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Aug 16, 2023 • 3:32 pm CDT
US CDC dengue case map August 16, 2023

While numerous countries are reporting dengue outbreaks in 2023, one U.S. state continues to confirm new cases.

The Florida Department of Health recently reported additional dengue infections in people through the bite of Aedes species mosquitoes.

As of August 12, 2023, one case of locally acquired dengue was reported this week in Miami-Dade County. In 2023, 11 cases of locally acquired dengue have been reported.

And 14 new dengue cases were reported this week in persons with international travel.

In 2023, 204 travel-associated dengue cases have been reported in Florida. Miami-Dade Country has reported 120 of these dengue cases this year. These travelers primarily came from Cuba and Brazil.

According to the U.S. CDC, 32 jurisdictions have reported a total of 513 dengue cases this year.

Dengue is a vaccine-preventable disease. The U.S. FDA, U.K., and Europe-approved Dengvaxia® (CYD-TDV) is a live attenuated tetravalent chimeric vaccine that requires pre-admission testing.

Aug 16, 2023 • 1:22 pm CDT
Florida Dept of Health RSV activity map August 12, 2023

The Florida Department of Health's RSV Review Activity Summary #32 reported a few counties confirmed increasing detection rates and one outbreak in a pediatric facility in Deval County.

As of August 12, 2023, Florida's overall respiratory syncytial virus (RSV) positivity rate had increased since last week, but emergency room visits had not changed.

In Florida, deaths per 100,000 population for children younger than five was .02 for the 2022-2023 RSV season. 

Florida says its RSV season is longer than the rest of the nation and has distinct regional patterns.

From a nationwide perspective, annual community-based outbreaks of RSV typically occur during late fall, winter, and early spring. The U. S. CDC's RSV detection graphs display the 5-week moving average.

RSV is a common respiratory virus that usually causes mild, cold-like symptoms. According to the CDC, young children and older adults, especially those with certain underlying health conditions, are at higher risk for severe illness from RSV.

A recent Original Investigation supports new RSV preventative interventions, including long-lasting monoclonal antibodies in infants and maternal vaccination.

On July 17, 2023, the U.S. Food and Drug Administration recently approved Beyfortus™ (Nirsevimab-alip), a long-acting monoclonal RSV-neutralizing antibody, for infants.

Aug 15, 2023 • 4:39 pm CDT

The New Zealand Government recently announced it was removing the remaining COVID-19 public health requirements.

Minister of Health Dr. Ayesha Verrall commented in a press release on August 14, 2023, ....While fluctuations from week to week are expected, overall COVID-19 case rates, wastewater levels, and hospitalizations have been trending downwards since the beginning of June 2023. And over the past month, reported COVID-19 cases have hit their lowest levels since February 2022.

.... and it’s safe to remove the final requirements.

COVID-19 cases accounted for 2.2% of recent hospital admissions, and New Zealand has now likely passed the winter influenza peak.

“While our case numbers will continue to fluctuate, we have not seen the dramatic peaks that characterized COVID-19 rates last year,” said Verrall, an infectious diseases doctor and Labour list MP from Wellington. 

Aug 15, 2023 • 12:38 pm CDT
GPEI / WHO polio case map August 8, 2023

Wiping out wild poliovirus, of which there are three strains, has been the goal of global eradication efforts since they began in 1988, wrote Clare Watson in an article today published by the journal Nature.

While types 2 and 3 were successfully eradicated in 1999 and 2020, respectively, type 1 continues circulating in Afghanistan and Pakistan 12 years after India quashed all forms of the wild virus and three years after Africa did the same.

An analysis of polio transmission dynamics published in 2020 found that global polio eradication efforts were “not on track to succeed” in achieving their goal of eliminating wild poliovirus type 1 by 2023.

Fears that eradication was falling out of reach increased again in 2021 when wild poliovirus broke containment lines and emerged in eastern Africa.

As recently as February 2023, an article in the New England Journal of Medicine suggested eradication of the virus had been “unsuccessful.”

However, polio cases are down in 2023.

Pakistan has reported just two wild polio cases in 2023, and Afghanistan has reported five.

In 2022, they recorded 22 cases combined. 

The full article, published on August 15, 2023, is available at this link.

In the U.S., poliovirus wastewater testing continues in 2023 following detections in New York in 2022.

The Centers for Disease Control and Prevention recommend travelers to polio-endemic areas be fully vaccinated before departure. Polio vaccines are available in most pharmacies in the U.S.

Aug 15, 2023 • 12:08 pm CDT
WHO mpox outbreak August 14, 2023

Over the past month, the World Health Organization (WHO) received reports of 1,020 newly confirmed mpox cases and three new deaths.

As of August 9, 2023, 15 of the 113 affected countries have reported new cases within the last 21 days.

The transmission of the monkeypox virus (MPXV) continues at a low level in most countries reporting cases to the WHO.

However, a significant number of mpox cases has been reported by China for July 2023.

Based on information shared with WHO, the main demographic characteristics of cases in China are similar to those of the global outbreak. These reported cases have been identified as clade IIb MPXV.

As of August 15, 2023, Bavarian Nordic's JYNNEOS® (MVA-BN) two-dose vaccine remains available in most impacted countries.

The U.S. Centers for Disease Control and Prevention Advisory Committee on Immunization Practices presented various mpox outbreak data on June 23, 2023, and did not endorse a third JYNNEOS vaccination.

Aug 15, 2023 • 6:59 am CDT
Tumisu from Pixabay

A leader in influenza prevention today announced significant growth in its vaccine business against a backdrop of reduced immunization rates worldwide.

CSL Seqirus confirmed that on August 15, 2023, its total revenue of $2,031 million was up 9%, driven by growth in seasonal influenza vaccines, particularly FLUCELVAX®, which increased 30%.

FLUCELVAX's indication now includes six months+ age indication in the U.S., Argentina, Canada, Taiwan, Australia & New Zealand.

Additionally, the U.S. Centers for Disease Control and Prevention (CDC) recognized FLUAD® as a preferentially recommended seasonal vaccine option for adults aged 65+ years.

Both of these vaccines for the 2023-2024 flu season began shipping globally, including the U.S., on July 17, 2023.

Dr. Gregg Sylvester, Chief Health Officer CSL Seqirus, commented in a related press release, "As we commence shipment to healthcare providers across the U.S., it's critical that we raise immunization rates this season to help protect as many people as possible from influenza and its potentially life-threatening complications."

The CDC encourages most people to get an annual flu shot before influenza viruses arrive. These vaccines are generally available at health clinics and community pharmacies in the U.S.

 

Aug 14, 2023 • 5:07 pm CDT
PAHO Avian influenza outbreak map August 4, 2023

The Pan American Health Organization (PAHO) recently stated that the detection of avian influenza (bird flu) outbreaks in 15 countries in Latin America and the Caribbean has never been recorded before.

These bird flu outbreaks are mainly located in areas along the Pacific Flyway.

As of epidemiological week #31 of 2023, the PAHO reported authorities in Argentina, Bolivia, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Ecuador, Guatemala, Honduras, Mexico, Panama, Peru, Uruguay, the USA, and Venezuela have detected outbreaks of Highly pathogenic avian influenza A(H5N1) viruses in domestic birds, farm poultry and/or wild birds, and in mammals.

Among the mammals identified as of August 9, 2023, red foxes and skunks were the most frequently affected in North America and fur seals in South America. For example, Argentina's Senasa reported on August 11, 2023, the country's first avian flu detections in sea lions.

And in Chile, about 16,000 sea lions have died due to HPAI infections this year.

Whenever avian influenza viruses circulate among poultry, there is a risk of sporadic occurrence of human cases due to exposure to infected poultry or contaminated environments.

From 2003 to July 14, 2023, twenty-three countries reported 878 human cases of influenza A(H5N1) infection, including 458 deaths (case fatality ratio 52%), says the PAHO.

While there are ongoing investments in bird flu vaccines for mammals and people, the U.S. CDC reaffirms the annual flu shot is not designed to protect people from HAPI viruses.

 

Aug 14, 2023 • 3:03 pm CDT
by Horst Müller

Australia's Department of Health and Aged Care's report No. 9 recently confirmed some good news regarding the 2023 flu season.

Influenza-like-illness (ILI) activity in the community has stabilized in the last fortnight (2-weeks), while ILI presentations to ASPREN sentinel general practitioners have decreased as of August 6, 2023.

And there is currently not enough information to comprehensively assess the potential severity of the 2023 influenza season at this time, stated this report.

Since seasonal surveillance commenced in April 2023, 173 (7%) ICU admissions and 194 influenza-related deaths have occurred.

Furthermore, of the 2,449 samples referred during 2023, 98% of influenza A(H1N1) isolates, 83% of influenza A(H3N2) isolates, and 99% of influenza B/Victoria isolates characterized were antigenically similar to the corresponding vaccine components.

However, it is too early to assess influenza vaccine effectiveness for this flu season.

Aug 14, 2023 • 2:24 pm CDT
APhA Pharmacists' Guide

The United States has maintained the elimination of measles since 2000. However, measles outbreaks have recently occurred when people travel to and from the U.S., especially when travelers are unvaccinated or under-vaccinated against measles.

The CDC updated its list of the top ten measles outbreaks on August 10, 2023, indicating India has reported over 57,000 measles cases during the past year.

And they reissued a Level 1 Travel Health Notice in late June 2023, confirming a global measles outbreak.

The U.S. Centers for Disease Control and Prevention (CDC) stated it would conduct a Clinician Outreach and Communication Activity (COCA) webinar on August 17, 2023, focused on eliminating measles in the U.S.

This effort requires continued investment in the measles vaccination program,s which are instrumental to achieving elimination.

Additionally, healthcare providers and public health authorities need to remain vigilant to rapidly recognize measles and take steps to mitigate the spread within communities for continued measles elimination. Healthcare providers should consider measles a diagnosis in anyone with a fever (≥101°F or 38.3°C) and a generalized maculopapular rash with cough, coryza, or conjunctivitis who has recently been abroad, especially in countries with ongoing outbreaks.

Furthermore, the CDC urges all healthcare providers to ensure their patients are current on measles, mumps, and rubella vaccination.

During this COCA Call, presenters will discuss the history of measles in the U.S., review clinical presentation and diagnosis of measles infection, review how to report suspected cases to public health agencies and outline recommendations for measles vaccination in the U.S.

When: Thursday, August 17, 2023, 2:00 PM – 3:00 PM ET; Webinar Link: https://www.zoomgov.com/j/1603132944; Webinar ID: 160 313 2944; Passcode: 532989.

In the U.S., various measles vaccines are generally available at health clinics and community pharmacies.

Aug 14, 2023 • 4:36 am CDT
ECDC global map of chikungunya outbreaks June 2023

Valneva SE today announced that the U.S. Food and Drug Administration (FDA) has revised the Prescription Drug User Fee Act (PDUFA) action date for the Biologics License Application (BLA) for VLA1553, a monovalent chikungunya virus vaccine candidate.

Valneva is committed to working with the FDA in its ongoing BLA review and potentially delivering the world's first chikungunya vaccine.

The previously communicated end of August PDUFA has been adjusted to the end of November 2023.

Valneva stated on August 14, 2023, the FDA extended the PDUFA date to allow sufficient time to align and agree on the phase 4 program necessary under the accelerated approval pathway.

Furthermore, no additional clinical data have been requested for the FDA approval process.

Juan Carlos Jaramillo, Chief Medical Officer of Valneva, said in a press release, "We appreciate and take pride in the fact that our BLA for VLA1553 if approved, will represent the first vaccine candidate to be approved under the accelerated approval pathway in an outbreak disease, and hence the necessary Phase 4 activities will set a future standard."

The Company reconfirms its previous guidance for potential BLA approval, initial launch, and potential award of a priority review voucher in 2023. This PDUFA extension does not impact Valneva's current regulatory submission in Canada or its planned submission with the European Medicines Agency.

VLA1553 is a single-dose, live-attenuated chikungunya vaccine candidate based on an infectious clone (CHIKV LR2006-OPY1) attenuated by deleting a gene encoding the non-structural replicase complex protein nsP3 protection against various Chikungunya virus phylogroups and strains.

Valneva's VLA1553 vaccine candidate is designed for prophylactic, active immunization against Chikungunya in humans over 1-year-old. 

Chikungunya is a viral disease transmitted to humans through the bites of mosquitoes, causing outbreaks in 2023.

The European Centre for Disease Prevention and Control reported that as of July 26, 2023, approximately 300,000 cases and over 300 deaths have been reported worldwide due to Chikungunya virus disease.

Aug 13, 2023 • 1:18 pm CDT
U.S. Department of Agriculture’s Animal and Plant Health Inspection Service August 2023

Since rabies is a serious ongoing public health concern, the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (APHIS) announced on August 4, 2023, its annual distribution of RABORAL V-RG®, an oral rabies vaccine (ORV) bait, would be distributed in select areas in the eastern United States to prevent the spread of raccoon rabies.

ORV baits are coated with a fishmeal attractant and are packaged in two-inch plastic sachets or one-inch square cubes.

The RABORAL V-RG vaccine is safe for many animals, including domestic dogs and cats. Humans and pets cannot get rabies from contact with the baits.

If adults or children come in contact with baits, immediately rinse the contact area with warm water and soap, says the APHIS.

While raccoons and dogs are high-risk rabies carriers, wild, infected bats are the leading cause of rabies in the U.S.

Rabies is found in more than 150 countries and territories, say the World Health Organization. And rabies infections are almost always fatal once symptoms appear, but deaths can generally be prevented with appropriate therapies.

The U.S. Centers for Disease Control and Prevention updated its recommendations for rabies preexposure prophylaxis for humans in 2022, now endorsing a two-dose program.

In the U.S., rabies vaccines are available in 2023.

Aug 13, 2023 • 12:51 pm CDT
US Service Dog Certifications 2023

When bringing a dog to the United States in 2023, people should continue to check federal regulations and the recently extended rabies vaccination requirements.

The U.S. Centers for Disease Control and Prevention (CDC) confirmed that effective August 1, 2023, it extended the temporary suspension of the importation of dogs from countries classified as high risk for dog rabies and countries that are not at high risk if the dogs have been in high-risk countries during the previous six months.

However, dogs vaccinated against rabies in the U.S. by a US-licensed veterinarian may re-enter the U.S. from a high-risk country without a CDC Dog Import Permit if the dog:

  • has a current, valid US-issued rabies vaccination certificate;
  • has ISO-compatible microchip;
  • is at least 6 months old;
  • is healthy upon arrival; and
  • arrives at one of the 18 airports with a CDC quarantine station.

On July 6, 2023, the CDC published the “Notice of Extension of Temporary Suspension of Dogs Entering the United States from Countries with a High Risk of Rabies” in the Federal Register. 

According to the CDC, most rabies cases in the U.S. follow bites by bats, not dogs.

An estimated 47,000–55,000 people successfully receive post-exposure prophylaxis each year in the U.S.

Unfortunately, a recent article published in Clinical Infectious Diseases presented the first documented failure of rabies-post-exposure prophylaxis in the Western Hemisphere.

This 84-year-old man died in 2021 about six months after a rabid bat bit his hand.

Aug 13, 2023 • 9:20 am CDT
by David Mark

The United States IHR National Focal Point recently informed the PAHO/WHO of the first human infection with a novel influenza A(H1N2) variant virus (swine flu) identified in 2023.

According to the IHR announcement, a human infection caused by a novel influenza A virus subtype is an event that has the potential for high public health impact. 

On July 29, 2023, the person sought medical care at an emergency department in Michigan, and an upper respiratory tract specimen tested positive for influenza A virus on the same day. Later, the patient received influenza antiviral treatment (Oseltamivir).

An investigation by local public health officials identified swine exposure by the patient at an agricultural fair in late July.

No person-to-person transmission of influenza A(H1N2)v virus associated with this case has been identified, and no additional cases of human infection with A(H1N2)v virus have been identified as of August 10, 2023.

The WHO stated in a media release it does not advise special traveler screening at points of entry or restrictions about the current situation of influenza viruses at the human-animal interface.

For recommendations on safe trade in animals and related products from countries affected by these influenza viruses, refer to WOAH guidance

Since 2005, there have been 512 influenza A variant virus infections (all subtypes), including 37 (human infections with influenza A (H1N2)v viruses reported in the U.S.

As of August 13, 2023, the U.S. FDA has not approved a swine flu vaccine.

Aug 12, 2023 • 1:35 pm CDT
JUAN SANTAMARÍA INTERNATIONAL AIRPORT - Costa Rica 2023

The Republic of Costa Rica's Juan Santamaría International Airport recently reported over 2.8 million passengers passed through its facility during the first half of 2023.

As of June 2023, this activity represents a 4.3% increase in arriving and departing travelers compared to 2019.

The Tico Times reported on August 11, 2023, "The airport now hosts twenty-five airlines serving thirty-five destinations, enhancing global connectivity," said Erick Barboza, AERIS Business Development Director.

Recent AERIS analyses indicate increased Millennial (42%) and Generation X (32%) travelers to Costa Rica.

While in the U.S., the Transportation Security Administration's latest report indicated airport activity has not increased compared to 2019.

From a health perspective, Costa Rica was confronted with dengue, malaria, and Zika cases in 2023.

Aug 11, 2023 • 4:02 pm CDT
WHO mpox 3-week case map August 2023

The World Health Organization (WHO) today reported that 15 countries had reported mpox outbreaks in the past three weeks.

As of August 9, 2023, the highest increase in mpox cases was reported in Mexico.

The most affected region was the Western Pacific Region, where 915 cases, the Region of the Americas (395 cases, 9 deaths), and the African Region (227 cases).

The ten most affected countries since May 2022 are the United States of America (30,446), Brazil (10,967), Spain (7,560), France (4,150), Colombia (4,090), Mexico (4,045), Peru (3,812), the United Kingdom (3,771), Germany (3,694), and Canada (1,496). 

These countries account for 82.9% of the cases reported globally, says the WHO.

As of August 11, 2023, mpox vaccines remain available in most impacted countries.