NEWS SCAN: Monkeypox rising in Congo, smallpox vaccine deliveries slow, H5N1 case in Egypt

Aug 31, 2010

Monkeypox has increased in Congo since end of smallpox vaccination
Monkeypox, a less severe smallpox-like disease caused by a relative of the smallpox virus, has grown more common in rural areas of the Democratic Republic of the Congo (DRC) over the 30 years since smallpox vaccination campaigns ceased, according to a study published yesterday in the Proceedings of the National Academy of Sciences (PNAS). Anne W. Rimoin of the University of California, Los Angeles, and colleagues suggest that the increase is related to the waning of cross-protective immunity conferred by the smallpox vaccine. Mass smallpox vaccination campaigns ended in 1980, following eradication of the disease Rimoin's international team of researchers conducted monkeypox surveillance in 2006-07 in nine health zones in the central DRC where the disease is endemic and compared their findings with surveillance data from the 1980s. They found an average annual incidence of 5.53 cases per 10,000 people in the recent period. Comparing data for several zones that had similar levels of surveillance in the 1980s and 2006-07 and were similar in other ways, they found that the incidence increased from 0.48 to 11.25 per 10,000, or more than 20-fold. Factors linked with an increased risk of monkeypox included living in forested areas (where rodents and monkeys may carry the virus), male gender, age under 15 years, and no smallpox vaccination.
Aug 30 PNAS report

Production problems cut flow of weakened smallpox vaccine to US
Bavarian Nordic will deliver only about 2 million doses of its non-replicating smallpox vaccine, Imvamune, to the US government this year instead of the 4 million to 5 million doses that were planned previously, the Danish biotechnology firm said in a semiannual performance report today. The company said "technical issues" have delayed the scaling up of Imvamune production, but the problems have been identified and corrective actions taken. The 18 million remaining doses under the firm's $500 million contract with the US government will be delivered from 2011 through 2013, officials said. The company began increasing production after it received delivery clearance from the Food and Drug Administration earlier this year. Imvamune is intended for use in people who have weakened immunity or other contraindications to conventional smallpox vaccine, which uses a replicating strain of vaccinia virus, a close relative of the smallpox virus. The US government previously stockpiled hundreds of millions of doses of the conventional vaccine for use in case of a smallpox attack by bioterrorists.
Aug 31 Bavarian Nordic statement

Latest Egyptian H5N1 case raises global death toll to 300
The World Health Organization (WHO) today confirmed the illness and death of an Egyptian woman from the H5N1 avian influenza virus. Her fatal infection was reported recently in the Egyptian media. The 33-year-old woman from Qalubia governorate got sick on Aug 17 and was hospitalized and treated with oseltamivir (Tamiflu) on Aug 24. She died 2 days later. An investigation into the source of her illness revealed that she had been exposed to sick and dead poultry. Egypt now has had 112 H5N1 cases with 36 deaths. The latest case raises the world's H5N1 count to 505 cases, including 300 deaths.
Aug 31 WHO statement

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