In a serologically diagnosed Nepalese scrub typhus cohort (n = 77), gastrointestinal symptoms were common. We assessed Orientia tsutsugamushi DNA in serum and performed TSA56 genotyping. Orientia DNA was detected in 10 of 77 samples (12%). TSA56 sequencing identified 4 genotypes. Polymerase chain reaction positivity was associated with diarrhea, groin lymphadenopathy, and stronger Th1-type cytokine responses.

BACKGROUND:Placental schistosomiasis (PS) is underdiagnosed and may compromise maternal and neonatal health. This study estimated the prevalence of PS in a rural Gabonese population of pregnant women with confirmed S. haematobium infection using light microscopy of macerated placental tissue. METHODS:This is a cross-sectional, diagnostic proof-of-concept study which applied an improved placenta maceration technique in real-world conditions to diagnose PS. Performing light microscopic assessment of a single sample of 10 mL urine, we screened pregnant women for S. haematobium infection who sought antenatal care in Lambaréné (Gabon) between January 2022 and January 2023. Women positive for S. haematobium infection were followed up until delivery. Additionally, a subsample of women with negative urine samples was recruited as a non-infected control group (1:1 ratio infected and non-infected groups) and followed up until delivery. Only participants with available macerated placental samples were considered for final analysis. Placental samples were subjected to light-microscopy-based screening for S. haematobium eggs and PS was considered present if a least one S. haematobium egg was detected. Positive light microscopic placental samples were confirmed by qPCR. RESULTS:Among 318 women screened for S. haematobium in urine, we found 40 (12.6%; 95% CI: 9.1-16.7%) to be positive. Together with 40 women in the non-infected control group all women were followed up until delivery. After loss-to-follow-up, 28 (70%; 28/40) women with S. haematobium infection and 20 (50%; 20/40) without infection provided placenta samples at delivery. In the group with S. haematobium infection, 14% (4/28; 95% CI: 4.0-32.7%) of women were positive for S. haematobium eggs in macerated placenta tissue. In the non-infected control group, one woman (5%; 1/20; 95% CI: 0.1-24.9%) had a positive microscopy result for PS. All five women with positive S. haematobium egg microscopy in placental tissue received a concordant qPCR result. CONCLUSION:14% of women with S. haematobium infection also had PS. Notably, PS was also observed in 5% of women without detectable S. haematobium eggs in urine. This suggests that PS could be an underestimated phenomenon in highly endemic regions and warrants further investigations of its implications for mother-and-child health.

Ebola virus (EBOV) causes Ebola virus disease (EVD), a multisystemic human disease associated with an extraordinarily high case-fatality rate. EVD survivors may experience recrudescent inflammation with viral persistence in immune-privileged tissues, including the central nervous system (CNS). Persistence, defined by ongoing replication of the EBOV genome beyond the acute disease phase, may lead to virion production. Productive persistence has been linked to re-initiation of EVD outbreaks. We developed a human cerebral organoid model to investigate the host and viral determinants of EBOV CNS persistence. In this model, EBOV persistence for 120 days was sustained by continuous infection of astrocytes and neurons and the recruitment and infection of microglia. This was accompanied by the emergence of EBOV defective viral genomes and genomic subvariants, cell-to-cell transmission, activation of cell-specific innate immunity, and late brain organoid inflammation, indicating that persistent infection of EBOV within immune-privileged niches drives local inflammation.

Borna disease virus 1 (BoDV-1) encephalitis has a (sub)acute and mostly fatal course. Initial flu-like symptoms are typically followed by rapid progressive panencephalitis and death within weeks. No curative therapy exists so far. We present a long-term survivor with distinctive clinical, imaging, and pathophysiological features. A previously healthy male in his fifties was admitted in summer 2023 with (sub)acute encephalitis (cerebrospinal fluid, CSF: 132 cells/µl, no pathogen detection). Brain magnetic resonance imaging (MRI) demonstrated vasogenic edema affecting basal ganglia, temporal and limbic regions bilaterally. Despite high-dose steroids, the clinical condition of the patient slowly worsened. Three months later, BoDV-1 reactive antibodies were detected by elevated titers in CSF (1:320) and serum (1:5120). Treatment with favipiravir, corticosteroids, and mycophenolate mofetil (MMF) was initiated. After recovery for months, the patient developed progressive bilateral optic atrophy, cognitive decline, and a sleep disorder resembling Kleine–Levin syndrome. Translocator protein (TSPO)-PET revealed widespread microglial activation, confirmed by targeted cortical biopsy. Immunosuppressive therapy was escalated with anakinra, cyclophosphamide, and intrathecal dexamethasone, achieving temporary stabilization. In the summer of 2025, a severe brainstem syndrome emerged, accompanied by increased TSPO uptake in the brainstem and detection of BoDV-1 RNA in CSF for the first time. Despite another treatment with favipiravir and high-dose corticosteroids, the patient remained in a minimally conscious state. This exceptional case with long-term survival in BoDV-1 encephalitis gives important insights: BoDV1-associated neuroinflammation leading to a slowly progressive decline can be visualized by TSPO-PET. Late BoDV-1 RNA detection and subacute re-exacerbation after prolonged survival provides evidence that BoDV-1 persists in human brain tissue.

Human bornavirus encephalitis (BVE) is a rare, emerging and fatal zoonotic disease mainly caused by the Borna disease virus 1 (BoDV-1), a non-cytolytic RNA virus. Despite increasing recognition, the immunopathogenesis of human BoDV-1 infection remains insufficiently characterised. Complete coronal and sagittal brain sections from four fatal BoDV-1 cases were analysed using digitised immunohistochemistry to quantify viral distribution and tissue responses. Transcriptome-based analyses characterised local immune cell profiles in relation to viral loads measured by RT-qPCR. BoDV-1 viral loads varied substantially between cases but showed region-specific enrichment in the basal ganglia and hippocampus, correlating with lymphocyte presence and reactive microglia and astrocytes. Immune cell deconvolution revealed viral load-dependent modulation dominated by innate immune and glial populations, including metabolic and reactive astrocyte states, IFNγ-responsive microglia, and dendritic cells, macrophages, neutrophils, basophils, and CD8⁺ T cells. This was accompanied by induction of interferon-stimulated genes, antigen presentation, protein synthesis, and oxidative stress pathways, with a transcriptional signature resembling non-lytic viral and autoimmune-like neuroinflammatory conditions rather than lytic infections. These findings support a model of BoDV-1 encephalitis characterised by a prominent innate immune response and comparatively limited adaptive immune signatures. This imbalance might potentially contribute to impaired viral clearance and extensive tissue damage, a possible relationship that warrants further investigation.

This study reports the detection of a relapsing fever Borrelia in the gilded boar tick, Dermacentor auratus, extracted from the ear canal of a human patient in Kedah, Peninsular Malaysia. Molecular analysis of the flaB gene identified the Borrelia species as identical to Borrelia sp. isolate HNF1F2 from China (ON060668) and closely related (99.60%) to Borrelia theileri isolate B22 from Colombia (ON135433). This article also provides a comprehensive review of human otoacariasis cases in Malaysia and discusses the limitations associated with these cases.

Abstract West Nile virus (WNV), an arbovirus of emerging global interest, can cause neuroinvasive disease in humans. Currently, no protective vaccine or specific treatment is available for human WNV encephalitis. The virus induces neuronal cell death, while astrocytes and microglia cells are suspected to contribute to WNV pathology. Hence, understanding their role is crucial for future treatment approaches. In this study, we establish a WNV encephalitis model using human cerebral organoids, generated with male iPSCs. Infection results in heterogeneous kinetics with an early strong replication potentially leading to viral clearance, while a late peak was associated with more long-term infection. Viral foci are seen in cortical-like areas, rich in neurons and astrocytes, however void of microglia. Pro-inflammatory cytokines (IL-6, TNF-α, IL-18), chemokines (CXCL10, CCL17, CX3CL1, CCL2) and biomarkers (IL-1RA, sTREM-1, sRAGE, BDNF) are increasingly released. Conclusively, human cerebral organoids make suitable WNV encephalitis models with valuable properties to study acute and long-term infection.

We report a case of severe acute kidney injury in a patient in Germany infected with Seoul virus. Clinical and laboratory analysis linked the infection to a pet rat breeding facility in central Germany. Increased surveillance and a One Health approach are needed, given the rising popularity of pet rats.

A young migrant from Benin presented with macrohaematuria to the Outpatient Department for Tropical Medicine in Hamburg. An infection with Schistosoma haematobium accompanied by hydronephrosis was diagnosed. In addition, asymptomatic malaria with both Plasmodium falciparum and Plasmodium malariae , as well as a suspected previous contact with Strongyloides were detected. Despite undergoing regular treatment for the infections and receiving a total of three treatment cycles of praziquantel against schistosomiasis, the presence of schistosomiasis eggs in the urine persisted 14 months after the end of the first treatment cycle. Implications of these findings are discussed on the background of treatment adherence, potential drug resistance and further medical management.

We report multiple life stages of Haemaphysalis wellingtoni ticks from the Chinese goose (Anser cygnoides) in Peninsular Malaysia. This finding constitutes not only a novel tick-host record, but also is the first report of ticks from geese in Malaysia. Based on the literature review, a checklist of the ticks parasitizing Anatidae birds worldwide, and an updated host index of H wellingtoni, are provided. Furthermore, a list of dubious tick species infesting ducks and geese is also included. The geographical distribution of H. wellingtoni, its host ecology on A. cygnoides, and the health risks of geese are discussed in this paper.

Infectious encephalitis in children can be caused by several pathogens, very rarely this can be caused by bornaviruses (BoDV-1). Due to the recent discovery of the disease in humans and the small number of cases, especially pediatric infections, knowledge about the disease pathology as well as therapeutic options is limited. Therefore, this review shall help raise awareness of this rare and mostly fatal disease, promote an early diagnosis, and present current knowledge about possible treatment options.

Borna disease, which is a severe encephalitis that primarily affects horses and sheep, has been recognised for over two centuries. Borna disease virus 1 (BoDV-1) has been identified as a cause of a predominantly fatal encephalitis in humans. Little scientific data exist regarding the virus' transmission, entry portal, and excretion routes. Lesional patterns, immunological responses, and pathogenetic mechanisms remain largely unexplored in both reservoir and dead-end hosts. This systematic review compiles current knowledge on these aspects and provides guidance for future research. PubMed, ScienceDirect, and EBSCO were searched for publications from Jan 1, 2000, to April 30, 2024. 823 records were found, of which 41 studies were included. This systematic review discusses BoDV-1 transmission, pathogenesis, histopathological changes, and immunology in both reservoir and dead-end hosts, with special regard for humans. The exact propagation mechanisms, entry portal, and viral spread within the CNS are not entirely clear in humans. Although more data exist in animals, much remains hypothetical. Future research should focus on identifying potential entry sites and viral spread in dead-end hosts, which could help to clarify the pathogenesis and lesion distribution in the CNS, thereby contributing to a better understanding of BoDV-1 infection in humans and parallels with animal infections.

Leishmania infantum is the only prevalent Leishmania species in Europe and manifesting predominantly as cutaneous or visceral leishmaniasis, whereas new world species like Leishmania (L.) braziliensis are well known pathogens in mucocutaneous leishmaniasis. Mucosal leishmaniasis caused by L. infantum is a rare clinical condition with only few cases described in literature. In contrast to our case, mostly immunocompromised patients with no history of leishmaniasis are affected. We describe the case of a 77-year-old German male who developed an ulcerous lesion of the tongue. As oral cancer was suspected, the patient underwent surgery. After suspected diagnosis of Leishmania spp. in histopathology, the patient was referred to our department for further diagnostics and treatment. Relapse from a cutaneous leishmaniasis acquired in Spain is likely, as L. infantum could be identified as the causative agent. The patient recovered after treatment. Mucosal leishmaniasis caused by L. infantum is rare and usually mistaken for malignancy. As demonstrated, it can be preceded by cutaneous leishmaniasis of the immunocompetent. Due to possible dissemination systemic treatment should be applied.

The clinical presentation of individuals infected with Plasmodium falciparum is exceptionally diverse, ranging from asymptomatic parasitemia to life-threatening disease. Frequent previous exposure to Plasmodium spp results in partial protection from severe disease; however, this protection wanes in individuals emigrating from holoendemic regions, and there are currently no reliable biomarkers that accurately indicate this semi-immunity. Data were analyzed from 1392 adults infected with P falciparum in Gabon and Germany. Full blood count parameters and ratios were evaluated individually and as a combined ensemble-based machine learning classifier to predict disease severity, ranging from asymptomatic infection to severe malaria. As a secondary objective, the influence of previous exposure to Plasmodium spp was assessed. Comparing asymptomatic parasitemia with uncomplicated malaria in Gabonese and comparing uncomplicated with severe malaria in German patients revealed significantly lower platelet counts (218 vs 150 ×103/µL, P < .0001; 85 vs 40 ×103/µL, P < .0001, respectively) and higher neutrophil counts (2.32 vs 2.57 ×103/µL, P = .0037; 3.08 vs 4.49 ×103/µL, P < .0001) in those with greater infection severity. The machine learning classifier outperformed single parameters in differentiating infection severity in both comparisons (area under the receiver operating characteristic curve, 0.94 and 0.84). Lymphocyte and monocyte counts showed a pattern that follows the level of previous malaria exposure, with lower cell counts in naive vs previously exposed patients, regardless of infection severity. The value of simple full blood count parameters for classification of P falciparum infection severity and previous exposure is considerable. The accuracy can be increased by integrating individual parameters into a joint machine learning model.

Ein jugendlicher Migrant aus Benin stellte sich wegen einer Makrohämaturie am Tropeninstitut vor. Eine Infektion mit Schistosoma haematobium mit begleitender Nierenektasie wurde diagnostiziert. Darüber hinaus wurden eine asymptomatische Malaria mit Plasmodium falciparum und Plasmodium malariae sowie eine mutmaßliche Exposition mit Strongyloides festgestellt. Trotz regelrechter Therapie der Infektionen und Verabreichung von insgesamt 3 Therapiezyklen der Schistosomiasis mit Praziquantel waren 14 Monate nach Beendigung des ersten Therapiezyklus weiterhin Schistosomaeier im Sammelurin nachweisbar. Die Implikationen dieses überraschenden Resultats in Bezug auf Medikamentenadhärenz, möglicher Praziquantel-Resistenz und dem weiteren medizinischen Management werden diskutiert.

Tick studies in Malaysia have experienced a dynamic evolution characterized by periods of growth,stagnation,and the potential for revival.Beginning during the colonial era in the early 1900s,tick studies were primarily conducted by European scientists and curators,establishing the foundation for tick taxonomy in the region.Pioneering works by George Henry Falknier Nuttall and Cecil Warburton introduced several new tick species,including Haemaphysalis(H.)calva,H.mjoebergi,H.vidua and H.wellingtoni[1].However,some records from this period are now considered doubtful,for instance Amblyomma(A.)breviscutatum,A.

A German traveller developed leg oedema with adenolymphangitis after a 3-week trip to Sri Lanka. Laboratory tests showed slight eosinophilia, positive filarial serology and motile microfilariae in day and night-time blood samples. PCR revealed 99% homology for Brugia malayi. Lymphatic filariasis has been eliminated in Sri Lanka, but zoonotic B. malayi has re-emerged. Physicians need to be alert and consider filariasis as potential differential diagnosis. Surveillance and vector control efforts should be sustained to prevent resurgence in Sri Lanka.

Human Borna disease virus 1 (BoDV-1) encephalitis is characterized by rapid clinical progression, an absence of a causal therapy and an extremely high case fatality rate. Here, we discuss prevention options through a hypothetical vaccine focusing on epidemiological features.