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The World Health Organization (WHO) yesterday announced its investigations into Marburg virus disease (MVD) outbreaks are ongoing as additional cases have been reported.

This first MVD outbreak in 2023 was reported in Equatorial Guinea. As of February 21, 2023, the cumulative number of fatal MVD cases was nine.

Recently, Spain detected its first suspected MVD patient.

This man had recently visited Equatorial Guinea, reported VOA News on February 25, 2023.

Spanish health officials stated that more than 200 people in Equatorial Guinea have recently been quarantined because of MVD.

As of February 25, 2023, the WHO assesses the risk posed by MVD outbreaks as high at the national level, moderate at the regional level, and low at the global level.

Previously, the U.S. CDC issued a travel alert focused on these MVD outbreaks.

Marburg spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with infected people's blood, secretions, organs, or other bodily fluids and surfaces and materials (e.g., bedding, clothing) contaminated with these fluids.

The incubation period varies from two to 21 days.

As of February 27, 2023, various MVD vaccine candidates are conducting clinical studies, but the U.S. FDA has not authorized any vaccine.

Update: Reuters reported Spain says patient does not have Marburg disease.

Moderna, Inc. and Merck recently announced that mRNA-4157/V940, an investigational personalized mRNA cancer vaccine, in combination with KEYTRUDA, has been granted Breakthrough Therapy Designation by the U.S. Food and Drug Administration (FDA) for the adjuvant treatment of patients with high-risk melanoma following complete resection.

Personalized cancer vaccines are designed to prime the immune system so that a patient can generate a tailored antitumor response specific to their tumor mutation signature. 

The FDA granted Breakthrough Therapy Designation based on positive data from the Phase 2b KEYNOTE-942/mRNA-4157-P201 trial.

"The FDA's Breakthrough Designation for mRNA-4157/V940 in combination with KEYTRUDA reflects the excitement that we have for the potential promise of individualized cancer treatments," said Stephen Hoge, M.D., Moderna's President, in a press release on February 22, 2023.

"mRNA-4157/V940 in combination with KEYTRUDA provided the first demonstration of efficacy for an investigational mRNA cancer treatment in a randomized clinical trial and potentially represents a new frontier in treating melanoma and other cancers."

"We look forward to publishing the full data set and sharing the results at an upcoming oncology medical conference, as well as continuing discussions with health authorities."

mRNA-4157/V940 is a novel investigational mRNA-based personalized cancer vaccine consisting of a single synthetic mRNA coding for up to 34 neoantigens that is designed and produced based on the unique mutational signature of the patient's tumor. Upon administration into the body, the algorithmically derived and mRNA-encoded neoantigen sequences are endogenously translated and undergo natural cellular antigen processing and presentation, a key step in adaptive immunity.

KEYTRUDA is an anti-programmed death receptor-1 (PD-1) therapy that works by increasing the ability of the body's immune system to help detect and fight tumor cells. KEYTRUDA is a humanized monoclonal antibody that blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2, thereby activating T lymphocytes which may affect both tumor cells and healthy cells.

The FDA's Breakthrough Therapy Designation is granted to expedite the development and review of drugs that are intended to treat a serious condition, and when preliminary clinical evidence indicates that the product may demonstrate substantial improvement over available therapies on at least one clinically significant endpoint.

This news is essential since the rates of melanoma have been rising over the past few decades, with nearly 325,000 new cases diagnosed worldwide in 2020.

In the U.S., skin cancer is one of the most common types of cancer diagnosed, and melanoma accounts for a large majority of skin cancer deaths.

In Mozambique, an outbreak of cholera has been growing exponentially since December 2022. The World Health Organization (WHO) recently reported heavy rainfall in the first weeks of February 2023 threatens to further worsen the situation with geographic spread to new districts.

The WHO confirmed on February 23, 2023, the first case of cholera in the current outbreak was reported from the Lago district in Niassa province in mid-September 2022.

And as of February 19, 2023, a cumulative total of 5,237 suspected cholera cases and 37 deaths (Case Fatality Ratio (CFR) 0.7%) have been reported in 29 districts from six out of 11 provinces in the country.

The WHO considers the risk of further disease spread as very high at the national and regional levels. 

For example, the neighboring African country of Malawi is facing the deadliest cholera outbreak in its history.

A request for approximately 700,000 doses of Oral Cholera Vaccine was approved by the International Coordinating Group on Vaccine Provision, and a vaccination campaign in affected districts in Gaza, Niassa, Sofala, and Zambezia provinces is in preparation and will start in late February 2023.

Additionally, the U.S. CDC recommends people visiting Mozambique should be vaccinated against measles and polio in 2023.

These travel vaccines are generally available at certified travel; clinics and pharmacies in the U.S.