TB continues to kill millions of people, despite advances in treatment and diagnosis. This year the disease has surpassed COVID-19 as the top infectious disease killer. Stephanie Nolen reports in The New York Times (US), “worldwide, 40% of people who are living with TB are untreated and undiagnosed, according to the World Health Organization. The disease killed 1.36 million people in 2022, according to a new WHO report released [last week]…. The numbers are all the more troubling because this is a moment of great hope in the fight against TB: Significant innovations in diagnosing and treating it have started to reach developing countries, and clinical trial results show promise for a new vaccine. Infectious disease experts who have battled TB for decades express a new conviction that, with enough money and a commitment to bring those tools to neglected communities, TB could be nearly vanquished.”
 
Bhekesia (South Africa) reports, “South Africa — one of the most unequal countries in the world — has for years ranked among those with the most cases of TB…. Ending TB can’t be untangled from tackling social issues such as poverty and inequality. People who are poor often live in crowded spaces with poor ventilation, have too little to eat and don’t have the financial buffer to change their circumstances. Add to that the two-way effect of HIV, which weakens people’s immune systems and so makes people vulnerable to getting infected with TB, it can seem like an unbreakable cycle.”
 
Read WHO’s Global tuberculosis report 2023.
 
If You Are in a Hurry

• Read Nature on the spread of dengue to new parts of the world.
• Read a Pew Research Center report on a decline in trust in science among Americans.
• Read CNN on the approval of the world’s first chikungunya vaccine and then read a blog post from CEPI’s Richard Hatchett on making the vaccine accessible for those who most need it.
• Read The Telegraph on Egypt’s success on HEP C elimination.
• Read The New York Times on long COVID and brain fog.
• Read CIDRAP on the success of mass COVID vaccination in Japan.

 
Mosquito-Borne Diseases Spreading Faster and to More Areas
 
Nature (UK) reports on an increase in dengue cases and the spread of the disease to new parts of the world. “This year, more than 4.2 million cases of the disease, which is caused by a virus transmitted by mosquitoes, had been reported by 2 October, compared with half a million in 2000. And the disease, which was once confined to the tropics, is spreading to new locations around the world, including southern Europe…. There is no specific treatment for dengue, which is also known as breakbone fever and can cause fever, bone pain and even death. The available vaccines have important limitations, and controlling the mosquitoes that transmit the disease is challenging.” Researchers are looking to develop new vaccines and ways to control the mosquito that carries the disease.
 
Think Global Health (US) reports, “Worldwide each year, mosquitoes infect roughly five hundred million people with malaria, dengue, Zika, yellow fever and Chikungunya, killing nearly one million adults and children. But these illnesses have generally been confined to warm, rainy tropical regions such as Central and South America, sub-Saharan Africa, and Southeast Asia. That is changing because the warming climate allows the ever-adaptable mosquito to thrive in new areas…. A 2021 study in The Lancet projected that diseases such as malaria and dengue will emerge in previously unaffected areas and reemerge in areas where they had disappeared, “where people might be immunologically naive and public health systems unprepared.” The appearance of locally acquired malaria in the United States is a frightening preview of the devastation mosquitoes will continue to wreak as climate change beckons them to more temperate areas.”
 
American’s Trust in Science is Declining
 
A new Pew Research Center report “finds the share of Americans who say science has had a mostly positive effect on society has fallen and there’s been a continued decline in public trust in scientists…. Overall, 57% of Americans say science has had a mostly positive effect on society. This share is down 8 percentage points since November 2021 and down 16 points since before the start of the coronavirus outbreak.
 
Ars Technica (US) reports on the report: “Overall, the latest iteration of the poll captures a key time in societal trends. It was probably inevitable that views on science would rise early in the pandemic when it seemed to offer hope for controlling COVID-19. Equally, it was probably inevitable that there would be a drop that brought us back to pre-pandemic levels of trust. The biggest question was whether any trends would drive science's levels of support to below where they were before the pandemic started. The new data indicates the answer is clearly yes, but other occupations, such as the military, police, and school officials, have also seen a slight erosion of trust over the same period. So, while we know more about what's happening in regard to feelings about science, it's still unclear whether there's something distinct happening with science or whether it's simply caught up in a larger growth of mistrust in institutions.”
 
Childhood Vaccine Exemptions Rise in US
 
NBC News (US) reports, “The number of kids whose caregivers are opting them out of routine childhood vaccines has reached an all-time high, the [US CDC] reported Thursday, potentially leaving hundreds of thousands of children unprotected against preventable diseases like measles and whooping cough. The report did not dive into the reasons for the increase, but experts said the findings clearly reflect Americans' growing unease about medicine in general…. The CDC report found that 3% of children entering kindergarten during the 2022-2023 school year were granted a vaccine exemption from their state. This is the highest exemption rate ever reported in the US” Read the CDC Report.
 
US FDA Approves Chikungunya Vaccine
 
CNN (US) reports the US FDA “approved the first vaccine to prevent disease caused by the chikungunya virus. The single-dose vaccine, Ixchiq, made by Valneva Austria GmbH, is approved for adults who are at an increased risk of exposure to the virus. Ixchiq was granted fast track and breakthrough therapy designations…. Health experts consider [chikungunya] to be an emerging threat to global health made worse by climate change, with at least 5 million cases in the past 15 years, although deaths and severe illness are rare, according to the World Health Organization. People most at risk of infection live in Africa, Southeast Asia and parts of the Americas, where chikungunya-carrying mosquitoes are endemic, but the climate crisis has driven the virus to new parts of the world.”
 
In a CEPI Blog Post, CEPI’s CEO Dr Richard Hatchett says the next step after FDA approval “is even more important: making this vaccine accessible to those living in endemic countries who are most at risk from the disease.” He notes that funding from CEPI and the EU will support “Technology transfer of Drug Product to Valneva’s partner in Brazil, Instituto Butantan, who will manufacture and market the vaccine in LMICs. This will enable sustainable, reliable, and affordable access to the vaccine for endemic countries in the future.”
 
Egypt’s Success in Hep C Elimination
 
The Telegraph (UK) reports, “When Egypt last month reached ‘gold-tier’ status for eliminating hepatitis C, the achievement was heralded by the international health community as ‘nothing short of astounding.’ Within a decade, the country has gone from having among the worst global rates of the disease to near eradication…. In 2008, the country’s first demographic health survey showed that 15% of the population had antibodies following exposure to HCV, with 10 per cent infected and in need of treatment…. A joint strategy with the World Health Organisation (WHO) and the Centers for Disease Control and Prevention in the US, published in 2014, was launched alongside the antiviral treatment programme; one million people signed up in the space of a week. ‘The numbers were staggering,’ remembers El-Sayed, confirming that Egypt had quickly become ‘the blueprint for all other countries to develop their strategies’.”
 
COVID-19 Vaccine Hesitancy in South Africa
 
Ronel Sewpaul and colleagues in Frontiers in Public Health (Switzerland) look at factors affecting vaccine hesitancy in South Africa. “Amidst widespread public health recommendations and availability of COVID-19 vaccinations, half of South African adults are vaccinated against COVID-19. This study investigated the socio-behavioral determinants of vaccine hesitancy in South Africa, where vaccine hesitancy was separated into unwilling ness and uncertainty to take a COVID-19 vaccine.” The authors conclude, “The determinants of COVID-19 vaccine hesitancy should be addressed in interventions to improve vaccine uptake. Public health interventions and health communication can be prioritized and tailored to the different forms of vaccination hesitancy.”
 
Clinical Trials Arena (UK) reports, “Sewpaul and her colleagues provide insights into the influence of demographics, culture and information consumption on attitudes toward vaccination for public health practice, and also portend formidable headwinds in South Africa’s mission to address vaccine hesitancy. Skepticism among the study’s vaccine-hesitant participants toward their country’s public health institutions in 2021 has likely only grown in the intervening years, following a high-profile corruption scandal surrounding the Ministry of Health’s suspected mishandling of COVID-19 contracts.”
 
Mpox Circulated for Years Before Global Explosion
 
The Guardian (UK) reports, “The disease formerly known as monkeypox, which spread around the world in an unprecedented outbreak in 2022, was circulating in humans for more than five years before the explosion of cases triggered a global public health emergency, researchers say. The discovery of longstanding, hidden transmission between humans has led to calls for improved global surveillance of the MPXV virus to eliminate the disease, renamed mpox last year, from humans and prevent it from re-emerging.” Read the research in Science.
 
“Criminal Incompetence” of UK COVID-19 Response
 
Richard Horton writes in a comment in The Lancet (UK), “The level of criminal incompetence exposed by recent witnesses to the UK COVID-19 Inquiry… has proven that many, if not most, of over 230,000 deaths were preventable. Amid the claims of extreme misogyny, profanity, and chaos that litter the evidence is a story of complete government breakdown…. It was a “historic catastrophe” based on ‘disastrous groupthink’ (Cummings). The lies, deceptions, and callous conceit that characterised the UK's initial response to COVID-19 must surely bring some kind of reckoning.”
 
Long COVID and Brain Fog
 
The New York Times (US) reports, “here are more Americans who say they have serious cognitive problems — with remembering, concentrating or making decisions — than at any time in the last 15 years, data from the Census Bureau shows. The increase started with the pandemic: The number of working-age adults reporting ‘serious difficulty’ thinking has climbed by an estimated one million people…. The sharp increase captures the effects of long Covid for a small but significant portion of younger adults, researchers say, most likely in addition to other effects of the pandemic, including psychological distress. But they also say it’s not yet possible to fully dissect all the reasons behind the increase.”
 
NPR (US) reports, “The virus appears to do most of its damage to the brain indirectly, scientists say. An infection in the body triggers an immune response that leads to inflammation in the brain. And the inflammation can persist long after the virus has apparently been cleared, scientists say. The brain may be especially vulnerable to COVID-19 because the disease appears to weaken the blood-brain barrier, which usually protects the organ from both germs and the immune cells that follow them. Another possibility is that COVID-related inflammation affects the vagus nerve, which carries signals between the body and brain that are important to memory and attention.”
 
Mass COVID Vaccination in Japan
 
CIDRAP (US) reports, “The population benefit of COVID-19 vaccination via direct and indirect effects was substantial in Tokyo in early 2022 during Omicron, with an estimated 65% reduction in the number of SARS-CoV-2 infections, according to a new model that compared risks between unvaccinated and vaccinated individuals…. The investigators calculated that mass vaccination campaigns directly prevented 640,000 COVID-19 cases during the sixth wave, and indirectly prevented as many as 8.5 million infections. Read the study.