H5N1

WHO: Weekly epidemiological update on COVID-19 - 3 August 2023

WHO has published Weekly epidemiological update on COVID-19 - 3 August 2023. Click or tap through to download the complete report. The overview:

Globally, over one million new COVID-19 cases and over 3100 deaths were reported in the last 28 days (3 to 30 July 2023). While five WHO regions have reported decreases in the number of both cases and deaths, the Western Pacific Region has reported an increase in the number of cases and a decrease in the number of deaths. 

As of 30 July 2023, over 768 million confirmed cases and over 6.9 million deaths have been reported globally. Currently, reported cases do not accurately represent infection rates due to the reduction in testing and reporting globally. 

During this 28-day period, 46% (107 of 234) of countries and territories reported at least one case to WHO – a proportion that has been declining since mid-2022. 

In this edition, we include:  

• The COVID-19 epidemiological update at the global and the regional levels  

• An update on hospitalizations and ICU admissions  

• An update on the SARS-CoV-2 variants of interest (VOI) and variants under monitoring (VUM)  

• An update on the vaccine effectiveness of primary series and booster vaccination against the Omicron and its descendant lineages

WHO: Influenza A(H1N2)v-United States of America

A WHO DON: Influenza A(H1N2)v-United States of America. Excerpt:

Situation at a glance:  

On 4 August 2023, the United States International Health Regulations (IHR) National Focal Point informed PAHO/WHO of a human infection with a novel influenza A(H1N2) variant virus identified in the State of Michigan. This was confirmed by Reverse Transcription Polymerase Chain Reaction at the United States (US) Centers for Disease Control and Prevention (CDC) on August 2.  

The case was not hospitalized and is recovering from the illness. Investigations by local public health officials identified swine exposure by the patient at an agricultural fair.  

Additional public health response efforts including enhanced surveillance for cases is undergoing. Given the potential impact on public health, human infections with these viruses need to be monitored closely. In this event, there was no reported evidence of sustained human-to-human transmission, the illness was mild and no further influenza variant virus transmission in the community has been identified.  

Description of the case:  

On 4 August 2023, the United States IHR National Focal Point informed PAHO/WHO of a human infection with a novel influenza A(H1N2) variant virus identified in the State of Michigan and confirmed by the US CDC.   

According to the report, the case is under 18 years old, with no comorbidities, resident in the State of Michigan, who developed respiratory illness on 29 July 2023. The case presented with fever, cough, sore throat, muscle aches, headache, shortness of breath, diarrhea, nausea, dizziness, and lethargy. On 29 July, the case sought medical care at an emergency department, and an upper respiratory tract specimen was collected on 30 July. The specimen tested positive for influenza A virus on the same day. On 1 August, the patient received influenza antiviral treatment (Oseltamivir).  

On 31 July, the specimen was tested at the Michigan Department of Health and Human Services (MDHHS), and RT-PCR results were positive for influenza A virus but lacked reactivity with diagnostic tests for contemporary human influenza viruses representing either (H1) pdm09 or (H3) subtypes. The specimen was then sent to the US CDC for further testing and received on 2 August. On the same day, RT-PCR analysis of the specimen indicated an influenza A(H1N2) variant (v) virus. The virus was isolated and subsequent analysis including genetic sequencing is underway.  

The case was not hospitalized. Investigation by local public health officials identified swine exposure by the patient at an agricultural fair, that took place between 23 and 29 July, within 10 days prior to illness onset. Additional investigation did not identify respiratory illness in any of the patient’s close contacts or household contacts. No additional cases were identified related to this agriculture fair. No person-to-person transmission of influenza A(H1N2)v virus associated with this case has been identified. No additional cases of human infection with A(H1N2)v virus have been identified as of 10 August 2023.  

This is the first influenza A(H1N2)v virus infection identified in the United States this year. Since 2005, there have been 512 influenza A variant virus infections (all subtypes), including 37 (human infections with influenza A (H1N2)v viruses reported in the United States.

WHO: Weekly epidemiological update on COVID-19 - 3 August 2023

WHO has published Weekly epidemiological update on COVID-19 - 3 August 2023. Click or tap through to download the full report. The overview:

Globally, over one million new COVID-19 cases and over 3100 deaths were reported in the last 28 days (3 to 30 July 2023). While five WHO regions have reported decreases in the number of both cases and deaths, the Western Pacific Region has reported an increase in the number of cases and a decrease in the number of deaths. 

As of 30 July 2023, over 768 million confirmed cases and over 6.9 million deaths have been reported globally. Currently, reported cases do not accurately represent infection rates due to the reduction in testing and reporting globally. 

During this 28-day period, 46% (107 of 234) of countries and territories reported at least one case to WHO – a proportion that has been declining since mid-2022. 

In this edition, we include:  

• The COVID-19 epidemiological update at the global and the regional levels  

• An update on hospitalizations and ICU admissions  

• An update on the SARS-CoV-2 variants of interest (VOI) and variants under monitoring (VUM)   

• An update on the vaccine effectiveness of primary series and booster vaccination against the Omicron and its descendant lineages

How we used machine learning to look where Ebola may strike

Via ProPublica: How We Used Machine Learning to Look Where Ebola May Strike. Excerpt:

ProPublica spent months teaching a computer to analyze past Ebola outbreaks linked to deforestation. What we found reveals a weakness in the way that governments and public health experts are preparing for future pandemics. 

The bright spots on the map struck us like a lightning bolt. 

We had spent months teaching a computer about the Ebola virus –– feeding it information about the landscapes and populations in places where the disease had previously emerged, showing it how to analyze those outbreaks for patterns, and then instructing it to flag other areas that looked similarly perilous.   

Some of the highlighted spots were predictable; the virus had repeatedly ravaged one of those countries.  

But we didn’t expect our model to light up Nigeria, the most populous country in Africa. The West African nation and international travel hub has never seeded an Ebola outbreak, but just a year ago, it served as the springboard for another virus to travel into Europe and the Americas and spread across the globe. However that virus, mpox, originally known as monkeypox, is rarely fatal.  

What if it had been Ebola, which kills about half of the people it infects?  

We asked Nigerian public health officials whether they were concerned.  

“Ebola is not part of our top concerns any more,” said Oyeladun Okunromade, the director of surveillance and epidemiology at the Nigeria Centre for Disease Control.  

In the aftermath of the 2014 West African Ebola epidemic, the worst on record, Nigerian officials were on high alert. But last year, they took the virus off the list of the top infectious diseases the country needed to prepare for, downgrading Ebola in relation to threats like mpox, which Nigeria was actively fighting.  

The disjoint between how our model sees Nigeria’s risk and how the nation’s health officials view it reveals a weakness in the way that governments and public health experts are preparing for future pandemics. The methods many countries use to rank threats focus mainly on factors that occur after an outbreak has already begun, such as the potential economic impact of an epidemic. Or they rely on past cases, looking at where a pathogen has previously struck.  

Neither approach considers the root causes.  

We’ve spent more than a year digging into the question of what causes outbreaks and what the world can do to prevent them. And we’ve learned that while science has advanced so we’re starting to understand the complex factors that trigger an outbreak, the world is not doing nearly enough to try to head off the next big one.

UK almost ‘flying blind’ on Covid this autumn, experts say

Via The Guardian: UK almost ‘flying blind’ on Covid this autumn, experts say. Excerpt:

The UK is nearly “flying blind” when it comes to Covid this autumn, experts have said, amid an increase in cases.  

While the UK Health Security Agency (UKHSA) continues to track some metrics of Covid, including hospitalisation numbers, many of the community surveillance studies tracking infection levels have finished.  

Now experts have said the situation is leaving the country in the dark about how Covid may play out in the months ahead.  

Christina Pagel, a professor of operational research at University College London, said a new wave of Covid appeared to be under way – possibly driven by waning immunity, new variants of Omicron, and factors including poor weather keeping people inside.  

With the autumn coming on and people returning to school and work, Covid pressures may increase, Pagel added.  

“We might see the wave continue to grow, and grow faster, in September,” she said.  

As well as public health measures including reintroducing high-quality masks within healthcare settings, Pagel said she would support bringing back the nationwide infection survey published by the Office for National Statistics for autumn and winter, as well as expanding it to cover flu and RSV.  

Failing that, she said, wastewater monitoring should be reinstated across the UK as a cheaper alternative that is used in many countries to track Covid prevalence and variants. Such schemes have recently been cut in England and Wales.  

“What worries me most is if we get a repeat of the last winter NHS crisis this winter again, with Covid, flu and RSV all hitting around the same time,” said Pagel. “We are definitely flying near blind.”  

Prof Rowland Kao, an epidemiologist at the University of Edinburgh, also highlighted the decline in surveillance.  

“With seasonal flu, we have of course a certain amount of predictability with the many years of data. However, with Covid, now that we don’t have those multiple data streams to rely on, it’s harder to say what is happening [in the general population],” he said.  

Kao added that the variant emergence patterns for Covid were largely unknown and Covid was not simply following seasonal patterns.

WHO: Weekly epidemiological update on COVID-19 - 3 August 2023

Via WHO: Weekly epidemiological update on COVID-19 - 3 August 2023. Click or tap through to download the full report. The overview:

Globally, over one million new COVID-19 cases and over 3100 deaths were reported in the last 28 days (3 to 30 July 2023). While five WHO regions have reported decreases in the number of both cases and deaths, the Western Pacific Region has reported an increase in the number of cases and a decrease in the number of deaths. 

As of 30 July 2023, over 768 million confirmed cases and over 6.9 million deaths have been reported globally. Currently, reported cases do not accurately represent infection rates due to the reduction in testing and reporting globally. During this 28-day period, 46% (107 of 234) of countries and territories reported at least one case to WHO – a proportion that has been declining since mid-2022.

WHO: Weekly epidemiological update on COVID-19 - 27 July 2023

WHO has published Weekly epidemiological update on COVID-19 - 27 July 2023. The overview:

Globally, over 868 000 new COVID-19 cases and over 3700 deaths were reported in the last 28 days (26 June to 23 July 2023). While five WHO regions have reported decreases in the number of both cases and deaths, the Western Pacific Region has reported an increase in the number of both cases and deaths.  

As of 23 July 2023, over 768 million confirmed cases and over 6.9 million deaths have been reported globally. Currently, reported cases do not accurately represent infection rates due to the reduction in testing and reporting globally. During this 28-day period, 52% (122 of 234) of countries and territories reported at least one case – a proportion that has been declining since mid-2022.    

In this edition, we include:  

• The COVID-19 epidemiological update at the global and the regional levels  

• An update on hospitalizations and ICU admissions  

• An update on the SARS-CoV-2 variants of interest (VOI) and variants under monitoring (VUM)

WHO: Weekly epidemiological update on COVID-19 - 20 July 2023

WHO has published Weekly epidemiological update on COVID-19 - 20 July 2023. Click or tap through to download the complete report. The overview:

Globally, over 836 000 new COVID-19 cases and over 4500 deaths were reported in the last 28 days (19 June to 16 July 2023). While five WHO regions have reported decreases in the number of both cases and deaths, the Western Pacific Region has reported a decline in cases but an increase in deaths. 

As of 16 July 2023, over 768 million confirmed cases and over 6.9 million deaths have been reported globally. Currently, reported cases do not accurately represent infection rates due to the reduction in testing and reporting globally. 

During this 28-day period, 56% (131 of 234) of countries and territories reported at least one case – a proportion that has been declining since mid-2022.

WHO: Dengue – the Region of the Americas

A WHO DON: Dengue – the Region of the Americas. Excerpt:

Situation at a glance  

Since the beginning of 2023, dengue outbreaks of significant magnitude have been recorded in the WHO Region of the Americas, with close to three million suspected and confirmed cases of dengue reported so far this year, surpassing the 2.8 million cases of dengue registered for the entire year of 2022. Of the total number of dengue cases reported until 1 July 2023 (2 997 097 cases), 45% were laboratory confirmed, and 0.13% were classified as severe dengue. The highest number of dengue cases to date in 2023 are in Brazil, Peru, and Bolivia. Additionally, 1302 deaths were reported in the Region with a Case Fatality Rate (CFR) of 0.04%, in the same period.  

As part of the implementation of the Integrated Management Strategy for the Prevention and Control of Arboviral Diseases (IMS-Arbovirus), WHO is actively working with the Member States to strengthen healthcare and surveillance capacity.  

WHO has assessed the risk of dengue as high at the regional level due to the wide spread distribution of the Aedes spp. mosquitoes (especially Aedes aegypti), the continued risk of severe disease and death, and the expansion out of historical areas of transmission, where all the population, including risk groups and healthcare workers, may not be aware of warning signs.  

WHO does not recommend any travel and/or trade restrictions for countries in the Americas experiencing the current dengue epidemics based on the currently available information.  

Description of the situation  

Dengue is the arbovirus that causes the highest number of cases in the Region of the Americas, with epidemics occurring cyclically every 3 to 5 years. During the first half of 2023, dengue outbreaks of significant magnitude were recorded in South America.  Between epidemiological week (EW) 1 and EW 26 of 2023 (week ending on 01 July), a total of 2 997 097 cases of dengue were reported in the Region of the Americas, including 1302 deaths with a CFR of 0.04%, with a cumulative incidence rate of 305 cases per 100 000 population. Of the total number of dengue cases until EW 26 of 2023, 1 348 234 (45%) were laboratory confirmed, and 3907 (0.13%) were classified as severe dengue.  

The highest number of dengue cases was observed in Brazil, with 2 376 522 cases, followed by Peru with 188 326 cases, and Bolivia with 133 779 cases.  

The highest cumulative incidence rates were observed in the following subregions: the Southern Cone with 862 cases per 100 000 inhabitants, the Andean Subregion3 with 268 cases per 100 000 inhabitants, and the Central American Isthmus and Mexico4 with 59 cases per 100 000 inhabitants.  

The highest number of severe dengue cases was observed in the following countries: Brazil with 1249 cases, Peru with 701 cases, Colombia with 683 cases, Bolivia with 591 cases and Mexico with 141 cases.  

All four dengue virus serotypes (DENV1, DENV2, DENV3, and DENV4) are present in the Region of the Americas. In 2023, up to EW 26 (ending on 1 July), simultaneous circulation of all four serotypes has been detected in Brazil, Colombia, Costa Rica, Guatemala, Honduras, Mexico, and Venezuela; while in Argentina, Panama, Peru, and Puerto Rico, DENV1, DENV2 and DENV3 serotypes circulate, and in Nicaragua the serotypes DENV1, DENV3 and DENV4.  

In 2022, 2 811 433 dengue cases were reported in the Region of the Americas, the third highest year on record, only surpassed by 2016 and 2019. In 2019, the highest number of historical dengue cases was registered, with more than 3.1 million cases for the Region of the Americas, including 28 203 severe cases and 1823 deaths.

ECDC: Enhanced surveillance of severe avian influenza virus infections in hospital settings in the EU/EEA

ECDC has published Enhanced surveillance of severe avian influenza virus infections in hospital settings in the EU/EEA. Click or tap through to download the PDF. The executive summary:

Avian influenza virus outbreaks are continuing during the summer months, causing mass mortality in sea-breeding bird colonies, including gulls. A larger exposure of human population to sick or dead birds and mammals is expected to occur. Transmission to humans cannot be excluded when avian influenza is circulating in wild birds and mammals and people are directly exposed without wearing protective equipment. 

During the summer months, infections with seasonal influenza viruses are considered to be very limited, and only a few patients with severe disease caused by the seasonal influenza virus are expected to be admitted to hospitals. 

 To identify sporadic severe human infections with avian influenza virus in hospital settings, the following approach is proposed: People admitted to hospitals with respiratory symptoms should be asked about exposure to birds (wild birds or poultry) or other wild animals (dead or alive) in the two weeks before admission. 

Consider testing for influenza virus hospitalised patients with unexplained viral encephalitis/ meningoencephalitis lacking the aetiological agent diagnosis. All influenza A-positive samples from hospitalised patients should be subtyped for seasonal influenza viruses A(H1)pdm09 and A(H3). Samples positive for influenza type A virus but negative for A(H1)pdm09 or A(H3) should be immediately sent to national influenza reference laboratories for further analysis and H5 testing.