India & South Asia Microbiology and Infectious Disease report (ISAMID) 25/10/2026

These stories were already being followed before this week. The table shows what changed since the figures reported on 18 Oct. NEW marks a changed figure. UNCHANGED means no newer figure was found. Four stories close this week because nothing further was reported.

Discussion frequency: Moderate·Status: ongoing since 15 March 2026

Location: Bangladesh (nationwide; Dhaka Division 502 and Sylhet Division 200 of all deaths)

• DGHS bulletin, 25 Oct non-X: five further deaths in the 24 hours to 08:00, all among suspected cases; 1,280 new suspected and 76 new confirmed cases. 196,703 people have been hospitalised since 15 March and 188,674 have recovered. Deaths by division: Dhaka 502, Sylhet 200, Chattogram 107, Rajshahi 93, Mymensingh 88, Barishal 65, Khulna 51, Rangpur 17. BSS · UNB · The Business Standard · Dhaka Tribune · bdnews24
• Emerging Infectious Diseases, November 2026 issue (non-X; shared on X 23 Oct):
  • A surveillance report covers 2 April–27 May: 67,079 suspected and 8,834 confirmed cases, with a nationwide measles–rubella campaign targeting about 18 million children aged 6–59 months.
  • A perspective from icddr,b authors links falling coverage to political instability, discontent among field staff, a change in procurement policy, COVID-19 disruptions and delayed supplementary campaigns. It says disrupted vitamin A supplementation and worsening malnutrition amplified severity. It reports that all 55 sequenced genomes were genotype B3, with no evidence of vaccine escape.
  • EID surveillance report · EID perspective · X: GlobalPHObserv · GlobalPHObserv
• X (English, political): one account claimed that H1N1 has now followed measles and dengue in Bangladesh. No supporting official or media report was found. Unverified discussion on X only. manavsaxenaz8

Discussion frequency: Moderate·Status: ongoing; still rising

Location: BangladeshDhaka North and South city corporations and all divisions

• DGHS, 25 Oct non-X: seven deaths and 2,249 admissions in 24 hours, the highest daily admission figure this year. The deaths were two each in DNCC and Mymensingh Division, and one each in DSCC, Khulna and Rajshahi. 6,164 patients are in hospital. The Daily Star
• DGHS, 24 Oct non-X: 1,898 admissions in 24 hours, with 121,699 hospitalised and 115,132 recovered this year. bdnews24 · Daily Observer · The Daily Star · The Business Standard
• Literature non-X: a PLoS NTD study of Rohingya camps and host communities in Cox’s Bazar (October 2021 to December 2024) reports 35,581 RDT-confirmed cases, with 8.0% admitted and four deaths. See Section 13.

Discussion frequency: Moderate–high·Status: ongoing; Northeast monsoon season

Location: Tamil NaduChennaiTenkasi (Kadayanallur)

• DT Next, 24 Oct non-X: 332 cases statewide on 23 Oct, 70 of them in Chennai, taking the 2026 tally to 25,481. Chennai rose from 605 cases in August to 1,290 in September. DT Next
• Dinamalar (Tamil) non-X: more than 25,000 cases, about 400 a day statewide (more than 100 a day in Chennai), and a 100-doctor team deployed. It gives the 2025 total as 25,278. Dinamalar · Daily Thanthi gave 23,241 on 15 Oct and a 2025 total of 25,585. Daily Thanthi
• DPH, 22 Oct non-X: 200–250 cases a day, a tally that has “crossed 22,000”, “90% asymptomatic”, and surveillance focused on school environments. The Hindu
• X (Tamil/English):
  • Paediatric case: News7 Tamil reported a “tragedy” involving a seven-month-old infant with dengue; the post does not give further detail.
  • Qdenga pilot: The New Indian Express re-posted the Kadayanallur pilot (covered last week).
  • Minister: AIR Chennai quoted the minister saying dengue is “under control” and described the repellent-cream pilot.
  • Pharmacies: the TN Chemists and Druggists Association told pharmacies not to sell specified medicines for fever without a prescription.
  • news7tamil · xpresstn · AIRNews_Chennai · AIRNews_Chennai · xpresstn
• X (political): Chennai Mayor Priya said TVK was responsible for Chennai’s rise in dengue (Thanthi TV, 24 Oct). ThanthiTV
• X (claim): one account cites an Apollo doctor saying that 15–25% of patients seen have dengue and influenza together. Unverified discussion on X only. Sir6ALotB

Discussion frequency: Moderate (widely shared 21–23 Oct)·Status: new; zoo reopened 25 Oct

Location: Tamil NaduChengalpattu districtArignar Anna Zoological Park, Vandalur

• Event non-X: seven water birds died between 3 and 7 October (per Forest Department officials quoted by The Hindu): four painted storks, a grey pelican, a grey heron and an oriental darter. NIHSAD Bhopal confirmed H5N1 on 21 October, and the zoo closed to visitors on 22–23 October. The Hindu · TNIE · Times of India
• Reopening, 25 Oct non-X: the zoo reopened with the bird enclosures cordoned off. RT-PCR tests on samples from 26 animal keepers were negative. The Hindu
• X: The Hindu and TNIE reporters, and FluTrackers, carried the closure. A wildlife news account noted that the zoo’s first notice did not say what the “reports” concerned. the_hindu · Krish_TNIE · FluTrackers · IndWildlifeNews

Discussion frequency: Low–moderate·Status: new to this report

Location: West BengalMurshidabadHowrahKolkataNorth 24 Parganas

• ABP Ananda (Bengali) non-X: more than 5,500 cases in the first 23 days of October, per health department sources. Murshidabad is the most affected, Howrah second and Kolkata third. Health Minister Sharadwat Mukherjee says the situation is “still under control”. ABP Ananda
• Howrah non-X: more than 150 cases in a week. Times of India · JK News 24
• X: Kolkata Hindi News gives more than 12,500 cases statewide this year, with Murshidabad, Howrah, Kolkata and North 24 Parganas the most affected. The Wall carried the minister’s “under control” claim. hindi_kolkata · TheWallTweets

Discussion frequency: Low–moderate·Status: ongoing

Location: Rajasthan (Alwar, Kota, Udaipur, Jaipur)Odisha (Sundargarh, Angul)

• Rajasthan, 22 Oct non-X: 2,234 cases in January–September against 2,039 in all of 2025. The leading districts are Alwar (461), Kota (249), Udaipur (239) and Jaipur (153), and more cases are being seen in urban areas. Times of India · X: TOIJaipurNews
• Odisha, Sundargarh non-X: a 63-year-old farmer from Ujjwalpur (Tangarpali block) tested positive on 21 Oct and died after discharge from hospital. The CDMO denied that the death was due to scrub typhus. Times of India · Kalinga TV · X: OrissaPOSTLive
• Odisha, Angul non-X: an 11-year-old boy from Rengali village (Kaniha block) died with suspected scrub typhus while being treated at Sishu Bhawan, Cuttack. Argus News

Discussion frequency: Low·Status: ongoing, post-monsoon

Location: NepalKarnali ProvinceSalyan (Darma, Bagchaur, Kumakh)

• Salyan, 22 Oct non-X: one more death takes the district toll to 10. Infections total 817, including Darma 281, Bagchaur 247 and Kumakh 82. Kathmandu Post · Ekantipur (Nepali) · X: Nepalnews_Eng
• Literature non-X: a school-based serosurvey in Kavrepalanchok and Dolakha reports a seroincidence of 6.3 per 1,000 person-years in children (see Section 13).

Discussion frequency: Low on X; Malayalam searches returned little·Status: ongoing

Location: KeralaPalakkad (Kodumbu)Kozhikode (Kavilumpara, Thottilpalam)

• Amoebic meningoencephalitis, Palakkad non-X: a 62-year-old from Kodumbu, confirmed on 8 Oct and reported on 23 Oct, is on a ventilator at Thrissur Medical College. Deshabhimani (Malayalam)
• Measles, Thottilpalam, 25 Oct non-X: five primary-school children from Paikkalangadi in Kavilumpara panchayat tested positive. Officials said the children had missed routine measles vaccination. Asianet Newsable
• Background: Kozhikode district’s figure of 161 confirmed cases and one death (14 Oct) was reported last week.

Discussion frequency: Low–moderate·Status: seasonal

Location: DelhiPuneMadhya Pradesh (Balaghat, Baihar block)

• Delhi, MCD data (non-X; Amar Ujala, 22 Oct): 304 cases in the first 17 days of October against 286 in all of September. The 2026 total of 901 compares with 994 in the same period of 2025. Central zone has the most cases (110). Amar Ujala (Hindi)
• Pune, PMC review, 23 Oct non-X:
  • Cases: 2,413 from January to 20 October (568 in August, 726 in September and 553 in October to the 20th).
  • Inspections: mosquito larvae were found in 18,885 containers, and PMC has stepped up its mosquito-control drive.
  • Punekar News · X: punekarnews
• Pune, first suspected dengue death: a nine-year-old girl from Lohegaon died at Ruby Hall Clinic on 18 October, and the PMC death audit committee will review the case. ThePuneMirror · pulse_pune
• Balaghat, 25 Oct non-X:
  • Deaths: three tribal children died within a week in the Baihar area. Two died on Sunday (25 Oct), including a three-year-old girl from Khairtola (Birsa block).
  • Attribution: the death of a child aged 1 year 4 months from Matla (22 Oct) is attributed to malaria, with the sample report pending.
  • Response: the CMHO has ordered child death reviews.
  • Dainik Bhaskar (Hindi)

Discussion frequency: Low–moderate (World Polio Day, 24 Oct)·Status: ongoing

Location: PakistanSindh (Karachi East)Khyber PakhtunkhwaPunjab (Lahore, Rawalpindi)

• WPV1, Karachi East non-X:
  • Case: a six-month-old malnourished boy from UC Jamali Colony, confirmed by NIH Islamabad and announced by NEOC on 19 October.
  • Context: this is the first Karachi case since December 2024. One Karachi environmental site was positive in September.
  • Follow-up: the Sindh Chief Minister ordered a probe into the source of the virus. On World Polio Day (24 Oct), the Prime Minister’s aide pledged full eradication as the tally stood at seven.
  • Dawn · Daily Pakistan · Dawn, 21 Oct · Dawn, 25 Oct
• X: a nationwide vaccination campaign runs from 2 to 8 November. pakistantimespk · SherEBaloch1983
• Dengue, Punjab non-X: 270 confirmed cases this year, led by Lahore (73) and Rawalpindi (58), with 101 in October (20 Oct). Rawalpindi’s own tally reached 70 by 23 Oct, with no deaths. Dunya (Urdu) · Dawn
• Mpox (literature): see Section 13 for the IJID Regions review of the Khairpur clade Ib neonatal cluster.

Discussion frequency: Low·Status: ongoing (Sri Lanka); declining (Maldives)

Location: Sri LankaMaldives

• Sri Lanka dengue non-X: the NDCU daily update for 12 Oct gives 102,769 cases and 79 deaths. The Morning reported 103,565 on 20 Oct and 104,094 on 22 Oct. NDCU 12 Oct PDF · The Morning · X: TheMorningLK
• X (institutional): WHO Sri Lanka met NIID and the national dengue programme to review the WHO Collaborating Centre for Dengue Clinical Management. WHOSriLanka
• Maldives measles, 21 Oct non-X: the HPA reported no new cases in the past week, compared with five in the previous update. There have been 287 cases since January, and 16,689 vaccinations have been given in the special drive. Edition.mv

Discussion frequency: Low; some clinician threads on novel β-lactam combinations·Status: ongoing theme

Location: India (multicentre; Manipal; Mumbai); Pakistan (Peshawar); Nepal (national)

• JAC-Antimicrobial Resistance (23 Oct): whole-genome sequencing of 32 carbapenemase-producing Enterobacterales from three Peshawar tertiary hospitals (2023).
  • Mechanisms: blaNDM-5 in 90.6%, often with OXA-48-like genes (46.9%).
  • Reduced susceptibility: reduced cefiderocol susceptibility in NDM-producing E. coli ST2 with cirA disruption and ftsI insertions; elevated aztreonam–avibactam MICs linked to ftsI insertions and CMY.
  • Virulence: 11 of 13 K. pneumoniae ST147 isolates carried virulence-associated genes.
  • doi:10.1093/jacamr/dlag233
• Trans R Soc Trop Med Hyg (22 Oct): a prospective cohort of 154 patients with carbapenem-resistant A. baumannii bacteraemia (Manipal, 2021–2023). Mortality was 57.1% at 7 days and 76.6% at 30 days. Diabetes, inotrope requirement and a higher tigecycline MIC were independent predictors of early mortality. doi:10.1093/trstmh/trag129
• J Patient Saf (23 Oct): a systematic review and meta-analysis of 46 Indian studies (2015–2025). It reports pooled resistance of 55.7% (I² 98.6%), most often with blaNDM, OXA-48-like and KPC genes. doi:10.1097/PTS.0000000000001604
• Indian J Med Microbiol (in window): AMR surveillance re-analysed using the WHO Bacterial Priority Pathogens List 2024 and AWaRe at an Indian tertiary centre. doi:10.1016/j.ijmmb.2026.101325 · A case report of Salmonella Kentucky ST198 urinary infection resistant to fluoroquinolones and extended-spectrum cephalosporins, described as the first Indian case report (PGIMER). doi:10.1016/j.ijmmb.2026.101326
• Other (in window):
  • Expert Rev Anti Infect Ther: antimicrobial consumption in Nepal, 2016–2023, with antibacterials averaging 48.6 DID. doi:10.1080/14787210.2026.2751989
  • Front Microbiol: novel K. pneumoniae phages from Mumbai hospital wastewater. doi:10.3389/fmicb.2026.1953496
  • J Assoc Physicians India: candidaemia at a Chennai centre, where C. auris was the commonest non-ICU isolate (11/30) and was highly azole-resistant. doi:10.59556/japi.74.1629
• X (clinician):
  • A microbiology EQA account highlighted a JAC-AMR paper on ertapenem/zidebactam (WCK 6777) against carbapenemase-producing E. coli and K. pneumoniae from nine Indian centres, cautioning that the comparators use CLSI breakpoints.
  • Another account shared the phase 2 cefepime–zidebactam study in carbapenem-resistant Gram-negative infections, including metallo-β-lactamase producers.
  • microeqas · carpe_diem0820
• X (institutional): an ISID/ISID-Africa webinar brought together experts from Pakistan, South Africa and Singapore on wastewater surveillance for AMR monitoring. ISID_org

• Indian J Med Microbiol (23 Oct): measles IgG serosurvey in Kavaratti, Lakshadweep (299 participants, September 2022). IgG rose with age, and negative or equivocal results clustered in younger participants. doi:10.1016/j.ijmmb.2026.101323
• Indian J Med Microbiol (21 Oct): region-specific OD cut-off for the InBios scrub typhus IgM ELISA in Manipur and Tripura. A cut-off of 0.562 gave an AUC of 0.992, and prospective validation is required. doi:10.1016/j.ijmmb.2026.101322
• medRxiv-derived (PubMed-indexed in window; posted 31 Aug): school serosurvey of 827 children in Kavrepalanchok and Dolakha, Nepal. Scrub typhus seroincidence was 6.3 per 1,000 person-years and seroprevalence 6.5%, higher in girls and older children. Not peer-reviewed. doi:10.64898/2026.08.28.26361601
• IJID Regions (online 25 Sep; indexed in window): review of Pakistan’s 2026 clade Ib mpox cluster in Khairpur, Sindh.
  • Cluster: 26 confirmed cases, half of them infants under six months, including eight neonates. The authors describe it as consistent with mother-to-infant and healthcare-associated transmission.
  • Karachi: a separate Karachi cluster (n = 8) followed an index case with travel to Central Africa.
  • Context: the review compares IPC gaps with earlier iatrogenic HIV and nosocomial CCHF outbreaks.
  • doi:10.1016/j.ijregi.2026.101028
• PLoS NTD (23 Oct): dengue in the Rohingya camps and host communities of Cox’s Bazar, 2021–2024. There were 35,581 RDT-confirmed cases, 46% in children aged 0–14. Epidemic peaks came progressively later and tails grew longer. doi:10.1371/journal.pntd.0014198
• Lancet Microbe (23 Oct): cholera RDT performance at seven Bangladeshi hospitals (2,078 analysed samples). Sensitivity fell from 0.46 to 0.38 when phage detection was included in the case definition, and antibiotics were detected in more than 80% of stools. doi:10.1016/j.lanmic.2026.101479
• J Glob Infect Dis (indexed in window): leptospirosis in eastern Uttar Pradesh. 550 of 2,430 suspected cases (22.6%) were IgM-positive, with peaks in October and November and the highest positivity in Deoria, Prayagraj and Azamgarh. doi:10.4103/jgid.jgid_244_25
• Lancet Reg Health SE Asia (editorial): rabies elimination in South-East Asia, “uneven progress”. doi:10.1016/j.lansea.2026.100882
• J Travel Med (22 Oct): commentary on public awareness and regional readiness for Nipah after India’s 2026 outbreak (Thai authors). doi:10.1093/jtm/taag098
• Emerg Infect Dis: disseminated trimethoprim/sulfamethoxazole-resistant nocardiosis in a renal transplant recipient, India. doi:10.3201/eid3211.260963
• medRxiv: the 19–25 Oct posting window returned no South Asia infectious-disease preprints. The South Asia items found were on child nutrition and maternal health.

Discussion frequency: Not discussed on X

• The latest report is still week 34 (17–23 Aug), re-uploaded on 23 Oct at a new address. The link given in the 18 Oct issue now returns an invalid file. Week 35 has not been published, so the lag is now about nine weeks. Week 34 content was summarised last week and is not repeated. Week 34 PDF (new address) · NCDC listing

• No Nipah report was found in the window. The latest state sheet that could be retrieved (16 Oct) still records a single 2026 case. The latest WHO Disease Outbreak News for India Nipah remains DON609 (25 June 2026). Kerala IDSP, 16 Oct PDF · WHO DON609

Discussion frequency: Low–moderate·Status: new

Location: Indianational

• DGHS directive on single-use medical devices (dated 16 Oct; reported 24 Oct; non-X):
  • Scope: states, UTs and drug controllers are to enforce a ban on reusing single-use devices in all public and private facilities, and manufacturers’ (OEM) instructions are to be followed.
  • Rationale: the stated risks include infection and device malfunction.
  • Reaction: The Hindu reports debate among professionals in Kerala over cost and feasibility.
  • Hindustan Times · NDTV · India Today · The Hindu BusinessLine · The Hindu (Kerala) · X: poppulse2026
• CDSCO NSQ alert, September 2026 non-X:
  • Totals: 330 samples were declared not of standard quality (42 by central and 288 by state laboratories), and one sample from NCT Delhi is spurious and under investigation.
  • Anti-infectives: the list includes co-amoxiclav injection 1.2 g (batch D0092509A; failed the clavulanic acid assay) and co-amoxiclav tablets (batch HPT25002; failed assay and dissolution). Alerts apply only to the listed batches.
  • The Hindu BusinessLine · Drug alert PDF (The Health Master copy) · CDSCO alerts page · X: PTI_News · airnewsalerts · uniindianews

• Tamil Nadu pharmacy directive: see Section 03 (TNCDA instruction on selling fever medicines).
• Kozhikode measles context: see Section 08.
• No dedicated signals found for Bhutan or for Afghanistan outside polio (Afghanistan WPV1 is covered in W2).

Global ID items active in or relevant to 19–25 Oct 2026 (after the India/South Asia clusters).

Meetings of interest to India/South Asia clinical microbiology and ID, checked against 25 Oct 2026.

No 2027 dates or abstract deadlines for CIDSCON or IDSI meetings were found at the time of writing.

On X this week, news outlets, government departments and municipal accounts again outnumbered clinicians and microbiologists.

• Dengue dominated every language stream: Bengali (Bangladesh), Tamil (Tamil Nadu, with sharp political exchanges involving the Chennai Mayor), Hindi and Bengali (West Bengal) and Marathi/English (Pune).
• The Vandalur H5N1 confirmation was the most widely shared new event. Coverage was factual, with one account noting the zoo’s initially vague notice.
• Regulatory news spread mainly through news agency accounts (PTI, AIR, UNI): the ban on reusing single-use devices and the NSQ list.
• Technically substantive material again came from journals and official documents with little X pickup: Peshawar CPE genomics, CRAB mortality, the neonatal mpox review and the cholera RDT study. The exception was a small number of clinician posts on zidebactam combinations.
• Searching more languages (Urdu, Nepali, Telugu, Kannada, Odia, Malayalam) added few distinct health signals beyond those already in the English and major-language streams.
• AI-generated replies were common and were not used as sources.

Topics with minimal or absent discussion this window:

• Hospital HAI clusters and Candida auris on X (literature only)
• Cholera laboratory confirmations (literature only)
• Mucormycosis (new clusters)
• Nipah (new event)
• Bhutan