Journal of Infection and Public Health最新文献

{"title":"Modeling the emergence of divergent mutants of SARS-CoV-2, “Omicron-like events”: A time-to-event analysis","authors":"Haruka Hayashi,&nbsp;Yuta Okada,&nbsp;Taishi Kayano,&nbsp;Katsuma Hayashi,&nbsp;Tetsuro Kobayashi,&nbsp;Hiroshi Nishiura","doi":"10.1016/j.jiph.2026.103140","DOIUrl":"10.1016/j.jiph.2026.103140","url":null,"abstract":"<div><h3>Background</h3><div>During the COVID-19 pandemic, several divergent mutants including the Omicron (B.1.1.529) BA.1 variant emerged, having a distinct mechanism of emergence compared with pre-existing variants of concern. Apart from playing a major role in causing recurrent epidemic waves, the highly divergent mutants also contributed to changing the fate of the pandemic by exhibiting large differences in phenotypic characteristics among even closely related variants. Given that several different variants emerged during the pandemic, the present study aimed to quantitatively evaluate the risk of emergence of divergent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutants and understand the mechanism of such emergence.</div></div><div><h3>Methods</h3><div>Upon identifying the emergence of phylogenetically distinct variants in “Omicron-like events” that have been recognized to date, a time-to-event analysis was carried out to estimate the monthly hazard rate of emergence. Four statistical models were established and compared using the Akaike Information Criterion.</div></div><div><h3>Results</h3><div>The model using the number of hospitalized cases was determined to be the best fit. The risk of Omicron-like events is not independent of time; instead, the monthly risk of emergence is likely to increase over time due to an increasing number of infection events.</div></div><div><h3>Conclusions</h3><div>Ongoing virus genomic surveillance is vital, and possible prevention among immunosuppressed individuals should be considered.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103140"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"USING GLOBAL SEQUENCE DATABASES TO INFORM AND ACCELERATE ASSAY DEVELOPMENT OF RAPID TESTS FOR NEISSERIA GONORRHOEAE ANTIMICROBIAL RESISTANCE","authors":"Abdulrahman Ayfan ,&nbsp;Leah Roberts ,&nbsp;David Whiley","doi":"10.1016/j.jiph.2025.103100","DOIUrl":"10.1016/j.jiph.2025.103100","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103100"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing definitions of SARS-CoV-2 infection in a prospective household transmission study","authors":"Jonas Frost ,&nbsp;Bianca Klee ,&nbsp;Sophie Diexer ,&nbsp;Kristin Maria Meyer-Schlinkmann ,&nbsp;Cornelia Gottschick ,&nbsp;Jonas Rosendahl ,&nbsp;Michael Gekle ,&nbsp;Stefan Moritz ,&nbsp;Simone Hettmer ,&nbsp;Jessica I. Hoell ,&nbsp;Irene Moor ,&nbsp;Thomas Frese ,&nbsp;Mascha Binder ,&nbsp;Christine Dierks ,&nbsp;Rafael Mikolajczyk","doi":"10.1016/j.jiph.2025.103069","DOIUrl":"10.1016/j.jiph.2025.103069","url":null,"abstract":"<div><h3>Background</h3><div>Identifying SARS-CoV-2 infections in field studies, especially if they are asymptomatic or reinfections, is challenging. This study aims to compare definitions of an infection and establish an approach to detect reinfections serologically, relying on titre increase.</div></div><div><h3>Methods</h3><div>In a household transmission study in autumn/winter 2022, we collected information on symptoms and two serological samples in a timespan of six to eight weeks from 389 participants of the German digital cohort DigiHero. Blood samples were drawn using dried blood spot cards and analysed in regard to the SARS-CoV-2 S and N antibody. We calculated secondary attack rates (SARs) using three definitions of infection from previous literature, based on reported symptoms or seroconversion, and two approaches accounting for reinfection in serological testing.</div></div><div><h3>Results</h3><div>SARs differed substantially between definitions. High initial seroprevalence in the study population led to underestimation of the SAR by over 20 % when using seroconversion compared to approaches accounting for reinfections. Symptom-based definitions resulted in misclassification likely due to infections with other pathogens and by disregarding asymptomatic cases.</div></div><div><h3>Conclusions</h3><div>This methodological study shows that relying on seroconversion is not adequate in high sero-prevalence settings and symptom-based approaches disregard asymptomatic cases. Approaches accounting for substantial titre increases between two antibody measurements reliably identified infections regardless of seroconversion and symptoms in a longitudinal serological assessment. This method could be useful for other pathogens, where asymptomatic disease and reinfections are common.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103069"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outbreak of foodborne illness caused by Salmonella Braenderup ST2443 in China: Epidemiological and pathogenic insights","authors":"Yezhen Fang ,&nbsp;Xiaoyan Wang ,&nbsp;Hua Yu ,&nbsp;Rui Tian ,&nbsp;Yiyi Wang ,&nbsp;Pan Zhao ,&nbsp;Shiwang Huang ,&nbsp;Xiaoting Hua","doi":"10.1016/j.jiph.2025.103053","DOIUrl":"10.1016/j.jiph.2025.103053","url":null,"abstract":"<div><h3>Background</h3><div><em>Salmonella</em> outbreaks, particularly those caused by <em>Salmonella</em> Braenderup (<em>S.</em> Braenderup), represent a significant public health challenge due to their potential for widespread food contamination. While <em>S.</em> Braenderup outbreaks are reported globally, research on this serotype in China remains limited, leading to gaps in understanding its epidemiological patterns, pathogenic characteristics, and molecular features. This study investigates a foodborne outbreak in Hangzhou, China, in July 2023 to elucidate the transmission dynamics and molecular features of the causative strain.</div></div><div><h3>Methods</h3><div>A detailed epidemiological investigation was conducted, with rectal swabs, fecal samples, food, and environmental samples collected. Rapid pathogen detection, isolation, serotyping, and whole-genome sequencing (WGS) were performed to identify the infection source and characterize the outbreak strain. Epidemiological and genomic data were analyzed to determine the genetic relationships among isolates.</div></div><div><h3>Results</h3><div>Ten <em>S.</em> Braenderup strains, identified by the antigenic formula 6,7:e,h:e,n,z15, were isolated from patient feces, rectal swabs of restaurant employees, and food samples. All outbreak strains were classified as ST2443. WGS revealed two distinct phylogenetic clusters, with intragroup single nucleotide polymorphism (SNP) distances ranging from 2 to 503, indicating both recent common ancestry and substantial genomic diversity among the isolates. Notably, two food isolates (SCGL31 and SCGL35) exhibited close genomic relatedness to a patient isolate (SCGL39), supporting a direct link between foodborne transmission and clinical infection. The outbreak source was traced to contaminated food and infected restaurant employees. Virulence profiling identified key determinants, including <em>invA</em>, SPI-1 to SPI-5, and fimbrial genes. All strains demonstrated resistance to nalidixic acid. Although no acquired resistance genes were detected, a <em>gyrA</em> D87Y mutation associated with quinolone resistance was present.</div></div><div><h3>Conclusion</h3><div>This study provides the first detailed characterization of a foodborne outbreak in China caused by <em>S. Braenderup</em> ST2443. The findings highlight the value of WGS in outbreak investigation and underscore the necessity of stringent hygiene protocols and ongoing genomic surveillance to mitigate future risks.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103053"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of an alert system for the care cascade of Hepatitis C infection in patients undergoing elective surgery","authors":"Jae Seung Lee ,&nbsp;Ho Soo Chun ,&nbsp;Hye Won Lee ,&nbsp;Mi Na Kim ,&nbsp;Beom Kyung Kim ,&nbsp;Jun Yong Park ,&nbsp;Do Young Kim ,&nbsp;Sang Hoon Ahn ,&nbsp;Seung Up Kim","doi":"10.1016/j.jiph.2025.103076","DOIUrl":"10.1016/j.jiph.2025.103076","url":null,"abstract":"<div><h3>Background</h3><div>A key barrier to an effective care cascade for Hepatitis C virus (HCV) is limited awareness, especially among patients undergoing elective surgery. To address this issue, we introduced an electronic medical record (EMR)-based automatic alert system in 2021 to enhance surgical healthcare providers’ awareness of HCV screening and referral rates.</div></div><div><h3>Methods</h3><div>The alert system was designed to alert surgeons to order preoperative HCV antibody testing for patients undergoing elective surgery before admission and, at discharge, recommend hepatology consultation for patients with positive HCV antibody testing.</div></div><div><h3>Results</h3><div>The system significantly improved the HCV screening rate by 73,834 (96.8 %) among 76,310 patients undergoing surgery after system implementation, compared to 106,854 (82.8 %) among 129,065 patients between 2016 and 2020 (<em>P</em> &lt; 0.001). Among them, the system alerted 12,048 (16.3 %) cases, and 463 patients tested positive for HCV antibodies. However, only 42 (15.3 %) were referred out of 275 (59.4 %) who required hepatology consultation. Linkage failure was associated with other surgery departments than hepatobiliary and transplant surgery departments (odds ratio [OR]=5.940, 95 % confidence interval [CI], 3.080–12.410, <em>P</em> &lt; 0.001) and shorter hospitalization duration (OR=0.980, 95 % CI, 0.950–0.990, <em>P</em> = 0.012).</div></div><div><h3>Conclusion</h3><div>The EMR-based automatic alert system effectively increased HCV screening for patients undergoing elective surgery before admission. However, it could not link them to care cascade in surgery departments. Combining more proactive approaches would be beneficial, such as reflex testing or a call-back strategy.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103076"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145723017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced immune recovery with B/F/TAF compared with DTG/3TC in HIV patients: A prospective observational study","authors":"Rui-Qi Fan ,&nbsp;Yan Zhao ,&nbsp;Cheng-Yu Li ,&nbsp;Wen-Jun Cao ,&nbsp;Juan Wang ,&nbsp;Xiao-Hong Zhu ,&nbsp;Xiao-Yi Zhou ,&nbsp;Mei-Yin Zou ,&nbsp;Gang Qin","doi":"10.1016/j.jiph.2025.103055","DOIUrl":"10.1016/j.jiph.2025.103055","url":null,"abstract":"<div><h3>Objective</h3><div>Real-world data on the efficacy, safety, and impact of Bictegravir/Emtricitabine/Tenofovir Alafenamide (B/F/TAF) and Dolutegravir/Lamivudine (DTG/3TC) in HIV patients remain limited in China. This study intends to address these gaps to inform antiretroviral therapy (ART) selection and improve patient care.</div></div><div><h3>Methods</h3><div>A single-center, prospective observational study was conducted in Nantong Third People's Hospital. Patients initiating ART with either B/F/TAF or DTG/3TC between January 1, 2021, and December 31, 2023, were enrolled. Comprehensive baseline and follow-up data, consisting of demographic characteristics, HIV-related metrics, and biochemical parameters, were collected and analyzed.</div></div><div><h3>Results</h3><div>Among 212 patients (140 on B/F/TAF and 72 on DTG/3TC), baseline characteristics were comparable. At week 48, both the B/F/TAF and DTG/3TC regimens achieved comparable virological suppression rates (91.42 % vs. 91.67 %, <em>P</em> = 0.953). However, the median increase in CD4 cell count was significantly higher with B/F/TAF (137 cells/µL) compared with DTG/3TC (112 cells/µL; <em>P</em> = 0.030). Logistic regression analysis further supported these findings, showing that the B/F/TAF regimen was significantly associated with immune recovery at week 48. The unadjusted odds ratio (OR) for immune recovery was 2.06 (95 % confidence interval: 1.10–3.87). This association remained significant after adjusting for gender, age, BMI, WHO stage, baseline CD4 count, HIV RNA, and additional laboratory results. No significant differences were observed in biochemical parameters or adverse events between the groups.</div></div><div><h3>Conclusions</h3><div>These findings underscore the clinical advantages of the B/F/TAF regimen in promoting immune reconstitution among HIV patients. Future studies should investigate whether the observed differences in immune recovery translate into reduced morbidity and mortality rates over time.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103055"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide longitudinal evaluation of a machine learning approach for enhanced interpretation of Xpert MTB/RIF ultra rifampicin-resistance results in low bacterial load tuberculosis specimens","authors":"Tai-Han Lin ,&nbsp;Hsing-Yi Chung ,&nbsp;Ming-Jr Jian ,&nbsp;Chih-Kai Chang ,&nbsp;Yun-Wen Lai ,&nbsp;Cherng-Lih Perng ,&nbsp;Feng-Yee Chang ,&nbsp;Yuan-Hao Chen ,&nbsp;Hung-Sheng Shang","doi":"10.1016/j.jiph.2025.103064","DOIUrl":"10.1016/j.jiph.2025.103064","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organization (WHO) has identified tuberculosis (TB) as the leading cause of death from a single infectious agent. False-positive rifampicin (RIF) resistance results from the Xpert MTB/RIF Ultra assay are common in TB patients with low bacterial loads, especially among HIV-coinfected individuals. Hence, to distinguish genuine RIF resistance from false-positive results, this study developed and validated an artificial intelligence clinical decision support system (AI-CDSS).</div></div><div><h3>Methods</h3><div>Between January 2021 and March 2025, Taiwan's national TB reference laboratory received 10,353 respiratory specimens nationwide, identifying 2443 MTB-positive samples. The specimens were subjected to Xpert MTB/RIF Ultra testing and RIF resistance was confirmed using GenoType MTBDRplus assays. Molecular features, including cycle threshold (Ct) values, melting temperatures (Tm), and fluorescence intensities of rpoB probes, were analyzed. Three machine learning algorithms: random forest, gradient boosting classifier, and light gradient boosting machine (LGBM) were trained and validated.</div></div><div><h3>Results</h3><div>Ultra initially reported RIF resistance in 174 samples (7.1 %), with the highest false-positive rate of 12.2 % observed in samples with very low bacterial loads. LGBM demonstrated superior diagnostic performance (AUC = 0.99, sensitivity = 0.97, specificity = 0.99, and F1-score = 0.98). Key predictive features included Tm and fluorescence intensity, particularly in the rpoB3 region. Implementing the AI-CDSS significantly improved accuracy and reduced diagnostic turnaround times.</div></div><div><h3>Conclusions</h3><div>By leveraging the LGBM model, AI-CDSS effectively distinguished true RIF resistance from false-positive Xpert Ultra results, particularly among patients with low MTB bacterial loads. This approach enhances clinical decision making, optimizes treatment initiation, and conserves vital multidrug-resistant TB resources.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103064"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic evolution and epidemiological impact of SARS-CoV-2 omicron subvariants in Taiwan, 2023–2025","authors":"Li-Teh Liu ,&nbsp;Chao-Ju Chen ,&nbsp;Po-Chih Chen ,&nbsp;Chun-Hong Chen ,&nbsp;Ping-Chang Lin ,&nbsp;Ching-Yi Tsai ,&nbsp;Shu-Hui Lin ,&nbsp;Chen-Hsuan Lin ,&nbsp;Yi-Ching Lin ,&nbsp;Jih-Jin Tsai","doi":"10.1016/j.jiph.2025.103075","DOIUrl":"10.1016/j.jiph.2025.103075","url":null,"abstract":"<div><h3>Background</h3><div>The continued evolution of SARS-CoV-2 Omicron sublineages requires ongoing genomic and epidemiological surveillance. This study investigated the genomic epidemiology, national trends, and clinical aspects of SARS-CoV-2 in Taiwan from November 2023 to February 2025.</div></div><div><h3>Methods</h3><div>We analyzed the molecular and clinical characteristics of a local cohort (n = 22) from southern Taiwan. Case and mortality trends were evaluated using nationwide surveillance data, considering changes in case definitions. Broader genomic surveillance included 1782 Taiwanese sequences from GISAID to characterize the distribution and evolution of Omicron subvariants, considering the rollout timeline of XBB.1.5 and JN.1 vaccines.</div></div><div><h3>Results</h3><div>Genomic surveillance revealed a major epidemiological shift driven by variant succession: JN.1 and its descendants (e.g., KP.2, KP.3) replaced XBB-related subvariants, coinciding with infection waves in early and mid-2024. A more stringent national case definition for “severe complicated COVID-19” implemented in September 2024, substantially altered epidemiological metrics, reducing reported cases but increasing case fatality. In the local cohort, no significant associations were observed between sex, age, Ct value, comorbidity number, or vaccination status and hospitalization or severity, likely due to limited sample size. Nationally, individuals aged ≥ 65 years were disproportionately represented among severe cases and deaths, with risk amplified in those with comorbidities and low recent XBB.1.5/JN.1 vaccination coverage.</div></div><div><h3>Conclusions</h3><div>Taiwan experienced dynamic evolution of SARS-CoV-2 Omicron, dominated by JN.1 and its derivatives, which drove successive infection waves. Changes in national case definitions created substantial surveillance artifacts complicating interpretation of disease burden. Although national data reaffirm advanced age as the key risk factor for severe outcomes, these findings underscore the importance of targeted vaccination strategies and integrated surveillance systems capable of distinguishing the effects of viral evolution from policy-driven reporting changes.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103075"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFICACY OF NOVEL ΒETA-LACTAMASE INHIBITOR COMBINATIONS AGAINST MULTIDRUG-RESISTANT GRAM-NEGATIVE BACTERIA FROM THE UNITED ARAB EMIRATES","authors":"Mansour Aljneibi,&nbsp;Mohammad AlAwadi,&nbsp;Mohammed AlManssori,&nbsp;Nouf Masood,&nbsp;Amna Alhashmi,&nbsp;Maitha Alshamsi,&nbsp;Fatima Alsaedi,&nbsp;Farah Alnaqbi,&nbsp;Mariam Adi,&nbsp;Ali Alnuaimi,&nbsp;Akela Ghazawi,&nbsp;Farah Al-Marzooq","doi":"10.1016/j.jiph.2025.103098","DOIUrl":"10.1016/j.jiph.2025.103098","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103098"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elephantiasis and verrucous lesions in an Ethiopian man living in Italy","authors":"Benedetta Rossi ,&nbsp;Federica Gottardi ,&nbsp;Diego Segala ,&nbsp;Claudia Zambelli ,&nbsp;Stefano Iannazzi ,&nbsp;Alberto Matteelli","doi":"10.1016/j.jiph.2025.103057","DOIUrl":"10.1016/j.jiph.2025.103057","url":null,"abstract":"<div><div>Elephantiasis refers to chronic, severe lymphedema caused by the abnormal accumulation of interstitial fluid due to reduced lymph transport and lymph stasis. This condition is observed secondary to injury, infection, cancer or cancer-related treatment, or congenital abnormalities of the lymphatic system. One of the several forms of elephantiasis is Elephantiasis Nostras Verrucosas (ENV), where “<em>nostras</em>\" refers to a non-filarial form of lymphedema that occurs primarily in non-tropical areas. We describe a case of ENV in an Ethiopian man living in Italy, presenting with fever, hypotension, woody edema, hyperemic skin, and diffuse verrucous lesions. The case poses a differential diagnosis challenge, considering the epidemiological and clinical characteristics of patients coming from countries where several different skin neglected conditions, including filariasis, podoconiosis, chromoblastomycosis and mycetoma, are endemic. Understanding this challenge is crucial for improving diagnostic accuracy and tailoring appropriate treatment strategies.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103057"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}