Recent EPI Publications

Foodborne diseases are important causes of illness and death. The first estimates of their burden were published by WHO in 2015. We updated WHO estimates of the global, regional, subregional, and national foodborne disease burden caused by 42 infectious and chemical hazards in 2021, including time trends for 2000–21. We provide a high-level summary of foodborne disease burden, expressed as incidence, deaths, and disability-adjusted life-years (DALYs).

Patients with inflammatory bowel disease (IBD) increasingly use cannabis. Studies investigating the effectiveness and safety of cannabis as a therapeutic option for IBD have reported conflicting findings, and recent reviews have not incorporated evidence from real-world studies. This systematic review assessed controlled non-interventional studies and interventional trials evaluating the effectiveness of delta-9-tetrahydrocannabinol (THC)-containing cannabis products in patients with IBD. The systematic review procedures—including search strategy across four databases, literature screening, data extraction, qualitative result synthesis, and risk of bias assessment—followed the Cochrane Handbook and adhered to PRISMA-compliant reporting. We used the GRADE approach to rate evidence quality for each outcome.

Type III interferons (IFNλs) represent the newest interferon family, comprising four human subtypes (IFNλ1–4) that signal through the tissue-restricted IFNLR1 receptor. While traditionally characterized as antiviral cytokines protecting mucosal barriers, accumulating evidence suggests that IFNλs possess broader physiological roles that remain incompletely understood. A critical gap in our knowledge concerns whether the four IFNλ subtypes function redundantly, or serve distinct biological purposes. Understanding subtype-specific IFNλ functions has become increasingly urgent as these cytokines enter clinical development. Critical questions remain. Addressing these questions will illuminate fundamental principles of mucosal immunity and guide rational design of IFNλ-based therapeutics that maximize protection while preserving epithelial health.

Aedes aegypti is the primary vector of dengue virus (DENV), a major arboviral disease affecting human health. Variation in detritus inputs and larval competition in containers where the species develop can influence female Ae. aegypti phenotypic traits, nutrient content (carbon, nitrogen, C:N ratio), and elemental isotopes (δ13C and δ15N), ultimately affecting vector competence for DENV. Female Ae. aegypti were reared under simulated urban detritus levels (low, medium, and high) and larval intra- (30:0 and 60:0) and interspecific (30:30 and 60:60) competition with Ae. mediovittatus (Ae. aegypti: Ae. mediovittatus). These findings suggest the potential use of δ15N as a tool to assess how larval nutritional and competitive environments shape dengue vector competence, with implications for understanding and predicting Ae. aegypti-driven DENV-1 dynamics in urban and suburban areas.

Wheat production in Pakistan faces persistent threats from diseases and pests. However, limited geographic information exists on local risks, economic impacts, and management practices. We used expert knowledge elicitation to provide the first integrated assessment of wheat health in Pakistan. Experts mapped yield losses for major diseases and pests at the district level. We analyzed networks of seed and grain exchange and stakeholder interactions. Analysis of wheat cropland connectivity identified locations that are likely to play important epidemiological roles.

In South Florida, the development and maintenance of high-quality golf courses are important to the state’s economy. The courses, however, are commonly affected by plant-parasitic nematodes (PPNs), which are highly damaging. Effective nematode management is reliant on accurate population and identification data to understand when and where population peaks occur. However, little data are available on turf-dwelling nematode population changes in southern Florida golf courses, often leaving golf course superintendents without the critical data needed to properly implement response strategies. The goal of this research was to determine the annual population fluctuations of PPNs in southern Florida golf courses and the impact of environmental, edaphic, and soil depth factors on PPN populations.

Pork is a common source of high-quality protein. However, it is typically recommended in moderation due to its saturated fat content, especially as its role in weight management, weight-loss (WL) programs, and overall diet quality is not well understood. This study aimed to identify associations among pork intake, WL, and diet quality among adults with overweight or obesity participating in a weight management program (WMP).

Cattle were not previously thought susceptible to highly pathogenic avian influenza (HPAI) H5N1 virus infection until March 2024, when outbreaks were reported among dairy cattle. Data are sparse regarding the immune response of cattle to infections with such viruses. To better understand the systemic humoral immune responses of HPAI H5N1-infected dairy cattle, we conducted a prospective study of 15 cows on an H5N1-affected farm. Our findings indicate a correlation among the three assays, with high levels of H5 antibodies persisting for more than a year after natural infections. This information is vital for guiding future use of H5 vaccines in dairy cattle farms.

Understanding the origins of obesity is critical for developing preventive strategies, and early life represents a particularly sensitive window. This study leverages a large, general-population cohort with prospectively collected data, including parental body mass index (BMI), cord blood proteomics, and the gut microbiome at age one, linked to obesity outcomes over 26 years. Using integrated machine learning models, we show that in addition to parental BMI, specific proteomic and microbial markers present in infancy can predict long-term obesity risk, highlighting the role of early metabolic programming. Several key markers point to bile acid signaling as a mechanism connecting early microbiome development with fat accumulation and insulin regulation. By identifying these early-life predictors long before obesity manifests, these results provide new insights into intergenerational risk and suggest measurable targets for preventing obesity and related metabolic disorders from the earliest stages of life.

In children with Chiari type I malformation and syringomyelia, neurosurgical posterior fossa decompression (PFD) provides clinical improvement, but whether duraplasty (incising the dura and placing a dural graft) improves outcomes is unclear. We conducted a multicenter, cluster-randomized, controlled trial of PFD with duraplasty (PFD-D) as compared with PFD alone. The percentage of participants with surgical complications did not differ significantly between those who underwent PFD-D and and those who underwent PFD alone. Larger trials are needed to determine the relative benefits and risks of these two procedures.