Oropouche virus: viral evolution, epidemiological trends, and challenges for control

Emerging arboviral infections, including Oropouche virus (OROV), pose increasing public health challenges due to their expanding geographic distribution and clinical impact. Historically confined to the Amazon basin, OROV has recently caused outbreaks across multiple countries in the Americas, with evidence of novel reassortant strains linked to severe disease, vertical transmission, and neurological complications. Here we review recent epidemiological, virological, and ecological studies employing genomic sequencing, vector analysis, and clinical surveillance that elucidate OROV's spread beyond endemic regions. Findings include new details of its transmission dynamics, multifocal viral introductions, potential sexual transmission, and new reports of severe clinical presentations with significant morbidity including adverse fetal outcomes. These insights underscore the need for enhanced diagnostic capacity, vector control, and vaccine development within a One Health framework. Strengthening surveillance and research is critical to mitigate OROV's impact and prevent further dissemination globally. Purpose of review In recent years, OROV has emerged as a significant public health threat beyond the Amazon region. Here we review current epidemiological, virological, clinical and ecological knowledge of OROV to inform health practitioners, public health authorities and the scientific community and to facilitate the development of effective control strategies for OROV. Recent findings We describe the epidemiological, virological, ecological and clinical characteristics of OROV, focusing on lessons from the recent expansion, and highlighting needs for control and management of this emerging arbovirus. Summary This review aims to inform health practitioners, public health authorities and the scientific community of the recent reemergence and expansion of OROV beyond the Amazon Basin. The ecology, epidemiology, virology of OROV and clinical presentations of OROV infection are discussed, and knowledge gaps are identified.