PANDEMIC INTEL REPORT - May 2025

May 2025 marked a critical juncture in global pandemic dynamics, underscored by the resurgence of multiple infectious diseases across regions. COVID-19 cases climbed steadily, with global test positivity reaching its highest point in nearly a year (~11%), driven primarily by emerging Omicron subvariants such as BA. 1.8.1 and BA. 8.1. Hospitalisations have increased, particularly in the Eastern Mediterranean, South-East Asia, and Western Pacific. However, no new variant of concern has been declared.

Parallel to the resurgence of COVID, vaccine-preventable diseases have re-emerged as significant threats. Measles outbreaks escalated in the United States, notably in Texas, and in Australia, highlighting the downstream impact of declining immunisation rates in the wake of the COVID-19 pandemic. Pertussis is also resurging across the Americas, further straining under-resourced public health systems.

On the policy front, the World Health Assembly adopted a landmark Pandemic Agreement in May, aiming to strengthen global cooperation, surveillance, and equitable access to vaccines and diagnostics—a significant step toward future pandemic preparedness.

At the animal-human interface, avian influenza continued to pose a potential spill over risk, with H5N1 spreading among mammals and H9N2 and H10N3 triggering concerns in Asia and the Middle East. The World Organisation for Animal Health (WOAH) now urges broad-scale animal vaccination campaigns to pre-empt zoonotic transmission.

Overall, May 2025 highlighted the fragility of global health systems in the post-COVID era, underscoring the urgent need for sustained vaccination efforts, robust genomic surveillance, and cross-sectoral coordination under the One Health approach.

1. 🌍 Global Overview (COVID‑19)

• Test positivity surge: Global SARS‑CoV‑2 test-positivity reached ~11% as of 11 May across 73 countries — the highest since July 2024 (~12%). This reflects a significant rise since mid-February (when it was around 2%).
• Case numbers: In the 28 days from 21 April to 18 May, WHO reported ~150,503 new COVID-19 cases from 90 countries (up from 30,553 in the prior 28 days).
• Hospitalisations: 133,734 hospitalisations and 195 ICU admissions were reported during the same period from 33 countries.
• Regional trends: Eastern Med, South-East Asia, and Western Pacific regions showed notable surges; Europe, Africa, Americas were relatively low (2–3% test positivity), though Caribbean and Andean areas are trending upward.
• Variant dynamics: VOIs/VUMs include JN.1, LP.8.1, NB.1.8.1. LP.8.1 makes up 31% of sequences; NB.1.8.1 jumped from 0.7% in April to 13.6% in May. No major variant of concern has emerged yet.

​Interpretation COVID‑19 remains in a phase of resurgence, especially in parts of Asia and the Pacific. While no explosive variant has taken hold, surveillance and hospital capacity preparedness should be heightened, especially in regions showing rising positivity.

2. Regional Impact AnalysisAmericas

• Measles: The 2025 Southwest US outbreak had 722 confirmed cases in Texas by 20 May (total US cases as of late May: ~866 with 3 deaths)  Measles resurgence is tied to dropping MMR vaccination rates post-COVID 
• Pertussis (Whooping Cough): PAHO reported a resurgence in the Americas, reminding governments to ramp up vaccine surveillance and coverage .

Europe

• Respiratory & zoonotic threats: In week 20 (10–16 May), ECDC flagged sporadic cases of avian norovirus (H10N3, H9N2) in China, MERS-CoV, diphtheria, chikungunya  The avian influenza cases are not yet transmissible among humans with low EU/EEA risk.

Asia-Pacific

• Measles: Outbreaks reported in Australia, with 46 cases by early 2025 — worst since 2019 — due to 2–3% drop in childhood vaccine coverage.
• New COVID variants: Bangladesh saw a rise from 23 cases in April to 86 in May (with one death), driven by Omicron subvariants XFG and XFC.
• Bird flu: WOAH urged animal vaccinations after Brazil reported its first domestic outbreak; H5N1 has jumped to mammals and humans.

3. Mortality & Recovery Rates

• COVID-19: ICU admissions and deaths are rising in certain regions, but global mortality tracking is limited due to incomplete reporting.
• Measles: In Croatia region of US outbreak, three deaths occurred (two children, one adult) .
• Other diseases (avian flu, pertussis): mortality remains very low for avian flu; pertussis fatalities not yet specified.

4. Government & Policy Response

• Global: On 20 May, the World Health Assembly adopted a historic Pandemic Agreement, securing equitable access to diagnostics, vaccines, surveillance, and research frameworks.
• WHO alerts: Continuous warnings on rising COVID in Asia-Pacific, measles and pertussis in the Americas.
• Animal health: WOAH’s recommendation of animal vaccination to control H5N1 reflects integrative One Health planning.

5. Healthcare System Capacity

• COVID-19: Some hospitals in the Eastern Med, SEA, and Western Pacific regions may face strain due to rising admissions; lack of comprehensive ICU reporting remains an issue .
• Routine immunisation gaps: Drops in MMR and pertussis vaccination challenge public health systems, requiring catch-up programs and public messaging.

6. Economic & Social Impact

• Public health reversal: Measles resurgence in US and Australia signals erosion of herd immunity, leading to greater healthcare costs and potential school/work disruptions.
• Trade & agriculture: Bird flu outbreaks in Brazil threaten poultry exports; WOAH stresses vaccine programs to stabilise trade.
• Pandemic trust: As The Guardian’s Raina Macintyre warns, vaccine misinformation is eroding public trust — something that could undermine all prophylactic efforts.

7. Future Risk Forecasts

• COVID-19: Watch emerging variants like NB.1.8.1. Continued global surveillance is vital — warranting updates to vaccines if necessary.
• Measles/Pertussis: Unless MMR and pertussis coverages are restored, expect further outbreaks — especially in areas affected by vaccination declines.
• Avian influenza: The presence of H9N2, H10N3, and H5N1 in birds and mammals, and worrisome signals of spillover, mean that enhanced zoonotic surveillance and vaccination strategies are urgent.
• Pandemic preparedness: The newly ratified Pandemic Agreement offers a roadmap for future responses — but needs strong implementation on data sharing, equitable vaccine distribution, and resilient systems.

🔍 Summary COVID‑19 Positivity ~11%, cases rising globally, NB.1.8.1 on the increase Scale up surveillance & hospital readiness; monitor variants
Measles US & Australia outbreaks; 866 cases/3 deaths in US Urgent catch-up MMR campaigns, combat misinformation
Pertussis Resurgence in Americas (43K+ cases in 2024)Strengthen surveillance & booster vaccination effort
Avian Flu Human animal-borne AI cases (H9N2, H10N3), H5N1 threat Enhance animal vaccination; maintain One Health integration
Pandemic Policy Pandemic Agreement signed 20 May Ensure ratification & operationalization globally

Key Recommendations

1. Scale up epidemiological surveillance — across both human and animal health for emerging pathogens.
2. Restore vaccination coverage — especially for MMR and pertussis in regions hit by post-pandemic decline.
3. Monitor COVID variants — NB.1.8.1 and LP.8.1 may need vaccine strain updates.
4. Implement Pandemic Agreement commitments swiftly — including better global vaccine equity.
5. Factor in socio-economic impacts — communicator strategies and healthcare injection are necessary to restore public trust.