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

Lalita Panicker · Jun 28, 2022 · Leave a Comment

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

WTO waters down IP restrictions on COVID-19 vaccines; The latest health stories from around the world

Lalita Panicker · Jun 21, 2022 · Leave a Comment

Vials containing the Moderna COVID-19 vaccine sit on a table in preparation for vaccinations at Kadena Air Base, Japan, Jan. 4, 2021. As part of the DoD strategy for prioritizing, distributing and administering the COVID-19 vaccine, those providing direct medical care and emergency services will be prioritized to receive the vaccine at units based in Japan, including Kadena AB. (U.S. Air Force photo by Airman 1st Class Anna Nolte) Photographer: Airman 1st Class Anna NoltePost-production: Zacharie Grossen, Public domain, via Wikimedia Commons. Moderna offered indemnity concept.
Photographer: Airman 1st Class Anna NoltePost-production: Zacharie Grossen, Public domain, via Wikimedia Commons

The World Trade Organization (WTO) approved a politically important deal Friday to water down intellectual property restrictions for the manufacture of COVID-19 vaccines after an almost two-year effort involving scores of high-level meetings and much political arm twisting. During the early morning hours in Geneva, WTO ministers approved a package of agreements that included the vaccine patent waiver, which Director-General Ngozi Okonjo-Iweala previously said was necessary to end the “morally unacceptable” inequity of access to COVID-19 vaccines. The WTO’s last-minute deal — secured after an all-night negotiating session in Geneva — is an important victory for Okonjo-Iweala, the former head of Gavi – the vaccine alliance, who actively stumped for the accord during her first year as the WTO’s top trade official.

https://www.bloomberg.com/news/articles/2022-06-17/wto-approves-vaccine-patent-waiver-to-help-combat-covid-pandemic

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US Centers for Disease Control and Prevention (CDC) Director Dr Rochelle Walensky signed off on COVID-19 vaccinations for children under 5 on Saturday, clearing the way for vaccinations to be administered soon.

This move comes after vaccine advisers to the CDC voted unanimously on Saturday in support of recommending the Moderna and Pfizer/BioNTech COVID-19 vaccines to children as young as 6 months.

“Together, with science leading the charge, we have taken  another important step forward in our nation’s fight against COVID-19. We know millions of parents and caregivers are eager to get their young children vaccinated, and with today’s decision, they can,” Walensky said in a statement.

https://edition.cnn.com/2022/06/18/health/cdc-covid-vaccine-children-under-5/index.html?

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Millions worldwide have already had COVID-19 and some if not all may be wondering how long they will have immunity from the coronavirus. Earlier in the pandemic, most people assumed that getting infected had at least one upside: that you would be protected against future encounters with the virus. But as the latest wave heads toward the Western region of the country and the virus shows no signs of easing up, reinfections seem to have become common. Already, many people are reporting second or even third infections with newer variants.

Experts have warned that exposure to the coronavirus — through vaccination or infection — does not mean that you are completely protected from future infections. Rather, the coronavirus is evolving to behave more like its closely related cousins, which cause common colds and infect people repeatedly throughout their lives.

However, the coronavirus doesn’t yet fit into clear seasonal patterns like the other common cold viruses. It can also cause debilitating symptoms that persist for months or years in some people, and has claimed the lives of millions of others. So what can you do to protect yourself, not only from infection but also reinfection?

Before Omicron, reinfections were rare. A team of scientists, led by Laith Abu-Raddad at Weill Cornell Medicine-Qatar, estimated that a bout with Delta or an earlier coronavirus strain was roughly 90 percent effective in preventing a reinfection in both vaccinated and unvaccinated people. “But Omicron really changed that calculus,” said Dr Abu-Raddad, an infectious disease epidemiologist.

After Omicron emerged, prior infections only provided about 50% protection against reinfection, Dr Abu-Raddad’s study showed. The coronavirus had acquired so many mutations in its spike protein that newer versions became more transmissible and better able to evade immunity. That means you can catch a version of Omicron after recovering from an older, non-Omicron variant. You can even get sick with one of the newer Omicron subvariants after getting over a different version of it.

Other factors also increase your vulnerability to reinfection, starting with how long it has been since you had COVID. Immune defences tend to wane after an infection. A study published in October 2021 estimated that reinfection could occur as soon as 3 months after contracting COVID-19.

The good news is that your body can call on immune cells, like T cells and B cells, to quash a reinfection if the virus sneaks past your initial antibody defences. T cells and B cells can take a few days to get activated and start working, but they tend to remember how to battle the virus based on previous encounters.

The result is that second or third infections are likely to be shorter and less severe.

(www.nytimes.com/2022/06/11/well/live/covid-reinfection.html?)

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Twelve years after the HPV vaccination program was introduced in the United States (US), the overall prevalence of cancer-causing HPV strains covered by the vaccine dropped by 85% among females (90% among vaccinated females and 74% among unvaccinated females), which is a strong sign of herd immunity, a new analysis of a nationally representative database in the US shows.

The study has been published online in the Annals of Internal Medicine.

The authors used data from the National Health and Nutrition Examination Survey (NHANES) to examine the 4 HPV types in the quadrivalent vaccine before 2003 and 2006 (the pre-vaccine era) and then again between 2007 to 2010, 2011 to 2014, and 2015 to 2018 (the vaccine era). For females, the authors analysed demographic and HPV prevalence data across each 4-year era.

“Analyses were limited to sexually experienced participants to ensure that all those included had an opportunity for HPV exposure and to participants aged 14 to 24 years with adequate self-collected cervicovaginal specimens,” the authors explain.

This resulted in a sample size of 3197 females. Demographic and HPV prevalence data were also collected from males, but only during the 2013 to 2016 era, because those are the only years for which male HPV typing data are available in NHANES. Again, analyses were limited to sexually experienced males aged 14 to 24 years with adequate self-collected penile specimens, which resulted in a sample size of 661 males.

During the 12 years of follow-up for females, there was a steady increase in females reporting having received at least 1 dose of the HPV vaccine, increasing from slightly more than 25% during 2007 to 2010 to 59% during 2015 to 2018. The percentage of males who reported having at least 1 HPV dose also increased.

Commenting on the findings, Rebecca Perkins, MD, from the Boston University School of Medicine, and colleagues point out that the COVID-19 pandemic has led to disruptions in HPV vaccination programs and has reversed much of the progress made in recent years. “During the pandemic, providers and health systems have deprioritized adolescent vaccination and particularly HPV vaccination, which in turn has led to more severe drops for HPV vaccination than for other adolescent vaccinations, and for adolescent vaccination compared with early childhood and adult vaccinations,” Dr Perkins and colleagues write in an accompanying editorial.

Thus, the need to compensate for the cumulative deficit of missed vaccinations during the past 2 years has created a “serious and urgent threat” to cancer prevention efforts–“a shortfall from which it may take a decade to recover,” the editorialists predict. To try and reverse this trend, several practices have been shown to improve HPV vaccination rates.

The first is a strong provider recommendation, such as, “Your child is due for an HPV vaccine today.” The second is to give standing orders to allow nurses and medical assistants to administer vaccinations without requiring intervention by a physician. Last, programs to remind patients when vaccines are due; recalling them for appointments also works well.

(www.medscape.org/viewarticle/975572_2)

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Beijing, the capital, and Shanghai have both endured months of intermittent, but severe, local lockdowns. And despite some improvement in the COVID numbers, the official strategy of “micro-lockdowns” and mass testing looks like a new norm. They are meant to replace economically destructive citywide closures, but people’s patience with the constant disruption and government interference in their lives is already wearing thin.

One test of how quickly China’s economy might bounce back from covid-19 comes on June 18, the date of the “618” shopping festival. This is promoted by JD.Com, an online retail giant founded on the same day in 1998. The signs are not good. For many Chinese, it seems, consumption has been forgone, not merely postponed. Indeed, consumer confidence is at a record low. Retail sales fell by almost 10% in real terms in May, compared with a year earlier. 

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

Un déclin surprenant des chiffres de la vaccination des enfants en Afrique dans le contexte du COVID-19, encore une autre victime de la pandémie

Sharon Quntai · Jun 17, 2022 · Leave a Comment

Day of the African Child 2022

Selon l’UNICEF, 23 millions d’enfants dans le monde n’ont pas reçu de vaccins essentiels dans le cadre des services de vaccination de routine à cause de la pandémie de COVID-19. À l’occasion de la Journée de l’enfant africain, le 16 juin 2022, nous examinons en profondeur la manière dont les enfants africains ont été affectés par ce fléau à travers les yeux des communautés locales. Avec un simple téléphone portable, une formation en ligne et une production et un montage gérés à distance, nous avons interviewé trois personnes sur le terrain en Afrique. Un agent de santé communautaire, un responsable du Programme élargi de vaccination (PEV) et la mère d’un enfant de trois ans.

Pamela Anyango, agent de santé communautaire à Nairobi, au Kenya, raconte son expérience des difficultés liées à la vaccination de routine et comment elle a pu les résoudre. Selon elle, le nombre d’enfants vaccinés dans sa localité a diminué de plus de 44 % au plus fort de la pandémie. Cette baisse drastique a nécessité un changement stratégique dans les efforts de sensibilisation de la communauté. Le contraste frappant entre les chiffres de la vaccination avant et après COVID-19 est représentatif de l’attitude générale de la population vis-à-vis de la vaccination. L’histoire de Pamela montre clairement qu’il faut redoubler d’efforts pour trouver des solutions permettant de relever les défis de la vaccination de routine dans un contexte de bouleversements socio-économiques.

L’histoire de l’Afrique de l’Ouest racontée par le Dr Essono Ngono Paulin, responsable du PEV au Cameroun, montre des similitudes dans le point de vue de la communauté sur la vaccination pendant l’épidémie de COVID-19. Le Dr Paulin a souligné que le fait de s’attaquer aux idées fausses sur les vaccins au niveau local était une méthode efficace pour encourager la vaccination et combattre la peur au sein de la communauté. 

Mbezele Anastasie Estelle, mère d’un fils de trois ans, confirme les propos du responsable du PEV. L’enfant de Mbezele n’a pas reçu son vaccin du 6ème mois, principalement parce que sa mère avait peur de contracter le COVID-19 lors d’une visite à l’hôpital. Les idées fausses sur le COVID-19 semblent être une force puissante dans la réduction du nombre de vaccinations et dans le fait que les mères évitent activement les visites aux centres de santé. C’est pourquoi les efforts d’information et de sensibilisation des communautés doivent être amplifiés de manière cohérente en Afrique pour combattre la désinformation qui prévaut. 

Le droit à l’accès aux soins de santé est un aspect essentiel de l’objectif de la Journée internationale de l’enfant africain. Si l’on tient compte des récits mentionnés plus haut, la pertinence de souligner le déclin de la vaccination des enfants lors de cette journée est évidente. De plus, le fléau du COVID-19 a mis en évidence des lacunes importantes dans les systèmes d’immunisation en Afrique. En outre, ces histoires, qui décrivent la situation réelle sur le terrain, devraient inciter les acteurs clés de la vaccination à prendre des mesures pour encourager l’innovation dans la sensibilisation et la mise en œuvre de protocoles de préparation à la pandémie. 

Il est inconcevable que, selon l’UNICEF, 23 millions d’enfants n’aient pas reçu de vaccins à cause de la pandémie de COVID-19. Ecrivez  à votre représentant local, où que vous soyez dans le monde, et dites nous  ce qu’il en pense !

Soyez indignés avec nous ! 

#DAC2022 #Immunisation #Afrique #Enfants

China reiterates commitment to “zero-COVID”; The latest health stories from around the world

Lalita Panicker · Jun 17, 2022 · Leave a Comment

Confirmed cases of COVID-19 concept. a covid-19 blood test tube with result of positive on yellow background the X has clipping path and can be removed. COVID-19 testing concept. Antibody tests concept. Image credit: 罗 宏志 / 123rf. COVID-19 cases now number at one million: concept. Testing illustration. Symptomatic COVID-19 illustration. Cases of COVID-19 in India concept. COVID-19 clusters concept.. new covid-19 variant mutant strain long covid. COVID-19 cases concept. Even after recovery from COVID-19, long-COVID symptoms may persist. Image credit: 罗 宏志 / 123rf. B.1.617 concept. black fungus. Delta plus variant concern. Delta variant concept. Excess mortality illustration. Fresh COVID-19 cases illustration.
Image credit: 罗 宏志 / 123rf

Xi Jinping reiterated China’s commitment to zero-COVID, declaring “persistence is victory”, as Shanghai and Beijing were hit with new lockdowns, shutdowns, and mass testing drives just a week after the cities celebrated the easing of restrictions. (www.theguardian.com/world/2022/jun/10/xi-jinping-says-persistence-is-victory-as-covid-restrictions-return-to-shanghai-and-beijing)

In response to China’s worst outbreak of the pandemic, Shanghai spent months under an arduous and strict citywide lockdown, while Beijing authorities imposed localised lockdowns, venue and public transport shutdowns, and work-from-home orders. In the last week both had begun easing restrictions, with authorities praising the containment of the community outbreaks of the Omicron variant.

But last Thursday both cities went back on high alert for Covid cases, with new lockdowns in Shanghai districts, home to millions of people, and the shutdown of entertainment venues in Beijing’s populous Chaoyang district. The return to restrictions sparked alarm and frustration among residents.

Experts predict that China will struggle to meet its economic growth target of about 5.5% this year as virus lockdowns force business shutdowns and snarl supply chains.

Half of Shanghai’s residents, about 14 million people, were this week ordered to undergo testing. All residents of the affected districts have been ordered to stay inside until it is completed.

Officials on Thursday traced three Shanghai infections to the Red Rose, a popular beauty salon in the trendy former French Concession area of the Xuhui district. The shop, which reopened in 1 June when the city did, had served 502 customers from 15 of Shanghai’s 16 districts in the past eight days, a local media outlet, The Paper, reported.

China reported 73 new local infections on Friday, including eight in Beijing and 11 in Shanghai, according to the National Health Commission.

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A team of international scientists tasked with understanding how the coronavirus pandemic began released their first report on Thursday, saying that all hypothesis remain on the table, including a possible laboratory incident. https://edition.cnn.com/2022/06/10/china/who-covid-pandemic-origins-report-intl-hnk/index.html?

The 27-member scientific advisory group convened by the World Health Organization (WHO) said available data suggests the virus jumped from animals to humans but gaps in “key pieces of data” meant a complete understanding of the pandemic’s origins could not be established.

The team, called the Scientific Advisory Group for the Origins of Novel Pathogens (SAGO), was formed last year to recommend further areas of study to better understand the pandemic’s origins and as well as the emergence of future pathogens.

Here are key takeaways from the report.

Animal origins

Current data suggests a zoonotic origin of SARS-CoV-2 — which means the virus originated in animals and jumped to humans.

The most closely genetically related viruses were found to be beta coronaviruses identified in bats in China and Laos, according to SAGO.

“However, so far neither the virus progenitors nor the natural/intermediate hosts or spill-over event to humans have been identified,” the report said.

The seafood market

Another area the group identified for further study is the Huanan Seafood Market in Wuhan, which investigations suggest “played an important role early in the amplification of the pandemic.”

However, it is not clear how the source of the virus was introduced to the market and where the initial spill over to humans occurred, the group said, adding that follow-up studies have not been completed.

The lab-leak theory

SAGO’s preliminary report said it “remains important to consider all reasonable scientific data” to evaluate the possibility that COVID-19 spilled into the human population through a laboratory incident.

However, the group said there “has not been any new data made available” to evaluate this theory and recommended further investigation “into this and all other possible pathways.”

The team also had access to unpublished blood samples from 40,000 donors in Wuhan between September and December 2019, and reported to have been tested for COVID antibodies. Their samples could contain crucial signs of the first antibodies made by humans against the disease.

According to the report, more than 200 samples initially tested positive for the antibodies but when tested again were not found to be positive.

Similarly, the group recommended further study of 76,000 COVID patients identified in the months before the initial outbreak in Wuhan in December 2019 and who were later discounted.

On Thursday, WHO Director-General Tedros said it has been two-and-a-half years since Covid-19 was first identified but “we do not yet have the answers as to where it came from or how it entered the human population.”

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The United States Food and Drug Administration’s (FDA’s) vaccine advisory panel this week recommended nearly unanimously that the agency authorize a protein-based COVID-19 vaccine from Novavax, which would be the first of its kind available to U.S. adults. FDA doesn’t have to abide by its advisers’ recommendations but usually does. In a 30,000-person trial in the US and Mexico, the vaccine was 90.4% efficacious at preventing symptomatic infection by early strains of SARS-CoV-2. www.science.org/content/article/news-glance-african-swine-fever-vaccine-low-dose-radiation-and-bees-fish?

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Eleven days after being bitten by one of her pet prairie dogs, a 3-year-old girl in Wisconsin on 24 May 2003 became the first person outside of Africa to be diagnosed with monkeypox. Two months later, her parents and 69 other people in the United States had suspected or confirmed cases of this disease. which is caused by a relative of the much deadlier smallpox virus. The monkeypox virus is endemic in parts of Africa, and rodents imported from Ghana had apparently infected captive prairie dogs, North American animals, when an animal distributor in Texas housed them together. (www.science.org/content/article/concern-grows-human-monkeypox-outbreak-will-establish-virus-animals-outside-africa?)

The outbreak now underway has affected more people outside of Africa than ever before—nearly 1300 cases as of 7 June, on multiple continents. But like the 2003 episode, today’s surge has raised a possibility that makes researchers gulp: Monkeypox virus could take up permanent residence in wildlife outside of Africa, forming a reservoir that could lead to repeated human outbreaks.

No animal reservoir currently exists outside of Africa, but the US outbreak of 2003 was a close call, some scientists suspect, especially because nearly 300 of the animals from Ghana and the exposed prairie dogs were never found. In the end, however, surveys of wild animals in Wisconsin and Illinois never found monkeypox virus, none of the infected humans passed on the disease to other people, and worries about this exotic outbreak evaporated.

Will North and South America, Europe, Asia, and Australia—all of which have reported monkeypox cases in this outbreak—be similarly fortunate this time?

Viruses frequently ping-pong between humans and other species. Although COVID-19 is widely thought to have resulted from SARS-CoV-2 jumping from a bat or other host into people, humans have, in “reverse zoonoses,” also infected white-tailed deer, minks, cats, and dogs with the virus. One study in Ohio found antibodies to SARS-CoV-2 in more than one-third of 360 wild deer sampled.

Public health officials in several countries have advised people who have monkeypox lesions to avoid contact with their pets until they heal. Some 80% of the cases have occurred in Europe, and the European Food Safety Authority said no pets or wild animals had been infected as of 24 May. But it added that “close collaboration between human and veterinary public health authorities is needed to manage exposed pets and prevent the disease from being transmitted to wildlife.”

Studies have yet to pinpoint the African reservoir of the monkeypox virus. Although a lab in Copenhagen, Denmark, in 1958 first identified it in research monkeys from Asia, scientists now believe the primates caught it from an African source. All human cases since the first one was reported in 1970, in the Democratic Republic of Congo (DRC which was then Zaire), could be tied to the virus spilling over from animals in Africa.

www.science.org/content/article/monkeypox-threat-grows-scientists-debate-best-vaccine-strategy?

In 1959, German microbiologist Anton Mayr took a strain of vaccinia, a poxvirus used to inoculate against smallpox, and started to grow it in cells taken from chicken embryos. After several years of transferring the strain to fresh cells every few days, the virus had changed so much it could no longer reproduce in most cells from mammals. But it could still produce an immune response that protected against smallpox.

Mayr had set out to study how poxviruses evolve, but by accident he had produced a potentially safer smallpox vaccine. Dubbed Modified Vaccinia Ankara (MVA) because the original viral strain came from that Turkish city, the vaccine had a short career. “With smallpox eradicated in 1980, it disappeared into the freezer,” says Gerd Sutter, a virologist at the Ludwig Maximilian University of Munich, who has studied Mayr’s vaccinia strain for decades.

Now, this virus, further weakened and brought to the market by the Danish pharma company Bavarian Nordic, may become key to arresting the largest outbreak of monkeypox ever seen outside Africa, which has already sickened more than 1000 people. It is the only vaccine licensed anywhere for use against monkeypox, although other, riskier smallpox vaccines also appear to offer some protection.

But what role the vaccine will ultimately play depends on a host of factors: whether those most at risk from infection can be identified and vaccinated, whether the vaccine is as effective as hoped, and whether enough is available to stop the burgeoning outbreak.

Hundreds of millions of doses of smallpox vaccine are stored around the world, insurance against a possible release of the dreaded virus by terrorists or in war, and they are known to offer some protection against monkeypox. A study in the DRC in the 1980s found that household contacts of people sick with monkeypox were seven times less likely to contract the disease if they had been vaccinated against smallpox. Yet the vast majority of existing smallpox vaccines consist still replicating vaccinia. These can cause rare but life-threatening side effects such as encephalitis or progressive vaccinia, the spread of the vaccine virus to the whole body, to which immunocompromised people are vulnerable.

Although 66 people have already died of monkeypox this year in African countries, the recent cases in nonendemic countries have mostly been mild. And many contacts of those infected are living with HIV, which could make them more likely to suffer from vaccinia side effects. Given the risks and benefits, “using these vaccines is out of the question,” Sutter says.

Bavarian Nordic’s nonreplicating vaccine, marketed as Jynneos in the United States and as Imvanex in Europe, sidesteps some of the risk. So does a vaccinia-based vaccine named LC16m8, licensed for smallpox only in Japan, which also appears to cause fewer side effects.

WHO’s Strategic Advisory Group of Experts on Immunization is set to release guidance in the next few days that will back MVA, but it will also recommend using earlier vaccines in certain scenarios.

How well MVA really protects humans from monkeypox is uncertain. The license for MVA in Canada and the US is based on animal studies, where it was shown to protect macaques and prairie dogs, plus data in humans showing a strong antibody response.

That is why WHO has urged countries that deploy monkeypox vaccine to study how well it works and how best to use it. One question is whether a single dose of the vaccine, which is normally given as two doses 4 weeks apart, may suffice. That could encourage more uptake and stretch supplies.

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

An astonishing decline in child immunisation numbers in Africa amid the rage of COVID-19, yet another victim of the pandemic

Sharon Quntai · Jun 17, 2022 · Leave a Comment

UNICEF reports that a staggering 23 million children worldwide missed out on essential vaccines through routine immunisation services due to the COVID-19 pandemic. On the Day of the African Child, 16th June 2022, we take an in-depth look into how African children were affected by this plight, as seen through the eyes of local communities. With just a mobile phone, some online training and production and editing managed remotely; we interviewed three people on the ground in Africa. A community health worker, an Expanded Programme on Immunisation (EPI) manager, and a three-year-old child’s mother.

Pamela Anyango, a community health worker from Nairobi, Kenya, tells her experience with routine immunisation challenges and how she was able to tackle them. According to her, the number of children immunised in her location declined by over 44% during the height of the pandemic. This decline was a drastic fall in numbers that necessitated a strategic change in community awareness efforts. The stark contrast in immunisation numbers before and after COVID-19 is representative of the general attitude of the population towards vaccination. From Pamela’s story, it is clear that there is a need for increased efforts at finding solutions to tackle routine immunisation challenges amid any arising socio-economic upheaval.   

Pamela Anyango, a community health worker from Nairobi, Kenya

An account from Western Africa as told by Dr Essono Ngono Paulin, an EPI manager from Cameroon, shows similarities in the community perspective around immunisation during the COVID-19 epidemic. Addressing vaccine misconceptions at the grassroots level was highlighted by Dr Paulin as an effective method to encourage immunisation and combat fear in the community. 

Dr Essono Ngono Paulin, an EPI manager from Cameroon

Mbezele Anastasie Estelle, a mother of a three-year-old son, further emphasises the EPI manager’s sentiments. Mbezele’s child missed out on his 6th-month vaccine primarily due to the mother’s fear of contracting COVID-19 from a hospital visit. Misconceptions about COVID-19 appear to be a powerful force in reducing immunisation numbers and in mothers actively avoiding visits to health centres. Therefore community outreach and awareness efforts should be amplified consistently in Africa to combat the prevailing misinformation. 

Mbezele Anastasie Estelle, a mother of a three-year-old son in Cameroon

The right to healthcare access is a core aspect of the purpose of the International Day of the African Child. Taking the narratives mentioned earlier into account, the relevance of highlighting the decline in child immunisation on this day is clear. Further, the COVID-19 scourge has exposed significant gaps in the immunisation systems in Africa. Also, these stories, depicting the actual picture from the ground, should spur key players in immunisation to take action in encouraging innovation in awareness creation and implementation of pandemic preparedness protocols. 

It is inconceivable that according to UNICEF, 23 million children missed out on immunisation vaccines due to the COVID-19 pandemic. Please write to your local representative wherever you are in the world and tell us what they say!

Be outraged with us!! 

#DAC2022 #Immunisation #Africa #Children

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