The intersection of climate change and health is becoming more and more apparent as viruses and other pathogens take advantage of climate disasters to spread more easily or into places where they haven’t normally been seen. A major dengue fever outbreak in Bangladesh is a case in point. The Daily Sun (Bangladesh) reports, “Hospitals across the country, particularly those in the capital, have been hit by a crisis of intensive care unit (ICU) beds due to the deadly surge in dengue patients with the condition of many critical…. Prof Dr Md Shahadat Hossain, director (MIS) of the Directorate General of Health Services…. Said there are around 1,100 ICU beds in government hospitals across the country, including in the capital. Sources said all of those are now occupied.” CNN (US) reports, “Bangladesh is battling its worst dengue outbreak on record, with more than 600 people killed and 135,000 cases reported since April, the World Health Organization said Wednesday, as one of its experts blamed the climate crisis and El Nino weather pattern for driving the surge…. This year, dengue has hit South America severely with Peru grappling with its worst outbreak on record. Cases in [the US state of] Florida prompted authorities to put several counties on alert. In Asia, a spike in cases has hit Sri Lanka, Thailand and Malaysia, among other nations. And countries in sub-Sarahan Africa, like Chad, have also reported outbreaks. Calling these outbreaks a ‘canary in the coalmine of the climate crisis,” Mahamud said ‘global solidarity’ and support is needed to deal with the worsening epidemic.”
 
If You Are in a Hurry
 

• Read NPR’s Goats and Soda Blog (US) on the status of the mRNA hub that is attempting to “crack the wealthy world's lock on mRNA vaccines.”
• Read a WHO news release calling for world leaders to make commitments to global public health at the upcoming UNGA.
• Then read an analysis of the draft political declaration from the Platform for Act-A Civil Society & Community Representatives.
• Read a study in Nature Communications Medicine on vaccine hesitancy and uptake in Africa.
• Read CIDRAP on a study that shows vaccination for mpox protects against hospitalization.
• Read Futurity on the discovery of a malaria parasite that evades detection and treatment.

 
African Vaccine Manufacturing
 
NPR’s Goats and Soda Blog (US) looks at the status of the mRNA hub that is attempting to “crack the wealthy world's lock on mRNA vaccines.” Afrigen, a South African biotech that is leading efforts reverse engineer Moderna’s mRNA vaccine. “Afrigen now appears to have accomplished this, says [CEO of Afrigen Biologics and Vaccines] Terblanche. ‘We've demonstrated in a number of variables that we are comparable with Moderna,’ she says…. As Afrigen has mastered each step, it's also created a training program to pass on that knowledge to the scientists from 15 countries currently participating in the mRNA hub effort – including Argentina, Bangladesh, Egypt, Nigeria, Serbia and Vietnam.”
 
Korea Biomedical Review (South Korea) reports, “EuBiologics together with the International Vaccine Institute (IVI), said on Tuesday that it signed a technology transfer agreement with DEK Vaccines to enable the domestic production and supply of the oral cholera vaccine (OCV) in Ghana…. Additionally, IVI will support both companies in the completion process and scale-up production by providing knowledge and technology transfer training to build and strengthen local vaccine manufacturing capacity. IVI will also lend experience to help coordinate with regulatory authorities for the necessary licensing procedures.”
 
Global Public Health at the UN General Assembly
 
A WHO news release calls on world leaders who will descend on New York next week for the UN General Assembly to make commitments to global public health. “WHO is urging leaders…. To put health for all on the highest political agenda and apply lessons learned from the COVID-19 pandemic. WHO’s appeal comes as the world faces multiple humanitarian and climate-related crises which are threatening lives and livelihoods around the world.”
 
There are several events at the UNGA that focus on health, but among the most important is a one-day meeting on September 20 to adopt a political declaration aimed at mobilizing political will at the national, regional and international levels for pandemic prevention, preparedness and response. The draft declaration has been published and the Platform for Act-A Civil Society & Community Representatives has published an analysis which “shows where Member States have delivered on the keys ask developed by over 100 civil society and community organisations and individuals and where further actioned is required.”
 
Air Pollution and Anti-microbial Resistance
 
NPR’s Goats and Soda Blog (US) reports, “a new study highlights a surprising potential vector for the spread of antimicrobial resistance (AMR): air pollution…. ‘The analysis suggests that PM2.5 is one of the leading factors driving clinical antibiotic resistance,’ says [study author] Chen…. The study reveals that low-income regions tend to face higher burdens of both pollution and antimicrobial resistant infection, with sub-Saharan Africa the most affected, followed by south Asia. The study nails down an association between particulate air pollution and AMR, but the researchers say it does not establish causality or reveal the biological mechanism at play.”
 
An Uptick in COVID-19 and in Conspiracy Theories
 
The New York Times (US) reports, “As COVID-19 cases have climbed [in the US] as part of a late-summer uptick, right-wing influencers and conspiracy theorists have responded by stoking fears about mass lockdowns and spreading unsubstantiated new ideas about COVID-19’s links to world events…. to conspiracy theorists and right-wing influencers online, each uptick is an opportunity to sow fear and rile up their supporters, according to disinformation experts. The use of ‘plandemic’ and ‘scamdemic’ — two terms describing COVID-19 as a ruse — rose sharply in August on right-wing websites, according to data from Pyrra, a company that monitors threats and misinformation on alternative social networks.
 
Washington Post (US) reports, “Instagram’s text-based social platform Threads last week rolled out its new search function…. Not even 24 hours later, the company was embroiled in controversy. When users went to Threads to search for content related to ‘COVID’ and ‘long COVID,’ they were met with a blank screen that showed no search results and a pop-up linking to the website of the Centers for Disease Control and Prevention. Meta acknowledged in a statement to The Washington Post that Threads is intentionally blocking the search terms and said that other terms are being blocked, but the company declined to provide a list of them. A search by The Post discovered that the words ‘sex,’ ‘nude,’ ‘gore,’ ‘porn,’ ‘coronavirus,’ ‘vaccines’ and ‘vaccination’ are also among blocked words.”
 
Assessing COVID-19 Vaccine Hesitancy in Africa
 
A study in Nature Communications Medicine (UK) looks at vaccine hesitancy and vaccine uptake in six countries in East and West Africa. “We show that vaccine acceptance remains generally high among respondents in Sub-Saharan Africa (between 95.1% and 63.3%) even though hesitancy is non-negligible among those pending vaccination. Many who are willing to get vaccinated are deterred by a lack of easy access to vaccines at the local level. Furthermore, social ties and perceptions as well as intra-household power relations matter for vaccine take-up. Among the unvaccinated population, radio broadcasts have widespread reach and medical professionals are highly trusted.”
 
Animals and Viruses
 
Time (US) reports, “In a paper published in Nature Communications, researchers led by Andrew Bowman, associate professor of veterinary preventive medicine at Ohio State University, studied the COVID-19 virus in deer populations in Ohio. While previous studies have documented the virus in deer populations, Bowman and his team focused on more granular genetic changes in the viral genome in infected animals, and found that SARS-CoV-2 evolves—meaning that it develops changes in its genetic code—three times faster than it does in people.” Read the study.
 
CIDRAP (US) reports, “Testing at the US Department of Agriculture (USDA) National Veterinary Services Laboratory has confirmed highly pathogenic H5N1 avian flu in three adult harbor seals found stranded on Marrowstone Island in Puget Sound. The animals initially tested positive at the Washington Animal Disease Diagnostic Laboratory. A statement from National Oceanic and Atmospheric Administration (NOAA) Fisheries said it is the first high-path avian influenza (HPAI) detection in marine mammals on the West Coast. In 2022, 17 H5N1 detections were reported in harbor seals in Maine.”
 
Science (US) reports, “In what many see as fallout from the concern that researchers studying bat viruses may have triggered the COVID-19 pandemic, the U.S. Agency for International Development (USAID) has prematurely ended a $125 million program aimed at identifying viruses in animals that might harm humans. USAID launched the program, known as the Discovery & Exploration of Emerging Pathogens – Viral Zoonoses (DEEP VZN), in October 2021. It tapped the Paul G. Allen School for Global Health at Washington State University (WSU) to lead a consortium that planned to work in up to 12 foreign countries over 5 years. Goals included training people in those countries to safely collect and characterize viruses found in animals, and to identify and develop strategies to thwart pathogens that might gain the capacity to jump to humans and spark a global pandemic. In late July, however, USAID officials notified WSU investigators that they had canceled DEEP VZN….”
 
Mpox Vaccine Protects Against Hospitalization
 
CIDRAP (US) reports on a study published in Morbidity and Mortality Weekly Report: In the study “researchers from the California Department of Public Health show that one or two doses of the Jynneos mpox vaccine effectively prevented hospitalization among those who contracted mpox, people with HIV…. The study was based on 5,765 mpox patients in California who contracted the virus from May 2022 to May 2023…. Of infected Californians, 250 (4.3%) reported mpox-associated hospitalizations, of which 233 were unvaccinated, 4 had received one Jynneos dose, 1 received two doses, and 12 received Jynneos as post-exposure prophylaxis (prevention).” Read the study.
 
A comment in Lancet Infectious Disease draws lessons from a modeling study that aimed “to investigate the transmission dynamics of the 2022 mpox outbreak among gay, bisexual, and other men who have sex with men (GBMSM) in England, with the aim of evaluating the effects of implemented control measures on the mpox epidemic…. Overall, this study highlights the importance of both early behavioural intervention and vaccination initiation in mpox control. The key message of this study echoes WHO's recommendations, that modification of risk behaviours, prompt diagnosis, and isolation will be crucial in reducing mpox transmission in the population, including in low-income countries. Early and widespread vaccination could play a significant role in preventing the reoccurrence of mpox.”
 
Malaria Parasite Evades Detection and Resist Treatment
 
Futurity (US) reports, “Researchers have detected new strains of malaria-causing parasites in Ethiopia that are both resistant to current treatments and escape detection by common diagnostic tests, according to a new study. The development could increase cases and deaths from malaria and makes eliminating the persistent disease an even greater challenge. The authors detail their findings from a genomic surveillance study in the journal Nature Microbiology.” Study author Jeffrey Bailey says, “Now we’re essentially seeing the worst-case scenario: parasites with the mutation that make them resistant to treatment have also picked up the chromosomal deletions that make them invisible to the diagnostic tests. This means that it will be harder to detect people who are infected, and then when infected people are treated with antimalarial drugs, that may not work to stop them from spreading the disease.”
 
Trying to Unravel Long COVID
 
NPR’s Shots Blog (US) looks at the state of research into long COVID. “For people suffering from long COVID's often disabling symptoms, including intense fatigue, breathing troubles, cognitive issues and heart palpitations, the list of scientific unknowns may sound defeating. There's still no validated treatment or diagnostic test specifically for the condition, although there are many candidates.” But Dr. Rasika Karnik says, “There's more information to work with now…. But doctors' approach still comes down to treating individual symptoms, rather than the underlying cause of the illness. ‘It's hard to look a patient in the eyes and say “we're not quite sure yet” and to keep repeating that,’ she says.
 
New Laws on Vaccination in Pakistan
 
The Guardian (UK) reports, “Parents in Pakistan who refuse to get their children vaccinated against infectious diseases could be jailed or fined under a new law introduced in Sindh province. The introduction of the legislation is an attempt to eradicate polio, which is endemic in Pakistan, but will cover vaccines for diphtheria, tetanus, whooping cough (pertussis), measles, mumps and rubella. Parents who do not allow their children to be vaccinated could be sentenced to a month in prison and fined 50,000 Pakistani rupees (£130). The law, the first of its kind in the country, was signed last week and will come into force this month.
 
US FDA and CDC Pave Way for New Boosters
 
Washington Post (US) reports, “Virtually all Americans should get an updated coronavirus shot, the Centers for Disease Control and Prevention recommended Tuesday, with the vaccines expected to become available within 48 hours — as the respiratory illness season looms. Mandy Cohen, director of the CDC, advised that anyone 6 months and older should get at least one dose of an updated shot. Her broad recommendation came after the agency’s expert advisers voted for a universal approach to seasonal coronavirus vaccination. The shots are intended to bolster defenses as the nation heads into the fall and winter virus season, when influenza and RSV are also primed to be on the rise.” Reuters (UK) reports, “The recommendation differs from those in most European countries that have issued guidance. This month, the European Centre for Disease Prevention and Control (ECDC) said vaccination programs in EU countries should prioritize people aged 60 and older as well as other vulnerable groups.”