Queen Astrid Military Hospital

Zika virus (ZIKV) is typically mild in humans but can cause severe congenital defects when contracted during pregnancy. Chimeric live-attenuated vaccine candidate YF-ZIK previously showed protective efficacy against lethal infection and developmental abnormalities in mice after a single dose. Here we demonstrate that YF-ZIK is safe, induces antiviral immunity, and protects rhesus macaques against high-dose experimental challenge. A single subcutaneous dose elicits neutralizing antibodies within 7–14 days, boosted by a second dose at 4 weeks. Passive serum transfer protects AG129 mice, supporting antibodies as a correlate of protection. YF-ZIK triggers balanced Th1/Th2 responses and a transcriptional profile resembling the licensed YF17D vaccine, involving multiple pathways favoring polyvalent immunity. Upon challenge, vaccinated macaques show no detectable viral RNA nor seroconversion to anti-ZIKV NS1 antibodies, suggesting sterilizing immunity. Systems analysis identifies TNFRSF17 as predictor of antibody responses to YF-ZIK, and GNAS and CD207 (Langerin) as potentially linked to clinical outcomes. The favorable preclinical safety, immunogenicity, and efficacy of YF-ZIK justify its future evaluation in humans.

Purpose: To conduct a premarket study of 3 new single-use lenses for the RESIGHT ophthalmoscopy system during routine vitrectomy surgery. Methods: In this investigator-initiated prospective, academic, interventional case study from a single center, 3 new single-use lenses (a wide-angle lens, ultra wide-angle lens, and macula lens) were compared head-to-head with reusable lenses in 181 patients who had retinal detachment surgery (n = 89) or macular surgery (n = 92). After each surgery, participating surgeons completed a survey grading the performance of the new single-use lenses compared with the reusable lenses. Results: For all 3 single-use lenses in the RESIGHT system, condensation was significantly reduced compared with that of the reusable lenses, and the image quality was clearly better. The telescopic design of the ultrawide-angle lens allowed a better view of the retinal periphery, enabling complete shaving of the vitreous base without indentation in the majority of phacovitrectomy cases. The macula lens offered a wider field of view with similar image quality to that of a flat contact lens, allowing better visualization of the surgical instruments without sacrificing detail in the image, thus facilitating safer surgery. The improved resolution of the wide-angle lens allowed sufficient magnification for use in macular surgery. Conclusions: Compared with their reusable counterparts, the newly designed single-use lenses for the RESIGHT system offer significant improvements during routine vitrectomy surgery.

Military personnel is often deployed in environmentally distinct areas across the globe and thereby exposed to a multitude of new plants, weeds or trees. Sensitisation to inhalant allergens occurs upon exposure in predisposed individuals. This causes frequent problems that may affect the readiness of the personnel. Study participants were recruited among the military personnel of the Belgian Army and invited to receive an allergy test by the skin prick automated test (SPAT) device for a panel of 22 inhalant allergens. A questionnaire was completed to retrieve information on demographics, lifestyle, history of allergy, rhinitis and asthma symptoms, as well as treatment and history of deployment. In total, 160 subjects were included with varying histories of deployment to the Middle East (n=68), Western Africa (n=53), Eastern Europe (n=50), Central Africa (n=47), the USA (n=20) or no international deployment (n=31). A majority of military personnel (79.9%) did not take allergy medication. Applying Allergic Rhinitis and its Impact on Asthma criteria, 26% and 27.9% of untreated soldiers were identified with, respectively, uncontrolled and partly controlled rhinoconjunctivitis. Sensitisation to house dust mite (Dermatophagoides farinae: 29.5%, Dermatophagoides pteronyssinus: 27.5%), timothy grass (28.8%), birch (20.9%), hazel (17.9%) and cat (16.3%) was commonly detected. Also, sensitisation to allergens that are less common in Belgium were detected: Cynodon dactylon (13.1%), Chenopodium alba (6.9%), Phoenix dactylifera (6.2%), Blattella germanica (3.9%), Blomia tropicalis (3.1%) and Salsola kali (1.5%). Over one-quarter of military personnel not treated with allergy medication were identified with uncontrolled rhinoconjunctivitis. Timely allergy diagnosis and treatment are crucial for optimal performance of military personnel during international deployment and avoid an 'unfit-for-duty'. Allergy testing of an extended allergen panel by SPAT can be efficiently implemented in medical screening programmes for military candidates. NCT05807958.

The growing threat of antimicrobial resistance (AMR) is a critical issue for both civilians and the military. With each successive conflict, pathogens become more resistant, making the management of infections in casualties increasingly challenging. To better understand the scope and characteristics of conflict-related AMR, a comprehensive literature search was conducted in the PubMed database in April 2025, using defined search terms related to war casualties and antimicrobial resistance. We screened and included 117 relevant publications, comprising original research articles, reviews, case series, case reports, editorials, and commentaries, published in English or French, with no date restriction. This narrative review synthesizes current evidence on multidrug-resistant bacteria most commonly isolated from war casualties, their associated resistance mechanisms, and the microbiological diagnostic tools available at various levels of the military continuum of care (Roles 1-4). It also presents strategies for preventing cross-contamination and infection in resource-limited combat settings and provides practical, field-adapted recommendations for clinicians, from first responders to specialized care providers, aiming to improve infection management in armed conflict zones and mitigate the spread of AMR.

High-speed boat operations expose personnel to slamming-induced impacts, which can lead to musculoskeletal injuries and cognitive impairments. Despite existing safety measures, regulations and protocols, the risk of injuries remains significant. The MultiAgency, prospective, exploratory, non-intervention, cohort Study on Human Impact Exposure oNboard high-speed boats study aims to investigate the nature and magnitude of these impacts, their acute and long-term health effects, and potential injury prevention strategies to improve operational safety and performance. This is an ongoing multicentre, prospective, non-intervention, observational cohort study. The first participant was enrolled on 23 August 2024. High-speed boat operators log self-reported pain data via a smartphone app, using a Visual Analogue Scale and pain drawings. Triaxial accelerometers are installed on boat hulls and worn by participants to measure impact exposure. Data analysis assesses correlations between exposure and reported pain, enabling the identification of risk factors and the development of safety guidelines for high-speed boat operations. The study has received ethical approval from the relevant ethics committees, including the Swedish Ethics Review Authority (no. 2022-04931-01). All participants will provide informed consent before enrolment. The findings will be disseminated through technical reports, articles in peer-reviewed journals, conference presentations and direct engagement with military and maritime stakeholders to enhance training protocols and safety measures. NCT05299736.

Abstract Acinetobacter baumannii is an opportunistic pathogen, often multi- to pandrug-resistant, including to last-resort antibiotics such as carbapenems. A. baumannii can acquire DNA through multiple mechanisms including natural competence and conjugation. An active Type VI Secretion System (T6SS), which kills nonkin bacteria and challenges and inhibits the conjugation. The acquisition of resistance genes has helped the spread of resistant clones of A. baumannii , such as those of Sequence Types (ST Pas ), ST1, ST2, ST10, ST15, ST25, ST79 and ST85. While ST1 and ST2 were thoroughly studied, there are new emerging clones whose genetic background facilitating the rise is still unknown or poorly understood. The emergence of Acinetobacter baumannii ST19 first peaked in 2003, coinciding with the Iraq conflict and increased detection among U.S. military personnel. Its prevalence later surged in Georgia and Ukraine, around the onset of the conflict in Ukraine in 2022, associating it with regions affected by military activity. In this study, we have sequenced whole-genome three isolates of A. baumannii ST19 and compared them with further 156 A. baumannii ST19 genomes were obtained from public repositories. In total, 157/159 genomes revealed loss of T6SS locus, which was replaced in 56/157 genomes (35,7%) by ΔTn 9 carrying chloramphenicol and ΔTn 10 carrying tetracycline resistance genes, and formaldehyde and chlorite resistance genes. Surprisingly, the antibiotic resistance-encoding transposons likely originated from Enterobacteriaceae plasmids. The loss of a functional T6SS in A. baumannii ST19 may potentially facilitate horizontal gene transfer and promoting a cooperative or less competitive lifestyle providing a selective advantage at the population level.