Monthly infectious diseases bulletin — October 15, 2026

This issue covers September 15 to October 15, 2026 (the specialty's first issue on the portal, so it spans the last 30 days). The month was dominated by surveillance: the Bundibugyo Ebola epidemic in Central Africa, measles in the Americas, autochthonous arbovirus transmission in Europe, and a rise in leptospirosis in the Dominican Republic. Several relevant studies will be presented at IDWeek (October 21–24) and will appear in the next issue.

1. HIV, viral hepatitis, and STIs

1. Long-acting lenacapavir plus cabotegravir in people with resistance or adherence challenges

[Publication] [United States]
A cohort from the Ward 86 clinic at the University of California, San Francisco, published in JAMA Network Open on October 8, describes 46 people with HIV treated with injectable lenacapavir plus cabotegravir (an unapproved combination that replaces rilpivirine in the licensed regimen). Nearly three-quarters had resistance that limits use of cabotegravir-rilpivirine, and more than half started with detectable viremia. All viremic participants achieved suppression within 13 weeks, those already suppressed remained so, and after a median of nearly two years all were still undetectable. Funded by the NIH.
Why it matters: it opens an option for patients with poor adherence and NNRTI resistance, a common profile in our clinics, but this is a single-center series without a comparator, using an off-label combination; the two announced trials are needed, and in the Dominican Republic access to lenacapavir remains the real constraint.
https://doi.org/10.1001/jamanetworkopen.2026.38182
https://www.ucsf.edu/news/2026/10/432761/how-new-long-acting-hiv-drug-combo-tackles-resistance
https://www.news-medical.net/news/20261008/New-long-acting-HIV-treatment-offers-hope-for-drug-resistant-infections.aspx

2. Healthcare-associated infections, immunocompromised hosts, and transplant

2. Ralstonia mannitolilytica bloodstream infection outbreak linked to prefilled saline flush syringes

[Publication] [Germany]
A Eurosurveillance rapid communication (October 8) reports 16 genetically related nosocomial R. mannitolilytica bloodstream infections (≤6 allelic differences by cgMLST) in seven German hospitals between March and September 2026. The common exposure was prefilled saline flush syringes from a single manufacturer, which temporarily quarantined the product and suspended its use. The product was distributed to other countries, so cases may have occurred elsewhere.
Why it matters: environmental non-fermenting gram-negative bacilli in blood cultures from catheterized patients should prompt a search for a common contaminated product; hospitals in the region should check whether they buy imported prefilled syringes and report Ralstonia or Burkholderia clusters to their infection control committee.
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.40.2600819

3. Vaccines, arboviruses, tropical and emerging diseases

3. Bundibugyo virus Ebola disease: more than 8,700 cases and the first imported case in Kenya

[Publication] [Central Africa]
According to WHO's Disease Outbreak News of October 8 (DON619), the Democratic Republic of the Congo has 8,728 confirmed cases and 4,205 deaths (crude case fatality 48.2%) across 64 health zones in 7 provinces, with 775 new cases since the September 25 report; Ituri accounts for most. Kenya reported its first imported case (died October 5 after traveling from the DRC through Uganda). Contact follow-up is 80.4%, below the 85% target. ECDC reports that Uganda's outbreak (20 confirmed cases) has been declared over. The public health emergency of international concern declared on May 17 remains in force.
Why it matters: there is no approved vaccine or treatment for Bundibugyo (the approved vaccine and antibodies are specific to the Zaire species), so the response rests on detection, isolation, and staff protection; risk to the Caribbean is very low, but hospitals should keep their protocol for febrile travelers from Central Africa up to date.
https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON619
https://www.ecdc.europa.eu/sites/default/files/documents/communicable-disease-threats-report-week-41-2026.pdf

4. Measles in the Americas: PAHO rates risk as "very high" ahead of mass religious gatherings

[Publication] [Americas]
PAHO (October 9) reports 55,792 confirmed cases and 77 deaths in 17 countries and territories between January 4 and October 3, 2026, 4.8 times the same period in 2025; Guatemala, Mexico, the United States, Peru, and Canada account for 99.5%. Regional coverage in 2025 was 88% for the first dose and 85% for the second, and 1.6 million children received no dose. PAHO recommends a measles-rubella dose, ideally at least two weeks in advance, for anyone 6 months or older without evidence of vaccination who travels or attends mass gatherings.
Why it matters: with coverage below 95% and high regional mobility, any Caribbean country can receive imported cases; this is the time to review healthcare worker vaccination and to suspect measles in febrile travelers with rash.
https://paho.org/es/noticias/9-10-2026-ops-evalua-como-muy-alto-riesgo-propagacion-sarampion-ante-proximos-eventos

5. Leptospirosis in the Dominican Republic: cases nearly doubled versus 2025

[Publication] [Dominican Republic]
According to Infobae's coverage (October 10) of the Ministry of Public Health surveillance bulletin (epidemiological week 38, SINAVE data), 279 leptospirosis cases and 20 deaths have been confirmed in 2026, versus 142 cases and 13 deaths in the same period of 2025; also 8 pertussis cases versus 1. The percentage increases given in that report (91% and 680%) do not exactly match the absolute figures (≈96% and 700%).
Why it matters: in the rainy season, the increase justifies empirical doxycycline or penicillin for fever with myalgia and water or rodent exposure, without waiting for serology.
https://www.infobae.com/republica-dominicana/2026/10/10/las-autoridades-sanitarias-dominicanas-notifican-un-marcado-repunte-de-tosferina-y-leptospirosis-en-lo-que-va-de-2026/

6. Autochthonous chikungunya and dengue in Europe, and West Nile virus in 18 countries

[Publication] [Europe]
ECDC's weekly threats report (week 41, October 3–9) counts 146 autochthonous chikungunya cases in France in 20 clusters (18 active) and one in Italy, plus 68 autochthonous dengue cases in Italy and 6 in France. There are 1,855 locally acquired human West Nile virus cases in 18 countries, and the first reported symptomatic autochthonous Sindbis virus case in Germany is described.
Why it matters: Aedes albopictus transmission in Europe is now seasonal rather than anecdotal; for our traveling patients, and for the differential diagnosis in travelers returning from Europe, chikungunya and dengue are no longer only "tropical" diseases.
https://www.ecdc.europa.eu/sites/default/files/documents/communicable-disease-threats-report-week-41-2026.pdf

Cross-cutting

7. IDWeek 2026: what industry says it will present

[Industry] [United States]
On October 14 Pfizer announced more than 50 abstracts for IDWeek (Washington, October 21–24), including phase 3 data (VALOR) for the Lyme disease vaccine developed with Valneva, under EMA review since August; phase 2 data for a 25-valent pneumococcal conjugate vaccine in infants compared with the 20-valent vaccine; and real-world effectiveness of its RSV vaccine among nursing home residents. The release gives no efficacy figures.
Why it matters: this is a corporate announcement without data, useful only as an agenda; we will assess the results when presented.
https://finance.yahoo.com/healthcare/articles/pfizer-showcases-clinical-advancements-across-104500556.html

Upcoming meetings and dates

• IDWeek 2026: Washington, D.C., October 21–24, 2026.

*Infectious Diseases Bulletin — October 2026*
Greetings, colleagues. The highlights from September 15 to October 15:

🦠 *Emerging diseases and surveillance*
*Bundibugyo Ebola in the DRC*
8,728 confirmed cases and 4,205 deaths (48% case fatality); first imported case in Kenya. No approved vaccine or treatment.
https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON619

*Measles in the Americas: very high risk*
55,792 cases and 77 deaths in 2026 (4.8 times 2025). PAHO urges vaccination before travel and mass gatherings.
https://paho.org/es/noticias/9-10-2026-ops-evalua-como-muy-alto-riesgo-propagacion-sarampion-ante-proximos-eventos

*Leptospirosis in the Dominican Republic*
279 cases and 20 deaths through week 38, versus 142 and 13 in 2025 (Ministry of Health bulletin, as reported by Infobae).
https://www.infobae.com/republica-dominicana/2026/10/10/las-autoridades-sanitarias-dominicanas-notifican-un-marcado-repunte-de-tosferina-y-leptospirosis-en-lo-que-va-de-2026/

*Autochthonous chikungunya and dengue in Europe*
146 local chikungunya cases in France and 68 dengue cases in Italy.
https://www.ecdc.europa.eu/sites/default/files/documents/communicable-disease-threats-report-week-41-2026.pdf

💊 *HIV*
*Long-acting lenacapavir plus cabotegravir*
Series of 46 patients with resistance or poor adherence: all with undetectable viral load at nearly two years. No control group.
https://doi.org/10.1001/jamanetworkopen.2026.38182

🏥 *Healthcare-associated infection*
*Ralstonia from prefilled saline flush syringes*
16 bloodstream infections in 7 German hospitals; product distributed to other countries.
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.40.2600819

Full bulletin and audio: https://boletinesmedicos.com/en/infectious-diseases/2026-10-15.html
MedBulletins · boletinesmedicos.com

Monthly infectious diseases bulletin — October 15, 2026
7 verified items (Sep 15–Oct 15) from WHO, PAHO, ECDC, Eurosurveillance, and JAMA Network Open, among others.

Three worth your time:
• Bundibugyo Ebola in the DRC: 8,728 confirmed cases and 4,205 deaths (48% case fatality), first imported case in Kenya. No approved vaccine or treatment.
• Measles in the Americas: 55,792 cases and 77 deaths in 2026, 4.8 times 2025; PAHO rates the risk as very high ahead of mass gatherings.
• Injectable lenacapavir plus cabotegravir: 46 patients with resistance or poor adherence, all undetectable at nearly two years. Single-center series, no control group.

Full bulletin, with a critical reading of each study and links to sources:
https://boletinesmedicos.com/en/infectious-diseases/2026-10-15.html

#InfectiousDiseases #HIV #Ebola #Measles #Arboviruses

Bundibugyo Ebola: 8,728 cases and 4,205 deaths in the DRC, first imported case in Kenya. Measles in the Americas: 55,792 cases in 2026, 4.8x 2025. October ID bulletin:
https://boletinesmedicos.com/en/infectious-diseases/2026-10-15.html