risk assessments to contribute to preparedness and surveillance strategy for both viruses across human and animal health sectors. Here, we present the first application of a mechanistic R0-based model, incorporating temperature dependence and combining data on vector species distribution with projected future climate scenarios, to assess transmission suitability for WNV and USUV across England and Wales. Under current climate conditions, the two viruses showed comparable spatial patterns, with risk concentrated most heavily in the southeast along the Thames estuary and extending into Kent, Essex and Surrey, as well as around Cambridgeshire and adjacent counties, and across Yorkshire, Nottinghamshire and Lincolnshire. This pattern broadly corresponded with the cumulative distribution of Culex mosquito abundance established in our earlier work (Culex pipiens pipiens, Culex pipiens molestus and Culex torrentium). Both viruses were projected to show increasing transmission suitability risk over time, with substantially steeper increases under Representative Common Pathway (RCP) 8.5 then RCP 4.5. Equine WNV cases were predicted to be most likely in southeast England, in particular around Newmarket, driven by the region's dense horse population. Among the human population, London was identified as the highest-risk area, with Liverpool and Manchester also showing elevated risk levels, driven by a combination of high human and mosquito distributions. When human population distributions were age-adjusted to account for the proportion of over 60 years-olds, there was elevated risk in coastal regions, particularly in the east (Norfolk and Suffolk) and southeast (Kent) of England. The geographic distribution of positive mosquito and bird USUV cases recorded in 2023 and 2024 broadly overlapped with areas predicted to have higher USUV suitability, providing validation for the model's spatial outputs. By characterising relative spatial transmission suitability risk, this work adds to a growing understanding of where arbovirus emergence and spread are most likely across England and Wales, and can support decisions around resource allocation, targeted surveillance efforts, and public health readiness. The results also underscore the importance of incorporating climate change and vector ecology into future modelling work, given their likely influence on how arbovirus risk evolves over time.

The 2026 multinational Andes virus (ANDV) outbreak linked to cruise-ship travel from Argentina triggered extensive contact tracing and quarantine. Whether intervention on this scale was necessary or sufficient depends on the risk of onward transmission, which can be difficult to estimate early in an outbreak. Using transmission-pair data from the 2018--2019 outbreak in Epuyen, Argentina, and a mechanistic model linking viral growth, symptom onset, and transmission, we estimated that 42.4% (95% CrI: 18.2-69.7\%) of transmission occurs before symptom onset and that the median incubation period is 18.5 days (95% CrI: 16.5-19.5). We simulated outbreaks under an Epuyen-calibrated estimate (R = 2.12, k = 0.316) and a pooled estimate from 15 prior ANDV investigations (R = 0.24, k = 0.39), with intervention beginning after two generations, as in the cruise-associated event. Under the higher-transmission scenario, missing 10% of exposed individuals or downstream contacts resulted in a 29.9% probability of continued spread and a 20.6% probability that at least 5,000 ultimately uninfected people would be quarantined. Under lower transmission, continued spread stayed below 8%. However, the risk of onward transmission could not be estimated precisely from the first several detected cases. These findings therefore support rapid, comprehensive contact tracing and quarantine after large international exposure events despite substantial costs.

Background Killed whole-cell oral cholera vaccines require multiple doses and have reduced efficacy in young children, limiting their utility. PanChol is a single-dose, oral live-attenuated cholera vaccine engineered from a current seventh pandemic El Tor O1 Vibrio cholerae strain. PanChol was shown to be safe and immunogenic in a previous phase 1a trial. In participants from this first-in-human trial, we aimed to assess the durability of the initial PanChol dose and the safety and immunogenicity of a second dose. Methods This open-label phase 1a booster study was conducted at Brigham and Women's Hospital (Boston, MA). Eligible participants were healthy adults aged 18-55 years without a history of cholera or gastrointestinal disorders and had received a PanChol dose ranging from 105-1010 colony-forming units (CFU) within the previous 322-1111 days. All participants received a booster dose of 2x107 CFU. The primary outcome was safety, including solicited, unsolicited, and serious adverse events following the second dose of PanChol. Secondary endpoints were the magnitude of pre- and post-vaccination serum vibriocidal titers to both Inaba and Ogawa V. cholerae, including seroconversion (4-fold rise in titers over baseline), and stool shedding of PanChol organisms using quantitative and qualitative stool cultures. Comparisons of the amount of vaccine shedding in stool following primary and secondary immunization were used to assess the intestinal mucosal immunity elicited by the initial PanChol dose. All outcomes were assessed in all participants. This trial is registered with ClinicalTrials.gov, NCT05657782, and is complete. Findings Between Aug 25, 2025, and Feb 20, 2026, 20 healthy adults who previously received a single oral dose of PanChol were enrolled to receive a booster dose of 2x107 CFU. Eleven (55%) of 20 participants were male and the median age was 43{middle dot}6 (IQR 30{middle dot}2-49{middle dot}5). Ten (50%) were White and 17 (85%) were not Hispanic or Latino. Nine (45%) of 20 boost recipients reported at least one solicited adverse event; 13 (93%) of 14 events were mild, and all were transient. The most common solicited adverse event was nausea, reported by 4 (20%) participants; all cases were mild. Most unsolicited adverse events were mild; one was grade 3 and was deemed unrelated to vaccination. Two unsolicited adverse events were deemed related to vaccination (mild gassy sensation and heartburn, both of which occurred on day 1 and resolved the same day). In most participants, vibriocidal antibody titers measured on the day of boosting exceeded baseline titers prior to the initial dose (17 (85%) for Inaba and 14 (70%) for Ogawa). Fifteen (75%) of 20 boost recipients seroconverted vibriocidal antibody titers to both serotypes. After the boost, 17 (85%) participants had no or self-limited vaccine shedding, compared with 10% after the first PanChol dose. Interpretation A second oral dose of PanChol had a favorable safety profile and induced vibriocidal seroconversion to both serotypes in 75% of boost recipients. Intestinal colonization of PanChol following the boost serves as a proxy for measuring mucosal immunity targeting V. cholerae. The decrease in in the abundance of PanChol fecal shedding following the second dose, compared with the first, suggests that a single dose of PanChol is sufficient to confer durable protective immunity against a cholera challenge. These observations underscore the need for further clinical development of PanChol. Funding Wellcome Trust.

Defective interfering particles (DIPs) represent promising antivirals against influenza A virus (IAV), yet strategies to further enhance their antiviral activity remain largely unexplored. Here, we engineered a next-generation OP7 DIP by truncating the viral interferon (IFN) antagonist non-structural protein 1 (NS1) to enhance IFN-mediated antiviral activity. A previously validated mathematical multiscale model predicted that loss of NS1 function would enhance antiviral activity, providing a mechanistic rationale for this design. We engineered OP7-trNS1 DIP, established a cell culture-based production process yielding infectious virus-free material, and evaluated its antiviral activity in human lung epithelial cells in vitro. OP7-trNS1 inhibited IAV replication by approx. two orders of magnitude more effectively than the parental OP7 DIP while inducing a stronger IFN response, consistent with the model predictions. Together, these findings demonstrate that reducing viral IFN antagonism is a viable strategy for rationally enhancing DIP antiviral activity and establish OP7-trNS1 as a promising candidate for further preclinical development.

Background: Filoviruses, specifically Ebola virus (EBOV), Bundibugyo virus (BDBV), and Marburg virus (MARV), have been the etiologic agents of multiple outbreaks of severe disease in the Democratic Republic of the Congo (DRC). Two EBOV-specific vaccine regimens have been approved for use in outbreak scenarios, including the Ad26.ZEBOV/MVA-BN-Filo (Zabdeno/Mvabea) two-dose vaccine, where the MVA-BN-Filo booster dose contains EBOV, MARV, and Sudan (SUDV) virus glycoproteins (GPs) and the nucleoprotein from Tai Forest virus. While long-term immunogenicity of up to two years has been found in clinical trial settings, limited real-world data exists. Methods: Using a multiplexed immunoassay, samples (n=698 at baseline) collected in Mbandaka, Equateur province, DRC, between September 2023 and October 2024 were assessed for seroreactivity to six filovirus antigens (1 BDBV, 2 EBOV, 2 MARV, and 1 SUDV) at three distinct periods: baseline/pre-vaccination, 6-8 weeks post-first dose (Zabdeno), at booster administration (Mvabea), and one-year post-boost dose. Results: Substantial filovirus seroreactivity was found at baseline, with 48.7% (n=340/698) of individuals being seroreactive to at least one virus antigen. High baseline seroreactivity was found against BDBV GP (31.1%, n=217/698), with lower baseline seroreactivity to EBOV GP (15.5%, n=106/698), comparatively. Overall EBOV GP seroreactivity increased to 66.8% (n=376/563) at one year-post vaccine boost and 57.6% (n=250/434) of participants were seroreactive. Despite the booster dose inclusion of SUDV GP and MARV GP, there were no substantial increases in reactivity against either antigen at subsequent timepoints. Overall filovirus seroreactivity increased at all timepoints for the entire cohort, although filovirus reactivity decreased over the study period for those who were seroreactive at baseline. Findings: These data highlight detection of significantly elevated seoreactivity to EBOV GP following first-dose administration of Ad26.ZEBOV, which remained relatively stable one-year post-booster dose administration. Additionally, this study identifies high levels of baseline seroreactivity to BDBV GP despite no previous documented outbreaks in this region of DRC. These data suggest that vaccination with the Ad26.ZEBOV-MVA-BN-Filo vaccine induces stable seroreactivity against EBOV GP, but not to other filovirus antigens.

BackgroundNipah virus (NiV) is a zoonotic pathogen in the Henipavirus genus that causes severe, often fatal disease in humans. The World Health Organization and the Coalition for Epidemic Preparedness Innovations (CEPI) have designated NiV as a priority pathogen with pandemic potential. While CEPI is funding research on medical countermeasures, including vaccines and monoclonal antibodies (mAbs), there remains limited understanding of how at-risk countries will use them. This study aims to address this gap through targeted interviews and demand forecasting for 10 countries: Australia, Bangladesh, Cambodia, India, Indonesia, Malaysia, the Philippines, Singapore, Thailand, and Vietnam. Methodology/Principal FindingsInterviews with country and global stakeholders gathered data on regional sentiment, financing, and affordability. Profiles were developed to summarize each countrys perceived outbreak risk and their likely use of countermeasures. Demand was estimated by integrating these perspectives into models of likely country-level responses to three NiV outbreak scenarios: Expected, Amplified, and Extended. In the Expected scenario, countries focused on reactive use with global annual demand ranging from approximately 800 to 5,000 doses for vaccine-only, mAb-only, and combination interventions. Ring strategies were preferred given outbreak size and infrequency. Demand was highest for vaccine-only and combination interventions, with lower demand for mAbs-only due to affordability concerns and less familiarity in Bangladesh and India. In Amplified and Extended scenarios, countries expanded their responses to include preventive campaigns for healthcare workers and rural populations. These campaigns would require approximately 410,000 and 6,300,000 doses, respectively, if introduced in all 10 countries. Conclusions/SignificanceThis study has revealed existing sentiments regarding Nipah disease and interventions and modeled demand across three outbreak scenarios. Given global annual demand based on current epidemiology, Nipah countermeasure markets are unlikely to be commercially viable solely on routine country-financed demand. Instead, market health will require external financing and stockpile mechanisms to maintain demand between sporadic outbreaks. Author SummaryNipah virus (NiV), which causes severe and often fatal disease in humans, is recognized by the Coalition for Epidemic Preparedness Innovations (CEPI) as a priority pathogen with pandemic potential. In response, CEPI has supported the development of vaccines and monoclonal antibodies (mAb). However, limited evidence exists on how at-risk countries will deploy these medical countermeasures. We interviewed key decision-makers across 10 at-risk countries, along with global experts on NiV, to better understand disease prioritization, financing and affordability considerations, and countermeasure preferences. Interview findings informed the development of a demand forecast in response to Nipah outbreaks of varying intensity. At expected outbreak levels, countries focused their response on reactive strategies given outbreak size and infrequency. As outbreaks grew in size, countries considered expanding their response to include preventive campaigns targeting healthcare workers and at-risk, rural populations. This study provides new insights into country-level perspectives on NiV and medical countermeasures and quantifies expected demand across three outbreak scenarios and 10 countries. Our findings can provide a foundation for the strategic development of an international Nipah countermeasure stockpile, designed to address episodic NiV outbreaks and enhance pandemic preparedness.

Background Influenza vaccines have seen many changes over recent years in terms of both policy recommendations and product types. Immune responses and vaccine effectiveness vary by vaccine strain composition and product type. This study aimed to explore this variation on a regional level through examining spatial and temporal autocorrelations of vaccine uptake of different product types within Michigan from 2017 to 2021. Methods Influenza vaccine administration data from the 2017/18 to 2021/22 seasons were obtained from the Michigan Care Improvement Registry. Population size estimates for 2017 and 2019 were obtained from the Michigan Department of Health and Human Services. Age-standardized and age-stratified vaccination rates were computed. Disparate county-level vaccine uptake clusters were constructed using spatial autocorrelation indicators and spatiotemporal clusters were identified using scan statistics. Linear mixed effect models were used to study the impact of social vulnerability and urbanicity level on seasonal influenza vaccination rate. Results Vaccination incidence rates for adjuvanted, recombinant, and nasal sprays vaccines and for any vaccines increased significantly through the study period. County-level spatiotemporal clusters of type-specific uptake rates were identified. Most notably, we identified an emerging cluster with high uptake of adjuvanted vaccine radiating from Ottawa County, located in suburban Grand Rapids, and the disappearance of high uptake cluster for high-dose vaccine uptake in the area. Vaccination rates by any product type were found to vary seasonally and showed weak negative association with more rural regions. The overall vaccination rates appear to be lower among counties with higher social vulnerability in certain urbanicity levels, but social vulnerability and urbanicity were not significantly associated with overall vaccination rate during the study period. Conclusions Vaccine type-specific uptake was spatially and temporally diverse in Michigan between 2017 and 2022. Mid and Northern Michigan had consistently relatively lower vaccination rate compared to other regions in Michigan.

In Germany, insecticide use is recommended during mosquito-borne disease outbreaks, yet nationwide data on insecticide resistance in key vector species are scarce. This is particularly relevant for Culex pipiens s.l., a vector of West Nile virus. Here, we provide the first broad-scale assessment of molecular insecticide resistance (kdr and ace-1 mutations) in Cx. pipiens f. pipiens across Germany. We associated insecticide resistances with environmental conditions, potential links with mitochondrial variation of the cytochrome c oxidase I (COI) gene as well as phenotypic resistance (CDC bottle assay with permethrin) of the Frankfurt population with elevated kdr frequencies. Kdr resistance alleles were detected in German Cx. pipiens f. pipiens reaching frequencies of up to 50% in the metropolitan areas of Berlin and Frankfurt am Main. Annual precipitation was negatively associated with kdr allele frequency. Interestingly, ace-1 resistance mutations were only present in the metropolitan area of Frankfurt am Main and in Muggensturm (Rhine valley, southwestern Germany). COI haplotype analyses revealed low genetic variability within German Cx. pipiens f. pipiens populations with no association to the insecticide resistance genotype. Phenotypic assays of the Frankfurt population showed early signs of permethrin resistance, but unmatched genotypic and phenotypic resistance state. This study provides the first broad-scale assessment of molecular insecticide resistance in Cx. pipiens f. pipiens across Germany, establishing a baseline for resistance surveillance and vector control. Further research is needed to identify factors shaping phenotypic resistance, as molecular markers alone may not reliably predict resistance. Since sampling was restricted to urban green spaces, broader sampling across environmental gradients is needed to identify additional environmental effectors.

Before 2026, Bundibugyo virus disease had only two recognized outbreaks. By August 2026, delayed recognition and multi-day sample transport in eastern Democratic Republic of the Congo had contributed to a large, spatially dispersed epidemic. We hypothesized that model-guided placement of decentralized diagnostics in frontier health zones could help contain spatial spread by acting as a spatial fence: delayed recognition would be converted into timely polymerase chain reaction (PCR) confirmation, isolation, and contact tracing before imported lineages became established. We fit a Bayesian spatial branching process to public situation reports through 2 August 2026, with Flowminder movement and a latent-burden anchor. Lineages had overdispersed offspring, PCR access and turnaround, clinical recognition, isolation, tracing, safe burial, and local behaviour change. Because the observed history did not identify future control, we assumed a national response ramp yielding West-Africa-scale status-quo burden and replayed 2,000 posterior trees with 5-100 zone-level PCR laboratories, deployment delays of 0-180 days, and postmortem rapid diagnostic test (RDT) coverage. The posterior reproduced case, death, latent-burden, and spatial targets. Speed dominated: 35 PCR laboratories averted a median 49% of future deaths if deployed immediately, 38% after 14 days, and 11% after 60 days, with 90% prediction intervals of 30-65%, 23-53%, and 5-20%, respectively. Placement also mattered: with a 30-day delay, model-informed placement averted 18-33% of future deaths with 20-100 laboratories, versus 1-8% under random placement. Postmortem RDTs partly filled gaps left by live-case detection, increasing future deaths averted from 26% to 41% with 20 laboratories, a 14-day delay, and 75% coverage. Decentralized diagnostics can slow spatial spread when they are placed ahead of likely importations and paired with staffing, isolation, tracing, and safe-burial capacity.

The 2025 measles outbreak in South Carolina, the largest in the United States in over two decades, produced 997 confirmed cases, predominantly among school-aged children in an under-vaccinated community in Spartanburg County. To support the South Carolina Department of Public Health (DPH) measles response, we developed a stochastic agent-based model to forecast outbreak trajectory and evaluate intervention strategies in real time, integrating transmission across three spatial scales and grounded in geocoded households, school enrollment records, and census-derived demographic data. The model predicted a median of 1,020 total infections (90% prediction interval: 840-1,273). Counterfactual simulations without active contact tracing and quarantine projected a median of 2,432 infections (90% prediction interval: 1,867-3,185), approximately 138% more than the model-predicted baseline (1,020 cases). Model fidelity required a highly localized between-school contact structure; broader contact assumptions substantially overpredicted both case counts and geographic spread. Simulated regional introductions confirmed that outbreaks arose only near connected clusters of undervaccination, while well-vaccinated areas remained contained. Model versions deployed prospectively at weeks 9, 17, and 34 of the response informed resource allocation decisions and provided operational evidence for the effectiveness of contact tracing and quarantine strategies. Critically, the model reproduced geographic spread, number of affected schools, and breakthrough infection counts not used in fitting, validating its structural fidelity and establishing a replicable framework for jurisdictions maintaining school-enrollment and vaccination records.