To explore the clinical value of routine laboratory tests in the early diagnosis of hemorrhagic fever with renal syndrome (HFRS), this study retrospectively analyzed the medical records of 146 patients, including 87 HFRS cases and 59 controls. Subsequently, a multivariable logistic regression model was employed to identify clinically relevant indicators for HFRS diagnosis. The sensitivity and specificity of these indicators were further evaluated by using receiver operating characteristic (ROC) curve analysis, both individually and in combination. Results showed that HFRS patients had significantly higher levels of leukocytes, neutrophils, lymphocytes, monocytes, eosinophils, basophils, erythrocytes, urinary proteins, and hemoglobin (all P < 0.05), while platelet counts were lower (P < 0.05). Multivariable logistic regression analysis revealed that monocyte count and hemoglobin were independent predictors of HFRS. The area under the ROC curve (AUC) for the combined use of monocyte count and hemoglobin level in diagnosing HFRS was 0.942, which was significantly higher than the AUC when either was used alone, indicating excellent predictive performance. In conclusion, elevated monocyte count and hemoglobin levels are independent predictors of HFRS. Their combined use enables effective prediction of HFRS and may serve as a key criterion for the early diagnosis of HFRS in primary care settings.

Coronavirus disease 2019 (COVID-19) clusters are serious for older adults in nursing homes. Several studies have analyzed patient epidemiology and trends in blood antibody titers after COVID-19 cluster outbreaks, but few comparative analyses of pre- and post-cluster outbreaks have been reported. This study aimed to investigate epidemiological surveys and whole-genome sequences of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in clinical specimens following a COVID-19 cluster occurrence in a nursing home. Routes and modes of infection were analyzed in the study participants using ‘Pomegraph’, a newly developed integrated graphical tool, in combination with epidemiological and genome information. Our findings showed that although the viruses were the same XBB subvariants of SARS-CoV-2 Omicron XBB.1.5 and XBB.1.16, they were imported from three different locations, based on the genome sequences. We evaluated the amount of antibodies and neutralizing antibody titers in the participants’ sera pre- and post- the cluster outbreak. Before the cluster outbreak, no significant differences were observed between infected and uninfected participants in the period after vaccination or in the amounts of antibodies and neutralizing antibody titers, which is difficult to determine in general clusters. Our results facilitated the analysis of cluster factors such as pathogens, susceptible persons, and transmission.

We aimed to specify the characteristics of group A Streptococcus M1 (n = 23) or non-M1 (n = 282) isolates from adult (n = 176) and pediatric (n = 129) populations in central Japan, October 2024–April 2025. Of the speA-possessing fourteen non-M1 isolates, there were seven emm3.93 isolates from six non-invasive samples of pediatric patients and one invasive specimen of an adult patient. We found the distribution of M1 clones containing M1_global (n = 1)/M1_13snps (n = 4)/M1_UK (n = 18)-lineages in central Japan of Tokyo/Chiba/Tochigi/Saitama/Kanagawa. The M1 clones were from twenty-one non-invasive samples of pediatric/adult patients and two invasive specimens of adult patients. Additionally, we determined the sic nucleotide alleles and observed the M1_global/M1_13snps/M1_UK sic clustering. Of the CovS amino acid (AA) mutations among M1, there was an insertion of transposase (ISAs1-like IS1548 transposase, 377 AA) into CovS histidine kinase-like ATPase domain (following AA position 458) of one invasive M1_UK isolate. Our observations suggest that CovS AA mutations of invasive isolates with M1_UK should be specified within its four functional domains to evaluate their hypervirulent properties.

The COVID-19 mortality seemed to be higher in high-income/hygienic countries; this is contrary to conventional communicable diseases which usually occur in low-income countries. Another characteristic of COVID-19 is that some proportions of the infected persons had no symptoms but transmitted the virus to others. In this paper, the author proposes a hypothesis that infected but asymptomatic persons produce two kinds of infectious respiratory particles (IRP) by speaking: large droplets and small aerosols. The large droplets are produced from the saliva by pronouncing a plosive, /p/ or /t/; and the small aerosols are produced from the laryngeal exudate by vibration of vocal cords for voicing of vowels. The heavy droplets collide with the face of other persons in conversation, resulting in droplet infection. In contrast, the lighter aerosols float in the air, accumulate inside an airtight room after a longer talking, and cause airborne infection in other persons staying in the same room. Then, the author discusses on the COVID-19 global epidemiology, which may have depended on 1) climate and housing structure, 2) cultural behaviors, and 3) languages among different countries.

Epidemics of respiratory syncytial virus (RSV) infection used to follow predictable and seasonal pattern. However, the emergence of COVID-19 and the accompanying public health measures disrupted the RSV seasonality worldwide. To investigate the long-term epidemiological impact, we analyzed weekly RSV-related hospitalizations in children under 15 years of age from 2018 to 2024 in Saitama Prefecture, Japan. During the COVID-19 pandemic, RSV admissions notably declined in 2020, but the number of hospitalizations returned to pre-pandemic levels. The peaks of admission rates occurred in March, in both 2023 and 2024, which were earlier than the August peaks seen in 2018 and 2019. We also found the proportion of hospitalized patients aged ≥2 years increased notably to 30% in 2021 and 2022, and declined to 21.2% in 2024. Although an upward trend in intubation rates was observed, no statistically significant differences were found. These findings suggest that the COVID-19 pandemic led to earlier RSV outbreaks and temporary shifts in age distribution. It remains unclear whether RSV seasonality and age patterns will return to their pre-pandemic status. Ongoing surveillance is essential to better predict future outbreaks and inform optimal timing for preventive interventions such as vaccination or monoclonal antibody administration.

Cyclospora cayetanensis, a food and waterborne pathogen, is responsible for prolonged diarrheal illness. This study aimed to investigate the prevalence, risk factors and seasonal patterns of C. cayetanensis infection among diarrheic patients in eastern India. A hospital-based cross-sectional study was conducted. The overall prevalence of C. cayetanensis in the study region was determined to be 2.11%. The highest incidence (7%) was observed during the monsoon months, particularly in July and August. Children aged >5-12years were the most susceptible group (17.8%,OR=47.45,P<0.0001). Individuals from households lacking proper sanitation or from rural areas showed higher burden of infection. Statistically significant association between infection and contact with animals was also found (3.45%; OR=2.81; P<0.0001). Symptomatic individuals predominantly experienced profuse diarrhea with abdominal cramps. Coinfections with Soil Transmitted Helminths (STHs) was found to be most common in Cyclospora positive cases. Limited genetic diversity of Cyclospora was found within the population, with 6 haplotypes circulating in the region. Overall, this study highlights the public health risk posed by C. cayetanensis in eastern India. We recommend including Cyclospora detection in routine laboratory diagnoses to prevent its spread. Raising awareness regarding hygiene and implementing rigorous control measures will prove effective in eradication of Cyclospora from this endemic country.

Staphylococcus argenteus is a novel bacterial species distinct from Staphylococcus aureus. Nevertheless, S. argenteus is often misidentified as S. aureus because they cannot be differentiated easily using routine diagnostic microbiology methods. An 81-year-old man was admitted because of persistent lumbar pain and fever. Strains from his blood cultures were initially identified as methicillin-susceptible S. aureus. Enhanced computed tomography revealed an erector spinae abscess connected with the L5 transverse process, and magnetic resonance imaging of the lumbar region showed a high intensity of L1 and L5 on short tau inversion recovery. The abovementioned pathogen was also cultured from the aspiration fluid of the abscess. Therefore, the patient was diagnosed with vertebral osteomyelitis with an erector spinae abscess. We analyzed the detected strain using matrix-assisted laser desorption ionization time-of-flight mass spectrometry and whole-genome sequencing, re-identifying the strain as S. argenteus sequence type (ST)1223. Although S. argenteus ST1223 has mainly enteric pathogenicity, our case suggests its potential to invade the musculoskeletal system. Its pathogenicity was similar to or greater than that of S. aureus in both previous studies and our case. Thus, the clinical differentiation of S. argenteus and S. aureus warrants further investigation.

The potency of diphtheria toxoid is determined by titrating neutralizing antibody levels in immunized mice using the Vero cell assay. The WHO manual recommends titration by determining the cytotoxic endpoint through measuring cell metabolism and observing cell morphology under a microscope, which has been conducted in our laboratory; however, the former is time-consuming and the latter subjective. To address these limitations, we have developed a novel endpoint determination method based on cell image analysis. We assessed the feasibility of this image analysis and compared it with microscopic observation and cell metabolism measurement. Consequently, image analysis proved effective for endpoint determination, yielding potency values comparable to existing methods in measuring potencies of commercial vaccines. These findings suggest that image analysis, being objective and convenient, can serve as a reliable alternative method for potency testing of diphtheria vaccines.

This study investigated the diagnostic accuracy of the quantitative polymerase chain reaction (qPCR) DNA assay in urine and saliva samples, as well as its concordance with serum CMV IgM/IgG testing in infants suspected of congenital cytomegalovirus (cCMV) infection. Furthermore, the study sought to elucidate the correlation between various diagnostic parameters in suspected cases of congenital CMV. A cross-sectional analysis was conducted on newborns suspected of having cCMV infection at RSSA Malang. CMV serology, complete blood count, and qPCR of urine and saliva samples were collected. Statistical analysis was performed on these data with a p-value < 0.05. A significant difference in urine PCR CT value distinguished positive from negative CMV IgM serology groups. A strong correlation (r = 0.728, p < 0.001) and high agreement (κ = 0.693, p < 0.001) between urine and saliva PCR testing suggested saliva as a reliable and non-invasive alternative for newborn screening. The findings of this study underscore the necessity of a comprehensive screening protocol for cCMV, particularly considering the high seroprevalence of CMV in the Indonesian population.

An ongoing pertussis epidemic in Okinawa has resulted in 227 reported cases since November 2024. Between December 2024 and February 2025, clinical specimens were collected from 31 cases. We isolated 18 macrolide-resistant Bordetella pertussis (MRBP) strains, all harboring the A2047G mutation in the 23S rRNA gene, confirmed by real-time PCR. Genomic analysis was performed on two MRBP isolated in November 2024 and the 18 MRBP from the current survey. All MRBP in Okinawa formed genetically related clusters with the ptxP3 allele in China (P745) and France (FR7302). However, MRBP strains from Okinawa were divided into three clusters, each with at least eight SNPs between them, and distinct from P745 and FR7302, suggesting the multi-source dissemination of ptxP3 MRBP in Okinawa.

Staphylococcus argenteus, a novel species formally named in 2015 and distinct from S. aureus, has a historical distribution that remains unclear. In this study, a total of 1,021 staphylococcal isolates collected from food-related specimens in Nagoya City between 1986 and 2022 were re-examined. Of these, 65 isolates (6.4%) were reidentified as S. argenteus. The earliest detection was in 1986, and the species has been identified in nearly every subsequent year. These findings suggest that S. argenteus had already disseminated into food-related environments by the 1980s. Furthermore, the results indicate that most S. argenteus isolates have been correctly identified in recent years, due to improvements in current MALDI-TOF MS identification. Multilocus sequence typing (MLST) revealed ST2854 as the most prevalent sequence type (ST) in this study, while clinically important strains such as ST1223 and ST2250 have been detected since the 1990s. The presence of novel and multiple STs with distinct POT types indicating that genetically diverse S. argenteus strains have been present in food-related environments since the 1980s. These results provide important insight into the historical background of S. argenteus and underscore the need for continued monitoring, particularly in food-related environments.

The present study developed a novel nano-structured nasal Bordetella pertussis vaccine candidate using encapsulating filamentous haemagglutinin (FHA) and pertussis toxoid (PTd) into N-trimethyl chitosan (TMC) with the help of CpG as an adjuvant and crosslinker (CpG-adjuvanted TMC/PTd-FHA), followed by physicochemical characterization and immune response evaluation after nasal administration. The TMC/CpG/PTd-FHA nanoparticle (NP) exhibited a particle size and zeta potential of 289.4 nm and +25.7 mV, respectively. The antigen/toxoid-loaded NPs exhibited >80% efficacy for encapsulation into polymer matrices, whereas in vitro antigen/toxoid release was found to be 95.18% after 96 hours. High immunization rates were observed in NP-treated mice with increased IgG and secretory IgA levels and proper capability to induce IFN-γ, IL-4, and IL-17 compared with the control group. Overall, nasal administration of the proposed approach, utilizing CpG as an adjuvant and crosslinker, could elicit humoral and Th1-type cellular immune responses, demonstrating promising potential as a vaccine delivery system.

Ensitrelvir is a novel antiviral drug that has been evaluated for its effectiveness against Coronavirus disease 2019 (COVID-19). This study aims to gather relevant evidence regarding the efficacy and safety of ensitrelvir in patients diagnosed with COVID-19. A systematic search was conducted in databases including PubMed, the Cochrane Library, Web of Science, and Scopus to identify pertinent studies on ensitrelvir's role in COVID-19 treatment up to September 2024. Nine studies were included in the analysis, comprising two retrospective studies, two phase 1 trials, three phase 2/3 trials, and two phase 3 trials. The findings indicated that ensitrelvir is associated with a reduced risk of death and shorter hospital stays for COVID-19 patients compared to control groups. Additionally, ensitrelvir demonstrated the ability to lower SARS-CoV-2 viral titers and RNA levels while accelerating the time to viral clearance compared to placebo. Reported adverse events were predominantly mild, with no serious adverse events noted. Ensitrelvir exhibited consistent pharmacokinetics across different populations, eliminating the need for dose adjustments. Ensitrelvir appears to be an effective and safe option for managing mild to moderate COVID-19 infections. However, further studies are needed to establish its efficacy and safety in treating COVID-19.

This study aimed to investigate the epidemiological and genetic characteristics of human astroviruses (HAstVs) detected during acute gastroenteritis (AG) outbreaks in Yokohama, Japan. We collected stool samples and epidemiological information between September 2017 and August 2023 and used real-time reverse transcription (RT)-PCR and/or RT-PCR to detect HAstV from 53 samples from 20 (3.1%) of the 648 virus-associated AG outbreaks during the study period. Of the 20 outbreaks investigated via sequencing, 13 were caused by classic HAstV, three by HAstV-MLB, and four were due to multiple genotypes, classic HAstV and HAstV-MLB. The strains detected in Yokohama were found to be closely related within their respective genotypes. The distribution of HAstV genotypes differed by age groups, with HAstV1 and HAstV-MLB1 primarily found in 0–3 year-olds, whereas HAstV4 typically occurred in individuals over 4 years of age. Of the 53 HAstV-infected patients, 49 (92.5%) experienced diarrhea, with 36 exhibiting only this symptom. Vomiting (18.9%) was less prevalent than diarrhea. There were no differences in the symptoms between individuals with classic HAstV and HAstV-MLB.

Klebsiella variicola, often misidentified as Klebsiella pneumoniae, is gaining recognition as a pathogen. This study reports the first human case of infection with K. variicola harboring bla_CTX-M-14 in Japan. MALDI time-of-flight mass spectrometry was used to confirm that clinical isolates from urine and blood cultures were K. variicola. The infection was successfully treated with cefmetazole. Whole-genome sequencing identified bla_CTX-M-14 in an 8,066 bp plasmid. Given the rarity of extended-spectrum beta-lactamase-positive K. variicola infections in Japan, this case highlights the importance of accurately identifying and monitoring multidrug-resistant pathogens.

Hand, foot, and mouth disease (HFMD) caused by enteroviruses is common in children. Recently, coxsackievirus A6 (CVA6) has been identified as a major causative agent. In this study, we conducted a phylogenetic analysis of a part of the VP1 coding region of 194 CVA6 strains detected directly from 767 nasopharyngeal swab or stool samples of HFMD patients in Japan from 2019 to 2024. The detected CVA6 strains were classified into genotype D. Moreover, the strains detected from before 2019 to 2023 belonged to cluster (cluster 1 and 2), whereas the most of strains detected in 2024 belonged to another cluster (cluster 3). Genetic identity among all detected CVA6 strains was 89.1%–100%, and genetic identity within the cluster for each detected strain was 90.6%–100% for the before 2019 (cluster 1) strains, 92.6%–100% for the 2019–2023 (cluster 2) and 94.5%–100% for the 2024 (cluster 3) strains. Most of the strains detected in 2024 were similar to the strains detected in China in 2023, suggesting that the influx of new strains caused the 2024 outbreak in Japan. HFMD is one of the most prevalent diseases in the world and its pathogenicity and antigenicity may be altered. Surveillance of the influx of new strains from outside Japan will become increasingly important.

Since we reported the first parechovirus A3-associated myalgia (PeVA3-M) outbreak in Yamagata in 2008 as an emerging disease, we have investigated PeVA3 infections as part of the National Epidemiological Surveillance of Infectious Diseases, Japan in sentinel hospitals/clinics and also performed a specific symptomatic surveillance targeting PeVA3-M. As PeVA3-M has only been reported from Japan, it is necessary to continue the above surveillance. In our surveillance from July 2022 to December 2023, we found 31 PeVA3 infections including three PeVA3-M and suspected cases using PCR and a virus isolation method. Further next-generation sequencing (NGS) analysis was performed for the representative isolates and their original specimens between 2022 and 2023 as well as those between 2003 and 2019. The NGS analysis showed that 7,245~7,309 and 7,118~7,287 nucleotides (98.7~99.8% and 97.1~99.4% compared with the reference strains) were available from 25 representative isolates and from 6 clinical specimens, respectively. This study indicated that the recombinant PeVA3 strains, which appeared in 2019, remained in circulation in Yamagata between 2022 and 2023. Furthermore, a NGS method is useful for the molecular epidemiological surveillance of PeVA3 infections, although improvements of the method used for the clinical specimens are required.

Tuberculosis (TB) is an endemic respiratory disease in several countries, including South Korea. The coronavirus disease 2019 (COVID-19) may pose greater risks to individuals with pre-existing respiratory diseases, but there are few reports on how the post-recovery state from TB affects COVID-19 infection and mortality. This study aimed to investigate the susceptibility and mortality of COVID-19 in patients with a history of TB. We retrospectively analyzed data from the National Health Insurance Service of Korea. We extracted individuals with TB from 2011 to 2019 and matched them with a population-based control group. The main outcomes were COVID-19 incidence and death within 30 days of infection. The study included 138,278 matched pairs of individuals with and without a history of TB. COVID-19 incidence was slightly lower in the TB group (38.0% vs. 38.4%, P-value = 0.023). Subgroup analysis showed significantly lower COVID-19 incidence in the pulmonary TB group compared to controls (P-value = 0.001). However, the mortality rate was higher in the TB group (0.9% vs. 0.7%, P-value < 0.001). This study showed that TB has a slightly protective effect against COVID-19 infection but increases the mortality rate. These findings will guide future research on the interaction between TB and COVID-19.

Chronic inflammation and persistent immune activation (IA) during HIV infection are associated with non-AIDS complications. We investigated sociodemographic and clinical characteristics influencing IA and exhaustion (IE), and platelet activation (PA) in newly diagnosed people living with HIV (PLHIV) and identified modifiable factors for early interventions. We analysed baseline blood samples from 365 PLHIV participating in a trial investigating the effect of aspirin on IA, IE, and PA. We assessed levels of markers of monocyte activation (soluble CD14), platelet activation (soluble P-selectin), T-cell activation (CD4⁺ and CD8⁺ expressing CD69 and co-expressing CD38 and HLA-DR), and T-cell exhaustion (PD-1). The median (IQR) age of the participants was 37 (28, 45) years, with females comprising 64.7%. Advanced age significantly predicted IA and IE, but not PA. Markers of IA and IE, but not of PA, inversely correlated with CD4 counts, while directly with HIV viral load (HVL). We show that most Tanzanian PLHIV initiating antiretroviral therapy (ART) have low CD4 count, high HVL, with a considerable proportion aged above 50 years, characteristics associated with heightened IA and IE. Adjunctive therapy, when available, should target such population and at ART initiation to prevent morbidity and mortality associated with persistent IA and IE.

After lifting travel bans imposed during the coronavirus 2019 pandemic, the number of reported measles cases in Japan started rising, culminating in 11 cases in Osaka Prefecture in 2024. We investigated the molecular epidemiology of these cases using 450 nucleotides of the C-terminal region of the nucleoprotein gene (N-450) and the noncoding region located between the matrix and fusion protein genes (MF-NCR). N-450 analysis revealed eight cases of genotype D8 and three of B3. Seven of the D8 cases were closely related to strains from Central Asia and Europe, harboring mutations in the primer binding region targeted by real-time PCR assays for measles virus. The remaining D8 case matched a strain from Thailand. All three B3 cases were identical to the strain detected in Vietnam in 2024. MF-NCR analysis of D8 cases revealed similar trends to those observed in the N-450 analysis. However, the B3 viruses from Vietnam differed by several bases from the closest related sequence and included a 6-base insertion. Given the resurgence of measles in Vietnam since 2024, the potential risk of continuous measles importation remains. Attention should focus on measles surveillance under circumstances of increased international human interactions, specifically the Exposition 2025 Osaka, Kansai in Japan.

The potencies of domestic influenza virus reference antigens were initially calibrated using a single radial immunodiffusion (SRID) assay using primarily prepared international reference antigens. The SRID potency should not be affected when using another reference antigen calibrated with the same international antigen. However, the SRID potency of the test antigens can vary, although the causes of these discrepancies remain unclear. Here, we calibrated two candidate reference antigens (LotA and LotB) in the A(H3N2) subtype with various pairs of reference reagent sets (antigen and antiserum). The potencies of LotA and LotB varied depending on the reagent pair used, with a more pronounced effect in LotA (CV = 5.4% vs. 3.8%). To explore the cause of these divergences, we analyzed the dissociation constant of each reagent pair and scored them based on the hypothesis that pairs exhibiting stronger antigen–antibody binding would have smaller precipitin rings. Comparing these scores with the respective potency scores, we observed a strong correlation between the Binding score (relative BLI-K_D) and potency score in LotA (r = 0.8464, p = 0.0001) but not in LotB (r = 0.4000, p = 0.1408). These data suggest that antigen–antibody binding strength is an influencing factor of SRID potency.

Necrotizing fasciitis (NF) is rapidly progressive soft tissue infection with a high mortality rate. Identifying the predisposing factors for NF is critical for enabling diagnosis and medical treatment. This study aimed to identify the factors associated with NF in a hospital located in rural Thailand. In total, 167 NF and 147 cellulitis cases were compared between 2019 and 2021. Among the NF cases, 13.17% required amputation and 7.69% were fatal. The study identified male sex, farming occupation, S. pyogenes infection, and comorbidities, including diabetes mellitus (DM), chronic kidney disease, and hypertension, as significant predisposing factors for NF. DM was statistically significantly associated with an increased risk of amputation. For pathogen-specific NF, advanced age (≥ 60 years) was the only statistically significant predisposing factor for S. pyogenes-associated NF. Conversely, NF caused by Staphylococcus aureus is significantly associated with farming occupation, DM, and hypertension. For NF caused by Enterobacterales, male sex, farming occupation, DM, and chronic kidney disease were statistically significant predisposing factors. These may not be risk factors that can be generalized, but may be the only risk factors for NF in Thailand. However, these findings may inform the development of guidelines for nursing care and pathogen-specific prevention of NF.

Tick-borne viruses are primarily transmitted to vertebrates by infected ticks during blood feeding and cause various diseases in humans and animals. Haemaphysalis longicornis is one of the main tick species responsible for human tick bites and is thought to be the primary vector of severe fever with thrombocytopenia syndrome, an important tick-borne viral disease in Japan. Although H. longicornis ticks pose a potential risk to humans in Japan, studies on tick-borne viral prevalence of this tick species in Japan are limited. In this study, we conducted RNA virome analysis of H. longicornis ticks collected in Toyooka City, Hyogo Prefecture, Japan. Two known viruses, Dabieshan tick virus and Hubei sobemo-like virus 15, and putative novel quaranjavirus-like sequences were detected. Additionally, assessments of endogenous viral elements (EVEs) related to the virus and virus-like sequences suggested putative novel quaranjavirus-like sequences existed in both RNA and DNA forms. However, we could not determine whether this quaranjavirus-like sequence was of viral origin and could not conclude whether the DNA forms of the quaranjavirus-like sequence existed as EVEs in ticks. This study provides new insights into the prevalence of tick-associated viruses in ixodid ticks and serves as a reference for future approaches to prevent tick-borne diseases.

Incompletely resolved immune dysfunction in people living with HIV (PLWH) on antiretroviral treatment (ART) could differentially impact CD4+ and CD8+ T cell subsets. In this study, we investigated SARS-CoV-2 vaccine-induced CD4+ and CD8+ T cell responses in 26 PLWH on ART following third-dose mRNA vaccination. Spike-specific CD4+ and CD8+ T cell responses were assessed based on the expression of activation markers, CD137/OX40 and CD137/CD25, respectively, in response to stimulation with overlapping peptides spanning the spike protein. All participants showed spike-specific T cell responses, with CD8+ responses at a higher median frequency than CD4+. Interestingly, 5 participants who showed a higher frequency of spike-specific CD4+, relative to CD8+ T cells, were significantly younger and had higher CD4 counts pre-ART, in comparison to other participants. Further multivariate analysis revealed that only CD4 count pre-ART was an important predictor of elevated spike-specific CD4+ T cell responses; whereas no association was observed with neutralizing antibody (nAb) potency towards SARS-CoV-2 spike. Our results highlight heterogeneous immune functionality of vaccine-induced, SARS-CoV-2 spike-specific CD4+ and CD8+ T cells in PLHW on ART.

Mpox is a viral zoonosis caused by the monkeypox virus (MPXV), a double-stranded DNA virus mostly transmitted by direct contact, respiratory droplets, and contaminated fomites. Immunodeficiency, younger age, chronic diseases, and lack of immunization are all associated with severe illness. Mpox was declared by the World Health Organization a Public Health Emergency of International Concern on May 20, 2022. This report aimed to provide a detailed histopathological and immunohistochemical findings of a fatal case of an immunosuppressed patient infected with MPXV, reported in Colombia in September 2022. A description of the clinical findings was made, followed by histopathological, immunohistochemical, and molecular studies to confirm the presence of MPXV genomes and viral antigens in different tissues. MPXV viral DNA of the clade IIb was identified, and MPXV genomes were found in the liver, lung, heart, and brain. Interestingly, MPXV antigens were observed in the skin and lung, mainly in necrotic areas surrounded by active inflammatory cell markers. The simultaneous use of several diagnostic tools, as histopathological, molecular and Next Generation Sequencing in fatal cases involving a variety of viral agents, provide relevant information to understand the pathogenesis and clarify the cause of death of this emerging infectious disease.

Currently, the mumps vaccine is not routinely recommended in Japan. Adding the mumps vaccine to the routine vaccination program requires an accurate estimation of the mumps viral infection disease burden. However, no precise estimate exists in Japan because mumps surveillance is sentinel surveillance with a reporting definition consisting of only a clinical diagnosis (parotid swelling). Since parotid swelling can be caused by pathogens other than the mumps virus, the estimation of mumps cases using the current surveillance data is inaccurate. To obtain an accurate burden of disease, we estimated the burden of the disease using the test results performed at a single sentinel site for laboratory-based surveillance during the mumps endemic (Week 14, 2015, to Week 13, 2016) in Kanazawa. The estimated number of mumps cases using laboratory-confirmed cases was 3,881 (95% confidence interval: 3,404–4,357), approximately 1,000 cases less than the estimated number using clinically compatible mumps cases. Although the estimated number of mumps cases using laboratory-confirmed cases was less than that of clinically compatible cases, the frequency of hearing loss due to mumps could potentially be 40% higher than that currently reported. To make the argument for routine mumps vaccination, surveillance using diagnostic testing information is important.

Non-typhoidal Salmonellae (NTS) are one of the significant food-borne pathogens with ≥2600 serovars and diverse range of hosts which significantly increases the chances of infections in humans. Salmonella enterica subsp. enterica serovar Oslo (S. Oslo) is a rare serovar, associated with foodborne illnesses. Here, we aim to report the draft whole genome sequences of S. Oslo ST2344 and ST1370 with reduced ciprofloxacin susceptibility, isolated from clinical samples. Thirty S. Oslo isolates were identified following the standard microbiological techniques. Twenty-six of the thirty (86.66%) S. Oslo isolates were pan-susceptible to the antimicrobials examined, except four isolates, which showed decreased ciprofloxacin susceptibility (MIC 0.12 - 0.50 µg/ml). PFGE analysis showed strains were heterogenous with two sequence types of ST1370 and ST2344 were observed in MLST. The average genome size of the four S. Oslo isolates ranged from 4,760,441 - 5,002,787 bp with average G+C content of 52 %. Different virulence genes encompassing Salmonella Pathogenicity Island (SPI) 1 to 5 linked to disease pathogenesis were found by genome analysis. The draft genome of S. Oslo clinical isolates gives an insight into the molecular characteristics of S. Oslo currently prevalent in India and the phylogenetic analysis sheds light on their evolutionary pattern.

Corynebacterium mucifaciens, usually isolated from sterile human specimens, is a rare Corynebacterium species. We describe a blood-origin C. mucifaciens isolate that was resistant to macrolides/lincosamides and had been isolated from a patient with diabetic gangrene. This isolate formed mucoid colonies harboring a fragment of erm(X). As an initial antimicrobial, piperacillin/tazobactam was intravenously administered to the patient for two weeks. Gangrene debridement resulted in good local management. The clinical course was uneventful. The subculture from blood on a blood agar plate revealed mucoid colonies with a positive string test. Gram staining revealed the presence of a mucoid layer around the coryneform. The minimum inhibitory concentrations determined using broth microdilution method indicated resistance to erythromycin/clindamycin. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS), 16S rRNA gene sequencing, and antimicrobial resistance (AMR) gene profiling were performed. MALDI-TOF-MS identified this isolate as C. mucifaciens based on its high score (2.22). 16S rRNA gene sequencing revealed 99.3% similarity with DMMZ 2278(T) 16S rRNA gene sequence. AMR gene profiling revealed that this isolate possessed a fragment identical to that of erm(X) from Actinotignum schaalii. MALDI-TOF-MS with 16S rRNA gene sequencing can be useful to identify C. mucifaciens when the coryneform shows a mucoid colony appearance with hyperviscosity.