When the World Comes Together, So Do the Pathogens

Recent key publications

The 2026 FIFA World Cup: Communicable disease risks and advice for visitors to Canada, the United States, and Mexico. 
Travel Med Infect Dis. 2026 May 28;102995. doi:10.1016/j.tmaid.2026.102995. Rodriguez-Morales AJ, Rodriguez-Sabogal IA, Porras-Pedroza BE et al.

 Link to article:https://pubmed.ncbi.nlm.nih.gov/42214730/

The 2026 FIFA World Cup, staged across Canada, the United States and Mexico, brought together the largest crowds in the tournament's history and, with them, real questions about infectious disease spread on a continental scale. This analysis looks at what that convergence meant: a resurgence of vaccine-preventable disease, with measles cases topping 14,000 for the year, arboviral threats gaining ground, foodborne illness risks tied to mass catering and antimicrobial resistance moving across borders more easily than usual precautions could contain. Because the tournament spanned three countries with markedly different epidemiological profiles, no single risk framework could cover it. Clinicians needed a stratified approach: surveillance tuned to each host region, vaccination strategies matched to traveller risk rather than blanket recommendations and attention that continued when fans went home. Post-travel vigilance mattered as much as pre-travel counselling, since many infections would only surface after return. This article was written for that audience: travel medicine specialists, infectious disease physicians and public health authorities who had to prepare for an event of this scale while these trends were unfolding in real time. The goal was practical guidance grounded in what the epidemiology showed, not a generic checklist repurposed for a big sporting event.

When rare zoonoses travel: Andes virus, hantavirus cardiopulmonary syndrome, and the preparedness gap. 
Int J Infect Dis. 2026 Aug:169:108778. doi: 10.1016/j.ijid.2026.108778. Epub 2026 May. Velavan TP, Schmidt-Chanasit J.

Link to article:https://pubmed.ncbi.nlm.nih.gov/42107872/

The recent MV Hondius outbreak spread across several nationalities, and revealed how poorly equipped confined, mobile settings are to handle rare zoonotic threats. The Andes virus stands apart from other hantaviruses in one important way: it can pass between people; a trait tied to high fatality and documented superspreading in Patagonia. This analysis walks through what sets ANDV apart virologically and ecologically, including its animal reservoirs, genetic factors like αVβ3 integrin variation that may affect host susceptibility and biomarkers such as IL-6 that could help predict severity. The authors make a strong case that travel medicine, maritime health protocols and One Health surveillance need to work together, so that remote itineraries stop turning into international health emergencies. Infectious disease specialists and preparedness planners should take note of the lessons learned with this recent outbreak.

Fever in the Returning Traveler: A Practical Overview for Initial Management and Assessment in the ED. 
J Clin Med. 2026 Jun 18;15(12):4733. doi: 10.3390/jcm15124733.15. Van Dessel L, Vanbrabant P, Henckaerts L, Sabbe M.

 Link to article:https://pubmed.ncbi.nlm.nih.gov/42355900/

With international travel topping 52 billion border crossings in 2025, emergency departments are seeing more febrile returning travellers, while most clinicians never received adequate training in figuring out what's actually going on. This review pulls together epidemiological patterns, incubation timelines and pathogen distributions by region to help ED physicians work through the initial evaluation of patients who are haemodynamically stable. Malaria, dengue and typhoid still top the list of concerns, though ordinary respiratory infections turn out to be a common cause of fever after travel too. The authors lay out practical algorithms built around exposure history, clinical findings and targeted testing, with a clear message to call in specialists early when the picture stays murky. With hantavirus clusters recently reported on expedition vessels and arboviral disease spreading further across the Americas, this framework gives ED physicians a useful tool for catching imported infections early and managing them well.

Beat the clock: One-hour diagnostics of emerging viral threats using fast molecular approaches. 
Diagn Microbiol Infect Dis. 2026 Jun;115(2):117319. doi: 10.1016/j.diagmicrobio.2026.117319. Epub 2026 Feb 17. Pavia G, Giorgio E, Marascio N et al.

 Link to article: https://pubmed.ncbi.nlm.nih.gov/41713041/

Monkeypox clade II appearing in Calabria and imported dengue serotype 2 in Catanzaro point to how far these pathogens have moved beyond the regions where they were once contained. This report describes two first diagnoses in Southern Italy, both confirmed using rapid molecular platforms that returned results in under an hour. The mpox case was detected through cross priming amplification, which allowed for prompt isolation and treatment. The dengue case was identified using a syndromic multiplex panel, despite an initial negative serology result that only turned positive a week later. With more than 700 dengue cases recorded in Italy in 2024 and mpox transmission continuing, these cases support the use of fast diagnostic tools for emerging infections, helping clinicians act quickly and strengthening surveillance in regions where such diseases are not normally seen.

Epidemiology and Spectrum of Imported Infectious Diseases in Children and Adolescents Returning to Europe: A Systematic Review. Pathogens. 2026 Jun 9;15(6):621. doi: 10.3390/pathogens15060621.15. Niestępski J, Baran JM, Waszak Z et al.

 Link to article: https://pubmed.ncbi.nlm.nih.gov/42347233/

This systematic review pulls together findings from 31 studies covering roughly 18,000 paediatric travellers returning to Europe with imported infections, a body of evidence that has stayed fairly scattered until now. Malaria shows up frequently in specific cohorts, but when looking at broader clinical data, gastrointestinal illness is actually the leading diagnosis after travel. Children visiting friends and relatives make up 46 to 87 percent of cases, a pattern that keeps pointing back to gaps in access to pre-travel care. Sub-Saharan Africa is the most common region of exposure, with Asia and the Americas following behind. The review also flags real gaps in the evidence: few studies break results down by age, methods vary too much to allow meta-analysis and vaccine-preventable diseases are consistently underrepresented in clinical cohorts. Taken together, this gives clinicians and public health planners a starting point and a strong argument for better paediatric surveillance and targeted prevention for children at higher risk.

Airplane wastewater as a gateway for pathogen surveillance. 
Infect Genet Evol. 2026 Jun; 140:105930. doi: 10.1016/j.meegid.2026.105930. Epub 2026 Mar 22. Rector A, Karatas M, Bloemen M et al.

 Link to article: https://pubmed.ncbi.nlm.nih.gov/41875962/

Aircraft wastewater surveillance provides a non-invasive, population-level means of detecting emerging pathogens as they cross international borders. In this pilot study of 32 flights from Beijing to Brussels, SARS-CoV-2 RNA was detected in 19 samples, including Omicron BA.4/BA.5 and XBB lineages, some of which had not previously been identified through Belgian clinical surveillance. Beyond targeted qPCR, hybrid capture metagenomics recovered complete genomes of polyomaviruses, herpesviruses, papillomaviruses, norovirus and hepatitis B virus, illustrating the method's capacity for pathogen-agnostic detection. Bacterial culture further confirmed the presence of viable organisms despite the use of onboard chemical disinfectants. Given the role of global air travel in pathogen dissemination and the recent detection of H5N1 in wastewater across US cities, this approach offers a scalable and ethically uncomplicated complement to conventional traveller screening, with value for regions where genomic surveillance capacity remains limited.