Travel Vaccine Breaking News

The Pan American Health Organization (PAHO) recently posted an update for another suspected polio case in the Republic of Peru.

PAHO announced on April 7, 2023, genetic analysis suggests this poliovirus isn't related to any other detected strains.

Local health officials are testing fecal samples, including that from a child from Atahualpa's native community who developed paralysis symptoms. The samples also include four contacts and four unvaccinated children as part of community surveillance.

The initial vaccine-derived poliovirus type 1 case in Peru involved an unvaccinated child with no travel history whose paralysis symptoms began in December 2022.

The PAHO confirms polio is a vaccine-preventable disease.

The PAHO / World Health Organization reiterates to Member States the importance of continuing efforts to achieve and maintain polio vaccination coverage greater than 95% to minimize the risk of a poliomyelitis outbreak.

And strengthen epidemiological surveillance of acute flaccid paralysis, a polio-like illness that affects the spinal cord and can cause sudden paralysis.

There have been 724 confirmed Acute flaccid myelitis (AFM) cases in the U.S. since the Centers for Disease Control and Prevention (CDC) began tracking AFM in August 2014.

As of April 3, 2023, there has been one confirmed AFM case in 2023 out of 13 reports of patients under investigation.

In the U.S., poliovirus wastewater surveillance programs are active in New York and other states as of April 10, 2023.

To alert international travelers of this health risk, the CDC issued a Global Polio Travel Advisory in March 2023, which stated before any international travel, make sure you are up to date on your polio vaccines.

The U.S. Department of State recently reissued its Level 2: Exercise Increased Caution for the Republic of Indonesia. On April 5, 2023, the State Department stated some areas in Indonesia had increased risk.

And reconsider visiting the provinces of Central Papua (Papua Tengah) and Highland Papua (Papua Pegunungan) due to civil unrest.

Furthermore, Indonesia’s revised criminal code, which takes effect in January 2026, includes penalties for defamation, blasphemy, cohabitation, and sex outside of marriage.

However, it is unclear how Indonesian authorities will implement the revised criminal code, says the State Department.

According to travel industry data, foreign tourist arrivals in Indonesia reached about 700 thousand in February 2023, amid several international events as the economy fully reopened from COVID-19 pandemic restrictions.

The United States, through the U.S. Agency for International Development (USAID), and the Indonesian Ministry of Health, recently celebrated their successful collaboration under the United States COVID-19 assistance program.

Throughout the pandemic, USAID helped deliver over 100 million vaccine doses to Indonesia, including 42 million donated directly from the United States.

“In the face of this unprecedented challenge, Indonesia and the United States stood together to confront the pandemic, and together, we have dramatically reduced deaths and severe illness,” said U.S. Deputy Chief of Mission Michael F. Kleine in a press release on April 5, 2023.

From a health-risk perspective, the U.S. Centers for Disease Control and Prevention (CDC) has issued several travel vaccination recommendations when planning to visit Indonesia.

These CDC Travel Alerts include measles and polio.

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

The U.S. Centers for Disease Control and Prevention (CDC) recently reissued a Watch - Level 1, Practice Usual Precautions notice regarding the Republic of Paraguay's chikungunya virus outbreak.

On April 6, 2022, the CDC confirmed that Paraguary's departments had reported chikungunya cases in 2023.

Furthermore, recent chikungunya cases have been reported among US travelers returning from Paraguay.

Since no approved vaccines target chikungunya, the CDC says people can protect themselves by preventing mosquito bites.

Furthermore, the CDC says travelers should seek medical care if they develop fever, joint pain, headache, muscle pain, joint swelling, or rash. 

Additional chikungunya outbreak news is posted at Vax-Before-Travel.

The World Health Organization (WHO) published a Weekly Epidemiological Update Edition #137 regarding the COVID-19 pandemic on April 5, 2023.

The WHO disclosed a decrease of 28% in new COVID-19 cases and 30% in related fatalities, respectively, compared to the previous 28 days (February 6 to March 5, 2023).

Despite this overall downward trend, it is essential to note that 74 (31%) countries have reported increases in new cases of 20% or greater during the last 28 days compared to the previous 28-day period.

As of April 2, 2023, over 762 million confirmed cases and over 6.8 million deaths have been reported globally.

Furthermore, the WHO continues Listing numerous COVID-19 vaccines available in various countries.

Researchers at the Oak Crest Institute of Science have been exploring new ways to prevent the spread of HIV-1 among young women in low and middle-income countries.

Some questions have been answered in a new study, and the answers may be surprising.

In a recent study published by the journal Nature on March 21, 2023, using humanized mice (mice that have received implants of human cells and tissues so that they can be infected with HIV-1), researchers tested the vaginal HIV-1 prevention efficacy of single and combination antiviral compounds applied locally.

They used a mathematical model to empirically study the effects of administering different doses of antiviral drugs.

The results were unexpected: when tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) – both drugs that share the same mechanism of inhibiting HIV-1 reverse transcriptase, thereby preventing viral replication in immune cells – were combined with a third drug that used a different mode of action against HIV-1, a strong antagonistic effect was observed.

This means that the drugs were less effective when used together than they were when used separately.

'Our approach provides a translational template for the preclinical, rational, and systematic evaluation of drug combinations for the prevention of HIV-1 and other viral diseases,' wrote these researchers.

As of April 7, 2023, there are no approved HIV vaccines available.

The Centers for Disease Control and Prevention (CDC) recently issued Health Alert Network Health Advisory CDCHAN-00489, informing clinicians and public health departments about Marburg virus disease (MVD) outbreaks in Equatorial Guinea and one in Tanzania.

As of April 7, 2023, there is no evidence to suggest that these outbreaks are related, as most experts agree that these represent two independent animal-to-human spillover events.

To date, no confirmed cases of MVD related to these outbreaks have been reported in the U.S. or other countries outside Equatorial Guinea and Tanzania. 

This CDC Health Advisory aims to increase awareness of the risk of imported cases in the U.S.

It also summarizes CDC’s recommendations for case identification, testing, and clinical laboratory biosafety considerations in the U.S.

Furthermore, the CDC confirmed no vaccines or treatments are authorized specifically for MVD.

Shionogi & Co., Ltd. today announced that two late-breaking poster presentations featuring results from clinical trials on its novel COVID-19 oral antiviral ensitrelvir would be published as posters at the 33rd European Congress of Clinical Microbiology & Infectious Diseases.

Ensitrelvir, known as Xocova® 125 mg tablet in Japan, received emergency regulatory approval from the Ministry of Health, Labour and Welfare (MHLW) to treat SARS-CoV-2 infection.

Recently, ensitrelvir was granted Fast Track designation by the U.S. Food and Drug Administration (FDA).

The first late-breaking poster presentation included a post-hoc analysis of the Phase 3 part showing that viral rebound and symptom recurrence were infrequently seen up to 21 days after treatment with ensitrelvir.

Viral RNA rebound by PCR testing was observed in 7.8% of the ensitrelvir 125 mg group (n=590) and 4.7% in the placebo group (n=574). Symptom recurrence was rare and was not associated with viral RNA rebound.

Although RNA rebound was observed in a few patients, there was only one (1/310) low-level viral titer positive in follow-up, suggesting no concerns for infectivity or transmission.

A second late-breaking poster presentation included new results from the study (Phase 2b/3 part) of patients who tested positive for SARS-CoV-2 but were either asymptomatic or had only mild symptoms at the time of randomization.

These results were based on 572 patients who were followed up for ten days after randomization. Ensitrelvir 125 mg showed a significant reduction from baseline viral RNA on Day 4, a reduction of 1.12 log10 copies/mL versus placebo (p<0.0001).

The time to the first negative SARS-CoV-2 culture was significantly shorter with ensitrelvir 125 mg compared to placebo (a median time of 38.3 hours versus 66.7 hours, p<0.0001, respectively).

Although these results were exploratory, the reduction in viral RNA and faster time to a negative viral culture may be predicted to reduce the period of infectivity, which may have implications for reducing the risk of transmission.

In a subset of 70 asymptomatic patients, ensitrelvir 125 mg (n=23) showed a numerical reduction in the proportion of patients developing symptoms.

In the 502 patients presenting with mild symptoms treated with ensitrelvir 125 mg (n=171), a numerical reduction in the proportion reporting a worsening of symptoms compared with placebo was observed.

Ensitrelvir was well tolerated, and no new safety concerns were identified.

A separate Phase 3 study of ensitrelvir (SCORPIO-HR) is underway across Asia, Africa, North America, and Europe in non-hospitalized adults who have tested positive for SARS-CoV-2. It includes those with and without risk factors for severe disease and regardless of vaccination status. Shionogi also plans to initiate a post-exposure prevention global Phase 3 study, SCORPIO-PEP.

“We are encouraged by these new data regarding the potential reduction of transmission among asymptomatic patients and patients with mild COVID-19 symptoms,” said Isao Teshirogi, Ph.D., in a press release on April 5, 2023.

“We are continuing to evaluate ensitrelvir in multiple patient populations through our robust global clinical program and look forward to continued scientific exchange on this important compound.”

Ensitrelvir remains an investigational drug outside of Japan and has not been approved outside of Japan. 

Other COVID-19 antiviral news is posted at Coronavirus Today.