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The current outbreaks of avian influenza ("bird flu") continue to cause devastation in animal populations worldwide. Although largely affecting animals, these outbreaks pose ongoing risks to humans, says the World Health Organization (WHO).

The WHO wrote today that an increasing number of H5N1 avian influenza detections among mammals, which are biologically closer to humans than birds, raises concern that the virus might adapt to infect humans more easily.

In addition, some mammals may act as mixing vessels for influenza viruses, leading to the emergence of new viruses that could be more harmful to animals and humans. 

Announced on July 12, 2023, the WHO, Food and Agriculture Organization of the United Nations, and the World Organisation for Animal Health urge countries to work together across sectors to save as many animals as possible and protect people. 

Sporadic influenza A(H5N1) clade 2.3.4.4b virus detections in humans have been reported but remain very rare, with 8 cases reported since December 2021.

But only one case in the U.S.

Infections in humans can cause severe disease with a high mortality rate, says the WHO.

The human cases detected thus far are mostly linked to close contact with infected birds and contaminated environments. 

"With the information available so far, the virus does not appear to be able to transmit from one person to another easily, but vigilance is needed to identify any evolution in the virus that can change that," said Dr. Sylvie Briand, Director of Epidemic and Pandemic Preparedness and Prevention, WHO, in a related press release.

"We encourage all countries to increase their ability to monitor these viruses and to detect any human cases. This is especially important as the virus now affects countries with limited prior experience in avian flu surveillance."

Studies are underway to identify any changes in the bird flu virus that may help the virus to spread more easily among mammals, including humans, says the WHO.

The U.S. CDC's Situation Summary issued as of July 5, 2023, confirmed the current risk to the public from bird flu viruses remains low. However, continued sporadic human infections are anticipated. 

During this bird flu outbreak, there have been 7,105 virus detections in 47 U.S. states.

As of July 12, 2023, the U.S. government has stockpiled and approved avian influenza vaccines.

Dengue fever outbreaks continue to confront numerous countries in 2023. To extend access to dengue vaccines, the U.S. Food and Drug Administration (FDA) recently approved a supplement Biologics License Application (sBLA) for Dengue Tetravalent Vaccine, Live (Dengvaxia®).

On June 30, 2023, the FDA issued to Michael F. Stirr, Sanofi Pasteur, Inc. BL 125682/40, to include safety and efficacy data that support the use of Dengvaxia in individuals 6 through 16 years of age, with laboratory-confirmed previous dengue infection and living in endemic areas.

This FDA expansion is important as no specific medication to treat dengue infection exists.

As of July 3, 2023, the FDA's review of this supplement was associated with the following National Clinical Trial numbers: NCT01373281, NCT01374516, NCT00842530, and NCT01983553.

The three-dose Dengvaxia's (CYD-TDV) original BLA was approved by the FDA on May 1, 2019. It was first licensed in Mexico in 2015 for use in individuals 9-45 years of age and is now licensed in over 20 countries. 

Dengvaxia is the only dengue vaccine recommended for routine use by the U.S. CDC's Advisory Committee on Immunization Practices.

Before being vaccinated with Dengvaxia, the CDC's vaccine committee says healthcare providers that if a patient has dengue symptoms or lives in or has recently traveled to an area with a risk of dengue and has not previously been infected, they are at increased risk for Severe Dengue disease when vaccinated and subsequently infected with the dengue virus. 

Dengue is caused by infection with any of the four dengue viruses.

According to the CDC, these viruses are transmitted in tropical and subtropical regions by infected  Aedes mosquito species.

During the summer of 2023, locally-acquired dengue cases have been reported in Florida, Texas, Puerto Rico, and Costa Rica.

Given an increase in outbreaks caused by different microorganisms associated with medical and health tourism, the Pan American Health Organization / World Health Organization (PAHO/WHO) recently announced it encouraged Member States to strengthen their capacity to detect and manage related infections.

On July 7, 2023, the PAHO/WHO stated in recent years, the Region of the Americas has experienced an exponential growth of international travel in search of health care. For example, millions of Americans travel to other countries for health care each year, primarily to Mexico, Canada, and other countries in Central America, South America, and the Caribbean.

It is estimated that for the United States alone, the annual number has increased from 750,000 to 1.4 million over ten years (2007 to 
2017). 

Additionally, the U.S. Centers for Disease Control and Prevention (CDC), the Mexican Ministry of Health, and U.S. state health departments are responding to a multinational fungal meningitis outbreak among 35 people who had procedures in Matamoros, Tamaulipas, Mexico.

Ten U.S. patients have confirmed cases of fungal meningitis, and eight have died, according to the U.S. CDC.

The CDC says anyone who had procedures under epidural anesthesia from January to May 13, 2023, is at risk for fungal meningitis.... and should go to the nearest emergency room as soon as possible to be evaluated for fungal meningitis, even if you do not currently have symptoms.

Fungal meningitis is a rare, life-threatening fungal infection that causes swelling of the areas around the brain and spinal cord. Starting treatment right away if you are found to have fungal meningitis greatly increases the likelihood of survival.

However, infections are not contagious and are not spread from person to person, says the CDC.