IDSA’s Journal of Infectious Diseases provides a monthly roundup of JID papers with direct relevance to clinicians. Read on to learn more about the effectiveness of the MMR vaccine in a contemporary outbreak setting in the U.S., evidence that rhinovirus is a dual respiratory tract pathogen capable of causing lower airway disease in adults and other research ready to inform clinical practice. (Titles and summaries are adapted from the May 2026 issue of JID.)
Companion editorial: When Time Is of the Essence: Hepatitis C Virus RNA Point-of-Care Testing in 15 Minutes Becomes a Reality
Hepatitis C virus infection is an underdiagnosed public health problem despite the availability of highly effective and curative direct-acting antiviral treatments. A rapid point-of-care test is needed for same-day diagnosis and treatment. The qualitative Research Use Only DASH Rapid PCR System HCV assay (with a 15-minute time-to-result) displayed wide dynamic range and detected HCV genotypes 1-6, with a detection limit of 200 IU/mL using a 100 μL specimen volume. In a preliminary study of 97 plasma specimens, this assay displayed 100% positive percent agreement and 100% negative percent agreement when compared to commercial platforms. This test holds potential to enable same-day diagnosis and treatment in support of HCV elimination efforts.
Cytomegalovirus affects 0.5%-2.0% of all live births and is the main nongenetic cause of congenital sensorineural hearing loss and neurological damage, yet no validated prenatal treatment exists for infected fetuses. Letermovir, a CMV-specific antiviral, is approved for prophylaxis in transplant recipients. In this study, seven pregnant women undergoing second-trimester termination of pregnancy for fetal anomalies received oral letermovir (240 mg or 480 mg once daily) for three days. On the day of termination, samples from maternal and fetal blood, placenta and fetal organs were collected and analyzed. Letermovir achieved therapeutic levels in all compartments and physiologically-based-pharmacokinetic modeling confirmed adequate fetal exposure across pregnancy stages. These unique in vivo data provide the first pharmacological rationale supporting letermovir use during pregnancy for congenital CMV therapy.
The role of human rhinovirus in adult lower respiratory tract infections remains controversial. In this large retrospective study (2020-2023), all hospitalized adults were screened for HRV via RT-PCR; detection of HRV infection of lower respiratory tract cells was tested by immunofluorescence staining on lung biopsies. HRV was detected in 4.6% (437/9,544) of patients, with bimodal seasonal peaks (February-April and September-November). Co-infection occurred in 49.0% (214/437), predominantly bacteria (34.1%) and viruses (25.7%). IF staining confirmed HRV VP3 protein in lung biopsy specimens in 61.5% (8/13) of cases, providing the first histological evidence of HRV’s LRT cell infection in immunocompetent adults.
Companion editorial: Uncovering the Hidden Impacts of Modern Medicine’s Expanding Pharmacopeia on Clostridioides difficile Infection Risk
This case-cohort study (2018-2023) examined the contribution of antibiotic and nonantibiotic drugs to CDI risk in those >65 years old and not hospitalized in the prior 30 days; the drug exposure time window was 90 days prior to hospitalization. Among 16,196 CDI cases and 549,831 controls, 335 drugs were included. After adjustment, antibiotics amoxicillin-clavulanate (odds ratio = 6.05), clindamycin (OR = 16.83), ciprofloxacin (OR = 3.83) and cephalexin (OR = 3.05) were the largest contributors to CDI risk. Nonantibiotic drugs pantoprazole (OR = 1.33) and ferrous fumarate (OR = 1.71) were the next-largest, and metformin had a protective association (OR = 0.67). Using a subset of 182 drugs, in vitro anti-commensal activity was positively associated with CDI risk (p < 0.001).
In 2024, the Chicago Department of Public Health was notified of a positive measles test in a resident of a shelter housing >2,100 persons. Measles was diagnosed in 52/2,243 (2.3%) residents who resided in the shelter ≥1 day. Attack rates were highest among children aged <6 months (57.1%) and 6-11 months (55.6%), and residents who were exposed for 8-13 days (10.1%). Estimated one-dose vaccine efficacy was ~70% (95% confidence interval, 28%-88%). Rapid administration of measles vaccine prevented disease in a congregate shelter, despite prolonged exposure.
