Early Release

Synopsis

• Neoehrlichiosis Causing Hemolytic Anemia in Patients Treated with Rituximab, Norway
  M. Paulson et al.

Research

• Improved Case Detection of Flea-Borne Typhus through Polymerase Chain Reaction Testing, Los Angeles County, California, 2022–2024
  A. Sanosyan et al.

Dispatches

• Chronic Elbow Nodules Caused by Fomitiporella Fungus in Immunocompetent Patients, United States
  G. S. Tansarli et al.
• Serologic Evidence of Hantavirus Exposure in Humans, Italy, 2004–2018
  G. Faolotto et al. View Abstract

  Rodentborne hantaviruses and lymphocytic choriomeningitis virus (LCMV) circulate in northern Italy but are rarely diagnosed. We tested samples collected from 371 patients during 2004–2018 and detected LCMV IgG in 2.7% of samples and hantavirus IgG in 7.3%. Puumala virus–neutralizing antibodies were confirmed in 10 cases, indicating unrecognized local hantavirus circulation.

• Serologic Evidence of Hantavirus Exposure in Humans, Italy, 2004–2018
  G. Faolotto et al.
• Seroprevalence of Influenza A(H5N1) Virus in Domestic Cats at Epicenter of Dairy Cattle Outbreaks, California, USA, 2024–2026
  I. G. Bemis et al. View Abstract

  We conducted a serologic study of domestic cats near the epicenter of the dairy cattle outbreaks of influenza A(H5N1) in California, USA. Three of the 12 cats sampled within 2 km of farms had neutralizing antibodies against H5N1 virus. Proximity to dairy farms was a statistically significant risk factor for seropositivity.

• Genetically Distinct African Swine Fever Virus Genotype II Variant in Wild Boar, Spain, 2025–2026
  C. Gallardo et al.
• Genomic and Epidemiologic Insights into Ongoing Measles Outbreak, Israel, 2025–2026
  E. Bucris et al. View Abstract

  An ongoing measles outbreak in Israel, involving ≈3,200 cases and 16 deaths, threatens the country’s measles elimination status and reflects declining vaccination rates observed globally and within Israel. Epidemiologic investigations supported by sequencing suggest that a single importation triggered the outbreak, underscoring the critical role of rapid genomic surveillance in outbreak control.

Research Letters

• Locally-Acquired Pulmonary Coccidioidomycosis Linked to Maritime Shipping Containers, Taiwan, 2025
  A. C. Huang et al.
• Rickettsia massiliae infection in a peri-urban area, Spain, 2023
  J. Martín-Trueba et al.
• Outbreak of Brazilian spotted fever, Southeastern Brazil, 2018
  J. Brasil et al.
• Southern Tick–Associated Rash Illness in Pediatric Patient, New York, USA, 2025
  A. S. Handel et al. View Abstract

  Southern tick–associated rash illness (STARI) is a tickborne disease of unknown etiology characterized by an erythema migrans–like skin lesion. We report a STARI case in New York in a child after an Amblyomma americanum tick bite; we detected Borrelia lonestari, a disputed cause of STARI, in the tick.

• Autochthonous Canine Pythiosis Linked with Freshwater Exposure, Italy, 2021–2024
  A. Peano et al.
• Powassan Virus in Ixodes scapularis Populations, Illinois, United States, 2025
  A. Marguccio et al.
• Pediatric Tuberculosis Care Outcomes in a Tertiary Care Center, France, 2014–2024
  D. Franco et al.

Letters

• Pulmonary Histoplasmosis, Taiwan, 1997–2024
  T. Kao et al.
• Pulmonary Histoplasmosis, Taiwan, 1997–2024
  C. Liang et al.
• Plausible Source Cases for Recent Mycobacterium tuberculosis Transmission, United States, 2018-2022
  R. Zubairi

Research

• Wastewater Surveillance to Track a Resurgent Outbreak of Measles, Ontario, Canada, 2025
  R. Corchis-Scott et al.

Dispatches

• Emergence of Divergent H5N1 (Clade 2.3.4.4b) in Central Park in São Paulo, Brazil, 2025
  J. de Araujo et al.
• Emergence of Rabies in Cape Fur Seals, South Africa
  C. Ngoepe et al. View Abstract

  Rabies was diagnosed in Cape fur seals by using direct fluorescent antibody testing in South Africa, 2024. We investigated the origin of rabies virus in this species. Phylogenetic analysis revealed virus introduction from jackals into seals, followed by sustained viral transmission within the seal population and spillover into a domestic dog.

• Emergence of Macrolide-Resistant Bordetella pertussis in Peru
  E. Juscamayta-López et al.

Research Letter

• Highly pathogenic avian influenza virus subtype 5 in Brazilian cetaceans: implications for surveillance in threatened species Influenza A Virus in Cetaceans from Brazil
  A. S. Melgarejo et al.

In Memoriam

• In Memoriam: The Enduring Influence of Nancy J. Cox (1948–2026)
  D. B. Jernigan et al.

• Implementation and Early Outcomes of Laboratory Proficiency Testing Program for National Wastewater Surveillance System, USA, 2024
  H. Dutcher et al.
• Evaluation of Detection Methods for Wastewater Surveillance of Antimicrobial-Resistant Bacteria from Healthcare Facilities
  E. Warren et al.
• Early-Season Detection of Influenza A(H3N2) Subclade K in Wastewater, Colorado, USA, 2025–26
  M. C. Hetherington-Rauth et al.
• Mpox Surveillance in Wastewater, North Carolina, USA, October 2023–May 2025
  N. L. Snyder et al.
• Targeted Wastewater Surveillance during the World Athletics Championship, Oregon, USA, 2022
  R. Falender et al. View Abstract

  Targeted wastewater surveillance during the 18th World Athletics Championships in Eugene, Oregon, USA, in 2022 detected influenza A virus, SARS-CoV-2, and hepatitis A virus. Poliovirus detections were inconclusive. Influenza B, hepatitis E, and measles viruses and Middle East respiratory syndrome coronavirus were not detected. Wastewater surveillance augments traditional surveillance to mitigate risks associated with large multinational gatherings.

• Wastewater Respiratory Virus Surveillance in Remote Community, Alaska, 2022–2024
  B. Lefferts et al.
• Correlations between Wastewater Concentrations of Influenza A and Respiratory Syncytial Viruses and Clinical Laboratory Testing and Hospitalization Data, California
  E. Burnor et al.
• Exploration of Public Perceptions of Wastewater Surveillance, United States, June 2024
  J. T. Moore et al.
• Temporal Alignment of Wastewater-based Signals with Clinical Indicators of Respiratory Illness in Post-Pandemic Texas
  K. Bi et al.
• Building National Wastewater Surveillance for Infectious Diseases in the United States
  J. Yoder et al.
• A Multi-Partner Effort to Launch and Sustain Wastewater Surveillance, United States
  J. Yoder et al. View Abstract

  The National Wastewater Surveillance System represents a groundbreaking initiative aimed at enhancing public health surveillance for infectious diseases through wastewater analyses. We have outlined current and planned collaborative efforts between the Centers for Disease Control and Prevention and key partners, including academic institutions, utilities, jurisdictions, and public health partner networks, to develop, implement, and sustain wastewater surveillance for infectious diseases to inform public health activities. By addressing critical challenges in assay development, community and clinician engagement, governance structures, public health ethics, data system development and integration, and innovation fostering, those partnerships lay the groundwork for a robust public health surveillance framework. Establishing this novel public health surveillance capability required developing new partnerships and skills, incorporating basic principles of public health surveillance, validating assays, and envisioning a system to meet current and future public health challenges. This capability will foster improved public health responses nationwide.