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The Republic of South Africa's year-long battle against measles outbreaks continues in September 2023.
In the past weeks (week 34 up until week 35), 17 laboratory-confirmed measles cases were detected across the country from four of the eight provinces.
As of September 2, 2023, Gauteng province reported most of the cases (11), Limpopo reported three, Kwa-Zulu Natal reported two, and North West reported one case.
Measles is highly contagious. Around 90% of people who are not protected will become infected following exposure to the virus.
The National Institute for Communicable Diseases (NICD) criteria for declaring the measles outbreak was met in the Northern Cape province in week 15, the North West province in week 24, and the Free State province in week 25.
Since late 2022, the NICD has tested 6,816 serum samples for measles, of which 1160 (17%) were confirmed positive.
The NICD has implemented numerous vaccination programs throughout the measles outbreaks and continue in September 2023.
According to the U.S. Centers for Disease Control and Prevention (CDC), India leads all other countries over the past year with about 57,000 cases.
In addition, the CDC published a global Travel Health Notice on June 29, 2023, highlighting various measles outbreaks.
While most people have heard of norovirus outbreaks on cruise ships, this diarrhea-causing virus also impacts people on land.
The U.S. CDC's Morbidity and Mortality Weekly Report on September 8, 2023, highlighted about 27 cases of acute gastroenteritis among hikers on the Pacific Crest Trail in 2022, suggesting a possible norovirus outbreak.
The CDC wrote preventing future outbreaks will require fostering increased awareness of handwashing and the lack of effectiveness of alcohol-based hand sanitizers against norovirus and more frequent cleaning of public facilities.
These hikers and others are eagerly awaiting news of a norovirus vaccine.
On September 6, 2023, Vaxart, Inc. announced top-line data from the Phase 2b challenge study of its oral tablet monovalent norovirus vaccine candidate, VXA-G1.1-NN.
Vaccination with VXA-G1.1-NN led to a statistically significant reduction in infection rate, a non-statistically significant reduction in norovirus acute gastroenteritis, and a substantial reduction in viral shedding.
The oral vaccine candidate was also safe and well tolerated with no vaccine-related serious adverse events.
Dr. James F. Cummings, Vaxart's Chief Medical Officer, commented in a press release, "The magnitude of the reduction in shedding could have an impact on transmission and may have important public health benefits, as norovirus spreads rapidly among people gathering in large numbers, including settings such as daycare centers, nursing homes, and workplaces, and may reduce the potential spread of the infection to families at home."
"The results of this study highlight the potentially distinctive profile of mucosal vaccination and the potential that our oral pill vaccines may have in protecting against infection and blocking transmission – potential benefits that have also been seen with our influenza vaccine," added Dr. Cummings.
Norovirus is the leading cause of acute viral gastroenteritis in all age groups in the U.S. On average, norovirus causes 19 to 21 million cases, infects 15% of all children under age 5, and leads to 465,000 emergency department visits, 109,000 hospitalizations, and 900 deaths, says the U.S. CDC.
As of September 9, 2023, norovirus vaccine candidate news is posted by Precision Vaccinations.
Most health experts say 'what happens in the Southern Hemisphere is a reliable indication of the next flu season in the United States.'
This opinion is based on the yearly circulating influenza viruses and flu shot composition.
Flu seasons in the Southern Hemisphere usually occur between April and September, compared with October through May in the north.
According to a new Morbidity and Mortality Weekly Report (MMWR) published today, the 2023-2024 influenza vaccines should protect people from severe hospitalizations.
On September 8, 2023, the U.S. Centers for Disease Control and Prevention (CDC) MMWR stated the adjusted vaccine effectiveness against severe acute respiratory infection hospitalization associated with any influenza virus during the 2023 Southern Hemisphere season was 51.9% (95% Confidence Interval 39.2%–62.0%).
Despite the encouraging data, fewer than 30% of persons identified in this CDC study were vaccinated against influenza in the five countries studied before their illness onset.
This news means the circulating influenza viruses were genetically similar to those targeted by the 2023–2024 Northern Hemisphere influenza vaccine available in the U.S.
Over 100 million flu shots have already been distributed this year.
In anticipation of the new flu season, the CDC recommends U.S. healthcare providers eagerly administer seasonal influenza vaccine to all eligible persons.
The findings in this CDC report are subject to at least five limitations, and no industry conflicts of interest were disclosed. Corresponding author: Ashley L. Fowlkes, [email protected].
Malaria was eliminated as a public health threat in the United States in the mid-1950s, recent locally-acquired cases refreshed the awareness of this mosquito-transmitted disease.
The species of Anopheles mosquitoes biologically capable of transmitting malaria have been found throughout the U.S.
The U.S. CDC published a Morbidity and Mortality Weekly Report on September 8, 2023, confirming eight malaria cases were reported in Florida (seven) and Texas (one) from May 18–July 17, 2023.
As of August 2023, no additional autochthonous P. vivax cases have been detected in Florida or Texas, and there has been no evidence of infected Anopheles mosquitoes since early June.
Although the risk for autochthonous malaria in the U.S. remains very low, U.S. clinicians need to consider a malaria diagnosis in patients with an unexplained fever, especially in areas where autochthonous malaria has been recently reported, wrote the CDC.
The recent cases underscore the potential for imported malaria cases from outbreak areas with competent vectors to produce local mosquito transmission of malaria parasites.
Before traveling internationally to areas where malaria is endemic, travelers should consult their healthcare provider regarding recommended malaria prevention measures, including potentially taking malaria prophylaxis.
Furthermore, malaria is preventable with vaccines available in Africa but not in the U.S.
Separately, the Pan American Health Organization (PAHO) called on Member States to maintain surveillance, early detection, and timely treatment of malaria cases in the Americas.
On September 7, 2023, the PAHO reported between 2022 and 2023, Argentina, Bahamas, and Jamaica reported sporadic cases of imported malaria and local transmission, including in areas where this disease had not previously been reported.
According to the U.S. Centers for Disease Control and Prevention (CDC) new report, very few influenza samples tested positive last week.
The CDC's FluView Week #35 report, published on September 8, 2023, data from clinical laboratories indicate 233 specimens tested positive for influenza, reflecting a 0.8% rate.
And public health laboratories reported only 41 positives out of 1,466 samples.
Nationwide, 1.8% of patient visits to healthcare providers last week were due to respiratory illness that included fever plus a cough or sore throat.
This data is increasing week over week, which can usually predict a flu outbreak is forecasted.
The unfortunate news is that influenza continues to cause related fatalities.
National Center for Health Statistics Mortality Surveillance data available on September 7, 2023, shows four death certificates listed influenza as an underlying or contributing cause of death.
Additionally, two influenza-associated pediatric deaths occurring during the 2022-2023 season were reported to the CDC during week #35.
A total of 174 influenza-associated pediatric deaths occurring during the 2022-2023 season have been reported to CDC. This is the most significant number of fatalities since the 2019-2020 flu season.
The CDC's new Director, Mandy K. Cohen, MD, MPH, recently recommended on X that people start getting their annual flu shot ahead of the 2023-2024 flu season.
'It's that time of year — I got my flu shot... Get yours to #FightFlu.'
A team of researchers at MIT today announced they are working on making mRNA vaccines produce a more robust immune response at a lower dose.
Published in the journal Nature Biomedical Engineering on September 7, 2023, this study showed how MIT researchers delivered COVID-19 antigen and the antigen to boost the immune response without needing a separate adjuvant.
The researchers’ tests also showed that the vaccine induced a strong immune response when delivered intranasally compared to the response elicited by traditional intramuscular vaccination.
In mice, intramuscular or intranasal administration of nanoparticles with the lead ionizable lipid and with mRNA encoding for the fusion protein (either the spike protein or the receptor-binding domain of SARS-CoV-2 increased the titres of antibodies against SARS-CoV-2 tenfold with respect to the vaccine encoding for the unadjuvanted antigen.
“With intranasal vaccination, you might be able to kill Covid (SARS-CoV-2) at the mucus membrane before it gets into your body,” commented Daniel Anderson, a professor in MIT’s Department of Chemical Engineering and the senior author of the study in an MIT News article.
“Intranasal vaccines may also be easier to administer to many people since they don’t require an injection.”
The researchers believe the effectiveness of other types of mRNA vaccines now in development, including vaccines for cancer, could be improved by incorporating similar immune-stimulating properties.
If further developed for use in humans, this type of mRNA vaccine could help to reduce costs, reduce the dosage needed, and potentially lead to longer-lasting immunity, wrote these researchers.
The National Institutes of Health and Translate Bio funded the research.
A joint team of Yale, University of Georgia, and Emory University scientists have received a $25 million government grant to develop an mRNA cancer vaccine.
On September 7, 2023, Carlos Salcerio with Yale News reported the research combines the team's expertise in mRNA and dendritic cells.
These researchers seek to develop synthetic mRNA that will carry instructions for cancer-specific antigens to dendritic cells.
By programming dendritic cells with synthetic mRNA, researchers can precisely instruct the immune system to target cancer-specific antigens without attacking healthy cells.
Healthy cells modified to include unrecognized proteins using mRNA might have otherwise been treated as a foreign entity.
The researchers recognized that vaccine breakthroughs often involve considerable complexities and difficulties.
"We're not naive.... we know how difficult this stuff is..... we have to pick our winners to move forward into the clinic.... but I would say that certainly there should be winners."
Three new outbreaks of cholera and/or Acute Watery Diarrhoea were recently reported from Uganda, Sudan, and the Republic of the Congo.
According to the World Health Organization (WHO) Edition #6, 28 countries have reported cholera cases since the beginning of 2023.
The WHO African Region remains the most affected region, with 16 countries reporting cholera outbreaks since the beginning of the year.
As of September 5, 2023, the overall capacity to respond to multiple and simultaneous outbreaks continues to be strained due to the global lack of resources, including shortages of oral cholera vaccines (OCV).
The WHO has pre-qualified three OCVs for use in 2023.
Based on the large number of outbreaks, their geographic expansion, and a lack of vaccines and other resources, WHO continues to assess the risk at the global level as very high.
In the U.S., there are very few cholera cases reported.
