Search Results (237)

Background: Crimean–Congo hemorrhagic fever virus (CCHFV) is an important tick-borne zoonosis and an emerging public health threat across Africa. Although evidence of viral circulation is mounting, information remains fragmented, limiting a comprehensive understanding of transmission ecology, regional hotspot heterogeneity, and preparedness needs across the continent. Methods: This narrative review critically synthesized published literature on CCHFV in Africa, identified through PubMed, Scopus, and Google Scholar and supplemented by citation tracking and authoritative public health reports. Evidence from epidemiological, ecological, molecular, surveillance, and One Health studies was integrated to examine transmission dynamics, geographic hotspot distribution, viral diversity, risk factors, diagnostic and surveillance challenges, and preparedness strategies. Results: Available evidence shows marked geographic heterogeneity in CCHFV transmission across Africa, with hotspot regions shaped by ecological suitability, Hyalomma tick distribution, livestock–human interactions, and health system capacity. Livestock consistently show higher exposure than humans, underscoring their role as key indicators of viral circulation. Diagnostic limitations, passive surveillance, ecological variability, and serological cross-reactivity contribute to substantial under recognition of disease burden, while molecular studies reveal considerable viral diversity and ongoing evolution across African regions. Conclusions: CCHFV remains underdiagnosed and underreported in many African settings because of limited surveillance and diagnostic capacity. Strengthening integrated One Health surveillance, expanding laboratory and genomic capacity, utilizing livestock as sentinel populations, and improving cross-sectoral collaboration are critical for enhancing early detection, outbreak preparedness, and effective public health response across the continent. Full article

Hantaviruses are emerging rodent-borne pathogens that pose increasing global public health concerns due to their association with hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS), both of which can result in substantial morbidity and mortality. Environmental change, climate variability, urbanization, and land-use transformation are increasingly recognized as critical drivers of hantavirus emergence and transmission. This review summarizes current evidence regarding hantavirus virology, epidemiology, pathogenesis, clinical manifestations, diagnostics, surveillance systems, prevention strategies, and One Health preparedness approaches. Emphasis is placed on the influence of climate change and ecological disruption on rodent reservoir dynamics and spillover risk, as well as major surveillance and diagnostic gaps in tropical and Caribbean regions where hantavirus circulation may be underrecognized. Advances in molecular diagnostics, genomic surveillance, vaccine development, monoclonal antibody therapies, and climate-based early warning systems are also discussed. Existing evidence highlights the importance of integrated One Health surveillance systems that combine human, animal, and environmental monitoring to improve early detection and outbreak preparedness. Strengthening laboratory capacity, ecological surveillance, regional collaboration, and public health infrastructure will be essential for reducing the global burden of hantavirus infections and improving preparedness for future zoonotic disease threats. Full article

Background and Objectives: Familial Mediterranean fever (FMF) is a chronic autoinflammatory disease characterized by recurrent inflammatory attacks and a persistent psychosocial burden. Although generalized anxiety symptoms have been investigated in FMF, disease-specific anticipatory concerns related to recurrent attacks remain insufficiently understood. This study aimed to investigate the associations of attack-related anticipatory anxiety symptoms with clinical characteristics, quality of life, and composite inflammatory indices in FMF. Materials and Methods: This exploratory cross-sectional study included 38 adult patients with FMF. Attack-related anticipatory anxiety symptoms were assessed using an exploratory six-item questionnaire. Generalized anxiety and quality of life were evaluated using the Generalized Anxiety Disorder-7 (GAD-7) and Short-Form–12 (SF-12), respectively. Composite inflammatory indices including the C-reactive protein–albumin–lymphocyte (CALLY) index, log-CALLY, hemoglobin–albumin–lymphocyte–platelet (HALP) score, and systemic immune-inflammation index (SII) were calculated from routine laboratory parameters. Results: Attack-related anticipatory anxiety scores demonstrated a significant positive correlation with GAD-7 scores (r = 0.581, p < 0.001) and an inverse correlation with SF-12 mental component scores (r = −0.380, p = 0.019). Direct correlations between attack-related anticipatory anxiety scores and composite inflammatory indices were weak and not statistically significant. In subgroup analysis, a higher annual attack burden was associated with higher GAD-7 scores, higher CRP and serum amyloid A values, and lower CALLY, log-CALLY, and HALP values. Differences in attack-related anticipatory anxiety, SF-12 MCS, and SII between attack burden groups did not reach statistical significance. In multivariable linear regression analysis, GAD-7 score remained independently associated with attack-related anticipatory anxiety symptoms (β = 0.438, p = 0.010). Conclusions: Attack-related anticipatory anxiety symptoms may represent an exploratory psychosocial dimension of FMF associated mainly with generalized anxiety symptoms and impaired mental well-being. Composite inflammatory indices appeared more closely related to annual attack burden than to attack-related anticipatory anxiety. These findings should be interpreted cautiously and considered hypothesis-generating. Full article

Background: Dengue fever has emerged as a major public health concern in Bangladesh, with increasing incidence and geographic spread of outbreaks in recent years. This study aimed to investigate the lagged and non-linear associations between climatic factors and dengue incidence across all eight administrative divisions of Bangladesh from 2014 to 2025. Materials and Methods: An ecological time-series design was employed using monthly dengue case data (n = 741,338) and meteorological variables. A generalized additive model (GAM) with a negative binomial distribution was applied to account for overdispersion and capture complex relationships. Descriptive analysis was conducted to assess spatial heterogeneity, and choropleth maps were constructed to visualize the spatial distribution and regional variation in dengue burden across the country. Cross-correlation analysis was performed to identify significant lagged associations between climatic variables and dengue incidence. Results: Descriptive analysis showed substantial spatial heterogeneity, with the highest incidence observed in Dhaka (6.53 per 100,000) and the lowest in Sylhet (0.21 per 100,000). Choropleth maps illustrated distinct spatial distribution and regional variation in dengue burden across the country. Cross-correlation analysis identified significant lagged associations for temperature and rainfall (lag 1–3 months), humidity (lag 1–2 months), and wind speed (lag 2–3 months). The final GAM explained 88.6% of the deviance in dengue incidence (AIC = 7404.15; dispersion = 0.767). The approximate significance of smooth terms revealed that temperature at a lag of 1 month (p < 0.001, edf = 12.28), rainfall at a lag of 3 months (p < 0.001, edf = 2.85), and wind speed at a lag of 2 months (p < 0.001, edf = 2.25) were highly significant non-linear predictors of dengue transmission. Relative humidity was not significantly associated with dengue incidence. Non-linear effects revealed peak dengue risk at temperatures between 25 and 30 °C and moderate rainfall (~10 mm), particularly during monsoon months (June–October). A strong autoregressive effect indicated that prior dengue incidence significantly influenced current transmission. Conclusions: Overall, dengue transmission in Bangladesh is driven by complex, lagged, and non-linear interactions between climatic variables, seasonality, and regional factors. These findings provide critical evidence for climate-based early warning systems, enhance outbreak prediction, and inform evidence-based vector control strategies. Full article

Background: Pediatric influenza-like illness (ILI) represents a major global health burden. However, international treatment guidelines lack robust evidence specific to children. Umifenovir (Arbidol) is a broad-spectrum antiviral approved for pediatric use in several countries, but clinical data are fragmented and regionally limited. Methods: A comprehensive search of PubMed, Russian (RSCI, national archives, regulatory documents), and Chinese (CNKI) databases was conducted for pediatric randomized controlled trials (RCTs) and non-randomized trials comparing umifenovir to symptomatic therapy (ST) or oseltamivir. Risk of bias was assessed using the RoB 2 tool for RCTs, and ROBINS-I for non-RCTs. Outcomes included the duration of fever and other symptoms, prophylactic efficacy, and adverse events. Random-effects models were used (Hartung–Knapp–Sidik–Jonkman approach). The review was not registered. Results: We included 16 therapeutic and eight prophylactic trials enrolling approximately 4700 and 2000 children, respectively. Compared with ST, umifenovir reduced the duration of fever (MD −1.41 days, 95% CI: −1.78 to −1.05), cough (−1.15 days, 95% CI: −1.50 to −0.79), and hospitalization. The complication risk decreased (RR 0.34, 95% CI: 0.23–0.51). For prophylaxis, umifenovir reduced the risk of ILI (RR 0.68, 95% CI: 0.54–0.87) and laboratory-confirmed influenza (RR 0.41, 95% CI: 0.29–0.59). Adverse events were generally mild and did not differ significantly from ST or oseltamivir (RR 0.78, 95% CI: 0.51–1.20). Conclusions: Umifenovir may reduce symptom duration, complications, and infection risk in pediatric ILI, with a favorable safety profile. However, the overall certainty of evidence is limited by the age of the studies, geographic restriction, and methodological quality. Full article

Leptospirosis is among the most widespread zoonotic infections globally and is particularly prevalent in tropical settings, where it remains endemic. In Malaysia, the disease burden has increased markedly over recent decades. Severe leptospirosis can result in multi-organ dysfunction and death; however, early identification of patients at risk of a severe clinical course remains a significant challenge. This study aimed to determine independent clinical and laboratory predictors of severe leptospirosis among adults admitted to hospitals in northeastern Malaysia. A multicenter retrospective cohort study was conducted at two tertiary referral hospitals in Kelantan, northeastern Peninsular Malaysia, over a seven-year period. Adults with confirmed leptospirosis were categorised as severe or non-severe according to established clinical criteria. Group comparisons were performed using appropriate statistical tests, followed by multivariable logistic regression with internal bootstrap validation to identify independent predictors of severe disease. Of 525 patients included in the final analysis (mean age 38.1 ± 16.8 years; 65.5% male), 303 (57.7%) met criteria for severe leptospirosis and overall, in-hospital mortality was 6.5%. Common presenting symptoms (>30% of patients) included fever, myalgia, nausea, vomiting, and arthralgia. Independent predictors of severe disease identified on multivariable analysis were; age > 40 years, delayed hospitalisation (presentation after four days of symptom onset), T-wave changes on electrocardiography, conjunctival suffusion, hyponatraemia, prolonged prothrombin time, and elevated alanine aminotransferase (all p < 0.05). The predictive model demonstrated good discriminatory ability (AUC 0.794, 95% CI: 0.747–0.841). Severe leptospirosis is associated with distinct clinical and laboratory features at presentation. Early recognition of key risk factors—particularly older age, delayed presentation, and electrocardiographic abnormalities—may enable clinicians to stratify risk, initiate timely targeted interventions, and potentially reduce morbidity and mortality in this endemic setting. Full article

Hantaviruses are emerging zoonotic pathogens responsible for two severe clinical syndromes: (i) haemorrhagic fever with renal syndrome (HFRS) and (ii) hantavirus cardiopulmonary syndrome (HCPS), collectively causing more than 200,000 human cases annually worldwide. Despite their public-health importance, the molecular mechanisms governing the host response and the population-level dynamics of rodent-to-human spillover remain incompletely characterised. The timeliness of this framework is underscored by the April–May 2026 outbreak of Andes orthohantavirus aboard the MV Hondius cruise ship, the first such cluster in a maritime setting, with three deaths reported across multiple countries. This event revealed critical gaps in existing models that treat humans solely as dead-end spillover hosts. Our coupled Susceptible-Exposed-Infectious-Recovered-Dead (SEIRD) model assumes no human-to-human transmission and is therefore designed for hantavirus strains where spillover does not lead to secondary human cases, specifically Hantaan virus (HTNV), Puumala virus (PUUV), Sin Nombre virus (SNV), and Dobrava-Belgrade virus (DOBV). The Andes virus (ANDV) outbreak aboard the MV Hondius is used as a real-world case study to assess the boundaries of our model and to motivate future extensions, not as a direct validation target for its quantitative predictions. Here, we present an integrated computational study combining three complementary analyses. First, we performed a preliminary phylogenetic analysis of the viral sequence, identifying Orthohantavirus andesense as the likely etiological agent responsible for the vessel-associated outbreak. Second, we carried out a downstream transcriptomic analysis of Hantaan virus (HTNV)-infected human umbilical vein endothelial cells (HUVECs), using publicly available RNA-seq data (GEO accession GSE133751, $n=3$ per group). This analysis identified 184 upregulated and 19 downregulated genes, highlighting a transcriptional response dominated by interferon-stimulated genes (ISGs), including CXCL10, CXCL11, MX2, DDX58, IRF7, STAT1, OASL, and CMPK2. We then constructed a protein–protein interaction (PPI) network using STRING, comprising 176 nodes and 3210 edges, and applied a composite network centrality score to rank putative regulatory hubs. This analysis identified ISG15, IRF1, CXCL10, STAT1, and DDX58 as the most central nodes. Pathway enrichment analysis confirmed a strong activation of interferon signalling (Reactome, $p=1.3\times {10}^{-63}$), antiviral defence mechanisms (Gene Ontology, $p=3.8\times {10}^{-58}$), and NF-$\kappa$B-related pathways, together with a concurrent suppression of ribosomal translation. Finally, we developed a coupled SEIRD epidemiological model that explicitly represents rodent-to-rodent and rodent-to-human transmission with logistic rodent population growth. Preliminary simulation analysis demonstrates that reducing human exposure to rodent excreta is substantially more effective than rodent population control alone for reducing human disease burden, and that rodent control in isolation can paradoxically increase human cases through a dilution-like effect. The integrated framework provides molecular and epidemiological insights relevant to hantavirus surveillance, therapeutic target identification, and public-health intervention design. Full article

Familial Mediterranean Fever (FMF) is among the most frequent autoinflammatory diseases in populations originating from the area of Middle Eastern and Mediterranean countries. It is caused by mutations in the MEFV gene, which causes dysregulated pyrin expression and thus an immunologic anomaly. FMF is diagnosed by recurrent episodes of fever and serosal inflammation, predominantly peritonitis and pleuritis, as well as other systemic symptoms. Recent research is dedicated to searching for factors beyond genetic code contributing to how FMF evolves, the severity of its symptoms and response to conventional therapy—colchicine. These factors include epigenetic modifications of the MEFV gene and other environmental factors, such as cold exposure, stress, composition of gut flora and diet. Among these factors, vitamin D, best known for its classical role in musculoskeletal health, has emerged as a powerful immune modulator. It has been documented that vitamin D has been implicated in the regulation of pro-inflammatory cytokines and may modulate immune responses. Notably, in regions with some of the highest reported prevalences of MEFV mutations—likely reflecting Mediterranean populations more broadly—vitamin D concentrations are frequently low. This overlap raises the hypothesis that vitamin D deficiency may be associated with FMF pathogenesis, although current data are largely correlational and do not establish causality. In this review, we summarize current evidence on FMF pathogenesis, potential triggers, and vitamin D metabolism, and explore how vitamin D may modulate immune responses and intersect with key autoinflammatory pathways, considering whether adequate vitamin D supplementation could help reduce disease burden in some patients with FMF. Full article

The concept of “fever burden” represents a quantitative and dynamic expression of the host immunometabolic response, integrating the duration, intensity, and temporal characteristics of postoperative temperature alterations. This review discusses the biological rationale underlying postoperative fever and explores its potential clinical relevance in the context of liver surgery, particularly in distinguishing infectious complications from sterile postoperative inflammation. This narrative review was based on a structured literature search of PubMed and Embase (2000–2025) to identify clinical and translational studies addressing postoperative fever after hepatic resection and liver transplantation. The retrieved literature was narratively synthesized with emphasis on fever burden, temperature trajectories, and biologically plausible mechanisms potentially associated with postoperative recovery and infectious complications. Current evidence suggests that postoperative fever may reflect dynamic activation of innate immune and inflammatory pathways rather than representing a purely binary sign of infection. In liver surgery, clinically relevant information may be better captured by temporal fever characteristics, including timing of fever onset, peak temperature, and recurrent febrile episodes, than by isolated temperature measurements alone. However, direct liver-surgery-specific evidence remains limited, and broader concepts related to temperature trajectories and immunometabolic phenotyping should currently be regarded as hypothesis-generating. Fever burden and temperature trajectory analysis may therefore represent promising conceptual approaches for interpreting postoperative host-response patterns after liver surgery, although their diagnostic and prognostic value requires prospective validation in liver-specific clinical cohorts. Full article

This study applied a syndemic framework to chikungunya virus (CHIKV) infection during the 2014–2015 Colombian epidemic, integrating biological and social determinants. Methods: A community-based cohort of 279 serologically confirmed adults from six cities was analyzed. Clinical, sociodemographic, and cytokine data were evaluated using multilevel and multivariate statistical approaches. Results: Among 279 patients, 141 (50.5%) met World Health Organization (WHO) criteria for acute CHIKV infection. The cohort was predominantly female and of lower socioeconomic status (SES). The most frequent manifestations were arthralgia (91%), fatigue (58%), fever (50.5%), myalgia (45.9%), and rash (45.2%). Multivariate models identified IL-15, IL-17A, IL-12p40, MCP-1, and MIP-1α as significant correlates of fever, rash, and myalgia. Socioeconomic and ethnic factors influenced cytokine expression; Caucasian patients showed higher proinflammatory cytokine levels than Afro-American patients. Lower SES was associated with greater symptom burden. Network analyses revealed distinct immune signatures linking biological responses with clinical and demographic variables. Conclusion: Immune responses, clinical manifestations, and social disadvantages interact significantly in CHIKV infection. These findings support a syndemic model in which socioeconomic vulnerability amplifies disease impact, highlighting the need for integrated biosociological public health strategies, particularly targeting populations with low socioeconomic status. Full article

The rising health threat to healthcare workers (HCWs) demands innovative preventive solutions that are affordable, scalable, and easy to deploy, especially in resource-limited settings. This present study investigated the effects of Lactococcus lactis strain Plasma (LC-Plasma) intake on upper respiratory infection (URI)-like symptoms in a healthy healthcare-associated population in Vietnam. A randomized, placebo-controlled, double-blind, parallel-group clinical trial was conducted, integrating clinical symptom analysis with ex vivo immune response analysis of peripheral blood mononuclear cells (PBMCs). The study found that after 4 weeks of continuous oral LC-Plasma intake, participants in the LC-Plasma group had significantly fewer cumulative days of fever and fatigue than those in the Control group. Increased expression of interferon-stimulated genes (ISGs), particularly MxA, was observed in PBMC cultures from the LC-Plasma intake group. In PBMCs from LC-Plasma recipients classified as low IFN-α responders, the addition of CpG ODN 2216, a mild TLR9 agonist, significantly enhanced interferon-α production. Humoral factors derived from LC-Plasma-primed PBMCs demonstrated inhibitory effects on dengue virus replication in Huh-7 cells. These results suggest that LC-Plasma consumption by the healthcare-associated population reduces the severity of viral infection symptoms, notably fever and fatigue. Elevation of systemic antiviral immunity through activation of plasmacytoid dendritic cells (pDCs) to produce IFN-α and upregulation of ISG expression could be the mechanisms of action. Lactococcus lactis LC-Plasma supplementation, hence, presents a promising adjunctive approach to alleviate the burden of URI-like symptoms in low-resourced vulnerable populations. Full article

Human adenovirus type 7 (HAdV-7) is a significant pathogen responsible for viral community-acquired pneumonia in children. To date, no specific antiviral agents have been approved for clinical use against HAdV infections. Traditional Chinese medicine (TCM) mixtures have shown promising potential in managing viral pneumonia. This study aimed to evaluate the antiviral activity of Yuanzhixingrenheji (YZ), a hospital-prepared TCM formulation from Beijing Children’s Hospital, against HAdV-7. Initial screening of four hospital formulations (Feiyanheji, Qingjieheji, Yindaizhikeheji, and Yuanzhixingrenheji) using a CCK-8 assay revealed that YZ exhibited the lowest cytotoxicity. In vitro, YZ pretreatment and post-infection treatment exhibited dose-dependent antiviral activity against HAdV-7 in A549 cells, significantly suppressing the DBP mRNA level and protein expression while reducing viral genome copies, HAdV-7-GFP fluorescence, hexon fluorescence, and DBP nuclear localization. In the hDSG2^+/+ C57BL/6 mouse model of HAdV-7 infection, YZ effectively mitigated infection-induced body weight loss and substantially reduced viral loads in lung tissue. Furthermore, a clinical retrospective analysis indicated that YZ treatment significantly decreased post-hospitalization serum C-reactive protein levels of pediatric patients with HAdV infection in various disease severities. Compared with conventional treatment, YZ treatment also significantly reduced peak temperature and shortened the duration of fever in children with HAdV infection, supporting its therapeutic potential. In summary, this study provides the first integrated evidence from in vitro, in vivo, and clinical retrospective investigations, demonstrating that the TCM mixture YZ has significant anti-HAdV-7 activity and clinical efficacy. Characterized by a favorable safety profile and low economic burden, YZ is a promising candidate for the treatment of pediatric adenovirus pneumonia. Full article

Toxoplasmosis is a widely distributed zoonosis caused by the protozoan parasite Toxoplasma gondii. Infection during pregnancy is a major public health concern due to its potential impact on both maternal health and fetal development. Early detection of maternal infection is critical to prevent adverse outcomes; however, maternal signs are often subtle, non-specific or absent, complicating timely diagnosis. This scoping review aimed to map and synthesise existing evidence on early maternal signs, pregnancy and foetal outcomes, frequently assessed risk factors, and diagnostic approaches of toxoplasmosis in expectant mothers in Africa. The review was done in accordance with the PRISMA-ScR guidelines. A literature search of PubMed, Scopus, ResearchGate, and Google Scholar was performed to identify studies published between 2000 and 2025. Retrieved records were managed using Zotero (version 8.0.4) for deduplication and screening. Only English-language studies conducted in Africa and reporting relevant maternal or clinical data were included. A total of 28 cross-sectional studies were included. Lymphadenopathy (25.0%) was the most frequently reported maternal early sign, followed by flu-like illness, asymptomatic infection, low-grade or mild fever, and fatigue or malaise (each 10.7%). Congenital anomalies (50.0%) and miscarriage or spontaneous abortion (42.9%) were the most commonly reported foetal and pregnancy outcomes. Frequently reported risk factors were exposure to cat faeces (57.1%) and ingestion of undercooked or raw meat (42.9%). Diagnostic approaches were commonly enzyme-based immunoassays (78.6%), with limited use of RDTs and molecular methods. These findings suggest the need for improved early detection and prevention strategies in high-risk, low-resource African settings. Enhancing routine screening, health education, and access to appropriate diagnostics are considered. Future studies should consider adopting standardised reporting and integrating sensitive, affordable, rapid diagnostic approaches to enhance early detection and reduce the burden of congenital toxoplasmosis. Full article

Background/Objectives: Febrile illness in returning travelers presents a diagnostic and operational challenge for emergency medicine clinicians as early symptoms of high-consequence tropical infections often overlap with common viral syndromes. This review synthesizes current evidence to guide frontline clinicians in the systematic evaluation, diagnosis, and management of internally acquired febrile illnesses with a focus on pathogen of greatest relevance to United States (US) emergency departments (ED). Methods: We conducted a narrative review of the literature addressing epidemiology, clinical presentation, diagnostic testing, and management strategies for key travel-associated infections. Special consideration was given to rapid diagnostic modalities, pediatric risk factors, and infections most frequently implicated in returning travelers, including chikungunya (CHIK), dengue virus (DENV) disease, Ebola virus (EBV) disease, malaria, Mpox, typhoid fever (TF), yellow fever (YF), and Zika virus (ZIKV) disease. Results: Effective evaluation begins with a detailed travel and exposure history, recognition of epidemiologic and clinical red flags, and targeted use of rapid diagnostic tests. Malaria remains the most common life-threatening cause of post-travel fever and the only pathogen with reliable Food and Drug Administration (FDA)-cleared rapid testing available in the ED. Arboviral infections such as DENV, CHIK, ZIKV, and YFrequire region-specific consideration and phase-appropriate molecular or serologic evaluation. Emerging and high-consequence pathogens, including Mpox and EBV, necessitate strict infection control measures and coordination with public health authorities. Pediatric travelers, particularly those visiting friends and relatives, face disproportionate risk for severe systemic infections and often require broader diagnostic testing. Conclusions: A structured approach integrating travel history, focused examination, rapid diagnostics, and early recognition of high-risk features is essential to improving outcomes for febrile returning travelers. Strengthened vector control, enhanced vaccination uptake, and global surveillance are critical to reducing future disease burden. Full article

Infections caused by arboviruses, a diverse group of viral pathogens transmitted by biting arthropod vectors, mainly mosquitoes, ticks, and midges, can cause a range of illnesses in humans, from mild, influenza-like symptoms to severe neurological complications including encephalitis and viral hemorrhagic fever. According to 2024 World Health Organization statistics, vector-borne diseases collectively account for over 700,000 human deaths annually, with mosquito-borne infections such as dengue, chikungunya, Zika, and yellow fever constituting a growing and significant proportion of this burden. What was once considered a problem localized to poorly resourced settings in tropical and subtropical regions is now becoming a pervasive global challenge. This is due largely to a combination of factors including climate change, transcontinental travel, and urbanization, with the geographical spread and intensity of arboviral outbreaks reaching unprecedented levels during the current century. In much the same way that the escalating global burden of bacterial infections resistant to antibiotics has been described as a silent pandemic, the insidious rise of arboviruses begs questions regarding outbreak preparedness, prevention and control. Here, we highlight the pressing need for comprehensive strategies that incorporate various health sectors to mitigate the emergence and resurgence of arboviral diseases. Future directives that should be prioritized are outlined. As demonstrated by epidemiological trends and historical outbreak data, an orchestrated global response is critical not only for managing current threats but also for preventing future epidemics. Full article