Infectious Disease Alert – November 1, 2025

Current Recommendations for Childhood Respiratory Vaccines

Amidst prevalent vaccine hesitancy, changing governmental advisory groups, and altered recommendations, COVID immunization still is recommended for all children aged 6 through 23 months and for older children with medical risk factors.

COVID-19 Rebound: To Retreat or to Re-Treat

Re-treatment of non-immunocompromised patients with mild-moderate COVID-19 rebound with nirmatrelvir/ritonavir provided no significant benefit.

Absence of Pleocytosis in Cerebrospinal Fluid Does Not Rule Out Encephalitis

A retrospective study that included 597 adults with encephalitis found 25.3% did not have pleocytosis in their cerebrospinal fluid, and 23.7% of those with HSV-1 encephalitis lacked pleocytosis on the initial lumbar puncture.

Recombinant Herpes Zoster Vaccine in a Medicare Population

Receipt of adjuvanted recombinant herpes zoster vaccine was effective in individuals older than 64 years of age and maintained its efficacy in immunocompromised individuals. Added benefit accrued from receipt of the second vaccine dose, even if its administration was delayed.

The Expanding Venues of Histoplasmosis and Blastomycosis in the United States

The occurrence of new cases of both histoplasmosis and blastomycosis is increasing in the United States, including in areas not generally considered endemic.

Enterococcal Infections: Getting More Difficult to Treat

Increasing resistance among enterococci dictates the need for careful antibiotic choices, even in the absence of high-quality clinical data.

Chikungunya in New York

On Aug. 21, 2025, a 60-year-old woman living in Nassau County on Long Island became ill with symptoms that were marked by severe joint pain involving her feet, ankles, knees, wrists, hands, and shoulders.

Infectious Disease Updates

Emerging Carbapenemase Resistance in Enterobacterales; Jamestown Canyon Virus Common in Northern Minnesota and Wisconsin