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The Florida Health Department reported on February 4, 2023, sixteen travel-associated and one locally acquired dengue cases have been confirmed this year.

In 2022, Florida reported 869 travel-associated and 68 locally-acquired dengue cases.

To alert residents of their potential health risks, the Florida Department of Health in Miami-Dade County issued a mosquito-borne illness advisory in mid-2022.

Additionally, Broward County, which is located north of Miami, issued its mosquito-borne illness alert in 2022.

In the Region of the Americas, 46 countries and territories reported dengue cases in 2022.

Four different viruses cause dengue fever, and a person can be infected with each serotype during their lifetime.

Dengue viruses are spread to people through the bite of an infected Aedes mosquito.

Most symptoms of dengue are mild and typically last 2–7 days. But, infections can turn severe.

The U.S. CDC says no specific treatment for dengue/severe dengue exists.

However, one approved vaccine (Dengvaxia) is available in the U.S. on a limited basis.

And the U.K., Europe, and Indonesia have recently authorized the newer, less restrictive Qdenga® vaccine.

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U.S. CDC Dengue map Feb. 4, 2023
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Since no U.S. Food and Drug Administration (FDA) vaccines are available to prevent Alzheimer's Disease (AD), can other vaccines reduce the risk of this old-age disease?

The Conversation published an article written by neurodegenerative disease experts on January 18, 2023, highlighting the potential value of existing FDA-approved vaccines to reduce AD aggravating factors from viral infections.

In previous studies, researchers identified that infections by varicella zoster (chickenpox and shingles) and influenza viruses could lead to a higher risk of AD.

However, researchers have been unable to consistently detect these suspect viruses in the brains of people who died of Alzheimer's. 

In other words, when researchers analyze AD patient brains, detectable viral components may have disappeared, and causation is difficult to establish.

The full unedited article published by The Conversation is posted at this link.

As of February 12, 2023, the FDA has not authorized any of the current Alzheimer's vaccine candidates.

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by Wolfgang Eckert
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Cholera outbreaks 2023
Cholera is a vaccine preventable disease
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An outbreak of an undefined disease that has killed several people in Equatorial Guinea was reported on February 8, 2023, according to a Health Alert issued by the U.S. Embassy in Malabo.

The Government of Equatorial Guinea (EG) announced that over the past month, there had been an epidemiological outbreak of an unidentified disease in the Nsok Nsomo district of the Kie-Ntem province in the mainland region.

In a statement, EG said that travel restrictions had been imposed in "view of the high risk of importation of this disease.

According to preliminary investigations, these fatalities were linked to a funeral ceremony.

In reaction, the neighboring country of Cameroon has restricted movement along its border with Equatorial Guinea.

This area of Africa has been involved with numerous Ebolavirus outbreaks over the past decade.

The Republic of EG is located on Africa's west coast, consisting of Río Muni and five islands.

The local U.S. Embassy website has not posted an alert regarding this situation as of February 11, 2023, but does say in case of emergency, American citizens have access to an after-hours help line: (+240) 555-516 008.

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Republic of Equatorial Guinea 2023
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Mammals infected with bird flu in U.S.
Mammal to mammal transmission of bird flu virus confirmed
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According to research published in The Lancet Infectious Diseases by researchers at the University of Maryland School of Medicine (UMSOM), a monoclonal antibody (mAbs) treatment conferred protection in people against P falciparum (malaria) at low doses 

Published on January 25, 2023, this phase 1 clinical study found the mAbs CIS43LS protected 18 (82%) of 22 participants who received a dose. In addition, no participants developed parasitemia following dosing at 5 mg/kg intravenously or subcutaneously or at 10 mg/kg intravenously or subcutaneously.

All six control and four of seven participants dosed at 1 mg/kg intravenously developed parasitemia after controlled human malaria infection.

"The study demonstrates the feasibility of using mAbs therapies to help prevent malarial infection and holds promise for deployment to places where the disease is endemic," said Kirsten Lyke, MD, at UMSOM, in a related press release.

"This may allow us to revisit malaria eradication efforts."

According to the World Health Organization (WHO), malaria is a vaccine-preventable disease caused by a parasite. 

Vaccines like Mosquirix™ (RTS,S), and R21/Matrix-M™ have been reported to be effective at preventing disease in Africa and India.

As of February 11, 2023, the U.S. Food and Drug Administration (FDA) had not approved a malaria vaccine.

According to the 2021 World Malaria Report, about half the world's population lives in areas at risk of malaria transmission.

There were 241 million malaria cases and 627,000 deaths reported worldwide in 2020 alone, a 12% increase from 2019.

However, outbreaks of locally transmitted malaria cases in the U.S. have been limited and relatively isolated. The FDA has approved Artesunate to treat severe malaria in adult and pediatric patients.

Malaria outbreak news is posted at Vax-Before-Travel.com/MalariaOutbreasks.

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U.S. CDC map of malaria 2023
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Through the Ministry of Foreign Trade and Tourism (Mincetur), the Peruvian government recently presented a national "Safe Tourism" strategy to ensure a good travel experience for tourists visiting Peru.

The Safe Tourism program has three components: Security, Formalization, and Strengthening applied in Peru's 25 regions.

For example, Minister Luis Fernando Helguero announced on February 9, 2023, that critical tourist infrastructure works would be inaugurated in the San Martín region in the coming weeks for more than S/ 50 million (~$13 million).

Peru has also established safe tourist corridors from the airports to historic centers in cities like Cusco, Arequipa, Puno, and Tacna.

These actions are essential since protests continue across Southern Peru, including in Cusco, Arequipa, Puno, and Lima, as of mid-February 2023.

Unfortunately, Machu Picchu remains closed to visitors until further notice.

The U.K. says the following States of Emergency and curfews have been announced:

  • A 60-day State of Emergency occurred on February 4, 2023, in Madre de Dios, Puno, Cusco, Apurimac, Arequipa, Moquegua, and Tacna regions.
  • A 10-day curfew in the Puno region came into force from 8 pm to 4 am on February 4, 2023.
  • A 30-day State of Emergency occurred on January 19, 2023, in Amazonas and La Libertad regions.
  • A 30-day State of Emergency occurred on January 15 on the roads: the Carretera Panamericana Sur, the Carretera Panamericana Norte, the Carretera Central, the Corredor Vial Sur Apurimac-Cusco-Arequipa and the Corredor Vial Interoceanica Sur.

The U.K. confirmed on February 11, 2023, that travelers arriving in Peru should be aware that traveling to some parts of the country or returning to Lima may not be possible and should be prepared for delays or disruption.

And the U.S. Embassy in Peru website says visitors should avoid demonstrations, and should they encounter any, remain in a safe location. For emergencies involving American citizens in Peru, please email [email protected] or call +51-1-618-2000.

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Gov. of Peru Travel Feb. 9, 2023
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Fungi pathogens
Fungal vaccine candidate progresses at University of Georgia
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CBS News recently reported scientists in the U.S. are preparing to test the first poultry vaccine against bird flu (avian influenza). 

Biden administration officials informed CBS News on February 9, 2023, they have now begun weighing an unprecedented shift in the U.S. strategy to counter the outbreak of bird flu since 2022.

The United States Department of Agriculture's Animal and Plant Health Inspection Service (APHIS) previously confirmed the Eurasian H5N1 strain appeared in North America in January 2022. 

Since then, APHIS reported over 6,000 H5N1 detections in wild birds affecting 47 states and losing over 58.3 million birds as of February 8, 2023.

While the U.S. Food and Drug Administration has approved a bird flu vaccine for people, there is not one available for birds.

A spokesperson for Merck Animal Health indicated to CBS News the company has an "extensive, ongoing research program" developing vaccines that can work with Differentiating Infected from Vaccinated (DIVA) strategies.

This approach systematically searches for the virus among vaccinated flocks to prevent undetected spread among immunized birds.

The DIVA strategy uses an inactivated oil emulsion vaccine containing the same haemagglutinin (H) subtype as the challenge virus but a different neuraminidase (N).

The possibility of using the heterologous N subtype to differentiate between vaccinated and naturally infected birds was investigated by developing an "ad hoc" serological test to detect specific anti-N1 antibodies.

In addition, the FDA confirms the annual flu shot is not designed to protect people from avian influenza viruses.

Other bird flu vaccine news is posted at PrecisionVaccinations.

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U.S. CDC Avian Influenza Cases Feb. 10, 2023
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The U.S. Embassy Nairobi, Kenya, recently published a security alert for high-traffic areas frequented by foreigners and tourists.

On February 9, 2023, the Embassy wrote, Locations frequented by U.S. citizens and other foreigners and tourists in Nairobi and elsewhere in Kenya continue to be attractive targets for civil unrest.

And groups could create chaos at hotels, embassies, restaurants, malls and markets, schools, police stations, places of worship, and other places frequented by foreigners and tourists.

As a precaution, the government of the Republic of Kenya has increased its patrols.

Kenya is a prime destination for international travelers, welcoming over 800,000 guests in 2021.

Previously, the U.S. Department of State issued a Kenya - Level 2: Exercise Increased Caution advisory in December 2022.

This advisory suggests the following:

Do Not Travel to:

  • Kenya-Somalia border counties and some coastal areas, and areas of Turkana County

Reconsider Travel to:

  • Nairobi neighborhoods of Eastleigh and Kibera and specific areas of Laikipia County, and through Nyahururu, Laikipia West, and Laikipia North Sub-counties.

The State Department also suggests citizens in Kenya enroll in Smart Traveler Program to receive related alerts.

From a health perspective, the U.S. CDC issued advisories in 2022 for yellow fever and measles outbreaks in Kenya.

These are vaccine-preventable diseases available at travel clinics and pharmacies in the U.S.

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U.S. Dept State Kenya 2023
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