2026年 · 第08卷第01期

Antimicrobials have been hugely successful in improving health outcomes. However, its positive impact is threatened by worldwide increase of antimicrobial resistance (AMR). Use, misuse and overuse are the drivers of AMR. Antimicrobials are used in healthcare, poultry farming and agriculture, horticulture, food production and feed additives, growth promoters, and in aquaculture. Other major drivers are poor infection control, environmental contamination, and geographical movement. AMR is a global public health concern. Without mitigation and remedial actions, estimated mortality attributed to AMR could rise to 10 million globally by 2050. AMR is a natural phenomenon. The use of antimicrobials creates a reservoir of resistance that exists within the ecosystem. AMR is a One Health concern. To contain AMR, a collaborative effort of all the relevant sectors, working locally, nationally, and globally, is the way to attain optimal One Health. Poor biorisk management measures in healthcare, poultry farms, agriculture and aquaculture, can lead to introduction and spread of infections and AMR. Wastewater is the reservoir of pathogens capable of transmitting infections, and at the same time, releasing antimicrobial, AMR genes into the environment, contaminating the entire biosphere. Although injudicious use of antimicrobials is mostly blamed for the failure of containment, improper waste management, likely plays a greater role, superseding the crisis, created by other means. AMR originates in, and passes vertically and horizontally through, microorganisms, among the ecosystems. Thus, the implementation of required biorisk management measures will ensure the protection from unintentional release of pathogens; protect the animals and the humans from zoonosis and reverse zoonosis; protect the environment and the entire biosphere from the spread of contaminants; protect the biological agent itself from loss, theft, misuse, diversion, or intentional release. Together with implemented biorisk management measures globally, judicious use of antimicrobials may lead to the total containment of AMR, strengthening global public health security.

Severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging tick-borne virus that poses a growing public health concern, especially in East Asia. However, its global distribution, disease burden, and economic impact remain insufficiently characterized. In this study, we have systematically reviewed literature databases, GenBank, and official reports to provide a comprehensive overview of global SFTSV detections. Seropositive or nucleic acid-positive individuals have been reported not only in East Asia, but also in Thailand, Myanmar, Vietnam, Pakistan, and Kenya. In addition, SFTSV has been identified in ten animal orders and in both ticks and other arthropod vectors. Severe fever with thrombocytopenia syndrome (SFTS) incidence, mortality, and disability-adjusted life years (DALYs) have shown an increasing trend across East Asia. China recorded the highest absolute DALYs, exceeding those of other neglected tropical diseases, such as dengue fever. The average cost per SFTS case was substantial, exceeding 75 % of the annual per capita disposable income in China, and 41.38 % and 23.52 % in Japan and South Korea, respectively. These findings highlight the expanding distribution of SFTSV and its significant per-case disease and economic burden in East Asia.

Immune imprinting, or original antigenic sin, challenges the control of evolving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). How the quantity and quality of pre-existing immunity modulate the recall antibody response upon re-exposure remains poorly understood. We immunized hamsters with a recombinant ancestral spike protein (S-2P) formulated with one of four distinct adjuvants to assess the impact of adjuvant-induced immunity on protective efficacy. Furthermore, we analyzed the modulatory effect of the adjuvant on the potency, breadth, and evolution of antibody responses after homologous viral challenge. We found that vaccination with Montanide ISA720-adjuvanted S-2P (S-2P:ISA720) not only induced higher initial neutralizing antibody titers and conferred stronger protection but also established a pre-existing immune state capable of cross-neutralizing the antigenically distant Omicron BA.1 variant. In contrast, aluminum hydroxide adjuvanted S-2P (S-2P:Al) elicited comparatively lower neutralizing titers and showed no cross-neutralization against BA.1. Following viral challenge, the S-2P:ISA720 group exhibited significant affinity maturation toward conserved epitopes, which markedly enhanced cross-neutralization against BA.1 without increasing neutralizing titers or affinity against the homologous strain or the antigenically related Delta variant. Conversely, the S-2P:Al group mounted a narrow, imprinting-facilitated response, characterized by boosting of strain-specific antibodies without substantial improvement in BA.1 neutralization. These findings suggest that in S-2P:ISA720-immunized animals, high-affinity antibodies mediate epitope masking of immunodominant sites, thereby redirecting responses toward subdominant conserved epitopes with cross-neutralizing potential. In conclusion, our study demonstrates that adjuvants can critically guide recall immune responses toward breadth and affinity maturation, offering a rational strategy for developing next-generation vaccines against SARS-CoV-2 and other variable pathogens.

Alternative splicing (AS) significantly increases the diversity of the eukaryotic proteome, and alterations in AS induced by viruses have emerged as a novel approach to studying virus-host interactions. Human metapneumovirus (HMPV) interacts with host cells through multiple mechanisms, directly or indirectly utilising various host systems to facilitate infection and replication. In this study, the BEAS-2B human normal lung epithelial cell line was used as the cell model for HMPV infection. The host gene alternative splicing events following HMPV infection were then characterised using RNA sequencing. Selected alternative splicing events were confirmed and the associated genes evaluated for their effect on HMPV replication in knockout cell lines. HMPV replication was found to be greatly reduced in cells lacking the SEC11A gene, suggesting that the SEC11A gene is a critical host factor for HMPV infection. Notably, the SEC11A splicing pattern was not altered during infection with other respiratory viruses. In summary, this study reveals that SEC11A, which encodes the core catalytic subunit of the signal peptidase complex (SPC), is an essential host factor for HMPV infection. We observed a specific exon-skipping event in its mRNA precursor that occurs within the regulatory region upstream of the coding sequence. This atypical splicing site suggests that the virus may regulate SEC11A expression by interfering with the host splicing machinery. These findings provide new insights into HMPV pathogenesis and lay the groundwork for further exploration of HMPV-host interactions and the development of potential host-directed antiviral therapies.

The study objectives were to analyze the epidemiological characteristics of pertussis in Henan Province, China, and to evaluate the impact of pertussis vaccination strategy adjustments on population infection rates. A retrospective analysis was conducted on the reported pertussis cases in Henan Province from 2012 to 2024. The concentration of IgG antibodies against pertussis toxin (anti-PT IgG) was measured in 18,528 healthy individuals from 2022 to 2024. The positive rate (≥20 IU/mL) and median concentration (MC) were calculated, and the infection rate was estimated based on anti-PT IgG ≥ 40 IU/mL, using the susceptible-exposed-infec tious-recovered-vaccinated (SEIRV) model to predict the effect of adding a pertussis booster dose at 6 years. The average annual incidence of pertussis in Henan Province from 2012 to 2024 was 2.21 per 100,000 population. The overall anti-PT IgG positivity rate was 16.42 %, and the MC was 4.66 IU/mL. The antibody concentration is influenced by age, gender, and vaccine type. The population that completed the full course of vaccination had the highest anti-PT IgG positive rate (17.81 %) and the highest MC (4.97 IU/mL). The population that vaccinated the diphtheria-tetanus-acellular pertussis-inactivated polio vaccine-haemophilus influenzae type b (DTaP-IPV/Hib) had the highest MC (14.83 IU/mL). The total estimated infection rate of pertussis was 7,833.45 per 100,000, peaking in the 6-year age group (10,809.72 per 100,000). When the estimated coverage rate of the pertussis booster vaccination reaches 83.21 %, the infection rate could be decreased by 71.41 %. The incidence of pertussis in Henan Province has increased, and the infection rate is higher than anticipated. Booster immunization at age six can significantly lower the risk of infection.

Infectious diseases pose a serious threat to human health and social safety. In order to better respond to largescale outbreaks of infectious diseases in the context of climate change, it is essential to identify potential highrisk areas in cities. However, there is currently a lack of a standardized metric or indicator for quantifying the potential risk of urban infectious diseases. The main objective of this study is to construct an urban infection susceptibility index (UISI) to identify and quantify susceptibility risk, thereby providing insights for constraining and prevent future epidemics. The UISI considers both human activities (population density, closeness index, betweenness index, life service, functional synthesis indicator, hospital accessibility) and climaterelated factors (temperature, particulate matter 2.5, wind speed, humidity), and is specifically designed to analyze potential high-risk areas of urban epidemics across cities worldwide. The index integrates a wide range of factors based on the criteria importance obtained through the intercriteria correlation method, producing finescale susceptibility maps at the urban grid level. We apply the UISI to the coronavirus disease 2019 risk assessment in Lanzhou and Shanghai, which has been well verified. This UISI is both easy and effective to calculate across various cities, providing a scientific basis for rapid policy-making and implementation to prevent the spread of infectious diseases. Furthermore, we predict the UISI trends across different shared socioeconomic pathways (SSP), specifically SSP5-8.5 and SSP2-4.5, which demonstrate an increasing trend from 2025 to 2100.

Global climate change and technological advancements have intensified the threats of pandemics, while complex transmission dynamics challenge infectious disease forecasting. Traditional compartmental models struggle to fully capture both the dynamic transmission processes and their associated uncertainties. Here, we develop a novel hybrid methodology that integrates dynamic modeling with statistical approaches, establishing a semi-mechanistic model for error correction and probabilistic prediction. Our error analysis of the dynamic model reveals that frequent population mobility compromises the accuracy of dynamic predictions and that meteorological conditions further modulate forecast performance by regulating human movement patterns. To capture these effects, we implement a quantile regression long short-term memory (QRLSTM) network to estimate prediction errors of the epidemic dynamic model based on mobility and environmental data. This hybrid approach corrects dynamic prediction errors and generates probabilistic forecasts. Validation using multi-state the United States (U.S.) coronavirus disease 2019 (COVID-19) outbreak data shows that our framework reduces dynamic prediction errors by over 50 %. Compared with pure deep learning approaches, the semi-mechanistic model significantly enhances long-term prediction performance and interpretability. By integrating mechanistic modeling with data-driven learning, the proposed approach improves the predictive accuracy and reliability of models in real-world outbreaks, thereby delivering more effective decision support for public health interventions.

The relentless emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants continues to challenge global health, as high mutation rates and complex pathogenicity obscure molecular mechanisms and impede clinical progress. Despite extensive research across viral evolution, structural biology, immunology, diagnostics, and therapeutics, the resulting vast and rapidly outdated literature has widened the gap between fundamental discovery and medical application. Here, we systematically mined 439,724 coronavirus disease 2019 (COVID-19) publications using fine-tuned large language models to extract and distill knowledge across nine domains: antibodies, vaccines, serology, biochemistry, therapeutics, clinical presentation, risk factors, biomarkers, and diagnostics. These insights were integrated into a unified graph of 1,427,596 triples (CoVAR-KG). Covering 90 % of known spike-protein variant sites, our knowledge graph forges molecular-to-clinical links that reveal how specific mutations influence antigenicity, transmissibility, and treatment response. By resolving data fragmentation, this resource accelerates target identification and streamlines hypothesis generation. Building on CoVAR-KG, we developed COVID-19 variant risk watcher (CVRW), an early-warning framework that quantifies the threat of emerging variants for real-time surveillance. Coupling the graph with retrieval-augmented GPT-4o enables rapid and in-depth comparisons of variant functionality and immune escape potential. These integrative tools furnish timely insights for vaccine design, therapeutic optimization, and pandemic preparedness, establishing a versatile platform for combating current and future viral threats.

China’s certification as malaria-free by the World Health Organization in 2021 marked the achievement of seven decades of adaptive surveillance, evolving strategies, and community engagement. The British Medical Journal series led by Qiyong Liu and colleagues provides comprehensive documentation of this process through regional case studies in Hainan Province, the Huai River Basin, and Yunnan Province, as well as national strategies and larval management priorities. This perspective interprets those findings within a One Health governance framework, emphasizing how China’s success demonstrates the value of integrated surveillance, regional cooperation, ecological intervention, and technological innovation. Together, these four pillars outline a pathway for sustainable vector control governance and future prevention of vector-borne diseases in an era of ecological disruption and climate change.