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The U.S. National Center for Immunization and Respiratory Diseases today reported five additional children with Acute Hepatitis of Unknown Etiology were reported over the past month.

Investigators are examining a possible relationship to adenovirus type 41 infection, which is not a common cause of hepatitis in otherwise healthy children.

'While rare, children can still have serious hepatitis, and we don't always know the cause. That's why investigators continue to look at possible causes and investigate,' wrote the U.S. Centers for Disease Control and Prevention (CDC).

The U.S. CDC is looking broadly, including hepatitis cases of unknown origin in children under ten years of age.

Since October 1, 2021, the number of persons under investigation (PUI) has reached 389 as of February 15, 2023.

Among the reported PUIs, about 90% required hospitalization, a few needed a liver transplant, and over ten died.

The World Health Organization, the U.K., Europe, and Canada have recently reported acute liver inflammation infections of unknown etiology among children.

Vaccine Treats: 
Hepatitis
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by Duernsteiner
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Karen McClorey Hackett
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Atlanta
Pregnant women with herpes

Genital Herpes Testing Still Not Recommended for Pregnant Women

Herpes vaccine candidates clinical trials continue in 2023
February 15, 2023
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VBI Vaccines Inc. today announced interim data from the Phase 2 study evaluating the combination of VBI-2601 (BRII-179), VBI's HBV immunotherapeutic candidate, and BRII-835 (VIR-2218), an HBV-targeting siRNA candidate, in chronically infected HBV patients.

The data, which will be featured in an oral presentation on February 18, 2023, demonstrated that the combination therapy was generally well-tolerated, restored strong anti-HBsAg antibody responses, and led to improved HBsAg-specific T-cell responses when compared to BRII-835 alone.

Notably, in two participants who received the combination therapy, maximum reductions in HBsAg to an undetectable level or the lower limit of quantification (LLOQ) were achieved by Week 40, which were associated with robust HBV-specific antibody and T-cell responses.

Dr. Francisco Diaz-Mitoma, M.D., Ph.D., VBI's Chief Medical Officer, commented in a press release on February 15, 2023, "Numerous studies have assessed the potential of siRNA candidates in hundreds of chronically infected HBV patients, but this is the first time we've seen data from the combination of an HBV siRNA with an HBV-specific immunomodulatory."

"Consistent with the known mechanism of action of VBI-2601 and its inclusion of the pre-S1 and pre-S2 antigens in addition to the S antigen, these interim data indicate that VBI-2601 may be able to break tolerance to the S antigen, achieving immune restoration."

"Additionally, the reduction of S antigen to at or below the LLOQ, as seen in the two patients, is a noteworthy achievement in this population."

"We are very encouraged by these interim data, which suggest that the combination of VBI-2601 and an HBV siRNA has the potential to be a meaningful part of a functional cure regimen."

"We look forward to additional data from this study, as well as data from the ongoing Phase 2 study of VBI-2601 as an 'add-on' to existing pegylated interferon and nucleos(t)ide reverse transcriptase inhibitor therapy in non-cirrhotic chronic HBV patients, both of which are expected later this year."

An abstract summarizing the interim data is available at this link.

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Hepatitis B
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Don Hackett
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VBI-2601 Hepatitis B Vaccine
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According to a recent World Health Organization (WHO) global report, 8 countries eliminated at least one neglected tropical disease last year. As of December 2022, 47 countries had eliminated at least one NTD.

Previously, more than 1 billion people were treated yearly for four consecutive years between 2016 and 2019.

But over the past decade, the number of people requiring interventions against NTDs has decreased by 25%.

And the burden of disease calculated in disability-adjusted life years is also steadily decreasing.

NTDs are a group of around 20 conditions that affect more than one billion people worldwide but have been largely overlooked by global health agendas.

The diseases generally affect people living in impoverished communities and can be caused by bacteria, viruses, fungi, parasites, or toxins.

The completed WHO Global Report (Jan. 2023) is posted at this link.

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travel vaccines
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WHO Global Report neglected tropical diseases (Jan. 2023)
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Karen McClorey Hackett
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Worldwide
London England

Norovirus Infections Increase 66% in England

Norovirus vaccine candidates are conducting clinical studies
February 14, 2023
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Vaxart, Inc. today announced that it had dosed the first subject in a Phase 2 dose-ranging clinical trial of its oral tablet bivalent vaccine candidate.

Vaxart expects to report topline data from the Phase 2 study in mid-2023.

"Initiating the Phase 2 clinical trial of this candidate is an important achievement toward our goal of developing an oral tablet vaccine that may reduce the significant global health threat that norovirus poses to children and seniors," said Dr. James F. Cummings, MD, Chief Medical Officer at Vaxart, in a press release on February 14, 2023.

"Results from the Phase 1b clinical trial in healthy adults demonstrate that this candidate stimulates robust IgA antibody-secreting cells against the prevalent strains of two norovirus genotypes that cause most norovirus disease."

"Data from the Phase 2 trial will inform our further clinical development strategy for this promising vaccine candidate."

As previously reported, Vaxart's bivalent vaccine candidate demonstrated robust immunogenicity, with an IgA ASC response rate of 78% for the GI.1 strain and 93% for the GII.4 strain, with no interference observed.

Three Phase 1 studies of Vaxart's norovirus pill vaccine indicated it is well tolerated and generated systemic and local immune responses that are both robust and persistent. 

In the U.S., norovirus causes 21 million illnesses each year, infecting 15% of all children under the age of five years and resulting in illness — which frequently requires hospitalization — in 7.5% of people over 65 years.

Other norovirus vaccine candidate news is posted at PrecisionVaccinations.

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Norovirus
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San Francisco
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The World Health Organization (WHO) today announced it would convene an urgent Marburg virus vaccine consortium (MARVAC) meeting on February 14, 2023, to discuss the new Marburg virus disease outbreak in Equatorial Guinea, in Africa.

This is an open webinar, and non-MARVAC members can digitally attend at this Zoom link.

The MARVAC includes leaders in the field of vaccine research and development, working together to develop vaccines against this infectious disease threat.

As of February 14, 2023, no vaccines or antiviral treatments have been U.S. FDA-approved to treat this severe virus.

However, there are vaccine candidates currently being evaluated.

The emergence of the Marburg virus disease (MVD)in Africa triggered the assembly of the MARVAC consortium in 2022.

MVD is in the same virus family that causes Ebola virus disease.

This urgent action is related to yesterday's WHO announcement that Equatorial Guinea had confirmed its first-ever outbreak of Marburg virus disease.

Preliminary tests carried out following the deaths of at least nine people in the country's western Kie Ntem Province turned out positive for MARV viral hemorrhagic fever.

"Marburg is highly infectious. However, thanks to the rapid and decisive action by the Equatorial Guinean authorities in confirming the disease, emergency response can get to full steam quickly so that we save lives and halt the virus as soon as possible," commented Dr. Matshidiso Moeti, WHO Regional Director for Africa, in a press release.

Vaccine Treats: 
Marburg Virus
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WHO Marburg outbreak Feb. 2023
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Don Hackett
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Geneva
Vaccine: 
cAD3-Marburg Vaccine
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Valneva SE today announced that it completed enrollment and vaccination for a Phase 3 clinical trial in adolescents, VLA1553-321, of its single-shot chikungunya vaccine candidate, VLA1553.

This live-attenuated, investigational vaccine candidate targets the chikungunya virus and was designed by deleting a part of the chikungunya virus genome.

The initial results of this trial are expected in mid-2023, which are intended to support the label extension in this age group following a potential initial regulatory approval in adults from the Food and Drugs Administration (FDA) in the United States (U.S.).

This adolescent trial is intended to support the label extension in this age group following a potential initial regulatory approval in adults from the FDA in the U.S.

Furthermore, the adolescent trial is expected to supvaccine'svaccine's licensure in Europe and Brazil, which would be the first potential approval for use in these chikungunya endemic regions.

Previously, Valneva completed the rolling submission of the Biologics License Application (BLA) to the FDA for approval of VLA1553 in persons aged 18 years and above (adults) in December 2022. 

If BLA filing is accepted and approved, VLA1553 could become the first chikungunya vaccine to be marketed in the U.S.

The Company also recently reported positive antibody persistence data with a 99% seroresponse rate 12 months after a single-dose vaccination.

Dr. Melanie Saville, Director of Vaccine Research & Development at CEPI, which provided funding for this pediatric study, commented in a press release on February 14, 2023, "Millions of people have been affected by chikungunya and, today, over a billion people live in areas where chikungunya outbreaks occur."

"The progress Valneva has made to date brings the world one step closer towards a safe and effective vaccine against this debilitating disease, for which there is currently no specific treatment nor vaccine licensed for use."

"Data from this Phase 3 study will help to ensure that the people most affected by this virus can benefit from this product and help regulators assess this important vaccine candidate.

To make VLA1553 more accessible to Low- and Middle-Income Countries, Valneva and Instituto Butantan in Brazil signed an agreement in January 2021 for the development, manufacturing, and marketing of the chikungunya vaccine.

Chikungunya is a mosquito-borne viral disease caused by the chikungunya virus (CHIKV), a Togaviridae virus transmitted by Aedes mosquitoes.

A CHIKV infection leads to symptomatic disease in up to 97% of humans after three to seven days following the mosquito bite.

While mortality with CHIKV is low, morbidity is high.

Clinical symptoms include acute onset of fever, debilitating joint and muscle pain, headache, nausea, rash, and chronic arthralgia.

Additional chikungunya outbreak news at Vax-Before-Travel.

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Chikungunya
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Don Hackett
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Saint-Herblain
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Chikungunya Vaccine (VLA1553)

Marburg Disease Outbreaks

Marburg Virus Disease Outbreaks 2025

Marburg virus is a Filovirus disease (MVD) that causes a severe and often fatal (up to 88%) viral hemorrhagic fever (VHF) infection. MVD was observed for the first time in 1967 during an outbreak in Marburg a der Lahn and Frankfurt am Main, West Germany. Twenty-nine people developed clinical signs, and seven eventually died. Before developing the disease, MVD patients directly interacted with grivets imported from Uganda or with grivet-derived tissues. 

As of December 2025, Angola, the Democratic Republic of the Congo, Ethiopia, Equatorial Guinea, Cameroon, Ghana, Guinea, Kenya, Serbia, South Africa, Tanzania, Uganda, and Rwanda have confirmed cases of MVD.

The U.S. Centers for Disease Control and Prevention (CDC) published Travel Health Notices for Ethiopia's outbreak in 2025 and a Level 3 - Practice Enhanced Precautions regarding the Republic of Rwanda's MVD outbreak on October 7, 2024. The CDC has previously issued Travel Health Advisories focused on various Marburg virus disease outbreaks and published a chronological list of known Marburg Outbreaks, titled "History of Marburg Outbreaks."

Burundi Marburg

The Republic of Burundi authorities confirmed via Twitter on March 28, 2023, the death of a third person following a mysterious illness that broke out in the northwest area. Local authorities have been ordered to prevent passengers from neighboring Tanzania from spreading Marburg disease.

Cameroon Marburg

On February 14, 2023, the Cameroon Regional Health Ministry reported two suspected MVD cases in the Olamze Commune. Cameroon previously restricted movement along the border with Equatorial Guinea, limiting the movement of populations in the area. It also activated the incident management system throughout the region.

Equatorial Guinea Marburg Outbreak

The Republic of Equatorial Guinea (EG) confirmed its first-ever outbreak of MVD on Febr20 February 3. The index case died in early January 2023. This EG outbreak was declared over on June 8, 2023. Since the outbreak declaration, 17 laboratory-confirmed cases of MVD and 12 deaths have been recorded (CFR 75%). The city of Bata in Litoral province is the most affected district, with nine laboratory-confirmed MVD cases reported. The U.S. Embassy in EG implemented a temporary policy under which official travel to the mainland region (Bata) by Embassy employees is only permitted for mission-critical needs, such as support for the MVD response.

Separately, the U.S. CDC updated its Level 2 travel advisory for EG regarding the MVD outbreak on May 12, 2023, stating, 'Reconsider non-essential travel to mainland EG.' The UK says health professionals should remain alert for travelers returning from MVD-affected areas who develop symptoms compatible with MVD. Guidance and information about high-consequence infectious diseases and their management in England, as well as additional information and advice on Marburg fever, are available from the UK. Health Security Agency.

Europe Marburg

The European Centre for Disease Prevention and Control (ECDC) reported on March 25, 2023, that the likelihood of exposure and infection for EU/EEA citizens traveling or residing in the affected areas in Equatorial Guinea is currently very low. The most likely route of introduction of MVD into Europe would be via infected travelers. Should a case be imported, the likelihood of the spread of MVD within Europe is considered to be very low, says the ECDC.

Gabon Marburg

The WHO Director-General stated on February 15, 2023, that the Gabonese Republic is preparing to rapidly detect, isolate, and care for suspected cases of MVD. More than 163 people have crossed the borders between Equatorial Guinea, Cameroon, and Gabon.

Germany Marburg Virus Event

Marburg virus disease was first detected in 1967 following outbreaks in Marburg and Frankfurt, Germany, as well as in Serbia. The outbreak was associated with laboratory work involving green monkeys imported from Uganda.

Nigeria Marburg

The Nigeria Centre for Disease Control and Prevention confirmed in late February 2023 that there is a moderate risk of importing the Marburg virus into the country. 

Rwanda Marburg Outbreak

On December 20, 2024, the WHO announced that the Marburg Virus Disease outbreak had been declared as over, no new cases had been reported over the last 42 days after following the previous patient's negative test results—the third WHO Disease Outbreak News on Marburg virus disease in Rwanda was published on November 1, 2024. As of October 31, 2024, there were 66 confirmed cases, including 15 deaths (CFR: 23%). Sabin confirmed that over 1,700 experimental vaccines had already been delivered to Rwanda during the 2024 outbreak. On September 27, 2024, the Rwanda Ministry of Health reported its first Marburg disease outbreak. 

Tanzania Marburg Outbreak

Since the declaration of the MVD outbreak in January 2025, the United Republic of Tanzania's Ministry of Health has reported an outbreak, which totaled 10 related deaths by June 2025. On January 20, 2025, the WHO and the Africa CDC received confirmation of an MVD case in the Kagera region of Tanzania. Nine suspected cases were reported across two districts – Biharamulo and Muleba. In March 2023, an MVD outbreak was declared in the Kagera region, Northwestern Tanzania. On January 23, 2025, and March 27, 2023, the U.S. CDC issued a Watch—Level 1 Practice Usual Precautions, stating that Tanzania had confirmed an MVD outbreak. To ensure that health systems fully recover from the effects of the epidemic and stay alert against future outbreaks, the WHO has developed the 90-day Post MVD Recovery Operational Plan and is also supporting the Ministry of Health in developing the National 90-day Post MVD Recovery Plan. 

Uganda Marburg Risk

Screening of travelers commenced at Kikagate Point of Entry in Isingiro District on March 27, 2023.

Marburg Virus Testing

Testing for Marburg virus and other causes of viral hemorrhagic fevers is available at the CDC in Atlanta, Georgia, and within the Laboratory Response Network (LRN).

Marburg Disease Vaccine Candidates

As of April 2025, the African CDC, the U.S. FDA, nd the European Medicines Agency (EMA) have not approved any Marburg vaccine candidate.

6 min read
Reviewer: 
Robert Carlson, MD
Last Reviewed: 
Monday, December 15, 2025 - 11:25
Description: 
Marburg virus outbreaks have been declared since 1967. Marburg disease is caused by a severe hemorrhagic fever.
Condition: 
Marburg Virus
Equatorial Guinea map

Marburg Virus Disease Outbreak Confirmed in Equatorial Guinea

Equatorial Guinea reported viral hemorrhagic fever fatalities in 2023
February 13, 2023