From the ECDC (European Centre for Disease Prevention and Control) Weekly Communicable Disease Threats Report, the US CDC, and the WHO:
Current data indicates significant ongoing transmission of chikungunya in the Seychelles. The ECDC is advising travellers to take enhanced mosquito bite-prevention measures, as well as to consider vaccination in line with recommendations in their country of origin.
Still significant seasonal respiratory virus circulation in much of the Northern hemisphere, now with a decreasing trend, and mostly affecting people older than 65 years in terms of seriousness. Influenza A(H3N2) has been this season’s dominant strain. In some tropical and Southern Hemisphere regions, influenza activity has been reported outside the usual peak season. Globally, COVID-19 activity has been unremarkable.
A small Nipah virus outbreak in West Bengal, India, in early 2026 was rapidly contained, with no evidence of further spread following the initial two cases in healthcare workers. On 3 February one confirmed case of Nipah virus infection was reported in Rajshahi Division in Bangladesh. No further cases have been detected to date and the WHO considers that the risk of international disease spread is low. Still, some airports have reacted by implementing screening measures without a clear scientific rationale; those measures are now being scaled back or discontinued. Screening can offer reassurance (or increase worry) to the public but has limited scientific value in detecting rare infections like Nipah, given its incubation period and transmission dynamics. Fruit bats are the natural hosts of Nipah virus, spillovers to humans have been rare, and person-to-person transmission is not easy.
On 1 December 2025, the DRC declared the end of the 16th Ebola virus disease outbreak, after meeting the recommended criteria - no new cases for two consecutive incubation periods following discharge of the last confirmed patient. The DRC has just finished an uneventful 90-day period of enhanced surveillance. No cases of Ebola have been reported elsewhere.
The first-ever outbreak of Marburg virus disease (MVD) in Ethiopia was declared over earlier on 26 January after 42 days (two incubation periods) with no new confirmed cases. No additional cases have been identified since then. MVD is a rare but severe viral haemorrhagic fever with clinical features similar to Ebola and a case-fatality rate that ranged from about 24% to 88% in previous outbreaks. There are currently no licensed vaccines or specific treatments, and clinical management remains supportive. However, a clinical trial is ongoing to evaluate the safety and efficacy of the investigational cAd3-Marburg vaccine – crossing fingers for some good news before the end of the year.
A selection of other publications of interest:
IATA report on risks to global economy 2026
IATA published on 28th December a report assessing the risks to the global economy in 2026. The report includes a matrix of 22 potential risks with respect to their likelihood of occurrence and possible negative impact (below). Pandemic risk, though currently fortunately low in likelihood (2% in any given year), is no longer limited to a once-in-a-century event and is at the top of potential damaging impact on a par with the risk of severe global economic slowdown. Nearly 10% of global land area is currently classified as being at high risk for disease outbreaks. You’ll find the report brief here: https://www.iata.org/en/iata-repository/publications/economic-reports/an-assessment-of-risks-in-2026/
Blue mirror
Blue Mirror is the EU monthly bulletin focused on promoting wastewater-based epidemiology as an essential tool for public health intelligence. You can access it here: https://wastewater-observatory.jrc.ec.europa.eu/#/content/monthly-chronicle
Impact of measles transmission on commercial flight operations
This Journal of Travel Medicine review https://pubmed.ncbi.nlm.nih.gov/40884489/ highlights the implications of measles transmission for airline operations and public health coordination. The measles virus is highly contagious through aerosolization. Despite risk reduction thanks to high rates of air exchange in commercial aircraft, transmission during air travel has been well documented. Transmissibility is further facilitated by the fact that persons with measles are infectious for up to 4 days before a visible rash breaks out.
Key points for airlines:
- Transmission is not confined to nearby seats: secondary measles cases were frequently identified outside the usual “two-row” zone rule of thumb. Measles exposure events may trigger wide contact investigations, not limited to adjacent rows. Different countries use differing contact definitions and procedures for notifying exposed passengers. Clear public health procedures and communication are essential.
- Contact tracing is resource-intensive: investigations were conducted for at least 182 flights, highlighting the operational and reputational burden on airlines after exposure events.
- Unvaccinated passengers are most at risk: nearly three-quarters of secondary cases with known status were unvaccinated.
- Post-exposure measures are underused: uptake of post-exposure prophylaxis (vaccine given within 72 hours of exposure or immunoglobulin within 6 days) was low, suggesting practical barriers once passengers have dispersed internationally, including the narrow time window of opportunity.
- Prevention matters most: From an airline perspective, background prevention (vaccination) at public health intervention level and preparedness for rational contact tracing are probably far more effective than post-exposure (post-flight) measures.
Updated evidence for covid-19 and influenza vaccines
In this systematic review published in the prestigious New England Journal of Medicine you will find an updated review of evidence on vaccines for COVID-19, respiratory syncytial virus (RSV), and influenza. The article looks at how well these vaccines are working in real-world settings to protect people against serious illness:
- COVID-19 vaccines continue to reduce the risk of hospitalization and serious outcomes, with effectiveness varying by age and immune status.
- Seasonal influenza vaccines also continue to reduce hospital admissions, with varying effectiveness depending on the season and population.
The safety profiles of all three vaccine types are consistent with what was previously known — serious adverse events are rare. This research supports current vaccine recommendations, even as viruses evolve. Article in full here: https://www.nejm.org/doi/full/10.1056/NEJMsa2514268
in-flight medical events on commercial airline flights
– an up-to-date, in-depth snapshot
This large landmark study by Paulo Alves et al looked at 77,790 medical incidents that happened during commercial airline flights globally between 2022 and 2023. These events were reported by 84 airlines, covering about 31 % of worldwide air traffic.
Medical events are probably more common than previously thought — about 39 events per 1 million passengers, or roughly 1 event every 212 flights. Most affected passengers were middle-aged adults.
1.7 % of medical events led to aircraft diversion, most often for neurologic (like suspected stroke) and cardiac emergencies. Only a small number of passengers died during flight or needed urgent hospital care after landing.
Volunteer physicians on board were linked with a higher likelihood that the flight would divert. This may reflect increased cautiousness and unfamiliarity with the aircraft cabin environment and crew and kit resources, but also that physicians often become involved in more severe or ambiguous cases, creating a selection effect.
These findings show that most in-flight medical events are managed successfully without diversion, pointing to the effectiveness of crew training, onboard medical kits, and ground-based medical support. Large-scale, real-world data help airlines anticipate common scenarios, refine crew preparedness, and optimize decision-making for diversions.
I definitely recommend that you read the full article here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2839407
Acute stress impairs decision-making
Speaking of stressful events, this is a very interesting study for colleagues concerned with human performance, human factors, and safety. This laboratory experiment showed that acute stress reduces decision quality, even when decisions have objectively correct answers. Eye-tracking suggested that altered attention allocation may partly explain the effect. The largest deficits occurred when stress coincided with time pressure. Bottom line: Acute stress impacts on the ability to decide correctly, with time pressure and task complexity acting as important factors. Full article here:
How to collect and manage data from peer support programmes?
Pilots and other safety-sensitive aviation professionals may avoid formal mental healthcare for fear of disclosure threatening their medical certification and careers. Peer support programmes (PSPs) help address this by offering confidential, non-judgmental support. Regulators and operators increasingly expect evidence of effectiveness and safety impact, which creates tension between data collection and confidentiality.
This commentary published in the aeromedical journal of reference Aerospace Medicine and Human Performance addresses how aviation PSPs should collect and use data while preserving the trust, confidentiality, and safety that make these programmes effective.
Data collection in PSPs should:
o Be based on informed consent and strong privacy governance
o Provide clear system benefit that outweighs risk to the individual
o Be used only to support wellbeing, programme quality, and system safety — never for disciplinary, legal, or certification action
o Be methodologically sound
o Never delay or withhold support on account of research priorities
o Be overseen through multi-stakeholder governance (e.g. operators, unions, clinicians, safety teams)
Type of data that can be collected (at an aggregated level):
o General programme characteristics (not operator-identifiable)
o User demographics (self-identified, minimal)
o Career stage and professional role
o Broad categories of concerns (e.g., family issues, fatigue, training stress)
o Number and duration of peer contacts
o Whether safety-relevant hazards were identified
o Whether referrals to professional support were suggested
Crucially, the intent is pattern recognition and Safety Management System (SMS) improvement, not individual surveillance. The authors argue that PSP data should be protected similarly to just-culture safety data, ideally with future alignment to ICAO Annex 13-type protections. International legal variability means implementation must occur with legal guidance.
In summary, this article puts forward welcome practical, ethically-grounded guidance for collecting PSP data without undermining trust. It supports the view, that we probably all share, that mental well-being data can enhance aviation safety, but only if confidentiality, governance, and purpose limitation are rigorously protected.
https://asma.kglmeridian.com/view/journals/amhp/96/9/article-p857.xml
Looking at When you eat rather than what or how much you eat
This small, experimental study examined whether when people eat, rather than how much they eat, can reduce the cardiovascular risks linked to night work and jet lag. Healthy participants underwent simulated night work and were randomly assigned either to eat both day and night (typical shift-work pattern) or to eat only during daytime hours.
Those who ate day and night showed adverse changes in cardiovascular risk markers, including reduced heart-rate variability (a sign of poorer cardiac autonomic control) and increased levels of a pro-thrombotic blood factor (PAI-1). In contrast, participants who restricted eating to daytime hours, despite sleeping at abnormal times, showed no such deterioration and even experienced modest reductions in blood pressure.
These really interesting findings suggest that daytime-only eating may help protect cardiovascular health in people exposed to circadian misalignment. Larger real-world studies are needed to confirm whether these benefits translate to actual shift workers and frequent long-haul travellers. https://www.nature.com/articles/s41467-025-57846-y
Postgraduate course in Airline Medicine for Aviation, Safety, Public Health and Other Professionals
I’m delighted to share news of a new international postgraduate course designed to equip professionals in aviation and related sectors with the core knowledge and practical tools needed to address health-related challenges in the airline industry and comparable operational settings.
The programme will be delivered fully online on a weekly basis and is scheduled to begin on 8 April. A quick note for full disclosure: the course is co-coordinated by me and Dr David Powell and is academically managed by NOVA University Lisbon https://www.unl.pt/en/ .
We are fortunate to be joined by an outstanding faculty of recognised world-class experts for what is, to the best of my knowledge, the first postgraduate programme dedicated specifically to airline health. Further details, including the course brochure and application information, are available here: https://advancededucation.learnworlds.com/course/taskly-project-383
Hope to welcome many of you to the course.
Dr Rui Pombal
IATA Medical Advisor