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According to the U.S. Centers for Disease Control and Prevention (CDC), New World screwworm (NWS) was documented in people in Panama (79), Costa Rica (33), Nicaragua, and Honduras in 2024, causing concern about continued northward spread.
In addition, in this Clinician Outreach and Communication Activity (COCA) call, Rebecca Chancey, MD, will discuss travel-associated NWS cases occasionally identified in people returning to the United States in 2024.
For example, an infested traveler returned to Florida this year after vacationing in the Dominican Republic.
The COCA Webinar (ID: 160 646 0872) is at 2 p.m. ET today. Subject matter experts will present the biology and life cycle of C. hominivorax, explain the current epidemiology in Central America, review guidance on identifying infestations, and discuss how to appropriately manage and report cases of NWS in humans.
The CDC says New World screwworm larvae are screw-shaped and tapering toward the head. They are an obligate parasite that consumes and damages healthy tissue and can cause infestations of any mucus membrane or open body orifice, including the ears, eyes, nose, mouth, vagina, and rectum.
Symptoms will vary based on the infestation site, and death may occur due to secondary infection or tissue destruction.
In vitro lab studies and studies in livestock show that ivermectin is effective for killing New World screwworm eggs and larvae. However, the CDC says no such studies have been conducted in humans.
A U.S. National Institutes of Health (NIH)-funded phase 2 clinical trial of a mpox vaccine in 229 adolescents found it was safe and well tolerated through study day 210, according to a planned interim analysis of study data.
As of October 16, 2024, the NIH also stated the analysis showed that the Bavarian Nordic A/S MVA-BN (JYNNEOS®) vaccine generated antibody levels in adolescents equivalent to those observed in adults at day 43.
According to the study team, the interim data support the safety and quality of the immune response generated by the MVA-BN vaccine in adolescents, findings relevant to the United States and other areas where mpox clade 2 cases have occurred.
The authors underscored the need to evaluate the MVA-BN vaccine in younger children to extend the evidence base to everyone affected by mpox clade 2.
The ongoing mpox clade 1 outbreak in Africa is evaluating the effectiveness of MVA-BN.
In the U.S., the JYNNEOS vaccine is commercially available at various pharmacies. Additionally, three other mpox vaccines are being offered internationally in 2024.
The Los Angeles County Department of Public Health recently announced it is investigating a new local dengue virus outbreak in Baldwin Park. Two additional cases of non-travel, locally acquired dengue have been identified, bringing the total to five cases concentrated in this area of the County.
L.A. County previously reported Panorama City (1) and El Monte (2) reported local dengue cases in 2024.
"We are still investigating, but these new cases raise concern about the potential for continued local spread of dengue through the bite of infected mosquitoes in Baldwin Park. Many people infected may not show symptoms, making it challenging to detect and control the spread of the disease. However, with the community's help, we can make a difference," said Muntu Davis, MD, MPH, Los Angeles County Health Officer, in a press release on October 15, 2024.
To the south of L.A., Escondido, CA, reported a local dengue patient on October 13, 2024.
Additionally, over 200 travel-related dengue cases have been confirmed in California this year.
Throughout 2024, the U.S. CDC has reported that 50 jurisdictions have reported 5,878 dengue cases. The state of Florida leads all other jurisdictions with 595 travel-associated dengue cases and 47 locally acquired cases, primarily in Miami-Dade County (29).
As of October 17, 2024, dengue prevention vaccines are not offered in the United States.
The U.S. Centers for Disease Control and Prevention (CDC) recently issued interim recommendations to prevent the transmission of the Oropouche virus.
Oropouche is usually spread to people by the bite of an infected biting midge. Biting midges are tiny flies, often called "no-see-ums."
A recent scientific report describes Oropouche virus was found in the semen of a patient, which raises health concerns about the possible risk of sexual transmission.
A previous study described the shedding of Oropouche virus RNA in a symptomatic traveler's whole blood, serum, and urine. Virus replication was detected in semen 16 days after infection, which the authors say suggests a risk of sexual transmission.
In June 2024, vertical transmission of the Oropouche virus was identified when RNA was detected in a stillborn infant born to a pregnant woman who had symptoms of Oropouche virus disease at 30 weeks gestation.
Therefore, as of October 15, 2024, the CDC announced men diagnosed with Oropouche infections are advised to use condoms or abstain from sex for six weeks starting from the onset of symptoms.
This is essential guidance since travel-related Oropouche cases have been confirmed in five states, including Florida (86).
Since there are no vaccines to prevent or medicines to treat Oropouche, the CDC says the best way to protect yourself from Oropouche is to prevent bites from biting midges and mosquitoes in areas where the virus is known to occur.
As of 2024, several countries in South America, Central America, and the Caribbean (Cuba) are reporting increased cases. In July 2024, the Brazil Ministry of Health reported two deaths, which represent the first reported fatalities attributed to the Oropouche virus disease in the Americas.
However, there is no evidence of Oropouche virus transmission within the U.S.
According to a report published by the Pan American Health Organization (PAHO) on October 14, 2024, various health authorities have confirmed the detection of vaccine-derived poliovirus type 3 (VDPV3) in an environmental wastewater sample in Leblond (Cayenne), French Guiana.
Additional sequencing results confirm that two samples collected at a Morne Coco plant and one from Saint Georges de l’Oyapock are genetically linked to the VDPV3 isolates detected in June 2024.
Further analysis showed that this sequence is not genetically related to any previously identified VDPV3 strains, including those circulated in other countries throughout 2021-2022.
This finding suggests it might not have spread from a known source and confirms the presence of circulating VDPV3 in French Guiana.
As of this PAHO update, there are no reports of any suspected polio outbreaks in French Guiana.
The U.S. CDC reissued a Global Polio Alert - Level 2, on August 20, 2024, regarding polio outbreaks and poliovirus detections in 37 countries.
And the World Health Organization (WHO) confirmed during the 39th meeting of the IHR Emergency Committee for Polio held in August 2024 that the spread of the poliovirus remained a Public Health Emergency of International Concern.
Both the CDC and WHO recommend that international travelers be fully immunized against polio before visiting endemic countries, such as Afghanistan and Pakistan.
CSL Seqirus today announced new data from several studies that reinforce the benefits of cell-based influenza vaccines among people.
On October 16, 2024, Seqirus stated results from multiple real-world evidence studies over different seasons showed improved relative vaccine effectiveness of cell-based vaccines compared with egg-based vaccines in preventing outpatient test-confirmed influenza across various age groups.
“The results from these studies, collected and analyzed over several recent influenza seasons, have shown that cell-based influenza vaccines are effective in preventing both test-confirmed and clinically diagnosed influenza,” stated Mendel Haag, Senior Director, Center of Outcomes Research & Epidemiology at CSL Seqirus, in a press release.
As of October 2024, the U.S. CDC recommends that people speak with a healthcare provider, such as a pharmacist, about which of nine different flu shots is best for their needs.
The CDC says flu vaccines for the 2024-2025 season will be trivalent. Most will be thimerosal-free or thimerosal-reduced vaccine, and about 21% will be egg-free.
As of September 21, 2024, over 92 million flu shots had been distributed to clinics and pharmacies in the U.S., targeting the 2024-2025 flu season.
While the Republic of Indonesia has been battling tuberculosis cases for years, its focus in 2024 has turned to testing various vaccine candidates to curtail future outbreaks.
Despite having the second-highest number of tuberculosis cases, Indonesia has not participated in all previous vaccine studies.
According to an ANTARA News report on September 26, 2024, Indonesia is conducting clinical trials for three tuberculosis vaccines, including the M72/AS01E vaccine developed by the Bill & Melinda Gates Foundation.
Indonesia's Health Minister Budi Gunadi Sadikin commented, 'the need for more discussions and conferences to eliminate tuberculosis by 2030, including by taking bold and aggressive action, especially in the vaccine development process.'
As of October 15, 2024, over ten tuberculosis vaccine candidates were being researched in various countries, including India, the unfortunate leader in TB cases.
In the United States, Merck's TICE BCG vaccine is FDA-approved for the prevention of tuberculosis; however, it has various access limitations, including those applicable when visiting Indonesia.
The U.S. CDC recommends pre-trip vaccinations for chikungunya, Japanese encephalitis, measles, and polio, but not TB, when visiting Indonesia in 2024. These travel vaccines are typically available at clinics and pharmacies in the United States.
In Europe, the mosquito vector Aedes albopictus, established in many parts of Europe for years, transmits both chikungunya and dengue viruses.
Recently, France's Public Health Ministry stated that detecting additional dengue and chikungunya cases in 2024 has prompted epidemiological and entomological investigations.
As reported on October 9, 2024, the majority of locally-acquired and travel-related cases have been detected in southern France.
From January to April 30, 2024, 2,271 travel-related dengue fever cases and six imported chikungunya cases were reported.
From May 2024 to October 8, 2024, 1,634 imported cases of dengue fever, including 1,468 in departments where the establishment of Aedes albopictus has been documented, and 16 imported cases of chikungunya.
Overall, France reported 78 locally acquired dengue cases in 2024. In 2023, France reported nine outbreaks of dengue involving 45 cases of autochthonous human dengue virus infections.
In the past, local dengue outbreaks have been reported in Italy, Spain, and Croatia.
As of October 15, 2024, the U.S. CDC says chikungunya and dengue are a year-round risk in many parts of the world, and international travelers should take action to prevent infections. The CDC has identified more than expected mosquito-transmitted cases among U.S. travelers returning from various countries.
