Open Forum Infectious Diseases最新文献

{"title":"Non-English Preferred Language and Hospital Mortality in Candidemia: A Retrospective Cohort Study.","authors":"Hamail Iqbal, Ahmet Dalkilic, Dejan Nikolic, Carlo Foppiano Palacios","doi":"10.1093/ofid/ofag626","DOIUrl":"https://doi.org/10.1093/ofid/ofag626","url":null,"abstract":"<p><p>We evaluated associations between social determinants of health and mortality in candidemia via a retrospective cohort (2017-2022). Among 237 episodes, non-English language was independently associated with higher mortality (aOR 3.22, 95% CI 1.03-10.08). Other social determinants were not significant. Non-English preferred language may identify an important difference in candidemia outcomes which warrants further investigation and validation in larger, multicenter studies.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag626"},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Clinical Trial Design to Accelerate Therapeutics for Arboviral Epidemics.","authors":"Andrea Alemany, Maria Paula Mourão, Ami Fazlin Bt Syed Mohamed, Steven Lim Chee Loon, Zaril Harza Bin Zakaria, Adriane Alves de Oliveira, Rozainanee Mohd Zain, Sergio Sosa-Estani, Manoel Barral-Netto, Meiruze Sousa Freitas, Marcus Vinicius Guimarães de Lacerda, Quique Bassat, Ganesan Karthikeyan, Prasert Auewarakul, Nor Fariza Ngah, Isabela Ribeiro, Andre M Siqueira, Mauro M Teixeira, Viviane Sampaio Boaventura","doi":"10.1093/ofid/ofag565","DOIUrl":"10.1093/ofid/ofag565","url":null,"abstract":"<p><p>Arboviral diseases represent an escalating global health threat, yet therapeutic development has been markedly slower than for other viral illnesses. Key barriers include the unpredictability and variability of arbovirus transmission, which complicate site selection, limit recruitment, and increase delays and the risk of inconclusive trials. Additional challenges include maintaining trial-ready sites, recruitment within the narrow therapeutic window, ensuring rapid diagnostics, and including high-risk groups. To address these barriers, we propose several innovative strategies based on a Clinical Experts meeting convened by the Dengue Alliance. These include pre-activated trial networks for rapid initiation during outbreaks; early-warning surveillance to guide geographic activation using real-time transmission signals; decentralized trial models to expand recruitment beyond major research centers; platform trial designs that allow treatment arms to be added or discontinued adaptively; and participant inclusion based on clinical syndrome supported by rapid diagnostics. Their successful adoption requires regulatory harmonization, ethical oversight, and emphasis on equity.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag565"},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fungal Periprosthetic Joint Infection: A Systematic Review and Meta-analysis of Treatment Approaches and Clinical Outcomes.","authors":"Farzad Pourghazi, Seyed Mohammad Amin Alavi, Takahiro Matsuo, Georges Baaklini, Matthew P Abdel, Aaron J Tande, Elie F Berbari","doi":"10.1093/ofid/ofag657","DOIUrl":"10.1093/ofid/ofag657","url":null,"abstract":"<p><p>Fungal periprosthetic joint infection (PJI) is a rare but serious complication of joint arthroplasty, with variable management and poorly defined outcomes. We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines, searching Ovid MEDLINE, Embase, Scopus, and Ovid Cochrane Central. Cohort studies were included in the quantitative synthesis, while case reports and series were reviewed qualitatively. Outcomes were treatment success, failure, reinfection, and mortality. We included 160 studies: 42 cohort studies and 118 case reports or case series, with 1025 fungal PJI cases. Pooled rates were 66.5% for treatment success, 36.5% for failure, 16.6% for reinfection, and 9.6% for mortality. Success and failure were extracted independently using study-specific definitions and are not necessarily complementary. Treatment-strategy estimates were descriptive; studies reporting DAIR had lower pooled success, but findings should be interpreted cautiously because of differences in patient selection, study design, and outcome definitions. These findings cannot establish comparative effectiveness.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag657"},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Toxoplasma gondii</i> Outbreak Associated With Catered Venison Dinners, Westchester County, New York-January-February 2024.","authors":"Kelly A Barrett, Amy Robbins, David Nicholas, Kevin Smith, Nicole Benevento, Allison Hopper, Robert Bellach, Ambika Soondar, Sherlita Amler, Valérie Bonetti, Alexander Chen, José G Montoya, Jorge P Rodriguez-Soto, Christelle Pomares, Hélène Yera, Karine Passebosc-Faure, Ada J Huang","doi":"10.1093/ofid/ofag596","DOIUrl":"https://doi.org/10.1093/ofid/ofag596","url":null,"abstract":"<p><p>On January 19 and 20, 2024, a caterer in Westchester County, New York, served a seven-course game dinner to approximately 250 guests each evening (500 total). Six courses contained venison from 10 deer harvested in early January through a donation program in another county. All venison courses were reheated on site except the backstrap steaks, which were never frozen and were grilled rare to medium-rare. On February 1, an infectious diseases physician notified the health department of attendees with fever, headache, and myalgia without gastrointestinal symptoms. The caterer and food preparation site were investigated on February 5, and the first positive <i>Toxoplasma gondii</i> serology on February 7 prompted a press release and provider alert. Sixty-three attendees contacted the health department, of whom 30 (48%) sought medical care and 26 (41%) were tested. Specimens from 16 of the 26 (62%) could be forwarded to the Remington Laboratory for confirmatory testing; the remaining 10 (38%) were tested at non-reference laboratories only. Symptom onset ranged from 23 January to 8 February 2024. Among attendees with onset within a biologically plausible interval after the dinners, 15 (24%) were confirmed, 10 (16%) probable, and 16 (25%) suspect; one (2%) had evidence of past infection only. Two raw venison samples were PCR positive for <i>T. gondii</i>, tissue cysts were observed on histopathology, and genotyping identified haplogroup 12, associated with wildlife and more severe human disease. Wild game from donation programs should not enter commercial food service, and at-risk guests should be informed when it is served.Keywords.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag596"},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149271536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Hepatocellular Carcinoma or Hepatic Decompensation Associated With Steatotic Liver Disease in People With and Without HIV.","authors":"Jessie Torgersen, Craig W Newcomb, Melissa Skanderson, Farah Kidwai-Khan, Dean M Carbonari, Janet P Tate, Catherine Mezzacappa, Emily J Cartwright, Debika Bhattacharya, Joseph K Lim, Jennifer C Price, Tamar H Taddei, Amy C Justice, Vincent Lo Re","doi":"10.1093/ofid/ofag617","DOIUrl":"10.1093/ofid/ofag617","url":null,"abstract":"<p><strong>Background: </strong>Steatotic liver disease (SLD) is highly prevalent in people with HIV (PWH), but factors influencing progression to hepatocellular carcinoma (HCC) and hepatic decompensation (HD) remain unclear. It is unknown if the risk of these outcomes associated with SLD differs by HIV status.</p><p><strong>Methods: </strong>Patients from the Veterans Aging Cohort Study-HIV (includes matched people without HIV [PWoH]) who underwent an ultrasound, computed tomography, or magnetic resonance imaging between 2001-2017 were included. Patients with diagnosed cirrhosis or chronic viral hepatitis were excluded. SLD was defined by a natural language processing algorithm; primary outcome of composite of HCC or HD was defined using International Classification of Diseases 9/10 codes and national cancer registry. Follow-up began on imaging study date and continued until incident HCC/HD, death, or 31 December 2024. Adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) of HCC/HD associated with SLD and HIV status were calculated.</p><p><strong>Results: </strong>Among 19 546 patients (mean age: 54 years; 96.6% male; 28.6% PWH), 13 617 (69.7%) had SLD identified by natural language processing. Rates of HCC/HD were lowest in PWoH and no SLD (18.0/10 000 person-years) and highest among PWH and SLD (46.8/10 000 person-years). When compared to PWoH without SLD, risk of HCC/HD was increased among PWH with SLD (aHR: 2.71; 95% CI: 2.10-3.49) and PWH without SLD (aHR: 1.62; 95% CI: 1.14-2.29), although no interaction between HIV and SLD was observed (<i>P</i> = .25).</p><p><strong>Conclusions: </strong>Among people without cirrhosis or chronic viral hepatitis, radiographic findings of SLD were associated with increased rates of HCC/HD, with the highest rate among PWH and SLD, independent of cardiometabolic factors, alcohol, and tobacco.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag617"},"PeriodicalIF":3.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of Using a Bedaquiline-Based Regimen to Treat Multidrug-Resistant Tuberculosis in Pregnancy.","authors":"Adriana A M Giuliani, Kristen A Wendorf, Jeffrey Percak, Annie N Cowell","doi":"10.1093/ofid/ofag661","DOIUrl":"10.1093/ofid/ofag661","url":null,"abstract":"<p><p>The treatment of multidrug-resistant tuberculosis (MDR-TB) in pregnancy has been historically limited by the exclusion of pregnant and breastfeeding persons from large clinical studies. We follow the case of a pregnant patient successfully treated for MDR-TB in California, United States, using a bedaquiline-based regimen and discuss the growing body of evidence and evolution of recommendations in the management of this patient population. We discuss obstacles in the patient's care, including issues of regimen selection, question of breastfeeding, supratherapeutic drug levels postpartum, and medication adverse effects-all which should be considered in the management of pregnant persons. Based on our experience, we would recommend to consider monitoring drug levels during this transition to postpartum status. Further inclusion of pregnant and breastfeeding patients in MDR-TB studies will continue to bolster knowledge base and improve patient outcomes.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag661"},"PeriodicalIF":3.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Delhi Metallo-β-Lactamase Plasmidomes of Intensive Care Unit Clinical and Environmental Enterobacterales Isolates.","authors":"Florencia Martino, Denise De Belder, Renata Monge, Agustina Forastiero, Molly Patrick, Kara A Moser, Alejandra Corso, Fernando Pasteran, Matthew Robinson, Valeria Fabre","doi":"10.1093/ofid/ofag663","DOIUrl":"10.1093/ofid/ofag663","url":null,"abstract":"<p><strong>Background: </strong>There are limited data on the molecular epidemiology of New Delhi metallo-β-lactamase (NDM)-producing carbapenem-resistant Enterobacterales (CRE) in Latin America, despite the high burden of NDM-CRE in the region. This study characterized <i>bla</i> _NDM-harboring plasmids from CRE from patients and the environment of an Argentine hospital.</p><p><strong>Method: </strong>We performed whole-genome sequencing of 40 environmental isolates (<i>Klebsiella</i> comple<i>x</i>, n = 11; <i>Enterobacter cloacae,</i> complex n = 16; <i>Citrobacter freundii</i>, n = 10; <i>Serratia marcescens</i>, n = 3) and 4 clinical isolates (<i>Klebsiella pneumoniae</i>, n = 4) recovered from the environment and rectal surveillance samples of patients in the same intensive care units (ICUs) at a tertiary care center in Argentina, July 2023-February 2024, respectively. Representative genomic groups underwent Oxford Nanopore sequencing and hybrid genome assembly for complete plasmid characterization. Resolved <i>bla</i> _NDM-harboring plasmids were compared across species and publicly available reference sequences to characterize plasmid relatedness and dissemination patterns.</p><p><strong>Results: </strong>Ten representative genomic groups were identified across species, including 7 defined sequence types and 3 assigned in this study. <i>bla</i> _NDM-1 and <i>bla</i> _NDM-5 were present in 72.5% (29/40) and 27.5% (11/40) of environmental isolates, respectively (all 4 clinical isolates were <i>bla</i> _NDM-5). Hybrid assembly of the representative genomic groups revealed <i>bla</i> _NDM-1 was located on highly conserved plasmids belonging to the IncC incompatibility group across multiple CRE species. <i>bla</i> _NDM-5 was restricted to <i>Klebsiella</i> spp. and was associated with structurally diverse plasmids including IncF- and IncHI1B/IncFIB-type backbones in both environmental and patient isolates.</p><p><strong>Conclusions: </strong>These findings highlight the ICU environment as a reservoir for <i>bla</i> _NDM plasmids.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag663"},"PeriodicalIF":3.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Mortality and Morbidity After Pediatric Sepsis.","authors":"Erik Edholm, Adam Linder, Malin Inghammar, Anton Nilsson, Sara Jesperson, Lisa Mellhammar","doi":"10.1093/ofid/ofag660","DOIUrl":"10.1093/ofid/ofag660","url":null,"abstract":"<p><strong>Background: </strong>Adults experience sustained disease burden in the years following sepsis, but data regarding long-term prognosis after pediatric sepsis are still limited. The objective of this study was to determine long-term outcomes after sepsis in children, in terms of mortality, morbidity, and socioeconomic factors.</p><p><strong>Methods: </strong>This cohort study was based on a nationwide historical cohort of 55 906 pediatric sepsis hospitalizations, as compared with a control cohort of 93 274 pediatric nonsepsis hospitalizations with organ dysfunction, with linked register data on patient characteristics. Exposure was defined as sepsis hospitalization before 18 years of age. Cox regression was used to estimate hazard ratios for long-term mortality, with adjustments for age and comorbidities. Logistic regression was used to compare the prevalence of diseases in the groups during follow-up. Socioeconomic outcome in terms of education level, unemployment, and disability pension was compared with logistic regression at 20, 25, and 30 years of age. The study was set in Sweden, 1 January 1987 to 31 December 2022.</p><p><strong>Results: </strong>During the first 5 years of follow-up, the sepsis cohort had higher mortality, with a hazard ratio of 1.17 (95% CI, 1.11-1.22), adjusted for age and comorbidities. Subsequent sepsis, infectious disease, and respiratory disease during the follow-up were more common in the sepsis cohort than in the control cohort.</p><p><strong>Conclusions: </strong>The findings of this study call for increased attention of health care to survivors of pediatric sepsis and enhanced follow-up.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag660"},"PeriodicalIF":3.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the Range and Duration of Post-influenza Symptoms, Conditions, and Diseases.","authors":"Aaron C Miller, D Erik Boonstra, Joseph E Cavanaugh, Roger D Struble, Constantina Boikos, Tianyan Hu, Timothy L Wiemken, Verna L Welch, Philip M Polgreen","doi":"10.1093/ofid/ofag629","DOIUrl":"https://doi.org/10.1093/ofid/ofag629","url":null,"abstract":"<p><strong>Background: </strong>Acute symptoms of influenza are understood; however, less is known about potential postacute sequelae. We conducted a retrospective matched cohort study to identify conditions with elevated risk following influenza.</p><p><strong>Methods: </strong>We analyzed data from the Merative MarketScan Research Databases (2001-2019), including 3.3 million patients with a diagnosis of influenza. Cases were matched 1:1 to patients based on similar age, sex, care setting, and enrollment period with no influenza diagnosis. We examined the frequency of diagnosis codes in the year before and after the index influenza event, applying K-means clustering to identify diagnoses with post-influenza visit patterns similar to cough, a known sequela of influenza. Conditions were reviewed and aggregated into clinical categories. We compared trends in diagnoses between influenza cases and controls using a difference-in-differences approach.</p><p><strong>Results: </strong>We identified 67 diagnostic categories with significantly increased incidence post-influenza infection. Both commonly known sequelae, such as pneumonia and otitis media as well as less expected findings, such as acute kidney failure and oral candidiasis were identified. The duration of elevated risk varied by condition, ranging from a week (eg, rhabdomyolysis) to 5 weeks (eg, hemoptysis) or 8 weeks (eg, chronic bronchitis).</p><p><strong>Conclusions: </strong>We found that influenza is associated with conditions not typically considered. Also, some symptoms last longer than commonly appreciated, suggesting that some patients may suffer from a prolonged illness due to the influenza infection. Our findings have important implications for not only demonstrating the full burden of influenza but also informing future studies to prevent or treat influenza.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag629"},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yellow Fever Reemergence in Tolima, Colombia 2024-2025: An Eco-epidemiological Study.","authors":"Seth D Judson, Nicole Stephan, Sofia Machuca, Andrés F Henao-Martínez, Gabriel Parra-Henao, Ricardo Vivas, Jose Fair Alarcón-Robayo, Mauricio Javier Vera Soto, Hernán Vargas","doi":"10.1093/ofid/ofag616","DOIUrl":"https://doi.org/10.1093/ofid/ofag616","url":null,"abstract":"<p><strong>Background: </strong>Yellow fever virus is transmitted by mosquitoes among humans and non-human primates (NHPs) in South America. The 2024-2025 yellow fever (YF) outbreak was notable for its spread into new areas, including the department of Tolima in Colombia's Andean region. We investigated the eco-epidemiology of human and NHP YF cases to understand the patterns and factors associated with the Tolima outbreak.</p><p><strong>Method: </strong>We collected spatiotemporal, sociodemographic, and mortality data on human YF cases in Tolima, as well as the locations of deceased NHPs with YF. We then conducted exploratory, descriptive, and spatial statistical analyses to identify risk factors and hotspots for YF. We then used inferential spatiotemporal modeling to compare ecological and sociodemographic factors.</p><p><strong>Results: </strong>From September 2024 to October 2025, 116 human and 53 non-human primate YF cases were detected in Tolima. Among the human cases, 77% were male (89/116), and the median age was 47 (interquartile range 34-63). Of these cases, 45 (39%) died, and older age was associated with increased odds of death (adjusted odds ratio, 1.43 per 10 years; 95% confidence interval, 1.18-1.78). There was significant clustering among human and NHP cases. Higher rainfall and poverty/deprivation were associated with increased YF incidence at the neighborhood level, and rainfall during the outbreak was above average due to La Niña.</p><p><strong>Conclusions: </strong>These findings demonstrate significant mortality from YF, which reemerged in Tolima after nearly a century. Rural populations with greater ecological risk and poverty/deprivation could benefit from targeted vaccination strategies for YF.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag616"},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}