CIDRAP

VIP's review of evidence on Tdap vaccination during pregnancy reinforces longstanding evidence: ✅ Maternal Tdap vaccination helps prevent pertussis infection, serious complications in young infants. Read the full report: ow.ly/uJwF50YZ3ok 🧵 1/2

US begins enhanced airport screening as the race to contain Ebola outbreak continues. All travel restrictions are in place for 30 days. Read more: ow.ly/X0MB50Z2X92 📷: USAID / Flickr cc

Avian flu hits 4 US poultry farms and a polar bear on Norway island. This is the first detection of avian flu in polar bears in Europe. Read more: ow.ly/YWYs50Z2VEe 📷: Anita Ritenour/Flickr CC

Sexually transmitted infections are reaching record highs in Europe New surveillance data show cases of gonorrhea, syphilis, and congenital syphilis have reached their highest levels in over a decade. Read more: ow.ly/wSBN50Z2Va4

CWD digest: Penn State Deer Research Center quarantined after buck tests positive for chronic wasting disease (CWD) The college is assessing how research activities & educational programming will proceed during 5-year quarantine. ow.ly/7sSP50Z2UWS 📷: Lisa Zins/Flickr cc

New Osterholm Update podcast episode: Awareness vs. Alarm: Making Sense of the Headlines 🎧 Listen as @mtosterholm & co-host Chris Dall discuss: -Hantavirus -A recent Ebola outbreak -VIP’s review of evidence on Tdap vaccination during pregnancy Listen: ow.ly/GYlO50Z2Qq1

A retrospective cohort study suggests that myocarditis rates surged during COVID and stayed high. Rates rose roughly 80% above baseline during the pandemic and disproportionately affected Black patients. Read more: ow.ly/PGmR50Z2KO1

At least 600 Ebola cases suspected as US pledges to fund 50 treatment clinics The WHO estimates the case-fatality rate of Bundibugyo at around 40%. Read more: ow.ly/XGgk50Z2tal 📷: UNMEER / Simon Ruf, from Flickr cc

𝗣𝘂𝗯𝗹𝗶𝗰 𝗛𝗲𝗮𝗹𝘁𝗵 𝗔𝗹𝗲𝗿𝘁𝘀 𝗥𝗲𝗽𝗼𝗿𝘁: On April 27, 2026, a man (later classified as Patient 3 in the outbreak) was medically evacuated to Ascension Island from the Dutch-flagged expedition cruise ship 𝘔𝘝 𝘏𝘰𝘯𝘥𝘪𝘶𝘴; he had severe acute respiratory infection (SARI) and reported shortness of breath and fever that had begun on April 21. He had signs of pneumonia, although findings on chest radiography were unremarkable. While he was on Ascension Island, his condition worsened, and he was transferred to Johannesburg, South Africa, for ventilator support and intensive care. He was in shock and had acute respiratory distress syndrome; findings on chest radiography were consistent with atypical pneumonia. The differential diagnosis in this clinical context is very broad and includes atypical pneumonias, bacterial or fungal sepsis, and vectorborne diseases such as malaria or dengue. The diagnostic evaluation, including respiratory pathogen panels, malaria smear and antigen, fungal biomarkers, blood cultures, and legionella urinary antigen, was unrevealing. On May 2, the cruise ship had a total of 147 persons on board, including 88 passengers and 59 crew members, from 23 countries. As of May 13, 2026, a total of 10 cases had been identified (an 11th was subsequently reclassified as not a case), including 3 resulting in death (seen in figure). However, because not everyone on board was tested, 3 deaths among 10 cases may represent an overestimation of the case fatality ratio. All cases to date have been among passengers or crew on board the ship. Beyond the first 3 cases, 7 additional confirmed or probable cases have been identified. A German national (Patient 4) died from a SARI on May 2, and later testing in the Netherlands confirmed Andes virus (ANDV). Two crew members — the doctor on the ship (Patient 5) and an expedition guide (Patient 6) — were medically evacuated to the Netherlands, tested positive by PCR and sequencing for ANDV on May 7 and 8, respectively, and were in stable condition at the time of this report. Read “Andes Hantavirus Outbreak on a Cruise Ship, 2026,” which includes clinical details, case timeline, genetic sequencing of the virus, and unresolved transmission questions, by the Andes Virus Outbreak Working Group: nej.md/4uQDeMQ

New Public Health Alert: Andes Hantavirus Outbreak on a Cruise Ship, 2026 This report provides detailed info on 10 of the 11 cases of Andes hantavirus infection on passengers of the MV Hondius cruise ship. Full alert from @NEJMEvidence, @NEJM, & CIDRAP: ow.ly/YZbp50Z2sPw

Trial findings indicate that rapid diagnostic tests aren’t a ‘silver bullet’ for unnecessary antibiotics. In a clinical trial in England, use of rapid, point-of-care tests failed to reduce antibiotic prescribing for respiratory infections. Read more: ow.ly/LwqN50Z2rWq

Malaria reintroduction into US is possible: CDC report A 2023 outbreak of locally acquired cases infected 10 people across 4 states. Read more: ow.ly/4PTO50Z2rNk

"Maternal Tdap vaccination helps protect infants from whooping cough during the first months of life, which is the period when babies are at highest risk of severe illness but are still too young to get vaccinated." -Elise Holmes, Program Manager at CIDRAP ow.ly/uJwF50YZ3ok

Quick takes: -Lawsuit over grad-student loan limits -Report on COVID vaccines, child deaths -Temporary surgeon general appointment Read more: ow.ly/Pl1r50Z2oQg.

Analysis of past Ebola outbreaks suggests 54% death rate & identifies hemorrhage as key risk factor. The current DRC outbreak is caused by the Bundibugyo Ebola strain, which was not the causative lineage in the analysis. ow.ly/VsCU50Z2nLI 📷: USAID/Flickr cc

American cruise ship passengers push for home quarantine after hantavirus exposure. Read more: ow.ly/M7e350Z2n70

Chris Dall, co-host of the Osterholm Update podcast, shares a sneak peek 👀 of this week's episode. Chris & @mtosterholm will discuss: -Hantavirus -Ebola -VIP's review of evidence on Tdap vaccination during pregnancy & more! 🎧 Episode 209 posts 5/21. ow.ly/1WPU50YVgIo

Study: Flu vaccination rates among older adults are strongly associated with prior-year vaccination status, frequent primary care visits, and a spouse’s vaccination status. 💉 Read more: ow.ly/V1ZJ50Z2bwp

WHO rep: ‘Significant uncertainty’ about how far Ebola has spread. There are at least 500 suspected cases, including 130 deaths, so far in the outbreak. Read more: ow.ly/4A5z50Z1S22 📷: World Bank/Vincent Tremeau/Flickr cc

Quick takes: -Canada hantavirus case confirmed -ACIP charter withdrawn -HHS antibiotic resistance meeting Read more: ow.ly/khbN50Z1PL1.

CIDRAP Op-Ed: RSV—the middle child of respiratory season who deserves more attention. The RSV vaccine is different. It does not have a reputation problem or a trust problem. It has an awareness problem. Read full Op-Ed by @unbiasedscipod's Jess Steier: ow.ly/V23350Z1Pog