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Monkeypox declared public health emergency of international concern; The latest health stories from around the world

One of the symptoms of monkeypox are lesions that can develop across the body. http://phil.cdc.gov (CDC’s Public Health Image Library) Media ID #2329

The World Health Organization (WHO) opted against calling the recent monkeypox outbreak a public health emergency of international concern. The outbreak is “clearly an evolving threat,” the WHO said in a statement Saturday, though it doesn’t constitute an international public health emergency “at this moment.” An emergency committee convened on Thursday to discuss the outbreak. “What makes the current outbreak especially concerning is the rapid, continuing spread into new countries and regions and the risk of further, sustained transmission into vulnerable populations including people that are immune-compromised, pregnant women and children,” according to the statement. “It requires our collective attention and coordinated action now to stop the further spread of the monkeypox virus.”

https://www.bloomberg.com/news/articles/2022-06-25/monkeypox-isn-t-international-public-health-emergency-who-finds

The first instances of “community transmission”, cases that could not be traced back to parts of Africa where the virus is endemic, were discovered in Europe last month. On May 29, the WHO changed its risk assessment for the outbreak from “low” to “moderate”. Now the disease has spread to other continents, too. A total of 3,337 cases in at least 53 countries have been reported. About 45% of cases are outside Europe. Cases in Britain have doubled since June 9 and had reached 793 by June 22, more than in any country outside Africa. Spain has reported 552 infections and Germany 469. South Korea and Singapore reported their first cases on June 22. 

Some countries are “ring” vaccinating the personal contacts of those infected, using the smallpox jab, which is estimated to be 85% effective against monkeypox.

Bavarian Nordic, the Danish maker of the jab, has already raised its revenue projections for the rest of the year, as rich countries have started to stockpile.

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Tests that screen seemingly healthy people for many kinds of cancer by analysing a blood sample are starting to enter the clinic—worrying some physicians and scientists that they could do more harm than good. Now, as part of President Joe Biden’s reignited Cancer Moonshot, the National Cancer Institute (NCI) is framing plans to evaluate the promise of such tests. www.science.org/content/article/complexities-are-staggering-u-s-plans-huge-trial-blood-tests-multiple-cancers?

Last week, NCI advisers endorsed a $75 million, 4-year pilot study enrolling at least 24,000 people to assess the tests, which mostly pick up trace amounts of DNA and proteins that tumours shed into the blood. What it shows about the feasibility of these tests, sometimes called liquid biopsies, will help NCI decide whether to launch a longer term clinical trial, in as many as 300,000 volunteers ages 45 to 70, to learn whether they save lives.

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Health authorities in Britain have declared a national incident after finding evidence suggesting local spread of the poliovirus in London.

Although health authorities indicated that the use of the term “national incident” was used to outline the scope of the issue, no cases of polio have been identified so far, and the risk to the public is low. But health authorities urged anyone who is not fully immunized against the poliovirus, particularly young children, to immediately seek vaccines. https://www.nytimes.com/2022/06/22/health/uk-polio-london-poliovirus.html

The last case of polio in Britain was in 1984, and the country was declared polio-free in 2003. Before the introduction of the polio vaccine, epidemics were common in Britain, with up to 8,000 cases of paralysis reported every year.

Routine surveillance of sewage in the country picks up the poliovirus once or twice a year, but between February and May, officials identified the virus in several samples collected in London, according to Dr. Shahin Huseynov, technical officer for the WHO’s vaccine-preventable diseases and immunization program in Europe.

Genetic analysis suggests that the samples have a common origin, most likely an individual who travelled to the country around the New Year, Dr. Huseynov said. The last four samples collected appear to have evolved from this initial introduction, likely in unvaccinated children.

British officials are now collecting additional samples and trying to identify the source of the virus. But the wastewater treatment plant that identified the samples covers about 4 million people, almost half of the city, making it challenging to pinpoint the source.

The virus in the collected samples came from a type of oral polio vaccine that is used to contain outbreaks, according to Dr. Huseynov.

In recent months, that type of vaccine has been used only in Afghanistan, Pakistan and some countries in the Middle East and Africa, he said.

Wild poliovirus has been eliminated from every country in the world, except Afghanistan and Pakistan. But vaccine-derived polio continues to cause small outbreaks, particularly in communities with low vaccination coverage.

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In a significant curtailment of women’s rights, the U.S. Supreme Court overturned  Roe v. Wade, a 1973 landmark decision giving women in America the right to have an abortion before the foetus is viable outside the womb — before the 24-28 week mark. The ruling, 6-3, was expected for some weeks now, after a draft opinion leaked in early May, sending shock waves through the country and sparking protests. Abortion rights — which have been available to women for over two generations — will now be determined by individual states.

Addressing the nation in the early afternoon on Friday, US President Joe Biden called the decision a “tragic error” and a “sad day” for the court and the country. “The court has done what it has never done before, expressly take away a constitutional right that is so fundamental to so many Americans,” he said.

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Leaders of the global scheme aiming to get COVID-19 vaccines to the world’s poorest are pushing manufacturers including Pfizer and Moderna to cut or slow deliveries of about half a billion shots to avoid waste. (https://www.medscape.com/viewarticle/976025?)

COVAX, the WHO-led scheme, wants between 400 and 600 million fewer vaccines doses than initially contracted from six pharmaceutical companies, according to internal documents seen by Reuters.

While at first the initiative struggled for shots as wealthy nations snapped up limited supply, donations from those same countries later in 2021, as well as improved output from manufacturers – alongside delivery challenges and vaccine hesitancy in a number of countries – has led to a glut of vaccines in 2022.

In total, COVAX has delivered more than 1.5 billion doses in the last 18 months.

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Deep in the human gut, myriad “good” bacteria and other microbes help us digest our food, as well as keep us healthy by affecting our immune, metabolic, and nervous systems. Some of these humble microbial assistants have been in our guts since before humans became human—certain gut microbes are found in almost all primates, suggesting they first colonized a common ancestor. But humans have also lost many of these helpers found in other primates and may be losing even more as people around the world continue to flock to cities, a researcher reported last week at a microbiology meeting in Washington, D.C.

The microbiome comprises all the bacteria, fungi, viruses, and other microscopic life that inhabit an individual, be it a person, a plant, or a planaria. For humans and many other species, the best characterized microbiome centres on the bacteria in the gut. The more microbiologists study these gut microbes, the more they link the bacteria to functions of their hosts. In humans, for example, gut bacteria influence how the immune system responds to pathogens and allergens, or interact with the brain, affecting mood.

Andrew Moeller, an evolutionary biologist at Cornell University, was one of the first to show that gut bacteria and humans have built these relationships over a very long time. Six years ago, he and colleagues reported the work showing human gut microbes are very similar to those in other primates, suggesting their intestinal presence predates the evolution of humans.

But his follow-up studies, and work by others, also indicate the human gut microbiome has, in a general sense, become less diverse than the gut microbes in our current primate cousins. One study found 85 microbial genera, such as Bacteroides and Bifidobacterium, in the guts of wild apes, but just 55 in people in U.S. cities. Splitting the difference, people in less developed parts of the world have between 60 and 65 of those bacterial groups, an observation that ties the decrease in microbial diversity to urbanization.

Changes in diet as humans moved on from their hunter-gatherer past and then into cities, antibiotic use, more life stresses, and better hygiene are all possible contributors to the loss of human gut microbes, says Reshmi Upreti, a microbiologist at the University of Washington, Bothell. Several prominent researchers have argued that this lower diversity could contribute to increases in asthma and other inflammatory diseases.

Moeller and his colleagues collected dung from several groups of African chimps and bonobos, isolating and sequencing microbial DNA in the faeces that derives from the gut’s microbes. They also gathered gut microbe DNA data previously collected for gorillas and other primates by other researchers—accumulating details on 22 non-human primates. With computers, they were able to compile the fragments of DNA sequenced into whole genomes of the gut microbes present.

They showed some specific gut microbes diversified as they evolved with their primate host, whereas others went missing. Quite a few microbes have abandoned the human gut, as humans have lost 57 of the 100 or so branches, or clades, of microbes currently found in chimps or bonobos and at least one other non-human primate, Moeller reported on June 11 at Microbe 2022, the annual meeting of the American Society for Microbiology. Moeller was also able to estimate when some of the human gut microbes disappeared.

Moeller and others also suggest identifying the missing microbes may be the first step toward bringing them back. “If we determine that these groups were providing important functions to keep humans healthy,”  says Jessica Maccaro, an evolutionary biology graduate student at the University of California (UC), Riverside “perhaps we can restore them with probiotics.”

www.science.org/content/article/modern-city-dwellers-have-lost-about-half-their-gut-microbes?

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Lalita Panicker is Consulting Editor, Views and Editor, Insight, Hindustan Times, New Delhi

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