Over the past five days, two more cases of hantavirus have been confirmed among passengers and crew who were aboard the MV Hondius Dutch cruise ship in April and May.

The outbreak now has 13 cases, three of which were fatal.

Several passengers remain in isolation and quarantine in various countries, including 18 Americans who are staying in a biocontainment unit in Nebraska through the end of the month. Hantavirus can have a 42-day incubation period. The Andes strain causing the outbreak is the only known hantavirus capable of spreading from person to person.

The first new case identified late last week was in a Dutch crew member who had disembarked the ship in Spain and was being monitored for the virus. 

WHO: 'Situation is stable’

“The situation is stable for now. We continue to remain vigilant and in close contact with all relevant governments,” Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), said on X on May 24. “All passengers and crew remain in quarantine and under close monitoring to ensure they receive care if needed.”

On May 25, Spain confirmed that a citizen who was aboard the MV Hondius and was isolated at a hospital in Madrid also tested positive for hantavirus.

So far, none of the cases have occurred in anyone who was not aboard the cruise ship.

A leptospirosis outbreak involving more than 200 pet dogs in Los Angeles County, California, in 2021 highlights the importance of canine vaccination and discusses the public health risk, a team led by University of California at Davis (UC Davis) researchers write in the Journal of Clinical Microbiology.

The team investigated the outbreak in dogs diagnosed as having leptospirosis at two animal hospitals. They conducted serotyping and whole-genome sequencing (WGS) on samples from four dogs. When the outbreak was over, the team compared data on 59 infected dogs with data on 15,536 controls.

Leptospirosis is a potentially serious bacterial illness that can cause acute kidney injury and death in dogs. People also are susceptible to the disease through contact with contaminated water or animal urine, particularly that from rodents. In people, the disease often causes flu-like symptoms and can be treated with antibiotics.

Infection likely underdiagnosed in people

All isolates were identified as Leptospira interrogans serovar Canicola. Of 47 dogs with a leptospirosis vaccination history, none were completely vaccinated.

The results of a survey conducted among healthcare professionals in 37 countries suggest over-the-counter (OTC) antibiotic sales remain all too common, researchers reported last week in JAC-Antimicrobial Resistance.

The electronic survey, sent to members of the AMR Insights Ambassador Network by a team of international researchers, assessed demographic characteristics, the existence of national regulations regarding OTC antibiotic sales, and the availability of specific antibiotics for purchase without a prescription. Although research has shown that the use of OTC antibiotics remains ubiquitous in many countries, particularly in Asia and Africa, the researchers said the practice “remains inadequately described on a global scale.”

“The acquisition and use of antibiotics without a prescription remains a significant barrier to addressing the global burden of AMR [antimicrobial resistance],” they wrote. “While all antimicrobial use contributes to the development of resistance, such use when unwarranted can lead to significant harm to both the individual and society.”

Community pharmacies a primary point of sale

Of the 75 respondents, 49 (65.3%) said antibiotics could be bought OTC in their countries without a prescription and only eight (10.7%) said antibiotic sales were strictly limited to people with a valid medical prescription. Of the 64 who answered questions about points of sale for non-prescription antibiotics, 55 (85.9%) said community pharmacies were the primary point of sale, with retail stores, internet vendors, and grocery stores identified as other sources.

While all antimicrobial use contributes to the development of resistance, such use when unwarranted can lead to significant harm to both the individual and society.

Penicillins (86.7%) and tetracyclines (83.3%) were the most frequently reported antibiotic classes available without a prescription, but respondents reported that other critical antibiotic classes deemed critical by the World Health Organization (WHO) were also available, including carbapenems, cephalosporins, fluoroquinolones, and macrolides.

“The finding that antibiotics are readily available in 37 countries—representing nearly 19% of the 194 WHO Member States—is concerning and highlights a critical gap in global stewardship,” the authors wrote, adding that the availability of last-resort antibiotics like carbapenems is particularly concerning and indicates that countries need to do more to ensure appropriate antibiotic use.

“Impactful change demands robust governance, political accountability, and an understanding of the cultural and behavioural drivers of unwarranted use,” they wrote.

• The Food and Drug Administration (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) will meet tomorrow to discuss the composition of the COVID-19 vaccines for the 2026-27 viral respiratory season. The focus of the discussion will be whether the committee will advise vaccine manufacturers to use the LP.8.1 subvariant as the antigen in a monovalent vaccine, as the World Health Organization recently did, or consider two other JN.1 lineage subvariants—NB.1.8.1 and XFG—that have become dominant in the United States. The vaccines used for the 2025-26 season were based on LP.8.1. “Because of the continuing virus antigenic drift, a review and discussion regarding the need for a strain composition update for COVID-19 vaccines is warranted,” the FDA said in a briefing document.

• The FDA and the Centers for Disease Control and Prevention are investigation another Salmonella outbreak linked to contaminated moringa leaf powder. The FDA said today that 18 people in 14 states have been sickened, and seven hospitalized, by the outbreak strain of Salmonella Typhimurium linked to Mogo brand Pure Moringa Oleifera capsules sold on Amazon, eBay, and the company’s website. Illness-onset dates range from February 3 to April 27. The FDA said the outbreak is new and the investigation separate from two previous Salmonella outbreaks linked to moringa powder. An investigation into one of those outbreaks was reopened today after 22 new cases were reported.
• A report published last week by the United Kingdom Health Security Agency (UKHSA) shows that cases of Lyme disease rose by 22% last year. The One Health vector-borne disease surveillance report shows 1,168 lab-confirmed cases of Lyme disease were reported in 2025, up from 959 in 2024 but close to the 1,151 recorded in 2023. UKHSA officials say they’ve seen an increasing geographic distribution of the ticks that carry the Borrelia burgdorferi bacterium, which causes Lyme disease, across the United Kingdom in recent years, but they expect case rates to vary year by year depending on awareness, testing rates, and weather.