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The virulent pathogen has significant individual and public health implications.
 

Exploring the Threat of MDR-TB in the United States

Along with a 1 reported case in Massachusetts, the

New Hampshire Department of Health and Human Services (DHHS) has confirmed a person infected with eastern equine encephalitis (EEE) has died. The public health agency said the person was hospitalized due to severe central nervous system disease. The last reported human EEEV infection in New Hampshire was in 2014, when DHHS identified 3 human infections, including 2 fatalities. In the same statement, DHHS mentions there has been 1 confirmed case in Vermont this summer.

On August 16, the Massachusetts Department of Public Health (MDPH) released a statement discussing the confirmation of the first human case of EEE in the state this year. The confirmed case was discovered in an 80 year old man who was exposed to the vector borne disease in Worcester County. As a result, the risk level in the local communities of Douglas, Oxford, Sutton, and Webster has been raised to critical, and in Dudley, Northbridge, and Uxbridge the risk is increased to high.

Additionally, the neighboring communities of Auburn, Charlton, Grafton, Leicester, Mendon, Millbury, Millville, Southbridge, and Upton are now considered at moderate risk according to MDPH.

“This is the first time we have seen a person infected with EEE in Massachusetts since 2020,” Public Health Commissioner Robbie Goldstein, MD, PhD, said in a statement. “EEE is a rare but serious disease and a public health concern. We want to remind residents of the need to protect themselves from mosquito bites, especially in areas of the state where we are seeing EEE activity.

Though very rare, EEE is serious and a potentially fatal disease that can affect people of all ages. EEE is generally spread to humans through the bite of an infected mosquito. There were 12 human cases of EEE in Massachusetts in 2019 with 6 deaths, and 5 human cases with 1 death in 2020. There were no human cases of EEE in Massachusetts in 2021, 2022, or 2023.

EEE has a fatality rate of 33% to 70%, with most deaths occurring 2–10 days after the onset of symptoms.

In addition to a high mortality rate, long-term physical and mental complications, including permanent neurological deficits have been identified in many people who survive EEE.

Plymouth is approximately 40 miles south of Boston along the coast, and Worcester County is in the middle of the state, so the 2 areas are not in close proximity, but due to the elevated risk locally, the town of Plymouth decided to take action in response to outdoor parks. As of last Friday, all town public parks and fields are close daily from dusk until dawn.

“As Mass DPH has now elevated Plymouth’s EEE risk status to high, it is important to take extra precautions when outdoors and follow state and local health guidelines to avoid unnecessary risk to exposure to EEE. The health and safety of our community, residents, and visitors remain our priority,” Plymouth’s Commissioner of Health and Human Services, Michelle Bratti, said in a statement.

According to the Centers for Disease Control and Prevention (CDC) most people who are infected with the virus do not develop symptoms; however, for those that do, the date from the bite to the onset of the illness is 4 to 10 days. EEE can also result in fever or neurologic disease. The type of illness will depend on the age of the person and other factors. Those who are infected can develop meningitis.

There are no FDA-approved treatments for EEE and for patients who develop severe cases, they can be hospitalized to receive supportive treatment.

Over the weekend, MDPH detailed plans of spraying for mosquitos including aerially in areas of Plymouth County, and truck-mounted spraying in parts of Worcester County. As of Saturday, 10 communities in Massachusetts were raised to high or critical risk for EEE virus.

“The risk from EEE is high in parts of Plymouth County and critical in parts of Worcester County,” State Epidemiologist Catherine M. Brown, DVM, said in a statement. “In addition to recommending that people use mosquito repellent with an EPA-registered active ingredient and clothing to reduce exposed skin, we also recommend that evening outdoor events be rescheduled to avoid the hours between dusk and dawn. The mosquitoes most likely to spread EEE are most active during the dusk to dawn hours.”

There are preventative strategies to avoid EEE, and the MDPH has listed such measures 

For those who live in Massachusetts and want more information on EEE, it can be found 

 or by calling the DPH Division of Epidemiology at 617-983-6800.

1.NH DHHS Identifies Person Infected with Eastern Equine Encephalitis Virus in New Hampshire.The New Hampshire Department of Health and Human Services. August 27, 2024. Accessed August 28, 2024.
https://www.dhhs.nh.gov/news-and-media/nh-dhhs-identifies-person-infected-eastern-equine-encephalitis-virus-new-hampshire
2. State health officials announce season’s first human case of Eastern Equine Encephalitis in Massachusetts. MDPH. August 16, 2024. Accessed August 27, 2024.
https://www.mass.gov/news/state-health-officials-announce-seasons-first-human-case-of-eastern-equine-encephalitis-in-massachusetts
3.Plymouth to Close all Public Parks and Fields from Dusk to Dawn. Town of Plymouth. August 23, 2024. Accessed August 27, 2024. PDF.
4. Eastern Equine Encephalitis: Symptoms, Diagnosis, and Treatment. CDC. May 15, 2024. Accessed August 27, 2024.
https://www.cdc.gov/eastern-equine-encephalitis/symptoms-diagnosis-treatment/index.html
5. State officials announce plans to spray for mosquitoes in sections of Worcester and Plymouth counties due to EEE. MDPH. August 24, 2024. Accessed August 27, 2024. 
https://www.mass.gov/news/state-officials-announce-plans-to-spray-for-mosquitoes-in-sections-of-worcester-and-plymouth-counties-due-to-eee



The town of Plymouth decided to prohibit people from using the parks from dusk to dawn due to concerns over eastern equine encephalitis after a man contracted the rare disease in the state.

Concerns Over Mosquito-Borne Illness Causes Massachusetts Town to Create Curfew for Parks, Spraying in Counties

Canine serologic testing data indicate a broader geographic distribution of coccidioidomycosis (Valley fever) in the United States than previously recognized, suggesting that current human surveillance may underestimate the true burden of the fungal disease.

Researchers analyzed 834,899 serologic test results from dogs across the US between 2012 and 2022, using data from all known diagnostic laboratories performing anti-

 antibody testing in dogs. The overall seropositivity rate was 37.6%, with substantial variation by state. Among states with ≥0.5 tests per year per 10,000 households, average seropositivity ranged from 35.4% in Texas to 74.1% in Montana.

Estimated annual canine incidence per 10,000 households was highest in Arizona (87.8), followed by New Mexico (.89), Nevada (.79), California (.75), and Montana (.63). Positive correlations were observed between canine and human incidence in Arizona (ρ = .75) and California (ρ = .65), based on surveillance data from 2012 to 2022.

The distribution of seropositive dogs expanded significantly over the past decade, increasing from 76 counties in 2012 (2.4% of US counties) to 390 counties in 2022 (12.4%). This trend may reflect both the spread of 

 spp. and improvements in veterinary testing availability.

Due to challenges such as inconsistent soil detection, underdiagnosis, and non-mandatory human case reporting, canine seroprevalence may serve as a valuable proxy for environmental risk. The findings support the need for enhanced human diagnostic capacity and clinician awareness to improve recognition of this emerging fungal infection.

The investigators, including Jane E Sykes, BVSc(Hons), MPH, MBA, PhD, from school of veterinary medicine, University of California-Davis, and Simon K Camponuri, MPH, division of environmental health sciences, School of Public Health at Berkeley, emphasize the value of canine seroprevalence as a proxy for environmental risk, given challenges such as inconsistent soil detection, underdiagnosis, and non-mandatory human case reporting. 

"The dog serologic data analysis showed that the incidence in dogs closely follows that in humans, at least in California and Arizona," said Sykes. "We are currently performing additional studies with the data to extrapolate where unrecognized disease might be occurring in humans-both in locations where reporting is required and in other parts of the country."

Sykes further explained that stronger reporting mechanisms for dog cases could improve monitoring of the disease's spread in both dogs and people. "Currently there is no requirement that dog cases be reported and no infrastructure to support such an activity. If there was a requirement for reporting of cases in dogs, we would be better prepared to monitor the spread of the disease in both dogs and people."

Sykes noted that the data could also inform occupational health strategies, "Human health care providers could be educated on the disease, and there may be implications for occupational exposure reduction, such as education of construction workers, military personnel, agricultural workers, or wildfire fighters regarding the need for PPE and dust avoidance," she said.

With the increasing distribution of seropositive dogs, Sykes stressed the importance of enhancing diagnostic infrastructure and provider knowledge in regions with expanding risk for coccidioidomycosis. "Educational materials on Valley fever and risk factors for Valley fever for providers, mandatory training in highly endemic regions for workers with occupational exposure, raising awareness with awareness days/weeks etc.," she added. "Another thing that is badly needed is inclusion of companion animals in census data, because currently we lack a good denominator for studies like this one."

Finally, Sykes highlighted the potential of a One Health approach, integrating animal and human health data, to help address emerging infectious diseases. "When all laboratories are willing to pitch in their results, we can overcome the spatial bias that occurs when only one laboratory participates," she said. "There are so many other emerging diseases where companion animals can be sentinels for human diseases."

This study highlights the need for improved surveillance and diagnostics to better track Valley fever, as canine serologic data reveals the disease is more widespread in the US than previously recognized. Current human surveillance may underestimate the true burden, particularly in the southwestern US.

Jane E Sykes, Simon K Camponuri, Amanda K Weaver, George R Thompson, Justin V Remais, Use of dog serologic data for improved understanding of coccidioidomycosis: A One Health approach, The Journal of Infectious Diseases, 2025;, jiaf184, 

Jane E. Sykes, BVSc (Hons), PhD, MPH, MBA, discussed how her study revealed a wider geographic distribution of valley fever, highlighting the need for improved human surveillance.

Canine Serology Sheds Light on Underreported Human Coccidioidomycosis Spread

 is highlighted as an emerging multidrug‑resistant yeast that has drawn urgent attention from global and UK health authorities amid rising outbreaks and antifungal resistance. A pathogen once obscure, it now symbolizes the broader crisis in fungal infections driven by scientific gaps, diagnostic delays, and agricultural practices.

 has rapidly spread to more than 60 countries. New data from the UK Health Security Agency (UKHSA) show that England reported 637 cases between 2013 and 2024, with 178 occurring in 2024 alone, the highest annual count to date. Most detections were colonizations, but the yeast can cause invasive infections with high mortality in immunocompromised patients.

 frequently resists azoles, like fluconazole, echinocandins, and polyenes, with resistance arising intrinsically or during therapy. In 2022, the WHO designated 

 a critical priority pathogen, a status previously limited to drug‑resistant bacteria.

 cases in England, particularly after COVID‑19 travel restrictions lifted, has been linked to prolonged hospital outbreaks that exposed lapses in routine screening, species‑level identification, and reporting. In response, UKHSA updated its guidance and, beginning April 2025, will require all diagnostic labs to notify on 

Globally, fungal infections now cause an estimated 3.8 million deaths per year, a figure that has nearly doubled over the past decade, yet they remain underfunded in antimicrobial resistance agendas. Fungal cells’ similarity to human cells complicates drug development. Resistance mechanisms in fungi differ from those in bacteria, so only three antifungal agents targeting priority pathogens are in late‑stage trials. The 

 editorial calls for multicenter clinical‑trial networks to advance these scarce candidates.

Environmental factors amplify the threat. Agricultural azole fungicides resemble clinical antifungals, driving cross‑resistance. India has banned certain agricultural azoles, and both the US Environmental Protection Agency and EU agencies are tightening approval criteria and waste‑management standards to protect human‑use drugs.

 infections within Florida’s Jackson Health System, a large academic medical center. Over five years (2019–2023), clinical cases surged from just five in 2019 to 115 in 2023, a staggering 2,200% increase. Most infections were bloodstream-based, but in recent years, cases originating from soft tissue and bone also rose sharply. All sequenced isolates belonged to clade III (South African), showing resistance to fluconazole but susceptibility to echinocandins and amphotericin B.

 These findings reflect the broader national trend, with the CDC reporting 4,514 clinical 

1. High time to tackle drug-resistant fungal infections. 

2. UK Health Security Agency. Increase in 

) auris reports in England, linked to hospital outbreaks. 

 Updated March 31, 2025. Accessed April 18, 2025. https://www.gov.uk/government/publications/health-protection-report-volume-19-2025/hpr-volume-19-issue-3-news-27-march-2025#:~:text=From%20April%202025%2C%20C.,Protection%20(Notification)%20Regulations%202010

3. Rosa R, Baptista RP, Tran TT, et al. Changing Trends in the Sources and Volumes of Clinical Cultures with Candida auris at a Large Health System, 2019-2023. 

. March 17, 2025. Accessed April 18, 2025. doi:10.1016/j.ajic.2025.03.013

4. Tracking C. auris. CDC. December 9, 2024. Accessed April 18, 2025.
https://www.cdc.gov/candida-auris/tracking-c-auris/index.html?2023=2023

Six hundred thirty-seven cases in England, 4514 US clinical cases in 2023, and only 3 late‑stage antifungal drugs reveal surveillance and treatment gaps.

Candida auris Epidemiology and Resistance Mechanisms Challenge Antifungal Treatment

The FDA has approved Brexafemme (ibrexafungerp) for treatment of vulvovaginal candidiasis (VVC). The therapy was developed by Jersey City, NJ-based Scynexis.

The therapy, which represents the first approved drug in a novel antifungal class in more than 20 years, was approved based on positive results from 2 phase 3 studies in which oral ibrexafungerp demonstrated efficacy and a favorable tolerability profile in women with VVC.

“The FDA approval of Brexafemme is the culmination of years of work and a significant milestone for Scynexis, marking our evolution to a commercial-stage antifungal company. We are pleased with the approved label, highlighting the unique attributes of Brexafemme, and thrilled to be able to offer a new treatment option to women with vaginal yeast infections,” Scynexis CEO Marco Taglietti, MD, said. “We believe ibrexafungerp has significant commercial potential. This first approval in the US is a major step towards building the ibrexafungerp antifungal franchise as we intend to leverage an extended 10-year period of regulatory exclusivity and 14 years of patent protection.”

 from their phase 3 VANISH program, which had its VANISH 306 AND VANISH 303 studies, showed ibrexafungerp met its endpoints and achieved statistically significant superiority vs. placebo. In its VANISH 306 study, 188 participants were in the treatment arm and 84 were placed in the placebo group. In its VANISH 303 study, 188 participants were in the treatment arm and 98 were placed in the placebo group.

The company is also studying ibrexafungerp in its CARES study program for life-threatening fungal infections such as Candida auris in hospitalized patients.

“We are in a strong financial position to execute on our commercial plans and are committed to advancing our hospital programs to maximize the broad potential of this novel therapeutic class to help patients with serious and often resistant fungal infections,” Taglietti said.

Scynexis has partnered with Amplity Health to support the US commercialization of ibrexafungerp with a potential launch scheduled in the second half of this year.

This is the first oral non-azole treatment for vaginal yeast infections.

FDA Approves Ibrexafungerp

Matthew Hepburn, MD, executive vice president of Research and Development at Panther Life Sciences, discusses the technology and its potential usage.

Panther's Microarray Patch Offers Novel Therapy Delivery System for Potential Infectious Disease Applications

In a previous life, Matthew Hepburn, MD, an infectious disease physician,  worked with the Biden and Trump Administrations, and held the role of vaccine development lead for Operation Warp Speed, which was instrumental in developing COVID-19 vaccines in less than a year. This task was monumental considering it typically takes years to develop vaccines, and the pandemic was causing such a large human toll. 

Prior to that position, he has had a variety of roles in the Army and government including his 6-year tenure as a program manager at DARPA. Prior to joining DARPA, Hepburn served as the director of Medical Preparedness on the White House National Security Staff. His service in the Army included deployments to Iraq as a hospital Chief Medical Officer and numerous international engagements in establishing public health and clinical research partnerships.

With a long track record in government service, he recently transitioned to the private sector. In his current role as executive vice president of Research and Development at Panther Life Sciences, he will drive the company’s efforts to commercialize its patented Microarray Patch (MAP) technology, with a primary focus on reducing time-to-market and delivering the first commercial product to customers within the next 2 years. Panther is a start-up life sciences company based in New York City. 

“I have a massive newfound respect for people that are part of the startup community, because it is so challenging to be successful. It is such a commitment,” Hepburn said. “What I love about it is it reminds me a lot of that commitment we had at Operation Warp Speed, where everybody on your team is committed to the goal of making a big vision real.”

The patch platform is a novel technology which incorporates transdermal drug delivery systems. This consists of an array of tiny needles—each just hundreds of microns long—designed to pierce the outermost layer of the skin without reaching the deeper pain receptors, resulting in a virtually pain-free experience. Upon application, the biocompatible tips, which are loaded with therapeutic agents or vaccines, begin to dissolve within the interstitial fluid of the skin, releasing the medication directly into the epidermis and dermis.

“Micro needles are much shorter than the needle you get with a shot, but they go into your skin at the level where you can get a really effective immune response or use it to treat something,” Hepburn said. “So this idea of precision medicine—putting the right amount of material at the right time for the right patient—you can achieve a magnificent effect. And the design of these needles are such that you can put the vaccine or the drug on them. You surround them with these micro needles that are formed of polymers that just dissolve right underneath your skin. And they stay stable at room temperature."

He says this last part about the patch being able to deliver treatments or vaccines at room temperature as opposed to very cold freezer temperatures is an attractive component, and is a lesson they learned from COVID-19. 

"We know that with the COVID vaccines, as example, we had an amazing logistics team with the army and with the CDC to get the COVID vaccines out to people, but because the vaccines had to be kept at really, really cold temperatures, the logistical challenges were absolutely massive, and our team did our best to overcome those," Hepburn said. "But what we saw, especially for worldwide distribution, that sometimes maintaining those vaccines at that very cold temperature was essentially impossible to do so that access for people to receive their COVID vaccines—that was the biggest limitation. And it's a big limitation for lots of other vaccines and for therapeutic products as well." 

Although the technology is in its earliest stages, Hepburn does see it being utilized for infectious disease. He says right now they are working on the proof of concept first before they can pivot to specific disease states and applications.

This is part 1 of a 2-part interview. In the second installment, Hepburn will offer some insights on his time working on Operation Warp Speed. 

Reference
1.Operation Warp Speed Leader Tapped as Panther Life Sciences’ New R&D Chief. EIN Presswire. March 24, 2025. Accessed April 18, 2025.
https://www.einpresswire.com/article/796443993/operation-warp-speed-leader-tapped-as-panther-life-sciences-new-r-d-chief

From Pathogen to Infectious Disease Diagnosis: Test Determines Between Bacterial and Viral Infections in 15 Minutes

MeMed CEO Eran Eden, PhD, discusses the MeMed BV test, a rapid diagnostic tool that distinguishes between bacterial and viral infections in just 15 minutes, aiding clinical decision-making and antibiotic stewardship. The blood test, which analyzes three host-response proteins and generates a score to assess bacterial infection likelihood, has received FDA 510(k) clearance and the European CE Mark. Clinical studies showed a 63% reduction in unnecessary antibiotic use, accurate identification of previously missed bacterial infections, and better performance than traditional biomarkers like procalcitonin. Eden highlights the test’s ability to address diagnostic gaps, such as inaccessible infections, pathogen colonization, and superinfections, and reduce uncertainty that often leads to antibiotic misuse. By improving diagnostic accuracy, the MeMed BV test contributes to safer patient care and helps combat antimicrobial resistance.

CDC ACIP Meeting Examines Next Steps for Meningococcal, RSV, and Chikungunya Vaccination

At its April 16, 2025, meeting, the CDC’s Advisory Committee on Immunization Practices (ACIP) issued updated guidance on meningococcal, RSV, and chikungunya vaccines. ACIP supported using GSK’s MenABCWY pentavalent vaccine when both MenACWY and MenB are indicated, while also reviewing safety concerns with Sanofi’s MenQuadfi in infants. For RSV, ACIP recommended vaccinating at-risk adults aged 50–59, with further guidance pending on risk criteria and potential expansion to younger adults. Regarding chikungunya, ACIP endorsed the virus-like particle vaccine for travelers aged 12+ and lab workers with exposure risk, and the live attenuated vaccine for younger travelers, while noting rare but serious adverse events under investigation.

Disrupting HBV Chromatin Structure Blocks X Gene Transcription and Infection

A recent study led by Yael David, PhD, at Memorial Sloan Kettering Cancer Center uncovers how nucleosome positioning on hepatitis B virus (HBV) cccDNA directly controls transcription of the X gene, a key step in establishing infection. The research demonstrates that the chromatin-destabilizing compound CBL137 selectively disrupts HBV chromatin structure, reducing X gene transcription and blocking infection in primary human hepatocytes. These findings highlight a novel antiviral strategy that targets the epigenetic regulation of cccDNA, marking a shift from traditional replication-inhibiting therapies toward approaches that silence the viral reservoir itself, offering new potential in the pursuit of a functional cure for chronic hepatitis B.

Follow the Science: Why CD4 Testing is Critical in the Fight Against HIV/AIDS

Andreas Boehmler, PhD, emphasizes that expanding access to CD4 testing is essential for meeting global HIV/AIDS targets, particularly the UNAIDS 95-95-95 goal. Despite advances in HIV care, millions remain undiagnosed or untreated, and only 51% of countries incorporate CD4 testing in screening protocols for patients reentering care. CD4 testing, which tracks immune cell levels and signals disease progression, is vital for identifying advanced HIV, detecting treatment failure, and guiding care. Technological advancements have streamlined the once-complex process, making testing faster and more accessible. However, achieving widespread implementation requires strong infrastructure, trained personnel, reliable reagent delivery, and public-private partnerships. Boehmler calls for increased investment and international cooperation to sustain testing efforts and ultimately combat the HIV/AIDS epidemic.

Longhorn Advances a Scalable Universal Flu Vaccine

Longhorn Vaccines and Diagnostics has developed a novel universal influenza vaccine, LHNVD-110, designed to protect against human, avian, and swine flu strains, including pandemic variants like H5N1. Presented at ESCMID 2025, the single-composite peptide vaccine uses conserved epitopes from multiple influenza proteins and an ALFQ adjuvant to generate strong, durable immune responses in preclinical models with no observed reactogenicity. Jeff Fischer, MBA, president of Longhorn, emphasized the vaccine’s scalability, year-round manufacturing potential, and advantages over current seasonal flu vaccines. Positioned as a key tool in pandemic preparedness and aligned with a One Health approach, the vaccine and its monoclonal antibody cocktail are expected to enter IND-enabling studies in late 2025, with human trials to follow.

This week, the CDC ACIP's endorsement of meningococcal, RSV, and chikungunya vaccines, the need to expand automated CD4 testing for improved HIV/AIDS care, and more.

JENNIFER BAILEY, PHARMD, BCPS, AAHIVP

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