Early Release

Synopses

• Three Fatal Gestational Psittacosis Cases Caused by Chlamydia psittaci Strains Belonging to Closely Related Lineages, Japan
  A. Nishino et al. View Abstract

  Gestational psittacosis is a rare infectious disease caused by Chlamydia psittaci that causes high maternal and fetal mortality rates. In Japan, gestational psittacosis has been reported in 7 patients, including 4 maternal deaths without antemortem diagnosis. We molecularly diagnosed C. psittaci infection postmortem in 3 patients treated during 2017–2024. We extracted DNA from formalin-fixed paraffin-embedded placenta, lung, and spleen tissues. Analysis of multilocus sequence typing indicated sequence type (ST) 269 in 1 patient and ST335 in 2; all 3 were closely related lineages that have not been previously reported in Japan or in animals. However, the ompA gene showed distinct clusters in the phylogenetic analysis. Quantitative PCR and immunostaining revealed higher amounts of C. psittaci detected in placenta than in lung or spleen, suggesting that proliferation of C. psittaci in the placenta might cause severe symptoms. ST335/ST269 lineage could be highly virulent strains for pregnant women.

• Borna Disease Virus 1 as Cause of Fatal Meningoencephalomyelitis in Wild Hedgehogs, Germany, 2022–2025
  E. Michelakaki et al. View Abstract

  Borna disease virus 1 (BoDV-1) causes encephalitis with a fatality rate of >90% in domestic mammals and humans. Currently, the bicolored white-toothed shrew is the only known reservoir host. We report BoDV-1 infections in 15 wild European hedgehogs from an endemic area in Germany. Because hedgehogs are distant relatives of shrews and often cared for by humans, the cases raise concern regarding a potential zoonotic risk. All the hedgehogs that tested positive for BoDV-1 died of neurological disease and exhibited severe polio-predominant lymphoplasmohistiocytic meningoencephalitis. However, because of the detection of viral antigens in nonneural cells in 1 animal, we cannot completely exclude that some infected hedgehogs shed the virus. Although direct BoDV-1 transmission is known to be inefficient, our results emphasize the necessity of hygiene measures when handling hedgehogs, especially those with neurological signs who are from BoDV-1–endemic regions.

Research

• Zoonotic and Anthroponotic Plasmodium spp. Circulation between Wild Primates and Indigenous Community, Peruvian Amazon, 2007–2020
  G. M. Ulloa et al. View Abstract

  Malaria transmission at the human–wildlife interface remains poorly characterized in the Amazon. We conducted a molecular survey of Plasmodium spp. in an Indigenous community (n = 141) and sympatric nonhuman primates (NHPs) (n = 341; 10 species) in the Peruvian Amazon during 2007–2020. By using nested or quantitative PCR (targeting cytb, cox3, and 18S rRNA genes) and sequencing, we estimated prevalence, parasite load, and genetic similarity. We detected Plasmodium in 43.3% of humans and 51.9% of NHPs. P. vivax/simium predominated in humans (42.1%), whereas P. brasilianum/malariae predominated in NHPs (24.6%). P. falciparum was rare in both hosts. Children <8 years of age showed higher parasite load than older persons. Bayesian phylogenies revealed >99.9% identity among human and NHP lineages, supporting shared Plasmodium lineages. NHP lineages showed low interannual variation. One third of human infections were asymptomatic. Our findings reveal hidden reservoirs and support integrating wildlife surveillance into Amazon malaria elimination strategies.

• Frequency, Duration, and Risk Factors for Diagnostic Delays Associated with Coccidioidomycosis
  D. D. Barber et al.
• Investigation of and Response to Autochthonous Dengue, Los Angeles County, California, USA, August–November 2024
  A. M. Vaughan et al. View Abstract

  Dengue is not endemic in the continental United States; most cases occur in returning travelers. During August–November 2024, a total of 14 locally acquired cases of dengue were identified in Los Angeles County, California, USA. Epidemiologic evidence indicates that locally acquired cases occurred in several neighborhoods, suggesting short transmission chains after introductions from returning travelers. In one neighborhood, evidence supported ongoing transmission for up to 7 weeks. Median patient age was 54 (range 5–79) years; 8 (57%) patients were female and 6 (43%) male, and 6 (43%) required hospitalization. Delays in healthcare seeking and diagnoses were noted; median time from symptom onset to specimen collection for dengue testing was 9 (range 2–34) days. Local dengue transmission in Los Angeles County highlights the emerging threat of mosquitoborne disease transmission in nonendemic areas and the need for rapid and coordinated public health and vector control responses to interrupt transmission.

• Updated Genomic Epidemiologic Description of Candida (Candidozyma) auris, United States
  L. A. Parnell et al. View Abstract

  The multidrug-resistant yeast Candida (Candidozyma) auris has caused several healthcare-associated outbreaks in the United States. We provide a genomic epidemiologic description of 1,535 C. auris isolates collected in the United States during 2013–2022. We identified clades I, II, III, and IV but not clades V or VI. Median pairwise single-nucleotide polymorphism distances indicated lower intraclade relatedness for clades I (91), III (43), and IV (43), compared with clade II (1,455). Phylogenetic analysis showed regional clusters with varying predominant clades. Of 809 isolates that underwent antifungal susceptibility testing, 53 were echinocandin resistant, distributed across 3 clades; 92% (49/53) had FKS1 hotspot mutations, which varied regionally. Our findings corroborate ongoing transmission and clonal expansion of C. auris, likely propagated by multiple introductions within and between geographic regions. Echinocandin resistance in multiple clades highlights the need to increase awareness, improve treatment practices, and engage in rapid public health response.

Dispatches

• Severe Respiratory Illness and Death Associated with Outbreak of Human Rhinovirus B14 among Older Adults, France, 2024
  J. Andreani et al. View Abstract

  We investigated an outbreak of unknown respiratory disease and 8 deaths among older adults in a long-term care facility in France. We identified human rhinovirus (HRV) by quantitative PCR and HRV-B14 by metagenomics. We obtained 5 HRV-B14 genomes that diverged from 5 publicly available genomes. Real-time metagenomics could enable rapid clinical diagnoses.

• Tropism and Replication Competence of Cattle Influenza A(H5N1) Genotype B3.13 Virus in Human Bronchus and Lung Tissue
  K. Hui et al. View Abstract

  In 2024, influenza A(H5N1) genotype B3.13 viruses emerged from cattle and caused mild spillover infections in humans. Using human bronchus and lung tissue, we evaluated tropism, replication, and pathogenesis of 2 cattle influenza isolates. Those viruses showed moderate replication competence and induced robust proinflammatory responses, suggesting potential risk for human health.

• Retrospective Phylogenetic Analysis of Mayaro Virus, French Guiana, 1996–2024
  A. Lagrave et al. View Abstract

  We conducted a retrospective phylogenetic analysis of Mayaro virus (MAYV) detected in French Guiana during 1996–2024. Analysis revealed circulation of MAYV genotype D sublineage 2 and suggested introduction from Brazil and spread to Haiti and Venezuela. Phylogenetic findings support endemic circulation and reinforce the need for MAYV surveillance in the region.

• Serologic Surveillance of Highly Pathogenic Avian Influenza Virus Subtype H5 in Wildlife, Northeast Germany, 2023–2025
  A. Günther et al. View Abstract

  We tested wild ruminants, boar, and carnivores in northeast Germany for highly pathogenic avian influenza subtype H5 antibodies. Wild ruminants were seronegative, but 3.5% of boar and 12.5%–21.9% of carnivores were seropositive, indicating frequent spillover. Because such events might accelerate mammalian (and ultimately human) adaptation, sustained monitoring remains essential.

• One Health Investigation into Fatal Encephalitis caused by Pigeon Paramyxovirus Type 1, France
  N. Veyrenche et al. View Abstract

  Pigeon paramyxovirus type 1 (PPMV-1) is a genotype of avian paramyxovirus type 1 that uses species of the family Columbidae as reservoir species. We report fatal PPMV-1 encephalitis in a human without immunosuppression or travel history outside metropolitan France. Postmortem analyses revealed PPMV-1 in tissues, underscoring that physicians should consider this potential diagnosis.

• Exposure in Horses to Human Tick-Borne Relapsing Fever Agent Borrelia persica, Israel, 2025
  D. Shwartz et al. View Abstract

  Human tick-borne relapsing fever caused by Borrelia persica is common in western Asia. A survey of 301 horses in Israel revealed 9.96% seropositivity toward B. persica antigens; 1 horse (0.33%) was also PCR positive for B. persica DNA. Phylogenetic analysis supported a transmission cycle involving ticks, humans, and horses.

• Clinical, Molecular, and Zoonotic Perspectives on Human Cases of Cryptosporidium OTUi
  T. Larsen et al. View Abstract

  We report a case of Cryptosporidium spp. OTUi identified in a tourist from Denmark who recently traveled to Indonesia. Previous detections include a traveler from Australia returning from Bali, a bat from the Philippines, and a patient from Australia. On the basis of those findings, we believe zoonotic transmission is plausible.

• Yezo Virus Diversity in Tick Bite Patients and Ticks, Russia
  Y. O. Epik et al. View Abstract

  Yezo virus is an emerging tickborne orthonairovirus. We detected Yezo virus RNA in tick bite patients and in Ixodes persulcatus ticks in west Siberia and Far East, Russia. Clinicians should consider the expanded area of Yezo virus identification and the I. persulcatus tick habitat when evaluating patients after tick bites in Russia.

• Replication Efficiency of Contemporary Highly Pathogenic Avian Influenza A(H5N1) Virus Isolates in Human Nasal Epithelium Model
  M. Flagg et al. View Abstract

  Replication of influenza A virus in human nasal epithelium affects transmissibility and disease. We compared virus replication and immune responses in human nasal epithelium infected with seasonal and highly pathogenic avian influenza A(H5N1) viruses. Contemporary H5N1 viruses replicated better than the historical isolate; however, interferon response to B3.13 genotype viruses was dampened.

• Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4b Virus and Mass Mortality in Eurasian Cranes, Germany, 2025
  A. Günther et al. View Abstract

  In autumn 2025, highly pathogenic avian influenza A(H5N1) clade 2.3.4.4b virus, genotype EA-2024-DI.2.1, caused systemic infections leading to a mass mortality event among the western migrating subpopulation of Eurasian cranes (Grus grus) in Germany. Gregarious behavior at feeding and resting sites likely promoted rapid viral spread within the population.

• Orthopoxvirus Antibodies in Feral Mammals in Mpox Outbreak Areas, Nigeria, 2021–2022
  A. Adedeji et al. View Abstract

  We analyzed tissue and serum samples from 124 wild animals from communities with confirmed mpox cases in Nigeria. Tissue samples were PCR-negative, but serum samples from 8 animals (6.45%)—3 feral cats, 4 giant pouched rats, and 1 shrew—revealed Orthopoxvirus antibodies, suggesting these species as probable reservoirs.

• Development and Validation of Real-Time PCR for Detecting Anaplasma bovis–Like Agent in Dermacentor spp. Ticks
  R. C. Smith et al. View Abstract

  We developed and validated a real-time PCR to detect an Anaplasma bovis–like agent. We applied that assay to 672 Dermacentor spp. ticks collected from across the United States and found 0.1% A. bovis–like agent prevalence. This assay could enhance epidemiologic surveys for this A. bovis–like agent in ticks and humans.

• Genomic Analysis of Sin Nombre Virus Sequences, Northwestern United States, 2023
  G. Rickard et al. View Abstract

  We report Sin Nombre virus (SNV) genome sequences in the northwestern United States, including SNV sequences recovered from montane voles. Analysis of samples collected from 189 individual rodents revealed high SNV prevalence in the region and evidence of virus reassortment or coinfection, highlighting ongoing virus diversification in rodents.

Photo Quiz

• Photo Quiz
  D. Raele and N. Cavaliere

Research Letters

• Genomic Surveillance of Lassa Virus through In-Country Sequencing, Guinea
  J. Camara et al. View Abstract

  Strengthened in-country sequencing generated 28 Lassa virus genomes from human clinical cases in Guinea, expanding knowledge of Lassa fever in the country. Phylogeographic analysis revealed cross-border exchange between Liberia and the N’Zérékoré region and a Sierra Leone introduction into Guéckédou. Enhanced genomic surveillance is crucial to guide public health.

• Highly Pathogenic Avian Influenza A(H5N1) Virus RNA in Bovine Semen, California, USA, 2024
  A. Lim et al. View Abstract

  Since March 2024, highly pathogenic avian influenza (HPAI) A(H5N1) virus has infected dairy cattle in the United States, prompting concern about novel transmission routes. During an outbreak in California, HPAI H5N1 RNA was detected in an asymptomatic bull’s semen. Although infectious virus was not isolated, semen-associated transmission risks and biosecurity practices remain a concern.

• Herpes Simplex Virus 1 in Trigeminal Ganglia of Trafficked Neotropical Primates, Peru, 2024
  F. Vilchez-Delgado et al. View Abstract

  We detected herpes simplex virus 1 in the trigeminal ganglia of trafficked Neotropical primates (1 Aotus azarai; 3 Sapajus macrocephalus) in Peru. Tests also revealed Saimiriine alphaherpesvirus 1 in the trigeminal ganglia of 2 Saimiri sp. monkeys. Our findings suggest latency and raise concerns about diagnostic standards, viral reactivation, and spillover risks.

• Serial Interval and Intervention Efficiency in Pertussis Outbreak, South Korea, 2024
  A. R. Akhmetzhanov et al. View Abstract

  We estimated an unmitigated mean serial interval during a school-based pertussis outbreak in South Korea at 14.7 (95% credible interval 9.0–27.4) days, comparable with previous estimates. Public health interventions reduced the effective reproduction number by 65% (95% credible interval 26%–88%), which likely brought it to <1 and contributed to curbing the outbreak.

• Borrelia turicatae in Ticks from Animals in a Public Park, Aguascalientes, Mexico
  E. Vázquez-Guerrero et al. View Abstract

  We obtained 5 isolates of Borrelia turicatae from ticks captured in a public park in Aguascalientes, Mexico. A serologic survey in resident fauna showed antibodies against B. turicatae. Relapsing fever borrelias are present in Ornithodoros turicata ticks and circulate in a zoonotic cycle, posing a risk for human infection.

• Probable Bartonella clarridgeiae Prosthetic Valve Endocarditis and Aortic Root Abscess, Australia, 2020
  M. Cribb and S. Coghill View Abstract

  We describe a case of endocarditis and aortic root abscess caused by Bartonella clarridgeiae bacteria in a patient in Australia. The patient initially sought care for leg pain and was found to have bilateral tibioperoneal trunk mycotic aneurysms. 16S rRNA PCR on excised aneurysm tissue identified the cause as B. clarridgeiae.

• Human Respiratory Syncytial Virus in Vaccinated and Unvaccinated Adults, Atlanta, Georgia, USA, 2024–2025
  S. Rachida et al.

Letters

• Evidence Lacking for Endemic Chagas Disease in the United States
  P. T. Cantey et al.
• Evidence of Rat Hepatitis E Virus Circulation through Wastewater Surveillance, Central Argentina
  F. Abravanel et al.
• Evidence Lacking for Endemic Chagas Disease in the United States (Response)
  N. L. Beatty et al.

Books and Media

• The Big One: How We Must Prepare for Future Deadly Pandemics
  C. N. Dillingham et al.

Etymologia

• Borealpox [bōr′-ē-әl-poks]
  J. L. Miranda

About the Cover

• Gone to the Dogs—The Canon of Kitsch
  L. Mitchell

Synopses

• Cerebrospinal Fluid Findings among Patients with Anaplasmosis and Central Nervous Involvement, Minnesota and Wisconsin, USA
  I. Dumic et al.
• Group A Streptococcal Outbreak Associated with Large Congregate Shelter, Chicago, Illinois, USA, October 2023–January 2024
  K. Toews et al.
• Outcomes of Hospitalized and Critically Ill Adults with Murine Typhus, Galveston, Texas, USA, 2019–2023
  M. Pickich et al.
• Emergence of Klebsiella pneumoniae Carbapenemase–Producing K. pneumoniae with Penicillin Binding Protein 3 Insertions, Taiwan, 2021
  T. Long et al.
• Public Health Response to Toxigenic Respiratory Diphtheria Outbreaks at Correctional Facility, South Africa, 2023–2025
  M. Jose et al.

Research

• Characteristics of Plausible Source Cases Responsible for Recent Mycobacterium tuberculosis Transmission, United States, 2018–2022
  S. Kammerer et al.
• Wickerhamomyces anomalus Fungemia during Healthcare-Associated Outbreak, Pereira, Colombia, 2025
  K. M. Ordoñez et al.
• Outbreak of Wickerhamomyces anomalus (formerly Candida pelliculosa) Bloodstream Infections, Venezuela, 2022–2023
  M. Franco et al.
• Association of Frailty and Frailty Trajectory with Risk for Respiratory Infectious Diseases
  J. Yang et al.
• In Vitro Antifungal Susceptibility of 1,178 Clinical Feline Sporothrix schenckii Complex Isolates, Thailand, 2023–2025
  C. Yurayart et al.
• Role of Households with Children in the Community Spread of Multi-Drug Resistant Enterobacterales
  B. Breeze et al.
• Identification of a novel recombinant human adenovirus genotype B117 from two pediatric community-acquired pneumonia cases in China
  J. Wang et al.
• National Surveillance of Enterovirus D68 Upsurge, France, 2024
  M. Jeannoël et al.
• Antimicrobial-Resistant Gonorrhea of Public Health Concern, Australia, 2022–2024
  L. Walker et al.

Dispatches

• Emergence of Ceftriaxone-Resistant Neisseria gonorrhoeae penA-60–Carrying Strains, Thailand, 2025
  R. Kittiyaowamarn et al.
• Yellow Fever Virus Surveillance in Callithrix spp. Marmosets during Epizootic Outbreak, Brazil, 2024–2025
  M. L. Siconelli et al.
• Adverse Outcomes of Travel-Related Cosmetic Procedures, 2014–2024
  K. McNamara et al.
• Therapeutic Challenges in Case of Trichophyton indotineae Dermatophytosis, Singapore, 2025
  T. Foo et al. View Abstract

  Trichophyton indotineae is an emerging dermatophyte frequently associated with terbinafine resistance. We report a case of recalcitrant T. indotineae infection in Singapore with limited response despite prolonged azole therapy, which only resolved after combination therapy with anidulafungin and itraconazole. This case highlights therapeutic challenges and need for improved diagnostics in T. indotineae infections.

• Suspected Sexual Transmission of Dermatophilosis among Men Who Have Sex with Men, Barcelona, Spain, 2025–2026
  V. Descalzo et al. View Abstract

  Dermatophilosis is considered a zoonotic infection. We report 9 cases among men who have sex with men in Barcelona, Spain, during December 2025–March 2026. Whole-genome sequencing revealed highly related isolates forming a distinct lineage within the genus Dermatophilus. Epidemiologic and clinical features of the cases support human-to-human transmission via sexual contact.

• Suspected Sexual Transmission of Dermatophilosis among Men Who Have Sex with Men, Lyon and Paris, France, 2025–2026
  M. Degreze et al. View Abstract

  We report a genomically linked cluster of 9 Dermatophilus congolensis cutaneous infections diagnosed within 2 months among men who have sex with men in Lyon and Paris, France, 2025–2026. Genomic similarity and shared sexual exposures strongly suggest interhuman sexual transmission of this zoonotic bacterium.

• Placental Vascular Pathology Associated with Congenital Lymphocytic Choriomeningitis Virus Infection, Philadelphia, Pennsylvania, USA
  A. Abraham et al. View Abstract

  Congenital lymphocytic choriomeningitis virus (LCMV) infection is associated with major neurologic malformations and fetal demise. We report 2 cases of probable congenital LCMV infection and chorioretinitis, cerebral ventriculomegaly, and placental histopathology in Philadelphia, Pennsylvania, USA. Clinicians who suspect congenital LCMV infection should screen for chorioretinitis, LCMV antibodies, and evidence of placental pathology.

• Concurrent Detection of Swine-Origin Influenza A(H1N1) Virus in Pigs and Farmer, Switzerland
  J. Steiner et al.
• Burden of Hospitalization for Disseminated Coccidioidomycosis and Coccidioidal Meningitis, Texas, USA, 2016-2023
  C. H. Szeto et al.
• Caballeronia Bacteremia in Children with Cancer, United States
  H. L. Glasgow et al.

Research Letter

• Outbreak of Neisseria gonorrhoeae ST16676 among Disseminated Infections, Minnesota, USA, 2025
  D. Evans et al.

Letter

• Utility of Phenotypic and Genomic Analysis to Characterize Antimicrobial-Resistant Neisseria gonorrhoeae of Public Health Concern
  J. H. Melendez

Books and Media

• Dangerous Miracle: The Astonishing Rise and Looming Disaster of Antibiotics
  J. P. Mills
• Myriad, Microscopic and Marvelous: The World of Antoni van Leeuwenhoek
  J. H. Sogin

Etymologia

• Bacteria [bak-tēr′-ē-ә]
  H. Santos-Dutra et al.
• New Delhi metallo-β-lactamase-1 [nū del′ē bāt′ә lak′tә-mās wuhn]
  S. Chakraborty

Online Report

• Assessing evidence to guide primary prevention of Pathogen X
  I. Holmes et al.

Research

• Clinical Predictors of Fatal Outcomes in Human Leptospirosis, Thailand, 2015–2024
  U. Limothai et al.

Dispatches

• Nipah Virus Shedding in Urine from Fruit Bats, Sri Lanka, 2018–2019
  C. Kohl et al.
• Phormia regina as a Vector for Ignatzschineria spp. Bacteremia in People Experiencing Homelessness, Vancouver, Canada
  E. Finlayson-Trick et al.