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Smallpox vaccine used to combat monkeypox; The latest health stories from around the world

Lalita Panicker · Aug 16, 2022 · Leave a Comment

Map of Monkeypox Outbreak 2022 as of 6th August
Map of Monkeypox Outbreak 2022 as of 6th August. Source: Wikieditor019, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

When monkeypox suddenly started spreading globally in May, the world was fortunate in one respect: A vaccine was available. MVA, originally developed by Bavarian Nordic as a smallpox vaccine, was already licensed for monkeypox in Canada and the United States (US). European Union (EU) regulators have since followed suit. Vaccine supplies are limited, and no doses have been shared with countries in Africa that have long been affected by monkeypox. But in Europe and North America, clinics have by now delivered thousands of doses to people in high-risk groups. www.science.org/content/article/how-effective-monkeypox-vaccine-scientists-scramble-clues-trials-ramp?

There’s little doubt the vaccine can help, but that’s about all that’s certain. Exactly how well MVA protects against monkeypox and for how long is not known. Nor is it clear how much protection is lost by giving just a single dose rather than the recommended two doses, as some countries are doing to stretch supply.

But the ethical and logistical complexities of the monkeypox crisis, which is overwhelmingly affecting men who have sex with men (MSM), are making these questions hard to answer. Placebo-controlled clinical trials are fraught because MVA is already licensed and people are clamouring to get it. And vaccine clinics are often set up at short notice as doses become available, making it harder to organize a trial and enrol subjects. Researchers are responding with a plethora of inventive trial designs.

MVA was licensed for monkeypox based on data from animal experiments and the immune response it triggers in humans. But its efficacy has barely been tested in people, and not at all for preventing sexual transmission, which results in “very significant mucosal exposure, which is not the same thing as just brushing up against somebody,” says Anne Rimoin, an epidemiologist at the University of California, Los Angeles.

So far, there’s scant data on how well the vaccine is working in the current outbreak. Among 276 individuals who received a shot at a Paris hospital as post-exposure prophylaxis (PEP) after reporting a high-risk contact, 12 developed a monkeypox infection, French scientists reported in a recent preprint, 10 of them within 5 days of vaccination and two after more than 20 days. That some people would develop monkeypox a few days after being infected is not surprising, says Jade Ghosn of Bichat Hospital, who led the study. “The vaccine is not a miracle, it needs time to be effective.”

The study had no control group, however, making it impossible to tell how many people would have developed monkeypox if no one had been vaccinated. And people eager to be vaccinated may have lied about having had a high-risk contact. “That makes results from these studies on PEP really hard to evaluate,” says immunologist Leif Erik Sander of the Charité clinic in Berlin, who’s setting up a vaccine study in Germany.

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President Joe Biden’s administration last week designated the monkeypox outbreak a national public health emergency, allowing US health officials easier access to funds and procedural flexibility as they respond to rising cases (more than 8,900 as of 8 August). www.science.org/content/article/news-glance-south-korea-lunar-orbiter-us-monkeypox-response-lost-satellite?

Earlier in the week, the White House appointed Robert Fenton, a senior official at the Federal Emergency Management Agency, as national monkeypox response coordinator. Demetre Daskalakis, a physician who directs the Division of HIV Prevention at the US Centers for Disease Control and Prevention, will serve as deputy coordinator. Daskalakis has experience working with the LGBTQ community; 97.5% of monkeypox cases with available data on sexual behaviour have been in men who have sex with men, according to a 3 August report from the World Health Organization. As Science went to press, the US had the world’s largest number of confirmed monkeypox cases.

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China’s financial hub Shanghai said on Sunday it would reopen all schools, including kindergartens, primary and middle schools on Sept. 1 after months of COVID-19 closures. The city will require all teachers and students to take nucleic acid tests for the coronavirus every day before leaving campus, the Shanghai Municipal Education Commission said. It also called for teachers and students to carry out a 14-day “self-health management” within the city ahead of the school reopening, the commission said in a statement.

https://www.reuters.com/world/china/shanghai-reopen-all-schools-sept-1-with-daily-covid-testing-2022-08-14/

Meanwhile, China reported more than 2,000 local COVID-19 cases on Friday as infections in the southern Hainan island edged higher despite stricter curbs imposed earlier this week. The southern province, a popular tourist destination, reported 1,426 cases. More than 1,230 of them were in the beach resort city of Sanya, where more restrictions were added on Thursday. Hainan’s authorities had aimed to eliminate community transmission by August 12.

https://www.bloomberg.com/news/articles/2022-08-13/china-local-covid-19-cases-top-2-000-as-more-lockdowns-imposed

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The US Centers for Disease Control & Prevention (CDC) has announced that because the risk of “medically significant” COVID-19 has decreased, some overall public health measures the agency initially recommended may no longer be necessary. www.medscape.com/viewarticle/979109?src=wnl_edit_tpal&uac=398271FG&impID=4525875&faf=1

For example, CDC recommendations on social distancing, quarantining and testing children for COVID-19 while allowing them to stay in school — known as the test-to-stay strategy — may no longer be necessary for most Americans. The agency said high levels of immunity from vaccinations and prior infections, along with the availability of effective treatments and tools that prevent the spread of SARS-CoV-2, the virus that causes COVID-19, prompted the action.

However, the agency also said people who know they are high-risk for severe COVID-19 should continue to practise a multi-layered approach to keeping themselves safe. Well-known strategies include improved ventilation, well-fitting masks and testing as warranted.

The new CDC guidance was published today in the agency’s Morbidity and Mortality Weekly Report.

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Polio outbreaks incited regular panics decades ago, until a vaccine was developed and the disease was largely eradicated. Then last Friday, New York City health authorities announced that they had found the virus in wastewater samples, suggesting polio was probably circulating in the city again. www.nytimes.com/2022/08/12/nyregion/polio-nyc-sewage.html?

Parents of young children found themselves wondering — perhaps for the first time in their lives, and, collectively, for the first time in generations — just how much they should worry about polio.

In New York City, the overall rate of polio vaccination among children 5 and under is 86 percent, and most adults in the US were vaccinated against polio as children. Still, in some city ZIP codes, fewer than two-thirds of children 5 and under have received at least three doses, a figure that worries health officials.

The state Health Department said in a statement the discovery of the virus underscored “the urgency of every New York adult and child getting immunized, especially those in the greater New York metropolitan area.”

The announcement came three weeks after a man in Rockland County, N.Y., north of the city, was diagnosed with a case of polio that left him with paralysis. Officials now say polio has been circulating in the county’s wastewater since May.

The spread of the virus poses a risk to unvaccinated people, but three doses of the current vaccine provide at least 99 percent protection against severe disease.

Health officials fear that the detection of polio in New York City’s wastewater could precede other cases of paralytic polio.

The polio virus had previously been found in wastewater samples in Rockland and Orange Counties, but the announcement on Friday was the first sign of its presence in New York City.

A research team has developed a way to assess the gene activity of single cells that harbour latent HIV genes—a technique that could aid the search for a cure. People living with HIV who take existing antiretrovirals invariably retain infected cells that dodge drugs and natural immune responses. Even though scientists could identify these rare reservoir cells, technical constraints prevented them from evaluating the cells’ gene activity. The new method, revealed at the 24th International AIDS Conference last week, hinges on “microfluidic” devices that allow investigators to retrieve genetic material from the infected cells for sequencing. The team found that the reservoir cells had unique patterns of gene activity, turning on genes that protect them from immune attack and self-destruction. Targeting these genes could, in theory, reduce, if not eliminate, the HIV reservoirs.

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

US declares monkeypox a public health emergency; The latest health stories from around the world

Lalita Panicker · Aug 9, 2022 · Leave a Comment

Map of Monkeypox Outbreak 2022 as of 6th August
Map of Monkeypox Outbreak 2022 as of 6th August. Source: Wikieditor019, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

The Biden administration in the United States (US) has declared monkeypox a public health emergency. 

There have been more than 7,000 cases detected in the US, but that is likely an undercount. The majority of cases are concentrated in the gay and queer community, primarily among men who have sex with men. But the Centers for Disease Control (CDC) and Prevention has also reported infections in a small number of cisgender women and at least two children.

Declaring a public health emergency in the US can trigger grant funding and open up more resources for various aspects of a federal response. It also allows the Department of Health and Human Services to enter into contracts for treatments and other necessary medical supplies and equipment, as well as support emergency hospital services, among other things. Public health emergencies last for 90 days, but can be extended.

CDC Director Rochelle Walensky said the declaration will provide resources and increase access to care. She also said it will expand the CDC’s ability to share data.

Epidemiologists and public health experts have warned that the US is running out of time to contain the outbreak.

Meanwhile, health officials in Britain said there were early signs that the spread of monkeypox was slowing. The country has some 2,900 confirmed cases of the virus.

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US administration has decided to stretch out its limited supply of monkeypox vaccine by allowing a different method of injection that uses one-fifth as much per shot, according to people familiar with the discussions. www.nytimes.com/2022/08/08/us/politics/monkeypox-vaccine.html?

In order for the Food and Drug Administration (FDA) to authorize so-called intradermal injection, which would involve injecting one-fifth of the current dose into the skin instead of a full dose into underlying fat, the Department of Health and Human Services will need to issue a new emergency declaration allowing regulators to invoke the FDA’s emergency use powers. That declaration is expected as early as Tuesday afternoon.

The move would help alleviate a shortage of vaccine that has turned into a growing political and public health problem for the administration.

Even though it invested more than $1 billion in developing the two-dose vaccine known as Jynneos that works against both monkeypox and smallpox, the government has only 1.1 million shots on hand. It needs about three times as many doses to cover the 1.6 million to 1.7 million Americans who, according to the CDC, are at high risk of contracting monkeypox.

The vaccine is currently delivered in two 0.5-milliliter doses 28 days apart, with immune protection reaching its “maximum” 14 days after the second dose, according to the CDC.

The shot is recommended by the C.D.C. for people who have been exposed to monkeypox and those who might be likely to get it. Those in the latter category include people identified as a contact of someone with monkeypox, those who know a sexual partner from the last 14 days was diagnosed with the disease and those who have had “multiple” sexual partners in that time frame in an area with “known monkeypox.”

Federal health officials said last week that so far, they have distributed about 600,000 doses of the vaccine to state and local jurisdictions.

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Japan’s health ministry on Tuesday approved KM Biologics freeze-dried smallpox vaccine LC16 KMB for use against monkeypox, after an experts’ panel recommended the move last week. www.medscape.com/viewarticle/978502?

KM Biologics, a unit of candy maker Meiji Holdings Co, has had “several inquiries from overseas” a company official told Reuters on Wednesday, declining to comment on any export plan for the shot.

Japan has had only two confirmed cases of monkeypox during the current global outbreak.

Based in the southern prefecture of Kumamoto, KM Biologics mainly produces vaccines for humans and veterinary use. It has an inactivated COVID-19 shot currently in development.

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The European Medicines Agency (EMA) is recommending Novavax’s COVID-19 vaccine carry a warning of the possibility of two types of heart inflammation, an added burden for a shot that has so far failed to win wide uptake.( www.medscape.com/viewarticle/978527?)

The heart conditions – myocarditis and pericarditis – should be listed as new side-effects in the product information for the vaccine, Nuvaxovid, based on a small number of reported cases, the EMA said last Wednesday.

Novavax said no concerns about heart inflammations were raised during the clinical trials of Nuvaxovid and that more data would be gathered, adding that the most common cause of myocarditis is viral infections.

In June, the US FDA flagged a risk of heart inflammation from the Novavax vaccine.

Myocarditis and pericarditis were previously identified as rare side- effects, mostly seen in young men, from ground breaking messenger RNA (mRNA) vaccines made by Moderna and the Pfizer and BioNTech alliance, with the vast majority of those affected recovering fully.

The EMA said on Wednesday it had asked Novavax to provide additional data on the risk of these side-effects.

Last month, the EU agency identified severe allergic reactions as potential side-effects of the vaccine.

Novavax was hoping that people who have opted not to take Pfizer and Moderna’s vaccines would favour its shot because it relies on technology that has been used for decades to combat diseases including hepatitis B and influenza.

However, only around 250,000 doses of Nuvaxovid have been administered in Europe since its launch in December, according to the European Centers for Disease Prevention and Control.

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North Korea says everyone who fell sick since the country confirmed its first Covid-19 infections has recovered. On Friday state media reported zero fever cases for a seventh straight day. North Korea refers to “fever” rather than “Covid” patients due to a lack of testing equipment. The country announced its first Covid outbreak in May and has reported fever infections and deaths since. But there is widespread doubt over the data, especially the number of deaths. “No new fever cases were reported during the past week and all those receiving treatment have recovered across the country,” the Korean Central News Agency (KCNA) reported on Friday.

https://www.bbc.co.uk/news/world-asia-62435809

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New York state health officials have urged unvaccinated residents to get their polio shot “right away.”

One case of polio was confirmed last month in a county north of New York City, which the state’s health commissioner described as possibly “the tip of the iceberg.”

Wastewater samples taken in several locations north of New York City potentially signal community spread of the highly contagious disease.

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The world’s response to the HIV/AIDS pandemic is faltering badly in the face of declines in spending and the COVID-19 pandemic, according to an annual update from the Joint United Nations Programme on HIV/AIDS (UNAIDS) released last week. In a campaign announced in 2015 to “end AIDS as a public health threat” by 2030, UNAIDS set targets for 2025 that the new report finds are far from being met. Last year, 1.5 million people became infected with HIV, 1 million more than the 2025 target. Of the 38.4 million people living with the virus in 2021, 10 million are still not receiving lifesaving antiretroviral drugs, and last year saw the lowest number of new people starting treatment in a decade. Alarmingly, UNAIDS notes, 52% of infected children aren’t being treated.

www.science.org/content/article/news-glance-ai-protein-structures-racism-memory-rising-tiger-numbers

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The British Heart Foundation will award £30 million ($36 million) over 5 years to an international team to develop genetic cures for some inherited heart diseases called cardiomyopathies. The group, dubbed CureHeart, won over three others shortlisted by the Big Beat Challenge, a competition launched in 2019 to fund transformative heart disease research. The team aims to use one-time injections of gene-editing tools to precisely correct or silence mutations that cause heart muscle cells to produce too little or a harmful form of a needed protein. These cardiomyopathies affect one in every 250 people, putting them at risk for heart attacks and heart failure; some will need a heart transplant. Within 5 years, CureHeart members in the United States, United Kingdom, and Singapore hope to develop one or more treatments to the point that companies will pick them up for clinical testing.

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

Monkeypox officially declared a global emergency by WHO; The latest health stories from around the world

Lalita Panicker · Jul 26, 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) has declared a global emergency for the second time in two years. This time the cause is monkeypox, which has spread in just a few weeks to 74 countries. https://www.nytimes.com/2022/07/23/health/monkeypox-pandemic-who.html
Dr Tedros Adhanom Ghebreyesus, the WHO’s director general, on Saturday overruled a panel of advisers, who could not come to a consensus, and declared a “public health emergency of international concern,” a designation the WHO currently uses to describe only two other diseases, COVID-19 and polio.

This is apparently the first time that the director general has overruled his advisers to declare a public health emergency.
The WHO’s declaration signals a public health risk requiring a coordinated international response. The designation can lead member countries to invest significant resources in controlling an outbreak, draw more funding to the response, and encourage nations to share vaccines, treatments and other key resources for containing the outbreak.

This is the seventh public health emergency since 2007; the COVID pandemic, of course, was the most recent. Some global health experts have criticized the WHO’s criteria for declaring such emergencies as opaque and inconsistent.
There are more than 16,500 cases of monkeypox outside Africa, roughly five times the number when the advisers met in June. Nearly all the infections have occurred among men who have sex with men.

Dr James Lawler, co-director of the University of Nebraska’s Global Center for Health Security, estimated that it might take a year or more to control the outbreak. By then, the virus is likely to have infected hundreds of thousands of people and may have permanently entrenched itself in some countries.

The WHO advisers said at the end of June that they did not recommend an emergency declaration in part because the disease had not moved out of the primary risk group, men who have sex with men.

In interviews, some experts said they did not agree with the rationale.
“Do you want to declare the emergency the moment it’s really bad, or do you want to do it in advance?” said Dr Isabella Eckerle, a clinical virologist at the University of Geneva.

A similar WHO committee that convened in early 2020 to evaluate the coronavirus outbreak also met twice, deciding only at its second meeting, on January 30, that the spread of the virus constituted a public health emergency.

Meanwhile, India’s national capital of New Delhi confirmed its first case of monkeypox, the fourth case of the disease in the country, a day after it was declared a public health emergency of international concern by the WHO. Three other cases have earlier been reported from Kerala in southern India. These are among the first cases to hit Asia.

The Delhi patient has no international travel history and was admitted some days ago with fever and skin lesions.

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In the short history of the COVID-19 pandemic, 2021 was the year of the new variants. Alpha, Beta, Gamma, and Delta each had a couple of months in the sun.

But this is the year of Omicron, which swept the globe late in 2021 and has continued to dominate, with subvariants—given more prosaic names such as BA.1, BA.2, and BA.2.12.1—appearing in rapid succession. Two closely related subvariants named BA.4 and BA.5 are now driving infections around the world, but new candidates, including one named BA.2.75, are knocking on the door.

Omicron’s lasting dominance has evolutionary biologists wondering what comes next.

www.science.org/content/article/omicron-rages-scientists-have-no-idea-what-comes-next

Some think it’s a sign that SARS-CoV-2’s initial frenzy of evolution is over and it, like other coronaviruses that have been with humanity much longer, is settling into a pattern of gradual evolution.But others believe a new variant different enough from Omicron and all other variants to deserve the next Greek letter designation, Pi, may already be developing, perhaps in a chronically infected patient.

Even with Omicron, Maria Van Kerkhove, technical lead for COVID-19 at the WHO, emphasizes, the world may face continuing waves of disease as immunity wanes and fresh subvariants arise. She is also alarmed that the surveillance efforts that allowed researchers to spot Omicron and other new variants early on are scaling back or winding down. “Those systems are being dismantled, they are being defunded, people are being fired,” she says.

The variants that ruled in 2021 did not arise one out of the other. Instead, they evolved in parallel from SARS-CoV-2 viruses circulating early in the pandemic. In the viral family trees researchers draw to visualize the evolutionary relationships of SARS-CoV-2 viruses, these variants appeared at the tips of long, bare branches. The pattern seems to reflect virus lurking in a single person for a long time and evolving before it emerges and spreads again, much changed.

On 2 July, for example, Yale University genomic epidemiologist Nathan Grubaugh and his team posted a preprint on medRxiv about one such patient they found accidentally. In the summer of 2021, their surveillance program at the Yale New Haven Hospital kept finding a variant of SARS-CoV-2 called B.1.517 even though that lineage was supposed to have disappeared from the community long ago. All of the samples, it turned out, came from the same person, an immunocompromised patient in his 60s undergoing treatment for a B cell lymphoma. He was infected with B.1.517 in November 2020 and is still positive today.

By following his infection to observe how the virus changed over time, the team found it evolved at twice the normal speed of SARS-CoV-2. That supports the hypothesis that chronic infections could drive the “unpredictable emergence” of new variants, the researchers write in their preprint.

But since Omicron emerged in November 2021, no new variants have appeared out of nowhere. Instead, Omicron has accumulated small changes, making it better at evading immune responses and—together with waning immunity—leading to successive waves.

If so, the US decision to update COVID-19 vaccines by adding an Omicron component is the right move. Even if Omicron keeps changing, a vaccine based on it is likely to provide more protection than one based on earlier variants.

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An unvaccinated young adult from New York recently contracted polio, the first US case in nearly a decade, health officials said Thursday.

www.medscape.com/viewarticle/977706?src=wnl_edit_tpal&uac=398271FG&impID=4454242&faf=1

Officials said the patient, who lives in Rockland County, had developed paralysis. The person developed symptoms a month ago and did not recently travel outside the country, county health officials said.

It appears the patient had a vaccine-derived strain of the virus, perhaps from someone who got live vaccine — available in countries other than the US — and spread it, officials said.

The person is no longer deemed contagious, but investigators are trying to figure out how the infection occurred and whether other people may have been exposed to the virus.

In 1979, polio was declared eliminated in the US, meaning there was no longer routine spread. Rarely, travellers have brought polio infections into the US. The last such case was in 2013, when a 7-month-old who had recently moved to the US from India was diagnosed in San Antonio, Texas, according the federal health officials. That child also had the type of polio found in the live form of vaccine used in other countries.

Polio is endemic in Afghanistan and Pakistan, although numerous countries in Africa, the Middle East and Asia have also reported cases in recent years.

Last month, health officials in Britain warned parents to make sure children have been vaccinated because the polio virus had been found in London sewage samples. No cases of paralysis were reported.

On 18 May, Mozambique declared a polio outbreak after the virus was detected in a child living in the north-eastern Tete region, the first case of the poliovirus in the country in almost three decades, the WHO said.

The case, which marks the second imported case of wild poliovirus in southern Africa this year following an outbreak in Malawi in February, was found in the child who began experiencing the onset of paralysis towards the end of March, the WHO said.

Malawi has undertaken a nationwide vaccination campaign focussing on nearly 3 million children under 5, who will receive four doses of the oral polio vaccine.

On 8 March, Israel detected its first polio case since 1989 in a 4-year-old boy in Jerusalem, according to an announcement from the country’s ministry of health.

The child wasn’t vaccinated against polio as part of routine vaccinations that children receive in Israel, the ministry said. The source of the disease in this case is a mutated strain of polio virus that can cause illness in unvaccinated people.

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In what UNICEF executive director Catherine Russell called a “red alert,” childhood vaccination rates in many countries worldwide have dropped to the lowest level since 2008, in part because of the COVID-19 pandemic.

www.science.org/content/article/news-glance-declining-childhood-vaccinations-superbug-infections-brazilian-fossil?

UNICEF and the WHO together track inoculations against diphtheria, pertussis, and tetanus—which are administered as one vaccine—as a marker for vaccination coverage overall. In 2021, only 81% of children worldwide received the recommended three doses of the combined vaccine, down from 86% in 2019. As a result, some 25 million children remain insufficiently protected against the three dangerous diseases. The majority of children who missed shots live in India, Nigeria, Indonesia, Ethiopia, and the Philippines, but the largest relative drops occurred in two countries with much smaller populations: Myanmar and Mozambique. A similar number of children did not get their first dose of the measles vaccine, and millions also missed polio and human papillomavirus inoculations.

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

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

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