Deadly diphtheria outbreak reported in Guinea

News brief

The World Health Organization (WHO) today said a diphtheria outbreak in Guinea has sickened at least 538 people since July, 58 of them fatally, for a 10.8% case-fatality rate, with young children the hardest-hit group.

Sanofi/Flickr cc

The outbreak is centered in Siguiri prefecture in the northeast, and overpopulation is among the contributing factors, given that the illness, caused by Corynebacterium diphtheria, spreads through direct contact or through the air by respiratory droplets. The WHO also said diphtheria, pertussis, and tetanus (DPT) vaccine coverage in Guinea is low, at an estimated 47% and is even lower (36%) in the region experiencing the outbreak.

Other challenges in Siguiri prefecture include lack of well-trained healthcare workers, a poorly resourced healthcare system, and the fact that the country is juggling several other outbreaks, including pertussis, polio, and rabies. The WHO said the risk of further diphtheria spread in Guinea is high, with the regional threat moderate and the global threat low.

The WHO also warned that the global diphtheria antitoxin supply is very constrained, due to a limited number of manufacturers and other large outbreaks under way in multiple parts of the world.

Estimates of rates of long COVID in Africa vary greatly

News brief

Research providing estimates of long COVID rates in Africa is scarce, and a new study published in The Lancet Global Health shows estimates across the continent vary greatly, from 2% in Ghana to 86% in Egypt.

The study was based on a review of scientific  literature published from December 1, 2019, through November 23, 2022, on any study type in Africa with participants who had symptoms for 4 weeks or more after an acute SARS-CoV-2 infection. The researchers identified 24 peer-reviewed manuscripts, reporting on 9,712 patients from eight African countries.

Comparing symptoms at 1-month and 3-month follow-up, one study observed a declining trend of long COVID, from 82.1% to 66.7%. The lowest prevalence—2%—was seen in a study from Ghana, and a 5% prevalence was noted in a cohort study of Ethiopian children.

Pain sensations, such as chest and muscle pain, were more frequent than respiratory symptoms, such as dyspnoea or shortness of breath.

"On the basis of reported prevalences in the included studies, the most common symptoms were neuropsychiatric symptoms, such as fatigue and headache," the authors said. "Pain sensations, such as chest and muscle pain, were more frequent than respiratory symptoms, such as dyspnoea or shortness of breath."

Low vaccination rates across continent

Three studies assessed risk factors for developing long COVID and found female sex, older age, non-Black ethnicity, and low level of education linked to the condition.

With more than 12 million long-COVID cases reported across the world, seroprevalence data suggest a pooled prevalence of 65.1% in Africa. Most cases on the continent, however, are not severe, likely because of a younger population. Africa also has low vaccination coverage, the authors said, and the studies included in this review occurred when 0.1% of the population had been vaccinated against COVID-19.

"In Africa, where vaccine coverage is low, the findings of this review should reignite discussions on the true toll of COVID-19 on the continent and guide advocacy and policy efforts to scale up effective interventions, including for vaccine uptake," the authors conclude.

Five states report more avian flu outbreaks in poultry flocks

News brief

Five states reported more highly pathogenic avian flu outbreaks in poultry, including Minnesota and South Dakota, where the virus struck again at commercial turkey farms, the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) said in its latest updates.

turkey flock
ene / iStock

Four are states—South Dakota, Minnesota, Montana, and North Dakota—that recently reported detections, which began picking up in early October after very low levels over the warmer months. Also, Washington reported its first detection in poultry since February. The state’s new outbreak involves backyard poultry at a location with 10 birds in King County. The latest outbreaks in Montana and North Dakota also involve backyard birds.

In Minnesota, the virus struck another turkey farm in Meeker County. The location has 72,100 birds. South Dakota reported turkey farm outbreaks in two counties, one in Faulk County affecting 49,700 birds and one on a Mcpherson County farm housing 65,000 birds.

In other US avian flu developments, APHIS also reported about 60 more detections in wild birds from multiple states, mainly involving hunter-harvested waterfowl.

Need for Paxlovid in poor countries far outstripped supplies in 2022, report says

News brief

Paxlovid box and tablets
Kches16414 / Wikimedia Commons

In 2022, the number of people with high-risk COVID-19 infections in low- and middle-income countries (LMICs) exceeded supplies of Pfizer's antiviral nirmatrelvir-ritonavir (Paxlovid) by 8 million or more treatment courses, finds a new analysis by Public Citizen and the Health Global Access Project (Health GAP).

The news coincides with Pfizer's announcement of planned US Paxlovid price hikes and the release of the US International Trade Commission report on access to COVID-19 diagnostics and therapeutics subject to World Trade Organization (WTO) intellectual property rules. The report may help guide US deliberations on exempting COVID-19 treatments and tests from some WTO procedural requirements to facilitate access in LMICs.

Continued coverage of treatments, tests needed

Using public data from supply agreements and the World Health Organization, Public Citizen determined that LMICs had procured about 916,120 Paxlovid courses in 2022, compared with a minimum need for 9,135,953 courses

Drug corporations' high prices, contract secrecy, and monopoly supply all suppress demand, and make it harder for resource-starved health agencies to purchase the treatment they need to care for people.

Peter Maybarduk, JD

The countries received 780,000 of those courses through bilateral supply agreements with Pfizer and 135,120 through the Access to COVID-19 Tools Accelerator. The COVID Treatment Quick Start Consortium donated another 1,000 courses.

"At a minimum, ten times more people needed Paxlovid than had any chance to receive it in developing countries, and that almost certainly significantly understates the problem," Peter Maybarduk, JD, director of the Access to Medicines program at Public Citizen, said in the news release.

He attributed the problem to intellectual property barriers, weak health funding, and failures to appropriately support the world's COVID response. "Drug corporations' high prices, contract secrecy, and monopoly supply all suppress demand, and make it harder for resource-starved health agencies to purchase the treatment they need to care for people," Maybarduk said.

The findings, Public Citizen said, emphasize the need for the United States to secure an extension of the 2022 WTO decision to cover COVID-19 tests and treatments. "Companies in LMICs will find it easier to issue compulsory licenses that remove patent barriers and allow expanded export/import to markets ill-served by Big Pharma monopolies," said Brook Baker, JD, Health GAP senior policy analyst.

This week's top reads

Our underwriters