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Growing evidence suggests that antimicrobials also interact with host innate immunity to provide potent indirect effects which enhance bacterial clearance and may result in more rapid and complete effects

Synergy Between Antibiotics and The Innate Immune System

Along with a 1 reported case in Massachusetts, the

New Hampshire Department of Health and Human Services (DHHS) has confirmed a person infected with eastern equine encephalitis (EEE) has died. The public health agency said the person was hospitalized due to severe central nervous system disease. The last reported human EEEV infection in New Hampshire was in 2014, when DHHS identified 3 human infections, including 2 fatalities. In the same statement, DHHS mentions there has been 1 confirmed case in Vermont this summer.

On August 16, the Massachusetts Department of Public Health (MDPH) released a statement discussing the confirmation of the first human case of EEE in the state this year. The confirmed case was discovered in an 80 year old man who was exposed to the vector borne disease in Worcester County. As a result, the risk level in the local communities of Douglas, Oxford, Sutton, and Webster has been raised to critical, and in Dudley, Northbridge, and Uxbridge the risk is increased to high.

Additionally, the neighboring communities of Auburn, Charlton, Grafton, Leicester, Mendon, Millbury, Millville, Southbridge, and Upton are now considered at moderate risk according to MDPH.

“This is the first time we have seen a person infected with EEE in Massachusetts since 2020,” Public Health Commissioner Robbie Goldstein, MD, PhD, said in a statement. “EEE is a rare but serious disease and a public health concern. We want to remind residents of the need to protect themselves from mosquito bites, especially in areas of the state where we are seeing EEE activity.

Though very rare, EEE is serious and a potentially fatal disease that can affect people of all ages. EEE is generally spread to humans through the bite of an infected mosquito. There were 12 human cases of EEE in Massachusetts in 2019 with 6 deaths, and 5 human cases with 1 death in 2020. There were no human cases of EEE in Massachusetts in 2021, 2022, or 2023.

EEE has a fatality rate of 33% to 70%, with most deaths occurring 2–10 days after the onset of symptoms.

In addition to a high mortality rate, long-term physical and mental complications, including permanent neurological deficits have been identified in many people who survive EEE.

Plymouth is approximately 40 miles south of Boston along the coast, and Worcester County is in the middle of the state, so the 2 areas are not in close proximity, but due to the elevated risk locally, the town of Plymouth decided to take action in response to outdoor parks. As of last Friday, all town public parks and fields are close daily from dusk until dawn.

“As Mass DPH has now elevated Plymouth’s EEE risk status to high, it is important to take extra precautions when outdoors and follow state and local health guidelines to avoid unnecessary risk to exposure to EEE. The health and safety of our community, residents, and visitors remain our priority,” Plymouth’s Commissioner of Health and Human Services, Michelle Bratti, said in a statement.

According to the Centers for Disease Control and Prevention (CDC) most people who are infected with the virus do not develop symptoms; however, for those that do, the date from the bite to the onset of the illness is 4 to 10 days. EEE can also result in fever or neurologic disease. The type of illness will depend on the age of the person and other factors. Those who are infected can develop meningitis.

There are no FDA-approved treatments for EEE and for patients who develop severe cases, they can be hospitalized to receive supportive treatment.

Over the weekend, MDPH detailed plans of spraying for mosquitos including aerially in areas of Plymouth County, and truck-mounted spraying in parts of Worcester County. As of Saturday, 10 communities in Massachusetts were raised to high or critical risk for EEE virus.

“The risk from EEE is high in parts of Plymouth County and critical in parts of Worcester County,” State Epidemiologist Catherine M. Brown, DVM, said in a statement. “In addition to recommending that people use mosquito repellent with an EPA-registered active ingredient and clothing to reduce exposed skin, we also recommend that evening outdoor events be rescheduled to avoid the hours between dusk and dawn. The mosquitoes most likely to spread EEE are most active during the dusk to dawn hours.”

There are preventative strategies to avoid EEE, and the MDPH has listed such measures 

For those who live in Massachusetts and want more information on EEE, it can be found 

 or by calling the DPH Division of Epidemiology at 617-983-6800.

1.NH DHHS Identifies Person Infected with Eastern Equine Encephalitis Virus in New Hampshire.The New Hampshire Department of Health and Human Services. August 27, 2024. Accessed August 28, 2024.
https://www.dhhs.nh.gov/news-and-media/nh-dhhs-identifies-person-infected-eastern-equine-encephalitis-virus-new-hampshire
2. State health officials announce season’s first human case of Eastern Equine Encephalitis in Massachusetts. MDPH. August 16, 2024. Accessed August 27, 2024.
https://www.mass.gov/news/state-health-officials-announce-seasons-first-human-case-of-eastern-equine-encephalitis-in-massachusetts
3.Plymouth to Close all Public Parks and Fields from Dusk to Dawn. Town of Plymouth. August 23, 2024. Accessed August 27, 2024. PDF.
4. Eastern Equine Encephalitis: Symptoms, Diagnosis, and Treatment. CDC. May 15, 2024. Accessed August 27, 2024.
https://www.cdc.gov/eastern-equine-encephalitis/symptoms-diagnosis-treatment/index.html
5. State officials announce plans to spray for mosquitoes in sections of Worcester and Plymouth counties due to EEE. MDPH. August 24, 2024. Accessed August 27, 2024. 
https://www.mass.gov/news/state-officials-announce-plans-to-spray-for-mosquitoes-in-sections-of-worcester-and-plymouth-counties-due-to-eee



The town of Plymouth decided to prohibit people from using the parks from dusk to dawn due to concerns over eastern equine encephalitis after a man contracted the rare disease in the state.

Concerns Over Mosquito-Borne Illness Causes Massachusetts Town to Create Curfew for Parks, Spraying in Counties

Christopher Sellers, MD, discusses its distinct program and diverse professional opportunities as well as many ID trainees and fellows stay at the University of North Carolina (UNC). 

UNC’s Infectious Disease Program Provides Diverse Career Paths

, where we spotlight individual medical institutions and infectious disease (ID) programs. Today, we spotlight the University of North Carolina (UNC)’s Institute for Global Health and Infectious Diseases (IGHID).

Overall, UNC leads over 20 postdoctoral training programs around the world and they give their medical students and trainees global health experiences that allow them to work in underserved areas. IGHID provides students with education and career skills to address complex health challenges of diverse populations, wherever they arise.

UNC has established project sites in Malawi, Zambia, China, Vietnam, and Liberia and has done work in 45 countries. The focus is not only international but in the US and locally in North Carolina, according to Christopher Sellers, MD, MPH, program director of the Infectious Disease Fellowship Training Program. One major emphasis attached to the ID program is public health.

“I think one of the things that is truly unique here is the strength of the public health ties and opportunities in our division,” Sellers said. He explained that trainees can work within local, county, national, and international public health departments and programs. 

Sellers explained that the ID fellowship offers trainees the ability to accelerate their learning with numerous opportunities due to the size of the university. For example, in addition to public health, UNC medical students can get into a variety of clinical practice and research opportunities.

“We have people who are primarily clinical doctors but in a lot of different interesting settings—taking care of patients in the prison system, taking care of people in specialized hospitals who've had organ transplants, caring for patients with tuberculosis in South Africa—there's a lot of different directions even within that,” Sellers said. “There are tons of research careers that people go on to have, spanning all different pathogens and types of research, from health behavior and health education research—which can be really important—to working on virology or epidemiology.”

In terms of UNC being attractive to young health providers, approximately 30% of ID trainees return to UNC to work in the infectious diseases department.

“There are a lot of people who are great colleagues, both in terms of being supportive and just in being interesting and fun to work alongside. I also think it's the opportunity to have an impact—to be working with other really talented people in ways that catalyze innovation and advances in the field. People often will look around and realize that this is the best place to do what they want to do,” Sellers said. 

And for those who do not stay, the trainees at UNC are prepared to take on new career opportunities in government agencies or hospital institutions such as the Centers for Disease Control and Prevention, National Cancer Institute, and the Cleveland Clinic.

One of the goals Sellers strives for is to help bring trainees to the next level and become the next experts and leaders in the field.

“We spend a lot of time thinking about how can we help you go from being a really good infectious disease doctor to a spectacular one,” he said. 

Look for the next episode tomorrow when William A. Fischer II, MD; and David Wohl, MD, discuss UNC’s Special Pathogens Response

Center and their participation in helping to lead UNC's preparedness drills.

Christopher Sellers, MD, discusses its distinct program and diverse professional opportunities and provides some insights as to why many ID trainees stay at the University of North Carolina. 

The University of North Carolina’s (UNC) Institute for Global Health and Infectious Diseases Director Myron Cohen, MD, discusses the uniqueness of the institution 

UNC’s ID Institute Offers Global Research, Education, and Clinical Opportunities

The University of North Carolina (UNC)’s renowned Institute for Global Health and Infectious Diseases (IGHID) was established in 2007 and brings together the university’s 5 health science schools with a particular interest in infectious disease.

“The institute was formed in order to bring together and create synergy among all these different parts, and that's proven to be true, and then to create opportunities that would otherwise be difficult,” said Myron Cohen, MD, the institute's director. “And in particular, [we wanted] to build infrastructure in North Carolina and in other countries so that investigators could pursue their goals with much greater ease.”

The institute’s roots are in research, and it offers opportunities around the world. They work in 45 countries.

“We have fairly large infrastructure in Asia, Africa, South America, and North Carolina, so we can help direct investigators from all of our health science schools and the rest of the campus to the best place to achieve their goals,” Cohen said.

In addition, he says the institute has large regulatory and grants management teams that help investigators more easily navigate potential research avenues and secure grants.

The institute secured $323 million in contracts and grants during fiscal years 2020-2024, conducted over 200 studies in 2024, and published over 1000 papers that same year.

In addition to research, UNC offers top-tier trainee and fellowship education. They have 35 postgraduates, physicians, and fellows and have trained over 750 fellows since 1998. The institute has also won 50 awards.

In future episodes, we will detail clinical service opportunities and the work IGHID members are performing both in the US and globally.



Look for the next episode on Monday when UNC Director of the Infectious Diseases Training Program Christopher Sellers, MD, discusses the percentage of infectious disease trainees who stay at UNC and potential career paths for them.

Reference
1. Institute for Global Health and Infectious Diseases. University of North Carolina. Accessed August 22, 2025. https://globalhealth.unc.edu/



The University of North Carolina (UNC) Institute for Global Health and Infectious Diseases Director Myron Cohen, MD, discusses the uniqueness of the institution and its ability to offer research and clinical opportunities globally as well as play a significant role in public health. 

UNC’s ID Institute Offers Global Research, Education, and Clinical Opportunities 

ACC Issues Vaccine Guidance for People With Heart Disease

The American College of Cardiology issued recommendations for influenza, COVID-19, RSV, and other vaccinations, emphasizing immunization as a cornerstone of cardiovascular care.

FDA Suspends Valneva’s Chikungunya Vaccine IXCHIQ License

The FDA suspended the license for IXCHIQ after 4 new serious adverse events (SAEs) were reported, halting US sales while Valneva continues investigations and global distribution.

CDC Confirms Biannual COVID-19 Peaks; ACIP Adjusts Guidance

CDC data confirmed consistent late-summer and winter COVID-19 surges. ACIP shifted to targeted recommendations, including 2 annual vaccine doses for adults 65 years or older.

HHS Reinstates Childhood Vaccine Safety Task Force

HHS revived the federal task force on vaccine safety after 27 years, amid rising exemption rates and parental hesitancy.

FDA Lifts Pause on IXCHIQ Use in Adults 60+

After review, the FDA allowed the resumed use of IXCHIQ in adults 60 years or older, adding updated prescribing warnings about SAE risk in older adults with comorbidities.

Rising COVID-19 Cases Spark Concern Over Narrow Booster Access

Experts warned of a late-summer surge due to low vaccine uptake (23% of adults, 16% of children) and booster restrictions that limited broader protection.

HHS Approves Removal of Thimerosal From Flu Vaccines

Following ACIP’s recommendation, thimerosal is being removed from influenza vaccines, with officials aiming to strengthen parental confidence in vaccine safety.

COVID-19 Boosters Cut Hospitalizations in People With Cancer

A large US study showed booster vaccination significantly reduced hospitalization risk in adults undergoing chemotherapy or immunotherapy.

FDA Approves Prefilled Syringe Format for Shingrix

The new format for GSK’s shingles vaccine eliminates reconstitution, simplifying administration and supporting broader uptake among older adults.

Danish Study Reinforces Aluminum Vaccine Safety

Research found no association between aluminum adjuvants in childhood vaccines and autism, asthma, or other health outcomes, reinforcing their safety profile.

FDA Authorizes Moderna COVID-19 Vaccine for Children 6 Months–11 Years

Moderna’s updated Spikevax will be available for children younger than 12 years for the upcoming respiratory virus season.

Monoclonal Antibody Shows Strong COVID-19 Prevention Efficacy

Invivyd’s pemivibart (Pemgarda) demonstrated 84% relative risk reduction of symptomatic COVID-19 vs placebo in phase 3 trials.

ACIP June 2025 Meeting: Targeted Vaccination Strategy Adopted

ACIP endorsed a shift away from universal vaccination toward population-specific recommendations, with 2 annual doses recommended for adults 65 years or older.

From chikungunya setbacks to COVID-19 booster guidance and childhood vaccine safety initiatives, here are the top regulatory and research developments this summer.

Summer 2025 Vaccine News Roundup: FDA, CDC, and HHS Updates

A 9-month pilot study in 3 nursing homes found that routine chlorhexidine bathing and nasal iodophor use reduced multidrug-resistant organism (MDRO) colonization among residents by 55%, but did not significantly affect environmental contamination in rooms of MDRO carriers.

Researchers analyzed outcomes across a baseline, phase-in, and intervention period. Colonization rates decreased from 46% (411/900) at baseline to 29% (262/900) during the intervention (OR, .45; 

 < .001). Significant reductions were observed in colonization with methicillin-resistant 

 (VRE), and extended-spectrum beta-lactamase producers (ESBL) (

Despite these reductions, environmental contamination remained high in rooms of residents who continued to carry MDROs. Of 330 colonized residents, 288 rooms (87%) had at least 1 high-touch object contaminated with an MDRO. Multivariable analysis found that contamination was associated with antibiotic use (OR, 1.54; 95% CI, 1.19-1.98), presence of wounds (OR, 1.34; 95% CI, 1.02-1.77), and certain fomites such as bedside tables and bedrails (OR, 12.7; 95% CI, 9.37-17.25). The intervention period itself was not significantly associated with changes in contamination (OR, 1.02; 95% CI, .81-1.27).

The investigators concluded that while decolonization strategies effectively reduce resident-level MDRO burden, additional measures targeting environmental cleaning in rooms of MDRO carriers are necessary to curb transmission risk.

Findings from another setting echo these challenges. A study reported by 

 exposure in dialysis centers across 4 US states. Standard infection prevention and control (IPC) practices, including bleach disinfection, routine use of PPE, and short patient stays, were sufficient to prevent new transmissions, even when facilities were unaware of colonization status. Communication gaps between health care settings delayed containment.

Together, these studies highlight the complexity of MDRO control in congregate care. Nursing homes demonstrated that colonization can be reduced, though environmental reservoirs persist. Dialysis centers showed that robust baseline IPC can block transmission despite colonization, but information sharing between facilities remains a critical weakness. Effective MDRO containment will require both strong routine IPC and improved cross-setting communication.

1.Flores EA, Singh R, McKinnell JA, et al. Impact of routine chlorhexidine bathing and nasal iodophor on MDRO colonization and environmental contamination in nursing homes. Infection Control & Hospital Epidemiology. Published online 2025:1-7. doi:10.1017/ice.2025.10234

2.Kurutz A, Innes GK, Sherman A, et al. Candida auris Containment Responses in Health Care Facilities that Provide Hemodialysis Services — New Jersey, North Carolina, South Carolina, and Tennessee, 2020–2023. MMWR Morb Mortal Wkly Rep 2025;74:415–421. DOI: 

A 9-month pilot study showed a 55% reduction in resident colonization with MRSA, VRE, and ESBL, but contamination of high-touch surfaces persisted in rooms of MDRO carriers.

Routine Decolonization Cuts MDRO Burden in Nursing Homes but Leaves Environmental Risks

The US Food and Drug Administration (FDA) has suspended the license for Valneva’s chikungunya vaccine IXCHIQ, effective immediately, after updated safety monitoring identified 4 new reports of serious adverse events (SAEs) consistent with chikungunya-like illness. The suspension requires Valneva to stop shipping and selling IXCHIQ in the US, the company announced on August 25, 2025.

The decision follows the FDA’s earlier August 6 action lifting a temporary pause on use of IXCHIQ in individuals 60 years or older, after a prior review of SAEs had concluded the benefits of vaccination outweighed risks in older adults with comorbidities. New VAERS data included 4 additional SAEs, all reported outside the US; 3 cases occurred in adults aged 70 to 82 years, including 1 hospitalization with recovery after 2 days, and 1 case in a 55-year-old.

Valneva stated that the clinical presentation of these cases was consistent with events observed in prior clinical trials and postmarketing reports, especially among older vaccine recipients, for whom the prescribing information includes warnings and precautions. The company reported IXCHIQ generated €7.5 million in sales during the first half of 2025, out of €91 million total product sales, largely from one-time deliveries to address an outbreak in La Réunion.

CEO Thomas Lingelbach emphasized that despite the suspension, Valneva remains committed to maintaining vaccine access in countries where IXCHIQ is licensed and to accelerating distribution in low- and middle-income endemic regions. The company is continuing to investigate the new SAE reports and may pursue further regulatory steps under FDA procedures. Valneva is also assessing the potential financial impact of a permanent withdrawal of the US license, but has not changed its 2025 revenue guidance.

Timeline: FDA Actions on Valneva’s Chikungunya Vaccine IXCHIQ

 Following a 3-month safety review in collaboration with the European Medicines Agency, the FDA lifted its pause on IXCHIQ use in adults 60 years or older. Updated labeling added warnings about SAE risks in older adults with chronic conditions. IXCHIQ remained indicated for high-risk adults 18 years or older, whereas use in low-risk US travelers and immunocompromised individuals was discouraged.

The FDA and CDC recommended pausing IXCHIQ use in adults 65 years or older after reports of SAEs, including 1 fatality, during a vaccination campaign in La Réunion. The precaution was based on VAERS reports, though no causal link was established.

 The Advisory Committee on Immunization Practices (ACIP) recommended chikungunya vaccination for travelers to outbreak regions and laboratory workers at risk. During the meeting, ACIP reviewed safety data from IXCHIQ trials, noting 6 serious adverse events (SAEs) and highlighting challenges in assessing reactions in older adults with comorbidities.

1.Valneva. Valneva Announces FDA’s Decision to Suspend License of Chikungunya Vaccine IXCHIQ® In the U.S. August 25, 2025. Accessed August 25, 2025. 

https://valneva.com/press-release/valneva-announces-fdas-decision-to-suspend-license-of-chikungunya-vaccine-ixchiq-in-the-u-s/

2.Valneva Announces Removal of FDA-Recommended Pause on Use of Chikungunya Vaccine IXCHIQ® in Elderly and Updates to the Prescribing Information. August 7, 2025. Accessed August 25, 2025. 

https://www.globenewswire.com/news-release/2025/08/07/3128880/0/en/Valneva-Announces-Removal-of-FDA-Recommended-Pause-on-Use-of-Chikungunya-Vaccine-IXCHIQ-in-Elderly-and-Updates-to-the-Prescribing-Information.html

3.Valneva. Valneva Provides Update on Recommended Use of IXCHIQ® by Elderly Individuals in the United States. GlobalNewswire. May 12, 2025. Accessed August 25, 2025. 

https://www.globenewswire.com/news-release/2025/05/12/3078777/0/en/Valneva-Provides-Update-on-Recommended-Use-of-IXCHIQ-by-Elderly-Individuals-in-the-United-States.html

4.Abene S. CDC ACIP Meeting Examines Next Steps for Meningococcal, RSV, and Chikungunya Vaccination. Contagion. April 16, 2025. Accessed August 25, 2025. 

https://www.contagionlive.com/view/cdc-acip-meeting-examines-next-steps-for-meningococcal-rsv-and-chikungunya-vaccination

Regulators cite four new serious adverse event reports, halting US distribution while global access efforts continue.

Andrew Berti, PharmD

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