The Australia mainland has thus far remained free from incursions of highly pathogenic avian influenza (HPAI) H5N1 clade 2.3.4.4b; however, the threat is escalating, particularly considering detections of the virus in Antarctica and Sub-Antarctic regions. While the East Asian-Australasian Flyway (EAAF) has been the primary hypothesised route for potential introduction, the emergence of cases in southern polar regions also highlights the need to consider the Southern Ocean Flyway as a credible transmission pathway.

The August 2024 outbreak of Meningococcal meningitis (Serotype B) in Peru's Loreto region presents an unusual epidemiological case worthy of detailed examination. The outbreak in San Antonio del Estrecho, Putamayo Province, affected individuals aged 13-18 years, with 20 suspected cases, 7 confirmed cases and one fatality, leading to a case fatality rate of 14.2%. The age of the infected is particularly noteworthy as Serotype B typically infects infants and young children rather than adolescents. This outbreak highlights gaps in Peru's public health infrastructure, particularly the absence of routine meningococcal vaccination programs and limited surveillance capabilities in the regions. While the Ministry of Health of Peru's rapid response effectively contained the outbreak, the incident highlights the vulnerability of Peru's population to meningococcal disease. This Watching brief demonstrates the urgent need for enhanced surveillance systems, expanded vaccination programs and improved provider training in meningococcal disease recognition. These findings are particularly relevant as the Pan American Health Organization and World Health Organization work towards their 2030 goals of reducing meningitis outbreaks by 50% and associated deaths by 70% in the Americas.

On 15 June 2024, open-source intelligence from EPIWATCH® detected signals of a botulism outbreak in the Russian Federation caused by the Clostridium botulinum neurotoxin. Initial reporting suggested a foodborne outbreak connected to a brand of fish. Further epidemiological investigations identified an additional ready-made salad from a food delivery company. The first report identified 10 cases that were all in intensive care, and by 16 July 2024, 417 cases were reported across 11 regions. Two fatalities were recorded in the outbreak. At least 172 cases were hospitalised, and 43 required mechanical ventilation. Although the outbreak affected 11 regions, the true extent of the outbreak may never be known. Recent reports from the Russian Federation found that 60 per cent of products failed to meet food safety standards. Furthermore, the ongoing Russia-Ukraine war will contribute to food insecurity and rising prices, forcing people to turn to cheaper and lower-quality products. The food service company was shut down because of the outbreak, and the investigative committee opened a criminal case against the implicated company. The Russian Federation is no stranger to these outbreaks. Whilst food producers who may be regulated but are going unchecked continue to operate, there is an ongoing risk of future large-scale outbreaks.

Introduction Bangladesh is committed to achieving the SDG target of ending the tuberculosis epidemic and achieving UHC by 2030. To inform policy and program decision-making, this nationwide sero-survey of HIV among tuberculosis patients was conducted. Methods The cross-sectional survey utilized a two-stage probability proportional to size (PPS) systematic random sampling technique for selected TB reporting centers (TRCs) from June 2020 to December 2021. The estimated 12,065 diagnosed tuberculosis patients, according to the NTP diagnostic algorithm, irrespective of age and sex, were included. The required information was collected through face-to-face interviews and record reviews using a pre-tested electronic TAB-based semi-structured questionnaire. With all aseptic precautions for all respondents who gave consent, 5 ml. venous blood was collected for the standard confirmatory test by 4th generation ELISA method for detection of antibody of HIV1/2/P24 antigen. Results Out of 12,065 TB patients surveyed, most of them were from the Dhaka division (25%), urban (76%), 55 years and above (28%), male (56%), married (82%), illiterate (36%) and living in a nuclear family (70%). A total of 12 (0.1%) HIV-positive cases were found among TB patients across the country, and the majority (33%) of them belonged to the age group of 35 to 44 years, male (58%), lower educational group (67%), urban resident (67%), and from nuclear family (77%). The HIV-positive patients found more among pulmonary TB patients (83%) who were detected bacteriologically positive (58%) but smear and gene expert negative (75%). Among them, none was found to have progressed to drug-resistant TB. Conclusion HIV affects the immune system, and TB is one of the leading causes of death in HIV-infected people. Although the rate is low, there is a need for continued efforts to prevent and treat TB in Bangladesh, particularly among older age groups, urban residents, and those with co-morbidities such as diabetes.

On June 27th, 2023, Mongolia registered its first case of bubonic plague in the Bugat settlement, Gobi-Altai province. Cases in this outbreak are widespread throughout the country with multiple close contacts identified and monitored. Environmental surveillance, including the testing of marmots, picked up the presence of Yersinia Pestis in many samples prior to the beginning of the outbreak. Marmots are seen as a delicacy in Mongolia which presents a challenge when preventing animal to human transmission of bubonic plague via the consumption of raw undercooked marmot meat. Although bubonic plague is endemic in Mongolia, cases are often sporadic and mostly registered in the western provinces of the region however, one case was recorded in the capital city of Ulan Bator on the eastern side of the country. The nature of this outbreak highlights the importance of effective preventive measures such as, PPE, awareness campaigns, health literacy and safe food handling practices.

The emergence of novel severe acute respiratory syndrome 2 (SARS-CoV-2) has prompted extensive research to identify its pathogenesis, transmission, and reservoir entry in animals. Syrian hamsters (Mesocricetus auratus) are being identified as an ideal animal model for the study of SARS-CoV-2 infection due to their susceptibility and respiratory symptoms similar to that observed in humans. This study focused on the specific biological risks associated with the use of infected Syrian hamsters in animal biosafety level 3 (ABSL-3) laboratories. The professional and psychological training of professionals working with laboratory animals should be a priority. Biological safety requires the involvement of all parties from technical staff to top management. The COVID-19 pandemic has shown a limitation in experimental studies when obtaining the right strain of mice proved difficult. A rare experimental model of Syrian hamsters started to be used in the work, which Syrian hamsters have several distinctive characteristics associated with increased aggressiveness of females, leading to a requirement to keep them isolated and some technical difficulties during manipulations in the biological safety cabinet. Therefore, a risk-based approach must be introduced to reduce the additional risks to workers to an acceptable level. This includes enhanced accuracy in the use of personal protective equipment (PPE), rigorously following biosecurity protocols, and monitoring staff health to detect potential risk of zoonotic transmission. The implementation of international standards and regulations on biological safety and biosecurity is of paramount importance.

Background: Following reports of seven deaths among children with seizure and vomiting in the village of Sirohi, Rajasthan in April 2022, an epidemiological investigation was conducted. Methods: We established a hospital-based surveillance and did active case finding. A case was defined as vomiting and acute onset seizure or altered sensorium in <18 years old in Verafalli village. We conducted verbal autopsy and collected information on food, behaviours and health-seeking. Food samples, cerebrospinal fluid (CSF) and blood specimens were collected for testing biochemical, bacterial and viral markers. Environmental surveys were conducted around cases’ houses for presence of poisonous vegetation and potential vectors. Results: Among 11 cases (median age 7 years (2-16 years), females 27%), all had vomiting, new-onset seizure was present in 73% and altered sensorium in 27%; 33% were hospitalized. Case fatality was 64%. No new cases were identified after April 2022. Median time between symptom onset and death was 9 hours (2-54 hours). Among deaths 28% (2/7) were hospitalized. Two deaths had low weight-for-age, blood glucose <25 mg/dl (refractory hypoglycemia) and elevated liver enzymes (SGPT >8000 IU/L). Lab results for food and CSF samples were inconclusive for bacterial and viral markers. Toxicology screen of one death was negative for organophosphates. In 25% (2/8), tick pools tested positive for rickettsia. All cases had houses in vicinity or within fennel crop area. Conclusions: This acute health event cluster presenting as acute seizures with rapid progression among children in a rural setting was likely due to environmental toxin consumption; high fatality may result from uncorrected metabolic derangement. Aflatoxin is commonly known to infect fennel crops. We recommend early identification and case management to prioritize metabolic derangement correction; continued surveillance and a systematic epidemiological investigation to evaluate the role of environmental toxins particularly aflatoxin as the underlying etiology for similar events in future.

Robots have been developed for use in a variety of settings over the past decade. Examples of applications include rehabilitation and mobility, surgery, telepresence, and social assistance. These technological innovations have incredible potential in helping combat the spread of infectious diseases around the world. In this paper, the applications of robotics in diagnostics and surveillance, healthcare delivery, and vaccine development and research in regard to infectious diseases will be discussed. Recent advancements in robotics and artificial intelligence allow robots to perform more functions than ever before including processing real time data and making public health recommendations, detecting and tracking the presence of pathogens via robotic biosensors, and assisting in image-based diagnostics. In the healthcare setting, robots are able to assist in sanitation, hospitality, and the delivery of food and medications to patients. Robots have also assisted in the development and mass-manufacturing of vaccines during outbreaks such as the recent COVID-19 pandemic. However, ethical considerations and technological limitations may ultimately determine how well robotics is received among the general public and medical community. The largest of these concerns pertain to privacy and data security, quality of care, and resource allocation. It is crucial for researchers, medical professionals, and public health officials to keep such aspects in mind as they continue to innovate and transform the medical landscape.

In January 2023, an outbreak of Murray Valley Encephalitits (MVE) was reported on January 16, 2023. Cases have subsequently been detected in Victoria (VIC)1, Northern Territory (NT)4, New South Wales (NSW)5, and Western Australia (WA), Australia. with 9 confirmed cases and 3 deaths as of April 6, 2023. This marks the first human case of MVE in Victoria since the last outbreak in 1974 and the first ever reported cases in NSW. Significant weather patterns throughout 2022 are thought to have contributed to the resurgance of MVEV. People of all ages are affected by MVE and those frequenting inland riverine regions, extending up towards the Murray River may be at increased risk of infection. This watching brief serves to inform on the increased transmission of MVE across Australia in 2023.

In December 2022 a large outbreak of anti-cholinergic toxidrome was reported in Australia associated with contamination of baby spinach leaves with Datura stramonium. Over 100 individuals around Australia experienced symptoms consistent with intoxication with the primary plant derived tropane alkaloids scopolamine, hyoscyamine and atropine. Tropane alkaloids are part of a wider group of incapacitating chemical substances that includes the chemical weapon BZ that results in the characteristic anti-cholinergic toxidrome. Human food production and manufacturing processes are prone to accidental and non-accidental contamination with tropane alkaloids, and food quality standards and measures are essential to protecting food security where incorporation of tropane alkaloids is possible. While mass non-accidental contamination of human food production and manufacture is a possibility, historically exposure scenarios involving tropane alkaloids have usually been limited to small scale poisoning events dating back to antiquity. This article summarises the risks of accidental and non-accidental exposure to tropane alkaloids with particular focus on the potential for mass exposure events.