Pandemic Watch: New DRC mpox strain, concern grows about avian flu, and more ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

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AVAC's weekly Pandemic Watch is a curated news digest on the latest pandemic prevention, preparedness and response (PPPR) news and resources.


One of the main points of disagreement between wealthy countries and developing states is the vexed issue of sharing drugs and vaccines fairly to avoid a repeat of COVID-era failures.” - from Reuters ([link removed])
Table of Contents
• If You Are in a Hurry (#If You Are in a Hurry)
• New DRC Mpox Strain May Be More Easily Spread (#New DRC Mpox Strain May Be More Easily Spread)
• Concern Grows About Avian Flu in US Cows (#Concern Grows About Avian Flu in US Cows)
• Stop Cuddling Cows (#Stop Cuddling Cows)
• Cholera Outbreaks Continue and So Does the Vaccine Shortage (#Cholera Outbreaks Continue and So Does the Vaccine Shortage)
• WHO Redefines Airborne (#WHO Redefines Airborne)
• Whooping Cough is Back (#Whooping Cough is Back)
• New Initiative to Tackle Climate Change and Disease (#New Initiative to Tackle Climate Change and Disease)
• Hopes for New Vaccine to Protect Against All Corona Viruses (#Hopes for New Vaccine to Protect Against All Corona Viruses)
• COVID Challenge Trial Complications (#COVID Challenge Trial Complications)
• US Tightening Rules on Risky Virus Research (#US Tightening Rules on Risky Virus Research)
• AstraZeneca Withdrawing COVID Vaccine (#AstraZeneca Withdrawing COVID Vaccine)
• Some Believe COVID Vaccine Side Effects Being Ignored (#Some Believe COVID Vaccine Side Effects Being Ignored)
• Looking for COVID in Animals (#Looking for COVID in Animals)
As negotiations continue on a global pandemic treaty that is hoped to help guide a more equitable response to future pandemics, WHO’s Tedros had a simple plea for a complicated process: "Give the people of the world, the people of your countries, the people you represent, a safer future… please, get this done, for them.” According toReuters ([link removed]) (UK), “Countries are due to finalise negotiations on the accord on May 10, with a view to adopting it at the WHO's annual meeting later this month, but sources involved say that big differences remain…. One of the main points of disagreement between wealthy countries and developing states is the vexed issue of sharing drugs and vaccines fairly to avoid a repeat of COVID-era failures.”

The People’s Health Movement, a global campaign for the right to health writes in The Daily Maverick ([link removed]) (South Africa), “there is very little in the draft negotiating text to translate equity and solidarity into legally binding practical actions…. The current text contains no legally binding mechanism for effective technology transfer coordinated by the WHO that would facilitate the sharing of technology and know-how to a geographically diversified production network. It contains no obligation on member states to transfer publicly funded pandemic-related product technology to such a technology transfer mechanism…. Countries of the Global South will remain dependent on buying pandemic products from manufacturers in the north and will never become self-sufficient.”

If You Are in a Hurry

* Read Reuters ([link removed]) and STAT ([link removed]) on what we know and don’t know about the avian flu outbreak in dairy herds in the US.
* Then read STAT ([link removed]) on what WHO’s Jeremy Farrar says about the social context around responding to outbreaks. And read Katherine Wu in The Atlantic ([link removed]) on the problems with the US response.
* Read Vox ([link removed]) on what’s behind the shortage of cholera vaccines to respond to growing outbreaks of the disease.
* Read KNN ([link removed]) on WHO’s redefining what airborne is and what that means for future pandemic responses.
* Read The Guardian ([link removed]) on very early research to find a pan-coronavirus vaccine.


New DRC Mpox Strain May Be More Easily Spread

AP ([link removed]) (US) reports, “Congo is struggling to contain its biggest mpox outbreak, and scientists say a new form of the disease detected in a mining town might more easily spread among people.” Research that has not yet been peer reviewed and published “suggests recent genetic mutations in mpox are the result of its continued transmission in humans; it’s happening in a town where people have little contact with the wild animals thought to naturally carry the disease…. In a report on the global mpox situation this week, WHO said the new version of the disease might require a new testing strategy to pick up the mutations.” Read the WHO report ([link removed]) .

Concern Grows About Avian Flu in US Cows

While stressing that risk to humans remains low, many experts are concerned about the spread of the avian flu strain H5N1 in dairy cows in the US and efforts are underway to better understand the extent of the outbreak and what is happening.

Helen Branswell reports in STAT ([link removed]) (US), “The responding agencies [the US CDC, US Department of Agriculture, the Food and Drug Administration, and state and local health departments] have long experience working with poultry farmers, who’ve been plagued by this virus for the past couple of years. But its move into cattle has been like crossing into a new country for the agencies. Dairy farmers have no experience with bird flu. Many farmers and farm workers haven’t been eager to cooperate with authorities.” In an interview with Vivien Dugan who leads the US CDC’s influenza division, Dugan notes that CDC is unable to do the testing they would like to do, because they must wait for states to invite them in. “CDC does not have the authority to go into a state. We have to have an invite from state public health.” And no states have invited CDC in and the one confirmed infected person and his contacts did
not consent to have blood drawn.

Branswell also reports in STAT ([link removed]) (US), “Another upload of genetic sequence data from the H5N1 bird flu outbreak in dairy cattle has exacerbated the scientific community’s frustration with the US Department of Agriculture after the agency again failed to include basic information needed to track how the virus is changing as it spreads…. Cows in 36 herds in nine states are known to have tested positive for the virus. But it is widely believed the outbreak, which may have begun late last year, is more widespread than the number of confirmed outbreaks would suggest.”

In a separate article in STAT ([link removed]) (US) Branswell reports WHO’s chief scientist Jeremy Farrar has experience with a previous H5N1 outbreak among poultry in Asia. “He recalls there was a reluctance among farmers to cull their chickens because they weren’t being compensated for them…. It’s important to keep that experience in mind, he told STAT Monday, as the H5N1 bird flu virus now spreads among dairy cattle in the US Farrar stressed that the social context is key in responding to disease threats like H5N1, noting that a similar reluctance among dairy farmers to report outbreaks or allow testing of their workers is adding to the challenges in assessing how much transmission is occurring and the risk it poses to people…. While he believes the risk of a human flu pandemic triggered by the H5N1 virus is low, should it happen, the social context will also be crucial, Farrar continued. The mental toll of
the taxing COVID-19 pandemic hangs over the public, health care workers, public health agencies, and governments. Getting people to again buy into measures that might slow spread, such as social distancing or school closures, would likely be tough, he said.”

Reuters ([link removed]) (UK) reports, “The outbreak - the first in cattle - is so far known to have infected 36 dairy herds in nine states. Infection by the bird virus is rare in humans, and the dairy worker's case, first reported in March, represents only the second known human infection in the United States. It follows a worrisome spread of the virus in a variety of mammal species, raising concerns that widespread exposure of people could cause the virus to spread more easily among the population and spark a global pandemic…. The CDC is urging farmers, workers, and emergency responders to wear appropriate protective gear when in direct or close physical contact with sick birds, livestock, feces, raw milk or contaminated surfaces.”

In The Atlantic ([link removed]) (US) Katherine Wu looks at how prepared the US is to respond to the avian flu, noting the outbreak “looks a lot like a public-health problem that the United States should be well prepared for…. ‘It’s almost like having the opportunity to catch COVID-19 in the fall of 2019,’ Nahid Bhadelia, the founding director of Boston University Center on Emerging Infectious Diseases [said]…. Yet the U.S. is struggling to mount an appropriate response. Because of the coronavirus pandemic, the nation’s alertness to infectious disease remains high. But both federal action and public attention are focusing on the wrong aspects of avian flu and other pressing infectious dangers, including outbreaks of measles within US borders and epidemics of mosquito-borne pathogens abroad…. The intensity of living through the early years of COVID split Americans into two camps: one overly sensitized to infectious
threats, and the other overly, perhaps even willfully, numbed. Many people fear that H5N1 will be ‘the next big one,’ while others tend to roll their eyes, [epidemiologist Bill] Hanage told me. Either way, public trust in health authorities has degraded.”

Stop Cuddling Cows

Reuters ([link removed]) (UK) reports, “Paying farmers to snuggle up with half-ton heifers is all the rage in the United States thanks to social media. For visitors, cuddling dairy or beef cattle can be therapeutic, or simply an adventure for city dwellers looking for good old country fun.” With the outbreak of avian flu in several dairy herds in the US, experts are warning against the practice. “In Michigan, where one dairy herd has tested positive, the head of the state's agriculture department this week signed an emergency response order with new sanitation measures and access limitations to dairy and commercial poultry farms starting May 8. The order does not expressly prohibit cow cuddling. But Michigan Department of Agriculture and Rural Development director Tim Boring told Reuters, ‘From a human to animal health standpoint, now is not a good time to cuddle cows. This is to protect the cows and
people.’"

Cholera Outbreaks Continue and So Does the Vaccine Shortage

Vox ([link removed]) (US) reports, “Amid a global resurgence of cholera, the world is fighting with one hand tied behind its back. The global stockpile of the oral cholera vaccine — a supply whose needs are difficult to predict and fill anyway — has dwindled to nearly nothing after the Indian drug manufacturer that produced about 15 percent of the world’s supply stopped making the vaccine last year. While other companies are setting up new production capacity, the stockpile is now effectively nonexistent. Demand is so great that as soon as doses are produced, they must immediately ship to one of the world’s current cholera hot spots…. Here are currently active cholera outbreaks in Zambia, Mozambique, Sudan, the Democratic Republic of the Congo, Syria, Ethiopia, Somalia, Zimbabwe, and Haiti…. Climate change and the conflict and displacement related to it also significantly contribute to the uptick in cholera
outbreaks, according to experts Vox spoke with. Higher temperatures and changing weather patterns make the environmental conditions ripe for outbreaks in new places unused to the disease.”

Amid devastating floods in Kenya, The Nation ([link removed]) (Kenya) reports, “The country has recorded 34 cholera cases, attributed to the widespread flooding affecting various parts of the country. Public Health and Professional Standards Principal Secretary Mary Muthoni said the long rains have destroyed sanitation facilities (latrines), resulting in the collapse and filling of latrines with flood water contaminating water sources with fecal matter.”

WHO Redefines Airborne

KNN ([link removed]) (US) reports, “The World Health Organization has issued a report that transforms how the world understands respiratory infections like covid-19, influenza, and measles. Motivated by grave missteps in the pandemic, the WHO convened about 50 experts in virology, epidemiology, aerosol science, and bioengineering, among other specialties, who spent two years poring through the evidence on how airborne viruses and bacteria spread…. The WHO concluded that airborne transmission occurs as sick people exhale pathogens that remain suspended in the air, contained in tiny particles of saliva and mucus that are inhaled by others. While it may seem obvious, and some researchers have pushed for this acknowledgment for more than a decade, an alternative dogma persisted — which kept health authorities from saying that covid was airborne for many months into the pandemic.”

Whooping Cough is Back

The Telegraph ([link removed]) (UK) reports, “Whooping cough might sound like a Victorian disease, but the bacterial infection has made a dramatic comeback in recent months across Europe, Asia, and America. The ‘100-day cough’ – known clinically as pertussis – infects the lungs and respiratory system, causing severe coughing fits and flu-like symptoms that can persist for months…. A jab – developed in the 1950s – helped to almost eliminate the disease in Britain.

But a steady decline in vaccine uptake coupled with a resurgence of respiratory diseases following Covid lockdowns have contributed to rapidly rising case numbers – with this year the worst on record since the mid-1980s.”

New Initiative to Tackle Climate Change and Disease

Reuters ([link removed]) (UK) reports, “Three of the biggest global health funders have joined forces for the first time in a $300 million partnership aimed at tackling the linked impacts of climate change, malnutrition, and infectious diseases and antimicrobial resistance. The Novo Nordisk Foundation, Wellcome and the Bill & Melinda Gates Foundation announced the research partnership, focused particularly on finding affordable solutions for people in low and middle-income countries…. The partners said the initiative was important given faltering global attention to health post-pandemic. Wellcome's chief executive, John-Arne Røttingen, also said it was about tackling ‘market failures’ and signalling a global commitment to equitable access to medical advances.”

Hopes for New Vaccine to Protect Against All Corona Viruses

The Guardian ([link removed]) (UK) reports, “Scientists have created a vaccine that has the potential to protect against a broad range of coronaviruses, including varieties that are not yet even known about. The experimental shot, which has been tested in mice, marks a change in strategy towards ‘proactive vaccinology’, where vaccines are designed and readied for manufacture before a potentially pandemic virus emerges. The vaccine is made by attaching harmless proteins from different coronaviruses to minuscule nanoparticles that are then injected to prime the body’s defences to fight the viruses should they ever invade.” Read the study in Nature Nanotechnology ([link removed]) .

COVID Challenge Trial Complications

Nature ([link removed]) (UK) reports, “Researchers deliberately infect participants with SARS-CoV-2 in ‘challenge’ trials — but high levels of immunity complicate efforts to test vaccines and treatments…. [none] of the 35 other people who participated in the ‘challenge’ trial actually got COVID-19. The study’s results, published on 1 May in Lancet Microbe1, raise questions about the usefulness of COVID-19 challenge trials for testing vaccines, drugs and other therapeutics. ‘If you can’t get people infected, then you can’t test those things.’ says Tom Peacock, a virologist at Imperial College London. Viral strains used in challenge trials take many months to produce, making it impossible to match emerging circulating variants that can overcome high levels of existing immunity in populations.” Read the study in Nature Medicine ([link removed]) .

US Tightening Rules on Risky Virus Research

New York Times ([link removed]) (US) reports, “The White House has unveiled tighter rules for research on potentially dangerous microbes and toxins, in an effort to stave off laboratory accidents that could unleash a pandemic. The new policy, published Monday evening, arrives after years of deliberations by an expert panel and a charged public debate over whether COVID arose from an animal market or a laboratory in China…. The new policy, which applies to research funded by the federal government, strengthens the government’s oversight by replacing a short list of dangerous pathogens with broad categories into which more pathogens might fall. The policy pays attention not only to human pathogens, but also those that could threaten crops and livestock. And it provides more details about the kinds of experiments that would draw the attention of government regulators.” Read the guidelines
([link removed]) .

AstraZeneca Withdrawing COVID Vaccine

Reuters ([link removed]) (UK) reports, “AstraZeneca said on Tuesday it had initiated the worldwide withdrawal of its COVID-19 vaccine due to a ‘surplus of available updated vaccines’ since the pandemic…. According to media, the Anglo-Swedish drugmaker has previously admitted in court documents that the vaccine causes side-effects such as blood clots and low blood platelet counts.”

Some Believe COVID Vaccine Side Effects Being Ignored

Apoorva Mandavilli reports in New York Times ([link removed]) , “thousands of Americans believe they suffered serious side effects following Covid vaccination. As of April, just over 13,000 vaccine-injury compensation claims have been filed with the federal government — but to little avail. Only 19 percent have been reviewed. Only 47 of those were deemed eligible for compensation, and only 12 have been paid out, at an average of about $3,600. Some scientists fear that patients with real injuries are being denied help and believe that more needs to be done to clarify the possible risks.

Looking for COVID in Animals

Jon Cohen reports inScience ([link removed]) (US), “An ambitious US project aims to sample more than 50 animal species to clarify how the COVID-19 virus moves between people and wildlife…. Motivated by growing evidence that the pandemic virus is entrenched in North America’s deer and reports that it can infect other species, Vandegrift, virologist and veterinarian Suresh Kuchipudi of the University of Pittsburgh, and others aim to collect and analyze more than 24,000 samples from 58 wildlife species over the next 2 years. They will test whether animals currently carry SARS‐CoV‑2 or have antibodies to it, indicating a past infection. That will clarify not only the threat SARS‐CoV‑2 poses to wildlife, but also the risk the virus will evolve into new variants that could spill back into humans, igniting new surges of illness.”
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