Seasonal influenza, global situation: Seasonal influenza activity has increased with the onset of northern hemisphere winter, with some areas experiencing earlier starts and higher-than-usual activity. Influenza A (H3N2) has dominated, with a rapid rise of a drifted A(H3N2) “subclade K” variant detected in over 34 countries. Data do not indicate increased severity. Vaccine effectiveness estimates suggest protection against hospitalization (70–75% in children, 30–40% in adults).
Avian influenza, Europe: From September to November 2025, 2,896 avian influenza detections were reported across 29 European countries, mainly in wild birds (notably waterfowl and common cranes), and affecting poultry. Most poultry outbreaks were due to primary introductions from wild birds, with environmental contamination posing an ongoing risk. Mammal cases (foxes, cats) have slightly increased; globally, five human H5 cases were recorded, all with poultry exposure and no human-to-human transmission. The risk remains low for the general public, but low to moderate for exposed workers.
Listeriosis, Europe: Serious Listeria infections are rising in Europe. Although rare, listeriosis is the deadliest foodborne infection in the EU, with around 70% needing hospital care and about one in 12 dying. Ready-to-eat foods are a key concern, with fermented sausages most often contaminated. Vulnerable groups are at greatest risk, such as older adults, pregnant women, and people with weakened immune systems.
Mpox, Europe: a novel inter-clade recombinant mpox virus was detected in the UK in a returning traveler from Asia. This is the first documented detection of such a recombinant strain, highlighting the ongoing genomic evolution of the virus and the potential for importation of new variants.
Coccidioidomycosis, Taiwan: Taiwan has reported its first autochthonous case of coccidioidomycosis, marking the first instance of local transmission of this fungal infection in the country. This case underscores the need for heightened awareness among clinicians in non-endemic regions and consideration of coccidioidomycosis in differential diagnoses of refractory respiratory infections.
This week’s Epi Alert highlights rising seasonal influenza activity globally, including early and strong H3N2 variant circulation with considerable vaccine protection. Europe is experiencing high avian influenza activity in wild and domestic birds, with a small number of human cases, but no evidence of human-to-human spread. Listeriosis continues to pose a significant threat to vulnerable populations due to contaminated ready-to-eat foods. The detection of a novel recombinant mpox virus in the UK and Taiwan's first local coccidioidomycosis case emphasize the ongoing need for vigilance, genomic surveillance, and consideration of uncommon pathogens in clinical practice.
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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