SARS-CoV-2 infections in children occasionally manifest with severe neurologic signs. We report a case series of life-threatening encephalopathy associated with SARS-CoV-2 in 25 children in Australia, Japan, Singapore, and Taiwan during February 2022–January 2024. All children had severe encephalopathy develop, characterized by rapidly progressive cerebral edema, conditions known as acute shock with encephalopathy and multiorgan failure or acute fulminant cerebral edema. Among the 25 patients, 22 (88%) eventually died; 11 (44%) children died within 24 hours of hospitalization. In addition, 18 (72%) had illness manifest with shock, and 14 (56%) had multiorgan failure develop within 6 hours of neurologic onset. Serum concentrations of cytokines/chemokines including interleukin 6 and tumor necrosis factor-α were significantly higher within 24 hours of onset than for controls. SARS-CoV-2–associated encephalopathy cases such as those described here represent an emerging neurologic crisis with high mortality rate resulting from rapidly progressive brain edema and multiorgan failure.

The tickborne disease Rocky Mountain spotted fever (RMSF) remains life-threatening among children in northern Mexico. We retrospectively investigated 500 pediatric RMSF patients hospitalized in Sonora during 2004–2024. We analyzed clinical, laboratory, and sociodemographic data to identify predictors of fatality by using descriptive statistics and multivariable logistic regression. We found that the overall case-fatality rate was 19.8%, decreasing over time from 31.4% (2004–2013) to 14.5% (2014–2024). Fatal outcomes were associated with delayed doxycycline treatment (>5 days after symptom onset), older age, Indigenous background, and abnormal laboratory markers. Among survivors, 16% had life-altering sequelae, including amputations and neurologic deficits. Cases occurred year-round, predominantly in urban settings. Timely doxycycline administration remains a critical factor in reducing mortality rates. Vulnerable populations, including persons living in poverty, children >10 years of age, and Indigenous communities, require targeted interventions. Strengthening early diagnosis and understanding mechanisms underlying severe disease and death could improve RMSF outcomes in endemic regions.

Scrub typhus is a common bacterial infection in many parts of Asia. The causative agent, Orientia tsutsugamushi, is transmitted by trombiculid mite (chigger) larvae that require small mammals as maintaining hosts. We studied the prevalence of O. tsutsugamushi infection in mites and small mammals in villages and land surrounding them in South India to determine high-risk settings. We identified 12,431 mite larvae on 883 small mammals, 32% of which were bandicoot rats, 31% black rats, and 31% Asian house shrews. Leptotrombidium imphalum was the most common mite species and the only species associated with O. tsutsugamushi infection (prevalence 3.6%). Orientia infection increased with mite population size on a host. Host numbers, the L. imphalum index, and the prevalence of Orientia infection in chiggers were considerably higher within human settlements than in surrounding fields, suggesting that most human scrub typhus infection occurs inside villages rather than during agricultural work.

Dengue virus poses a growing global health threat, yet inconsistent local surveillance limits global risk assessments. We analyzed 10,530 travel-associated dengue cases among US travelers reported to ArboNET during January 2010–April 2024, involving travel to 128 countries. By using negative binomial and Poisson models, we developed country-specific thresholds (75th, 80th, 90th percentiles) to identify elevated travel-associated dengue risk. We applied a >10-case threshold in a 3-month period to improve specificity. The final dual-criteria method accurately identified high-risk periods, including sustained transmission in countries with limited official reporting, such as Cuba in 2022–2023. Threshold comparisons revealed a tradeoff between early detection and overclassification, whereas real-time and retrospective assessments revealed consistent high-risk signals. This traveler-based approach offers a timely, complementary method for travel-associated dengue risk detection, although timeliness might be reduced if reporting delays increase beyond our observations. Our findings support integrating travel surveillance into global dengue monitoring and preparedness efforts.

Yellow fever (YF) mainly causes severe hepatitis; data on pulmonary pathology remain limited. We investigated respiratory tract pathology in 73 fatal YF cases during the 2017–2019 epidemic in São Paulo, Brazil. All patients died from YF-related fulminant hepatitis. Autopsies revealed frequent tracheitis (91%), pulmonary edema and hemorrhage (100%), diffuse alveolar damage (84%), secondary pneumonia (84%), and bronchoaspiration (60%). Microabscesses, thrombi, and hemophagocytosis were also observed. In 5 cases of vaccine-associated viscerotropic disease, hemorrhage and diffuse alveolar damage were prominent. We detected antigens of YF virus in all cases and viral RNA in 94%. Molecular analysis identified bacterial and fungal pathogens in pneumonia, including gram-negative bacilli, Candida spp., and Aspergillus spp. Electron microscopy did not reveal viral particles in 3 examined cases. Our findings underscore the respiratory tract involvement in severe YF and could help guide diagnosis, intensive care, and public health preparedness in future outbreaks.

We examined 89 travel-related clade Ib monkeypox virus cases detected in 33 countries during August 2024–July 2025. Most cases were among men; approximately one third led to secondary transmission. Secondary transmission risk was highest among sexual, then household, contacts. Those groups should be the focus of response strategies and interventions.

We reviewed 8 episodes of Desulfovibrio bacteremia in Japan (2020–2025) and confirmed 4 species by 16S rRNA gene and whole-genome sequencing. We detected β-lactamase genes in 2 D. desulfuricans (bla_DES-1-like), 1 D. falkowii (bla_MUN-1), and 2 D. fairfieldensis (bla_CfiA-like). Mass spectometry failed to identify D. falkowii or D. legallii.

We inspected 16S rRNA sequences of 784 publicly available Treponema pallidum subspecies pallidum genomes and 17 new T. pallidum subsp. pallidum genomes from Canada for putative mutations associated with doxycycline resistance. Variants were detected in 9 non-Canada genomes. These findings establish a global genomic baseline for monitoring doxycycline resistance in syphilis.

We evaluated effectiveness of respiratory syncytial virus (RSV) vaccines against RSV-associated thromboembolic events among community-dwelling Medicare fee-for-service beneficiaries >65 years of age in the United States enrolled during October 1, 2023–March 30, 2024. RSV vaccines protected against RSV-associated thromboembolic events (effectiveness 79% [95% CI 74%–83%]) in the same season as vaccine receipt.

We designed a multiplex quantitative PCR to differentiate monkeypox virus clades. For clinical samples collected in the United Kingdom and Nigeria, sensitivity was 78% (95% CI 67.67%–86.14%) and specificity 94% (95% CI 80.84%–99.30%); for samples with cycle thresholds <35, sensitivity was 98% (95% CI 91.72%–99.96%) and specificity 94% (95% CI 80.84%–99.30%).

During March–July 2023, we investigated a measles outbreak in Armenia. Of 287 patients, 130 were <5 years of age and 215 (75%) were unvaccinated. Among 3 transmission chains involving 183 cases, 70% of patients were exposed in healthcare facilities. To minimize nosocomial transmission, measles vaccination should be encouraged among healthcare workers.

In northern Vietnam, during March 2021–March 2022, prevalence of influenza A(H9N2) in chickens was higher in distribution facilities than on farms and varied between facility types. Phylogenetic analysis indicated extensive viral mixing along networks of chicken production and distribution, highlighting a need for risk mitigation across the entire network.

The rat lungworm, Angiostrongylus cantonensis, is an emerging veterinary and public health concern. We describe A. cantonensis infections in a zoo-housed parma wallaby and free-ranging Virginia opossums and roof rats in San Diego, California, USA. Angiostrongyliasis should be considered in central nervous system disease in humans and animals in this region.

Seventeen pediatric encephalitis (n = 12) or stroke (n = 5) cases clustered temporally during the 2023–2024 Mycoplasma pneumoniae epidemic in South Korea; similar patterns had not been noted in previous seasons. Those findings might reflect postpandemic changes in clinical manifestation and underscore the need for neurologic surveillance during M. pneumoniae epidemics.

Legionnaires’ disease is a severe respiratory infection that causes increased mortality in hospitalized and immunocompromised patients. We report a nosocomial case in France linked to a water flosser. Our findings underscore the need for vigilance regarding such devices and highlight strategies for their safe management within healthcare settings.

We used immunohistochemistry and PCR to identify Neospora caninum in 6 infected marine mammal species, including 2 pups, that stranded in the northeastern Pacific Ocean. Our findings suggest the expansion of this parasite’s host range to marine mammals, underscoring the effect of terrestrial pathogens that flow from land to sea.

We report 2 cases of donor-derived West Nile virus infection in kidney transplant recipients in France. Both recipients had mild disease develop and recovered without sequelae. A more proactive screening strategy in France, particularly during periods of highest risk for West Nile virus circulation, would help reduce risk for donor-derived infections.

US retail milk monitoring during April 13–May 3, 2024, identified influenza A(H5N1) viral RNA in 36% of retail milk samples, indicating widespread undetected infections in US dairy cows. After federal initiatives, reported infections more closely aligned with findings in retail milk during December 27, 2024–January 29, 2025, reflecting improved detection and control.

Oral rabies vaccination campaigns helped eliminate rabies from parts of Europe, but rabies appears to be reemerging. We analyzed 2022–2024 data, which demonstrated reemergence of 2 virus variants; both were detected in Ukraine, Moldova, Poland, and Romania. Our findings highlight the need to strengthen rabies control efforts in the region.

We report a possible zoonotic case of severe diphtheria-like respiratory illness in Norway caused by a previously unreported toxigenic Corynebacterium ulcerans sequence type. This case highlights C. ulcerans as an emerging pathogen that can cause life-threatening disease. Clinicians should be aware of C. ulcerans infection, even in regions where diphtheria is rare.

We describe acute severe hepatitis B virus (HBV) infection with liver failure requiring transplantation in a patient in Poland treated with acalabrutinib. The patient was fully vaccinated against HBV and had adequate HBV antibody titers and no HBV exposure documented before therapy. Differential diagnoses for jaundice should consider HBV in patients receiving acalabrutunib.

US data on invasive pneumococcal disease incidence among pregnant and postpartum women are limited. We estimated incidence in those groups using population-based surveillance. Compared with nonpregnant women of childbearing age, incidence was similar for pregnant women but 3.5 times higher for postpartum women. Our findings could inform pneumococcal vaccine recommendations.

We conducted a multicenter study in Europe (France, Italy, and Ukraine) to assess the seroprevalence of influenza D virus (IDV) in domestic cats and dogs. Serum samples from France (2015–2018) and Italy (2023–2024) showed no IDV positivity. In Ukraine, 2.46% of dogs and 0.85% of cats tested IDV-positive in 2024.

Vesicular disease caused by Seneca Valley virus infection occurred in pigs from 5 outdoor pig farms in England during June–September 2022. Clinical signs resembled notifiable vesicular diseases, such as foot-and-mouth disease. Full genome sequences shared a common ancestor with a virus circulating in the United States.

African swine fever virus genotype II is endemic in Thailand, typically causing acute disease. We investigated a vaccine-like strain, characterized by 6 multigene family gene deletions, from nonvaccinated herds. We found this strain was associated with chronic disease in pigs.

A 2-dose regimen of the vaccine modified vaccinia Ankara–Bavarian Nordic (MVA-BN) can generate neutralizing antibodies for monkeypox virus clades Ib and IIb. We observed higher response to clade IIb; that result provides evidence that MVA-BN vaccination can induce cross-neutralizing antibodies for monkeypox virus clade Ib as well as for clade IIb.

In November 2024, an autochthonous cluster of 4 Plasmodium falciparum cases (1 fatal) was identified near Benina International Airport, Benghazi, Libya. Epidemiologic and entomologic investigation ruled out local transmission, pointing to airport malaria as the cause and highlighting the vulnerability of malaria-free regions to imported vectors.

During 2022–2023, the Antimicrobial Resistance Laboratory Network tested 8,033 Candida auris clinical isolates in the United States. Overall, 95% of isolates were fluconazole resistant, 15% amphotericin B resistant, and 1% echinocandin resistant. Laboratory capacity for C. auris identification and antifungal susceptibility testing is essential to address this emerging public health threat.