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[Comment] Detection of H5N1 clade 2.3.4.4b in external quality assessment programmes: a pandemic preparedness initiative

Recent outbreaks of avian influenza H5N1 infections have caused ripples of pandemic preparedness activities but no truly noticeable waves yet.1,2 An important part of pandemic preparedness is the ability for a fast provision of an appropriate testing infrastructure that delivers reliable test results. The COVID-19 pandemic has highlighted the importance of monitoring the performance of pathogen detection assays and the role of external quality assessment (EQA) programmes in pandemic preparedness.

[Comment] Protecting the future of vaccine development amidst US funding withdrawal for mRNA vaccine research

On Aug 5, 2025, the US Department of Health and Human Services Secretary announced a coordinated scale-down of mRNA vaccine development programmes under the Biomedical Advanced Research and Development Authority.1 The decision to cancel and wind down research grant contracts led by major pharmaceutical companies, worth approximately US$500 million, affected 22 mRNA vaccine development initiatives and posed a major setback to advancing new mRNA vaccine development for pandemic influenza viruses (H5N and H7N9), respiratory syncytial virus, second-generation pan-coronavirus candidates, COVID-19 booster designs, and early-stage bacterial and parasitic vaccine prototypes.

[Comment] A layered strategy for tackling antimicrobial resistance: the Swiss cheese model for policy, prevention, and engagement

Murphy’s Law, “anything that can go wrong will go wrong”,1 finds no more fitting application in public health than in the case of antimicrobial resistance (AMR). AMR will emerge whenever conditions permit. Despite robust evidence on the health and economic burdens of AMR, policy makers, governments, and international organisations face persistent challenges in implementing and financing comprehensive strategies.2 Low political will, competing health priorities, weak health systems, and economic constraints hinder meaningful action.

[Editorial] Neglected tropical diseases: golden age of elimination?

The latest Global Report on Neglected Tropical Diseases was published by WHO in October. The report documents progress towards the 2030 neglected tropical disease (NTD) goals and persistent challenges regarding diagnostics, monitoring, advocacy, and funding. In the report’s foreword, WHO Director–General Tedros Adhanom Ghebreyesus declares that “we are living in a golden age of disease elimination”.

[Personal View] Zoonotic infections due to avian Chlamydia abortus: what are we missing?

Chlamydia abortus is an obligate intracellular bacterium primarily affecting ruminants and causing reproductive failures in sheep and goats. As a recognised zoonotic pathogen, C abortus can cause obstetric and respiratory infections in humans, with severe consequences in pregnant women and immunocompromised individuals. Previous studies have identified novel C abortus strains in avian species, closely related to the zoonotic Chlamydia psittaci, with some strains associated with cases of human pneumonia.

[Review] Role of gut microbiota disruption in prosthetic joint infection: a scoping review

Prosthetic joint infection (PJI) is a serious complication of joint replacement surgery. Emerging evidence suggests that gut dysbiosis (characterised by reduced microbial diversity, altered immune responses, and increased intestinal permeability) could facilitate bacterial translocation from the gut to prosthetic joints and contribute to the development of PJI. In this scoping review, we analysed eight studies (three preclinical and five clinical) that investigated the potential link between gut microbiota alteration (dysbiosis) and PJIs.

[Articles] Duration of the serological response and effectiveness of the inactivated influenza vaccine in healthy adults aged 18–65 years: a systematic review and meta-analysis

IIV-induced HAI titres in healthy adults aged 18–65 years persisted 5–7 months after vaccination, but might not be significantly sustained at 11–13 months. For influenza A/H3 and influenza B, there was a significant decline in vaccine effectiveness beyond 5 months after vaccination. Evaluating the temporal changes in vaccine effectiveness remains challenging due to methodological biases; a greater understanding is needed to optimise vaccine design and timing to maximise effectiveness throughout the influenza season.

[Articles] Inferring the sensitivity of wastewater metagenomic sequencing for early detection of viruses: a statistical modelling study

The large variation in viral relative abundance after controlling for epidemiological factors indicates that other sources of inter-study variation, such as differences in sewershed hydrology and laboratory protocols, have a substantial impact on the sensitivity and cost of W-MGS. Well chosen hybridisation capture panels can greatly increase sensitivity and reduce cost for viruses in the panel, but might reduce sensitivity to unknown or unexpected pathogens.

[Articles] Estimating the association of antimicrobial resistance genes with minimum inhibitory concentration in Escherichia coli: an observational study

Quantitative estimates of the independent effect of the acquisition of ARGs on MIC add to the interpretability and utility of existing databases. Compared with approaches using machine learning models, the use of these estimates yields similar or better performance in the prediction of antibiotic resistance phenotype with more readily interpretable results. The methods outlined here could be readily applied to other antibiotic–pathogen combinations.

[Articles] A viral clonality evenness score to predict progression to adult T-cell leukaemia in asymptomatic carriers of human T-lymphotropic virus type 1 in Japan: a retrospective longitudinal cohort study

The implementation of VCE scoring in clinical practice could inform early pre-emptive therapeutic interventions, exclusively targeting individuals with HTLV-1 at high risk and aiming to prevent progression to aggressive, treatment-refractory disease. Further validation, including independent confirmation of the performance of VCE scoring in multiple populations and the characterisation of its temporal dynamics, will be crucial to determine its clinical utility and potential integration into care pathways.

[News] Hepatitis A outbreak in Europe

Four European countries have reported increases in hepatitis A virus (HAV) incidence in 2025, prompting the European Centre for Disease Prevention and Control (ECDC) to declare a multi-country outbreak. In a Rapid Risk Assessment published on June 18, 2025, the agency called for coordination, collaboration, timely detection, and targeted interventions in affected countries.

[News] UK Government dismantles the Fleming Fund

On July 15, 2025, the UK Government confirmed that it planned to dismantle the country’s flagship international programme for tackling antimicrobial resistance (AMR). The Fleming Fund is overseen by the Department of Health and Social Care (DHSC) and supports 25 low-income and middle-income countries (LMICs) in Africa and Asia. It was established in 2015 with a stated aim to “address chronic underinvestment in LMIC laboratory capacity and to support local, national and international AMR data use by strengthening surveillance systems”.

[Correspondence] Modelling drug resistance dynamics for long-term schistosomiasis management

We read with interest the Article by Benjamin J Singer and colleagues published in The Lancet Microbe1 on the potential impact of novel drugs against schistosomiasis. The study offers valuable insights; however, a key consideration is the omission of dynamic modelling for the emergence and spread of drug resistance, which could affect long-term projections.

[Correspondence] Import of multidrug-resistant Vibrio cholerae from Ethiopia to Germany and the UK

Since 2018, the emergence of multidrug-resistant Vibrio cholerae strains in eastern Africa has raised serious public health concerns due to the potential loss of effective treatment options.1–3 Recently, concurrent cholera outbreaks among travellers from Germany and the UK returning from Ethiopia as well as among residents were traced to a sacred fountain contaminated with a highly drug-resistant V cholerae O1 strain. Whole-genome sequencing and comparative genomics of V cholerae isolates from both patients and water samples confirmed the fountain as the source of infection, and antimicrobial susceptibility testing showed a multidrug-resistant phenotype.

[Correspondence] Clostridioides difficile should be considered a bacterial priority pathogen

In 2024, WHO published its Bacterial Priority Pathogen list,1 which was thoughtfully highlighted by Timothy Jesudason in a News article in The Lancet Microbe.2 The impact of this list is substantial. Although WHO states that the list is intended “to guide research, development, and strategies”, policy makers and funders often use the list to impose eligibility criteria that directly influence public health and drug development decisions by academic, government, and private organisations, thereby affecting patient care.