Top 5 Infectious Disease Pieces of 2025

The top 5 infectious disease stories on AJMC.com this year covered both outbreaks and government-related developments. Bird flu and tuberculosis (TB), 2 conditions many might consider relics of the past, were hot topics earlier this year after outbreaks were reported across the US.

In government-related news, one top story highlighted the FDA’s approval of a treatment for uncomplicated urinary tract infections (uUTIs), marking the first new class of oral antibiotics for this condition in nearly 30 years. On a less positive note, another popular topic was the impact of the Trump administration’s termination of National Institutes of Health (NIH) grants, with infectious disease research being the area most affected.

Here are the top 5 infectious disease pieces of 2025; stay up to date with all infectious disease content from The American Journal of Managed Care^® (AJMC^®) here.) here.

5. Bird Flu Risk Remains Low, Despite First Reported Death

The first US death from bird flu, also known as avian influenza or H5N1, was reported by the Louisiana Department of Health on January 6. The individual, who was older than 65 years and had underlying medical conditions, developed severe illness and was hospitalized following exposure to a noncommercial backyard flock and wild birds. The CDC confirmed the infection as bird flu on December 18, 2024.

Although no cases of human-to-human transmission were reported, a multistate outbreak was been identified among dairy cattle, alongside widespread transmission in wild birds and sporadic outbreaks among poultry, other mammals, and workers in affected industries. In addition to Louisiana, human cases have been confirmed in California, Colorado, Iowa, Michigan, Oregon, Texas, Washington, and Wisconsin. The CDC emphasized that the overall public health risk remained low due to the lack of concerning virologic changes, with the highest risk among individuals who work with or have recreational exposure to birds, poultry, or cows.

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4. NIH Grant Terminations Disrupt 1 in 30 Clinical Trials, Impacting Over 74,000 Participants

About 1 in 30 trials were disrupted by research grant terminations at the NIH earlier this year, impacting more than 74,000 trial participants, according to a research letter published in November in JAMA Internal Medicine. Since President Donald Trump took office in January, his administration has directed the NIH to terminate grants for topics that do not align with its priorities, including COVID-19 and diversity, equity, and inclusion efforts. As a result, hundreds of NIH-funded clinical trials have since lost grant funding.

The National Institute of Mental Health and the National Institute on Minority Health and Health Disparities (NIMHD) experienced the highest number of terminated grants (n = 128 and n = 77, respectively). Meanwhile, the National Institute of Allergy and Infectious Diseases and the NIMHD accounted for the largest amounts of terminated funding ($505,968,126 and $223,566,041, respectively). Overall, infectious disease trials were the most affected by topic area (14.4%) compared with 2.2% of neurologic (11/498) and reproductive health (48/2161) trials (P < .001).

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3. FDA Approves First New Class of Oral Antibiotics for Uncomplicated UTIs in Nearly 30 Years

In March, the FDA approved gepotidacin (Blujepa; GSK) for the treatment of uUTIs in female patients aged 12 and older, marking the first new class of oral antibiotics for this condition in nearly 30 years. The approval was supported by positive results from the phase 3 EAGLE-2 (NCT04020341) and EAGLE-3 (NCT04187144) trials, which compared the efficacy and safety of oral gepotidacin with that of the antibiotic nitrofurantoin in adolescent and adult female patients with uUTIs.

In EAGLE-2, therapeutic success was observed in 50.6% of patients receiving gepotidacin and 47.0% of those treated with nitrofurantoin (adjusted difference, 4.3%; 95% CI, –3.6 to 12.1). EAGLE-3 yielded similar results, with therapeutic success rates of 58.5% for gepotidacin and 43.6% for nitrofurantoin (adjusted difference, 14.6%; 95% CI, 6.4-22.8). Based on these results, gepotidacin was deemed noninferior to nitrofurantoin in both trials and demonstrated superiority in EAGLE-3.

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2. Kansas City Tuberculosis Outbreak Highlights Ongoing Public Health Challenge

A TB outbreak in the Kansas City metro area resulted in dozens of cases and at least 2 deaths, the Kansas Department of Health and Environment (KDHE) reported in a January press release. The outbreak, traced back to January 2024, primarily affected individuals in early 2024 and throughout the summer. As of February 7, 2025, there were 67 active TB cases, 79 latent TB cases, and 2 related deaths. Among those with active TB, 35 had completed treatment and were considered cured, while 30 remained in treatment. For latent TB, 31 have completed treatment, and 28 are still undergoing treatment.

The KDHE emphasized that the outbreak poses a very low risk of infection to the general public. To prevent further spread, it is actively identifying and testing at-risk individuals and possible close contacts. Those who test positive are further screened to determine whether they have active or latent TB to ensure appropriate treatment.

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1. Kansas City Tuberculosis Outbreak: A Deadly Wake-Up Call

Amid the ongoing TB outbreak in the Kansas City metro area, Michael A. Bernstein, MD, director of pulmonary and critical care at Stamford Health, addressed common TB misconceptions in a February interview with AJMC. He noted that many people assume TB is rare and no longer a concern in 2025, but in reality, it remains relatively common. Bernstein explained that although the Kansas City outbreak itself is not surprising to most pulmonologists, the deaths are more unexpected, as TB is generally not highly fatal given available treatment options; this makes the outbreak somewhat unique.

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