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Infectious Diseases
2nd Dec, 2025
The Lancet
Today, Seema Sahay is Head of Division of Social Behavioural Research at the Indian Council of Medical Research, National Institute of Translational Virology & AIDS Research (NARI), Pune, India. Raised in New Delhi, India, Sahay has followed the path her father predicted for her as a researcher. Although she tragically lost him when aged just 17 years, she still remembers him discussing various aspects of science with her at home. While she had wanted to study genetics at university, such courses were not widely available, so Sahay ended up studying botany.
Researchers in southern California (USA) investigated the proportion of urinary tract infections (UTIs) attributable to zoonotic extraintestinal pathogenic E coli (ExPEC). 3379 E coli isolates from retail meat were sequenced and compared with 2349 E coli isolates from urine samples from patients with UTIs in eight southern Californian counties between 2017 and 2021. More than 80% of the meat E coli isolates came from contaminated turkey. Overall, around 18% of human UTIs were attributable to zoonotic ExPEC strains, with sequence type 69 being the most prevalent among the zoonotic strains.
On Oct 14, 2025, the New York State Department of Health announced that a locally acquired chikungunya infection had been confirmed in New York state, USA. This marks the first recorded locally acquired case of chikungunya in the state, and the first locally acquired infection reported in any US state or territory since 2019. The infection is thought to have been caused by a mosquito bite; however, the source of exposure is currently unknown. The State Health Commissioner said that given cold night-time temperatures in the state right now, the risk of infection is very low.
Choi MH, Hung IFN. Beyond ritonavir-boosted nirmatrelvir: the case for ensitrelvir in COVID-19 treatment. Lancet Infect Dis 2025; published online Oct 10. https://doi.org/10.1016/S1473-3099(25)00549-3—In this Comment, the first author's name has been corrected to Ming Hong Choi. This correction has been made to the online version as of Oct 22, 2025, and will be made to the printed version.
Donovan J, Cresswell FV, Tucker EW, et al. A clinical practice guideline for tuberculous meningitis. Lancet Infect Dis 2025; published online Aug 18. https://doi.org/10.1016/S1473-3099(25)00364-0—In the blue ART box in figure 2, the text was changed to, “if CD4 count less than 50 then consider ART at 2 weeks, if there is an urgent clinical need and close monitoring and optimal tuberculosis treatment can be ensured89”. The declaration of interests statement for Felicia C Chow was changed to: “FCC received funding from the NIH (R21TW011035)”.
Paterson A, Mughogho KK, Cheyne A, et al. The (Re)-emerging And ePidemic Infectious Diseases (RAPID) Stigma Scales: a cross-outbreak scale development and psychometric validation study. Lancet Infect Dis 2025; 25: e635–44—In this Review, the study type should have been a psychometric validation study. This correction has been made as of Oct 24, 2025.
Cornely OA, Sprute R, Bassetti M, et al. Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM. Lancet Infect Dis 2025; 25: e280–93—In figure 3 of this Review, the fluconazole dose was incorrect. The fluconazole dose has been updated to “800 mg daily”. Additionally, to improve clarity, the flucytosine dose has been revised to “37·5 mg/kg four times a day”. The appendix has also been updated. These corrections have been made as of Oct 15, 2025.
Lymphatic filariasis is a mosquito-borne parasitic disease that causes disfiguring, and often disabling, limb lymphoedema and hydroceles. WHO's Global Programme to Eliminate Lymphatic Filariasis has reduced the number of individuals requiring mass drug administration for this disease from approximately 1·3 billion in 72 countries to 657 million in 39 countries. Of these, 206 million live in Africa, where lymphatic filariasis is usually co-endemic with onchocerciasis and where mass drug administration with ivermectin is used as preventative chemotherapy for both diseases.
In our previous national cohort study in 6 million residents in Denmark, we showed that COVID-19 was still more widespread and severe than influenza in the 2022–23 and 2023–24 seasons.1 The incidence rate was twice as high for COVID-19 hospitalisations (incidence rate ratio [IRR] 2·04 [95% CI 1·38–3·02]) and three times as high for COVID-19 deaths (3·19 [95% CI 2·24–4·53]) relative to influenza. In addition, COVID-19 hospitalisation had a higher 30-day mortality risk than influenza hospitalisation (risk ratio [RR] 1·23 [95% CI 1·08–1·37]), with patients with comorbidities, those who were unvaccinated, and male patients particularly vulnerable.
Shang-Yi Lin and colleagues highlight the emerging role of metagenomic next-generation sequencing (mNGS) as a diagnostic adjunct for tuberculous meningitis. The diagnosis of tuberculous meningitis is notoriously challenging and new diagnostic approaches, such as mNGS, are much needed.1 However, the use and integration of mNGS into routine diagnostic practice must overcome the considerable challenges of cost and global availability.2 When we developed the scope of our practice guideline in 2021, these challenges had not been met; mNGS was therefore not included.
We read with interest the Review in The Lancet Infectious Diseases by Joseph Donovan and colleagues on the management of tuberculous meningitis, which emphasised the use of Xpert Ultra alongside mycobacterial culture and appropriately highlighted the limitations of current diagnostics in the context of low bacillary load.1 However, the Review does not address the potential role of metagenomic next-generation sequencing (mNGS), including nanopore-based approaches, which are increasingly applied in real-world CNS diagnostics.
We thank Emmanuel Novy and colleagues for their Correspondence on our recently proposed definitions for uncomplicated candidaemia.1 The authors suggest a more differentiated view for intra-abdominal candidiasis, emphasising two aspects: the presence of Candida in the abdominal cavity does not necessarily indicate intra-abdominal candidiasis requiring antifungal treatment, and isolate-specific expression of virulence-associated factors might guide future individualised treatment strategies. The authors conclude that intra-abdominal candidiasis represents the clinical form of candidiasis most amendable to individualised treatment.
We read with interest the Review by Ilana Reinhold and colleagues in The Lancet Infectious Diseases,1 and commend the authors for proposing a pragmatic framework to distinguish uncomplicated from complicated candidaemia. Their emphasis on intra-abdominal candidiasis as a source of candidaemia is pertinent, although candidaemia from this origin is uncommon, occurring in fewer than 5% of patients.2 Their proposal to classify patients with candidaemia in cases of intra-abdominal candidiasis according to timing of source control and adequacy of antifungal therapy is pragmatic but, in our view, incomplete.
Ending tuberculosis is more than just a global health necessity; it is fundamental to sustainable development and global health security. With at least 10 million new cases and more than 1 million deaths annually, tuberculosis is one of the leading causes of death globally, the leading cause of death in people living with HIV, and a substantial cause of morbidity and mortality from antimicrobial resistance.1
Against the gloomy backdrop of a large-scale global measles resurgence in 2024–25, the announcement by WHO that all 21 Pacific island countries and areas (PICs) were verified to have eliminated endemic measles and rubella is very encouraging news (panel).1 The Regional Verification Commission's rigorous review considered five evidence lines—disease epidemiology, quality of laboratory and epidemiological surveillance, population immunity, sustainability of the immunisation programme and elimination, and genotyping data—to conclude that the Pacific subregion had interrupted endemic measles and rubella transmission for at least 36 months.
Medical Journal
15th Jan, 2026
Wiley
Surgery
Journal of the American Medical Association
Regional Health – Americas
