Pandemic Watch News Brief: Updates on mpox, malaria vaccine success, and more ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

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[link removed] August 7. 2024
AVAC's weekly Pandemic Watch is a curated news digest on the latest pandemic prevention, preparedness and response (PPPR) news and resources.


This virus [mpox] can and must be contained with intensified public health measures including surveillance, community engagement, treatment, and targeted deployment of vaccines for those at higher risk of infection." - Dr. Tedros of WHO in Science ([link removed])
Table of Contents
• If You Are in a Hurry (#If You Are in a Hurry)
• More on Mpox (#More on Mpox)
• Malaria Vaccine Success (#Malaria Vaccine Success)
• Avian Flu Updates (#Avian Flu Updates)
• Not Learning the Lessons of COVID (#Not Learning the Lessons of COVID)
• Call to Strengthen Research to Prepare for the Next Pandemic (#Call to Strengthen Research to Prepare for the Next Pandemic)
• New Vaccine Could Help Curtail Vaccine-Derived Polio (#New Vaccine Could Help Curtail Vaccine-Derived Polio)
• COVID in the Olympics and More (#COVID in the Olympics and More)
• Concerns about Oropouche virus in Latin America (#Concerns about Oropouche virus in Latin America)
• Dengue’s “Banner Year” (#Dengue’s “Banner Year”)
There is growing concern as the mpox outbreak that started in DRC is spreading into more countries in the region and there are still few if any diagnostics, treatment or vaccines available to communities at risk. The New Times ([link removed]) (Rwanda) via All Africa reports WHO “is considering a major step in response to a rapidly escalating mpox outbreak that has so far been confirmed in 12 African countries. The WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, has pointed out that he ‘might convene an expert committee to advise on whether the outbreak should be declared an international public health emergency.”

CIDRAP ([link removed]) (US) reports, “While 96% of cases have been recorded in the Democratic Republic of the Congo (DRC), several other African countries this week have reported new outbreaks, including Kenya, Cote d’Ivoire, and the Central African Republic (CAR)…. ‘While mpox is moderately transmissible and usually self-limiting, the case fatality rate has been much higher on the African continent compared to the rest of the world,’ the Africa CDC said.”

Science ([link removed]) (US) reports, “Sequencing of the mpox viruses in three cases reported earlier this week in Uganda and Kenya has now confirmed all belong to a deadlier variant previously seen only in the DRC. ‘We warned everyone about it,’ says Placide Mbala, an epidemiologist at the DRC’s National Institute of Biomedical Research. ‘People are very mobile at the eastern part of the country with great connection with neighboring countries. It was just a matter of time to start seeing cases in those neighbor countries.’.… ‘This virus can and must be contained with intensified public health measures including surveillance, community engagement, treatment, and targeted deployment of vaccines for those at higher risk of infection.’ [Tedros said].”

If You Are in a Hurry

* Read The Nation ([link removed]) on steps Africa CDC is taking to combat the mpox outbreak.
* Read Reuters ([link removed]) on mpox cases among children in DRC camps for displaced persons.
* Read STAT ([link removed]) on work to develop an mRNA H5N1 vaccine undertaken by low- and middle-income countries.
* Read The New York Times ([link removed]) on a study that shows H5N1 spreading among cows may be more complex than we thought.
* Read about the long search for malartia vaccines and what’s next in STAT ([link removed]) .
* Read STAT ([link removed]) on work in low- and middle-income countries on the development of an mRNA vaccine for H5N1.
* Read France 24 ([link removed]) on a COVID outbreak among Olympians, a global COVID surge and vaccine fears.
* Read opinions in NEJM ([link removed]) and The Lancet ([link removed](24)00439-0/fulltext?) that argue we haven’t learned the needed lessons from COVID.


More on Mpox

The Nation ([link removed]) (Kenya) reports, “Africa CDC has received an emergency approval of Sh1.3 billion (USD 10.4 million) from the African Union, money drawn from the existing COVID-19 funds to combat the outbreak.… [to] strengthen five critical areas in the fight against mpox: enhancing mpox surveillance and deployment surge capacity, boosting laboratory testing and genomic sequencing capacity, strengthening regional and national data collection and analytics, enhancing case management, infection prevention and control, and risk communication and community engagement, and improving access and delivery of vaccines, diagnostics, and supplies across the continent.”

A CEPI press statement ([link removed]) says, “A clinical trial due to launch in the Democratic Republic of Congo (DRC) and other countries in Africa will assess whether an mpox vaccine can protect people against the disease after they have come into contact with the potentially deadly infection. The ‘SMART’ trial (#NCT05745987) has received US $4.9 million from CEPI and the Canadian Institutes of Health Research to find out if post-exposure vaccination of Bavarian Nordic’s MVA-BN® mpox vaccine could reduce the risk of secondary mpox cases, or, if a person contracts mpox, could reduce their severity of illness…. The evidence generated could be crucial in shaping mpox vaccination strategies to help tackle a large and deadly mpox outbreak escalating in the DRC and neighbouring countries.”

The Independent ([link removed]) (Uganda) reports, “The World Health Organisation (WHO) has provided Uganda’s Ministry of Health with a set of 2,400 test kits to strengthen the country’s response to mpox through rapid laboratory identification of cases. These kits are among the first mpox laboratory tools received in the country and will be used by the Uganda Virus Research Institute (UVRI) to begin testing for the disease. Already the test kits have borne fruit as samples sent to the facility have confirmed two cases of mpox as per a statement released by the Ministry of Health on August 2.

Reuters ([link removed]) (UK) reports on the mpox risk for children in camps for displaced persons in DRC. “Local doctors say they have seen 130 suspected mpox cases, almost entirely in children and adolescents, in the last four weeks at a nearby facility that treats displaced people from the camps in the last four weeks…. In Congo, there are no vaccines or specific treatments for mpox available outside of clinical trials. Stigma, regulatory hurdles, a lack of money, along with measles and cholera outbreaks in the displacement camps have made it a challenge for people to access medical tools, especially in the densely-packed locations.”

Malaria Vaccine Success

In a long profile, STAT ([link removed]) (US) reports on the decades long search for malaria vaccines and the two successful vaccines now being rolled out. “Health officials have projected that the shots could save the lives of tens of thousands of kids. In some countries, malaria accounts for 25% of all childhood deaths. The vaccines — the first to target any human parasite — represent a feat of both scientific grit and fundraising ingenuity. Researchers took on a sophisticated biological adversary that eludes our immune systems’ schemes to identify and dispatch it. They also had to find ways to nudge forward products that would never result in blockbuster sales, a reality that sapped much of the biopharma industry’s interest…. ‘We’re very fortunate, and when I say we I mean our generation, to be present for the last mile of this, and to see these vaccines be introduced,’ said Eusebio Macete, a
Mozambican researcher who two decades ago helped run an early trial of RTS,S. ‘And to see that one of the major killers in Africa could now have another tool to save lives, that’s amazing.’”

Avian Flu Updates

Most health officials still say there is low risk of H5N1 avian flu for most people, but there is growing concern that there may be more cases among farm workers than have been reported and that more needs to be done to find cases and contain potential outbreaks.

NPR’s Shots Blog ([link removed]) (US) reports on a preprint study. “A new study lends weight to fears that more livestock workers have gotten the bird flu than has been reported. ‘I am very confident there are more people being infected than we know about,’ said Gregory Gray, the infectious disease researcher at the University of Texas Medical Branch who led the study, posted online Wednesday and under review to be published in a leading infectious disease journal. ‘Largely, that’s because our surveillance has been so poor.’” Read the study ([link removed]) .

STAT ([link removed]) (US) reports, “A network of nascent vaccine manufacturers in low- and middle-income countries will soon start preliminary work to develop messenger RNA vaccines targeting the H5N1 bird flu virus, an effort that could speed production during a pandemic, should this virus trigger one. The World Health Organization announced Monday that Argentina’s Sinergium Biotech will begin doing pre-clinical testing of candidate vaccine viruses for H5N1 using mRNA technology. The company, which is doing the work at the behest of the Argentinian government, is part of a network of emerging manufacturers that have been working with the WHO and the Medicines Patent Pool to expand mRNA production capacity around the globe.”

The Guardian ([link removed]) (UK) reports, “In the face of serious concerns over the spreading bird flu virus in US agriculture, the US Centers for Disease Control and Prevention (CDC) is pushing a major flu vaccination campaign among farm workers in a bid to prevent healthcare strain and combat potential mutations from the highly pathogenic bird virus. Part of the campaign will seek to combat disinformation about vaccines, which has hampered previous efforts…. Officials also hope the seasonal flu vaccine will reduce the chance of co-infection – when someone gets sick with multiple strains of the flu at the same time. While the flu shot doesn’t prevent all infections, it can lower the risks. The seasonal flu shot could thus help prevent reassortment, where a worker might get bird flu and human flu at the same time and mix them to make an even worse variant.”

The New York Times ([link removed]) (US) reports on a new study from Nature that shows a “more complex” picture of the outbreak among cows in the US. “Some farms have reported a significant spike in cow deaths, according to the paper, which investigated outbreaks on nine farms in four states. The virus, known as H5N1, was also present in more than 20 percent of nasal swabs collected from cows. And it spread widely to other species, infecting cats, raccoons and wild birds, which may have transported the virus to new locations. ‘There’s probably multiple pathways of spread and dissemination of this virus,’ said Diego Diel, a virologist at Cornell University and an author of the study. ‘I think it will be really difficult to control it at this point.’” Read the study ([link removed]) .

Undark ([link removed]) (US) looks at how to understand the mortality rate of H5N1., noting that WHO says 52% of people known to have been infected with the virus have died. “The figure has been widely cited in academic papers, public health communications, and media reports, where it can provoke apocalyptic visions…. The actual picture, while still alarming, is more complicated. The WHO’s H5N1 mortality figure, an average of wildly different death rates from past outbreaks, doesn’t factor in mild cases that went undetected. Even less certain is how lethal H5N1 would be if it evolves to spread not just from animals to humans, but also from person to person…. But answering how lethal an H5N1 pandemic might be is no easy feat. A dive into that question reveals the ongoing challenges — and, some experts say, failures — of tracking the virus. And it offers a glimpse at the difficulty of communicating the risks and unknowns about an emerging
pathogen.”

Not Learning the Lessons of COVID

Michael S. Sinha and colleagues write in a commentary in NEJM ([link removed]) (US) that changes in laws and withdrawal of support for public health programs in the US after the COVDI pandemic may have a disastrous effect on the next pandemic. “With fewer tools at the public health community’s disposal, a new pandemic could potentially spread even faster than COVID-19 did, overwhelming hospitals and morgues more quickly, putting more stress on health care workers, and causing more deaths — even if the causative virus isn’t more lethal than SARS-CoV-2. Most troubling, we believe, is the apparent inability of politicians and pundits to understand that a new pandemic may look different from the previous one, threatening different populations and presenting different trade-offs. Certain key community-level mitigation measures, such as school closures — which might be far more important, should a new pathogen be associated with higher mortality among young
people than SARS-CoV-2, as has been seen in multiple avian influenza outbreaks — are now likely to face political, legal, and popular resistance. The blanket nature of new restrictions on public health authority and certain mitigation measures, especially in an environment rife with misinformation and attacks on public health workers, may deter officials from making evidence-based decisions that could help protect vulnerable populations.”

An editorial in The Lancet ([link removed](24)00439-0/fulltext?) (UK) notes, “Searching for ‘COVID-19 lessons learned’ on PubMed gives you 4840 results—a long list of opinion pieces, reviews, and consensus statements telling us what we can learn from our recent pandemic experience…. Have we learned from the COVID-19 pandemic? Judging from the H5N1 and mpox outbreaks, not really. Or maybe not the right people. The cynical view is that instead of producing all those biomedical “lessons learned” articles, we should have been focusing more on political lessons from the devastating economic impact of the pandemic and the influence of a country's pandemic performance on subsequent voter behaviour. However, this is not our purview as a medical journal, but we would like to stress that the time to react is now, before we have the next pandemic.”

Call to Strengthen Research to Prepare for the Next Pandemic

In a press release ([link removed]) WHO and CEPI, “called on researchers and governments to strengthen and accelerate global research to prepare for the next pandemic. They emphasized the importance of expanding research to encompass entire families of pathogens that can infect humans–regardless of their perceived pandemic risk–as well as focusing on individual pathogens. The approach proposes using prototype pathogens as guides or pathfinders to develop the knowledge base for entire pathogen families.” Read a report ([link removed]) “urging a broader-based approach by researchers and countries.”

New Vaccine Could Help Curtail Vaccine-Derived Polio

CIDRAP ([link removed]) (US) reports, “Biological E, a vaccine and pharmaceutical company based in India, announced today that the World Health Organization has prequalified its novel oral poliovirus type 2 (nOPV2) vaccine, a next-generation vaccine for battling circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks. The company said the live attenuated oral vaccine has improved genetic stability and has a decreased chance of seeding new outbreaks in low-immunity settings compared to the Sabin poliovirus type 2 vaccine. It added that real-world deployment in outbreak regions suggests that it can successfully reduce the incidence of cVDPV2 outbreaks.”

COVID in the Olympics and More

France 24 ([link removed]) (France) reports, “More than 40 athletes at the Paris Olympics have tested positive for Covid-19, highlighting a new global rise in cases as vaccination coverage plunges, the World Health Organization said Tuesday. The WHO said the virus behind the COVID-19 pandemic was still circulating -- and countries need to sharpen up their response systems and get jabbing those most at risk.

VOA ([link removed]) (US) reports, “The World Health Organization is warning that governments throughout the world are unprepared to combat the global surge of COVID-19, which is putting millions of people at risk of severe disease and death. ‘COVID-19 is still very much with us,’ Dr. Maria Van Kerkhove, WHO director for epidemic and pandemic preparedness and prevention, told journalists in Geneva Tuesday. ‘The virus is circulating in all countries. Data from our sentinel-based surveillance system across 84 countries reports that the percent of positive tests for SARS-CoV-2 has been rising for several weeks,’ she said.”

Concerns about Oropouche virus in Latin America

CIDRAP ([link removed]) (US) reports, “The Pan American Health Organization (PAHO) recently issued an epidemiological alert for rising Oropouche virus infections, urging countries to step up surveillance amid spread to new areas, reports of the first deaths, and suspected maternal transmission. Oropouche virus is typically spread by a species of biting midge called Culicoides paraensis, but multiple factors including climate change, deforestation, and urbanization have contributed spread beyond Brazil's Amazon region to countries that haven't reported cases before, including Bolivia and Cuba. Since the first of the year, 8,078 cases have been reported from five countries, mostly from Brazil. The others include Bolivia, Peru, Colombia, and Cuba. Two deaths have been reported, both from Brazil. Both of the fatal cases occurred in young women who didn't have underlying health conditions.:

Dengue’s “Banner Year”

NPR’s Goats and Soda Blog ([link removed]) (US) reports, “In the Americas alone, almost 10.4 million suspected cases of dengue, a mosquito-borne viral disease, were reported to the World Health Organization in 2024 as of the first week of July, an increase of 232% compared with the same period the year before. Peru is a case in point. When torrential rains started to fall there in 2023, a record-breaking dengue epidemic exploded shortly afterward. The case count is estimated at well over 100,000 so far this year. And dengue isn't just stalking the Americas. Bangladesh, Burkina Faso, Chad, Nepal, Sri Lanka and Vietnam are among the countries now registering uncharacteristically high numbers of cases of the disease. Many are struggling to get epidemics under control.”
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