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In the Region of the Americas, 2024 has been marked as the worst year ever for dengue virus infections, 12.8 million, and related fatalities, 7,855.

From a country perspective, the United States has experienced a significant impact, with dengue cases increasing by approximately 43%. According to the U.S. CDC, 8,863 dengue cases were reported as of mid-December 2024, compared to 6,164 cases in 2023.

Within the U.S., the Florida Department of Health recently reported some unsettling news.

As of late December 2024, 911 travel-associated dengue cases had been reported, mainly by visitors to Brazil (61), Cuba (506), and Puerto Rico (41). Additionally, 85 locally acquired dengue cases were reported from ten counties, led by Miami-Dade (47).

In 2023, 609 travel-associated dengue cases were reported, and 186 humans contracted dengue while in Florida.

With international travel expected to increase in 2025, this CDC data suggests that more international visitors may unintentionally introduce one of the four dengue viruses in Florida next year.

Furthermore, since mosquitoes transmit dengue, locally acquired infections will likely increase next year.

From a disease prevention perspective, there is hope that access to dengue vaccines may improve in 2025 as approved vaccines increase production and vaccine candidates seek approvals.

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Florida Arbovirus Reports Dec. 2024
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The Costa Rican Ministry of Health published a notice in December 2024 regarding changes to yellow fever certificate requirements for travelers, effective January 11, 2025.

The countries that are now considered at risk and for which yellow fever vaccination against yellow fever is required are the following: Bolivia, Brazil, Colombia, Ecuador, Guyana, French Guiana, Paraguay, Peru, Suriname, Venezuela, and Trinidad and Tobago. Additionally, countries in Africa have been added to Costa Rica's list.

When visiting Costa Rica, a yellow fever vaccination (YF-VAX or Stamaril) certificate may be required at the airport. Foreigners who arrive in Costa Rica and do not present the International Certificate of Vaccination against Yellow Fever to the immigration authority will not be allowed to enter the territory.

As of December 31, 2024, the YF vaccine is not part of the mandatory vaccination schedule, so it must be purchased at private pharmacies.

In addition to YF, Costa Rica has reported Chikungunya (45), Dengue, and Zika (25) cases in 2024.

Most of this year's Dengue cases (30,000) have been detected near San Jose in the mountains, not at Costa Rica's beaches.

Previously, in early December 2024, the U.S. State Department issued a Level 2: Exercise Increased Caution, Travel Advisory, for the Republic of Costa Rica. This U.S. advisory says visitors to Costa Rica should exercise increased caution due to various civil unrest targeting tourists.

Last year, about 2.4 million people visited Costa Rica, many traveling from the United States.

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Costa Rica Ministry of Health Dec. 2024
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As 2024 draws to a close, the World Health Organization (WHO) published an in-depth update on malaria burden and trends at global, regional, and country levels. As of December 19, 2024, the WHO reported malaria outbreaks remain a formidable public health challenge.

In 2023 alone, there were an estimated 597,000 malaria-related fatalities and 263 million new cases, an increase of 11 million cases over 2022.

The WHO wrote, 'Given current trends, progress towards critical targets of the WHO global malaria strategy is off track.'

As the WHO Director-General stated: "No one should die of malaria.... An expanded package of lifesaving tools now offers better protection against the disease, but stepped-up investments and action in high-burden African countries are needed to curb the threat."

The WHO African Region continues to be most impacted, accounting for an estimated 94% of global cases, led by Nigeria and the Democratic Republic of the Congo.

When visiting these countries, the WHO recommends international travelers speak with a travel vaccine expert one month before departure. In November 2024, the WHO published a revised version of the consolidated Guidelines for malaria with an updated vaccine recommendation.

While malaria vaccines are available in Africa, they are unavailable in the USA in 2024.

In the U.S., most malaria cases are travel-related.

The U.S. Centers for Disease Control and Prevention reported that as of the week ending November 23, 2024 (#47), 1,772 malaria cases had been confirmed in 2024, mostly among international travelers arriving in New York City (232), Texas, Miami, Florida, and Los Angeles, California. In 2023, there were 2,013 travel-related malaria cases in the U.S. 

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WHO Malaria Report 2024
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A recent study published by the JAMA Network measured antibody response to Respiratory syncytial virus (RSV) vaccinations in immunocompromised individuals.

This Research Letter, published on December 30, 2024, disclosed a heterogeneous antibody response to RSV vaccines among immunocompromised persons.

In contrast to universal seroconversion and preF IgG fold rises greater than 10 in immunocompetent persons, approximately 40% of immunocompromised participants did not seroconvert or achieve a conservative neutralization threshold postvaccination.

Better neutralization was seen among RSVA-AS01E (AREXVY™) recipients, suggesting possible augmentation by the vaccine adjuvant.

These researchers wrote, 'Low antibody titers may indicate a role for additional vaccine doses to enhance immune response among immunocompromised persons.

As of December 31, 2024, various RSV vaccines are offered at local pharmacies, and monoclonal antibody passive immunization is approved.

 

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from Pixabay 2024
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Whooping cough outbreak in 2024
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The U.S. Centers for Disease Control and Prevention (CDC) today announced active person-to-person transmission of mpox clade 1 in Burundi, Central African Republic, Democratic Republic of the Congo, Kenya, the Republic of the Congo, Rwanda, and Uganda.

As of December 30, 2024, the CDC's Level 2 Travel Health Advisory says person-to-person transmission has occurred through various means during this mpox outbreak. Historically, clade I have been associated with a higher percentage of people with mpox developing severe illness or dying, compared to clade II. 

The mpox clade II outbreak began in the United States in late May 2022.

As of November 2024, there have been 2,455 confirmed clade II mpox cases this year, which has exceeded the 1,407 confirmed cases in 2023.

Furthermore, the CDC says mpox vaccination is recommended for certain people traveling to countries with ongoing person-to-person transmission of clade I mpox.

In the U.S., the JYNNEOS® (MVA-BN, IMVANEX®, IMVAMUNE®) Smallpox and Mpox Vaccine has been approved by the U.S. FDA since September 2019. Other mpox vaccines and vaccine candidates are actively seeking regulatory approvals in 2025.

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Google Maps - CDC THN Mpox Outbreak map Dec. 30, 2024
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UTI Vaccination Appointment

As of December 2025, the Uromune MV140 vaccine is not FDA-approved and unavailable in the United States. However, this oral spray vaccine is available in various countries, such as London, England.

 

In England, these PassportHealth clinics offer the Uromune UTI vaccine in Hampstead, London, and the Marylebone area.

 

In the Dominican Republic, here is the local contact.

 

In Mexico, the Benavides pharmacy website lists Uromune's availability in 2025. A prescription from a local doctor is required. Several other pharmacies also offer Uromune in Mexico.

 

Across the Pacific, this clinic in Singapore offers UTI vaccination service.

 

Additionally, here are links to additional UTI information:

 

  • Pivya (pivmecillinam) tablets for Uncomplicated UTIs.
  • RECCE 327 is an intravenous and topical treatment for UTIs.
  • The BCG vaccine is available for off-label use.
  • LBP-EC01 is a bacteriophage cocktail engineered with a CRISPR-Cas3 construct targeting the E. coli genome for the treatment of uncomplicated UTIs.
  • UTI clinical trials in the USA.
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Uromune MV140 vaccine appointments
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While the Region of the Americas experienced the most significant Dengue virus outbreak in 2024, with over 12.8 million cases and 7,855 related fatalities, effective vaccines have become available in many countries.

However, safety concerns about dengue vaccines focus on the potential for enhanced disease after vaccine-induced seroconversion and subsequent infection.

On December 28, 2024, in a Brief Report, clinical researchers present a fatal case of severe dengue in an unvaccinated traveler without known prior dengue virus infection but longitudinal serologic and molecular evidence for secondary infection.

In the context of this Dengue case and vaccination guidance for travelers, they discuss pre-vaccination screening and potential implications for travelers to regions with ongoing outbreaks and emphasize the importance of serostatus-independent vaccines.

As of December 30, 2024, Dengvaxia® and Qdenga® vaccines are not offered in the U.S.

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PAHO Dec. 30, 2024
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MV140 Is Effective in the Reduction of Urinary Tract Infections in Prospective Real-Life Study
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The Kentucky Department for Public Health (KDPH) recently reported a resident of northern Kentucky has died after being infected with the rabies virus.

As of December 28, 2024, KDPH stated transmission of the rabies virus from person to person is rare. In 1999, skunks accounted for 21 of Kentucky's 35 confirmed rabies cases. 

State Public Health Veterinarian Kelly Giesbrecht, DVM, MPH, is the primary consultant in Kentucky for Rabies and other zoonotic diseases.

Rabies is an infectious viral disease that affects the nervous system and kills about 70,000 people worldwide each year.

. People get Rabies from the bite of an infected or rabid animal. Wild mammals like raccoons, skunks, foxes, coyotes, or bats can have and transmit Rabies.

According to the U.S. CDC, bats, not dogs, are the leading source of rabies infection in the United States.

In late November 2024, the Fresno County Department of Public Health announced a rabies death involving a county resident who was suspected to have been bitten by a bat in Merced County, located east of San Jose.

Furthermore, Rabies is a vaccine-preventable disease, with various U.S. FDA-approved vaccines available in 2024.

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US CDC type of rabies death worldwide
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