Rubella is an acute, contagious viral illness that is generally mild, yet infection during early pregnancy can cause congenital rubella syndrome (CRS), a serious condition associated with deafness, blindness, congenital heart defects, and developmental disabilities. Although vaccination is the only effective preventive measure, rubella continues to circulate in regions with low immunization coverage. This study assessed the pre-vaccination seroprevalence of rubella IgM antibodies among women of reproductive age in Southeast Nigeria. A retrospective cross-sectional study was conducted from 2020 to 2024 among 405 women aged 15–49 years across five states in Southeast Nigeria. Serum samples were tested for rubella IgM antibodies using ELISA. Rubella IgM seroprevalence was 6.7% (27/405). Adolescents, 15–19 years had the highest positivity (11.7%), with prevalence declining steadily with age to 1.9% among women aged 30–34 years. Rubella positivity peaked in 2020 (16.0%) and 2024 (14.5%), with Imo State showing the highest prevalence (10.1%) and an incidence of 7.3 per 1,000,000 population. Rubella IgM positivity among women of childbearing age indicates ongoing transmission and susceptibility, particularly among adolescents. These findings provide baseline data for assessing vaccine impact and highlight the need for stronger surveillance and improved uptake to prevent CRS in Nigeria.

The economic burden of respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) and caregiver quality of life (QOL) were assessed in a population-based epidemiological study of infant RSV LRTI in Chiba, Japan. Medical costs were calculated based on diagnosis procedure data, and multiplied by the average number of hospitalization days. Outpatient medical costs were calculated as the cost per visit and laboratory fees. Productivity loss was calculated by multiplying the number of days spent in the care of guardians. The QOL of caregivers was assessed by directly administering the EuroQol five-dimensional-five-level (EQ-5D-5L) questionnaire to guardians. These data can be extrapolated to the national level, estimating an overall economic burden of JPY 5.3 billion, including JPY 2.5 billion in medical expenses and JPY 2.8 billion in productivity loss. Low QOL scores were observed, with 70–80% of respondents experiencing issues in the “anxiety and depression” and “usual activity” including mobility and self-care dimensions of the EQ-5D-5L scale. Stratified analysis revealed lower QOL scores among those with RSV infection. RSV LRTI imposes a significant social and economic burden on children and their caregivers. This information could be instrumental in advancing discussions on RSV preventive measures in the National Immunization Program.

We developed a highly sensitive and reproducible enzyme-linked immunosorbent assay (ELISA) and a qualitative immunochromatography (IC) test to specifically measure antibodies against tetanus toxoid. These methods detect tetanus antibodies in human, mouse, rabbit, and horse sera. These assays demonstrated high accuracy and precision for mouse and human samples. Using the developed ELISA, we quantified tetanus antibody titers in a mouse immunization model (tetanus toxoid potency test) and in human samples. The relative potency of tetanus toxoid calculated from ELISA titers was comparable to that determined by the traditional in vivo toxin challenge method. In human pooled plasma, ELISA titers correlated strongly with neutralizing antibody titers (r = 0.9826), enabling the estimation of the latter. Furthermore, ELISA titers correlated highly with results from the Kaketsuken particle agglutination method (r = 0.9866) and the novel IC (r = 0.8209). These findings demonstrate the utility of these methods for evaluating vaccine efficacy and immune responses, suggesting broad applications in basic research and clinical settings.

Rubella elimination in Japan was verified in September 2025; however, importation and immunity gaps can still precipitate outbreaks. We investigated a multi-prefecture rubella outbreak in 2016 linked to an introductory training course for foreign workers. After a rubella case was reported in Saitama Prefecture on June 6, 2016, we investigated the training facility and conducted active nationwide surveillance. We collected roster and dispatch information, monitored cases reported to the National Epidemiological Surveillance of Infectious Diseases, and interviewed trainees, host-company staff. Ninety-two trainees were dispatched to 41 companies in 23 prefectures. Thirteen rubella cases were identified. Ten patients were Vietnamese trainees, nine were likely infected during group training, and one was suspected to have imported rubella from Vietnam. Three individuals were likely infected at host companies, including two Japanese supervisors. No patient had documented records of a rubella-containing vaccine. Viruses from three cases belonged to genotype 2B. A single importation into a congregate training setting can rapidly create multi-prefecture exposure. Vaccination and/or verification of immune status among incoming trainees and susceptible host-company workers is essential to prevent similar events and sustain rubella elimination in Japan.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to heterogeneous clinical outcomes, suggesting that dysregulated host immune responses and inflammation contribute to divergent disease trajectories. We examined early immune correlates of disease severity using 32-week-old C57BL/6J mice and evaluated whether modulation of regulatory T cells (Tregs) would alter disease outcome. Oral administration of the CDK8/19 inhibitor AS2863619 did not markedly improve early weight loss, gross lung inflammatory scores, bronchoalveolar lavage fluid (BALF) viral RNA levels, or histopathological findings. Despite this limited impact on clinical outcomes, AS2863619 increased the frequency of KLRG1⁺ subsets in lung Foxp3⁺ CD4⁺ Tregs at 5 days post-infection. Across infected animals, lung Foxp3⁺ CD4⁺ Treg numbers inversely correlated with early weight loss. In parallel, several BALF inflammatory cytokines and chemokines were associated with disease severity, and the frequency of KLRG1⁺ Tregs inversely correlated with multiple inflammatory mediators. These findings indicate that endogenous lung Treg numbers and KLRG1⁺ Treg frequencies were linked to a less inflammatory airway milieu during acute SARS-CoV-2 infection.

Klebsiella quasipneumoniae is a member of the Klebsiella pneumoniae complex that is difficult to distinguish from K. pneumoniae using conventional laboratory methods, and information on its clinical manifestations is limited. We describe the first known case of invasive infection with hypervirulent K. quasipneumoniae subsp. similipneumoniae in Japan. A 65-year-old woman with pancreatogenic diabetes mellitus presented with fever and nausea. Computed tomography revealed a liver abscess and multiple pulmonary nodules with cavitation suggestive of septic pulmonary emboli. Blood cultures yielded an isolate identified as K. pneumoniae complex. Whole-genome sequencing (WGS) subsequently identified the isolate as K. quasipneumoniae subsp. similipneumoniae, sequence type 367 (ST367) and capsular type K1 (KL1). The isolate exhibited a hypermucoviscous phenotype and harbored the virulence-associated genes iroBCDN, iucABCD/iutA, rmpA/A2, and peg-344. The patient improved following antimicrobial therapy with meropenem for 10 days, followed by cefmetazole for 13 days, and was discharged home after a hospital stay of 81 days. This case highlights the potential for invasive infection caused by hypervirulent K. quasipneumoniae, the usefulness of WGS for species identification, and the need for ongoing clinical and genomic surveillance to monitor the emergence of this pathogen.

Dengue remains a global health concern, especially in tropical regions like Indonesia. As of July 2024, there were 149,866 reported cases and 844 deaths, with children aged 0–14 years accounting for 63% of fatalities. Dengue presents a wide clinical spectrum, ranging from asymptomatic infection to Severe Dengue. Early detection of Severe Dengue still heavily relies on clinical warning signs, which are often unreliable. This study aimed to identify potential biomarkers to predict Dengue severity in children. An observational study using secondary data from medical records at RSSA Malang (2014–2022) was conducted, involving 304 pediatric patients (161 Severe Dengue, 143 Non-Severe Dengue). Patient characteristics such as gender, age, weight, nutritional status, and hospital stay duration showed no significant correlation with severity. However, significant differences were found in several biomarkers, notably SGOT, SGPT, ΔHb, PT, albumin, platelets, monocytes, and NLR. SGPT (AUC 0.894; OR 24.3) and SGOT (AUC 0.884; OR 16.148) emerged as the most predictive biomarkers. SGPT showed the highest diagnostic performance with 73% sensitivity, 90% specificity, and a cut-off value ≥52 µ/dL, indicating a 24.3-fold increased risk for Severe Dengue. SGPT may serve as a reliable early indicator of severity in pediatric Dengue cases.

Cellulitis is one of the most common forms of skin and soft tissue infections, traditionally attributed to beta-hemolytic streptococci and Staphylococcus aureus. While Gram-negative organisms, particularly nonfermentative gram-negative bacilli (NFGNB), are ubiquitous in soil and aquatic ecosystems, they are rarely reported as causative pathogens of cellulitis. We report a case of metachronous cellulitis caused by two species of NFGNB: Sphingobacterium and Myroides species. An 81-year-old male was admitted with cellulitis of the left upper extremity. Sphingobacterium species was identified from blood cultures using Oxford Nanopore Technologies MinION sequencer. The patient was treated with antibiotics and recovered. Eleven months later, the patient was readmitted with similar symptoms of cellulitis in the left upper extremity. Myroides species was identified from blood cultures using MinION sequencer and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass-Spectrometry. The occurrence of cellulitis caused by NFGNB is rare, and this case is unique because two different NFGNB species caused cellulitis at separate time points.

Tick-borne encephalitis (TBE) is a severe neurological disease caused by infection with the TBE virus (TBEV), primarily transmitted to humans through tick bites. As there is no effective treatment, prevention through vaccination and avoidance of tick bites is essential. In Japan, only five cases had been reported up to 2023, all from Hokkaido, the northernmost main island. Here, we report the sixth case of TBE in Japan. The patient was a 58-year-old male, in whom magnetic resonance imaging revealed enhancing lesions in the brain and spinal cord, accompanied by severe neurological symptoms. Despite intensive treatment, his condition deteriorated, and he died 5 months after the onset. At the initial consultation, no tick-bite sites were identified. However, interviews with the patient’s family revealed he had engaged in outdoor activities before disease onset. Based on the clinical course, epidemiological history, and detection of anti-TBEV antibodies, the patient was diagnosed with TBE. During hospitalization, serum neutralizing antibody titers gradually decreased but remained extremely high for 5 months. This case underscores the importance of epidemiological investigation, including history-taking for possible tick exposure, and highlights the need to raise awareness of tick-borne diseases among healthcare workers, particularly in endemic areas.

In Japan, nationwide surveillance of acute respiratory infections (ARI) was launched in April 2025, enabling monitoring of multiple respiratory pathogens. Human parainfluenza virus type 3 (HPIV3) is an important cause of respiratory infections. In 2025, HPIV3 increased from spring to summer, and Japanese media raised concerns about the emergence of a novel pathogen because public surveillance data on HPIV3 trends had not previously been available. In this study, phylogenetic analysis of HPIV3 isolates obtained in eastern Japan in 2025 was performed using nearly complete genome sequences. The isolates were grouped within previously circulating clusters (C1 and C2), and several sequences were closely related to viruses detected in Fukushima between 2018 and 2024, suggesting continued circulation of HPIV3 within the same geographic region (Fukushima Prefecture and surrounding areas), although broader circulation cannot be excluded. Some sequences were related to strains reported outside Japan, suggesting possible introduction from abroad. Overall, the sequences were highly similar and no distinct lineage forming a new cluster was observed. These findings indicate that the HPIV3 strains detected in 2025 belong to previously circulating lineages and do not represent the emergence of a new lineage.

Human rhinovirus (HRV) commonly causes mild respiratory illness but may occasionally result in severe disease requiring hospitalization. Herein, we report a respiratory outbreak at a residential hospital for individuals with severe motor and intellectual disabilities (SMID) where HRV was detected. The facility housed 47 residents, 31 of whom developed symptoms. Further, 20 symptomatic patients were tested, and HRV-C was detected in 15 of them using RT-PCR. The nucleotide identity of the detected strains was 100%, and based on phylogenetic analysis, the strain was identified as the HRV-C56 type. No other pathogens were detected. Although the specific mode of transmission remains unclear, the patients had been residing at the facility for an extended period of time with limited mobility. Therefore, healthcare workers or visitors may have been the source of infection. In this outbreak, HRV-C disseminated rapidly among the residents, resulting in the spread of infections to healthcare workers and affecting healthcare. It is imperative for medical institutions, particularly long-term care facilities, to establish systems for the early detection and management of respiratory infections.

The global COVID-19 pandemic caused substantial psychological burden, resulting in a 25% increase in the prevalence of anxiety and depressive disorders worldwide. This study examined factors associated with the multifaceted fear of COVID-19 among South Korean adults, providing crucial insights for culturally tailored public health interventions. We utilized a cross-sectional secondary data analysis from the 2022 Korea Community Health Survey (n = 228,470) and the Korean Statistical Information Service. Using multilevel linear regression, we evaluated three pre-specified primary community-level hypotheses: the proportion of one-person households, the density of internal medicine clinics by jurisdiction, and unmet healthcare needs. Results revealed that a higher proportion of one-person households correlated with increased fear, while a greater density of internal medicine clinics by jurisdiction was linked to reduced fear. To estimate these community-level associations, we adjusted for individual-level covariates. Exploratory analyses of these covariates suggested that factors such as female sex, older age, higher education, living with a spouse, economic activity, and better self-rated health were associated with heightened COVID-19 fear. These findings emphasize the need for culturally sensitive mental health support, community-based initiatives, and strategic healthcare resource allocation in Asian communities to strengthen resilience during future health crises.

There is no clear consensus regarding the optimal strategy for preventing the spread of COVID-19 among hematopoietic stem cell transplantation (HSCT) units. We conducted a questionnaire survey of 16 Japanese HSCT units in the greater Tokyo area to investigate the actual infection control strategies for COVID-19 implemented during 2023. Four facilities (25.0%) conducted active screening tests when patients were admitted to the HSCT unit. Regarding the admission of recipients with a history of COVID-19, 10 facilities (62.5%) had no clearly defined rules; instead, decisions were made based on factors such as the patient’s symptoms, the local epidemic situation, clinical course, and absence of pneumonia. For current COVID-19 cases, 9 facilities (56.3%) set the standard isolation periods based on the number of days from the onset of symptoms. Microbiological retest results were used as a reference at 11 facilities (68.8%), and 6 facilities considered extended isolation periods with the retest results. Seven facilities (43.8%) implemented additional extended isolation management for recovered recipients who still required hospitalization. Although little is known about vulnerability to SARS-CoV-2 among HSCT recipients and there is potential selection bias due to the small sample size, this summary serves as a reference for reviewing infection control strategies.

This study aimed to serologically diagnose Brucella spp. and Francisella tularensis in patients presenting with overlapping clinical symptoms. A total of 467 serum samples were tested for antibodies against smooth Brucella spp., Brucella canis, and F. tularensis using Rose Bengal Plate Test (RBPT), Serum Agglutination Test (SAT), Microagglutination Test (MAT), and indirect ELISA (iELISA). Seropositivity for smooth Brucella spp. was 12.85% (60/467) by RBPT/SAT and 10.06% (47/467) by iELISA, with moderate agreement (κ = 0.505). The diagnostic titer-based (sole) seropositivity rate was 9.85% (46/467). For B. canis, seropositivity was 5.14% (24/467) by RBPT and 3.64% (17/467) by iELISA, showing substantial agreement (κ = 0.715). The sole seropositivity rate was 3.64% (17/467). For F. tularensis, both MAT and iELISA showed 3.64% (17/467) seropositivity, with moderate agreement (κ = 0.561), while the sole seropositivity rate was 3.43% (16/467). Co-seropositivity was observed in 1.07% (n= 5) of samples between B. canis RBPT and smooth Brucella iELISA, and in 4.07% (n= 19) between smooth Brucella spp. and F. tularensis. One sample (0.21%) was noteworthy, suggesting possible co-infection. These findings confirm the regional presence of brucellosis and tularemia and highlight the value of combining serological methods in patients with non-specific symptoms and low antibody titers.

Human sapoviruses (HuSaVs), which cause acute diarrhea worldwide, are genetically diverse and divided into four genogroups (GI, GII, GIV, and GV). These were further subdivided into 18 genotypes (GI.1-7, GII.1-8, GIV.1, GV.1, and -2). Among them, only one strain has been reported worldwide for GII.7 to date. This strain was detected during a fecal pathogen screening of outpatients with gastroenteritis in Kumamoto Prefecture, Japan in 2008. We established a virus stock panel of diverse HuSaV strains as bioresources for further virological characterization studies and successfully propagated multiple HuSaV strains using a human duodenum cell line, HuTu80, supplemented with conjugated bile acids. However, several HuSaV genotypes including GII.7 strain did not propagate under the tested conditions. This study reports the successful propagation of the HuSaV GII.7 strain in HuTu80 subcloned cells. The propagated virus is an additional bioresource. We further used scaled-up serially passaged progeny viruses as antigens for antiserum production and demonstrated differences in immunogenicity among the cell culture-propagated HuSaV GII strains.

Information regarding the disease burden of respiratory syncytial virus (RSV) infection among the elderly in Japan is limited. A comprehensive review of the medical records from January 1, 2002, to December 31, 2023, was conducted for adult cases of community-onset pneumonia encountered in routine clinical practice at a community hospital in Shiogama, Japan. The pneumonia case definition employed in this study, for pathogens including major respiratory viruses, required laboratory diagnosis supported by solid virological data, such as virus isolation or rising antibody titers, rather than merely gene detection. The results indicated that, before the emergence of the Coronavirus disease-2019 pandemic in 2020, RSV and influenza virus infections accounted for a substantial proportion (30% each) of the detected respiratory viruses, and RSV persisted as the second most prevalent virus, surpassed only by Severe Acute Respiratory Syndrome Coronavirus-2, even after the pandemic emerged. The mortality rate associated with RSV as a prognostic factor reached 5-10%, depending on the period. The temporal pattern of case emergence from June 2011 to March 2025 suggested that community-acquired RSV infections in children likely precede the occurrence of RSV pneumonia in adults.

The proportion of people who have anti-nucleocapsid (N) protein antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported as a surrogate for the proportion of previously infected individuals. This seroepidemiologic survey, conducted from 6 November 2023 to 19 January 2024, aimed to measure the levels of anti-N protein antibodies produced in the body by SARS-CoV-2 among residents over 18 years of age in Bizen City, Okayama, Japan. We evaluated the prevalence of SARS-CoV-2 antibodies in the target population at the time of the investigation and assessed changes over time among participants who had previously been infected. Of the 444 participants, a total of 235 (52.9%) were infected within one year. The seroprevalence of participants testing positive remained above 80% until four months post-infection, after which the number of people who remained positive declined rapidly. Six months after infection, around 10% of participants tested positive for anti-N protein antibodies, and this seroprevalence remained the same for up to one year post-infection. We demonstrated that the anti-N protein antibodies test is useful for identifying recently infected individuals for several months post-infection. We showed that it becomes increasingly difficult to detect past infections as time elapses since infection.

Zika virus (ZIKV) is a mosquito-borne orthoflavivirus that causes acute symptoms, such as fever and conjunctivitis. Aedes (Stegomyia) aegypti and Ae. (Stg.) albopictus are the primary and secondary vectors, respectively, although other Aedes species may also transmit ZIKV. Aedes (Ochlerotatus) japonicus, native to East Asia, has recently spread to North America and Europe; however, its potential in ZIKV transmission, particularly in Japanese populations, remains unclear. In our previous study, a low viral titer of ZIKV was detected in a single virus-challenged Ae. japonicus individual. In the present study, we increased the sample size and compared infection rates and viral titers among Ae. japonicus, Ae. aegypti, and Ae. albopictus following exposure to the ZIKV strain MR766. Cumulative infection rates of Ae. japonicus (18%) were lower than those of Ae. aegypti (71%) and Ae. albopictus (67%). Nonetheless, some Ae. japonicus individuals had higher viral titers than the challenge dose, indicating efficient replication. ZIKV RNA was also detected in 14% of the saliva samples at 10 days post-infection. These findings suggested that the Japanese population of Ae. japonicus could potentially serve as a vector.

We report a rare case of human brucellosis caused by Brucella suisbiovar 5 in a 75-year-old man from Nagano Prefecture, Japan. He had no history of immune disorders and presented with fatigue, left ankle pain, and swelling. Initial antimicrobial therapy for suspected cellulitis and tenosynovitis failed, leading to admission to our hospital. Imaging and synovial fluid analysis suggested septic arthritis with a periarticular abscess. Gram-negative rods were recovered from synovial fluid obtained via arthrocentesis of the left ankle joint. Although the isolate could not be identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry using a MALDI Biotyper system, it was successfully identified as B. suisbiovar 5 using species-specific PCR and nine-locus multilocus sequence typing (MLST). The patient was successfully treated with surgical debridement and prolonged antimicrobial therapy. This is the third documented human case of B. suisbiovar 5 infection in Japan, all originating from Nagano Prefecture, suggesting a localized cluster. This case highlights the diagnostic challenges of brucellosis, the limitations of routine identification methods, and the biosafety concerns for clinical laboratories. Enhanced awareness and surveillance are warranted in regions with emerging cases.

Seasonal influenza viruses continuously evolve, and the composition of the seasonal influenza vaccine is reviewed by the World Health Organization twice a year due to antigenic drift in the viral hemagglutinin (HA) protein. A timely assessment of how well vaccine-induced antibodies react to circulating viruses remains warranted. Here, immunogenicity of reference split vaccines for the 2025/26 season in Japan was analyzed in a mouse model using a microneutralization (MN) antibody assay against circulating A(H1N1)pdm09, A(H3N2), and B/Victoria-lineage viruses. In Japan, the vaccine used in the 2025/26 season consisted of three virus strains: A/Victoria/4897/2022 (IVR-238) (H1N1)pdm09, A/Perth/722/2024 (IVR-262) (H3N2), and B/Austria/1359417/2021 (BVR- 26). Reduced MN reactivity was observed against the tested circulating viruses, including A/Tokyo/EIS11-980/2025 (H1N1)pdm09 (HA subclade D.3.1), A/Tokyo/EIS13-029/2025 (H3N2) (HA subclade J.2.3), A/Tokyo/EIS13-355/2025 (H3N2) (HA subclade K), and B/Kanagawa/AC2414/2025 (B/Victoria lineage, HA subclade C3.1), with MN titers at least four-fold lower than those for the corresponding vaccine strains. These isolates had several amino acid substitutions at the antigenic or glycosylation sites in HA compared to the vaccine strains. These findings provide early laboratory indication of decreased immunogenicity of the vaccine against specific circulating viruses during the 2025/26 season in Japan.

Mumps vaccination, which is routinely administered in many countries, is not covered by Japan’s national immunization program. Therefore, mumps epidemic occurs every 3 or 4 years in Japan due to a low vaccine coverage rate. To prepare for the next resurgence, we examined the immunity against mumps using neutralizing antibodies (NT) against vaccine strain (genotype B) and wildtype virus (genotype G), and mumps-specific enzyme immunoassay for immunoglobulin G (IgG). We enrolled 83 children admitted to the Kawasaki Medical Hospital for diseases other than mumps between April and December 2022. The positive rates of NT for both of wild type and vaccine type were lower (25 .3%) than that of IgG (38.5%). No significant difference among them. Though individual infection histories were not confirmed, the absence of any mumps epidemic during the coronavirus disease pandemic, Therefore, almost all enrolled children were unlikely to have been infected with mumps, that is, they might have acquired immunity only by voluntary vaccinations. Therefore, we evaluate the immunity for mumps in the real world at three novel points as follows, (1) to evaluate under non-national immunization program (2) to evaluate Hoshino vaccine strains (3) to evaluate both IgG and the other immunity.

This study aimed to increase the data on characteristics and predictors of pediatric hMPV infection severity. Children admitted with ARI symptoms between 2021 and 2025 and diagnosed with hMPV by molecular testing were included. Seventy-eight children were included, of whom 48.7% were female. Most admissions occurred during winter and spring (92.3%). The median age was 14.9 months (IQR, 7.5–54.7), and 84.6% were younger than 5 years. At least one underlying comorbidity was present in 41% of patients, most commonly chronic lung disease. Major symptoms were cough (83.1%), rhinorrhea (61%), fever (59.2%), and stridor (41.6%), and tachypnea/dyspnea was observed in 31.2%. Median leukocyte count was 10,020/mm³ (IQR, 6,200–13,860), and median C-reactive protein level was 7.5 mg/dL (IQR, 1.1–26). Infiltration on chest radiographic (58.7%) were predominantly reticulonodular. About half of the patients (55.1%) required hospitalization; 21.8% needed respiratory support, and 6.4% were admitted to the pediatric intensive care unit. The need for respiratory support was significantly higher in children with comorbidities (p = 0.025), mortality was 2.6%. HMPV is a significant cause of ARIs in small children, particularly during winter and spring. Underlying comorbidities are associated with increased disease severity.

This study examined pediatric tuberculosis (TB) cases in Osaka City from 2008-2023, focusing on diagnostic methods and molecular epidemiology using variable number of tandem repeats (VNTR) analysis and whole-genome sequencing (WGS). Among 29 children aged 0-14 years (notification rate: 0.04 per 100,000), three (10.3%) were born abroad, and five (17.2%) were born in Japan with source cases from foreign countries. Source cases were identified for 20 children (69.0%); 18 of these (90.0%) had smear-positive pulmonary TB. Seventeen children (58.6%) were identified through contact investigations, highlighting the crucial role of contact tracing and early detection. Diagnosing pediatric TB was challenging: 15 children (51.7%) were asymptomatic and 17 (58.6%) had culture-negative results. To enhance diagnostic accuracy, interferon-gamma release assays, chest computed tomography, and gastric aspirate examination for acid-fast bacilli are recommended. In pediatric TB cases with identified source patients, VNTR clusters were confirmed by WGS to be closely related. Among children without identified sources, four formed VNTR clusters, and WGS of one representative case revealed no epidemiological links. These findings highlight the need to integrate molecular and epidemiological investigations to clarify transmission routes. Overall, this research underscores the need to integrate diagnostic and epidemiological approaches for effective control of pediatric TB.

Disasters such as earthquakes create conditions that amplify the risk of ectoparasitic infestations due to overcrowding, disrupted sanitation, and limited hygiene resources. This study explores ectoparasite-related online search interests in Türkiye before and after the earthquakes of February 2023, offering insights into potential secondary health concerns during disaster recovery. Weekly Google Trends data on scabies, lice, bed bugs, ticks, and insect bites were extracted for Türkiye and its provinces. Relative search volumes (RSV) were analysed to compare two years pre- and post-earthquake periods. Statistical analyses included time series comparisons. Following the earthquake, RSV for scabies and bed bugs increased sharply, while lice RSV significantly declined; tick and insect bite queries maintained consistent seasonal cycles. Integrating digital epidemiology insights with field-based surveillance could enhance the early detection and response to outbreaks following disasters. Long-term monitoring should be included in surveillance systems.

We investigated the association between frequenting 3Cs (closed spaces, crowded places, and close-contact settings) and trust in information on COVID-19, to elucidate information sources affecting public preventive measures. Nonprobability quota sampling was used to recruit 2000 residents of Tokyo and 2000 from Osaka. The retrospective survey was conducted in April 2024. These participants responded to an online survey about two periods, with and without an emergency declaration. Multiple regression analyses were performed and standardized partial regression coefficients for the independent variables calculated. Without an emergency declaration, a negative association between frequenting 3Cs and trust in family/relatives and a positive association with daily conversation were observed. 3Cs anxiety was positively associated with trust in three sources: medical professionals, family/relatives, or television (TV). During the emergency declaration period, a negative association between frequenting 3Cs and trust and a positive association between 3Cs anxiety and trust in the three sources above were observed, while there was a positive association between frequenting 3Cs and trust in celebrities, weekly magazines, or social networking services. A mediation analysis showed that trust in medical professionals, family/relatives, or TV increased 3Cs anxiety, and frequenting 3Cs decreased in state of emergency situations.

Escherichia coli O157 and O26 are well-known Shiga toxin-producing E. coli (STEC) serotypes, but other serotypes such as O91, O103, O111, O121, O145, and O165 have also emerged as important public health concerns. PCR-based methods, such as multilocus variable-number tandem-repeat analysis (MLVA), are commonly used for rapid genotyping of STEC strains. However, MLVA requires analysis of numerous loci, some of which are serotype-specific, limiting its applicability across multiple STEC serotypes. In this study, we developed a PCR-based open reading frame typing (POT) method for genotyping diverse STEC serotypes. By detecting 22 ORFs using two multiplex PCR assays, STEC genotypes were determined based on the presence or absence of specific ORFs. Most STEC serotypes, except for O121, were classified with high discriminatory power (Simpson’s index: 0.95–0.98). STEC-POT represents a rapid, cost-effective, and broadly applicable molecular typing tool. It facilitates timely outbreak detection and enhances public health surveillance by enabling rapid molecular epidemiological investigations.

Safety procedures for entering and exiting suit-type Biosafety level 4 (BSL-4) laboratories are essential to minimize the risk of exposure to high-risk pathogens and prevent their release outside the facility. Exiting a BSL-4 laboratory particularly requires complete decontamination of the positive-pressure protective suit. A critical challenge in maintaining BSL-4 safety operations is effectively training personnel in proper decontamination techniques using chemical showers. In this study, we introduce a training method that evaluates decontamination efficacy using a colored cream as a visualized pseudo-contaminant. The colored cream successfully visualized the physical removal process achieved by the chemical shower, thereby enhancing the efficacy of decontamination training.

Urban wastewater is increasingly recognized as a major reservoir of antimicrobial resistance and horizontal gene transfer. From urban wastewater in Hanoi, Vietnam, we isolated a multidrug-resistant Pseudomonas guariconensis strain, KNHN1, resistant to most antimicrobials, including carbapenems and cephalosporins, but susceptible to cefiderocol; and intermediate to colistin. Whole-genome sequencing revealed two chromosomally integrated integrative and conjugative elements (ICEs): ICE_{PgKNHN1_KPC} (131 kb) carrying bla_KPC-2 and ICE_{PgKNHN1_NDM} (108 kb), carrying bla_NDM-1, both flanked by conserved 18-bp att sites in the tRNA^Gly loci and encoding MOB_H-type relaxases. Polymerase chain reaction and subsequent sequencing confirmed ICE excision from the chromosome and formation of circular intermediates. Conjugation to Pseudomonas putida KT2440 occurred at ~10⁻² frequency, producing transconjugants with ICE_{PgKNHN1_NDM} (~85%), ICE_{PgKNHN1_KPC} (~10%), or both, all showing broad range β-lactam resistance. Comparative analysis indicated that ICE_{PgKNHN1_NDM} has a highly conserved backbone across multiple species and often co-carries bla_PME-1 and other resistance genes. To our knowledge, this is the first report of chromosomally integrated bla_NDM‑1 and bla_KPC‑2 in P. guariconensis mediated by functional ICEs. These findings underscore the pivotal role of environmental bacteria as reservoirs of clinically significant resistance genes, and highlight ICEs as key drivers in the dissemination of carbapenem resistance.

This large-scale post-marketing surveillance study (163 sites; February 2022–May 2023) evaluated the real-world safety and effectiveness of a newly initiated nirmatrelvir plus ritonavir combination for patients with COVID-19 in Japan. The current study reports the safety evaluation. The observation period was 28 days after the last day of administration. The safety analysis set comprised 2829 patients (mean [standard deviation] age, 63.1 [18.0] years; mild COVID-19, 80.8%; ≥1 risk factor for progression to severe COVID-19, 97.3%). The most common reason for discontinuing follow-up was symptom improvement (17.1%). Adverse drug reactions (ADRs) were observed in 423 (15.0%) patients (incidence [%]): dysgeusia (6.7%), diarrhea (2.6%), taste disturbance (1.5%), nausea (1.2%), vomiting (0.5%), decreased appetite (0.5%), and rash (0.5%). The median times to onset and recovery of these ADRs were 1–2 days and 2–6 days, respectively. Serious ADRs were observed in 6 patients (0.2%). No new safety signals were observed. The study showed that nirmatrelvir plus ritonavir was well tolerated in Japanese patients with COVID-19 in a real-world clinical setting.

ClinicalTrials.gov number: NCT05263908

Early detection of leprosy is crucial since delayed treatment can result in deformities and impairments. Recombinase Polymerase Amplification (RPA) is an isothermal DNA amplification technique that amplifies DNA fragments at a single, moderate temperature using a mixture of recombinase enzymes. In this work, PCR-confirmed cases of leprosy (positive for Mycobacterium leprae DNA) were subjected to RPA targeting an in-house designed RLEP amplicon of 175 bp. Following amplification, the RPA amplicons were analysed using agarose gel electrophoresis and SYBR Green I. The RPA-based detection of M. leprae DNA can be achieved within 20 min at 39 °C. The analytical sensitivity of the test was 0.5 cells/µl when tested using purified M. leprae genomic DNA standards. The clinical performance of the RPA was evaluated using 28 DNA samples extracted from skin biopsies. This assay has greater potential for developing a quick, accessible and field-friendly method for the visual detection of M. leprae DNA.

Dengue virus (DENV), a mosquito-borne flavivirus, has emerged as a major global public health concern, with outbreaks occurring with increasing frequency worldwide, including in India. Laboratory confirmation is essential for accurate diagnosis, effective clinical management, and timely public health response. Real-time PCR (RT-PCR) is recognised as a sensitive and specific method for early diagnosis. This study evaluated the performance of the NeoDX Dengue Virus Screening Real-Time PCR Kit (NeoDX, Bengaluru, India), a pan-DENV assay, against the CDC DENV 1-4 RT-PCR assay. RNA extracted from 51 sera, obtained from suspected dengue cases, was tested by both assays. Of the 51 samples, 23 were positive by the CDC assay (DENV-1: 6, DENV-2: 4, DENV-3: 10; DEN-4:3). The NeoDX Dengue Virus Screening Real-Time PCR detected 24 positive samples, including all 23 positive samples by CDC assay, yielding a sensitivity of 100% and specificity of 96.4%. The Kappa value (0.961; 95% CI: 0.88–1.0) indicated very good agreement, supporting NeoDX Dengue Virus Screening Real-Time PCR as a reliable assay for early DENV detection.

Cefiderocol (CFDC) is a novel siderophore cephalosporin with a unique cell entry feature and a high stability against a wide range of β-lactamases. We conducted antimicrobial susceptibility testing on 89 clinical isolates of carbapenem-non-susceptible gram-negative bacilli (CNS-GNB) strains detected at our hospital, evaluating the efficacy of novel antibiotics including CFDC, ceftolozane/tazobactam, ceftazidime/avibactam, and imipenem/cilastatin/relebactam. The strains included were as follows, 21 carbapenemase-producing Enterobacterales (CPE), 40 carbapenem-resistant Pseudomonas aeruginosa (CRPA), and 28 Stenotrophomonas maltophilia. Carbapenemase production were detected using NG-Test^® CARBA 5. Carbapenemase genes were analyzed by PCR-sequencing and extended-spectrum β-lactamase (ESBL) genes were detected by PCR. CPE isolates produced 17 IMP-, 3 NDM-, and one KPC-type carbapenemases, and 12 out of 21 CPE isolates produced ESBLs. All 40 CRPA did not produce carbapenemases. All 21 CPE isolates and 95% of CRPA were susceptible to CFDC. Colistin were intermediate against all CPE and 92.5% of CRPA isolates. In S. maltophilia isolates, susceptibility to CFDC and trimethoprim-sulfamethoxazole were 100% and 89.3 %. Although non-susceptibility to CFDC appeared in 2 CRPA isolates, MIC₉₀ of CFDC was within susceptible range against all three groups of clinical isolates. CFDC showed significant promise as a treatment option for infections caused by CNS-GNB.

The aim of this study was to determine the prevalence and persistence of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) carriage among hospital food handlers. A prospective, single-center study was conducted in Sagamihara, Japan, from July to December 2021. Residual fecal specimens from routine examinations of 119 hospital food handlers were analyzed for ESBL-E and carbapenem-resistant Enterobacteriaceae (CRE). ESBL-E were detected in 32 isolates from 11 participants (9.2%), with Escherichia coli as the predominant species and a mean monthly positivity rate of 4.48%. The frequency of ESBL-E carriage was higher in individuals younger than 40 years of age (17.5%) than in those aged 40 years or above (5.1%). Highly homologous strains were detected within and between participants; the most common resistance genes were bla_CTX-M-1 group and bla_CTX-M-9 group. Six participants showed persistent ESBL-E carriage but CRE was not detected. These findings suggest that ESBL-E carriage is common among hospital food handlers, particularly among younger individuals, highlighting the need for enhanced surveillance and targeted hygiene interventions to limit ESBL-E transmission in healthcare food services.

During the COVID-19 pandemic, Mycoplasma pneumoniae infections were rarely observed in Japan, but a significant outbreak occurred in 2024. At Oita Children’s Hospital, a rapid quenching probe polymerase chain reaction (QP-PCR) method was employed to detect the pathogen and to determine the prevalence of macrolide resistance. Between April 1 and September 30, 2024, we tested 679 patients — 462 (68.0%) were positive and 399 (86.4%) were macrolide resistant. The resistance rate was among the highest reported in Japan and comparable to those in neighboring Asian countries. Inpatients were younger than outpatients, and their diagnoses required longer periods of time; corticosteroids were used in 86% of hospitalized cases. QP-PCR detects common A2063G and A2064G mutations and provides results within 40 minutes, which could promote timely therapy, and this is true particularly in the case of younger children whose options could be limited. Early administration of effective antimicrobial agents is crucial for the control of macrolide-resistant M. pneumoniae. These findings indicate that QP-PCR-based diagnostics could significantly contribute to the management and control of M. pneumoniae outbreaks.

The Coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected vulnerable populations in long-term care hospitals (LTCHs). This study examined the interplay between patient and hospital factors in relation to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 mortality in Korean LTCHs. This retrospective cohort study included 262,221 patients (aged ≥60) who were hospitalized for ≥30 days in 2021. Multilevel logistic regression models were used to assess the association of hospital and patient factors with SARS-CoV-2 infection and COVID-19 mortality. At the hospital level, more doctors were associated with a decreased risk of SARS-CoV-2 infection (odds ratio [OR] = 0.84, 95% confidence interval [CI]: 0.73–0.98) and COVID-19 mortality (OR = 0.85, 95% CI: 0.78–0.93), whereas nurses/aides were associated with an increased risk of SARS-CoV-2 infection (OR = 1.02, 95% CI: 1.00–1.03) and COVID-19 mortality (OR = 1.01, 95% CI: 1.00–1.02). Among patient-level factors, female sex (infection OR = 0.89, 95% CI: 0.83–0.96; mortality OR = 0.65, 95% CI: 0.55–0.77) was associated with decreased risks of both infection and mortality. These findings highlight the importance of staffing and infection control measures to mitigate COVID-19 risk in LTCH settings.

This study estimated the incidence of extraintestinal pathogenic Escherichia coli (E. coli; ExPEC) infections at Kyushu University Hospital from 2013-2018, analyzing 63,041 hospitalized and 178,690 outpatients aged ≥20 years. ExPEC infections were defined as E. coli detection in sterile specimens or urine specimens (≥103 CFU/mL) with increased SOFA scores or urological infection diagnosis codes. The incidence rate was substantially higher in hospitalized patients (1,209.3 per 100,000 person-years) compared to outpatients (94.5 per 100,000 person-years), with females showing slightly higher rates in both groups. Age was a significant risk factor, with incidence rates increasing markedly in patients ≥60 years (inpatients: 1,431.6; outpatients: 125.3 per 100,000 person-years). Importantly, the study revealed that relying solely on diagnostic names underestimated the true number of ExPEC infection cases. The precision rate, defined as the proportion of cases (n=61) with both E. coli isolated and clinically inflammatory symptoms who received an infectious disease diagnosis (n=46), was at most 75% in female outpatients. It is suggested that comprehensive microbiological data combined with clinical criteria provides more accurate surveillance. These findings establish baseline incidence rates for ExPEC infections in a Japanese hospital setting and highlight the clinical significance of these infections, particularly in elderly hospitalized patients.

This study investigated the etiology of hand, foot and mouth disease (HFMD) in Yunnan Province, China, in 2023 by sequencing the complete VP1 region of enteroviruses. A total of 185 enteroviruses were identified from 429 stool samples collected from nine prefectures/cities in Yunnan Province in 2023. These findings revealed that CVA16 was the most prevalent serotype, followed by CVA4, CVA6, CVA10 and EV-A71. Phylogenetic analysis revealed that among the 76 CVA16 strains, 73 strains were subgenotype B1a, and 3 strains were B1b. Among the 32 CVA4 strains, 31 strains were subgenotype C2, and only 1 strain was C5. All 25 CVA6 strains belong to subgenotype D3a, all 22 CVA10 strains are genotype C, and all 11 EV-A71 strains are of the C4a subgenotype. HFMD genotypes and sub-genotypes are crucial for public surveillance and outbreak response, and can inform vaccine development.

Group A Streptococcus (GAS) is a major pathogen of respiratory infections in children. This study investigated recent trends in antimicrobial susceptibility among GAS isolates in our hospital and compared them with past data. Between 2021 and 2023, 195 GAS isolates were obtained from 195 pediatric patients. Minimum inhibitory concentrations (MICs) of 22 antimicrobial agents were determined using the broth microdilution method. Susceptibility was categorized as susceptible (S), intermediate (I), or resistant (R) according to the Clinical and Laboratory Standards Institute criteria and compared with six previous surveys (1996–2018; total 1,871 isolates). The number of isolates was low in 2021–2022 but increased sharply in 2023 (n=157). Most isolates were from throat swabs, and the median age was 5 years (range: 1–15 years). Resistance (I + R) rates were as follows: azithromycin (20%), erythromycin (19%), clarithromycin (19%), tetracycline (8%), and clindamycin (4%). Erythromycin resistance increased from 9% in 1996 to 58% in 2013 but declined to 19% in this study. No β-lactam resistance was previously observed; however, two isolates (1%) showed elevated MICs to cefalexin, suggesting reduced susceptibility. These findings underscore the importance of continued monitoring of GAS isolation trends and antimicrobial resistance, including emerging β-lactam reduced susceptibility.

The human bocavirus (HBoV) in children have been identified with an acute lower respiratory tract disease (LRTD). Its prevalence, clinical characteristics, and function as an RTD causal agent are unclear. This study sought to evaluate the laboratory and clinical data of HBoV patients, pinpoint the clinical characteristics linked to HBoV, and examine the distinctions between detecting HBoV alone and in combination with other agents. We used molecular testing to confirm the presence of HBoV DNA and 20 other respiratory pathogens in 1739 nasopharyngeal samples from hospitalized children at the Pediatric Infectious Diseases Service. 73 children, whose median age was 15 months, had HBoV. Concomitant infection of Bocavirus with another virus was observed in 41 (56.1%) of the patients. Coinfections were observed most frequently with rhinovirus (n=17) and RSV (n=10). There was no difference between the isolated bocavirus and coinfection groups in terms of age, clinical presentations, chest X-ray findings, or laboratory results. A role of HBoV in RTD is supported by the fact that the majority of patients were admitted to the hospital with a diagnosis of pneumonia or bronchopneumonia. HBoV mainly affects the respiratory tract, but it can also cause different clinical manifestations.

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.

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.