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October 3, 2024 |
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| Any outbreak of an epidemic is likely to cause panic in society and fear within the population – driven by a barrage of information shared across digital platforms, some of which are false, misleading or exaggerated." - Linda M. Kagire of The New Times |
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A new Marburg virus outbreak in Rwanda has killed at least nine people and raised alarm in the country, the region and globally. This is the first outbreak of the virus in Rwanda. As STAT (US) reports, “The number of cases detected so far, 27, already makes the outbreak one of the biggest involving Marburg on record. Nine of those individuals have died. There are currently no licensed vaccines to combat the disease…. ‘WHO assesses the risk of this outbreak as very high at the national level, high at the regional level, and low at the global level,’ the WHO said.” Nature (UK) reports, “if the current outbreak continues — most are small and quickly contained — health officials and researchers hope to gather valuable data on the safety and potential effectiveness of vaccines and treatments…. A WHO ethics committee had previously approved plans for the vaccine trial, as well as one for treatments such as the antiviral drug remdesivir, which was tested against Ebola and COVID-19, and monoclonal antibody treatments that have shown promise in animals. The WHO spokesperson said the next urgent step is for the trials to be approved in Rwanda.”
At the same time as health officials in Rwanda are dealing with the Marburg outbreak, they must fight an outbreak of mis- and dis-information. The New Times (Rwanda) reports, “Any outbreak of an epidemic is likely to cause panic in society and fear within the population – driven by a barrage of information shared across digital platforms, some of which are false, misleading or exaggerated. It is even more so for a deadly viral haemorrhagic disease like Marburg, whose fatality rate is at 88 per cent – which means that at least 9 out of 10 people, who contract it are likely to die…. Several studies have shown that an outbreak of the magnitude of Marburg – which is in the same category as Ebola, can generate misconceptions, beliefs and practices which can in fact impede the control of the outbreak.
If You Are in a Hurry
- Read a STAT interview with NIAID director Jeanne Marrazzo on a wide range of issues including mpox and avian flu.
- Read Devex on the difficulties of tracing mpox cases in the African outbreak.
- Read The Telegraph on the need for wealthy countries to give vaccines from their smallpox stockpiles to fight mpox in Africa.
- Read The New York Times on a cluster of avian flu cases among humans in Missouri.
- Read an opinion piece in The Telegraph from WHO’s Tedros on the AMR crisis and the recent UNGA declaration.
- Read Reuters on a new WHO recommendation on RSV vaccines and antibodies to protect infants.
Mpox Outbreak Continues with Slow Responses
Devex (US) reports, “As cases of mpox steadily increase across the African continent, some 68% of them don’t have an epidemiological link — meaning they’re popping up among people that health workers aren’t monitoring and who aren’t known to have been in contact with previously identified cases…. So far Africa CDC has recorded cases in 15 countries, but this may be an underrepresentation, Kaseya said. For example, Tanzania hasn’t officially declared a case, but several of its neighboring countries have…. Kaseya blamed the international community for dropping the ball on researching mpox, which he said is part of the reason there are so many gaps in understanding. In July 2022, WHO declared a public health emergency of international concern as mpox spread globally — and research focused on the strain known as clade 2b, which was circulating in Europe and the US, Kaseya said. But the clade circulating in Africa was sidelined.”
AP (US) reports, “Sex workers are among those hardest-hit by the mpox outbreak in Kamituga [DRC], where some 40,000 of them are estimated to reside — many single mothers driven by poverty to this mineral-rich commercial hub where gold miners comprise the majority of the clientele. Doctors estimate 80% of cases here have been contracted sexually…. Disease experts say a lack of vaccines and information makes stemming the spread difficult. Some 250,000 vaccines have arrived in Congo, but it’s unclear when any will get to Kamituga. Sex workers and miners are among those slated to receive them first.
Ngozi Okonjo-Iweala, Director-General of the World Trade Organization, writes in a Project Syndicate (US) opinion piece, “The response to the mpox outbreak in Central Africa suggests that we have not learned the lessons of COVID-19, when inequitable access to vaccines prolonged the pandemic and worsened its economic consequences. Even more alarmingly, it demonstrates how unprepared we are for a new global health crisis…. To avoid such delays in future emergencies, countries must be better prepared to receive vaccines. Governments could start recognizing regulatory approvals by other countries, and they can use the negotiations on a proposed WHO Pandemic Agreement to give national and regional regulators and the WHO new tools to speed up approvals.”
In a wide ranging interview in STAT (US) NIAID director Jeanne Marrazzo says about the outbreak in Africa, “I don’t think you can put it back into the box. When you’ve got planes, or people having sex or human contact, and when you have people breathing, the genie’s out of the bottle. I think it’s probably going to be a matter of time before we see cases of clade Ib in other countries and I think the hope is that we can at least get a handle on what’s going on in the worst affected areas. The problem is, I don’t even think we know what the magnitude of the problem is there, because some of those places are so remote.”
Reuters (UK) reports, “US President Joe Biden announced on [September 24] the donation of 1 million mpox vaccine doses and at least $500 million to African countries to support their response to the outbreak. Biden made the announcement at the United Nations General Assembly in New York, and called on other countries to follow suit…”
Read a KFF explainer on the global mpox crisis and the US response.
The Telegraph (UK) reports, “Wealthy countries with millions of smallpox vaccines stockpiled for national security should urgently donate more doses to African countries battling the latest outbreak of mpox, the World Health Organization has warned. For decades governments including the UK, Japan, United States and South Korea have been stockpiling shots of smallpox – the only disease ever eradicated – in case the lethal pathogen makes an accidental or intentional comeback. Many of these smallpox vaccines are also effective against mpox as the two viruses are closely related. Yet, as a worrying outbreak of a dangerous new mpox strain intensifies in east Africa, few vaccines have reached the hardest hit regions.”
The Spy (Uganda) reports, “The Minister of Science, Technology, and Innovation, Dr. Monica Musenero, has unveiled the government's plan to begin manufacturing vaccines for Monkey pox virus commonly known as Mpox, which is currently affecting several African nations. ‘We have teams from both Africa and abroad. We are formulating a strategy to develop diagnostics, vaccines, and treatments for Monkeypox, which has been declared a public health threat,’ Musenero stated.”
The Herald (Zimbabwe) reports, “Zimbabwe has heightened surveillance for mpox at three major ports of entry — bordering Zambia, South Africa and Mozambique…. The Ministry of Health and Child Care is currently updating its mpox preparedness and response plan… The country's healthcare system is being fortified to respond effectively to mpox cases. Healthcare workers are set to undergo training on disease recognition and management, while Government laboratories are being equipped with the necessary reagents to diagnose infections. The authorities are also planning to roll out a mass vaccination programme targeting those at risk of the virus once the Government receives Zimbabwe's consignment of vaccines from the Africa Centres for Disease Control and Prevention (Africa CDC). No case of mpox has been discovered in Zimbabwe yet.”
Possible Avian Flu Spread Among Humans in US State
US News (US) reports, “In what could be the first cases of bird flu spreading between humans in the United States, a group of potential H5N1 infections in Missouri has now grown to eight. Antibody tests to confirm any H5N1 infection are still pending. After a patient with bird flu was hospitalized last month, state and federal health officials first determined the patient may have infected one household member and two hospital workers. However, ‘Missouri has since identified four additional health care workers who later developed mild respiratory symptoms,’ the US Centers for Disease Control and Prevention said in a health alert issued Friday.”
The New York Times (US) reports, “If confirmed, the cases in Missouri could indicate that the virus may have acquired the ability to infect people more easily. Worldwide, clusters of bird flu among people are extremely rare. Dr. James Lawler, co-director of the University of Nebraska’s Global Center for Health Security is quoted: “’Nobody should be hitting the panic button yet, but we should really be devoting a lot of resources into figuring out what’s going on.’ If officials confirm H5N1 infection in the household member or any of the health care workers, ‘it means the virus is inching closer and closer to what would be a real pandemic virus. That is when Pandora’s box is open.’”
World Leaders Pledge Action on AMR
Modern Ghana (Ghana) reports, “In a move to safeguard the future of modern medicine, global leaders convened at the United Nations General Assembly in New York and unanimously adopted a new political declaration aimed at combating antimicrobial resistance (AMR). Dr. Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization (WHO), said AMR is associated with over a million deaths a year, with an escalating death toll projected over the coming decades.” Read the WHO press release and the full text of the declaration.
In an opinion piece in The Telegraph (UK) WHO’s Tedros writes, “AMR threatens to unwind a century of medical progress, and could return us to the pre-antibiotic era, where infections that are treatable today could become much harder to treat and potentially deadly tomorrow. AMR is caused largely by the misuse and overuse of antimicrobial medicines – such as antibiotics – making microbes resistant to them, and diseases more dangerous and deadly…. Headline commitments include reducing the global deaths associated with drug-resistant bacteria by 10 per cent by 2030 and ensuring that at least 70 per cent of antibiotics used for human health globally should belong to the safer WHO Access group, which have the lowest potential to cause AMR. Projections show that many of these deaths are avoidable, including by ensuring access to life-saving antimicrobial medicines in LMICs.”
The Star (Kenya) reports, “Kenya may need to set up a fund to fight antimicrobial resistance – where germs are increasingly defeating the drugs designed to kill them. A United Nations assessment shows the country ticks nearly all the boxes on national action plans to fight AMR, but progress is extremely slow partly because of poor funding. In 2019, about 8,500 Kenyans died of easily treatable diseases when drugs failed to work. Another 37,300 deaths were associated with AMR, according to the Institute for Health Metrics and Evaluation.”
Mothers’ COVID Vaccination in Pregnancy Protects Newborns
NPR (US) reports, “Nearly 90% of babies who had to be hospitalized for COVID-19 had mothers who didn’t get the vaccine during pregnancy, according to new data from the Centers for Disease Control and Prevention. Babies too young to be vaccinated had the highest COVID hospitalization rate of any age group except people over 75…. The only effective protection for babies during those six months comes from vaccinating pregnant women, so they pass the antibodies on to their newborns. Vaccination during pregnancy also protects pregnant people from contracting severe disease.” Read the study in MMWR.
Call to Change Public Health “Forecasting”
Epidemiologist Caitlin Rivers writes in an opinion essay in The New York Times (US) that the public health community should learn from the weather community about changing ways of communicating to ensure people are better prepared for disease outbreaks, citing reent communications about mpox and bird flu outbreaks. “Public health communications often take a different approach, choosing conservatism over a duty to warn… Some public health experts fear crying wolf when it comes to uncertain threats. This is a mistake. It would be a missed opportunity to resist honoring the public’s interest in remaining well in a bid to prevent alarm fatigue…. The job of public health experts is to give people clear guidance about what they will face and how they can protect themselves. That does not include a special mandate to prevent panic or stigma when doing so sacrifices clarity. The impulse to offer unfounded reassurance or conceal tough truths is a mistake — one that we need not make again.”
WHO Recommends Maternal RSV Vaccines and Infant Antibodies
Reuters (UK) reports WHO this week “recommended vaccinating pregnant women and administering infants with an antibody to prevent severe respiratory synctial virus (RSV) infection in newborns. RSV, which typically causes cold-like symptoms, is a leading cause of severe infection and death in babies and older adults. A majority of RSV-related deaths occur in low- and middle-income countries, with about 101,400 annual deaths in children under the age of five, according to the WHO… WHO's strategic advisory group noted the concerns around supply and the high cost of the antibody, which it said could seriously limit global access and equity for the treatment. ‘We are looking forward to more products to enter the market to allow for global access and increase the equity to use these products,’ said Hanna Nohynek, chair of WHO's strategic advisory group on immunizations.”
Politics and Health
In a New York Times (US) opinion piece physician Rachael Bedard writes about the impact of a potential leadership role on health in a Trump administration by Robert Kennedy Jr. “Robert Kennedy Jr. reportedly wants to be the secretary of Health and Human Services, or a similarly powerful health position in a Trump White House. Mr. Kennedy claims he’s been promised influence over the two issues he is most eager to address: federal agency corruption and chronic disease. ‘I’m going to be deeply involved in helping to choose the people who can run FDA and NIH and CDC,’ he told Tucker Carlson on a recent panel…. Mr. Kennedy says he will also cease funding for infectious disease research and brags that he will round up the editors of the top medicine journals and accuse them of publishing ‘fake science’ at the behest of industry…. We should learn from what the pandemic revealed about our culture’s deep divisions. If Mr. Kennedy is in the administration, I fear we never will.” |
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