Highly Pathogenic Avian Influenza (H5N1) in Humans after the emergence of clade 2.3.4.4b in 2020.

The highly pathogenic avian influenza virus A (HPAI) H5N1 was first identified in a farmed goose in 1996 from China. High pathogenic avian influenza viruses cause severe disease in poultry and represent a smaller proportion of avian influenzas. In 2008, the H5Nx acquired the function to reassort its neuraminidase (N) and created the 2.3.4.4 H5Nx clade. Initial outbreaks of 2.3.4.4b began in H5N8 and H5N6 in 2016. However, in 2020, whole genome sequencing (WGS) conducted in the Netherlands detected a new H5N1 clade, 2.3.4.4b in wild birds along the Adriatic flyway, which reassorted from H5N8 2.3.4.4b clade. Currently, the 2.3.4.4b HPAI H5N1 outbreak is the dominant circulating strain in the panzootic outbreak. This clade has been responsible for large outbreaks within avian species and spillover into human cases has occurred. The earliest reported human case was in 2021. The reported human cases of this clade have been within the United Kingdom (UK), the United States (US), China, Spain, Vietnam, Ecuador, and Chile

Resurgence of Sudan Virus Disease (SUVD) in Uganda

On September 20th, 2022, a case of ebola virus disease was confirmed in Uganda by the World Health Organization. The presumed index case of a 24-year-old male was sequenced and identified as the Sudan strain. This was the first known outbreak of ebola in Uganda since 2012. At the time of publication, 43 cases have been confirmed, including nine deaths. Of all confirmed, suspected, and probable cases, 63 have been identified, with 29 deaths. The current outbreak has spread across five districts within Uganda. The rapid increase in a short period and the growing list of close contacts make outbreak control difficult. Furthermore, a lack of viable vaccines preventing protection and poor health infrastructure with limited finances seem to contribute to the current outbreak. Whilst the true natural reservoir and how spillover to human hosts occurs remains unknown, these outbreaks of EVD will continue to occur in African countries where the virus remains endemic

COVID-19-associated encephalitis.

COVID-19 associated encephalitis has been reported in patients infected with SARS-CoV-2 since February 2020. The index case was reported in Japan, but since then, reports have emerged worldwide, with a global incidence rate of 0.215%, and regional incidence rates of up to 18%. While in the acute phase of infection, COVID-19-associated encephalitis can biologically mimic infectious limbic encephalitis, immune-inflammatory-mediated encephalopathy, herpes simplex encephalitis, produce hyperintensities in multiple regions of the brain, and mimic Alzheimer’s Disease. With a high mortality rate of 13.4%, COVID-19-associated encephalitis poses a significant burden on health systems and resources, requiring a combination diagnostic approach, supportive treatment regimens, and regular monitoring for secondary worsening of symptoms. COVID-19-associated encephalitis can emerge up to six weeks post-infection, and elevated risk levels can persist for six months post-infection. Despite emerging evidence and research, significant longitudinal research is required to ascertain the true prevalence and lifetime health risk of developing encephalitis following SARS-CoV-2 infection. This report aims to provide a summary of COVID-19 associated encephalitis

Legionnaires’ disease: A critical report of the pneumonia of unknown origin outbreak in Argentina

An outbreak of pneumonia of unknown origin was identified in a health facility in Tucumán, Argentina in August 2022. Initial laboratory testing has suggested Legionella pneumophila and Legionella spp. as the causative agent of this pneumonia cluster. However, confirmation of these early results is ongoing and requires identification of the bacteria in environmental samples, matching of environmental samples to patient samples and wider testing of those affected by the outbreak. Official identification of a Legionnaires’ disease outbreak faces many challenges including limited diagnostic capabilities in local laboratories, reduced sensitivity of available tests and inadequate clinical samples. In the absence of official identification of the source of the outbreak, other differential diagnoses for pneumonia should not be overlooked as this may result in missed cases and inadequate control measures being implemented