Study: MIS-C may be triggered by latent Epstein-Barr virus

News brief

A new study suggests that kids who develop MIS-C (multisystem inflammatory syndrome in children), a severe complication following COVID-19 infections, may do so because COVID reactivates a latent Epstein-Barr virus (EBV) in their bodies. The study appears in Nature.

For 5 years, researchers have struggled to explain how MIS-C, a severe inflammatory response that mimics symptoms of toxic shock and Kawasaki shock syndromes, can occur in children who seem to recover completely from mild or even asymptomatic COVID infections. Kids with MIS-C typically develop the condition 4 to 8 weeks after SARS-CoV-2 infection.

German researchers say the answer may be in virus-reactive memory T cells, which are triggered by COVID infection. 

We’ve now found indications, however, that a resurgence of a second pathogen—Epstein-Barr virus—is responsible for the inflammatory shock.

“We’ve now found indications, however, that a resurgence of a second pathogen—Epstein-Barr virus—is responsible for the inflammatory shock. Put simply, it wakes up from a dormant state because the COVID infection has thrown the child’s immune system in such disarray that it becomes unable to keep the dormant infection in check,” said Tilmann Kallinich, MD, co-senior author of the study, in a press release from Charite hospital in Berlin. 

80.7% OF MIS-C patients seropositive for EBV

Epstein-Barr is the virus that causes mononucleosis, and while some have symptoms, almost 90% of people are infected, and most never have a symptom, but EBV is dormant in immune cells. 

In the study, 145 children aged 2 to 18 years old who had been treated for MIS-C in European hospitals were compared to 105 controls who had COVID-10 but never developed MIS-C. Researchers found that 80.7% of kids with MIS-C had evidence of EBV in blood samples, compared to 56.0% of controls. EBV antibody titers were higher in patients with MIS-C compared with controls and treated patients, the authors said.

They added that COVID may trigger an inflammatory immune response in kids that damages organs.


 

Tanzania declares end to Marburg virus outbreak

News brief

Tanzania’s government today declared the end of the country’s Marburg virus outbreak, after passing 42 days—two incubation periods—with no new cases following the death of the last patient.

Marburg purple blue
NIAID/Flickr cc

The outbreak was declared on January 20, with two confirmed cases reported from Kagera region. Both patients died from their infections. In a statement, health minister Jenista Mhagama urged the public to remain vigilant, continue taking precautions, and to report any unusual events.

In a statement today praising Tanzania’s swift response, the World Health Organization (WHO) said alongside the two confirmed cases there were eight probable cases, all fatal. The outbreak marked Tanzania’s second Marburg virus outbreak; the country’s first occurred in the same region in 2023.

The WHO said growing expertise in the African region has been crucial for mounting effective outbreak control strategies. The group added that it helped support Tanzania in its response by training more than 1,000 frontline health workers and delivering essential medical supplies and equipment.

Source still under investigation

Regarding the 100% case fatality rate, the WHO said in a separate overview that the high level was concerning but had been seen in earlier outbreaks. It added that the eight probable cases are a sign of late health seeking behavior, which increases the risk of further transmission. 

So far, the source of the outbreak still isn’t known, and the risk of re-emergence from a new spillover from the animal reservoir remains, the WHO said.

The WHO said all of the cases were from the Biharamulo district of Kagera region and that the eight probable cases were people who died before the outbreak was confirmed. Patient ages ranges from 1 to 75 years old and seven were female. 

Marburg virus, a member of the same family as Ebola virus, is highly transmissible through infected body fluids and can cause severe hemorrhagic disease. Earlier outbreaks and sporadic cases have been reported by nine African countries.

Vermont reports measles case; Europe warns of highest case count in 25 years

News brief
measles on boy
CDC / Tatiana Lanzieri, MD, MPH

The Vermont Department of Health has said a school-aged child in Lamoille County is confirmed to have measles, the first case in 2025. 

“The child became sick after returning with their family from traveling internationally in recent days,” the department said in a statement. “The risk to the public is believed to be low, as the child has been isolated from most community settings while they have been contagious. Investigation is ongoing.”

While the United States is currently reporting large outbreaks of measles in West Texas and surrounding areas, Europe is also seeing surging case counts. A new analysis from the World Health Organization (WHO) and UNICEF found that 2024 had the highest measles case count since 1997.

Highest measles case count in Europe since 1997

Last year, European countries reported 127,350 measles cases, with children under the age of 5 accounting for 40% of cases. More than half of the reported cases required hospitalization, the WHO said. 

Measles is back, and it’s a wake-up call.

“Measles is back, and it’s a wake-up call. Without high vaccination rates, there is no health security. As we shape our new regional health strategy for Europe and central Asia, we cannot afford to lose ground. Every country must step up efforts to reach under-vaccinated communities,” said Hans Henri P. Kluge, MD, the WHO Regional Director for Europe. “The measles virus never rests—neither can we.” 

In 2016, the European region reported only 4,440 cases. But as pandemic-era disruptions dropped vaccine rates, the virus has resurged, the WHO said. 

Romania, where less than 80% of eligible kids have been vaccinated against measles, has the highest count of 30,692 cases.


 

Australian study highlights safety, efficacy of fecal microbiota transplants for C diff

News brief
Fecal microbiota transplantation
TopMicrobialStock / iStock

A real-world study of patients with Clostridioides difficile infection (CDI) in Australia over 10 years shows that fecal microbiota transplantation (FMT) manufactured from the stool of screened donors is safe and effective, researchers reported today in Open Forum Infectious Diseases.

The study, led by researchers at the University of Adelaide in South Australia, evaluated data on FMT donor screening and outcomes in CDI patients who underwent FMT from 2013—when the procedure first became available in Australia—to 2023. 

While FMT has demonstrated success as a treatment for recurrent CDI in multiple randomized controlled trials and is recommended in treatment guidelines from several medical societies, the researchers wanted to assess the FMT screening process and the safety and efficacy of the procedure in patients with recurrent, refractory (unresponsive to antibiotics), and/or severe or fulminant (quickly escalating) CDI in real-world settings.

84% of FMT recipients achieved primary cure

Of the 98 donors who had stool screened, 32 (33%) failed, 5 (5%) had incomplete screening, and 61 (62%) passed their initial screening. Detection of an extended-spectrum beta-lactamase–producing organisms, which can be resistant to multiple classes of antibiotics and have been linked to the death of an FMT patient in the United States in 2019, occurred in 9 (14%) donors and was the most common reason for screening failure.

Of the 220 CDI cases managed with FMT over the study period, 90-day follow-up information was available for 216. Overall, primary cure (no relapse within 90 days) occurred in 84% of cases (182/216), including 88% (132/150) for recurrent, 76% (50/66) for refractory, 85% (51/60) for severe, and 65% (17/26) for fulminant CDI. In 33 patients who did not achieve primary cure, repeat FMT was delivered in 23 (70%), with secondary cure achieved in 17 (74%).

Serious adverse events occurred in six patients overall, with no deaths directly attributable to CDI.

The study authors say the findings are consistent with data from randomized controlled trials. But they add that further studies are needed to optimize the use of FMT for severe or fulminant CDI.

Cow elk is first CWD case in Wyoming Elk Hunt Area 93, first infected elk on Black Butte Feedground

News brief
Cow elk
David Minty / Flickr cc

An adult cow elk in the Pinedale region of northwest Wyoming is the first documented case of chronic wasting disease (CWD) in Elk Hunt Area 93 and the first case of an elk with the fatal neurologic disease on the Black Butte Feedground, the Wyoming Game and Fish Department (WGFD) said in a news release this week. 

Elk Hunt Area 93 is bordered by CWD-positive elk hunt areas 87 and 92. WGFD operates 21 feedgrounds in the Jackson and Pinedale regions, where it has supplied supplemental winter elk feed for over a century. 

The discovery of CWD on feedgrounds in 2025 has been anticipated as the disease has continued to spread across the state.

"The discovery of CWD on feedgrounds in 2025 has been anticipated as the disease has continued to spread across the state," the department said. "Game and Fish is actively working on Feedground Management Action Plans, a public process exploring short- and long-term strategies to reduce elk dependence on feedgrounds and minimize disease transmission risks." 

The plans, WGFD said, will align with the guidelines established during the development of the Wyoming Feedground Management Plan. 

CDC, WHO advise against eating the meat of CWD-positive cervids

Caused by infectious misfolded proteins called prions, CWD spreads among cervids such as deer, elk, and moose through direct contact or environmental contamination. No people have been diagnosed as having the disease, but the US Centers for Disease Control and Prevention and the World Health Organization caution against consuming meat from infected animals.

This week's top reads

Our underwriters