Travel Vaccine Breaking News

According to numerous reports, the Republic of Peru is confronted with another Guillain-Barré Syndrome (GBS) outbreak.

The Peruvian Government recently published Supreme Decree No. 019-2023-SA in the Official Gazette El Peruano, declaring a national health emergency due to the unusual increase in GBS cases in 18 of the country's 24 departments.

As reported on July 10, 2023, 182 cases of GBS have been confirmed, and four people have died since June 2023, per MercoPress.

Peru's president Dina Boluarte also issued a decree allocating $3.27 million for an action plan to improve patient care, including acquiring 5,000 immunoglobulin vials for treating patients affected by GBS.

Issued on July 8, 2023, this emergency declaration will be valid for 90 calendar days.

The U.S. Centers for Disease Control and Prevention (CDC) says GBS is the most common form of acute flaccid paralysis worldwide. It is characterized by motor weakness and other symptoms.

The CDC reported in a November 2020 Research Letter that from May 20–July 27, 2019, the Government identified 683 suspected or confirmed GBS cases in Peru.

Of the 683 GBS patients, 287 (42%) had descending muscle weakness, and 446 (65.3%) had ascending muscle weakness.

Of 426 patients for whom hospitalization data were available, 64 (15%) required mechanical ventilation.

Of 147 patients with an electrodiagnostic exam, 100 (68%) had acute motor axonal neuropathy.

The CDC stated this GBS outbreak was unusual because of the many cases. The incidence rate was nearly 25 times higher than expected.

And the rapid increase in numbers was followed by an equally precipitous decrease, which might suggest a point-source exposure. 

While official updates on H5N1-infected cats in Poland have increased over the past week, Polish authorities provided the European Centre for Disease Prevention and Control (ECDC) with an update, confirming that a total of 24 sick or dead cats were positive for influenza A(H5N1) virus (bird flu).

According to ECDC's testing guidance on avian influenza viruses in humans, any person exposed to sick/dead cats confirmed with A(H5N1) infection who develops symptoms should be tested as soon as possible for A(H5N1).

And persons exposed to sick/dead cats confirmed with A(H5N1) infection are advised to monitor their symptoms for 10–14 days after the last exposure and self-isolate if they develop symptoms.

They are also advised to wear a surgical mask or FFP2 respirator when in contact with others, seek medical advice and report it to public health authorities immediately.

And recently, the Italian Ministry of Health announced on July 6, 2023, that several dogs (and one cat) on a farm in Brescia, Italy, recently hit by avian influenza (bird flu), have seroconverted.

And the Italian Union of Public Medicine Veterinarians confirmed this HPAI H5N1 belonging to clade 2.3.4.4 b, and in particular to the H5N1-A/Herring_gull/France/22P015977/2022-like genotype, responsible for the cases reported in northern Italy in gulls.

This virus also has a mutation considered a marker of adaptation of mammalian viruses (T271A in the PB2 protein) with a possible increase in its zoonotic potential.

This mutation sparked considerable concern earlier this year when it was detected in infected mink in the fall of 2002, wrote the Avian Flu Diary.

The ECDC stated that considering the information and genomic data available until now and the fact that no human cases related to this event have been reported so far, ECDC assesses the current risk to the general public as low.

However, the risk is considered moderate for persons exposed to sick and/or dead cats confirmed with A(H5N1) infection, particularly if they belong to a vulnerable population group (immunocompromised people).

Considering the existing uncertainties, this assessment is preliminary and will be reviewed as soon as more information becomes available, says the ECDC.

The Global Polio Eradication Initiative (GPEI) reported this week, three African nations reported continuing polio outbreaks.

Burkina Faso reported it's first circulating vaccine-derived poliovirus type 2 (cVDPV2) case of the year.

Chad reported two more cVDPV2 cases increasing its total for the year to ten.

And Nigeria reported six more polio cases, raising its total to 16 in 2023.

Furthermore, various countries reported cVDPV2-positive environmental samples as of July 5, 2023.

Previously, the World Health Organization (WHO) reconfirmed that the spread of poliovirus remained a Public Health Emergency of International Concern. As of July 2023, the WHO recommends travelers to polio-outbreak areas be fully vaccinated.

As of July 9, 2023, various polio vaccines are available worldwide.

The Republic of South Africa's  National Institute for Communicable Diseases (NICD) today reported the year-long measles outbreak continues in the northern provinces.

As of July 7, 2023, the NICD confirmed in the past week (week #25) that ten laboratory-confirmed measles cases were detected across the country, most of which were from Limpopo (6).

In week #25, Limpopo reported a total of 5 cases.

The vaccination campaign in Limpopo province targeting the 5-15 years age group has come to an end with overall vaccination coverage of 56%.

To achieve a higher coverage rate, the NICD is informed that a mop-up campaign will be conducted through the end of August 2023.

Various measles vaccines are available globally, and most health agencies recommend full vaccination before visiting measles outbreak areas.

The NICD says measles is a highly contagious disease caused by an airborne virus. Complications are more serious in those who catch measles as young infants and in children who are malnourished.

Infected patients with measles present with fever and with a rash. The rash looks like small, red, flat spots over the body. The rash does not form blisters, nor is it itchy or painful.

Other signs include cough, red eyes, and a running nose.

Complications of measles can include diarrhea, dehydration, brain infection, blindness, and death.

The Florida Department of Health in Sarasota (DOH-Sarasota) recently reported two additional locally-acquired malaria infections caused by mosquito bites. 

The Plasmodium species reported were Plasmodium vivax as of July 1, 2023.

According to Florida's surveillance report #26, the new malaria cases were in similar locations in greater Sarasota as the previous four cases with onsets in May and June 2023.

Regarding Travel-Associated Malaria Cases, twenty-three cases of malaria with onset in 2023 have been reported in Florida. 

The countries of origin were Burundi, Côte D'Ivoire, Democratic Republic of the Congo (2), Equatorial Guinea, Ghana (2), Kenya, multiple countries (4), Nicaragua (2), Nigeria (2), Pakistan, Sierra Leone (2), Sudan, and Uganda (3).

The U.S. Centers for Disease Control and Prevention says malaria is a mosquito-borne disease.

Left untreated, malaria infections can develop severe complications. In 2020, an estimated 241 million cases of malaria occurred worldwide.

Malaria vaccines are currently in use in Africa and are reported to be effective at preventing disease.

As of July 7, 2023, the U.S. Food and Drug Administration had not approved a malaria vaccine for use in Florida.

Eisai Co., Ltd. and Biogen Inc. announced today that the U.S. Food and Drug Administration (FDA) had approved the supplemental Biologics License Application (sBLA) supporting the traditional approval of LEQEMBI® (lecanemab-irmb) 100 mg/mL injection for intravenous use.

This approval makes LEQEMBI the first and only approved treatment shown to reduce the rate of disease progression and slow cognitive and functional decline in adults with Alzheimer's disease (AD).

In a phase 3 clinical trial, LEQEMBI demonstrated clinically meaningful slowing of cognitive and functional decline in a patient group generalizable to U.S. Medicare beneficiaries, which included a mix of racial and ethnic groups, patients with common comorbid conditions, concomitant medications, and patients with mild cognitive impairment (MCI) due to AD or mild AD.

Treatment with LEQEMBI should be initiated in patients with MCI or mild dementia stage of disease, the population in which treatment was initiated in clinical trials.

Furthermore, CMS confirmed that broader coverage of LEQEMBI is now available. The CMS-facilitated registry is now available for healthcare professionals to submit required patient data to CMS.

This action will facilitate reimbursement for and access to LEQEMBI across a broad range of healthcare settings in the U.S.

As of July 7, 2023, there are no approved Alzheimer's disease vaccines in the U.S.

The Lancet Infectious Diseases recently published results from a  phase 1 clinical trial of a Lyme disease vaccine candidate, showing that Valneva's VLA15 produces a strong but waning immune response against six common strains of the Borrelia burgdorferi bacterium found in Europe and the United States.

Valneva Austria researchers led this company-sponsored, partially randomized, observer-masked study of the novel, multivalent outer surface protein A (OspA) subunit vaccine candidate.

OspA is one of the most dominant surface proteins expressed by the bacteria when present in a tick.

VLA15 produced immune responses for all strains, but responses were greater in the higher-dose adjuvanted groups. And one month after the third dose, responses declined, reaching baseline by one year.

And a booster dose given 13 months after the first dose triggered a strong immune response for about six months.

This study's findings are good news since Lyme borreliosis is the most common tick-borne disease in the northern hemisphere.

In Europe, there are estimated to be more than 200,000 cases each year. And in the U.S., approximately 30,000 patients per year.

In a related commentary also published by The Lancet, Nicole Bézay, and colleagues reported Valneva's novel vaccine represents a milestone in our fight against Lyme disease."

Initially developed by France-based Valneva SE, New York-based Pfizer, Inc. is VLA15's current development and commercialization collaboration.

Pfizer previously indicated it could submit a Biologics License Application in 2025 and Marketing Authorization Application in Europe in 2026, subject to positive data.