MERS, global update (WHO): The World Health Organization reports ongoing sporadic Middle East respiratory syndrome coronavirus (MERS-CoV) cases, primarily linked to the Middle East (Saudi Arabia), with continued risk of exportation via travel.
Hantavirus, South America: The Pan American Health Organization reports 229 cases and 59 deaths in 2025, underscoring persistent transmission across affected countries. Exposure to rodent reservoirs remains the principal risk. Public health advice focuses on rodent control, environmental hygiene, and early clinical recognition of cardiopulmonary or renal syndromes.
Seasonal Influenza, South America: Early seasonal influenza detections have been reported in Colombia, Panama, Bolivia, and Argentina, suggesting an earlier-than-usual start to the season. Clinicians should anticipate increasing activity. Vaccination of risk groups, antiviral preparedness, and surveillance strengthening are recommended.
Norovirus, Germany: Germany is experiencing an early and severe gastroenteritis season driven by norovirus GII.17, with >5,300 reported cases. Increased transmissibility and institutional outbreaks are notable. Reinforcement of hand hygiene, environmental disinfection, and exclusion policies in healthcare and care facilities is essential.
Hemorrhagic fever with renal syndrome (HFRS), Russia: HFRS cases increased by ~50% in 2025, exceeding 3,000 cases, with an unusual predominance in urban settings. This shift raises concerns about changing rodent ecology and exposure patterns. Prevention should emphasise urban rodent control, public awareness, and prompt diagnosis of renal involvement.
This week’s Epi-Alert underscores continued global and regional infectious disease risks, including sporadic MERS-CoV cases linked to Saudi Arabia with ongoing travel-related exportation risk, and persistent hantavirus transmission in South America with substantial mortality. An early start to the seasonal influenza season in multiple South American countries signals the need for timely vaccination and preparedness, while Germany faces an unusually early and severe norovirus season driven by GII.17. In addition, a marked rise in urban HFRS cases in Russia highlights shifting rodent–human exposure patterns and the importance of strengthened rodent control, surveillance, and early clinical recognition.
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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