Guillain-Barré syndrome (GBS) is a leading cause of acquired acute neuromuscular paralysis and is an immune-mediated disorder of the peripheral nervous system (PNS). Accumulating evidence indi-cates that GBS is often preceded by infectious events that trigger autoimmune responses through mechanisms such as molecular mimicry and autoantibody production. Campylobacter jejuni remains the most common bacterial agent, but viral pathogens also contribute to the development of GBS. This review summarizes the current evidence regarding viruses as triggers of GBS, including herpes-viruses, hepatotropic viruses (A, B, C, and E), human immunodeficiency virus, Zika virus, influenza virus, varicella-zoster virus, and the coronavirus SARS-CoV-2. Emphasis is placed on laboratory test results related to viral GBS, including antiganglioside antibodies, serological markers of recent in-fection, molecular diagnostic methods, and cerebrospinal fluid analysis. From the standpoint of la-boratory medicine, both the clinical diagnosis and the distinction of GBS subtypes can be supported by the identification of recent viral infections and the detection of immunological biomarkers. How-ever, cross-reactivity, extended antibody persistence, and inadequate assay standardization frequently make it difficult to interpret laboratory test results. In patients with probable viral GBS, this review shows the diagnostic significance and limitations of routine laboratory testing. It also highlights the significance of close coordination between laboratory professionals and clinicians.

Highly pathogenic avian influenza A(H5N1) viruses circulate globally in wild birds, causing poultry outbreaks and spillover infections in mammals and sporadic human infections. Recent detections in domestic cats highlight occupational risks for veterinarians handling cats in areas where A(H5N1) virus is circulating. Although the potential risk for cat-to-human A(H5N1) virus-transmission is currently low, vigilance is warranted. Veterinarians can use published recommendations to evaluate exposure risks, implement infection control practices, use recommended personal protective equipment, train staff, and coordinate with health officials. The One Health approach can help reduce risks of A(H5N1) virus infection to veterinary staff, cat owners, and other animals.

The recent spread of clade 2.3.4.4b H5N1 high pathogenicity avian influenza (HPAI) viruses into mammals, despite limited human infections to date, has raised serious public health concerns and highlights the need for rapidly deployable vaccines, such as mRNA-based platforms, to strengthen pandemic preparedness. Here, we evaluated the effectiveness of an mRNA vaccine encoding the HA of NIID-002, a WHO-recommended H5 candidate vaccine virus (CVV) derived from A/Ezo red fox/Hokkaido/1/2022 (clade 2.3.4.4b) against A/Texas/37/2024 (TX37; clade 2.3.4.4b) and A/Cambodia/2311257/2023 (Cam23; clade 2.3.2.1e). The mRNA was formulated with ssPalmO, a low-inflammatory self-degradable ionizable lipid nanoparticle (LNP). BALB/c mice were immunized intramuscularly twice with the mRNA-LNP vaccine containing either 1 μg or 10 μg of H5 HA mRNA. After boosting, strong, dose-dependent serum IgG responses against NIID-002 HA were detected by ELISA. The mice were then challenged with a lethal dose of homologous TX37 or heterologous Cam23. All mice in the 10-μg group survived both challenges, demonstrating robust cross-clade protection. In the 1-μg group, complete protection without significant body weight loss was observed against TX37, whereas partial protection was observed following Cam23 challenge. Viral titers were significantly reduced in multiple tissues of the vaccinated mice compared to the unvaccinated controls. Our findings demonstrate that the NIID-002-HA mRNA vaccine confers protection against homologous and heterologous zoonotic H5N1 strains in a mouse model. This low-inflammatory ssPalmO-LNP platform thus supports safe, rapid vaccine development against emerging H5N1 viruses with pandemic potential.

Nucleic acid amplification tests (NAATs), including PCR, are considered the gold standard for pathogen detection. Amplification is commonly detected by fluorescence from probes or intercalating dyes, with internally-quenched probes most widely used for enhanced specificity. However, these methods require elaborate instrumentation for fluorescence detection, limiting their usability at point-of-care. We found that the chemical excitation of fluorophores, as used in consumer glow sticks, can be used to detect PCR probe hydrolysis with minimal instrumentation using a smartphone or simple digital camera. By systematically optimizing reagent composition, including hydrogen peroxide, catalyst, viscosifier, and surfactant concentrations, we tuned the reaction kinetics to maximize signal intensity and stability for "Glow" readout. In spiked nasal-swab matrix, smartphone Glow readout detected reactions containing 50 Flu A copies/reaction and 10 SARS-CoV-2 copies/reaction in single-target assays; duplex detection was demonstrated at 500 copies/reaction per target. The assay is compatible with nasal swab extracts and demonstrated two-color duplex readout because the same peroxyoxalate chemistry can chemiexcite multiple fluorophores simultaneously. We establish a general chemiexcitation-based end-point readout architecture for fluorogenic nucleic acid assays, identify fluorophore properties associated with probe-compatible Glow performance in biphasic peroxyoxalate media, and show that this chemistry enables multiplexed post-amplification readout without optical excitation hardware. Peroxyoxalate chemiexcitation may provide a route toward lower-cost molecular diagnostic readout for low-resource settings.

The recombinant H3N8 avian influenza virus (AIV) continues to circulate among poultry in China, with sporadic human infections reported, posing a significant threat to both the poultry industry and public health. However, no commercial vaccine against H3N8 AIV is currently available. Our previous studies have showed that serotype 4 fowl adenovirus (FAdV-4) with the deletion of fiber-2 gene is highly attenuated and serves as an ideal vaccine vector for expressing foreign genes. In this study, a novel recombinant FAdV-4 carrying HA of H3N8 was generated by targeting fiber-2 through the CRISPR/Cas9 and Cre-LoxP systems, designed as FA4-CMV-H3. In vitro, studies demonstrated that FA4-CMV-H3 not only efficiently expressed the HA protein of H3N8 but also replicated efficiently in LMH cells stably expressing Fiber-2 protein of FAdV-4. Chicken studies showed that FA4-CMV-H3 is highly attenuated in vivo and induces high neutralizing antibodies against FAdV-4 and high HI titers against H3N8. Moreover, FA4-CMV-H3 could provide full protection against both H3N8 and FAdV-4 challenges. All these demonstrate that the generated recombinant virus FA4-CMV-H3 is a promising bivalent efficient vaccine candidate against both FAdV-4 and H3N8.

Post-Orgasmic Illness Syndrome (POIS) is a rare con-dition characterized by flu-like symptoms after ejacula-tion, lasting several days and impairing quality of life. A 62-year-old man developed POIS after percutaneous ep-ididymal sperm aspiration, with symptoms lasting seven days and worsening over six years. Multiple treatments offered minimal relief until combined therapy with tam-sulosin, ebastine, escitalopram, and montelukast achieved complete resolution and restored sexual function. Immune hypersensitivity to seminal or epididymal antigens is a leading hypothesis. The success of α-blockers, antihista-mines, and SSRIs highlights the interplay between im-mune, autonomic, and psychological mechanisms. POIS is a complex, underrecognized disorder. Multimodal therapy addressing both immune and neuropsychological pathways may yield optimal outcomes. Greater awareness and stan-dardized diagnostic and treatment criteria are needed to improve management and research.

Avian influenza viruses (AIVs) are zoonotic pathogens that pose an increasing global threat due to their potential for significant economic losses in agriculture, and the risk of a pandemic should human-to-human transmission occur. In light of this, we need rapid, sensitive, and specific tests to detect and differentiate circulating AIVs. Current AIV diagnostic methods require specialized laboratory equipment, limiting their use in the field and in low-resource settings. Here, we develop three CRISPR-based Streamlined Highlighting of Infections to Navigate Epidemics (SHINE) assays that address these limitations. We designed, optimized, and validated a SHINE assay for H5 AIV, achieving 100% specificity when tested on seasonal-influenza-positive clinical samples, and a limit of detection of 121.7 copies/μL. We also developed SHINE assays targeting the 2.3.4.4b A(H5N1) and Eurasian H7 lineages. Together, these SHINE assays offer a promising platform for AIV diagnosis and surveillance, particularly outside laboratory settings.

Antibody-producing plasmablasts (PB) and plasma cells (PC) are critical for humoral immunity, autoimmunity and vaccine responses. Despite the importance of environmental stressors in regulating humoral immune responses, the influence of pH on PB and PC differentiation remains elusive. Here, we identify SLC4A7/NBCn1, a Na[+]/HCO3[-] cotransporter, as a selective regulator of PB differentiation in vitro. SLC4A7 deletion also impairs the formation of antibody secreting cells (ASCs) and antibody responses in mice in vivo following immunization and influenza A virus infection. Mechanistically, SLC4A7 deletion results in intracellular acidification and lysosomal alkalinization, and is associated with impaired function of the mechanistic target of rapamycin complex 1 (mTORC1). Enforcing mTORC1 activation in SLC4A7-deficient B cells or B cells in which intracellular pH is acidified by blocking Na[+]/H[+] exchanger (NHE) function restores PB differentiation in vitro. Moreover, ASC differentiation and antibody responses are impaired under conditions of extracellular acidosis in vitro and in a mouse model of metabolic acidosis. Altogether, we identify a critical relationship between intracellular pH regulation through SLC4A7 and mTORC1-dependent ASC differentiation and humoral immunity.

Nonstructural protein 1 (NS1) is the key virulence factor of influenza A virus (IAV) that affects the replication and pathogenicity of IAV, which can be used as a promising anti-IAV target. Herein, we identify a marine derived NS1 inhibitor HDN2398 with broad-spectrum anti-IAV effects in different cell lines and female mice, superior to oseltamivir and baloxavir. HDN2398 attenuates the interferon antagonist function of NS1 by blocking NS1 dimerization and its binding to dsRNA. HDN2398 can block NS1 nucleolar localization, viral mRNA splicing and nuclear export through destroying the interaction between NS1 and nucleolin or NXF1. Phe9 and Trp187 may be required for the interaction between HDN2398 and NS1. In summary, our findings support the development of HDN2398 as a promising anti-IAV agent targeting NS1-host interaction.

Disease now-casting increasingly relies on non-traditional data, such as online activity, which offer fast, inexpensive insights but are often noisy, unstructured, and influenced by behavioral confounders. Models using search engine data have frequently suffered from overfitting and unstable performance. However, pandemics may help distinguish true disease signals from behavioral noise, as both tend to surge during outbreaks. We propose a hybrid approach to improve prediction that combines model evaluation with behavioral insight. We apply simple supervised and unsupervised methods to different flu and COVID-19 datasets, using the 2009 H1N1 and 2020 COVID-19 pandemics as training periods. In both cases, selecting a curated subset of search terms improved model performance, reduced overfitting, and increased stability, consistently outperforming models that used search terms indiscriminately. These results suggest that feature curation informed by behavioral insights can enhance now-casting beyond purely statistical approaches. Our method offers a scalable and adaptable framework for integrating digital epidemiology into public health surveillance.

Unannounced drills using professional patient actors (mystery patients) have been used to evaluate health care facility management of patients with infectious diseases of public health concern. Ongoing outbreaks and the expanding role of urgent care centers highlight the need to evaluate the ability of health care facilities to rapidly identify, isolate, and safely manage patients with transmissible diseases. During January-June 2026, 73 drills were conducted in three jurisdictions within U.S. Department of Health and Human Services Region 2 (New Jersey, New York, and the U.S. Virgin Islands) using a simulated avian influenza A(H5) scenario. During these drills, facilities conducted symptom screening in 68 (93%) drills and obtained travel history upon patient arrival in 58 (80%) drills. Among 60 (82%) drills during which the patient was appropriately masked, the median interval from arrival at the facility to masking was 2 minutes (IQR = 1.0-6.0 minutes) (target = 1 minute), and among 52 (71%) drills during which the patient was isolated, the median interval from arrival to isolation was 11 minutes (IQR = 8.0-19.2 minutes) (target = 10 minutes). Both masking and isolation occurred in 44 (60%) drills. The clinical team planned to notify infection prevention and control teams in 40 (54%) drills. The clinician wore all recommended personal protective equipment in 17 (25%) drills. These drills provided an opportunity for facilities to examine implementation of the principles of identification, isolation, and informing. Findings from these drills will help guide future public health interventions to improve readiness among regional health care facilities for emerging and reemerging infectious disease threats.