Infectious Disease Alert – September 1, 2025

Influenza and Acute Necrotizing Encephalopathy in Children

Of 41 U.S. pediatric patients with influenza-associated acute necrotizing encephalitis, 56% were female, the median age was 5 years, and 12% had underlying complex medical conditions. Influenza A accounted for 95% of cases. Despite the use of a variety of immunomodulating agents, 27% of these children died, and 63% of the survivors were left with at least moderate disability.

The Health and Economic Burden of Long COVID in the United States

Researchers using a computational simulation model found that the current health and economic burden of long COVID already exceeds the cost of several chronic diseases and will continue to grow as COVID-19 cases increase.

Routine Boosting Against Tetanus and Diphtheria in Adults: A Time to Reconsider

Slifka and colleagues make a strong argument against the routine booster vaccination of adults against tetanus and diphtheria as recommended by the Centers for Disease Control and Prevention.

Aluminum-Adsorbed Vaccines and Chronic Diseases in Children

A large Danish cohort study of 1.2 million children found no association between cumulative aluminum exposure from childhood vaccines and increased risk for autoimmune, atopic/allergic, or neurodevelopmental disorders, adding to nearly a century of safety data for aluminum adjuvants, although the study’s findings have been the subject of public debate about interpretation of secondary analyses.

Community-Acquired Pneumonia Guidelines: Updates and Disputes

An update of elements of community-acquired pneumonia guidelines have been published. Of note is that these were not endorsed by the Infectious Diseases Society of America because of disagreement over recommendations for empiric antibiotic administration to some patient subsets with positive tests for respiratory viral infection.

Infectious Disease Updates

Eradication of Polio Around the World; Candida auris in Dialysis Facilities: How Great Is the Risk?