Assessments
Time-bound predictions under active review, including assessments that reached horizon and still need a final human resolution.
Time-bound predictions under active review, including assessments that reached horizon and still need a final human resolution.
Public note
For situational awareness and research transparency. Not medical advice.
CDC will issue updated XDR Shigella clinical guidance or treatment advisory by December 31, 2026, specifying carbapenem-class or pivmecillinam as first-line therapy for confirmed XDR Shigella cases, triggered by the April 2026 XDR emergence and the complete failure of standard empirical enteric treatment regimens.
When CDC releases the 2026 AR Threats Report (electronic format covering ≥19 threats), Candida auris US clinical case count will be reported as ≥2x the 2022 burden (i.e., further multiplication beyond the documented 5x rise from 2019→2022), with ongoing geographic expansion to ≥48 US states.
Cefiderocol-resistant clinical outbreak cluster (≥3 epidemiologically/genomically linked patients) confirmed in any EU/US tertiary care center by 2027-06-30, driven by PirA/PiuA/PiuD TonB-dependent transporter mutations and heteroresistance, following the 2026 Shionogi-BARDA contract expansion of US cefiderocol procurement.
A peer-reviewed clinical case series or surveillance report documenting cefiderocol-resistant carbapenem-resistant Acinetobacter baumannii (CRAB) or carbapenem-resistant Pseudomonas aeruginosa with ≥10 isolates from a single US or European hospital network will be published by 2027-04-20, marking the first major US/EU cefiderocol resistance cluster following Shionogi's BARDA contract for cefiderocol (CIDRAP 2026-04-09) and the expert statement on cefiderocol's role in CR-NF-GNB infections (PMC12924807).
The updated PASTEUR Act (reintroduced in US Congress February 2026 per CIDRAP 2026-02-09) will NOT be signed into law by 2027-01-15, leaving the subscription-style payment model for novel antimicrobials unfunded despite escalating large-pharma exit from antibiotic R&D (statnews 2026-03-10 "Large drugmakers are developing fewer antibiotics") and growing pipeline gap (CIDRAP Mar 11 2026 "spots of progress in challenging landscape").
At least 5 additional novel NDM (New Delhi metallo-β-lactamase) variants (NDM-64 through NDM-68 or beyond — building on the ~100 variants reported through NDM-63, the L3-loop variant in Klebsiella pneumoniae described in PMC12888852) will be deposited in NCBI Pathogen Detection / Beta-Lactamase Database / GenBank between 2026-04-20 and 2027-04-20.
The next WHO/ECDC "TB Surveillance and Monitoring in Europe" report (covering 2025 surveillance year, expected publication ~March 2027) will show the WHO European Region MDR/RR-TB rate among NEW TB cases ≥20% (no improvement of >3 percentage points vs the 23% reported in the 2024 surveillance year published 2026-03-23).
At least one secondary MDR-TB case epidemiologically or genomically linked to the Southwestern Community College (Chula Vista, San Diego County) index exposure announced 2026-04-09 will be confirmed by San Diego County HHSA Tuberculosis Program contact tracing by 2026-06-19.
A locally-acquired Clade I mpox transmission chain (≥2 epidemiologically linked cases without African travel history) will be confirmed in North America within 90 days of the San Francisco Clade I detection (Apr 19 2026).
Pakistan (Khairpur/Sindh) mpox cases will be genomically confirmed as Clade Ib by WHO DON or Pakistan MoH by June 2026, representing the third non-African Clade Ib community transmission geography after Spain (Dec 2025) and Singapore (Apr 2026), based on infant mortality in Khairpur district (7 infants dead/positive, Apr 2026) and demographic severity patterns consistent with Clade Ib rather than Clade IIb.
At least one confirmed mpox Clade Ib case with travel linkage to Singapore will be detected in Japan, South Korea, or Australia by October 2026, given Singapore's confirmed local Clade Ib transmission (2 cases, CDA Apr 4 2026) and Singapore's role as the primary aviation hub for East Asia–Pacific travel.
At least one confirmed mpox Clade IIb case linked to Singapore will be detected in Japan, South Korea, or Australia by October 2026, given Singapore's confirmation of local Clade IIb transmission (Apr 14 2026) and its role as the primary aviation hub for East Asia–Pacific travel.
Mpox clade Ib will be confirmed in at least 2 East African countries outside the DRC by April 2026.
California will confirm at least 2 additional Clade I mpox cases (beyond the San Francisco Apr 16 index) within 60 days of Apr 20 2026, with at least one in Los Angeles County or adjacent counties — indicating multi-focus Clade I circulation rather than isolated importation.
WHO will issue a Disease Outbreak News (DON) specifically addressing Clade Ib community transmission outside Africa (Spain Dec 2025, Singapore Apr 2026, Pakistan unconfirmed Apr 2026) as a distinct non-African Clade Ib spread pattern by June 30, 2026, given that the existing global PHEIC DONs have not yet characterized the non-African Ib pattern as a separate epidemiological entity.
At least one confirmed mpox Clade Ib case imported to the US will be significantly delayed in diagnosis (>7 days from symptom onset to laboratory confirmation) or go initially undetected due to CDC diagnostic capacity gaps, by October 2026, given that CDC paused mpox and rabies diagnostic testing capability (Apr 1–2 2026) during an active global PHEIC with confirmed Clade Ib community transmission outside Africa.
Pakistan Khairpur Sindh Clade Ib cluster (Apr 2026) will trigger WHO or Pakistan MoH-coordinated enhanced surveillance in Afghanistan and/or Iran within 90 days, resulting in at least one MPXV case detected in either country by July 14 2026, based on cross-border population movement patterns in the Balochistan/Sindh/Afghanistan corridor and the unprecedented pediatric severity profile indicating likely Clade Ib circulation at a regional rather than isolated scale.
At least one Asian country outside Africa will report sustained community Clade Ib transmission (≥3 locally acquired cases in ≥2 distinct chains) confirmed by WHO DON or national health authority by end of 2027, based on the documented non-African Clade Ib emergence pattern: Spain Dec 2025, Singapore Apr 2026, Pakistan cluster under investigation Apr 2026 — three geographies in 5 months demonstrating Clade Ib fitness outside its endemic African zone.
At least one confirmed mpox case (clade unspecified) will be detected in India within 90 days of the Pakistan Khairpur Sindh infant deaths cluster (by July 14 2026), given Pakistan-India cross-border movement in the Punjab/Rajasthan/Gujarat corridor and the unprecedented pediatric severity profile suggesting Clade Ib circulation in an adjacent geography.
Mpox Clade Ib will establish at least one additional documented sustained community transmission chain outside the African continent by July 2026.
Uganda Sudan Virus Disease outbreak (Africa CDC Brief 15, Apr 2026) will include ≥1 confirmed healthcare worker case, indicating nosocomial amplification within the initial cluster.
A novel recombinant mpox lineage arising from tri-clade co-circulation (Clade Ia, Ib, and Clade IIb) in the Republic of the Congo will be genomically documented by April 2027, based on the first reported co-circulation of all three major mpox clades in a single geography.
Mpox Clade IIb C.1 will establish sustained community transmission in at least one additional Southeast Asian country beyond Cambodia by October 2026, based on the documented Phnom Penh outbreak and regional mobility patterns.
WHO will issue pediatric-specific mpox vaccination guidance or Emergency Committee recommendation addressing Clade Ib-affected/at-risk regions including South/Southeast Asia within 180 days, driven by documented pediatric mortality in Pakistan (9 deaths) and Singapore community transmission.
A new confirmed filovirus spillover event (Ebola, Marburg, or Sudan virus ≥1 laboratory-confirmed human case) will be reported in Central or East Africa within 180 days of the Uganda SVD closure, consistent with the ~1-2 per year regional filovirus base rate.
Oropouche virus will cause ≥1,000 confirmed cases in a country outside Brazil/Bolivia in the 2026 Americas arbovirus season (April–December 2026), based on 11,634 confirmed multi-country cases by Nov 2024 and WHO confirmation that the 2026 season is now beginning.
A new confirmed VHF outbreak (Ebola, Marburg, Sudan Virus, or CCHF) with ≥3 laboratory-confirmed cases will be detected in sub-Saharan Africa within 90 days of the Uganda Sudan Virus Disease outbreak closure, consistent with endemic spillover frequency in the Great Lakes/East African bat reservoir zone.
An 8th (or subsequent numbered) published case of sustained HIV-1 remission (≥12 months viral suppression off ART after analytic treatment interruption) will be reported in a peer-reviewed journal or a CROI/IAS conference abstract within 180 days, extending the series following the Dec 2025 Nature paper on heterozygous CCR5Δ32 stem-cell-transplant remission.
At least one Eastern Europe / Central Asia (EECA) country will release official national HIV surveillance data showing a ≥15% year-over-year increase in newly diagnosed HIV cases (2024 vs 2023 OR 2025 vs 2024), published in UNAIDS, ECDC, WHO EURO, or national MoH surveillance reports within 180 days.
At least one PEPFAR-supported sub-Saharan African country will report a ≥10% relative increase in mother-to-child HIV transmission rate in a 2025 cohort vs 2024 baseline, published in PEPFAR Country Operational Plan data, UNICEF Global AIDS Update, UNAIDS epidemiological estimates, or peer-reviewed literature within 180 days.