Microregistrar Infection Newsletter · Sunday 25 October 2026
Avian influenza season gets going in north-west Europe: Denmark culls 40,000 turkeys after its first HPAI outbreak of the season, following England’s first commercial H5N1 case near Belford; the Washington human H5N1 case is reported as dairy genotype B3.13.
Denmark’s Veterinary and Food Administration (Fødevarestyrelsen) confirmed highly pathogenic avian influenza in a flock of about 40,000 turkeys at Bøgelunde, Slagelse Municipality, on 23 Oct, with Statens Serum Institut confirming the result. It is Denmark’s first poultry outbreak since April. The birds were to be culled on Saturday 24 Oct, and 3 km protection and 10 km surveillance zones are in force. The agency links the timing to autumn migration and recent HPAI finds in wild birds, but has kept its wild-bird threat level at “medium”.
In Great Britain, APHA’s situation page lists two HPAI poultry outbreaks so far in the 2026/27 season: H5N5 in backyard poultry at Ness, Isle of Lewis (2 Oct), and H5N1 in commercial poultry near Belford, Northumberland (19 Oct, England’s first), with zones declared and the flock culled. Last season there were 100 HPAI cases in the UK. In the US, GISAID data reported on Avian Flu Diary place the mild Washington State human case (a dairy worker in Yakima, detected 12 Oct) in the B3.13 dairy lineage, as Washington’s infected dairy herds rise to nine.
Check before quoting: the B3.13 genotype and the herd count come from a blog that cites GISAID and USDA; we didn’t check them against CDC or USDA. The Danish figures are from the agency’s press release (23 Oct). We didn’t find a new UKHSA human-health statement in the window.
Counted from today’s digest. The four journal items are three from OFID and one NEJM clinical image. Links are unique content links across the issue, not counting our two website links. The GB figure is from APHA’s situation page (one H5N5 in Scotland, one H5N1 in England). Gaps are the items in the Coverage gaps list; reports that simply haven’t been published yet (it’s a Sunday) are listed separately.
Also today
The other headlines from today’s issue. Each card links to its source and to the full summary. It’s a weekend issue: UKHSA, MHRA, WHO and ECDC published nothing in the window, so this is mainly a Sunday round-up of the week on X.
World Polio Day: African detections down 33% since 2024
But cVDPV1 and cVDPV3 detections are rising; 133 of the 183 latest detections were cVDPV2. Five type 2 outbreaks were closed earlier this year.
WHO AFRO confirms 9 cases in one cluster, 7 in care
WHO AFRO repeats MoH: no evidence of community transmission. CDC now has a Level 1 travel notice for Kenya.
US measles cases reach 4,588
More than twice last year’s total; Pennsylvania accounts for nearly 30% (CIDRAP, 23 Oct).
IPEA founding documents published
The Quadripartite has published the founding documents of the Independent Panel on Evidence for Action against AMR, ahead of its expected launch in Abuja.
Dolutegravir-based first-line ART and incident hypertension
In a Spanish cohort of 1,134 people, INSTI-based ART carried a higher hypertension risk than NNRTIs (aHR 1.61).
B 6 whooping cough consultation closes tomorrow
RCPath still lists UK SMI B 6 (Investigation of whooping cough) as open until Monday 26 Oct.
What we could not confirm
The Washington B3.13 genotype and herd count are blog-reported, and we didn’t check them against CDC or USDA. We found no new UKHSA human-health risk statement on the Belford outbreak. The CIDRAP measles article and RSS feed didn’t load, so the US figure is headline only. CDC HAN and measles pages were blocked, and ECDC’s week 43 CDTR still isn’t on the archive. Two journal items are title-only.
Microregistrar Moodle update
No new entries. We read the Microregistrar moodlecloud sheet (Index tab, “Whats new?”) directly at about 07:52 GMT. The latest entries are still the two dated 23 Oct, both reported in yesterday’s issue.
Interactive HYN – Anthrax
Still the most recent entry, alongside PVL. Nothing has been added since. Moodle ›
Interactive HYN – PVL Staph aureus
Reported on 24 Oct; no newer row in the sheet. Sheet ›
The full list is in the Microregistrar moodlecloud sheet ›
Watched pages
We check nine pages every morning for anything new, compared with what we saw last time (checked 25 Oct 2026 ~07:50 GMT). All nine were reached today, and none has anything new, as you’d expect on a weekend.
UK SMI News (RCPath)
No changeConsultations still list only B 6, Investigation of whooping cough (open 12–26 Oct), so it closes tomorrow, Monday 26 Oct. Consultations ›
RCPath Examinations
No changeThe page still says autumn 2026 FRCPath, Certificate and Diploma applications are closed. Examinations ›
Green Book
No changeNo chapter updated in the window; the last change was the hepatitis A chapter on 22 Oct. Hepatitis A chapter ›
UKHSA organisation page (GOV.UK)
No changeThe newest UKHSA item is still the flu antiviral update (23 Oct), covered earlier in the week. UKHSA ›
NICE published guidance
No changeThe listing loaded; the newest items are still the 23 Oct non-infection updates. NICE published ›
Journal of Antimicrobial Chemotherapy
No changeNo new items in the Crossref sweep (online 24–25 Oct). JAC advance articles ›
Agencies & guidance
No UKHSA, MHRA, DHSC, WHO DON or ECDC items were published in the window. Today’s agency content is the start of the avian influenza season in Europe (APHA and the Danish authority), WHO AFRO’s World Polio Day data, Ebola updates from official accounts, and a new CDC Kenya travel notice.
Guidance changes
No UKHSA, MHRA or Green Book guidance change since Friday afternoon
The last infection guidance change was UKHSA’s influenza antiviral update (23 Oct), covered earlier in the week. MHRA’s newest items are two non-infection approvals (23 Oct), and there’s no new drug or device alert relevant to infection.
UKHSA / MHRA / England
Bird flu in Great Britain: H5N1 near Belford (England’s first) and H5N5 on Lewis
- 19 Oct: HPAI H5N1 confirmed in commercial poultry near Belford, North Northumberland (AIV 2026/21). 3 km protection and 10 km surveillance zones are in place, and all poultry on the premises are being culled.
- 2 Oct: HPAI H5N5 in backyard poultry at Ness, Isle of Lewis (AIV 2026/20), the first outbreak of the season. GB lost its HPAI-free status.
- 21 Oct: the risk of poultry exposure is assessed as low where biosecurity is suboptimal and very low where it is stringent (high uncertainty for both). Last season there were 100 UK HPAI cases.
Action: ask about poultry and wild-bird exposure in people with respiratory illness or conjunctivitis, especially farm and cull workers near Belford. Follow UKHSA’s avian influenza guidance on testing and antiviral prophylaxis for exposed people.
Press reports (Farmers Guardian) say last season’s 100 cases included 79 in England. We didn’t see a flock size from APHA, and we found no UKHSA human-health statement on this outbreak.
APHA latest situation › · Control zone dates › · UKHSA avian flu guidance ›
GOV.UK health protection weekly update (24 Oct)
This is the only infection email in the window. It is a digest of 19–23 Oct GOV.UK health protection changes, all covered in earlier issues (including flu antivirals, HCID country risk and the hepatitis A Green Book chapter). Nothing in it is new.
Measles and flu/COVID data unchanged
Measles is still at the 15 Oct update (next due 12 Nov). The latest flu/COVID-19 report (22 Oct) gave flu positivity at 6.3% and hospital COVID-19 PCR positivity at 8.9%, with RSV at baseline. The next report is due Thursday 29 Oct.
ECDC / Europe
Denmark: first HPAI poultry outbreak of the season, in 40,000 turkeys
- Confirmed by Statens Serum Institut in a turkey flock of about 40,000 at Bøgelunde, Slagelse. It is the first outbreak in Danish poultry since April, and the birds were to be culled on Saturday 24 Oct.
- A 3 km protection zone and 10 km surveillance zone apply around the farm.
- The wild-bird threat level stays at medium (assessment of 4 May)., although HPAI has been found in several wild birds in recent weeks.
ECDC published nothing new in the window. Its last items were the Kenya/Nigeria Ebola threat brief (23 Oct) and the first human Shamonda virus infection in France (22 Oct). The week 43 CDTR still isn’t on the archive; the latest there is week 42.
Fødevarestyrelsen (Danish) › · Danish situation page › · ECDC CDTR ›
Global
Polio in Africa: detections down 33% since 2024, but cVDPV1 and cVDPV3 are rising
- WHO AFRO (Jan–Sep 2026): more than 168 million children vaccinated in 55 campaigns. Detections fell 33% between 2024 and 2026, with 31 of 47 countries reporting fewer. Of the 183 latest detections, 133 were cVDPV2; recent increases in cVDPV1 and cVDPV3 are a concern.
- Outbreak closures: Burundi, Ghana, Guinea-Bissau, the Republic of the Congo and Uganda closed cVDPV2 outbreaks. These were announced on 19 Aug and highlighted again for World Polio Day (Africa CDC, 24 Oct).
- Reimportation: the Regional Director’s message cites a new poliovirus type 1 detection in Madagascar after it closed an earlier outbreak in 2025.
The five closures aren’t new (August). The 33% figure is regional detections, not cases.
WHO AFRO leaflet › · Closures (19 Aug) › · RD message › · @WHOAFRO ›
Kenya: nine cases in one cluster, seven in care; Nigeria trains contact tracers in Abuja
- Kenya: WHO AFRO (24 Oct, 17:50 BST) repeated the MoH position: seven patients in care, and all nine confirmed cases linked to a single cluster of known contacts with no evidence of community transmission. MoH is running anti-stigma messaging on contact tracing and promoting its 719 / *719# line. No new case count was published in the window.
- Nigeria: NCDC still reports one confirmed case. It convened a national IPC alumni network (“500+ IPC alumni”) for facility IPC and early reporting, and published Ebola FAQs (toll-free line 6232). Africa CDC says FCT health workers from Abuja’s area councils have been trained in contact tracing.
- DRC: WHO has supplied 25 motorbikes, 7 tricycles and 30 vests for surveillance in seven health areas of Haut-Uélé, including mining sites. There’s been no new WHO DON since DON622 (23 Oct).
@WHOAFRO (Kenya) › · @MOH_Kenya › · @NCDCgov › · @AfricaCDC › · @WHOAFRO (Haut-Uélé) › · WHO DON622 ›
WHO
Oral cholera vaccine supply: one manufacturer, about 93% of stockpile doses
Dr Tedros (23 Oct) visited EuBiologics in Korea, which he says supplies about 93% of doses to the global stockpile. Global OCV production more than doubled from 30 million to 80 million doses a year between 2022 and 2025.
No new Disease Outbreak News in the window
The latest is still DON622 (Ebola, 23 Oct).
CDC / US
Level 1 notice: Ebola Bundibugyo in Kenya
“Practice usual precautions.” The notice says Kenya’s MoH has confirmed an imported case and linked cases in Nairobi. It wasn’t on the list we checked yesterday. There’s still no Nigeria notice. The DRC Level 4/Level 3 and DRC–Uganda Level 2 Ebola notices are still listed.
The page didn’t show a posting date in our fetch.
Washington human case is B3.13; WA dairy herds at nine
Avian Flu Diary (24 Oct) reports that GISAID lists the Washington human case (a dairy worker, detected 12 Oct, mild) as B3.13. It clusters with Idaho and Utah samples carrying an NA mutation the blog associates with mild drug resistance. Infected Washington herds have reached 9, with Texas reporting 4 and Kansas 1 in 30 days (USDA, as cited).
Blog-reported; we didn’t check it against CDC or USDA. The clinical relevance of the NA change hasn’t been established.
HAN and measles pages still blocked; no new EID ahead-of-print items
The HAN archive returned an error page again. CDC’s measles count couldn’t be checked directly; CIDRAP reports 4,588 US cases (see On X). EID’s newest early-release items are the 22–23 Oct articles we covered earlier in the week. The CDC 2026 AR Threats Report is trailed for “next week” by a post from 20 Oct.
Journals
New since the 24 Oct issue (online 24–25 Oct), from a Crossref sweep of the 19 watched titles. Only OFID and NEJM had new infection items; the OFID linezolid syphilis pilot was covered yesterday. JAMA’s two items weren’t infection-related.
Open Forum Infectious Diseases
First-line ART and incident hypertension: Spanish cohort
1,134 adults starting first-line ART; 18.1% developed hypertension (4.9/100 person-years). INSTI-based ART carried a higher risk than NNRTI-based ART (aHR 1.61, 95% CI 1.20–2.17). Within the INSTI group, 5-year cumulative hypertension ranged from 9% with EVG/c/FTC/TAF to 37% with dolutegravir-based regimens, more than double the adjusted hazard.
Takeaway: monitor blood pressure after starting dolutegravir. The study is observational and residual confounding is likely.
Long-acting cabotegravir–rilpivirine as a catalyst for opioid use disorder treatment
A retrospective single-site cohort of 40 people with HIV and substance use disorder. Viral suppression rose from 73% to 98%, and MOUD use from 32.4% to 78.4% at 6 months and 89.2% at study end; reported opioid use fell from 81.1% to 48.6%.
Small, uncontrolled and single-site. The percentages imply a denominator of 37, not 40, and the abstract doesn’t explain why.
Prevotella species in incident bacterial vaginosis: a longitudinal PNA-FISH study
Title only (no abstract in Crossref).
New England Journal of Medicine
Thelaziasis
An Images in Clinical Medicine piece on the ocular eyeworm infection. Title only. Worth knowing as a cause of conjunctivitis with a foreign-body sensation in travellers.
On X
The Sunday heavy check: seven searches and one post lookup covering ID, AMR, IPC and outbreaks over the past week (18 Oct 08:00 to 25 Oct ~07:55 GMT). Each item links to the post we read. Official accounts are cross-checked in Agencies where possible.
Avian influenza: Farmers Guardian on England’s first commercial case near Belford, with 3/10 km zones and a cull (21 Oct). Farmers Guardian › FluTrackers on Denmark’s first outbreak of the season in Slagelse turkeys (24 Oct). FluTrackers › A virologist’s post that the Washington human case is B3.13. @Nucleocapsoid › The Hindu Chennai reported H5N1 at Vandalur zoo (21–22 Oct; not verified). The Hindu ›
Measles: CIDRAP reports 4,588 US cases this year, more than twice last year’s total, with Pennsylvania nearly 30% (23 Oct). CIDRAP › CIDRAP quick takes also covered an Ebola spread warning, a malaria vaccine price cut and polio in six nations. CIDRAP quick takes ›
Polio: WHO AFRO’s World Polio Day data (168M+ children vaccinated; detections down 33%; types 1 and 3 rising). @WHOAFRO › Africa CDC on the five closed type 2 outbreaks. @AfricaCDC › PAHO says the Americas mark 35 years without wild poliovirus, but coverage is below the 95% target. @pahowho › Dr Tedros’s World Polio Day message. @DrTedros ›
Ebola: Dr Tedros on the TUMAINI Ebola vaccine trial (23 Oct; the post spells Ervebo as “Everbo”). @DrTedros › Kenya MoH: contact tracing isn’t a punishment (25 Oct, anti-stigma message). @MOH_Kenya › NCDC Ebola FAQs. @NCDCgov ›
AMR: The Quadripartite has published IPEA founding documents, with information sessions on 27 and 29 Oct (12:00–13:30 CET) ahead of the launch at the 5th Ministerial Conference on AMR in Abuja. @GLGAMR › NCTC has five new UKHSA-PACE AMR panels of 145 contemporary Gram-negative isolates for research. @NCTC_3000 › The CDC 2026 AR Threats Report is trailed for this coming week (secondary account). @ABsteward ›
Arboviruses / fungi / mpox: PAHO data shared on X: dengue down 58% in the Americas, while chikungunya is resurging (secondary account). Post › Goiás, Brazil reports 11,309 chikungunya cases this year, up 343% (unverified). Post › Las Vegas reports its first clade I mpox case (20 Oct; local account, not verified). Post › US Fox affiliates are still sharing the C. auris antifungal-survival press story. FOX 5 NY ›
UK / IPC: UKHSA’s weekly flu (6.3%) and COVID-19 (8.9% hospital PCR positivity) graphs, with RSV at baseline (22 Oct). @UKHSA › RCPath: the IPD2026 poster deadline is 27 Oct @RCPath ›, and Pathology Week webinars (including microbiology) run 2–30 Nov. @RCPath › MHRA: CE-marked devices will be recognised in GB indefinitely (21 Oct). @MHRAgovuk ›
Unverified: the Vandalur zoo H5N1, Goiás chikungunya, Las Vegas clade I mpox and B3.13 posts weren’t checked against primary sources. We retrieved no ECDC, Eurosurveillance or CDC posts in the window.
What we could not confirm
We want you to know exactly where today’s issue has limits, so here are the 8 gaps we couldn’t close, plus the reports that simply weren’t out yet. It’s a Sunday, so most agencies won’t publish until Monday.
| Source | Issue |
|---|---|
| US H5N1 | The Washington B3.13 genotype, the NA mutation and the herd counts come from Avian Flu Diary, which cites GISAID and USDA. We didn’t check them against CDC or USDA. |
| UK avian flu | We found no UKHSA human-health risk statement or exposure follow-up figures for the Belford outbreak, and APHA gives no flock size. Last season’s England figure (79) is press-reported. |
| US measles | The CIDRAP article and RSS feed didn’t load (feed returned a not-found page), so 4,588 is from CIDRAP’s post only. CDC’s measles page wasn’t checked. |
| CDC | The HAN archive returned an error page. The posting date of the new Kenya Level 1 notice wasn’t visible. |
| ECDC | The week 43 CDTR still isn’t on the archive (latest week 42). |
| Kenya / Nigeria | No updated case or contact counts were published in the window; the figures are as of 23–24 Oct official posts. |
| Journals | Crossref sweep only, and indexing can lag. The OFID Prevotella study and the NEJM thelaziasis image are title-only. The OFID LA-ART percentages imply n=37, not 40 (flagged). |
| X | Several posts (Vandalur zoo, Goiás, Las Vegas mpox, B3.13) are unverified. Search results lean towards US and Indian accounts. |
Not out yet
- Weekend: UKHSA, MHRA, NICE, RCPath and ECDC don’t normally publish at weekends. Expect the next releases on Monday 26 Oct.
- RCPath: the UK SMI B 6 (whooping cough) consultation closes Monday 26 Oct.
- ECDC: CDTR week 43 (overdue) and week 44 (Friday 30 Oct).
- WHO: the revised Ebola rapid risk assessment; the next DON and AFRO situation report.
- UKHSA: flu/COVID-19 surveillance (Thursday 29 Oct); measles (12 Nov).
- CDC: 2026 AR Threats Report (trailed for this week); MMWR (Thursday 29 Oct).
- AMR: IPEA information sessions on 27 and 29 Oct; Africa CDC ministerial Ebola meeting on 28 Oct.
Sources
What we checked for this issue. Every link in the issue was retrieved and checked during this run.
- Watched pages (9 of 9 checked, 25 Oct ~07:50 GMT)
- Microregistrar moodlecloud Google Sheet (Index tab), read directly through the Sheets connector
- UKHSA, MHRA and DHSC on GOV.UK (search API); Green Book, HCID country risk, Health Protection Report and measles (content API); APHA bird flu situation page and control zone dates
- RCPath UK SMI consultations, UK SMI and Examinations pages; NICE published guidance
- Mail (microregistrar2021@gmail.com, read only): one in-window infection email (GOV.UK health protection weekly update, 24 Oct), filed under UKHSA. No Mail Sorter forwards found
- ECDC: news feed, CDTR archive; Denmark: Fødevarestyrelsen press release and situation page
- WHO Disease Outbreak News (API); WHO AFRO polio leaflet, news release and Regional Director’s message
- CDC: travel notices (Kenya Level 1 new), HAN (error), EID early release; Avian Flu Diary (secondary)
- Journal sweep (Crossref, online 24–25 Oct): Lancet Infect Dis, Lancet Microbe, NEJM, JAMA, CID, JID, OFID, IJID, ICHE, AJIC, JAC, JAC-AMR, J Hosp Infect, J Infect, CMI, ARIC, AAC, JCM, Eurosurveillance
- X (Sunday heavy check): seven searches plus one post lookup over 18–25 Oct, covering agency, journalist, avian influenza, polio, measles, mpox, AMR, arbovirus and fungal topics; 30 posts cited. Live microregistrar.com/newsletter/ checked (24 Oct issue is the current baseline)