https://www.cidrap.umn.edu/all-news
PAHO warns of increase in yellow fever cases
News brief
Today at 3:35 p.m.
Stephanie Soucheray, MA
Topics
Yellow Fever
Yellow fever cases in the Americas are increasing, the Pan American Health Organization (PAHO) said yesterday in an epidemiologic alert.
Officials have confirmed 131 cases this year in four countries, 53 of them fatal, for a 40% case-fatality rate. This is roughly 70 more cases than PAHO reported in early February.
"In 2024, yellow fever cases were mainly reported throughout the Amazon region of Bolivia, Brazil, Colombia, Guyana, and Peru. In 2025, however, cases have also been detected in the state of Sao Paulo in Brazil and the department of Tolima in Colombia, regions outside the Amazon region of both countries," PAHO said in the alert.
Almost all cases in unvaccinated people
Brazil has 81 confirmed cases, 31 of which have been fatal. Only 1 of the confirmed case-patients had a history of yellow fever vaccination.
Colombia has 31 confirmed cases, including 13 deaths. “All cases had a history of exposure in areas at risk for yellow fever, in the context of work activities that included agriculture, and had no documented history of vaccination against yellow fever,” PAHO said.
Peru has 18 cases and 8 deaths so far in 2025, all in unvaccinated people, while Bolivia has confirmed 1, in an unvaccinated man.
PAHO said the uptick in cases highlights the need for countries to achieve vaccination coverage of at least 95% in populations in at-risk areas.
Drug-resistant gonorrhea cases rising in England
News brief
Today at 2:25 p.m.
Chris Dall, MA
Topics
Antimicrobial Stewardship
UK health officials say cases of drug-resistant gonorrhea are rising in England, including extensively drug-resistant (XDR) strains.
According to provisional data published today by the UK Health Security Agency (UKHSA), 17 cases of ceftriaxone-resistant gonorrhea were reported from January 2024 to March 20, 2025, compared with 16 in all of 2022 and 2023. The first case of ceftriaxone-resistant gonorrhea in England was detected in 2015.
Nine cases of XDR gonorrhea, which is also resistant to azithromycin, were reported over the same period, compared with five XDR cases in 2022 and 2023.
In England and elsewhere, ceftriaxone is the guideline-recommended first-line antibiotic, and the last remaining effective antibiotic option, for gonorrhea infections. Azithromycin is the second-line treatment and sometimes used in combination with ceftriaxone.
Cases linked to travel
UKHSA says most cases are linked to travel to or from the Asia-Pacific region, where ceftriaxone resistance is common, and that transmission of resistant gonorrhea within England has been limited so far.
"Gonorrhoea is becoming increasingly resistant to antibiotics, which could make it untreatable in future," Katy Sinka, MSc, head of the sexually transmitted infection section at UKHSA, said in a news release. If left untreated, it can cause serious problems like pelvic inflammatory disease and infertility.
The news comes amid a leveling out of gonorrhea cases in England. UKHSA said the latest provisional data from sexual health services in the first 9 months of 2024 show approximately 54,965 gonorrhea diagnoses, compared with 85,000 reported in all of 2023.
COVID impact survey: New doctors less likely to opt for rural practice, more likely to report poor job market
News brief
Today at 1:49 p.m.
Mary Van Beusekom, MS
Newly graduated New York physicians' likelihood of practicing in rural areas, as well as their base salaries, declined amid the COVID-19 pandemic—especially for primary care doctors—which could constrain healthcare access in those areas.
The findings come from a Harvard Pilgrim Health Care Institute–led study published in Medical Care.
The researchers used annual data from the 2010-2022 Survey of Residents Completing Training in New York to retrospectively analyze the job market for 31,925 graduating medical residents and fellows, including base salary in 2022 dollars.
Perceptions of job market dim
Of the 31,925 participants, 16,612 (52.0%) had accepted a job offer. Their odds of receiving an offer rose 1.6 percentage point from 2010 to 2022, from 86.6% vs. 88.2%, but the proportion reporting a good job market fell from 55.8% to 44.1%, without a significant change in accepting an offer from before to during the pandemic.
We found that the COVID-19 pandemic was associated with concerning changes in new physician job market outcomes, especially substantial reductions in new physicians' likelihood of entering rural practice and compensation.
Tarun Ramesh, MD candidate
The likelihood of practicing in a rural area decreased 82%, from 3.4% to 0.62%, reversing prepandemic gains, and average base salary declined $23,569, from $288,257 to $264,687. Similarly, the probability of receiving job-related incentives dropped 4%, from 69.2% to 66.3%, as did salary satisfaction (86.5% to 84.1% [-3%]).
New primary care doctors saw larger reductions in rural practice rates and compensation than physicians in other specialties. Noncitizen medical graduates experienced the largest salary reductions, which the researchers said underscores vulnerabilities in this group.
"We found that the COVID-19 pandemic was associated with concerning changes in new physician job market outcomes, especially substantial reductions in new physicians' likelihood of entering rural practice and compensation," lead author Tarun Ramesh, an MD candidate and research fellow at Harvard Pilgrim Health Care Institute, said in an institute news release.
The researchers said the results highlight the need for expanding financial incentives (eg, student loan forgiveness, bonuses) for rural practice, financially supporting primary care practices, and strengthening protections for noncitizen physicians to ensure equitable compensation and reduce the risk of exploitation.
ALL BRIEFS
PAHO warns of increase in yellow fever cases
News brief
Today at 3:35 p.m.
Stephanie Soucheray, MA
Topics
Yellow Fever
Yellow fever cases in the Americas are increasing, the Pan American Health Organization (PAHO) said yesterday in an epidemiologic alert.
Officials have confirmed 131 cases this year in four countries, 53 of them fatal, for a 40% case-fatality rate. This is roughly 70 more cases than PAHO reported in early February.
"In 2024, yellow fever cases were mainly reported throughout the Amazon region of Bolivia, Brazil, Colombia, Guyana, and Peru. In 2025, however, cases have also been detected in the state of Sao Paulo in Brazil and the department of Tolima in Colombia, regions outside the Amazon region of both countries," PAHO said in the alert.
Almost all cases in unvaccinated people
Brazil has 81 confirmed cases, 31 of which have been fatal. Only 1 of the confirmed case-patients had a history of yellow fever vaccination.
Colombia has 31 confirmed cases, including 13 deaths. “All cases had a history of exposure in areas at risk for yellow fever, in the context of work activities that included agriculture, and had no documented history of vaccination against yellow fever,” PAHO said.
Peru has 18 cases and 8 deaths so far in 2025, all in unvaccinated people, while Bolivia has confirmed 1, in an unvaccinated man.
PAHO said the uptick in cases highlights the need for countries to achieve vaccination coverage of at least 95% in populations in at-risk areas.
Drug-resistant gonorrhea cases rising in England
News brief
Today at 2:25 p.m.
Chris Dall, MA
Topics
Antimicrobial Stewardship
UK health officials say cases of drug-resistant gonorrhea are rising in England, including extensively drug-resistant (XDR) strains.
According to provisional data published today by the UK Health Security Agency (UKHSA), 17 cases of ceftriaxone-resistant gonorrhea were reported from January 2024 to March 20, 2025, compared with 16 in all of 2022 and 2023. The first case of ceftriaxone-resistant gonorrhea in England was detected in 2015.
Nine cases of XDR gonorrhea, which is also resistant to azithromycin, were reported over the same period, compared with five XDR cases in 2022 and 2023.
In England and elsewhere, ceftriaxone is the guideline-recommended first-line antibiotic, and the last remaining effective antibiotic option, for gonorrhea infections. Azithromycin is the second-line treatment and sometimes used in combination with ceftriaxone.
Cases linked to travel
UKHSA says most cases are linked to travel to or from the Asia-Pacific region, where ceftriaxone resistance is common, and that transmission of resistant gonorrhea within England has been limited so far.
"Gonorrhoea is becoming increasingly resistant to antibiotics, which could make it untreatable in future," Katy Sinka, MSc, head of the sexually transmitted infection section at UKHSA, said in a news release. If left untreated, it can cause serious problems like pelvic inflammatory disease and infertility.
The news comes amid a leveling out of gonorrhea cases in England. UKHSA said the latest provisional data from sexual health services in the first 9 months of 2024 show approximately 54,965 gonorrhea diagnoses, compared with 85,000 reported in all of 2023.
COVID impact survey: New doctors less likely to opt for rural practice, more likely to report poor job market
News brief
Today at 1:49 p.m.
Mary Van Beusekom, MS
Newly graduated New York physicians' likelihood of practicing in rural areas, as well as their base salaries, declined amid the COVID-19 pandemic—especially for primary care doctors—which could constrain healthcare access in those areas.
The findings come from a Harvard Pilgrim Health Care Institute–led study published in Medical Care.
The researchers used annual data from the 2010-2022 Survey of Residents Completing Training in New York to retrospectively analyze the job market for 31,925 graduating medical residents and fellows, including base salary in 2022 dollars.
Perceptions of job market dim
Of the 31,925 participants, 16,612 (52.0%) had accepted a job offer. Their odds of receiving an offer rose 1.6 percentage point from 2010 to 2022, from 86.6% vs. 88.2%, but the proportion reporting a good job market fell from 55.8% to 44.1%, without a significant change in accepting an offer from before to during the pandemic.
We found that the COVID-19 pandemic was associated with concerning changes in new physician job market outcomes, especially substantial reductions in new physicians' likelihood of entering rural practice and compensation.
Tarun Ramesh, MD candidate
The likelihood of practicing in a rural area decreased 82%, from 3.4% to 0.62%, reversing prepandemic gains, and average base salary declined $23,569, from $288,257 to $264,687. Similarly, the probability of receiving job-related incentives dropped 4%, from 69.2% to 66.3%, as did salary satisfaction (86.5% to 84.1% [-3%]).
New primary care doctors saw larger reductions in rural practice rates and compensation than physicians in other specialties. Noncitizen medical graduates experienced the largest salary reductions, which the researchers said underscores vulnerabilities in this group.
"We found that the COVID-19 pandemic was associated with concerning changes in new physician job market outcomes, especially substantial reductions in new physicians' likelihood of entering rural practice and compensation," lead author Tarun Ramesh, an MD candidate and research fellow at Harvard Pilgrim Health Care Institute, said in an institute news release.
The researchers said the results highlight the need for expanding financial incentives (eg, student loan forgiveness, bonuses) for rural practice, financially supporting primary care practices, and strengthening protections for noncitizen physicians to ensure equitable compensation and reduce the risk of exploitation.
ALL BRIEFS