Spain reports first known human-to-human mpox clade 1b transmission outside Africa

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Health officials in Spain have documented what appears to be the first case of human-to-human transmission of mpox clade 1b outside of endemic regions in Africa without any known travel link.

The report, published in the International Journal of Infectious Diseases, describes a 49-year-old man who presented to a Madrid clinic in October 10, 2025, with a single genital ulcer and swollen, painful lymph nodes in his groin area. 

The patient, who had previously received two doses of the Imvanex smallpox/mpox vaccine (known as Jynneos in the United States), had not traveled abroad. He reported sexual contact with two local partners, neither of whom had traveled to endemic regions. 

Polymerase chain reaction (PCR) testing of the lesion confirmed an infection with mpox clade 1b, a highly transmissible strain that emerged during an outbreak in the Democratic Republic of the Congo in 2023. In August 2024, the World Health Organization (WHO) declared mpox a Public Health Emergency of International Concern (PHEIC) because of the risk of international spread. 

Previous cases in Europe tied to endemic regions

After Spanish authorities reported the case, investigations in Europe and the United States identified additional cases not associated with travel to endemic regions. The WHO lifted the PHEIC designation in September 2025 after cases declined in affected countries, but the newly identified infection highlights the need to be alert to possible human-to-human transmission in non-endemic regions.

Several countries in Africa have sustained human-to-human transmission of mpox clade 1b. The first case reported outside of Africa was in a Swedish national who traveled to an endemic African region. Cases have been detected in countries outside of Africa since then, though almost all have been in people who recently traveled to endemic African countries or who had contact with others who had traveled to those regions. 

To help prevent mpox spread and ensure an effective publish health response, the authors recommend control measures when a case is detected, clade-specific testing in all confirmed cases, vaccination of individuals at higher risk of exposure (particularly men who have sex with men), and coordination with scientific societies and community organizations.

WHO expert panel reaffirms no link between vaccines and autism

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new analysis released today by the World Health Organization’s (WHO’s) Global Advisory Committee on Vaccine Safety (GACVS) suggests that, based on the available evidence, there is no causal association between vaccines and autism spectrum disorders (ASD), reaffirming decades of evidence supporting the safety of childhood immunizations.

GACVS, an independent panel of international experts established in 1999, reviewed the findings during its November 27 meeting. The committee examined two claims: that thiomersal-containing vaccines are associated with an increased risk of ASD and that vaccines in general contribute to autism diagnoses.

The review drew on 31 primary research studies published from 2010 to August 2025 and including data from multiple countries. Across the studies, the committee found consistent evidence of vaccine safety in childhood and pregnancy and no evidence of a causal link with ASD.

No tie between aluminum adjuvants and autism

GACVS also evaluated the safety of vaccines containing aluminum adjuvants, which are used to enhance immune response. The review looked at studies conducted from 1999 through 2023, as well as a recent large-scale cohort study that used nationwide data from Denmark on children born from 1997 to 2018. The committee found no association between the trace amounts of aluminum in some vaccines and ASD.

Global childhood immunization efforts represent one of the greatest achievements in improving lives, livelihoods and the prosperity of societies.

The findings reaffirm previous GACVS conclusions issued in 2002, 2004, and 2012, all of which found no evidence linking the preservative thimerosal or aluminum in vaccines to autism.

The WHO urged national health authorities to align immunization policies with the latest scientific evidence, noting the profound global impact of vaccines. Over the past 50 years, childhood immunization programs have saved an estimated 154 million lives.

“Global childhood immunization efforts represent one of the greatest achievements in improving lives, livelihoods and the prosperity of societies,” noted the WHO in a statement about the analysis. 

Quick takes: Measles reappears in Connecticut, more infant botulism, avian flu in Florida birds

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  • Connecticut has reported its first measles case since 2021. Media reports say the case is in an unvaccinated child from Fairfield County who had symptoms after traveling internationally.
  • The Centers for Disease Control and Prevention (CDC) said there are now 51 cases of infant botulism tied to ByHeart powder formula in 19 states—12 new cases, but 10 of those are backdated after California officials discovered 10 cases in sick infants from December 2023 to July 2025. All infants have required hospitalization, but no deaths have been reported. In a press release yesterday, the CDC said this is the first ever outbreak of infant botulism in the United States. “While we typically expect to see 150-180 individual cases of infant botulism annually, an outbreak of infant botulism is unprecedented,” says Jennifer Cope, MD, MPH, chief of the CDC’s enteric diseases epidemiology branch.
  • Dozens of new detections of highly pathogenic avian influenza have been confirmed in Florida, mostly in hunter-harvested green-winged teal, according to the latest update from the US Department of Agriculture’s Animal and Plant Health Inspection Service (APHIS). St Johns County, Florida, has 46 detections in wild birds. Other hot spots include Lake County, Florida, and McIntosh County, Georgia, which each have dozens of detections in waterfowl. APHIS also noted two new positive avian flu tests in bobcats, one in Alpena County, Michigan, and the second in Marion County, Oregon. 

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