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Preliminary evidence indicates no direct evidence for intrauterine transmission of the SARS-CoV-2 virus from pregnant women with COVID-19 to their infants.

COVID-19, SARS-CoV-2 and Pregnancy: Does the Past Predict the Present?

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

 found that fecal microbiota transplantation (FMT) and standardized microbiome therapeutics such as SER-109 and RBX2660 demonstrate significantly higher cure rates and favorable safety profiles compared with standard antibiotic therapy for recurrent 

Across 7 studies involving 1030 patients, FMT achieved clinical cure rates of 70% to 91%, compared with 23% to 62% for antibiotics or placebo. Donor FMT outperformed autologous FMT (90.9% vs 62.5%; 

 = .042) and standard regimens, including fidaxomicin (33% resolution) and vancomycin (19%; 

< .01). Microbiota-based products showed similar efficacy, with relative risk reduction of recurrence up to 68%. Safety outcomes were favorable over a 5-year follow-up, with most adverse events limited to mild gastrointestinal symptoms and no new safety concerns identified.

The review followed PRISMA 2020 guidelines and included 6 randomized controlled trials and one cohort study published between January 2015 and May 2025. Bias assessments were conducted with the Cochrane Risk of Bias 2.0 tool for randomized controlled trials and the Newcastle-Ottawa Scale for cohort studies. Heterogeneity in administration routes (capsules vs colonoscopy) and donor material (fresh vs frozen) was noted.

Investigators concluded that FMT and standardized microbiome-based therapies provide highly effective treatment options for patients with recurrent or refractory CDI. They emphasized the need for further research to standardize treatment protocols and evaluate outcomes in higher-risk populations.

This emphasis on microbiome therapies reflects a broader trend in 2025, with multiple studies highlighting both opportunities and challenges. For example, Clemson University researchers reported in 

 that FMT failures may stem less from microbial engraftment and more from functional incompatibility between donor microbes and the recipient gut environment. In mouse models, human donor stool successfully colonized but failed to clear 

, whereas mouse donor stool proved effective. These findings help explain why up to 10% of rCDI patients do not respond to FMT, and why failure rates are even higher in more complex conditions such as inflammatory bowel disease or irritable bowel syndrome.

In addition, a large real-world cohort study from Aarhus University Hospital examined more than 1100 adults treated with FMT between 2016 and 2023. The most successful strategies involved administering FMT via multiple-dose capsules or colonoscopy after prolonged antibiotic pretreatment, with repeated FMT outperforming antibiotics alone for recurrent cases. Overall, 81% of patients achieved cure by 8 weeks, supporting clearer guidance on FMT dosing, delivery, and pretreatment duration.

Together, these studies illustrate a consistent trend in rCDI research this year: while FMT and microbiome-based products are proving highly effective and generally safe, optimizing their functional compatibility, delivery strategies, and treatment protocols remains essential for maximizing clinical benefit.

1. Weerakoon S, Avula S, Mandefro BT, et al. Microbiota-based therapies for recurrent clostridium difficile infection: a systematic review of their efficacy and safety. 

. 2025;17(8):e90737. doi:10.7759/cureus.90737

2. Landrum, C. Clemson research could lead to improved treatment for C. diff and other GI illnesses. Clemson University, College of Science. June 16, 2025. Accessed August 24, 2025. 

https://news.clemson.edu/clemson-research-could-lead-to-improved-treatment-for-c-diff-and-other-gi-illnesses/

3. Paaske SE, Baunwall SMD, Rubak T, et al. Clinical management of Clostridioides difficile infection with faecal microbiota transplantation: a real-world cohort study. 

. 2025;85:103302. doi:10.1016/j.eclinm.2025.103302

Systematic review finds FMT and standardized microbiome products outperform antibiotics in efficacy and safety.

Microbiota-Based Therapies Show Superior Outcomes for Recurrent C difficile Infection

This article was originally published on our sister-site, 

New research is shedding light on the need for 

 strategies beyond antibiotic stewardship, highlighting antibiotic exposure’s minimal impact on infection risk in asymptomatic carriers.

The retrospective cohort study examined more than 33,000 hospitalizations among 23,001 patients and found asymptomatic carriers had a greater hazard of CDI, with antibiotic exposure, particularly to amoxicillin and clavulanate and piperacillin and tazobactam, linked to increased infection risk. Of note, antibiotic exposure was not significantly associated with additional hazard among carriers, suggesting antibiotic stewardship may not effectively reduce CDI risk in this population.

According to the US Centers for Disease Control and Prevention, 

, a bacterium that causes diarrhea and colitis, is estimated to cause almost half a million infections in the US each year. Receipt of certain antimicrobials is associated with increased susceptibility to CDI.

, ie, individuals with positive test results for the bacterium without exhibiting symptoms, present unique challenges in health care settings. These carriers not only act as potential reservoirs for transmission but also are at an elevated risk of progressing to clinical CDI,” Mayan Gilboa, MD, Infectious Control Unit, Sheba Medical Center in Israel, and colleagues wrote.

 “However, the specific interactions among antibiotic use, type, and duration of treatment in this high-risk group remain poorly understood.”

To evaluate the risk of CDI among asymptomatic carriers vs noncarriers of 

 and whether it is associated with antibiotic exposure, investigators conducted a retrospective cohort study between June 2017 and June 2023, assessing hospitalizations from Sheba Medical Center in Ramat Gan, Israel, a center that routinely screens for 

 in high-risk patients admitted to internal medicine.

Eligible patients were adults who were hospitalized in internal medicine wards and deemed high risk for 

 carriage due to reasons like hospitalization within the past 6 months or transfer from another hospital or a long-term-care facility.

All patients were followed up from 2 days after hospitalization until death, discharge, day 21 of the hospitalization, admission to the ICU, or CDI, whichever was earliest. The primary outcome was the development of CDI, as confirmed by laboratory testing for 

. Antibiotic exposure was assessed as a time-varying variable.

In total, the study included 33,756 hospitalizations among 23,001 patients, the majority of whom were male (52.8%) with a median age of 78 (interquartile range [IQR], 68-87) years. A total of 1624 (4.8%) admissions had a positive screening result for 

 and were defined by investigators as carriers.

Overall, 67 of 1624 (4.1%) carriers and 47 of 32,132 (.1%) noncarriers with negative screening results developed CDI.

Among carriers, 251 CDI tests were sent (15.5%) compared with 2067 tests among noncarriers (6.4%). Despite more frequent testing in carriers, investigators noted the positivity rate was markedly higher at 26.7% (67 of 251) in carriers vs 2.3% (46 of 2067) in noncarriers.

Among the entire cohort, exposure to any antibiotic was associated with an increased risk of CDI (HR, 1.98; 95% CI, 1.24-3.16), with each additional day of exposure to antibiotics having an HR of 1.08 (95% CI, 1.03-1.13). Exposure to piperacillin and tazobactam was associated with increased risk (HR, 2.18; 95% CI, 1.41-3.36), with each additional day having an HR of 1.13 (95% CI, 1.07-1.20).

 screening result at admission was associated with a high risk of infection (HR, 27.5; 95% CI, 18.7-40.3). Among asymptomatic carriers, investigators pointed out that antibiotic exposure was not significantly associated with a further increase in CDI hazard (HR, 1.07; 95% CI, .73-1.58).

“While antibiotic stewardship is crucial for reducing CDI in general, additional approaches are needed for carriers to mitigate their substantially high baseline risk,” investigators concluded.

 “Further research should explore modifiable factors beyond antibiotic use to improve outcomes in patients with CDI and to reduce the overall burden of CDI in health care settings.”

1. Gilboa M, Regev-Yochay G, Meltzer E, et al. Antibiotic use and the risk of hospital-onset 

2. US Centers for Disease Control and Prevention. About C. diff. December 18, 2024. Accessed August 11, 2025. 

https://www.cdc.gov/c-diff/about/index.ht

C difficile carriers faced a higher baseline risk for hospital-onset infection compared to noncarriers, and this risk was not significantly influenced by antibiotic use.

Antibiotic Stewardship Alone May Be Insufficient for Preventing C Diff Infections

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.

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

David A. Schwartz, MD, MS Hyg, FCAP

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