Seasonal influenza, global updates: Influenza transmission is rising globally, with influenza A predominant. A(H3N2), especially subclade K, drives the surge and dominates over half of the countries. Illness is highest in children, while hospitalizations are climbing mainly among adults 65+. The season began 3–4 weeks earlier than usual. Europe’s early vaccine effectiveness is moderate (any influenza: 44%; H3N2: 52%). U.S. activity is increasing (about 90% H3N2), Canada reports an early H3N2 wave, and subclade K is also seen in Peru, Chile, and Brazil.
Marburg virus, Ethiopia, update: The outbreak has grown by one case and one death since 12 December 2025. To date, 17 cases and 12 deaths have been reported, including two healthcare-worker deaths. Affected areas are Jinka (epicentre) and Hawassa. Five patients have recovered and none are currently in treatment. ECDC assesses EU risk as low.
Dengue, global updates: Since early 2025, >5 million dengue cases and >3,000 deaths were reported across 106 countries/territories spanning WHO regions (EURO, PAHO, SEARO/WPRO, EMRO, Africa). In mainland Europe, 29 local cases occurred in France and 4 in Italy. Madeira reported two locally acquired cases (symptom onset January).
Chikungunya, global updates: This year: 485,908 cases and 229 deaths. ECDC lists 14 countries with ongoing outbreaks in the last 60 days, mainly in the Americas and Asia. In the Americas, notable patterns include sustained transmission in Cuba and widespread reporting in Brazil. In Asia, Guangdong (China) shows a decreasing trend; Pakistan reports year-round cases. In mainland Europe, there were 1,172 local cases: 788 in France and 384 in Italy, with one open cluster remaining.
West Nile virus, Europe and USA, 2025: In Europe, 1,112 local infections and 97 deaths were reported across 14 countries, with most in Italy (779 cases, 72 deaths), concentrated in Lazio and Campania; 35 regions reported human cases for the first time, indicating geographic expansion. Animal outbreaks were widespread, including first detections in Belgium (wild birds) and The Netherlands (equids). In the USA 1,981 cases (1,359 neuroinvasive) occurred across 46 states; the 2025 death total is pending. Colorado, Illinois, Texas, and Minnesota led case counts, totals are similar to 2024.
Rabies, Pakistan: Karachi is facing a major dog-bite (~29,000) and rabies emergency (19 human deaths) in 2025. The surge is linked to growing stray-dog populations, abundant garbage, weak municipal oversight, and inconsistent sterilization efforts. Long-term control measures and reliable access to post-exposure prophylaxis are required.
Seasonal influenza: Influenza is rising early worldwide, driven by A(H3N2) subclade K; children are most affected, with hospitalizations increasing in adults 65+.
Marburg virus, Ethiopia: Ethiopia reports 17 cases and 12 deaths; five recovered, none hospitalized. EU risk is low.
Dengue: Since 2025, dengue exceeded five million cases and 3,000 deaths globally, with limited European transmission.
Chikungunya: About 486,000 cases and 229 deaths occurred worldwide, with ongoing outbreaks.
West Nile virus: Europe reported 1,112 cases and 97 deaths; the United States reported 1,981 cases.
Rabies, Pakistan: Karachi faces ~29,000 dog bites and 19 human rabies deaths, highlighting urgent control needs.
The ESCMID-AUMC Epi Alert, a strategic collaboration between the ESCMID Emerging Infections Subcommittee and the Center of Tropical Medicine and Travel Medicine of Amsterdam University Medical Center (AUMC) that integrates expertise and resources to advance emerging infectious diseases surveillance and intelligence sharing. This collaboration integrates ESCMID's extensive international network and emerging infections expertise with AUMC's proven surveillance capabilities, led by Dr. Abraham Goorhuis and the AUMC team.
The Epi Alert aims for weekly publication, with frequency adapted to emerging threats. The briefings are curated by infectious disease specialists prioritising data from trusted sources (WHO, ECDC, CDC, ProMED) based on potential impact, geographic region and urgency/relevancy to clinical practice. It aims to provide concise summaries for busy healthcare professionals with direct links for further investigation and transparency.
This integrated collaboration represents a significant milestone in ESCMID's commitment to emerging infections preparedness, strengthening our collective capacity to detect, analyse, and respond to infectious disease threats through international cooperation.
Disclaimer: The information in this epi-alert is a weekly summary of the information that is available on the internet, mainly the websites of WHO, ECDC, CDC, and others. For this summary, we consider issues that are most relevant to the ESCMID members involved in clinical patient care. Therefore, this report is not comprehensive, but we strive to include all major global issues in this report on a weekly basis.
On 14 November 2025, Ethiopia confirmed its first outbreak of Marburg virus disease (MVD) in the South Omo Zone, Southern Ethiopia. This outbreak represents a significant epidemiological shift: Ethiopia has never previously reported MVD. Genetic sequencing suggests the strain is closely related to East African lineages, pointing to a regional reservoir. Laboratory testing identified Marburg virus in samples from a cluster of suspected haemorrhagic fever cases. To date, 10 cases have been reported, including five fatalities (CFR 50%), two among healthcare workers, highlighting the risk of nosocomial transmission. A total of 57 suspected cases have been investigated, including four in the past 24 hours.
The recent re-emergence of avian influenza (H5N1) in parts of Asia, including isolated human cases in Cambodia and India, highlights the need for continued vigilance. While sustained human-to-human transmission has not been observed, the current situation warrants close monitoring. Strengthening surveillance, improving poultry vaccination strategies, and promoting regional One Health collaborations can support risk assessment and management, including early containment efforts.
Since the previous update on 5 May 2025, and as of 12 May 2025, nine new MERS-CoV cases—including two deaths—have been reported by health authorities in Saudi Arabia, bringing the total number of cases this year to ten.
Seven of the recent cases were part of the same cluster in Riyadh, including one patient with no history of contact with camels and six healthcare workers who acquired nosocomial infections from that patient in early May.
The risk of sustained human-to-human transmission in Europe remains very low. However, the current MERS-CoV situation is concerning, as this rise in cases comes just two weeks ahead of the Mecca pilgrimage—a period typically associated with high international travel.
Since April 2012, and as of 12 May 2025, a total of 2,638 confirmed MERS cases—including 957 deaths—have been reported globally.
A Marburg virus disease (MVD) outbreak is evolving in Rwanda, East Africa. As of 7 October 2024, over 40 confirmed MVD cases have been reported, mainly in healthcare facilities in Kigali, with many healthcare workers affected. This outbreak represents a spread from known endemic areas to urban settings, including nosocomial transmission in Kigali hospitals. While outbreaks are typically limited to remote areas, this one spans across Rwanda, with potential for satellite cases and further spread. No vaccines or treatments are currently available.
This compilation includes the latest news, publications, and resources, covering recent developments such as vaccine distribution in Africa and WHO policy updates. It provides links to '2022-2024 Mpox Outbreak: Global Trends,' which features interactive dashboards and epidemiological data. This update offers a brief overview of the developments of the mpox situation for healthcare professionals, researchers, and policymakers.
As of August 2024, the world is facing a significant mpox outbreak, primarily affecting countries in Central and East Africa, particularly the Democratic Republic of the Congo (DRC) and neighbouring countries, with cases reported across several regions. The outbreak is characterised by the sustained human-to-human transmission of the clade I monkeypox virus (MPXV).
This ESCMID EIS mpox commentary provides up-to-date, evidence-based information on mpox (formerly known as monkeypox) for healthcare professionals, researchers, and public health officials.
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