EIS activities and resources

Most Recent Epi Alert

18 November - Epi Report

Highlights: 18 November 2025

Marburg virus. Ethiopia has confirmed its first-ever outbreak of Marburg virus disease in Jinka town, South Ethiopia Regional State, near the borders with South Sudan and Kenya. As of mid-November 2025, authorities report nine cases and six deaths, among them at least two healthcare workers. Genetic analysis suggests the virus belongs to the same lineage seen in recent East African outbreaks. Marburg virus, a filovirus related to Ebola, has a high case-fatality ratio and no licensed vaccines or specific treatments. Control measures include rapid detection, isolation and supportive care while monitoring for wider regional spread.

Dengue and chikungunya, global updates: In 2025, >4.5 million dengue cases and about 3,000 deaths were reported across 103 countries. The Americas are most affected (>3.9 million cases); trends in Asia are mixed, and Africa has >40,000 cases. In Europe, 35 autochthonous dengue cases occurred (France 29, Italy 4, Portugal 2), plus activity in outermost regions (e.g. Madeira, Guadeloupe, Martinique). Chikungunya caused >458,000 cases and 146 deaths worldwide, mainly in the Americas and Asia. Brazil, Cuba, Bolivia and Paraguay report sustained transmission; China, Pakistan and Singapore have ongoing outbreaks. Africa reported >2,000 cases, mostly in East Africa. In Europe, local transmission is documented only in France (776 cases) and Italy (384), with clusters especially in northern Italy. Risk in mainland Europe is driven by viremic travelers and widespread presence of Aedes mosquitoes.

West Nile virus, Europe: In 2025, 14 European countries reported 1,096 locally acquired West Nile virus infections and 95 deaths. Italy experienced its largest outbreak to date (773 cases, 71 deaths), concentrated in Lazio and Campania. Thirty-five regions, mainly in Italy and France, reported human infections for the first time. Most patients were men ≥65 years; 85% required hospitalization and 56% had neurological disease. Belgium and the Netherlands reported their first WNV detections in wildlife or equids, confirming further north-west spread and indicating continued geographic expansion. Transmission is now declining as the season ends.

Seasonal influenza, Europe: Influenza A activity, dominated by H3N2, is increasing and began three to five weeks earlier than usual. England faces an unusually early wave, with rapidly rising test positivity and growing hospital and ICU admissions. Vaccination uptake is low in all priority groups, including older adults, those with chronic conditions, young children and healthcare workers. The 2025–26 vaccine provides moderate protection, but early circulation of a mutated H3N2 variant, poor coverage, and limited hospital surge capacity raise concern for a prolonged, severe season.

Summary

Marburg virus, Ethiopia: nine cases, six deaths, including healthcare workers
Dengue and chikungunya, global updates. Dengue has caused over 4.5 million cases globally and chikungunya over 458,000, mainly in the Americas and Asia; Updates on local transmission in Europe
West Nile virus, Europe. West Nile virus caused 1,096 locally acquired infections and 95 deaths in 14 European countries in 2025, mostly in Italy, with spread to new regions but now declining.
Seasonal influenza, Europe. Seasonal influenza A(H3N2) is rising across Europe and started early, especially in England.

Epi Reports

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11 November 2025

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About

The ESCMID-AUMC Epi Alert, a strategic collaboration between the ESCMID Emerging Infections Subcommittee and the Center of Tropical Medicine and Travel Medicine of Amsterdam University Medical Center (AUMC) that integrates expertise and resources to advance emerging infectious diseases surveillance and intelligence sharing. This collaboration integrates ESCMID's extensive international network and emerging infections expertise with AUMC's proven surveillance capabilities, led by Dr. Abraham Goorhuis and the AUMC team. 

The Epi Alert aims for weekly publication, with frequency adapted to emerging threats. The briefings are curated by infectious disease specialists prioritising data from trusted sources (WHO, ECDC, CDC, ProMED) based on potential impact, geographic region and urgency/relevancy to clinical practice. It aims to provide concise summaries for busy healthcare professionals with direct links for further investigation and transparency. 

This integrated collaboration represents a significant milestone in ESCMID's commitment to emerging infections preparedness, strengthening our collective capacity to detect, analyse, and respond to infectious disease threats through international cooperation.

Disclaimer: The information in this epi-alert is a weekly summary of the information that is available on the internet, mainly the websites of WHO, ECDC, CDC, and others. For this summary, we consider issues that are most relevant to the ESCMID members involved in clinical patient care. Therefore, this report is not comprehensive, but we strive to include all major global issues in this report on a weekly basis.

2025


Avian Influenza: Renewed Threats in Asia

The recent re-emergence of avian influenza (H5N1) in parts of Asia, including isolated human cases in Cambodia and India, highlights the need for continued vigilance. While sustained human-to-human transmission has not been observed, the current situation warrants close monitoring. Strengthening surveillance, improving poultry vaccination strategies, and promoting regional One Health collaborations can support risk assessment and management, including early containment efforts.

General: WHOMost updated report: WHO


Saudi Arabia Reports Rise in MERS-CoV Cases Ahead of Religious Travel Peak

Since the previous update on 5 May 2025, and as of 12 May 2025, nine new MERS-CoV cases—including two deaths—have been reported by health authorities in Saudi Arabia, bringing the total number of cases this year to ten.

Seven of the recent cases were part of the same cluster in Riyadh, including one patient with no history of contact with camels and six healthcare workers who acquired nosocomial infections from that patient in early May.

The risk of sustained human-to-human transmission in Europe remains very low. However, the current MERS-CoV situation is concerning, as this rise in cases comes just two weeks ahead of the Mecca pilgrimage—a period typically associated with high international travel.

Since April 2012, and as of 12 May 2025, a total of 2,638 confirmed MERS cases—including 957 deaths—have been reported globally.

Read more: WHORead more: ECDC


2024


Commentary on the Marburg Virus Outbreak in Rwanda

A Marburg virus disease (MVD) outbreak is evolving in Rwanda, East Africa. As of 7 October 2024, over 40 confirmed MVD cases have been reported, mainly in healthcare facilities in Kigali, with many healthcare workers affected. This outbreak represents a spread from known endemic areas to urban settings, including nosocomial transmission in Kigali hospitals. While outbreaks are typically limited to remote areas, this one spans across Rwanda, with potential for satellite cases and further spread. No vaccines or treatments are currently available.

Read more


EIS Update on Mpox: 2 September 2024

This compilation includes the latest news, publications, and resources, covering recent developments such as vaccine distribution in Africa and WHO policy updates. It provides links to '2022-2024 Mpox Outbreak: Global Trends,' which features interactive dashboards and epidemiological data. This update offers a brief overview of the developments of the mpox situation for healthcare professionals, researchers, and policymakers.

EIS Update on mpox


EIS Commentary on the Recent Mpox Outbreak

As of August 2024, the world is facing a significant mpox outbreak, primarily affecting countries in Central and East Africa, particularly the Democratic Republic of the Congo (DRC) and neighbouring countries, with cases reported across several regions. The outbreak is characterised by the sustained human-to-human transmission of the clade I monkeypox virus (MPXV). 

This ESCMID EIS mpox commentary provides up-to-date, evidence-based information on mpox (formerly known as monkeypox) for healthcare professionals, researchers, and public health officials. 

EIS commentary on mpox

WHO declaration