Tuberculosis — Global
A March 2026 report indicates that Nigeria recorded over 510,000 tuberculosis cases in 2025. The report also notes that ongoing case detection gaps persist in the country. Reports from the Philippines indicate that tuberculosis cases exceeded 101,000 in Metro Manila during the first six weeks of 2026. Also, in 2025, extrapulmonary presentations accounted for 53% of new tuberculosis cases in Morocco, a rate substantially higher than global norms. Clinicians should be aware of this substantial regional incidence of Mycobacterium tuberculosis when evaluating patients with relevant epidemiological exposure.
Chikungunya — Global
The ECDC reports that since the start of 2026, and as of 28 February 2026, a total of 32 758 chikungunya virus disease (CHIKVD) cases and nine associated deaths have been detected from 18 countries (not including EU/EEA countries and territories). Cases reported in February have increased compared to January, when 4 361 cases were reported. Deaths have increased in February compared to the previous month, when two deaths were reported.
Borna virus disease — Germany
A human Borna disease virus 1 (BoDV-1) infection was reported in Erding District, Bavaria, on March 23, 2026. The virus is endemic to southern Germany, typically causing 2 to 6 human cases annually with a 95% case fatality rate. As no specific treatments or vaccines exist, early detection and supportive care remain essential for managing this zoonotic infection.
Avian influenza — Global
The Italian Ministry of Health reported Europe's first human case of low-pathogenicity avian influenza A(H9N2) in the Lombardy region. The patient, who has concomitant illnesses, contracted the infection in a non-European country and is currently hospitalized. The United States is experiencing widespread highly pathogenic avian influenza (HPAI) H5N1 outbreaks affecting diverse species, including dairy cattle, marine mammals, and domestic cats linked to raw milk and pet food. Notably, Washington State reported the first known human case and fatality from avian influenza A(H5N5) in November 2025. The Italian case highlights the geographic spread of typically Asia-associated low-pathogenic avian influenza strains, while the US report reflects ongoing circulation in animal populations with potential zoonotic implications.
Nigeria recorded over 510,000 tuberculosis cases in 2025, highlighting persistent global detection gaps alongside Morocco's unusually high 53% rate of extrapulmonary presentations. In the Americas, chikungunya virus disease cases surged, with the ECDC reporting 32,758 cases and nine deaths across 18 countries by late February 2026. Europe faced emerging viral threats, including a human Borna disease virus 1 infection in Bavaria, Germany, and Italy's first human case of low-pathogenicity avian influenza A(H9N2) in Lombardy. Meanwhile, the United States reported widespread highly pathogenic avian influenza H5N1 outbreaks in animals and its first human fatality from A(H5N5) in Washington State. Adding to the global infectious disease burden, New Caledonia declared its first dengue epidemic since 2019, and Vietnam reported over 25,000 hand, foot, and mouth disease cases with four associated deaths.
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.
13:00–13:05 CET | Welcome and introduction
Chairs: Nitin Gupta & Pikka Jokelainen (ESCMID Emerging Infections Subcommittee and supported by the Indian Association of Medical Microbiologists)
13:05–13:27 CET | Clinical management of Nipah virus infection: lessons from recent Indian outbreaks
Speaker: Sayantan Banerjee (AIIMS Kalyani, India)
13:27–13:49 CET | Public health response and One Health coordination: the Kerala experience
Speaker: Anish TS (Kerala One Health Centre for Nipah Research and Resilience, India)
13:49–14:00 CET | Panel Discussion and Audience Q&A
Nipah virus is a highly pathogenic zoonotic virus that can be transmitted to humans through fruit bats, contaminated food, or close human-to-human contact, and is associated with severe encephalitis and high case-fatality rates. In January 2026, Nipah virus disease was reported in eastern India, with two confirmed cases identified among healthcare workers at a single hospital in West Bengal. This represents the seventh documented outbreak in India and the third reported in the state. According to an official update issued on 27 January 2026 by the Ministry of Health and Family Welfare of India, both cases were laboratory confirmed at the National Institute for Virology. A total of 196 contacts were identified, traced, monitored, and tested; all remain asymptomatic and have tested negative, with no additional cases detected to date, indicating no evidence of community transmission. Prompt and comprehensive public health measures, including enhanced surveillance, laboratory testing, and coordinated field investigations, have been implemented by national and state authorities, and the situation remains under close monitoring. While importation into Europe via infected travellers cannot be entirely excluded, the absence of Pteropus fruit bats in Europe limits the risk of onward transmission. No additional measures beyond monitoring, information sharing, and traveller advisories are expected at this stage.
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.
Past, present and future of dengue in Europe
Jan Felix Drexler, Anna-Bella Failloux, Didier Fontenille, Thomas Jaenisch, Jolyon M. Medlock, Xavier N. de Lamballerie, F. Xavier Lescure, Sotirios Tsiodras, Martin P. Grobusch
Endemic avian influenza landscape in Asia: sustained zoonotic risks
Nitin Gupta, Martin P Grobusch, Jan Felix Drexler, José Ramón Paño-Pardo, Galadriel Pellejero-Sagastizabal, Sotirios Tsiodras, Aleksandra Barac, F-Xavier Lescure, Pikka Jokelainen for the Emerging Infectious Subcommittee, European Society of Clinical Microbiology and Infectious Disease
Yellow fever in South America in 2025: a concerning increase, but a true resurgence?
Aleksandra Barac, Nitin Gupta, Pikka Jokelainen , Sotirios Tsiodras, Marta Mora-Rillo, Effrossyni Gkrania-Klotsas, José Ramón Paño-Pardo, Casandra Bulescu, Galadriel Pellejero-Sagastizabal, Abraham Goorhuis, Maria Paquita Garcia Mendoza, Jacob Van der Ende, François-Xavier Lescure, Martin P Grobusch, Jan Felix Drexler
Delayed correct diagnoses in emerging disease outbreaks: historical patterns and lessons for contemporary responses
Galadriel Pellejero-Sagastizábal, Casandra Bulescu, Nitin Gupta, Pikka Jokelainen, Effrossyni Gkrania-Klotsas, Aleksandra Barac, Abraham Goorhuis, Shevin T Jacob, Selidji T Agnandji, Francine Ntoumi, Marta Mora-Rillo, José Ramón Paño-Pardo, F-Xavier Lescure, Martin P Grobusch
Is a human highly pathogenic avian influenza A H5N1 pandemic inevitable?
Effrossyni Gkrania-Klotsas, Pikka Jokelainen, Anne L Wyllie, Nitin Gupta, Aleksandra Barac, José Ramón Paño-Pardo, Marta Mora-Rillo, Martin P Grobusch, Charles B Holmes, Marion Koopmans, Francois-Xavier Lescure
Marburg virus disease outbreak in Rwanda, 2024'-author's response
Martin P Grobusch, Galadriel Pellejero-Sagastizábal, Pikka Jokelainen, F-Xavier Lescure, Marta Mora-Rillo, Nitin Gupta
Marburg virus disease outbreak in Rwanda, 2024
Martin P Grobusch, Pikka Jokelainen, Anne L Wyllie, Nitin Gupta, José Ramón Paño-Pardo, Aleksandra Barac, Casandra Bulescu, Galadriel Pellejero-Sagastizábal, Abraham Goorhuis, F-Xavier Lescure, Effrossyni Gkrania-Klotsas, Marta Mora-Rillo
Poliomyelitis in Gaza
Nitin Gupta, Martin P Grobusch, Pikka Jokelainen, Anne L Wyllie, Aleksandra Barac, Marta Mora-Rillo, Effrossyni Gkrania-Klotsas, Galadriel Pellejero-Sagastizabal, José Ramón Paño-Pardo, Erwin Duizer, François-Xavier Lescure
Complex mpox situation, 2024
Pikka Jokelainen, Anne L Wyllie, Nitin Gupta, Aleksandra Barac, Effrossyni Gkrania-Klotsas, Casandra Bulescu, José Ramón Paño-Pardo, Marta Mora-Rillo, Martin P Grobusch, F-Xavier Lescure