Search Results (328)

Background/Objectives: Since 2023, a significant increase in measles cases has been reported worldwide, and Italy has been among the most affected European countries. In this context, the integration of laboratory and epidemiological data enables timely case classification and helps distinguish between imported and indigenous cases, supporting disease control. However, most studies address only selected aspects of surveillance. Therefore, this study aimed to provide an integrated analysis of virological and epidemiological surveillance activities conducted between November 2023 and December 2025 by the Regional Reference Laboratory in the Emilia-Romagna Region (ERR). Methods: A total of 806 clinical samples (269 urine, 267 oral fluids—saliva or oropharyngeal swabs—and 270 sera) from 291 suspected measles cases were tested by molecular and/or serological methods, and MV genotyping was performed. Samples from discarded cases were also analysed for parvovirus B19 (B19V), human herpesvirus 6 (HHV-6), enterovirus (EV), and varicella zoster virus (VZV), chikungunya virus (CHIKV) and dengue virus (DENV). Results: Of 291 suspected cases, 176 (60.5%) were confirmed. Median age was 33 years, with 46% in the 15–39 year group. Vaccination status was available for 165: 90.3% were unvaccinated, 5.4% had one dose, and 4.2% had two doses. Notably, over half of confirmed cases occurred in areas with vaccine-hesitant communities. MV strain characterisation was performed in 99.4% of MV-RNA positive cases, with 84.3% genotype D8 and 15.6% genotype B3; 83% of strains were of indigenous origin, suggesting an ongoing endemic circulation. Clinical data showed complications in 19.3%, mainly pneumonia and diarrhoea. Additionally, differential diagnosis enabled the identification of the etiological agent in 37.5% of measles/rubella discarded cases, and 37.6% (29/77) tested positive for B19V. Conclusions: The study results highlight that effective measles surveillance must be supported by integrating timely virological diagnosis, molecular and epidemiological investigations, and differential diagnosis, to achieve the WHO goals of eliminating measles transmission. Full article

Background: Measles and rubella remain major public health concerns in the Eastern Mediterranean Region (EMR), despite regional elimination goals. In 2023, the region experienced an increase in measles outbreaks. This study assessed outbreak detection and response challenges in either case definition or data analysis, in addition to gaps in laboratory and genotyping data integration to improve preparedness and response. Method: A retrospective epidemiological study was conducted using official World Health Organization (WHO) data on measles and rubella (MR) in EMR countries, from 1 January to 31 December 2023. Routine MR surveillance line list, genotyping data and supplemental immunization activity (SIA) reported by countries were used. Results: In 2023, 1206 suspected measles outbreaks were reported in 13 countries; 942 (78%) were confirmed. Rubella accounted for 158 confirmed outbreaks. Children under 5 years old comprised 76% of cases, with 62% zero dose. Timely detection was achieved in only 46% of outbreaks, with wide national variation. Genotype B3 predominated, but missing genotyping data limited verification. Six immunization campaigns occurred; however, outbreaks persisted due to high zero dose, limited targeting, and delayed responses. Conclusions: Persistent immunity gaps, under detection, inconsistent genotyping, and delayed response hindered MR control in EMR. Strengthening surveillance, integrating epidemiological and molecular data, expanding targeted supplementary immunization activities, and ensuring timely response are essential tasks. Standardized outbreak definitions, capacity building, and regular subnational analyses remain critical to regional elimination goals. Full article

Background: At the end of each year, stakeholders of the Essential Immunization Programme (EPI) in the DR Congo meet to review progress made and lessons learned from the implementation of the Annual Operational Plan (AOP) and to set priorities for the following year. This paper presents a conference report that summarizes the main outcomes of the 2025 annual review meeting, which took place from 15 to 20 December 2025, and attracted 76 participants. Conference takeaways: While the 2024 WUENIC data show that the DR Congo is off-track for the 2030 Immunization agenda targets for all antigens, the administrative coverages were reported as optimal in 2025. EPI activities are planned based on administrative coverages, likely overestimated. In 2025, 47% of health zones in North-Kivu, South-Kivu and Ituri (49 out of 104) were fully or partially controlled by armed groups, leading to partial disruptions of immunization service delivery. In 2025, the DR Congo successfully launched the measles–rubella vaccine introduction preceded by a catch-up vaccination campaign in children aged from 6 months to 14 years old and continued to roll out malaria vaccines using a phased approach. Conclusions: Learning from the implementation of the 2025 AOP, the EPI stakeholders adopted a set of priority actions for the immunization programme in 2026. Full article

TORCH pathogens are often asymptomatic in healthy adults but can cause foetal death when transmitted during pregnancy; therefore, accurate regional data are essential for screening. This study aimed to determine first-trimester TORCH seropositivity and to inform the development of hospital-based and national screening algorithms. This study analysed test results from 7481 pregnant women aged 15–49 years who participated between January 2020 and December 2024. TORCH serological results obtained using the MAGLUMI X3/X6 system (Snibe, Shenzhen, China) were analysed with Statistical Package for the Social Sciences. Anti-HCV positivity was 0.12% (9/7166), anti-Toxoplasma gondii IgG positivity was 16.5% (1027/6204), anti-rubella IgG positivity was 95.5% (5809/6080), and anti-CMV IgG positivity was 98.69% (6130/6211). Syphilis seropositivity among pregnant women was 0.2% (13/4991). Significant differences by age groups (15–24, 25–34, and >35 years) were observed for rubella IgG (p < 0.001), T. gondii IgG (p < 0.001), and HBsAg positivity (p = 0.009). This study investigated TORCH seropositivity among pregnant women in our hospital region and underscores the need for targeted public health initiatives to reduce the risk of congenital infections. It recommends systematic first-trimester assessment of TORCH exposure, standardized data recordings, the establishment of national screening programmes, and careful consideration of testing costs. Full article

During a taxonomic revision on Caridina of East and Southeast Asia, a group of amphidromous and anchialine Caridina species, i.e., Caridina serratirostris, C. celebensis, C. rubella, C. troglodytes, C. magnovis, C. rintelenorum, and C. henriettae, widely distributed in the Indo-Pacific region has been found to exhibit distinct and unique morphological characters, e.g., rostra moderately long and straight, armed with many dorsal teeth, at least six of them on the carapace; telson terminating in a posteromedian projection; stylocerite long, reaching to or beyond the end of the basal segment of the antennular peduncle; and preanal carina with a spine, and with slender walking legs. Genetically, the group forms a monophyletic clade, either alone or together with the genus Marosina. The clade is well-separated from other species/species groups of Caridina. By taking a conservative taxonomic approach, the genus Marosina is thus redefined to accommodate members of the C. serratirostris species group. The revised genus Marosina can be separated from the typical Caridina species (represented by Caridina typus species group) by the structure of the endopod of the male first pleopod, which does not have an appendix interna, and the long stylocerite, which reaches to or beyond the end of the basal segment of the antennular peduncle, and the high number of postorbital teeth on the carapace. The paper provides a revised diagnosis of Marosina, with a key to all species assigned to it. Diagnosis, taxonomic remarks, habitat, and distribution information for all species are provided. The ecology, biogeography, and conservation of the genus are briefly discussed. Full article

Background/Objectives: Despite large-scale measles and rubella (MR) vaccination campaigns in West Africa, measles outbreaks persist, raising concerns about campaign effectiveness, coverage, and underlying determinants. This study assesses the impact of MR follow-up campaigns in 12 of 17 West African countries (2024–2025) and examines the factors contributing to post-campaign outbreaks. The main objective of this study is to evaluate the impact of MR campaigns on measles transmission, identify the characteristics of post-campaign outbreaks, and propose strategies to improve campaign effectiveness and accelerate progress toward measles elimination in West Africa. Methods: We conducted a cross-sectional and ecological analytical study to examine spatial and temporal variations based on measles surveillance data from 2024 to 2025, post-campaign coverage surveys (PCCS), district-level outbreak reports, and administrative coverage reports. Trends in measles cases before and after the MMR campaigns were assessed, along with demographic characteristics and spatial analyses of confirmed cases. Results: In 2024, 70.5% (12/17) of countries conducted measles vaccination campaigns, but measles outbreaks increased in 2025 (64 districts in 2024 versus 383 in 2025). Children under five remained the most affected (54%), with 85% of cases being either unvaccinated (57%) or of unknown status (28%). Administrative coverage exceeded 95% in most countries, but measles PCCS revealed gaps, with only Senegal (93%) and Guinea-Bissau (94%) achieving high verified coverage. No country achieved 95% national MPCC. Conclusions: Suboptimal campaign quality, gaps in immunity beyond target age groups, and unreliable administrative data contributed to the persistence of outbreaks. Recommendations include extending Measles vaccination campaigns to older children (5–14 years), improving preparedness by drawing on experiences from other programs such as polio, standardizing PCCS data survey and analysis methodologies across all countries, and integrating Measles vaccination campaigns with other services such as nutrition. Full article

Mumps virus (MuV) is a single-stranded, negative-sense RNA virus of the Family Paramyxoviridae. MuV is a highly contagious human pathogen that causes primarily mild symptoms, including hallmark swelling of the parotid glands. Severe cases can occur, leading to neurological complications, including deafness, meningitis, and encephalitis. The mumps vaccine, now included in combination with measles and rubella vaccines (MMR), was first made available in the 1960s. After its introduction, mumps incidence dropped dramatically to less than 500 cases annually in the US. However, even with long-standing vaccination programs, MuV continues to challenge the landscape of public health due to a resurgence of cases in the past several decades and a still present lack of approved antiviral drugs and treatments available for the disease. This review will explore the biology of MuV, focusing on how MuV replicates and interacts with the host immune system. Recent studies have also shed light on the role of protein phosphorylation in regulating viral RNA synthesis—particularly the dynamic interactions between the nucleoprotein (NP) and phosphoprotein (P)—offering new insights into how the virus controls its replication machinery both mechanistically and through utilizing host cell advantages. We also examine how the immune system responds to mumps infection and vaccination, and how those responses may vary across viral genotypes. Although the Jeryl Lynn vaccine strain has played a key role in controlling mumps for decades, outbreaks among vaccinated individuals have raised questions about the present vaccine’s efficacy against circulating and emerging genotypes and if novel strategies will be required to prevent future outbreaks. We review current epidemiological data, highlighting shifts in MuV transmission and genotype distribution, and discuss the need for updated or genotype-matched vaccines. By connecting molecular virology with real-world trends in disease spread and vaccine performance, this review aims to support ongoing efforts to strengthen mumps control strategies and inform the development of next-generation vaccines. Full article

Background/Objectives: Vaccination programs are highly effective public health interventions, yet parental hesitancy toward combination vaccines has led to growing demand for alternative vaccination schedules, defined in this study as parental requests to split or replace recommended combination vaccines with single-antigen vaccines for non-clinical reasons. While parental attitudes have been widely studied, little empirical evidence exists on the real-world use of single-antigen vaccines and their public health implications in countries with otherwise high coverage. This study examined the prevalence patterns and parental motivations for requesting such alternative vaccination schedules in Israel, where national guidelines recommend specific combination vaccines, including measles-mumps-rubella-varicella (MMRV) and the pentavalent diphtheria-tetanus-pertussis–inactivated polio–Haemophilus influenzae type b (DTaP+IPV+Hib) vaccines, but informal accommodations exist. Methods: A mixed-methods design was employed: a retrospective cohort analysis of vaccination data from 2018 to 2021 (before and during the COVID-19 pandemic) focused on measles (first dose at 12 months) and pertussis (four-dose primary series), followed by semi-structured interviews with Maternal and Child Health clinic providers, policymakers, and parents. Results: Alternative vaccination schedules involving single-antigen measles or pertussis vaccines are occasionally used despite official policy, accounting for less than 1% of vaccinations overall. Outcomes include delayed administration, lower uptake of combination vaccines, and incomplete protection in certain groups. Parents cited safety concerns, fear of immune overload, and mistrust of authorities. These concerns were often amplified by misinformation, while providers described balancing parental preferences with the need for adequate coverage. Conclusions: This study provides new evidence on how vaccine hesitancy translates into service utilization, highlights the tension between individualized parental decision-making and contribution to collective health, and underscores the need for communication, policy strategies and service designs that sustain high coverage while addressing community-specific concerns. Full article

Based on morphological and phylogenetic analyses, during a study on the biodiversity of the lichenized fungi family Arthoniaceae in Yunnan, China, three new species of Arthonia, Eremothecella, and Synarthonia (Arthonia yunnanensis sp. nov., A. pararubella sp. nov., Eremothecella pruinocarpa sp. nov.) and three new Chinese records (A. rubella, E. calamicola, Synarthonia inconspicua) were reported in this present study. A phylogenetic analysis using maximum likelihood and Bayesian inference based on a two-gene dataset (mtSSU and RPB2) revealed that all these species form distinct independent clades. In addition, this study represents the first report of molecular sequences for the genus Eremothecella. Detailed descriptions, ecological and chemical characteristics, and illustrations for each species are provided. Full article

Parvovirus B19 and cytomegalovirus are significant causes of congenital infections that can lead to adverse pregnancy outcomes. The present study aimed to investigate the infection of B19V and CMV in pregnant women with fetal anemia, effusions and intrauterine growth restriction and determine the utility of routine laboratory screening in pregnancy follow-up. Thirteen women with such pathological pregnancy complications attending an antenatal clinic from April 2024 to March 2025 were tested. Three types of clinical material were examined: maternal blood, amniotic fluid and umbilical cord serum. Participants underwent molecular and serological testing for both B19V and CMV. Demographic data, obstetric histories, and pregnancy outcomes were recorded and analyzed. Our results indicate that three participants showed evidence of either current infection with CMV and seven with B19V. Pregnant women with active infections required further follow-up and fetal surveillance. A stillbirth was reported in one woman with CMV infection. For seven samples that tested positive for B19V DNA, viral sequences were obtained and clustered with genotype 1a reference strains. The findings of this study highlight the significant contribution of B19V and CMV infections during pregnancy, particularly in cases complicated by fetal anemia, effusions, and intrauterine growth restriction. Full article

Background: Women’s empowerment has been significantly associated with improved child health outcomes. Cambodia, amid a rapid socioeconomic transition, offers a critical setting to examine how advancements in women’s empowerment over the past decade have influenced child immunization completion within the first two years of life. Methods: Data from the Cambodia Demographic and Health Surveys conducted in 2010, 2014, and 2021–22, encompassing 9222 women with recent births, were analyzed. Empowerment was measured across literacy and information access, employment, and decision-making domains. Multinomial logistic regression assessed associations between empowerment factors and completion of oral polio (OPV), diphtheria–tetanus–pertussis (DTP), pneumococcal conjugate (PCV), and measles–rubella (MR) vaccines, adjusting for demographic and socioeconomic variables. Results: Between 2010 and 2022, women’s empowerment in Cambodia improved significantly, marked by higher literacy rates, nearly half of women completing primary education, and expanded digital access, with 82.4% owning mobile phones and approximately 50% using the internet daily. While non-working women slightly increased, agricultural employment declined by 20%, and cash earnings rose from 48.7% to 82.5%. Most women participated in major household decision-making, either independently or jointly. Completion rates for OPV, DTP, and PCV ranged from 79% to 83%, while just over half of children were fully vaccinated against measles. Higher maternal education and cash earnings were positively associated with OPV, DTP, and PCV completion but negatively associated with measles vaccination. Women in agricultural work were less likely to complete measles vaccination for their children than non-working women. Joint decision-making regarding the use of respondents’ income was associated with a higher likelihood of measles non-completion (OR = 2.26, 95% CI: 1.13–4.51), whereas joint decision-making about respondents’ health care was associated with a higher likelihood of measles completion (OR = 0.42, 95% CI: 0.21–0.83). Conclusions: Women’s empowerment remains a key determinant of vaccination outcomes in Cambodia. The distinct pattern observed for measles suggests that vaccines scheduled for older ages encounter greater structural and behavioral barriers. To overcome these challenges, strategies should focus on enhancing defaulter tracking, implementing reminder systems, expanding outreach and catch-up programs, and improving the convenience of vaccination services. Full article

Introduction: Seroprevalence of antibodies for vaccine-preventable diseases (VPDs), due to vaccination or previous infection, can provide a more accurate estimate of immunity compared to vaccination coverage data alone. This study aimed to examine the seroepidemiology and spatial distribution of VPD seroprevalence in Samoa in 2018 and 2019. Methods: Dried blood spot (DBS) samples were collected from two nationally representative community-based surveys of participants aged ≥5 years from the Surveillance and Monitoring to Eliminate Lymphatic Filariasis and Scabies from Samoa (SaMELFS) project. DBSs were tested using multiplex bead assays (MBAs) to detect antibodies against measles, rubella, diphtheria, and tetanus. Seroprevalence was estimated at the national and primary sampling unit (PSU) levels, and cluster analysis was completed using SaTScan. Results: Overall, 8394 valid MBA results were analysed across 35 PSUs. The highest overall seroprevalence was observed for tetanus (91.0%; 95% CI: 90.2–91.7), followed by diphtheria (83.7%; 95% CI: 82.7–84.7), rubella (79.3%; 95% CI: 78.2–80.3), and measles (45.8%; 95% CI: 44.8–46.9) with substantial heterogeneity across PSUs. Clusters of seronegativity to measles (relative risk [RR]: 1.16, p < 0.001) and diphtheria (RR: 1.16, p < 0.001) were also identified. Conclusions: These findings demonstrate significant variation in seroprevalence and pockets of low population immunity to multiple VPDs, highlighting the key advantage of an integrated rather than siloed approach. The relatively high seroprevalence to rubella suggests potential community transmission, emphasising the need to strengthen congenital rubella surveillance and improve vaccination coverage. Identifying low immunity to VPDs can provide an early warning to potential outbreak risk and support the Ministry of Health to target public health interventions in higher-risk areas. Full article

Rubella virus (RV) IgG quantification is essential for verifying immunity, particularly in prenatal care. However, substantial variability exists among commercial immunoassays, especially when testing low-antibody sera. In this study, we evaluated five commercial assays—four chemiluminescent immunoassays (CLIAs) and one Enzyme-linked Immunosorbent Assay (ELISA)—using a recombinant immunoblot (IB) as the reference method. A panel of 137 serum samples with low or undetectable IgG levels was analyzed. Sensitivity ranged from 19.6% to 70.1%, while specificity exceeded 94%. Only 18.6% of immunoblot-positive samples tested positive across all assays. Marked quantitative differences were observed, with the Atellica assay yielding the highest titers and Alinity the lowest. Reclassifying equivocal results as positive improved concordance without compromising specificity. These findings suggest that current cut-off values, derived from post-infection sera, may be inadequate for vaccinated populations. A single universal threshold may lead to misclassification and underestimation of immunity. Harmonization of assay calibrations, antigenic targets, and interpretation criteria is urgently needed to ensure reliable rubella immunity assessments in clinical and public health settings. Full article

There are no FDA-approved antiviral treatments for measles virus (MeV). Management is mainly supportive care. MeV treatments may include vitamin A, ribavirin, the MeV vaccine, or human immunoglobulin for pregnant patients exposed to MeV but lacking immunity. The Edmonston strain of MeV serves as the basis for the MeV vaccine and remains a component of the measles-mumps-rubella (MMR) vaccine. We previously showed that probenecid can be used therapeutically to prevent the replication of several key respiratory viruses. This study indicates that pre-treatment with probenecid (prophylaxis) can inhibit the replication of the Edmonston MeV strain in VeroE6 cells (1.12 μM) and Vero-SLAM cells (1.03 μM), while treatment (1 h post-infection, hpi) inhibits replication in VeroE6 cells (1.32 μM) and Vero-SLAM cells (8.66 μM). These results suggest that probenecid is an effective, host-directed antiviral drug against MeV replication in vitro. Full article

Background: In Mexico, the measles vaccine was first introduced in 1971. The last case of measles acquired through endemic transmission was recorded in 1995. In 1998, the monovalent measles vaccine was replaced by the combined measles–mumps–rubella (MMR) vaccine. The MMR vaccination schedule consists of two doses: the first is administered at 12 months of age, and the second is administered at either 18 months or 6 years of age. Materials and Methods: A retrospective analysis was conducted using secondary data from 2006 to 2024. Vaccine procurement and administration records from IMSS, ISSSTE, and SSA were reviewed to evaluate the performance of both the MMR and MR programs, focusing particularly on the trends in coverage and data consistency across institutions. Results: The analysis revealed persistent inconsistencies between vaccine procurement and administration for both the MMR and MR vaccines across all institutions. Several years exhibited notable mismatches, including surpluses and deficits in the administered doses relative to their procurement. Between 2006 and 2024, only 69 million of the 91.6 million required MMR doses were administered in Mexico, leaving a deficit of approximately 22.5 million doses (25% of the target population). For MR, a cumulative deficit of approximately 24.6 million procured but unadministered doses was identified. National coverage remained suboptimal, with significant variability across years and institutions. Comparisons with WHO and ENSANUT data indicated marked discrepancies. The seroprevalence findings, along with the 2025 measles outbreak, confirm significant gaps in immunity. Discussion: This study highlights systemic challenges in Mexico’s MMR vaccination program, including inconsistencies in vaccine procurement, administration, and reported coverage across institutions. Overestimated official MMR coverage rates and unclear target definitions for MR contribute to program inefficiencies and missed vaccination opportunities. The resurgence of measles in 2025, along with persistently high incidences of mumps, aligns with the observed immunity gaps, although a direct causal relationship cannot be established from this study. These findings are consistent with previous national studies and seroprevalence data. Conclusions: Despite limitations in the data, this study effectively evaluated the performance of Mexico’s MMR vaccination program, identifying critical gaps in coverage, data reliability, and operational alignment. The findings underscore the need for improved procurement planning, harmonized coverage estimates, and robust monitoring systems. To address the existing gaps in immunity, catch-up campaigns should prioritize the use of the MMR vaccine over MR. Strengthening nominal coverage tracking and implementing evidence-based strategies are essential to restoring public trust and maintaining the goals of measles elimination. Full article