Journal Description
Pathogens
Pathogens
is an international, peer-reviewed, open access journal on pathogens and pathogen-host interactions published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, MEDLINE, PMC, Embase, PubAg, CaPlus / SciFinder, AGRIS, and other databases.
- Journal Rank: JCR - Q2 (Microbiology) / CiteScore - Q1 (Infectious Diseases)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 14.1 days after submission; acceptance to publication is undertaken in 2.6 days (median values for papers published in this journal in the second half of 2025).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journals for Pathogens include: Parasitologia and Bacteria.
- Journal Cluster of Microbiology: Acta Microbiologica Hellenica, Applied Microbiology, Bacteria, Journal of Fungi, Microorganisms, Microbiology Research, Pathogens and Viruses.
Impact Factor:
3.3 (2024);
5-Year Impact Factor:
3.6 (2024)
Latest Articles
Neuroinflammation and Senescence Are Detected in Brainstems of Mice Latently Infected with HSV-1
Pathogens 2026, 15(5), 510; https://doi.org/10.3390/pathogens15050510 (registering DOI) - 9 May 2026
Abstract
Following acute infection, herpes simplex virus type 1 (HSV-1) establishes life-long latency in neurons. Although sensory neurons in trigeminal ganglia (TG) are primary sites for latency, the brainstem is also an important site for latency. The rationale for examining the principal sensory nucleus
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Following acute infection, herpes simplex virus type 1 (HSV-1) establishes life-long latency in neurons. Although sensory neurons in trigeminal ganglia (TG) are primary sites for latency, the brainstem is also an important site for latency. The rationale for examining the principal sensory nucleus of the spinal trigeminal tract (Pr5) receives afferent inputs from TG. Notably, the (LC) is indirectly linked to Pr5. Our previous studies revealed that senescent cells and inflammation were detected in the Pr5 and LC of aged mice and young mice that are latently infected with HSV-1. To expand our understanding of how HSV-1 influences senescence and inflammation in Pr5 and LC, NanoString studies in mice latently infected with wild-type HSV-1 or a latency-associated transcript (LAT) null mutant (dLAT2903) was compared to age-matched uninfected C57Bl/6 male and female mice. LAT is the only viral gene abundantly expressed during latency, suggesting it influences cellular gene expression during latency. Cellular genes that regulate neuron differentiation, axonal projection, and pro-inflammatory mediators were more prevalent in mice latently infected with wild-type (wt) HSV-1 and dLAT2903 versus uninfected mice. Finally, these studies revealed that latency in Pr5 and LC is a dynamic process.
Full article
(This article belongs to the Special Issue Viral Infections, Chronic Inflammation and Carcinogenesis)
Open AccessArticle
Temperature-Based Predictions for West Nile Virus Outbreaks in Endemic Regions of Continental Croatia
by
Ljubo Barbić, Gorana Miletić, Maja Maurić Maljković, Vladimir Stevanović, Vladimir Savić, Ivona Ćorić, Maja Bogdanić, Ivana Rončević, Ana Sanković, Marko Belamarić and Tatjana Vilibić-Čavlek
Pathogens 2026, 15(5), 509; https://doi.org/10.3390/pathogens15050509 - 8 May 2026
Abstract
Weather conditions, especially temperature, rainfall, and humidity, affect the transmission and spread of West Nile virus (WNV). This study investigated the effects of weather patterns on WNV activity in Croatia using climatological, equine seroprevalence, and human case data collected in two endemic continental
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Weather conditions, especially temperature, rainfall, and humidity, affect the transmission and spread of West Nile virus (WNV). This study investigated the effects of weather patterns on WNV activity in Croatia using climatological, equine seroprevalence, and human case data collected in two endemic continental Croatian regions with high WNV activity from 2015 to 2024. Overall equine WNV IgG prevalence was significantly higher in East Croatia (30.34%) than in Central Croatia (10.90%) and increased over time in both regions with a similar temporal pattern, indicating a shared upward trend in viral circulation. Higher equine seroprevalence was observed in areas with confirmed recent equine infections (IgM positive) within the same transmission season. In addition, human cases and recent equine infections were significantly associated with higher equine seroprevalence in the following season, with increases of 4% and 7%, respectively. In contrast to precipitation and humidity, temperature was significantly associated with human WNV cases, whereas no comparable effect was found in horses. Temperatures in February, April, May, and October emerged as key predictors, and the model including mean April and May temperatures showed the best predictive performance for human WNV cases, further supported by analysis of the epidemic year 2018. However, when 2018 was excluded, the effects of temperature remained significant only for May and July, with increased May temperatures emerging as the most important predictor of WNV activity in the upcoming transmission season.
Full article
(This article belongs to the Special Issue Epidemiology of Vector-Borne Pathogens)
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Open AccessArticle
Molecular Surveillance of Plasmodium vivax and Plasmodium falciparum Drug Resistance Genes in the Republic of Korea: 2022–2025
by
Haneul Jung, Hyun-Il Shin, Bora Ku, Esther Park, Myoung-Ro Lee, Jung-Won Ju and Hee-Il Lee
Pathogens 2026, 15(5), 508; https://doi.org/10.3390/pathogens15050508 - 8 May 2026
Abstract
In the Republic of Korea (ROK), chloroquine is the first-line treatment for Plasmodium vivax (P. vivax), and primaquine is also prescribed to prevent relapse. For Plasmodium falciparum (P. falciparum), atovaquone-proguanil, pyronaridine-artesunate, and mefloquine are recommended. This study monitored drug
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In the Republic of Korea (ROK), chloroquine is the first-line treatment for Plasmodium vivax (P. vivax), and primaquine is also prescribed to prevent relapse. For Plasmodium falciparum (P. falciparum), atovaquone-proguanil, pyronaridine-artesunate, and mefloquine are recommended. This study monitored drug resistance genes in blood samples collected from patients with P. vivax (soldiers, relapsed, and imported) and P. falciparum (soldiers and civilians) between 2022 and 2025. In P. vivax, several Pvmdr-1 mutations showed high prevalence, with S515R, G698S, L845F, M908L, T958M, and F1076L observed in nearly all isolates, while T529 and E1233 mutation showed moderate prevalence. S513R, Y541C, A829V, and S1358 mutation were occasionally identified, all of which were imported or soldiers receiving prophylactic chemotherapy. Significant differences in mutation prevalence were identified among groups (p < 0.05). However, no significant temporal trends were observed. In P. falciparum, the Y184F mutation in Pfmdr-1 was highly prevalent, and A675V mutation in PfK13 was detected only in soldiers. Group comparisons revealed significant differences (p < 0.05), whereas temporal trends were not observed. Because drug resistance gene mutations can be closely linked to treatment, surveillance of drug resistance genes is expected to contribute to malaria eradication in the ROK through providing basic information related to treatment.
Full article
(This article belongs to the Section Parasitic Pathogens)
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Open AccessArticle
Salivary Prevalence of Four Oral Pathogens in Postpartum Women in Northeast Romania: An Exploratory Cross-Sectional Study
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Giorgio Nichitean, Elena Teona Cosovanu, Oana Bejan, Silvia Ionescu, Doina Ivanov, Costin Damian, Demetra Socolov, Mihaela Grigore, Cristina Daniela Dimitriu, Cezar Foia, Ionut Luchian, Diana Tatarciuc, Irina Draga Caruntu, Luminita Smaranda Iancu and Ramona Gabriela Ursu
Pathogens 2026, 15(5), 507; https://doi.org/10.3390/pathogens15050507 - 8 May 2026
Abstract
Background: Oral dysbiosis during pregnancy has been associated with adverse outcomes, including preterm birth, premature rupture of membranes (PROM), and low birth weight, yet oral health remains an underappreciated component of routine prenatal care. Dental caries and gingival bleeding are frequently reported during
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Background: Oral dysbiosis during pregnancy has been associated with adverse outcomes, including preterm birth, premature rupture of membranes (PROM), and low birth weight, yet oral health remains an underappreciated component of routine prenatal care. Dental caries and gingival bleeding are frequently reported during pregnancy and may remain clinically relevant in the immediate postpartum period, but their relationship with specific oral pathogens in postpartum women has been insufficiently characterised, particularly in Eastern European populations. Methods: This exploratory cross-sectional, single-centre study included 60 postpartum women recruited consecutively at “Cuza-Vodă” Clinical Hospital of Obstetrics and Gynecology, Iași, Romania, between December 2025 and February 2026. All participants completed a structured questionnaire covering obstetric history, demographic characteristics, and oral hygiene behaviours and underwent a standardised clinical oral examination by two calibrated examiners. Before study initiation, the two examiners underwent a joint calibration session based on the predefined visual oral assessment criteria used in this study and agreed on uniform recording procedures for visible dental caries, self-reported gingival bleeding during brushing, tooth mobility, and overall oral status. Saliva samples were collected after delivery. Genomic DNA was extracted using a magnetic-bead protocol and analysed by Real-Time PCR using TaqMan-based assays to detect four oral pathogens: Porphyromonas gingivalis, Streptococcus mutans, Mycoplasma salivarium, and Fusobacterium nucleatum. Results: Most participants were primiparous (55.0%) and delivered at term (≥37 weeks of gestation; 78.3%). The prevalence of pathogen detection was: P. gingivalis 38.3% (23/60), S. mutans 70.0% (42/60), M. salivarium 71.7% (43/60), and F. nucleatum 100% (60/60). Poly-microbial carriage was common: 15.0% of participants carried all three variable pathogens simultaneously (S. mutans, M. salivarium, and P. gingivalis), and the most frequent two-pathogen combination was S. mutans + M. salivarium (30.0%). No statistically significant associations were identified between pathogen detection and clinical or obstetric variables, consistent with limited statistical power in this small convenience sample. Conclusions: This exploratory study provides the first salivary prevalence estimates for these four oral pathogens in postpartum women in Northeast Romania. The high prevalence of poly-microbial carriage, including the novel quantitative estimate for M. salivarium, provides an empirical foundation for power calculations and future confirmatory research integrating standardised periodontal assessment with pregnancy outcome data.
Full article
(This article belongs to the Special Issue Host–Microbiota Interactions in Periodontal Disease: Pathogenic Invasion, Immune Evasion, and Commensal Defense)
Open AccessReview
Leptospira Infections in Cats—What Do We Know?
by
Bernard Wasiński
Pathogens 2026, 15(5), 506; https://doi.org/10.3390/pathogens15050506 - 8 May 2026
Abstract
The incidence of Leptospira spp. infections in cats did not seem to be of major importance until the early 21st century. The relatively rare occurrence of individuals presenting antibodies against Leptospira spp. and the almost unheard of clinical cases appeared to suggest that
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The incidence of Leptospira spp. infections in cats did not seem to be of major importance until the early 21st century. The relatively rare occurrence of individuals presenting antibodies against Leptospira spp. and the almost unheard of clinical cases appeared to suggest that felids are poorly prone to Leptospira infections. Considering the close contact of cats with rodents (mice, rats, etc.), which are the main reservoir of leptospires, the above observations may, on the one hand, be surprising, but on the other hand, may reflect species-specific biological or ecological factors influencing susceptibility, although the underlying mechanisms remain poorly understood. The suspicions indicating cats as incidental hosts or asymptomatic carriers of Leptospira spp., their proximity to humans, and the “One Health” approach—particularly relevant recently in control of zoonoses—contributed in recent decades to greater research interest in feline leptospiral infections. Recent increasingly frequent data on the occurrence of antileptospiral antibodies in cats, cases of isolation of leptospiral DNA or viable spirochetes from blood or urine samples, and finally cases of clinical disease may support these hypotheses, although the available evidence remains limited and warrants further investigation. This review presents the current data on the incidence and pathogenesis of infections caused by Leptospira spp. in cats and their potential epidemiological role, including their possible contribution to environmental contamination and zoonotic transmission.
Full article
(This article belongs to the Special Issue Leptospira and Leptospirosis: New Insights into an Old Disease)
Open AccessArticle
Cellugyrin (Synaptogyrin-2) Regulates Macrophage Phagocytosis of Aggregatibacter actinomycetemcomitans (Aa)
by
Taewan J. Kim, Sherry Schneider, Aleena Defreitas, Lisa P. Walker, Bruce J. Shenker and Kathleen Boesze-Battaglia
Pathogens 2026, 15(5), 505; https://doi.org/10.3390/pathogens15050505 - 8 May 2026
Abstract
Grade C molar-incisor pattern periodontitis (C-MIP) is a rapidly progressive form of periodontal disease affecting young individuals that is often linked to a highly virulent genotype of Aggregatibacter actinomycetemcomitans (Aa). Although Aa is present in the healthy oral microbiome, its transition
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Grade C molar-incisor pattern periodontitis (C-MIP) is a rapidly progressive form of periodontal disease affecting young individuals that is often linked to a highly virulent genotype of Aggregatibacter actinomycetemcomitans (Aa). Although Aa is present in the healthy oral microbiome, its transition into subgingival tissue correlates with the conversion from healthy to diseased status within the periodontal pocket. These changes may be due to immune evasion strategies attributed to Aa exotoxins. We previously demonstrated that a host cell protein, cellugyrin, plays a critical role in exotoxin internalization and subsequent cytotoxicity. Herein, we assess the contribution of cellugyrin to Aa phagocytosis and intracellular trafficking in human macrophages. Confocal imaging demonstrated that Aa co-localizes with cellugyrin. Importantly, cellugyrin-deficient macrophages exhibited a significant reduction in phagocytosed Aa. Furthermore, we analyzed the role of retrograde trafficking in Aa survival. Retro-2-mediated inhibition of this trafficking pathway resulted in increased intracellular Aa, likely due to increased survival. Collectively, our findings suggest that cellugyrin is involved in Aa phagocytosis and that retrograde trafficking may play a role in subsequent host cell clearance of Aa.
Full article
(This article belongs to the Special Issue Oral Microbes and Oral Diseases)
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Open AccessArticle
Prevalence of pfdhfr-pfdhps Sextuple and Gametocyte-Associated Quintuple Sulfadoxine-Pyrimethamine Resistance Mutations in Plasmodium falciparum Isolates from Pregnant Women in Mozambique
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Yasmina Drissi-El Boukili, Eduard Rovira-Vallbona, Pieter Guetens, Driss Chiheb, Johanna Helena Kattenberg, Luc Kestens, Sonia Maria Mauricio Enosse, Anna Rosanas-Urgell and Paulo Arnaldo
Pathogens 2026, 15(5), 504; https://doi.org/10.3390/pathogens15050504 - 7 May 2026
Abstract
Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) remains the main strategy to prevent malaria in pregnancy. However, continued drug pressure may also contribute to the emergence of resistant parasites and impact the gametocyte carriage and subsequent infectiousness. Pregnant women are thought to be a
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Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) remains the main strategy to prevent malaria in pregnancy. However, continued drug pressure may also contribute to the emergence of resistant parasites and impact the gametocyte carriage and subsequent infectiousness. Pregnant women are thought to be a potential reservoir for malaria transmission due to the increased carriage of gametocytes following long-lasting infections. We used molecular methods to examine 100 Plasmodium falciparum (P. falciparum) isolates collected from Mozambican women at delivery in 2014-15 to determine sulfadoxine-pyrimethamine (SP) resistance polymorphisms in P. falciparum dihydrofolate reductase (pfdhfr) and dihydropteroate synthetase (pfdhps) genes, as well as the presence of gametocytes by RT-qPCR. Overall, 54% and 7% of parasites harbored quintuple and sextuple pfdhfr/pfdhps mutant haplotypes, respectively. Gametocytes were detected in 34% of isolates. Gametocyte carriage was significantly associated with quintuple mutant infections (AOR = 7.5, p = 0.001), which accounted for 80% of infections with detectable gametocytes. Results indicate the relevance of ongoing surveillance of SP resistance in Mozambique to guide future evaluation of alternative intermittent preventive treatment in pregnancy (IPTp) approaches as resistance levels evolve and anticipate potential implications for parasite transmission and maternal–fetal health.
Full article
(This article belongs to the Special Issue Epidemiology and Molecular Diagnosis of Vector-Borne Diseases)
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Open AccessArticle
Tick-Borne Encephalitis Vaccine Effectiveness and Impact in Slovenia, 2019–2024
by
Jan Kordež, Frederick J. Angulo, Pingping Zhang, Alexander Davidson, Juanita Edwards, Lisa R. Harper, Andreas Pilz and Hannah Gould
Pathogens 2026, 15(5), 503; https://doi.org/10.3390/pathogens15050503 - 7 May 2026
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Slovenia has a high tick-borne encephalitis (TBE) incidence and TBE vaccination is recommended for all residents ≥1 year-of-age. Despite widespread TBE vaccine use in Slovenia, TBE vaccine effectiveness (VE) has not been reported for Slovenia. We defined individuals who received ≥3 TBE vaccine
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Slovenia has a high tick-borne encephalitis (TBE) incidence and TBE vaccination is recommended for all residents ≥1 year-of-age. Despite widespread TBE vaccine use in Slovenia, TBE vaccine effectiveness (VE) has not been reported for Slovenia. We defined individuals who received ≥3 TBE vaccine doses in accordance with the recommended vaccination schedule as fully vaccinated. Using the screening method, TBE VE was determined by comparing the proportions of TBE cases and survey respondents who were fully vaccinated. TBE incidence and VE were used to estimate the number of TBE cases prevented by TBE vaccination. Of 637 surveillance-reported TBE cases in 2019–2024, 332 (52.1%) had a known vaccination history. Of these 332 TBE cases, 322 (97.0%) were unvaccinated and 10 (3.0%) received ≥1 doses of a TBE vaccine. Among 25,242 persons surveyed with known TBE vaccination history, 57.9% were unvaccinated. VE of ≥3 TBE doses for the prevention of TBE was 93.4% (84.0–97.3%). TBE vaccination prevented 426 TBE cases in 2019–2024. If the entire population was vaccinated against TBE, vaccination would have prevented 994 TBE cases in 2019−2024. TBE vaccination in Slovenia was highly effective, preventing hundreds of TBE cases a year. Most of the Slovenian population, however, is not vaccinated against TBE. To prevent additional TBE cases in Slovenia, further efforts are needed to enhance TBE vaccine uptake.
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Open AccessArticle
Challenges in Achieving Viral Suppression Among Adolescents and Young Adults Under a Dolutegravir-Based Regimen: Living with HIV in Gabon
by
Berthold Bivigou-Mboumba, Pamela Moussavou-Boundzanga, Falone L. Akombi, Carine Eyi Zang, Aurore F. Bouassa-Bouassa, Sahara Luzolo, Pélagie Okome, Augustin Mouinga-Ondeme and Simon Ategbo
Pathogens 2026, 15(5), 502; https://doi.org/10.3390/pathogens15050502 - 7 May 2026
Abstract
Background: Children, adolescents and young adults living with HIV represent a vulnerable population. Achieving viral suppression in this population remains a major challenge in sub-Saharan Africa. Methods: We conducted a cross-sectional study among HIV-positive individuals aged 0–24 years in Gabon. Data were collected,
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Background: Children, adolescents and young adults living with HIV represent a vulnerable population. Achieving viral suppression in this population remains a major challenge in sub-Saharan Africa. Methods: We conducted a cross-sectional study among HIV-positive individuals aged 0–24 years in Gabon. Data were collected, including viral load (VL), CD4 counts, and immunosuppression levels. Viral suppression was defined as VL < 1000 copies/mL. Statistical comparisons across age groups and immunosuppression categories were performed. Results: Of the 130 (100%) participants included, 59 (45.4%) were males and 71 (54.6%) females. Overall, 72 (55.4%) achieved viral suppression, while 58 (44.6%) remained uncontrolled. Viral suppression increased with age (23.8% (5/21) in 0–7 years; 29.2% (14/48) in 8–15 year and 42.6% (26/61) in 16–24 years), yet uncontrolled VL were predominant across all groups. Median VL values were low but showed wide interquartile ranges, indicating heterogeneity in viral control. Mean CD4 counts declined significantly with age (780 in 0–8 years vs. 470 in 16–24 years; p = 0.001). Immunosuppression levels correlated inversely with virological control (p < 0.001). Conclusions: Despite moderate overall viral suppression, nearly half of adolescents and young adults failed to achieve virological control. The decline in CD4 counts with age highlights increased vulnerability in this population.
Full article
(This article belongs to the Special Issue Pediatric Viral Infections: Epidemiology, Treatment, and Emerging Challenges)
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Open AccessArticle
Associations of Biomarkers and Body Water with Dengue Status and Length of Hospital Stay: A Single-Center Observational Study
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Thang Van Dao, Binh Nhu Do, Minh Duc Pham, Duc Minh Cap, Kien Trung Nguyen and Tuyen Van Duong
Pathogens 2026, 15(5), 501; https://doi.org/10.3390/pathogens15050501 - 6 May 2026
Abstract
Objectives: This study investigated the associations of biochemical and body water distribution parameters with dengue status, as well as their discriminatory ability, among hospitalized adults with febrile illnesses and evaluated whether dynamic changes in body water volumes were associated with length of hospital
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Objectives: This study investigated the associations of biochemical and body water distribution parameters with dengue status, as well as their discriminatory ability, among hospitalized adults with febrile illnesses and evaluated whether dynamic changes in body water volumes were associated with length of hospital stay (LOS) in dengue patients. Methods: A prospective observational cohort study was conducted at a tertiary care hospital involving 186 hospitalized adults (age ≥ 18 years) with fever onset ≤ 5 days and suspected dengue. Body water parameters were assessed by bioelectrical impedance analysis (BIA) using the InBody S10 body composition analyzer at admission (T1), defervescence (T2), and discharge (T3) in dengue patients and at admission only in other febrile illness (OFI) cases. Laboratory data and LOS were retrieved from the hospital information system. Linear and logistic regression models were used to examine the associations and interactions. Discriminative performance was assessed using a receiver operating characteristic (ROC) curve analysis. Results: The proportion of dengue cases was 55.9% (n = 104). Higher levels of lymphocytes, hematocrit, hemoglobin, AST, and ALT were associated with an increased likelihood of dengue, whereas elevated WBC counts, neutrophils, platelets, CRP, sodium, chloride, and the extracellular water-to-total body water ratio (ECW/TBW) were associated with a reduced likelihood of dengue. ROC analysis indicated that WBC showed the best diagnostic performance. In dengue patients, a greater increase in ECW volume from admission to defervescence was associated with a longer LOS in males, and ratio-based body water parameters showed longitudinal variation across dengue phases. Conclusions: Several hematologic, biochemical, and BIA-derived body water parameters were associated with dengue status. Among dengue patients, dynamic ECW changes were associated with longer LOS in males, and ratio-based fluid indices were more sensitive than absolute water volumes in reflecting fluid redistribution throughout the dengue course.
Full article
(This article belongs to the Special Issue Biomarkers in Infectious Diseases)
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Open AccessSystematic Review
Six Decades of Global Research on Bovine Babesiosis Vaccines: A Comprehensive Systematic Review and Meta-Analysis
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Uriel Mauricio Valdez-Espinoza, Chyntia Pérez-Almeida, Alma Cárdenas-Flores, Edwin Esaú Hernández-Arvizu and Juan Mosqueda
Pathogens 2026, 15(5), 500; https://doi.org/10.3390/pathogens15050500 - 6 May 2026
Abstract
Bovine babesiosis is a tick-borne disease that poses significant economic losses to global cattle production, and diverse vaccine platforms have been developed to combat it. This work critically evaluates global research on bovine babesiosis vaccines, integrating historical milestones with recent advances in antigen
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Bovine babesiosis is a tick-borne disease that poses significant economic losses to global cattle production, and diverse vaccine platforms have been developed to combat it. This work critically evaluates global research on bovine babesiosis vaccines, integrating historical milestones with recent advances in antigen discovery and immunization approaches and assessing their protective efficacy through meta-analysis. Using comprehensive database searches, we identified 413 publications on bovine babesiosis vaccines, of which 168 met the inclusion criteria, spanning from 1960 to August 2025. Analysis revealed that B. bovis dominated the research output, followed by B. bigemina and B. divergens. Five key methodological approaches emerged: field trials, controlled experiments, immunogenicity assessments, in vitro assays, and in silico antigen analyses, with a notable shift toward immunogenicity and computational studies post-2000. Frequently studied antigens included RAP-1, MSA-2c, AMA-1, 11C5, and 12D3 (B. bovis); RAP-1 and GP45 (B. bigemina); and Bd37 (B. divergens). Geographically, research was concentrated in the United States, Australia, Argentina, Mexico, and France, which were identified as the top contributors in that order, primarily focusing on live and recombinant vaccines, with minimal African participation despite high cattle populations. Bibliometric analysis showed increasing publication output, with leading journals such as Veterinary Parasitology, Infection and Immunity, and Parasites & Vectors as the top three. Thematic evolution highlighted a transition from live vaccines to recombinant and multi-epitope strategies, with increasing emphasis on conserved antigens and novel platforms. However, more field evaluations are required to determine whether these new technologies can achieve protective efficacy comparable to that of live vaccines. This work underscores the need for sustained investment, intersectoral collaboration, and validation using standardized and comparable metrics in field trials to translate laboratory innovations into effective, safe, and globally accessible vaccines against bovine babesiosis.
Full article
(This article belongs to the Special Issue Ticks and Tick-Borne Pathogens in a Changing World)
Open AccessArticle
Epidemiological and Clinical Insights from 68 Veterinarian-Reported Cases of Feline Infectious Peritonitis During the Documented FIP Epizootic in Cyprus
by
Demetris Epaminondas, Stella Mazeri, Maria Lyraki, Christine Tait-Burkard, Danielle Gunn-Moore, Stavroula Loukaidi, Efstathia-Evangelia Georgiadi, Stavros Loizides, Demetris Demetriou, Zoe Polizopoulou, Charalampos Attipa and Maria-Eleni Filippitzi
Pathogens 2026, 15(5), 499; https://doi.org/10.3390/pathogens15050499 - 6 May 2026
Abstract
In 2023, Cyprus experienced a large-scale epizootic of feline infectious peritonitis (FIP) temporally associated with the emergence of a novel feline coronavirus, FCoV-23. While molecular investigations have elucidated the recombinant origin of FCoV-23, field-based clinical and other epidemiological data from FIP cases reported
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In 2023, Cyprus experienced a large-scale epizootic of feline infectious peritonitis (FIP) temporally associated with the emergence of a novel feline coronavirus, FCoV-23. While molecular investigations have elucidated the recombinant origin of FCoV-23, field-based clinical and other epidemiological data from FIP cases reported during the epizootic period were needed to characterize the outbreak better. A prospective study was conducted using a structured 31-item questionnaire embedded in veterinary management software to characterize FIP cases diagnosed during the epizootic period (late 2022–2025). Data were voluntarily submitted by registered veterinarians across Cyprus. Cases were included based on a clinical diagnosis of FIP; virological confirmation of FCoV-23 infection was not required for inclusion. Data from 68 FIP cases reported by 22 clinics (response rate 21.0%) were analyzed. Affected cats were older than typically reported for FIP (mean age 3.9 years; median 3.0; range 0.4–12.9 years; SD 3.41). Most cases were documented in Limassol (51.5%) and Nicosia (25.0%). The most frequently reported clinical signs were non-specific, like anorexia (60.3%) and weight loss (54.4%), while a variety of neurological and mental manifestations were documented in 35.3% of cases. An albumin-to-globulin ratio < 0.8 was observed in 86.8% of tested cats. Antiviral therapy (GS-441524 or molnupiravir) was administered in 92.2% of cases, with reported clinical improvement of 88.9%. These findings demonstrate the value of questionnaire-based surveillance in documenting outbreak-associated FIP patterns. Although individual cases were not uniformly confirmed as FCoV-23 infections, the increased proportion of neurological presentations among FIP cases reported during the epizootic period supports previous molecular evidence suggesting that neurological involvement was associated with FCoV-23 circulation.
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(This article belongs to the Section Epidemiology of Infectious Diseases)
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Open AccessSystematic Review
COVID-19 in Space: Possible Health Risks and Preparedness Guidelines
by
Ishan Vashishat, Sanghyun Eddie Han and Barnabe D. Assogba
Pathogens 2026, 15(5), 498; https://doi.org/10.3390/pathogens15050498 - 6 May 2026
Abstract
Background: The COVID-19 pandemic resulted in over 705 million infections and 7 million deaths, underscoring the importance of understanding disease behavior across diverse environments. As NASA, SpaceX, and ISRO prepare for more frequent missions, managing health risks for astronauts and space tourists is
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Background: The COVID-19 pandemic resulted in over 705 million infections and 7 million deaths, underscoring the importance of understanding disease behavior across diverse environments. As NASA, SpaceX, and ISRO prepare for more frequent missions, managing health risks for astronauts and space tourists is essential. Objective: This study reviews the literature on airborne infections in space, identifies research gaps, and establishes preparedness strategies for potential COVID-19 outbreaks during space missions. Methods: A systematic literature review was conducted to identify studies examining airborne infectious diseases in space. To compare these findings with Earth-based data, pathogen safety data sheets were used. A separate systematic review was conducted to explore similarities between COVID-19 and the identified airborne infectious diseases. A comparative approach was used to predict COVID-19’s potential behavior in microgravity. Existing guidelines for managing airborne diseases in space and on Earth were reviewed and compared to develop a set of preparedness recommendations for COVID-19 in space. Results: Nine airborne infectious diseases occurring in space were identified. Six tentative effects of COVID-19 in a microgravity environment were theorized in this study. We propose recommendations to improve current space travel health guidelines and address the identified risks. Conclusions: The results of this study will change the course of human space exploration by assisting in the protection of space travelers and guiding the development of new protocols that include comprehensive safety features.
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(This article belongs to the Collection SARS-CoV Infections)
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Open AccessSystematic Review
Arrhythmias in Dengue: A Systematic Review and Meta-Analysis
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Darío S. López-Delgado, Mathias S. Renteros-Ramirez, Joshua Emmanuel Arteaga-Bolaños, Harold E. Vásquez-Ucros, Kevin Alexander Burbano-Castro, Valentina Reina-Melo, Jessica Niebles-Blanco, Nancy Calzada-Gonzales, Lysien I. Zambrano, Valmore Bermudez and Alfonso J. Rodriguez-Morales
Pathogens 2026, 15(5), 497; https://doi.org/10.3390/pathogens15050497 - 5 May 2026
Abstract
Background: Cardiac involvement in dengue has been increasingly recognized, yet the true burden and spectrum of arrhythmias remain uncertain due to heterogeneous and fragmented evidence. We conducted a systematic review and meta-analysis to estimate the proportion of cardiac arrhythmias in patients with dengue
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Background: Cardiac involvement in dengue has been increasingly recognized, yet the true burden and spectrum of arrhythmias remain uncertain due to heterogeneous and fragmented evidence. We conducted a systematic review and meta-analysis to estimate the proportion of cardiac arrhythmias in patients with dengue and to describe the distribution of major arrhythmia subtypes. Methods: We searched PubMed/MEDLINE, EMBASE, LILACS, Global Index Medicus, and Google Scholar from inception to November 2025 without language restrictions. Observational studies reporting the number of dengue patients evaluated for arrhythmias and the number with at least one rhythm disturbance were included. Random-effects generalized linear mixed models with a logit transformation were used to estimate pooled proportion with 95% confidence intervals (CIs). Subgroup analyses were performed by age group. Risk of bias was assessed using the Joanna Briggs Institute tool, and certainty of evidence was evaluated with GRADE. Results: Thirty-five studies, including 6948 patients, were analyzed. The pooled proportion of any arrhythmia was 24.48% (95% CI 17.54–33.07), with a higher proportion in adults (30.00%) than in children (10.73%). Sinus bradycardia (11.84%) and sinus tachycardia (10.63%) were the most frequent abnormalities. Atrioventricular block was uncommon (1.33%). Between-study heterogeneity was high for most outcomes. No significant small-study effects were detected. Conclusions: Cardiac arrhythmias occur in approximately one in four patients with dengue, predominantly as sinus rate abnormalities. While often transient, these findings support the role of baseline and risk-based ECG monitoring, particularly in hospitalized adults and patients with severe disease.
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(This article belongs to the Special Issue Arboviruses Infections and Pathogenesis)
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Open AccessSystematic Review
Prevalence of Liver Cystic Echinococcosis in Türkiye: A Systematic Review of Population-Based Ultrasound Imaging Surveys
by
Cuneyt Kayaalp, Basak Kayaalp, Cemalettin Aydin and Servet Karagul
Pathogens 2026, 15(5), 496; https://doi.org/10.3390/pathogens15050496 - 4 May 2026
Abstract
Background: Cystic echinococcosis (CE) is a chronic zoonotic parasitic disease with a significant impact on public health in endemic regions. The liver is the most frequently affected organ, and ultrasound-based surveys are considered a reliable tool for detecting asymptomatic infections. As population-based
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Background: Cystic echinococcosis (CE) is a chronic zoonotic parasitic disease with a significant impact on public health in endemic regions. The liver is the most frequently affected organ, and ultrasound-based surveys are considered a reliable tool for detecting asymptomatic infections. As population-based data specifically addressing hepatic CE prevalence in Türkiye remain limited, we aimed to assess the prevalence of liver cystic echinococcosis in Türkiye using only ultrasound-based surveys. Methods: A systematic review was conducted, in accordance with the PRISMA guidelines, to estimate the prevalence of liver CE in Türkiye based exclusively on ultrasound-based field surveys. Electronic databases (PubMed and Scopus) were searched up to March 2026. Eligible studies included population-based human screening surveys reporting hepatic CE prevalence confirmed via ultrasonography. Data were extracted and descriptively pooled, with subgroup analyses performed according to age group (children vs. adults) and residential setting (urban vs. rural). The protocol was prospectively registered in the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY; registration Number: INPLASY202630029). Only human ultrasound-based screening studies including liver CE data were accepted; alveolar echinococcosis studies were excluded. Pooled prevalence estimates with 95% confidence intervals (CIs) were calculated using a random-effects model, and between-study heterogeneity was assessed with the I2 statistic. Results: We analyzed the data of 23,154 people from 11 different provinces reported in 8 studies. The overall pooled liver CE prevalence was 0.31% (95% CI: 0.14–0.54), while it was 0.12% and 0.43% for urban and rural residents, respectively. Adults had higher prevalence of liver CE than children (0.43% vs. 0.16%). When separated by both living area and age, the prevalence rates were as follows: urban children 0.07%, urban adults 0.21%, rural children 0.29% and rural adults 0.60%. Conclusions: This is the first systematic review evaluating the prevalence of liver CE in Türkiye exclusively from ultrasound-based studies. While the overall prevalence of liver CE was 0.31%, adults living in rural areas presented a nearly two-fold higher rate (0.60%). Ultrasound-based screening provides a practical and effective approach for epidemiological surveillance. Targeted control strategies—including community-based screening, health education, and veterinary interventions—are essential to reduce transmission and disease burden, particularly in high-risk rural populations.
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(This article belongs to the Section Parasitic Pathogens)
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Open AccessArticle
Increasing Case Numbers and Earlier Age at Diagnosis of Alveolar Echinococcosis: Insights from a 13-Year Retrospective Swiss Study
by
Lasse Weikert, Sophie Kasmi, Michael Schneider, Mohamed Faouzi, Sabine Schmidt Kobbe, Christine Sempoux, Matthias Cavassini, Emeline Gauthiez, Emilie Uldry and Montserrat Fraga
Pathogens 2026, 15(5), 495; https://doi.org/10.3390/pathogens15050495 - 4 May 2026
Abstract
Introduction: Alveolar echinococcosis (AE) is a rare zoonotic infection caused by Echinococcus multilocularis. In recent years, the number of reported cases has increased across Europe, including Switzerland. Methods: We conducted a retrospective observational study at Lausanne University Hospital (CHUV), including all AE
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Introduction: Alveolar echinococcosis (AE) is a rare zoonotic infection caused by Echinococcus multilocularis. In recent years, the number of reported cases has increased across Europe, including Switzerland. Methods: We conducted a retrospective observational study at Lausanne University Hospital (CHUV), including all AE cases diagnosed between 2010 and 2023 within the Departments of Gastroenterology and Hepatology, Visceral Surgery, and Infectious Diseases. Results: Eighty patients with AE were identified. Half of them were male. The mean annual incidence was 0.53 cases per 100,000 population (range, 0.14–0.85), with a statistically significant increase over time in the canton of Vaud (p = 0.037). The median age at diagnosis was 61.5 years, showing a significant downward trend during the study period. At diagnosis, 45 patients (56.3%) were asymptomatic, and 17 (21.3%) were immunosuppressed. Compared with immunocompetent patients, immunosuppressed individuals more often presented asymptomatically, had significantly smaller hepatic lesions, and were more frequently seronegative. Conclusions: This study demonstrates evolving epidemiological patterns of AE in Switzerland, characterized by increasing incidence and a high proportion of asymptomatic cases. Immunosuppressed patients tended to present with milder disease. Our findings highlight the need for strengthened surveillance and support the ongoing efforts to establish a national AE registry.
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(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)
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Open AccessArticle
Pathogenesis of Aleutian Mink Disease Virus Infection—Comparison of Natural Transmission with Experimental Aerosol and Intraperitoneal Inoculation
by
Mette Sif Hansen, Mariann Chriél, Lars Erik Larsen and Charlotte Kristiane Hjulsager
Pathogens 2026, 15(5), 494; https://doi.org/10.3390/pathogens15050494 - 3 May 2026
Abstract
Though intraperitoneal (IP) inoculation is not the natural pathway of Aleutian Mink Disease Virus (AMDV) infection in mink, it is frequently used experimentally. To investigate AMDV pathogenesis, we compared the effects of IP, aerosol (AE), and natural infection in mink. Forty-six sapphire mink
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Though intraperitoneal (IP) inoculation is not the natural pathway of Aleutian Mink Disease Virus (AMDV) infection in mink, it is frequently used experimentally. To investigate AMDV pathogenesis, we compared the effects of IP, aerosol (AE), and natural infection in mink. Forty-six sapphire mink were divided into groups: negative controls, IP and AE AMDV-inoculated mink, and sentinels exposed to IP-inoculated mink for two-week periods. Mink in the control, IP, and AE groups were euthanized 2, 5, or 10 weeks post-inoculation. The mink were tested for AMDV antibodies and by PCR on serum samples throughout the study, and by PCR and histology in organs after euthanasia. The sentinel mink were introduced to determine when the risk of natural transmission was highest. AMDV was detected in the sentinels exposed during weeks 3–6, indicating that AMDV transmission risk is highest early in infection, before antibody-positive animals can be detected on the farm. Infection in the AE group progressed more gradually than in the IP group, which developed more pronounced lesions and higher viral loads in the liver. Compared to IP inoculation, the aerosol model provides a superior experimental approach for studying natural infection and transmission of AMDV.
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(This article belongs to the Section Viral Pathogens)
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Open AccessReview
Tackling Biofilm-Forming Pathogens: A Challenge to Overcome in the Fight Against Infectious Diseases
by
Elenoire Sole, Giuseppe Motta, Federica Marcoli, Angelina Midiri, Cinzia Sindona, Liliana Imbesi, Giuseppe Mancuso, Mohamed Zemzem and Carmelo Biondo
Pathogens 2026, 15(5), 493; https://doi.org/10.3390/pathogens15050493 - 3 May 2026
Abstract
Microorganisms can aggregate and organise into structured communities embedded within an exopolysaccharide-based matrsix, which serves as a protective barrier and a functional environment around microbial cells. The formation of biofilms is widely recognised as a pivotal factor in bacterial virulence, impeding the efficacy
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Microorganisms can aggregate and organise into structured communities embedded within an exopolysaccharide-based matrsix, which serves as a protective barrier and a functional environment around microbial cells. The formation of biofilms is widely recognised as a pivotal factor in bacterial virulence, impeding the efficacy of antimicrobial agents and hindering immune responses, whilst concomitantly contributing to the development of antimicrobial resistance and the onset of persistent infections. Biofilm formation is a tightly regulated and dynamic process, controlled by quorum-sensing mechanisms and profoundly influenced by environmental factors and nutrient availability. The objective of this review is to elucidate the significance of biofilms in clinical settings, with a particular focus on their role in the pathogenesis of infectious diseases. Particular attention is devoted to biofilm-associated infections and infections related to invasive medical devices, with a particular emphasis on the most prevalent microbial pathogens, which include S. aureus, S. epidermidis, P. aeruginosa, E. coli, K. pneumoniae, A. baumannii and various species of Candida. Furthermore, the present review encompasses biofilm-associated chronic infections, conditions manifesting in predisposed patients, including individuals affected by cystic fibrosis. This review further examines the most recent strategies for combating antibiotic resistance in bacterial biofilms. This review focuses on recent biofilm pathogenesis advancements, with a focus on diagnosis challenges and the need for new ways to disrupt biofilm integrity.
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(This article belongs to the Special Issue Epidemiology of Bacterial Pathogens)
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Clinical Characteristics and Outcomes of Cytomegalovirus DNAemia in Non-HIV-Infected and Non-Transplant Patients: A Propensity Score-Matched Analysis
by
Ixchel Salter, Michaele-Francesco Corbisiero, Daniel B. Chastain, Chia-Yu Chiu, Leland Shapiro, Jose G. Montoya, Raymund R. Razonable and Andrés F. Henao-Martínez
Pathogens 2026, 15(5), 492; https://doi.org/10.3390/pathogens15050492 - 1 May 2026
Abstract
Cytomegalovirus (CMV) establishes lifelong latency following primary infection and can reactivate to cause severe illness in immunocompromised hosts. CMV DNAemia in non-HIV-infected, non-solid organ/bone marrow transplant (NHNT) hosts is poorly characterized, with limited clinical insights. We aim to describe the clinical presentation, prognostic
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Cytomegalovirus (CMV) establishes lifelong latency following primary infection and can reactivate to cause severe illness in immunocompromised hosts. CMV DNAemia in non-HIV-infected, non-solid organ/bone marrow transplant (NHNT) hosts is poorly characterized, with limited clinical insights. We aim to describe the clinical presentation, prognostic indicators, and outcomes of CMV DNAemia among NHNT patients. We used the TriNetX international patient database to identify adult patients diagnosed with CMV DNAemia from 2016 until March 2023. We evaluated hospitalization, intensive care unit (ICU) level care, and all-cause mortality at 30 days and 1 year. We also completed a post-propensity score analysis comparing clinical characteristics of survivors versus non-survivors at 90 days. We identified 1123 NHNT patients with CMV DNAemia, most of whom had neoplasms (63%). Venous thromboembolism occurred in 31% of the population. The 30-day hospitalization and all-cause mortality rates were 35% and 14%, respectively. After propensity score matching and Bonferroni correction, weakness, purpura, acute respiratory failure, malnutrition, encephalopathy, and hypotension were associated with increased 90-day all-cause mortality. NHNT patients with CMV DNAemia carry a substantial morbidity and all-cause mortality. Further studies are warranted to clarify whether CMV DNAemia is a causative factor or an incidental finding in this population.
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(This article belongs to the Special Issue Viral Infections in Immunocompromised Patients)
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Open AccessArticle
Phellodendron amurense Leaf Extract Inhibits Rhabdovirus Infection by Targeting Early Stages of Viral Entry
by
Su Yeon Kim, Taek-Kyun Lee and Tae-Jin Choi
Pathogens 2026, 15(5), 491; https://doi.org/10.3390/pathogens15050491 - 1 May 2026
Abstract
RNA viruses exhibit high mutation rates, necessitating antivirals targeting conserved infection mechanisms. In this study, viral hemorrhagic septicemia virus (VHSV), a non-human pathogenic negative-sense RNA virus, was used as a surrogate model to enable high-throughput antiviral screening under reduced biosafety conditions. A recombinant
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RNA viruses exhibit high mutation rates, necessitating antivirals targeting conserved infection mechanisms. In this study, viral hemorrhagic septicemia virus (VHSV), a non-human pathogenic negative-sense RNA virus, was used as a surrogate model to enable high-throughput antiviral screening under reduced biosafety conditions. A recombinant VHSV expressing enhanced green fluorescent protein was used to screen 17,265 compounds, 2000 plant extracts, and 100 marine extracts. Among the candidates, the leaf extract of Phellodendron amurense Rupr. (PL extract) exhibited antiviral activity with low cytotoxicity (selectivity index ≈ 10). The extract reduced viral infectivity in a dose-dependent manner and showed cross-activity against snakehead rhabdovirus. Mechanistic analyses indicated that the PL extract acts primarily at early stages of infection. Virucidal assays demonstrated direct, time-dependent inactivation of viral particles, while pre-treatment reduced host cell susceptibility. Time-of-addition experiments confirmed that antiviral activity was restricted to early infection, suggesting interference with viral attachment or entry rather than intracellular replication. Fractionation revealed that activity was associated with the non-polar n-hexane fraction, implicating lipophilic compounds that may disrupt viral envelope integrity or membrane interactions. These findings suggest that P. amurense leaf extract is a promising candidate for broad-spectrum antivirals targeting conserved entry processes in enveloped RNA viruses.
Full article
(This article belongs to the Special Issue Advances in Virology of Aquatic Animal Viruses)
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